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
Deprivation necessities such as food, clothing, shelter, supervision, medical care and education
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
Dull and inactive affect; excessively passive or sleepy
Self-stimulatory behaviors such as finger sucking or rocking
Begging or stealing food
Absenteeism from school
Vandalism or shoplifting
Factors predisposing abuse
Child maltreatment occurs in every socioeconomic group, culture, religion, race, and ethnic group.
Additional stressors in household
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
Chronic stress environment- unemployment, poverty, poor housing, alcoholism, drug addiction
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
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
A vague term that includes “indecent liberties” such as touching, fondling, kissing, single or mutual masturbation, or oral-genital contact
Indecent exposure, usually exposure of the genitalia by an adult man to children or women
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
Involving children in sex acts for profit and usually with changing partners
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.