F.A.Q
1. Is
child abuse causing long-term effects a new issue?
a. No,
there are new guidelines from the American Academy of Pediatrics that have
updated older reports linking abuse and long-term effects. These new guidelines are built on previous
information that suggests pediatricians pay attention for signs of
maltreatment. These guidelines have
connected early childhood trauma to both medical and psychological
complications. Such complications begin
during the trauma in childhood and continue into adulthood. With these new
guidelines pediatricians will be able to identify children who are potentially
being abused. Pediatricians can then help
these children before the abuse causes chronic stress and leads to behavior
problems. (Garner, et al., 2012)
2. What
types of abuse causes behavioral problems?
a. There
are five different forms of abuse that can cause chronic stress on a child. The
different forms of abuse include neglect, physical abuse, sexual abuse,
emotional abuse, and abandonment. If the child’s basic needs are not being
fulfilled by a parent, guardian, or caretaker, this is NEGLECT. If a child is harmed on purpose by a parent,
guardian, or caregiver, this is physical abuse.
Forcing a sexual act onto a child is considered sexual abuse. These acts can include fondling a child’s
genitals, penetration, incest, rape, sodomy, and indecent exposure. The last form of child abuse is abandonment.
This is a type of neglect and happens when a parent, guardian, or caregiver
leaves a child and fails to provide reasonable support (Child Welfare, 2016)
3. What
are the signs of abuse pediatricians should watch for?
a. Signs
of abuse differs depending on the type of abuse, extent of abuse, and who is
the abuser. Pediatricians must assess
each child on a case by case base. (Child Welfare, 2013)
4. What
types of health problems can children develop after being abused?
a. After
being abused some children develop post-traumatic stress disorder (PTSD), which
can be linked with depression, anxiety or disruptive or defiant behaviors.
b. Children
can also develop attention deficit/hyperactivity disorder (ADHD). (behavior problems, 2017)
5. What
causes these behavior problems to develop?
a. When
children suffer abuse their bodies are under stress. Exposure to toxic stress disrupts the normal
development of a child’s brain. Particularly,
the development of adaptive capacities and coping skills that are vital later
in life. Without these skills children
are at a high risk of developing behavior problems. (behavior problems, 2017)
6. What
is PTSD?
a. Post-traumatic
stress disorder is considered to be a mental health problem. It is brought on by different traumatic
experiences such as sexual abuse, being a witness to a life-threatening event,
or experiencing a life-threatening event themselves.
b. People
who suffer from PTSD often have a hard time sleeping, feel upset often, feel on
edge, and have memories that cause them to be upset. PTSD can cause an
individual to have a hard time doing their normal routine things such as going
to work and even being surrounded by their families.
c. Anyone
who has been through a traumatic experience can develop PTSD. However, factors such as age, gender, history
of traumatic exposure, events following the traumatic event, and stress can
make PTSD more likely to develop.
Support from family and friends to reduce the risk of developing PTSD.
d. There
are four different types of symptoms of PTSD and they can be different for each
individual.
i.
Having flashbacks or reliving the
event. Individuals may feel like they
are experiencing the event again.
ii.
Avoiding any situation that reminds them
of the event. These individuals avoid
situations that can trigger memories of their traumatic experience.
iii.
Developing negative thought and
feelings. PTSD can cause people to start
thinking of themselves in a negative way and cause them to become uninterested
in things they once enjoyed.
iv.
Feeling hyperarousal. Individuals become anxious and may be
paranoid that there is danger. They can become angry, irritated, have trouble
sleeping, or startle easily (PTSD: National Center for PTSD,
2016)
7. Is
PTSD different for children than adults?
a. Children
suffering from PTSD often experience different symptoms than adults. Younger
children (under the age of 6) often wet to bed, even after they have been
toilet trained. Some children forget how
to talk, they act out the trauma during playtime, and they become over clingy
with a parent or other adult. As the child gets older their symptoms start to
resemble that of an adult. Teens often develop behaviors that tend to be
disruptive, disrespectful, and/or destructive. (PTSD: National Center for PTSD,
2016)
8. What
is ADHD?
a. According
to the National Institute of Mental Health, Attention-deficit/hyperactivity
disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention
and/or hyperactivity-impulsivity that interferes with functioning or
development.
b. Inattention
is when a person cannot focus and is disorganized
c. Hyperactivity
is when the person cannot sit still, they are up and about constantly.
d. Impulsivity
is when people act without thinking about the situation first.
e. A
pediatrician, psychologist, or psychiatrist with expertise in ADHD can diagnose
a person only after completing a comprehensive evaluation. The symptoms of
inattention and/or hyperactivity must be chronic, long lasting and interfere
with the normal development of the individual. ADHD symptoms can appear as
early as between the ages of 3 and 6 and can continue through adolescence and
adulthood. Symptoms change over time as the child becomes older.
f.
