CHILD ABUSE

AND
BATTERED CHILD SYNDROME
 INTRODUCTION
Childhood should be a care-free time filled with love, and
the joy of discovering new things and experiences.

However, it is a dream for many children.

Child abuse and neglect is an increasing social problem.

The effects of child abuse and neglect are not limited to

childhood but cascade throughout life, with significant
consequences for victims (on all aspects of human
functioning), their families, and society.
 DEFINITIONS OF CHILD
ABUSE
According to Stewart:

Defined child abuse as any interaction or lack of interaction

between a care giver and a child resulting in non- accidental harm to the
child’s Physical or developmental state.

According to WHO:

Child maltreatment is the abuse and neglect that occurs

to children under 18 years of age.
It includes all types of physical and/or emotional ill-
treatment, sexual abuse, neglect, negligence and commercial or
other exploitation, which results in actual or potential harm to the
child’s health, survival, development or dignity in the context of a
relationship of responsibility, trust or power.
PREVALNCE OF CHILD ABUSE
In 2016, there were an estimated 676,000 victims of abuse and neglect or
approximately 9.1 cases per 1000 children. Seventy-five percent of child
maltreatment reports were from neglect, 18% from physical abuse, and 8.5%
from child sexual abuse. The overall child fatality rate was 2.36 deaths per
100,000 children

In 2020 , Nearly 3 in 4 children - or 300 million children - aged 2–4 years

regularly suffer physical punishment and/or psychological violence at the
hands of parents and caregivers
One in 5 women and 1 in 13 men report having been sexually abused as a
child aged 0-17 years.

120 million girls and young women under 20 years of age have suffered
some form of forced sexual contact

Every year, there are an estimated 40 150 homicide deaths in children under
18 years of age, some of which are likely due to child maltreatment.

- WHO
 PREDISPOSING FACTORS OF CHILD ABUSE

PARENTAL CHILD
ENVIRONMENTAL
CHARACTERISTICS CHARACTERISTICS
CHARACTERISTICS

• Unwanted or unplanned • Chronic stress

• Violence child • Problem of divorce
• Poverty • No. of children in the • Poverty
family • Unemployment
• Parental history of abuse
• Child's temperament • Poor housing
• Socially isolated • Position in the family • Frequent relocation
• Low self esteem • Additional physical • Alcoholism
• Less adequate maternal needs if ill or disabled • Drug addiction
functioning. • Activity level or degree
of sensitivity to parental
needs.
 TYPES OF CHILD ABUSE

A. Physical abuse
I. Battered child syndrome
II. Shaken Baby Syndrome
III. Munchausen syndrome
B. Sexual abuse
C. Emotional abuse
D. Family violence
E. Child Neglect
 A. PHYSICAL ABUSE
DEFINITION
Physical abuse is when someone hurts or harms
a child or young person on purpose.
includes:
• shaking
• hitting
• burning/ scalding
• female genital mutilation
• fabricated and induced illness
• drowning
• suffocating

Most easily recognizable form of maltreatment.

BATTERED BABY SYNDROME
I. BATTERED CHILD SYNDROME

DEFINITION
 
Battered child syndrome (BCS) refers to non-
accidental injuries sustained by a child as a result of
physical abuse, usually inflicted by an adult caregiver.
Conti……

DESCRIPTION

Internal injuries, cuts, burns , bruises , and broken or fractured

bones are all possible results of battered child syndrome.
Because adults are so much larger and stronger than children
are, an abused can suffer severe injury or death without the
abuser intentionally causing such an injury.

BCS is alternatively referred to as child physical abuse or non-

accidental trauma (NAT)
 CAUSES AND SYMPTOMS
CAUSES
♥ higher in lower-income households
♥ lack of education
♥ single parenthood
♥ alcoholism or other drug addictions
♥ anger
♥ Stress
♥ cultural traditions
♥ history of mental or emotional problems in parents

