Child abuse and neglect Flashcards
1
Q
Definition of child abuse?
A
- serious injury inflicted upon a child by a parent or caretaker
- each state defines child abuse and neglect within its own civil and criminal codes
2
Q
Major types of child abuse?
A
- physical
- sexual
- emotional
- child neglect
3
Q
Main perps of child abuse?
A
- bilogicial parents: 81%
- nonbiological parents and parent partners: 12%
- other adult: 7%
4
Q
RFs of child abuse?
A
- young or single parents
- lower education
- many abusers were abused themselves as kids
- many suffer from drug/acohol addiction and psych illnesses
5
Q
How does environment have an affect on child abuse?
A
- stress factors within family: either acute or chronic
- social isolation
- distant or absent extended family
- acceptability of violence as a means of problem solving
6
Q
What children are more likely to be victims of child abuse?
A
- less than 1 (67%), less than 3 (80%)
- psat h/o of abuse: abused child 50% chance of experiencing further abuse and 10% of dying
- children with speech/learning disorders, learning disabilities, non-conduct psych probs
- children with handicaps, chronic illness
- hyperactive, adopted and step children
7
Q
What is child neglect? diff types?
A
- most prevalent form of child abuse (more than 1/2 of the cases)
- failure to provide for child’s basic physical, emotional, educational or medical needs
- types: physical, emotional, educational, and medical neglect
8
Q
Management of neglect?
A
- ID/recognize the problem
- discuss it with the family/interdisciplinary team
- cases of medical neglect: simplify care as much as possible, give written instructions, remove barriers to access
- hospitalization: for serious medical conditions, to protect the child, to observe parent-child interaction
9
Q
Mandated reporting?
A
- all 50 states have laws requiring health professionals to report child neglect/abuse to CPS
10
Q
Clinical manifestations of child abuse - orofacial injuries?
A
- face is area most commonly injured:
- intraoral injuries
- burns
- fractures of maxilla, mandible or facial bones
- oropharyngeal gonorrhea or syphilis
- black eyes or basilar skull fracture
- bruising or scarring corners of mouth from being gagged
- traumatic alopecia
11
Q
Clinical manifestations of child abuse: bruises?
A
- most common type of injury of abused kids
- noninflicted bruising tends to be over bony prominences and central bruising suggests abuse
- bruising in babies who are not mobile is uncommon
- mult bruises in clusters - consistent with inflicted injury
- bruises in pattern of an implement suggest inflicted injury (shape of handprint, belt, rope loop)
- ligature marks or rope burns seen on neck, wrists and ankles
12
Q
DDx of bruises?
A
bleeding disorders:
- bruises are uniform in color
- inflicted bruises have diff colors
- check clotting studies, CBC with platelets, PT, PTT
- salicylate ingestion: look for other sxs
- Henoch-Schonlein purpura/other vasculitides
- mongolian spots
13
Q
Other clinical manifestations that indicate abuse?
A
- bite marks: assoc with physical or sexual abuse
- burns: brands/contact burns
cigarette burns
immersion burns: legs and buttocks
microwave oven burns
stun gun burns - fractures:
fracture doesn’t fit explanation, fractures at mult stages of healing - get skeletal survey if this is found
14
Q
DDx of burns?
A
- phytophotodermatitis: sun can cause severe burns
- complementary and alt therapies: garlic applied to skin, cupping, coining, moxibustion
- congenital insensitivity to pain: can’t feel pain
15
Q
Clues to dx eval of child abuse?
A
- historical inconsistencies
- hx is inconsistent with injury of child
- hx is vague or lacking detail
- no hx
- parent isn’t upset about injury
- talk to parent and chil together, let child answer first
- if 3 or older - try to talk to kid alone, if parent doesn’t allow this- RED FLAG!!!
- ask child who, what, where, and when questions
