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Flashcards in Abuse/Neglect/Shaken Baby Deck (23):

What is the legal term for a report of child abuse or neglect? WHO, by law, is considered to be a MANDATED reporter?

-WHEN must a report be made?

51A report

-anyone with a PROFESSIONAL responsibility for children (includes any/all docs)

-where there is SUSPICION/reason to believe that a child has been abused/neglected


potential consequence if you...

-don't report suspected abuse/neglect, child is INJURED:

-don't report suspected abuse/neglect, child DIES:

injured: license loss/fine

dies: license loss/fine, JAIL


approximately how many kids DIE each year from suspected child abuse/neglect?

~1,500, give or take 100ish


Most common fatalities:

-more than 75% of deaths are under WHAT age?

white boys, usually LESS THAN 3 Y/O


~80% of fatalities involved at least one ____

-another 15% of fatalities are performed by a perpetrator (with/without) a PARENTAL RELATIONSHIP to the child


-15% WITHOUT parental relationship (but still known)

-only 5% by UNKNOWN perpetrator


About what percent of reported cases of abuse/neglect actually get "screened in"



MOST COMMON type of maltreatment?


17% physical abuse, 8% sexual abuse, 7% "other"


for YOUNGER victims: boys/girls more commonly victimized?

for OLDER: boys/girls?

-who dies more? boys/girls?

younger: boys

older: girls (sexual)

boys die more


Bruises (physical abuse) are concerning when they're in multiple locations, unusual locations, and/or when they have WHAT characteristics?

-different healing stages
-oddly shaped
-small, round, oval
-@ corners of mouth, wrists/ankles
-loop or linear shapes

-DON'T mistake for congenital mongolian spots, hemangiomas, accidentals, CT disorders, coining, or cupping (cultural)


Sexual abuse:

1 in __-__ girls by 18Y/O
1 in __-__ boys by 18 Y/O
__% KNOW offender
__% are committed BY __, AGAINST ___

96% men against women/children


If you suspect ANY type of abuse, you have ___hrs to VERBALLY report, and ___hrs to submit a ____ report

-DCF (Massachusetts type of CPS) has __ days to investigate a 51A report that was screened in

24h verbal
48h written

10 days


T/F: YOUR role is not to determine guilt, innocence, or outcome, but rather, to gather basic info and interview parent/child separately


-may sure to ask both parent/child (separately) - how it happened, where/what/when/who


In most cases, you should tell the parent that you will be filing a 51a...EXCEPT in which circumstances?

DON'T tell parent you're filing if:

-domestic violence
-kidnapping threat
-guns/drugs in home
-suicidal parent
-parents w/ hx of threatening to harm child if tell, or if they abuse the child after report was made


T/F: about 40% of cases are d/t false allegations by children trying to get their parents in trouble, or by docs that don't like the parents

false. only ~1%.


Most common intracranial hemorrhage in SBS?

Most common eye finding in SBS

Other classic signs of shaken baby syndrome?


RETINAL hemorrhaging (multi-layer)

-skeletal injuries, esp fractured RIBS, LONG bones in parents w/ an inconsistent hx and/or delay in seeking medical care


One of the biggest triggers to SBS?

Prolonged crying

Mech: weak neck muscles can't support head weight, angular acceleration/deceleration lead to shearing/traction on vitreoretinal adhesion sites

-NO surface impact necessary


Symptoms of child w/ SBS are usually (delayed/immediate), and include what?

**most common misdiagnosis of SBS

IMMEDIATE - irritability, lethargy (or poor feeding), vomiting, bruising, seizures

-Viral gastroenteritis!! (general flu-like sx)


T/F: mild/moderate abuse will likely lead to SBS sx/signs/retinal hemes?

FALSE. must be severe/serious car accident or significant fall onto hard surface/concrete


Retinal hemorrhage ddx:

-accidental trauma (severe only)
-birth trauma: most hemes present d/t birth are gone by __ wks
-CPR - key differential?

birth trauma: hemes gone by 6 wks

-CPR: hemes will only be 1 or 2


Up to ___% of victims die from SBS injuries

-two common manifestations of abnormal visual fxn?

25% (1 in 4 die)

-CVI, optic atrophy

-note: amblyopia also possible if (+)vit heme lead to dense amblyo over long course


How many cases of SBS are reported annually in the U.S.?

Typically, victims are how old?



Other ddx for retinal hemorrhages:

accidental trauma, birth trauma (resolved in 6wks), CPR/Purtcher, terson, ruptured cerebral aneurysm, CNS infx, seizures, blood anomaly (anemia/leukemia)


5 types of disclosure for a child to tell you they've been abused/neglected? (DTARR)

Denial, tentative disclosure, active disclosure, recanting, reaffirmation

-AVOID these!