Child Abuse: Mitigation Strategies Report - Health and Society

This report delves into the multifaceted issue of child abuse, examining its various forms, prevalence, and the factors that contribute to its occurrence. It explores the significant impact of abuse on a child's physical, psychological, and social well-being, highlighting potential long-term consequences such as mental health disorders, behavioral issues, and difficulties in forming relationships. The report reviews relevant literature, including case studies and research articles, to provide a comprehensive understanding of the topic. It emphasizes the importance of early intervention and evidence-based approaches, such as person-centered strategies and family support programs, to improve the functional capacity of affected children and adolescents. Furthermore, the report outlines various mitigation strategies, including educational programs, family support services, and interventions aimed at reducing the risk of abuse. The report concludes with recommendations for healthcare professionals, social workers, and policymakers to address and prevent child abuse effectively.

Child abuse: Mitigation strategies
Word count 2238 excluding references
1

1.0. Introduction
Child abuse is a condition of enthusiastic, physical, financial and sexual abuse occasionally
observed in humans worldwide at an age of below 18 years. The developing risk of life and
the sensational changes occur due to economic conditions have assumed to be the major
contributing factor for expanding the vulnerability of towards the diverse forms of abuse
(Kiran, 2011). The abuse is an infringement and is an essential part for the privileges and it is
the result of an arrangement between familial, social, mental and financial elements. The part
of child misuse and human rights infringement is a standout amongst basic matters globally.
It was estimated that about 3.3-10 million kids are suffered each year to aggressive behavior
at home (Moylan et al., 2010). According to the reports, about 900,000 children were found
to be categorized as maltreated by either parents or caretakers (Moylan et al., 2010). The kids
who exposed to misuse are more prone to experience a broad range of untoward psychosocial
and behavioral attitude (Herrenkohl et al., 2008). In addition, the untoward experiences
developed during childhood are one of the risk factor for the development of diverse
psychiatric symptoms (Yang et al.,2013). In addition, the factors that potentiate abuse
symptoms include tobacco or cigarette smoking, excessive eating, drinking alcohol and drug
use.
The present paper describes the evidences of child abuse and its repercussions on health and
society. Emphasis was given for the case study pertaining to the development of abuse,
impact on Samuel health followed by possible recommendations to minimize the potential of
abuse.
2.0. Literature review
The supporting evidences that related to current context has been searched utilizing on-line
sources, magazines, articles with case studies and text books from library. The keywords used
for the online search include, potential impact of abuse, contributing factors for abuse and its
2

effect on child growth, risk in children and adolescents; interventions and risk management.
The web sources used for the search include Pub med, Springer link, Ingenta, Informa
healthcare, Science direct and Weily science. Precautions were taken to filter the search in
order to get relevant articles to the current context. The summary of search was described in
subsequent sections.
3.0. Potential impact of abuse on the development and wellbeing of the child
The humans at young age are in general moves around either parents or care-providers. The
care providers are the major source for the safety and wellbeing of children in terms of
affection, understanding and support (Daro & Dodge, 2009). The abuse damages the trust and
confidence on kid’s relationship with the society. In case of negative relationship, can
influence the individual’s ability to develop and maintain significant attachments throughout
life. Survivors experience conflictual associations and rambunctious lifestyles, frequently
report inconveniences forming adult intimate associations and the behavior showed that
undermine and bother comfortable associations. The long haul effect of misuse on child
wellbeing is extensive; a few studies demonstrate that, without regards to adequate support
the impact abuse can last a lifetime (Draper et al., 2008). The survivors of kids misuse exhibit
a poor emotional well-being, misery, poor physical wellbeing, and adolescence physical and
sexual misuse, expanded danger of medicinal illnesses, connections, disconnection and
behavioral wellbeing impacts. If the management of abuse is neglected, can lead to
depression, anxiety disorders, aggressive behavior, suicide attempts and eating disorders etc
(CDC, 2016).
4.0. Factors influencing child abuse
The factors that contribute for child abuse include parental factors, environmental factors and
child factors (Fraser et al., 2010). The parental factors include, has already abused a child,
being an abused parent; unsupported mother with low education; caregiver is detached and
3

