Review Article
Volume 10 Issue 7 - 2021
SCAN: A Succinct and Practical Guide for Recognizing and Reporting Suspected Child Abuse and Neglect
Nicholas A Kerna1,2*, Hilary M Holets3,4, Abdullah Hafid5, Kevin D Pruitt6, ND Victor Carsrud7, Uzoamaka Nwokorie8, John V Flores3,4, Raymond Nomel9 and Shain Waugh10
1SMC–Medical Research, Thailand
2First InterHealth Group, Thailand
3Beverly Hills Wellness Surgical Institute, USA
4Orange Partners Surgicenter, USA
5Academy of Integrative Health & Medicine (AIHM),
6Kemet Medical Consultants, USA
7Lakeline Wellness Center, USA
8University of Washington, USA
9All Saints University, College of Medicine, St. Vincent and the Grenadines
10Fettle Path, USA
*Corresponding Author: Nicholas A Kerna, (mailing address) POB47 Phatphong, Suriwongse Road, Bangkok, Thailand 10500.
Received: May 28, 2021; Published: June 30, 2021




Abstract

Child abuse and neglect are significant public health issues with adverse consequences that can carry over into adulthood, affecting the child's physical, psychological, and emotional development. Approximately 25% of all children confront some form of abuse or neglect during their life. Any violation of a child (a minor–under 18 years of age) by an adult resulting in harm or injury is deemed child abuse.

Abuse recognizes no boundaries. It occurs in every country, at every socioeconomic level, in all races and ethnicities, and spans all education levels. The signs of child abuse and neglect include impulsive and aggressive behavior, depression, anxiety, frequent absence from school, hesitation to return home, and a withdrawal from friends and activities. Physical abuse is suspected due to unexplained bruises, burns, and fractures. Sexual abuse is more difficult to detect without a medical examination. The signs of neglect are poor hygiene, inadequate clothing, stealing, obsessive craving for food, and being overweight or underweight.

Repeated facial trauma is a characteristic of physical abuse. Physicians, dentists, and especially pediatric dentists are uniquely positioned to identify such injuries. Abusive head trauma, known as a shaken baby syndrome, results in brain injury in infants and young children. Nevertheless, it is difficult to detect due to the lack of external signs. While anogenital examinations of victims of sexual abuse are frequently negative, sexual abuse causes prepubertal genital bleeding, mandating routine prepubertal genital examinations in females.

The circumstances for reporting child abuse and neglect have changed drastically in recent years. Many countries have systems in place to respond to reports of child abuse. However, the socioeconomic and cross-cultural differences between developed and developing countries significantly impact the identification, prevention, and management of child abuse. In actuality, child abuse and neglect are frequently overlooked or not reported due to the complex legal procedure inherent to its reporting. Among health care professionals, physicians play a crucial role in detecting, identifying, and reporting suspected child abuse and neglect (SCAN). However, their abilities to do so are considerably influenced by the lack of formal training in this area, starting from their task as medical students, residents, and recent physicians.

Physical abuse is described as a non–accidental bodily injury inflicted on a child by hitting, slapping, pushing, pulling, biting, burning, violent shaking, or any other physical means to control the child. Sexual abuse is any sexual contact or exploitation of the child that includes performing and forcing sex acts upon the child. Sex acts include rape, fondling, indecent exposure, and the exploitation of the child in any sexually explicit manner. Emotional abuse is more prevalent than psychological abuse, acting as a means of control. Similar to physical abuse, it can take the form of threatening to leave the child, being severely critical, shouting, or name-calling. Although psychological abuse encompasses psychological abuse, the latter aims to convince the child that they are incompetent, stupid, or crazed.

While abuse is extreme, neglect—whether physical or emotional—also impacts the child. Physical neglect involves refusing to provide food, clothing, medical care, adequate shelter or supervision, and abandonment. Emotional neglect includes refusing to spend time or displaying affection towards the child. More often, child abuse and neglect are recurrent patterns of behavior involving regular attacks that harm the child with damage directly related to the length of the abusive behavior.

Importantly, this review further covers specifically SCAN for medical students, SCAN for medical residents, SCAN for physicians, and the mandatory reporting of SCAN. Also addressed are 1) the comparative life of the abused or neglected child before and after recognizing and reporting SCAN and 2) legislation to defend children against abuse.

