Bruises in Children: Normal or Child Abuse?

Tomika S. Harris, DNP, MSN, CPNP


J Pediatr Health Care. 2010;24(4):216-221. 

In This Article

Legal Issues

Laws exist in all 50 states regarding reporting suspected child abuse. Nurse practitioners and other health care providers are mandated by law to report suspected abuse; however, the provider is not required to prove that the abuse occurred prior to reporting. Health care providers report most but not all cases of child abuse (Flaherty, Sege, Binns, Mattson, & Christoffel, 2000). Flaherty & Sege (2005) cite several barriers to recognizing and reporting abuse, including lack of knowledge, psychological barriers, family racial and socioeconomic factors, and prior experience with child protective services. Education regarding the identification, management, and outcomes of child maltreatment can help overcome these barriers and increase medical providers' reporting of child abuse. Providers should be aware of local reporting laws and child protective service contacts, and all suspected abuse should be reported immediately. A summary of specific state laws is available at (U.S. Department of Health and Human Services, 2008).

Health care providers may be required to testify in court regarding their involvement in a case of suspected child abuse, which often causes a great deal of stress and concern. Thoroughly reviewing the medical record and meeting with the requesting attorney in advance can help to minimize this stress. The role of the provider is to testify to the facts of the case based on his or her knowledge, experience, and expertise in pediatrics and/or child abuse (Kellogg & American Academy of Pediatrics [AAP], 2007).


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.