Skip to main content

Physical Child Abuse

  • Chapter
  • First Online:
Clinical Forensic Medicine

Abstract

Physical child abuse is common and carries a significant morbidity and mortality. Child health professionals have an important role in recognizing, assessing, and managing children with suspected physical abuse.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Children Act 2004. http://www.opsi.gov.uk/acts/acts2004/ukpga_20040031_en_1

  2. Child Abuse Prevention and Treatment Act Amendments of 1996. http://www.acf.hhs.gov/programs/cb/laws_policies/cblaws/capta/index.htm

  3. Child Maltreatment Surveillance. http://www.cdc.gov/ncipc/dvp/CM_Surveillance.pdf

  4. Gilbert R, Widom CS, Browne K et al (2009) Burden and consequences of child maltreatment in high-income countries. Lancet 373:68–81

    PubMed  Google Scholar 

  5. Govindshenoy M, Spencer N (2007) Abuse of the disabled child: a systematic review of ­population-based studies. Child Care Health Dev 33:552–558

    PubMed  CAS  Google Scholar 

  6. Sidebotham P, Heron J, Golding J; The ALSPAC Study Team (2002) Child maltreatment in the “Children of the Nineties:” deprivation, class, and social networks in a UK sample. Child Abuse Negl 26:1243–1259

    Google Scholar 

  7. Berger LM (2005) Income, family characteristics, and physical violence toward children. Child Abuse Negl 29:107–133

    PubMed  Google Scholar 

  8. Child Maltreatment 2007. http://www.acf.hhs.gov/programs/cb/pubs/cm07/

  9. Jayawant S, Rawlinson A, Gibbon F et al (1998) Subdural haemorrhages in infants: population based study. BMJ 317:1558–1561

    PubMed  CAS  Google Scholar 

  10. Collins KA, Nichols CA (1999) A decade of pediatric homicide: a retrospective study at the Medical University of South Carolina. Am J Forensic Med Pathol 20:169–172

    PubMed  CAS  Google Scholar 

  11. Behrman RE, Kliegman RM, Jenson HB (2000) Nelson textbook of pediatrics, 16th edn. W. B. Saunders, Philadelphia

    Google Scholar 

  12. Murty OP, Ming CJ, Ezani MA et al (2006) Physical injuries in fatal and non-fatal child abuse cases: a review of 16 years with hands on experience of 2 years in Malaysia. Int J Med Toxicol Legal Med 9:33–43

    Google Scholar 

  13. Trocme N, MacMillan H, Fallon B, De Marco R (2003) Nature and severity of physical harm caused by child abuse and neglect: results from the Canadian Incidence Study [see comment]. CMAJ 169:911–915

    PubMed  Google Scholar 

  14. King WK, Kiesel EL, Simon HK (2006) Child abuse fatalities: are we missing opportunities for intervention? Pediatr Emerg Care 22:211–214

    PubMed  Google Scholar 

  15. Sugar NF, Taylor JA, Feldman KW (1999) Bruises in infants and toddlers: those who don’t cruise rarely bruise. Puget Sound Pediatric Research Network. Arch Pediatr Adolesc Med 153:399–403

    PubMed  CAS  Google Scholar 

  16. Labbé J, Caouette G (2001) Recent skin injuries in normal children. Pediatrics 108:271–276

    PubMed  Google Scholar 

  17. Dunstan FD, Guildea ZE, Kontos K et al (2002) A scoring system for bruise patterns: a tool for identifying abuse. Arch Dis Child 86:330–333

    PubMed  CAS  Google Scholar 

  18. Atwal GS, Rutty GN, Carter N, Green MA (1998) Bruising in non-accidental head injured children; a retrospective study of the prevalence, distribution and pathological associations in 24 cases. Forensic Sci Int 96:215–230

    PubMed  CAS  Google Scholar 

  19. Carpenter RF (1999) The prevalence and distribution of bruising in babies. Arch Dis Child 80:363–366

    PubMed  CAS  Google Scholar 

  20. Chang L-T, Tsai M-C (2007) Craniofacial injuries from slip, trip, and fall accidents of ­children. J Trauma 63:70–74

    PubMed  Google Scholar 

  21. Jessee SA (1995) Physical manifestations of child abuse to the head, face and mouth: a hospital survey. ASDC J Dent Child 62:245–249

    PubMed  CAS  Google Scholar 

  22. Feldman KW (1992) Patterned abusive bruises of the buttocks and the pinnae. Pediatrics 90:633–636

    PubMed  CAS  Google Scholar 

  23. Hanigan WC, Peterson RA, Njus G (1987) Tin ear syndrome: rotational acceleration in pediatric head injuries. Pediatrics 80:618–622

    PubMed  CAS  Google Scholar 

  24. Wedgwood J (1990) Childhood bruising. Practitioner 234:598–601

    PubMed  CAS  Google Scholar 

  25. Nayak K, Spencer N, Shenoy M et al (2006) How useful is the presence of petechiae in distinguishing non-accidental from accidental injury? Child Abuse Negl 30:549–555

