Non-Accidental Injuries in Children: 1. Physical Injury: Is it a result of Punishment or abuse?



A.M. Zeglam

Department of Paediatrics Al-Khadra Hospital, Tripoli Libya

JMJ Vol.3 No.2 (September) 2004: 14-18


If an angry man comes into his home and takes the back of his hand to his wife, society calls it assault. If he takes the palm of the hand to his child, it may be called discipline. A court of law may sentence that man for assaulting his wife but dismiss the case against him for doing the same thing to his child.8 Children-generally- more vulnerable than the rest of us, and in our community are not fully protected under the current law from assault and I think the law has to be revised and updated. Non-accidental injuries in children (NAI) are an area of paediatric medicine that has grown in recent times. NAI is a common and tragic societal problem that has reached epidemic proportion at least in the west. In the second half of the 19th century, Ambrose Tardieu, a French physician, described the maltreatment of children by their parents. Caffey pioneered the use of diagnostic radiology for the evaluation of inflicted injuries with 1946 study of fractures and chronic subdural haematoma in abused children. The Battered Child Syndrome, a title used by Silverman and Kempe, further elucidated the type of injuries attributable to inflict trauma. It is vital and important that medical professionals be alert to this diagnosis, because prompt recognition of abusive injuries is important for rapid therapeutic intervention, protection of children from further abuse, and the subsequent prosecution of its perpetrator. (1) In these series of reviews I will start with physical injuries in children and the different issues relating to these types of injury. My aim is to increase the level of awareness of the condition among medical and paramedical professionals. Throughout this review “parents” should be read to include those acting in parental caretaking role’.

Keywords: Non-Accidental Injuries, children, Punishment, abuse