“Can you share an experience where you had to address a case of suspected child abuse or neglect? What was the most crucial factor in your approach to this sensitive situation?”
During my last year in the career I was in my pediatric rotation where the main goal was for us to learn how to properly examine an infant. First thing I learned was that you should see the skin of the child looking for bruises, scratching lesions and any skin condition there could be.
I was assigned to follow up a little girl, about 2 years old who was just admitted to be treated for pneumonia.
As I wanted to take out the most of all my rotations I didn’t limit to the pulmonary physical exam but decided to do a complete physical examination, that’s when I took off her diaper and I noticed some skin tags on her crotch that extended to her vulva and buttocks.
I discussed this with the PG resident who came with me to examine the child, then she took me aside and explained to me that those were not just skin tags but HPV warts.
To me that was shocking, I met the parents and they seem like good people.
This case was reported to the authorities and investigated resulting in sexual abused committed by a family friend that was living in the same house.
From that experience I understood the importance of being precise and meticulous when visiting a child.
Maybell Nieves, Surgical Oncologist, AlynMD
During my pediatric rotations, I saw a 4-year-old girl in the outpatient clinic presenting with whitish vaginal discharge and swelling around her private parts. It was a scary sight for me, and very traumatic. She lived with her busy, working parents, who often left her in the care of her uncle, and they never suspected any foul play, but I knew something was off immediately after I heard the story.
Despite the parents’ denial of any abuse, the history and physical findings strongly suggested otherwise, and I had to do my best to protect this girl. In my experience, the most crucial factor in cases of abuse is ensuring immediate protection by separating her from the suspected abuser, her uncle in this case. I also involved other members of the nuclear family in a sensitive discussion. We didn’t achieve this in one clinic visit, but we found a solution as the patient’s elder sister volunteered to take her to a safer environment in a different house. We also reported the case to the police, though the evidence was limited for legal action. At her follow-up visit, she appeared more cheerful than usual (I’ve always known her to be withdrawn), and she even hugged me. Separating her from the abuser was a big part of our care and we protected her from a lifetime of trauma.
Austin Anadu, Doctor, AlynMD
I had one situation that really stuck with me—one of those moments where your gut tells you something’s off, even if the signs are subtle. I was working closely with a child who had become increasingly withdrawn over a few weeks. I noticed small things at first: flinching at loud voices, coming to school with consistent bruising explained away as clumsiness, and frequently showing up hungry. I couldn’t ignore it.
I took a breath, checked my emotions, and reminded myself that my role was to listen and document—not jump to conclusions. I talked gently with the child and followed up by immediately reporting it through the proper mandated channels. I made sure the report was detailed, specific, and compassionate—because I knew how important that would be.
What I learned is that it’s never about being “sure”—it’s about being alert, responsible, and willing to act. I still think about that child and I’m glad I didn’t brush those signs off.
Please let me know if you will feature my submission because I would love to read the final article.
I hope this was useful and thanks for the opportunity.
Nick Bach, Owner and Psychologist, Grace Psychological Services, LLC
I once had to address a case of suspected child abuse when a child at my school showed signs of distress and had unexplained bruises. The most crucial factor in my approach was maintaining a calm, non-judgmental demeanor. I made sure to create a safe, private space to talk with the child, asking open-ended questions and giving them control of the conversation as much as possible. I also focused on listening carefully without pushing for details, knowing that children may be reluctant to speak up about sensitive topics. Afterward, I immediately reported my concerns to the proper authorities and followed the established protocols to ensure the child’s safety. The key takeaway was that, in these situations, empathy and clear communication are vital, and it’s crucial to act quickly, but always with care and professionalism.
Nikita Sherbina, Co-Founder & CEO, AIScreen
Recognizing financial red flags, such as unexplained withdrawals or misuse of funds meant for a child’s care, raised concerns. Collaborating with legal and social services ensured the situation was addressed appropriately and confidentially. Documenting financial irregularities provided critical evidence for authorities to investigate further. Maintaining sensitivity and professionalism throughout the process protected the child’s well-being and privacy. Supporting the family with financial guidance helped stabilize their situation during a challenging time.
Maintaining confidentiality and professionalism was paramount to protect the child and family involved. Ensuring clear communication with the appropriate authorities helped address the issue effectively and within legal guidelines. Prioritizing the child’s well-being guided every decision and action taken. Collaborating with social services and legal experts ensured a comprehensive and sensitive approach. Providing support and resources to the family helped foster stability during a difficult time.
Linda Chavez, Founder & CEO, Seniors Life Insurance Finder
In any situation involving suspected child abuse or neglect, the single most crucial factor is maintaining compassionate objectivity. Your immediate, unwavering priority is the child’s safety, which requires a swift, objective assessment. However, the approach must be grounded in compassion to effectively gather information and manage the therapeutic relationship with the family, which is often in crisis.
I recall a composite of cases where a young child was brought to my practice for issues like severe anxiety or disruptive behaviors. While the parents focused on the outbursts, I observed subtle but persistent signs of neglect: the child was consistently underweight, tired, and emotionally flat. Their patterns of play often hinted at a chaotic home environment, a common manifestation of trauma’s impact on a child.
These objective facts—missed medical appointments, the child’s physical state, and concerning narratives from play—created a clear picture. The collection of these details, rather than one single sign, is what met the threshold for my mandated duty to file a report with child protective services.
The crucial element here was separating my objective duty from any personal feelings of anger or judgment. As a mandated reporter, my role is not to investigate or accuse but to observe, document, and report the facts. By approaching the parents with compassionate inquiry rather than accusation, it allowed for a conversation about their own overwhelming struggles, which were contributing to the neglect.
This approach serves two purposes. First and foremost, it initiates the necessary protective measures for the child in the most direct way. Second, it keeps the door open for the parents to potentially engage with the very help they need to address the root cause of the neglect. The ultimate goal is to break a dangerous cycle, and that begins with ensuring a child’s safety through a process guided by professional, compassionate, and objective action.
Ishdeep Narang, MD, Child, Adolescent & Adult Psychiatrist | Founder, ACES Psychiatry, Orlando, Florida
You Don’t Hesitate—You Act.
At Ridgeline Recovery, we work with individuals whose trauma runs deep, and sadly, that includes survivors of child abuse. One case that’s stayed with me was when a young client—barely 18—broke down during a routine group session. Her language was vague, but any experienced clinician knows what to listen for when someone talks around pain they’ve normalized.
The moment we suspected ongoing abuse involving younger siblings still in the home, we didn’t wait for “confirmation.” We followed protocol, contacted child protective services, and documented every detail—word for word, time-stamped, factual. No speculation. Just clear, clinical reporting.
The most crucial factor? Clarity over comfort. You don’t soften the truth, you document it. You don’t play investigator, you play protector. And above all, you protect the client’s dignity in the process. We made sure she felt safe, believed, and supported—without ever making her feel like a “case.”
This isn’t just about ethics—it’s about trauma-informed care. How you handle that first disclosure can either re-traumatize someone or become the turning point in their healing. The way we responded built trust. She stayed in treatment. And her siblings got out.
So to any provider reading this: Don’t freeze. Don’t overthink. Know your duty, train your team, and act with precision and compassion. That’s what saves lives.
Andy Danec, Owner, Ridgeline Recovery LLC