COMMON TRIGGER

♥ incessant crying or whining of infants or children

♥ excessive "fussiness" of an infant or child
♥ acts of disobedience
♥ toddler's failed toilet training
 SYMPTOMS
delayed visit to the emergency room with an injured child
implausible explanation of the cause of a child's injury
bruises that match the shape of a hand, fist or belt
cigarette burns
scald marks
bite marks
black eyes
Unconsciousness
lash marks
bruises or choke marks around the neck
circle marks around wrists or ankles (indicating twisting)
separated sutures
unexplained unconsciousness
bulging fontanel in small infants
Abused children may exhibit
♥ a poor self-image
♥ sexual acting out
♥ an inability to love or trust others
♥ aggressive, disruptive, or illegal behavior
♥ anger, rage, anxiety , or fear
♥ self-destructive or self-abusive behavior
♥ suicidal thoughts
♥ passive or withdrawn behavior
♥ fear of entering into new relationships or activities
♥ school problems or failure
♥ sadness or other symptoms of depression
♥ flashbacks or nightmares
♥ drug or alcohol abuse
 DIAGNOSIS
Diagnosed by an emergency room physician or pediatrician, or by
teachers or social workers

 Physical examination
 X rays
 MRI or scans
 Others:
- presence of injuries at different
stages of healing
- often hindered by the excessive
cautiousness of caregivers
 TREATMENT
• vary according to the type of injury incurred
• Counselling
• abused child removed from the home to prevent further
harm
• government agency
• physical and psychological therapy

PROGNOSIS

• depend on the severity of injury

 PREVENTION
 Recognizing
 seeking or offering of intervention
 Counselling
 training in good parenting skills
 educational programs
 Support
 Overcome from the Signs from which physical
abuse may occur
 PARENTAL CONCERNS
 Parents who are in danger of abusing their
children
 should seek professional counselling
 Parents may also call the National Child
Abuse Hotline
 Parents should also exercise caution
 Teach their children to report abuse
 II. SHAKEN BABY SYNDROME

DEFINITION
A serious brain injury resulting from forcefully shaking
an infant or toddler.

Shaken baby syndrome usually occurs when a parent or

caregiver severely shakes a child in frustration or
anger, often because the child won't stop crying.
Permanent brain damage or death may result.

Also called:
•Slam syndrome
•Shaken-impact syndrome
 ETIOLOGY
Act of violent shaking that leads to serious or
fatal injuries
Generally results from tension and frustration
generated by a baby’s crying or irritability

MECHANISM OF INJURY

Whiplash forces cause subdural hematomas by

tearing cortical bridging veins. (Guthkelch 1971)
 CLINICAL FINDINGS IN INFANTS
THAT INCLUDED

• Retinal hemorrhages
• Subdural and/or Subarachnoid
hemorrhages
• External cranial trauma.

Serious form of child maltreatment most

often involving children younger than 2 years
but may be seen in children upto 5 years. 
 CLINICAL FEATURES

•Signs may vary from mild and non-specific

to severe.
Non-specific signs:
•Moderate ocular or cerebral trauma
•History of poor feeding, vomiting,
lethargy and/or irritability occurring for
days or weeks.
•Non-specific signs are sometimes
attributed to viral illness, feeding
dysfunction and colic.
 DIAGNOSIS
History
Physical findings: External injuries,
fractures should be documented
Radiology: CT scan and MRI
Triad of subdural hemorrhage, retinal
hemorrhage and encephalopathy.

A study have demonstrated a 50% greater rate of

detection of subdural hematoma using MRI,
compared with CT.

Shaken baby is also seen to be mildly to

moderately anemic.
 III. MUNCHAUSEN SYNDROME
DEFINITION

Munchausen syndrome (also known as

factitious disorder) is a rare type of mental
disorder in which a person fakes illness.

The person may lie about symptoms, make

themselves appear sick, or make themselves
purposely unwell.
RISK FACTORS
• chronic illness during childhood – the person may have
received a lot of attention because of their illness
• chronic illness of a significant family member when the
person was a child
• self-esteem or identity problems
• relationship problems
• difficulty distinguishing reality from fantasy
• ability to lie and manipulate
• a history of mental problems such as depression,
hallucinations or post-traumatic stress disorder (PTSD)
• the need to blame personal failures on external factors,
such as illness.
 SYMPTOMS
• a spectacular medical history that includes many tests, medical
procedures and operations
• an odd collection of seemingly unrelated symptoms
• a lack of conclusive results despite intense medical
investigations
• new symptoms that appear after medical tests prove negative
• extensive medical knowledge of many different illnesses
• frequently visiting many different doctors, sometimes in other
states or territories
• frequent presentation at emergency departments, usually at
different hospitals
• requests for invasive medical procedures or surgeries
• failure to improve despite medical treatment, including relapsing
for unknown reasons.
 DIAGNOSIS
• physical and mental illnesses must be ruled out first

