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Child Abuse

Fatality of Child Abuse

04/09/2000

Question:

Sometimes people think abuse is just a smack on the hand or face. In fact many people do not realize how many people actually die from child abuse. Is it very commonly turned into a fatality if so can it happen by mistake?

Answer:

Child abuse is a very significant cause of fatalities of children in the United States. In the database for the National Center for Injury Prevention and Control for the years 1987-1997, homicide is the 4th leading cause of death for children of ages 1-10 years and the 12th leading cause of death for children less than 1 year of age. Of the deaths caused by injuries, child abuse is the second leading cause of mortality. In a recent (January 2000) review article in the Archives of Pediatrics and Adolescent Medicine, the fatality rate for head injury in children less than 5 years old was 13% for cases caused by child abuse versus 2% for cases secondary to accidental causes. In a second article in the same journal, a review of the National Pediatric Trauma Registry for 10 years showed child abuse to have a five-times higher mortality rate than accidental injuries. The question regarding "can it be a mistake", if referring to intent, is much more difficult to answer. In some cases of child abuse, it is unclear whether there was definite intent to cause serious injury to the child. In other incidents, there appears to be intent to harm because of the mechanism of the injury and/or the complete disregard for the child`s safety or developmental level.

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Response by:

Robert Shapiro, MD
Professor of Clinical Pediatrics
College of Medicine
University of Cincinnati

Elena Duma, MD
Assistant Professor of Pediatrics
College of Medicine
University of Cincinnati