Abuse does not discriminate againts age. Children of all ages suffer abuse and some of the most fragile are at the younger end of the spectrum. Shcool age children often suffer from abuse and the abuse can come in a variety of different types ranging from sexual, physical, emotionaly, and from neglect. The most common form of abuse within this age group is neglect.

Neglect occurs when the responsible party fails to provide basic needs for the child. This may manifest in the form of malnutrition, lack of medical care, or lack of basic needs like clothing and hygiene. "Neglect is dangerous and can cause serious, long-term damage - even death." (NSPCC, 2007).

Warning signs may be hard to detect. Changes in the child behavior may be evident. The child may also seem more paranoid or easily frightened. Often neglected children may have poor hygiene, wear dirty clothes, and have poor nutrtitional and dental health. Difficulty concentrating may also be something the neglected child suffers from. "Some children may directly disclose that they have experienced abuse or neglect." (Child Welfare Information Gateway, 2013).

When assessing a school age child a nurse should always assess for any signs and symptoms of abuse. Physical abuse may be easily visable by bruises, broken bones, and injuruies healing at different levels. However, many of these types of symptoms can be due to the active life of a school aged child. Cultural practices may also be mistaken as abuse.

For example, some cultures believe in cupping and coining to ward off infection. This can leave marks that look like abuse but are simply the cultural practices and beliefs of some people. Often you will have to dig deeper and look for other clues and remain culturaly competent to not misdiagnose abuse. Sexual abuse may be aparent with extreme fear and avoidance of assessment of the genitals where neglect may be aparent in the childs BMI and growth records.

In California all healthcare providers are mandated reporters for any suspision of abuse at any level. I work at a hospital and we have a resource binder we access when any abuse if suspected. We would fill out a report and fax to the appropriate agency which would be child welfare or adult protective services. As nurses it is our responsiblility to advocate for all patients, big and small.

Reference:

NSPCC. Child Neglect. (2007).

Child Welfare Information Gateway. What is Child Abuse and Neglect: Recognizing Signs and Symptoms. (2013).