Child Abuse and Neglect - Exams and Tests
maltreated child who is taken to a doctor will first
have a general physical exam. Also, the child's medical history will be
reviewed, and parents or caregivers will be questioned about the child's
condition. A child who is able to talk will be separated from the caregiver
during the interview.
Doctors have a professional duty and legal
obligation to evaluate the possibility of abuse or neglect. Along with
observing signs of
physical abuse or
neglect, a doctor may become suspicious when:
- The injury is uncommon or unlikely to be an
accident, especially for the child's developmental
- Explanations given by the parents or caregivers change or do
not adequately account for the child's condition.
- There was no
reported witness to the injury.
- Medical records document that
similar injuries or patterns of neglect have occurred.
- Parents or
caregivers delayed seeking medical help for the child without a credible or
sexual abuse may not be identified during a physical
exam. Not all types of sexual abuse leave physical signs. Also, many types of
sexual abuse injuries heal quickly. But if a child is examined soon after the
incident, a doctor is more likely to observe and record the symptoms and be
able to take samples for lab analysis.
Tests that are frequently used to help confirm or
rule out suspected abuse or neglect include:
- Imaging tests such as
CT scan, or
magnetic resonance imaging (MRI). These types of tests
can help determine whether a child's injuries include any broken bones. Some
tests may also show evidence of past injuries.
- Blood tests.
partial thromboplastin time, and
platelet count can help determine whether a bleeding
disorder is present. This may help rule out abuse or neglect as a diagnosis.
Other blood tests can be used to look for signs of organ
- Urinalysis (UA), to check for blood in
the urine. If the test is positive, this may be a sign of internal
- Specialized laboratory tests, to determine whether sexual
abuse has occurred. For example, sample cultures of fluids found in or around
the vagina may be taken and analyzed. If abuse has occurred within 72 hours of
the exam, forensic samples of certain body tissues, such as skin or hair, also
- Lumbar puncture, also called spinal tap, which may reveal blood from a brain
- Eye exam by an
ophthalmologist, to find out if damage has occurred
that points to
shaken baby syndrome, also called intentional head
Other exams and tests done to
help confirm child abuse or neglect vary depending on the specific medical
problem suspected or observed. For example, psychological testing may be
requested for some children. Victims of suspected sexual abuse may be tested
sexually transmitted diseases.