How is the injury recognized?

Child abuse is typically recognized in several ways. Often, a professional will be the first to recognize and report suspected abuse. This may be a teacher, day care worker, or healthcare provider. In other instances, a family member or neighbor suspects abuse. Once abuse is suspected, the child should be evaluated by a healthcare provider.

The provider's evaluation will vary depending upon the type of abuse suspected. Unless sexual abuse is suspected, a gynecologic or rectal exam is not routinely performed. Unless the abuse is recent and rather severe, sexual abuse typically does not leave any physical marks.

If physical abuse is suspected, the healthcare provider will do a complete physical exam. For any injury or condition associated with child abuse, the provider should thoroughly question the caretaker.

Sometimes abuse is diagnosed indirectly. During an examination, a healthcare provider may notice evidence of old injuries.