Lecture 8- Violence Affecting Families

- bilateral retinal hemorrhage - subdural or subarracnoid hematomas - no other external signs of abuse - breathing difficulties, - seizures - dilated pupils - lethargy - unconsciousness

Symptoms of shaken baby syndrome

true

T/F Developmental crises have a degree of predictability.

True (easier to deal with because there is an electronic trail that provides proof to show parents, teachers, and/or even police)

T/F Effects of cyberbullying can be more far-reaching than those of traditional schoolyard bullying but is often easier to deal with

false (not predicted, expected, or planned)

T/F Situationsal crises have a degree of predictability.

true

T/F There is evidence that bullying and violence are linked

crisis theory

The body of knowledge that helps to explain why people respond in certain ways; it is useful to predict the phases that people will go through in a crisis of any kind.

delayed puberty, be gender nonconforming, have unique physical appearance, or be socially rejected and isolated

The child that is at high risk to get bullied

battered child syndrome; different viewpoint on child abuse as being something that could happen in "average families" and not just those with known psychopathic disorders.

The collection of injuries sustained by a child as a result of repeated mistreatment or beatings is _________; this lead to ________

depression; CVD; suicide; sexually transmitted disease; cancer

The effects of maltreatment of children lead to long-term conditions that include

prevent unintentional injuries and violence and reduce their consequences

The goal for Healthy People 2020 regarding injury and violence prevention

shaken baby syndrome

The intentional abusive action of violently shaking an infant or toddler, usually a child of 2 years or younger

child maltreatment

The leading cause of morbidity and mortality among children

promote trust, obtain needed specimen evidence, and treat the sexual abuse victim

The main things that a SANE nurse does for the vicium

relatives to the child

The majority of those committing ongoing sexual abuse and assault against children are who?

biological mother (most have mental illness and have been abused themselves)

The most common perp for Munchausen Syndrome by Proxy

United States Children's Bureau (USCB)

The orginization that became a model for other countries, with well-developed programs targeting infant mortality.

SANE nurse

The person who assisting the victim and appropriate family members immediately after the victim presents to the police or to an emergency department setting.

Amber Alert program and the Child Abduction Response Teams (CART)

The programs established to provide a prompt and professional response to child abduction.

human trafficking

The recruitment, harboring, transportation, provision, or obtaining of a person for compelled labor or commercial sex or for labor or services through the use of force, fraud, or coercion

Cyberstalking

The repeated pursuit of an individual using electronic or Internet-capable devices

The Youth Risk Behavior Survey

The resource that collects information about health and prevention issues of adolescents. Included in the survey are questions about violence risks such as fighting, use of illegal drugs, carrying a weapon, and being threatened or injured with a weapon on school property.

using whatever resources are available to him or her, in an effort to cope with the situation.

The way that the individual attempts to restore equilibrium

educational neglect

What type of abuse is this? 8-year-old may get to school only 3 days a week, possibly without breakfast and no lunch money or packed lunch

medical neglect

What type of abuse is this? Parents may refuse to buy eyeglasses for a child who needs them or to access dental care for severely decayed teeth

general neglect

What type of abuse is this? sparsely furnished apartment with very little food available and only intermittent heat and multiple people coming and going in the residence, while the children may appear at school unwashed and without coats in winter weather

emotional neglect

What type of abuse is this? when demands placed on a child are excessive or inappropriate for his or her development, or the caretaker berates or verbally humiliates a child frequently and without reason.

violence risks such as fighting, use of illegal drugs, carrying a weapon, and being threatened or injured with a weapon on school property.

What types of questions are asked in the youth behvaior survey?

minutes to hours after the injury (the baby begins to show symptoms such as irritability, lethargy, vomiting, breathing problems, seizures, or unconsciousness)

When do symptoms start to occur for shaken baby syndrome?

When some internal or external force disrupts our system's balance and alters functioning, a loss of equilibrium occurs--> and the individual cannot readily cope with the stressful event

When does a crisis occur?

