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CHILD ABUSE & NEGLECT: ESSENTIAL INFORMATION FOR PRACTICING & PRESIDING IN CHILD WELFARE CASES

CHILD ABUSE & NEGLECT: ESSENTIAL INFORMATION FOR PRACTICING & PRESIDING IN CHILD WELFARE CASES. KAREN T. CAMPBELL, MD FORENSIC PEDIATRICIAN MEDICAL DIRECTOR, CYFD/PS CO-MEDICAL DIRECTOR UNM CART. Incidence and Prevalence.

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CHILD ABUSE & NEGLECT: ESSENTIAL INFORMATION FOR PRACTICING & PRESIDING IN CHILD WELFARE CASES

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  1. CHILD ABUSE & NEGLECT:ESSENTIAL INFORMATION FOR PRACTICING & PRESIDING IN CHILD WELFARE CASES KAREN T. CAMPBELL, MD FORENSIC PEDIATRICIAN MEDICAL DIRECTOR, CYFD/PS CO-MEDICAL DIRECTOR UNM CART

  2. IncidenceandPrevalence • There wereapproximately a millionvictims of Child Maltreatment in2005 in the United States. • The rate of victimization in theUnited States is 12.1 children per1000 children.

  3. Further breakdown of statistics… • In the United States- • 54 % of the children suffered from neglect • 23% were physically abused • 12% were sexually abused. • Highest victimization rates were in the 0-3year age group.

  4. In New Mexico • The child population inNew Mexico was 489,482in 2005 • 32,950 childrenwere the subject of areport for abuse/neglectin 2005 • During the same year therate of substantiation was14.9 per 1000 children • 12 children died as aresult of abuse/neglectduring 2005

  5. Remember, every day inAmerica, four (4) childrendie as a result of abuseandneglect!

  6. INJURIES IN CHILD ABUSE

  7. Examples of ExternalInjuries • Contusions • Abrasions • Lacerations • Incisions • Thermal/Chemical/Scald Burns

  8. Examples of InternalInjuries • Fractures • Contusion • Laceration • Incision • Ischemia • Edema • Hemorrhage

  9. Common sites ofAccidentalInjuries • Forehead • Forearms • Elbows • Spinal Prominences • Hips / Iliac Crest • Knees • Shins

  10. Common sites of Non-AccidentalInjuries • Face • Ears • Neck • Upper Arms • Back • Chest and Abdomen • Upper legs • Buttocks • Genitalia

  11. Differentiating betweenAccidental and Non-AccidentalTrauma • Age and/or developmental capability of thechild • Parent/Caretaker explanation for how theinjury occurred • Type of Injury • Location of Injury • Risk Factors- • Infant/Child and Parent/Caretaker

  12. Child Abuse Work-up • History • Complete Physical Exam • Skeletal Survey • Head CT Scan • Bone Scan • MRI/MRA of the Head andNeck • Ophthalmology Exam • Chest/Abdominal CT Scan • Laboratory Studies • Genetics/Dysmorphology Consult

  13. ABUSIVE HEAD INJURY

  14. NORMAL RETINA

  15. Corner Metaphyseal Fracture

  16. FRACTURES

  17. PATTERNED INJURIES

  18. BURNS

  19. CONDITIONS MISTAKEN FOR CHILD ABUSE

  20. CHILD NEGLECT

  21. DEFINITION OF NEGLECT: • Historically, neglect has been difficult to define • Definitions have varied across states, disciplines, agencies, and individuals • Broadly stated, neglect is a condition where a child’s basic needs are not being met by their parent(s) or caretaker(s)

  22. TYPES OF NEGLECT: • Physical Neglect • Inadequate food and housing • Adult substance abuse • Domestic violence • Failure to Thrive (FTT) • Educational Neglect • Truancy and school absences • Non-approved home schooling • Emotional Neglect • Medical Neglect • Lack of appropriate Well Child Care and immunizations • Lack of appropriate medical care for acute and chronic medical conditions

  23. FAILURE TO THRIVE (FTT) • Growth failure from malnutrition • Drop of 2 or more standard deviations on a standard growth chart • Weight at less than the 3rd percentile • Can be “organic” or “non-organic” • Can be a combination of “organic” and “non-organic”

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