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Cleveland, England: Child Abuse in the Public Eye

Cleveland, England: Child Abuse in the Public Eye Abstract A major problem has developed in England that may have profound effects on the practice of pediatrics, particularly in relation to identification of child abuse. Two pediatricians, Dr Marietta Higgs and Dr Geoffrey Wyatt, working in Cleveland, England, identified a series of children as potential victims of child abuse. In so doing, they relied heavily on a sign described by Hobbs and Wynne1 in Lancet in 1986, reflex anal dilatation. This sign is elicited by stroking the skin near the anus and observing dilatation instead of puckering. The claim is made that such dilatation reflects anal penetration, hence sexual abuse of the child in question. The two pediatricians claim that the sign was only part of their assessment, and that other signs and historical data were also used in their diagnosis. The public claimed otherwise. The problem became a public issue when the number of patients identified as being References 1. Hobbs DJ, Wynne JM. Buggery in childhood: a common syndrome of child abuse . Lancet . 1986;2:792-796.Crossref 2. Report of the Inquiry Into Child Abuse in Cleveland, 1987 . London, England: 1988. 3. Child Abuse after Cleveland . Lancet . 1988; 2:139-140. Editorial. 4. Helfer RE, Kempe CH. The Battered Child . Chicago, Ill: University of Chicago Press; 1968. 5. Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK. The battered child syndrome . JAMA . 1962;181:17-20.Crossref 6. The Diagnosis of Child Sexual Abuse: Guidance for Doctors . London, England: Her Majesty's Stationery Office; 1988. 7. Child protection: Guidance for Senior Nurses , Health Visitors and Midwifes. London, England: Her Majesty's Stationery Office; 1988. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Cleveland, England: Child Abuse in the Public Eye

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References (7)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1989.02150180029013
Publisher site
See Article on Publisher Site

Abstract

Abstract A major problem has developed in England that may have profound effects on the practice of pediatrics, particularly in relation to identification of child abuse. Two pediatricians, Dr Marietta Higgs and Dr Geoffrey Wyatt, working in Cleveland, England, identified a series of children as potential victims of child abuse. In so doing, they relied heavily on a sign described by Hobbs and Wynne1 in Lancet in 1986, reflex anal dilatation. This sign is elicited by stroking the skin near the anus and observing dilatation instead of puckering. The claim is made that such dilatation reflects anal penetration, hence sexual abuse of the child in question. The two pediatricians claim that the sign was only part of their assessment, and that other signs and historical data were also used in their diagnosis. The public claimed otherwise. The problem became a public issue when the number of patients identified as being References 1. Hobbs DJ, Wynne JM. Buggery in childhood: a common syndrome of child abuse . Lancet . 1986;2:792-796.Crossref 2. Report of the Inquiry Into Child Abuse in Cleveland, 1987 . London, England: 1988. 3. Child Abuse after Cleveland . Lancet . 1988; 2:139-140. Editorial. 4. Helfer RE, Kempe CH. The Battered Child . Chicago, Ill: University of Chicago Press; 1968. 5. Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK. The battered child syndrome . JAMA . 1962;181:17-20.Crossref 6. The Diagnosis of Child Sexual Abuse: Guidance for Doctors . London, England: Her Majesty's Stationery Office; 1988. 7. Child protection: Guidance for Senior Nurses , Health Visitors and Midwifes. London, England: Her Majesty's Stationery Office; 1988.

Journal

American Journal of Diseases of Children – American Medical Association

Published: Jun 1, 1989

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