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Battered child syndrome
Alternative namesNon-accidental trauma (NAT); Child abuse
DefinitionBattered child syndrome refers to children who have undergone physical abuse that has left them with both physical and psychological trauma.
Causes, incidence, and risk factors
Physical abuse of children occurs in every socioeconomic class, though it is most common amongst the poor due to increased stress and greater lack of control over stressful circumstances.
Abuse tends to occur at moments of greatest stress, when the perpetrator strikes out in anger at the child. Many perpetrators were themselves abused as children and they often don't realize that abuse is not appropriate discipline. Abusers also frequently have poor impulse control, which prevents them from thinking through the consequences of their actions.
Because of the relative size and strength difference between adults and children, the abused child can be severely injured or killed unintentionally. Shaking an infant, for example, can cause bleeding over the brain ( subdural hematoma ) which can cause permanent brain damage or death ( shaken baby syndrome ).
The incidence of child abuse is remarkably high. The total abuse rate is 25.2 per 1,000 children with physical abuse counting for 5.7 per 1000, sexual abuse 2.5 per 1,000, emotional abuse 3.4 per 1000 and neglect accounting for the vast majority, 15.9 per 1,000 children. Of course, these categories often overlap, with sexual and physical abuse often occurring together and with sexual abuse, physical abuse or neglect seldom occurring without emotional abuse.
These numbers may also be underestimates due to failure to diagnose or report this problem. Risk factors include poverty, lack of education, single parenthood, alcoholism or other drug addictions and a host of other factors.
Signs and testsPhysical examination may show other injuries, such as:
Physical injuries are treated as appropriate for the specific injury. Counseling or intervention of some type for the parent(s) is mandatory. Life-threatening abuse or abuse resulting in permanent damage to the infant or child may result in incarceration for the perpetrator. In some cases, the child may be temporarily or permanently removed from further danger.
Many states require that known or suspected child abuse be reported to the police, and reporting is automatic. Child protection services are also notified. The disposition of the child will be determined by the severity of the abuse, the likelihood of recurrence, and other factors. Decisions regarding placing the child with an outside caregiver or returning the child to the home usually are made by the appropriate government agency through the court system. The structure of these agencies varies from state to state.
Support groups are available for survivors of abuse and for abusive parents who want to get help. See the resource page for contact information.
Expectations (prognosis)The child's recovery depends on the severity of the injuries, and the outcome of the family or abuser rests with the authorities. Child protection agencies generally make every effort to reunite families when possible.
ComplicationsPhysical abuse of a child can lead to severe brain damage, disfigurement, blindness , crippling, and death. Abused individuals may carry emotional scars for a lifetime. Children can be removed permanently from the parents' custody if the parents are the perpetrators and the cause is sufficient to warrant termination of parental rights.
Calling your health care providerCall your health care provider or protective services if you suspect or know that someone is being abused.
PreventionRecognition of pending abuse can help prevent actual abuse. Warning signs include the following:
Update Date: 12/22/2002Philip L. Graham III, M.D., F.A.A.P., Department of Pediatrics, Children's Hospital of New York, Columbia University, New York, NY. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT