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Key Topics
- Requirement
- Solution
- Introduction
- Literature review
- Potential impact of abuse on the development and wellbeing of the child
- Factors influencing child abuse
- Effect of abuse on normal and abnormal patterns of growth
- Effect of physical, psychological, and sociological factors on health risks
- Evidence-based approach: Symptoms, functional status, and risk in children and adolescents
- Evaluation for the effectiveness of risk management strategies
- Conclusions and recommendations
- References
Requirement
Question: Child abuse Mitigation strategies
Solution
Introduction
Child abuse is a condition of enthusiastic, physical, financial and sexual abuse occasionally observed in humans worldwide at an age of below 18 years. The developing risk of life and the sensational changes occur due to economic conditions have assumed to be the major contributing factor for expanding the vulnerability of towards the diverse forms of abuse (Kiran, 2011). The abuse is an infringement and is an essential part for the privileges and it is the result of an arrangement between familial, social, mental and financial elements. The part of child misuse and human rights infringement is a standout amongst basic matters globally. It was estimated that about 3.3-10 million kids are suffered each year to aggressive behavior at home (Moylan et al., 2010). According to the reports, about 900,000 children were found to be categorized as maltreated by either parents or caretakers (Moylan et al., 2010). The kids who exposed to misuse are more prone to experience a broad range of untoward psychosocial and behavioral attitude (Herrenkohl et al., 2008). In addition, the untoward experiences developed during childhood are one of the risk factor for the development of diverse psychiatric symptoms (Yang et al.,2013). In addition, the factors that potentiate abuse symptoms include tobacco or cigarette smoking, excessive eating, drinking alcohol and drug use.
The present paper describes the evidence of child abuse and its repercussions on health and society. Emphasis was given for the case study pertaining to the development of abuse, impact on Samuel health followed by possible recommendations to minimize the potential of abuse.
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Literature review
The supporting evidences that related to current context has been searched utilizing on-line sources, magazines, articles with case studies and text books from library. The keywords used for the online search include, potential impact of abuse, contributing factors for abuse and its effect on child growth, risk in children and adolescents; interventions and risk management. The web sources used for the search include Pub med, Springer link, Ingenta, Informa healthcare, Science direct and Weily science. Precautions were taken to filter the search in order to get relevant articles to the current context. The summary of search was described in subsequent sections.
Potential impact of abuse on the development and wellbeing of the child
The humans at young age are in general moves around either parents or care-providers. The care providers are the major source for the safety and wellbeing of children in terms of affection, understanding and support (Daro & Dodge, 2009). The abuse damages the trust and confidence on kid’s relationship with the society. In case of negative relationship, can influence the individual’s ability to develop and maintain significant attachments throughout life. Survivors experience conflictual associations and rambunctious lifestyles, frequently report inconveniences forming adult intimate associations and the behavior showed that undermine and bother comfortable associations. The long haul effect of misuse on child wellbeing is extensive; a few studies demonstrate that, without regards to adequate support the impact abuse can last a lifetime (Draper et al., 2008). The survivors of kids misuse exhibit a poor emotional well-being, misery, poor physical wellbeing, and adolescence physical and sexual misuse, expanded danger of medicinal illnesses, connections, disconnection and behavioral wellbeing impacts. If the management of abuse is neglected, can lead to depression, anxiety disorders, aggressive behavior, suicide attempts and eating disorders etc (CDC, 2016).
Factors influencing child abuse
The factors that contribute for child abuse include parental factors, environmental factors and child factors (Fraser et al., 2010). The parental factors include, has already abused a child, being an abused parent; unsupported mother with low education; caregiver is detached and has few backings; caregivers with mental issue. The ecological variables include overcrowded, absence of chance to improve the income of family; family brutality and family is encountering numerous burdens. The kids elements include infant is wiped out; kid has a physical or formative handicap; kid is the result of a damaging relationship and absence of connection amongst child and caregiver. However, the tendency of child abuse can be minimized utilizing with educating the child and their caregivers. Nurses play an essential responsibility in educating the patients to minimize the abuse. According to Fraser et al., (2010), the association between the characteristics of nurses towards practical skills, learning of authoritative reporting obligation and attitude for child misuse and neglect. The nurses with adequate training showed significant reduction in the symptoms of abuse (Fraser et al., 2010).
Effect of abuse on normal and abnormal patterns of growth
The critical period of child is infancy as most of the organs are under development including brain. The abuse can influence positive and the negative impacts of the outer environment E.g., shaken child disorder, is an outcome of physical misuse (Al Odhayani et al., 2013) due to damage of brain structure. The underlying mechanisms for such effect could be the high levels of cortisol and catecholamine. The toddler age begins from second year, where the child shows certain symptoms of stress and reaction towards emotional expression. Similar developments could happen during preschool age along with certain developments for the verbal bullying (Leeb et al., 2007). In contrast, girls develop ‘depression’ kind of symptoms and pain at head and abdomen region due to the involvement of somatic nerves (Dehon & Weems, 2010). The children with normal physiology and development show an interacting behavior with peers during primary school stage. Whereas the children with abuse show poor academic performance, attentively of listening, and substantial friendship. Adults with normal developments did not show evidence of development of psychological disorders (Fryers & Brugha, 2013). In contrast, the adults who had suffered from abuse may be associated with depressive disorder, tension, or social withdrawal. In addition, adolescents who live in violent circumstances tend to flee to what they see to be safer environments (Bartlett et al., 2007). In the current case, the boy is 2 year old and appears to show some kind of aggressive behavior.
