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When the first edition of this ABC was published, sexual abuse was reaching the headlines, and the Children Act 1989 was coming into force. Now, 18 years later, media interest and, sometimes, misconceptions continue, and a new Children Act has been published for England and Wales.
Yet much has changed, there is more recorded experience, a stronger basis of evidence for detection of abuse, and clearer guidelines for those suspecting or identifying it. This book is a text for doctors about the recognition and diagnosis of child abuse. It emphasises those aspects of the clinical history, examination, and investigation that are useful in deciding whether the child’s problems are the result of natural or unnatural (abusive) causes. The medical contribution depends not only on doctors but also on nurses and other staff of the health service who deal with children and who may be the fi rst to notice abuse or be informed of it. This book should help them. It will also be helpful to all those concerned with child protection whether from social services, the police, legal or teaching professions, in understanding the way that medical diagnosis is made and the strengths and weaknesses of medical opinions and reports. The book outlines procedures and the respective roles of those who contribute to child protection but does not go into the detail of management. For the benefi t of readers who consult individual chapters, some essential information is repeated. Our aim has been to provide a balanced view of contemporary issues.
The level of knowledge is that to which a paediatrician should aspire. Regardless of their speciality interest, all paediatricians need to be knowledgeable about child abuse because of its commonness and the diversity of its presentation. For general practitioners, accident and emergency staff, and other medical specialists there should be more than enough information in this book. The further reading includes detailed reviews and important papers about commonly encountered, and contested, topics. The clinician involved should always check the recent scientifi c literature for additional information, and be cautious in giving undue priority to any single published study. In addition to national guidelines, there are usually local guidelines about procedures to be followed when child abuse is suspected or detected. This book should be used in conjunction with those guidelines. Compared with the previous edition, nearly half the chapters are completely new, and the rest have had major revision. The authors include nine new contributors, representatives from different disciplines and different specialties, as well as a more international fl avour, with fi ve from USA and Canada. The new co-editors refl ect those trends. Dr Jacqueline Mok is the lead clinician in child protection in Edinburgh, and Dr Donna Rosenberg, formerly director of the child protection service at Henry Kempe Center/University of Colorado Health Sciences Center, is a consulting forensic paediatrician in the United States. They bring experience, knowledge and wisdom to challenging work.
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