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An Overview of Child Abuse and Neglect for Community Health Professionals

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An Overview of Child Abuse. and Neglect for Community Health Professionals ... Indicators for Abuse. Parents verbalize unrealistic expectations of the child ... – PowerPoint PPT presentation

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Title: An Overview of Child Abuse and Neglect for Community Health Professionals


1
An Overview of Child Abuse and Neglect for
Community Health Professionals
  • Heidi Malott, LISW
  • Mayerson Center for Safe and Healthy Children

2
Topics of Discussion
  • Physical Abuse
  • Neglect
  • Sexual Abuse

3
Child Abuse A New Frontier
  • Early 1900s SPCA
  • 1962 First article written by physicians
  • 1960s First child abuse reporting laws
  • 1980s 50 increase in reporting

4
Statistics
  • Annually, _at_ three million
  • reports of abuse and neglect
  • were made to Childrens
  • Services agencies
  • 1/3 of these reports
  • resulted in substantiated
  • child abuse/neglect

5
Physical Abuse
  • Any non-accidental injury suffered by a child as
    the result of the acts of commission or omission
    of a person responsible for the care of the child

6
Risk Factors for Physical Abuse
  • Infants or young children
  • Disabled Children - mental and physical
  • Children in dysfunctional or isolated families
  • Children in family where there is substance abuse
  • Children in families where there is domestic
    violence

7
Indicators for Abuse
  • Parents verbalize unrealistic expectations of the
    child
  • Parents lack concern for the childs injury or
    pain
  • Parents lack ability to comfort the child
  • Parents who delay in seeking medical care
  • Parents who provide an explanation that is
    incompatible with the injury

8
Presentations Suspicious for Physical Abuse
  • Bruising
  • Burns
  • Fractures
  • Head Trauma
  • Abdominal Trauma

9
Discipline versus Abuse
  • Cultural issues
  • Personal beliefs vs. professional practice
  • Does age play a role?
  • Permanent physical harm

10
Burns
  • Usually seen in a sock or glove formation when
    the child is dipped in hot water
  • Cigarette burns
  • Branding burns
  • Burns usually associated with more intent on the
    part of the perpetrator - requires planning

11
Fractures
  • Non-ambulatory children should not have fractures
  • Often history is not consistent with the injury -
    insignificant event causing a fracture
  • Fractures indicative of abuse - ribs,
    metaphyseal, fractures of different ages

12
Mimicking Physical Abuse
  • Ethnic Differences
  • mongolian spots
  • Ethnic Practices
  • Cupping
  • Coining

13
Neglect
  • Most common form of child maltreatment
  • Accounts for the majority of total child abuse
    reports
  • This form of child maltreatment is often
    associated with poverty
  • Can include medical neglect, educational neglect
    and neglect of supervision

14
Neglect
  • See multiple accidental injuries
  • Ingestions
  • Drownings/near drownings
  • Falls from windows
  • Fires
  • Rollover deaths
  • Non-compliance with care

15
Sexual Abuse
  • Children may disclose to anyone at any time It
    could be you!
  • Disclosure tends to be a process, not an event -
    testing the waters
  • Disclosures may be accidental - STDs, pregnancy,
    injury, witnessed by others

16
How Do Children Tell?
  • Young children
  • School aged Children
  • Adolescent Children
  • Boys

17
Sexual Abuse
  • Evaluation should include
  • Forensic Interview
  • a non-leading interview by a trained professional
  • Examination by a child abuse physician
  • Assessment by a child services investigator and
    law enforcement officer to address risk and
    evidentiary issues
  • A multidisciplinary team approach

18
What can we do?
  • Be open to the fact that the children you work
    with can be a victim of abuse
  • Be objective multiple hypotheses
  • Language issues in younger children
  • Offer opportunities for children to practice
    free narrative
  • Can you tell me more about that?

19
What are your ethical decisions?
  • Worried about losing the patient/family to care.
  • Agree with the use of physical discipline.
  • Dont believe the childs disclosure or unsure.
  • Cant prove the abuse.

20
Answers to Ethical Issues
  • Your call can be anonymous and your identity as a
    caller is confidential.
  • You do not have to tell the family you called or
    could say I think someone may have hurt your
    child.
  • You only have to have a suspicion.
  • You are a mandated reporter.

21
Reporting Child Abuse
  • Is this a new disclosure/concern?
  • Are there acute safety issues?
  • Report to the Childrens Protective Services
    Agency where the child resides
  • Report to the law enforcement agency where the
    offense occurred

22
Contact Information
  • Mayerson Center 513.636.7233
  • 24/7 Social Work at CCHMC 736 4410
  • Heidi Malott, LISW
  • - 513.636.0039
  • heidi.malott_at_cchmc.org
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