|How would you react if your Pediatrician suspected that your child was being abused?
What would you say if your doctor asked about bruises on your child?
Not surprisingly, if you actually were abusing your child, you would likely have quick explanations for how each bruise happened and would casually dismiss the accusations.
But what if you weren't abusing your child and were accused or someone simply asked about a bruise? Would you be angry and become defensive, after all, how could anyone ever think that you would harm or would let someone else harm your child?
Would you change doctors?
Or would you be appreciative that your Pediatrician was looking out for your child's best interests?
Sadly, children are abused everyday. According to the National Child Abuse and Neglect Data System, in the year 2000, 879,000 children were found to be victims of child abuse, with an incidence rate of 12.2 per 1,000 children.
That is a little over 1 out of every 100 children. If a Pediatrician (or some other person, especially someone that is around a lot of children, such as a daycare worker or teacher) hasn't reported any suspected cases of abuse, it is likely more because he or she hasn't recognized the abuse rather than that they don't have any abused children coming into their office (or daycare, school, etc.).
In reporting possible abuse, or asking about bruises and injuries to see if a child could have been abused, your Pediatrician is likely motivated by a desire to keep your child safe and healthy. He or she isn't out to get you.
And he is meeting his legal obligation, in addition to the moral obligation, to report suspected abuse. All states now have mandatory child abuse reporting laws, so that a doctor could actually get in legal trouble for not reporting abuse. In Texas, where I practice, failing to report abuse is punishable by imprisonment of up to 180 days and/or a fine of up to $2,000.
In many states, in addition to doctors, the following people are obligated to report suspected abuse, including:
- Nurses, hospital personnel, dentists;
- Medical examiners;
- Mental health professionals and social workers;
- School personnel;
- Law enforcement officials; and
- Child care providers.
Unfortunately, the motivation for writing this article came from an incident that I was involved in last year. During a routine office visit for a cold, I noticed suspicious bruises on a child and reported the case of suspected abuse to Child Protective Services. The case involved a child who had received several suspicious bruises on his back and others in the shape of an adult hand print, which had likely grabbed or squeezed him.
Was I 100% sure that the child had been abused? No. But I didn't have to be. Child abuse experts instead say that you should simply report your reasonable suspicions and not to try to investigate the case yourself or confront the abuser.
Afterwards, the family switched doctors and a few other parents that knew about the situation said that they didn't want to see me either because they were afraid that I would report them if their child ever had bruises.
Would you react like this in a similar situation? Hopefully not, because if professionals have to second guess themselves when considering reporting suspected abuse, it may result in abusers going unrecognized and unpunished and children being hurt or killed.
Do you have to worry about being reported for abuse every time your child falls and gets a bruise? Of course not. Most children, especially active toddlers and preschool age children, with all of their jumping and climbing and falling, are expected to get frequent bruises, often on their lower legs or shins, knees, elbows, etc. However, according to the American Academy of Pediatrics, 'if you see a child with injuries on other parts of the body, such as the stomach, cheeks, ears, buttocks, mouth, or thighs, you should think twice.'
An easy way to think about whether or not a bruise is normal on a child is to think about what kind of bruises your own children got when they were growing up. Sure they got bumps and bruises on their forehead, shins, knees and elbows. But how often did you notice an unexplainable bruise on their back, throat, ears, chest or face?
In conclusion, learn to recognize the signs of child abuse and don't be afraid to report abuse when you suspect it.
And if confronted or asked about your child's bruises or suspected abuse, give honest explanations for how the bruises occurred and don't get angry or defensive. Instead, be thankful that someone is concerned about and is looking out for your child.