Department Of Paediatric

And Preventive Dentistry

Seminar On: CHILD ABUSE

Submitted
4668923by
Anandhu Sudhakaran
180020305
CONTENTS
• Introduction
• Child Abuse
• Types Of Child Abuse
• Physical Abuse
• Battered Child Syndrome
• Indicators Of Child Abuse
• Emotional Abuse
• Types Of Emotional Abuse
• Indicators Of Emotional Abuse
• Sexual Abuse
• Indicators Of Sexual Abuse
• Munchausen Syndrome By Proxy
• Intentional Drugging Or Poisoning
• Shaken Baby Syndrome
• Prevention Of Child Abuse
• Conclusion
Introduction
• Child abuse has existed since the dawn of history.
• Religious sacrifice and abandonment of children are frequency
referred to in Greek and Roman mythology as well as in the bible.
• But only in the recent times that the changing social values have led
to the identification of child abuse as a widespread medico-social
problem nationally and internationally.
• This seminar is on child abuse and child neglect and also the ways to
prevent it.
Child Abuse
• Child abuse and neglect encompass a variety of experiences that are
threatening or harmful to the child and are the result of acts of commission
or omission on the part of the responsible caretaker.
• Child abuse refers to the intended, unintended and perceived maltreatment
of the child, whether habitual or not, including any of the following :
1. Psychological and physical abuse, neglect, cruelty, sexual and emotional
maltreatment.
2. Any act, dead or word, which debases, degrades or demeans the intrinsic
worth and dignity of a child as a human being.
3. Unreasonable deprivation of his or her basic needs for survival such as
food and shelter, or failure to give timely medical treatment to an injured
child resulting in serious impairment of his or her growth and development
or in his or her permanent incapacity or death.
TYPES OF CHILD ABUSE
• There are different types of child abuse:
1. Physical abuse
2. Emotional abuse
3. Sexual abuse
4. Munchausen syndrome by proxy
5. Intentional drugging or poisoning
6. Shaken baby syndrome
Physical Abuse
• Physical abuse can be defined as any act of which results in nom-
accidental trauma or physical trauma.
• It can also be defined as any act resulting in a non-accidental physical
injury, including not only intentional assault but also as the result of
unreasonable punishment.
• Unintentional or accidental injuries to the mouth are common and
must be distinguished from abuse by judging whether the history,
including the timing and mechanism of injury, is consistent with the
characteristics of the injury and the child’s developmental capabilities.
• It is the most visible form of abuse.
Battered Child Syndrome
• It is a severe form of physical abuse often successfully hidden b it’s
perpetrators.
• It is defined as the collection of injuries sustained by a child as a result
of repeated mistreatment or beating.
• If a child’s injuries indicate intentional trauma or appear to be more
severe than could reasonably be expected to result from an accident,
battered child’s syndrome should be expected.
• This syndrome was first described by Kempe in 1962.
Indicators Of Physical Abuse
1. Injury unusual for a specific age group(e.g. fractures in an infant)
2. Specific bruising patterns.
3. Injuries with poor explanations.
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4. Multiple injuries in different stages of healing.

Battered Child Syndrome

Emotional Abuse
• Emotional abuse can be defined as a systematic tearing down of
another human being.
• It can seriously interfere with the child’s positive development as it
attacks the child’s psyche and self-concept.
• These children have a low self-esteem and feel him or her to be
unworthy of love and affection.
Types Of Emotional Abuse
1. Rejecting :
• Parents who lack the ability to bond often display rejecting behaviour towards a child.
• They tell their child in a variety of ways he/she is unwanted.
• Eventually the child becomes the family scapegoat, being blamed for all the family problems.

2. Ignoring :
• Parents who have had a few of their emotional needs met are often unable to the needs of
their children.
• They may not show attachment to the child or provide nurturance.

3. Terrorizing :
• Parents may single out one child to criticize and punish.
• They may ridicule him/her for displaying normal emotions and have expectations far beyond
his/her normal abilities.
• The child may be threatened to death, mutilation or abandonment.
4.Isolating :
• A parent who abuses a child through isolation may not allow the child to engage in
appropriate activities with his/her peers, may keep the baby in his/her room or may
prevent teenagers from participating in extra curricular activities.

