CHILD ABDUCTION, CHILD ABUSE

CHILD ABDUCTION, CHILD ABUSE

CHILD:

• A young human being below the age of puberty.
• An unborn or newborn human being.

CHILD ABDUCTION:

DESCRIPTION:

• Child abduction is the kidnapping of a child (or infant) by an older person.

OCCURRENCES:

• A stranger may kidnap a child for criminal or mischievous purposes.
• A stranger may kidnap a child (or infant) to bring up him or her as that person's own child.
• A parent removes or retains a child from the other parent's care (often in the course of or after divorce proceedings).

→  Because of the increased independence that occurs in the preschool-age child, parents are less able to provide the constant protection they once did when the child reaches this age; interventions (including teaching the child) that ensure protection are necessary.

INTERVENTIONS:

Instruct the parents to teach a child basic guidelines about personal safety that include the following:

• Do not go anywhere alone.
• Always tell an adult where he or she is going and when he or she will return.
• Say no if he or she feels uncomfortable with a situation.
• Do not talk with strangers or get into their cars.
• Do not help anyone look for a lost dog or ct and do not accept candy from a stranger.
• If lost in a store, do not wander around looking for the parents; go at once to a clerk or guard.

Children need to learn their full name, address, and parent's name.

Watch for post traumatic stress disorder in any child who has experienced an abduction.

CHILD ABUSE:

• Non accidental physical injury or the non accidental act of omission of care by a parent or person responsible for a child; includes neglect and physical, sexual, or emotional maltreatment.

DESCRIPTION:

• Neglect can be in the form of physical or emotional neglect and involves the deprivation of basic needs, supervision, medical care, or education and failure to meet a child's needs for attention and affection.
• Sexual abuse can involve incest, molestation, exhibitionism, pornography, prostitution, or pedophilia; findings associated with sexual abuse may not be easily apparent in a child.
• Shaken baby syndrome is caused by the violent shaking of an infant and results in intracranial (usually sub-dural hemorrhage) trauma; this can lead to cerebral edema and death.

ASSESSMENT:

NEGLECT:

• Inadequate weight gain
• Poor hygiene
• Consistent hunger
• Inconsistent school attendance
• Constant fatigue
• Reports of lack of child supervision
• Delinquency

PHYSICAL ABUSE:

• Unexplained bruises,burns,or fractures
• Bald spots on the scalp
• Apprehensive child
• Extreme aggressiveness or withdrawal
• Fear of parents
• Lack of crying (older infant, toddler, or young preschool child) when approached by a stranger.
• Spiral fractures without history of trauma from a ports injury.

EMOTIONAL ABUSE:

• Speech disorders
• Habit disorders such as sucking,biting, and rocking
• Psycho neurotic reactions
• Learning disorders
• Suicidal attempts

SEXUAL ABUSE:

• Difficulty walking or sitting
• Torn, stained, or bloody underclothing
• Pain, swelling, or itching of genitals 
• Bruises, bleeding, or lacerations in genital or anal area
• Unwillingness to change clothes or unwillingness to participate in gym activities
• Poor peer relations

SHAKEN BABY SYNDROME:

• External signs of trauma are usually absent
• Ophthalmoscopic examination reveals retinal hemorrhages
• Full bulging fontanels and head circumference greater than expected.

INTERVENTIONS:

• Support the child during a thorough physical assessment.
• Assess injuries.
• If shaken baby syndrome is suspected, monitor the infant for a decrease in level of consciousness, which can indicate increased intracranial pressure (ICP). 
• Report a case of suspected abuse; nurses are legally required to report all cases of suspected child abuse to the appropriate local or state agency.
• Place the child in an environment that is safe, preventing further injury.
• Document information related to the suspected abuse in an objective manner.
• Assess parents strengths and weaknesses, normal coping mechanism, and presence or absence of support systems.
• Assist the family in identifying stressors, support systems, and resources.
• Refer the family to appropriate support groups.