Children neglected may have physical, behavioral health problem

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Children who have suffered from neglect may have physical or behavioral health problems even after the mistreatment stops. The guidelines from the American Academy of Pediatrics build on previous advice for doctors to be on the lookout for signs of past maltreatment, The Telegraph reported.
Since the last guidelines came out in 2008, new evidence has documented the connection between mistreatment early in childhood and subsequent health problems, and studies have provided fresh insight into the lasting effects of chronic stress.
“Child maltreatment is seriously under-reported,” said lead author of the guidelines, Dr Robert Sege of Tufts University and Health Resources in Action in Boston. “As a result, pediatricians who are treating a child for complex behavioral problems, especially when these problems seem difficult to treat, might do well to consider that the symptoms may have arisen due to prior abuse or neglect,” Sege said. Although some children recover from adversity, traumatic experiences can result in significant disruption of normal development, researchers note in Pediatrics. Children, like adults, can develop post-traumatic stress disorder (PTSD) that may be accompanied by depression, anxiety or disruptive or defiant behaviors, for example.
When children have experienced neglect, they may respond to certain sights, sounds, smells or actions in ways that appear overly dramatic or inappropriately emotional, the guidelines note. This may happen because when children are exposed to reminders of past maltreatment, their brain experiences a fight- or-flight response similar to what occurred during the initial abuse or trauma.
Kids may also have behavioral responses to teachers or caregivers that are shaped by past mistreatment. For example, stern warnings can become louder and brusquer and discipline can seem harsher. Early brain development can also be impacted by what’s known as toxic stress, or chronic exposure to severe stress over a long period of time. This can also alter kids’ hormonal development and influence how soon they enter puberty.
Pediatricians can ask about exposure to stress, neglect as part of taking down a child’s medical history, the guidelines note. Doctors can also help parents and caregivers understand that children with a history of maltreatment may not feel psychologically safe and may need different types of support or discipline than other kids. “The good news is that once in the safe care of non- maltreating adults, there are a set of parenting skills that can be learned that are very helpful in responding to child behavior that may be the result of traumatic response,” said Melissa Jonson-Reid, a researcher at Washington University in St. Louis who wasn’t involved in the guidelines.

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