Press Release

Given the complexities involved in identifying and reporting suspected cases of child abuse and neglect, it's crucial that the Mandated Reporter Guide emphasizes the importance of objective findings as solid evidence.

Objective Findings

Objective findings, such as radiological findings in chiropractic clinics, can provide concrete evidence of abuse that may otherwise be missed. Radiological examinations often reveal patterns of injuries that are inconsistent with the explanations provided. For example, multiple fractures at different stages of healing, unusual fractures for the child's developmental stage, or injuries that are rare from accidental trauma.

Therefore, the guide should recommend that:

Chiropractors should consider ordering radiological examinations when physical examination and patient history raise suspicion of abuse, even in the absence of visible injuries.

Findings from these examinations should be thoroughly documented, including the location, nature, and age of injuries.

Any discrepancy between these findings and the provided history of the injury should be noted as it may indicate a potential case of abuse.

Subjective Findings

While subjective findings such as inconsistencies in injury history or behavioral signs can be crucial, they should not be the sole basis for reporting suspicion of abuse. Children and elderly patients may have difficulty accurately recalling events, leading to inconsistencies that are not necessarily indicative of abuse.

This doesn't mean we should disregard subjective findings. On the contrary, the guide should instruct chiropractors to:

Be attentive to verbal and non-verbal cues that may indicate distress or fear.

Document any observed behavioral changes or emotional responses that seem disproportionate to the situation.

Note any inconsistencies in the history and presentation of injuries.

Limitations of Physical Examination

Given the nature of chiropractic practice, chiropractors may not examine private parts such as breasts and female chest, potentially missing signs of abuse. The guide should acknowledge this limitation and recommend that:

Chiropractors should be trained to identify signs of abuse visible in the areas they typically examine.

If suspicion arises from observed or reported symptoms that fall outside the chiropractor's scope of practice, the chiropractor should refer the patient to a suitable medical professional for a more comprehensive examination.

In conclusion, the Mandated Reporter Guide should emphasize the importance of both objective and subjective findings in identifying potential abuse cases. It should also acknowledge the limitations of physical examinations in chiropractic settings and provide guidance on referring patients for further evaluation when necessary.