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<< Nonaccidental Injury in Pediatric Patients: Detection, Evaluation, and Treatment (Trauma CME)

Etiology

Schmitt identified 7 developmental phases in children that are challenging periods for caregivers and may trigger abuse: colic, nighttime awakening, separation anxiety, exploratory behavior, negativism, poor appetite, and toilet-training resistance.21 Indeed, caregivers often take children to the ED for evaluation of some of these complaints. Crying is the most common trigger of AHT, based on both epidemiological data that show that the age-specific incidence curve of AHT has a similar starting point and shape to the crying curve in infants (the peak occurs 4 to 6 weeks later) as well as from data on perpetrator confessions.22-25 Acknowledging that parenting can be frustrating, normalizing behaviors in children and providing alternative coping strategies, even during an ED visit, may prevent maltreatment.

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