Child abuse can include physical, emotional, sexual abuse or neglect that harms a child's health or welfare. It is defined as any non-accidental injury or maltreatment of a child under 18 by a caretaker. Common types of child abuse include physical abuse, sexual abuse, emotional abuse, and neglect. Physical signs of abuse may include bruises in various stages of healing, hand marks, burns, fractures, and other injuries. Preventing and intervening in child abuse requires a multi-level approach through laws, child protective services, and community organizations working to protect children's rights and welfare.

1. CHILD ABUSE
SHAREEF

2. Definition
non accidental physical injury,minimal
or fatal.inflicted upon children by persons
caring for them(Selwyn et al)

3. “The physical or mental injury,sexual abuse or
exploitation,negligent treatment,or maltreatment
of a child under age of 18 by a person who is
responsible for the child’s welfare under
circumstances which indicate that the child’s
health or welfare is harmed or threatened”
Child Welfare Act

4. Historical Background
First documented and reported case of child abuse neglect
occurred is 1874 with a child named Mary Ellen
In1946 in a classic by article Caffey, some common features of
child abuse were first described and it reported the common
association of subdural hematoma and long bone, pathosis.

5. A review by Radbill (1973)is indicated that historically children
were considered to be their parents property, having a few rights of
their own. It was taken for granted that parents and guardian had
every right to treat there children as they wished
In1962 the term battered child syndrome was coined by Henry
Kempe is his milestone article.It was further elaborated by kempe
and Helfer in 1972

6. Types of child abuse
physical abuse - 31.8 %
educational abuse - 26.3%
emotional abuse - 23.3%
sexual abuse - 06.8%
failure to thrive - 04.0%
international drugging
or poisoning - not specified
munchausen syndrome
by proxy - not specified

7. Physical abuse
Any non-accidental injury to a child under the age
of 18 by a parent or caretaker.
These injuries include
beatings,shaking,burns,human bites,strangulation,or
immersion in scalding water or others,with resulting
bruises and welts,fractures,scars,burns,internal
injuries or any other injuries

8. According to Wrights(1975) classification
of child’s behavior physically abused
children are included in STOIC type
in which they are cooperative and
passively accept all treatment without
any facial expression

9. Bruises in physical child abuse
Inflicted bruises
Accidental bruises
Unusual bruises
Pseudo bruises

10. Colour change during healing of bruise
0-2 days swollen,tender
0-5 days red,blue purple
5-7 days green
7-10 days yellow
10-14days brown
2-4 weeks cleared

11. Marks is physical child abuse
Human hand marks
Strap marks
Lash marks
Loop marks
Bizarre marks
circumferential tie mark
Gag marks

14.  Sexual abuse : Child sexual abuse include
contact or interactons between a child and an
adult when the child is being used for the sexual
stimulation of the preparator or another person

15. Emotional abuse
It includes the failure of a caregiver to
provide an appropriate and supportive
environment,and includes act that have an
adverse effect on the emotional health and
development of a child.

17. Battered baby : Is a child who shows clinical or radiographic
evidence of lesion that are frequently multiple and involve merely
the head, soft tissue, long bones, thoracic cage and that cant be
unequivocally explained (Selwyn)
Neglected child : Is one who shows evidence of physical or
mental ill health primarily due to failure on the part of the parent
or caretaker to provide adequately for the child`s needs

18. Persecuted child : Is one who shows evidence of
mental ill-health caused by deliberate infliction of
physical or psychological injury that is often
continues is nature

19. Some of the identifying features of the abused child
are:
Unduly afraid or passive child
Evidence of prolonged confinement like delay in speech
Evidence of repeated skin or other injuries
Child is undernourished and is given inappropriate food or drink
Evidence of poor overall care
Child is cranky irritable or cries easily
Physically abused children were more aggressive than neglected

20. Clinical assessment
History
Physical examination
Intraoral examination
Documentation
- written observation
1 number
2 type
3 location
4 resolution
5 possible cause
6 opinion
- photographs
1 35mm color photograph

21. 2 various views
- Radiographs
- Bite-marks
- Saliva
Treatment
Parental consultation
Reporting

22. Munchausen Syndrome by proxy
It was first described by Dr.Richard Ashes in 1951. He
reported adult who fabricated symptoms about themselves and
produced sign of illness. They presented themselves for medical
care but did not inform the medical professional about the
deception on the other hand `Munchausen syndrome` by proxy`a
parent or care taker attempts to bring medical attention to
themselves by injuring or inducing illness in their children…

24. Dental Neglect In Children
The following definition of dental neglect has been
recommended by the Ad hoc committie on child abuse and neglect
of the American Academy of Pediatric dentistry. The failure by a
parent or guardian to seek treatment for visually untreated
caries,oral infection and/or oral pain.

25. Identification of Neglect
.Undetected rampant caries that is easily detected by a lay person
.Untreated pair, infection, bleeding or trauma affecting the
orofacial region
.History of a lack of continuity of care in the presence of previously
identified dental pathology

26. Indian laws for child abuse
India has no law on/for child abuse per se
physical abuse
- violence in home : Indian Penal Code(IPC)323IPC324
sexual abuse :
- girls : statutory rape :IPC 376
- boys : unnatural sexual offence : IPC 377
there is no law which protects child from other types of abuse
like emotional and educational abuse

27. • In India child labor is the commonest type
of abuse
Preliminary notification issued on October
5,1993 the government has prohibited
employement of children in occupation
processes

28. Child protective agencies
In India police is the concerned authority
national human right commission (NHRC) also have similar role

29. Government Organizations (GOs)and Non-
Government Organization(NGOs)Working against
child abuse
the United Nations International Children s Education Fund (UNICEF)
the Child line Organization, New Delhi
Ummid Sanstha, New Delhi
Asha Sevabhavi Sansatha, Mumbai,
Shakti, Kolkatta
Sparsh Seva Sanstha, Mumbai,

30. National commission for Indian council for
ptrotection of child rights child welfare

32. Intervention and prevention
Primary level :Dentist should follow approaches
which are applicant to population is general without
targeting a particular high risk group
Secondary level :Concern and effects directed to
those who are know to be especially at high risk
Tertiary level : If refers to intervention after the
condition is already identified. Prevention is considered as
the goal is to prevent recurrence of the condition.

33. The parliament of India passed the
protection of children against sexual offences bill 2011
regarding child sexual abuse on may 22 ,2012 in to act and
notified on November 14,2012 and law has become ready
for implementation.

34. Conclusion
Abusing a child affect or impairs the mental, physical and
sexual emotional and social development of child. Which may result
in the generation with emotional immaturity and increased criminal
behavior.So identification and management of child behavior is very
important for the development of person society and nation.