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Chapter Twelve: Child Abuse. 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. Policies for Child Abuse.

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Chapter twelve child abuse l.jpg
Chapter Twelve: Child Abuse


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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


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Policies for Child Abuse

Preventive Measures

Protective Measures


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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


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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


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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


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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


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Protective Measures

Recognition

Indicators of Abuse

Physical Abuse

Emotional Abuse

Sexual Abuse

Neglect


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Physical Indicators of Physical Abuse (see Table 12-3)

Bruises

Burns

Bite marks (unexplained)

Lacerations or abrasions

Head injury or whiplash

Other


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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


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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


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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


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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


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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


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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


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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


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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


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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


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Caregiver may want to talk to parents first

Caregiver may want to plan to help parents through process to support family


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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


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To help and support abused child the caregiver need to provide

Trust

Predictable routines

Consistent behavior

Safe boundaries

Confidence

Good communication skills


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Implications for Caregivers provide

Education

For parents

With children

Empower children with knowledge

Help children verbalize feelings

Cultural Competence

Observation

Supervision


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Reality Check: provideShaken 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


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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


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Fathers or boyfriends of mothers most likely to do this damage

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


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Reality Check: damage 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


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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