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The extent to which child abuse occurs goes unnoticed. A report of child abuse is
made every ten seconds and in 2007, there were approximately 4.8 million cases involving child
abuse and neglect in the United States. From these shocking statistics we are able to see the
drastic implications of abuse on todays youth.
There are several factors that can lead to the cause and extent of child abuse.
Unemployment, marital strains, and unplanned pregnancy are just some of factors can set off
violence leading to several types of child abuse. Children at risk of abuse are those who come
from a family in which intimate partner violence is present, are under age 4; greatest risk
for severe injury and death, live in communities with a high level of violence and one that
accepts abuse, live in household environment with great stress due to substance abuse,
poverty, and chronic illness (Stanhope). Girls are slightly higher (51%) at risk than boys
(47%) for neglect, emotion, physical and sexual abuse. Sadly, 68% of all sexual abuse
involves a family member, and Father-daughter incest is the type of sexual abuse most
often reported (Child Help).
Maltreatment of children during their early years of life may result in serious and
irreversible physical and psychological effects. Abuse can cause stress that can disrupt
early brain development. Babies are at greatest risk when parent is feeling overwhelmed,
violently shaking the baby whose muscles are too weak, thereby exposing the brain to
injury. Extreme levels of abuse can affect nervous and immune systems as well
(Stanhope).
While physical abuse is shocking due to the scars it leaves, not all child abuse is as
obvious. Emotional scarring has just as much of an effect on a child, if not worse. Abused
children are also at risk for several adult health problems such as, alcoholism, depression,
substance abuse, eating disorders, obesity, sexual proximity, smoking, and suicide
(Stanhope). Both men and women, who were abused as a child, are more likely to abuse
their children, experience PTSD and exhibit aggressive behavior (Child Help).
As stated earlier, there is a report of child abuse made every ten seconds, and with these
staggering statistics there is a great social, developmental and psychological impact being
placed upon our youth. As early as infancy, children are being exposed to all types of
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abusive behaviors including physical abuse, emotional abuse, sexual abuse and the most
prevalent, neglect.
A day in the life of a child who experiences abuse may start like any other normal
day. A child may wake in the morning but may have no availability to food, bathing and
hygienic facilities, and no parental figure to help or provide for them. These circumstances,
as unpleasant as they may be, occur everyday. Children who experience these conditions
most likely have limited family economic resources and lack social support from their
communities. The burden of society, economic factors, substance abuse, domestic violence,
and other cumulative stressors increase the risk of abusive parenting. For children that are
found in these circumstances there are deep psychological and developmental implications,
which may ultimately result in mental disorder and physical deformity as an outcome of
malnutrition and bodily trauma.
Specifically examining the physical aspects of child mistreatment, common
findings include cuts, burns, broken bones, bruises, and concussions, all of which,
depending on the severity can greatly impact the normal physical development of a
growing child. For example, a child who has received a fracture or break impeding on the
epiphyseal plate of a growing bone may cause permanent damage and deformity. In a day
in the life of a young child that has experienced any of these physical traumas, there may be
significant implications that interfere with their participation in normal activities of daily
living such as playing, eating, washing, and other everyday behaviors.
In addition, there are severe psychological effects that are related to physical abuse.
A child may be ashamed of their bodies because of their physical trauma, such as a child
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hiding bruises or cuts and feeling embarrassed about them. They may also develop a
skewed perspective of relationships, thinking its acceptable to hit others or treat others in
an unhealthy manner. These behaviors may result in problematic social interactions that
can lead to disciplinary measures or inability to form friendships with others.
Emotional abuse is another common form of abuse found in the household
environment and can also lead to psychological abnormalities than can affect a childs daily
life. Parents may yell at their children, ignore them, taunt and tease them, have unrealistic
expectations for them, or fail to provide them with any means of love and psychological
support. A child that is constantly being put down and ridiculed may develop a skewed
self-image of being worthless, incompetent, inadequate and pathetic. This skewed
perspective can lead to developmental abnormalities that may affect their social
