Sunday, May 22, 2011

A topic that needs to be spoken about more....

As someone who wishes to become a child psychologist/peds nurse child abuse is a topic that I have to be very aware of. Child abuse is not something that a lot of people talk about because they feel that it is not their place to bring up concerns they may have. However, it is their place to protect children.The paper below goes into more detail about abuse and its many forms.

There is a lot of information that a victim services provider needs to know. A service provider needs to know the stats about rape and child abuse. They need to know how to talk to young children, teens, and adults about the trauma they have been through. A service provider needs to know how to talk to the parents of a victim as well as those parents who are suspected to be abusive. It is important that service providers are taught how to handle situations effectively.

            In early history children were seen as property. They were headed by their fathers. We can see this in the medieval time. Kings would usually marry off their daughters to the biggest neighboring kingdom. They did this to ensure that they had a large number of subjects and so there would be no fighting between the two kingdoms. Infanticide (the killing of infants) has occurred since early times. It was a way for people to ensure that the strongest humans survived. It was a way for unwed mothers to “correct” their mistake. It was an acceptable way to control the population and make sure only the strong survived.

            Rape victims are encouraged to report the rape to the authorities. However, a lot of people do not report the rape because of the fear that they wont be believed. A rape victim is often re-victimized when the come forward. Once reported the victim will undergo a rape kit. This kit has 13 steps to it. At first they receive authorization from the victim. They will take a medical history and the information from the assault. The person who is performing the kit will collect the clothing  and place them into a clothing bags. They will collect debris from under the nails, collect hairs and fibers, do rectal, vaginal, and oral swabs and smears. The rape kit can be as traumatizing as the actual rape to the victim. The victim is asked to re-tell their story over and over. They may be interviewed by someone that does not believe the story they tell. The victim may be told that their rapist will go free because their story is not true or there wasn’t enough evidence. Going through all of this can re-traumatize them. A victim of LGBT sexual assault is even less likely than a victim of a hetero sexual assault to report the assault to the authorities. This is because if they report it they could be outed. It is perceived that caregivers and police are homophobic there for would treat the victim differently. The victim of a homosexual assault may fear that they will be seen as a traitor to the larger LGBT community. Often the assault is blamed on the victims sexual orientation. It is assumed that the sexual contact between homosexuals is always consensual. Where as that is not the case in reports of heterosexual assaults.

            When a victim provider is interviewing a child they need to keep their voice soft and comforting. It is important that they make they child feel comfortable and safe. The service provider should inform the parents of what the interview and rape kit will include before they are in the room with the child. They should give the tools they will use funny names to make them seem less scary to the child. When interviewing the child they should let the child draw or act out what happened to them if it is not too traumatic for the child. When they talk to the child they should get down on their level. This will allow the child to feel safer and not threatened. The service provider that is conducting the interview should like children and be good with them. The service provider should let the child ask any questions that they want and try to answer them to the best of there ability. They should also allow the parents to ask what ever questions they wanted before and after the interview. It is important that the service provider takes the concerns of the child and parents to the heart and show them that everything will be okay. 

            There are different types of abuse. Out of all of them psychological and emotional abuse is the hardest to define, isolate, and prove/ This form of abuse is said to underlie all other forms of abuse.. It is not an isolated event but instead it is a pattern of destructive behavior that could include: rejecting, isolating, terrorizing, ignoring, and corrupting. Emotional abuse, in my opinion is the most destructive form of abuse. It can cause long term emotional problems in the child.

            Sometimes the courts need to remove a child from their home and will require a child to be placed in foster care. Many times the parents may believe that they are cooperating with the social worker and the placement of the child will be short term. The separation can be very traumatic for the child and it may cause inner conflict for the child. Foster care can be a very unstable place for a child. They are unsure of where they will end up because a foster parent may request that the child be removed. In Foster care the child has to make a lot of adjustments. They have to adjust to the separation from their family, they may have a new school, new neighbors, and sometimes even a different culture. For this reason foster care is considered as a last resort. For this reason a social worker needs to be creative in placing and protecting a child. Sometimes removing the child is not it their best interest. When this is the case a social worker will try family preservation. Family preservation is one option that is preferred over removing the child. The exact reason for the removal of a child needs to be closely analyzed. Is the child in danger? Or will the removal hurt the child more than staying at home would? Steps need to be taken to insure that foster placement will provide the best therapeutic atmosphere possible. The biggest concern is what is best for the child.

