Transcript Age-related signs of Abuse

Age-related signs of Abuse
Ages 0-3
Signs of physical injury
 Signs of physical illness, especially to
genital or urinary systems
 Unusual fussiness
 Refuses his/her favorite food
 Becomes extremely shy
 Exhibits a sudden or unusual fear of
strangers

Ages 0-3
Shows a lack of enjoyment of his/her
favorite play things
 Clings to parents as if fearful
 Experiences great difficulty getting to
sleep
 Suffers from frightening dreams
 Regresses to an earlier pattern of behavior
 Regression of skills
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Ages 0-3
Experiences a loss of his/her sense of
security
 Becomes unable to adjust to his/her
normal schedule
 Manifests any change from normal
behavior pattern such as:
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Ages 0-3
* Feeling ugly
* Very concrete symptoms- hitting self
in eye, etc.
* Difficulty cuddling
* Seeking attention from any adult
Ages 4-12
A sign of physical injury
 Signs of physical illness, with a variety of
symptoms from recurrent headaches,
upset stomachs, or urinary tract infections
 Exhibits sudden shyness
 Suffers from frightening dreams
 Experiences great difficulty getting to
sleep

Ages 4-12
Refuses his/her favorite foods
 Suffers from depression
 Exhibits some loss of memory
 Worries excessively, interrupting his/her
normal life pattern
 Exhibits a fear of specific adults
 Has a sudden and unwarranted fear of the
dark

Ages 4-12
Exhibits extreme fear of being alone
 Shows regression in patterns of behavior
or skills
 Exhibits a change in school relationships,
including possible fighting and the sudden
inability to adjust
 Shows lack of enjoyment in his/her
favorite TV shows, movies, games, or
other activities

Ages 4-12
Seems easily distracted as though his/her
mind is wandering
 Manifests a change in his/her attitude
 Manifests a change in his/her pattern of
normal behavior
 Acts out in a sexual manner, appearing
more knowledgeable about sex than
his/her peers.

Ages 4-12
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Develops a pseudomature character, taking over
specific parental responsibilities in the home ( a
sign predominately associated with incest)
Bedwetting
Excessive masturbation
Approaching strangers for affection
Dependency issues
School phobia
Ages 4-12
Excessive lying or manipulation
 Use of precocious sexual language
 Cruelty or excessive concern for animals
 Fear or aversion to sports
 Phobia
 Emotional lability
 Recurrent nightmares
 Lack of joy
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Ages 4-12
Shame
 Excessive or total lack of interest in dating
 Excessive drug or alcohol use
 Self-injury
 Eating disorders
 Problems with boundaries:
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– Difficulty saying “no”
– Problems with closed doors
– Excessive modesty or nudity
Ages 4-12
Intrusive behavior with siblings, parents,
or friends
 Blocked feelings or memories
 Rejection issues are primary
 Early sexual acting out
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Ages 13-19
Manifests signs of physical injury
 Manifests signs of physical illness,
headache, stomach cramps, urinary tract
infections
 Suddenly refuses food
 Suffers from sudden and violent dreams
 Manifests difficulty in getting to sleep
 Seems in depths of depression

Ages 13-19
Exhibits inability to concentrate
 Shows irritability or manifests angry
outbursts toward others
 Exhibits a sudden and unwarranted fear of
the dark
 Has a sudden lapse of enjoyment in dating
 Feels an unexplainable fear of being left
alone
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Ages 13-19
Worries excessively, interrupting his/her
normal life patterns
 Experiences a loss of memory
 Exhibits fear of specific adults
 Exhibits a change in his/her level of
scholastic achievement
 Acts out the sexual encounter with sibligns
or friends
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Ages 13-19
Experiences a lack of enjoyment of his/her
favorite activities
 Makes an attempt to run away from home
 Contemplates suicide
 Appears passive or overly compliant n
behavior
 Behaves seductively with the opposite sex
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Ages 13-19
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Manifests a deviation from his/her normal
patterns or attitudes
*Lack of interest in dating
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Promiscuity
Excessive drug/alcohol use
Self-injury
Eating disorder ( too much or too little)
Ages 13-19
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Problems with boundaries:
– Saying “no” to friends
– Closing doors
– Excessive modesty/nudity
– Being intrusive with friends, parents, siblings
Ages 13-19
Blocked memories/feelings
 Lack of joy
 Shame
 Rejection issues are primary
 Dependency issues
 Truancy
 Early marriage/early pregnancy/early
sexual experience
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Ages 13-19
Lying and manipulation
 Cruelty or excessive concern for animals
 Excessive masturbation
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Signs of Credibility
Important information to keep in mind
during the interview process. What
enhances and what will detract from a
child’s allegation of sexual abuse
Credibility of Language
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Increase of
credibility
Uses own language
Facts stay the same
even if the vocabulary
changes
Gives details
Tells from a child’s
viewpoint
Decrease of
credibility
- Adult terms
- Rote phrases
- Lack of details
Credibility of Affect
Increase in
credibility
- Congruent with
allegations
Decrease of
credibility
- Inappropriate
allegations
Credibility of Behavior
-
Increase in
Credibility
Seductive
Precocious
Regressed
Guarded
Somatic
Complaints
Decrease in
Credibility
- No behavioral changes
Credibility of Cognitive
Development
Increase in
Credibility
- Differentiates fact
from fantasy
Decrease in
Credibility
- Impaired reality
testing
Credibility of Memory
Increase in
Credibility
- Good recall of details,
including
sensorimotor
- Absence of denial
- Idiosyncratic detail
Decrease in
Credibility
- Vague
- Evasive
- Prior abuse may
confuse allegation
Credibility of Motives
Increase in
Credibility
- Absence of secondary
gain
Decrease in
Credibility
- Possible secondary
gain
- Need parent’s
approval
Credibility of Play
Increase in
Credibility
- Sexual Themes
- May reenact trauma,
exaggerates or avoids
sexual features
Decrease in
Credibility
- Sexual themes absent
Credibility of Drawings
Increase in
Credibility
- Will show
characteristics of
sexually abused
children
Decrease in
Credibility
- Will not show
characteristics of
sexually abused
children
Credibility of History
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Increase in
Decrease in
Credibility
Credibility
Progressive sexual
- Other medical history
activity over time
to explain heightened
sexual concerns
Delayed disclosure
Child threatened to
keep secret
Psychological coercion
Sex rings, rituals,
pornography
Credibility of Physicality
-
Increase in Credibility
Gonorrhea under age 14
other than newborn
Strong indicators,
hymenal disruption, anal
scars or relaxation,
gonorrhea of rectum or
vagina, other venereal
diseases
Decrease in Credibility
- Normal physical exam in
spite of history of
penetration.