4R's of Child Abuse

Forensic Assessment

Injured Child Survey Draft Guide


Noninclusive: to be used as a draft guide for teaching purposes only. 

This does not include information and those signs and symptoms normally documented in a history and physical examination.


All personnel in contact with the child should be instructed to be alert and document what was said and/or observed. This includes physicians and nurses, as well as ancillary personnel, such as the phlebotomists, admissions staff, radiology personnel, etc. (This is considered a first-hand disclosure.) Most importantly, everyone who is in contact with the child must use common sense.

When medical personnel document, they should use lay terms as much as possible, (not medical jargon, symbols, abbreviations, etc.) If an abuse case is being presented, the physician may be required to present the information in court. 

The interview with the child may need to be conducted in private. This is contingent upon the child being old enough to respond to questions. Disclosure can be obtained in a child as young as two.


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