PSYCHOSOCIAL ISSUES AND CHILD ABUSE Flashcards
Factors that determine the understanding of death and expression of grief
Chronologic age and levels of cognitive development
What does exposure to high levels of parental conflict lead to?
Predictive of poor emotional adjustment by the child regardless of the parents’ marital status
What are the most helpful measures for children in cases of divorce?
Regular schedule with flexibility Consistency with structure and routine Cooperative co-parenting
Consequences of divorce on a child’s emotional adjustment
May affect his/her subsequent intimate relationships
Consequences of adoption on children from institutional or orphanage care
A higher risk of medical and developmental problems than their counterparts who have resided in foster care
Child is being placed in foster care; how soon should this child be evaluated by a provider?
Initial visit should take place within 72h after placement in the foster care system
TV watching is not recommended at what age?
Children younger than 2years of age
How long should children 2years and older be allowed to watch TV?
2h/day or less for all children, including other forms of screen (solitary TV watching is highly discouraged)
Increased aggressive behavior and acceptance of violence, obscuring of the distinction between fantasy and reality, trivialization of sexuality are effects of
Excessive media time
One of the most common causes of school refusal in children
Separation anxiety disorder
A set of clinical features in which unfounded parental anxiety about the health of a child results in disturbances of the parent–child interaction
Vulnerable child syndrome
At what age should discussions start regarding transition of care for adolescents and young adults with chronic medical conditions?
Around 12years of age
A child tends to have asynchronous developmental patterns, very advanced in one domain area compared to the rest
Gifted child
Maternal depression, substance use/abuse, and physical injuries
May indicate intimate partner violence
A frequent risk factor for child abuse
Intimate partner violence
Consequences of children who are exposed to corporal punishment and intimate partner violence
More likely to exhibit aggressive/violent behaviors than other children
What is the most common form of child abuse?
Neglect
What is the most common presentation in an abused child?
Asymptomatic—just because there are no physical signs does not mean that the child has not been abused
What is the most common cause of head injury in a child less than 1year of age?
Child abuse
A 3-week-old girl presents to ER with lethargy, poor sucking, and retinal hemorrhages; mother stated the child rolled over and fell from the bed. What is the most likely cause?
Abusive head trauma (shaken baby syndrome)
What are the consequences of child abuse during early development?
Physiologic and anatomic changes in the brain, increased risk of physical and behavioral problems
Parents or guardians who failed to provide adequate medical care for a child, e.g., refused to administer medications for a serious medical condition
Medical neglect
Parents or guardian fail to provide basic needs (nutrition, shelter, clothes) or who abandon the child
Physical neglect
Parents or guardian fail to enroll the child in school or provide homeschooling, allow frequent absenteeism, or ignore special education needs
Educational neglect
Parents or guardian isolate the child, withhold emotional support, expose the child to interpersonal violence or substance abuse, e.g., fight or engage in sex in front of the child
Emotional neglect
Parents or guardian leave the child alone or improperly supervised, fail to keep the child from safety hazards, e.g., leaving strong chemicals open and not safely secured in the house
Supervision neglect
Posterior rib fracture, bucket handle fracture, femur fracture in child less than 1year old, distal humeral physeal fracture, and humeral shaft fracture in child less than 3years old are high suspicion of
Child abuse
Bucket handle fracture (also known as a classic metaphyseal fracture or metaphyseal corner fracture) in infants
High specificity for child abuse. It may occur with shaking, vigorous pulling or twisting of an infant’s extremity
What is the next best step with any suspicion of child abuse in a child less than 2years of age?
Skeletal survey
Difference between bucket handle fractures and buckle fractures
Fracture of the distal radius (buckle fracture) is common and is not associated with child abuse
A 7-month-old healthy infant with a few bruises on arms and legs
Must be evaluated for child abuse and reported to child protective services
A 7-year-old healthy child with multiple bruises on both tibial shins and elbows
Reassurance
Entire foot is burned, with a well- demarcated line of injury around the leg and absence of splash marks (stocking distribution)
Child abuse (possible forced immersion into hot water)
Entire hand is burned, with a well- demarcated line of injury around the forearm and absence of splash marks (glove distribution)
Child abuse (possible forced immersion into hot water)
What is the most common physical examination finding in a child with sexual abuse?
Normal examination
Physical contact between the victim and the perpetrator, with or without oral, anal, or vaginal penetration
Child sexual abuse
Which gender is less likely to disclose sexual abuse and might be victimized more often than the reported ratio
Boys
A 16-year-old adolescent presents to the ER due to a sexual assault that occurred 1day ago, what should be done?
SANE exam—should be done by a specialized nurse. The cutoff for exam 72–120h (within 5days)
What is the SANE exam?
Exam performed by a Sexual Assault Nurse Examiner who examines the victim of sexual assault and collects all forensic evidence
A healthy child with multiple recurrent ER visits; the mother is a healthcare professional who demands tests and imaging with each visit; before discharge patient’s blood glucose is 40mg/ dL.Further evaluation shows high serum insulin level and absence of serum C-peptide level
Caregiver-fabricated illness
