topic : Child abuse and maltreatment is not limited to a particular age. It can occur in the infant/toddler (1 month-3 years of age), preschool (3-5 years of age), school-age (5-11 years of age), and adolescent (12-18 years of age) age groups. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. Identify two factors that increase the vulnerability of a child for abuse in the age group you have selected.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN DQ Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
example 1 ( Charmaine)
In the Infant/toddler age group (1 month to 3 years), child abuse often manifests in several forms, primarily physical abuse and neglect. Physical abuse can include injuries such as bruises, burns, fractures, or head trauma that are inconsistent with the child’s development stage or explanations provided. Signs of neglect may included poor hygiene, malnutrition, and failure to thrive (Falkner & Green, 2022).
Emotionally, abused infants and toddlers may display extreme behaviors such as excessive crying, withdrawal, or extreme fearfulness around caregivers. Developmental delays or regression in milestones could be indicators of abuse or neglect (Falkner & Green, 2022)
Culturally, practices such as co-sleeping, beliefs about illness treatment, caregiver roles, and nutritional practices. These might be misunderstood as neglect or abuse, making is important of culturally competent assessments.
Certain professionals, including teachers, healthcare workers, and law enforcement personnel, are mandatory reporters. They are legally obligates to report suspected child abuse or neglect. In Colorado, the Colorado Child Abuse and Neglect Hotline is 1-844-CO-KIDS, this hotline operates 24 hours a day, 7 days a week. Colorado also offers reporting online through the Colorado Department of Human Services (CDHS) the website: https://www.colorado.gov/pacific/cdhs/reporting-child-abuse-and-neglect.
Factors increasing vulnerability to abuse in this age group include dependency on caregivers for basic needs, limited communication skills to express distress, and the potential for caregivers to misinterpret or neglect their needs due to stress, substance abuse, or lack of parenting skills.
In summary, it is crucial to recognize and report instances of child abuse in infants and toddlers to safeguard their safety and welfare. Nurses have a central role in early identification and to ensure prompt actions are taken to shield vulnerable children from harm.
Reference:
Falkner, A., & Green, S.Z.(2022) Chapter 1 [Health assessment of the infant]. Health assessment Foundations for effective
practice (2nd ed.) Grand Canyon University.
Colorado Department of Human Services.(2024).Colorado Child Abuse and Neglect Hotline Reporting System.
https://cdhs.colorado.gov/colorado-child-abuse-and-neglect-hotline-reporting-system
example 2 ( Eileen)
Child Abuse and Maltreatment in Preschool Children (3-5 Years of Age)
Child abuse and maltreatment can occur in any age group, including preschool children (3-5 years). Common types of abuse in this age group include physical abuse, emotional abuse, sexual abuse, and neglect.
Types of Abuse
- Physical Abuse: Intentional use of physical force causing injury or harm. Signs include unexplained bruises, burns, fractures, or cuts.
- Emotional Abuse: Behaviors that harm a child’s self-worth or emotional well-being. Signs include extreme behavior (compliant, demanding, passive, or aggressive), delayed development, and lack of attachment to the parent.
- Sexual Abuse: Any sexual activity with a child, including fondling and penetration. Signs include difficulty walking or sitting, inappropriate knowledge of sexual behavior, and regression to earlier behaviors like bedwetting.
- Neglect: Failure to meet a child’s basic needs, such as food, clothing, shelter, and supervision. Signs include poor hygiene, untreated medical conditions, and lack of supervision.
Warning Signs and Physical/Emotional Assessment Findings
Nurses may observe several warning signs indicating child abuse:
- Physical Assessment Findings: Unexplained injuries, injuries in various stages of healing, patterned injuries, and frequent emergency room visits.
- Emotional Assessment Findings: Fear of going home, withdrawal from others, aggressive behavior, extreme anxiety or depression, and lack of stranger danger.
As noted, “A common symptom of physical abuse in young children is bruises in various stages of healing, especially in areas less prone to accidental injuries, such as the buttocks, back, thighs, or face” (Hockenberry & Wilson, 2019, p. 42). It’s important to differentiate Mongolian spots from bruises; Mongolian spots are congenital, benign birthmarks often found on the lower back and buttocks, particularly in children of certain ethnicities. These spots are not indicative of abuse but rather a common, natural condition.
Cultural Variations and Misidentification
Cultural practices can sometimes be misidentified as abuse. Traditional healing practices, such as coining or cupping, may leave marks on the skin that could be mistaken for abuse. Nurses must understand the cultural context of these practices to avoid misidentification.