has few backings; caregivers with mental issue. The ecological variables include
overcrowded, absence of chance to improve the income of family; family brutality and family
is encountering numerous burdens. The kids elements include infant is wiped out; kid has a
physical or formative handicap; kid is the result of a damaging relationship and absence of
connection amongst child and caregiver. However, the tendency of child abuse can be
minimized utilizing with educating the child and their caregivers. Nurses play an essential
responsibility in educating the patients to minimize the abuse. According to Fraser et al.,
(2010), the association between the characteristics of nurses towards practical skills, learning
of authoritative reporting obligation and attitude for child misuse and neglect. The nurses
with adequate training showed significant reduction in the symptoms of abuse (Fraser et al.,
2010).
4.1. Effect of abuse on normal and abnormal patterns of growth
The critical period of child is infancy as most of the organs are under development including
brain. The abuse can influence positive and the negative impacts of the outer environment
E.g., shaken child disorder, is an outcome of physical misuse (Al Odhayani et al., 2013) due
to damage of brain structure. The underlying mechanisms for such effect could be the high
levels of cortisol and catecholamine. The toddler age begins from second year, where the
child shows certain symptoms of stress and reaction towards emotional expression. Similar
developments could happen during preschool age along with certain developments for the
verbal bullying (Leeb et al., 2007). In contrast, girls develop ‘depression’ kind of symptoms
and pain at head and abdomen region due to the involvement of somatic nerves (Dehon &
Weems, 2010). The children with normal physiology and development show an interacting
behavior with peers during primary school stage. Whereas the children with abuse show poor
academic performance, attentively of listening, and substantial friendship. Adults with
normal developments did not show evidence of development of psychological disorders
4

(Fryers & Brugha, 2013). In contrast, the adults who had suffered from abuse may be
associated with depressive disorder, tension, or social withdrawal. In addition, adolescents
who live in violent circumstances tend to flee to what they see to be safer environments
(Bartlett et al., 2007). In the current case, the boy is 2 year old and appears to show some
kind of aggressive behavior.
4.2. Effect of physical, psychological, and sociological factors on health risks
The physical abuse refers to the harm to a child’s body. The physical wounds may be outside
(eg, a cut or seethe) or inside (eg, injured organs). There are diverse strategies for causing
physical misuse; for example, unequivocally shaking an infant tyke, hitting a tyke cutting a
youngster's skin, or blazing the skin with a hot actualize. The 2-year old boy in the current
study showed fracture to his right scapula, significant swelling and bruising over his right
shoulder indicates that he might have undergone for a physical abuse. As soon as the child
grows, the physical abuse can contributes for increase of risk of alcoholism (Norman et al.,
2012). Hovens et al., (2010) reported that the physical, emotional abuse and negligence of
individual contributes for the development of risk of anxiety disorders. The sociological
status for instance, low social interaction with either family or society can increase the risk of
abuse.
4.3. Evidence-based approach: Symptoms, functional status, and risk in children and
adolescents
The children with abuse behavior can show ‘guilty’ feeling and ‘phobia” towards expression.
They show withdrawal or isolation kind of tendency from the vicinity of humans, aggressive
behavior, psychological distress, misery, nervousness or abnormal fears or a sudden loss of
sufficient fearlessness. Reluctance in attending and leaving the school and even absence
without a valid reason. In addition other symptoms include suicidal attempts, certain physical
injuries (bruises and/or, fractures), and inappropriate sexual behavior for the child's age,
5

STDs, in adequate growth/weight gain, lack of hygiene, clothing etc. The symptoms so
associated in child can be carried to adult and even intensified symptoms could be observed
(Kemoli & Mavindu, 2014). There exists a risk of development of symptoms with age if the
symptoms are not addressed by medical intervention.
4.4. Person-centered approaches to maintain or improve the functional capacity of the
child or adolescent
The functional capacity of children and adults with abuse can be improved utilizing a person-
centered approach. The approach is one of the services offered by public child welfare
agency. The agency took about 24 x 7 days to respond to child misuse and neglect reports. As
a part of the procedure, the parents in case of child misuse or caregivers in case of adults are
required to take them to the designated state child welfare agency. Upon physical
examination, the agency settles on a strategy identified with the result of the investigation.
The initial care is considered to be transitory, giving a chance to alter in the conduct, social
supports, and in the vicinity of environment of the caregivers and/or the children’s conduct or
wellbeing status such that is sheltered to reunify the children with their families. According to
data (CCMR, 2014), the child welfare agency found that about 37% were on the basis of
‘neglect’, 15% of parental substance misuse; 13% of physical misuse; 7% of youngster's
conduct, 4% of abusive behavior at home, 4% of sexual misuse, 4% of adolescent equity
framework, 3% of relinquishment, 3% of therapeutic disregard, 3% of strength of guardian,
2% of wellbeing of tyke, 1% of enthusiastic abuse, and 0.4% of substance misuse of the tyke.
It indicates that there were a significant proportion of individuals with abuse. As a part of
mitigation strategy, the reports of child abuse should be reviewed to assess the extent of
abuse. In the current context, Samuel can be referred to child welfare agency to assess the
intensity of abuse and based on which the treatment can be initiated. A sequence of
interventions to be followed is shown in Table-1.
6

