FRANKFORT, Ky. - April is Child Abuse Prevention Month, and dentists can play a key role in spotting signs that something may be wrong in a child's life.

Dental hygienist Jennifer Hasch, dental director at Shawnee Christian Healthcare Center in Louisville, said that when poor oral health - infection or tooth decay - are going unaddressed by a parent or caregiver, that possibly could be a red flag for abuse or neglect.

"It has been a stressful year, so we know that there's likely a lot of child abuse happening that's not getting caught right now," she said, "and if they are coming to the dental office, I think it's an opportunity for us to intervene."

A virtual training on Friday aims to help oral-health professionals recognize signs of abuse. They can register for the training at kyoralhealthcoalition.org/event. A new online toolkit developed by The Kosair Charities Face It Movement and Delta Dental of Kentucky also has tips on how to help people in dental offices spot signs of child abuse. It's online at faceitabuse.org/health-professionals.

More than 20,000 Kentucky children were victims of child abuse or neglect in 2019, the highest rate in the nation. Because more than half of a child's injuries from abuse involve the head or neck, said Kara Farris, marketing and communications strategist for Delta Dental of Kentucky, dentists and hygienists are in a unique position to ask important questions.

"And the whole goal is to train them on what to ask, how to ask these questions without throwing any red flags to the child or to the parent."

According to the latest federal report in 2019, Kentucky had the highest rate of child victims of maltreatment for the third year in a row. Keith Inman, president of Kosair Charities, a group spearheading child-abuse awareness efforts statewide, said he believes the situation in Kentucky is a public-health crisis that requires the same level of resources and attention being given to the coronavirus.

"Unless more people know the warnings, it's going to continue," he said. "So, I want us to spend as much time and effort on this 'pandemic' as we have on the current pandemic."

Inman said the "TEN-4 rule" can help spot unusual bruising on kids. TEN-4 stands for bruises on the torso, ears and neck on any child four years of age or younger, or bruising anywhere on an infant who is not yet taking steps.

A bill in Congress with a Connecticut House sponsor aims to reduce child labor in the United States.

Called the "Children Harmed in Life-Threatening or Dangerous Labor Act," its aim is to strengthen current child labor laws and increase civil penalties for companies violating them. And the bill puts a new wrinkle on protections: It allows the Secretary of Labor to label goods produced with child labor, and to issue a 'stop work' order for any person violating child labor laws.

Rep. Rosa DeLauro, D-Conn., the bill's House sponsor, described its importance.

"This is in response to industry, to have more workers -- more than likely who are underpaid -- and that they can get cheap labor for doing the jobs that they are doing, and taking risks with children," DeLauro explained. "There is a labor shortage, so they're looking to children."

The Economic Policy Institute reported 10 states introduced or passed bills rolling back child labor protections in the last two years.

The Labor Department's Wage and Hour Division concluded almost 1,000 investigations, uncovering child labor violations, an 88% increase since 2019. The bill has been introduced in both chambers of Congress.

Ultimately, the goal is to have stiffer penalties in place for companies that ignore child labor laws. DeLauro acknowledged backers of the bill expect some opposition, most likely from states rolling back protections and industries using underage workers.

"We've got a very strong meat packing industry -- I mention Tyson, JBS, Turkey Valley Farms -- and Packers Sanitation Services provides cleaning services at these meat processing facilities," DeLauro outlined. "I'm going to anticipate that we're going to see industry come out of the woodwork in opposition."

Some companies are already being held accountable with civil penalties. A meatpacking plant owned by Tennessee-based Monogram Meats Snacks was fined a little more than $140,000 for employing children. However, the company made more than $1 billion in 2021.

When a Texas woman began her six-year journey to adopt, she hoped to affect one child's life.

Felicia Lewis, an adoptive parent, is now making a difference in the lives of three young sisters. After considering adoption for years, Lewis and her partner Ruth were introduced to the three girls, all recently displaced from their birth parents.

She encouraged those considering adoption to "get involved to change a life and see how it impacts yours."

"These are children, and it's really important because you're going to be shaping their future, shaping their minds, shaping how they view the world," Lewis pointed out. "It is critical that people are just invested in it."

November is National Adoption Month. Lewis works for Bank of America, ranked among the "Top 100 Best Adoption Friendly Workplaces" by the Dave Thomas Foundation for Adoption. The connection helped pay the adoption legal fees through Bank of America's Family Planning Reimbursement program.

Over several years, Lewis and her partner built a deep connection to the children and finally saw their petition to foster with the intention to adopt granted in 2020. The process was finalized in August. Lewis noted she received an outpouring of support and encouragement from work colleagues to adopt her three daughters, now ages 6, 8 and 9.

"We walked into this thinking that we were helping them," Lewis recounted. "We're going to give them a better life, a better future, a better home, etc. And we certainly did all that, but they gave us such a better perspective on being better human beings."

Lewis added those considering adoption should not take it lightly, because it is an intense process.

"Agencies, the government, etc., they want to make sure the children are going to a safe home; that they're going to a place they can be cared for," Lewis emphasized. "There's a process, so just be patient, and know that it may not happen overnight, and you might have to try, try and try again. But in the end, it is so well worth it."

The average paid leave given to adoptive parents is 9 weeks - up from 8.4 weeks last year.

Lawmakers in Congress are facing mounting pressure from corporate lobbyists to pass business tax breaks before the end of the year but new analysis suggests cuts would be far more costly than promised.

Joe Hughes, federal policy analyst at the Institute on Taxation and Economic Policy, said reinstating the expanded Child Tax Credit would be a better investment. He pointed out it is unclear whether corporate tax breaks would achieve their stated policy goals, but they would make a lot of very rich people even richer.

"The child tax credit, on the other hand, the beneficiaries and the effects are entirely clear," Hughes asserted. "It's children in low- to middle-income families, middle-class families, people making less than about $86,000 a year."

Reinstating the pandemic-era Child Tax Credit would help nearly 60 million children in Wyoming and across the U.S. Proponents of corporate tax breaks passed in 2017 argue they are essential to economic growth and should be made permanent. Critics of the expanded child tax credit, which expired last year doubling child poverty rates, warned it would discourage people from re-entering the workforce.

Researchers at the University of Chicago and the Massachusetts Institute of Technology found the expanded Child Tax Credit did not affect parents' decisions to enter or leave the workforce. Hughes noted working is not free if you have children. For many parents, it is less expensive to stay home than pay rising child care costs.

"An expanded child tax credit that's available to all low-income families can actually help some families re-enter the workforce," Hughes emphasized. "Because now they can receive child care."

Making corporate tax breaks permanent is projected to cost $500 billion but Hughes stressed making the Child Tax Credit fully refundable, where families get assistance even if they don't earn enough to owe taxes, would have a much lower price tag of between $10 billion and $20 billion.

"The most impactful part of the legislation was what made it available to all families, including very low-income families," Hughes added. "In 2021, as a result of the child tax credit, child poverty was cut in half."


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