Doctor's Notes on Child Abuse
Child abuse is a general term that means harmful behavior directed against a child. The following are examples of types of child abuse:
- Sexual abuse
- Neglect (physical and/or emotional)
- Physical abuse
- Mental abuse
- Failure to thrive
- Munchausen syndrome
The symptoms and signs vary with the type of abuse and the age of the child. However, many signs and symptoms can be shared by several types. For example, sexual abuse, pedophilia, and mental abuse may share symptoms of inappropriate knowledge of sexual acts for the child's age, isolation, behavioral changes, and depression. Physical abuse may show signs of cuts, bruises, burns, welts, hostility, and/or fear of adults, or fear of a particular family member. Neglect symptoms include a child wearing dirty, unwashed clothes, poor hygiene, and lack of apparent supervision. Failure to thrive (usually seen in infants) could include neglect symptoms plus extreme hunger. School-aged children may show general symptoms of aggression, hostility, regression (like bedwetting), and apathy that results in school problems. Teens may show signs of anxiety, isolation, depression, behavioral changes, and drug use. Munchausen syndrome is when a caregiver is actively causing or faking symptoms of their child to gain attention. Each person is different, so many of the signs and symptoms may overlap.
There are a number of leading causes of child abuse. Many child abuse problems have more than one cause and/or risk factors. The abuse results from a combination of individual, family, and social factors. Often the abuse problem occurs when a caregiver has one or more problems such as being poor, being the only caregiver, has drug or alcohol abuse problems, a history of violence, has mental problems, and/or a history of abuse. Treatments are individualized and ideally involve a medical caregiver, a non-abusing caregiver, and the child in a safe environment over time. The abuser may be treated separately. Law enforcement and/or a child protection agency may need to be involved in some instances for safety of the child and others.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.