Clinical Approach to Child/Elder Abuse Flashcards
What are child risk factors for child maltreatment
Fussy, Colicky infant Hyperactive (other behavioral problems) Illness or medically fragile Non-biologic relationship with caregiver Prematurity
What is the definition of child abuse
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
What are the four main types of child abuse
- Neglect
- Emotional
- Physical
- Sexual
Which type of child abuse is the most common type and cause of death
Neglect
- failure to provide food, shelter, clothing
- emotional
- Educational
- MEdical
What is the physicians role when suspecting neglect
Full medical history
Psychosocial history
Complete physical exam
What are the two routes to pursue if emotional abuse is suspected
Isolated no immediate danger - recommend family therapy or parenting classes
Recurrent or immediate hard - Call child protective services
What are suspicious findings on physical exam for child abuse
Posterior rib fractures Scapular fracture Spinous process Sternal fracture Cigarette burns metaphyseal lesions
What are the three types of sexual abuse
- Non-touching
- Touching
- Exploitation
What are some examples of non-touching sexual absue
- expose child to pornography
2. allow child to see/hear sexual activity (not a kid walks in once)
What are examples of touching sexual abuse
- fondling
- making child touch sexual organs
- penetration of object not for medical purposes
- oral-genital contact
What are some examples of sexual exploitation
engaging child in prostitution
using child to film, photograph or model pornography
Human trafficking
What is the age range of most victims of sexual abuse
9-12 years old
What percent of females report they were victims of sexual abuse and what percent remain silent
25% report
50-70% of victims have never told anyone
What is the physicians role when suspecting child abuse
PE will usually be normal
if acute setting, work fast to document thorough history and any signs (vaginal bleeding, discharge etc)
document in quotes.
What is the minimal facts interview
Who, what, where, and location
Who? uncle …
What? his pee pee
Where? on my privates
Where? in my room
