Physical abuse is characterized by physical injury (for example, bruises and fractures), resulting from punching, beating, kicking, biting, burning or otherwise physically harming a child. Although the injury is not an accident, the parents or caretaker may not have intended to hurt the child. The injury may have resulted from too much discipline, physical punishment that is inappropriate to the child's age or condition, an unexpected loss of control in response to a child not meeting parental expectations, or poor coping skills on the part of the parent (DePanfilis and Salus, 1992). In 1996, 24 percent of confirmed child maltreatment reports involved physical abuse (U.S. Department of Health and Human Services, Children's Bureau [HHS/CB], 1998d).
The injury may be the result of a single episode or of repeated episodes and can range in severity from minor bruising to death. According to 1996 data collected under the auspices of the National Child Abuse and Neglect Data System (NCANDS), some 1,077 children died in the U.S. that year due to maltreatment, about half as a result of physical abuse and half as a result of neglect. Children younger than age 4 accounted for 76 percent of fatalities (HHS/CB, 1998d). Any injury resulting from physical punishment that requires medical treatment is considered outside the realm of normal disciplinary measures. A single bruise may be inflicted inadvertently; however, old and new bruises in combination, bruises on several areas of the face, or bruising in an infant suggest abuse. In addition, any punishment that involves hitting with a closed fist or an instrument, kicking, inflicting burns, or throwing the child is considered child abuse regardless of the severity of the injury sustained (DePanfilis and Salus, 1992).