In responding to an injured 5-year-old child, when should child abuse be suspected?

When evaluating a potential case of child abuse, one crucial factor to consider is the discrepancy between the injury pattern and the history provided regarding the mechanism of injury. If the injuries sustained by the child do not logically correlate with what the caregiver describes as the cause, this may raise suspicions of abuse. For example, if a child presents with serious bruising or fractures that are inconsistent with an accidental cause—such as falling from a small height—this disparity should prompt further investigation.

In cases of suspected abuse, it is vital to carefully assess the injuries and the explanations for them. If the injuries seem severe or unusual given the circumstances described, it could indicate that the child has experienced abuse or trauma from a source other than an accident.

While other indicators, such as the child being unresponsive, having multiple contusions, or exhibiting an overly compliant demeanor, may raise concerns about the child's wellbeing, the specific mismatch between injury patterns and history is a more direct and telling sign pointing toward the possibility of abuse. It serves as a critical piece in discerning the nature of the child's injuries and guiding the appropriate response and intervention strategies.