This guide provides practical pointers for police in determining whether a child's injuries are accidental or intentional. Police should begin their investigation by asking the caretaker for an explanation of the child's bruises or injuries. All bruises must be investigated. If bruises are found on two or more planes of a child's body, investigators should be suspicious. A physical examination of the suspected child victim must be conducted and the data clearly and accurately recorded. Laboratory data should be obtained to support or refute the evidence of abuse. If the reported history of an injury or injuries changes during the course of an investigation, or if there is conflict between two adult caretakers as to the cause of injury, the likelihood of child maltreatment increases. The demeanor of the child's parents or caretakers should be carefully observed. This booklet outlines key points in the areas of repetitive accidents, skin injuries, and bruises. The latter discussion focuses on the age dating of bruises, bruise configurations, and natural or normal bruising. Guidelines are also provided for investigating the following types of injuries: burns, poisoning, head injuries, eye injuries, and internal injuries. Also discussed are criteria for distinguishing sudden infant death syndrome from fatal child abuse and other medical conditions. 23 supplemental readings and a list of 23 organizational resources.

The investigation of child abuse is a critical and sensitive issue that affects the safety and well-being of children nationwide. It is estimated that law enforcement agencies in the United States investigate more than 3.3 million cases of child maltreatment each year and that as many as 2,000 children die as a result of this maltreatment. Law enforcement personnel are responsible for protecting children and often have the difficult task of determining if a child's injury is accidental or deliberately inflicted. Careful investigation is required to determine whether a child's injuries are accidental or intentional. This guide, first developed in 1996, provides information about the many indicators of child maltreatment and abuse to help first responders and investigators differentiate between physical abuse and accidental injury. Over the years, advancements in medicine have helped further distinguish between accidental and abusive injuries. This fourth edition of the guide reflects the most current literature on how to distinguish between types of injuries and includes the questions that investigating officers must ask.

Updates "Resources" section; adds "Other titles in this series."

Address major issues relating to child abuse (CA), including: battered child syndrome: investigating physical abuse & homicide; burn injuries in CA; child neglect & Munchausen syndrome by proxy; criminal investigation of child sexual abuse; diagnostic imaging of CA; forming a multidisciplinary team to investigate CA; interviewing child witnesses & victims of sexual abuse; law enforcement response to CA; photo-documentation in the investigation of CA; recognizing when a child's injury or illness is caused by abuse; sexually transmitted diseases & child sexual abuse; & understanding & investigating child sexual exploitation.