Child, Elder Abuse - Schmidt

Question 1

what are the risk factors for child maltreatment?

Answer 1

• fussy, colicky infant
• hyperactive
• illness
• non-biologic relationship with caregiver
• prematurity
• *substance abuse in the household**
• mental health hx

Question 2

how is child abuse defined?

Answer 2

a recent act or failure to act that results in death, serious physical or emotional harm, sexual abuse or exploitation, or imminent risk of serious harm

Question 3

what are the 4 main types of child abuse?

Answer 3

1. neglect
2. emotional
3. physical
4. sexual

Question 4

what is the most common cause of death in abused children?

Answer 4

neglet

Question 5

what is the physicians role when suspecting neglect?

Answer 5

• full medical hx
• psychosocial hx
• complete physical exam

contact CPS, even when in doubt

Question 6

results in demonstrable hard to the child

- impaired psychological growth and development

Answer 6

emotional abuse

Question 7

what should you do if the incident seems to be recurrent, or there is possibility of imminent harm to the child?

Answer 7

report to CPS

Question 8

what are some suspicious signs on PE that would indicate abuse?

Answer 8

posterior rib fractures
scapular fracture
spinous process, sternal fracture
cigarette burns
metaphyseal (end of long bone) fractures
patterns of bruises/marks

Question 9

the employment, use, persuasion, inducement, enticement or ceorcion of any child to engage in any sexual conduct

Answer 9

sexual abuse

Question 10

what are the 3 types of sexual abuse?

Answer 10

1. non-touching (exposing to porn)
2. touching
3. exploitation (prostitution, trafficking)

NOTE: no single behavior, sign, or sx is diagnostic

Question 11

how old are most victims of sexual abuse?

Answer 11

9-12 years old

• 60% female
• 50-70% of victims have never told anyone

Question 12

what actions should raise your index of suspicion for sexual abuse?

Answer 12

• child puts mouth on other child/adults sex parts
• child puts objects in vagina or rectum
• touches another child’s sex parts

Question 13

what is the best practice if immediate review of suspected sexual abuse is necessary?

Answer 13

do a minimal facts interview (who, what, where, how)

• who touched you?
• what did they touch you with?
• where did they touch you?
• where were you when this happened?

Question 14

what are the very high risk populations for sexual abuse?

Answer 14

• deaf children: 50% are victims in childhood or adulthood
• developmentally disabled adults: 83% of females are victims
• transgender: 50% are victims in childhood or adulthood

Question 15

failure to report is what class of misdemeanor in MO and KS?

Answer 15

• class A in MO

- class B in KS, even when another mandated reporter has made a report. all mandated reporters must report

Question 16

who are the victims are risk for elderly abuse?

Answer 16

• dementia, psychiatric diagnosis
• physical dependence
• incontinence

perpetrators are usually financially dependent on the victim, and/or have issues with substance abuse

Question 17

what are the signs of neglect in elderly abuse?

Answer 17

• lack of needed nutrition
• poor personal care (urine odor in incontinent person)
• lack of needed medication or health aides
• bruises (often b/l and on inner surface of arms)
• spiral fractures, fractures at different stages of healing
• wrist rope burns
• injuries to the mouth caused by forced feeding
• depleted personal finances
• findings of sexual abuse

Question 18

failure to report is what class of misdemeanor in MO and KS?

Answer 18

• class A in MO (1 year jail and $2,000 fine)

- class B in KS (6 months jail and $1,000 fine)