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KENTUCKY — A national report released by the U.S. Department of Health and Human Services has Kentucky ranked fourth in the nation for child maltreatment rates.

Fourteen out of every 1,000 children in Kentucky experience abuse or neglect, which is double the national average.

An extreme case of child abuse occurred in Louisville on Thursday, when 40-year-old Zeinab Abdi confessed to hitting her 6-year-old child in the head with a hammer multiple times.

The attack caused the child to have multiple skull fractures as well as brain bleeds.

After being arrested, Abdi told police she frequently gets “extremely angry” and has trouble controlling herself as a result.

In the state of Kentucky, reporting suspected abuse is mandatory.

“Everybody in Kentucky is a mandated reporter, so we all have a responsibility,” said the president and CEO of the Family and Children’s Place, Elea Fox. “If we have reasonable suspicion of abuse, then it’s everybody’s responsibility to notify authorities so that it can be investigated.”

The most common signs that a child is being abused or neglected, according to Fox, are bruising.

“So, if you see a kid that has regular bruising, especially bruising on the face, it doesn’t necessarily mean abuse, but it could be a major indicator,” said Fox. “Often, children who maybe have poor hygiene, maybe they’re lethargic. They don’t have enough to eat, or they’re prone to angry outbursts. All of those kinds of things could be signs of abuse.”

If you are a parent and begin to feel frustrated or like you are hitting your breaking point, Dr. Melissa Currie, a child abuse pediatrician for Norton Children’s, said the best thing you can do is to take a step back and breathe before reacting.

“Make sure the child’s in a safe place, then take a break, call a friend or a family member,” said Currie. “Remember that the child isn’t doing this on purpose to be disrespectful or on purpose to make you upset. They are doing what is developmentally appropriate for them at that age.”

The Family and Children’s Place is the only child advocacy center in the region. They offer resources to children who experience abuse and to families to help create stability when needed.

“We understand, as horrific as it is, what children are experiencing, that families are also under a lot of strain. And so the more we can do to support families, to support parents, especially young parents, we’re here to do it,” said Fox.

To report suspected child abuse, you can call 1-877-KYSAFE1.

Click here to read the video and watch the segment from WLKY.