Child abuse and neglect Flashcards
T/F, in the US each state defines child abuse and neglect within its own civil & criminal codes.
True.
Types of child abuse?
Who are the MC perpetrators?
- physical
- sexual
- emotional
- child neglect
MC perpetrators:
-biological parents
Certain children are more likely to be victims of child abuse, who are these children?
- age less than 3YO
- Past hx of abuse; 50% chance of experiencing further abuse and 10% chance of dying.
- children w/ speech/language disorders, learning disabilities, non-conduct psych problems
- children with handicaps, chronic illness
- hyperactive adopted and step children.
What is the more prevalent form of child abuse? What are the types?
CHILD NEGLECT!!!
Types :
- physical = food, clean clothes, basic hygiene
- emotional
- educational
- medical
Medical Neglect:
-management
- simplify care as much as possible
- give written instructions
- remove barriers to access
- may require hospitalization:
- for serious medical conditions
- to protect the child
- to observe the parent-child interaction.
What is the most commonly injured area of the body? What is the most common type of injury seen?
Oralfacial injuries:
- intraoral injuries
- burns
- fx of maxilla, mandible, or facial bones
- oropharyngeal gonorrhea or syphillis
- black eyes or basilar skull fx
- bruising or scarring corners of the mouth from being gagged
- traumatic alopecia
Bruises are MC type of injury.
- central bruising suggests abuse
- bruising in babies who are not mobile is uncommon
- ligature marks or rope burns of the neck, wrists, and ankles
DDX of bruises
- Bleeding disorders::
- bruises uniform in color
- inflicted bruises have different colors
- check clotting studies, CBC w/ platelets, PT, PTT
Salicylate ingestion
Henoch Schonlein purpura
Mongolian Spots
Clinical manifestations of abuse
- bite marks
- burns: immersion, microwave, stun gun burns, cigarette
- fractures; fx of multiple stages of healing
PE looking for what signs?
If you suspect abuse what labs/studies should you get?
- skin lesions, swelling, deformity
- bone tenderness, reluctance to use and extremity
- retinal hemorrhages (shaken baby syndrome)
- trauma to genital or mouth
Labs/Studies:
- bleeding eval: CBC w/ platelets, PT, PTT
- CMP: check LFT, electrolytes, r/o bone dz
- UA: hematuria
- toxicology: inappropriate administration of medications
- skeletal survey (any child less than 2YO w/ concerning fx, abd injury or concern for head trauma)
- neuroimaging
- ophthalmologic eval
sexual assault in children definition
-when 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
Sexual abuse includes:
- fondling
- forms of oral-genital, genital or anal contact with a child
- nontouching abuses:
- -exhibitionism
- -voyeurism: peepers
- -involving the child in pornography
Is sexual play normal?
yes. Involves children separated by no more than 4 years.
Women between the ages of ___ and __ are at greatest risk of intimate partner violence.
Women between 20-34 are at greatest risk of intimate partner violence.
Children who witness intimate partner show an increase in?
- aggression and conduct disorders
- impulsivity
- anxiety and intrusive thoughts
- disrupted sleep patterns and depression
- PTSD
- risky behavior
What is RADAR?
Routinely screen pts for abuse.
Ask direct questions
Document findings
Assess safety of victim and children
Review options/referrals/reportng requirements.
*Perform this on new pts, yearly, when mother or teenager is involved in a new intimate relationship or becomes pregnant.
