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Sexual Abuse
Warning Signs
When a child:
Reports an instance of abuse by a parent or caregiver
Has difficulty walking or sitting
Suddenly refuses to change for gym class or refuses to take part in physical activities
Demonstrates bizarre, sophisticated or unusual sexual knowledge or behavior
Becomes pregnant or contracts a venereal disease, particularly if under 14 years old
Runs away
Or when a parent:
Shows an extreme protection toward the child, to the extent where the child cannot have contact with other children, especially
with children of the opposite sex
Is secretive and isolated
Describes marital problems involving family power struggles or sexual relations
What To Do
The American
Academy of Pediatrics says that the first important action to take if a child tells you about sexual abuse is to take what
the child says seriously. Many children who report sexual abuse are not believed, and when a plea for help is ignored, the
child may not risk telling again.
If the abuser is a friend or family member, parents will often try to stop sexual
abuse themselves, but the AAP reports that a parental intervention is almost always unsuccessful.
Instead, they recommend
reporting abuse to a local Child Protective Services, and also asking for crisis support help. Also, discussing the problem
with the child's pediatrician, who can offer support and counseling, can help.
After sexual abuse is reported, what
happens depends on the circumstances of the case. The risk of further abuse to the child is the first concern for authorities.
The offender and the entire family may be required to attend a treatment program, and the offender may even face criminal
charges. If the child's safety is in question, authorities can take the offender or victim out of the home during the investigation.
In
order to prevent sexual abuse, the AAP suggests teaching children what sexual abuse is. Tell them they can and should say
"no" or "stop" to adults who may threaten them sexually. Make sure they know that it's okay to talk about any attempt to molest
them - no matter whom the offender may be.
The AAP also suggests that prevention measures should begin early since
a number of child abuse cases involve preschoolers. They offer these guidelines for age-appropriate topics to discuss with
children.
Age:
18 months: Teach your child the proper names for body parts.
3-5 years: Teach your child about "private parts" of the body and how to say "no" to sexual advances.
5-8 years: Discuss safety away from home and the difference between being touched in private parts of the body and other
touching. Encourage your child to talk about scary experiences.
8-12 years: Stress personal safety and give examples of potential problem areas: arcades, malls, locker rooms, out-of-the-way
places outdoors.
13-18 years: Re-stress personal safety and potential problem areas. Discuss rape, "date rape," STDs and unintended pregnancy.
Physical Abuse
Warning Signs
Unexplained bruises, burns, broken bones and black eyes
Fading bruises or other marks after an absence from school
The child is frightened or cries when it is time to go home from school
The child shrinks at the approach of adults
Sudden changes in behavior or school performance
The child has not received medical help for injuries reported to parents
The child has learning problems that cannot be attributed to specific psychological causes
Or when a parent:
Offers conflicting, unconvincing or no explanation for the child’s injuries
Has a history of abuse as a child
Uses harsh physical discipline
Shows little concern for the child
Denies the existence of the child’s problems in school or at home
Asks a teacher to use harsh discipline if the child misbehaves
Sees the child as entirely bad or worthless
Demands a level of perfection that the child cannot achieve
What To Do
If you suspect that a child
is being abused or neglected, you should call your local Child Protective Services (CPS) agency or the CPS agency in the state
in which the abuse occurred. As you identify the appropriate agency for making a report, remember that each state has jurisdiction
over these matters, and has specific laws and procedures for reporting and investigating. In some states, all citizens are
required to report any suspicion of child abuse or neglect.
You can also call Childhelp USA, a national non-profit
organization that provides contact information and counselors, at 1-800-4-A-CHILD.
When suspected child abuse or neglect
is reported, the state’s child welfare system must conduct an investigation. The system is a group of services designed
to promote the well being of children by ensuring safety. Child welfare may remove the child from his or her home to be placed
in a safe environment.
As part of its "prevention initiative," the Department of Health and Human Services' Administration
for Children and Families offers a wealth of information on child abuse, including numerous resources and tips for parents
to help them realize where parenting ends and abuse begins. The ACF Website
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Depression
"Depression" can describe a normal human emotion, but it also refers to a mental health illness. Depression
as an illness in children is when the feelings of sadness and despair interfere with a child’s ability to function.
It's more than just having a "bad day," and you can't just "shake off" the feeling. The American Academy of Family Physicians
says that changing homes or schools, the death of a pet or friend, an illness in the family, or the hormonal changes of puberty
can trigger depression.
Warning Signs
The AAFP reports that infants and preschool children who are depressed
have poor appetites and may lose weight. They also don't enjoy playing.
School-aged children may be less confident
or feel like they can't do anything right.
