Emotional Assessment Findings Indicating Child Abuse. Child abuse and maltreatment are not limited to a particular age and can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups (infant, toddler, preschool, or school age) and discuss the types of abuse that are most often seen in this age. Discuss warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse.

Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. Identify two factors that increase the vulnerability of a child for abuse in the age group you have selected. According to the Centers for Disease Control and Prevention, child abuse is any harmful action or lack of action by a parent or caregiver that can cause physical harm, potential harm, or a threat of physical harm to a child. Child abuse can take four forms: physical abuse, sexual abuse, emotional abuse, and neglect (Falkner, 2022). Children under 2 have the highest risk of maltreatment, with over a quarter of victims falling in this age range (HHS, 2022). Physical abuse is more common in infants, and if an infant cannot move and has any injury, it is essential to consider the possibility of physical abuse. Evaluating and addressing the needs of infants can prove to be quite daunting as they have not yet developed their verbal abilities. With infants, excessive crying or developmental delay may indicate mistreatment. One such indication is the lack of bonding between the mother and baby, which could signal an increased likelihood of maltreatment in the future (Lyden, 2011). If an infant is unable to move and has any injury, it is essential to consider the possibility of physical abuse. Physical abuse can leave identifiable patterns that reveal the method of injury (Lyden, 2011). These patterns include bruising, bite marks, hand or shoe prints, and burn injuries in children. A skeletal survey should also be performed to check for fractures (Lyden, 2011). Another common physical abuse among infants is Shaken Baby Syndrome (AANS, 2023). Shaken Baby Syndrome is a serious injury that can occur up to two years of age. The symptoms resulting from generalized brain swelling caused by trauma may vary. They can occur right after the shaking and typically peak within 4-6 hours. Doctors can use CT scans or MRIs to diagnose it, as there may be no visible signs. A skeletal survey should also be performed to check for fractures (Lyden, 2011). Some traditional folk remedies, like Caida de Mollera in Hispanic culture, can cause injuries that resemble those seen in shaken baby syndrome (Hansen, 1998). This can lead to inaccurate accusations of child abuse. Caida de Mollera is a folk illness that occurs when an infant is abruptly taken off the nipple, causing suction that pulls the fontanel down. It can also occur from a sudden bump or fall. The folk remedy involves gentle maneuvers to restore the fontanelle's original position,

such as manually manipulating the palate, shaking the infant upside down, or applying poultices made from soap, eggs, or herbs. These methods are nonviolent and different from the violent shaking that causes Shaken Baby Syndrome. Various factors can increase the infant's risk of abuse or neglect (CDC, 2022). Some infants have special needs that can put extra strain on their caregivers. These needs may include disabilities, mental health challenges, and chronic physical illnesses. There is a potential risk to consider when dealing with a crying infant who cannot be soothed. Shaken Baby Syndrome occurs when a parent or caregiver shakes a baby out of anger or frustration, often because the baby will not stop crying (AANS, 2023). Parents who are stressed or have a history of domestic violence and substance abuse are likely to commit this type of abuse. In Minnesota, nurses must report maltreatment if they have witnessed it or have reason to believe that a child has been maltreated within the past three years (MDHS, 2023). Immediate reporting to one of the agencies is mandatory and should be done as soon as possible but within 24 hours. If the maltreatment occurs within a licensed facility regulated by the Minnesota Department of Human Services, the report is made to the Licensing Division's Central Intake line. The report is made to the local county social services agency or law enforcement for maltreatment within a family, in the community, at a family child care program, or in a child foster care home. Failure to report maltreatment is considered a misdemeanor, and nurses aware of or suspect it must report it. References: American Association of Neurological Surgeons (2023) Shaken Baby Syndrome. Retrieved from: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Shaken-Baby-Syndrom e