Child abuse and maltreatment is a common occurrence in the United States there for it remains very important as nurses to be able to recognize the signs and symptoms of possible abuse.

According to American Academy of Pediatrics, approximately three million cases of child abuse and neglect are reported each year, with the majority of cases being neglect followed by physical and sexual abuse (AAP, 2017). Some statistics show that the highest rate of fatal child abuse occurs in children 0-4 years of age commonly caused by head injuries, then suffocation and abdominal injuries (WHO, 2002).

These young children are most vulnerable to physical abuse most likely by a family member or someone close to them. It is not always an easy task to recognize when a child has been abused or neglected due to either fear, the abuser was a loved one, or the child thinks they will be blamed or no one will believe them. This is where us nurses come in by being able to recognize the signs without being verbally told, and be able to understand that there are no specific signs that point to specific types of abuse.

There can be physical signs, such as any injuries that have no explanation, genital pain or bleeding out of the norm; behavioral changes such as fearful behaviors for no reason, bedwetting, extreme sexual behavior, changes in self-confidence, physical complaints with no medical causes, education issues, passive or aggressive behaviors out of the norm, weight changes, and social withdraw(AAP,2017). Most times children do not come out and report abuse, so being diligent in an assessment, asking the right questions and making this children feel safe and comfortable will be important in getting them proper treatment as soon as possible in cases of suspected abuse.

Child abuse and maltreatment comes with a great amount of long term emotional damage that can be detrimental to their wellbeing as adults. Some cultures practice differently than others and how they treat children can often be seen in Western Medicine as abusive behavior such as cao gio which is performed in some Southeast Asian cultures (Davis, 2000).

This method of dermabrasion is used to treat wind diseases by rubbing or pinching the skin to bring bad blood to the surface of the skin which allows bad wind to escape from the body of the sick (Davis, 2000). This is often performed on the back, shoulders, chest, temples and forehead often leaving large bruises or extreme redness that can often look like signs of child abuse.

As a nurse, it is my responsibility to report suspected child abuse appropriately, only after I have gathered as much information as possible. I must be very confident I believe the signs I am assessing have come from child abuse or neglect before reporting my findings to the local department of social services or the Child Abuse and Neglect Hotline. There is a list of local departments of social services, addresses and phone numbers for the Virginia area available(VDSS, n.d.).

I will be asked to provide as much information as possible in order for a CPS worker to investigate further. I, as the nurse of this child, have a legal and ethical responsibility to report suspected abuse to local social services to ensure this abuse does not go on and prevent future abuse and neglect cases for this child.

American Academy of Pediatrics. (2017). What to Know About Child Abuse.

Davis, R. E. (2000). International scene: Cultural health care or child abuse? the southeast asian practice of cao gio. Journal of the American Academy of Nurse Practitioners, 12(3), 89.

Virginia Department of Social Services (VDSS) (n.d.). A Guide for Mandated Reporters in Recognizing and Reporting Child Abuse and Neglect.

World Health Organization. (2002). Child Abuse and Neglect.