U.S. flag

An official website of the United States government

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

National Collaborating Centre for Women's and Children's Health (UK). When To Suspect Child Maltreatment. London: RCOG Press; 2009 Jul. (NICE Clinical Guidelines, No. 89.)

  • July 2019: Definition of multi-agency safeguarding arrangements added and section 4 of 'Using this guidance' amended by NICE to include arrangements. Recommendations 1.1.18 and 1.1.19 updated to reflect wording used in Royal College of Paediatrics and Child Health purple book. October 2017: Since publication of this guideline, NICE has produced a guideline on child abuse and neglect. Recommendations relevant to both health and social care practitioners appear in this guideline and the child abuse and neglect guideline. Clinical features (including physical injuries) are covered in this guideline. Recommendations 1.3.2, 1.3.3, 1.3.4, 1.3.10, 1.3.12, 1.4.1, 1.4.2, 1.4.3, 1.4.4, 1.4.5, 1.4.12, 1.4.13, 1.5.1, 1.5.2, 1.5.3, 1.5.4 and 1.5.5 have had minor edits in line with NICE's child abuse and neglect guideline. Recommendation 1.3.6 has had a link added to the NICE guideline on faltering growth. Recommendation 1.4.8 has been updated with information on Prader-Willi syndrome. 2013: The recommendation which states "Be aware that sexual intercourse with a child younger than 13 years is unlawful and therefore pregnancy in such a child means the child has been maltreated" (pages 8 and 55) should be accompanied by a footnote which states the following: "Under the sexual Offences Act 2003, any sexual intercourse with a girl younger than 13 years is unlawful and will be charged as rape. It is illegal for children aged 13-15 years to have sexual intercourse. However, The Crown Prosecution Service guidance instructs that children of these age groups involved in consensual experimentation should not be prosecuted."

July 2019: Definition of multi-agency safeguarding arrangements added and section 4 of 'Using this guidance' amended by NICE to include arrangements. Recommendations 1.1.18 and 1.1.19 updated to reflect wording used in Royal College of Paediatrics and Child Health purple book. October 2017: Since publication of this guideline, NICE has produced a guideline on child abuse and neglect. Recommendations relevant to both health and social care practitioners appear in this guideline and the child abuse and neglect guideline. Clinical features (including physical injuries) are covered in this guideline. Recommendations 1.3.2, 1.3.3, 1.3.4, 1.3.10, 1.3.12, 1.4.1, 1.4.2, 1.4.3, 1.4.4, 1.4.5, 1.4.12, 1.4.13, 1.5.1, 1.5.2, 1.5.3, 1.5.4 and 1.5.5 have had minor edits in line with NICE's child abuse and neglect guideline. Recommendation 1.3.6 has had a link added to the NICE guideline on faltering growth. Recommendation 1.4.8 has been updated with information on Prader-Willi syndrome. 2013: The recommendation which states "Be aware that sexual intercourse with a child younger than 13 years is unlawful and therefore pregnancy in such a child means the child has been maltreated" (pages 8 and 55) should be accompanied by a footnote which states the following: "Under the sexual Offences Act 2003, any sexual intercourse with a girl younger than 13 years is unlawful and will be charged as rape. It is illegal for children aged 13-15 years to have sexual intercourse. However, The Crown Prosecution Service guidance instructs that children of these age groups involved in consensual experimentation should not be prosecuted."

Cover of When To Suspect Child Maltreatment

When To Suspect Child Maltreatment.

Show details

Appendix FGlossary of terms

The GDG acknowledges the RCPCH document Physical Signs of Child Sexual Abuse5 for some of its definitions.

Absolute risk reduction

The difference between the observed rates of an event (i.e. the proportions of individuals with the outcome of interest) in the groups being compared.

Abandonment

Leaving a child on his or her own without any intention of returning to ensure their safety and wellbeing.

Affect

Emotion, feeling.

Apnoea

A period when there is no external breathing.

Apparent life-threatening event

A sudden event characterised by a combination of apnoea, colour change, marked change in muscle tone and choking or gagging.