Older children and teens may stop caring about themselves or family members,
may not want to go to school and, in general, may lose interest in life activities. Older children may also show signs of
erratic sleeping and eating patterns.
In some children, the only signs of depression may be headaches, stomachaches,
not wanting to go to school or losing their temper. When these signs last for several weeks, the child might be depressed.
What
To Do
The first step is to talk to your child about his or her thoughts and feelings. It is also a good idea to
talk to a doctor about your child's behavior and your concerns about depression. A doctor may be helpful because a medical
problem may be causing the depression.
The treatment for depression may involve both medicine and counseling. Most
depressed children and teens should talk to a counselor, therapist, psychologist or psychiatrist about what is making them
feel the way they are feeling. A family doctor can refer you and your child to someone for counseling. Common medications
given to children to treat depression include Paxil and Zoloft, but there is ongoing debate over whether it benefits children
to prescribe anti-depressants.
Substance Abuse
Warning signs can be divided into two categories: physical signs and behavior signs.
Physical
signs
Smelling of alcohol or marijuana
Vomiting
Change in eating and sleeping patterns
Impaired coordination
Glassy, bloodshot eyes
Marked changes in weight or appearance
Respiratory problems
Slurred speech
Behavior signs
Friends suddenly change (be wary if new friendships are with much older teenagers or young adults)
Fighting
Erratic, unpredictable behavior and mood swings
Little contact or avoidance of family
Constant disciplinary concerns at school and home
Talks positive about chemical use
Depressed, withdrawn and hopeless attitudes or statements
Talks about running away from home
Overly preoccupied with secrecy or privacy
Memory problem
Difficulty with attention span
Entertains suicidal thoughts
Gang involvement or identification
Sudden outbursts of verbal abuse and abusive language or easily provoked Irresponsibility - blaming, denying,
fault-finding or lying
Hyperactivity or nervousness
Trouble with the law, shoplifting, truancy, DUI, disorderly conduct
What To Do
By way
of prevention, it seems that all experts agree that kids need to be educated at young ages about drugs and alcohol, and their
dangers. The process starts when parents educate themselves about substance abuse, and then establish the family rules for
drugs and alcohol.
Then it comes down to good parenting. This means making time for kids, listening and knowing everything
about them and knowing whom they hang out with.
If prevention strategies are too late, and you think your child may
be using drugs, it's best to communicate with your child about your concerns. If he or she is reluctant to talk, ask other
adults in your child's life if they have noticed changes in behavior. The best place to start is at school - teachers, guidance
counselors, school nurses and coaches can be helpful. Many schools have prevention specialists who can help you if you suspect
substance abuse.
Even when the signs are obvious, parents sometimes have difficulty admitting that their child could
have a problem. Anger, guilt, and a sense of failure as a parent are common reactions. If a child is using drugs, it is important
for parents to avoid blaming themselves, and to get help as soon as possible.
Many young people lie about their drug
use. If evidence suggests that a child is not being truthful, a doctor’s evaluation could be helpful.
Depending
upon the severity of a child's drug use, parents will probably need help to intervene. Call a doctor, local hospital, state
or local substance abuse agencies, or county mental health society for a referral to a drug treatment program in the area.
School districts should have a substance abuse counselor who can give referrals to treatment programs. Parents whose children
have been through treatment programs can also provide information and support to help.
Self Mutilation
What It Is
Self-mutilation is when someone intentionally injures himself or herself when under emotional
stress. The injuries are often cuts or bites, or something severe enough to damage body tissue. Self-mutilation often occurs
as a result of psychological disorders (such as depression or borderline personality disorder) or sexual abuse, and is also
a warning sign of a potential suicide.
A person usually begins self-mutilation at the onset of puberty, according
to S.A.F.E. (Self-Abuse Finally Ends). The warning signs are fairly obvious: recurring wounds that look like they have been
inflicted with scissors, knives, glass, razorblades, or belts, as well as burn marks form lighters or cigarettes. If discovered,
the person will often make up excuses as to how they got the injuries. S.A.F.E. also reports that many sufferers are also
struggling with eating disorders and substance abuse.
The Bio-Behavioral Institute reports that the prevalence rate
of self-mutilation in the U.S. is estimated to be about 1 to 2%, with higher rates among institutionalized individuals and
survivors of childhood abuse. The acts are often a form of self-punishment that the victims feel they need to impose to feel
in control of themselves.
What To Do
Self-mutilation is a serious condition, and effective medical
treatment involves a combination of therapy and medication. There is no specific drug used to treat the condition, but there
are medications that help reduce the symptoms of anxiety, obsessive-compulsive disorder, lack of sleep and depression that
are prevalent in victims of the illness.
A good starting point to get help is the S.A.F.E. program’s Web site, at
www.selfinjury.com
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