Medical assessment of suspected traumatic head injury due to child maltreatment (THI-CM)

Traumatic head injury due to child maltreatment (THI-CM) is a serious form of child abuse with significant morbidity and mortality, particularly in infants and young children. Healthcare providers have important roles to play, including identifying and treating these children, reporting concerns of child maltreatment to child welfare authorities, assessing for associated injuries and medical conditions, supporting children and their families, and communicating medical information clearly to families and other medical, child welfare, and legal professionals. Symptoms associated with head trauma often overlap with those of other common childhood illnesses, and external signs of injury may be subtle or absent. As a result, THI-CM is frequently overlooked and its identification is often delayed, leading to a risk of ongoing injury. Assessing for head trauma in cases of possible child maltreatment includes considering medical causes for clinical findings and assessment for occult injuries. This practice point provides health care providers with guidance for identifying and medically assessing suspected THI-CM in infants and children.