Keywords: Child, Emotional Abuse; Neglect; Physical Abuse; Psychological Abuse; Reporting

References

  1. Brown CL., et al. “Child Physical Abuse And Neglect (2020).
  2. Gonzalez D., et al. “Child Abuse and Neglect (2020).
  3. 42 US Code § 5101 - Office on Child Abuse and Neglect. LII / Legal Information Institute (2021). https://www.law.cornell.edu/uscode/text/42/5101
  4. Hornor G. “Child neglect: assessment and intervention”. Journal of Pediatric Health Care2 (2014): 186-192. https://www.jpedhc.org/article/S0891-5245(13)00349-0/pdf
  5. Child maltreatment (2021).
  6. Al Odhayani A., et al. “Behavioural consequences of child abuse”. Canadian Family Physician8 (2013): 831-836. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743691/
  7. Kempe CH., et al. “The battered-child syndrome”. The Journal of the American Medical Association 181 (1962): 17-24. https://jamanetwork.com/journals/jama/article-abstract/327895
  8. D'Antonio IJ., et al. “Child maltreatment: international perspectives”. The American Journal of Maternal/Child Nursing2 (1993): 39-52. https://pubmed.ncbi.nlm.nih.gov/8412346/
  9. Mathews B and Kenny MC. “Mandatory reporting legislation in the United States, Canada, and Australia: a cross-jurisdictional review of key features, differences, and issues”. Child Maltreatment1 (2008): 50-63. https://pubmed.ncbi.nlm.nih.gov/18174348/
  10. Mathur S and Chopra R. “Combating child abuse: the role of a dentist”. Oral Health and Preventive Dentistry3 (2013): 243-250. https://pubmed.ncbi.nlm.nih.gov/23534033/
  11. Paglia L. “Child abuse: Awareness is the first step to action”. European Journal of Paediatric Dentistry2 (2018): 89. https://pubmed.ncbi.nlm.nih.gov/29790771/
  12. Nagarajan SK. “Craniofacial and oral manifestation of child abuse: A dental surgeon's guide”. Journal of Forensic Dental Sciences1 (2018): 5-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080162/
  13. Joyce T and Huecker MR. “Pediatric Abusive Head Trauma (2020). https://www.ncbi.nlm.nih.gov/books/NBK499836/
  14. Piteau SJ., et al. “Clinical and radiographic characteristics associated with abusive and nonabusive head trauma: a systematic review”. Pediatrics2 (2012): 315-323. https://pubmed.ncbi.nlm.nih.gov/22778309/
  15. Hadley J., et al. “Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination”. Journal of Pediatric and Adolescent Gynecology (2021). https://pubmed.ncbi.nlm.nih.gov/33482332/
  16. Bailhache M., et al. “Is early detection of abused children possible?: a systematic review of the diagnostic accuracy of the identification of abused children”. BMC Pediatrics 13 (2013): 202. https://pubmed.ncbi.nlm.nih.gov/24314318/
  17. Diaz A., et al. “Comparison of Modes of Administration of Screens to Identify a History of Childhood Physical Abuse in an Adolescent and Young Adult Population”. Annals of Global Health5-6 (2017): 726-734. https://pubmed.ncbi.nlm.nih.gov/29248088/
  18. Teeuw AH., et al. “Parents' Opinion About a Routine Head-to-Toe Examination of Children as a Screening Instrument for Child Abuse and Neglect in Children Visiting the Emergency Department”. Journal of Emergency Nursing2 (2016): 128-138. https://pubmed.ncbi.nlm.nih.gov/26547572/
  19. Teeuw AH., et al. “Screening for child abuse using a checklist and physical examinations in the emergency department led to the detection of more cases”. Acta Paediatrica2 (2019): 300-313. https://pubmed.ncbi.nlm.nih.gov/29992712/
  20. Giroux ME., et al. “Differences in child sexual abuse cases involving child versus adolescent complainants”. Child Abuse and Neglect 79 (2018): 224-233. https://pubmed.ncbi.nlm.nih.gov/29482109/
  21. Rizvi MB., et al. “Pennsylvania Child Abuse Recognition and Reporting (2020).
  22. Rizvi MB., et al. “New York State Child Abuse, Maltreatment, and Neglect (2020). https://pubmed.ncbi.nlm.nih.gov/33351402/
  23. Regis A. https://scholars.unh.edu/cgi/viewcontent.cgi?article=1014&context=honors
