Child Abuse: Risk Factors and Possible Indicators
Authors: Alexa Scarcello Reviewers: Jaimie Bird Dr. Jenn D’Mello* * MD at time of publication
Note: Child abuse is most frequently missed when parents are upper or middle class, Caucasian, & married
Parental Factors
Low education
Substance abuse Mental illness Unwanted pregnancy Personal hx of abuse
Child Factors
Behavioral problems
Medical problems
Male gender
Young (non-verbal), especially <1 year old ↑ Risk Note: Special Indicators for Sexual Abuse Definition: Child Abuse • Any act or omission by a parent or caregiver that results in actual or potential harm to a child • Includes physical, sexual, & emotional abuse, or neglect Family Factors Unrelated caregiver Low SES Single parent Domestic violence Social isolation Indicators on History Indicators on Physical Exam Injury blamed on pet or sibling Delays in seeking treatment Frequent visits to different healthcare providers for injuries Self-inflicted injury not compatible with child’s development Child described as “difficult” Hx of injury changes with time History not compatible with injury Extensive physical injury with hx of minor trauma • • • • • Regressive behaviour Difficulty sleeping Sexually inappropriate behaviour Sudden change in behaviour School difficulties Burns (esp. immersion) Frenulum tear in infants Bruising: Pattern, Location (esp. face), Number, Shape (esp. ligature marks, instrumentation), Age of child (“those who don’t cruise don’t bruise”) Abusive head trauma See “Non-accidental Head Trauma” slide Fractures (esp. posterior rib, shearing/twisting forces) Evidence of injury with no hx of trauma Suspicion of child abuse Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published November 5, 2018 on www.thecalgaryguide.com