Information about Abuse

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Abuse Information

Recognizing When a Child's Injury or Illness
is Caused by Abuse

Author: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention
Reprinted From: This is an overview of a booklet from the, Portable Guides to Investigating Child Abuse series, published by the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention.
To order: Call the Juvenile Justice Clearinghouse at 1-800-638-8736. (Metropolitan D.C. area can call the local number: 301-251-5500.)
Order Code: Recognizing When a Child's Injury or Illness is Caused by Abuse (#NCJ 160938)

Overview:
In recent years the public's increased awareness and reports of suspected child abuse have put pressure on law enforcement to improve their investigations of such cases. This was underscored in late 1987 when a New York City toll collector observed a small girl covered with bruises in the rear of a car. The collector radioed the New York State Police, who stopped the car. The child's foster father, an attorney, explained to police that the bruises were accidental, and he was released. A week later, the child was dead from a beating.

Law enforcement personnel frequently must determine whether a child's accident or illness was caused by a parent or caretaker. However, it is often difficult even for medical personnel to discriminate between injuries and illnesses that are accidental and those that are not. The following information can help law enforcement personnel to determine if it is likely that abuse has occurred.

Could This Be Child Abuse?
Investigators must determine whether the explanation for an injury is believable. Police should begin their investigation by asking the caretaker for an explanation of the child's bruises or injuries. This is best done by asking the question: How did the accident happen?

All bruises must be investigated. If bruises are found on two or more planes of a child's body, investigators should be even more suspicious. For example, a child has bruises on his buttocks and stomach. The caretaker's explanation is

that the child fell backward in the living room of the family home. This might explain the bruises on the buttocks, but not the stomach bruises. If a discrepancy exists between the reported cause of an injury and the injuries seen, law enforcement personnel should investigate further. They should also keep in mind the following points:

* All other children in the home should be examined for possible signs of child abuse.

* Victims of physical abuse often have been intimidated and will usually support the abuser's version of how their injuries occurred to avoid further injury. They also feel that the abuse was just punishment because they were bad.

* A physical examination of the child in suspected cases of maltreatment must be done and the data recorded precisely.

* Laboratory data should be obtained to support or refute the evidence of abuse.

* If the reported history of an injury or injuries changes during the course of an investigation, or if there is conflict between two adult caretakers as to the cause of injury, the likelihood of child maltreatment increases.

* The demeanor of the child's parents or caretakers is sometimes revealing. For example, the mother's assessment of her pregnancy, labor, and delivery will often provide an insight into her attitude about her child as well as give an indication of whether there is something about the child that is influencing her behavior.

* Investigators should ask questions in an unobtrusive manner; for example:

-- Was this a planned pregnancy?
-- Did you want the baby?
-- Do you like the baby?
-- How did the accident happen?
-- What were you doing just before the accident?
-- Who was at home at the time of the accident?
-- What do you feed the baby? How often? Who feeds the baby?

* Information about a child's birth and his or her neonatal and medical history are critical elements in investigations. Hospital records can confirm or eliminate the existence of birth injuries.

* Any child may be abused, and child abuse occurs in all levels of society.

However, there are some factors that increase a child's risk of abuse. These include:

Premature birth or low birth weight.
Being identified as "unusual" or perceived as "different" in terms of physical appearance or temperament.
Having a variety of diseases or congenital abnormalities.
Being physically, emotionally, or developmentally disabled (e.g., mentally retarded or learning disabled).
Having a high level of motor activity, being fussy or irritable, or exhibiting behavior that is different from the parent's expectations.
Living in poverty or with families who are unemployed.
Living environments with substance abuse, high crime, and familial or community violence.

From the National CASA Site.