Chapter Twelve: Child Abuse

1. Chapter Twelve: Child Abuse

2. Every Year 2,000 children die 18,000 become permanently disabled 142,000 are seriously injured 3.1 million children are affected by child abuse More than one-half of the children who die are under one year of age

3. Policies for Child Abuse Preventive Measures Protective Measures

4. Preventive Measures Begin at the child care site Screening for abuse potential Screen potential employees for history of abuse Queries about childhood Reasons for working with children “What if” situations to elaborate on Probationary period enforced to observe of treatment of children

5. Prevent Accusations Inform parents of child abuse policy Caregivers are mandated reporters Child care steps to prevent abuse in care Set up to be “open”—no situation that could lead to “privacy” for caregiver and child Written policy of discipline and guidance that is followed by all “Ouch reports” are filled out, a copy given to parents, and a copy in child’s health file

6. Intervention Observation Identify when parents are under stress Identify when children are under stress Discussion Establish good communication relationship with parents Talking with caregiver may help parents relieve stress

7. Action Inform parents of coping skills Refer parent to resource for help Understand factors that may lead to abuse, for example Significant changes in lifestyle Unrealistic expectations of child’s capabilities (lack of developmental knowledge) Poor impulse control Under influence of drugs or alcohol

8. Protective Measures Recognition Indicators of Abuse Physical Abuse Emotional Abuse Sexual Abuse Neglect

9. Physical Indicators of Physical Abuse (see Table 12-3) Bruises Burns Bite marks (unexplained) Lacerations or abrasions Head injury or whiplash Other

10. Behavioral Indicators of Physical Abuse Tells you parent(s) or other adult hurt them Overcompliant Poor self-concept Extremes in behavior Does not want to leave child care Indiscriminately seeks affection or wary of contact Vacant, withdrawn, or detached

11. Physical Indicators of Emotional Abuse (see Table 12-4) Failure to thrive Depressed or withdrawn Disruptive or hyperactive Repetitive rhythmic movement (rocking, etc.) Little facial effect Speech or language disorders

12. Behavioral Indicators of Emotional Abuse (see Table 12-4) Rigid in conformity to authority Destructive or antisocial Parent is demanding and has unrealistic expectations of child’s capabilities Unusual fears Lagging in cognitive or emotional development Aggressive/Compliant extremes

13. Physical Indicators of Sexual Abuse (see Table 12-5) Torn, stained, or bloody underclothing Pain, itching, or swelling of genital area Bruises, lacerations, or bleeding in genital or anal area Discharge in genital area Difficulty in walking or sitting Pain during urination or defecation Venereal disease

14. Behavioral Indicators of Sexual Abuse Frequent masturbation Inappropriate sexual knowledge or behavior Withdrawn, fantasizing, infantile Depression Poor self-esteem/image Exceptional fear of a person or place Draws scary pictures with black and red

15. Physical Indicators of Neglect (see Table 12-6) Always hungry, dirty, or inappropriately dressed Unsupervised for long periods of time Lacks medical or dental care Unsanitary home conditions Poor growth, underweight Poor school attendance Abandonment

16. Behavioral Indicators of Neglect Stealing or begging for food or money for food Parent brings child early and picks up late Inappropriate attachment or affection Shows or expresses no emotion Parent abusing drugs or alcohol Overly responsible, assumes adult role

17. Documentation If abuse is suspected, document indicators Observe child at different times, in different situations, and record in note form Record behavior, conversation and physical signs Anecdotal record best type for this Keep records for a period of time to refer to later

18. Reporting Reporting process should be clear State process should be kept at child care site Child’s name, address, and age must be included Parents’ names and addresses (if separate addresses) should be given Anonymity for caregiver will be provided

19. Caregiver may want to talk to parents first Caregiver may want to plan to help parents through process to support family

20. Caring for the Abused Child Caregiver should examine feelings about the issue Can the caregiver “deliver” the care the child needs without prejudice? Caregiver determines level of understanding of “normal” behavior Caregiver needs to learn how to redirect behaviors that may result from abuse

21. To help and support abused child the caregiver need to provide Trust Predictable routines Consistent behavior Safe boundaries Confidence Good communication skills

22. Implications for Caregivers Education For parents With children Empower children with knowledge Help children verbalize feelings Cultural Competence Observation Supervision

23. Reality Check:Shaken Baby Syndrome Form of child abuse that involves forceful or violent shaking of a child from birth to five years of age Only shaking—not dropping, not seizures, nor vaccinations Most common in children under two Sudden movements cause parts of brain to pull away and it tears brain cells and blood vessels

24. Shaking need only last 20 seconds (40 to 50 shakes) to do damage One in four babies die Most others have permanent brain damage Permanent injuries range from Partial to complete blindness and hearing loss Seizure disorder Cerebral palsy Others May include permanent vegetative state

25. Fathers or boyfriends of mothers most likely to do this Females are more likely to be child caregivers than mothers Immediate medical help may reduce the degree of impact Education is needed for caregivers and parents to prevent this syndrome

26. Reality Check: Domestic Violence and Its Effect on Children’s Lives Women battered, children abused or neglected 14% of children in U.S. experience family violence Changes in family systems has led to greater stress Divorce/Single parent Poverty Drug and alcohol abuse

27. Occurs at every SES level, in every racial, ethnic, and religious group Even if not “abused,” witnessing abuse has traumatic effect on children Children feel isolated with nowhere to go Caregivers can provide trust and a safe haven Caregivers can model prosocial behaviors