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In the UK a large-scale survey of young adults by the NSPCC showed that seven per cent had, as children, suffered serious physical abuse, defined as violence causing injury or occurring regularly throughout childhood.
Most children acquire small quite routinely, reflecting part of the rough and tumble of daily life, and injuries should always be interpreted in light of the child's medical and social history, developmental stage and the explanation given. But physical abuse may have occurred when one or more of the following apply. Any child with unexplained signs of pain or illness should be seen promptly by a doctor.
The National Society for the Prevention of Cruelty to Children in the UK have identified the following signs as requiring further profesional investigation
- injuries which the child cannot explain, or explains unconvincingly
- injuries which have not been treated or have been treated inadequately
- injuries on parts of the body where accidental injury is unlikely, such as the cheeks, chest or thighs
- bruising in babies and in children who are not independently mobile
- bruising to the face, back, abdomen, arms, buttocks, ears and hands
- bruising which reflects an imprint – of an implement or cord, or hand or finger marks
- multiple bruises – in clusters or of uniform shape
- human bite marks
- fractures in children under 18 months
- fractures that are inconsistent with the child's developmental stage
- scalds, especially those with upward splash marks where hot water has been deliberately thrown over the child, or tide marks – rings on the child's arms, legs or body where the child has been made to sit or stand in very hot water
- multiple burns, burns with a clearly demarcated edge and burns affecting unusual areas of the body such as the back, shoulders or buttocks.
- reluctance to have their parents contacted
- aggressive behaviour or severe temper outbursts
- running away or showing fear of going home
- flinching when approached or touched
- reluctance to get undressed for sporting or other activities where changing into other clothes is normal
- covering arms and legs even when hot
- depression or moods which are out of character with the child's general behaviour
- unnatural compliance with parents or carers.