battered child syndrome

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Battered child syndrome

 

Definition


Battered child syndrome refers to injuries sustained by a child as a result of physical abuse, usually inflicted by an adult caregiver. Alternative terms include: shaken baby; shaken baby syndrome; child abuse; and non-accidental trauma (NAT).

Description


Internal injuries, cuts, burns, bruises, and broken or fractured bones are all possible signs of battered child syndrome. Psychological damage to a child is also often the by-product of child abuse and can result in serious behavioral problems such as substance abuse or the physical abuse of others. According to the United States Department of Health and Human Services Administration for Children and Families, in 2006 in the United States 1,530 child fatalities resulted from physical child abuse. Of these, about three-quarters of the children were under four years old, with the largest number of deaths occurring in infants under one year old. In addition, about 905,000 children were documented victims of nonfatal maltreatment, a term that includes neglect and psychological abuse, as well as physical and sexual abuse. Nearly 83% of abused children were abused by a parent or a parent acting with another individual.

Causes and symptoms


Battered child syndrome (BCS) is found at every level of society, although the incidence may be higher in low-income households where adult caregivers experience greater financial stress and social difficulties, have less education and understanding of child development, and may have less access to social services. In addition, children of parents who are substance abusers are more likely to experience abuse than children living in households where there is no substance abuse. Many child abusers were also themselves abused as children.
The child batterer most often injures a child in the heat of anger. The incessant crying of an infant or child, refusal to follow directions, or the child creating a mess or breaking an object may trigger abuse. Symptoms may include a delayed visit to the emergency room with an injured child, an implausible explanation of the cause of a child's injuries, bruises that match the shape of a hand, fist or belt, cigarette burns, scald marks, bite marks, black eyes, unconsciousness, bruises around the neck, and a bulging fontanel in infants.

Diagnosis


Battered child syndrome is most often diagnosed by an emergency room physicians, pediatricians, teachers, or social workers. Physical examination detects bruises, burns, swelling, or retinal hemorrhage. X rays, MRI, CT, or other imaging techniques may confirm bone fractures or internal soft tissue injuries. The presence of injuries at different stages of healing (i.e., having occurred at different times) is nearly always indicative of BCS. Establishing the diagnosis is often hindered by the caregiver's intentional concealment of the true origin of the child's injuries, as a result of fear, shame, avoidance, or denial mechanisms.

Treatment


Medical treatment for battered child syndrome varies according to the type of injury incurred. Counseling and the implementation of an intervention plan for the child's parent(s) or guardian(s) is necessary. The child abuser may be incarcerated, and/or the abused child removed from the home to prevent further harm. Reporting child abuse to authorities is mandatory for doctors, teachers, and childcare workers in most states as a way to prevent continued abuse. Both physical and psychological therapy are often recommended as treatment for the abused child.

Prognosis


The prognosis for battered child syndrome depends on the severity of injury, actions taken by the authorities to ensure the future safety of the injured child, and the willingness of parents or guardians to seek counseling for themselves as well as for the child.

Prevention


Recognizing the potential for child abuse in a situation, and the seeking or offering of intervention and counseling before battered child syndrome occurs is the best way to prevent it. Signs that a child may be at risk for physical abuse include parental alcohol or substance abuse, previous abuse of the child or the child's siblings, history of mental or psychological problems in parents, parents abused as children, absence of visible parental love or concern for the child, and the child's hygiene neglected.

Key Terms


Fontanel
Soft spot on top of an infant's skull.

Retinal hemorrhage
Bleeding in the back of the eye.

For Your Information

Resources


American Help Hotlines

  • Childhelp National Child Abuse Hotline 1-800-4-A-CHILD. TDD for the Deaf 1-800-2-A-Child. Help for children who are being abused or adults who are concerned that a child they know is being abused or neglected.

  • Rape, Abuse and Incest National Network (RAINN) Online hotline http://www.rainn.org/get-help/national-sexual-assault-online-hotline or telephone: 1-800-656-HOPE. Online counseling and referral to local rape crisis centers using anonymous instant messaging or telephone counseling and referrals to local crisis center.

Websites

  • "Child Abuse." MedlinePlus, National Institutes of Health. December 4, 2008 [cited December 17, 2008]. http://www.nlm.nih.gov/medlineplus/childabuse.html.

  • "Child Welfare Information Gateway." United States Department of Health and Human Services. December 1, 2008 [cited December 17, 2008]. http://www.childwelfare.gov.

Organizations

  • Prevent Child Abuse America. 500 North Michigan Avenue, Suite 200, Chicago, IL 60611-3703. Telephone: 1-800-CHILDREN or (312) 663-3520. Fax: (312) 939-8962 email: mailbox@preventchildabuse.org Web site: http://www.preventchildabuse.org

Child abuse
Battered child syndrome
Physical abuse

bat·tered child syn·drome

the clinical presentation of child abuse: various injuries to the skeleton, soft tissues, or organs of a child sustained as a result of repeated mistreatment or beating, usually by the person responsible for the child's care.

battered child syndrome

(băt′ərd)
n.
A combination of physical injuries or conditions, such as broken bones, bruises, burns, and malnutrition, experienced by a child as a result of gross abuse, usually by a parent or other caregiver.
Paediatrics A tragedy that claims 2,000–5,000 lives/year and causes countless injuries in the USA; it is often first recognised by characteristic radiologic findings
Social medicine Behaviour by a parent or guardian that causes significant negative emotional or physical consequences in a child
Types Physical abuse, emotional abuse, sexual abuse, neglect