Child Abuse: Hurting the Most Vulnerable

It’s the unthinkable. According to the physician website UpToDate, between 700,000 and 1.25 million children are abused or neglected. Child abuse or maltreatment can be physical, emotional, sexual abuse or neglect. Closer to home, Washington County Department of Social Services reported 2,766 cases of threatening family conditions in fiscal year 2015-16.

Vicky Wright-Conner, RN, forensic nurse examiner, evaluates child abuse patients at Meritus Medical Center and trains other health care providers to know the signs and report suspected child abuse cases.

“We’re seeing more sexual abuse cases than physical abuse,” says Vicky. With three months left in the fiscal year, Vicky has recorded 82 cases of adult and pediatric abuse, 89 percent of the cases involved children under the age of 18.

The abused and the abusers

Young children are at greatest risk for child abuse with more than 27 percent age three or younger. Research indicates that boys and girls are equally mistreated and a child who is from an unplanned pregnancy or has a disability is at greater risk for abuse. Most often, victims know their abuser and the abuse occurs at home with 70 percent of children maltreated by a parent.*

The roots of child abuse

Child abuse may stem from several risk factors: a family history of maltreatment; drug and alcohol use; lack of parenting skills; a merry-go-round of caregivers in the home; and family stressors such as job loss, lack of financial resources or divorce. “A parent may have an unrealistic expectation; for example, expecting a newborn not to cry,” says Gail Callaway, M.D., pediatrician and internist, with Meritus Pediatric & Adult Medicine-Smithsburg. “Caring for little children can be incredibly overwhelming, especially if you’re not prepared for it.”

Regardless of the trigger, the effects of child abuse are cumulative, long-lasting and come at great cost to individuals and society.

Recognizing child abuse

Sudden changes in a child’s behavior can signal child maltreatment. Look for children who go from happy to sad, outgoing to withdrawn or the child who is rebellious or defiant. Frequent absences from school is another red flag. As a pediatrician, Dr. Callaway looks for injuries inconsistent with the caregiver’s story. “Physicians know when an injury is unrealistic or developmentally inaccurate,” says Dr. Callaway.

A neglected child may have poor hygiene, ill-fitting clothes and is often left alone without adult supervision or allowed to play in unsafe situations. A sexually abused child may have trouble sitting or walking or show interest in sexual activity beyond his or her age.

What you can do

Awareness lets professionals intervene to prevent further abuse. “People are talking about child abuse more,” says Vicky. “Children learn about child abuse in school and know that there’s help out there.”

“If you know a caregiver at risk, be specific on how you can help them,” says Dr. Callaway. If you suspect a parent is stressed out or having difficulties coping with parenthood, offer to babysit, listen to the parent’s concerns or suggest resources in the community. Simply offer to help and establish a relationship.

Contacting Child Protective Services is another way to intervene and remain anonymous. According to Vicky, you need only a suspicion to report the abuse. Hospitals are also safe havens for abused children. Forensic nurses like Vicky are trained to read the signs of child abuse, ask the right questions and work with law enforcement and social services to place the child in a safe environment. Resources within Washington County include:

Washington County Child Protective Services, 240-420-2222 (24-hour phone line).

Safe Place, the Washington County Child Advocacy Center, 240-420-4300.

Parent-Child Center, 301-791-2224.

Citizens Assisting and Sheltering the Abused (CASA), 301-739-8975.

*Source: Children’s Bureau (Administration on Children, Youth and Families, Administration for Children and Families) of the U.S. Department of Health and Human Services.