Effect of physical, psychological, and sociological factors on health risks
The physical abuse refers to the harm to a child’s body. The physical wounds may be outside (eg, a cut or seethe) or inside (eg, injured organs). There are diverse strategies for causing physical misuse; for example, unequivocally shaking an infant tyke, hitting a tyke cutting a youngster's skin, or blazing the skin with a hot actualize. The 2-year old boy in the current study showed fracture to his right scapula, significant swelling and bruising over his right shoulder indicates that he might have undergone for a physical abuse. As soon as the child grows, the physical abuse can contributes for increase of risk of alcoholism (Norman et al., 2012). Hovens et al., (2010) reported that the physical, emotional abuse and negligence of individual contributes for the development of risk of anxiety disorders. The sociological status for instance, low social interaction with either family or society can increase the risk of abuse.
Evidence-based approach: Symptoms, functional status, and risk in children and adolescents
The children with abuse behavior can show ‘guilty’ feeling and ‘phobia” towards expression. They show withdrawal or isolation kind of tendency from the vicinity of humans, aggressive behavior, psychological distress, misery, nervousness or abnormal fears or a sudden loss of sufficient fearlessness. Reluctance in attending and leaving the school and even absence without a valid reason. In addition other symptoms include suicidal attempts, certain physical injuries (bruises and/or, fractures), and inappropriate sexual behavior for the child's age, STDs, in adequate growth/weight gain, lack of hygiene, clothing etc. The symptoms so associated in child can be carried to adult and even intensified symptoms could be observed (Kemoli & Mavindu, 2014). There exists a risk of development of symptoms with age if the symptoms are not addressed by medical intervention.
Person-centered approaches to maintain or improve the functional capacity of the child or adolescent
The functional capacity of children and adults with abuse can be improved utilizing a person-centered approach. The approach is one of the services offered by public child welfare agency. The agency took about 24 x 7 days to respond to child misuse and neglect reports. As a part of the procedure, the parents in case of child misuse or caregivers in case of adults are required to take them to the designated state child welfare agency. Upon physical examination, the agency settles on a strategy identified with the result of the investigation.
The initial care is considered to be transitory, giving a chance to alter in the conduct, social supports, and in the vicinity of environment of the caregivers and/or the children’s conduct or wellbeing status such that is sheltered to reunify the children with their families. According to data (CCMR, 2014), the child welfare agency found that about 37% were on the basis of ‘neglect’, 15% of parental substance misuse; 13% of physical misuse; 7% of youngster's conduct, 4% of abusive behavior at home, 4% of sexual misuse, 4% of adolescent equity framework, 3% of relinquishment, 3% of therapeutic disregard, 3% of strength of guardian, 2% of wellbeing of tyke, 1% of enthusiastic abuse, and 0.4% of substance misuse of the tyke. It indicates that there were a significant proportion of individuals with abuse. As a part of mitigation strategy, the reports of child abuse should be reviewed to assess the extent of abuse. In the current context, Samuel can be referred to child welfare agency to assess the intensity of abuse and based on which the treatment can be initiated. A sequence of interventions to be followed is shown in Table-1.
Evaluation for the effectiveness of risk management strategies
Various danger components are connected with tyke misuse including parental absence of comprehension of kids' needs, kid improvement, or child rearing abilities. Poor guardian child affiliation or negative correspondences and parental contemplations or emotions that additionally reinforce misuse rehearse. Other contributing factors for abuse, family brokenness or viciousness; parental history of abuse or disregard in the group of beginning; substance abuse inside the family; social separation, neediness, or other financial weaknesses; and parental stretch and trouble. The family chance elements incorporate social seclusion, destitution and other financial detriments, personal accomplice viciousness, and poor parent–child connections and adverse communications (CDC, 2016). Moyer, (2013) gave the result of assorted studies relating to the adequacy of casualties of kids who got essential consideration to forestall tyke misuse. It shows that one reasonable quality investigation of a mediation gave in a clinical setting and 10 reasonable quality investigations of home visit to control the kid misuse. The trial executed in a clinical setting assessed the Safe Environment for Every Kid model, which incorporates hazard evaluation, doctor preparing, and assets for guardians and doctors, and social work administrations for families fancying them.
Conclusions and recommendations
From the available sources, it indicates that diverse factors contribute for the development of child abuse. Samuel appears to be belonging to a family with poor socioeconomic state. From the health history view, the two-year-old boy is free of diseases. However, suddenly he showed bruises on his upper arm indicates that he has developed physical abuse. Probably the environment in which he was growing could be causing him to develop such abuse symptoms. If he is untreated, can lead to an intensifying the symptoms of abuse. Therefore, an immediate action is required to take for the management of abuse in children like Samuel.
