The results of a survey of pediatricians who are members of the Sections on Child Abuse and Emergency Medicine of the American Academy of Pediatrics indicated that the most stressful task, relative to child maltreatment involvement, was appearance in court. Physicians may refrain from recognizing and reporting child abuse to avoid this perceived stress. If the physician approaches testimony as a teacher who is prepared to communicate with a lay audience, this familiar role may help to decrease stress and assure that the judge and jury comprehend complex medical findings. Increased understanding also should assure that justice is served. Charts and models that have been found useful in explaining medical aspects of physical and sexual abuse during court testimony are described. Meeting with attorneys prior to court appearance and review of feedback about the quality of testimony from attorneys can be used to improve testimony.
Get full access to this article
View all access options for this article.
References
1.
Adams, J. A.
(1992). Significance of medical findings in suspected sexual abuse: Moving toward concensus. Child Sexual Abuse, 1, 91-92.
2.
Berenson, A. B.
, Hegar, A. H., Hayes, J. M., Bailey, R. K., & Emans, S. J., (1992). Appearance of the hymen in prepubertal girls. Pediatrics, 89, 387-389.
3.
Bernat, J. E.
(1992). Dental trauma and bite mark evaluation. In S. Ludwig & A. E. Kornberg (Eds.), Child abuse: A medical reference (2nd ed., pp. 175-190). New York: Churchill Livingstone.
4.
Chadwick, D. L.
, Chin, S., Salerno, C., Landsverk, J., & Kitchen, L. (1991). Deaths from falls in children: How far is fatal?The Journal of Trauma, 31, 1353-1355.
5.
Edmond Scientific Company Order Department, Edscorp Bldg. Barrington, New Jersey 08007-1380
6.
Emans, S. J.
, Woods, E., Flagg, N., & Freeman, A. (1987). Genital findings in sexually abused, symptomatic, and asymptomatic girls. Pediatrics, 79, 788-785.
7.
French, G. M.
, & Johnson, C. F. (1994). Bites in the night: Determining the etiology of bite marks on an infant. Pediatric Emergency Care, 10, 281-283.
8.
Helfer, R. E.
, Slovis, T. L., & Black, M. (1977). Injuries resulting when small children fall out of bed. Pediatrics, 60, 533-535.
9.
Horsley, J. I.
, & Carlova, J. (1983). Testifying in court: A guide for physicians. Oradell, NJ: Medical Economics Books.
10.
Johnson, C. F.
(1988). Constricting bands: Manifestations of possible child abuse. Clinical Pediatrics, 27, 439-444.
11.
Johnson, C. F.
(1990). Inflicted injury vs. accidental injury. Pediatric Clinics of North America, 37, 791-814.
12.
Johnson, C. F.
(1993). Physicians and medical neglect: Variables which affect reporting. SCAN: Newsletter of the Section of Child Abuse and Neglect of the American Academy of Pediatrics, 17, 605-612.
13.
Johnson, C. F.
(1994a). Consequences of a fall. SCAN: American Academy of Pediatrics, 6, 4.
14.
Johnson, C. F.
(1994b). Sagittal view of female genitalia. SCAN: American Academy of Pediatrics, 6, 5.
15.
Johnson, C. F.
(1994c). Stress and child abuse: Preliminary survey results. SCAN: Newsletter of the Section of Child Abuse and Neglect of the American Academy of Pediatrics, 6, 1.
16.
Johnson, C. F.
(1994d). Symbolic scarring and tattooing: Unusual manifestations of child abuse. Clinical Pediatrics, 33, 46-49.
17.
Johnson, C. F.
(1995). Injury sheet, skeletal system. SCAN: American Academy of Pediatrics, 7, 4.
18.
Johnson, C. F.
(1996a). Bruises and abuse: Bruise location in accidental and non-accidental injury. Physical abuse: Accidental versus intentional trauma in children (chapter 12). In J. N. Briere (Ed.), The APSAC handbook on child maltreatment. Thousand Oaks, CA: Sage.
19.
Johnson, C. F.
(1996b). Consultation: CT and MRI Review. SCAN: American Academy of Pediatrics, 8, 4.
20.
Johnson, C. F.
(1996c). Physical abuse: Accidental versus intentional trauma in children. In J. N. Briere, Berliner, L., Bulkley, J. A., Jenny, C., & Reid, T. (Eds.), The APSAC handbook on child maltreatment (chapter 12, pp. 206-227). Thousand Oaks, CA: Sage.
21.
Johnson, C. F.
(1997). Dynamics of posterior rib fracture. SCAN: American Academy of Pediatrics, 9, 2.
22.
Ladson, S.
, Johnson, C. F., & Doty, R. E. (1987). Do physicians recognize sexual abuse?American Journal: Diseases of Children, 141, 411-415.
23.
Lentsch, K.
, & Johnson, C. F. (1997). Physicians' recognition of child abuse: A reappraisal. Manuscript submitted for publication.
24.
Leventhal, J. M.
, Thomas, S. A., Rosenfield, N. S., & Markowitz, R. (1990). Skull fractures in young children: Do characteristics of the fractures clearly distinguish child abuse from accidental injuries?American Journal: Diseases of Children, 144, 429.
25.
Meservy, C. J.
, Towbin, R., McLaurin, R. L., Myers, P. A., & Ball, W. (1987). Radiographic characteristics of skull fractures resulting from child abuse. American Journal of Neuroradiology, 8, 455-457.
26.
Nimityongskul, P.
, & Anderson, L. D. (1987). The likelihood of injuries when children fall out of bed. Journal of Pediatric Orthopedics, 7, 184-186.
27.
Purdue, G. F.
, & Hunt, J. L. (1992). Burn injuries. In S. Ludwig & A. E. Kornberg (Eds.), Child abuse: A medical reference (pp. 105-117). New York: Churchill Livingstone.
28.
Richardson, A. H.
(1994). Cutaneous manifestation of abuse. In R. M. Reece (Ed.), Child abuse: Medical diagnosis and management (pp. 167-185). Philadelphia: Williams & Wilkins.
29.
Williams, R. A.
(1992). Injuries in infants and small children resulting from witnessed and corroborated free falls. Journal of Trauma, 31, 1350-1352.
