Bennett CE, Christian CW. Clinical evaluation and management of children with suspected physical abuse. Pediatric Radiology. 2021; 51 (6) : 853-860.
Keywords: Child, *Child Abuse/diagnosis/prevention & control, Diagnosis, Differential, Humans, *Physical Abuse, Physical Examination
Evaluating and managing children with suspected physical abuse is challenging. …
Evaluating and managing children with suspected physical abuse is challenging. Few single injuries are pathognomonic for abuse and, as a result, child abuse is easily missed. As such, a healthy bit of skepticism is needed to recognize and protect abused children. The medical history and clinical presentation should guide evaluation. Medical providers must consider the differential diagnosis, epidemiology of injuries, and child development to inform the assessment. In this review, we address evidence-based recommendations to inform child physical abuse evaluations. We also discuss the role of medical providers in communicating with families, mandated reporting and interpreting medical information for investigative agencies and other non-medical colleagues entrusted with protecting children.
Braverman PK, Alderman WP, Alderman EM, Breuner CC, Levine DA, Marcell AV, O’Brien RF; COMMITTEE ON ADOLESCENCE. Contraception for adolescents.
Pediatrics. 2014; 134 (4) : e1244-56.
Reaffirmed 2021
Keywords: Adolescent, *Adolescent Behavior/psychology, Contraception/*methods/psychology/*standards, Female, Health Insurance Portability and Accountability Act/*standards/trends, Health Policy/trends, Humans, Male, *Patient Compliance/psychology, Pediatrics/standa
Contraception is a pillar in reducing adolescent pregnancy rates. The American …
Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report.
Centers for Disease Control and Prevention
Sexually Transmitted Infections (STI) Treatment Guidelines
American Academy of Pediatrics: Committee on Child Abuse and Neglect and Committee on Children With Disabilities. Assessment of maltreatment of children with disabilities. Pediatrics. 2001; 108 (2) : 508-12.
Keywords: Child, Child Abuse/legislation & jurisprudence/prevention & control/*statistics & numerical data, Child Advocacy, Children with Disabilities/classification/legislation & jurisprudence/*statistics & numerical data, Humans, Incidence, Organizational Policy,
Widespread efforts are continuously being made to increase awareness and …
Widespread efforts are continuously being made to increase awareness and provide education to pediatricians regarding risk factors of child abuse and neglect. The purpose of this statement is to ensure that children with disabilities are recognized as a population that is also at risk for maltreatment. The need for early recognition and intervention of child abuse and neglect in this population, as well as the ways that a medical home can facilitate the prevention and early detection of child maltreatment, should be acknowledged.
Crawford-Jakubiak JE, Alderman EM, Leventhal JM; COMMITTEE ON CHILD ABUSE AND NEGLECT; COMMITTEE ON ADOLESCENCE. Care of the Adolescent After an Acute Sexual Assault.
Pediatrics. 2017; 139 (3).
Erratum: https://doi.org/10.1542/peds.2016-4243
Keywords: Adolescent, Contraception, Postcoital, *Crime Victims, Persons with Disabilities, Female, Forensic Medicine, Forensic Toxicology, Humans, Mandatory Reporting, Physical Examination, Post-Exposure Prophylaxis, Pregnancy, Pregnancy, Unwanted, *Sex Offenses/l
Sexual violence is a broad term that encompasses a wide range of sexual …
Sexual violence is a broad term that encompasses a wide range of sexual victimizations. Since the American Academy of Pediatrics published its last policy statement on sexual assault in 2008, additional information and data have emerged about sexual violence affecting adolescents and the treatment and management of the adolescent who has been a victim of sexual assault. This report provides new information to update physicians and focuses on the acute assessment and care of adolescent victims who have experienced a recent sexual assault. Follow-up of the acute assault, as well as prevention of sexual assault, are also discussed.
Doukrou M, Segal TY. Fifteen-minute consultation: Communicating with young people-how to use HEEADSSS, a psychosocial interview for adolescents. Archives of Disease in Childhood. Education and Practice Edition. 2018; 103 (1) : 15-19.
