Topic A: Pediatric Abusive Head Trauma

“Shaken Baby Syndrome”

Pediatric Abusive Head Trauma (PAHT), previously referred to as Shaken Baby Syndrome, describes the constellation of signs and symptoms resulting from violent shaking or shaking and impacting the head of an infant or small child, birth to 5 years.

Examples of pediatric abusive head trauma:

  • Violent shaking
  • Violent shaking with impact
  • Direct blows to the head
  • Dropping or throwing child against a hard foundation

Characteristics that MAY distinguish pediatric abusive head trauma:

  • Poor sucking or swallowing
  • Seizures
  • Unequal pupil size
  • Inability to lift head
  • Location of injury not typical of accidents (should be no bruising until they are cruising)

  Behavioral Indicators of pediatric abuse head trauma

  • Lack of smiling or vocalizing
  • Cries become less and less (due to brain damage)
  • Lethargic
  • Irritable


NOTE: In any abusive head trauma case, the duration and force of the shaking, the number of episodes, and whether impact is involved all affect the severity of the child’s injuries.

In the most violent cases, children may arrive at the emergency room unconscious, suffering seizures, or in shock.

In many cases, children may never be brought to the attention of the medical professional if they don’t exhibit such severe symptoms.

Mandatory Requirements for Preventing Pediatric Abusive Head Trauma for Child Care Providers

Legislation was passed during the General Assembly in 2010 that mandates education on the identification and prevention of Pediatric Abusive Head Trauma (PAHT) for various groups in the state who work with or care for young children. This training will help caregivers recognize early signs of maltreatment, which can prevent escalation to Abusive Head Trauma. Caregivers will learn effective strategies for dealing with a crying infant—the most common trigger for Abusive Head Trauma. All employees and owners of child-care centers are required to take a minimum of 1.5 hours of training on PAHT once every 5 years as a part of their continuing education requirements. This training will count towards the provider’s required annual training total.

During this training, participants will:

  • Review statistics of Abusive Head Trauma
  • Define and describe Abusive Head Trauma and its associated injuries
  • Describe the anatomy of the infant head and brain
  • Understand the range of outcomes for victims of Abusive Head Trauma
  • Discuss risk factors for Abusive Head Trauma
  • Discuss prevention of Abusive Head Trauma

Pediatric Abusive Head Trauma Training regulations (page 12 of your Child Abuse Handout for this course) to read what the law says about Preventing Pediatric Abusive Head Trauma Training for Child Care Providers.

Availability of Pediatric Abusive Head Trauma Training:

This training is available online or face to face from a select group of approved trainers. To find an approved trainer for Preventing Pediatric Abusive Head Trauma Training for Child Care Providers do a trainer search on the ECE-TRIS website.  For those of you that are not familiar with ECE-TRIS, it is a centralized database which maintains training records for Early Care and Education professionals in Kentucky.

To locate a trainer or to access the free online training log on to the ECE-TRIS website


1Team for West Virginia Children (2001)

  1. Child Abuse Prevention Council of Sacramento (no date)

Lesson 2.2: Identify Child Abuse

In this section, you will learn about four types of child abuse:

  • Neglect
  • Physical Abuse (includes Pediatric Abusive Head Trauma [PAHT])
  • Sexual Abuse
  • Emotional Abuse

Some types of abuse or neglect are more difficult to detect than others, but there are always signs or indicators, which, individually or together, suggest a child may need help.  The indicators listed in the following sections are examples of what you might see if a child is being abused or neglected.

NOTE: These lists do not include every indicator, nor does the presence of an indicator necessarily mean a child is being abused or neglected.

You must be observant and look for the following indicators:

  • Physical indicators- things you see in the child’s appearance or circumstances
  • Behavioral indicators- the way the child behaves or acts
  • Environmental indicators- social, cultural or familial circumstances associated with various kinds of abuse or neglect

Section 5: Approximate Developmental Age Levels

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After reviewing this final section, click the button below to begin the post-assessment –  to check your knowledge of the HELP® after completing the course. The post-test IS graded and is part of your overall score for the course.

Meet Logan

Here is Our First Practice!IMAG1450

  • Logan is Marcia and Raymond’s 26-month-old son.  Marcia had an uneventful pregnancy, and Logan is a handsome blonde-headed boy.  He seemed typical in his development for the first year, but then Marcia became concerned that Logan was not doing things that her friends’ toddlers were doing. He wasn’t saying “Mommy” and “Daddy,” and didn’t stay interested in his toys for more than a few seconds.


