WHAT YOU NEED TO KNOW:

What is physical abuse of a child? Physical abuse of a child occurs when someone knowingly harms or places a child in danger. Physical abuse includes punching, beating, kicking, hitting, biting, shaking, throwing, choking, burning, and force-feeding. It may also include disciplining a child with physical punishment that is too much for his age or condition. Harmful force or restraints may also be considered physical abuse.

What increases a child's risk for physical abuse? A child's risk for physical abuse increases as he gets older. The following also increase the risk:

• Poor, violent, or crowded living conditions
  
  
• Learning or memory problems, a long-term medical condition, or special needs
  
  
• Not having relatives or friends who can take care of him
  
  
• Care from a single or teenaged parent, or someone who lacks knowledge about the normal development of a child
  
  
• Being around someone who drinks alcohol or uses illegal drugs, or is under stress
  
  
• Being around someone who has a history of physical, sexual, or other abuse
  
  
• Being around someone who has a personality disorder, depression, or another mental illness

What are the signs and symptoms of physical abuse? The child may have unexplained repeated falls or injuries. He may have old injuries that were never treated. He may also have any of the following:

• Scratches, bite marks, or marks from objects used for restraining, such as belts, ropes, or electrical cords
  
  
• Broken or dislocated bones
  
  
• Bruises, cuts, or scars
  
  
• Scars or burns from cigarettes, irons, or hot water
  
  
• Blood or discharge coming from the nose, mouth, or eyes
  
  
• Unusual loss of body hair, or a low body weight
  
  
• Fights, absences, or other problems at school
  
  
• Trouble being social
  
  
• Depression, self-esteem problems, or trouble sleeping
  
  
• Fear of strangers, or clinging onto strangers or healthcare providers

How is physical abuse diagnosed? Healthcare providers who specialize in child abuse will examine the child's body. They will look for injuries caused by physical abuse. The child may be asked if he has been hit or slapped. Healthcare providers may also want to know who the abuser is, and how long the abuse has been taking place. The child's body may need to be examined or photographed to record the physical abuse. He may also need any of the following:

• Blood and urine tests may show signs of injury or infection. They may also be used to get information about the child's overall health.
  
  
• X-ray, MRI, or CT scan pictures may show broken or displaced bones. The pictures may also show injuries such as bleeding, joint dislocations, or broken bones. The child may be given contrast liquid to help healthcare providers see any injuries better. Tell the healthcare provider if the child has ever had an allergic reaction to contrast liquid. Do not let the child enter the MRI room with anything metal. Metal can cause serious injury.

How is physical abuse treated? A child who has been physically abused may be placed in a home or daycare center. Services may be offered to make sure the child is safe and healthy.

• Counseling may help the child feel less scared, depressed, or anxious. A counselor can help him talk about how he feels.
  
  
• Medicines may be needed to help ease pain, or to treat or prevent an infection. Medicines may also be given if the child has other medical conditions.
  
  
• Surgery may be needed to treat the child's injuries. Surgery can help fix a broken bone. Surgery may also be needed to correct a deformity caused by his injuries.

What are the risks of physical abuse? If the child is placed in a foster home or care, it may be hard to be away from family or friends. Counseling may be emotionally difficult and painful. The child may have changes in behavior and school performance. He may develop other serious problems. These include running away from home, alcohol or drug use, depression, and problems with self-esteem, moods, and relationships. Repeated acts of violence may lead to severe injuries and be life-threatening. He may have thoughts of harming himself or others.

How can I care for a child victim of physical abuse?

• Apply ice and heat. Ice helps decrease swelling and pain. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on the child's injury for 15 to 20 minutes every hour or as directed. After the first 24 to 48 hours, the child's healthcare provider may have you use heat. Heat helps decrease pain and muscle spasms. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed.
  
  
• Let the child rest as needed. Tell the child's healthcare provider if the child has trouble sleeping.
  
  
• Report suspected or known physical abuse. It may be hard to report physical abuse in children, but it is very important. Healthcare providers can help the child if he is at risk for or is a victim of physical abuse. Healthcare providers are required by law to report physical abuse. The child may need to leave the current living situation and be placed in foster care to protect him from abuse.

Call 911 for any of the following:

• The child feels like harming himself or someone else.
  
  
• The child has trouble breathing, chest pain, or a fast heartbeat.

When should I seek immediate care?

• The child feels that he cannot cope with the abuse, or recovery from it.
  
  

When should I contact the child's healthcare provider?

• The child has new signs and symptoms since the last visit.
  
  
• You have questions or concerns about the child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.