May 25, 2015

Dr. Gellner: It's hard to imagine someone intentionally hurting a child, yet nearly a million children are abused every year just in the United States alone. Child abuse is today's topic on The Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kid Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Child abuse happens when a parent or other adult causes serious physical or emotional harm to a child. Child abuse can take the forms of physical abuse, sexual abuse, neglect and abandonment, or emotional or psychological abuse. The most serious cases of child abuse can end in death. Those who survive may suffer emotional scars that can linger long after the physical bruises have healed. Kids who are abused are more likely to have problems building and maintaining relationships throughout their lives and they are also more likely to have low self-esteem, depression, and thoughts of suicide.

When people think of child abuse their first thought is of physical abuse, such as striking, kicking, or shaking a child. But physical abuse can also include holding a child underwater, tying a child up, intentionally burning a child with scalding hot water or other objects like cigarettes, using an object to beat a child, starving a child, or failing to provide a child with food intentionally. Abusive head trauma or Shaken Baby Syndrome is a specific form of child abuse and is the leading cause of death in child abuse cases in the United States. Most incidents last just a few seconds but that's enough time to cause brain damage and kill a baby.

Sexual abuse happens when a child is raped or forced to commit a sexual act. It's also any sort of sexual contact with a child that is meant to sexually arouse the abuser. So in addition to having sex with a child or even just inappropriate touching with a child, sexual abuse includes making a child pose or perform for pornographic pictures or videos, showing a child pornographic material, forcing a child to undress, not just normally like changing your clothes, but forcing a child to undress in front of you for gratification purposes, and flashing a child or showing one's privates.

Neglect is any action or inaction on the part of a caregiver that causes a child physical or emotional harm such as withholding food, withholding warmth in cold weather, or not providing proper housing. Basically anything that interferes with a child's growth and development constitutes neglect. This also includes failing to provide medical care when a child is injured or critically sick, locking a child in a closet or a room, and placing them in a dangerous situation that could lead to physical injury or death. Abandonment is a type of neglect.

Emotional abuse or psychological abuse is a pattern of behavior that has negative effects on a child's emotional development and sense of self-worth. Ignoring a child or withholding love, support, or guidance is considered emotional abuse. Just like threatening, terrorizing, belittling, or constantly criticizing a child.

Child abuse due to substance abuse problems include allowing a child to drink alcohol or take illegal drugs, manufacturing, ingesting, or distributing illegal drugs in the presence of a child, and in some states, exposing a fetus to illegal drugs or other substances while pregnant.

It would be easier if all child abusers followed a pattern and were easy to recognize, but the truth is that child abusers come from all walks of life. It's also sometimes difficult to tell the difference between ordinary scrapes and scratches of childhood and a physical sign of child abuse. Pediatricians often can tell the difference but not always.

Some ways that kids who are being abused might act include sad or angry, they may act withdrawn, fearful, have low self-esteem, or engage in self-harm, and many have persistent nightmares. Those who are abused usually have trouble developing and maintaining relationships. They are often unable to love or trust others, especially adults with whom they can be afraid of. A telling sign that something is just not right is when a child fails to seek comfort from a parent or other caregiver who happens to be their abuser.

Kids who are abused sometimes act out. They may lose interest in activities they once loved. They may turn to drug and alcohol abuse as well as sexual promiscuity. Other kids might not act out in the typical ways but will avoid going home after school or doing any activity that would cause them to spend time alone with the abuser. But just because a child is showing these signs doesn't necessarily point to abuse. Children who are going through stressful situations, like a parent separation or divorce, a family move, or the loss of a friend or family member, may also may undergo changes in their mood or disposition.

So what should you do if you suspect some child that you know is being abused? Remember that abuse is not a private family matter, although it most often occurs within families and is often kept as a family secret. Once you suspect child abuse, you need to act to protect the child from further possible harm.

It is your responsibility to contact your local child protective services agency, police, hospital, or emergency hot-line. You may remain anonymous. Pediatricians, by law, are required to call child protective services if there is any concern that a child has been abused. If you think you may have abused your own child or you're worried that you might make sure the child is somewhere safe away from you. Speak to a trained professional and that can be an effective way to work through the reasons behind your abusive feelings.

If you suspect that someone you know is abusing a child, keep the child away from that person until authorities have been notified. Never threaten a person or take the law into your own hands. Let the legal system decide an appropriate punishment for the abuser.

Pediatricians recommend that children who are suspected abuse victims be taken to a local children's hospital where the initial diagnosis can be made and treatment can be given. Hospitals often see abused kids, especially battered children, and they can do the needed X-rays or cultures for a diagnosis to be made. They also work very closely with social workers, child protective services, and the police department to file all the necessary paperwork for the child abuser to be charged.

Psychological help is also strongly recommended. Without it, children who may have been abused may suffer emotional problems or repeat the pattern of abuse with their own children.

Abuse does not have to ruin a child's life as long as it is stopped and dealt with. The earlier abuse can be identified and stopped, the less destructive it will be.

Announcer: TheScopeRadio.com is University of Utah Health Science's Radio. If you like what you heard be sure to get our latest content by following us on Facebook. Just click on the the Facebook icon at TheScopeRadio.com.

For Patients