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Understanding Child Physical Abuse
What is Physical Abuse?
Child physical abuse is defined as a non-accidental injury inflicted upon a child by a parent or caretaker. Based on this definition, if your neighbor slaps your child leaving a hand print on their face, this is not child abuse. This would be seen as battery in most jurisdictions. However, if your neighbor is babysitting your child when this occurs, then that would be classified as child abuse. An intentional injury can be;
Bruises are the most common type of injury caused by physical abuse. Let's face it, young children fall when learning to walk and are often bruised on their shins, knees, elbows, and forehead. Older children are sometimes scraped and bruised from bicycle accidents. How can we determine what is accidental and what is abuse? Bruises caused by abuse are generally in the areas of the back, buttocks, and back of the thighs. In the case of abuse a hand or object is used to inflict the injury. The outline of the hand or object can often be seen in the bruising.
Burns can be inflicted with hot water, cigarettes, or with a heated object. When a child is held in hot water there will be a distinctive line indicating which body parts were held under the water. If the child's hands or feet are held in the water they will exhibit what are called glove or sock burns. If a child is put into hot water accidentally, you will see splotches of burns where the child flailed their arms and legs in an attempt to exit the water. When a cigarette is held to the skin a small, round burn is evident. There is a bacterial infection called impetigo which can mimic a cigarette burn. A doctor will need to determine if the mark is a burn or an infection.
Broken bones can result from abuse as well. A spiral fracture is caused by twisting the arm. This is usually an indicator of abuse. Broken ribs in an infant or small child are determined to be abuse as they would not be able to exert the force necessary to break those bones. Full body x-rays will usually be ordered when a broken bone is suspicious. There is a bone disease called Osteogenisis Imperfecta, or brittle bone disease, which can result is multiple fractures. With this illness the bones in the body may be less dense, because of a lack of collagen, and will appear so in an x-ray.
X-Ray of Brittle Bone Disease
Abusive Head Trauma
Abusive head trauma can be inflicted by a blow to the head or shaking of the child. The brain is damaged when it moves back and forth in the skull. This can impact the child's sight, hearing, speech, or mobility. More children die from head trauma than any other kind of abuse.
I once worked a case involving a two year old child who was repeatedly slammed on the floor by the mother's boyfriend. When the mother arrived home she saw the child was injured and took him to the hospital. The child passed away two days later. The boyfriend told the police the child fell off of the kitchen counter. The doctor stated the child would have had to fall from the top of a two story building to incur the injuries he had. The worst part was that family members had documented previous injuries to the child, but did not report those to child protection services.
Report Child Abuse
Report if you Suspect Abuse
If you notice any signs of abuse you need to make a report to your local child protection service. You must only have a reasonable suspicion of abuse. If you fear retribution you can make a report anonymously. You do not need to be certain or attempt to investigate yourself. Child protection services will conduct an investigation to determine the child's safety, and take action if necessary. Helping to keep our children safe is everyone's responsibility.