child abuse

Question 1

abuse vs neglect

Answer 1

abuse: physical, sexual, emotional, Munchausen syndrome by proxy ( caretaker simulates or creates dz in the child). Neglect: physical, emotional, medical care, educational

Question 2

Most common form of child abuse

Answer 2

neglect

Question 3

reporting child abuse

Answer 3

All 50 states in the United States require any professional who works with children to report suspected cases to the designated authority. There are civil and criminal legal consequences for failure to report. Child welfare will investigate intrafamilial abuse/ neglect. Law enforcement will investigate all instances

Question 4

historical features in child abuse cases

Answer 4

discrepant history (doesn’t match up), delay in seeking care, stressed caretaker, behaviors by child that triggers abuse (crying, toileting accidents), history of abuse in the abuser, unrealistic expectations of child, social isolation of caretaker, increasing severity of injuries, use of multiple hospitals or caretakers

Question 5

Tin ear syndrome

Answer 5

bruising of pinna in infants- associated with ipsilateral subdural and retinal hemorrhages

Question 6

When do spiral fractures of the humerus often occur

Answer 6

during a diaper change or when a child is yanked out of a crib by the leg.

Question 7

what are common associated conditions with child abuse

Answer 7

alcohol abuse, drug abuse (meth is particularly dangerous), interpersonal violence (spouse/ partner violence)

Question 8

•Public Health Nurse home visitation

Answer 8

visitation during last two trimesters of pregnancy and the first two years of the child’s life can reduce physical abuse by 87% over the lifespan of the child. Also leads to reduced smoking, improved diet, increased social support and formal services

Question 9

What has happened to rates of sexual abuse of children over the last decade

Answer 9

it has decreased by 40%

Question 10

preconditions of sexual abuse

Answer 10

1. individual who is aroused and/or views sexual involvement with children as “normal”, and may be blocked from a developmentally appropriate sexual relationship. 2. internal inhibitors -laws and moral standards. Alcohol and drugs are potent disinhibitors. 3. external inhibitors- presence of other people who protect from abuse. 4. resistance by child- the lower their self esteem, the more likely they are to be preyed upon

Question 11

sexual abuse prevention

Answer 11

1. build resistance by good touch, bad touch training. Some evidence that this works, but children with training who have been abused are more likely to be physically harmed. 2. External inhibitors- add parent volunteers to high risk venues for sex abuse

Question 12

MAOA gene and abuse

Answer 12

The presence of the gene for MAOA is associated with “survival” of early abuse. Low levels lead to repetition of the cycle.