  • Logan’s pediatrician suggested a referral to early intervention to examine Logan’s development.  Marcia and Raymond were pleased with the interest that the intake coordinator showed in Logan and in their home routines.  Now the evaluator wants to do a “developmental assessment” to determine what Logan does and doesn’t do.  Marcia feels rather nervous when the evaluator starts to ask her so many questions.
Now, let’s take a few minutes to reflect on Logan and then complete a Pre-Test to let us know what you already know about the HELP 0-3.

START HERE: Welcome and Introductions

Thank you for registering for this Kentucky Partnership for Early Childhood Services online training.

Course Requirements

To complete this course, you will be required to:

  • Read this Introductory section and print the handout.
  • Submit a pre-test: “What do you know?”
  • Watch a series of presentations.  This course has interactive content displayed in HTML5. Know that it might take a moment for the content to load, depending on your internet connection and browser. If you would like to test your browser’s compatibility with HTML5, please click here. What does the HTML5 test mean? Scores under 400 points will likely not have full functionality of the content. We would recommend using an alternate browser or device. Please note: the most compatible browser is Google Chrome though Firefox and later versions of Internet Explorer are also compatible.
  • Complete 4 quizzes and one final assessment: a quiz follows each Sections 1-4, with a Knowledge Check at the end of the course. Quizzes must be passed at 80% or higher to move to the next section. Quizzes may be retaken multiple times until a score of 80% has been achieved.
  • Answer a few short evaluation questions.
  • Lastly, you can print or save your certificate. If you lose your certificate or need a verification of course completion, please email

Course Presentations

  • Slides which contain narration will be indicated with a symbol 
  • Closed captioning for the narration is available. Click on the CC button below the presentation to enable.
  • Most sections will allow you to close and then return at a later time; quiz content will be lost if the quiz is not completed.
  • Occasionally throughout the course you will see a Think Spot  a place for you to consider one of the ideas presented on that slide; it is for your reflection only!
  • If you need additional reflection time for the think spot, use the pause button || to pause the presentation. Then click the same button to resume presentation.

Helpful Tips

Before you get started, here are some tips to help you.

  • First, this course is not intended to be completed in one sitting; rather, we recommend you complete one section at a time.  Allow yourself approximately 30 minutes of uninterrupted time for each section.
  • Second, note that you will be viewing some videos in You Tube! You will need internet access that allows this site.
  • Third, have fun! This training is designed to introduce you to the HELP® and we hope you enjoy the learning experience as well.

Course Handout

A handout is available for you which contains the key concepts for administering the HELP®.  Space also is provided for you to record your answers to practice activities provided during the course.  PRINT the handout before proceeding, as it will be helpful as a later reference.

Required Materials

You will need the following materials to complete this course, which must be purchased from VORT Corporation at

  • Inside HELP® Administration and Reference Manual (for Birth – 3 years); order item #159
  • HELP® Strands (2013 version) stapled booklet; order item #158
  • HELP® Checklist 2004 version (optional); order item #151

Be sure you have all of these materials, plus a pencil, before continuing!!

  • Do not copy any of the HELP® materials. You must purchase one copy of the Strands or Checklist for each child being assessed. Copies can be purchased directly from the VORT Corporation website:
  • Important Note:  If you are not using the most recent version of the above materials, the page numbers cited may not correspond to your version.  Refer to the Strand and/or Skill # instead.

Interchangeable Terms used during this Course

  • HELP® ~ Hawaii Early Learning Profile®;
  • HELP® 0-3 System ~ HELP® 0-3 Curriculum-Based Assessment System ~ the HELP®;
  • HELP® Strands Protocol ~ HELP® Strands Assessment Recording Booklet;
  • HELP® Checklist ~ Protocol;
  • DAL ~ Developmental Age Level;
  • Items ~ HELP® skills ~ Skills/behaviors;
  • CBA ~ Curriculum-Based Assessment;
  • Crediting ~ Items are credited in the HELP® rather than scored.



If you encounter any problems, email or call (800) 956-8950.



Meet your Trainers

About Carol Schroeder:

Carol Schroeder holds advanced degrees in Montessori Preschool Education and Early Childhood Special Education.  She directed programs in early intervention, inclusive preschool education, and early childhood projects at the University of Kentucky, Human Development Institute.
E-mail: (retired)

Carol Schroeder

About Caroline Gooden:

Caroline Gooden is an Associate Director at the Early Childhood Department, Human Development Institute, University of KY. She has degrees in psychology, Early Childhood Special Education, and Special Education Administration. She has experience as an adjunct faculty, researcher, early interventionist, child evaluator, and early childhood program director. She is Co-PI for projects at the University of Kentucky including the National Early Childhood Transition Center and Kentucky Early Childhood Data System projects. Email:

Caroline Gooden


Now, let’s learn more about Logan. Click the topic below to continue in the course.

