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Child abuse is a worldwide problem that affects children of all age group. According to the American Academy of Pediatrics (AAP) 2018, most cases of child abuse in the pre school age group are neglect, followed by physical and sexual abuse. Some children may be affected by a combination, meaning that a child might be victim of both physical and neglect at the same time. Sexual abuse may include fondling, genital and anal intercourse or oro- genital contact, (AAA 2018). Neglect may include failure to provide food, shelter, clothing, inadequate health care or even emotional support to the child. Physical abuse may include injuries resulting from the child being hit, burnt or any other physical activity that results in injury to the child, (AAP 2018).

Some warning signs may include the care giver delay in seeking medical care for an injured child, or showing no concerned for the injuries sustained by the child, burn to the genitalia, bruises to the child’s body, sometimes these are frequent with no explanation as to how the child got the injuries or the explanation is contradictory to the type of injury, (McCalla, G. D., 2018). McCalla 2018 further stated that when a child is observed to be identified with unacceptable behaviors such as undressing in front of others, touching other children’s genitalia or always trying to look at other person undressing, these may be cues to assess for abuse. Signs of neglect may include the child being dirty and unkept, poor hygiene, especially poor dental hygiene with extensive dental caries, the child may be malnourished with them being very small for their age.

There are some cultural variations of health practices that can be mistaken for child abuse. One such practice is moxibustion, which is a cultural healing practice originating in Asian medicine. It involves burning pieces of moxa herb and putting it on the skin above the acupuncture points, until there is pain. This results in small round lesion that may be mistaken for cigarette burns. This practice is used to treat abdominal pain and fever. (McCalla, G. D., 2018).

To report child abuse for the state of Georgia, we should call DFCS Child Protective Service at 1855.GACHILD (422-4453), or E-mail the mandated report to cpsintake@dhr.state.ga.us, or Fax mandated report to 299-317-9663.


American Academy of Pediatrics, (2018). Child Abuse and Neglect. Retrieved from www.healthychildren.org

Killion, C. (2017). Cultural Healing Practices that Mimic Child Abuse. Retrieved from www.semanticscholar.org

McCalla, G. D., (2018). Child Abuse and Neglect. Retrieved from www.ncbi.nlm.nih.gov

Family and Children Services (n.d.). Child Abuse and Neglect. Retrieved from https://dfcs.georgia.gov/child-abuse-neglect


Child abuse is defined as “any act or a series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child” (Falkner, 2018). Child abuse is seen in various stages and can be sexual abuse, physical abuse, psychological abuse or even a combination of both. Cases of child abuse are more rampant in unstable families, where parents are always in constant fights, families that have a parent or both indulging in drugs like alcohol, and other substance abuse. Children of a parent or parents who practice prostitution are also at highest risk because they may tend to lure the child, and especially if female, into practicing the same vice for financial benefits.

School aged children are a good example in child abuse. This affects the children psychologically and always manifests in class performance and behavior. Abused children start performing poorly in class as their grades start dropping as compared to how they used to perform academically. Behaviors will change and they they become withdrawn, overtly aggressive to their peers, they may become bullies because they use this as revenge or getting out the anger in them. Concentration in class dwindles and may want to either come to school early or stay until very late in school just to avoid the situation at home.

Abused children will have medical and or physical problems which are brought to the parent’s attention, but parents will always assume these issues and fail to address them. Physically abused children may have wounds in different healing stages, this may involve burns, bruises, cuts and bites. They will always be afraid and shy away from adults by trying to avoid them. Neglected children may always appear in dirty tattered clothing, undone hair, foul smelling clothes which are not changed, lack of body hygiene, having inappropriate clothing for the weather. They are in constant need of medical attention for different ailments. They would have missed scheduled appointments with the care providers and even miss immunizations. Sexually abused school children may shy away from there peers and avoid changing clothes in the same room with fellow peers, they may have difficulty walking or sitting and they will have sophisticated, bizarre or unusual sexual knowledge with decrease in appetite, ( Childwelfare.gov, 2007). These children may become thieves and keep begging for money and food. As care provers, we should do a thorough assessment and make sure that such cases are reported to the authorities because as much as all these are indicators of abuse, it does not mean that 100% they are.

As care providers, we should also be aware of some cultural practices which may seem as abuse but are culturally considered a normal practice in certain ethnicities. In Africa we have the Sudanese and Kenyan Nilotic who use sharp blades to make patterns on human skin, especially on the face as a sign of beauty and they also make incisions in the abdomen and chest and herbs are burnt over the raw incision areas when someone is sick, or for protection from evil spirits. So, when they come to the hospital, the provider might see this as a sign of abuse, which is not the case to them culturally.

Reporting suspected abuse or neglect in the state of Maine is made to the Maine Office of Child and Family Services at 1-800-452-1999.This is a 24hour service line. One has to state there name and contact information, name of the family you are calling about, physical address, work/ school information for the adults or children in the family, a description of the problem you are concerned about, your knowledge of other risk factors as domestic violence, substance abuse or mental health issues, any relatives or resources you are aware of. One may request for confidentiality or anonymity. Report is recorded and investigated but not all reports are worked upon.


Falkner, A. (2018) Health Assessment: Foundations for Effective Practice retrieved from


 Home-Child Welfare Information Gateway (2019) Retrieved from


Abuse Reporting -Child Welfare Maine DHHS :OCFS (2019) Retrieved from


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