By Meggan Goodpasture, M.D.
Pediatrician at Brenner Children’s Hospital and member of the Child Abuse Team

Unfortunately, child abuse and neglect is far more common than we would all like to imagine. It is estimated that a report of child abuse is made every 10 seconds in this country. Even though we frequently hear about child abuse on the news or read about it in the newspaper, we may falsely regard child abuse as a problem that exists in “other communities.” However, it is important to remember that child abuse crosses ethnic and cultural lines, occurs at all socioeconomic levels and within all religions. It is critical that we are all able to recognize the signs of child abuse as well as know the appropriate steps to take if we suspect that a child is being mistreated.

What is child abuse?

There are four main types of child abuse: neglect, physical abuse, sexual abuse, and emotional or psychological abuse. Neglect is the most frequently reported form of child abuse and accounts for almost 60% of all reports made. It is defined as a state where the basic needs of a child, such as food, shelter, clothing, education, safety, medical attention, and emotional support, are not being met. Physical abuse is when a child’s body is injured and can include hitting, burning, shaking, as well as other forms of physical force. Sexual abuse is defined as anytime a child is being used for sexual stimulation by an older child or adult, who is in a position of power or control over that child. This is commonly thought of as inappropriate touching, but has many other forms including exhibitionism or exposing a child to pornography. Lastly, emotional abuse occurs when a parent’s actions interfere with a child’s emotional, psychological or social development. Examples include ignoring, rejecting or isolating a child, as well as verbally assaulting or terrorizing a child.

How can I recognize if a child is being abused?

It can be very difficult to determine if a child is being abused. In fact some victims show absolutely no signs of abuse at all. However, it is helpful to be familiar with some common signs that may be exhibited by an abused child:
• Unexplained physical injuries or symptoms
• Changes in behavior
• Returning to earlier behaviors also known as “regression”
• Fear of going home
• Changes in eating and sleeping habits
• Changes in school performance and attendance
• Risk-taking behaviors
• Inappropriate sexual behaviors

It is important to remember that children who are being mistreated are often afraid to tell out of fear of their abuser or a fear that they will not be believed.

If I suspect a child is being abused, what should I do?

If you suspect that your child or someone else’s child is being abused you must remember that the child’s safety is the number one priority. It is important to first make a report to your local child protective service agency or the department of human services in your state, county or city. If their offices are closed or you are unable to get the assistance you need, you can also report directly to your local law enforcement agency, such as the police department or the sheriff’s department.

If the child is your own, it is critical that you share your concerns immediately with your child’s care provider. Your pediatrician can help evaluate your child for signs and symptoms of abuse, as well as treat any existing medical injuries. Additionally, your pediatrician can help refer your child to a qualified mental health provider and other community services to ensure that he or she gets the psychological support that is needed. If you are concerned that your child may have injuries and you are unable to see your pediatrician, it may be warranted to be evaluated in the emergency department. Your physician’s nurse triage phone line can often help you to determine if this is necessary. Remember, ensuring that the child is in a protected environment, safe from further harm, is the primary concern.

A resource commonly utilized by community physicians and child protection agencies is Brenner Children’s Hospital’s Multidisciplinary Child Abuse Team. The team consists of pediatricians, emergency medicine physicians, nurses and social workers who have all undergone additional training in the field of child abuse and neglect. Our team of professionals is dedicated to providing a medical assessment, diagnostic services and treatment for all forms of child maltreatment. We work very closely with community agencies such as the department of social services and mental health providers to ensure that needed services are in place for victimized children. It is our goal as care providers to ensure that every child is given the opportunity to live in a safe and nurturing environment where he or she can grow and thrive.

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