{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T01:51:39Z","timestamp":1791510699012,"version":"4.3.4"},"reference-count":74,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T00:00:00Z","timestamp":1711756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Non-accidental trauma (NAT) is a major cause of morbidity and mortality for children around the world and most significantly impacts children under one year of age. Prompt and comprehensive treatment of these children relies on a high index of suspicion from any medical provider that treats pediatric patients. This review discusses those most at risk for experiencing NAT, and common initial presentations, to assist providers in the identification of potential victims. In addition, this review provides guidance on the recommended workup for these patients so that the full extent of associated injuries may be identified and the appropriate healthcare team may be assembled.<\/jats:p>","DOI":"10.3390\/children11040413","type":"journal-article","created":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T13:42:30Z","timestamp":1711892550000},"page":"413","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Identification and Evaluation of Non-Accidental Trauma in the Pediatric Population: A Clinical Review"],"prefix":"10.3390","volume":"11","author":[{"given":"Sophia M. V.","family":"Schermerhorn","sequence":"first","affiliation":[{"name":"Naval Medical Center San Diego, San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2790-4395","authenticated-orcid":false,"given":"Oliver J.","family":"Muensterer","sequence":"additional","affiliation":[{"name":"LMU Medical Center, Pediatric Surgery, Dr. von Hauner Children\u2019s Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, 80337 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Romeo C.","family":"Ignacio","sequence":"additional","affiliation":[{"name":"Department of Surgery, UCSD School of Medicine, 9500 Gilman Dr, La Jolla, CA 92093, USA"},{"name":"Division of Pediatric Surgery, Rady Children\u2019s Hospital San Diego, 3020 Children\u2019s Way, San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1001\/jama.1962.03050270019004","article-title":"The Battered-Child Syndrome","volume":"181","author":"Silverman","year":"1962","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.rbo.2012.03.003","article-title":"Review Article: Child Abuse: Review of the Literature","volume":"48","author":"Terra","year":"2013","journal-title":"Rev. Bras. Ortop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/S0140-6736(08)61706-7","article-title":"Child Maltreatment 1 Burden and Consequences of Child Maltreatment in High-Income Countries","volume":"373","author":"Gilbert","year":"2009","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/TA.0b013e3182984831","article-title":"Mortality Increases with Recurrent Episodes of Nonaccidental Trauma in Children","volume":"75","author":"Deans","year":"2013","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Sethi, D., Yon, Y., Parekh, N., Anderson, T., Huber, J., Rakovac, I., and Meinck, F. (2018). European Status Report on Preventing Child Maltreatment, World Health Organization.","DOI":"10.1016\/S2352-4642(18)30280-3"},{"key":"ref_6","unstructured":"United States Department of Health and Human Services, and Administration on Children, Youth, and Families (2021). Child Maltreatment 2021, The Administration for Children and Families."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1177\/0009922819829045","article-title":"Demographics and Risk Factors for Non-Accidental Orthopedic Trauma","volume":"58","author":"Sivasundaram","year":"2019","journal-title":"Clin. Pediatr."},{"key":"ref_8","unstructured":"(2023, November 03). Fast Facts: Preventing Child Abuse and Neglect, Available online: https:\/\/www.cdc.gov\/violenceprevention\/childabuseandneglect\/fastfact.html."},{"key":"ref_9","unstructured":"Sethi, D. (2013). European Report on Preventing Child Maltreatment, World Health Organization. Regional Office for Europe."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1097\/01.TA.0000068992.01030.A8","article-title":"The Positive Predictive Value of Rib Fractures as an Indicator of Nonaccidental Trauma in Children","volume":"54","author":"Barsness","year":"2003","journal-title":"J. Trauma"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/j.jpedsurg.2019.03.009","article-title":"Child Abuse and the Pediatric Surgeon: A Position Statement from the Trauma Committee, the Board of Governors and the Membership of the American Pediatric Surgical Association","volume":"54","author":"Escobar","year":"2019","journal-title":"J. Pediatr. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1177\/1077559511411179","article-title":"Report of Maltreatment as a Risk Factor for Injury Death: A Prospective Birth Cohort Study","volume":"16","year":"2011","journal-title":"Child Maltreat"},{"key":"ref_13","unstructured":"United States Department of Health and Human Services, and The Administration for Children and Families (2017). Child Maltreatment 2017, The Administration for Children and Families."