involvement and formation of feasible relationships with peers, friends and family.
Margaret Camn, currently an employee at the University of Delawares student
health center, had firsthand experience in dealing with abused children while working at
the Childrens Hospital of Philadelphia a few years past. After an interview about nursing
involvement in child abuse in the hospital setting we were able to better understand the
implications of child abuse in todays society. From cuts and bruises to extreme cases of
brain trauma and death, child abuse is a major problem of todays culture and Margaret
was able to better explain the direct impact of abuse on nursing. Margaret stated that a
day in the life of a abused child is even more difficult then I can bare to imagine. Every time
I cared for a child who had experienced a traumatic event, or an event of extreme neglect, I
always thought about the times where this child was not brought in for care, which Im sure
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were numerous, and it broke me heart. As a nurse in the ER at the childrens hospital,
Margaret saw the repercussions of abuse immediately after a traumatic event, and even in
those short lived, emergency situations she was able to see serious psychological effects
that would interfere with normal development and daily living.
As health care providers, it is essential that nurses be prepared to intervene in any
situations that can compromise the health of an individual, whether it may be physical,
emotional, or mental. The most important intervention a nurse can take regarding child
abuse is recognition. Spotting an abused child and offering them help could save them from
years of neglect and abuse, or even death. Signs to look out for may include, but are not
limited to, withdrawal, anxiety, frequent injuries (especially injuries with specific shape,
such as a hand or belt), jumpy, inappropriate clothes (to cover up their injuries), poor
hygiene, and isolation.
If a nurse detects that a child has been abused, or if a child comes to the nurse for help
and shelter, the best thing a nurse can provide is calm reassurance and unconditional
support. It was likely a very difficult thing for the child to do to seek help, and they should
be reassured that they have made the right decision. It is essential that denial and
interrogation of the child and their claims be avoided, as they may intimidate the child or
cause them to shut down. Reassure the child that they did nothing wrong and that their
safety is important to you.
Intervening personally with the parents or guardians of a child who is being abused is
not the nurses job. It is very likely that the child will need protection from those who are
abusing them, and that the abusers need mental help. The best people for this job are
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authorities or abuse help lines. Personal action by the nurse could be dangerous to both the
child and the nurse. The nurse can help this process by contacting the correct people for
this situation, and continue to provide support for the child as long as they are within the
nurses care.
A nursing research article written by Sue Gabriel on child abuse discusses the fact
that child abuse is most prevalent in children under the age of 5 years old. She references
specific cases in which the parent who inflicted the abuse is the same parent to call the
police or take their child to the hospital due to the injury to death. Due to the young age at
which these children face both mental and physical abuse, it is not surprising that so many
of them would suffer from emotional problems later in life. Similarly, it is clear to see that
the abusers have some sort of mental instability, causing them to want to inflict emotional
or physical damage to their children. Growing up in an environment like that, where the
people who they are suppose to look up to and who are suppose to be caring for them are
instead mentally disturbed and abusive, are clear causes for the future emotional and
physical development issues that many children who have been abused suffer from.
In conclusion, child abuse plays a significant role in the physical and psychological
maturity of children and can lead to detrimental developmental, behavioral and emotional
effects later in life. With the shocking numbers of abuse victims in todays society, it is
imperative, that as the future of nursing, we recognize the individual nursing interventions
we may enact to promote the health and wellbeing of our patients. Child abuse affects
millions of children each year, but through the involvement of nursing and our
understanding of child abuse we may hopefully increase the quality of living for our youth.
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References


Stanhope, M. & Lancaster, J. (2006). Foundations of nursing in the community:
Community-oriented practice. St. Louis, MO: Mosby.

National child abuse statistics: Child abuse in America. (2007, August 22). Retrieved
April 30, 2010, from Child Help: Prevention and treatment of child abuse
website: http://www.childhelp.org/pages/statistics












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Child Abuse
NURS232
5/12/2010
Hilary Barrer, Eleanor Bowman, Nicole Pavich