Child Abuse and Neglect

Table of Contents

1. Child Abuse and Neglect
2. What is Child Abuse and Neglect?
3. Physical Abuse
   1. Bruises
   2. Case Study #1
   3. Burns
   4. Case Study #2:
   5. Fractures
   6. Case Study #3:
   7. Quickchecks
   8. Abusive Head Trauma in Infants
   9. Evaluating a child for suspected physical abuse
4. Sexual Abuse
5. Child Neglect
6. When you suspect abuse or neglect
7. Domestic Violence and Children
8. Preventing Child Abuse
9. References

Physical Abuse

Minor injuries are an inevitable part of childhood. Distinguishing accidental from inflicted injury is not always easy, but in most cases can be achieved by following these guidelines:

1. Does the parent's explanation remain consistent? Does the parent/guardian' explanation remain the same even when questions are repeated by other members of the medical team?
2. Is the explanation consistent with generally-accepted mechanisms of injury? Major injuries are the result of high-energy impacts. Thus, if a parent explains that an infant has massive head injuries because he fell off a couch, that explanation would not be consistent with the observed findings.
3. Is the explanation consistent with the developmental capability of the child? If a parent says a 2-week-old infant was injured when she rolled off a bed, that explanation would not be consistent with published developmental milestones (infants are not generally capable of rolling over until approximately 4 months of age).
4. If the injury is severe or painful, did the family promptly seek medical attention for the child? In general, after a major accidental injury, parents will immediately call Emergency Medical Services or transport the child themselves to a medical facility. After an inflicted injury, the perpetrator will often delay seeking care for the child.