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How Health Care Providers Can Identify and Report Child Abuse

Abstract

Children’s abuse and neglect can manifest in various ways, including bodily, well-being, carnal, and psychosomatic violation. Child abuse indicators include odd bruises, abnormally violent behaviour, malnourished, and substantial behavioural and eating habits changes. Unfortunately, child abuse remains prevalent in the United States. In the United States, ill-treatment has legal and medical consequences. According to federal law, child maltreatment is any latest act or letdown act by a guardian leading to death, significant bodily damage, carnal mishandling or mistreatment, or miscarriage that puts a child in immediate danger. Because of their exposure, public child healthcare personnel play a key role in preventing and detecting child abuse among the most vulnerable children. Healthcare practitioners can utilize several preventative techniques ranging from basic to intermediate to tertiary to reduce child abuse and related costs and human suffering. In addition to visible signals, healthcare workers can use their intuition to detect signs of abuse and neglect. Other strategies employed in suspected abuse and neglect situations included (unexpected) house visits, discussing with colleagues, engaging parents in dialogue, and monitoring and registration.

Children’s abuse and neglect can manifest in various ways, including bodily, carnal, emotional, and psychosomatic abuse. Child abuse indicators include odd bruises, abnormally violent behaviour, and substantial behavioural and eating habits changes. Regrettably, child abuse remains prevalent in the United States. In 2020, 618,399 child abuse and neglect cases were reported, with neglect the most generic type of mistreatment in the United States (Statista, 2022). Maltreatment’s health magnitudes include injuries, emotional and behavioural disorders, neurologic and musculoskeletal ailments, and mental disorders such as anxiety, post-traumatic stress disorder (PTSD), and personality issues (Strathearn et al., 2020). Thus, child maltreatment is a noteworthy public health snag and one of the most potent risk factors for psychopathology, health morbidity, and delayed development.

In the United States, child mistreatment has legal and medical consequences. Federal law describes child abuse and neglect as any recent act or failure to act by a parent that leads to death, significant bodily or psychological injury, sexual exploitation or abuse, or miscarriage that creates an imminent risk of serious harm to a child (Children’s Bureau, 2022). Regardless of how their laws differ, states are obligated to adopt the minimal federal law standards. All states have laws requiring physicians, other health professionals, and other authorities interacting with children to report speculated child mistreatment to child protective services. The protective services are a division of the U.S. Department of Children and Human Services that explicitly handles child cruelty intelligence (Children’s Bureau, 2022). Because of their exposure, public child healthcare staff play a key role in preventing and detecting child abuse among the most vulnerable children.

Healthcare providers can apply various preventative measures, spanning from primary to intermediate to tertiary, to reduce the occurrence of child abuse and its accompanying costs and human suffering. Primary prevention includes identifying risk factors for child abuse and recognizing child abuse and neglect instances. Healthcare professionals must be aware of child abuse risk factors such as domestic violence, parental mental health disorders, and poor parenting skills; secondary prevention focuses on vulnerable adult and child groups to identify and report child abuse or neglect cases. Health care providers can use a range of secondary prevention strategies, such as monitoring the child, referring them to health treatment, and reporting to child welfare services. Doctors and other healthcare practitioners attending to progenies and households are well-positioned to recognize children vulnerable to maltreatment and initiate strategies to prevent harm during well-child and other visits. Although paediatricians cogitate assessment for exploitation and abandonment, an essential aspect of their profession, it is seldom practised.

It is difficult to detect and report child maltreatment and neglect. The presence of risk factors, for example, does not automatically suggest that abuse is occurring or will occur in the future. As a result, physicians and healthcare workers must pay particular attention to child abuse diagnosis and the procedure to identify risk factors. Signs of abuse can appear in various locations, including a child’s social environment, parents, and other professionals interacting with high-risk families (Javakhishvili & Widom, 2021). Healthcare practitioners and physicians can assess a child’s conduct and the parents’ efforts to learn about the child’s environment. A child clambering onto everyone’s lap, for example, shows anxiousness due to a dysfunctional environment. However, professionals feel that not all abused children exhibit symptoms. Furthermore, physicians and healthcare workers may visit preschools rather than observe the child’s symptoms. According to public child healthcare workers, preschool is crucial in identifying abuse since childcare providers see the children regularly.

In addition to apparent signs, healthcare workers can use their intuition to identify signs of abuse and neglect. They define their intuition as an unconscious, instinctual, and critical aspect of child abuse detection. If a physician has an intuitive feeling that anything is wrong with the baby, they must objectify their feelings. These instincts are typically the starting point for a complete investigation, including talking with parents, seeking confirmation through direct observation, and obtaining auxiliary data (Stolper et al., 2020). Listening, asking appropriate questions, following through, and being respectful are all-important communication skills to have while dealing with parents. Other approaches utilized in suspected abuse and neglect situations included doing (unexpected) house visits, discussing the issue with colleagues, engaging parents in communication, and monitoring and registration (Rapoport, Reisert, Schoeman, & Adesman, 2021). When they perform home visits and suspect something, they may regularly ask the mother to the well-baby clinic to assess how the baby is developing against the growth curve. Before determining whether or not child abuse or neglect is occurring, they may consider the child’s perception and consult with others.

Healthcare workers are uniquely positioned to isolate children vulnerable to cruelty and inattention and give them the services they need to avoid it. Healthcare workers can only excel in these duties if they first become acquainted with the entangled systems of ill-treated children. The child safety system and, in particular, the legal system is crucial in determining the physical placement and well-being of abused or neglected children.

References

Children’s Bureau. (2022). Definitions of Child Abuse & Neglect. Childwelfare. Retrieved 20 February 2022, from https://www.childwelfare.gov/topics/can/defining/#:~:text=Federal%20law%20definitions%20of%20child%20abuse%20and%20neglect&text=%22Any%20recent%20act%20or%20failure,imminent%20risk%20of%20serious%20harm.%22.

Erisman, J., de Sabbata, K., Zuiderent-Jerak, T., & Syurina, E. (2020). Navigating complexity of child abuse through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners. BMC Family Practice21(1). https://doi.org/10.1186/s12875-020-01226-6

Javakhishvili, M., & Widom, C. (2021). Childhood maltreatment, sleep disturbances, and anxiety and depression: A prospective longitudinal investigation. Journal Of Applied Developmental Psychology77, 101351. https://doi.org/10.1016/j.appdev.2021.101351

Rapoport, E., Reisert, H., Schoeman, E., & Adesman, A. (2021). Reporting of child maltreatment during the SARS-CoV-2 pandemic in New York City from March to May 2020. Child Abuse & Neglect116, 104719. https://doi.org/10.1016/j.chiabu.2020.104719

Statista. (2022). Child abuse in the U.S – Statistics & Facts. Statista. Retrieved 20 February 2022, from https://www.statista.com/topics/5910/child-abuse-in-the-united-states/#topicHeader__wrapper.

Stolper, E., Verdenius, J., Dinant, G., & van de Wiel, M. (2020). GPs’ suspicion of child abuse: how does it arise and what is the follow-up?. Scandinavian Journal Of Primary Health Care38(2), 117-123. https://doi.org/10.1080/02813432.2020.1755784

Strathearn, L., Giannotti, M., Mills, R., Kisely, S., Najman, J., & Abajobir, A. (2020). Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect. Pediatrics146(4). https://doi.org/10.1542/peds.2020-0438

 

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