Table-1: List of interventions for the treatment of child abuse
Enhance the capabilities for earning
and to support the family
Strengthening family unit for money related security.
Enhancing the facilities to increase the revenue
Family-accommodating work strategies. Involvement
of family members to increase the work
Change social standards to bolster
guardians and positive child rearing
Establishing public training and education programs
Authoritative ways to deal with diminish flogging
Facilitate a education and quality of
care
Preschool enrichment with family engagement
Child rearing expertise and family relationship
approaches
Upgrade child rearing abilities to
advance sound development of child
Early adolescence home appearance
Child rearing ability and family relationship
approaches
Intercede to decrease hurts and
anticipate future danger
Increased first-line care
Upgraded essential education
Treatment to diminish damages of abuse
Treatment to counteract issue conduct and later
inclusion in viciousness
4.5. Evaluation for the effectiveness of risk management strategies
Various danger components are connected with tyke misuse including parental absence of
comprehension of kids' needs, kid improvement, or child rearing abilities. Poor guardian
child affiliation or negative correspondences and parental contemplations or emotions that
additionally reinforce misuse rehearse. Other contributing factors for abuse, family
brokenness or viciousness; parental history of abuse or disregard in the group of beginning;
substance abuse inside the family; social separation, neediness, or other financial weaknesses;
and parental stretch and trouble. The family chance elements incorporate social seclusion,
destitution and other financial detriments, personal accomplice viciousness, and poor parent–
child connections and adverse communications (CDC, 2016). Moyer, (2013) gave the result
of assorted studies relating to the adequacy of casualties of kids who got essential
consideration to forestall tyke misuse. It shows that one reasonable quality investigation of a
mediation gave in a clinical setting and 10 reasonable quality investigations of home visit to
control the kid misuse. The trial executed in a clinical setting assessed the Safe Environment
7

for Every Kid model, which incorporates hazard evaluation, doctor preparing, and assets for
guardians and doctors, and social work administrations for families fancying them.
5.0. Conclusions and recommendations
From the available sources, it indicates that diverse factors contribute for the development of
child abuse. Samuel appears to be belonging to a family with poor socioeconomic state. From
the health history view, the two-year-old boy is free of diseases. However, suddenly he
showed bruises on his upper arm indicates that he has developed physical abuse. Probably the
environment in which he was growing could be causing him to develop such abuse
symptoms. If he is untreated, can lead to an intensifying the symptoms of abuse. Therefore,
an immediate action is required to take for the management of abuse in children like Samuel.
The aspects of child and adult abuse were discussed. The causes of abuse should be identified
by appropriate diagnostic methods. More emphasis should be given for behavioral aspects as
they linked for the development of secondary symptoms such as psychological symptoms.
The behavioral aspects of the individual have to be corrected by providing an adequate
counseling to the children and caregivers to avoid the damage happen due to altered
psychology. The health workforce should maintain a good relation with patient and their
caregivers in order to make them in following the instructions. The government of respective
country has to take an initiation in educating the public utilizing audio and video
presentations. So that the common people can learn and understand the problems of abuse
and take enough precautions to minimize the harm. In addition, the implementation of
interdisciplinary approaches is needed among every one of the establishments sharing duty
regarding child violence so that the issue of savagery against children can be successfully
tended to and the number and seriousness of cases can be diminished. The medical students
and attendants should be better prepared in the subject, and doctors in the important claims to
fame general medicine, pediatrics, and trauma surgery need to be improved
8

References
Moylan, C. A., Herrenkohl, T. I., Sousa, C., Tajima, E. A., Herrenkohl, R. C., & Russo, M. J.
(2010). The effects of child abuse and exposure to domestic violence on adolescent
internalizing and externalizing behavior problems. Journal of Family Violence, 25(1),
53–63. http://doi.org/10.1007/s10896-009-9269-9
Kemoli, A. M., & Mavindu, M. (2014). Child abuse: A classic case report with literature
review. Contemporary Clinical Dentistry, 5(2), 256–259. http://doi.org/10.4103/0976-
237X.132380
Yang, B.-Z., Zhang, H., Ge, W., Weder, N., Douglas-Palumberi, H., Perepletchikova, F.,
Joel, G., & Kaufman, J. (2013). Child abuse and epigenetic mechanisms of disease
risk. American Journal of Preventive Medicine, 44(2), 101–107.
http://doi.org/10.1016/j.amepre.2012.10.012
Moylan, C., Herrenkohl, T., Sousa, C., Tajima, E., Herrenkohl, R., & Russo, M. (2010) The
effects of child abuse and exposure to domestic violence on adolescent internalizing
and externalizing behavior problems. Journal of Family Violence, 25(1), 53-63
Herrenkohl, T.I., Sousa, C., Tajima, E.A., Herrenkohl. R.C & Moylan, C.A. (2008)
Intersection of child abuse and children's exposure to domestic violence. Trauma
Violence Abuse. 9(2) 84-99.
Kiran, K (2011) Child abuse and neglect J Indian Soc Pedod Prev Dent. 29(6 Suppl 2), S79-
82.
Daro, D., & Dodge, K. A. (2009). Creating Community Responsibility for Child Protection:
Possibilities and Challenges. The Future of Children / Center for the Future of
Children, the David and Lucile Packard Foundation, 19(2), 67–93.
Draper, B., Pfaff, J.J., Pirkis, J., Snowdon, J., Lautenschlager, N.T., Wilson, I & Almeida,
O.P (2007) Long-term effects of childhood abuse on the quality of life and health of
9

older people: results from the Depression and Early Prevention of Suicide in General
Practice Project. J Am Geriatr Soc. 56(2), 262-71
Fraser, J.A., Mathews, B., Walsh, K., Chen, L & Dunne, M (2010) Factors influencing child
abuse and neglect recognition and reporting by nurses: a multivariate analysis. Int J
Nurs Stud. 47(2), 146-53
Al Odhayani, A., Watson, W. J., & Watson, L. (2013). Behavioural consequences of child
abuse. Canadian Family Physician, 59(8), 831–836.
Leeb, RT., Barker, LE & Strine TW (2007) The effect of childhood physical and sexual
abuse on adolescent weapon carrying. J Adolesc Health. 40(6), 551-8.
Dehon, C & Weems, C.F (2010) Emotional development in the context of conflict: the
indirect effects of interparental violence on children. J Child Fam Stud. 19(3), 287–97
Fryers, T., & Brugha, T. (2013). Childhood Determinants of Adult Psychiatric
Disorder. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 9, 1–
50. http://doi.org/10.2174/1745017901309010001
Bartlett, R., Holditch-Davis, D & Belyea, M (2007) Problem behaviors in adolescents.
Pediatr Nurs. 33(1), 13-8.
Hovens, J.G., Wiersma, J.E., Giltay, E.J., van Oppen, P., Spinhoven, P., Penninx, B.W &
Zitman, F.G (2010) Childhood life events and childhood trauma in adult patients with
depressive, anxiety and comorbid disorders vs. controls. Acta Psychiatr Scand.
122(1), 66-74.
Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The Long-
Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect:
A Systematic Review and Meta-Analysis. PLoS Medicine,9(11), e1001349.
http://doi.org/10.1371/journal.pmed.1001349
10

Moyer, VA (2013) Primary care interventions to prevent child maltreatment: U.S. Preventive
Services Task Force recommendation statement. Ann Intern Med. 159(4), 289-95.
CCMR (25-Mar-2014), Committee on Child Maltreatment Research, Policy, and Practice for
the Next Decade: Phase II; Board on Children, Youth, and Families; Committee on
Law and Justice; Institute of Medicine; National Research Council; Petersen AC,
Joseph J, Feit M, editors. New Directions in Child Abuse and Neglect Research.
Washington (DC): National Academies Press (US); The Child Welfare
System. Available from: http://www.ncbi.nlm.nih.gov/books/NBK195980/
CDC (6-Apr-2016) Child abuse and neglect: consequences Retrieved from
http://www.cdc.gov/violenceprevention/childmaltreatment/consequences.html
11