Diagnosis may depend on abstract concepts such

as: 

• The person’s symptoms don’t make sense when

compared with the test results.
• The person is unusually eager to undergo invasive
medical procedures and operations.
• The person doesn’t respond to treatments in a
predictable fashion.
• Other people in the patient’s life don’t confirm the
person’s symptoms. 
 TREATMENT
Treatment aims to manage rather than cure
Recovery tends to be slow or non-existent
Treatment options may include:
Medications to treat associated mental
health illnesses
Cognitive behaviour therapy (CBT)
Avoiding unnecessary tests and surgeries is
important
However, a person with Munchausen
syndrome is likely to move on to other
doctors and start again
 COMMON COMPLICATIONS

A person with Munchausen syndrome is at risk of many

complications including: 
• side effects from prescription medicines, including
overdose
• complications from poisoning or self-harm practices
• complications from medical procedures or surgeries
• death from self-harm or complications of medical
intervention.
CLINICAL FINDINGS PHYSICAL ABUSE

BRUISES and Welts

Sites for inflicted bruises:

– Lower back and buttocks (Patting)
– Genitals and inner thighs
– Cheek (slap marks)
– Ear lobe (pinching)
– Upper lip and frenum (forced feeding)
– Neck (Choke marks)

CULTURAL BRUISES
• Cupping
• Coining
• Spooning
BRUISES

WELTS CUPPING, COINING AND SPOONING

CLINICAL FINDINGS PHYSICAL ABUSE

MARKS

• HUMAN HAND MARKS

• STRAP MARKS 
• LASH MARKS
• LOOP MARKS
• GAG MARKS
• CIRCUMFERENTIAL TIE MARKS
• BIZARRE MARKS
• BITE MARKS
 STRAP MARKS
HUMAN HAND MARKS

LOOP MARKS LASH MARKS

 CLINICAL FINDINGS PHYSICAL ABUSE

BURNS
2 general patterns:
• Immersion
• Splash
- on sole of feet
- palms of hand
- back or buttocks

Patterns descriptive of object used such as:

- sound cigar or cigarette burns
- immersion in scalding water
- rope burns on wrists
ROPE BURNS ON WRIST

CIGARETTE BURNS
 CLINICAL FINDINGS PHYSICAL ABUSE
LACERATIONS AND ABRASIONS

- On back of arms torso

- face or external genitalia

Descriptive marks such as from human bites or pulling hair out

FRACTURES AND DISLOCATIONS

• Are diagnosed in up to third of children who have been investigated for physical abuse.
• Often occult fractures.
• 80 % of all fractures from abuse are seen in children under 18 months. (Merten et al)
• 25-50% of fractures in children under 1 year of age resulted from abuse. (Feldman et al 1984, Belfer et al 2001,
Day F et al 2006)
• A child with rib fractures has a 7 in 10 chance of having been abused.
• Mid-shaft fractures of humerus are more common in abuse than in non- abuse children.
• Commonly seen –
•Ribs
•Skull
•Long bones
• nose or facial structures
• Multiple new or old fractures in various stages of healing
LACERATION ON ARM LACERATION ON FOREHEAD
RIB FRACTURE

SKULL FRACTURE

NASAL BONE
 CLINICAL FINDINGS PHYSICAL ABUSE

MUTILATION INJURIES

CHEMICAL
- repeated poisoning
- drug overdose
SEXUAL ABUSE
 B. SEXUAL ABUSE
DEFINITION

• Sexual abuse is when someone is forced, pressurised or tricked into taking part in any
kind of sexual activity with another person.

• Child sexual abuse is the involvement of a child in sexual activity that he or she does not
fully comprehend, is unable to give informed consent to, or for which the child is not
developmentally prepared and cannot give consent, or that violates the laws or social
taboos of society. Child sexual abuse is evidenced by this activity between a child and an
adult or another child who by age or development is in a relationship of responsibility,
trust or power, the activity being intended to gratify or satisfy the needs of the other
person.
- WHO
 SEXUAL ABUSE
happen to both girls and boys
someone could be sexually abused by a
stranger
somebody you love and trust
happens by a person of the same sex
sexual abuse isn’t always ‘full sex’ – it
can also include touching, kissing, oral
sex or anything sexual
can happen online as well as offline
 PREVALENCE
PREVALENCE had increases dramatically but reporting is
less due to following reasons:
•Cultural morals: stigma for the victim and family.
•Doesn’t have visible physical signs.
•Inability of clinician to identify correctly.
•Victims are often young children whose fear,
lack of awareness, or lack of language skills makes
them easy prey.