    PubMed  Google Scholar 

  26. Ellerstein NS (1979) The cutaneous manifestations of child abuse and neglect. Am J Dis Child 133:906–909

    PubMed  CAS  Google Scholar 

  27. Brinkmann B, Püschel K, Mätzsch T (1979) Forensic dermatological aspects of the battered child syndrome. Aktuelle Derm 5:217–232

    Google Scholar 

  28. Polson CJ, Gee DJ et al (1985) Injuries: general features. In: Polson CJ, Gee DJ, Knight B (eds) The essentials of forensic medicine. Pergamon, Oxford, pp 91–147

    Google Scholar 

  29. Maguire S, Mann MK, Sibert J, Kemp A (2005) Can you age bruises accurately in children? Arch Dis Child 90:187–189

    PubMed  CAS  Google Scholar 

  30. Munang LA, Leonard PA, Mok J (2002) Lack of agreement on colour description between clinicians examining childhood bruising. J Clin Forensic Med 9:171–174

    PubMed  CAS  Google Scholar 

  31. Becker DB, Needleman HL, Kotelchuck M (1978) Child abuse and dentistry: orofacial trauma and its recognition by dentists. J Am Dent Assoc 97:24–28

    PubMed  CAS  Google Scholar 

  32. Naidoo S (2000) A profile of the oro-facial injuries in child physical abuse at a children’s hospital. Child Abuse Negl 24:521–534

    PubMed  CAS  Google Scholar 

  33. Maguire SA, Hunter B, Hunter LM et al (2007) Diagnosing abuse: a systematic review of torn frenum and intra-oral injuries. Arch Dis Child 92:1113–1117

    PubMed  Google Scholar 

  34. Cameron JM, Johnson HRM, Camps FE (1966) The battered child syndrome. Med Sci Law 6:2–21

    PubMed  CAS  Google Scholar 

  35. Tate RJ (1971) Facial injuries associated with the battered child syndrome. Br J Oral Surg 9:41–45

    PubMed  CAS  Google Scholar 

  36. Price EA, Rush LR, Perper JA, Bell MD (2000) Cardiopulmonary resuscitation-related injuries and homicidal blunt abdominal trauma in children. Am J Forensic Med Pathol 21:307–310

    PubMed  CAS  Google Scholar 

  37. Torriani DD, Bonow ML, Fleischmann MD, Muller LT (2008) Traumatic intrusion of primary tooth: follow up until eruption of permanent successor tooth. Dent Traumatol 24:235–238

    PubMed  Google Scholar 

  38. Cordner SM, Burke MP, Dodd MJ et al (2001) Issues in child homicides: 11 cases. Leg Med 3:95–103

    CAS  Google Scholar 

  39. Thackeray JD (2007) Frena tears and abusive head injury: a cautionary tale. Pediatr Emerg Care 23:735–737

    PubMed  Google Scholar 

  40. AAPD; American Academy of Pediatrics Committee on Child Abuse and Neglect & American Academy of Pediatric Dentistry Ad Hoc Work Group on Child Abuse and Neglect (1999) Oral and dental aspects of child abuse and neglect. Pediatrics 104:348–350

    Google Scholar 

  41. Wright J, Thornton J (1983) Osteogenesis imperfecta with dentinogenesis imperfecta. A mistaken case of child abuse. Pediatr Dent 5:207–209

    PubMed  CAS  Google Scholar 

  42. Carrotte PV (1990) An unusual case of child abuse. Br Dent J 168:444–445

    PubMed  CAS  Google Scholar 

  43. Baker MD, Moore SE (1987) Human bites in children. A six-year experience. Am J Dis Child 141:1285–1290

    PubMed  CAS  Google Scholar 

  44. Whittaker DK, MacDonald DG (1989) Bitemarks in flesh. In: Anonymous (eds) A colour atlas of forensic dentistry. Wolfe Medical Publications, London, p 108

    Google Scholar 

  45. Freeman AJ, Senn DR, Arendt DM (2005) Seven hundred seventy eight bite marks: analysis by anatomic location, victim and biter demographics, type of crime, and legal disposition. J Forensic Sci 50:1436–1443

    PubMed  Google Scholar 

  46. Levine LJ (1984) Bite marks in child abuse. In: Sanger RG, Bross DC (eds) Clinical management of child abuse and neglect. Quintessence, Chicago, pp 53–59

    Google Scholar 

  47. Bernitz H, Owen JH, van Heerden WF, Solheim T (2008) An integrated technique for the analysis of skin bite marks. J Forensic Sci 53:194–198

    PubMed  Google Scholar 

  48. BAFO (British Association of Forensic Odontology) (2001) Guidelines bitemark methodology. http://www.forensicdentistryonline.org/Forensic_pages_1/bitemarkguide.htm

  49. Chester DL, Jose RM, Aldlyami E et al (2006) Non-accidental burns in children – are we neglecting neglect? Burns 32:222–228

    PubMed  Google Scholar 

  50. Montrey JS, Barcia PJ (1985) Nonaccidental burns in child abuse. South Med J 78:1324–1326

    PubMed  CAS  Google Scholar 

  51. Daria S, Sugar NF, Feldman KW et al (2004) Into hot water head first: distribution of intentional and unintentional immersion burns. Pediatr Emerg Care 20:302–310

