Child abuse and neglect: diagnosis and management

Abstract

Background: The findings of studies on the frequency of violence against children imply that many cases go undetected.

Methods: Selective literature review based on a search of different databases for publications on all types of violence against children, except sexual abuse.

Results: The physical abuse of children can involve blunt trauma, thermal injury, and the so-called shaking trauma syndrome (STS). Physical and psychological child neglect have very serious long-term effects. It can be difficult to draw a clear distinction of child abuse and neglect on the one hand, and acceptable behavior on the other, because of the varying social acceptance of certain child-raising practices. Münchhausen's syndrome by proxy (MSbP) is a rare, special type of child abuse.

Conclusion: At the beginning of the 21(st) century, well-established normative structures are in place to protect children against abuse and neglect, and the available help from social organizations can also have a preventive effect. Further improvements will depend on interdisciplinary coordination and better training of specialists in all of the involved disciplines.

Figure 1

Parallel stripes after blows to the buttocks

Figure 2

Cigarette burns on the dorsum on tyhe left hand of a girl aged 8 yeras and 4 months

Figure 3

A five-week old baby thrown from a child-carrying unit onto a cobbled pavement.