Article Sections

Introduction

Nonaccidental trauma (NAT) occurs when a caregiver intentionally injures a child.  NAT is the leading cause of traumatic injury in infants age <1.  Healthcare professionals must be vigilant in identifying signs of NAT and protecting the child.

Pathogenesis and risk factors

NAT occurs when a caregiver intentionally injures a child.  NAT can occur in the setting of:

  • Physical abuse (eg, shaking, scalding)
  • Neglect (ie, malnutrition resulting in failure to thrive)
  • Sexual abuse

Therefore, risk factors include child-related, caregiver-related, and environmental factors ( Table 1).

Child-related risk factors

  • Age (infants and toddlers at highest risk due to physical vulnerability and dependence on the caregiver)
  • Physical, intellectual, or emotional disabilities or chronic illnesses

Caregiver-related risk factors

  • Substance use disorders
  • Mental health disorders (eg, depression, anxiety, impulse control disorders)

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Tables

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