Clinical Approach to Child/Elder Abuse (Schmidt) Flashcards
What are some signs of child maltreatment?
1) Fussy, colicky infant
2) Hyperactive behavior
3) Illness
4) Non-biologic relationship with caregiver
5) Prematurity
What is an important caregiver risk factor for child maltreatment?
Substance abuse
What are the four main types of child abuse?
1) Neglect
2) Emotional
3) Physical
4) Sexual
What is the most common type of child abuse?
Neglect
Neglect is the most common cause of?
Death in abused children
What is the physician’s role when suspecting neglect?
1) Full medical history
2) Psychosocial history
3) Complete physical exam
What should you do when suspecting neglect, even when in doubt?
Ensure safety of child and contact Child Protective Services
When should the physician report to child protective services due to emotional abuse?
If it appears recurrent or possibility of imminent harm to child
What are suspicious signs of abuse on the physical exam?
1) Posterior rib, scapular, and sternal factures
2) Cigarette burns
3) Metaphyseal lesions
What are the three types of sexual abuse?
1) Non-touching
2) Touching
3) Exploitation
What are examples of non-touching sexual abuse?
1) Expose child to porn
2) Neglectfully allow child to see/hear active sexual activity
What are examples of sexual exploitation?
1) Engaging a child for purposes of prostitution
2) Using a child to film, photograph or model pornography
3) Human trafficking
Most victims of sexual abuse are in what age range?
9-12 years old
While 25% of US females report were a victim of child sexual abuse, what percentage of victims have never told anyone?
50% - 70%
In the evaluation of sexual abuse what is the general rule in diagnosis?
No single behavior, sign, or symptom is diagnostic
What is usually found on PE when examining a child for sexual abuse?
Normal PE
If immediate interview is necessary, what should be done?
Minimal Facts Interview
What is asked in a Minimal Facts Interview?
What should be avoided?
Why is this question avoided and what should be asked instead of this question?
1) Who, what, where, how
2) When
3) Young children are poor at spatial timing, instead ask “Did this happen one time or more than one time?”
What are very high risk populations for sexual abuse?
1) Deaf children
2) Developmentally disabled adults
3) Transgender
What is a Class A misdemeanor in Missouri and a Class B in Kansas for physician’s when presented with a sexual abuse case?
Failure to report
What are victim risk factors for elder abuse?
1) Dementia, psychiatric diagnosis
2) Physical dependence
3) Incontinence
What is a perpetrator characteristic for elder abuse?
Substance abuse
What are the types of elder abuse?
Which type makes up 50% of cases?
1) Physical
2) Sexual
3) Psychological
4) Financial
5) Neglect (50% of cases)
What are abuse signs of elderly neglect?
1) Lack of nutrition
2) Poor personal care
3) Lack of medications
What are signs of elderly abuse in terms of bruises?
Often bilateral and on the inner surface of the arms from being grabbed
What are signs of elderly abuse in terms of burns?
Often cigarette burns
What are signs of elderly abuse in terms of fractures?
1) Fractures at different stages of healing
2) Spiral fractures caused by twisting of limbs
What are other common signs of elderly abuse?
1) Wrist rope burns
2) Injury to mouth caused by forced feeding
3) Depleted personal finance
What is a class A misdemeanor in Missouri (1 year jail + $2,000 fine) and a class B misdemeanor in Kansas (6 months jail + $1,000 fine) in terms of elderly abuse?
Failure to report
