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Update on child maltreatment: toward refining the evidence base

Denton, Jennifera,b; Newton, Alice Wa,b,c; Vandeven, Andrea Md,e

Current Opinion in Pediatrics: April 2011 - Volume 23 - Issue 2 - p 240–248
doi: 10.1097/MOP.0b013e3283446010
Office pediatrics: Edited by Henry H. Bernstein

Purpose of review This review is designed to aid general pediatricians as they assess cases of possible child maltreatment. The authors have selected salient articles that inform the daily practice of any professional involved in assessing child abuse.

Recent findings The incidence of child abuse continues to decline in the United States, although a large number of children still suffer from abuse and neglect, and many are subject to more than one type of maltreatment. Clinicians are encouraged to be vigilant about the subtle indicators of physical abuse, with many authors adding to our understanding about how children present after inflicted abdominal or skeletal trauma. Clinicians are also cautioned to watch for signs of Munchausen syndrome by proxy, which may be elusive and difficult to discern.

Summary The field of child abuse pediatrics is still young, with the first board certification in 2009. The volume of research in the field is exploding and there is a greater level of awareness and data collection occurring throughout the world. Pediatric clinicians are encouraged to play a role in preventing abuse and neglect, as well as addressing intimate partner violence, and to maintain vigilance about child maltreatment and its subtle clinical presentations.

aDepartment of Pediatrics, Harvard Medical School, USA

bChild Protection Program, Children's Hospital Boston, USA

cChild Protection Consultation Program, Massachusetts General Hospital, Boston, Massachusetts, USA

dDepartment of Pediatrics, University of Missouri Kansas City, USA

eSCAN Program, Children's Mercy Hospital, Kansas City, Missouri, USA

Correspondence to Alice W. Newton, MD, Child Protection Program, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA Tel: +1 617 355 7979; fax: +1 617 730 0492; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.