Signs Of Child Abuse Research Articles

Evaluation of Know & Tell®: Increasing Adults' Knowledge of Child Maltreatment and Reporting Responsibilities.

Many educational programs aimed at addressing child maltreatment focus on teaching people how to recognize only one type of child maltreatment, most commonly child sexual abuse, rather than all types of abuse and neglect children might experience. Limited empirical evidence exists on the effectiveness of educational programs that teach adults how to identify all types of child maltreatment, as well as what reporting responsibilities are and how to properly make a report of maltreatment once it is suspected. The goal of the present study was to fill that gap by examining whether an educational program called KNOW and TELL® increased participants' knowledge on how to identify various types of child maltreatment, what the state's mandated reporting laws are, and how to make a report in the event maltreatment is suspected. A comparison of pre-training and post-training assessment results suggests that participants demonstrated improved knowledge on the signs of child maltreatment, reporting responsibilities, and intervention procedures after completing the training. The findings of this research support the development and implementation of state-specific educational programs that raise awareness on child maltreatment and teach adults what their statutorily mandated responsibilities are and how to report child maltreatment when it is suspected.

Turning Towards the Affective: Medical Semiotics of Child Maltreatment in Denmark

ABSTRACT Signs of child maltreatment may be physical and detectable by clinical examination but may also arise as a feeling of strangeness that sparks uncertainty. Based on fieldwork in Danish general practice, and thinking along recent discussions around semiotics and affect, the article explores how feelings of “strangeness” arise in child consultations. It focuses on how subjective, embodied, and interpersonal reactions arise, how signs, however tactile and arbitrary, are felt and experienced, and how engaging with affective aspects when doing diagnosis, could expand the medical semiotics of child maltreatment.

Knowledge and Attitudes Towards Child Abuse and Neglect Among Dental Students from North Macedonia

Introduction. Signs of child abuse and neglect are often found in the orofacial region and, therefore, it is very important for dental students, as future dentists, to recognize and report them.
 The aim of the study was to investigate the knowledge and attitudes towards child abuse and neglect among dental students.
 Material and Methods. The study was performed at the Faculty of Dental Medicine, Saints Cyril and Methodius University, among all dental students of the six-year undergraduate dental programme. The data were collected between January and February 2022 using a Google Form and shared via available social media platforms. The definition of physical indicators of abuse, awareness regarding legal and ethical issues, students’ experience of child abuse recognition were evaluated by a questionnaire.
 Results. The questionnaire completion rate was 70%. As many as 20.86% of dental students very rarely received training on recognizing and reporting child abuse and neglect; 79.75% of dental students had never received any information about child abuse during their university education; about 91.41% of students wanted to receive more knowledge about child abuse and neglect. No differences were observed in terms of gender and year of study.
 Conclusions. Dental students in North Macedonia are not sufficiently prepared for their role in diagnosing suspected cases of child abuse. An educational program about diagnosing, reporting, and preventing child abuse and neglect should be involved in the curriculum of undergraduate students from North Macedonia.

Making every contact count: Can healthcare professionals do more to avoid preventable child deaths?

BackgroundHealthcare professionals (HCPs) have a responsibility and unique opportunities to identify and act on safeguarding concerns. Child Safeguarding Practice Reviews (CSPRs) are produced in the United Kingdom when a child has died or been seriously harmed, and abuse or neglect is suspected or confirmed. To our knowledge there is no recent systematic analysis of CSPRs from an HCP perspective. ObjectiveTo establish if HCPs are acting in an appropriate and safe manner when confronted with cases of potential child abuse and neglect and recommend areas for further improvement. Participants and settingsCSPR abstracts published on a specialist UK database between 2018 and 2021 involving the death of a child. MethodsAfter applying the exclusion criteria we used stratified random sampling to select one third of eligible reports. Using a systematic framework, common qualitative themes were extracted and analyzed. Results42 of 125 eligible CSPRs were analyzed. Child deaths were more common in male children and those aged under one. We identified areas where communication could be further improved including better understanding of the referral process, coordination at discharge, and communication between primary and secondary care. We found that HCPs were not well equipped to identify risk factors for child abuse such as poor parental health and complex family structures. ConclusionsThere is significant scope for improvement in strengthening the knowledge and skill base of HCPs in identifying and acting on signs of child abuse. We propose improvements in terms of staff training, resources and better systems to ensure HCPs respond to safeguarding concerns safely and appropriately.

