NCJ Number
202587
Journal
Child Maltreatment Volume: 8 Issue: 4 Dated: November 2003 Pages: 242-247
Date Published
November 2003
Length
6 pages
Annotation
This article discusses the basic elements of residency education in child abuse and neglect.
Abstract
Physicians that evaluate children will be exposed to battered children throughout their careers and require the tools necessary to conduct a thorough evaluation of these patients. Primary care and emergency medicine residents should be exposed to the elements of complete evaluation of suspected child abuse while in their training programs. They should know which cases they can manage in their own practice and which cases require further consultation or referral. Optimally, residents will have mandatory exposure to clinics where sexually abused children are evaluated, as well as exposure to consultative evaluations of children hospitalized for physical abuse and neglect. Residents should have general knowledge and assessment skills relating to child abuse. General knowledge skills include accepting that any parent or caretaker can abuse a child, and the stressors that increase the likelihood of abuse, such as depression, substance abuse, and unrealistic expectations of the child. Assessment skills include taking a thorough history of all the events involving apparent trauma to a child, and identifying the historical patterns associated with abuse, including trauma history or delay in seeking care for a serious injury. Residents should be able to interpret multiple, unexplained, or inadequately explained severe injuries as highly suspicious for child abuse. These injuries include cutaneous, skeletal, head injury, and visceral injury. Child fatalities, neglect and failure to thrive, Munchausen Syndrome by Proxy, and sexual abuse characteristics should be familiar to residents. Child abuse reporting, documentation, and court testimony are important as part of the educational process for residents. Residents familiar with these topics should be able to conduct competent evaluations of children that present to them with suspected child abuse or neglect. 6 references