Abuse Protection Support

Abuse Protection SupportDefinition identification of high risk dependent relationship and actions to prevent furtherInfliction of physical or emotional harm

Activities:

Identify adult(s) with a history of unhappy childhoods associated with abuse, rejection, excessive criticism, or feelings of being worthless and unloved as children

Identify adult(s) who have difficulty trusting others or feel disliked by others

Identify whether individual feels asking for help is an indication of personal incompetence

Identify level of social isolation present in family situation

Determine whether family needs periodic relief from care responsibilities

Identify whether adult at risk has close friends or family available to help with children when needed

Determine relationship between husband and wife

Determine whether adults are able to take over for each other when one is too tense, tried, or angry to deal

With a dependent family member

Determine whether child/dependent adult is viewed differently by an adult based on sex, appearance, or behaviorIdentify crisis situations that may trigger abuse such as poverty, unemployment, divorce, or death of a loved oneMonitor for signs of neglect in high-risk families

Observe a sick or injured child/dependent adult for signs of abuse

Listen to the explanation of how the illness or injury happened

Identify when the explanation of the cause of the injury is inconsistent between those involved

Encourage admission of child/dependent adult for further observation and investigation, as appropriate record times and durations of visits during hospitalization

Monitor parent-child interactions and resend observations, as appropriateMonitor for under reactions or overreactions on the part of an adult

Monitor child/dependent adult for extreme compliance, such as passive submission to hospital procedures monitor child for role reversal, such as comforting the parent or overactive or aggressive behavior

Listen attentively to adult who begins to talk about own problems

Listen to pregnant womans feelings about pregnancy and expectations about the unborn child

Monitor new parents reactions to infant, observing for feelings of disgust, fear, or unrealistic expectations

Monitor for a parent who holds newborn at arms length, handles him/her awkwardly, or ask forExcessive assistance

Monitor for repeated visits to a clinic, emergency room, or physicians office for minor problems

Monitor for a progressive deterioration in the physical and emotional care provided to child/dependentAdult in the family

Monitor child for signs of failures to thrive, depression, apathy, developmental delay, or malnutrition

Determine expectations adult has for child to determine if expected behaviors are realistic

Instruct parents on realistic expectations of child based on developmental level

Establish rapport with families with a history of abuse for long-term evaluation and support

Help families identify coping stressful situations

Activities:-contd

Instruct adult family members on signs of abuse

Refer adults(s) at risk to appropriate specialists

Inform the physician of observations indicative of abuse

Report any situations where abuse is suspected to the proper authorities

Refer adult(s) to shelters for abused spouses, as appropriate

Refer parents to parents anonymous for group support, as appropriateEncourage patient to contact police when physical safety is threatened

Inform patient of laws and services relevant to abuse

Abuse Protection Support: Child

Definition identification of high risk dependent child relationship and action to prevent

Possible or further infliction of physical, sexual, or emotional harm or neglect of basic

Necessities of life

Activities:

Identify mother who have a history of late (4 month or later) or no prenatal care

Identify parents who have had another child removed from the home or have placed previous children

With relatives for extended periods

Identify mother who have a history of substance abuse, depression, or major psychiatric illness

Identify parents who demonstrate an increased need for parent education (e.g. parents with learning problems, parents who verbalize feelings of inadequacy, parents of a first child, teen parents)Identify parents with a history of domestic violence or mother who has a history of numerous

Accidental injuries

Identify parents with a history of unhappy childhoods associated with abuse, rejection, excessive criticism, or feelings of being worthless and unloved

Identify crisis situations that may trigger abuse (e.g. poverty, unemployment, divorce, homelessness, and

Domestic violence)

Determine whether the family has an intact social support network to assist with family problems, respite child care, and crisis child care

Identify infants/children with high care needs (e.g. prematurity, low birth weight, colic, feeding

Intolerances, major health problems in the first year of life, developmental disabilities, hyperactivity,

And attention deficit disorders)

Identify caretaker explanations of childs injuries that improbable or inconsistent, allege self-injury,

Blame other children, or demonstrate a delay in seeking treatment

Determine whether a child demonstrates signs of physical abuse, including numerous injuries in variousStages of healing; unexplained bruises and welts; unexplained pattern, immersion, and friction, burns:

Facial, spiral, shaft, or multiple fractures, unexplained facial lacerations and abrasions human

Marks: intracranial, subdural, intraventricular, and intraocular hemorrhaging: whir lash shaken infant

Syndrome and diseases that are resistant to treatment and/or have changing signs and symptoms

Determine whether the child demonstrates signs of neglect including poor or inconsistent growth patterns.