Association of ‘Low Risk’ Fractures With Abuse in Young Children

Association of ‘Low Risk’ Fractures With Abuse in Young Children

Teachers’ Attitudes and Knowledge toward Child Maltreatment in the Kingdom of Saudi Arabia

Background: Child abuse, along with the negative impact of it has affected many aspects of children’s lives. It is now prevalent that its prevention has become a global healthcare priority. Teachers have a great role to play, as integral part of the community, in the prevention of this phenomenon.
 Objective: The aim of this study is to evaluate teachers’ knowledge regarding their roles, their opinions on physical punishment, signs of abuse in children, and reporting policies.
 Method: A cross-sectional study was conducted to 320 participants who teach in different educational stages and school levels located in Saudi Arabia’s Eastern Province. Participants completed a questionnaire assessing the ability to recognize and evaluate different types of child maltreatment, knowledge of reporting procedures, and participants’ opinions on corporal punishment as a method of child discipline.
 Results: Results showed a considerable improvement regarding the issue of child maltreatment among teachers. Female gender was associated with the level of significance in reporting procedures and other important legal issues surrounding child abuse.
 Conclusion: Teachers reported having an awareness of their roles, the signs of child abuse and reporting procedures. Since the majority of them possessed a good level of awareness regarding the occurrence of child abuse, we encouraged them to take appropriate steps to learn how to identify different types of abuse and apply the knowledge gained through training and practical.

Child Abuse Screening in the Emergency Department Before and After Implementation of a Formal Screening Tool

Background: 
 Child abuse and neglect is a leading cause of mortality and morbidity in children. Victims of abuse often present to emergency departments due to these injuries. Early identification of suspected child abuse by emergency department staff allows the opportunity for intervention prior to a devastating injury. Signs of child abuse can be subtle and may not always be identified. Recent efforts have worked to improve suspected child abuse identification by implementation of validated screening protocols. Specifically, the IU Health Riley Emergency Department has recently implemented a new child abuse screening tool (effective on 15Apr2021). The Covid-19 pandemic has further exacerbated this issue, creating social isolation and additional socioeconomic stressors that contribute to child abuse. 
 Method: 
 A retrospective chart review was conducted to analyze patients identified for child abuse evaluation in the Riley emergency department. Patients prior to the implementation of the screening tool were identified by those undergoing a social work evaluation for child abuse. For patients presenting after implementation of the screening tool, all patients with a positive screen were reviewed. Charts were then reviewed for baseline demographics, diagnostic testing performed, and injuries identified. All data was recorded in an electronic Redcap database. 
 Results: 
 Implementation of a formal screening tool increased the number of patients identified for a child abuse evaluation (1.34% vs 3.17%) and those evaluated who had an injury also increased (1.15% vs 1.81%). More patients received a head CT scan after implementation of the screening tool (0.89% vs 1.07%), while the percentage of patients with an abnormal head CT decreased (62% vs 45%). 
 Conclusions: 
 Implementation of a formal screening tool for child abuse in the emergency department successfully improved identification of patients that should be further evaluated for child abuse. These results may be used to support implementation of the tool in additional emergency departments.

Signs of abuse in children with disabilities: A rapid review with expert panel social validation

ABSTRACT Background Children with intellectual disabilities are at risk of becoming victims of abuse. However, persons working with this population often lack knowledge on how to interpret signs of abuse. The purpose of this study was to identify and socially validate signs of abuse in children with disabilities. Method The study employed a mixed-method sequential design. The first phase consisted of a rapid review of publications that described signs of abuse in children with disabilities (n = 23). The second phase included social validation using an online survey. The participants were professionals working with disability and/or child abuse (n = 39). Results A significant difference between the 10 highest rated signs of abuse compared to the 10 lowest rated signs was found. Group comparisons between participants showed significant differences in the ratings of eight signs. Conclusions The results from the study can provide guidance to the accuracy of signs of abuse in children with disabilities.

Child maltreatment: knowledge, attitudes and reporting behaviour of physicians in teaching hospitals, Egypt.

Lack of diagnosis and reporting of child maltreatment are important problems worldwide. This study aimed to assess the knowledge, attitude and practice of physicians in Alexandria University teaching hospitals about the diagnosis and reporting of child maltreatment cases. A descriptive cross-sectional study was conducted at three hospitals. All physicians working regularly in emergency units were invited to complete a self-administered questionnaire. Data collected included sociodemographic characteristics, knowledge of and formal training on child maltreatment, attitude to dealing with child maltreatment, and experience of child maltreatment cases and reporting behaviour. A total of 90 physicians were included in the study. Only 11% correctly identified all the signs of child maltreatment and 29% correctly answered all questions on the social indicators of maltreatment. Only 41% of the participants had a good knowledge score (≥ 75%) on child maltreatment. Longer work experience (P = 0.019) and older age (P = 0.039) were associated with better knowledge. Of 249 suspected cases of child maltreatment that the physicians reported they had experienced, only 36% were reported. Formal training on child maltreatment (P < 0.001) and older age (P = 0.006) were associated with physicians' reporting behaviour. Over half (56%) of the participants thought their workplaces did not provide them with procedures to follow if they suspected child maltreatment. Physicians' knowledge of the signs and social indicators of child maltreatment was unsatisfactory. Clinical training and education are needed to improve their ability to diagnosis and report cases of child maltreatment.

