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Is it abuse or an accident when children have injuries

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What is the true meaning of Child Abuse

Child Abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or other exploitation, resulting in actual or potential harm to the child??™s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.

The Reality of Child Abuse

1. Children are more likely to be abused by people they know than strangers
2. The number of children being abused and neglected is increasing
3. Child abuse can lead to depression, drug abuse and homelessness in later life
4. Disabled children are more likely to become victims of abuse than non-disabled children
5. It is not always obvious that a child is being abused
6. If abuse happened once it is likely to happen again

Risk Factors
* Mental or physical disabilities
* The ???challenging??? child
* Infants and young children
* Dysfunctional or isolated families
* Substance abuse in the home
* Unrealistic parental expectations

Indicators of Possible Abuse

* Lack of concern for child??™s injuries/pain
* Inability/unwillingness to comfort child
* Delay in seeking needed medical care
* Incompatible or absent history

Many different types of Abuse

* Physical abuse
* Emotional abuse
* Neglect
* Sexual abuse

Physical abuse ??“ any injury to a child that is not accidental (broken bones, bruises, cuts and other injuries) or any action which could have seriously harmed the child but luckily did not (striking a child with a weapon, discharging a gun in the presence of a child, or other similar actions).
Consequences of physical abuse would lead into:
-Bruises, welts
-Ocular damage
-Fractures
-Injuries in central nervous system
-Poisoning

Emotional abuse ??“ includes making a child feel that he/she is not loved or that he/she is bad or has no value (demeaning or belittling a child, not allowing a child to have friends, name calling, and other similar behaviors). All these actions may lead for a child to commit suicide.
Consequences of emotional abuse would lead into:
* Poor self-esteem
* Self -inflicted injury
* Sleeping disorders
* Eating disorders
* Depression and anxiety
* Feelings of shame and guilt

Neglect ??“ includes not providing a safe home, food, clothing, or medical/dental care, as well as leaving a young child alone or with someone who is not able to care for him/her, driving while intoxicated with an unrestrained child in the car, etc. Failure to supervise older children can also be considered neglect.
Consequences of neglect would lead into:
* Developmental effects
* Disability
* Alcohol/drug abuse
* Reproductive health outcomes
* At risk of being abusive
* Violent behavior

Sexual abuse ??“ includes using a child for sex acts, taking pornographic pictures of a child, or other types of sexual activity with a child.
Consequences of sexual abuse would lead into:
* Unwanted pregnancy
* Sexually-transmitted Infections
* HIV/AIDS
* Adverse outcomes for reproductive health

Indications of Bruises
Abuse
* on padded areas
* pattern injuries
* many lesions
Accidental
* on poorly padded areas
* non-specific patterns
* few lesions

How to distinguish an abuse from an accident
* Where is the injury
Certain locations on the body are more likely to sustain accidental injury: knees, elbows, shins, and the forehead; all are parts of the body which can be injured during an accidental fall or bump. Protected or non-protuberant parts of the body, such as the back, thighs, genital area, buttocks, back of the legs, or face, are less likely to accidentally come into contact with objects which could cause injury.
* How many injuries does a child have
The greater the number of injuries, the greater the cause for concern. Unless involved in a serious accident, a child is not likely to sustain a number of different injuries accidentally. Injuries in different stages of healing can suggest a chronological pattern of occurrence.

* What are the size and shapes of the injury
Many non-accidental injuries are inflicted with familiar objects, such as a stick, a board, and a belt or hair brush. The marks that result bear strong resemblance to the object that was used.

* Does the description of how the injury occurred seem likely
If an injury is accidental, there should be a reasonable explanation of how it happened that is consistent with its severity, type, and location. When the description of how the injury occurred and the appearance of the injury do not seem related, there is cause for concern.

* Is the injury consisted with the child??™s developmental capabilities
As a child grows and gains new skills, he increases his ability to engage in activities that can cause injury.

* Accidents do happen.
Parents are not perfect. Injuries occur which may have been avoided. Still, accidents of this nature should not happen repeatedly.

Inform the family of your concerns
These injuries were probably not caused by the events that you are describing.
I??™m concerned that someone may be harming your child. Do you have any of these same concerns at home

What you should do when you notice the signs of abuse
Recognition of suspicious injuries
Perform physical evaluation
* obtain supporting evidence
* find alternative diagnosis
Report suspected abuse
Remain alert
Advocate for the child
Show children they are important and that you care how they feel
Try to understand the seriousness and consequences of child abuse and neglect
Don??™t keep it to yourself ??“ do something if you are worried about a child before it??™s too late!!
Child Protection Crisis Service: 1-888- PREVENT
Kids Helpline: 1-800-4-A-CHILD

Conclusion
1. Reiterate the types of child abuses
2. Point out the difficulties of determining whether child abuse has occurred. Often times there are no clear answers.
3. Inform the class that reporting child abuse can reduce the possibility of further child abuse to victims by removing the child to different custody and sometimes pursuing criminal prosecution of the abuser.

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