Pediatric Education and Advocacy Kit (PEAK): Child Abuse

The purpose of this document is to provide emergency care professionals with key facts and recommendations for identifying and managing suspected physical abuse in children.

TEN-4-FACESp is a useful acronym to help screen children under 4 years of age with bruising to identify when a bruise is more likely to be caused by abuse than accidental injury. TEN-4-FACESp stands for bruising to the Torso, Ears, Neck, Frenulum, Angle of the jaw, Cheeks, Eyelids or Subconjunctivae, “4” represents infants 4 months and younger with any bruise, anywhere, and “p” represents the presence of patterned bruising.

Dr. Mary Clyde Pierce, an Emergency Medicine physician at Ann & Robert H. Lurie Children's Hospital of Chicago, discusses her research to help early detection of child abuse, called TEN-4-FACESp.

The LCAST app designed to support recognition of abuse in babies and young children who have bruises. It was developed by researchers Mary Clyde Pierce, MD, and Kim Kaczor, from Ann & Robert H. Lurie Children’s Hospital of Chicago in partnership with Slingshot and BioDigital.

This module focuses on the crucial role of prehospital professionals in ensuring child safety, particularly in recognizing signs of physical abuse. Although the subject is challenging and emotionally charged, it is essential to equip healthcare providers with the knowledge and skills to identify and respond to suspected cases of child abuse.

These online educational modules are intended to assist healthcare providers in determining the difference between accidental and intentional injuries in children. Considering many clinicians see few cases of child abuse in their daily practice, these case studies will improve assessment skills and build confidence in knowing when to report suspected abuse to appropriate authorities. The cases presented contain real images of injured children. Some learners, including experienced healthcare professionals, may find these images upsetting. You may exit and/or return to this module at any time and completion of this program is voluntary.

In this Rebeat, we discuss a challenging but important aspect of emergency medicine – identifying and addressing child abuse or non-accidental trauma (NAT). We talk with expert Dr. Mary Clyde Pierce about her paper, which validates the TEN-4 FACESp clinical decision rule for predicting abuse in young children, and share insights on how we can save a child’s life through vigilance and awareness of specific findings.

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis; and Dr. Mary Clyde Pierce, Professor of Pediatrics at Northwestern University, Pediatric Emergency Physician and Director of Child Abuse Research at Laurie Children’s Hospital; dive deeper into why a bruised baby is worrisome, important aspects of a social history, and screening for abuse in the ED.

In this Heartbeat, Dr. Julia Magaña talks with child abuse pediatrician, Dr. Antoinette “Tony” Laskey, MD, MPH, MBA, Professor of Pediatrics and Division Chief University of Utah Pediatrics and medical director of Safe and Healthy Families, a child abuse assessment and treatment center. Dr. Laskey shares what happens when we can’t see past a single diagnosis. She defines anchoring bias, how it can trip us up, and how to see past it.

In this episode, Dr. Julia Magaña, Dr. Sarah Medeiros, and Dr. Mary Clyde Pierce discuss the new LCAST app developed by Lurie Children’s Hospital to help clinicians identify non-accidental trauma (NAT). We love this app! It’s quick and easy to use – and it’s even better than using the decision rule alone. Listen to the episode to hear why!

Child Protector assists Children’s Protective Services, law enforcement, attorneys and medical personnel when evaluating children who may have been physically abused. The free app was developed by Children’s Mercy and the University of Texas Health Science Center (San Antonio) through Children’s Justice Act Funding from Texas and Missouri.