Keywords: Adolescent, Adolescent Behavior/*psychology, Adolescent Health Services/*standards, *Communication, Female, Humans, Male, Mental Health Services/*standards, *Practice Guidelines as Topic, Referral and Consultation/*standards
Adolescents undergo a period of biological, social and psychosocial development, …
Adolescents undergo a period of biological, social and psychosocial development, and each of these domains impacts each other. Psychosocial areas of concern often emerge over the adolescent period (such as mental health conditions, drug use and risky sexual behaviour); those with chronic illness being at higher risk. The paper aims to guide health practitioners on when and how to approach the psychosocial interview with young people and assess areas of risk or concern. This will include putting them at ease, developing rapport, seeing them alone and explaining confidentiality before commencing the assessment. Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicidal ideation and Safety (HEEADSSS) is a recognised psychosocial interview framework that allows a better understanding of the young person's situation and what their specific needs may be. By exploring each section in turn briefly or more fully, it gives the professional an overall impression of the young person's life and any risky behaviours or concerns. This systematic structure should develop an easily accessible approach to adolescents as a group of patients whatever their developmental stage.
Flaherty E, Legano L, Idzerda S. Ongoing Pediatric Health Care for the Child Who Has Been Maltreated. Pediatrics. 2019; 143 (4).
Keywords: Child, Child Abuse/*prevention & control/*therapy, *Child Welfare, Child, Preschool, Delivery of Health Care/*methods, Female, Humans, Male, Pediatricians, Pediatrics/*standards/trends, Physician's Role, Practice Patterns, Physicians', Societies, Medical,
Pediatricians provide continuous medical care and anticipatory guidance for …
Pediatricians provide continuous medical care and anticipatory guidance for children who have been reported to state child protection agencies, including tribal child protection agencies, because of suspected child maltreatment. Because families may continue their relationships with their pediatricians after these reports, these primary care providers are in a unique position to recognize and manage the physical, developmental, academic, and emotional consequences of maltreatment and exposure to childhood adversity. Substantial information is available to optimize follow-up medical care of maltreated children. This new clinical report will provide guidance to pediatricians about how they can best oversee and foster the optimal physical health, growth, and development of children who have been maltreated and remain in the care of their biological family or are returned to their care by Child Protective Services agencies. The report describes the pediatrician's role in helping to strengthen families' and caregivers' capabilities and competencies and in promoting and maximizing high-quality services for their families in their community. Pediatricians should refer to other reports and policies from the American Academy of Pediatrics for more information about the emotional and behavioral consequences of child maltreatment and the treatment of these consequences.
Jenny C, Metz JB. Medical Child Abuse and Medical Neglect. Pediatrics in Review. 2020; 41 (2) : 49-60.
Keywords: Child, Child Abuse/*diagnosis/prevention & control/statistics & numerical data/therapy, Child Protective Services, Complementary Therapies, Family/psychology, Health Services Accessibility, Humans, Mandatory Reporting, Munchausen Syndrome by Proxy/diagnos
Kellogg ND, Lukefahr JL, Koek W. Medical assessments for abuse and neglect in contacts of maltreated children. Journal of Paediatrics and Child Health. 2024; 60 (8) : 349-354.
Keywords: Humans, *Child Abuse/diagnosis/statistics & numerical data, Child, Female, Male, Child, Preschool, Risk Factors, Infant, Prevalence, Adolescent, Retrospective Studies
AIM: Identifying abuse or neglect in one child (index) implicates risk to other …
AIM: Identifying abuse or neglect in one child (index) implicates risk to other children residing in the same home (contacts). While child protection investigators may interview and visually examine contacts, there is lack of consensus regarding when contacts should have a medical assessment. Our goal was to describe the prevalence, characteristics and predictors of abuse and neglect among contacts medically assessed by a child maltreatment evaluation centre over a 5-year period. METHODS: Records of 381 maltreated index children and their 588 contacts were reviewed. Abuse or neglect was diagnosed in 15% of contact children. RESULTS: When index children had more than one type of maltreatment or more than three risk factors, their contacts were more likely to be neglected or abused, respectively. Failure to thrive, patterned injuries, and unmet medical needs were the most common findings among maltreated contacts, and most were diagnosed with injuries or conditions that would not be evident to a child protection investigator. CONCLUSIONS: Clinicians should consider evaluating contacts of maltreated children who have multiple risk factors or maltreatment types. These evaluations should include a careful assessment for injuries, growth and unmet medical needs.
