child maltreatment cont. Flashcards
What questions can be asked to screen parents for emotional maltreatment?
- What kind of child is ____?
- Are they easy to care for?
- Tell me something good/positive about ____.
- What is hard/difficult about ____?
What questions can be asked to screen children for emotional maltreatment?
- How are things at home? At your dad’s?
- How do you get along with mom/dad/stepdad/stepmom?
- Tell me something you like to do with mom/dad/stepmom/stepdad.
- Tell me something you like about mom/dad/stepmom/stepdad.
- Tell me something you do not like about mom/dad/stepmom/stepdad.
- Does anyone make you feel scared, sad, or dumb?
What are red flags for sexual maltreatment?
- Child report
- Sexual awareness or vocabulary beyond age expectations
- Sexual play with toys
- Genitalia with inflammation, tears, anal fissures
- Pregnancy under age 15, STIs
- Anxiety, sleep disturbance
- Change in school performance
- Fear of perpetrator
- Vague abdominal pain
- Acting-out behavior
What are key anticipatory guidance points for preventing sexual abuse?
- Most children who are sexually abused are not abused by a stranger.
- Children are most at risk of being sexually abused by someone they know, trust, and even love.
- Never leave your child with someone you do not know well.
- Never leave your child with anyone who has a history of sexually abusing a child.
- People who sexually abuse children are at high risk of abusing again.
- Pedophiles often present as normal, healthy individuals. They may be married and have children, even grandchildren.
- Pay attention if an adult likes to spend a lot of time alone with your child.
- Most children who are sexually abused have no physical signs, even on examination by a health care provider.
- If you have a concern about sexual abuse, do not ignore it. Share your concerns with a health care provider, teacher, counselor, or child protective services.
- If your child discloses sexual abuse, always report to child protective services.
- You are your child’s best protection against sexual abuse.
What is physical neglect in child maltreatment?
Failure to provide for a child’s basic needs, including food, shelter, medical care, and supervision.
What percentage of child maltreatment cases in the U.S. involve neglect?
0.6
What is intimate partner violence (IPV)?
Maltreatment by a family member against another adult living in the household.
How does IPV relate to child maltreatment?
It often coexists with child maltreatment.
When is IPV risk highest?
During pregnancy.
What percentage of females in the emergency department are there due to IPV?
20%-30%
What are the long-term effects of IPV on children?
It can lead to negative health outcomes.
What should healthcare providers always ask about regarding IPV?
Safety.
What self-care strategies can nurses use when working with maltreatment cases?
- Emotional processing: debriefing, therapy, journaling.
- Boundary setting: limiting emotional involvement, seeking support, knowing when to refer.
- Healthy coping: physical activity, mindfulness, relaxation techniques.
- Self-awareness: identifying triggers, monitoring well-being.
- Workplace support: using EAPs, educating colleagues.
What observational data are assessed in pediatric mental health?
General appearance, motor behaviors, speech and language, affect, thought process, ability to relate to the evaluator, behaviors during the interview, interpersonal relationships, self-concept and image, conscience or moral reasoning.
What factors are included in assessing a child’s general appearance?
Height, weight, grooming and hygiene, nutrition, physical health, rhythmic movements or tics.
What is assessed in a child’s motor behavior?
Fine and gross motor balance, unusual motor activity.
What aspects of speech and language are assessed?
Receptive and expressive language, content, tone, and articulation.
How is affect evaluated in pediatric mental health?
Predominant emotion (depressed, angry, anxious, happy, labile) and emotional reactions to interview content (appropriate, inappropriate, congruent).
What aspects of thought process are assessed?
Estimated intellectual level via language and knowledge base, orientation (person, place, time), perceptual distortions (hallucinations, illusions, obsessions, delusions), attention span, learning disabilities.
What factors indicate a child’s ability to relate to the evaluator?
Eye contact, attitude toward the interviewer (negative, positive, shy, suspicious, withdrawn, friendly, self-centered).
What behaviors are assessed during an interview?
Impulsivity, aggression, inhibition, distractibility, low frustration tolerance, ability to have fun, sense of humor, creativity.
What factors are considered in assessing interpersonal relationships?
Attitudes toward and perceptions of family, siblings, peers, transitional objects, social skills, behavior problems, conflicts, adjustment to changes.
How is self-concept and self-image evaluated in pediatric mental health?
Self-appraisal, comparison of self to others, what the child would like to change about themselves, sense of pride in accomplishments, sex role, and gender identity.
How is conscience or moral reasoning assessed?
Understanding of right and wrong, ability to express common judgments or values.
Why are LGBTQ+ youth at greater risk for mental health issues?
Higher risk across all developmental stages due to discrimination, adverse childhood experiences (ACEs).
How can nurses ensure a healthcare system free of social stigma for LGBTQ+ patients?
- Addressing implicit biases.
- Providing educational material geared toward LGBTQ+ patients.
- Using assessment forms with neutral terms.
- Asking about relationship status.
- Displaying safe-space and nondiscrimination policies.
