Primary Prevention in Pediatric PT

Question 1

Child abuse & maltreatment

Defined

Answer 1

• Abuse→ phys, sexual or emotional harm or neglect to a child under the age of 18 caused by parent or other person who acts as a caregiver for child
  
  • any race, religion, econom stat.
  • *most often abuser is someone child knows/loves

Question 2

Phys. Signs of Phys. Abuse

Answer 2

• Unusual/Unexplained:
  
  • bruises→ where does not typ occur from reg fall/injury→ low back, face, etc.
  • welts, cuts in diff stages healing, fx’s, burns*, human bite marks*

Question 3

Behavioral Signs of Phys Abuse

Answer 3

• Child may:
  
  • wear clothing inappr for weather→ hide injuries
  • seem w/drawn/depressed
  • afraid to go home, runs away
  • shy away from phys contact
  • paranoid/hypER alert around adults
  • acts out→ aggressive

Question 4

Child Abuse: Image w/ s/s

Answer 4

see pics

Question 5

Child Neglect

Defined

Answer 5

Neglect occurs when parent/caregiver fails to provide proper supervision for a child or adeq food, clothing, shelter, edu or med care although financially able or assisted to do so

Question 6

Physical signs of Neglect

Answer 6

• May have:
  
  • Poor hygiene
  • *Slowed phys. dev.→ not exploring environ, malnourished, no energy/motivation, no superV @ home
    
    • may appear under wt
  • Unattended med. needs
  • Little or no superV @ home

Question 7

Behavioral signs of Neglect

Answer 7

• Child may:
  
  • Miss med/therapy appts, freq tired/hungry (steals food), inapprop. dress, poor hygiene
• Parent may:
  
  • indiff. to child, behave irrationally or in bizarre manner

Question 8

Emotional Abuse

Defined

Answer 8

• Emo/psychological abuse includes→ speech & actions that have a neg. impact on child
  
  • parents/caregivers, adults in childs life
• Examples:
  
  • name call, insults, threatening violence (even w/out carrying out), allow children to witness phys/emo abuse of another, w/holding love, support, guidance

Question 9

Phys. signs of Sexual Abuse

Answer 9

• Child may:
  
  • diff walking/sitting, suddenly refuse to part. phys acts, nightmares/bedwetting
  • bizarre, sophisticated, or unusual sexual knowledge/behavior, pain/itching genitals
  • report sexual abuse by parent or adult caregiver

Question 10

Signs Adult might be Abusing Child

Answer 10

• cannot explain or gives strange explanations for childs injuries, talks negative about child, harsh discipline, was abused as child, alcohol/drug probs, emo/mental illness probs, high stress, does not look after childs hygiene or care, no love or concern for child OR overly affectionate and protective

Question 11

Legal Obligation to Report

Answer 11

• Failure to report== misdemeanor most states
• Need only to suspect to report
• DO NOT investigate independently!
• 15% abused and neglected children have disability

Question 12

Car Seat Safety

Answer 12

• Important→ understand what proper pos’ing and buckling looks like in car seats
  
  • Parents often not installing properly
  • educate to prevent injury
• TYPES:
  
  • Infant seats/rear facing
  • convertible car seats
  • booster seats

Question 13

SAFEST car seat

Answer 13

Infant car seat

*use until child hits seats max weight OR height limits

Question 14

NJ Car Seat Law

Answer 14

NOTE: under age of 2 weighing <30lbs→ MUST be in rear-facing car seat w/ 5-point harness

Question 15

Common Car Seat Errors

Answer 15

• Not installing properly, *turning forward too soon (rear-facing as long as possible!), improper strapping, bulky winter coats, buying secondhand seats (expiration dates), car seat accessories, not using booster seat (bridge gap for in bw too big/too small)

Question 16

Correct Strapping Placement

Answer 16

**Chest clips @ nipple-line/arm pits

• Rear facing→ straps come from below shoulder out of back of car seat
• Forward facing→ straps come out of the back of car seat @ lvl or just above shoulders
  
  • should not be able to pinch straps
    
    • no more than 1 finger able to slide behind straps

Question 17

5 point harness system pics and reminder

Answer 17

Rear-facing car seat as long as you can!!! (until they reach max ht.or wt.)

Question 18

Booster Seats reminder!!!

Answer 18

see pics!!!!

Question 19

Preventing “Container Syndrome”

What is “Container Syndrome?”

Answer 19

Results from use of too may positioning devices and decreased floor play time in developing infants====> Gross Motor Delay!!!!

• Containers:
  
  • swings, bouncer seats, rock n play, walkers, door jumpers, exersaucers, Bumbo seats

Question 20

Why are these devices BAD???

Answer 20

• Limit active mvmt/floor exploration→ lack postural control (no actual work!)
• Used @ inapprop. ages when children not ready for them (know your milestones 0-12***)→ super-impose upright pos’s who’re not @ this stage of dev.
  
  • poor postural control=poor align.
    
    • head shape issues, torticollis
  • abnorm recruit. of mm structures to maintain pos’s
• Safety→ walkers banned in certain states, parental ignorance
• Cannot say never use these devices→ PTs recommend limited use which actually delay acquisition of motor skills
  
  • *Limit to no more than 30mins/day
  • Just put them on floor!!!