Child Abuse Part 1: Introduction & Screening for Physical Abuse

Course overview

Practitioners in primary care, particularly Pediatrics and Family Medicine, are uniquely poised to not only detect but also to prevent child abuse. In addition to primary care, practitioners in other acute-care specialties and environments bear the responsibility for early identification and reporting of suspected child abuse. These practice environments include Emergency Departments, Urgent Care centers, and clinics. Child physical abuse exists in all corners of the country and affects children of all ages, ethnicities and socioeconomic groups. The recognition and identification of child abuse is not an easy task. Not all practitioners are aware of the risk factors for abuse nor are they knowledgeable regarding the "sentinel injuries" that represent just the tip of the child abuse iceberg. In this activity, we present the scope of the problem of child physical abuse and discuss when and how to screen for child physical abuse, including an actual case where the diagnosis of child abuse was delayed in a 4-month-old child. After completing this activity, learners should be able to: appraise the scope and epidemiology of child physical abuse in the United States; outline the basic principles of detection and diagnosis of child physical abuse; and compare clinical strategies to improve outcomes when the diagnosis of child maltreatment is uncertain.