Child Abuse: Mitigation Strategies, Impacts and Recommendations

This report delves into the critical issue of child abuse, examining its multifaceted nature, potential impacts on children's health and well-being, and the broader societal consequences. The report begins by defining child abuse, highlighting its prevalence and the diverse factors that contribute to its occurrence, including parental, environmental, and child-specific elements. A comprehensive literature review synthesizes existing research on the effects of abuse on child development, mental health, and physical well-being, emphasizing the long-term repercussions. The report then analyzes the case of a two-year-old boy, Samuel, exhibiting signs of physical abuse, and explores the physical, psychological, and sociological factors contributing to health risks. It presents evidence-based approaches, including symptom identification and functional status assessment, and proposes person-centered interventions to improve the child's functional capacity. Furthermore, the report evaluates the effectiveness of various risk management strategies, such as family strengthening programs and early childhood interventions, drawing on empirical evidence from multiple studies. The report concludes with recommendations for mitigation strategies, emphasizing the importance of a multi-faceted approach involving healthcare professionals, social services, and community support systems to prevent and address child abuse effectively.

Child abuse: Mitigation strategies
Word count 2232 excluding references
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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 growing complexities of life
and the dramatic changes brought about by socioeconomic transitions have played a major
role in increasing the vulnerability of children to various and newer forms of abuse (Kiran,
2011). Child abuse is an infringement of the essential human privileges of a child and it is the
result of an arrangement of between familial, social, mental and financial elements. The
problem of child abuse and human rights infringement is a standout amongst the most basic
matters on the International Human Rights. It was estimated that about 3.3-10 million
children are exposed each year to domestic violence (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 children who exposed to child abuse are more likely
to experience a wide range of adverse psychosocial and behavioral outcomes (Herrenkohl et
al., 2008). In addition, the adverse childhood experiences are nonspecific risk factors for
multiple psychiatric disorders (Yang et al.,2013) and several health risk behaviors including
smoking, overeating, and excessive 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
effect on child growth, risk in children and adolescents; interventions and risk management.
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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 primary source for the safety and wellbeing of children in terms of
affection, understanding and support (Daro & Dodge, 2009). Child abuse damages the trust at
the center of a child’s relationship with the world. When the primary relationship is a
negative schema, can affect the individual’s capacity to establish and sustain significant
attachments throughout life. Survivors experience conflictual connections and clamorous
ways of life, frequently report troubles forming adult intimate connections and the attitudes
displayed that threaten and disturb cozy connections. The long haul effect of abuse on child
wellbeing is extensive; a few studies demonstrate that, without the right support, the effects
of childhood abuse can last a lifetime (Draper et al., 2008). Child abuse survivors
demonstrate a poor mental health, unhappiness, poor physical health, and childhood physical
and sexual abuse, increased risk of medical diseases, relationships, isolation and behavioral
health effects. 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; parent is isolated and has
few supports; parents with mental disorders. The environmental factors include overcrowd in
the house, poverty or lack of opportunity to enhance the earnings of family; family violence
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and family is experiencing multiple stresses. The child factors include baby is sickly; child
has a physical or developmental disability; child is the product of an abusive relationship and
lack of attachment between child and parent. However, the tendency of child abuse can be
minimized utilizing with educating the child and their caregivers. Nurses play an important
role in educating the patients to minimize the abuse. According to Fraser et al., (2010), the
relationship between nurse characteristics, training, learning of authoritative reporting
obligation and attitude on the reporting by nurses of different types of child abuse 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 effects of the external environment
E.g., shaken baby syndrome, is a result of physical abuse (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
(Fryers & Brugha, 2013). In contrast, adolescents who had experienced abuse may suffer
from depressive disorder, tension, or social withdrawal. In addition, adolescents who live in
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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 injuries might be
external (eg, a cut or smolder) or interior (eg, wounded organs). There are different methods
of inflicting physical abuse; for instance, unequivocally shaking a newborn child, hitting a
child cutting a child’s skin, or burning the skin with a hot implement. 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, depression, anxiety or unusual fears or a sudden loss of
adequate self-confidence. 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,
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
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(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 abuse and neglect reports. As
a part of the procedure, the parents in case of child abuse 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 change in the conduct, social
supports, and living environment of the parents 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 abuse; 13% of physical abuse; 7% of child's behavior, 4% of
domestic violence, 4% of sexual abuse, 4% of juvenile justice system, 3% of abandonment,
3% of medical neglect, 3% of health of parent, 2% of health of child, 1% of emotional
maltreatment, and 0.4% of substance abuse of the child. 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.
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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 childhood home visitation
Parenting skill 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
Numerous risk factors are associated with child abuse including parental lack of
understanding of children’s needs, child development, or parenting skills. Poor parent child
association or negative communications and parental considerations or feelings that also
bolster abuse practices. 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) provided the outcome
of diverse studies pertaining to the effectiveness of victims of children who received primary
care to prevent child abuse. It indicates that one fair-quality study of an intervention provided
in a clinical setting and 10 fair-quality studies of home visit to control the child abuse. The
trial executed in a clinical setting assessed the Safe Environment for Every Kid model, which
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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
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