Lindberg DM, Shapiro RA, Laskey AL, Pallin DJ, Blood EA, Berger RP. Prevalence of abusive injuries in siblings and household contacts of physically abused children. Pediatrics. 2012; 130 (2) : 193-201.
Keywords: Adolescent, Adult, Child, Child Abuse/psychology/*statistics & numerical data, Child, Preschool, Cross-Sectional Studies, Domestic Violence/psychology/statistics & numerical data, Ethnicity/psychology/statistics & numerical data, Female, Fractures, Bone/e
OBJECTIVE: Siblings and other children who share a home with a physically …
OBJECTIVE: Siblings and other children who share a home with a physically abused child are thought to be at high risk for abuse, but rates of injury in these contact children are unknown and screening of contacts is highly variable. Our objective was to determine the prevalence of abusive injuries identified by a common screening protocol among contacts of physically abused children. METHODS: This is an observational, multicenter cross-sectional study of children evaluated for physical abuse, and their contacts, by 20 US child abuse teams who used a common screening protocol for the contacts of physically abused children with serious injuries. Contacts underwent physical examination if they were <5 years old, physical examination and skeletal survey (SS) if they were <24 months old, and physical examination, SS, and neuroimaging if they were <6 months old. RESULTS: Protocol-indicated SS identified at least 1 abusive fracture in 16 of 134 contacts (11.9%, 95% confidence interval [CI] 7.5-18.5) <24 months of age. None of these fractures had associated findings on physical examination. No injuries were identified by neuroimaging in 19 of 25 eligible contacts (0.0%, 95% CI 0.0-13.7). Twins were at substantially increased risk of fracture relative to nontwin contacts (odds ratio 20.1, 95% CI 5.8-69.9). CONCLUSIONS: SS should be obtained in the contacts of injured, abused children for contacts who are <24 months old, regardless of physical examination findings. Twins are at higher risk of abusive fractures relative to nontwin contacts.
Mankad K, Sidpra J, Oates AJ, Calder A, Offiah AC, Choudhary A. Sibling screening in suspected abusive head trauma: a proposed guideline. Pediatric Radiology. 2021; 51 (6) : 872-875.
Keywords: Child, *Child Abuse/diagnosis, Consensus, *Craniocerebral Trauma/diagnostic imaging, Humans, Infant, Siblings
Abusive head trauma (AHT) is the leading cause of death from child abuse in …
Abusive head trauma (AHT) is the leading cause of death from child abuse in children younger than 5 years. It is well documented that the infant contacts of children presenting with suspected AHT are at an increased risk of abuse when compared to the general infant population. Despite this association, a paucity of literature stratifies this risk and translates it to the clinic such that this high-risk group is stringently screened for abusive injuries. In this light, the authors propose a standardised screening method for all contact children of the index case and call for further consensus on the subject.
Mankad K, Sidpra J, Mirsky DM, Oates AJ, Colleran GC, Lucato LT, Kan E, Kilborn T, Agrawal N, Teeuw AH, Kelly P, Zeitlin D, Carter J, Debelle GD, Berger RP, Christian CW, Lindberg DM, Raissaki M, Argyropoulou M, Adamsbaum C, Cain T, van Rijn RR, Silvera V. International Consensus Statement on the Radiological Screening of Contact Children in the Context of Suspected Child Physical Abuse. Jama Pediatrics. 2023; 177 (5) : 526-533.
