A call for action for all who have children, work with them, or know someone who does.
Advocates say it's everyone's job to prevent child abuse. The state can't do it alone, as the turnover rate for case managers spikes in some areas. 13 Investigates broke down the numbers and the warning signs.
Every 10 seconds, a report of child abuse is made nationwide. Here in Indiana, 198 children have died from abuse or neglect over a four-year period. Those are the latest numbers available between 2006 and 2010.
"It certainly is frightening in terms of what is happening or may be happening to our children. So anything we can do to prevent child abuse and neglect is going to make our entire society healthier," said Dr. Roberta Hibbard.
Hibbard has fixed the broken bones and bruises of wounded children as the director of the Child Protection Program and Riley/IU Health. She has a warning for grandparents, parents and babysitters.
"Babies shouldn't have any bruises and if they do, you need to ask really serious questions," Dr. Hibbard warned.
When it comes to older children, she says to watch out for "when you see lots of bruises, weird places or are in the shape of a specific object, that's a big red flag."
Indiana's Department of Child Services is charged with investigating abuse and neglect. For years, the agency has faced the challenge of keeping trained workers on the job.
13 Investigates obtained the department's turnover rates for family case managers. We found in a one-year period, DCS hired 511 new case managers. Twenty-one transferred to other positions during that same time, while 280 simply quit. It created a loss of 18.1 percent agency-wide, roughly the same loss as the previous year at 18.7 percent.
13 Investigates found much higher turnover in specific DCS regions. Struggling most was Region 10, which consists only of Marion County, where more than a quarter of its case managers left - 26.6 percent, to be exact.
DCS Director Judge James Payne recently talked about the turnover improvement in Marion County.
"In 2004, in Marion County, I know it was over 35 percent," he said of the revolving door of case workers.
Neighboring Region 11, including Hamilton, Hancock and Madison counties, took a dramatic jump, up 10 points from 16 percent to a 26 percent loss.
Pam Knight has had 12 years on the job in Madison County and says she wouldn't want to be anywhere else.
"It's an honor to have families allow you to walk into their lives and help them," Knight said.
"I think we have grown and made great strides and have saved a lot of lives," added Heidi Jordan, who has 17 years with DCS and now works at its central office.
Last month, Governor Mitch Daniels was so worried about case workers throwing in the towel, he delivered a pep talk at a DCS training.
"Yes, a great case worker or manager is really important. The training they have and if they're really good at what they do, we don't want to lose a single one and I just didn't want that to start happening," Daniels told 13 Investigates.
The numbers are more alarming when it comes to keeping workers answering the state's child abuse hotline. Half of the workers hired left.
Still, Payne was unavailable for comment, but said at a news conference weeks ago, that families were helped last year.
"We received over a 140,000 phone calls, 97,500 families actually received an assessment or a referral for services," he said.
DCS has been actively recruiting case managers for years, pushing their rolls up to around 1,500, but losing roughly 18 percent of their expertise each of the last two years.
Now here's what you can do: Don't ignore patterns of suspicious bruising or changed behavior in children. If you suspect abuse or neglect, call 1-800-800-5556. It could save a child's life.
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