Citation

Wilson B, Smith H. Child Abuse Rev. 2015; 24(1): 16-27.

Copyright

(Copyright © 2015, John Wiley and Sons)

DOI

10.1002/car.2256

PMID

unavailable

Abstract

A retrospective review was carried out of the histories given by the carers of children aged from newborn to three years with abusive fractures of the shafts of long bones, regardless of the truth or falsehood of their statements. Textual analysis of the medical and legal records was used to extract and define recurrent themes in a recursive fashion. Statements and reports were studied relating to 18 children under three-years old with proven child abuse, including 13 boys. Seventeen of the 18 families presented to the health services because of signs of major injuries. Five families spontaneously described a 'trigger account', a minor household incident said to have caused the major injury. After repeated questioning, a total of 41 accounts were produced. Thirty two of these were minor household incidents and nine were confessions or accusations of rough handling of the child. The accounts were often vague or uncertain and multiple accounts were often given to explain the same injury. Three accounts were challenged by another carer. The misleading accounts given by parents and carers formed a distinctive 'narrative' and can be considered a likely indicator of serious child abuse. Copyright © 2013 John Wiley & Sons, Ltd.

'The accounts were often vague or uncertain and multiple accounts were often given to explain the same injury'.

Key Practitioner Messages




* Carers of children with abusive long bone shaft fractures often give typical histories.

* At presentation to the health services, they may give no history or they may describe a narrow range of trivial accidents.

* On further questioning, they may give further accounts including accusations of rough handling.

* Most accounts show internal reasons for suspicion of their truth.

* These accounts may be used to identify abusive fractures.

'Most accounts show internal reasons for suspicion of their truth'

Language: en