Topic B: Minimizing the Risk of Child Abuse and Neglect

Bend over backwards to minimize the risk of child abuse and neglect2

There are many things that can be done to reduce the risk of child abuse or neglect from occurring in early care and education programs.  Some guidelines to follow are:

  • Provide adequate supervision (no hidden or blind spots); maintain staff to child ratios.  Maintain health and safety standards to help protect children and to keep them safe 3.
  • Know who is authorized to pick up each child.
  • Create a policy which clearly outlines appropriate and inappropriate touches.
  • Manage your own stress level.


1U.S. Department of Health and Human Services: The Administration for Children and Families (2001). 2Training into Practice Project (2003) 3 The health and safety standards for Type I and Type II licensed programs are described in 922 KAR 2:120.; Child care facility health and safety standards.  The standards for certified family child care homes are described in 922 KAR 2:100.  Certification of family child care homes.

arrowClick We Deserve to be Free from Child Abuse and Neglect to print out a Job Aid that can be posted in your program. The Job Aid summarizes the Indicators for all 4 types of abuse on one page.

Topic B: Roadmap for Health, Safety and Sanitation

🎯 Workplace Outcome

Early care and education professionals will take appropriate actions to keep children healthy and safe.

🎯 Training Outcomes

By the end of this section of the training, you will:

  • Identify actions you can take to prevent injuries.
  • Generate a list of potential safety hazards in early care and education settings and appropriate steps to remove or limit the hazards.
  • Describe recommended procedures and documentation for administering medication.
  • Identify appropriate actions to minimize the spread of infectious diseases.
  • Demonstrate or describe proper hand washing techniques.
  • Distinguish between cleaning and sanitizing.

🖼️ Overview: Big Picture

In this module you will learn about two critical components of health, safety, and sanitation.

As an early care and education professional, you need to comply with state regulations and professional standards in order to:

  • Prevent injuries
  • Prevent the spread of infectious disease.

Doing so will help you safeguard the children in your care.

regulation icon in redRegulations are minimum standards that all programs must follow in order to operate legally.  The four types of regulated child care programs in Kentucky are:

  • Licensed child care centers
  • Licensed family child care homes
  • Certified family child care homes
  • Registered Child Care Providers

Professional standards represent high quality practices, which are widely agreed upon by personnel in the early care and education field.  While not mandated by law, it is strongly recommended that professional standards be followed.


Why you MUST know…

How to prevent injuries

Unintentional injuries are the leading cause of death among children one to five years of age1.  Most common injuries can be prevented by creating a safe environment and by properly supervising children.

How to prevent the spread of illness:

Children who attend early care and education programs experience a higher incidence of common infectious diseases than children cared for exclusively in their own homes2.  For example, children in early care and education programs have a significantly higher risk of developing upper and lower respiratory tract infections.  Routine sanitation and personal hygiene are effective ways to reduce these infections and other infectious diseases3.


For the most current copy of Kentucky’s regulations pertaining
to child care, go to the Kentucky Cabinet for Health and Family Services Division of Child Care

You can also obtain a copy of the regulations by contacting:
Division of Child Care,
275 East Main Street, 3C-F, Frankfort, KY 40621
(502) 564-2425

American Academy of Pediatrics

American Public Health Association

National Resource Center for Health and Safety in Child Care It does not cover ALL relevant health and safety requirements. Please refer to a complete copy of the regulations for information regarding keeping children safe and healthy while in your care.


1The Health Foundation of Greater Cincinnati (2003)

2Holmes, Morrow & Pickering (1996)

3American Academy of Pediatrics (AAP), American Public Health Association (APHA), & National Resource Center (NRC) for Health and Safety in Child Care (2002)



Introduction to The CCPSN Web-Based Course

Introduction to the CCPSN Web-Based Course

Welcome to the online course: Introduction to the Carolina Curriculum for Preschoolers with Special Needs (otherwise known as the CCPSN)

These are some tips to help you as you progress through this course:

  1. Do not try to complete the entire course at one time. Instead, plan for approximately 30 minutes of uninterrupted time to work through each section.
  2. We are here to help! Click on the Contact Us button at any time or call (859) 257-4913 if you have questions or need assistance.  Please remember our staff is not available evenings or weekends, but they will get back to you as soon as possible.
  3. Have fun! We hope you will enjoy completing the activities while you learn about the CCPSN.

General directions

  • Each section will allow you to close and then return at a later time to complete.
  • Once you begin a quiz, you must complete the quiz or your answers will be lost. Graded quizzes are included for Lessons 2 and 3 and a post test is included at the end of the course in the Course Overview.
  • You must pass all graded quizzes with a score of at least 80% or higher to move on to the next section. You may repeat activities as many times as you wish—your highest score will be recorded.

