46 - Dependent Adult and Child Abuse and Neglect III

Question 1

What are the three Cs of child abuse

Answer 1

• Child (under 18, unless married)
• Caretaker (anyone responsible for the care of the child - not teachers though)
• Circumstance (SUSPECTED is the key - suspected abuse)

Question 2

What are the different types of offenders?

Answer 2

• Well-intentioned, but overwhelmed caregiver
• Well-intentioned, but ignorant caregiver
• Unwilling, could care less caregiver
• Abusive personality
• Sadistic personality

Same as for elder abuse

Question 3

What is physical abuse of children? How does this occur?

Answer 3

• Non-accidental physical injury
• At variance with history
• By acts or omissions
• Reasonably foreseeable
• Injury does not have to be observable (all you have to do is suspect it, you don’t need proof)

Even if a child reports something from 3 years ago, still report it - nothing may come from it, but protect yourself and report it

Question 4

What are the most important questions to ask?

Answer 4

• Have you been hurt before?

- Do you hurt anywhere else?

Question 5

What is the safe haven law?

Answer 5

A lot of states don’t have one, but Iowa does

- If the parent drops off a child that is under 14 days, they are not punished for abandonment or abuse

Question 6

What are physical and dental indicators of abuse?

Answer 6

• Fractured teeth: force feeding, repeated trauma
• Burns on lips: force feeding of hot foods
• Bruises of lips: forced pacifier use
• Frenula bruises: force feeding
• Oral or perioral syphilis or gonnorrhea: probable sexual abuse
• Palatal petechiae or erythema: probable sexual abuse
• Facial, head, and neck trauma

Question 7

What does an upper eye lid only bruise mean?

Answer 7

A skull fracture above the eye

Question 8

What if there is child abuse that is rooted in cultural practices?

Answer 8

Just report it - protect yourself

Question 9

Describe sexual abuse of a child

Answer 9

• A sexual offense
• With or to a child
• As a result of the acts or omissions

All sex crimes are reported to
LAW ENFORCEMENT

Question 10

What are sex crimes based on?

Answer 10

Age

• Sex crimes are based on age
• “Consensual” sex can be a crime based on age
• Sex acts involving persons of ANY age when threats, violence, and incapacitation are involved

Question 11

What are the laws of ages in sex crimes

Answer 11

• The legal age of consent in Iowa for sexual contact is 16
• If the other person is in a position of authority it is 18+
• Felony sexual abuse is committed if the child is under age 13
• 14 and 15 year olds can consent if the other person is less than 4 years older*
• 16 and 17 year olds having sexual contact with a child at least 5 years younger are referred to juvenile court

Question 12

What are the indicators of sexual abuse?

Answer 12

• Physical symptoms of pain, swelling, bruising, discharge
• Hints about sexual activity
• Compulsive masturbation or persistent and inappropriate sex play
• Sexually aggressive or seductive towards others
• Promiscuous
• New or detailed understanding of sexual behavior
• Regressive behaviors, or behavior
  characteristic of someone much younger
• Wearing multiple layers of clothing
• Urinating or defecating in clothing
• Pregnancy

Question 13

How common sexual abuse?

Answer 13

Evidence indicates between 15-30% of females and 3-15% of males

Question 14

What do you need to know about you as a podiatrist?

Answer 14

Up to 30% of your patients have had sexual abuse

Be cautious when having them lay down, don’t do anything without explaining it - could trigger the abuse

Question 15

Describe child pornography

Answer 15

Major issue, happens in Iowa

Question 16

Describe internet facilities and child abuse

Answer 16

• It allows networking among perpetrators
• It is used to seek out and groom victims—-cyber-stalking
• It is used to promote child sexual tourism
• It is used in trafficking children
• Mail-order children are available over the Internet

Question 17

Describe mental injury

Answer 17

Observable substantial impairment in the ability to function within normal range of performance and behavior based on age

Question 18

Describe denial of critical care (neglect)

Answer 18

Caregivers, advised of the extent of the medical or dental condition and consequences of failure to treat, yet do nothing

Report this!

Question 19

Describe the presence of illegal drugs in a child’s body

Answer 19

• Cocaine, heroin, marijuana, amphetamines, methamphetamine—not alcohol, or prescription drugs
• Confirmed by a lab report

Question 20

Describe child prostitution

Answer 20

• Child is encouraged or allowed to prostitute
• Child does not actually have to engage in the sex act
• The offer for sale or purchase is sufficient
• Exchange can be money, goods, or services

Make a report if you suspect it

Question 21

Describe manufacturing or possession of a dangerous substance

Answer 21

Manufacturing of a substance in the presence of a child where it can be seen, smelled, or heard

Meth lab in a bottle can happen

Question 22

Describe besiality in the presence of a minor

Answer 22

Commission of a sex act with an animal in the presence of a minor

As a result of acts or omissions of a person responsible for the care of the child

Question 23

Describe when a child is allowed access by a registered sex offender

Answer 23

A caretaker knowingly allows

• unsupervised access to a child by a registered sex offender or
• allows a registered sex offender to have custody or control of a child up to age 14 or
• Up to age 18 if the child has a mental or physical disability