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    Child Abuse & Neglect: MBCHB Iv 2006

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    Malueth Angui
    This document discusses child abuse and neglect. It defines physical abuse, psychological abuse, and neglect, which can result in morbidity or mortality. Risk factors for abuse include poverty, disabilities in the child, prematurity, and the abuser having been abused themselves as a child. Signs of physical abuse include unexplained injuries in various stages of healing like bruises, fractures, burns and head injuries. Sexual abuse involves any sexual activity with a minor and often involves incest. Prevention efforts include identifying at-risk parents and communities, encouraging infant bonding, and teaching children about body safety and boundaries.

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    Child Abuse & Neglect: MBCHB Iv 2006

    Uploaded by

    Malueth Angui
    33 views24 pages
    This document discusses child abuse and neglect. It defines physical abuse, psychological abuse, and neglect, which can result in morbidity or mortality. Risk factors for abuse include poverty, disabilities in the child, prematurity, and the abuser having been abused themselves as a child. Signs of physical abuse include unexplained injuries in various stages of healing like bruises, fractures, burns and head injuries. Sexual abuse involves any sexual activity with a minor and often involves incest. Prevention efforts include identifying at-risk parents and communities, encouraging infant bonding, and teaching children about body safety and boundaries.

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    Child Abuse 2006

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    This document discusses child abuse and neglect. It defines physical abuse, psychological abuse, and neglect, which can result in morbidity or mortality. Risk factors for abuse include poverty, disabilities in the child, prematurity, and the abuser having been abused themselves as a child. Signs of physical abuse include unexplained injuries in various stages of healing like bruises, fractures, burns and head injuries. Sexual abuse involves any sexual activity with a minor and often involves incest. Prevention efforts include identifying at-risk parents and communities, encouraging infant bonding, and teaching children about body safety and boundaries.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    33 views24 pages

    Child Abuse & Neglect: MBCHB Iv 2006

    Uploaded by

    Malueth Angui
    This document discusses child abuse and neglect. It defines physical abuse, psychological abuse, and neglect, which can result in morbidity or mortality. Risk factors for abuse include poverty, disabilities in the child, prematurity, and the abuser having been abused themselves as a child. Signs of physical abuse include unexplained injuries in various stages of healing like bruises, fractures, burns and head injuries. Sexual abuse involves any sexual activity with a minor and often involves incest. Prevention efforts include identifying at-risk parents and communities, encouraging infant bonding, and teaching children about body safety and boundaries.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 24

    Child Abuse & Neglect

    MBCHB IV 2006
    Definition
    Spectrum
    Acts of commission
    Lack of action
    Acts of omission
    Results in morbidity or mortality
    PHYSICAL Food
    Clothing
    Fractures
    Schooling
    Bruises
    Medical care
    Burns
    ABUSE NEGLECT
    commission omission
    Terrorize Love
    Put down Support
    Compare Recognize
    Insult PSYCHOLOGICAL Stimulate
    Epidemiology
    Everyone
    Increased reports in physical abuse among
    the poor
    >90% of abusing parents have no psychotic
    or criminal personalities
    Mentally retarded children are at greater risk
    Abusive parents have often themselves been
    abused
    Epidemiology
    High risk children
     Premature
     Children with chronic medical conditions

     Colicky children

     Children with behavioural disorders


    Clinical Manifestation
    Unexplained, unexplainable, or
    implausible injury
    Delay is seeking medical attention
    Clinical Manifestation
    Type of injuries
     Bruises in unusual places, various stages
    of healing
     Burns
     Bites
     Fractures
     Spiral fractures
     Corner chip fractures

     Various stages of healing


    Clinical Manifestation
    Type of injuries- Head trauma
     common cause of death from physical
    abuse
     95% of intra-cranial injuries in infancy due
    to abuse
     Shaking-retinal hemorrhages
    Clinical Manifestation
    Type of injuries- Intra-abdominal injuries
     Recurrent vomiting
     Abdominal distension

     Absent bowel sounds

     Localized tenderness

     Shock
    Laboratory data
    Rule-out bleeding tendencies (PT, PTT
    and platelet counts)
    Bone survey for children < 2 years
    (skull, thorax, long bones, hands feet ,
    pelvis, & spine)
    Diagnosis
    History not in keeping with child’s
    developmental stage
    Analysis of circumstances of injury
     Child variables
     Environmental variables

    Interview older children> 3 years


    without presence of parent/guardian
    Differential diagnosis
    Scurvy
    Rickets
    Osteogenesis imperfecta
    Bleeding disorders
    Management
    Report immediately
    Hospital admission or placement in a
    safe environment
    Be courteous helpful and observant
    Multi-disciplinary team (Paediatrician,
    Psychiatrist, Social worker)
    Consult with child welfare agencies
    (children’s dept.0
    Prevention
    Identify & support high risk parents
    Encourage bonding in pre-term infants
    Community support structures
    Prognosis
    Return to parents with no intervention:
     5% killed
     25% seriously re-injured
    80-90% can successfully be rehabilitated
    Long term consequences include
     Learning problems, fearfulness, aggression, lack
    of trust, low self esteem, substance abuse,
    hyperactivity)
    Sexual Abuse
    Any adult or older child activity with a minor
    that is for sexual gratification
     Oral-genital
     Genital-genital
     Genital-rectal
     Hand-genital/rectal, breast
     Exposure of sexual anatomy
     Forced viewing of sexual anatomy/pornography
     Needs to differentiated from sexual play
    Sexual Abuse
    Incest is the most common form of
    sexual abuse in children
    Abuse of daughters by fathers and step
    fathers most common
    Enticement of highly vulnerable victims
    Clinical manifestation
    Disclosure by child
    Symptoms
     Vaginal, penile, rectal pain
     Chronic dysuria, enuresis, constipation,
    encopresis
     Nightmares, suicide gestures, withdrawal,
    low self-esteem, depression
     Age inapproriate sexual knowledge,
    seductive behaviour
    Diagnosis
    History
    Physical exam
     Rectal trauma and laxity
     Genital trauma & discharge

     May need to be done under aneasthesia


    Diagnostic signs
    Hymen with new or healing lacerations
    Vaginal wall tears
    Perineal lacerations
    Presence of sperm/semen
    Laboratory tests
    Obtain cultures for STIs (syphilis,
    chlamydia, GC, HIV, Hep B)
    Treatment
    Psychological support
    Treatment of STIs
    Prevention
    Teach children about their bodies using
    correct terminology
    Teach children to say ‘no’
    Careful screening and supervision of
    caregivers
    Prognosis
    Victims may lead normal adult lives
    However some victims may have
    difficulties with close relationships, need
    psychiatric help for depression, anxiety,
    substance abuse & eating disorders
    Greatest risk of poor outcomes is in
    incest victims

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