EXAMPLES of sexual abuse include:

• being touched
• flashing or exposing themselves
• being forced
• Sexual abuse can include lots of things like
rape and sexual assault, sexual harassment, online
grooming and domestic abuse or violence.
• It can also include sexual exploitation, sexting
or child pornography
 RISK FACTORS FOR VICTIMIZATION

female sex
unaccompanied children
children in foster care
adopted children
Stepchildren
physically or mentally handicapped children
history of past abuse
Poverty
war/armed conflict
psychological or cognitive vulnerability
single parent homes/broken homes
social isolation
parent(s) with mental illness, or alcohol or drug dependency
PHYSICAL AND BEHAVIOURAL INDICATORS OF
CHILD SEXUAL ABUSE
PHYSICAL INDICATORS BEHAVIOURAL INDICATORS

difficulty in walking or sitting - torn Regression in behaviour, school performance or attaining

developmental milestones
stained or bloody underclothing Acute traumatic response such as clingy behaviour and irritability
in young children
itching in the genital area Sleep disturbances

Unexplained genital injury changes in the personality

Recurrent vulvovaginitis drop in school performance

Bedwetting and fecal soiling beyond the usual age sleep disturbances

Anal complaints (e.g. fissures, pain, bleeding) Eating disorders

bruises or bleeding in rectal / genital area Problems at school

Pain on urination Social problems

Urinary tract infection Depression

STI Poor self-esteem

Pregnancy Inappropriate sexualized behaviours

Presence of sperm
 FINDINGS SUGGESTIVE OF ABUSE INCLUDE

 acute abrasions
 lacerations or bruising of the
- Labia
- perihymenal tissues
- Penis
- scrotum or perineum
 hymenal notch/cleft extending through more than
50% of the width of the hymenal rim
 scarring or fresh laceration of the posterior
fourchette not involving the hymen (but
unintentional trauma must be ruled out)
 condyloma in children over the age of 2 years
 significant anal dilatation or scarring
FINDINGS THAT ARE DEFINITIVE EVIDENCE OF ABUSE
OR SEXUAL CONTACT INCLUDE

• sperm or seminal fluid in or on the child’s body

• positive culture for N. gonorrhoeae or serologic confirmation of acquired syphilis
• intentional, blunt penetrating injury to the vaginal or anal orifice.

HEALTH CONSEQUENCES

• GI Disorders
• gynaecological disorders
• Somatization

PSYCHOLOGICAL AND BEHAVIOURAL SYMPTOMS

• depressive symptoms
• Anxiety
• low self-esteem
• symptoms associated with PTSD such as re-experiencing, avoidance/
numbing, hyperarousal
• increased or inappropriate sexual behaviour
• loss of social competence
• cognitive impairment
• body image concerns
• substance abuse
 DIAGNOSTIC CONCLUSION

By observations made during the course of a patient evaluation:

history
behavioural or physical indicators (if present)
symptoms
acute injuries
STIs
forensic evidence

A diagnostic tool in child sexual abuse cases:

Definite abuse or sexual contact

Probable abuse
Possible abuse
No indication of abuse
 COUNSELLING AND SOCIAL SUPPORT

● Abuse-specific cognitive behavioural treatment is generally the

most effective form of therapy for post-traumatic stress reactions.
● Group therapy for children is not necessarily more effective
than individual therapy.
● Many sexually abused children may have co-morbid conditions
that require specific treatment.
● Younger children may not understand the implication of abuse
and therefore may appear to be less distressed than older
children.
● A believing and supportive mother or non-offending caretaker
can be a strong determinant for a good prognosis.
 C. EMOTIONAL ABUSE
DEFINITION

It is maltreatment which results in impaired

psychological growth and development.
Involves words, actions and indifference.

