Thomas was 3 years old when he first arrived at his new pediatrician’s office for a visit. He had several small bruises in various states of healing. The reason for this visit was that his mother stated he had slipped and fallen when he was in the bathtub. She said she did not see the fall because she had gone to answer the door after she placed him in the tub. When she got back to the bathroom, she stated that Thomas had burns across the lower half of his body due to the fall into the hot bathtub water.
On examination, Thomas had a “straight line” burn mark across his waist and legs, giving the appearance of someone who was “dipped” into scalding water rather than someone who had fallen (with corresponding irregular burn shapes). He was shaking, fearful, whimpering, and withdrawn. His vital signs were stable and he appeared thin. The skin on his legs, torso, and lower back was bright red and beginning to peel off. A cool moist sheet was immediately placed on his wounds and emergency services were summoned.
The pediatrician patiently asked the mother how the situation had occurred. Each time, she repeated the same story. By the time the physician had asked her a fourth time about the incident, she suddenly blurted out that she had been angry at Thomas for crying when he didn’t get extra food at lunch. He had spilled food on his clothes from his lunch and so she decided to “teach him a lesson” and place him in the bath. When he screamed, she became fearful of the neighbors hearing and of the injuries and brought him to the doctor’s office. Child Protective Services (CPS) was notified.
The child was admitted to the hospital and, after further investigations, it was determined that his mother was single, dating a new boyfriend, and was struggling to support herself and her child. It was also discovered, after further assessment, that Thomas had old fractures of the forearm as well as old burn marks (from cigarettes) on his buttocks. He was treated successfully for his burns and placed in foster care.
This case represents a typical case of child abuse. Until the 1960s, most of U.S. society was unaware of the incredibly heinous conditions in which abused children lived. People viewed abuse as a rare phenomenon that occurred only in “other people’s lives” or in poverty-stricken, lower class families. However, most of society now knows that child maltreatment is a frightening daily reality for millions of children (Barnett, Miller-Perrin, & Perrin, 2011).