Identification and management of child abuse and neglect

### What you need to know Child abuse and neglect, collectively known as maltreatment, is common, and most healthcare providers who care for children will encounter some form of maltreatment in their practice.1 Common presentations include physical abuse, sexual abuse and commercial sexual exploitation of children, and neglect. In this article, we make recommendations for frontline healthcare providers on identifying child maltreatment and making evidence based assessments in primary care and emergency department settings. While presentations of maltreatment may be similar internationally, the subsequent investigation and management recommendations vary according to culture, legislation, income classification, and resources. We discuss broad principles with respect to recognition and subsequent escalation and reporting to child welfare authorities or social services, largely in keeping with North American and European settings. If raising concerns about a child’s welfare, we recommend all healthcare providers consult local laws and statutes in the first instance. Child maltreatment is the physical, sexual, and psychological/emotional abuse, and neglect of infants, children, and young people aged 0-17 years by parents, caregivers, and other authority figures, as defined by the World Health Organization (box 1).6 Emotional abuse and fabricated or induced illness in children are forms of child maltreatment, but beyond the scope of this article. Child maltreatment may present acutely or may be …