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• W3149298161 abstract "In 2012 there were 3.4 million cases of child abuse or neglect reported to agencies in the United States. Of this number, the majority were related to neglect (78.3 %), 18.3 % to physical abuse, and 10 % to sexual abuse [1]. The estimated cost of child abuse and neglect in the United States is 124 billion dollars [2]. While recent research suggests some reductions in the incidence of abuse and neglect, the occurrence of child maltreatment remains a major public health concern, both because the incidence remains high and because of the potential long-term implications for the physical and mental health of victims of abuse. Children under 1 year of age are most likely to be victimized. Children under the age of 3 are at greatest risk for death due to maltreatment or neglect. Children of African-American or Native American heritage are at greatest risk of victimization [1]. Approximately 47 % of all victims are under 5 years of age. Risk factors that may place a child at increased risk of abuse include caregivers living in poverty, caregivers suffering from mental health problems or drug abuse, and domestic violence in the home. Characteristics of children who are more likely to be abused include those suffering from a disability, chronic illness, behavior problems, or a child who is a premature infant [1]. Child maltreatment is classified as abuse (physical, sexual, emotional, and others) or neglect. Definitions for what constitutes each of these areas are made by federal agencies and defined by each state (including each Indian Nation). It is important for the physician to be aware of the rules and laws for the jurisdiction in which they practice or to have a resource to discover this information if needed. Mandated reporting, likewise, is defined and legislated by each state and includes professional reporting requirements in each jurisdiction and the method of reporting (phone call and/or written report) and also the time frame required for reporting. It is the responsibility of the physician to know what the laws are for the state in which they practice. The physician is generally provided immunity from legal risk if the filing of suspected abuse is carried out as specified in the state’s requirements and for the safety of the child. There are many reasons that providers have difficulty in differentiating abuse from other causes. First, there are many medical conditions that can mimic abuse such as toddler fractures, lichen sclerosus, and metabolic disorders. Second, many of the “injuries” are unwitnessed, and therefore, the cause of the injury is unknown. Third, children heal much more quickly than adults, so the injury may completely resolve or change dramatically over the course of several days before the physician has an opportunity to examine the child. And lastly, some children either lack the vocabulary skills to offer an explanation or are not ready to disclose at the time of the event." @default.
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• W3149298161 title "Child Abuse and Neglect" @default.
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