Physical Abuse Video Script

Video: A young child talks with Child Care Provider. Cut to Dr. Foster on camera.

Graphic: Dr. Robin Foster, Director of Pediatric ER, VCU/MCV Hospitals

Dr. Foster: There is no doubt that children are very active and after the age of one have great first motor skills that can get them into a lot of trouble out on a playground or even in household play, and there are studies out in the literature that show that the average three-year-old has twelve bruises on their body at any one given point of time. So how do we discern the difference between inflicted and accidental injury? There are several elements of the injury that help you identify whether it was inflicted or accidental.

Video: Child takes off shirt in presence of teacher and points to area of his midsection that hurts.

Narrator: Inflicted injuries will be evident in scars that look far different than the accidental fall off a bike or scraped knee.

Video: Fade to running child who trips and falls down.

Narrator: Accidental injuries most often occur on the bony parts of a body—knees, elbows, shins, or forehead.

Video: Fade to image of a child with Child Care Provider. Child takes off shirt and shows teacher bruise marks on left side of abdomen.

Narrator: Inflicted injuries affect the soft or hidden parts of a body…the back, thighs, buttocks and the back of the legs. The greater the number of injuries, the greater the cause for concern. Unless a child is involved in a serious accident, that child is unlikely to sustain a multiple injuries. Multiple injuries in different stages of healing may indicate abuse.

Video: Graphic treatment of photographs showcasing various types of bruises and scars on children.

Narrator: Abusive injuries are often inflicted with familiar objects such as a belt, stick, and paddle. The resulting marks often bear a strong resemblance to the instrument that was used.

Video: Fade back to Child Care Provider examining the child.

Narrator: Accidental injuries resulting from bumps and falls usually have no defined shape. If an injury is accidental, there should be a reasonable explanation of how it happened that is consistent with the appearance of the injury. When the injury and the explanation are inconsistent, there is cause for concern.

Video: Various photos of young children with rope burns on wrists, forearms, and burns on the soles of feet.

Narrator: These photographs are of children who have had injuries inflicted by their parents or caretakers.

Video: Cut to Dr. Foster on camera.

Dr. Foster: There is frequently an expectation from the caretaker that their developmental level is much higher than their age so they expect them to get this activity done in a fashion similar to an adult. That it’s not... it shouldn’t be a task to eat and it shouldn’t be a task to be able to get dressed. So when the caretaker loses his patience with this age child, the child is frequently grabbed around the upper part of the arm, around the forearm, frequently around the face. You’ll find oval matching marks over, around either jaw-line from being forced to eat at a faster rate or forced to brush their teeth at faster rate.

Video: Graphic treatment of photograph showcasing multiple bruises on a child's right, lower extremity.

Dr. Foster: When you look at this picture, there are more than a dozen bruises that have been incurred to this right lower extremity area and these bruises are not all at the same age. They’re in different stages of healing and that can be determined by the fact that they’re different in coloration. This location is not a bony prominent area on this child. It is mostly soft tissue. It would be unusual for this child to have a couple of bruises in this area, much less the greater than one dozen bruises that we see.

Video: Graphic treatment of photographs showcasing various types of bruises and scars on children.

Dr. Foster: Loop marks are inflicted by a variety of instruments: Venetian blind cords, ropes, electrical cords, belts, so common household items are used to hit the child.

Video: Image of baby’s buttocks with multiple linear scars.

Dr Foster: This picture shows us an example of classic switch marks. The location of these marks is across this child’s buttocks. The child we are seeing here actually was still diaper dependant, so the diaper needed to have been taken off for these marks to be inflicted. The explanation that was offered for these marks when this child was examined was actually that it was a diaper rash. A daycare worker is actually who identified the lesions and spoke to Social Services about it because of her concern that it was not consistent with diaper rash.

Video: Close-up of young child’s wrists and forearms with lesions.

Dr. Foster: Ligature marks simply represent an area in which a child was bound or tied and left somewhere for a protracted period of time. With that child being bound it is most often frequently by a rope. It can be by other forms of restraints like handcuffs. With the child moving against that restraint, usually what occurs is breakdown and rubbing of the skin so that the injury that is left is similar to a rope burn mark.

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