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Chapter Twelve: Child Abuse


3.1 million children are affected by child abuse ... of child abuse policy. Caregivers are mandated reporters. Child care steps to prevent abuse in care ... – PowerPoint PPT presentation

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Title: Chapter Twelve: Child Abuse

Chapter Twelve Child Abuse
Every Year
  • 2,000 children die
  • 18,000 become permanently disabled
  • 142,000 are seriously injured
  • 3.1 million children are affected by child abuse
  • More than one-half of the children who die are
    under one year of age

Policies for Child Abuse
  • Preventive Measures
  • Protective Measures

Preventive Measures
  • Begin at the child care site
  • Screening for abuse potential
  • Screen potential employees for history of abuse
  • Queries about childhood
  • Reasons for working with children
  • What if situations to elaborate on
  • Probationary period enforced to observe of
    treatment of children

  • Prevent Accusations
  • Inform parents of child abuse policy
  • Caregivers are mandated reporters
  • Child care steps to prevent abuse in care
  • Set up to be openno situation that could lead
    to privacy for caregiver and child
  • Written policy of discipline and guidance that is
    followed by all
  • Ouch reports are filled out, a copy given to
    parents, and a copy in childs health file

  • Intervention
  • Observation
  • Identify when parents are under stress
  • Identify when children are under stress
  • Discussion
  • Establish good communication relationship with
  • Talking with caregiver may help parents relieve

  • Action
  • Inform parents of coping skills
  • Refer parent to resource for help
  • Understand factors that may lead to abuse, for
  • Significant changes in lifestyle
  • Unrealistic expectations of childs capabilities
    (lack of developmental knowledge)
  • Poor impulse control
  • Under influence of drugs or alcohol

Protective Measures
  • Recognition
  • Indicators of Abuse
  • Physical Abuse
  • Emotional Abuse
  • Sexual Abuse
  • Neglect

  • Physical Indicators of Physical Abuse (see Table
  • Bruises
  • Burns
  • Bite marks (unexplained)
  • Lacerations or abrasions
  • Head injury or whiplash
  • Other

  • Behavioral Indicators of Physical Abuse
  • Tells you parent(s) or other adult hurt them
  • Overcompliant
  • Poor self-concept
  • Extremes in behavior
  • Does not want to leave child care
  • Indiscriminately seeks affection or wary of
  • Vacant, withdrawn, or detached

  • Physical Indicators of Emotional Abuse (see Table
  • Failure to thrive
  • Depressed or withdrawn
  • Disruptive or hyperactive
  • Repetitive rhythmic movement (rocking, etc.)
  • Little facial effect
  • Speech or language disorders

  • Behavioral Indicators of Emotional Abuse (see
    Table 12-4)
  • Rigid in conformity to authority
  • Destructive or antisocial
  • Parent is demanding and has unrealistic
    expectations of childs capabilities
  • Unusual fears
  • Lagging in cognitive or emotional development
  • Aggressive/Compliant extremes

  • Physical Indicators of Sexual Abuse (see Table
  • Torn, stained, or bloody underclothing
  • Pain, itching, or swelling of genital area
  • Bruises, lacerations, or bleeding in genital or
    anal area
  • Discharge in genital area
  • Difficulty in walking or sitting
  • Pain during urination or defecation
  • Venereal disease

  • Behavioral Indicators of Sexual Abuse
  • Frequent masturbation
  • Inappropriate sexual knowledge or behavior
  • Withdrawn, fantasizing, infantile
  • Depression
  • Poor self-esteem/image
  • Exceptional fear of a person or place
  • Draws scary pictures with black and red

  • Physical Indicators of Neglect (see Table 12-6)
  • Always hungry, dirty, or inappropriately dressed
  • Unsupervised for long periods of time
  • Lacks medical or dental care
  • Unsanitary home conditions
  • Poor growth, underweight
  • Poor school attendance
  • Abandonment

  • Behavioral Indicators of Neglect
  • Stealing or begging for food or money for food
  • Parent brings child early and picks up late
  • Inappropriate attachment or affection
  • Shows or expresses no emotion
  • Parent abusing drugs or alcohol
  • Overly responsible, assumes adult role

  • Documentation
  • If abuse is suspected, document indicators
  • Observe child at different times, in different
    situations, and record in note form
  • Record behavior, conversation and physical signs
  • Anecdotal record best type for this
  • Keep records for a period of time to refer to

  • Reporting
  • Reporting process should be clear
  • State process should be kept at child care site
  • Childs name, address, and age must be included
  • Parents names and addresses (if separate
    addresses) should be given
  • Anonymity for caregiver will be provided

  • Caregiver may want to talk to parents first
  • Caregiver may want to plan to help parents
    through process to support family

  • Caring for the Abused Child
  • Caregiver should examine feelings about the issue
  • Can the caregiver deliver the care the child
    needs without prejudice?
  • Caregiver determines level of understanding of
    normal behavior
  • Caregiver needs to learn how to redirect
    behaviors that may result from abuse

  • To help and support abused child the caregiver
    need to provide
  • Trust
  • Predictable routines
  • Consistent behavior
  • Safe boundaries
  • Confidence
  • Good communication skills

Implications for Caregivers
  • Education
  • For parents
  • With children
  • Empower children with knowledge
  • Help children verbalize feelings
  • Cultural Competence
  • Observation
  • Supervision

?Reality CheckShaken Baby Syndrome
  • Form of child abuse that involves forceful or
    violent shaking of a child from birth to five
    years of age
  • Only shakingnot dropping, not seizures, nor
  • Most common in children under two
  • Sudden movements cause parts of brain to pull
    away and it tears brain cells and blood vessels

  • Shaking need only last 20 seconds (40 to 50
    shakes) to do damage
  • One in four babies die
  • Most others have permanent brain damage
  • Permanent injuries range from
  • Partial to complete blindness and hearing loss
  • Seizure disorder
  • Cerebral palsy
  • Others
  • May include permanent vegetative state

  • Fathers or boyfriends of mothers most likely to
    do this
  • Females are more likely to be child caregivers
    than mothers
  • Immediate medical help may reduce the degree of
  • Education is needed for caregivers and parents to
    prevent this syndrome

?Reality Check Domestic Violence and Its Effect
on Childrens Lives
  • Women battered, children abused or neglected
  • 14 of children in U.S. experience family
  • Changes in family systems has led to greater
  • Divorce/Single parent
  • Poverty
  • Drug and alcohol abuse

  • Occurs at every SES level, in every racial,
    ethnic, and religious group
  • Even if not abused, witnessing abuse has
    traumatic effect on children
  • Children feel isolated with nowhere to go
  • Caregivers can provide trust and a safe haven
  • Caregivers can model prosocial behaviors