Which finding would raise suspicion of physical abuse in a school-age child during data collection?

Which finding would raise suspicion of physical abuse in a school-age child during data collection?

• A. Bruises at various stages of healing
• B. Frequent headaches
• C. Sleep difficulties
• D. Poor appetite

Answer: (A)

Pattern of injuries over time is a crucial clue when assessing for physical abuse. Bruises at various stages of healing strongly suggest repeated injuries rather than a single accidental event. In a single incident, healing bruises tend to be at similar points in the healing process and the explanation for the injury is usually consistent with the mechanism described. When you see multiple bruises in different locations and at different ages, it raises concern that harm has occurred on more than one occasion and that the caregiver’s account may not align with the injuries. Other symptoms like frequent headaches, sleep difficulties, or poor appetite can be caused by many factors, including stress, vision problems, poor sleep environment, or medical issues. While these can accompany abuse, they are not as specific to nonaccidental trauma as bruising with varied healing times. If suspicion arises, follow your mandated reporting procedures and take steps to ensure the child’s safety while gathering information.

Pattern of injuries over time is a crucial clue when assessing for physical abuse. Bruises at various stages of healing strongly suggest repeated injuries rather than a single accidental event. In a single incident, healing bruises tend to be at similar points in the healing process and the explanation for the injury is usually consistent with the mechanism described. When you see multiple bruises in different locations and at different ages, it raises concern that harm has occurred on more than one occasion and that the caregiver’s account may not align with the injuries.

Other symptoms like frequent headaches, sleep difficulties, or poor appetite can be caused by many factors, including stress, vision problems, poor sleep environment, or medical issues. While these can accompany abuse, they are not as specific to nonaccidental trauma as bruising with varied healing times. If suspicion arises, follow your mandated reporting procedures and take steps to ensure the child’s safety while gathering information.