    PubMed  Google Scholar 

  52. Ojo P, Palmer J, Garvey R et al (2007) Pattern of burns in child abuse. Am Surg 73:253–255

    PubMed  Google Scholar 

  53. Zaloga WF, Collins KA (2006) Pediatric homicides related to burn injury: a retrospective review at the Medical University of South Carolina. J Forensic Sci 51:396–399

    PubMed  Google Scholar 

  54. Maguire S, Moynihan S, Mann M et al (2008) A systematic review of the features that indicate intentional scalds in children. Burns 34:1072–1081

    PubMed  CAS  Google Scholar 

  55. Yeoh C, Nixon JW, Dickson W et al (1994) Patterns of scald injuries. Arch Dis Child 71:156–158

    PubMed  CAS  Google Scholar 

  56. Caniano DA, Beaver BL, Boles ET (1986) Child abuse: an update on surgical management in 256 cases. Ann Surg 203:219–224

    PubMed  CAS  Google Scholar 

  57. Lowell G, Quinlan K, Gottlieb LJ (2008) Preventing unintentional scald burns: moving beyond tap water. Pediatrics 122:799–804

    PubMed  Google Scholar 

  58. Dressler DP, Hozid JL (2001) Thermal injury and child abuse: the medical evidence dilemma. J Burn Care Rehabil 22:180–185

    PubMed  CAS  Google Scholar 

  59. Feldman KW, Schaller RT, Feldman JA, McMillon M (1998) Tap water scald burns in ­children. Inj Prev 4:238–242

    PubMed  CAS  Google Scholar 

  60. Allasio D, Fischer H (2005) Immersion scald burns and the ability of young children to climb into a bathtub. Pediatrics 115:1419–1421

    PubMed  Google Scholar 

  61. Titus MO, Baxter AL, Starling SP (2003) Accidental scald burns in sinks. Pediatrics 111:e191–e194

    PubMed  Google Scholar 

  62. Hicks RA, Stolfi A (2007) Skeletal surveys in children with burns caused by child abuse. Pediatr Emerg Care 23:308–313

    PubMed  Google Scholar 

  63. Grellner W, Metzner G (1995) Kindesmißhandlung durch thermische Gewalt: Abgrenzung und Rekonstruktion [Child abuse caused by thermal violence – determination and reconstruction]. Arch Kriminol 195:38–46

    PubMed  CAS  Google Scholar 

  64. Baron S, Moss C (2003) Images in paediatrics: caustic burn caused by potassium permanganate. Arch Dis Child 88:96

    PubMed  CAS  Google Scholar 

  65. Alexander RC, Surrell JA, Cohle SD (1987) Microwave oven burns to children: an unusual manifestation of child abuse. Pediatrics 79:255–260

    PubMed  CAS  Google Scholar 

  66. Wilson Jones N, Wong P, Potokar T (2008) Electric hair straightener burns an epidemiological and thermodynamic study. Burns 34:521–524

    PubMed  CAS  Google Scholar 

  67. Hobbs CJ, Wynne JM (1990) The sexually abused battered child. Arch Dis Child 65:423–427

    PubMed  CAS  Google Scholar 

  68. Badger K, Anderson L, Kagan RJ (2008) Attention deficit-hyperactivity disorder in children with burn injuries. J Burn Care Res 29:724–729

    PubMed  Google Scholar 

  69. Barnes PM, Norton CM, Dunstan FD et al (2005) Abdominal injury due to child abuse. Lancet 366:234–235

    PubMed  Google Scholar 

  70. Gaines BA, Shultz BS, Morrison K, Ford HR (2004) Duodenal injuries in children: beware of child abuse. J Pediatr Surg 39:600–602

    PubMed  Google Scholar 

  71. Lindberg D, Makoroff K, Harper N et al (2009) Utility of hepatic transaminases to recognize abuse in children. Pediatrics 124:509–516

    PubMed  Google Scholar 

  72. Wood J, Rubin DM, Nance ML, Christian CW (2005) Distinguishing inflicted versus accidental abdominal injuries in young children. J Trauma 59:1203–1208

    PubMed  Google Scholar 

  73. Worlock P, Stower M, Barbor P (1986) Patterns of fractures in accidental and non-accidental injury in children: a comparative study. BMJ 293:100–102

    PubMed  CAS  Google Scholar 

  74. Leventhal JM, Thomas SA, Rosenfield NS, Markowitz RI (1993) Fractures in young children. Distinguishing child abuse from unintentional injuries. Am J Dis Child 147:87–92

    PubMed  CAS  Google Scholar 

  75. Kemp AM, Dunstan F, Harrison S et al (2008) Patterns of skeletal fractures in child abuse: a systematic review. BMJ 337:a1518

    PubMed  Google Scholar 

  76. Pandya NK, Baldwin K, Wolfgruber H et al (2009) Child abuse and orthopaedic injury ­patterns: analysis at a level I pediatric trauma center. J Pediatr Orthop 29:618–625