Keywords: Child, Humans, Infant, *Physical Abuse, *Child Abuse, Physical Examination, Radiography, Siblings
IMPORTANCE: Physical abuse is a common but preventable cause of long-term …
IMPORTANCE: Physical abuse is a common but preventable cause of long-term childhood morbidity and mortality. Despite the strong association between abuse in an index child and abuse in contact children, there is no guidance outlining how to screen the latter, significantly more vulnerable group, for abusive injuries. Consequently, the radiological assessment of contact children is often omitted, or variably performed, allowing occult injuries to go undetected and increasing the risk of further abuse. OBJECTIVE: To report an evidence-based and consensus-derived set of best practices for the radiological screening of contact children in the context of suspected child physical abuse. EVIDENCE REVIEW: This consensus statement is supported by a systematic review of the literature and the clinical opinion of an internationally recognized group of 26 experts. The modified Delphi consensus process comprised 3 meetings of the International Consensus Group on Contact Screening in Suspected Child Physical Abuse held between February and June 2021. FINDINGS: Contacts are defined as the asymptomatic siblings, cohabiting children, or children under the same care as an index child with suspected child physical abuse. All contact children should undergo a thorough physical examination and a history elicited prior to imaging. Contact children younger than 12 months should have neuroimaging, the preferred modality for which is magnetic resonance imaging, and skeletal survey. Contact children aged 12 to 24 months should undergo skeletal survey. No routine imaging is indicated in asymptomatic children older than 24 months. Follow-up skeletal survey with limited views should be performed if abnormal or equivocal at presentation. Contacts with positive findings should be investigated as an index child. CONCLUSIONS AND RELEVANCE: This Special Communication reports consensus recommendations for the radiological screening of contact children in the context of suspected child physical abuse, establishing a recognized baseline for the stringent evaluation of these at-risk children and providing clinicians with a more resilient platform from which to advocate for them.
Whitehouse C, McKenzie P, Hobbs C. The First 72 Hours After Child Sexual Assault: Reporting Children, Young People, and Mothers' Experiences of Police, Hospital, and Psychosocial Care in Victoria. Journal of Interpersonal Violence. 2025; : 8862605251324962.
In Victoria, Australia, children who are reported to authorities to have …
In Victoria, Australia, children who are reported to authorities to have experienced very recent sexual assault routinely undergo a forensic medical examination and receive psychosocial care. There is very little known about how children and their families experience this process and whether current practices are meeting their needs. This study seeks to understand these experiences by undertaking a thematic analysis of in-depth interviews with 10 children/young people (aged between 4 and 16) and 8 mothers (n = 18). The study draws on constructivist grounded theory methodology and incorporates the contextual-embedded perspective of the clinician/researcher. The study identified three stages participants navigated in the hours following the assault: (a) reaching out for help, (b) hospital processes and procedures, and (c) discharge. Nested within these stages, five key themes emerged: confusion, distress, and minimization when reporting; valuing a caring presence; feeling exposed, vulnerable, and ashamed; being lost in space and time; and going home alone. The need for a sensitive, trauma-informed, accessible, and consistent response to acute sexual assault is discussed; one that acknowledges the experiences and centralizes the priorities and psychosocial needs of the child and their family.
American Association for the Study of Liver Diseases and the Infectious Diseases Society of America (AASLD-IDSA)
(Accessed June 2025)
HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C
American College of Obstetricians and Gynecologists. Emergency Contraception. Practice Bulletin No. 152, Reaffirmed 2022. 2010.
Emergency contraception, also known as postcoital contraception, is therapy …
Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception 1 2 3. Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen–progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises 4 5 6. The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician–gynecologists and other gynecologic providers.
Sege RD, Siegel BS. Effective Discipline to Raise Healthy Children. Pediatrics. 2018; 142 (6).
Keywords: Child, *Child Behavior, Child Behavior Disorders/*prevention & control/psychology, Child Rearing/*psychology, Humans, *Parent-Child Relations, Parenting/*psychology, Parents/*psychology, Reinforcement, Psychology, *Societies, Medical
Pediatricians are a source of advice for parents and guardians concerning the …
Pediatricians are a source of advice for parents and guardians concerning the management of child behavior, including discipline strategies that are used to teach appropriate behavior and protect their children and others from the adverse effects of challenging behavior. Aversive disciplinary strategies, including all forms of corporal punishment and yelling at or shaming children, are minimally effective in the short-term and not effective in the long-term. With new evidence, researchers link corporal punishment to an increased risk of negative behavioral, cognitive, psychosocial, and emotional outcomes for children. In this Policy Statement, the American Academy of Pediatrics provides guidance for pediatricians and other child health care providers on educating parents about positive and effective parenting strategies of discipline for children at each stage of development as well as references to educational materials. This statement supports the need for adults to avoid physical punishment and verbal abuse of children.
