HD_300 1st Edition Lecture 8 Outline of Last Lecture I. Physical Abuse DefinedII. Overviewa. Physical abuseb. Physical abuse continuumc. Types of physical abuseIII. Catastrophic Abusea. CCM definedb. Categories of CCMc. Proposed legislationIV. Response of the Medical Community a. Background Informationb. The role of the physicianc. ER Protocolsd. “Red Flags” on Patient Historye. “Red Flags” on Examf. Injuries commonly seen in the ERg. Typical Sites for abusive markingsh. Types of markingsOutline of Current Lecture I. Neglecta. General definitionb. Legal definitionc. SESd. Selective Neglecte. Fatal Neglectf. Parental Investmentg. Maternal DeprivationThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.h. Features of Maternal Deprivationi. Profound Neglectj. Non-Organic Failure to Thrivek. Psychosocial DwarfismCurrent LectureNeglectI. General Definitiona. Failure to provide minimally adequate care and attention to basic for childb. Tempered by notion of community standards of carec. Consistent omission of care considered neglectful in all communitiesII. Legal Definitiona. Inadequate physical careb. Inadequate supervisionc. Absence of/or inadequate health cared. Lack of prenatal caree. Cruel or abusive treatmentf. Exploitation of child’s earning capacity g. Unlawfully keep child out of schoolh. Exposing child to criminal or immoral influence III. SES a. Negative correlation between income and neglectIV. Selective Neglecta. Any combination of medical, nutritional, physical or emotional neglect of a childb. In comparison to other children in family or to children in equivalent circumstances c. In some cultures: girls and later borns receive lesser standard of cared. In some families 1 child is object of neglecti. Not all of the childrenV. Fatal Neglecta. 2 types- can lead to child’s death: i. Failure to provide for child’s needs (starvation, dehydration) 1. Failure to provide medical interventionii. Lack of adequate supervision1. Leading to accidentsa. Child runs into traffic b. Drownsc. Gets into toxic medicationsVI. Parental Investmenta. Crucirla to child’s survivalb. Rejection -> vulnerability c. Total maternal rejection -> deathd. Requires considerable timee. Parents have a choice VII. Maternal Deprivationa. Of all forms of neglect, MD had most lasting effects on children’s emotional well-beingb. Early separation from mother results in widespread behavioral and psychological consequences that may endure for yearsVIII. Features of MDa. 1st: inconsolable cryingb. 2nd: withdrawlc. Flat effectd. Constant eventless rockinge. Developmental delaysf. Unable to initiate in social interactionIX. Profound Neglecta. Reactive attachment disorderi. Incapable of lovingii. Incapable of empathyiii. May be dangerous to other childreniv. Physiological changes begin that appear to be irreversible for most partX. Non-Organic Failure to Thrivea. Primary cause= emotional neglectb. Below 5th percentile in height and weight after having been in normal rangec. Delay in psychomotor developmentd. Apathetic- flat affecte. Anorexic- not interested in eatingXI. Psychosocial Dwarfism a. Symptoms of NOFTZi. Behavioral problemsii. Bizarre eating patternsiii. Hyperactivityiv. Sleep walkingv. Bed wetting (enuresis) and soiling