This article summarizes two recently completed National Institute of Justice-funded studies that address challenges of identifying child abuse cases versus accidental fall cases when physicians are presented with an injured child; the studies were designed to quantify the mechanical properties of infant and toddler skulls for the sake of predicting the crack and fracture patterns in infant cranial bones, and to develop an evidence-based statistical model that can predict the probability of head injury in young children to determine if an accident was the cause of an injury.
Every year almost 3 million children are brought into emergency rooms with fall-related injuries, and in each case a physician must examine the child to determine if the injury was an accident or a case of abuse. The problem is daunting because accidental falls are common in children, but it’s also common for individuals to conceal child abuse by claiming accidental injury. For more than a decade, the National Institute of Justice (NIJ) has supported research to help physicians and law enforcement sort accident from abuse cases when presented with an injured child. The research has often focused on bringing the science of biomechanics to the world of pediatric medical assessment. Although progress is being made, the challenges of getting definitive answers remains. This article summarizes two recently completed studies that continue that progress.