    PubMed  Google Scholar 

  77. Farnsworth CL, Silva PD, Mubarak SJ (1998) Etiology of supracondylar humerus fractures. J Pediatr Orthop 18:38–42

    PubMed  CAS  Google Scholar 

  78. Dalton HJ, Slovis T, Helfer RE et al (1990) Undiagnosed abuse in children younger than 3 years with femoral fracture. Am J Dis Child 144:875–878

    PubMed  CAS  Google Scholar 

  79. Anderson WA (1982) The significance of femoral fractures in children. Ann Emerg Med 11:174–177

    PubMed  CAS  Google Scholar 

  80. Beals RK, Tufts E (1983) Fractured femur in infancy: the role of child abuse. J Pediatr Orthop 3:583–586

    PubMed  CAS  Google Scholar 

  81. Altman DH, Smith RL (1960) Unrecognised trauma in infants and children. J Bone Joint Surg 42:407–413

    PubMed  Google Scholar 

  82. Grayev AM, Boal DKB, Wallach DM, Segal LS (2001) Metaphyseal fractures mimicking abuse during treatment for clubfoot. Pediatr Radiol 31:559–563

    PubMed  CAS  Google Scholar 

  83. Kemp A, Joshi A, Mann M et al (2010) What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review. Arch Dis Child 95(5):355–360

    PubMed  CAS  Google Scholar 

  84. Merten DF, Radlowski MA, Leonidas JC (1983) The abused child: a radiological reappraisal. Radiology 146:377–381

    PubMed  CAS  Google Scholar 

  85. The Royal College of Radiologists and Royal College of Paediatrics and Child Health (2008) Standards for radiological investigations of suspected non-accidental injury. The Royal College of Radiologists, London

    Google Scholar 

  86. ACR revised standards for SS in children. http://www.acr.org

  87. Hansen KK, Prince JS, Nixon GW (2008) Oblique chest views as a routine part of skeletal surveys performed for possible physical abuse-is this practice worthwhile? Child Abuse Negl 32:155–159

    PubMed  Google Scholar 

  88. Kleinman PK, Nimkin K, Spevak MR et al (1996) Follow-up skeletal surveys in suspected child abuse. Am J Roentgenol 167:893–896

    CAS  Google Scholar 

  89. Zimmerman S, Makoroff K, Care M et al (2005) Utility of follow-up skeletal surveys in suspected child physical abuse evaluations. Child Abuse Negl 29:1075–1083

    PubMed  Google Scholar 

  90. Prosser I, Maguire S, Harrison SK et al (2005) How old is this fracture? Radiologic dating of fractures in children: a systematic review. Am J Roentgenol 184:1282–1286

    Google Scholar 

  91. Kleinman PK (1998) Diagnostic imaging of child abuse, 2nd edn. Mosby, St. Louis

    Google Scholar 

  92. Offiah AC, Hall CM, Fairhurst J (2009) Radiological atlas of child abuse. Radcliffe Publishing, Oxford

    Google Scholar 

  93. Bishop N, Sprigg A, Dalton A (2007) Unexplained fractures in infancy: looking for fragile bones. Arch Dis Child 92:251–256

    PubMed  Google Scholar 

  94. Ettaro L, Berger RP, Songer T (2004) Abusive head trauma in young children: characteristics and medical charges in a hospitalized population. Child Abuse Negl 28:1099–1111

    PubMed  Google Scholar 

  95. Hettler J, Greenes DS (2003) Can the initial history predict whether a child with a head injury has been abused? Pediatrics 111:602–607

    PubMed  Google Scholar 

  96. Vinchon M, Defoort-Dhellemmes S, Desurmont M, Dhellemmes P (2005) Accidental and nonaccidental head injuries in infants: a prospective study. J Neurosurg 102:380–384

    PubMed  Google Scholar 

  97. Hobbs C, Childs AM, Wynne J et al (2005) Subdural haematoma and effusion in infancy: an epidemiological study. Arch Dis Child 90:952–955

    PubMed  CAS  Google Scholar 

  98. Runyan DK (2008) The challenges of assessing the incidence of inflicted traumatic brain injury: a world perspective. Am J Prev Med 34:112–115

    Google Scholar 

  99. Caffey J (1946) Multiple fractures in the long bones of infants suffering from chronic subdural haematoma. Am J Roentgenol 56:163–173

    CAS  Google Scholar 

  100. Maguire SA, Watts PO, Taylor RH, Shaw AD, Holden S, Watkins WJ, Mann MK, Tempest V, Kemp AM (in press) Retinal hemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

    Google Scholar 

  101. Morad Y, Kim YM, Mian M et al (2003) Nonophthalmologist accuracy in diagnosing retinal hemorrhages in the shaken baby syndrome. J Pediatr 142:431–434

    PubMed  Google Scholar 

  102. Maguire SA, Moynihan S, Bunting HJ, Watts PO, Adams GG, Mann MK, Lumb RC, Kemp AM (in press) A systematic review of the differential diagnosis of retinal hemorrhages in children

    Google Scholar 

  103. Ichord RN, Naim M, Pollock AN et al (2007) Hypoxic-ischemic injury complicates inflicted and accidental traumatic brain injury in young children: the role of diffusion-weighted imaging. J Neurotrauma 24:106–118

