In a speech addressed to a crowd at the SECO 2015 in Atlanta, Andrea Gregory, MD, FAAP, discussed the need for optometrists to pay special attention to signs of abuse in their pediatric patients. Laws are clear that any physician who sees indications of abuse is compelled to contact social services to document the cases, and parents who abuse their children are more likely to take them to physicians who do not give full body exams.
Signs and Reporting
Bruising is an obvious sign but healthy, active children do often have bruises. Normal places for a child to have bruises are shins and knees from frontward falls. Bruises on backs or backs of legs are not as common naturally. Regular patterns of bruising might also be a warning sign.
Anytime bruising is in a pattern from an implement, such as a hairbrush or belt, it is a cause for concern. Restraint marks or burns are also red flags that are against the norm. Dr. Gregory recommended asking the patient and parents simple, non-judgmental questions. Often in cases where there was just a natural accident, it will become apparent right away in their response.
Dr. Gregory was adamant that optometrists worry more for the safety of the child than over falsely reporting abuse. The key is to document your observations without bias and lean toward the side of caution. Once the report is made, social services is trained to find and deal with the matter. She advised doctors not to second guess their initial instincts. “Don’t talk yourself out of this. If you have an initial suspicion, make the report.”