Skip to main content
SpringerLink
Log in

Medical evaluation of child abuse

  • Symposium : Behavioural Pediatrics-II
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Child abuse is a world-wide problem and has existed in all societies and cultures in various forms since ancient times. Intrafamilial physical and sexual abuse is well recognized in United States and other western countries. In countries like India there is a general lack of sensitivity to the issue among professionals and the lay public alike. The pressing issues of poverty, malnutrition, and infectious diseases take priority on resource allocation. Although some of the methods of child rearing and discipline may be culturally sanctioned and inherent, it does not necessarily mean they are harmless. In this paper the authors present clinical signs and symptoms of physical and sexual abuse which occur in the intrafamilial context and are of direct relevance to the medical practitioner.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Finkelhor D The international epidemiology of child abuse.Child Abuse and Neglect 1994; 18 (5): 409–417.

    Article  PubMed  CAS  Google Scholar 

  2. Maitra B. Child abuse: a universal ‘diagnostic’ category ? The implication of culture in definition and assessment.Int J Soc Psychiatry 1996; 42 (4): 287–304.

    Article  PubMed  CAS  Google Scholar 

  3. Korbin JE. Culture and child maltreatment, In: Helfer ME, Kempe RS, Krug-man RD (eds)The Battered Child, 5th ed, Univ of Chicago Press, Chicago 1997; 29–48.

    Google Scholar 

  4. Segal UA. Child abuse in India: A theoretical overview.Indian J of Social Work. 1991; 52 : 293–302.

    Google Scholar 

  5. Mahajan A, Madhurama. Family violence and abuse in India, Deep & Deep Publications, New Delhi; 1995.

    Google Scholar 

  6. Segal UA Child abuse in India: an empirical report on perceptions.Child Abuse & Neglect. 1992; 16 (6) : 887–908.

    Article  CAS  Google Scholar 

  7. Ten Bensal RW, Rheinberger MM, Radbill SX. Children in a world of violence; the roots of child maltreatment, In: Helfer ME, Kempe RS, Krugman RD (eds).The Battered Child, 5th ed. The University of Chicago Press, Chicago 1997 : pp 3–28.

    Google Scholar 

  8. Doek JE. Management of child abuse and neglect at the International level: trends and perspectives.Child Abuse & Neglect, 1991; 15: 51–56.

    Article  Google Scholar 

  9. Mehta M. Child abuse and neglect. In: Udani PM (ed).Textbook of Pediatrics, Jaypee Brothers, New Delhi. 1991; pp 1520–28.

    Google Scholar 

  10. Segal UA. Child abuse by middle class? A study of professionals in India.Child Abuse & Neglect 1995; 19 (2): 217–231.

    Article  CAS  Google Scholar 

  11. Segal UA, Ashtekar A. Detection of intrafamilial child abuse: children at intake at a children’s observation home in India.Child Abuse & Neglect 1994; 18 (11) : 957–67.

    Article  CAS  Google Scholar 

  12. Dave AB, Dave PB, Mishra KD. Child abuse and neglect practices in drug district of Madhya Pradesh.Indian Pediatr 1982; 19 (11): 905–12.

    PubMed  CAS  Google Scholar 

  13. Mehta MN. Physical abuse of abandoned children in India.Child Abuse & Neglect, 1982; 6: 171–175.

    Article  CAS  Google Scholar 

  14. Bhattacharyya AK. Child abuse and neglect: Indian perspective.Indian Pediatr 1983; 20 (11) : 803–10.

    PubMed  CAS  Google Scholar 

  15. Reece R.M.Child Abuse: Medical Diagnosis and Management. Philadelphia : Lea & Febinger, 1994.

    Google Scholar 

  16. Stephenson T, Bialis Y. Estimation of the age of bruising.Arch Dis Childh 1996; 74: 53–5.

    PubMed  CAS  Google Scholar 

  17. Schwartz AJ, Ricci LR. How accurately can bruises be aged in abused children?Pediatrics 1996; 97: 254–6.

    PubMed  CAS  Google Scholar 

  18. Giardino AP, Christian CW, Giardino ER.A Practical Guide to the Evaluation of Child Physical Abuse and Neglect. New Delhi: SAGE Publications India Pvt. Ltd. 1997.

    Google Scholar 

  19. Fischer H, Allasio D. Nasal destruction due to child abuse.Clin Pediatr 1996; 35: 165–166.

    CAS  Google Scholar 

  20. Feinberg AN, Gushurst CA, Purdy WK, Tunnessen WW. Picture of the month: nasal septal hematomas.Arch Pediatr Adolesc Med 1998; 152: 601–602.

