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Our Bodies: Spotting Child Abuse

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Dear Dr. Levister: I believe my granddaughter is being abused. What are the warning signs?
V.L.

Dear V.L. If you’ve had contact with the child and you are suspicious, follow your instincts.
Arrange to have the child evaluated by a qualified health care professional. Or contact authorities.

If the child is being abused, don’t expect honest answers from parents or caretakers. Some people think child abuse is a Black issue. The truth is, it crosses all racial, ethnic and social lines.

The National Medical Association reports that a child is abused every nine seconds. Abuse of children appears more frequently among the economically disadvantaged: many factors contribute: to include poverty, mental illness, alcohol-drug abuse, stress, joblessness, homelessness, domestic violence, and poor parenting skills.

Clearly child abuse is an important public health issue, but when it comes to coping with violence against children, African-American families tend to engage in denial rather than face up to the problem.

The problem is further compounded by over burdened social service and child resource agencies and in some cases racially insensitive and heavy-handed law enforcement.

Doctors being suspicious: use a checklist to help spot child abuse. It’s estimated that up to 10 percent of childhood injuries presenting to emergency rooms are the result of abuse.

Physicians are taught to spot signs of child abuse. One technique doctors use to spot child abuse is a simple, four point checklist.
The checklist questions are easy to understand. Has there been a delay between injury and seeking medical attention for which there is not a satisfactory explanation?

If there is a delay, this is one mark for suspicion for child abuse. Is the (medical) history consistent each time (it’s given)? Is the child’s behavior and interaction appropriate? i.e. does the child cry or resist returning to what might be a hostile environment?

Is there a history of past child abuse. If the answer to these questions are unsatisfactory child abuse should be considered. Finally, on examination, does the child have any unexplained injuries? If so child abuse might be more of a consideration.

Now, no one or even the best checklist can positively identify child abuse. Sometimes it comes down to “a grandmother’s instinct.” If you are unable to get the child in for medical evaluation, contact your local child protective agency. Ask for a face-to-face confidential consultation.

Document your observations. If your suspicions continue, don’t hesitate to contact authorities. We must admit that child abuse does happen. Unfortunately, it could be at the hands of your daughter or son-in-law.

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