Child Abuse and Neglect

Question 1

how many cases of child abuse are reported each year?

Answer 1

3 million

Question 2

how many kids die every day due to abuse?

Answer 2

5

Question 3

which types of kids are the most vulnerable to abuse?

Answer 3

-youngest children (70% that die are under 4)

Question 4

which type of injuries are the most common for child abuse?

Answer 4

• craniofacial, head, face, neck are more than half the cases
• all stuff that you look at on a daily basis

Question 5

where does child abuse occur?

Answer 5

EVERY socioeconomic level, across ethnic and cultureal lines, within all religions, and all educational levels

Question 6

kids that were abused are more likely to what?

Answer 6

• teen pregnancy
• sexual risk taking
• substance problem
• psychological disorder
• criminal activity

Question 7

what are the risk factors for child abuse?

Answer 7

• family violence
• psychological factors in guardian
• substance abuse by guardian
• family distress
• child with special needs
• single parent

Question 8

what is abuse?

Answer 8

• causes non-accidental physical injury
• uses a child for sexual purposes or involves a child in sexual acts
• harms a child’s mental or social development or causes severe emotional harm

Question 9

what are the borders of the “triangle of safety”

Answer 9

• ears, side of face, neck, top of shoulders

* injuries in this area are most likely abuse

Question 10

what are the most common types of injuries in abused children

Answer 10

bruising

*these are also the most common type of injury in NON-abused child so be careful of rushing to conclusions

Question 11

% of kids with bruising inc with what?

Answer 11

age

so if an infant come in with bruising know that it was probably not bc they fell down the stairs…

Question 12

where are the NON-INTENTIONAL areas of bruising?

Answer 12

• forehead
• vertex of chin
• elbos
• knees/shins
• bony prominences are by accident
• soft tissue areas are by intent

Question 13

can a bruise be dated by color?

Answer 13

no, everyone is different, but:

• red/blue/purple are recent
• yellow/brown/green are older

“assessment of the age of a bruise in children is inaccuarte and has no scientific basis

Question 14

what is the pattern of bruising with a hand?

Answer 14

impact of the hand forces blood into nearby capillaries causing them to rupture
-result is an outline of the fingers/hand

Question 15

what is the pattern of bruising for inflexible objects

Answer 15

• may produce short linear bruises
• bruising refects impact in one plane and does not follow curvature of body
• may lead to ecchymosis that have no definable pattern

Question 16

what is the pattern of bruising for flexible objects?

Answer 16

• may cause bruising pattern that follows the curvature of the body
• extention cords, belts, ropes…

Question 17

what can occur with bite injuries?

Answer 17

• possible central ecchymosis related to either:
• -negative pressure of suction or tongue thrust
• -distruption of blood vessels enclosed within the area of the bite

Question 18

what are the qulaificaitons of an adult-inflicted bite?

Answer 18

• bites often only distinct in one arch
• avg max intercuspid distance of 33mm
• teeth tend to be rectangular

Question 19

what are the qualificaitons of a child-inflicted bite?

Answer 19

• distinct in both arches
• intercuspid distance of less than 30mm
• teeth then to be more round

Question 20

where is the most common area for a biting injury?

Answer 20

upper extremities

Question 21

which have a higher morbidity, abuse related or accidental burns?

Answer 21

abuse related

Question 22

most common form of abuse burn

Answer 22

scalding

• more than 80% of abusive scald burns are from tap water
• check for immersion patterns

Question 23

type of abuse burn that is characterized by the configuaration of the burning object (abusive are more sharply defined than accidental ones)

Answer 23

contact burns

Question 24

what is the difference btw intentional or accidental cigarette burns?

Answer 24

intentional: sharpy defined 5-10mm diameter circle on exposed areas like hand or neck
accidental: superficial brush burns and layer of ash

Question 25

why do abusers choose to abuse the head and the neck areas most often?

Answer 25

“communicaiton” part of the child

Question 26

if a child presents with a frenum tear, what do you do?

Answer 26

any non-ambulatory child with a frenum tear should be evaluated for abuse

Question 27

concerning the teeth, what are some red flags for abuse?

Answer 27

• missing teeth
• fracutred
• non-vital
• injury to primary teeth is injury to developing permanent
• enamel hypoplasia in the future
• injury of PDL or pulp

Question 28

caregiver does not give the care, supervision, affection, or support needed for a child’s health, safety, and well-being

Answer 28

dental neglect

Question 29

as far as dental neglect goes, what does the law mandate that you do?

Answer 29

• YOU ARE THE MANDATED REPORTER
• requires that you make a report to child protective services or law enforcement if you suspect abuse or neglect (you could lose your liscense)
• do not have to provide proof or conduct a full investigation
• you cannot be help civially or criminally liable
• if you fail to report, however, it is a misdemenor criminal offense

Question 30

when making a report, what do you need?

Answer 30

• name and address of victim
• name and address of gaurdian
• name and address of person you suspect to be the abuser
• the reason you suspect for the neglect
• any other info