Examples:
•Verbal abuse
•Excessive demands on a child’s performance
•Discouraging caregiver and child attachment
•Penalizing a child for positive, normal behaviour
•Overlaps with physical abuse.
 ETIOLOGY
• Stressful life of parents
• Reduced capacity to understand children
• Alcoholism
• Drug abuse
• Psychopathology
• Mental retardation
• Controlling personality of parents
• Family stress
• Unemployment
• Poverty
• Isolation
• Divorce
• Death of spouse
 SIGNS OF EMOTIONAL ABUSE

Signs of emotional abuse in the child may include:

• Attempted suicide
• Extreme behavior (very passive or very active)
• Actions that seem too old or too young for their age
• Lack of attachment to the parent

Signs that a parent may know about or be the cause

of emotional abuse may include:

• Harsh rejection of the child

• Blaming or insulting the child often
• Lack of concern about the child’s problems
 EFFECTS

Psychopathologic symptoms are more likely to

develop in emotionally abuse children.
•Lifelong pattern of depression
• estrangement
• anxiety
• low self-esteem
• lack of empathy
 D. CHILD NEGLECT
DEFINITION

Child neglect is defined as any confirmed or suspected

egregious act or omission by a parent or other caregiver that
deprives a child of basic age-appropriate needs and thereby
results, or has reasonable potential to result, in physical or
psychological harm. Younger children are neglected most,
and more girls suffer from neglect than boys.

Neglect is the ongoing failure to meet a child's basic needs

and the most common form of child abuse2. A child might be
left hungry or dirty, or without proper clothing, shelter,
supervision or health care. This can put children and young
people in danger. And it can also have long term effects on
their physical and mental wellbeing.
 Who's at risk

Children who:
• are born prematurely
• have a disability
• have complex health needs
• are in care
• are seeking asylum.
TYPES OF NEGLECT

Neglect may be:

• Physical
• Medical
• Educational
• Emotional
• Providing inadequate supervision
• Exposing a child to violent situations
 CAUSES

Socioeconomic status
Number of children
Stress
Psychological problem
Drug and alcohol misuse
Being abused or having been in care as children
Strict behaviour
SIGNS OF NEGLECT

Signs of neglect may include the following:

• The parent or caregiver leaving a child

• The child not having enough food
• The child lacking medical care
• The child not getting help with special needs
• The parent failing to provide for emotional needs

Signs that a parent may know about or be the cause of neglect

include:

• Carelessness or apathy concerning their child’s needs

• Misuse of alcohol or other drugs
• Senseless behaviour
• Depression or carelessness regarding their own life or health
 E. FAMILY VIOLENCE
DEFINITION

Family violence, or domestic violence,

usually refers to the physical assault of
children and women by male relatives,
usually a father and husband/partner.

In these situations, a man uses violence to

control his partner and children, often in
the belief that violence is a male perogative
("I'm a guy, I can't control myself"), or that
his victims are responsible for his
behaviour ("You bought it on yourself").
SIGNS IN CHILDHOOD
A child witnessing family violence, and
domestic violence, is at risk of:
Behavioural and emotional difficulties
Learning difficulties
Long-term developmental problems
Aggressive language and behaviour
Restlessness, anxiety and depression
 DIAGNOSIS OF CHILD ABUSE
Factors that may be considered in determining child
abuse include:

• Physical exam, including evaluating injuries or signs and

symptoms of suspected abuse or neglect
• Lab tests, X-rays or other tests
• Information about the child's medical and developmental
history
• Description or observation of the child's behavior
• Observing interactions between parents or caregivers
and the child
• Discussions with parents or caregivers
• Talking, when possible, with the child

Early identification of child abuse can keep children safe

by stopping abuse and preventing future abuse from
occurring.
 OBSERVE THE
LAB TESTS

PHYSICAL CHILD
EXAMINATION X RAY

OBSERVE THE TALK TO THE

CAREGIVER CAREGIVER TALK TO THE CHILD
 TREATMENT OF CHILD ABUSE
• depends on the type of abuse
• first priority is creating a safe environment for
the child
• mental health professionals and/or a physician
will figure out the best type of therapy

There are different types of therapy, such as:

• Developmental therapy
• Intrapersonal therapy
• Cognitive and behavioural therapy
Conti….