Failure to thrive, wasting of subcutaneous tissue. Consistent hunger, poor hygiene, constant fatigue and

Listlessness, bald patches on scalp or other skin afflictions, apathy, unyielding body posture, and

Inappropriate dress for weather conditions

Determine whether a child demonstrates signs of sexual abuse, including difficulty walking or sitting:

Torn, stained, or bloody underclothing: reddened or traumatized genitals; vaginal or anal lacerations;

Recurrent urinary tract infections; poor sphincter tone; acquired sexually transmitted diseases;

Pregnancy; promiscuous behavior or prostitution; a history of running away, sudden massive weight

Loss or weight gain, aggression against self, or dramatic behavioral or health changes of undetermined

Etiology

Determine whether a child demonstrates signs of emotional abuse, including lags in physical

Development, habit disorders, conduct learning disorders, neurotic traits/psychoneurotic reaction,

Behavioral extremes, cognitive developmental lags, and attempted suicide

Encourage admission of child for further observation and investigation, as appropriate

Record times and durations of visits during hospitalizations

Monitor parent-child interactions and record observations

Determine whether acute symptoms in child abate when child is separated from family

Activities:-contdDetermine whether parents have unrealistic expectations for childs behavior or whether they have

Negative attributions for their childs behavior

Monitor child for extreme compliance, such as passive submissions to invasive procedures

Monitor child for role reversal, such as comforting the parent, or overactive or aggressive behavior

Listen to pregnant womans feelings about pregnancy and expectations about the unborn child

Monitor new parents reactions to their infant, observing for feelings of disgust, fear, or disappointment in gender

Monitor for a parent who holds newborn at arms length, handles newborn awkwardly, asks or excessive

Assistance, and verbalizes or demonstrates discomfort in caring for the child

Monitor for repeated visits to clinics, emergency rooms, or physicians offices for minor problems

Establish a system to flag the records of children who are suspected victims of child abuse or neglect

Monitor for a progressive deterioration in the physical and emotional state of the infant/child

Determine parents knowledge of infant/child basic care needs and provide appropriate child care information as indicated

Instruct parents on problem solving, decision making, and childrearing and parenting skills, or refer parents to programs where these skills can be learnedHelp families identify coping strategies for stressful situations

Provide parents with information on how to cope with protracted infant crying, emphasizing that they should not shake the baby

Provide the parents with no corporal punishment methods for disciplining children

Provide pregnant woman and their families with information on the effects of smoking poor nutrition, and substance abuse on the babys and their health

Engage parents and child in attachment-building exercises

Provide parents and their adolescents with information on decision making and communication skills and refer to youth service counseling as a appropriate

Provide older children with positive affirmations of their worth, nurturing care, therapeutic communication and developmental stimulation

Provide children who have been sexually abused with reassurance that the abuse was not their fault and allow them to express their concerns through play therapy appropriate for age

Refer at-risk pregnant woman and parents of newborns to nurse home visitation service

Provide at-risk families with a public health nurse referral to ensure that the home environment is monitored, that siblings are assessed, and that families receive continued assistance

Refer families to human service and counseling professional, as needed

Provide parents with community resource information that includes addresses and phone numbers of agencies that provide respite care, emergency child care, housing assistance, substance abuse treatment, sliding-fee counseling service, food pantries, clothing distribution centers, health care, human services, hot lines, and domestic abuse shelters

Inform physician of observations indicative of abuse or neglectReport suspected abuse or neglect to proper authorities

Refer a parent who is being bettered and at-risk children to domestic violence shelter

Refer parents to parents anonymous for group support, as appropriate