Why Healthcare and Education Professionals Underreport Suspicions of Child Abuse: A Qualitative Study

Education and healthcare professionals are crucial in detecting and reporting child abuse and neglect. However, signs of child abuse are often undetected, and professionals tend to underreport their suspicions of abuse and neglect. This qualitative study aimed to examine experiences, attitudes, perspectives, and decision-making skills of healthcare and education professionals with regard to identifying and reporting child abuse and to gain insight into how detection and reporting can be improved. Semi-structured interviews were conducted with 49 Dutch professionals working in child health care, mental health care, primary schools, and secondary schools. The I-Change model was used as a theoretical framework to organize the results. Many professionals believe they miss child abuse signs in their daily work, partially due to a lack of focus on child abuse. Further, professionals indicated having insufficient knowledge of child abuse, and lack communication skills to detect or discuss signs indicative of child abuse in conversations with parents or children. As for risk assessment, professionals barely use structured instruments even though these are regarded as very helpful in the decision-making process. Finally, professionals experience deficits in the cooperation with child welfare organizations, and in particular with Child Protective Services (CPS). Various directions for improvement were discussed to overcome barriers in child abuse detection and reporting, including developing tools for detecting and assessing the risk of child abuse and improving communication and information transfer between organizations.

Acute Vulvar Ulcer (Lipschutz Ulcer) in a Sexually Inactive 11-Yearold Girl

Non-sexually acquired genital ulceration, also known as Lipschutz ulcer, is a rare condition that typically occurs in prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even a sign of child abuse, causing great anxiety for patients and their families. It is often accompanied by systemic symptoms such as fever, myalgia, or lymphadenopathy. Several viruses such as Epstein-Barr virus, cytomegalovirus, and mumps virus have been associated with this entity. Furthermore, Mycoplasma pneumonia has rarely been linked to such ulcers in the literature. We present a case of Lipschutz ulcer in a sexually inactive 11-year-old girl.

The dark side of Paediatric dentistry: Child abuse

Background: Children who have been abused could exhibit lesions and diseases in their oral cavity and develop psychological consequences towards the dentist-patient relationship. Objectives: Analyse the oral lesions and diseases, the psychological consequences and understand the role of the dentist in the detection and notification of child abuse. Methods: Systematic review, according to PRISMA statement, with two search strategies in the MEDLINE/PubMed database. 19 publications were included after the application of selection and eligibility criteria. Results: Physical-abuse-related lesions and Münchausen syndrome are not pathognomonic; this requires the detection of indicators of suspicion. Physical-neglect diseases usually have associated other chronic health problems. Specifically, diseases related to sexual abuse are the oral infection caused by Treponema pallidum and Neisseria gonorrhoeae; while other lesions and diseases might only suggest abuse. The most frequent psychological sign of child abuse in the dentist-patient relationship is dental phobia. Typically, when detecting and notifying, dentist face the following barriers: insufficient information; fear of wrong suspicion; impact in the professional practice; fear of consequences on the minor; fear of violence against the dentist; lack of knowledge of necessary documents/procedures; fear of judicial statement. Conclusions: Child-abuse-related lesions and diseases often appear in the oral region. Dentists play a fundamental role in the detection and notification of those. It is essential to establish training and action protocols as well as reliance strategies in the patient-dentist relationship.

Child Safeguarding in Dental Practice – What you need to know

This paper aims to define the types of child abuse and how this may present to the dental team. It briefly outlines actions which should be taken if and when safeguarding concerns may arise. CPD/Clinical Relevance: The dental practice is an environment where signs of child abuse commonly present. It is both an ethical and legal duty for the dental practitioner to act appropriately in the protection of children attending the practice. Child safeguarding is one of the GDC's recommended topics for Continuing Professional Development.

Ring any alarm bells?

