An abused child is hurting physically and emotionally and so needs care which may be interdisciplinary in scope to obtain relief. Appropriate care is given to physical injuries detected such as plaster of Paris casting for fractures of long bones, dressing and antibiotic cover for wounds and burns. Children who suffered very violent shaking from their care giver may present with central nervous system injuries such as subdural hematoma. This will require a Neurosurgeon’s intervention to drain the collection of blood. Different specialists may be consulted in the severely abused child; eye specialist may be consulted to diagnose or exclude retinal hemorrhage.
The emotional wounds are typically more devastating because they attack the very essence of the child and can set in motion a cycle of self-destructive behaviors. Not every abused child turns out to be an emotional wreck; it all depends on what coping strategies the child adopts. An abused child out of desperation is prone to adopting coping strategies that could be injurious to him/her and so must be counseled against such habits. Habits like social withdrawal as a result of low self-esteem, resorting to violence as a means of settling issues, delinquency, skipping school, use of drugs to overcome depression, early indulgence in sex as a means of getting back at the parents or as a means of escape from reality, getting involved in gangs as a means of getting back at perceived enemies. The physically abused child may also indulge in stealing, lying, gambling and other deviant behaviors in order to survive. Depression is a common problem in physically abused children and it arises from unexpressed anger. Some could get so depressed as to attempt suicide or run away from home.
For psychosocial care, child protective services agency in the community should be contacted if medical evaluation had established a case of child abuse. The agency does its investigations in assessing the caregiver’s background, care giving abilities and potential, environmental safety, risk for repeat abuse and risk to other siblings. The services rendered by the agency may range from periodic contact with the child and family to see that the home situation is improving to removal of the child from home either temporarily or permanently with termination of parental rights. For mild cases of child abuse, the child returns home with care givers with or without services. For moderately severe cases, the child is removed from the home and family with care givers consent. The family is then offered services to assist them in working towards reuniting with the child. In severe cases, the child is removed from the home and family without care giver’s consent usually with a court’s approval as well as commencement of legal steps and processes to determine the ultimate plan for the child.
Dr Francis Edo Olotu is the Medical Director of Christ Hospital, Ondo. He is also a family counselor who regularly counsels married persons and administers pre-marriage counseling to couples about to marry in his home church of St John Bosco Catholic Church Ondo. He is a frequently featured speaker in the Catholic Charismatic Renewal. He is married to Catherine and their marriage is blessed with four children in the age bracket of twelve to twenty two. Dr Olotu is the author of the following books: The Amazing Power in Fatherhood; Releasing the Power in Fatherhood as well as Your Guide to Cancer Prevention. caregiver agency montreal