Every year an estimated 1,760 children die from injuries related to child abuse. Another 150,000 children suffer permanent disabilities. Of the children fatally injured, over 75 percent are younger than four years old. If medical personnel, law enforcement officers, and child protection services were able to differentiate between bruising from accidents and bruising from abuse, many of these deaths or injuries could be preventable. Early detection is a critical component in preventing escalating injuries but many times it is difficult to determine the actual cause behind the bruises. Abuse is commonly and falsely reported as injuries. Now, a team of researchers from the University of Louisville are conducting studies on a system to detect whether bruises are the result of injury or child abuse.
The new system takes into account skin and soft tissue injuries. A child surrogate, otherwise known as an anthropomorphic test device (ATD) has been routinely been used for predicting injuries to head, chest, and femurs of children in motor vehicle accidents and has provided the base of the new studies. Now, researchers are modifying the ATD with a sensing skin to acquire data during injury simulations from falls or trauma from abuse. The system records the data, the potential areas of bruising which are caused either by abuse to the child or injury and will ultimately help detect what type of bruising comes from which type of injury.
The clinical studies are now beginning to determine patterns and characteristics on individual body locations. The research team is developing the sensors to run simulated tests on both abusive events and various accidents to identify the outcomes on the sensors and the skin. The current protocols fail to recognize child abuse cases up to 71 percent of the time. The new sensors contain three elements on the surrogate to detect bruising. These elements include the sensing skin, a data acquisition system, and image mapping which all come together to form a single functional unit which is utilized to detect impact events. The events are mapped by computer which displays both the force of the impact and the location.
The investigations, diagnoses, and legal examinations conducted during cases of child abuse often do not take into account bruising patterns which typically display as constellations of individual bruises. These missed opportunities to gain a higher understanding of the child’s environment are not taken into account due to the fact that these injuries are generally not life-threatening. However, the patterns of bruising would provide information on whether or not the bruising is a result of accident, injury, or abuse.
Using the device has the potential to support the diagnosis of child abuse and aid in further investigations. The information gained would also contribute to the overall injury assessment of the child. The sensor system could be used to determine whether the injury has been caused by an accident or it may detect false accident reporting and determine if the injury occurred from child abuse. Additionally, the detection system could also exonerate those whom have been falsely accused of abuse by providing objective data in each case. The future could see similar methods used to determine accident versus abuse in elderly patients as well. The procedure and system are not without limitations. One of the main limitations is that individuals all have a number of factors which influence not only the severity of bruising but the occurrence as well. Variables from distribution of force over either larger or smaller areas can affect bruise development as well as such factors as fat content of the individual, skin toughness, and vessel fragility, which all play a role in the bruising process. While the bruising threshold may vary between different patients, generally it can be said that larger forces are generally associated with higher bruising potentials. Regardless, the system has been tested and baseline models are being documented. A future where child abuse may be differentiated from accident or injury with a much higher certainty than is currently available is possible.
By Dee Mueller
on twitter @TuesdayDG