CHILD ABUSE

BY
DR KIMWERO.M
DEPT OF PATHOLOGY
 Definition of Child Abuse
• It is any act or failure to act that endangers a child’s
physical or emotional development.

• It is more than just abrasions, bruises, swellings or

broken bones. While physical child abuse is shocking
due to the scars it leaves, not all child abuse is obvious.

• Ignoring children’s emotional needs, putting them in

unsupervised & dangerous situations, or making a child
feel worthless or stupid are also forms of child abuse.
 Cont
• While physical child abuse is more obvious, neglect
& emotional abuse can be just as damaging, & since
they are less obvious, others are less likely to
intervene.

• All forms of child abuse leave lasting scars, some of

which might be physical, but emotional scarring has
far reaching effects, damaging a child’s sense of self
& ability to have healthy relationships.

• Abused children are more likely to repeat the cycle

as adults.
 Types of Child Abuse
A) Physical Child Abuse:
- It involves physical harm or injury to the child.

- May result from a deliberate attempt to hurt the

child, but not always.

- May be the result of severe discipline/physical

punishment that is inappropriate to the child’s age.

- Many physically abusive parents/care givers think

that their actions are simply disciplinary
 Physical Abuse Vs Physical Disciplining
Unlike physical forms of discipline, the following
elements are present in physical abuse:

a) Unpredictability:

- The child never knows what is going to set the parent

off.

- There are no clear boundaries or rules.

- The child is constantly walking on egg shells, never

sure what behaviour will trigger a physical assault.
 Cont
b). Lashing out in anger:

- Physically abusive parents/care givers act out of anger & desire to

assert control.

- There is no motivation to lovingly teach the child.

- The angrier the parent, the more intense the abuse.

c). Using fear to control behaviour:

- Parents may believe that their children need to fear them in order to
behave.

- So they use physical abuse to keep the child in line.

 Signs of Physical child abuse
- Frequent injuries of various causes, ages

- Delay in seeking medical help or it is not sought at all

- Because of repeated injuries, children are treated at different

clinics by different doctors

- The history & explanation for the injuries is vague & inconsistent
with the injuries in question

- Child is always watchful & alert as if waiting for something bad to

happen

- Wearing inappropriate clothing to cover up injuries

 Cont
B) Emotional Child Abuse:

- ‘Sticks & stones may break my bones but words will

never hurt me’

- Contrary to this old saying, emotional abuse can

severely damage a child’s social development &
mental health, leaving life long psychological scars
 Examples of Emotional Child Abuse

• Constant belittling, shaming & humiliating a child

• Calling names & making negative comparisions to

others

• Frequent yelling & threatening

• Telling a child that they are no good, worthless

 Examples of Emotional Abuse

• Rejecting/Ignoring a child as a punishment

• Giving a child silent treatment

• Limited physical contact with the child ie no hugs,

no kisses

• Exposing the child to violence or abuse of others e.g

a parent, a sibling
 Signs of Emotional Child Abuse

- Excessively withdrawn, fearful, anxious about doing

some thing wrong

- Shows extremes of behaviour(extremely compliant,

demanding, passive, aggressive)

- Doesn’t seem attached to the parent or care giver

- Acts either inappropiately adult (taking care of other

children or inappropiately infantile(Thumb sucking,
throwing tantrums)
 Cont
C) Child Neglect:

- It is a very common type of child abuse

- It entails failing to provide for a child’s basic needs

e.g food, clothing, hygiene, supervision

- Parent may be physically or mentally unable to care

for the child e.g untreated depression, anxiety,
alcohol & drug abuse may impair judgement & the
ability to keep the child safe
 Signs of Child Neglect

- Clothes are ill-fitting, filthy or inappropriate for weather.

- Hygiene is consistently bad.

- May have untreated illness or physical injuries.

- Frequently unsupervised or left alone or allowed to play

in unsafe situations.

- Frequently late or missing from school. etc

 Cont
D) Sexual Abuse:

- This is the involvement of children in sexual activities which

they cannot fully comprehend & to which they cannot give
informed consent.

