Forensic nursing and understanding normal child development

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Behavior in a physically abused child is an illustration of how abuse inhibits the normal progression of stages which Erickson believes is important to becoming a self-actualized adult.
“Behavior in a physically abused child can cover a wide range and depends on his developmental level and the severity and duration of abuse” (Mulryan, et. al.)
Erickson describes the psychosocial task in infancy as “basic trust versus basic mistrust” A young child who is being abused “may be wary or cling to strange adults, and he may become upset if another child begins to cry” (Mulryan, et. al). This behavior illustrates the fact that the child has never accomplished the basic tasks of infancy.
During older childhood, Erickson defines the development task as Industry vs. inferiority. An older child who is being abused “may seem fearful around his parents and other adults/ his behavior could range from passive and withdrawn to aggressive” (Mulryan, et. al). The child has never developed confidence and the ability to make friends.
An adolescent who is being abused may exhibit antisocial behaviors, such as truancy, running away from home, stealing or substance abuse. (Mulryan, et. al.) Role confusion develops and the adolescent is unable to develop a sense of his identity.
The provider who has a comprehensive understanding of normal developmental milestones has an invaluable tool at her disposal. Deviations from normal will send up red flags, cautioning the provider to stop and explore the situation further.

Mulryan, K., Cathers, P., and Fagin, A. “ Learn How to Identify and Help Victims—and What You Can Do to Prevent Abuse in the First Place,” Lippencott & Wilkings, Inc. 34(10): 52-57, October 2004.
Wilson, S, and Gideens, J. Health Assessment for Nursing Practice. St. Louis, Mo., Mosby, 2005.

Behavior in a physically abused child can cover a wide range and depends on his developmental level and the severity and duration of abuse. A young child may be wary or cling to strange adults, and he may become upset if another child begins to cry. An older child may seem fearful around his parents or other adults; his behavior could range from passive and withdrawn to aggressive. A preteen or adolescent may exhibit antisocial behaviors, such as truancy, running away from home, stealing, or substance abuse. Problems are easier to recognize if you understand the child’s emotional and social development and are familiar with his typical behavior patterns.

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