Child Abuse and Neglect
Child Abuse and Neglect
Exams and Tests
The physical exam
An abused or neglected child who is taken to a doctor will first
have a general physical exam. The doctor will review the child's medical history and ask parents or caregivers questions about the child's
A child who is able to talk will be separated from the caregiver
during the interview.
The law requires doctors to consider the possibility of abuse or neglect. Along with
seeing signs of
physical abuse or
neglect, a doctor may become suspicious when:
- The injury is unusual or is not likely to be an
accident, especially for the child's age.
- The parents or caregivers don't have a good explanation, or the explanation changes.
- The parents or caregivers say no one saw the injury happen.
- Medical records show that
similar injuries or patterns of neglect have occurred in the past.
- The parents or
caregivers put off taking the child to the doctor without a good reason.
- The doctor finds signs of sexual abuse.
children in the care of the same person may also be examined and have X-rays
if police or doctors think it's needed.
Tests that are often used to help confirm or
rule out abuse or neglect include:
- Imaging tests such as
CT scan, or
MRI. These types of tests
can help determine whether a child's injuries include any broken bones. Some
tests may also show signs of past injuries.
- Blood tests. Prothrombin time,
partial thromboplastin time, and
platelet count can help determine whether the child has a bleeding
disorder. Other blood tests can be used to look for signs of organ
- Urinalysis, to check for blood in
the urine. This can be a sign of internal
- Specialized lab tests. For example, the doctor may take skin or hair samples or samples of fluids in or around
the vagina to be tested.
- Lumbar puncture, also called spinal tap, which may reveal blood from a brain
- Eye exam, to find out if damage has occurred
that points to
shaken baby syndrome.
Other exams and tests depend on the specific medical
problem suspected or observed. For example:
Tracking a child's injuries
Information about a child's injuries is carefully recorded. A detailed
account of the injuries goes into the child's permanent health record.
This record usually
includes photographs and drawings of the injuries.
Measurements such as weight,
height, and head circumference are also taken and recorded to help establish a
child's baseline growth pattern. Recording these measurements on growth charts
can help identify
failure to thrive that sometimes is related to
John Pope, MD - Pediatrics
Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
March 12, 2012
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