Impairments_10

Abuse and Neglect
https://www.youtube.com/watch?v=PFsyC5mzyl8 1:54
Abuse:
“All forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to a child’s health, survival, development, or dignity at the hand of a person in a relationship of responsibility”
- WHO
3 categories:
1.) Physical abuse; shaking, burning, and beating. Can’t explain how child got hurt, describes child in a negative way. (usually has history of abuse as a child)
2.) Sexual abuse; rape, incest, sodomy, exploitation.
3.) Psychological maltreatment or emotional abuse(chronic acts) that interfere with the psychological and social development of a child.
- Belittling or rejecting the child
- Ignoring the child
- Blaming the child for things over which he or she has no control
- Isolating child from social experiences
- Using harsh and inconsistent discipline
Neglect:
- “An act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act of failure to act which presents an imminent risk of serious harm.” CAPTA
Physical neglect:
- Failure to provide adequate shelter, supervision, , safety, support, food and clothing.
  Emotional neglect:
-   Failure to provide praise,  affection
Most common abuse is neglect
https://www.youtube.com/watch?v=ROIGfGGx80U 2:24

Warning Signs for Child Abuse or Neglect
There are often certain recognizable physical and behavioral indicators of child abuse or neglect. The following signs, by themselves, may not be conclusive evidence of a problem, but serve as indicators of the possibility that a problem exists.
Signs of Physical Abuse
• Bruising, welts or burns that cannot be sufficiently explained; particularly bruises on the face, lips, and mouth of infants or on several surface planes at the same time;
• Withdrawn, fearful or extreme behavior;
• Clusters of bruises, welts or burns, indicating repeated contact with a hand or instrument;
• Burns that are insufficiently explained; for example, cigarette burns; and
• Injuries on children where children don't usually get injured (e.g., the torso, back neck buttocks, or thighs).
Signs of Sexual Abuse
• Difficulty walking or sitting;
• Pain or itching in the genital area;
• Torn, stained or bloody underclothing;
• Frequent complaints of stomachaches or headaches;
• Venereal disease;
• Bruises or bleeding in external genitalia;
• Feeling threatened by physical contact;
• Inappropriate sex play or premature understanding of sex
• Behaviors displayed during play, recreation, social experiences
https://www.youtube.com/watch?v=Kbkgj2YDNlU (.30)
• Frequent urinary or yeast infections.
Signs of Emotional Injury
• Speech disorders;
• Inability to play as most children do;
• Sleeping problems;
• Anti-social behavior or behavioral extremes; and
• Delays in emotional and intellectual growth.
Signs of Neglect
• Lack of medical or dental care;
• Chronically dirty or unbathed;
• Lack of adequate school attendance;
• Lack of supervision; for example young children left unattended or with other children too young to protect or care for them;
• Lack of proper nutrition;
• Lack of adequate shelter;
• Self-destructive feelings or behavior; and
• Alcohol or drug abuse.
https://www.youtube.com/watch?v=MWB4dy_ObPE




Long term results of abuse and neglect:
- Lower self-esteem
- Marriage difficulties
- Ingrained lack of empathy
- Depersonalization
- Conduct disorders phobias
- Psychosomatic complaints
- Major depressive disorder
- Suicidal behavior
- Posttraumatic stress disorder
- Substance abuse
- Reluctance to seek therapy
- Repetition of the same sexual abuse ritual to others
- Feeling strange, scared, or anxious, and not knowing why
- Distrust
- Isolation
- Inability to form close relationships
- Criminal behavior
https://www.youtube.com/watch?v=95ovIJ3dsNk (6.36-9:55)
The longer the abuse, the more damage there will be
Abuse in adult relationships:
 Analysis done by the U.S department of justice found that violent behavior among men is strongly linked to material status. From 1979-1987, about 57,000 woman per year were violently assaulted by their husbands. But 200,000 woman per year were assaulted  by their boyfriends and 216,000 by ex-husbands.  (Carolyn Wolf Harlow)
 A 2000 department of justice report showed that married and widowed woman had the lowest rates of violent abuse by an intimate partner. Divorced and cohabiting woman had the highest rates of violent abuse by their ex-spouses, or boyfriend, followed by never-married woman.

Nursing home abuse and neglect:
https://www.youtube.com/watch?v=HgLynjE662A 1:12
How to identify; https://www.youtube.com/watch?v=5OO5Tnglad8 1:46

TR Intervention: interventions happen in a team member setting
- Help youth develop appropriate age behaviors
- Family expectations
- Skills to express their needs and frustrations
- Training to assist in the identification and management of stressful situations that might support child maltreatment to children’s parents.
- Prevent the occurrence of abuse and neglect and promote well-being by facilitating access to safe and supportive environments like after-school programs for youth in high-risk situations
Setting treatments:
- Treated in hospitals
- Foster care settings
- Shelters
- Private residential clinics
- Through referral and outstretch programs of schools, camps, and juvenile justice systems
Adults:
- Neighborhood support networks
- Day treatments
- Outpatient clinics
- Private psychotherapy
- Short-team inpatient psychiatrics programs
Example of interactions:
- Outdoor adventure activities with a debriefing process, problem-solving, cooperation, and sharing feelings, and also enhances self-concept.
- Educational programs for families and youth at-risk that incorporate strategies like time and stress management, assertiveness, physical activity, values clarification, relaxation, and journaling. Adventure experiences with youth and families that promote healthy family interactions
- Physical activity relieves tension and offers the TRS opportunities to access developmental delay attributable to maltreatment. Psychometric symptoms may result from abusive situations and can negatively affect and individual’s performance. TR articulate the relationship between emotional and physical, well-being and help clients manage conditions such as hyper-and-hypo-activity.
- Experiential activities like expressive and creative arts and animal-assisted therapy encourage expression, playfulness, and altruistic behavior.

Sources:
Carter, M, J., Van Andel, E, G. (2011) Therapeutic Recreation A Practical Approach. Problems related to abuse and neglect. Pp, 384-392
Warning signs: http://www.mass.gov/eohhs/gov/departments/dcf/child-abuse-neglect/warning-signs.html
 Andrea J. Sedlak and Diane D. Broadhurst, The National Incidence Study of Child Abuse and Neglect, U.S. Department of Health and Human Services, Washington, D.C. (1996): 5-19.
Carolyn Wolf Harlow, Female Victims of Violent Crime, U.S. Department of Justice, Washington D.C. (1991): 1-2.
Bureau of Justice Statistics, Intimate Partner Violence, National Crime Victimization Survey, U.S. Department of Justice, Washington, D.C. (May 2000): 5.