Child Abuse Statistics and Definitions
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Questions and Answers

Of all child abuse fatalities, ____% were infants younger than 1 year old.

46.6

____% of all child abuse fatalities were children less than 3 years old.

70.6

What is the movement at 2 months?

Head up 45 degrees.

What is the movement at 4 months?

<p>Roll over and sit with support.</p> Signup and view all the answers

What is the movement at 6 months?

<p>Sit without support.</p> Signup and view all the answers

What is the movement at 9 months?

<p>Cruise.</p> Signup and view all the answers

What is the movement at 12 months?

<p>Walk.</p> Signup and view all the answers

Why is abuse so common under 12 months?

<p>Cannot speak for themselves, can be 'hidden' from society, may be too immature to have injured themselves.</p> Signup and view all the answers

What is important to evaluate in potential child abuse?

<p>It is absolutely crucial to understand an individual child's developmental ability when assessing an injury.</p> Signup and view all the answers

What are normal bruises in neonates?

<p>Some degree of bruising may be normal and not suggestive of physical abuse depending on the age and developmental ability.</p> Signup and view all the answers

Is a frenulum tear consistent with accidental injury?

<p>True</p> Signup and view all the answers

Do most kids who don't cruise bruise?

<p>True</p> Signup and view all the answers

Where are bruises found in babies that walk?

<p>All bruises were found on the front of the body and were located over bony prominences.</p> Signup and view all the answers

What else can cause bruising in young kids?

<p>Bleeding diathesis, childhood cancers.</p> Signup and view all the answers

What is a congenital dermal melanocytosis?

<p>Sometimes called a Mongolian spot, it is a very common birthmark that fades.</p> Signup and view all the answers

What is the bruising clinical decision rule (BCDR)?

<p>To identify discriminating bruising characteristics and to model those findings into a decision tool for screening children at high risk for abuse.</p> Signup and view all the answers

What is the TEN4 FACESp rule?

<p>T torso, E ears, N neck, 4 DOUBLE MEANING under four years of age and ANY BRUISING four months of age and younger, F frenula, A angle of the jaw, C cheek, E eyelid, S sclera, p patterned injuries.</p> Signup and view all the answers

Any bruising at all in an infant ____ months old and younger is suggestive of abuse.

<p>four</p> Signup and view all the answers

What does TEN stand for?

<p>Torso, Ear, Neck.</p> Signup and view all the answers

What does FACES stand for?

<p>Frenula, Angle of the Jaw, Cheek, Eyelid, Sclera.</p> Signup and view all the answers

What is a patterned injury?

<p>Lines around where a grip may be.</p> Signup and view all the answers

What is a sentinel injury?

<p>A relatively minor, but still suspicious, injury.</p> Signup and view all the answers

What happens when a sentinel injury is identified?

<p>Recognize the urgency for an ED visit and a workup for 'occult' injury.</p> Signup and view all the answers

What are challenges in evaluating sentinel injuries?

<p>Sometimes these injuries are not recognized and caregiver behavior can undermine recognition.</p> Signup and view all the answers

What is bias in child abuse cases?

<p>Race and intact families were big factors in missing an abuse case.</p> Signup and view all the answers

What is bias in recognition and reporting abuse?

<p>Studies have shown racial differences in the evaluation and reporting of children.</p> Signup and view all the answers

Study Notes

Child Abuse Statistics

  • 46.6% of child abuse fatalities involve infants under 1 year old.
  • 70.6% of fatalities are in children less than 3 years old.

Developmental Milestones

  • At 2 months: infants can lift their heads to a 45-degree angle.
  • At 4 months: infants can roll over and sit with support.
  • At 6 months: infants can sit without support.
  • At 9 months: infants can cruise.
  • At 12 months: infants can walk.

Vulnerability Factors

  • Infants under 12 months cannot communicate, making them more susceptible to hidden abuse.
  • Many may be too immature to sustain injuries independently.

Injury Assessment

  • Understanding a child's developmental ability is crucial in assessing potential abuse-related injuries.
  • Not all bruising in neonates is indicative of abuse; normal bruising depends on age and development.

Bruising Patterns in Infants

  • A frenulum tear is typically consistent with accidental injury.
  • Generally, children who do not cruise do not bruise.
  • Bruising in walking infants occurs primarily on the front of the body, especially over bony prominences, with no bruises on the back or diaper region.

Other Causes of Bruising

  • Conditions like bleeding diathesis and childhood cancers may lead to unexplained bruising.

Congenital Dermal Melanocytosis

  • Known as Mongolian spots, these are common birthmarks that fade, mostly occurring in Asian and Black children.

Bruising Clinical Decision Rule (BCDR)

  • A tool designed to identify bruising characteristics to screen children at high risk for abuse, known as TEN4-FACESp BCDR.

TEN4-FACESp Components

  • TEN stands for Torso, Ear, Neck with associated risks of bruising.
  • FACES details specific areas: Frenula, Angle of the Jaw, Cheek, Eyelid, Sclera, and patterned injuries which may indicate abuse.

Sentinel Injuries

  • Minor injuries in non-mobile infants that are suspicious of abuse and can serve as indicators for potential future harm.
  • High prevalence of sentinel injuries in abused children (27.5%), with 80% being bruises.

Response to Identified Sentinel Injuries

  • Immediate assessment and thorough examination in the hospital.
  • Conduct a full skeletal survey and neuroimaging for injuries not immediately visible.

Challenges in Recognizing Sentinel Injuries

  • Injuries may be overlooked or misinterpreted due to bias or caregiver behaviors.
  • Some caregivers may downplay injury significance or repeatedly seek care for the injured child.

Bias in Child Abuse Cases

  • Racial and family structure biases can lead to missed abuse cases.
  • Higher rates of missed abuse in white children (37.4%) compared to non-white (19%).
  • Children from intact families show a higher missed rate (40.2% compared to 18.7% in non-intact families).

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Description

This quiz covers important statistics and definitions related to child abuse, focusing on age-related fatalities and developmental milestones. Test your knowledge on the critical facts surrounding child abuse and its impact on vulnerable populations.

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