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Pediatric expert gives tips to help you better identify child abuse
e-Reports, March 19, 2012
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Medical records for a LaGrange County girl documented bruising on her face. A few months later, the one-year old child presented with an arm injury noted as suspected abuse. Two weeks later, the child was dead from blunt force trauma.

Your duty to report
Indiana law requires everyone who suspects child abuse to report it either to police or the Indiana Department of Child Services (DCS) office. If you don’t, you could be subject to a Class B misdemeanor – a penalty resulting in a jail term of up to 180 days and a fine of up to $1,000. You also could be found liable for medical malpractice.

Call the DCS hotline at (800) 800-5556. 

About 21 percent of child injury cases, indicative of abuse, were not reported by health professionals, according to a study published in Academic Pediatrics.

During the same period in the Merrillville area, a 13-year-old boy told his doctor he was being locked up at night. Not long after, he died of blunt force trauma injuries and a skull fracture.

In that area, an 18-month-old boy presented to his doctor with a skull fracture and a left arm he couldn’t use. A month later, he died from abuse-related injuries.

Riley Pediatric Abuse Specialist Antoinette Laskey, M.D., commented that many physicians are reluctant to report abuse because they:

  • Don’t want to get involved
  • Don’t want to take time to go to court
  • Don’t want to lose the family as patients

“It is a doctor’s moral, professional and legal obligation to report child abuse,” said Dr. Laskey. ”It’s not wrong to call and discuss a case with Child Protective Services. You don’t want to get a call that you have lost a patient.”

Tips to identify abuse

Dr. Laskey
Antoinette Laskey, M.D.
Riley Pediatric Abuse Specialist

Dr. Laskey noted that one of the best identifiers of child abuse is bruising, especially in children under four years old.

“A skin exam is crucial and is quick and easy,” she said. “Look at the chest, the back and the legs. Bruising in young children and fractures in preverbal children are concerning and can be a sentinel injury prior to a final, fatal episode of abuse.”

A thorough medical history also can help you identify abuse. The more information you obtain, both clinically and diagnostically, the better.

“We learn in medical school that 80 percent of a diagnosis is based on the history,” noted Dr. Laskey. “That very much is the case in possible child abuse.”

While abuse can be a tough diagnosis, Dr. Laskey urges you to call one of the state’s four pediatricians who specialize in child abuse when you have questions. Contact them at (317) 944-5000.

Also, watch future issues of ISMA Reports for information about a seminar this summer addressing child abuse screening and reporting.

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