Occasionally throughout the course, you will see the following figure 💭

This “Think Spot” graphic indicates a place for you to consider one of the ideas presented on that slide; it is for reflection only!

Required Materials for this course

  • The manual: The Carolina Curriculum for Preschoolers with Special Needs (2nd Edition)
  • The protocol:  Assessment Log and Developmental Progress Chart
  • You may purchase both of these from

You MUST have the CCPSN Second Edition manual and a blank Assessment Log before proceeding with this course.

Purpose of the course

  • To provide a self-paced, accessible training to professionals who assess and monitor young children’s developmental status
  • To fulfill federal and state mandates to provide accurate, timely, and valid measures of child progress

Training Outcomes

After completing this module, participants will possess knowledge and skills to:

  • Gather information from the family and others re: a child’s present level of development using sequences from the CCPSN
  • Observe and/or directly assess a child’s present level of development using sequences from the CCPSN
  • Accurately record a child’s skills and score the CCPSN using the Assessment Log
  • Accurately report a child’s present level of development or developmental progress on the Developmental Progress Chart

Workplace Outcomes

As a result of completing this module, participants will have the knowledge and skills to complete the following in their work settings:

  • Accurately assess a child’s present level of development using the CCPSN
  • Accurately score the CCPSN and report scores for all curriculum sequences on the Developmental Progress Chart
  • Use assessment information to develop an IEP
  • Use the CCPSN to monitor a child’s ongoing progress

Course Outline

This course includes the following lessons:

  • Introduction to The CCPSN Web-Based Course
  • Lesson 1: Introduction to CCPSN
  • Lesson 2: CCPSN Nuts and Bolts
  • Lesson 3: CCPSN Tool Belt
  • Lesson 4: Applying What You Know: Sharpening Your Assessment Skills

This Introduction is followed by a pre-test, which is not graded, but must be completed before continuing to Lesson 1 of the course. Lessons 2 and 3 are each followed by a graded quiz, with a final assessment to be completed after Lesson 4. The purpose of the pre-test is to help you target the topics for which you already have sufficient knowledge as well as the areas to which that you will want to pay close attention.  The post-test will be graded and must be completed to at least 80% accuracy to pass the course.

You CAN TAKE the lesson quizzes AS MANY TIMES as you need to pass.

  • The course will take approximately 4 hours to complete; however, the actual length of time to complete will depend on prior experience using this and other assessments.
  • Practice is included throughout the course and periodic assessments are included to lead to mastery of skills. Practice and completion of assessments may require more time for some participants than for others.

Meet your trainers

Picture of Carol Schroeder

Carol SchroederCarol Schroeder recently retired from the University of Kentucky, where she had directed the Training Into Practice Project (TIPP) at the Human Development Institute.  She holds education degrees/ certificates in the areas of English, Early Childhood Special Education, and Montessori Preschool.  She worked as a preschool director, early interventionist, early childhood evaluator, trainer, and technical assistant, before becoming an early childhood project director for the state of Kentucky.  Carol also served as a state-wide and national trainer and provided leadership in the development of Kentucky’s Trainer Credential system. She now enjoys travel, gardening, and the performing arts.

Caroline Gooden
Caroline Gooden

Caroline Gooden is a Project Director at the Early Childhood Department at the Human Development Institute at the University of KY. She has experience as an adjunct faculty, researcher, early interventionist, child evaluator, and early childhood program director. She has been Co-PI for several projects at the University of Kentucky, including three Kentucky Early Childhood Data System projects. Email: :

Picture of Sally Dannenberg
Sally Dannenberg

Sally Dannenberg is a Research and Development Associate with the Human Development Institute at the University of Kentucky.  She has degrees in Nursing and Education with an emphasis in Early Childhood, Parent and Early Childhood Special Education.  She has worked as a trainer for many years with early educators and special education staff.  Email:



Content by Dr. Susan Attermeier, adapted by Carol Schroeder, Caroline Gooden and Sally Dannenberg.

Funding provided by The Kentucky Cabinet for Health and Family Services, Department of Public Health

Johnson-Martin, N.; Hacker, B., & Attermeier, S. M. Carolina Curriculum for Preschoolers with Special Needs (CCPSN), Second Edition. Copyright © 2004 by Paul H. Brookes Publishing Co., Inc. Baltimore.

Used by permission of the publisher.


  • Alicia and other children from Results Matter Video Library, Colorado Department of Education; used with permission.
  • Jamaal from Hanline, M. F., Wetherby, A., Woods, J., Fox, L., & Lentini, R. (2004). Positive Beginnings: Supporting Young Children with Challenging Behavior [CD- ROM]. (Available from Positive Beginnings, 625 B North Adams Street, Tallahassee, Florida 32301).