● Difficulty or pain when sitting or walking. ● Sexually suggestive, inappropriate, or promiscuous behavior or verbalization. ● Sexual victimization of other children. Indicators of maltreatment ● Obvious malnourishment, listlessness, or fatigue. ● Stealing or begging for food. ● Lack of personal care such as poor personal hygiene, torn or dirty clothes. ● Untreated need for glasses, dental care, or other medical attention. ● Frequent absence from or tardiness to school. ● Child inappropriately left unattended or without supervision. ● The Child Welfare Information Gateway in its April 2019 publication What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms and the Mayo Clinic (2019) list the following symptoms that may indicate child abuse: ○ Regression : Children often regress to an earlier developmental stage if abused. For example, 8-year-old Amanda in Scenario 2 is observed sucking her thumb, a behavior associated with much younger children. ○ Developmental problems : Children may fail to thrive socially, emotionally, or academically. They may also demonstrate delayed physical development. ○ Speech disorders : Children may develop speech disorders such as stammers or lisps. ○ Problems with attachment : Children may be uncomfortable with physical contact or developing interpersonal relationships. ○ Changes in school performance : School performance may decline in children who are abused. ○ Changes in behavior : Children may become aggressive or isolate themselves from friends and activities. ○ Changes in emotional behavior : Children may become irritable and quick to anger. ○ Crying : Children may cry more often and more easily. ○ Behavior toward the abuser : Children display a tendency to avoid, go out of their way to please, or try to ingratiate themselves with the abuser.
Self-Assessment Quiz Question #3 What signs and/or symptoms of abuse does this scenario present, if any? (Select all that apply.) a. There are no signs of abuse. b. There are vague physical symptoms and unusual anxiety. c. Amanda is complaining of headaches and stomachaches and crying for no reason. d. Amanda will not let her mom out of sight and clings to her. Healthcare consideration: In addition to signs and symptoms of specific types of abuse, social workers must be alert to more general complaints that may also be caused by abuse (Mayo Clinic, 2019). Signs of developmental regression such as thumb-sucking in an 8-year-old or bed-wetting in older children may be stress related. All social workers must be prepared to evaluate the safety and well- being of all children they encounter in their professional practices. According to New York State’s Office of Children and Family Services, Child Protective Services (n.d.d), the following are the most common signs of abuse, though the list is not all inclusive, and not all children will display all the signs. Indicators of physical abuse: ● Injuries to the eyes or both sides of the head or body—accidental injuries typically affect only one side of the body. ● Frequently appearing injuries such as bruises, cuts, and burns, especially if the child is unable to provide an adequate explanation of the cause—these may appear in distinctive patterns such as grab marks, human bite marks, cigarette burns, or impressions of other instruments. ● Destructive, aggressive, or disruptive behavior. ● Passive, withdrawn, or emotionless behavior. ● Fear of going home or fear of parents. Indicators of sexual abuse: ● Symptoms of sexually transmitted diseases (STDs). ● Injury to the genital area.
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