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Child Maltreatment - Coggle Diagram

- - - - Stranger anxiety
      - Emotional withdrawal
      - Inappropriate fearfulness
      - Delinquency
      - Lag in emotional and intellectual development
      - Language difficulties
      - Suicide attempts
    - - Failure to thrive
      - Feeding difficulties
      - Enuresis or encopresis
      - Sleep disturbances
  - - - Begging or stealing food
      - Extended stays at school
      - **Fatigue or listlessness at school
      - Delinquency
      - Alcohol or drug abuse
    - - Failure to thrive
      - Lag in growth and development
      - Consistent hunger
      - Poor personal hygiene
      - Inappropriate dress for season
      - Unattended medical needs
      - Abandonment
- - - - Ecchymosis reflecting the shape of object used to inflict injury (electrical cord, belt buckle, iron, radiator, or a hand)
      - Evidence of human bites
      - Lacerations or abrasions
      - Burns that are symmetric and have no “splash marks”
      - Ecchymosis, welts, and bite marks
      - Cigar or cigarette burns on soles, palms, back, or buttocks
      - Fractures: • To skull, nose, or face • Multiple or spiral • Various stages of healing • Discovered during the examination, not reported by caretaker
    - - Frequent injuries explained as accidents
      - Conflicting stories about the “accident” or injury from the parents or others
      - Wary of contacts with parents or other adults
      - Apprehension when other children cry
      - Fear of parents or going home
      - Concealing clothing worn to hide injuries
      - Low self-esteem
      - Suicide attempts
  - - - Pain or pruritus in genital area
      - Ecchymosis or bleeding in external genitalia, vaginal, or anal area
      - Torn, stained, or bloody underclothing
      - Ecchymosis to the hard or soft palate
      - *Difficulty in walking or sitting
      - Sexually transmitted diseases in preteens
      - Adolescent pregnancy
      - Enuresis or encopresis
      - Vaginal or penile discharge
      - Foreign bodies in vagina or rectum
      - Presence of semen
      - Recurrent urinary tract infection
    - - Unwillingness to change for gym
      - Withdrawal, fantasy, or infantile behavior
      - Age-inappropriate sexual knowledge
      - Promiscuous behavior
      - *Nonspecific symptoms such as sleep disturbances or
        abdominal pain noted by provider
      - Poor peer relationship
      - Forcing sexual acts on other children
      - Fear of being touched
      - Excessive or public masturbation
      - Declining school performance
      - Prostitution