Identify the signs and symptoms which may indicate that a child or young person is injured or unwell

You head towards the office kitchen to grab a glass of water where you encounter a box of treats that seems to be calling your name.

Identify the signs and symptoms which may indicate that a child or young person is injured or unwell

Unnecessary or excessive use of restraints Ignoring dietary restrictions Toileting abuse leaving someone on the toilet too long or not taking them to the bathroom when they need to use it Bathing in water that is too hot or too cold Frightening Physical Actions Using frightening physical actions that stop short of causing serious physical harm is another form of physical abuse that is too often used by abusive caregivers of people with developmental disabilities.

Consider how these actions might affect a person with developmental disabilities: Grabbing persons with visual impairments from behind Jumping in front of persons with visual impairments, or trying to trip them Abruptly moving persons with mobility impairments Forcing persons with physical disabilities to move from one position to another when they are exhausted or in pain Physical Signs of Abuse: Questionable Bruises Bruises are among the most common injuries found in children and adults with developmental disabilities who have been abused.

It is important to remember that occasional bruising is also common in people who are not abused, and that people with some disabilities may be prone to bruising for other reasons.

Here are some of the more common bruises that may indicate signs of abuse: Facial Frequent, unexplained, or inadequately explained In unlikely places In various stages of healing On several different surface areas Patterned, reflecting shapes Bilateral: Bruises would appear on both upper arms, for example, may indicate where the abuser applied pressure while forcefully shaking the person.

Bruises on both sides of the body rarely result from accidental causes.

Identify the signs and symptoms which may indicate that a child or young person is injured or unwell

Regularly evident after an absence, home visit, or vacation The following are some other physical indicators of abuse or neglect of persons with developmental disabilities. In each case, other indicators such as behavior and circumstances must be considered.

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Questionable cuts and scrapes Consider: Frequent, repetitive, unexplained, or inadequately explained scrapes Atypical locations such as mouth, lips, gums, eyes, external genitalia e. Human bite marks are easily distinguished from those of animals by their size and shape, and whether flesh is torn.

Ligature marks and welts which could have come from being tied up or gagged Could be the result of whipping Welts often follow clearly defined stroke patterns, especially if the person was immobile during the whipping Chafing and bruising, sometimes accompanied by swelling, on the wrists, ankles, throat, or penis can be the result of being tied up or choked Even when choking is severe or fatal, bruising may be faint or entirely absent Eye and ear injuries Sudden or unexplained hearing loss Cauliflower ears i.

Repeated or multiple fractures in the absence of a known disease process or clear explanation may indicate abuse Old, untreated fractures can indicate chronic abuse Spiral fractures that result from twisting limbs may be related to abuse in non-ambulatory children and adults with developmental disabilities Coma: Shaking and other forms of abuse can result in coma of undetermined origin without external injuries.

Comas not associated with known accidental causes or clearly identified disease processes should also be suspected. Accidents happen with everyone, including people with developmental disabilities.

The following is a guide to help you tell the difference between accidental and non-accidental injuries. When observing an injury that might be the result of abuse, consider these factors: Location of the injury: Certain locations on the body are more likely to sustain accidental injury.

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These include the knees, elbows, shins, and forehead. Protected body parts and soft tissue areas, such as the back, thighs, genital area, buttocks, back of legs, or face, are less likely to accidentally come into contact with objects that could cause injury. Number and frequency of injuries: The greater the number of injuries, the greater the cause for concern.

Multiple injuries in different stages of healing are also a strong indicator of chronic abuse. Size and shape of the injury: Many non-accidental injuries are inflicted with familiar objects: The marks which result bear a strong resemblance to the objects used.

Accidental marks resulting from bumps and falls usually have no defined shape.

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Description of how the injury occurred: If an injury is accidental, there should be a reasonable explanation of how it happened that is consistent with the appearance of the injury. When the description of how the injury occurred and the appearance of the injury are inconsistent, there is cause for concern.

As children grow and gain new skills, their ability to engage in activities that can cause injury increases. A toddler trying to run is likely to suffer bruised knees and a bump on the head. Toddlers are less likely to suffer a broken arm than an eight-year-old who has discovered the joy of climbing trees.

Behavioral Signs of Abuse Behavioral signs can be extremely important in detecting abuse and neglect, especially in people who have communication challenges and are unable to tell anyone about what happened to them.

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Identify the signs and symptoms which may indicate that a child or young person is injured or unwell

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