Other stresses to a family member or to the family unit.
These profiles of the abusive parent and the abused child's family unit paint a
picture of child abuse in only one segment of American society (the lower end
of the socioeconomic structure). Remember that child abuse occurs in all
parts of society in the United States. The abuser may be rich or poor,
educated or uneducated, socially prominent or virtually unknown in a town,
immaculately dressed in the latest style or slovenly and dirty, etc. People are
very good at concealing what they really do and how they really act from
outsiders. It is, therefore, doubly important that you as a health care provider
be observant and thorough in examining an injured child and that you report
to the proper authorities according to local standing operating procedure
(SOP) any suspicions of child abuse.
BEHAVIOR OF ADULT SUSPECTED OF CHILD ABUSE
No single sign is proof of child abuse or mistreatment. It is a pattern of repeated
suspicious injuries that is strong evidence of child abuse. Behavior of parents who bring
a child to a medical facility for treatment may alert you that a problem exists. The
following are indicators that parents are abusing their children.
a. Parent is abnormally nervous.
b. Parent is reluctant to volunteer information or gives contradictory information.
When children hurt themselves, the parents can usually provide a large number of
details about what happened and how it happened. A parent who keeps changing the
story of how the child was injured may be trying to cover up child abuse. Accidents
happen in every family. What is important to know is that it was an accident.
c. Parent is hostile toward the child.
d. Parent blames others for the child's injury; for example, the babysitter, a
neighbor, or other children in the family.
e. Parent shows too much concern for what appears to be a minor injury.
f. Parent shows no concern and seems disinterested or unaware of the child's
condition. The parent is more concerned with himself than the injured child.
g. Parent refuses to hospitalize the child.
h. The story told by the parents does not seem a logical explanation for the
particular injuries the child has suffered.