Overview
This lecture covers the four main types of child abuse, their risk factors, key signs to recognize, and mandatory reporting responsibilities for nurses.
Types of Child Abuse
- Physical abuse: intentional physical harm (hitting, kicking, shaking, burning, etc.).
- Emotional abuse: behaviors harming self-worth or emotional well-being (name-calling, shaming, rejection).
- Sexual abuse: forcing a child into sexual acts (fondling, penetration).
- Neglect: failure to provide basic needs (housing, food, education, medical care).
Risk Factors for Child Abuse
- Children under 4 years old or with special needs are at increased risk.
- Family history of mental health issues or substance abuse increases risk.
- Inconsistent, non-biological, or transient caregivers are a risk factor.
- Low income, low education, teenage or single parents, or parents with many young children are risk factors.
General Signs of Child Abuse
- Injury stories inconsistent with the injury or with the child's developmental age.
- Inconsistent explanations between child and caregiver.
- Injuries that could have been prevented by parental supervision.
Reporting Requirements for Nurses
- Nurses are mandated reporters: required to report any suspicion of child abuse.
- Proof is not needed to report abuse; report based on suspicion with factual circumstances.
- The reporter is not responsible for proving abuse occurred.
Signs of Specific Types of Abuse
- Physical abuse: multiple injuries in various healing stages, bruises on soft tissue (cheek, neck, genitals, buttocks, back), bruises or burns in the shape of objects, immersion burns with clear borders, spiral fractures.
- Shaken-baby syndrome: poor feeding, irritability, lethargy, vomiting, seizures, apnea, retinal hemorrhage.
- Emotional abuse: extreme behavior (overly compliant/demanding, passive/aggressive), delayed physical or emotional development.
- Sexual abuse: difficulty walking/sitting, advanced sexual knowledge/behavior, sexually transmitted infections, frequent urinary tract infections, new-onset bedwetting.
- Neglect: frequent school absences, begging or stealing food/money, unclean clothes, poor hygiene or dental health, inappropriate dress for weather.
Key Terms & Definitions
- Mandated Reporter — A professional legally required to report suspected child abuse.
- Neglect — Failure to meet a child's basic physical needs.
- Spiral Fracture — A bone break caused by a twisting motion, suspicious for abuse.
- Immersion Burn — Burn with a clear line, often from forced submersion in hot liquid.
- Nocturnal Enuresis — Bedwetting during the night.
Action Items / Next Steps
- Review quiz questions covering types of abuse, nurse responsibilities, red-flag fractures, and signs of sexual abuse.
- Study signs and risk factors for all abuse types.