What arethe clinicalindicators or evidencethat should promptparents or health care providers to suspectyoung childrenmay be victims of abuse?

1) When adults give a history of injury that changes over time or with different inverviews during the investigation or treatment of the child. The story keeps changing.

2) When an adult blames another child for the injury and it is not consistent with the level of development for either child. Blaming another child for severe injuries is common.

3) The history of how the injury occurred is not consistent with the type or severity of the injury. Frequently the abuser will give themselves away with partial truths, such as "I shook the baby when he wouldn't wake up".

4) When the adult delays seeking treatment for the injured child. The abuser hopes the child's condition will improve without seeking help. Or they hide the incident until someone else finds the child injured.   

5) Other injuries are present that are unexplained or do not match the mechanism of injury. Bruises and injuries on different areas of the body that are not prominent or have normal pattern of injury distribution commonly associated with child's play. For example, scraped knees is common for children. But bruises on the belly or upper back are not commonly associated with play activity.   

6) When injuries that the child has do not match the level of development of the child (for example, bruises on a two-month old infant's face, back or buttocks from a "fall")  
Christopher Keane
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California Child Abuse and Child Injury Lawyer