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Module 5 > Child Maltreatment > Flashcards

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
Q

Even though its typical in families to have one child that is abused what happens when CPS decides the home is unsafe

A

Removes all of the children in the home

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26
Q

Parental characteristics contributing factors

A

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

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27
Q

Substance abuse

A

Makes up 40% of child abuse cases

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28
Q

What is it that we ccan provide to younger parents

A

Anticipatory guidance
Teaching about normal growth and development ( at pedis office or clinical at well checks)

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29
Q

Important parental characteristic of contributing factors of maltreatments

A

Inadequate knowledge of appropiate parenting skills / inappropiate or unrealistic expectations for child’s developmental
( getting mad for potty training a 8 mo old)

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30
Q

Enviromental contributing factors to abuse

A

Chronic stress
Poverty
Unemployment
Poor housing /crowded living conditions
Frequent relocations
Divorce
Day care providers, baby sitters ( not guy evaluated)

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31
Q

Assessment findings indicators

A

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)

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32
Q

Types of injuries

A

Skin or soft tissue injuries
Musculoskeletal injuries/fracture
Abdominal injuries
Head injuries

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33
Q

Skin or soft tissue injuries

A

Bruises bites burns lacerations

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34
Q

most common manifestation of physical abuse

A

Bruises
How many do they have?
Color- tells if they all happen at the same time

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35
Q

Accidental bruises how can we tell ?

A

Locations (boney prominences)
Shines, lower areas
Under the chin forehead
Appearance - minor or small

36
Q

Non accidental bruises

A

Upper arms
Trunk
Upper anterior les
Sides of face
Ears and back
Genitalia and buttocks

37
Q

At what ages should you not see bruising

A

Less than 4 mo of age
Those who don’t cruise rarely bruises

38
Q

How many bruises is considered suspicious

A

4-5 unless they had a big accident like on a 4wheeler which wouldn’t be a surprise

39
Q

Patterned bruises

A

Grab marks- finger tip
Slap marks / handprints
Pinch marks which are often in occult areas, e hind ears on genitalia
Loop marks instrumental

40
Q

Symmetrical bruises

A

bruises that are on both sides of the body ( both upper arms )

41
Q

Binding bruises

A

Result from being tied with an object such as an electrical cord , rope , belt , etc

42
Q

Bite marks adult canine to canine distance

A

> 3cm between the two Dracula teeth)

43
Q

Burns

A

Time of immersion and water temp
How long was child in it?

44
Q

Recommended to lower the water heater to

A

120f

45
Q

Accidental patterns

A

Splash burns (anterior surfaces, tapering (water running down) )
Objects burns (palms, soles, forearms)

46
Q

Non accidental patterns for burns

A

Forced immersion burns
Extremity immersion (glove like) (sock like)
Trunk Emerson (donut)

47
Q

Pattern object burns

A

Irons
Curling irons
Cigarette burns

48
Q

Suspicious lacerations

A

Frenulum of upper lip
Rectal area
Vaginal area

49
Q

Suspicious skeletal fractures

A

May be single or multiple
New or old or combination
Femur
Rib(especially bilateral0
Scapular
Sternal
Skill
Humerus

50
Q

When is a femur fracture suspicious

A

Children less than 1 yr

51
Q

When is a humerus fracture suspicious

A

Less than 3 y of age

52
Q

Types of fractures (suspicious )

A

Spiral fractures
Metaphysical fractures

53
Q

Spiral fractures

A

Twisting/pulling

54
Q

Metaphysical fractures

A

Twisting/pulling/yanking

55
Q

Corner/bucket handle fractures

A

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
Q

Abdominal injuries

A

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
Q

Suspicious abdominal injuries

A

Injury inconsistent w history
Delay in seeking care

58
Q

Head injuries external

A

Ear boxing , periorbital injuries, traumatic alopecia (hair pulled out)

59
Q

Other head injuries

A

Subdural /sub arachnoid hemorrhages
Retinal hemorrhages

60
Q

Abusive head trauma / shaken baby syndrome

A

Caused by violent shaking of infants and young children

Also called inflicted head injury
Neuro inflicted brain injury

61
Q

S/s of shaken baby syndrome

A

Poor feeding
Vomitting
Irritability
Listlessness
Seizures
Posturing
Apnea
Bradycardia
Alterations in LOC

62
Q

Characteristics detailed injuries of abusive head trauma

A

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
Q

Common triggers for Shaking

A

Crying
Maternal stress or depression

64
Q

What can you do to reduce abuse related to theses triggers?

A

Anticipatory guidance about how to care for infants with inconsolable crying

65
Q

Purple crying

A

Peak pattern
Unpredictable
Resistant to sooting
Pain like look on face
Long bouts of crying
Evening crying

66
Q

Peak pattern of crying

A

Peaks around 2 mo then decreases

67
Q

Unpredictable crying

A

Crying for long periods can come and go for no reason

68
Q

Resistant to soothing

A

The baby may keep crying for long periods

69
Q

Pain in purple

A

Pain like look in face

70
Q

Long in purple

A

Long bouts of crying - crying can go for hours

71
Q

Evening crying -purple

A

Baby cries more in the afternoon and evening

72
Q

Münchausen syndrome by proxy (PSBP) or medical child abuse or fictitious disorder by proxy

A

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
Q

Example of MSPB

A

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
Q

Cultural practices

A

Cupping- pain or healing
Coining- linear bruising- healing

75
Q

Congenital anomalies of genitalia

A

May look like possible penetration of vagina but is not. Born that way

76
Q

Erythema multi form or phytophotodrmatitis

A

May look like burns but are not

77
Q

Idiopathic thrombocytopenia purpora (ITP) or hemophilia

A

Bruise like but not

78
Q

Leukemia

A

Due to bleeding you can see bruising not abuse

79
Q

Trauma focused cognitive behavioral therapy CBT

A

Helps a child who has been abused to better manage distressing feelings and to deal w trauma related memories

80
Q

Child parent psychotherapy

A

Focuses on improving the parent child relationship and and on building a stronger attachment between the two

81
Q

If you suspect abuse

A

Document history
Document physical findings
Drawings and photo doc
Report to cps
Consider hospital admission for child’s safety

82
Q

Reporting

A

Mandatory reporting in good faith
Within 48 hrs

83
Q

What is the priority when reporting

A

To remove the child from the abusive situation to prevent further injury

84
Q

How do you report

A

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
Q

Info when reporting

A

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
Q

Resources

A

Us dept of hhs
Children’s bureau
The period of purple crying

87
Q

Local agencies

A

Children’s advocacy center
Casa of the south plains
Parenting cottage
Voice of hope

Module 5 (39 decks)

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