Childhood deaths from physical abuse

Abstract

This paper gives a detailed account of 30 cases of childhood deaths caused by physical abuse, detected by the Suspected Child Abuse and Neglect (SCAN) team, General Hospital, Kuala Lumpur. They consisted of 12 Malays, 6 Chinese, 9 Indian, and 1 Indonesian child. Three cases could not be ascertained as to their ethnic origin. There were 13 male and 17 female children. The average age of the abused children was 2 years 5 months. The most frequent causes of death were intracranial hemorrhage and intraabdominal trauma. Of the 17 cases of intracranial hemorrhage, only four had X-ray evidence of skull fracture. This suggests the possibility of whiplash injuries with/without the abuser suspecting that he/she had injured the child. Of the 22 abusers who could be identified, there was no sex differentiation. Fathers formed the largest group of perpetrators, followed by mothers and childminders. Fifteen of the natural parents of the abused children were married, four were divorced and four were never married. Five of the abusers had aggressive personalities and three were drug addicts. Only one abuser was found to be an alcoholic even though a few were also under suspicion. For most cases, trigger factors could not be identified.