Term
| Behavioral indicators of abuse |
|
Definition
- violent behavior
- aberrant behavior
- sexually related behavior
- parental behaviors associated with risk
|
|
|
Term
| behavior indicators: violent beheaviors |
|
Definition
- violence and sexuality in artwork, written schoolwork, language, or play
- violence against younger kids
- fire setting
|
|
|
Term
| Behavior indicators: aberrant behavior |
|
Definition
- self mulilation
- dissociative disorders
- acting out
- overly compliant
- pseudo mature
- repulsion or extreme fear when touched by adult
- excessive bathing
- fear of being along with adult
- fear of bathroom, showers
- sleep disturbance
- encorpresis, enuresis
- regressive behavior
- MDD
- suicide attempt
- problems with school concentration
- running away
|
|
|
Term
| behavioral indicators: sexually related behaviors |
|
Definition
- sexually victimizing younger children
- overt sexual acting out toward adults
- excessive masturbation
- detailed knowledge about sexual matters and adult sexual activity inappropriate for age
- hinting about sexual activity
- promiscuity
- prostitution
|
|
|
Term
| behavioral indicators: parental behavior |
|
Definition
- inappropriate expectation from child
- psychiatric impairment
- substance abuse
- domestic violence
|
|
|
Term
| non specific symptoms of sexual abuse in pre school age |
|
Definition
- failure to thrive
- excessive clinging behavior
- sleep disturbance
- encorpresis, enuresis
- changes in appetite or behavior
- vomit
- speech problems
- nail bitting
- thumb sucking
|
|
|
Term
| non specific symptoms of sexual abuse in school aged kids |
|
Definition
- sleep disturbance
- change in appetite
- decrease school performance
- fear states
- anxiety
- depression
- phobia
- obsession
|
|
|
Term
| Non specific symptoms of sexual abuse in adolescents |
|
Definition
- antisocial behavior, truancy, running away
- loss of self esteem
- depression
- psychosomatic complaints
- change in appetite
- assume parental role
- drug abuse
- promiscuity/prostitution
|
|
|
Term
| exams for suspected sexual abuse |
|
Definition
- frog leg position
- lithotomy position
- knee chest position
|
|
|
Term
| physical exam findings that can be considered definitive of sexual abuse |
|
Definition
- acute laceration of hymen
- bruising of hymen
- perianal lacerations extending deep to the external anal sphincter
- healed hymenal tissue
- sperm obtained from child body
- pregnancy
- positive gonorrhea test
- T. vaginalis in kid greater than 1 yr old
- Chlamydia in child greater than 3 yrs old
- syphillis not perinatally acquired
- HIV infection with nonsexual transmission ruled out
|
|
|
Term
| differential dx of acquired vs congential anogenital features |
|
Definition
- acquired
- straddle injury
- lichen schlerosis
- Behcet;s disease
- anogenital Streptococcal infection
- urethral prolapse
- Crohn's disease
- neurogenic patulous anus
- congenital
- linea vestibularis
- failure of midline fusion
- diastasis ani
- anal verge anatomy
|
|
|
Term
| reasons for delay in physical findins on sexual abuse |
|
Definition
- delay in exam (healing often rapid and complete)
- nature of molestation
- rape can occur without vaginal pentration, ejaculation, or damage to tissue
- many types dont leave physical findints
- elasticity of anogenital tissue
- hymen penetration may cause no visible trauma because of elasticity in older (pubertal) child
- anal spincter allow passage of stools larger than an erect penis
|
|
|
Term
| Role as a physician in suspected abuse |
|
Definition
- prevention
- early ID
- documentation
- mandatory reporting
- tx
- cooperation with outside agencies
|
|
|
Term
| how to report child abuse |
|
Definition
- report to protective service agency in jurisdiction of occurrence
- provide victim's and parent's names and DOM, address, phone number (number and names of siblings as well)
- explain what form of abuse you are reporting with as many details as possible
|
|
|
Term
|
Definition
- any act involving sexual molestation or exploitation of a child by parent or any other person with care or custudy/responsibility for supervision of child
|
|
|
Term
|
Definition
| any type of sexual activity not wanted or agreed to |
|
|
Term
| challenges for pre school age victims |
|
Definition
- verbal skills of child
- may have imaginary friends (credibility questioned)
- custody disputes)
|
|
|
Term
| challenges for school aged victim |
|
Definition
- are they lying?
- custody disputes
|
|
|
Term
| challenges for the adolescent victim |
|
Definition
- questions of consent
- sexually active
- other at risk behaviors
|
|
|
Term
| Studies show about history of sexual assault victims |
|
Definition
| history and physicals are normal in MOST |
|
|