If physical punishment is administered in anger, while the parent is under the influence of mind-altering substances or out of a sense of frustration

When does discipline cross the line into physical abuse?

usually takes place over some extended time period, and in most cases, the child does not readily disclose the abuse.

When does sexual abuse of a child usually take place and when is it disclosed?

Many minors find the attention from this stranger inviting or exciting and make plans to meet the person

When is the child at greatest risk for internet crimes?

Because of the invisibility of neglect and often attention of the proper authority is done only during the investigation of other forms of abuse or family issues

Why is child ceglect prevelence hard to estimate?

infantcide neoaticide

_____ is defined as the murder of a child during the first year of life, whereas ______ is the murder of an infant within the first 24 hours of life

baby was "fine" and then suddenly went into respiratory arrest or began having seizures

A typical explanation given by the parents or caretakers is that the baby in shaken baby syndrome

parents

The relationship that has the biggest sexual abuse perpetrator for children

sexual contact "without consent of the recipient"

When does sexual assulat occur?

Munchausen Syndrome by Proxy

A diagnosis applied to parents and other caregivers who intentionally feign, exaggerate, and/or induce illness or injury in a child to get attention from health professionals and others

Sexual Assault Response Team (SART).

A group who is responsibily fo obtaining the evidence and providing support to the victim and family after an episode of sexual abuse has been reported

National Survey of Child and Adolescent Well-Being (NSCAW)

A longitudinal study on the well-being of children who have encountered the child welfare system. It is taken to improve data gathering and information about violence toward children, as well as outcomes for these children.

situational crisis

A stressful, disruptive event arising from external circumstances that occur suddenly, often without warning, to a person, group, aggregate, or community.

domestic violence

A systematic pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks and economic coercion, that adults or adolescents use against their intimate partner

1. individual behavior 2. physical environment 3. access to services 4. social environment 5. societal- level factors

Healthy people 2020 5 Determinants that affect violence

child abuse

Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm

bullying

Any unwanted aggressive behavior (s) by another youth or group of youths, who are not siblings or current dating partners, involving an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated

staying with groups of other children or teens, having a cell phone, leaving an itinerary with the parents, and not changing their plans without contacting parents.

Beahviors to pormote to a teenager to prevent abduction

- withdrawn - alway tired - depressed - overly compliant - Over- or under reaction (hysteria or cavalier attitude) to a genital exam Poor hygiene or excessive bathing - Poor peer relations and social skills; inability to make friends - alcohol or drug abuse - Refusal to change clothes for physical education class - Fearful of showers or restrooms - Sudden acquisition of money, new clothes, or gifts with no reasonable explanation - Suicide attempt or other self-destructive behavior

Behavioral Indicators of Sexual Abuse in Older Children and Adolescents

- may be frightened or overprotective of parents - may be passive/ apathetic or excessivly aggressive and destructive - child and/or parent or caretaker attempts to hide injuries - child doesnt want to go home - clingy and forms indiscriminate attachments. - apprehensive when other children cry. - wary of physical contact with adults. - drastic behavioral changes in and out of parental/caretaker presence - seizures or vomminting

Behavioral Indicators that the child may display if they are getting Physically abused

threatened by the demands placed on them and have difficulty making the changes necessary to fit the new stage of development

How do people feel when a developmental crisis is occuring?

family member

Child abduction by a (stranger/ family member) is more commmon

filicide

Child murder by the parent

- keep child in seat of shopping cart - keep young child in sight at all times - Not putting the child's name or initials on clothing or backpacks - Teaching the child a "password" that only the parents and child know to use when someone is picking them up - Teaching children to recognize when they feel unsafe and get help - Making safety plans with children and having them practice getting help - teaching when it is and isnt okay to give personal info out

Community health nurses can help parents improve their child's safety by promoting close supervision of young children and practicing behaviors that promote anonymity. Ideas that help improve the child's safety include the following:

sexual eploitation

Conduct or activities related to pornography that depict minors in sexually explicit situations and promotion of prostitution by minors

a specific identifiable event that becomes too much for the usual problem-solving skills of those involved.

