NCJ Number
58371
Journal
Clinical Symposia Volume: 29 Issue: 5 Dated: (1977) Pages: 2-36
Date Published
1977
Length
35 pages
Annotation
SUGGESTIONS FOR PHYSICIANS IN FORMULATING A MANAGEMENT PROGRAM FOR CASES OF CHILD ABUSE ARE PRESENTED IN THIS MONOGRAPH; RECOGNITION, DIAGNOSIS, REPORTING, AND DEVELOPING AWARENESS ARE EMPHASIZED.
Abstract
THE PROTECTION OF CHILDREN FROM ABUSE HAS SHOWN A MARKED LACK OF PROGRESS UNTIL RECENTLY. IN IMPLEMENTING A CLINICAL APPROACH TO IDENTIFICATION AND MANAGEMENT, IT IS ESSENTIAL THAT THE PHYSICIAN RECOGNIZE AND DIAGNOSE ABUSE; REPORT ABUSE TO APPROPRIATE STATE AGENCIES; RECOGNIZE FACTORS WITHIN THE FAMILY SUGGESTIVE OF POTENTIAL FOR ABUSE; DEVELOP A COMPREHENSIVE MANAGEMENT PROGRAM INVOLVING THE CHILD, PARENTS, AND AGENCIES; AND DEVELOP AN AWARENESS OF THE PROCEDURES INVOLVED IN ABUSE TREATMENT. SEVERAL FORMS OF CHILD ABUSE EXIST, OFTEN OCCURING IN COMBINATION: PHYSICAL ABUSE AND NEGLECT, SEXUAL ABUSE, AND EMOTIONAL ABUSE AND NEGLECT. DESPITE GROWING PUBLIC AWARENESS, THE TRUE DIMENSIONS OF CHILD ABUSE ARE AS YET UNKNOWN. THE NUMBER OF CASES PER YEAR IS THOUGHT TO RANGE FROM 70,000 TO FOUR OR FIVE MILLION; A MORE REALISTIC CALCULATION IS THAT 1.6 MILLION CHILDREN ARE ABUSED EACH YEAR AND OF THESE, 2,000 ARE KILLED. CHILD ABUSE IS A FAMILY AFFAIR AND MAY OCCUR IN THE FORM OF AN ISOLATED INCIDENT OR MAY BE CHRONIC. CHILDREN WHO ARE ABUSED USUALLY SHOW EXTREME OR INAPPROPRIATE BEHAVIOR FOR THEIR AGES; THE PHYSICIAN SHOULD NOTE SUCH CHARACTERISTICS, AS WELL AS PHYSICAL SIGNS, UPON EXAMINATION. IN ADDITION, CHARACTERISTICS OF PARENTS, SUCH AS IMMATURITY OR DEPRESSION, SHOULD BE NOTED, AS THEY ARE OFTEN INDICATIVE OF ABUSERS. THE PHYSICIAN'S ROLE IN MANAGEMENT OF CHILD ABUSE CASES SHOULD FOCUS UPON IDENTIFICATION OF THE ABUSED CHILD, TREATMENT, AND PREVENTIVE MEASURES. PARENTAL ATTITUDES UPON HOSPITAL ADMISSION, AND APPARENT DELAYS IN SEEKING TREATMENT ARE OFTEN REFLECTIVE OF THE SITUATION. IT IS THE PHYSICIAN'S RESPONSIBILITY TO BOTH TREAT THE CURRENT INJURIES AND TO EVALUATE THEIR ETIOLOGY WITHIN THE FRAMEWORK OF HISTORIES PROVIDED BY THE PARENTS. THE PHYSICIAN SHOULD ALSO PROVIDE EXTENSIVE EDUCATION IN BASIC CHILD CARE FOR THE POTENTIALLY ABUSIVE MOTHER, PROMOTE MOTHER-INFANT ATTACHMENTS, AND KEEP IN CONTACT WITH PARENTS AFTER THE BABY IS DISCHARGED FROM THE HOSPITAL. ABOVE ALL, THE PHYSICIAN'S ROLE IN DEALING WITH THE PROBLEM INVOLVES A PERSONAL COMMITMENT TO FINDING SOLUTIONS. DIAGRAMS, SKETCHES, AND REFERENCES PROVIDED. (LWM)