Physical Abuse Flashcards
A child that may relate well to their parents could still suffer from non accidental injury?
Yes. Some physically abused children may relate to their parents remarkably well and should not be considered the only sign to assess abuse.
What should we note about bruising?
Most accidental injuries occur on parts of the body where the skin or flesh passes over a bony protuberance ( where bones stick out or just underneath the skin)
What are the physical signs of accidental injuries?
Sites of bruising - generally over a bony protuberance such as forehead and shin
Swelling
Child indicating the skin is tender or painful
Also be aware of things you cannot see as much as those you can
Bruising in other sites is more suspicious.
Fractures especially when occurring to children under 2 years old
Fabricated and induced illness for the emotional gain of the carer
Burns and scalds
What should we note about fractures?
Accidents happen but keep eye open for anything suspicious. Children quite frequently sustain fractures which are accidental and where the causes is clear.
The younger the child the more suspicious the fractures become.
Look for explanations that are clear and makes sense.
Many as half of all fractures occurring in children under 2 years old are non accidental.
What is Fabricated and induced illness also know as Munchausen’s syndrome by proxy?
Where parents and carers fabricate or induce the symptoms of illness in their child for their own emotional gain and is a form of physical and emotional abuse.
What are the signs of a fabricated and induced illness?
It’s a very difficult condition to diagnose.
Incidents of injuries or illness in records
Child being investigated for numerous problems over a period of time : physical illnesses, psychological and educational problems.
What’s the difference between neglect and abuse?
Neglected children are more prone to accidental injuries
Abused children may be deliberately injured
Should you take the same approach for a child that got an accidental burn to a child that may have been burned deliberately?
Yes. They can both be signs of abuse. A child that got burned accidentally can be suffering neglect. Both accidents should be checked further and they are both relevant to diagnose an abuse.
What physical abuse may involve?
Hitting Shaking Throwing Poisoning Burning Scalding Drowning Suffocating Anything causing physical harm When a carer fabricates symptoms or deliberately induces illness in a child
Are all injuries a sign of abuse?
No. All children, especially toddlers, are injured from time to time and a vast majority of these injuries are accidental even those which are unexplained.
Signs of alert of a possible non-accidental injuries.
Delay by parents or carers in seeking medical help or not looking for such a help at all.
Account of accident vague or vary from one telling to another. Parents reliving a genuine accident will usually give details, vivid and consistent story
Don’t offer explanations to the injury at all
Child not allowed to tell the story
Parents more concerned about their own problems than about the child’s injuries and may leave before the discussion is finished.
Interaction between the child and carer may be abnormal and child sad, afraid or even withdrawn.
Classic frozen watchfulness: large staring eyes, still and emotionless expression and child seeming to watch carefully what is going on. Is a late state resulting from repeated physical and emotional abuse.
If children think they may be going home with their carers, they may be unwilling to say what has happened while the parents are present. Give a safe environment they may well give an accurate account of the incidents or abuse.
Discrepancies between injuries and story given: 4 week old baby falling over ( they are unable to sit or roll)
Multiple bruises or injuries may be of more concern than a single one.
