Dental aspects of 1248 cases of child maltreatment on file at a major county hospital.

The frequency of head, face, mouth, and neck injuries due to child maltreatment was investigated in a review of 1248 cases on file in the pediatrics office at Hennepin County Medical Center in Minneapolis, Minnesota, from January, 1985, to December, 1989. There were 485 boys (38.8%) and 763 girls (61.2%) examined. Physical abuse cases (41.0%) outnumbered sexual abuse (35.4%) and neglect episodes (23.6%). The gender ratio was distributed equally except in sexual abuse, where there were 4.7 girls for each boy examined. More than half of the children (52.9%) were in the 0-to-4 year age group. Considering all cases together, 37.5% presented with injuries to the head, face, mouth, and neck. However, that percentage doubled (75.5%) when physical abuse episodes were reviewed alone. The intraoral injuries seen were five tooth fractures, three tongue and tongue frenulum lacerations, two lip frenulum lacerations, 11 injuries to the oral mucosa, eight palatal lesions, two fractures of the mandible or maxilla, loose and missing teeth, and dental neglect. Despite the high frequency of injuries, no dentists examined children at the time of the hospital intake or referred children for suspicion of maltreatment in the population studied. The findings suggest the importance of involving dental professionals in identifying, reporting, and preventing child abuse and neglect.

Perinatal stress: a study of factors linked to the risk of parenting problems.

Infants who are born preterm are at high risk for subsequent maltreatment. This study examines the relationship between family functioning, infant morbidity, parents' experience following their infant's admission to a neonatal intensive care unit, and postdischarge risk of parenting problems. For the sample as a whole, family factors emerged as the best predictors of outcome.

The neglect and abuse of children and youth: the scope of the problem and the school's role.

We have attempted to define the spectrum of maltreatment of children seen in our current society. The potential for abuse in the child's caretaker, a child who is somewhat different, and a stressful situation are ingredients which often interact to produce maltreatment. The maltreatment rendered to the child includes many mechanisms ranging from direct blows from a variety of objects, to violently shaking the child, to neglect. The spectrum of the pathological findings is as varied as the means to inflict the trauma or neglect and involves every organ system. The predominate pathology of abuse is located in the central nervous system, bones and cutaneous tissues. The school's role primarily involves awareness of the problem of maltreatment, a method of approach to identify and report "suspected" cases, and the documentation of the injuries or neglect which have been observed. The school plays an important role in the follow-up of individual cases in providing a supporting environment for the child and coordinating with other agencies dealing with the family. The school personnel and all professionals must work together if adequate services are to be provided to protect children and rehabilitate families.

Neglect and abuse of children: historical aspects, identification, and management.

The dentist's role primarily involves awareness of the problem of maltreatment, a method of approach to identify and report suspected cases, the documentation of the injuries or neglect which have been observed, and follow-up of any orofacial injuries. Orofacial trauma is present in up to one half of the reported cases of child abuse and consists of bruises, burns, lacerations, and fractures of teeth and jaws. Further studies in the dental field are needed to delineate the types and incidences of orofacial injuries and their relationship to child abuse. Dentists and all professionals must work together, if adequate services are to be provided to protect children and rehabilitate families.

Sexual abuse of children. An epidemiologic study.

An epidemiologic study of sexual abuse of children was made by reviewing Minneapolis Police Department records. Children were involved in 33% of all cases reported. Eighty-five percent of cases involved exposure or indecent liberties. Half of the cases occurred in the summer; half of the cases occurred from 2 to 6 PM. The mean age of victims was 10.7 years, and 88% were girls. All reported offenders were men; their "mean estimated age" was 28 years. The method of study did not allow determination of social relationships between victims and the offenders. Little information regarding the magnitude of the problems of medical, psychological, and social sequelae of sexual abuse of children is available in the literature.