Physical Abuse

Physical Abuse—California Penal Code Section 11165.3-11165.6

Physical Abuse is defined as physical injury inflicted on a child by other than accidental means to include but not limited to the following:

Willful cruelty or unjustifiable punishment of a child where a person willfully causes or permits any child to suffer, or inflicts thereon unjustifiable physical pain or mental suffering.
When a person willfully causes or permits the person or health of the child to be placed in a situation such that this or her person or health is endangered.
Unlawful cruel or inhumane corporal punishment resulting in a traumatic condition.

Physical Abuse—Federal Guidelines

Physical injury as a result of punching, beating, kicking, biting, burning, shaking or otherwise harming a child.
The parent or caretaker may not have intended to hurt the child; rather the injury may have resulted from over-discipline or physical punishment.

The Four Distinct Characteristics of Non-Accidental Injuries

Location of the Injury

Injury from abuse is most often located on the following areas:

Head and neck area (This area is vulnerable to injury because of a child’s small stature...it may the closest body part to an adult’s hand or fist. Also, it is often targeted as it is where the crying, back talk, sass, bad language, etc. is emanating from. The area of the head covered by hair may be targeted as the hair covers any bruising or lumps).
Hands are targeted as they are actively exploring or “getting into things”
Upper arms
Front and backs of thighs
Genital area
Stomach
Back
Buttock

"Normal" childhood injuries are typically located on areas where the skin is close to the bone, such as:

Pattern of the Injury

Injury or bruises in a pattern which reflects the object used - a belt buckle, a handprint (the hand is the most common object used), knuckles, bottom of an iron, etc.
Frequency of and/or recurrent injuries to the same site - child abusers often injure their victim in the same manner or use the same implement
Clustered bruises
Human bite marks - this might be found in sexual abuse cases as well as physical abuse.
Two black eyes - it is very unusual to have two black eyes unless you have been in a car accident, or have broken your nose

Correlation of the Story

The parent and/or child tell conflicting or confusing stories on how the injury occurred
Treatment is delayed for fear of being caught
Hospital or Doctor “hopping” to avoid suspicion because of frequent visits
County “hopping” to avoid CPS intervention
School “hopping” to avoid suspicion from school personnel
Poisoning, especially in children under 6 months and over 6 years of age - children over six generally “know better” and children under 6 months are not “mobile.”

Conditions That Could Be Mistaken for Child Abuse

Children with hemophilia, low blood platelet count or Leukemia tend to bruise easily.
A birth mark (sometimes call Mongolian Spot) is a deep purple/bluish/grayish birthmark which looks like a bruise. They can be anywhere on the body, but typically are on the buttocks and lower back. Mongolian spots are commonly found in African Americans, Asians and Hispanics.
Impetigo is a skin condition with sores that look like crusty, healing burns.

General Indicators of Physical Abuse

Bruises

Burns

Burns in unusual places such as the soles of feet, palms of hands, buttocks, etc.
Perfectly round burns the size of a cigarette tip or car lighter.
Burns reflecting the pattern of the electrical appliance used, such as BBQ starter.
Rope burns on limbs, neck or torso
Scalding burns are the most common. Deliberate immersion burns will leave distinct waterlines such as:
- Burns resembling sock-like or mitten-like markings on the hands or feet
- “Doughnut” burn pattern on the buttocks - the child was pressed against in the bottom of the tub so forcibly, water doesn’t come in contact with the center part of the buttock A child accidentally falling into scalding water would have splash or irregular shaped burns, not distinct lines
- No burns in areas where the child has “flexed” in reaction to what was happening, I.e., arms tightened and folded against body, folds in the stomach, thighs against abdomen.
- Scalding burns on the back - child was probably trying to run away from perpetrator.

Behavioral Indicators of Physical Abuse

School difficulties

Arriving early and leaving late from school to avoid going home
Wary of physical contact
Parent may send child to school with the subconscious hope that someone will recognize the problem
Parent responds inappropriately to the seriousness of the problem
Parent hostile or antagonistic when talking about the problem