    PubMed  Google Scholar 

  104. Bechtel K, Stoessel K, Leventhal JM et al (2004) Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma. Pediatrics 114:165–168

    PubMed  Google Scholar 

  105. Ewing-Cobbs L, Prasad M, Kramer L et al (2000) Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury. Childs Nerv Syst 16:25–34

    PubMed  CAS  Google Scholar 

  106. Wells RG, Vetter C, Laud P (2002) Intracranial hemorrhage in children younger than 3 years: prediction of intent. Arch Pediatr Adolesc Med 156:252–257

    PubMed  Google Scholar 

  107. Feldman KW, Bethel R, Shugerman RP et al (2001) The cause of infant and toddler subdural hemorrhage: a prospective study. Pediatrics 108:636–646

    PubMed  CAS  Google Scholar 

  108. Kelly P, Hayes I (2004) Infantile subdural haematoma in Auckland, New Zealand: 1988–1998. N Z Med J 117:U1047

    PubMed  Google Scholar 

  109. Tung GA, Kumar M, Richardson RC et al (2006) Comparison of accidental and nonaccidental traumatic head injury in children on noncontrast computed tomography. Pediatrics 118:626–633

    PubMed  Google Scholar 

  110. Vinchon M, Noulé N, Tchofo PJ et al (2004) Imaging of head injuries in infants: temporal correlates and forensic implications for the diagnosis of child abuse. J Neurosurg 101:44–52

    PubMed  Google Scholar 

  111. Kemp AM, Rajaram S, Mann M et al (2009) What neuroimaging should be performed in children in whom inflicted brain injury (iBI) is suspected? A systematic review. Clin Radiol 64:473–483

    PubMed  CAS  Google Scholar 

  112. Vezina G (2009) Assessment of the nature and age of subdural collections in nonaccidental head injury with CT and MRI. Pediatr Radiol 39:586–590

    PubMed  Google Scholar 

  113. Royal College of Paediatrics and Child Health (2002) Fabricated or induced illness by carers. Royal College of Paediatrics and Child Health, London

    Google Scholar 

  114. Adshead G, Bluglass K (2005) Attachment representations in mothers with abnormal illness behaviour by proxy. Br J Psychiatry 187:328–333

    PubMed  Google Scholar 

  115. Galvin HK, Newton AW, Vandeven AM (2005) Update on Munchausen syndrome by proxy. Curr Opin Pediatr 17:252–257

    PubMed  Google Scholar 

  116. Feldman MD (2004) Munchausen by proxy and malingering by proxy. Psychosomatics 45:365–366

    PubMed  Google Scholar 

  117. Fisher GC, Mitchell I, Murdoch D (1993) Munchausen’s syndrome by proxy. The question of psychiatric illness in a child. Br J Psychiatry 162:701–703

    PubMed  CAS  Google Scholar 

  118. Katz RL, Mazer C, Litt IF (1985) Anorexia nervosa by proxy. J Pediatr 107:247–248

    PubMed  CAS  Google Scholar 

  119. MacDonald TM (1989) Myalgic encephalomyelitis by proxy. Br Med J 299:1030–1031

    Google Scholar 

  120. Schreier HA (1997) Factitious presentation of psychiatric disorder: when is it Munchausen by proxy? Child Adolesc Ment Health 2:108–115

    Google Scholar 

  121. Scourfield J (1995) Anorexia by proxy: are the children of anorexic mothers an at-risk group? Int J Eat Disord 18:371–374

    PubMed  CAS  Google Scholar 

  122. Barker LH, Howell RJ (1994) Munchausen syndrome by proxy in false allegations of child sexual abuse: legal implications. Bull Am Acad Psychiatry Law 22:499–510

    PubMed  CAS  Google Scholar 

  123. Marcus A, Ammermann C, Klein M, Schmidt MH (1995) Munchausen syndrome by proxy and factitious illness: symptomatology, parent-child interaction, and psychopathology of the parents. Eur Child Adolesc Psychiatry 4:229–236

    PubMed  CAS  Google Scholar 

  124. Meadow R (1993) False allegations of abuse and Munchausen syndrome by proxy. Arch Dis Child 68:444–447

    PubMed  CAS  Google Scholar 

  125. Schreier HA (1996) Repeated false allegations of sexual abuse presenting to sheriffs: when is it Munchausen by Proxy? Child Abuse Negl 20:985–991

    PubMed  CAS  Google Scholar 

  126. McClure RJ, Davis PM, Meadow SR, Sibert JR (1996) Epidemiology of Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. Arch Dis Child 75:57–61

    PubMed  CAS  Google Scholar 

  127. Meadow R (1998) Munchausen syndrome by proxy abuse perpetrated by men. Arch Dis Child 78:210–216

    PubMed  CAS  Google Scholar 

  128. Parnell TF, Day DO (1997) Munchausen by proxy syndrome: misunderstood child abuse. Sage, Thousand Oaks

    Google Scholar 

  129. Rosenberg DA (1987) Web of deceit: a literature review of Munchausen syndrome by proxy. Child Abuse Negl 11:547–563

    PubMed  CAS  Google Scholar 

  130. Bluglass K (1993) ‘Factitious’ illness or ‘Munchausen by proxy’. Curr Pediatr 3:81–85

    Google Scholar 

  131. Bools C (1996) Factitious illness by proxy. Munchausen syndrome by proxy. Br J Psychiatry 169:268–275

    PubMed  CAS  Google Scholar 

  132. Bools C, Neale B, Meadow R (1994) Munchausen syndrome by proxy: a study of psychopathology. Child Abuse Negl 18:773–788

