Neglect, Cruelty, and Battering

Abstract

An anonymous annotation recently stated “It should be axiomatic that any injury (other than a road traffic accident) to a child under 2 must be considered to be an instance of the battered-baby syndrome.”1This is, fortunately, obviously incorrect, even if a more recent estimate that 500 children die each year from battering is nearer the truth-2The very word “battering,” and the term “battering parent,” add to the already considerable difficulties of determining which injured children have been damaged by their families-So do exaggerated estimates of the size of the problem and alarmist claims that it is on the increase. Up to a point publicity and catch phrases have been effective in drawing attention to a problem which certainly has been underestimated. Now that research is in progress it could only be helpful if the emotional temperature were lowered. Our understanding has been increasing faster in the last 15 years since Caffey3 described the periosteal changes and other injuries seen on x-ray films of children who had been swung fiercely by their ankles or their wrists. From work done independently in different parts of the world and in different social situations4-6we know that much of this deadly or potential deadly damage can be prevented. Also that most families which have produced or permitted grave physical or emotional injury and neglect can recover and achieve their ambition of nurturing thriving children. We have learnt too that the suspicious, over-simplified, and potentially accusatory approach epitomized in my first quotation makes recovery more difficult and further injury more likely. We have learnt it in the process of discovering that the opposite approach of sympathetic and concerned, but controlled, curiosity is essential if recurring tragedy is to be avoided. © 1972, British Medical Journal Publishing Group. All rights reserved.