According to the CDC, child abuse and neglect are serious public health issues and can have long-term effects on the victims. In the past year at least 1 in 7 children in the US have suffered child abuse and/or neglect. As startling as that number is, it likely isn’t a true representation of the frequency of child abuse occurrences, because a large number of cases go unreported.
Child abuse and neglect, however, are not a foregone conclusion or an unstoppable event. It can, in fact, be prevented, treated, and stopped in the cases where it is already taken place. Medical professionals, such as nurse practitioners, who provide primary care to a child, are in a unique position to help in preventing, treating, and intervening in child abuse/neglect cases.
According to the American Association of Pediatrics (AAP), because of their relationship with families throughout a lifespan, pediatric clinicians including family and pediatric nurse practitioners can be effective at preventing child abuse. This prevention can be accomplished when clinicians successfully promote “safe, stable, nurturing relationships and communities.”
In support of the goal of prevention, AAP provides several resources for medical professionals and families in recognizing and preventing child abuse. Those resources as well as references for child abuse prevention partner programs and resources can be found on the AAP site: https://www.aap.org/en/patient-care/child-abuse-and-neglect/.
An article published in Pediatrics, the official journal of the AAP details the triggers such as crying and toilet training accidents as well as other factors such as chronic illnesses or physical disabilities, that may place a child at risk for maltreatment, neglect, or abuse. This article also details several intervention and prevention programs that can assist in aiding the child and the family.
The complete article can be read here: https://publications.aap.org/pediatrics/article/126/4/833/65643/The-Pediatrician-s-Role-in-Child-Maltreatment. Additional resources including resources on treatment can be found here: https://www.aap.org/en/patient-care/child-abuse-and-neglect/resources-to-help-prevent-and-treat-child-abuse-and-neglect/.
In November 2018, Sherri Carson, a University of Arizona clinical instructor was named Pediatric Nurse Practitioner of the Year by the Arizona Chapter of the National Association of Nurse Practitioners. Because the US has no standardized screening process to identify early signs of child abuse, many cases are not identified. Hearing the statistics regarding missed child abuse cases in the emergency room, prompted Carson to seek to improve those statistics and change the lack of standardization.
Carson spent several years researching and developing a screening program that identifies child abuse signs early. The program has three major factors: a “validated screening tool” to determine if the injuries are consistent with abuse, the education of healthcare providers, and a standardized process to guide healthcare providers from the time of a child’s arrival at the care facility through the result of the screening.
The program has proven to be effective in helping identify more cases of child abuse in places where the program is implemented. Carson hopes that this will become a policy that will be implemented at all health care facilities.
These components of this program are applicable to all care settings including the practice of a nurse practitioner. Implementation of such could lead to the opportunity to intervene in cases of abuse.
Identifying the Signs
In order to intervene, and also as a part of health care provided education, which is a key aspect of Carson’s program, recognition of the signs of abuse is vital. Patricia M. Speck, DNSc, a board-certified family nurse practitioner explains the warning signs of child abuse.
Emotional abuse victims typically are fearful or anxious about doing something wrong as well as extremely withdrawn. They may also show extremes in behavior, such as being extremely compliant or demanding, or passive or aggressive.
Physical and sexual abuse often have signs that are more visible, such as frequent injuries, unexplained bruising, trouble sitting or walking, flinching, or always being on alert. They may also make efforts to avoid a specific person or place. Further elaboration on Speck’s instructions on how to prevent, spot signs of and report child abuse can be found here: https://www.uab.edu/news/youcanuse/item/9355-what-you-need-to-know-to-prevent-spot-signs-of-and-report-child-abuse.
It is clear that nurse practitioners both have made a difference and can continue to do so in the lives of those most vulnerable amongst us. In light of this, consider that this focus could be a launching point for your practice. Prevention, intervention, and treatment of child abuse cases are very real possibilities and very attainable goals.
Starting your practice may place you in a key position to make a significant difference in a child’s life. For more information and assistance in starting your practice, schedule an appointment with us today. Let Silver Leaf PMS help you get started. Let’s help those who cannot help themselves.
For more information about child abuse prevention, treatment and intervention visit the AAP page on Child Abuse and Neglect: https://www.aap.org/en/patient-care/child-abuse-and-neglect/. Also check out the factsheet, “What is Child Welfare? A Guide for Health Care Professionals.” https://www.childwelfare.gov/pubs/cw-healthcare/.