Centers for Disease Control and Prevention (CDC). U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR. Morbidity and mortality weekly report. 2024; 73 (4).
The 2024 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) …
The 2024 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) comprises recommendations for the use
of specific contraceptive methods by persons who have certain characteristics or medical conditions. These recommendations for
health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta,
Georgia, during January 25–27, 2023. The information in this report replaces the 2016 U.S. MEC (CDC. U.S. Medical
Eligibility Criteria for Contraceptive Use, 2016. MMWR 2016:65[No. RR-3]:1–103). Notable updates include 1) the
addition of recommendations for persons with chronic kidney disease; 2) revisions to the recommendations for persons with certain
characteristics or medical conditions (i.e., breastfeeding, postpartum, postabortion, obesity, surgery, deep venous thrombosis or
pulmonary embolism with or without anticoagulant therapy, thrombophilia, superficial venous thrombosis, valvular heart disease,
peripartum cardiomyopathy, systemic lupus erythematosus, high risk for HIV infection, cirrhosis, liver tumor, sickle cell disease,
solid organ transplantation, and drug interactions with antiretrovirals used for prevention or treatment of HIV infection); and
3) inclusion of new contraceptive methods, including new doses or formulations of combined oral contraceptives, contraceptive
patches, vaginal rings, progestin-only pills, levonorgestrel intrauterine devices, and vaginal pH modulator. The recommendations
in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals
of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the
provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always
consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a
substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care
providers about contraceptive use.
Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2024. MMWR. Morbidity and mortality weekly report. 2024; 73 (3).
The 2024 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) …
The 2024 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a selected group of common, yet sometimes complex, issues regarding initiation and use of specific contraceptive methods. These recommendations for health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta, Georgia, during January 25–27, 2023. The information in this report replaces the 2016 U.S. SPR (CDC. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR 2016;65[No. RR-4]:1–66). Notable updates include 1) updated recommendations for provision of medications for intrauterine device placement, 2) updated recommendations for bleeding irregularities during implant use, 3) new recommendations for testosterone use and risk for pregnancy, and 4) new recommendations for self-administration of injectable contraception. The recommendations in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care providers about contraceptive use.
Centers for Disease Control and Prevention
Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC)
Centers for Disease Control and Prevention
Sexually Transmitted Infections (STI) Treatment Guidelines
CHAMP - ChildabuseMD
Directory of Child Abuse Agencies and Organizations. (n.d.)
Child Welfare Information Gateway
Factsheet, April 2019, Washington, DC: U.S. Department of Health and Human
Services, Children’s Bureau.
Child Welfare Information Gateway
Child Welfare Information Gateway. (2022). Definitions of child abuse and …
Child Welfare Information Gateway. (2022).
Definitions of child abuse and neglect. U.S. Department of Health and Human Services, Administration for Children and Families, Children's Bureau.
https://www.childwelfare.gov/topics/systemwide/laws-policies/statutes/define/.
State Statutes
CHAMP
Handout for the CHAMP webcast by Blair Hammond, Striving to Promote Early Relational Health and Child Development in the Healthcare Space. A Primary Preventive Model
New York State Laws
NY State Sanitary Code Title 10 § 2.1
New York State Association of County Health Officials (NYSACHO)
Directory of County Health Offices
New York State Department of Health Aids Institute
HIV Testing and Acute HIV
New York City - Administration for Children's Services
What is Child Abuse/Neglect?
New York State Laws
Social Services Law - SOS § 412
New York State Department of Health
The New York State Early Intervention Program (EIP) is part of the national Early Intervention Program for infants and toddlers with disabilities and their families.
Early Intervention Program
New York State Office of Children and Family Services
2025 New York State Child Protective Services Manual, Chapter 14: Definitions of abuse and maltreatment. 2022, June.
https://ocfs.ny.gov/programs/cps/manual/2022/2022-CPS-Manual-Ch14-2022Jun.pdf
