AAP recommendations on reporting child abuse – American Academy of Pediatrics

AAP recommendations on reporting child abuse – American Academy of Pediatrics – Brief Article

Carrie Morantz

The American Academy of Pediatrics (AAP) has issued a policy statement on determining when inflicted skin injuries in children constitute physical abuse. The report is available online at www.aap.org/policy/0105.html.

For more than 50 years, recognition of child abuse has been increasing. However, new social legislation, judicial decisions, and administrative policies can pose a problem for physicians in deciding when to report injuries as child abuse. According to the AAP, possible indicators that an injury is the result of child abuse include the following:

* The injury is not only inflicted, but also nonaccidental (compared with, for example, a parent accidentally stepping on the child’s toes, causing bruising).

* The pattern of injuries fits a biomechanical model of trauma that is considered abusive (e.g., a handprint bruise on the face).

* The pattern of injuries may correspond to infliction with an instrument in a manner that would not occur through play or natural environmental interactions (e.g., loop cord injuries).

* The provided history of injury is not in keeping with the child’s development (e.g., a one-month-old child rolling off the bed).

* The history does not explain the injury (e.g., bruising versus temporary red marks from spanking).

The AAP recommends that physicians consider child abuse the most likely explanation for inflicted skin injuries if they are nonaccidental and there is any injury beyond temporary reddening of the skin. The AAP also calls on physicians to counsel or provide appropriate referral to caregivers to help with behavioral management of children.

COPYRIGHT 2002 American Academy of Family Physicians

COPYRIGHT 2002 Gale Group