d. Your Observations. Observe the child carefully. The person who brings in a
physically abused child rarely gives a clear and honest explanation of the acts that
produced the injury. Additionally, the adult who brings the child in may have either
waited several days or taken the child to other medical facilities for treatment. Since
what you are told about how the injury happened may not be correct and since the
injury may not have just occurred, it is very important for you to observe the child. Your
detection of the nature of the child's injuries is vital in starting proper treatment.
TYPES OF CHILD ABUSE
Child abuse can be divided into several categories. In this lesson, the types of
child abuse are divided into physical abuse, neglect and emotional abuse, and sexual
a. Physical Abuse.
(1) Definition. Physical abuse to a child can be defined as nonaccidental
injury to a child. Such abuse is usually inflicted by someone taking care of the child
(parent or other caretaker), not by a total stranger. The abuse can be triggered by an
angry attempt on the adult's part to punish the child for misbehavior. Physical abuse
can also be the result of furious adult lashing out at a child who just happens to be
around when the adult has some crisis. The physical abuse may be mild (a few bruises,
welts, scratches, cuts, scars), moderate (numerous bruises, minor burns, a single
fracture), or severe (large burn, central nervous system injury, abdominal injury, multiple
fractures, other life-threatening injuries). All forms of physical child abuse (even mild
abuse) are unnecessary and damaging to the child.
Signs and symptoms of physical child abuse. Included are the following.
(a) Bruises. Typical bruises are caused by a forceful slap on the face,
upper arms, or buttocks.
(b) Distinctive marks. Rectangular, linear, or round marks which might
have been caused by blunt instruments are common. Choke marks on the neck may be
evident. There may be circumferential bruises from restraints on the ankles or wrists as
well as bruises at the corners of the mouth from gags.
(c) Human bite marks. Human bite marks may be found on any part of
the child's body but are most frequently found on the cheeks and arms. A physically
abused child may have healed, healing, and/or fresh bite marks.
(d) Burn injuries. Cigarette burns on hands, feet, or buttocks indicate
physical abuse. Burn injuries may be in the shape of a household appliance such as an
iron, or burn injuries may be the result of scalding from boiling liquid poured on the child.