Review Question - QID 4394

Children without siblings have not been shown to be at increased risk of abuse. All the other listed answers are associated with increased stress on the family and have been shown to increase the likelihood of abuse.

There are certain social, parental and child indicators that statistically place children at a higher risk for abuse. Some of them are obvious, such as spousal abuse while others are more subtle, i.e. separation of mother's parents. It is important for the treating physician to screen for the presence of these factors to identify situations of child abuse.

Kempe et al. discusses that certain children are more vulnerable to abuse (hyperactive, precocious, premature, adopted, and step child). Often the act of abuse is a final common pathway of conflict when there is potential for abuse in combination with certain child characteristics as viewed by the involved parent.

Rockwood and Wilkins' chapter on child abuse includes a list of parental, social, and child risk factors. A few from each group include: Parental- age <20 years, lower education, history of psychiatric disease; Social- job loss, family death, job loss, unplanned births, high levels of stress; Child- age <3 years, premature, stepchildren, handicapped.

Illustration A is a table showing some of the clinical findings in child abuse.