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.pcl.2014.06.007","article-title":"Sentinel Injuries: Subtle Findings of Physical Abuse","volume":"61","author":"Petska","year":"2014","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.jpedsurg.2019.03.024","article-title":"Understanding Non-Accidental Trauma in the United States: A National Trauma Databank Study","volume":"55","author":"Rosenfeld","year":"2020","journal-title":"J. Pediatr. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/SCS.0000000000006294","article-title":"Differences in Facial Fracture Patterns in Pediatric Nonaccidental Trauma","volume":"31","author":"Wasicek","year":"2020","journal-title":"J. Craniofacial Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/01.bpb.0000271328.79481.07","article-title":"Orthopaedic Injuries in Children With Nonaccidental Trauma: Demographics and Incidence from the 2000 Kids\u2019 Inpatient Database","volume":"27","author":"Loder","year":"2007","journal-title":"J. Pediatr. Orthop."},{"key":"ref_18","unstructured":"Department of Health and Human Services (2005). Aspe Research in Brief Male Perpetrators of Child Maltreatment: Findings from Ncands, Department of Health and Human Services."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.chiabu.2017.04.033","article-title":"History, Injury, and Psychosocial Risk Factor Commonalities among Cases of Fatal and near-Fatal Physical Child Abuse","volume":"69","author":"Pierce","year":"2017","journal-title":"Child Abus. Negl."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.chiabu.2018.08.004","article-title":"Intergenerational Transmission of Child Abuse: Predictors of Child Abuse Potential among Racially Diverse Women Residing in Domestic Violence Shelters","volume":"85","author":"Anderson","year":"2018","journal-title":"Child Abus. Negl."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s00038-018-1185-4","article-title":"Transmitting Trauma: A Systematic Review of the Risk of Child Abuse Perpetrated by Parents Exposed to Traumatic Events","volume":"64","author":"Montgomery","year":"2019","journal-title":"Int. J. Public Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/s40471-020-00252-3","article-title":"Risk and Protective Factors for Child Maltreatment: A Review","volume":"7","author":"Austin","year":"2020","journal-title":"Curr. Epidemiol. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Rybi\u0144ska, A., Bai, Y., Goodman, W.B., and Dodge, K.A. (2023). Birth Spacing and Child Maltreatment: Population-Level Estimates for North Carolina. Child Maltreat, online ahead of print.","DOI":"10.1177\/10775595231171879"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1080\/02813432.2019.1571002","article-title":"The Use of the Brief Child Abuse Potential Inventory in the General Population in Finland","volume":"37","author":"Ellonen","year":"2019","journal-title":"Scand. J. Prim. Health Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1097\/PEC.0000000000003012","article-title":"Nonaccidental Pediatric Trauma: Which Traditional Clues Predict Abuse?","volume":"39","author":"Lawsing","year":"2023","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e2129068","DOI":"10.1001\/jamanetworkopen.2021.29068","article-title":"Variations in Guidelines for Diagnosis of Child Physical Abuse in High-Income Countries: A Systematic Review","volume":"4","author":"Blangis","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s00383-020-04706-z","article-title":"Prevalence and Distribution of Occult Fractures on Skeletal Surveys in Children with Suspected Non-Accidental Trauma Imaged or Reviewed in a Tertiary Dutch Hospital","volume":"36","author":"Loos","year":"2020","journal-title":"Pediatr. Surg. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/1754-9485.13270","article-title":"A Review of Current Imaging Techniques Used for the Detection of Occult Bony Fractures in Young Children Suspected of Sustaining Non-Accidental Injury","volume":"66","author":"Lawson","year":"2022","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1136\/bmj.a1518","article-title":"Patterns of Skeletal Fractures in Child Abuse: Systematic Review","volume":"337","author":"Kemp","year":"2008","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1302\/0301-620X.92B2.22923","article-title":"Orthopaedic Aspects of Paediatric Non-Accidental Injury","volume":"92","author":"Jayakumar","year":"2010","journal-title":"J. Bone Jt. Surg. Br. Vol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.acap.2018.08.007","article-title":"Use and Utility of Skeletal Surveys to Evaluate for Occult Fractures in Young Injured Children","volume":"19","author":"Wood","year":"2018","journal-title":"Acad. Pediatr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1136\/archdischild-2015-308418","article-title":"Imaging in Suspected Child Abuse: Necessity or Radiation Hazard?","volume":"100","author":"Bajaj","year":"2015","journal-title":"Arch. Dis. Child."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1007\/s00247-020-04944-2","article-title":"Evaluation of the Abdomen in the Setting of Suspected Child Abuse","volume":"51","author":"Henry","year":"2021","journal-title":"Pediatr. Radiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1542\/peds.2008-2348","article-title":"Utility of Hepatic Transaminases to Recognize Abuse in Children","volume":"124","author":"Lindberg","year":"2009","journal-title":"Pediatrics"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.annemergmed.2013.02.031","article-title":"PECARN Abdominal Injury Rule Should Exclude Potentially Abused Children","volume":"62","author":"Lindberg","year":"2013","journal-title":"Ann. Emerg. