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Child abuse - physical

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Contents of this page:

Alternative Names   

Battered child syndrome; Physical abuse - children

Definition    Return to top

The physical signs of child abuse used to be called battered child syndrome. This syndrome referred to multiple fractures in different states of healing. The fractures occurred at different times in children too young to have received the fractures as a result of an accident.

The definition of child abuse has since expanded significantly. Physical child abuse or non-accidental child trauma refers not only to multiple fractures at different ages, but it also includes numerous other signs of injury.

See also:

Causes    Return to top

Physical abuse tends to occur at moments of greatest stress, when someone strikes out in anger at the child. Many of those who commit physical abuse have been abused themselves as children. As a result, they often do not realize that abuse is not appropriate discipline. Those who commit physical abuse also frequently have poor impulse control, which prevents them from thinking about what happens as a result of their actions.

Because adults are so much stronger and bigger than children, an abused child can be severely injured or killed by accident. For example, shaking an infant, especially if the head hits something, even against a soft object like a mattress or pillow, can cause bleeding over the brain (subdural hematoma). This can cause permanent brain damage or death. (See shaken baby syndrome.)

Unfortunately, the rate of child abuse is fairly high. The most common form is neglect. Child abuse accounts for at least 1,400 deaths in children each year.

The major risk factors for someone to abuse another person include:

Symptoms    Return to top

Adult may bring an injured child to an emergency room with a strange explanation of the cause of the injury. The child's injury may not be recent.

Symptoms include:

Exams and Tests    Return to top

Typical injuries in abused children include:

The following tests can reveal physical injuries:

The following medical conditions have symptoms similar to physical abuse:

Treatment    Return to top

The specific physical injuries are treated as appropriate.

Counseling or an intervention of some type for the parents is mandatory. In some cases, the child may be temporarily or permanently removed from the home to prevent further danger. Life-threatening abuse, or abuse resulting in permanent damage to the infant or child, may result in legal action.

Counseling, including play therapy, is also necessary for abused children over age 2. Failure to help the child deal with the fear and pain resulting from abuse by adults, who should be trusted figures, can lead to significant psychological problems, such as post traumatic stress disorder (PTSD).

All states require that you report any known or suspected child abuse. Call the police and Child Protection Services.

Decisions about placing the child with an outside caregiver or returning the child to the home usually are made by the appropriate government agency through the court system. The structure of these agencies varies from state to state.

Support Groups    Return to top

Support groups are available for survivors of abuse and for abusive parents who want to get help. See the resource page for contact information.

Outlook (Prognosis)    Return to top

The child's physical recovery depends on the severity of the injuries. Psychological recovery depends on the results of psychotherapy and whether the child can develop trusting relationships with adult caretakers.

The authorities will determine whether the abuser receives psychiatric help, such as parenting training and impulse/anger management training.

Child protection agencies generally make every effort to reunite families when possible.

Possible Complications    Return to top

Physical abuse of a child can lead to severe brain damage, disfigurement, blindness, crippling, and death. Abused individuals may carry emotional scars for a lifetime.

Children can be removed permanently from the parents' custody if the parents are the perpetrators and the cause is sufficient to warrant termination of parental rights. However, this experience itself can result in significant psychological problems due to feelings of rejection, or if the placement does not result in a strong, long-term attachment to new caregivers.

When to Contact a Medical Professional    Return to top

Call your health care provider, Child Protective Services, or local police if you suspect or know that someone is being abused.

Prevention    Return to top

Recognize the warning signs of potential abuse. For example, a caregiver may:

Counseling or parenting classes may prevent abuse when any of these factors are present. Watchful guidance and support from the extended family, friends, clergy, or other supportive persons may prevent abuse or allow early intervention in cases of abuse.

Update Date: 10/11/2007

Updated by: Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

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