NCJ Number
137816
Journal
Clinical Symposia Volume: 43 Issue: 1 Dated: special issue (1991) Pages: complete issue
Date Published
1991
Length
32 pages
Annotation
This review of the clinical manifestations of the physical, sexual, and emotional abuse of children suggests that, unlike 25 years ago, children today are more likely to suffer from injuries resulting from sudden, impulsive acts of violence. These changes in type and severity will necessitate new approaches to detection, treatment, and prevention.
Abstract
The risk factors associated with abuse include a child's physical, mental, or psychosocial deficits; substance abuse, depression, and a history of abuse in the parents' childhood; and various economic and social variables. Abuse is often identified through the observations of a physician, interviews with parents, and an adequate clinical history of the child. A forensic assessment of a child requires meticulous attention to detail and careful documentation. It may include dating of injuries, imaging techniques, and laboratory studies. Physical abuse most often is manifested through injuries to the skin and subcutaneous tissues, the head and central nervous system, chest and abdomen, and skeletal system. Differential diagnoses are crucial when supposed cases of child abuse actually involve nonabusive injuries including bruising, dermatologic conditions, retinal hemorrhage, or bone injuries and disease. A clinical evaluation of sexual abuse cases must consider characteristics of the victim and molester, psychosocial and medical assessments, and management techniques. Prevention of child abuse must occur on the primary, secondary, and tertiary levels. 15 figures and 18 references