Body mass index

A person's weight (in kilograms) divided by the square of their height (in metres). It is used to determine whether a person is underweight, overweight or obese.

Cognition

Thinking, believing, knowing.

Craniocerebral

Related to the skull and the brain.

Cyanosis

An appearance of blueness in skin and mucous membranes due to a lack of oxygen or fall in arterial oxygen saturation.

Dental caries

Tooth decay.

Dysuria

Pain on passing urine.

Ecchymosis

A type of bruise that looks bluish-black and which is caused by the leaking of blood into tissues as a result of injury or blood disorder.

Emotional dysregulation

The inability to regulate emotions such that reactions to situations are out of proportion to or inappropriate for the situation causing the reaction.

Erythema

Redness of the skin.

Externalising

Behaviours that represent interpersonal conflict such as aggression, oppositional behaviour and other antisocial behaviour.

Failure to thrive

When a child's growth falls through two or more centile spaces on standard growth charts.

Femoral

Of the femur, the thigh bone.

Gaping, anal gaping

An anus that is open (dilated) on separation of the buttocks such that a view into the anal canal or rectum is possible, and which remains so for the duration of the examination in a fixed or constant way. This is a static sign.

Genital mycoplasmas

A bacterial sexually transmitted infection.

Gingival

Of the gums.

Hymenal laceration

A fresh wound made by tearing through the hymen which may be partial or complete.

Hymenal notch

An identation in the hymen not extending to its base.

Hymenal transection

A discontinuity in the hymenal membrane that extends through the width of the hymen to its base so that there appears to be no hymenal tissue remaining at that location. The term is used to describe healed appearances.

Hypernatraemia

An elevated level of sodium on biochemical blood test.

Hyperphagic

Excessive eating.

Hypoxic ischeamia

Damage to the brain due to lack of blood and oxygen supply.

Internalising

Describes a number of internal stresses such as anxiety and depression.

Labial frenum

The small piece of tissue that connects the lips to the gums.

Laceration

A tear in the flesh.

Metaphyseal

A fracture to the portion of bone between the shaft (diaphysis) of a long bone and the epiphysis or growing point at either end of the bone.

Mucosal laceration

A cut to the mucosa, which is the cellular lining of the alimentary canal from mouth to anus and the male and femal genital areas.

Near-drowning

Survival after suffocation caused by a (potentially fatal) submersion in water/fluid.

Neurological sequelae

Consequences that manifest as neurological symptoms or signs, for example impaired consciousness, fits and nerve damage.

Normative

Normal/usual.

Oedema

Excessive accumulation of fluid in the body tissues.

Oppositional defiant disorder

A psychiatric disorder where a child is excessively defiant and hostile towards figures of authority.

Osteogenesis imperfecta

A congenital disorder in which the bones are unusually fragile and brittle.

Osteopenia of prematurity

Brittle or weak bones in preterm infants.

Petechiae

Minute haemorhages into the skin giving an appearance of clusters of tiny red dots.

Posterior fourchette/fossa

The anatomical area of the female genitalia at the base of the vagina where the labia minora (thin folds of tissue on either side of the vaginal opening) join. It lies between the vaginal opening and the anus.

Post-traumatic stress disorder

An anxiety disorder that arises after exposure to one or more extreme stressors.

Reflex anal dilatation

The dynamic action of the opening of the anus due to relaxation of the external and internal sphincter muscles with minimal buttock traction.

Somatic

Relates to the body (as distinguished from the mind).

Subconjunctival

Anatomical part of the eye below the conjunctiva, which is a clear membrane (thin layer) that covers the white of the eye.

Supracondylar

Portion of the bone, namely humerus above the condyle or articular lower portion of the bone (elbow).

Trichomonas vaginalis

A single-cell anaerobic protozoan that causes trichomoniasis, which is a sexually transmitted infection.

Visceral injury

An injury to the organs within the body cavities.

Copyright © 2009, National Collaborating Centre for Women's and Children's Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

Bookshelf ID: NBK57152

Views

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...