children s health issues
Overview of Child Neglect and Abuse
Symptoms of Child Neglect and Abuse
The symptoms of neglect and abuse vary depending partly on the nature and duration of the neglect or abuse, on the child, and on the particular circumstances. In addition to obvious physical injuries, symptoms include emotional and mental health problems. Such problems may develop immediately or later and may persist. Sometimes children who are abused seem to have symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and are mistakenly diagnosed with that disorder. Physically neglected children may appear undernourished, tired, or dirty or may lack appropriate clothing and may be Failure to Thrive in Children . They may frequently be absent from school. In extreme cases, children may be found living alone or with siblings, without adult supervision. Unsupervised children may become ill or injured. Physical and emotional development may be delayed. Some neglected children die of starvation or exposure. Bruises, burns, welts, bite marks, or scrapes are some of the signs of physical abuse. These marks may have the shape of the object used to inflict them, such as a belt or lamp or extension cord. The children's skin may have handprints or round fingertip marks caused by slapping or grabbing and shaking. Cigarette or scald burns may be visible on the arms or legs or other parts of the body. Children who have been gagged may have thickened skin or scarring at the corners of the mouth. Patches of hair may be missing or the scalp may be swollen in children whose hair has been pulled. Severe injuries to the mouth, eyes, brain, or other internal organs may be present but not visible. However, signs of physical abuse are often subtle. For example, a small bruise or reddish purple dots may appear on the face, neck, or both. Children may have signs of old injuries, such as broken bones, which have already begun to heal. Sometimes injuries result in disfigurement. Toddlers who have been intentionally dunked into hot water (such as in a bathtub) may have scald burns. These burns may be located on the buttocks and may be shaped like a doughnut. Burns are not seen on skin that did not enter the water or that was pressed against the cooler bathtub floor. The splash of hot water may cause small burns on other parts of the body. Infants may have brain injury resulting from what is now called abusive head trauma (AHT). AHT is caused by violent shaking and/or hitting the child's head against a firm object. Abusive head trauma has replaced the term "shaken baby syndrome" because more than shaking may be involved. Infants who have AHT may be fussy or have vomiting, or they may have no visible signs of injury but appear to be sleeping deeply. This sleepiness is due to brain damage and swelling, which may result from bleeding between the brain and skull ( Subdural Hematomas ). Infants may also have bleeding in the retina (retinal hemorrhage) at the back of the eye. Ribs and other bones may be broken. Children who have been abused for a long time may appear fearful and irritable. They often sleep poorly. They may be depressed and anxious and have symptoms of Posttraumatic Stress Disorder (PTSD) . They are more likely to act in violent or suicidal ways. Changes in behavior are common signs of sexual abuse. Such changes may occur abruptly and may be extreme. Children may become aggressive or withdrawn or develop phobias or sleep disorders. Children who are sexually abused may show sexual behavior, such as touching themselves excessively, or touching others in ways that are not appropriate. Children who are sexually abused by a parent or other family member may have conflicted feelings. They may feel emotionally close to the abuser yet betrayed. Sexual abuse may also result in physical injuries. Children may have bruises, tears, or bleeding in areas around the genitals, anus, or mouth. Injuries in the genital and rectal areas may initially make walking and sitting difficult. Girls may have a vaginal discharge, bleeding, or itching. A sexually transmitted infection, such as Gonorrhea , In general, children who are emotionally abused tend to be insecure and anxious about their attachments to other people because they have not had their needs met consistently or predictably. Other findings vary depending on the specific way children were emotionally abused. Children may have low self-esteem. Children who are terrorized or threatened may appear fearful and withdrawn. They may be insecure, distrustful, unassertive, and extremely anxious to please adults. They may inappropriately reach out to strangers. Children who are not allowed to interact with others may be awkward in social situations and have difficulty forming normal relationships. Others may commit crimes or develop a Substance Use Disorders . Older children may not attend school regularly, may not do well when they attend, or may have difficulties in forming relationships with teachers and peers. Infants who are emotionally neglected commonly Failure to Thrive in Children and may seem unemotional or uninterested in their surroundings. Their behavior may be mistaken for Most victims of sexual abuse know their abuser. 