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Physical Abuse of Children: An Update

Now, more than ever, physicians must be willing to suspect child abuse and report their concerns. New information from the past decade warns us that reports of violence against children continue to increase. We are learning that MRI imaging of the head may, in some cases, help date subdural hematomas, but long-term developmental follow-up studies of "shaken" infants are lacking. Intentional thoracic and abdominal injuries carry a high mortality. Finally, new information in the field of child abuse—in particular, physical abuse—is slow to come. Lack of funding for basic medical child abuse research and lack of trained researchers in the field are the two most important barriers.²⁰

Preventive intervention at the community and family level needs to be supported by both the pediatrician and the local and national government leaders. As the U.S. Advisory Board on Child Abuse and Neglect says, "We need to make it as easy for parents to pick up the telephone and get help before they abuse their child as it is now for their neighbor or physician to pick up the telephone and report them after it has happened." Child health practitioners may be in the best position to implement such a policy.

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				A. P. Sirotnak, T. Grigsby, and R. D. Krugman Physical Abuse of Children Pediatr. Rev., August 1, 2004; 25(8): 264 - 277. [Full Text] [PDF]

				A. D. Theodore and D. K. Runyan A Medical Research Agenda for Child Maltreatment: Negotiating the Next Steps Pediatrics, July 1, 1999; 104(1): 168 - 177. [Abstract] [Full Text]

				K. C. Daly and R. M. Siegel Henoch-Schonlein Purpura in a Child at Risk of Abuse Arch Pediatr Adolesc Med, January 1, 1998; 152(1): 96 - 98. [Full Text] [PDF]

				C S Ng, C M Hall, and D G Shaw The range of visceral manifestations of non-accidental injury Arch. Dis. Child., August 1, 1997; 77(2): 167 - 174. [Full Text]