Abuse & Neglect

Question 1

Define Child Abuse

Answer 1

Serious injury inflicted upon a child by a parent or caretaker

Question 2

Major Types of Child Abuse

Answer 2

Physical abuse
Sexual abuse
Emotional abuse
Child neglect

Question 3

Most common perpetrators in child abuse

Answer 3

Biological parents
Nonbiological parents/partners
Other adult

Question 4

Risk Factors for Child Abuse

Answer 4

Young or single parents
Lower levels of education
Abusers were abused themselves as children
Drugs/alcohol addiction and/or psychiatric illness

Question 5

Environment of Child Abusers

Answer 5

Stress factors within the family
Social isolation
Distant or absent extended family
Accepting violence as a means of problem solving

Question 6

Children More Likely to be Victims

Answer 6

Younger than 3
Past abuse
Children with speech/language disorders, learning disabilities, non-conduct psych problems
Children with handicaps, chronic illness
Hyperactive, adopted, & step-children

Question 7

Most prevalent form of child abuse

Answer 7

Child neglect

Question 8

Define Child Neglect

Answer 8

Failure to provide for a child’s basic physical, emotional, education, or medical needs

Question 9

Types of Child Neglect

Answer 9

Physical neglect
Emotional neglect
Educational neglect
Medical neglect

Question 10

Management of Child Neglect

Answer 10

Identify/recognize the problem

Discuss with family/interdisciplinary team

Question 11

Management of Cases of Medical Neglect

Answer 11

Simplify care as much as possible
Give written instructions
Remove barriers to access

Question 12

Why hospitalize a patient for child neglect?

Answer 12

Serious medical conditions
Protect the child
Observe parent/child interaction

Question 13

Clinical Manifestations of Child Neglect

Answer 13

Orofacial injuries
Bruises
Bite marks
Burns
Fractures

Question 14

Types of Orofacial Injuries in Child Neglect

Answer 14

Intraoral injuries
Burns
Maxilla, mandible, or facial bone fractures
Oropharyngeal gonorrhea or syphilis
Black eyes
Basilar skull fracture
Bruising/scarring corners of the mouth
Traumatic alopecia

Question 15

Bruises in Abused Children

Answer 15

In clusters
In pattern of an implement suggest inflected injury
Ligature marks or rope burns

Question 16

Differential Diagnosis of Bruises

Answer 16

Bleeding disorders
Salicylate ingestion
Henoch-Schonlein purpura
Mongolian spots

Question 17

Types of Burns

Answer 17

Brands/contact burns
Cigarette burns
Immersion burns
Microwave oven burns
Stun gun burns

Question 18

Reason to Suspect Fractures

Answer 18

Doesn’t fit explanation

Multiple stages of healing

Question 19

Differential Diagnosis of Burns

Answer 19

Phyophotodermatitis
Complementary & alternative therapies
Congenital insensitivity to pain

Question 20

What are some complementary and alternative therapies?

Answer 20

Garlic applied to skin
Cupping
Coining
Moxibustion

Question 21

What to assess in the PE

Answer 21

Skin lesions, swelling, deformity
Bone tenderness
Retinal hemorrhages
Trauma to genitals or mouth

Question 22

Parental behaviors that may lead to child abuse

Answer 22

Arguing, roughness, or violence
Aloofness/lack of emotional intersection
Inappropriate response to severity of injury
Inappropriate delay in seeking medical care
Partial/frank confession by parent

Question 23

Lab/Studies to Diagnose Child Abuse

Answer 23

CBC, PT, PTT
CMP
UA- hematuria
Toxicology
Skeletal survey
Neuro-imaging
Ophthalmologic exam

Question 24

Define Sexual Assault

Answer 24

Attempted sexual touching of another person without their consent & includes sexual intercourse, sodomy, and fondling

Question 25

Define Sexual Abuse For Children

Answer 25

When a child engages in sexual activity for which he/she cannot give consent, is unprepared for developmentally, cannot comprehend, and/or an activity that violates the law or social taboos of society

Question 26

Sexual Abuse Includes

Answer 26

``` Fondling Oral-genital, genital, or anal contact with a child Exhibitionism Voyeurism Involving child in porn ```

Question 27

Define Exhibitionism

Answer 27

Man/woman shows naked body to another

Question 28

Define Voyeurism

Answer 28

Peepers looking at naked children

Question 29

Presentation of Sexual Abuse

Answer 29

``` Stomach ache Sore throat Rectal/genital bleeding STIs Pregnancy Rectal/genital trauma ```

Question 30

Goals of Evaluation of Sexual Abuse in Child

Answer 30

``` Identify injuries Screen/diagnose STIs Evaluate/reduce risk of pregnancy Document findings Gather evidence ```

Question 31

Children who witness intimate partner show an increase in what?

Answer 31

``` Aggression/conduct disorders Impulsivity Anxiety/intrusive thoughts Disrupted sleep patterns and depression PTSD May lead to risky behavior ```

Question 32

Screening for Child Abuse/Neglect

Answer 32

RADAR

Question 33

What does RADAR stand for?

Answer 33

R- routinely screen patients for abuse A- ask direct questions D- document your findings A- assess safety of victim & children R- review options/referrals/ reporting requirements

Question 34

Barriers to Reporting Child Abuse/Neglect

Answer 34

Alternative strategies could be more effective than CPS Inadequate training Cultural attitudes Perception that CPS ineffective

Question 35

Types of Child Neglect

Answer 35

Physical neglect Emotional neglect Educational neglect Medical neglect

Question 36

Approach to Neglect

Answer 36

Discuss with caregivers the concerns Team approach Reportable

Question 37

Emotional Abuse

Answer 37

``` Rejecting Isolating Terrorizing Ignoring Corrupting Verbal assault or spurning Over pressuring ```

Question 38

Emotional Disturbance Clinical Features of Emotionally Abused Children

Answer 38

Anxiety Depression Agitation Fearfulness

Question 39

Social Withdrawal Clinical Features of Emotionally Abused Child

Answer 39

Running away from home Developmental delay Drug or alcohol problems Eating disorders