The aspects of child and adult abuse were discussed. The causes of abuse should be identified by appropriate diagnostic methods. More emphasis should be given for behavioral aspects as they linked for the development of secondary symptoms such as psychological symptoms. The behavioral aspects of the individual have to be corrected by providing an adequate counseling to the children and caregivers to avoid the damage happen due to altered psychology. The health workforce should maintain a good relation with patient and their caregivers in order to make them in following the instructions. The government of respective country has to take an initiation in educating the public utilizing audio and video presentations. So that the common people can learn and understand the problems of abuse and take enough precautions to minimize the harm. In addition, the implementation of interdisciplinary approaches is needed among every one of the establishments sharing duty regarding child violence so that the issue of savagery against children can be successfully tended to and the number and seriousness of cases can be diminished. The medical students and attendants should be better prepared in the subject, and doctors in the important claims to fame general medicine, pediatrics, and trauma surgery need to be improved
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Moylan, C. A., Herrenkohl, T. I., Sousa, C., Tajima, E. A., Herrenkohl, R. C., & Russo, M. J. (2010). The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. Journal of Family Violence, 25(1), 53–63. http://doi.org/10.1007/s10896-009-9269-9
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Kemoli, A. M., & Mavindu, M. (2014). Child abuse: A classic case report with literature review. Contemporary Clinical Dentistry, 5(2), 256–259. http://doi.org/10.4103/0976-237X.132380
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Yang, B.-Z., Zhang, H., Ge, W., Weder, N., Douglas-Palumberi, H., Perepletchikova, F., Joel, G., & Kaufman, J. (2013). Child abuse and epigenetic mechanisms of disease risk. American Journal of Preventive Medicine, 44(2), 101–107. http://doi.org/10.1016/j.amepre.2012.10.012
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Moylan, C., Herrenkohl, T., Sousa, C., Tajima, E., Herrenkohl, R., & Russo, M. (2010) The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. Journal of Family Violence, 25(1), 53-63
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Herrenkohl, T.I., Sousa, C., Tajima, E.A., Herrenkohl. R.C & Moylan, C.A. (2008) Intersection of child abuse and children's exposure to domestic violence. Trauma Violence Abuse. 9(2) 84-99.
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Kiran, K (2011) Child abuse and neglect J Indian Soc Pedod Prev Dent. 29(6 Suppl 2), S79-82.
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Daro, D., & Dodge, K. A. (2009). Creating Community Responsibility for Child Protection: Possibilities and Challenges. The Future of Children / Center for the Future of Children, the David and Lucile Packard Foundation, 19(2), 67–93.
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Draper, B., Pfaff, J.J., Pirkis, J., Snowdon, J., Lautenschlager, N.T., Wilson, I & Almeida, O.P (2007) Long-term effects of childhood abuse on the quality of life and health of older people: results from the Depression and Early Prevention of Suicide in General Practice Project. J Am Geriatr Soc. 56(2), 262-71
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Fraser, J.A., Mathews, B., Walsh, K., Chen, L & Dunne, M (2010) Factors influencing child abuse and neglect recognition and reporting by nurses: a multivariate analysis. Int J Nurs Stud. 47(2), 146-53
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Al Odhayani, A., Watson, W. J., & Watson, L. (2013). Behavioural consequences of child abuse. Canadian Family Physician, 59(8), 831–836.
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Leeb, RT., Barker, LE & Strine TW (2007) The effect of childhood physical and sexual abuse on adolescent weapon carrying. J Adolesc Health. 40(6), 551-8.
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Dehon, C & Weems, C.F (2010) Emotional development in the context of conflict: the indirect effects of interparental violence on children. J Child Fam Stud. 19(3), 287–97
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Fryers, T., & Brugha, T. (2013). Childhood Determinants of Adult Psychiatric Disorder. Clinical Practice and Epidemiology in Mental Health?: CP & EMH, 9, 1–50. http://doi.org/10.2174/1745017901309010001
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Bartlett, R., Holditch-Davis, D & Belyea, M (2007) Problem behaviors in adolescents. Pediatr Nurs. 33(1), 13-8.
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Hovens, J.G., Wiersma, J.E., Giltay, E.J., van Oppen, P., Spinhoven, P., Penninx, B.W & Zitman, F.G (2010) Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. controls. Acta Psychiatr Scand. 122(1), 66-74.
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Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis. PLoS Medicine,9(11), e1001349. http://doi.org/10.1371/journal.pmed.1001349
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Moyer, VA (2013) Primary care interventions to prevent child maltreatment: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 159(4), 289-95.
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CCMR (25-Mar-2014), Committee on Child Maltreatment Research, Policy, and Practice for the Next Decade: Phase II; Board on Children, Youth, and Families; Committee on Law and Justice; Institute of Medicine; National Research Council; Petersen AC, Joseph J, Feit M, editors. New Directions in Child Abuse and Neglect Research. Washington (DC): National Academies Press (US); The Child Welfare System. Available from: http://www.ncbi.nlm.nih.gov/books/NBK195980/
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CDC (6-Apr-2016) Child abuse and neglect: consequences Retrieved from http://www.cdc.gov/violenceprevention/childmaltreatment/consequences.html
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