Child Abuse As A Non Accidental Injury example essay topic

One million children become victims of child abuse each year. A major component of this physical abuse; harm to a child for which there is no reasonable explanation. Children exhibit multiple signs and symptoms of abuse. This paper illustrates how to accurately diagnose child abuse through obtaining an accurate history accompanied with a physical and radiological examination. Currently, prevention measures are being taken to increase awareness and educate the public in hopes of solving this problem. Child abuse is the number one leading cause of death of a child.

The National Committee for the Prevention of Child Abuse (NCP CA) defines child abuse as a non-accidental injury or pattern of injuries to a child, including physical abuse and neglect, sexual abuse, and emotional abuse. The statistics, signs and symptoms, diagnosis, and treatment of physical abuse will show that child abuse is a major problem and help promote awareness in society today. Statistics Child abuse has become a national epidemic-more than one million children are confirmed victims of child abuse and neglect each year by state departments. A study conducted for the Federal Government, breaks abuse down to 300,000 children physically abused, 140,000 sexually abused and another 700,000 neglected and maltreated each year.

These numbers represent a 41% increase between 1988 and 1997. Many cases of physical abuse eventually result in death to the child. With the number of deaths increasing by 34% in the past decade, 1,200 children die each year as victims of abuse. This equates to at least three children a day. One half of abuse fatalities result form the physical form of abuse, generally from the parents in the home.

Nearly all Fatalities occur at a very young age, with children remaining at high risk for loss of life until the age of five. The incidence of physical abuse generally decreases during early school years and increases again during adolescent years. Physical abuse can be recognized nationally as well as internationally. It affects children of all ethnic groups and scoioeconomics status. There is not a dominant gender when discussing physical abuse. Many of those who are abused as children will later go on to abuse their own children.

Being poor, sick or on drugs, also increases the risk of abuse. Signs and Symptoms A disturbance in behavior is a strong signal that the child is living in an abusive environment. Behavior in physically abused children covers a wide range and depends on the developmental level of the child and length of abuse. Children who have been abused tend to be far more aggressive than others, show detachment, estrangement, and unhappiness. In the school setting, signs of abuse include poor school achievement, failing grades, and school disciplinary problems.

Abuse problems are easier to recognize when one pays attention to the child's emotional and social development and are familiar with the child's emotional trends. Children who show changing emotional trends are often victims of abuse. Physical signs almost always accompany the emotional signs in abused children. Physical signs that a child is a victim of abuse include visible bruises, unexplained injuries and blunt-instrument marks or burns.

Evidence of poor care or failure to thrive is also an indicator. Children may appear to be malnourished, unclean, and have an overall appearance that is gloomy. Picking up on physical as well as emotional trends in children is a vital step in the detecting abuse. Physical Diagnosis The most important information leading to a diagnosis of physical abuse is obtained through the medical history of the child.

Certain "red flags" in the medical history raise the possibility of a diagnosis of child abuse. In cases of suspected abuse, a history should be obtained privately with the child. In many cases, however, children may be to young, frightened, or intimidated to give an accurate or harmful history. Obtaining an accurate history form the child is the key to diagnosing abuse. When an accurate history form the child is unattainable the caregiver must then be questioned. A history by the caregiver that is inconsistent with the patient's injuries is the hallmark of physical abuse.

A complete physical examination is an important step in the overall process of detecting abuse. A complete examination requires determination of the location, size, shape, and age of all external and internal injuries. Young children are commonly injured accidentally in the course of daily play and activities. However, the patterns of injuries seen in children who are physically abused differ form accidental injuries. Non-accidental trauma commonly involves the skin, bone, or central nervous system. The Skin is the most commonly injured organ system and the easiest to examine.

The location of bruises can sometimes be suggestive of accidental versus non-accidental trauma. Accidental bruises most often occur on surface over bones that are close to the surface. Bruising to protected parts of the body such as the buttocks, thigh, torso, and neck are suggestive of child abuse. Bruising that present in the shape of an object such as handprints, belt buckles, bite marks, or paddles is a signal that injury was intentional. It is important to determine if the age of bruises is an indicator of how old the bruise is and how deep into the tissue damage was done. The presence of bruises that have various ages may signify multiple episodes of injury caused by ongoing abuse.

The physical examination should proceed to carefully inspect and palpate all body surfaces. Any areas of tenderness may represent occult trauma and should be evaluated radiologically. The role of imaging in cases of child abuse is to identify the extent of injury over tender areas of the body. It serves as a case-finding tool, and can be used as a guide to the management of know cases.

Radiological Diagnosis In cases when physical abuse is suspected, the presence of radiographic changes in the skeleton can support the diagnosis. however, the absence of radiological change in the skeleton system does not exclude abuse either. The radiological signs of skeletal injuries are similar in most cases. Radiologic findings of abused children have become well known in the medical field including epiphysial-metephyseal fractures, multiplicity of fractures, and different stages of healing and repair of multiple fractures. Direct blows to the extremities usually results in transverse or spiral diaphysial fractures. These are common type of fracture in children however, under certain circumstances they can be suspicious. For example, a transverse fracture in a 3 month old is a little more suspicious than the same in a 6 year old.

There are several common types of fractures that result from direct blows as seen in abuse. A direct blow to the Clavicle results in a mid shaft fracture. Direct blows to the scapula result in nonspecific linear or stellate fractures. Because these fractures are relatively uncommon in infants and young children, their presences should cause suspicion.

The same pertains to uncommon sternal fractures resulting form a direct blow. Other areas include rib, skull, and extremity fractures due to direct blows. Conclusion Child abuse is harm to a child for which there is no "reasonable" explanation; it includes non-accidental and / or physical injury to a child. it is an international problem that affects over a million children each year. Abuse can occur at any age however infants and young children are at greatest risk. The devastating affect of abuse can last up to a lifetime and not only harm the child physically but also emotionally. For this reason efforts to make a greater awareness and programs of prevention needs to continue to go forth in hopes of ending this tragedy.