Introduction
One of the most acute issues that people face worldwide is child abuse. According to the information posted on the SafeHorizon website, “over 7 million U.S. children come to the attention of Child Protective Services each year according to a Children’s Bureau 2015 report” (“Child Abuse,” n.d., para. 1). Various types of child abuse include physical and sexual violence and emotional, educational, and physical neglect. At least four children die annually in America because of being exposed to any of the listed abuse types, which highlights the urgency and the need to address the concern (“Child Abuse,” n.d.). Medical evaluations are essential in helping young victims recover and be protected. The purpose of this paper is to review the different steps involved in determining neglect, physical abuse, and sexual abuse.
Determination of Child Abuse
Neglect
The first type of child abuse discussed in this paper is neglect. According to Harper and Foell (2023), this is the most prevalent form of kid violence that “refers to any action or failure to act which causes serious physical or emotional harm or death or puts the child at imminent risk for such harm” (para. 2). Since neglect can be manifested in a number of forms, a medical professional might need to assess various factors and characteristics.
Overall, obtaining the kid’s medical history is the first step made by the medical worker performing the examination. It is essential to interview the parent or carer and ask the child all relevant questions without the presence of the adult if the kid is verbal (Harper & Foell, 2023). When collecting the information, the practitioner learns whether the young patient is healthy and developed, their typical behavior, whether and how their basic needs are met, and what the relationship between the child and their caregiver is like (Harper & Foell, 2023).
Barriers to care, religious and cultural factors, the parent’s mental state, and the kid’s clothing and hygiene are also essential to be evaluated. Further, the practitioner screens for psychosocial risk factors, including the caregiver’s criminal and drug abuse history and other critical factors, and conducts a psychological assessment of both the child and their carer. A thorough physical examination then follows with a focus on the kid’s nutritional status, hair, mouth, nails and skin, and clothing.
Physical Abuse
Physical violence is the second type of child abuse to be explored in this paper. Research indicates that “the evaluation of suspected child abuse begins with obtaining a complete history, performing a physical examination, and observing the interactions between the parents/caregivers and the child” (Boos, 2023, para. 5). In most cases, first several hours of an evaluation are not enough for a practitioner to become sure that precisely physical abuse has occurred so that additional examinations might be needed.
Similar to suspected child neglect, alleged physical abuse requires obtaining a complete medical history, as well as the history of the identified trauma itself. The adult and child present at the assessment must be asked to describe and explain the abuse so that it can be documented (Safeguarding Board for Northern Ireland, n.d.). The medical professional decides whether informed consent from the carer is needed before offering privacy to the child.
When physical abuse is suspected, the practitioner also assesses the kid’s nutritional status, hygiene, general appearance, neglect or sexual violence signs, development, and emotional disturbance (Boos, 2023). Further, “lesions visible to the unaided eye” are evaluated and documented. Blood tests, X-rays, ophthalmological, dental assessment, orthopedic, and other assessments are ordered as required (Safeguarding Board for Northern Ireland, n.d., para. 5). The results are communicated to the relevant stakeholders, including social services and caregivers, if applicable.
Sexual Abuse
Lastly, it is essential to review the steps involved in the examination when child sexual abuse is suspected. The primary characteristic of sexual violence is that the child involved does not or cannot provide their consent, and sexual touching, intercourse, rape, sodomy, and fondling are included in this type of abuse (Cognata & Nazer, 2022). Physical examination is essential, and the practitioner decides whether HIV, pregnancy, and other tests are required.
In alleged sexual violence, timing is the key factor because an acute examination is performed if the young patient presents within 120 hours after the incident. This allows to collect forensic evidence and check for anal or genital injuries (Cognata & Nazer, 2022). However, if more time has passed, a nonacute evaluation is made. In both cases, medical history and information about sexual abuse are obtained accurately, and it is probably more important during the nonacute examination because of lacking evidence.
According to Bechtel and Bennett (2022), “the examination should include the mouth, breasts, genitals, inner thighs, perineal region, buttocks, and anus” (para. 5). Photographs of the found injuries might be taken if the caregiver and the child give their consent (“Pediatric Sexual Abuse Medical Examination,” n.d.). The assessment outcomes are reported to social services, and the practitioner provides their recommendations for treatment and rehabilitation.
Conclusion
To conclude, when child neglect, sexual abuse, or physical violence is suspected, some similar steps are performed during the medical evaluation. Thus, physical examination and obtaining a medical history from both the young patient and their caregiver, if relevant, are needed to determine all three types of abuse. Further, in alleged sexual abuse, the practitioner is unlikely to find evidence but focuses on the potential trauma to the anal and genital areas. To detect neglect, it is essential to assess all relevant factors, paying greater attention to what the child and their parent say. Finally, in suspected cases of physical abuse, the practitioner’s primary aim is to find and explain injuries.
References
Bechtel, K., & Bennett, B. L. (2022). Evaluation of sexual abuse in children and adolescents. UpToDate. Web.
Boos, S. C. (2023). Physical child abuse: Diagnostic evaluation and management. UpToDate. Web.
Child abuse. (n.d.). SafeHorizon. Web.
Cognata, A., & Nazer, D. (2022). Medical evaluations for child sexual abuse. Web.
Harper, N. S., & Foell, R. (2023). Child neglect: Evaluation and management. UpToDate. Web.
Pediatric sexual abuse medical examination. (n.d.). The Sex Abuse Treatment Center. Web.
Safeguarding Board for Northern Ireland. (n.d.). Medical assessment of alleged or suspected child abuse. Web.
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