    PubMed  CAS  Google Scholar 

  133. Buchta R (1988) Deliberate intoxication of young children and pets with drugs: a survey of an adolescent population in a private practice. Am J Dis Child 142:701–702

    PubMed  CAS  Google Scholar 

  134. Feldman MD, Hamilton JC (2006) Serial factitious disorder and Munchausen by proxy in pregnancy. Int J Clin Pract 60:1675–1678

    PubMed  CAS  Google Scholar 

  135. Davis P, McClure RJ, Rolfe K et al (1998) Procedures, placement, and risks of further abuse after Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. Arch Dis Child 78:217–221

    PubMed  CAS  Google Scholar 

  136. Denny SJ, Grant CC, Pinnock R (2001) Epidemiology of Munchausen syndrome by proxy in New Zealand. J Paediatr Child Health 37:240–243

    PubMed  CAS  Google Scholar 

  137. Eminson DM, Postlethwaite RJ (2000) Munchausen syndrome by proxy abuse: a practical approach. Butterworth Heinemann, Oxford

    Google Scholar 

  138. Ifere OA, Yakubu AM, Aikhionbare HA et al (1993) Munchausen syndrome by proxy: an experience from Nigeria. Ann Trop Paediatr 13:281–284

    PubMed  CAS  Google Scholar 

  139. Oyelami OA, Alhaj AM, Airede IK (1994) Münchausen syndrome by proxy – a case report and review of literature. Cent Afr J Med 40:222–226

    PubMed  CAS  Google Scholar 

  140. Warner JO, Hathaway MJ (1984) Allergic form of Meadow’s syndrome (Munchausen by proxy). Arch Dis Child 59:151–156

    PubMed  CAS  Google Scholar 

  141. Godding V, Kruth M (1991) Compliance with treatment in asthma and Munchausen syndrome by proxy. Arch Dis Child 66:956–960

    PubMed  CAS  Google Scholar 

  142. Meadow R (1982) Munchausen syndrome by proxy. Arch Dis Child 57:92–98

    PubMed  CAS  Google Scholar 

  143. Davis P (2000) The Cardiff Leeds study of alleged Munchausen syndrome by proxy, non accidental poisoning and non-accidental suffocation. Welsh Pediatr J 13:32–41

    Google Scholar 

  144. Wenk RE (2003) Molecular evidence of Munchausen syndrome by proxy. Arch Pathol Lab Med 127:36–37

    Google Scholar 

  145. Bennett AM, Bennett SM, Prinsley PR, Wickstead M (2005) Spitting in the ear: a falsified disease using video evidence. J Laryngol Otol 119:926–927

    PubMed  CAS  Google Scholar 

  146. McSweeney JJ, Hoffman RP (1991) Munchausen’s syndrome by proxy mistaken for IDDM. Diabetes Care 14:928–929

    PubMed  CAS  Google Scholar 

  147. Ulinski T, Lhopital C, Cloppet H et al (2004) Munchausen syndrome by proxy with massive proteinuria and gastrointestinal hemorrhage. Pediatr Nephrol 19:798–800

    PubMed  Google Scholar 

  148. Meadow R (1990) Suffocation, recurrent apnea, and sudden infant death. J Pediatr 117:351–357

    PubMed  CAS  Google Scholar 

  149. Southall DP, Plunkett MC, Banks MW et al (1997) Covert video recordings of life-threatening child abuse: lessons for child protection. Pediatrics 100:735–760

    PubMed  CAS  Google Scholar 

  150. Clark GD, Key JD, Rutherford P, Bithoney WG (1984) Munchausen’s syndrome by proxy (child abuse) presenting as apparent autoerythrocyte sensitization syndrome: an unusual presentation of Polle syndrome. Pediatrics 74:1100–1102

    PubMed  CAS  Google Scholar 

  151. Gray J, Bentovim A (1996) Illness induction syndrome: paper 1 – A series of 41 children from 37 families identified at The Great Ormond Street Hospital for Children NHS Trust. Child Abuse Negl 20:655–673

    PubMed  CAS  Google Scholar 

  152. Baskin DE, Stein F, Coats DK, Paysse EA (2003) Recurrent conjunctivitis as a presentation of Munchausen syndrome by proxy. Ophthalmology 110:1582–1584

    PubMed  Google Scholar 

  153. Clin B, Ferrant O, Dupont C, Papin F (2009) Recurrent caustic esophagitis: a clinical form of Münchausen syndrome by proxy. Child Abuse Negl 33:293–295

    PubMed  Google Scholar 

  154. Friedman EM (1987) Caustic ingestions and foreign body aspirations: an overlooked form of child abuse. Ann Otol Rhinol Laryngol 96:709–712

