Healthcare BLS + First Aid

73 videos, 5 hours and 32 minutes

Course Content

Child Abuse and Neglect

Video 71 of 73
14 min 56 sec
English, Español
English, Español

Child abuse and neglect is a very serious topic and not one that anyone enjoys reading about. But it's vitally important, especially for those of you working in an industry mandated to report any suspicions of abuse and neglect.

Pro Tip #1: A mandated reporter is a person required by law to report reasonable suspicions of abuse and neglect, such as teachers, day care providers, EMS personnel, coaches, camp staff, and other professionals.

According to statistics from the U.S. Department of Health and Human Services, 679,000 children were the victims of abuse and neglect in 2013, and in that same year 1500 children died as a result.

Of those 679,000 child abuse victims, 80 percent suffered from neglect, 18 percent from physical abuse, and nine percent from sexual abuse. These numbers indicate a serious problem that has become far too common.

In this lesson, you'll learn the key indicators for recognizing abuse and neglect in children.

How to Recognize Abuse and Neglect

Child abuse is a prevalent problem that can occur anywhere, including:

  • Child day care centers
  • Schools
  • Religious institutions
  • Recreational and athletic facilities
  • Camps
  • Residential facilities
  • The child's home

What is Neglect?

Neglect by a parent or primary caregiver is the most prominent type of child abuse. It's defined as a failure to provide adequate food, clothing, shelter, supervision, or medical attention.

Indications of neglect include a child who …

  • Looks undernourished
  • Appears lethargic and tired
  • Has poor hygiene
  • Is inappropriately dressed for the weather
  • Sustains injuries due to lack of supervision
  • Has poor self esteem
  • Has trouble relating to others

What is Physical Abuse?

Physical abuse is defined as non-accidental physical injury to a child – by striking, shaking, throwing, burning, biting, cutting, etc.

Pro Tip #2: All kids get bumps and bruises from time to time, particularly those that are more adventurous or into sports. It's important for you to understand when those injuries occur due to abuse versus regular childhood mishaps.

Physical indications of physical abuse include:

  • Questionable bruises, cuts, and welts
  • Cuts and bruises to the torso, back, buttocks, and thighs
  • Injuries in various stages of healing, indicating abuse over time
  • Bruises shaped like the objects that were used – belt buckle, electrical cord, etc.
  • Burns like those from cigarettes, particularly on the soles of the feet, palms of the hands, back, and buttocks
  • Immersion burns like you would get from scalding hot water
  • Burns in the shape of irons, stove top burners, etc.
  • Rope burns, especially on the arms, legs, neck, and torso
  • Fractures
  • Black eyes

Behavioral indications of physical abuse include when the child is …

  • Uncomfortable with physical contact
  • Wary of adults
  • Apprehensive when other children cry
  • Emotionally unstable, aggressive one moment, withdrawn the next
  • Frightened of own parents
  • Afraid to go home – perpetually arrives to school early and stays late
  • Trying to hide the injuries – reluctant to change in front of others, wears clothes to conceal injuries

Pro Tip #3: Does the child have a history of running away from home? A child with a long history of repeated attempts to run away can also be cause for concern, particularly when combined with any other indicators of abuse.

What is the Difference Between Discipline and Abuse?

This comes up occasionally as corporal punishment (spankings and such) are still allowed in certain areas of the U.S.

What defines discipline? It is a learning process to teach appropriate behavior.

What defines abuse? Inflicting pain; that's it. There's no learning objective. It's usually the result of anger, frustration, and loss of control.

How Can You Tell the Difference Between Abuse and Accidental Injury?

As mentioned earlier, kids get hurt sometimes; it's part of being a kid. But sometimes it's much more than that. And while injuries from abuse and accident can look similar, there are some important differences you should know about.

  • When it comes to accidental cuts and bruises, the areas most affected are on the outside of the body, like knees and elbows. However, with abuse, the common areas are the stomach and buttocks.
  • As frequency goes up, the chances of accidental injury go down. Look for injuries, especially bruises, in different stages of healing, as in different colors. This may become a moot point if the child is a tackle football player.
  • Do the injuries resemble an object – like a wooden spoon or electrical cord – or appear in a pattern. These are pretty suspicious circumstances and most likely from an adult.
  • Has the parent or primary caregiver provided the same story as the child?
  • Does their relationship appear normal, or does the child appear afraid of the parent or caregiver?

What is Sexual Abuse?

Sexual abuse is a complex type of child abuse and is defined as any illegal sexual act upon a child including incest, rape, indecent exposure, fondling, child prostitution, and child pornography.

There are often no visible signs to accompany sexual abuse, or else they're too subtle to notice or attributed to something else. Add to that how the adult abuser is usually able to manipulate the child into silence and uncovering sexual abuse becomes even more difficult.

For the child, this sort of manipulation is beyond their scope of understanding. It's emotionally confusing. And it results in a wide range of emotional responses.

Indications of child sexual abuse include when the child has …

  • Inappropriate knowledge of sex
  • Sexually explicit drawings
  • An unexplained fear of a person or place or is attempting to avoid a familiar adult
  • Nightmares or sleep disruptions
  • Become withdrawn
  • Guilt and shame issues
  • Symptoms of depression and anxiety
  • Wild mood swings

Pro Tip #4: The best indicator is when a child says so. Take statements seriously. Resolve doubt in favor of the child. And err on the side of protection.

Three Ways Sexually Abused Children Share Their Experience

Because of the secrecy involved or the fact they're told something bad will happen, children who are sexually abused rarely tell anyone. They may, however, provide a mix of clues if you're paying attention.

Here are three examples of things a child suffering from sexual abuse may say.

  • Indirectly – My babysitter keeps bothering me.
  • Disguised – What would happen if a girl was being touched in a bad way and she told someone?
  • With strings attached – I'm having a problem, but if I tell you about it, you have to promise not to tell anyone.

When dealing with a child who has been sexually abused, listen, remain calm, and encourage the child to talk, but never press them. Be honest. Tell them the truth, which is that you may need to tell someone in order to get them the help they need.

If you ever suspect abuse or neglect, report your suspicion to local law enforcement or child protective services in your area. And if you're a mandated reporter, you have a legal responsibility to report.