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Child Maltreatment Flashcards

1
Q

Types of child abuse*

A

Neglect
Physical abuse
Sexual abuse
Emotional abuse (psychological maltreatment)

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2
Q

What type of child maltreatment goes unreported

A

Sexual abuse

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3
Q

Which type of child maltreatment is hard to prove

A

Emotional abuse

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4
Q

Signs of child abuse / neglect

A

Changes in behavior
Changes in school performances
And attendance
Unexplained injuries
Changes in eating
Changes in sleeping
Lack of personal care or hygiene
Comes to school early stays late , doesn’t want to go home
Risk taking behavior
Fear of certain places, people
Returning to earlier behaviors (regression))
Inappropriate sexual behaviors

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5
Q

What does stress cause?

A

Regression

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6
Q

Types of child maltreatment

A

Physical neglect
Emotional abuse/neglect
Physical abuse
Sexual abuse

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7
Q

Physical neglect

A

Deprivations of necessities
Food , clothing, shelter, supervision, medical care, education
Common form

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8
Q

What is another contributing factor to physical neglect

A

May be due to a lack of knowledge of the child’s needs, lack of resources,and caregiver substance abuse

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9
Q

Emotional maltreatment

A

Emotional neglect
Emotional abuse

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10
Q

Emotional needs

A

Failure to meet the needs of affection, attention and emotional nurturance

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11
Q

Emotional abuse

A

Deliberate attempts to destroy or significantly impair a child’s self esteem or competence

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12
Q

Forms of emotional abuse

A

Rejecting the child
Isolating
Terrozing(bleach ex)
Ignoring
Verbally assaulting
Overly pressuring the child

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13
Q

Physical abuse

A

The deliberate infliction of physical injury on a child usually by the child’s caregiver

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14
Q

Rule of thumb for spanking

A

Only use hand, no objects
And only on the seat of the pants (buttocks area) with clothes on

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15
Q

Injuries from abuse

A

Bruises
Bites
Burns
Lacerations
Pinch mark
Swelling
Tenderness

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16
Q

What can injuries occur from?

A

Punching, beating, shaking, kicking, biting , throwing , burning

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17
Q

Sexual abuse

A

Persuading any child to engage in or assisting another person to engage in sexual conduct or simulation of such conduct

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18
Q

Typical abusers

A

Male victims knows (can be however including women and siblings)
Father
Step father
Relatives

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19
Q

Physical signs and symptoms of sexual abuse

A

Injury to external genitalia, anus mouth and throat
Painful urination
Recurrent UTI
Constipation or stool incontinence
STI
Difficulty walking or sitting
Pregnancy

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20
Q

Emotional psychological s/s of sexual abuse

A

Sexual comments, behaviors or play
Regressive behavior -bedwetting
Personality change (withdrawn)
May resist in removing clothes for exam
Phobias (dark, strangers, leaving the house)
Reports nightmares
Sudden change in apetite

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21
Q

Contributing factors for child maltreatment

A

Child
Parent environmental
Exact cause unknown
Interaction of these factors is thought to increase the risk of abuse occurring in a particular family

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22
Q

Characteristics of child (contributing )

A

Temperament (difficult)
Ordinal position (birth order)
Age-
Prematurity ,
behavioral disorder ,
unwanted pregnancy
, cognitive impairment,
hyperactivity
physical disability or chronic illness

