|CURRENT Diagnosis & Treatment: Pediatrics|
Chapter 7. Child Abuse & NeglectAntonia Chiesa, Andrew P. Sirotnak
Sections: Prevention, Clinical Findings, Differential Diagnosis, Treatment, Prognosis.
Excerpt:"In 2008 an estimated 3.3 million referrals were made to child protective service agencies, involving the alleged maltreatment of approximately 6.0 million children. This translates to an approximate national referral rate of 44.1 referrals per 1000 children. The total number of children confirmed as maltreated by child protective services was 758,289 in 2008, yielding an abuse victimization rate of 10.3 per 1000 American children. This is the lowest victimization rate over the previous five year period. 1740 children were victims of fatal child abuse in 2008, resulting in a rate of 2.33 child abuse deaths per 100,000 children.
- Forms of maltreatment:
- Physical abuse.
- Sexual abuse.
- Emotional abuse and neglect.
- Physical neglect.
- Medical care neglect.
- Munchausen syndrome by proxy (medical child abuse).
- Common historical features in child physical abuse cases:
- Implausible mechanism provided for an injury.
- Discrepant, evolving, or absent history.
- Delay in seeking care.
- Event or behavior by a child that triggers a loss of control by the caregiver.
- History of abuse in the caregiver's childhood.
- Inappropriate affect of the caregiver.
- Pattern of increasing severity or..."
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