In recent years two documents have had significant political influence on medical and social work practice related to child abuse. In his report on Victoria Climbié [1] Lord Laming (para 11.53) said: ‘Investigation and management of a case of possible harm to a child must be approached in the same systematic and rigorous manner as would be appropriate to the investigation and management of any other possible fatal disease.’ His inquiry was followed by the publication of Working Together to Safeguard Children: a Guide to Inter-Agency Working to Safeguard and Promote the Welfare of Children [2].

Definition of a child

According to the Children Acts 1989 and 2004, a child is anyone who has not yet reached his or her eighteenth birthday, but the term ‘children’ includes persons aged 18, 19 and 20 years who have been looked after by a local authority at any time after attaining the age of 16 years or who have a learning disability.

Definitions of abuse or neglect

Child abuse involves acts of commission or omission resulting in harm to the child. Harm takes various forms, but it is not uncommon for a child to suffer from more than one type of abuse. The definitions are taken from Working Together to Safeguard Children [2]. Emotional abuse and neglect do not usually come within the remit of forensic physicians and will not be considered in this chapter. It is imperative for the forensic physician to remember that one type of abuse rarely occurs in isolation, and a holistic approach to the child is required.