Safeguarding children is second nature. Here, we look at how to recognise the subtle signs of child abuse

Follow-up study regarding the medium-term effectiveness of the home-visiting program \u201cPro Kind\u201d at age 7 years: study protocol for a randomized controlled trial

BackgroundPro Kind is a German adaptation of the US Nurse Family Partnership program. It is an intervention based on home visits targeting first-time mothers from disadvantaged populations. Pro Kind was implemented as a randomized control trial from 2006 to 2012 with N = 755 first-time mothers (TG n = 394, CG n = 391). The 7–8-year follow-up aims to assess the mid-term effects of the program.Methods/designMid-term outcomes are being assessed by trained assessors. In a multimethod approach telephone interviews, on-site interviews, observations and developmental tests will be held in order to assess children’s and mothers’ life satisfaction, mental health, cognitive and social development, parenting behavior, signs of child abuse or neglect as well as the family’s socio-economic status. Furthermore, administrative data will be accessed to obtain information regarding the mother’s usage of pediatric health care, welfare usage and employment history.DiscussionResults regarding the mid-term effects of the intervention from the Pro Kind Follow-up will provide a scientific basis for future primary prevention programs as well as help stakeholders legitimizing early childhood investments.Trial registrationGerman Clinical Trial Registration DRKS-ID, ID: DRKS00007554. Registered on 11 June 2015, updated on 6 October 2017.

The role of dentist and forensic odontologist in oral and dental aspects of child abuse and neglect

Child abuse can take many forms like physical abuse, sexual abuse, emotional abuse and Munchausen’s syndrome. It is important to realize that dentist should be aware that such physical and sexual abuse may result in oral and dental injuries or conditions. This review is going to highlight the facts of child abuse and neglect that are overlooked and unnoticed in routine dental practice. Dentists are in an ideal position to detect signs of child abuse because 65% of all physical trauma associated with abuse occurs in the face or neck area. This paper lays emphases on such findings, their significance and to meticulously observe and document them. Furthermore, prominences on key steps in recognizing and reporting abuse while conducting and documenting interviews with the children and parents culminating with discreet cases of abuse related to dentistry

School nurse role 'compromised'.

School nurses have never been more vital, writes Anne Longfield in Nursing Children & Young People. These nurses are in a unique position to identify the early signs of abuse in children, as well as to offer a safe space to talk about sex, problems at home and mental health concerns, and the author questions why this aspect of their role is being compromised.

We need school nurses now more than ever.

School nurses are in a unique position to spot the early signs of abuse in children, but evidence suggests that this aspect of their role is being compromised.

Physical abuse: more certainty now?

Abstract There is now a strong evidence base for the characteristics of inflicted injury. Professionals within the multidisciplinary team and the courts are increasingly relying on other features such as the child's presentation to help determine whether child maltreatment has occurred. These features are somewhat subjective in nature, with little or no evidence to assist the clinician, particularly where there is uncertainty surrounding the possibility of child maltreatment. This paper will examine further evidence on the physical signs of child maltreatment, focussing on primary research on bruising, sentinel injuries, occult rib fractures and conditions that mimic physical injury such as the resurgence in the use of cupping as a remedy for childhood illness. It will also examine emerging evidence on a child's presentation, including history, response to injury and time to seek medical attention. If uncertainty surrounding the causation of an injury remains following advice and peer review, this must be acknowledged and stated unequivocally.

Child abuse and fabricated or induced illness in the ENT setting: a systematic review.

Child maltreatment is persistently under-recognised. Given that a third of maltreated children may return with serious or fatal injuries, it is imperative that otolaryngologists who are in frequent contact with children are able to detect maltreatment at first presentation. This review aims to identify ENT injuries, signs or symptoms that are indicative of physical abuse or fabricated or induced illness (child maltreatment). Systematic review. An all-language search, developed in Medline Ovid and consisting of 76 key words, was conducted of published and grey literature across 10 databases from inception to July 2015, for primary observational studies involving children aged <18years. Each relevant article underwent two independent reviews with full critical appraisal, applying strict quality standards. Of the 2448 studies identified and screened, 371 underwent full review, resulting in 38 included studies that detailed 122 maltreated children. Pharyngeal perforations (n=20) were the most frequent abusive ENT injury, predominantly affecting neonates and infants, presenting with dysphagia, drooling, haemoptysis and surgical emphysema. At least 52% of children with abusive pharyngeal injuries had additional co-existent injuries. The majority of ear injuries were inflicted to the external ear (n=11) and included auricular deformity, abrasions, petechiae, lacerations and burns. Fabricated or induced illness cases presented most commonly with recurrent, unexplained otorrhoea or ENT lesions that failed to heal despite appropriate therapy. All clinicians should be familiar with the signs of child maltreatment. Pharyngeal injuries, or injuries to the external ear, presenting in young children without an explicit history of witnessed injury should prompt a child protection referral for full evaluation. Likewise, children who present with recurrent, or apparently intractable symptoms and signs despite appropriate treatment, should raise the possibility of fabricated or induced illness, and discussion with a child protection specialist is advised. Early recognition of possible child maltreatment and instigation of appropriate safeguarding measures are essential to prevent repetition and escalation of injury. This is of paramount importance to otolaryngologists, who have the potential to identify these children in their practice.