ABP Child Abuse Pediatrics key terms

Brain and skull injury caused by violent shaking, impact, or both in a young child, often producing subdural bleeding, retinal hemorrhage, and encephalopathy without a plausible accidental explanation.

Bleeding in the retina visible on fundoscopic examination; extensive or multilayered retinal hemorrhages in an infant raise concern for abusive head trauma, though other causes must be considered.

Blood collection between the dura and arachnoid mater, often from torn bridging veins; in infants it may result from acceleration-deceleration injury and can be acute, mixed, or chronic.

Fracture through the growth plate margin at the end of a long bone, producing a corner or bucket-handle appearance; in infants it strongly suggests forceful pulling or twisting of a limb.

Break near the spine on the back of a rib, typically from forceful squeezing of an infant's chest; it has high specificity for physical abuse and may not be visible initially.

An injury that signals possible abuse and predicts later serious harm, such as bruising in a nonmobile infant or a femur fracture in a child not yet walking.

A bruising decision rule flagging torso, ear, or neck bruises in children younger than four, plus any bruise in infants under four months, as concerning for abuse.

A mark whose shape matches the object that struck the child, such as a loop, belt buckle, hand, or bite; patterned bruises and burns support inflicted injury.

Scald injury from forced submersion in hot liquid, often showing a sharp waterline, sparing of flexed areas, and symmetric involvement of buttocks or feet; accidental spills usually look different.

A standardized series of X-rays of the entire skeleton used to detect occult fractures in suspected child abuse, especially in infants and children under two years.

The clinical judgment of whether the stated mechanism, the child's developmental stage, and the injury severity fit together; a mismatch raises concern for abuse.

The process of comparing abuse with conditions that mimic it, including osteogenesis imperfecta, bleeding disorders, metabolic bone disease, infections, and cultural practices, before concluding harm was inflicted.

A structured inspection of the genitalia and anus, using appropriate positioning, lighting, and magnification, to document normal anatomy, identify injury or infection, and avoid overinterpreting innocent findings.

A feature of the hymen such as a notch, transection, or narrowed rim; some findings are concerning for penetration, while many variants are normal and require expert interpretation.

A child's statement that abuse occurred, which may be delayed, partial, or recanted; interviewers should avoid repeated questioning and preserve the child's own words.

A gradual process of building trust, isolating the child, testing boundaries, and normalizing sexual contact, often involving gifts, secrecy, and manipulation of caregivers.

Images or videos depicting a child in sexual activity or sexualized poses; possession, production, and distribution are crimes and evidence must be handled forensically.

Using a child for sexual purposes in exchange for something of value, including trafficking, prostitution, online solicitation, or coercion through images and threats.

A genital, anal, or oral infection such as gonorrhea, chlamydia, trichomonas, or syphilis; in a prepubertal child, some infections are highly suggestive of sexual contact.

Recent forced or coerced sexual contact requiring urgent medical care, pregnancy and infection prophylaxis consideration, and forensic evidence collection when indicated.

A standardized set of swabs and containers used to collect biological and trace evidence after recent sexual assault, with documented chain of custody.

Failure to provide basic necessities such as food, shelter, clothing, hygiene, and medical care, resulting in harm or substantial risk of harm to the child.

Inadequate supervision for a child's developmental stage, leaving the child exposed to dangerous situations, injuries, or harmful people.

Failure to seek or follow needed medical or mental health care despite available resources and clear professional recommendations, when delay or omission risks the child's health.

Inadequate weight gain or growth in a child, evaluated with accurate measurements, feeding history, medical causes, and social factors; neglect is one possible explanation but not automatic.

Failure to obtain routine or urgent dental care, leading to untreated caries, pain, infection, or tooth loss that affects nutrition, sleep, and school attendance.

The distinction between inability to provide due to material hardship and failure to provide despite resources; professionals must assess both risk and family supports before labeling neglect.

A pattern of caregiver behavior such as terrorizing, isolating, degrading, exploiting, or ignoring that harms a child's emotional, cognitive, or social development.

A caregiver deliberately falsifies or induces illness in a child to assume the sick role, causing unnecessary tests, treatments, and harm; the caregiver, not the child, has the disorder.

Harm from unnecessary or harmful medical care driven by a caregiver's fabricated or exaggerated history, often requiring review of records across multiple providers.

A professional required by law to notify child protective services when they have reasonable suspicion of abuse or neglect, even without proof or caregiver permission.

A belief based on specific observations or statements that a child may have been abused or neglected; it is a lower threshold than certainty and triggers reporting duties.

A government agency that receives reports, assesses child safety, provides services, and may seek court involvement to protect children from abuse or neglect.

A structured, nonleading interview of a child by a trained professional in a neutral setting, designed to obtain accurate information for protection and legal proceedings.

A documented record of who collected, handled, stored, and transferred evidence, used to show that items were not altered or contaminated.

A group of professionals from medicine, child protection, law enforcement, mental health, and prosecution who coordinate evaluation, safety planning, and legal action in child abuse cases.

A person with specialized knowledge who may offer opinions in court about medical findings, child development, or forensic interview reliability, within the limits of their expertise.

A written, practical agreement among caregivers and agencies describing who supervises the child, what services are in place, and what triggers escalation.

An approach that recognizes the impact of trauma, prioritizes safety and trust, avoids re-traumatization, and supports the child's and family's choices and resilience.

Efforts to reduce abuse before it occurs through home visiting, parenting support, safe sleep education, quality child care, and policies addressing poverty and family stress.