Child/Elder Abuse Flashcards
What is the physician’s primary role in abuse?
to report, not investigate
What are child factors that increase risk for maltreatment or abuse?
make caretaking difficult–> increase risk for abuse
fussy or colicky infant
under 1 year old
hyperactive/behavior problems
illness or medically fragile
non-biologic relationship with caregiver
premature
unwanted pregnancy or infant
special needs
twins
What are caregiver/environmental factors that increase risk for child maltreatment or abuse?
criminal history
substance abuse (major)
mental health history
misconceptions about childcare or development
teen parents, especially with no family support
non-biologic father figure
social isolation
intimate partner violence
high local unemployment, poverty
Define child abuse
recent act or failure to act
results in death, serious physical or emotional harm
sexual abuse or exploitation
imminent risk of serious harm
involves child, carried out by caregiver responsible for child’s welfare
4 main types of child abuse
neglect
emotional
physical
sexual
What is the most common cause of death in abused children?
neglect
–> failure to provide for child’s basic needs (physical, emotional, educational, medical)
What does the physician need to obtain when suspecting neglect?
full medical history
psychosocial history
complete PE
ensure safety and contact CPS
Behavior patterns that MAY suggest emotional abuse
each of these are not the result of abuse, but may point to it
social withdrawal excessive anger or aggression eating disorders failure to thrive developmental delays depression, anxiety sleep disorders self-injurious behaviors
Suspicious signs on PE
bites burn marks posterior rib fx scapular fx different healed injuries spinous process fx sternal fx cigarette burns metaphyseal lesions
anything doesn’t match story
3 types of sexual abuse
non-touching
-exposed to porn, allow child to see/hear sex
touching
exploitation
Age of sexual abuse victims
9-12
half occurs within family
What is physician’s role when suspecting sexual abuse?
most have no PE findings
history most important to document
no single behavior, sign or sx is diagnostic
What is the best practice for interviewing a suspected sexual child abuse case?
minimal facts interview
who, what, when, where, how
AVOID asking WHEN d/t poor spatial timing in kids
Very high risk populations of abuse
developmentally disabled (F)
deaf children
transgender
LGBTQ
Are most elder abuse cases reported?
NO, 80% not reported
