ABSTRACT
The diagnosis of abuse in children is a difficult intellectual and emotional exercise. It has been described as one of the most demanding tasks in clinical practice requiring time, experience and emotional energy.1 One of the biggest barriers to the diagnosis is the continuing existence of emotional blocks in the minds of professionals. Paediatricians are accustomed to working in partnership with parents in identifying and treating their child’s illness or injury and find it very hard to make the cognitive shift to suspecting that they are the cause of their child’s suffering.2 In some fields, for example infants presenting with intracranial bleeds or multiple fractures, the differential diagnosis between an underlying medical condition and non-accidental injury is fraught with difficulty. These cases are frequently strongly contested when they reach the Courts, further discouraging paediatricians from becoming involved.
