week 8 response 1

Case Scenario 3: Mandy is a 10-year-old who has been brought in by her new foster mother for a well-child exam. The foster mother states that Mandy was removed from her home due to neglect and physical and sexual abuse and expresses concerns Mandy may have an eating disorder.

What types of abnormal behaviors might Mandy exhibit?

There can be a broad spectrum of emotions, behavioral, and developmental problems in children experiencing physical abuse, sexual abuse, and neglect. In this case Mandy can experience internal behaviors of experienced maltreatment. There can be disorder behaviors that can include restrictive eating, binge eating, fasting, or picky patterns. Additional behavioral manifestation can include mood, sleep disturbances, regression behavior, self-harm, and difficulties with interpersonal relationships.

What physical findings might you find during the physical examination?

Some physical findings can be patient skin findings are bruising in protected areas like buttocks, neck, torso, ears, and upper arms. There can be a pattern of bruises, oral injuries, and subconjunctival hemorrhage.

How should you manage Mandy’s history of abuse?

The American Academy of Pediatrics recommends a trauma-informed care framework that recognize the impact stress on children and families. Obtain comprehensive history and use open-ended, non-accusatory questions when talking to the foster mother. Review available Child Protective Service report and court documents. Conduct a thorough physical examination. We also want to document all findings and with detailed descriptions and photography when possible.