Peds - Child Abuse & Neglect
Neglect is the most common form of maltreatment 74.9% of cases
17.5% of cases involved physical abuse
9.3% involved sexual abuse
When is abuse and neglect most common in children?
3 and younger
Prevention is key for abuse and neglect. How?
What about sexual abuse?
Parent education and primary care providers' anticipatory guidance are helpful, with
attention to handling situations that stress parents (eg, colic, crying behavior, and toilet
training), age-appropriate discipline, and general education about child developmental
issues
Teach kids to protect themselves
Discussion about private parts- introduce with toilet training Promote internet and social
media safety
What are the most common presenting problems seen in abuse?
Substance abuse and mental health issues in caregivers
Poverty and economic strains
Parental capacity and skills
Domestic violence
COVID pandemic- parental job loss, psychological and emotional mistreatment
What are the most common manifestations of physical abuse?
bruises, burns, fractures, head trauma, and abdominal injuries
What is the medical diagnosis of physical abuse based on? What are the signs?
the presence of a discrepant history (history offered by the caregiver is not consistent
with the clinical findings)
Discrepancy may exist because the history is absent, partial, changing over time, or
simply illogical or improbable
Bruising: < 4 M old; cheek/buttocks/jawline/face; bite marks; striking marks
Burns: sharp demarcations, immersion ("high tide marks", cig burns
Fractures: diff stage of healing; sev skull fxs; bilateral long bone fxs, rib fxs, bucket
handle, spinous process fxs
Oral: Lip/tongue lacs/bruising/wounds in immobile children; missing/fx teeth
Alopecia (2/2 hair pulling)
Retinal hemorrhages
Describe the bruises of abuse. Compare them to normal accidental bruising
Bruises in physically abused children are sometimes patterned (eg, belt marks, looped
cord marks, or grab or pinch marks) and are typically found over the soft tissue areas of
the body
Toddlers or older children typically sustain accidental bruises over bony prominences
such as shins and elbows
Neglect is the most common form of maltreatment 74.9% of cases
17.5% of cases involved physical abuse
9.3% involved sexual abuse
When is abuse and neglect most common in children?
3 and younger
Prevention is key for abuse and neglect. How?
What about sexual abuse?
Parent education and primary care providers' anticipatory guidance are helpful, with
attention to handling situations that stress parents (eg, colic, crying behavior, and toilet
training), age-appropriate discipline, and general education about child developmental
issues
Teach kids to protect themselves
Discussion about private parts- introduce with toilet training Promote internet and social
media safety
What are the most common presenting problems seen in abuse?
Substance abuse and mental health issues in caregivers
Poverty and economic strains
Parental capacity and skills
Domestic violence
COVID pandemic- parental job loss, psychological and emotional mistreatment
What are the most common manifestations of physical abuse?
bruises, burns, fractures, head trauma, and abdominal injuries
What is the medical diagnosis of physical abuse based on? What are the signs?
the presence of a discrepant history (history offered by the caregiver is not consistent
with the clinical findings)
Discrepancy may exist because the history is absent, partial, changing over time, or
simply illogical or improbable
Bruising: < 4 M old; cheek/buttocks/jawline/face; bite marks; striking marks
Burns: sharp demarcations, immersion ("high tide marks", cig burns
Fractures: diff stage of healing; sev skull fxs; bilateral long bone fxs, rib fxs, bucket
handle, spinous process fxs
Oral: Lip/tongue lacs/bruising/wounds in immobile children; missing/fx teeth
Alopecia (2/2 hair pulling)
Retinal hemorrhages
Describe the bruises of abuse. Compare them to normal accidental bruising
Bruises in physically abused children are sometimes patterned (eg, belt marks, looped
cord marks, or grab or pinch marks) and are typically found over the soft tissue areas of
the body
Toddlers or older children typically sustain accidental bruises over bony prominences
such as shins and elbows
