Recognizing Child Abuse: Physical Abuse OBJECTIVES After completing the program, the learner will be able to: • Identify many of the specific symptoms of physical abuse. • Describe the responsibility that professionals have in identifying and reporting abuse. • Understand the context and prevalence of child abuse in society. • Describe some of the behaviors that abusers can exhibit when communicating with caregivers. • Discuss some of the behaviors that children may exhibit that indicative of an abused child. DISCUSSION QUESTIONS 1. What do you feel your responsibility would be as a caregiver in identifying and reporting physical abuse? 2. How difficult would it be for you to report a case of suspected child abuse? 3. Do you think physical abuse happens in all areas of society, or mainly in special populations? 4. What distinguishes child abuse from disciplining a child? PRETEST 1. Even those children who survive abuse are likely to suffer some form of permanent physical injury or emotional trauma. True 2. Because of the intensely negative memories that come from abuse, past victims are very unlikely to become abusers of their own children. False 3. Boys and girls are almost equally at risk of physical abuse. True 4. Women are a larger percentage of abusers. True 5. Virtually all healthcare providers are required to report suspected abuse if they have reason to suspect that a child is being abused. True 6. Failure to report suspected child abuse may be a strong cause for counseling by supervisors, but won’t leave the professional open to prosecution and malpractice suits because it is so difficult to identify. False 7. Most states also offer immunity from civil suits to all good faith reporters of suspected child abuse. True 9. Caretakers of abused children will frequently claim the injuries are accidents. True 10. In many cases of abuse the child will not show fear of the parent True 11. Any injuries should be evaluated by a pediatrician, nurse practitioner, physician's assistant or some other healthcare provider with experience evaluating child abuse. True 12. Many children may be afraid to talk, but try to listen calmly without leading the child. True
13. Since the assessment of child abuse should always be done by a trained professional, caregivers should not burden themselves with learning the policies and procedures of their facility and their local laws concerning child abuse and neglect. False 14. The first key to recognizing physical abuse is the fact that the injuries often present as more severe or more purposeful than those that could be inflicted by other children or in normal play. True 15. Caregivers must do a full and thorough interview before informing Child Protective Services. False 16. Injuries should not be documented and photographed before treatment takes place. False 17. No community is immune from child abuse, from the richest to the poorest. True 18. In terms of soft-tissue injuries, one should consider the developmental ability of the child. True
1. The following professions are mandated reporters: a) Physicians and nurses, school and law enforcement personnel b) hospital personnel and dentists c) medical examiners and mental health professionals d) All of the above 2. Suspicious signs in an abusive caretaker could include: a) unrealistic expectations for the child's age b) fear of the healthcare provider c) signs of drug use, intoxication, or signs of mental instability d) All of the above. 3. Signs suggesting that a child may have been tied up for punishment or strangled would be: a) rope marks b) ligatures, especially on wrists ankles or neck c) cutaneous injuries d) both a and b 4. Another sign of abuse is: a) apparent fear of a parent or caretaker b) fear of going home c) a lack of reaction on the part of the child d) All of the above 5. Abuse must be suspected if, in describing injuries: a) the adult caretaker is evasive or contradictory b) the story changes abruptly or is implausible c) the child's own explanations seem implausible or fear-filled, abuse must be suspected d) all of the above 6. The reported history that a 2-month-old has supposedly crawled to and then fallen down a staircase: a) is normal for that age b) suspicious on its face c) should not be taken seriously as abuse d) none of the above 7. The names of those who report abuse are: a) by law, given out to families involved b) irrelevant in a child abuse case c) not given out to families d) none of the above
8. Because many abused children may be afraid to talk: a) it is best to get the story from the caregiver b) try to strongly encourage lead the child toward story telling c) try to listen calmly without leading the child d) none of the above 9. Sometimes abused children act out in meetings with caretakers with: a) aggression b) excessive story telling c) attention-seeking d) both a and c 10. Caregivers should be aware of cigarette burns, or any unusual burns, particularly on "punishment areas" such as: a) the buttocks b) the face c) soles d) both a and c 11. All caregivers should learn the: a) policies and procedures of their facility b) how to do a thorough physical assessment c) their local laws concerning child abuse and neglect d) both a and c 12. In an abuse case, child protective services will probably ask for: a) the child's name b) the name of the suspected abuser, if known c) a description of what was observed d) all of the above 13. In the classic case of inflicted traumatic brain injury, the injury may result from: a) blunt trauma b) shear forces secondary to repeated shaking c) extreme nutritional neglect d) both a and b
Answer Key: 1. d 2. d 3. d 4. d 5. d 6. b 7. c 8. c 9. d 10. d 11. d 12. d 13. d
