Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T17:35:48.494Z Has data issue: false hasContentIssue false

Chapter 11 - Child Maltreatment

Published online by Cambridge University Press:  20 July 2023

By
Nisha Narayanan  and
Dana Lauture
Edited by
Mark Curato ,
Kaushal Shah  and
Christopher Reisig
Mark Curato
Affiliation:
Weill Cornell Medicine, New York
Kaushal Shah
Affiliation:
Weill Cornell Medicine, New York
Christopher Reisig
Affiliation:
Weill Cornell Medicine, New York
Get access

Summary

While child maltreatment is a global problem, urban settings highlight the problem due to large concentrations of people, which increase the likelihood that the maltreatment will be noticed and reported; urban Emergency Departments (EDs) are particularly situated for the detection of child maltreatment. The ability of the emergency physician to recognize and respond to child maltreatment is crucial in preventing further harm to the child. Emergency physicians are also mandated reporters, and are required by law to inform child protective services of all suspected cases. There are certain risk factors for child abuse and subtle red flags in the history and physical exam that we must familiarize ourselves with in order to appropriately identify child abuse. These risk factors and rates of child abuse may be unique for the clinician practicing emergency medicine in an urban setting. The evaluation of a child with suspected abuse also requires an extensive workup and detailed documentation, and such cases are prone to medical and legal consequences.

Keywords

Mandated reporterChild maltreatmentChild abuseChild neglectPhysical abuseSentinel injurySexual abuseEmotional abusePhysical neglectMedical neglect
Type
Chapter
Information
Urban Emergency Medicine , pp. 133 - 147
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

NYC Administration for Children’s Services. What is child abuse/neglect? (cited April 29, 2022). Available from: www1.nyc.gov/site/acs/child-welfare/what-is-child-abuse-neglect.pageGoogle Scholar
Centers for Disease Control and Prevention. Fast Facts: Preventing Child Abuse & Neglect. 2022. Available from: www.cdc.gov/violenceprevention/childabuseandneglect/fastfact.htmlGoogle Scholar
The Child Abuse Prevention Center. Physical Neglect [California Penal Code Section 11165.2]. 2014 [cited April 27, 2022]. Available from: www.thecapcenter.org/why/types-of-abuse/physical-neglectGoogle Scholar
World Health Organization. Child maltreatment. 2020. Available from: www.who.int/news-room/fact-sheets/detail/child-maltreatmentGoogle Scholar
Sedlak, A, Mettenburg, J, Basena, M, Petta, I, McPherson, K, Greene, A, Li, S. Fourth National Incidence Study of Child Abuse and Neglect (NIS-4) [Report to Congress]. 2010. US Department of Health and Human Services, Administration for Children and Families. Available from: www.acf.hhs.gov/sites/default/files/documents/opre/nis4_report_congress_full_pdf_jan2010.pdfGoogle Scholar
Puls, H, Bettenhausen, J, Markham, J, Walker, J, Drake, B, Kyler, K, et al. Urban–rural residence and child physical abuse hospitalizations: a national incidence study. J Pediatr. 2019;205:230–235.Google Scholar
Boos, S. Physical child abuse: recognition. 2022. UpToDate.Google Scholar
Centers for Disease Control and Prevention. Risk and Protective Factors. 2022. Available from: www.cdc.gov/violenceprevention/childabuseandneglect/riskprotectivefactors.htmlGoogle Scholar
McDonald KC. Child abuse: approach and management. Am Fam Physician. 2007;75(2):221–228Google Scholar
Boos, S. Physical child abuse: diagnostic evaluation and management. 2021. UpToDate.Google Scholar
Henry, K, Wood, J. What’s in a name? Sentinel injuries in abused infants. Pediatr Radiol. 2021;51,6:861–865.Google Scholar
Kodner, C, Wetherton, A. Diagnosis and management of physical abuse in children. Am Fam Physician. 2013;88(10):669–675.Google Scholar
Kellogg, N, Committee on Child Abuse and Neglect. Evaluation of suspected child physical abuse. Pediatrics. 2007;119.(6):1232–1241. Available from: https://publications.aap.org/pediatrics/article/119/6/1232/70638/Evaluation-of-Suspected-Child-Physical-AbuseGoogle Scholar
Shanahan, M, Zolotor, A, Parrish, J, Barr, R, Runyan, D. National, regional, and state abusive head trauma: application of the CDC algorithm. Pediatrics. 2013;132(6):e1546–1553.Google Scholar
Christian, C. Child abuse: evaluation and diagnosis of abusive head trauma in infants and children. 2021. UpToDate.Google Scholar
Lindberg, D, Makoroff, K, Harper, N, Laskey, A, Bechtel, K, Deye, K, Shapiro, R, ULTRA Investigators. Utility of hepatic transaminases to recognize abuse in children. Pediatrics. 2009. 124(2):509–516. doi:10.1542/peds.2008-2348CrossRefGoogle ScholarPubMed
Pierce, M, Kaczor, K, Aldridge, S, O’Flynn, J, Lorenz, D. Bruising characteristics discriminating physical child abuse from accidental trauma. Pediatrics. 2010;125(4):861.CrossRefGoogle ScholarPubMed
Adams, JA, Harper, K, Knudson, S, Revilla, J. Examination findings in legally confirmed child sexual abuse: it’s normal to be normal. Pediatrics. 1994;94:310–317.CrossRefGoogle ScholarPubMed
Boos, S. Differential diagnosis of suspected child physical abuse. 2020. UpToDate.Google Scholar
Walsh, W, Mattingly, M. Understanding child abuse in rural and urban America: risk factors and maltreatment substantiation. 2012. Available from: https://scholars.unh.edu/cgi/viewcontent.cgi?article=1169&context=carseyGoogle Scholar

Further Reading

King, W, Kiesel, E, Simon, H. Child abuse fatalities: are we missing opportunities for intervention? Pediatr Emerg Care. 2006;22(4):211–214. Available from: https://pubmed.ncbi.nlm.nih.gov/16651907/Google Scholar
The American College of Radiology. ACR-SPR Practice parameter for the perfroance and interpretation of skeletal surveys in children. 2021. Available from: www.acr.org/-/media/ACR/Files/Practice-Parameters/Skeletal-Survey.pdfGoogle Scholar
Lawson, M, Piel, M, Simon, M. Child maltreatment during the COVID-19 pandemic: consequences of parental job loss on psychological and physical abuse towards children. Child Abuse Negl. 2020;110(Pt 2):104709. doi:10.1016/j.chiabu.2020.104709Google Scholar
Griffith, A. Parental burnout and child maltreatment during the COVID-19 pandemic. J Fam Violence. 2022;37(5): 725–731. doi:10.1007/s10896-020-00172-2CrossRefGoogle ScholarPubMed
Physical child abuse. 2022. VisualDx. Available from: www.visualdx.com/visualdx/diagnosis/physical+child+abuse?diagnosisId=51004&moduleId=102.Google Scholar
Bechtel, K, Bennett, B. Evaluation of sexual abuse in children and adolescents. 2021. UpToDate.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×