  24. Christian CW. “Professional education in child abuse and neglect”. Pediatrics1 (2008): S13-17. https://pubmed.ncbi.nlm.nih.gov/18676509/
  25. Alpert EJ., et al. “Interpersonal violence and the education of physicians”. Academic Medicine 1 (1997): S41-50. https://pubmed.ncbi.nlm.nih.gov/9008586/
  26. Narayan AP., et al. “Pediatric residency training in child abuse and neglect in the United States”. Pediatrics6 (2006): 2215-22221. https://pubmed.ncbi.nlm.nih.gov/16740867/
  27. Jenny C., et al. “Analysis of missed cases of abusive head trauma”. The Journal of the American Medical Association 7 (1999): 621-626. https://pubmed.ncbi.nlm.nih.gov/10029123/
  28. Dubowitz H. “Child sexual abuse and exploitation-A global glimpse”. Child Abuse and Neglect 66 (2017): 2-8. https://pubmed.ncbi.nlm.nih.gov/28237191/
  29. Starling SP., et al. “Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors”. Pediatrics4 (2009): e595-602. https://pubmed.ncbi.nlm.nih.gov/19273504/
  30. Pelletier HL and Knox M. “Incorporating Child Maltreatment Training into Medical School Curricula”. Journal of Child and Adolescent Trauma3 (2017): 267-274. https://pubmed.ncbi.nlm.nih.gov/29026450/
  31. Donohue B., et al. “A standardized method of diplomatically and effectively reporting child abuse to state authorities. A controlled evaluation”. Behavior Modification5 (2002): 684-699. https://pubmed.ncbi.nlm.nih.gov/12375381/
  32. Warner-Rogers JE., et al. “The influence of case and professional variables on identification and reporting of physical abuse: a study with medical students”. Child Abuse and Neglect9 (1996): 851-866. https://www.sciencedirect.com/science/article/abs/pii/0145213496000737
  33. Jonson-Reid M., et al. “Child and adult outcomes of chronic child maltreatment”. Pediatrics5 (2012): 839-845. https://pubmed.ncbi.nlm.nih.gov/22529281/
  34. Deblinger E and Runyon MK. “Understanding and treating feelings of shame in children who have experienced maltreatment”. Child Maltreatment4 (2005): 364-376. https://journals.sagepub.com/doi/10.1177/1077559505279306
  35. Burgic Radmanovic M. “Mental Disorders in Sexually Abused Children”. Psychiatria Danubina3 (2020): 349-352. https://pubmed.ncbi.nlm.nih.gov/33030451/
  36. Teicher MH and Samson JA. “Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect”. Journal of Child Psychology and Psychiatry3 (2016): 241-266. https://pubmed.ncbi.nlm.nih.gov/26831814/
  37. Teicher MH., et al. “The effects of childhood maltreatment on brain structure, function and connectivity”. Nature Reviews Neuroscience10 (2016): 652-666. https://www.nature.com/articles/nrn.2016.111
  38. Flaherty EG., et al. “From suspicion of physical child abuse to reporting: primary care clinician decision-making”. Pediatrics3 (2008): 611-619. https://pediatrics.aappublications.org/content/122/3/611
  39. Flaherty EG., et al. “Pediatrician characteristics associated with child abuse identification and reporting: results from a national survey of pediatricians”. Child Maltreatment4 (2006): 361-369. https://journals.sagepub.com/doi/10.1177/1077559506292287
  40. Gunn VL., et al. “Factors affecting pediatricians' reporting of suspected child maltreatment”. Ambulatory Pediatrics2 (2005): 96-101. https://www.researchgate.net/publication/7955112_Factors_Affecting_Pediatricians%27_Reporting_of_Suspected_Child_Maltreatment
  41. Al Hajeri H., et al. “Assessment of the knowledge of United Arab Emirates dentists of Child Maltreatment, protection and safeguarding”. European Journal of Paediatric Dentistry2 (2018): 105-118. https://ejpd.eu/EJPD_2018_2_3.pdf
  42. European Status Report On Preventing Child Maltreatment.
Citation: Kerna NA, Holets HM, Hafid A, Pruitt KD, Carsrud NDV, Nwokorie U, Flores JV, Nomel R, Waugh S. “SCAN: A Succinct and Practical Guide for Recognizing and Reporting Suspected Child Abuse and Neglect”. EC Paediatrics 10.7 (2021): 63-74.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.