5.Corrupting :
• Parents permit children to use children to use drugs or alcohol.
• Parents who insist child to watch cruelty against animals.
• Parents who allow children to participate in criminal activities.
Indicators Of Emotional Abuse
1. Poor self-esteem, insecurity.
2. Destructive behaviour.
3. Angry acts.
4. Alcohol or drug abuse.
5. Difficulty in forming relationships.
Sexual Abuse
• Sexual abuse can be defined as the involvement of dependent,
developmentally immature children in sexual activities that they are
unable to give informed consent and which violates the taboos of the
society.
• Sexual abuse has the potential to interfere with child’s normal healthy
development, both emotionally and physically.
• These children experiences severe emotional disturbances from their
own feelings of guilt and shame.
• Exhibitionism, fondling and other sexual contact with children are also
considered sexually abusive.
Indicators Of Sexual Abuse
1. Compulsive masturbation.
2. Excessive curiosity about sex.
3. Difficulty in sitting or walking.
4. Pregnancy in early adolescence.
Munchausen Syndrome By Proxy
• In cases of Munchausen syndrome by proxy, a parent or caretaker
attempts to bring medical attention to themselves by injuring or
inducing illness in their children.
• Munchausen syndrome by proxy is defined as the intentional
production or feigning or psychological signs and symptoms in
another person who is under the individual’s care for the purpose of
assuming the sick role by proxy.
Diagnosis : The most difficult form of child maltreatment to identify and treat is
Munchausen syndrome by proxy.
The diagnosis of this factious disorder is based on the following
factors ;

1.Knowledge and awareness of the syndrome.

2.Warning signs and guidelines.
3.Characteristics of the perpetrator.
4.Characteristics of the father.
5.Characteristics of the child victim
Intentional Drugging Or Poisoning
• It can occur for many different reasons, and involves a variety of toxic
substances and have no classic clinical presentation.
• As in all cases of suspected child abuse, signs and symptoms that
remain unexplained by history should raise the possibility of poisoning.
• In the absence of obvious historical or physical clues, this diagnosis may
be overlooked.
• Such occurrences of non-accidental or drugging or poisoning of a child
in a household tends to recur.
• Hence, the need to remove the patient from the caretaker may be one
of the management options under such circumstances.
Shaken Baby Syndrome
• This syndrome was first reported by Guthkelch in 1971.
• This syndrome occurs primarily in children 18 months of age or younger.
• It is a form of child abuse where the infant’s head is shaken vigorously
forward and backward, hitting the chest and shoulders.
• It is most often associated with infants less than 1 year old, because their
neck lacks muscle control and their heads are heavier than the rest of their
body.
• In most of the cases of this syndrome, there will be any skull fractures and no
external signs of trauma.
• The shaking necessary to cause death or severe intracranial injury is never an
unintentional or non-abusive action.
Prevention Of Child Abuse
It is generally accepted that most effective strategy for
management of child abuse in it’s various forms is prevention. Some of
the measures are described below :
1. Dental professionals against violence (DPAV) :
• It was initiated by Californian Dental Association in 2001.
• It consists of both train-the-trainer and direct provider training
programs designed to assist dental professionals and their teams in
recognising and responding to child abuse and neglect.
2. Prevent abuse and neglect through dental awareness (PANDA) :
• The objective of PANDA is to ensure professionals and dental
auxiliaries about their role and responsibility in recognition,
reporting and prevention of child abuse and neglect.
Conclusion
• Every professional must understand the need for identification of
child abuse and neglect.
• Moreover, reporting to the concerned authority will help the child in a
great way.
• Cooperation of the health care professionals with the law
enforcement officials by providing as much information as possible
will help them in making the best informed decisions.
• Child abuse and neglect can be identified in a dental and the dental
practitioner and their auxillaries should be alert in identifying any
possible instances.
References
• Paediatric Dentistry Principles And Practices :M S Muthu, N Sivakumar
• Textbook Of Pedodontics : Shobha Tandon