Child Abuse

Child Abuse at the Extreme: Torture

The Tribal Forensic Healthcare project’s pediatrics webinar for February is Child Abuse at the Extreme: Torture. Dr. Barbara Knox will be the featured speaker. It will be held February 11th from 3-4:30 ET. As with all sessions offered by this project, CEUs and CMEs are available, free of charge. Sessions are available in the archive if live attendance doesn’t work for your schedule.

From the website:

This presentation describes clinical findings and case characteristics of children who are victims of severe and multiple forms of abuse; and proposes clinical criteria that indicate child abuse by torture. Medical records, investigation records, and transcripts of testimony regarding a non-consecutive case series of 28 children with evidence of physical abuse, neglect and psychological abuse such as terrorizing and isolation were reviewed for types of injuries, duration of maltreatment, medical and physical neglect, social and family history, and history of prior Child Protective Services (CPS) involvement. The median age was 7.5 years (9 months to 14.3 years). Thirty-six percent died. Duration of abuse ranged from 3 ½ months to 8 years (median 3 years). Ninety-three percent of children were beaten and exhibited cutaneous injury; 21% had fractures. There were 25 victims of isolation (89%), including 61% who were physically restrained and 89% who were restricted from food or water. All of the children were victims of psychological abuse; 75% were terrorized through threats of harm or death to themselves or loved ones and 54% were degraded and/or rejected by caregivers. Nearly all children were medically neglected. Half had history of prior referrals to CPS. The children in this case series were physically abused, isolated, deprived of basic necessities, terrorized, and neglected. We define child torture as a longitudinal experience characterized by at least two physical assaults or one extended assault, two or more forms of psychological abuse and neglect resulting in prolonged suffering, permanent disfigurement or dysfunction, or death.


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