Child Abuse (cont.)

Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is the scope of the child abuse problem?
• What age child is abused?
• Are girls more often abused than boys?
• Is the pattern of abuse different for girls and boys?
• What is known about the perpetrators of child abuse?
• Is there an association between poverty and child abuse?
• Who abuses children?
• What is child abuse?
• What does the term child neglect include?
• What actions are viewed as physical child abuse?
• What constitutes emotional child abuse?
• What is sexual child abuse?
• What causes child abuse deaths?
• What factors predispose a person to child abuse?
• How is alleged child abuse evaluated?
• How is child abuse treated?
• How can child abuse be prevented?
• What more can be done to prevent child neglect?
• Are people who were abused as children more likely to become criminals later in life?
• Child Abuse At A Glance
• Patient Comments: Child Abuse - Experience
• Child Abuse Index

A thorough nonjudgmental history of the immediate events as well as a review of past similar experiences are often independently done by a physician, social worker, and/or the police department. The child may be interviewed separately from the parents as part of this information-gathering process.

A complete physical exam of the child (which may include the taking of photographs to document physical/sexual abuse) is often followed by radiologic studies (x-rays, CT and MRI scans) and/or laboratory tests to support the potential diagnosis of inflicted trauma and to rule out the possibility of medical conditions which could account for the physical findings noted during the examination. A complete eye examination is indicated in all infants to evaluate to possibility of retinal hemorrhages associated with the shaken baby syndrome.

Steps which are often taken to correct child abuse are as follows:

• The safety of the abused child and any other potential victim of abuse in the household is paramount. Removal of the victim and placement in protective custody in a group home or foster care is often necessary.



• Effective counseling for the child, family, and the abuser is essential to deal with the associated emotional and psychological stress and trauma.



• In the event of neglect, establishing realistic expectations of the child's needs and capabilities is required.



• Parental high-risk behaviors such as substance/alcohol abuse must be addressed.



• Law-enforcement evaluation is performed, followed by the filing of charges, court appearance, and (if found guilty) sentencing as indicated.



• Pedophiles (people who have sexually abused children) often require intense psychological and pharmacological therapy prior to release into the community because of the high rate of repeat offenders.