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"82","DOI":"10.21315\/mjms2018.25.4.8","article-title":"Computed Tomography Dose in Paediatric Care: Simple Dose Estimation Using Dose Length Product Conversion Coefficients","volume":"25","author":"Selvarajah","year":"2018","journal-title":"Malays. J. Med. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1111\/acem.12689","article-title":"Analysis of Radiation Dose to Pediatric Patients during Computed Tomography Examinations","volume":"22","author":"Kharbanda","year":"2015","journal-title":"Acad. Emerg. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1136\/archdischild-2018-316286","article-title":"Radiation Doses in Diagnostic Imaging for Suspected Physical Abuse","volume":"104","author":"Rao","year":"2019","journal-title":"Arch. Dis. Child."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.clinimag.2021.11.008","article-title":"Value of Chest CT over Skeletal Surveys in Detection of Rib Fractures in Pediatric Patients","volume":"82","author":"Pomeranz","year":"2022","journal-title":"Clin. Imaging"},{"key":"ref_40","unstructured":"United States Nuclear Regulatory Commission (2017). Biological Effects of Radiation, United States Nuclear Regulatory Commission."},{"key":"ref_41","unstructured":"(2023, November 23). Bundesmant fur Strahlenschutz Radiation Exposure of Airline Passengers. Available online: https:\/\/www.bfs.de\/EN\/topics\/ion\/environment\/air-soil\/flight\/flight_node.html#:~:text=Depending%20on%20the%20location%20the,therefore%20by%20about%20five%20percent."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1136\/adc.2003.044065","article-title":"Are There Patterns of Bruising in Childhood Which Are Diagnostic or Suggestive of Abuse? A Systematic Review","volume":"90","author":"Maguire","year":"2005","journal-title":"Arch. Dis. Child"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e215832","DOI":"10.1001\/jamanetworkopen.2021.5832","article-title":"Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics","volume":"4","author":"Pierce","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1542\/peds.2012-2780","article-title":"Sentinel Injuries in Infants Evaluated for Child Physical Abuse","volume":"131","author":"Sheets","year":"2013","journal-title":"Pediatrics"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1542\/peds.64.2.245","article-title":"Patterns of Skin Injury in Nonaccidental and Accidental Injury","volume":"64","author":"Pascoe","year":"1979","journal-title":"Pediatrics"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.1097\/PEC.0000000000001311","article-title":"A Prospective Study of the Causes of Bruises in Premobile Infants","volume":"36","author":"Feldman","year":"2020","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1542\/peds.2020-0203","article-title":"Abusive Head Trauma in Infants and Children","volume":"145","author":"Narang","year":"2020","journal-title":"Pediatrics"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"481","DOI":"10.3171\/2019.7.PEDS18394","article-title":"Abusive Head Trauma: Evidence, Obfuscation, and Informed Management","volume":"24","author":"Duhaime","year":"2019","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e20153756","DOI":"10.1542\/peds.2015-3756","article-title":"Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma","volume":"138","author":"Fromkin","year":"2016","journal-title":"Pediatrics"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1053\/j.sult.2020.05.006","article-title":"Pearls and Pitfalls in Imaging of Abusive Head Trauma","volume":"41","author":"Blumfield","year":"2020","journal-title":"Semin. Ultrasound CT MRI"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00062-018-0663-7","article-title":"Various Cranial and Orbital Imaging Findings in Pediatric Abusive and Non-Abusive Head Trauma, and Relation to Outcomes","volume":"29","author":"Gencturk","year":"2019","journal-title":"Clin. Neuroradiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/jon.12670","article-title":"MRI Findings in Pediatric Abusive Head Trauma: A Review","volume":"30","author":"Orman","year":"2020","journal-title":"J. Neuroimaging"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"105518","DOI":"10.1016\/j.chiabu.2022.105518","article-title":"Screening for Pediatric Abusive Head Trauma: Are Three Variables Enough?","volume":"125","author":"Hymel","year":"2022","journal-title":"Child Abus. Negl."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1111\/acem.13155","article-title":"The PECARN TBI Rules Do Not Apply to Abusive Head Trauma","volume":"24","author":"Magana","year":"2016","journal-title":"Acad. Emerg. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S0140-6736(09)61558-0","article-title":"Identification of Children at Very Low Risk of Clinically-Important Brain Injuries after Head Trauma: A Prospective Cohort Study","volume":"374","author":"Kuppermann","year":"2009","journal-title":"Lancet"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"E164","DOI":"10.5435\/JAAOS-D-18-00502","article-title":"Predictors for Nonaccidental Trauma in a Child With a Fracture\u2014A National Inpatient Database Study","volume":"28","author":"Zhao","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1136\/bmj.293.6539.100","article-title":"Patterns of Fractures in Accidental and Non-Accidental Injury in Children: A Comparative Study","volume":"293","author":"Worlock","year":"1986","journal-title":"Br. Med. J. (Clin. Res. Ed.)"