Those who regularly work with children can sometimes be caught in a quandary. Of course, any active child is going to occasionally be bruised or injured. Those who abuse will often use this to their advantage by claiming that the injuries they have caused happened in the normal course of activity or play. It is hard to rebut that claim even if your instincts tell you otherwise. It can be helpful to be able to differentiate between different kinds of bruises and injuries. I would like to direct you to comments by Vincent Iannelli, M.D. under the heading “Pediatrics” at about.com. This is very helpful and very well stated.
“Since children typically receive bruises during the course of play or while being active, the leading or bony edges of the body, such as knees, elbows, forearms, or brows, are most likely to be bruised. The soft tissue areas, such as cheeks, buttocks, and thighs, are not normally injured in such circumstances. Additionally, bruises received during the normal course of childhood activity are rarely in distinct shapes, such as a hand, belt buckle, or adult teeth marks. Bruises in soft tissue areas or in distinct shapes are much more indicative of physical abuse.
Unlike bruises, abuse directed to the abdomen or the head, which are two particularly vulnerable spots, often are undetected because many of the injuries are internal. Injuries to the abdomen can cause swelling, tenderness, and vomiting. Injuries to the head may cause swelling in the brain, dizziness, blackouts, retinal detachment, or even death. Referred to more recently as the ‘shaken baby’ syndrome, violent shaking can cause severe damage in children at any age.”
It is exactly these kinds of specifics that you can use to formulate intelligent opinions about what may be happening in the life of a child. While we all want to be watchful for occasions or patterns of child abuse, we definitely do not want to get false accusations started. Even with this particular information, bruises in soft tissue areas are not guarantees of abuse. However, by using professional information we are able more effectively to put together the pieces of the puzzle as we seek to interpret the larger picture.