There is no cure for ADHD, but treatments
can help reduce symptoms and improve functioning. Treatments can include
medication, psychotherapy, education or training, or a combination of
treatments. (Attention Deficit Hyperactivity,
2016)
9. What
role does the pediatrician play in helping children who have been or are being
abused?
a. Pediatricians
are vital in preventing the long-term effects of child abuse in children. They are the ones who can identify that abuse
is happening and get the child intervention.
They are also the ones that treat the child after abuse has occurred,
whether that is for physical injuries or behavioral problems (Garner, et al., 2012)
10. What
is the current screening process pediatricians use to identify abuse?
a. A
thorough assessment of each individual must be made and include the following
areas. . .
i.
Abuse-related information
1. Characteristics
of the abuse
2. Type
of response to the child's disclosure
3. Type
of legal involvement expected
4. Current
living situation
5. Cognitions/attributions
about abuse
ii.
Behavioral functioning
1. Sexualized
behavior
2. Aggression
3. Withdrawal
4. Self-destructive
behavior
5. Substance
abuse
6. Suicidal
thoughts/behaviors
iii.
Emotional functioning
1. Depression
2. Anxiety
3. Fear
4. Anger
5. Trauma-specific
symptoms
6. Social
functioning
7. Peer
involvement
8. Social
skills
9. School
achievement and behavior (Lipovsky & Hanson)
11. Are
the parents screened by professionals in abuse cases?
a. Yes,
parents undergo thorough assessments by professionals in suspected abuse cases.
These assessments can include:
i.
Caregiver functioning, Level of support,
Level of supervision, Trauma history, Cognitions/attributions regarding child’s
abuse experiences, Substance abuse, Emotional functioning, Cognitive functioning,
Future abuse/neglect potential, Parenting and social skills, Level of familial
and community support. (Lipovsky & Hanson)
References
Attention Deficit Hyperactivity. (2016, March). Retrieved April 19, 2017, from
National Institute of Mental Health:
https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
Christian, C. W. (2015, May 1). The evaluation of suspected
child physical abuse. AAP News & Journals Gateway, 135(5).
doi:10.1542/peds.2015-0356
Child Welfare Information Gateway. (2013). Long-term
consequences of child abuse and neglect. Washington, DC: U.S. Department of Health
and Human Services, Children’s Bureau.
Child
Welfare Information Gateway. (2016). Definitions
of child abuse and neglect. Washington, DC: U.S. Department of Health and
Human Services, Children's Bureau.
Child Welfare Information Gateway. (2013). What is
child abuse and neglect? Recognizing the signs
and symptoms. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.
Garner, A. S., Shonkoff, J. P., Siegel, B. S., Dobbins, M.
I., Earls, M. F., McGuinn, L., . . . Wood, D. L. (2012, January 1). Early
childhood adversity, toxic stress, and the role of the pediatrician:
translating development science into lifelong health. AAP News &
Journals Gateway, 129. doi:10.1542/peds.2011-2662
Health and behavior problems can linger after child abuse. (2017, March 21). Retrieved March 21, 2017, from Fox
News:
http://www.foxnews.com/health/2017/03/21/health-and-behavior-problems-can-linger-after-child-abuse.html
Jenny, C., & Crawford-Jakubiak, J. E. (2013, August 1).
The evaluation of children in the primary care setting when sexual abuse is
suspected. AAP News & Journals Gateway, 132(2).
doi:10.1542/peds.2013-1741
Lipovsky, J. A., & Hanson, R. F. (n.d.). Treatment
of child victims of abuse and neglect. National Crime Victims Research
and Treatment Center Medical University of South Carolina. Children's Law
Center. Retrieved April 19, 2017, from
http://childlaw.sc.edu/frmPublications/TreatmentforChildVictimsofAbuseandNeglect.pdf
PTSD: National Center for PTSD. (2016, October 4). Retrieved April 2017, from U.S
Department of Veterans Affairs:
https://www.ptsd.va.gov/public/PTSD-overview/basics/what-is-ptsd.asp
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