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Child Abuse MCN Notes

Recognizing and Reporting Child Abuse

Overview

Mission Statement

  • Objective: To prevent child abuse and support victims and their families through coordinated, child-friendly services from report to resolution.

Objectives

  • Define "child abuse".

  • Distinguish between accidental and abusive injuries.

  • Review commonly seen abusive injuries.

  • Discuss Abusive Head Trauma (AHT).

  • Outline appropriate inquiries when abuse is suspected.

  • Describe the role of nurses in reporting child abuse suspicions.

Definition of Child Abuse

What Child Abuse Entails

  • Intentional infliction of injury: Physical or mental harm intentionally caused to a child.

  • Acts resulting in potential harm: Engaging in behavior that could logically cause injury to a child.

  • Encouragement of harmful acts: Motivating or instigating behavior that may injure a child.

  • Negligence to protect: Displaying violent conduct that risks the child's safety.

Statistics on Child Abuse

  • Annual Reports: 4.1 million

  • Prevalence: 1 in 7 children face abuse.

  • Fatalities: Approximately 5 deaths/day.

  • Sexual Abuse: 1 in 4 girls and 1 in 6 boys abused before age 18.

  • Head Injuries: 80% of fatal head injuries in children under 2 are non-accidental.

Profiles of Abusers

Demographics of Perpetrators

  • Gender: 59% female, 41% male.

  • Relationship: 81% are parents of the victim.

Risk Factors for Abuse

  • Socioeconomic status

  • Gender and age of child

  • Caregiver mental health issues

  • Substance abuse (drugs/alcohol)

  • Domestic violence exposure

  • Chronic illness or premature birth of the child

  • History of parental abuse

  • History of animal cruelty.

Recognizing Child Abuse

Indicators of Abuse

  • Detailed history: May not align with the observed injuries.

  • Injury reports: Child claims injury from parent or caregiver.

  • Fear of going home: Expressed by the child.

  • Trauma involvement: Multiple injuries at various healing stages.

  • Medical attention: Delays in seeking care.

  • Inconsistent history: Changes over time in the child's explanation.

Red Flags for Physical Abuse

  • Bruising Patterns: Specific areas indicate potential abuse, such as:

    • Common Sites: Forehead, shins, elbows.

    • Questionable Sites: Neck, abdomen, buttocks, inner thighs.

    • Locations indicating abuse: More likely bruising on arms, thighs, back, and genitalia.

Common Types of Injuries

  • Bite Marks: Detectable semi-circular or oval shapes.

  • Fractures: Significant in children under three years; particularly skull and rib fractures.

  • Burns: 25% of physical abuse injuries; common scald burns from heated liquids.

  • Scald Burns: Characterized by well-defined margins; pattern and location are revealing.

  • Contact Burns: Caused by heated objects, often revealing patterns.

Abusive Head Trauma (AHT)

Overview of AHT

  • Refers to inflicted head injuries including shaking.

  • Leading cause of death from trauma: Most affected are children under two.

  • Characteristics: High infant head-to-body ratio, leading to severe effects when injured.

Sexual Abuse

Definition and Considerations

  • Involves adults or older minors engaging in sexual acts with minors unable to give consent.

  • Indicators include:

    • Child discloses abuse.

    • Genital injuries.

    • Evidence of STDs or pregnancy.

    • Inappropriate sexual behaviors reported by the child.

Neglect

Description of Neglect

  • Failure to provide basic needs: clothing, nutrition, shelter, medical care, and supervision.

  • Most prevalent form of abuse: Accounts for significant child abuse deaths, especially in young children.

Types of Neglect

  • Medical Neglect: Including dental care omissions.

  • Dangerous situations: Leaving children unattended in cars or unsafe sleeping situations.

Emotional Abuse

Characteristics of Emotional Abuse

  • Patterns of damaging interactions resulting in feelings of worthlessness in the child.

  • Indicators include:

    • Lack of attachment or responsiveness.

    • Reports of ongoing emotional harm.

Reporting Child Abuse

Mandatory Reporting

  • All individuals must report any known or suspected cases of abuse, neglect, or abandonment.

  • Florida Statute provides guidelines for reporting:

    • Report through 1-800-96-ABUSE or online.

    • Necessary information for reporting includes child details and nature of abuse suspicion.

Conclusion

  • Child maltreatment is frequently underreported.

  • Important to remember that abusive parents may appear "nice" or "appropriate".

  • Reporting suspicions based on reasonable concern is crucial; it does not imply direct accusations.

Questions and Further Discussion

  • Open floor for any questions regarding recognizing and reporting child abuse.