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CHILD ABUSE

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CHILD ABUSE

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    1. CHILD ABUSE DR LEILA WILLIAMS LCDR, USN, MC FAMILY MEDICINE PHYSICIAN NAVAL HEALTHCARE NEW ENGLAND-GROTON

    2. OBJECTIVES Discuss different types of Child Abuse Reporting Family Advocacy

    4. CHILD ABUSE/MALTREATMENT Three million cases of child abuse reported in the United States each year It includes physical abuse, sexual abuse, psychological abuse, and general medical and educational neglect Includes both acts and omissions on the part of the responsible person

    5. Consecquences of Child Abuse

    6. Child Abuse Average per year Total incidents over 3 million - Substantiated 59% - Unsubstantiated 18% - FINS (Family In Need of Services) 23% - Fatalities 6/yr

    7. Incidence of Reported Cases of Child Abuse TYPE OF ABUSE Neglect Physical abuse Sexual abuse Emotional abuse Other % OF TOTAL 54 25 11 3 7

    8. Child Neglect Physical neglect Emotional neglect Medical Neglect Educational Neglect

    9. Physical Neglect Lack of home, bedding, nutrition, clothing or safety Failure to thrive - Medical problem (genetic, structural, physiologic) - Emotional (lack of nurturance) - Nutritional (decreased intake/improper technique)

    10. Physical Appearance of a Physically Neglected Child Large forehead Prominent ears Sunken eyes No fat paddings Glassy stare Hollow cheeks Prominent abdomen Defensive posturing

    11. Emotional Child Neglect Lack of love and nurturance Lack of discipline and boundaries Domestic violence Parental drug/alcohol abuse

    12. Medical neglect Delayed care ER abuse Chronic illness Religious barriers

    13. Educational Neglect Basic life skills Social norms Unstructured home schooling No school attendance/school withdrawal

    14. Neglect evaluation Safety Is it neglect or Family in Need of Services (FINS) Minor vs major issues Contributing factors

    15. Physical Abuse Hallmark-history that is inconsistent with the patients injuries Non accidental traumas Diagnosis and treatment Ensure childs safety and assist in collection of evidence for possible litigation Mandated to report

    16. Physical Indicators of Child Abuse Bruises on uncommonly injured body surfaces Blunt-Instrument marks or burns Human hand marks or bite marks Circumferential immersion burns Multiple injuries at different stages of healing Evidence of poor care or failure to thrive Unexplained retinal hemorrhages

    17. Bruising of the ear from being boxed

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