How to Check for Possible Child Abuse, Step by Step

The concept of child abuse raises a great concerns at the current time. Consequently people are starting to get aware of it. Child abuse doesn't mean a physical abuse only but it can manifests as sexual abuse, emotional mistreatment and even neglect.
I am writing here to help you know how to check if a child is a victim of abuse.

History:

1. Take a complete descriptive history from parents and caregiver.
2. Take a history from the child in separate room and ask for previous similar events.
3. Raise suspicion if there is any inconsistent in the history or inappropriate reactions of the parents.

Inspect and examine:

4. Look generally if there is any sign of neglect or inadequate hygiene or delay in development in speech and language.
5. Examine the scalp carefully for any trauma.
6. Asses all the joints and the range of motion.
7. Look for any lesion on non-prominent surface like face, buttock, ears, thighs, neck and abdomen.
8. Look for any sign of burn that look circumferential from immersion.
9. Check for bite marks.
10. Look for any well- demarcated shape lesion (belts buckle, cigarette, and fist).
11. Inspect for hand mark from grabbing.
12. Examine the genitalia for any signs of bruising or perforated hymen in girls, most likely need to be examined by physician.
13. Look for lesions with multiple healing stages.
14. Take photos!!

Plan:

15. Treat the patient appropriately.
16. Inform parents about the concern of abuse and the steps required by law to protect the child.
17. Notify Child Protective Service in all the cases where there is a suspicion.
18. Don't forget to consult the child's pediatrician or the family physician.

Tips & Warnings:

Any child with the following have increase the risk of abuse:
1. Children with special needs such as mental retardation, down syndrome.
2. Hyperactive children.
3. Unplanned child.
4. Parent and caregiver who are under tremendous stress include low economic status.
5. Parent/ abuser either inadequate or aggressive.
6. Mother was sexually abused in her childhood.
7. Maternal depression and physical illnesses.
8. Poor parental sexual relationship.