    PubMed  CAS  Google Scholar 

  21. Kleinman PK.Diagnostic Imaging of Child Abuse, 2nd ed. St. Louis: Mosby, Inc. 1998.

    Google Scholar 

  22. Actams JA, Harper K, Knudson S, Revilla J. Examination findings in legally confirmed child sexual abuse: it’s normal tp be normal.Pediatrics 1994; 94: 310–317.

    Google Scholar 

  23. Berenson AB, Heger AH, Hayes JM, Bailey RK, Emans SJ. Appearance of the hymen in prepubertal girls.Pediatrics 1992; 89: 387–394.

    PubMed  CAS  Google Scholar 

  24. McCann J, Well R, Simon M, Voris J. Genital findings in prepubertal girls selected for nenabuse s a descriptive study.Pedidtrics 1990; 86: 428–439.

    CAS  Google Scholar 

  25. Chadwick DL, Berkowitz CD, Kerns DL, McCann J, Reinhart MA, Strickland SL.Color Atlas of Child Sexual Abuse. Chicago: Yearbook Medical Publ, Inc. 1989.

    Google Scholar 

  26. Emans SJ, Laufer MR, Goldstein DP (eds).Pediatric and Adolescent Gynecology, 4th ed. Philadelphia: Lippincott-Raven Publ, 1998.

    Google Scholar 

  27. Comparison of genital examination techniques in prepubertal girls.Pediatrics 1990; 85: 182–187.

    Google Scholar 

  28. Centre for Disease Control and Prevention (CDC). Guidelines for Treatment of Sexually Tansmitted Diseases.Morbidity and Mortality Weekly Report 1998; 47 RR-1: 108–117.

    Google Scholar 

  29. McCann J, Voris J, Simon M, Wells R. Perianal findings in prepubertal children selected for nonabuse: a descriptive study.Child Abuse and Neglect 1989; 13 : 179–193.

    Article  PubMed  CAS  Google Scholar 

  30. McCann J, Voris J. Perianal injuries resulting from sexual abuse: a longitudinal study.Pediatrics 1993; 91: 390–397.

    PubMed  CAS  Google Scholar 

  31. Hymel K, Abshire T, Luckey D, Jenny C. Coagulopathy in pediatric abusive head trauma.Pediatrics 1997; 99: 371–375.

    Article  PubMed  CAS  Google Scholar 

  32. Ingram DL, Everett VD, Lyna Pr, White ST, Rockwell LA. Epidemiology of adult sexually transmitted disease agents in children being evaluated for sexual abuse.Pediatr Infect Dis J 1992; 11: 945–950.

    Article  PubMed  CAS  Google Scholar 

  33. Seigel RM, Schubert CJ, Myers PA, Shapiro RA. The prevalence of STD in children and adolescents evaluated for SA in Cincinnati: rationale for limited STD testing prepubertal girls.Pediatrics 1995; 96 : 1096–4.

    Google Scholar 

  34. Hammerschlag MR. Sexually transmitted diseases in sexually abused children: Medical and legal implications.Sex Transm Inf 1998; 74: 1–8.

    Google Scholar 

  35. Pandhi RK, Khanna N, Sekhri R. Sexually transmitted diseases in children.Indian Pediatrics 1995; 32: 27–30.

    PubMed  CAS  Google Scholar 

  36. Plunkelt MCB, Banks MW, Falkov AF, Samuels MP. Covert video recordings of life threatening child abuse; lessons for child protection.Pediatrics 1997; 100: 735–760.

    Article  Google Scholar 

  37. Meadow R. Munchausen syndrome by proxy: the hinterland of child abuse.Lancet 1977; 2: 343.

    Article  PubMed  CAS  Google Scholar 

  38. Rogasta K. Pediculosis masquerades as child abuse.Pediatric Emergency Care 1989; 5: 253–4.

    Article  Google Scholar 

  39. Stewart GM, Rosenberg NM. Conditions mistaken for child abuse: Part I and II.Pediatric Emergency Care 1996; 12 : 116–119, 217–221.

    Article  PubMed  CAS  Google Scholar 

  40. Gahagan S, Rimsza MB. Child Abuse or osteogenesis imperfecta: how can we tell?Pediatrics 1991; 88: 987–992.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Kalatnazoo Centre for Medial Studies, Michigan State University, 1000, Oakland Drive, Kalamazoo, Michigan, USA

    Dilip R. Patel & Colette Gushurst

Authors
  1. Dilip R. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Colette Gushurst
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dilip R. Patel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Patel, D.R., Gushurst, C. Medical evaluation of child abuse. Indian J Pediatr 66, 577–587 (1999). https://doi.org/10.1007/BF02727175

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02727175

Key words

Search

Navigation