Crises are precipitated by...

positively; negatively; 4-8 weeks

Crises are resolved, either ____ or _____, within a brief period, usually ______

adaptive; maladaptive

Crisis resolution can be an _____ process in which growth and improved health occur, or it can be _______, resulting in illness or even death

- bullying - dating violence - sexual violence

Current Healthy People 2020 trends identified for youth

Trafficking Victims Protection Act (TVPA) of 2000

Human trafficking of children on a national and international scale is recognized by the United States in the....

- Enuresis - eating distrubances - fears/ phobia - compulsive behavior - change in school preformance - Age-inappropriate behavior that includes pseudomaturity or regressive behavior - cant concentrate - Frightened of parents/caretaker or of going home or being at home

Day-day Behavioral Indicators of Sexual Abuse in Younger Children

multiple crises

Different kinds of crises can overlap in actual experience, compounding the stress felt by the persons involved

The British Children's Act was passed in 1908, and the first White House Conference on Children

Early attempts to define a role for the state in the welfare of children.

- transition into parenthood - leaving home - marrying - retirement - starting school - entering into adolescenses

Examples of Developmental crises

• natural disaster • a baby grabs her mother's hot cup of tea and burns her chest; • a college student is raped in the library parking lot; • an older adult falls and fractures a hip; • a mother with a van full of Little League baseball players is involved in a traffic collision at a busy intersection; • or a hurricane devastates a state • dissease • unemployment • divorce

Examples of situational crisis

sexual abuse

Exposure of a child to sexual experiences that are inappropriate for his or her level of physical and emotional development, are coercive in nature, and are usually initiated for the purpose of sexual gratification

frequently adolescent, unmarried woman with an unwanted pregnancy, and who have received no prenatal care.

Factors most common in neoacide

Project Safe Childhood

Federal awareness and justice program focusing solely on technology-facilitated sexual exploitation and abuse against children

instant collaboration and partnership in the community to assist in the search and safe recovery of the child

Goal of amber alert

many cases are not investigated and death reports may not be classified as the result of abuse or homicide.

Identifying and gathering worldwide data about child abuse is difficult because...

incest

Ihe most hidden form of child abuse.

physical abuse

Intentional harm to a child by another person that results in pain, physical injury, or death.

Part of normal growth and development that can upset normalcy Precipitated by a life transition point Gradual onset Response to developmental demands and society's expectations

Major aspects of Developmental Crisis

Unexpected period of upset in normalcy Precipitated by a hazardous event Sudden onset Externally imposed "accident"

Major aspects of Situational Crisis

child maltreatment

Maltreatment toward a child under age 18 that may include physical, emotional, general neglect, medical or educational neglect, physical punishment or battering, emotional or sexual maltreatment and exploitation, or other exploitation that results in actual or potential harm to the child's health, survival, or dignity in the context of a relationship of responsibility, trust, or power

gradual; evolutionary rather than revolutionary.

Most family developmental crises have a (abrupt/gradual) onset. The change is ______ rather than ________.

- lacks medical or dental care - often sleepy or hungry - child is dirty/ inadequately dressed - poor or inadequate supervision for the child's age - conditions in the home are unsafe or unsanitary. - malnurished - child is depressed, withdrawn, or apathetic; exhibits antisocial or destructive behavior; shows fearfulness; or suffers from substance abuse or speech, eating, or habit disorders

Neglect may be suspected if one or more of the following conditions exist

- Sexually transmitted diseases, especially in prepubescent girls - Genital discharge or infection - Physical trauma or irritation to the anal/genital area - Pain during urination or defecation - Difficulty in walking or sitting due to genital or anal pain - Psychosomatic symptoms (stomach aches, headaches, chronic pain)

Physical Symptoms of Sexual Abuse

• Reduce homicides • Reduce child maltreatment deaths • Reduce the number of adolescents carrying weapons on school property during the past 30 days

Selected violence and abuse objectives for Healthy People 2020 include the following:

