The Preschooler and Family : Child Neglect

  • Child Neglect
    • Most common form of maltreatment
      • Neglect: 
        • Failure of a parent or other person legally responsible for the child’s welfare to provide for her or his basic needs and an adequate level of care 
      • Physical neglect: 
        • Deprivation necessities such as food, clothing, shelter, supervision, medical care and education
          • Physical abuse
            • Physical abuse: deliberate infliction of physical injury on a child 
            • Abusive head trauma (AHT) 
              • Shaken baby syndrome, inflicted head injury, neuro—inflicted brain injury 
              • Present with vomiting, irritability, poor feeding
            • Munchausen syndrome by Proxy 
              • Medical child abuse- caregivers exaggerate histories and symptoms of induce symptoms 
              • Child endures painful and unnecessary medical tests and procedures
            • Suggestive physical findings
              • Failure to thrive (growth failure)
              • Signs of undernutrition such as thin extremities, abdominal distention, lack of subcutaneous fat
              • Poor personal hygiene
              • Unclean or inappropriate dress
              • Evidence of poor health care such as delayed immunizations, untreated infections, frequent colds
              • Frequent injuries from lack of supervision
            • Suggestive behaviors
              • Dull and inactive affect; excessively passive or sleepy
              • Self-stimulatory behaviors such as finger sucking or rocking
              • Begging or stealing food
              • Absenteeism from school
              • Substance abuse
              • Vandalism or shoplifting
          • Child abuse
            • Factors predisposing abuse 
              • Child maltreatment occurs in every socioeconomic group, culture, religion, race, and ethnic group. 
              • Parental characteristics 
                • Younger parents 
                • Single-parent families 
                • Additional stressors in household 
              • Child characteristics 
                • Birth to 1 year of age are more likely to be abused 
                • Small children have more needs and require constant attention that can fatigue parents 
              • Environmental characteristics 
                • Chronic stress environment- unemployment, poverty, poor housing, alcoholism, drug addiction
          • Sexual abuse
            • Sexual abuse: the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other to person to engage in or assist any other person to engage in, sexually explicit conduct or any simulation of such conduct; or rape, molestation, prostitution, or other forms of sexual exploitation of children, or incest with children
            • Typical abuser is a man that the victim knows (could be anyone) 
            • Nurses job to try to identify and report possible abuse
              • Incest: 
                • Any physical sexual activity between family members; blood relationship is not required (abusers can include stepparents, unrelated siblings, grandparents, uncles, and aunts); does not include sexual relations between legally sanctioned partners such as spouses
              • Molestation:  
                • A vague term that includes “indecent liberties” such as touching, fondling, kissing, single or mutual masturbation, or oral-genital contact
              • Exhibitionism: 
                • Indecent exposure, usually exposure of the genitalia by an adult man to children or women
              • Child pornography: 
                • Arranging and photographing, in any media, sexual acts involving children, alone or with adults or animals, regardless of consent by the child’s legal guardian; also, may denote distribution of such material in any form with or without profit
              • Child prostitution: 
                • Involving children in sex acts for profit and usually with changing partners
              • Pedophilia: 
                • Literally means “love of child” and does not denote a type of sexual activity but rather the preference of an adult for prepubertal children as the means of achieving sexual excitement
            • Methods used to pressure children into sexual activity
              • The child is offered gifts or privileges.
              • The adult misrepresents moral standards by telling the child that it is “okay to do.”
              • Isolated and emotionally and socially impoverished children are enticed by adults who meet their needs for warmth and human contact.
              • The offender asks the child for help in finding a favorite pet or object with which the child can easily identify.
              • The successful sex offender pressures the victim into secrecy regarding the activity by describing it as a “secret between us” that other people may take away if they find out.
              • The offender plays on the child’s fears, including fear of punishment by the offender, fear of repercussions if the child tells, and fear of abandonment or rejection by the family.
            • Talking with children who reveal abuse
              • Provide a private time and place to talk.
              • Do not promise not to tell; tell them that you are required by law to report the abuse.
              • Do not express shock or criticize their family.