Types of sexual abuse include:

- Erotic touching e.g fondling, digital penetration.

- Sexual intercourse e.g incest, rape, sodomy.

- Exposing a child to sexual situations & materials e.g

pornography.
 Cont

• It is especially complicated because of its layers of

guilt & shame.

• Usually occurs at the hands of someone the child

knows, most often a close relative.

• Girls and boys are equally at risk

 Signs of Sexual Abuse
- Trouble walking or sitting

- Displays knowledge or intrest in sexual acts, inappropriate to his or

her age or even seductive behaviour

- Makes strong efforts to avoid a specific person without an obvious

reason

- Don’t want to change clothes in front of others

- An STD, Pregnancy especially under the age of 14

- Runs away from home

 Risk Factors for Child Abuse

A) Parent/Care giver factors:

- Alcohol & drug abuse

- Lack of knowledge & wrong attitudes

- Age ie immaturity

- History of child abuse

- Marital conflict & domestic violence

 Cont

- Poverty & Unemployment

- Lack of social support

- Violent communities

- More in single parent households

- Psychological well being

 Cont
B) Child Factors:

- Age ( Birth - 3 years)

- Disabled Children

- Other Child characteristics eg aggression, attention

deficits, difficult temperaments, etc

- Male children

- Illegitimate children
 EFFECTS OF CHILD ABUSE
• Low self esteem

• Depression & anxiety

• Aggressive behaviour & anger issues

• Relationship difficulties

• Personality disorders

• Problems in school & work

• Suicide attempts
 Cont

• Criminal or antisocial behaviour

• Teen pregnancy

• Alcohol & drug abuse

• Eating disorders

• Bed wetting

• Spousal abuse
 Cont
• Shame and guilt

• Excessive promiscuity
 FORENSIC DENTISTRY/ODONTOLOGY

- This is the application of dentistry in legal

proceedings deriving from any evidence that
pertains the teeth.

- The enamel component of the teeth is the hardest

tissue of the body.

- Enamel can withstand decomposition, heat

degradation, water immersion & desiccation better
than other tissues in the body.
 Cont

- Each individual has a set of teeth which can be

traced back & matched with established dental
records to identify missing persons.

- The teeth follow a chronological and standardized

pattern in their development. This helps in
estimating the age of a person.

- Teeth are a source of DNA: dental pulp or a crushed

tooth can provide nuclear or mitochondrial DNA
that help identify a person.
 Applications of Forensic Dentistry

- Identification of human remains(Individual or

mass).

- Estimation of the age of victim and perpetrator

- Analysis of bite marks

 Challenges in Identifying of Human Remains

- Severely decomposed or burned individuals are

common in the mortuary.

- In these types of cases, forensic dentistry can be

most helpful in establishing the identity of the dead.

- In such cases, visual identification is usually not

possible or the deceased’s fingers may be too
damaged to get fingerprints.
 Cont

- DNA may be too degraded to develop a satisfactory

post-mortem DNA profile of the deceased.

- An antemortem DNA profile of the deceased or the

deceased’s family members may not be available for
comparison
 Human Remains Dental Identification

Examination of Dentition:

- Charting the teeth: Noting existing dental protheses, Restorations,

Root canal Rx, missing teeth, Taking radiographs & photographs.

Individual Teeth Characteristics:

- Noting size & shape of teeth, roots, number of teeth, combination
of dental work done e.g crowns, extractions, fillings etc.

If the deceased’s dentist can be located & antemortem records got,

identification by comparing antemortem & postmortem records
can be done quickly, reliably & cost-effectively
 Bite Mark Analysis

- Bite marks may be found on the body of victims of a

violent attack.

- They may also be found on the suspect, left by the

victim during self defence.

- Once a bite mark has been found, it should be

sufficiently photographed with a scale & a saliva
sample is taken from the site for potential DNA
evidence.
 Bite Mark Analysis

- Impressions of the potential suspect’s teeth should

be made and cast.

- Comparision of the suspect’s teeth casts and the

bite marks should be analysed.
Images
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 HOME WORK

AGE ESTIMATION USING THE DENTION