Reporting Mechanism and Nurse Responsibilities
In Wyoming, nurses are mandated reporters, meaning they must report suspected cases of child abuse or neglect. The reporting mechanism includes:
- Recognizing and Documenting: Document findings and observations accurately.
- Immediate Reporting: Report suspicion to local child protective services (CPS) or a similar agency immediately.
- Filing a Written Report: A written report must be filed within a specified period, usually 24-48 hours.
In Wyoming, only law enforcement, pediatricians, nurse practitioners, and medical doctors can take emergency custody of children.
Factors Increasing Vulnerability
Two factors increasing preschool children’s vulnerability to abuse include:
- Dependence on Caregivers: Preschool children rely heavily on caregivers for their basic needs, making them more vulnerable to neglect and physical abuse.
- Limited Verbal Skills: Preschool children may not effectively communicate abuse, increasing their risk of ongoing abuse without detection.
In conclusion, recognizing and responding to signs of abuse in preschool children requires vigilance, cultural competence, and adherence to legal reporting obligations. Nurses play a critical role in safeguarding children by identifying abuse early and ensuring appropriate interventions are initiated. Due to the abuse seen within the home, children often have limited verbal skills, complicating their ability to communicate their experiences and increasing their vulnerability.
References
Hockenberry, M. J., & Wilson, D. (2019). Wong’s essentials of pediatric nursing. Elsevier. Retrieved from https://bibliu.com/app/#/view/books/1000000000584/epub/Chapter2.html#page_42
Child Welfare Information Gateway. (2019). Recognizing child abuse and neglect: Signs and symptoms. Retrieved from https://www.childwelfare.gov/pubs/factsheets/signs/
U.S. Department of Health & Human Services. (2020). Child maltreatment 2018. Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. Retrieved from https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2018.pdf
Example 3 (Desiree)
The age group I chose for this discussion is school age (5-11 years of age). According to Bethencourt et. al. (2023) the types of abuse most seen among children of this age include the following:
- Neglect includes inadequate healthcare, education, supervision, protection from environmental dangers, and lack of essential items such as clothing and food.
- Physical abuse involves actions like beating, shaking, burning, and biting. Among physical abuse cases, rib fractures are something seen often.
- Emotional abuse includes verbal insults, humiliation, and actions that cause fear in a child, that can lead to future psychological disorders.
- Sexual abuse refers to situations where children are involved in sexual activities that they don’t understand, can’t consent to, or violate family norms. It can involve exposure to sexual content, touching genitals, or other sexual acts, even without penetration.
Signs that a nurse might notice indicating child abuse include unexplained injuries like bruises or fractures, changes in behavior such as withdrawal or aggression, emotional distress like anxiety or nightmares, and unusual fear of certain people or places. These signs suggest a need for further assessment and support for the child (Bethencourt et. al., 2023). Cultural variations of health practices that can be misidentified as child abuse due to similarities with various medical conditions and the effects of cultural healing practices like coining, cupping, guasha, moxibustion, and caida de mollera, which are ancient practices that some individuals still use today. There are certain birthmarks like Mongolian spots that can resemble signs of abuse due to the dark coloring on the buttocks (Killion, 2017). In California, nurses must promptly report suspected child abuse to local law enforcement or child protective services. This includes making an immediate verbal report followed by a written report within 36 hours using the Suspected Child Abuse Report form. Nurses must receive training to recognize signs of abuse and understand their reporting obligations (Mandatory Reporting of Child Abuse and Neglect – California, 2023). In the 5-11 age group, two factors that increase vulnerability to abuse include growing independence without full awareness of risks, and social and emotional development that can expose children to bullying or manipulation (Child maltreatment, 2022).
References:
Child maltreatment. (19 September 2022). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/child-maltreatment/.
Bethencourt, Arian., Doerr, Chaddie.,Gonzalez, Dulce.,McCall, Janelle. (2023). Child Abuse and Neglect (Nursing). (2023). National Library of Medicine.https://www.ncbi.nlm.nih.gov/books/NBK568689/
Killion, C. (2017). Cultural Healing Practices that mimic child abuse. National Children’s Advocacy Center.https://calio.dspacedirect.org/items/16a199fb-4ff5-4a98-bd91-639e002967a0/.
Mandatory Reporting of Child Abuse and Neglect – California. (2023). Child welfare.https://www.childwelfare.gov/resources/mandatory-reporting-child-abuse-and-neglect-california/.