- way to detailed age inappropriate understanding of sex - sexually explicit language - Inappropriate, unusual, or aggressive sexual behavior with peers or toys - Compulsive indiscreet masturbation - Excessive curiosity about sexual matters or genitalia (self or others) - Unusually seductive or flirtatious behavior with classmates, teachers, and other adults - Excessive concern about homosexuality, especially by boys

Sexual Behavioral Indicators of Sexually Abused Children

- bloody/ torn/ satined undercloting - Knowledge that a child's injury/disease (vaginal trauma, sexually transmitted disease) is unusual for the specific age group. - discrepancies in explanation of injury; blame is placed on a third party; explanations are inconsistent with medical diagnosis - young girl is pregant (not always indicitive of abuse)

Signs of sexual abuse in the history of the patient

The adolescent exhibits depression, self-mutilation, suicide attempts, substance abuse, or sleeping and eating disorders

Signs that an adolescent child may be getting abused

emotional abuse

Type of abuse that involves psychological mistreatment or neglect, such as when parents do not provide the normal experiences that produce feelings of being loved, wanted, secure, and worthy

child neglect

Type of abuse that occurs when the physical, emotional, medical, or educational resources necessary for healthy growth and development are withheld or unavailable.

fatal maltreatment or accidental filicide

Type of filicide that is the most common when the child's death is an unintentional result from repeated abuse or Munchausen syndrome by proxy.

revenge filicide

Type of filicide that is the most rare when a parent murders the child as revenge toward the other parent, sometimes as a result of adultery

unwanted

Type of filicide when occurs when the child is unwanted and the parent feels the child is a hindrance.

altruistic filicide

Type of filicide when situation when the parent kills a child out of love, in the belief that the child's life or fate is worse than death; the parent may then commit suicide

acute psychotic filicide

Type of filicide when wherein the mother or father may suffer from delirium or psychosis and murder her or his child as a result of an unstable mental disorder.

Corporal punishment

Type of violence against a child as a form of discipline, was an acceptable form of discipline earlier in our country's history and is still condoned in some subgroups

developmental crisis

Types of crisis that is periods of disruption that occur at transition points during normal growth

insults, belittling, constant humiliation, intimidation, or threats of harm

Ways emotional abuse is given to the child

"I know someone ..." "What would you do if ... ?" "I heard something about somebody..."

Ways that childern may disclose information about sexual history indirectly by such statements as

- urging parents to discuss dangers or online friendships (sending photos, giving info, responding to people they dont know) - having a parent child contract for smartphone use - only permitting specific phone numbers for smartphone calls and regularly checking for deleted phone calls and texts - monitioring times and intrenet sites used - Keeping the computer in a high-traffic area in the home, - Installing a firewall, antivirus, and antiadware/spyware programs that increase privacy - have access and randomly check the childs device

Ways that the Community health nurses can assist families to prevent Internet crimes

child wears excessive layers of clothing, especially in hot weather; child is frequently absent from school or misses physical education classes if changing into gym clothes is required

Ways to try to hide physical injuries that parents or childern may use

peoples strong need to regain homeostaisis and intense nature of crisis

What contributes toward making the crisis a temporary condition that will not continue indefinitely?

the United States Children's Bureau (USCB) later known as the Child Welfare League of America

What did the first White House Conference on Children lead to?

behavioral changes and coping mechanisms beyond the abilities of the people involved

What do situational crisis require of a person usually?

self by injuring or inducing illness in his or her child.

What does the caregiver with Munchausen Syndrome by Proxy do to get attention?

passing himself off as a teen or young man who has similar interests, and states affection for and understanding of the youth's "problems."

What does the perp for Internet Crimes Against Children usually do?

individual's interpretation of the event, rather than the event itself (A situation that throws one person off course may merely create an interesting detour for another)

What is crucial for a person to consider something a crisis?

emotional (Some parents "shun" their children as a form of punishment. They will not speak to them and do not look at them; they behave as if their child does not exist)

What type of abuse is shunning?