    PubMed  CAS  Google Scholar 

  155. Postlethwaite RJ (2010) Caustic ingestion as a manifestation of fabricated and induced illness (Munchausen syndrome by proxy). Child Abuse Negl 34:471

    Google Scholar 

  156. Tamay Z, Akcay A, Kilic G et al (2007) Corrosive poisoning mimicking cicatricial pemphigoid: Munchausen by proxy. Child Care Health Dev 33:496–499

    PubMed  CAS  Google Scholar 

  157. Libow JA (1995) Munchausen by proxy victims in adulthood: a first look. Child Abuse Negl 19:1131–1142

    PubMed  CAS  Google Scholar 

  158. Lacey SR, Cooper C, Runyan DK, Azizkhan RG (1993) Munchausen syndrome by proxy: patterns of presentation to pediatric surgeons. J Pediatr Surg 28:827–832

    PubMed  CAS  Google Scholar 

  159. Vennemann B, Perdekamp MG, Weinmann W et al (2006) A case of Munchausen syndrome by proxy with subsequent suicide of the mother. Forensic Sci Int 158:195–199

    PubMed  CAS  Google Scholar 

  160. Kiechl-Kohlendorfer U, Hof D, Peglow UP et al (2005) Epidemiology of apparent life threatening events. Arch Dis Child 90:297–300

    PubMed  CAS  Google Scholar 

  161. McGovern MC, Smith MB (2004) Causes of apparent life threatening events in infants: a systematic review. Arch Dis Child 89:1043–1048

    PubMed  CAS  Google Scholar 

  162. Rahilly PM (1991) The pneumographic and medical investigation of infants suffering apparent life threatening episodes. J Paediatr Child Health 27:349–353

    PubMed  CAS  Google Scholar 

  163. British Paediatric Association (1994) Evaluation of suspected imposed upper airway obstruction: report of a Working Party. British Paediatric Association, London

    Google Scholar 

  164. Krous HF, Nadeau JM, Byard RW, Blackbourne BD (2001) Oronasal blood in sudden infant death. Am J Forensic Med Pathol 22:346–351

    PubMed  CAS  Google Scholar 

  165. McIntosh N, Mok JY, Margerison A (2007) Epidemiology of oronasal hemorrhage in the first 2 years of life: implications for child protection. Pediatrics 120:1074–1078

    PubMed  Google Scholar 

  166. Walton LJ, Davies FC (2010) Nasal bleeding and non-accidental injury in an infant. Arch Dis Child 95:53–54

    PubMed  CAS  Google Scholar 

  167. Ackerman NB Jr, Strobel CT (1981) Polle syndrome: chronic diarrhea in Munchausen’s child. Gastroenterology 81:1140–1142

    PubMed  Google Scholar 

  168. Baldwin MA (1994) Munchausen syndrome by proxy: neurological manifestations. J Neurosci Nurs 26:18–23

    PubMed  CAS  Google Scholar 

  169. Barber MA, Davis PM (2002) Fits, faints, or fatal fantasy? Fabricated seizures and child abuse. Arch Dis Child 86:230–233

    PubMed  CAS  Google Scholar 

  170. Martinović Z (1995) Fictitious epilepsy in Munchausen syndrome by proxy: family psychodynamics. Seizure 4:129–134

    PubMed  Google Scholar 

  171. Meadow R (1982) Munchausen syndrome by proxy and pseudo-epilepsy. Arch Dis Child 57:811–812

    PubMed  CAS  Google Scholar 

  172. Meadow R (1984) Fictitious epilepsy. Lancet 2:25–28

    PubMed  CAS  Google Scholar 

  173. Meadow R (1991) Neurological and developmental variants of Munchausen syndrome by proxy. Dev Med Child Neurol 33:270–272

    PubMed  CAS  Google Scholar 

  174. Dine MS, McGovern ME (1982) Intentional poisoning of children – an overlooked category of child abuse: report of seven cases and review of the literature. Pediatrics 70:32–35

    PubMed  CAS  Google Scholar 

  175. Fischler RS (1983) Poisoning: a syndrome of child abuse. Am Fam Physician 28:103–108

    PubMed  CAS  Google Scholar 

  176. Meadow R (1989) ABC of child abuse. Poisoning. Br Med J 298:1445–1446

    CAS  Google Scholar 

  177. Rogers D, Tripp J, Bentovim A et al (1976) Non-accidental poisoning: an extended syndrome of child abuse. Br Med J 1:793–796

    PubMed  CAS  Google Scholar 

  178. Shnaps Y, Frand M, Rotem Y, Tirosh M (1981) The chemically abused child. Pediatrics 68:119–121

    PubMed  CAS  Google Scholar 

  179. Giurgea I, Ulinski T, Touati G et al (2005) Factitious hyperinsulinism leading to pancreatectomy: severe forms of Munchausen syndrome by proxy. Pediatrics 116:e145–e148

    PubMed  Google Scholar 

  180. Green RP, Hollander AS, Thevis M et al (2010) Detection of surreptitious administration of analog insulin to an 8-week-old infant. Pediatrics 125:e1236–e1240