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"E601","DOI":"10.1097\/BPO.0000000000002145","article-title":"Nonaccidental Trauma in Pediatric Elbow Fractures: When You Should Be Worried","volume":"42","author":"Tadepalli","year":"2022","journal-title":"J. Pediatr. Orthop."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.2106\/JBJS.21.01534","article-title":"Transphyseal Distal Humeral Fractures: A 13-Times-Greater Risk of Non-Accidental Trauma Compared with Supracondylar Humeral Fractures in Children Less Than 3 Years of Age","volume":"104","author":"Crowe","year":"2022","journal-title":"J. Bone Jt. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"106","DOI":"10.2106\/JBJS.N.00664","article-title":"Transverse Fractures of the Femoral Shaft Are a Better Predictor of Nonaccidental Trauma in Young Children than Spiral Fractures Are","volume":"97","author":"Murphy","year":"2015","journal-title":"J. Bone Jt. Surg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1007\/s11999-010-1414-5","article-title":"The Radiographic Approach to Child Abuse","volume":"469","author":"Dwek","year":"2011","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3855","DOI":"10.1111\/iwj.14236","article-title":"Prevalence of Non-Accidental Burns and Related Factors in Children: A Systematic Review and Meta-Analysis","volume":"20","author":"Tehrany","year":"2023","journal-title":"Int. Wound J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.burns.2017.08.018","article-title":"Raising Suspicion of Maltreatment from Burns: Derivation and Validation of the BuRN-Tool","volume":"44","author":"Kemp","year":"2018","journal-title":"Burns"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.burns.2020.01.008","article-title":"Incidence and Characteristics of Non-Accidental Burns in Children: A Systematic Review","volume":"46","author":"Loos","year":"2020","journal-title":"Burns"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1097\/01.ta.0000196437.07011.b1","article-title":"Distinguishing Inflicted versus Accidental Abdominal Injuries in Young Children","volume":"59","author":"Wood","year":"2005","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jpedsurg.2015.10.056","article-title":"Pediatric Abdominal Injury Patterns Caused by \u201cFalls\u201d: A Comparison between Nonaccidental and Accidental Trauma","volume":"51","author":"Carter","year":"2016","journal-title":"J. Pediatr. Surg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.chiabu.2012.10.009","article-title":"A Systematic Review of Abusive Visceral Injuries in Childhood-Their Range and Recognition","volume":"37","author":"Maguire","year":"2013","journal-title":"Child Abus. Negl."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1001\/archsurg.1988.01400330077012","article-title":"Diagnostic and Surgical Implications of Child Abuse","volume":"123","author":"Ledbetter","year":"1988","journal-title":"Arch. Surg."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1097\/01.pec.0000238734.76413.d0","article-title":"Patient and Injury Characteristics in Abusive Abdominal Injuries","volume":"22","author":"Trokel","year":"2006","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e20200438","DOI":"10.1542\/peds.2020-0438","article-title":"Long-Term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect","volume":"146","author":"Strathearn","year":"2020","journal-title":"Pediatrics"},{"key":"ref_71","first-page":"195","article-title":"Non-Accidental Trauma in Pediatric Patients: A Review of Epidemiology, Pathophysiology, Diagnosis and Treatment","volume":"3","author":"Paul","year":"2014","journal-title":"Transl. Pediatr."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e356","DOI":"10.1016\/S2468-2667(17)30118-4","article-title":"Articles The Effect of Multiple Adverse Childhood Experiences on Health: A Systematic Review and Meta-Analysis","volume":"2","author":"Hughes","year":"2017","journal-title":"Lancet Public Health"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e2012563","DOI":"10.1001\/jamanetworkopen.2020.12563","article-title":"Association of Childhood Maltreatment with Suicide Behaviors among Young People: A Systematic Review and Meta-Analysis","volume":"3","author":"Angelakis","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/1524838016675479","article-title":"Pediatric Abusive Head Trauma Prevention Initiatives: A Literature Review","volume":"19","author":"Lopes","year":"2018","journal-title":"Trauma Violence Abus."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/4\/413\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:21:23Z","timestamp":1760106083000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/4\/413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,30]]},"references-count":74,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["children11040413"],"URL":"https:\/\/doi.org\/10.3390\/children11040413","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,30]]}}}