Complete Your CE Test Online - Click Here ● ● Forcefully slapping or otherwise striking a child under one year of age. ● ● Interfering with the breathing of a child. ● ● Causing serious physical neglect of a child. ● ● Fabricating, feigning or intentionally exaggerating or inducing a medical symptom or disease which results in a potentially harmful medical evaluation or treatment to the child through any recent act. Characteristics of maltreated infants Maltreated infants often are apathetic and listless, placid or immobile, do not manipulate objects, or do so in repetitive, and do not explore their environments which restricts opportunities for learning, lack mastery of object permanence and lack development of basic problem- solving skills. Maltreated infants: ● ● Fail to form attachments to primary caregivers and do not appear to notice separation from the parent. ● ● May not develop separation or stranger anxiety. ● ● May be passive, apathetic, and unresponsive to others. ● ● May not maintain eye contact with others. ● ● May not become excited when talked to or approached. ● ● Cannot often be engaged into vocalizing (cooing or babbling) with an adult. Types of child abuse: ● ● Unreasonably restraining or confining a child, based on consideration of the method, location or the duration of the restraint or confinement. ● ● Forcefully shaking a child under one year of age. ● ● Forcefully slapping or otherwise striking a child under one year of age. ● ● Interfering with the breathing of a child. ● ● Causing serious physical neglect of a child. ● ● Fabricating, feigning or intentionally exaggerating or inducing a medical symptom or disease which results in a potentially harmful medical evaluation or treatment to the child through any recent act. Abused or neglected toddlers may not develop play skills, and cannot often be engaged into reciprocal, interactive play. Maltreated infants often fail to develop basic trust, which can impair the development of healthy relationships. Maltreated infants are often: ● ● Withdrawn or listless. ● ● Apathetic or depressed. ● ● Unresponsive to the environment. ● ● Passive and immobile, but intently observant. Abused toddlers may feel that they are “bad children” affecting the development of self- esteem; they may become fearful and anxious, depressed and withdrawn, aggressive and physically hurt others. Punishment (abuse) in response to normal exploratory or autonomous behavior can interfere with the development of a healthy personality, and children may become chronically dependent, subversive, or openly rebellious. Preschool children The following are typical consequences of maltreatment on the development of preschool children: ● ● Physical ○ ○ Small in stature, and show evidence of delayed physical growth. ○ ○ Sickly, and susceptible to frequent illness; particularly upper respiratory illness (colds, flu) and digestive upset. ○ ○ Poor muscle tone, poor motor coordination, gross and fine motor clumsiness, an awkward gait, lack of muscle strength. ○ ○ Delayed or absent gross motor play skills. ● ● Cognitive ○ ○ Speech may be absent, delayed, or hard to understand. The preschooler whose receptive language far exceeds expressive language may have speech delays. Some children do not talk, although they are able. ○ ○ Poor articulation/pronunciation, incomplete formation of sentences, incorrect use of words. ○ ○ Cognitive skills may be at a level of a younger child. ○ ○ Unusually short attention span, lack of interest in objects, and an inability to concentrate. ● ● Social ○ ○ Demonstrate insecure or absent attachment; attachments may be indiscriminate, superficial, or clingy. The child may show little distress, or may overreact, when separated from caregivers. ○ ○ Appear emotionally detached, isolated, and withdrawn from both adults and peers. ○ ○ Demonstrate social immaturity in peer relationships; may be unable to enter into reciprocal play relationships; may be unable to take turns, share, or negotiate with peers; may be overly aggressive, bossy, and competitive with peers. ○ ○ Prefer solitary or parallel play, or may lack age appropriate play skills with objects and materials. Imaginative and fantasy play may be absent. The child may demonstrate an absence of normal interest and curiosity, and may not actively explore and experiment. ● ● Emotional ○ ○ Excessively fearful, easily traumatized, have night terrors, and seem to expect danger. ○ ○ Show signs of poor self esteem and a lack of confidence. ○ ○ Lack impulse control and have little ability to delay gratification; may react to frustration with tantrums, aggression. ○ ○ Have bland, flat affect and be emotionally passive and detached. ○ ○ Show an absence of healthy initiative, and must often be drawn into activities; may emotionally withdraw and avoid activities. ○ ○ Show signs of emotional disturbance: anxiety, depression, emotional volatility, or exhibit self-stimulating behaviors such as rocking, or head banging, enuresis or encopresis. School-age children The following are common outcomes of maltreatment in school-age children: ● ● Physical ○ ○ May show generalized physical developmental delays. ○ ○ Lack the skills and coordination for activities that require perceptual-motor coordination. ○ ○ Sickly or chronically ill. ● ● Cognitive ○ ○ Display thinking patterns that are typical of a younger child, including egocentric perspectives, lack of problem solving ability, and inability to organize and structure his thoughts. ○ ○ Speech and language may be delayed or inappropriate. ○ ○ Unable to concentrate on school work, and may not be able to conform to the structure of the school setting; may not have Page 14 nursing.elitecme.com