Abusive head trauma/shaken baby syndrome Abusive head trauma (AHT)—also known as shaken baby syndrome, shaken impact syndrome, and inflicted traumatic brain injury— is used to describe a constellation of signs and symptoms (National Center on Shaken Baby Syndrome, n.d.). It usually occurs when a parent or caregiver forcibly shakes the baby, usually while the baby is crying inconsolably. The shaking causes acceleration and declaration of the brain against the skull because of the baby’s weak neck muscles, causing direct brain damage and rupture of blood vessels in the brain, which leads to hemorrhaging. AHT is primarily seen in children younger than 2, with peak incidence between 3 and 8 months (American Association of Neurological Surgeons, n.d.), AHT is the leading cause of death in child abuse cases in the United States (KidsHealth, 2015). The effects of AHT in children who survive include the following (American Association of Neurological Surgeons, n.d.): ● Partial or complete blindness.
The following are signs and symptoms of AHT (American Association of Neurological Surgeons, n.d.): ● Retinal hemorrhages. ● Skull fractures. ● Swelling of the brain. ● Subdural hematomas. ● Bruising around the head, neck, or chest. ● Cyanosis. ● Respiratory distress. ● Unequal pupil size. ● Inability to lift the head, to focus the eyes, or to track movement.
● Lethargy. ● Vomiting. ● Irritability. ● Poor sucking.
● Difficulty swallowing. ● Decreased appetite.
● Rigidity. ● Seizures. ● Diminished smiling or vocalizing.
● Developmental delays. ● Intellectual impairment. ● Cerebral palsy. ● Epilepsy or seizures. ● Paralysis. ● Intellectual disabilities.
Healthcare consideration: AHT frequently results in death and, in those children who survive, lifelong detrimental effects. It is imperative that social workers help parents and other caregivers develop child- raising skills, as well as assist them in finding ways to diminish stress.
SEXUAL ABUSE
Scenario 4 Eric is a single father raising three children alone after the death of his wife. His youngest child, 6-year-old Steven, was especially devastated by his mother’s death. Since her death, Steven has avoided his friends and is reluctant to be separated from his father. This has led to problems at school and problems interacting with his older brother and sister. Eric is relieved when new neighbors move into the house across the street. They are a young couple with two children close to Steven’s age. Steven seems to enjoy playing with the children and often talks about how nice their mother, Ellen, is. Eric is relieved that Steven seems to be “getting over” his mother’s death. One day, Eric realizes that Steven has left his backpack at the neighbor’s home, and the backpack contains the boy’s homework. Eric drops by to retrieve it. Ellen welcomes him and tells him to sit down in the family room while she finds the missing backpack. As Eric waits, he notices some papers on the floor underneath the sofa. He picks them up and realizes that they are photos. He idly begins to page through them. To his dismay, he notices that they are pictures of young children who are naked and posed in various sexual positions. One of the children is Steven. Eric realizes that Steven is the victim of sexual abuse.
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