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23
Q

What ages are at higher risk for abuse

A

Birth to 1 year . Birth to 2 yr makes up about 25% of cases

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24
Q

Difficult developmental stages that contribute to maltreatment

A

Colic
Potty training
Teenagers

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25
Even though its typical in families to have one child that is abused what happens when CPS decides the home is unsafe
Removes all of the children in the home
26
Parental characteristics contributing factors
History of abuse/neglect”parent imprint” Difficulty controlling aggression Substance abuse Inadequate support systems One abuser while other parent permits it Younger parents Socially isolated Marital probs
27
Substance abuse
Makes up 40% of child abuse cases
28
What is it that we ccan provide to younger parents
Anticipatory guidance Teaching about normal growth and development ( at pedis office or clinical at well checks)
29
Important parental characteristic of contributing factors of maltreatments
Inadequate knowledge of appropiate parenting skills / inappropiate or unrealistic expectations for child’s developmental ( getting mad for potty training a 8 mo old)
30
Enviromental contributing factors to abuse
Chronic stress Poverty Unemployment Poor housing /crowded living conditions Frequent relocations Divorce Day care providers, baby sitters ( not guy evaluated)
31
Assessment findings indicators
Inconsistent with injury Incompatible with the child’s development Delay in seeking medical treatment History changes repetition (asking over and over again) Contradictory histories Non-accidental injuries (loop marks)
32
Types of injuries
Skin or soft tissue injuries Musculoskeletal injuries/fracture Abdominal injuries Head injuries
33
Skin or soft tissue injuries
Bruises bites burns lacerations
34
most common manifestation of physical abuse
Bruises How many do they have? Color- tells if they all happen at the same time
35
Accidental bruises how can we tell ?
Locations (boney prominences) Shines, lower areas Under the chin forehead Appearance - minor or small
36
Non accidental bruises
Upper arms Trunk Upper anterior les Sides of face Ears and back Genitalia and buttocks
37
At what ages should you not see bruising
Less than 4 mo of age Those who don’t cruise rarely bruises
38
How many bruises is considered suspicious
4-5 unless they had a big accident like on a 4wheeler which wouldn’t be a surprise
39
Patterned bruises
Grab marks- finger tip Slap marks / handprints Pinch marks which are often in occult areas, e hind ears on genitalia Loop marks instrumental
40
Symmetrical bruises
bruises that are on both sides of the body ( both upper arms )
41
Binding bruises
Result from being tied with an object such as an electrical cord , rope , belt , etc
42
Bite marks adult canine to canine distance
> 3cm between the two Dracula teeth)
43
Burns
Time of immersion and water temp How long was child in it?
44
Recommended to lower the water heater to
120f
45
Accidental patterns
Splash burns (anterior surfaces, tapering (water running down) ) Objects burns (palms, soles, forearms)
46
Non accidental patterns for burns
Forced immersion burns Extremity immersion (glove like) (sock like) Trunk Emerson (donut)
47
Pattern object burns
Irons Curling irons Cigarette burns
48
Suspicious lacerations
Frenulum of upper lip Rectal area Vaginal area
49
Suspicious skeletal fractures
May be single or multiple New or old or combination Femur Rib(especially bilateral0 Scapular Sternal Skill Humerus
50
When is a femur fracture suspicious
Children less than 1 yr
51
When is a humerus fracture suspicious
Less than 3 y of age
52
Types of fractures (suspicious )
Spiral fractures Metaphysical fractures
53
Spiral fractures
Twisting/pulling
54
Metaphysical fractures
Twisting/pulling/yanking
55
Corner/bucket handle fractures
Twisting injury o=w consequent seperation of the corner piece of the metaphysics from the remainder of the bone Caused by grabbing , twist or shake of a child’s limb in frustration
56
Abdominal injuries
2nd most common cause of death Secondary to a blow Rarely see Bruises (may or may not) Ruptured liver, spleen , bladder, intestinal perforation , pancreatic injuries)
57
Suspicious abdominal injuries
Injury inconsistent w history Delay in seeking care
58
Head injuries external
Ear boxing , periorbital injuries, traumatic alopecia (hair pulled out)
59
Other head injuries
Subdural /sub arachnoid hemorrhages Retinal hemorrhages
60
Abusive head trauma / shaken baby syndrome
Caused by violent shaking of infants and young children Also called inflicted head injury Neuro inflicted brain injury
61
S/s of shaken baby syndrome
Poor feeding Vomitting Irritability Listlessness Seizures Posturing Apnea Bradycardia Alterations in LOC
62
Characteristics detailed injuries of abusive head trauma
Intracranial bleeding (subdural , sub arachnoid hematomas) Bilateral retinal hemorrhages (80% of cases) May also include fractures of the rubs and long bones Most often there are no signs of external injury
63
Common triggers for Shaking
Crying Maternal stress or depression
64
What can you do to reduce abuse related to theses triggers?
Anticipatory guidance about how to care for infants with inconsolable crying
65
Purple crying
Peak pattern Unpredictable Resistant to sooting Pain like look on face Long bouts of crying Evening crying
66
Peak pattern of crying
Peaks around 2 mo then decreases
67
Unpredictable crying
Crying for long periods can come and go for no reason
68
Resistant to soothing
The baby may keep crying for long periods
69
Pain in purple
Pain like look in face
70
Long in purple
Long bouts of crying - crying can go for hours
71
Evening crying -purple
Baby cries more in the afternoon and evening
72
Münchausen syndrome by proxy (PSBP) or medical child abuse or fictitious disorder by proxy
The caregiver usually the mother with some degree of health care knowledge and training deliberately exaggerates or fabricates histories and symptoms or induce symptoms . The caregiver is often very attentive to the child and may refuse to leave them
73
Example of MSPB
May give drugs to poison child May suffocate them to cause seizures May give large doses of laxatives to cause diarrhea Mothers have been know to inject feces or lighter fluid in their child’s IV lines
74
Cultural practices
Cupping- pain or healing Coining- linear bruising- healing
75
Congenital anomalies of genitalia
May look like possible penetration of vagina but is not. Born that way
76
Erythema multi form or phytophotodrmatitis
May look like burns but are not
77
Idiopathic thrombocytopenia purpora (ITP) or hemophilia
Bruise like but not
78
Leukemia
Due to bleeding you can see bruising not abuse
79
Trauma focused cognitive behavioral therapy CBT
Helps a child who has been abused to better manage distressing feelings and to deal w trauma related memories
80
Child parent psychotherapy
Focuses on improving the parent child relationship and and on building a stronger attachment between the two
81
If you suspect abuse
Document history Document physical findings Drawings and photo doc Report to cps Consider hospital admission for child’s safety
82
Reporting
Mandatory reporting in good faith Within 48 hrs
83
What is the priority when reporting
To remove the child from the abusive situation to prevent further injury
84
How do you report
Texas abuse neglect hotline Can be confidential but do have to identify you to district attorney or law enforcement if case requires further investigation
85
Info when reporting
Name age address of child Your name contact info Description of situation Childs current condition Any info that will help identify or locate the child
86
Resources
Us dept of hhs Children’s bureau The period of purple crying
87
Local agencies
Children’s advocacy center Casa of the south plains Parenting cottage Voice of hope

Module 5 (39 decks)

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