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Lesson Two - Physical - Considerations
Distinguishing Between Accident and Abuse
In recognizing physical abuse, it is most important to recognize when an injury may be caused by non-accidental means. The very nature of childhood invites accidents. Children are curious and fearless. They run, climb, jump, and explore. A child’s motor skills usually outpace cognitive skills allowing him to approach danger without recognizing it. The following is a guide to help you distinguish between accidental and non-accidental injuries.
When observing an injury you suspect might be the result of abuse, consider:
Location of Injury
Certain locations on the body are more likely to sustain accidental injury. They include knees, elbows, shins or forehead. Protected body parts and soft tissue areas, such as the back, thighs, genital area, buttocks, back of the legs, or face, are less likely to accidentally come into contact with objects which could cause injury.
Number and Frequency of Injuries
The greater the number of injuries, the greater the cause for concern. Unless the child is involved in a serious accident, he or she is not likely to sustain a number of different injuries accidentally. Multiple injuries in different stages of healing may indicate abuse.
Size and Shape of Injury
Non-accidental injuries are inflicted with familiar objects: a stick, a board, a belt, and a hairbrush, leaving marks bearing the shape and size of the object. Accidental marks resulting from bumps and falls usually have no defined shape.
Description of how the injury occurred
If an injury is accidental, there should be a reasonable explanation of how it happened that is consistent with the appearance of the injury. When the description of how the injury occurred and the injury itself are inconsistent, there is cause for concern. For example, it is not likely that a fall off a chair onto a rug would produce bruises all over the body.
Consistency of a Child’s Developmental Capacity
As a child grows and gains new skills, his or her ability to engage in activities which can cause injury increases. A toddler trying to run is likely to suffer bruised knees and a bump on the head. He or she is less likely to suffer a broken arm than an eight year old who has discovered the joy of climbing trees. When assessing an injury, consider whether the child is capable of causing his or her own injuries. Also consider the child’s size and whether he or she is able to generate sufficient force to create the injury.
Source: Besharov D. J. (1990). Recognizing Child abuse: A Guide for the Concerned. The Free press: New York.