            Many people believe that if someone was abused or neglected as a child they will abuse or neglect their own children. This, however, is a myth. People will not always abuse their children if they themselves were abused. It is also a myth that children who were abused will become deviant adults. For every inmate in a correctional facility who was abused as a child there may be 50 more that were abused but did not turn to crime. People who have been abused may exhibit many different things listed in the chart below.

Physical Abuse
Sexual Abuse
Difficulty Trusting others
Low self-esteem
Anxiety and fear
Physical problems
Inability to play
Low self-esteem
Impaired object relations
Lowered intelligence
Verbal inaccessibility
Difficulty with relationships
Perception of powerlessness
Difficulty trusting others
Anxiety and fears
Shame and guilt
Abuse of alcohol
Sexual problems

            In 93 percent of child sexual abuse cases, the victims know their abuser; and up to 88 percent of sexual abuse cases are never reported. It is alarming how many children are abused and are never believed. There are several warning signs that one needs to be aware of.  They are listed below.

Behavior you may see in a child or adolescent

  • Has nightmares or other sleep problems without an explanation
  • Seems distracted or distant at odd times
  • Has a sudden change in eating habits
    • Refuses to eat
    • Loses or drastically increases appetite
    •  Has trouble swallowing.
  • Sudden mood swings: rage, fear, insecurity or withdrawal
  • Leaves “clues” that seem likely to provoke a discussion about sexual issues
  • Writes, draws, plays or dreams of sexual or frightening images
  • Develops new or unusual fear of certain people or places
  • Refuses to talk about a secret shared with an adult or older child
  • Talks about a new older friend
  • Suddenly has money, toys or other gifts without reason
  • Thinks of self or body as repulsive, dirty or bad
  • Exhibits adult-like sexual behaviors, language and knowledge

Signs more typical of younger children

  • An older child behaving like a younger child (such as bed-wetting or thumb sucking)
  • Has new words for private body parts
  • Resists removing clothes when appropriate times (bath, bed, toileting, diapering)
  • Asks other children to behave sexually or play sexual games
  • Mimics adult-like sexual behaviors with toys or stuffed animal
  • Wetting and soiling accidents unrelated to toilet training

Signs more typical in adolescents

  • Self-injury (cutting, burning)
  • Inadequate personal hygiene
  • Drug and alcohol abuse
  • Sexual promiscuity
  • Running away from home
  • Depression, anxiety
  • Suicide attempts
  • Fear of intimacy or closeness
  • Compulsive eating or dieting

Physical warning signs

Physical signs of sexual abuse are rare.  If you see these signs, bring your child to a doctor.   Your doctor can help you understand what may be happening and test for sexually transmitted diseases.

  • Pain, discoloration, bleeding or discharges in genitals, anus or mouth
  • Persistent or recurring pain during urination and bowel movements
  • Wetting and soiling accidents unrelated to toilet training

To cope with the complex society children need more, or different, skills from the generations before them. Several basic and appropriate skills can be taught to children. Schools can teach the children to prioritize things to enable them to choose among tasks. Some schools teach their students that appropriate people to approach when a crisis occurs. Officers from the community give talks at schools to promote safety. Children are being educated on what do to during the crisis of being abused. There are three times of prevention, primary prevention, secondary prevention, and tertiary prevention.  Primary prevention is the effort to educate to public about how to prevent maltreatment. Secondary prevention consists of efforts directed toward high-risk populations. Tertiary prevention is the intervention to prevent the abuse or neglect from continuing. The quest for prevention should begin in schools. It can be hoped that if we teach the children are taught what abusive parents have never learned. The school can teach the child:

Life skill training

Preparation from parenthood

Self-protection training

Educational services for the community

Help for at-risk families

Schools today need to become more involved in the protection and education of children.

            Child abuse and any abuse for that matter needs to be stopped as soon as it is found out about. A child can die because someone did not come forward and report their concerns. If you know someone who is being abused or even if you have a concern please please report it. If you are being abused tell someone, a teacher, family member, church member or someone else that you trust. Abuse is not okay and you can get help.

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