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Semester Three - Half One - Nursing 211 > Child Abuse > Flashcards

Flashcards in Child Abuse Deck (18)
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Child Abuse






inflicts or allows abuse, allows risk of physical injury, commits or allows sexual abuse or offense


Child Maltreatment/Neglect

a maltreated child is a child under 18 yr of age whose physical, mental or emotional condition has been impaired or is in danger of becoming impaired as a result of the failure of the caretaker to exercise a minimum degree of care


Characteristics of abusive caregivers

  • Often suffered from abuse, neglect or severe discipline as a child
  • Isolated from friends, family & neighbors
  • Have unmet dependency needs
  • May have substance abuse problems/chronic illness/low IQ
  • Have high expectations of other people’s behavior
  • May be hostile and blame others for their problems
  • Impulsive and immature with low self-esteem
  • Are generally law abiding and only a danger to family
  • Are extreme disciplinarians who believe in physical punishment
  • Poor parenting skills with high expectations of child
  • Use threats or intimidation to control the victim
  • May state “no hope” that child will behave
  • See child as bad, evil, friend of the devil
  • Home environment is chaotic, no routine
  • Exposes child to unsafe living conditions
  • Concerned about child’s gender or performance before birth
  • May have had pregnancy or labor/delivery difficulties


Parental Behavior Indicators

  • Inappropriate response of caregiver, such as an overly protective/domineering or absent emotional response; refusal to sign for additional tests or adamantly insist on necessary treatment
  • Parents cannot be found

  • Injuries with no report of trauma

  • Delay in seeking treatment for a significant injury

  • Parent attempts to conceal full extent of injury

  • Changes in the child’s or adult’s story of what


  • Histories that are  inconsistent  with severity of trauma

  • Unusual injuries for a child of that particular age or

    level of development.

  • Parents treat children differently

  • Parent demonstrates inconsistent behavior toward child


Child's Behavior Indicators

  • Behavioral Extremes: aggressiveness, withdrawal, passivity, regressiveness
  • Little or no response to pain/Lack of separation anxiety
  • Disorganized thinking; self-injurious or suicidal behavior
  • Fear of parent or caretaker
  • Fear of going home
  • Apprehension when other children cry
  • Verbal reporting of abuse
  • Extreme hyperactivity, irritability and distractibility
  • Seeks affection from any adult
  • Wearing clothing that covers the body that may be inappropriate for warm weather
  • Running away from home or engaging in illegal behavior such as drug abuse or stealing
  • Displaying severe depression
  • Cheating, lying or poor achievement in school
  • Inability to form satisfactory peer relationships


Child's physical indicators of sexual abuse

  • Torn, stained or bloody underclothing
  • Frequent urinary tract infections
  • Any STD of the throat/mouth
  • Difficulty or pain in walking or sitting
  • Foreign matter in the bladder, rectum or vagina
  • Rashes or itching of the genital area; scratching the area a great deal or fidgeting when seated
  • Bruises or pain in the genital area
  • Genital or rectal bleeding; vaginal discharge
  • Pregnancy, especially in early adolescent years
  • Sleep problems, nightmares


Child's behavioral indicators of sexual abuse

  • Seductive  behavior, advanced sexual knowledge for the child’s age, promiscuity, prostitution
  • Expressing fear of a particular person or place
  • Compulsive masturbation, precocious sex play, excessive curiosity about sex
  • Withdrawal, fantasy or infantile behavior
  • Sexually abusing another child
  • Appearance of an inordinate number of gifts or money from a questionable source
  • Drop in school performance or sudden non-participation in school activities/truancy/delinquency
  • Self-injurious behavior
  • Poor peer relationships
  • Reports sexual assault by caretaker
  • Exaggerated aversion to closeness or physical contact
  • Sudden onset of enuresis
  • Excessive anxiety
  • Expression of low self-worth; verbalizations of being “damaged”
  • Excessive bathing
  • Suicide attempts        



Child's physical indicators to emotional/psychological abuse

  • Conduct disorders are more frequent
  • Habit disorders  (rocking, biting, sucking fingers)
  • Neurotic disorders (speech, inhibition of play)
  • Psychoneurotic reactions (phobias, compulsions)
  • Lags in physical development
  • Failure to thrive


Child's behavioral indications of emotional/psychological abuse

  • Age inappropriate behaviors (older or younger)
  • Developmental delays (emotional/psychological)
  • Behavioral extremes (compliant, passive, aggressive, demanding)
  • Anorexia Nervosa (especially in adolescents)
  • Social Isolation


Child's physical indicators of neglect

  • Inappropriate or soiled clothing
  • Consistent hunger
  • Poor hygiene, bad breath, body odor
  • Unattended physical problems
  • Medical/Dental problems
  • Abandonment


Child's behavioral indicators of neglect

  • Begging for or stealing food
  • Signs of malnutrition
  • Long   stays at school
  • Truancy
  • Constant fatigue
  • Alcohol or drug abuse
  • States there is no caretaker


TNI Child Abuse

  • Conduct a physical exam
    • Interview the child
    • Interview parent or caretaker
    • Observe the child’s interactions with parents and other adults
  • Ensure the child’s safety and well-being. Try to establish some trust
  • Facilitate the child’s ability to talk and think about the abuse with decreasing anxiety. Make it clear to the child that you understand that talking about the abuse is difficult.
  • Create a safe and predictable environment in which the child feels supported.
  • Provide a private place and time to talk.
    • Do not express shock or criticize their family
    • Use their vocabulary to discuss body parts
    • Avoid using any leading statements that can distort their report
    • Reassure them that they have done the right thing by telling
    • Tell them that the abuse is not their fault, that they are not bad or to blame
    • Let the child know what is likely to happen when you report the abuse
  • Plan interventions that will encourage affective release in a supportive environment. Child victims must be able to experience a range of emotions.


Play Therapy

helps children play out traumatic themes, fears and distorted beliefs. It is a non-threatening way to process thoughts and feelings associated with the abuse both symbolically and directly.


Art Therapy

provides an opportunity to express feelings for which there are no words


Therapeutic Stories

present the traumatic issue of abuse, link victim’s feelings and behaviors and describe new coping methods to children.


Journal Writing

can help children over age 10 cope with intrusive thoughts and feelings. They often chose to bring their journals into the one-to-one sessions with their therapist.


Report Content

  • Identity and location of potentially abused child
  • Age of the child
  • Jurisdiction – where the abuse occurred, current location of child
  • Person(s) legally responsible for the child
  • Allegations of abuse or neglect
  • Submit a written report within 48 hours of the phone call
  • Send the form to the local child protective services for children living at  home
  • Send to the Central Registry in Albany for foster or group home children


Conseqences for failing to report suspicion of child abuse

  1. Class A misdeamenor charge
  2. Civil liability for the damages promixately caused by such failure