    PubMed  Google Scholar 

  181. Marks V (2009) Murder by insulin: suspected, purported and proven-a review. Drug Test Anal 1:162–176

    PubMed  CAS  Google Scholar 

  182. Meadow R (1993) Non-accidental salt poisoning. Arch Dis Child 68:448–452

    PubMed  CAS  Google Scholar 

  183. Royal College of Paediatrics and Child Health (2009) The differential diagnosis of hypernatraemia in children, with particular reference to salt poisoning. An evidence-based guideline. Royal College of Paediatrics and Child Health, London

    Google Scholar 

  184. Bauman WA, Yalow RS (1981) Child abuse: parenteral insulin administration. J Pediatr 99:588–591

    PubMed  CAS  Google Scholar 

  185. Dershewitz R, Vestal B, Maclaren NK, Cornblath M (1976) Transient hepatomegaly and hypoglycemia. A consequence of malicious insulin administration. Am J Dis Child 130:998–999

    PubMed  CAS  Google Scholar 

  186. Mayefsky JH, Sarnaik AP, Postellon DC (1982) Factitious hypoglycemia. Pediatrics 69:804–805

    PubMed  CAS  Google Scholar 

  187. Zitelli BJ, Seltman MF, Shannon RM (1987) Munchausen’s syndrome by proxy and its ­professional participants. Am J Dis Child 141:1099–1102

    PubMed  CAS  Google Scholar 

  188. Amin RS (2000) Gastroesophageal reflux and infant apnea. J Pediatr 137:298–300

    PubMed  CAS  Google Scholar 

  189. Alexander R, Smith W, Stevenson R (1990) Serial Munchausen syndrome by proxy. Pediatrics 86:581–585

    PubMed  CAS  Google Scholar 

  190. Baron HI, Beck DC, Vargas JH, Ament ME (1995) Overinterpretation of gastroduodenal motility studies: two cases involving Munchausen syndrome by proxy. J Pediatr 126:397–400

    PubMed  CAS  Google Scholar 

  191. Colletti RB, Wasserman RC (1989) Recurrent infantile vomiting due to intentional ipecac poisoning. J Pediatr Gastroenterol Nutr 8:394–396

    PubMed  CAS  Google Scholar 

  192. Goss PW, McDougall PN (1992) Munchausen syndrome by proxy – a cause of preterm delivery. Med J Aust 157:814–817

    PubMed  CAS  Google Scholar 

  193. Klebes C, Fay S (1995) Munchausen syndrome by proxy: a review, case study, and nursing implications. J Pediatr Nurs 10:93–98

    PubMed  CAS  Google Scholar 

  194. Kosmach B, Tarbell S, Reyes J, Todo S (1996) “Munchausen by proxy” syndrome in a small bowel transplant recipient. Transplant Proc 28:2790–2791

    PubMed  CAS  Google Scholar 

  195. Schreier HA, Libow JA (1994) Munchausen by proxy syndrome: a modern pediatric ­challenge. J Pediatr 125:110–115

    Google Scholar 

  196. Turk LJ, Hanrahan KM, Weber ER (1990) Munchausen syndrome by proxy: a nursing ­overview. Issues Compr Pediatr Nurs 13:279–288

    PubMed  CAS  Google Scholar 

  197. Royal College of Paediatrics and Child Health (2009) Fabricated or induced illness by carers (FII): a practical guide for paediatricians. Royal College of Paediatrics and Child Health, London

    Google Scholar 

  198. Samuels MP, Southall DP (1992) Munchausen syndrome by proxy. Br J Hosp Med 47:759–762

    PubMed  CAS  Google Scholar 

  199. McGuire TL, Feldman KW (1989) Psychologic morbidity of children subjected to Munchausen syndrome by proxy. Pediatrics 83:289–292

    PubMed  CAS  Google Scholar 

  200. Porter GE, Heitsch GM, Miller MD (1994) Munchausen syndrome by proxy: unusual ­manifestations and disturbing sequelae. Child Abuse Negl 18:789–794

    PubMed  CAS  Google Scholar 

  201. Saulsbury FT, Chobanian MC, Wilson WG (1984) Child abuse: parenteral hydrocarbon administration. Pediatrics 73:719–722

    PubMed  CAS  Google Scholar 

  202. Bools CN, Neale BA, Meadow SR (1993) Follow up of victims of fabricated illness (Munchausen syndrome by proxy). Arch Dis Child 69:625–630

    PubMed  CAS  Google Scholar 

  203. Bools CN, Neale BA, Meadow SR (1992) Co-morbidity associated with fabricated illness (Munchausen syndrome by proxy). Arch Dis Child 67:77–79

    PubMed  CAS  Google Scholar 

  204. Berg B, Jones D (1999) Outcome of psychiatric intervention in factitious illness by proxy (Munchausen’s syndrome by proxy). Arch Dis Child 81:465–472

    PubMed  CAS  Google Scholar 

  205. Gregory J (2004) Sickened. The true story of a lost childhood. Bantam, Sydney

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alison Kemp .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Kemp, A., Maguire, S., Davis, P. (2011). Physical Child Abuse. In: Stark, M. (eds) Clinical Forensic Medicine. Humana Press. https://doi.org/10.1007/978-1-61779-258-8_5

Download citation

Publish with us

Policies and ethics