Federal, state, and local agencies can help with these

efforts by:

• Helping parents and children create stronger bonds

• Informing parents about good parenting techniques
• Teaching parents to be emotionally tough
• Creating stronger social and community connections
• Supporting parents who are struggling
• Helping children learn better social and emotional skills 
CHILD ABUSE PREVENTION GUIDELINES
• Never discipline your child when your anger is out of control.
• Participate in your child’s activities and get to know your child’s friends.
• Never leave your child unattended, especially in the car.
• Teach your child to use their voice to allow them to prevent abuse in their own life.
• Ask questions; for example, when your child tells you he or she doesn’t want to be with
someone, this could be a red flag.
• Listen to them and believe what they say.
• Be aware of changes in your child’s behavior or attitude and inquire into it.
• Teach your child what to do if you and your child become separated while away from
home.
• Teach your child the correct names of his/her private body parts.
• Be alert for any talk that reveals premature sexual understanding.
• Pay attention when someone shows greater than normal interest in your child.
• Make certain your child’s school or day care center will release him/her only to you or
someone you officially designate.
 COPING AND SUPPORT
If a child tells you he or she is being abused, take the situation
seriously
• Encourage the child to tell you what happened
• Remind the child that he or she isn't responsible for the abuse
• Offer comfort
• Report the abuse
• Help the child remain safe
• Consider additional support
• If the abuse has occurred at school, make sure the principal of
the school is aware of the situation
 ROLE
OF
NURSE
 ROLE OF NURSE
Physical Care

Abuse victims often require physical nursing care

This may include:

• cleaning wounds or applying a dressing.

• If injuries are severe - need surgery and nursing care during the convalescent
period.
• provide medications for pain or help the patient learn to walk with crutches.
• victims of abuse may need education for self-management if they have
injuries that will take some time to heal
 ROLE OF NURSE
Emotional Support

The empathetic nurse can help provide emotional support

Children may respond to the gift of a stuffed toy
The older adult may be ashamed to admit
Nurses offer an opportunity to talk about feelings
Suggest a referral to a counsellor - experienced dealing
abuse victims.
The nurse may also be the first person to recognize
symptoms of depression or suicidal intent in an abuse victim
 NURSING DIAGNOSIS
ACTUAL
• Pain, acute related to physical abuse and inflicted injuries
• Fear and anxiety related to the threat of punishment, negative interpersonal
interaction, repeated maltreatment
• Skin integrity, impaired related to inflicted injuries
• Imbalanced Nutrition less than Body Requirement related to parent neglect and
inadequate calorie intake
• Sleep pattern disturbance related to repeated maltreatment and mental stress of child
• Impaired family coping related to situational crisis
• Impaired parenting related to child/caregiver or situational characteristics that
precipitate abusive behaviour
• Self-care deficit related to physical weakness
• Impaired Home Maintenance/Management related to insufficient family organization
• Deficit knowledge about the child’s realistic development abilities how to access
external support resources related to past inexperience with parenting
• Impaired self-esteem related to poor coping or negative family interactions
 NURSING DIAGNOSIS
POTENTIAL
• Hypovolemia, Risk for related blood loss during physical
injury
• Trauma, Risk for related to characteristics of
child/caregiver or environment
• Infection, Risk for related to physical injuries and abuse
• Social isolation, Risk for related to the parents' fear of
disclosure to others outside of the dysfunctional family unit
• Delayed growth and development, Risk for related to
inadequate care taking
 SUMMARY
The total abuse rate of children is 25.2 per 1,000 children,
with physical abuse accounting for 5.7 per 1,000, sexual
abuse 2.5 per 1,000, emotional abuse 3.4 per 1,000, and
neglect accounting for 15.9 per 1,000 children.

These categories overlap, with sexual and physical abuse

often occurring together; physical abuse or neglect seldom
occur without emotional abuse
These numbers may be underestimates due to underreporting
of the problem or failure of diagnosis by medical personnel.
CONCLUSION
 JOHN
BOWLBY’S
THEORY OF
ATTACHMENT
 THEORY APPLICATION
JOHN BOWLBY - BRITISH PSYCHOLOGIST
Attachment theory is focused on the relationships and bonds between people,
particularly long-term relationships, including those between a parent and
child and between romantic partners.

THE THEME OF ATTACHMENT THEORY

The central theme of attachment theory is that primary caregivers who are
available and responsive to an infant's needs allow the child to develop a
sense of security. The infant knows that the caregiver is dependable, which
creates a secure base for the child to then explore the world.
STAGES OF ATTACHMENT
PATTERNS OF ATTACHMENT
Ambivalent Avoidant
attachment: attachment:
Children with an
The child become avoidant attachment
greatly distressed when tend to avoid parents or
the parent leaves and caregivers, showing no
do not appear to be preference between a
comforted by the return caregiver and a
of the parent complete stranger.

