Lecture 12 - Neglect and Abuse

Question 1

When is the highest rate of child abuse

Answer 1

between birth and 3 years

Question 2

Sheehan 2011 Stanford Child Neurology: (statistics about abused babies)

Answer 2

• 25% die

* 50% survive with neurological deficits

Question 3

Define neglect:

Answer 3

The failure to provide for a child’s basic needs. Can be emotional, educational, or physical

Question 4

physical neglect

Answer 4

parent’s are unable to provide what they need because they are poor. Children may be inappropriately left at home alone.

Question 5

Affects of physical neglect

Answer 5

• trouble doing well in school - basic needs aren’tmet

* hungry, cold, lice, difficulty concentrating

Question 6

Perpetrators relationships

Answer 6

mostly parents, then other relatives (85% are related)

foster parents, daycare providers, unmarried partners of child’s parent, friends or neighbors

Question 7

Affects of emotional neglect

Answer 7

• lethargic and apathetic
• demonstrate learned helplessness
• cognitive problems - poor impulse control and problem solving skills

Question 8

Abuse of disabled

Answer 8

Physical and sexual abuse runs 3-4 times higher than abuse in general population

Disabled girls are vulnerable targets, often abused by family

Question 9

If disabled child reports abuse…

Answer 9

• they often aren’t seen as credible - can’t describe details clearly
• SLPs sometimes called to assist, especially if case goes to court
• SLPs can ensure interviews are conducted at child’s levels

Question 10

Research suggests (regarding craniofacial anomalies)

Answer 10

Mothers may be less attached to and nurturing of infants

Decreased attachment - increase risk of AN

Question 11

Caregivers of disabled children

Answer 11

• have a lot of stress and are more likely to neglect and abuse
• may not see light at the end of the tunnel
• be stressed - typical childhood experiences not available
• Parents are uncomfortable - kids not invited to parties, etc
• isolation of parent and child

Question 12

Behavioral and language characteristics

Answer 12

• often
• difficulty with expressive language
• lesser conversational skills than peers
• less likely than peers to discuss information or volunteer
• do poorly in school
• underperform academically
• more behavior problems

Question 13

Difficulties with pragmatics include

Answer 13

• decreased descriptive utterances
• language used to get things done with little social affect
• poor conversational skills
• inability to discuss feelings
• shorter conversations

Question 14

Nelson, 2010 (re: pragmatics)

Answer 14

• they lack ability to take perspective of a conversational partner
• demonstrate alexithymia - absence of words for emotions (no feelings, no pain)

Question 15

Other specific language issues…

Answer 15

• shorter, less complex utterances
• fewer decontexualized utterances; more talk about the here and now
• Auditory and reading comprehension problems

Question 16

Behavior of mothers who neglect or abuse:

Answer 16

• may punish for normal risk-taking behavior
• may not interact
• may be unresponsive when babies initiate, so babies learn to be passive

Question 17

Shaken baby syndrome causes a lifetime of cognitive and linguistic damage.

Answer 17

.

Question 18

Sheehan 2011 Stanford neurology (re: shaken baby)

Answer 18

when caregiver is done shaking, baby is slammed down hard against surface –> TBI
• bilateral damage

Question 19

Assessment and intervention

Answer 19

• we work as part of multidisciplinary team that often includes a social worker and psychologist
• mandated to document and report what we see and hear
• Schools - tell principal

Question 20

focus on evaluation of…

Answer 20

overall expressive language skills, pragmatics, narrative skills, vocab

Question 21

intervention involves…

Answer 21

• encouraging verbal expression
• warm, nurturing environment with clear rules and boundaries
• increase child’s ability to accurately describe emotions
• increased ability to appropriately express emotions (eg. use your words, not hitting or kicking)
• playing - dolls, action figures, art supplies

Question 22

Paul and Norbury, 2012 (AN behaviors)

Answer 22

AN Children more likely than peers to engage in behavior that elicits negative reactions from others

• need to increase ability to communicate socially

Question 23

Ways to work on self esteem

Answer 23

• Star of the week
• Me collage
• problem wall
• trip to the future

Question 24

Culturally and linguistically diverse families may especially need direct instruction about American child abuse laws. We should do this before we refer to CPS

Answer 24

.

Question 25

Lorber and Eneland (2011) study of mother-child dyads

Answer 25

267 high risk mother-child dyads studies • conduct problems (CP) at 5-6 years old were predicated by negative parenting • angry, hostile mother-toddler interactions at 24-42 mos were very predicative of CPs in school

Question 26

Sheehan 2011 Stanford Neurology (re caregivers)

Answer 26

• find out who they can call, where they can find relief * parents who abuse have decreased ability to tolerate infant crying * abused babies don't actually cry more than other babies * parents think they do - unrealistic expectations of baby behavior

Question 27

Tips for caregivers (7)

Answer 27

1. Ask about their needs, attempt to help them meet those needs (parenting classes, food stamps) 2. Provide info about overall child development (some expectations are too high) 3. point out what they are doing right 4. provide support groups of other caregivers whose ch have similar challenges 5. Use DVDs that model good parenting 6. teach them how to use words to discipline instead of physical means 7. model language stimulation strategies such as extensions that caregivers can easily fit into their daily routines