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Physical Abuse

Page setting out a definition of physical abuse and possible signs and symptoms.

Actual, attempted or risk of serious physical injury to a child including the administration of toxic substances, where there is a definite knowledge or reasonable suspicion, that the injury was inflicted or knowingly not prevented.

Scottish Office Guidance 1998

Physical injury may include a serious incident or a series of minor incidents involving bruising, fractures, scratches, burns or scalds, poisoning, attempted drowning or smothering, fictitious illness by proxy, serious risk of injury or actual injuries resulting from parental lifestyle prior to birth, for instance substance abuse or physical chastisement deemed to be unreasonable.

Recognition of physical injury

The following indicators should alert workers to the possibility of children having been abused:

Bruises

Bites

These can leave clear impressions of the teeth.

Burns and scalds

It can be very difficult to distinguish between accidental and non-accidental burns, but as a general rule of thumb, burns or scalds with clear outlines are suspicious.  So are burns of uniform depth over a large area.  Also, splash marks about the main burn area (caused by hot liquid being thrown).

Concerns should be raised where the adult responsible has not checked the temperature of the bath. A child is unlikely to sit down voluntarily in too hot a bath and cannot accidentally scald its bottom without also scalding its feet. A child getting into too hot water of its own accord will struggle to get out again and there will be splash marks. Small round burns may be cigarette burns.

Scars

Many children have scars, but notice should be taken of an exceptionally large number of differing age scars (especially if coupled with current bruising), unusual shaped scars (e.g. round ones from possible cigarette burns), or of large scars that are from burns or lacerations that did not receive medical treatment.

Fractures

Should be suspected if there is pain, swelling and discolouration over a bone or joint.  The most common non-accidental fractures are to the long bones (i.e. the arms, legs, ribs).  Due to the lack of mobility and stage of development it is very rare for a child under one year to sustain a fracture accidentally. Generally, fractures also cause pain and it is difficult for a parent to be unaware that a child has been hurt.

Genital/anal area injury

It would be unusual for a child to have bruising or bleeding in this area and a medical opinion should be sought.

Shaken baby

Shaken baby refers to the constellation of non accidental injuries occurring in infants and young children as a consequence of violent shaking.  Occurrence of the syndrome is unrelated to race, gender, socio-economic status or education. Violent shaking can result in death.

Poisoning

Poisoning often occurs in Fabricated or Induced Illness (FII, formerly Munchausen Syndrome by Proxy). Medical advice should be sought in respect of child and parent.

Where there are concerns or uncertainty regarding physical signs, medical advice should be sought.

This page was added to the website on 2 July 2015