Disorganized Secure attachment:

attachment: 
Children who can
These children display depend on their
a confusing mix of caregivers show
behaviour, seeming distress when separated
disoriented, dazed, or and joy when reunited.
confused. They may
avoid or resist the
parent.
JOURNAL ABSTRACT
 JOURNAL ABSTRACT
Stress and parenting during the global COVID-19 pandemic

Date: December 2020 Method

Authors: Samantha M.Brown Tests of group differences and hierarchical multiple
Jenalee R.Doom regression analyses were employed to assess the relationships
Stephanie Lechuga-Peña among demographic characteristics, COVID-19 risk factors,
mental health risk factors, protective factors, parental
Sarah Enos Watamura
perceived stress, and child abuse potential.
Tiffany Koppels
Abstract Results
Greater COVID-19 related stressors and high anxiety and
Background depressive symptoms are associated with higher parental
Stress and compromised parenting often place children at risk of perceived stress. Receipt of financial assistance and high
abuse and neglect. Child maltreatment has generally been viewed anxiety and depressive symptoms are associated with higher
as a highly individualistic problem by focusing on stressors and child abuse potential. Conversely, greater parental support
parenting behaviors that impact individual families. However, and perceived control during the pandemic are associated
because of the global coronavirus disease 2019 (COVID-19), with lower perceived stress and child abuse potential. Results
families across the world are experiencing a new range of stressors also indicate racial and ethnic differences in COVID-19
that threaten their health, safety, and economic well-being.
related stressors, but not in mental health risk, protective
factors, perceived stress, or child abuse potential.
Objective
• This study examined the impacts of the COVID-19 pandemic in Conclusion
relation to parental perceived stress and child abuse potential. Findings suggest that although families experience elevated
• Participants and Setting stressors from COVID-19, providing parental support and
• Participants included parents (N = 183) with a child under the increasing perceived control may be promising intervention
age of 18 years in the western United States. targets.
 JOURNAL ABSTRACT
Child Maltreatment during the COVID-19 Pandemic: Method
Consequences of Parental Job Loss on Psychological and A community sample of 342 parents (62% mothers) of 4- to 10-
Physical Abuse Towards Children year-olds (M = 7.38, SD = 2.01; 57.3% male) living in the
United States completed online questionnaires regarding
experiences with COVID-19, the Parent-Child Conflict Tactics
Date:  4 September 2020 Scale, and the Family Crisis Oriented Personal Evaluation
Authors: Monica Lawson Scales.
Megan H.Piel
Results
Michaela Simon
Two logistic regression analyses evaluated predictors of whether
parents psychologically maltreated or physically abused their
Abstract children during the pandemic controlling for maltreating history,
parental depressive symptoms, financial stability, parent age,
parent gender, child age, and child gender. Parents who lost their
Background
jobs (OR = 4.86, 95% CI [1.19, 19.91], p = .03), were more
Job loss resulting from the COVID-19 pandemic presents depressed (OR = 1.05, 95% CI [1.02, 1.08], p < .01), and
significant risk for child abuse. Protective factors, such as previously psychologically maltreated their children (OR =
reframing coping, may mitigate the risk of job loss on child 111.94, 95% CI [28.54, 439.01], p < .001) were more likely to
maltreatment. psychologically maltreat during the pandemic. Regarding
physical abuse, a significant interaction between job loss and
reframing coping emerged (OR = 0.76, 95% CI [0.59,
Objective
0.99], p = .04). Among parents who lost their jobs, the
The current study investigated factors associated with child probability of physical abuse decreased as reframing coping
maltreatment during the COVID-19 pandemic, including increased.
parental job loss, and whether cognitive reframing
moderated associations between job loss and child Conclusions
maltreatment. Job loss during the COVID-19 pandemic is a significant risk
factor for child maltreatment. Reframing coping may be an
important buffer of this association on physical abuse and
presents implications for maltreatment prevention .
 REFERENCE
BOOK REFERENCE

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JOURNAL REFERENCE

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♥ https://www.who.int/news-room/fact-sheets/detail/child-maltreatment
♥ https://emedicine.medscape.com/article/800657-overview#:~:text=In%202016%2C%20there%20were%20an,2.36%20deaths%20
per%20100%2C000%20children%20
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me%20(also%20known%20as,or%20make%20themselves%20purposely%20unwell
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♥ https://www.childline.org.uk/info-advice/bullying-abuse-safety/abuse-safety/sexual-abuse/
♥ https://www.who.int/violence_injury_prevention/resources/publications/en/guidelines_chap7.pdf
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/
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