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Child abuse is the actions of a person of authority that result in the harm, potential harm or threat of harm to a minor. A person of authority could be a parent, family member, caregiver or person in a position of trust such as a teacher or religious leader. The CDC (2022) recognizes 4 common types of abuse and neglect: physical abuse, emotional abuse, sexual abuse and neglect. In the United States, 1,750 children lost their lives in 2020 due to child abuse and neglect. An estimated 1 in 7 children have experienced neglect.

Assessing a toddler for abuse can be difficult. Many toddlers are nonverbal or limited vocabulary. Toddlers are active, walking up and down stairs, and running. Bruises and other injuries may be in various stages of healing and may be a normal result of active play. Toddlers’ behavior is unpredictable. The psychosocial stage for toddlers is autonomy vs. shame and doubt (Faulkner, 2018). When assessing a toddler for abuse, start by taking in the whole picture. Look for clothing that is inappropriate for the weather, such as no coat on a cold winter day, unwashed appearance, such as matted hair, dirty face. Look at the interaction between the caregiver and the child, does the child look to the caregiver for reassurance or is the child overly clingy or not engaging the caregiver at all? Look for injuries that are inconsistent with the story the caregiver has said happened. Look at bruises, do they look like the shape of a hand or belt buckle? Is there bruising on the thighs or genitals? These things can be a result of abuse or neglect.

The United States is made up of different cultures and people come from a very diverse background. Some cultural practices can appear like child abuse, such as coining, a practice of using oils, herbs and a form of dermabrasion to rid the body of illness (Walters-Tozier, 2020). This might leave marks on the body, so it is important to be culturally aware and talk to the parents about where certain marks came from.

 

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