Čes-slov Pediat 2026, 81(1):33-42 | DOI: 10.55095/CSPediatrie2026/004

Child or adolescent abuse and neglect

Ivan Peychl^{1, 2}, Eliška Popelová³, Helena Neumannová⁴, Terezie Pemová⁵, Jana Kocourková⁶

¹ Pediatrické oddělení, Fakultní nemocnice Bulovka, Praha

² Klinika dětí a dorostu, Fakultní nemocnice Královské Vinohrady, Praha

³ Klinika zobrazovacích metod, 2. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Motol, Praha

⁴ Gynekologicko-porodnická klinika, Fakultní nemocnice Bulovka, Praha

⁵ Justiční akademie

⁶ Dětská psychiatrická klinika, 2. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Motol, Praha

Physical, sexual, psychological, emotional abuse, and neglect of a child can have serious consequences - both immediate, including fatal outcomes, and long-term or lifelong effects. Perpetrators are most often parents or other family members. Physical abuse may be identified by various external injuries, fractures, and damage to soft tissues or internal organs. A specific and severe form is abusive head trauma in infants and young children, where violent shaking may cause subdural hemorrhage and brain injury. Sexual abuse can sometimes present with physical signs of past violence, though more often the physical findings are normal. In such cases, changes in the child's behavior and medical history are key to diagnosis. Psychological and emotional abuse involves repeated humiliation and intimidation. Observing interactions between the parent and child can aid in detecting this type of abuse. Child neglect can take many forms, including failure to meet the child's hygienic, nutritional, educational, health, or emotional needs, or failure to provide age-appropriate supervision. A specific form of abuse is medical child abuse, in which a caregiver fabricates or induces illness in the child. Hospital admission is warranted when physical abuse is suspected. Depending on the case, the evaluation may include a detailed medical history, physical examination, targeted laboratory tests, and imaging studies. For children presenting with acute neurological symptoms, an immediate CT scan of the head is indicated. In all children under one year of age with suspected physical abuse, MRI of the brain and cervical spine may be performed - even if there are no neurological symptoms. Children under two years of age undergo a radiographic skeletal survey. Treatment depends on the type of abuse. Initial care focuses on stabilizing the child's condition, often in an intensive care unit for severe cases, followed by thorough examination and trauma management. Ongoing care is complex and multidisciplinary, typically involving physicians and surgeons from various specialties, psychologists, social workers, and the Czech Police.

Keywords: child abuse, child physical abuse, child psychological and emotional abuse, child sexual abuse, child neglect, radiological skeletal survey

Accepted: December 4, 2025; Published: January 30, 2026  Show citation