Glossary of Terms

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Abandonment – The act of a parent or caretaker leaving a child for an excessive period of time without adequate supervision or provision for the child's needs.  State laws vary in defining adequacy of supervision and the length of time a child may be left alone or in the care of another before abandonment is determined. The age of the child is also an important factor in determining whether the child has been abandoned.

Abdominal Distention – Swelling of the abdomen (the area located between the chest and pelvis), which may be caused by internal injury, bowel blockage or malnutrition.

Abnormal – Deviating from the standard; not average, typical or usual.

Abrasion – A wound in which either skin or mucous membrane have been scraped off.

Accidental Death – A mode of death indicating non-intentional trauma.  See Mode of Death, Intentional and Non-Intentional Injury.

Accountability – The measurable extent to which an organization, individual or the general public keeps the promises made to the people served.  Most often this involves providing assurance to someone or some organization that expected action occurred.

Accused – See Defendant.

Acute – In medicine, refers to a health effect that is brief, intense and short term (as compared to chronic).

Acute Pancreatitis – An acute inflammation of the pancreas (the organ in the body which produces and secretes the enzymes which aid digestion).  Symptoms include severe abdominal pains, nausea and fever.  In children, trauma should be considered as a possible cause.

Addiction – Over-dependence on the intake of certain substances (such as alcohol, nicotine and other drugs). Inability to overcome a habit or behavior pattern.

Adjudication (Adjudicatory Hearing) – In a child welfare case, the hearing in which the court determines whether a child has been maltreated or whether there is some other basis for the court to take jurisdiction (or authority) over the case.  The grounds upon which the court may take jurisdiction vary from state to state.  If the court finds that there is a basis for jurisdiction, the next stage of the process is the disposition hearing.

Adoption – A legal process that vests all legal rights and responsibilities of parenthood in persons other than the child’s biological or previously adoptive parents.

Anemia – Any condition in which the number of red blood cells (carriers if oxygen throughout the body) are less than normal.

Anorexia – Lack or loss of appetite for food.

Anorexia Nervosa – A personality disorder manifested by an extreme aversion to food.  It usually, but not exclusively, occurs in young women.  May include binging and purging (Bulimia). 

Anterior – In human anatomy, the front surface of the body. 

Apnea – The absence of breathing. 

Appeal – In law, resort to a superior (appellate) court or administrative agency to review the decision of an inferior court (trial or lower appellate) or administrative agency.

Arraignment – One of the first steps in the criminal process in which a defendant is formally charged with an offense and informed of his/her constitutional rights.

Asphyxia – Death caused by being deprived of oxygen.  Can be caused by strangulation, suffocation, choking or smothering.

Assault – The attempt to inflict bodily injury on another person, with unlawful force and the apparent ability to inflict the bodily injury unless stopped.  Assault is both a crime and a tort (private/civil wrong).

Atrophy – Wasting away of flesh, tissue, cell or organ.

Autism – A syndrome appearing in childhood with symptoms of self-absorption, inaccessibility, aloneness, inability to relate to others, highly repetitive play and language disturbances.  The cause is unknown.

Autopsy – The dissection of a dead body for the purpose of inquiring into the cause of death.  Post mortem examination to determine the cause or nature of a disease.  An autopsy is normally required by statute for cases of violent, unexpected, sudden or unexplained deaths.


Baby Gram – (Slang) One or two x‑rays taken in order to see all of a baby’s body at one or two angles (often inadequate).

Battered Child Syndrome – A term describing a combination of physical and other indicators that a child’s internal and external injuries result from acts committed by a parent or caretaker. 

Birth Parent – A parent to whom a child is born.  Also called “biological” or “natural” parent.

Blunt Force Trauma – Injury caused by force from a blunt object (such objects may include hands and feet). 

Bone Scan – A nuclear medicine study that can assist in diagnosis of early or minimal fractures, especially in children under two years of age where bones have not yet ossified.

Brain Stem – Portion of the brain connecting the cerebrum and the cerebellum to the spinal cord.

Bruise – An injury that does not break the skin but causes ruptures of the small underlying vessels with resultant discoloration of tissues.  Organs can also be bruised, e.g., brain, kidneys.  Synonymous with contusion and ecchymosis.  See also Hemorrhage.

·    Petechiae – Very small bruises caused by broken capillaries.

·    Purpura – Petechiae occurring in groups or a small bruise up to one centimeter in diameter.

·    Ecchymosis – Bruise larger than one centimeter in diameter.

Burn – A wound resulting from the application of heat, cold, electricity or chemicals to the body.  Burns are classified in terms of the degree of damage.

·    First Degree (Partial Thickness)– Injury limited to the epidermis (outer skin layer).

·    Second Degree (Partial Thickness) – Injury through the epidermis and dermis, typically causing the formation of blisters.

·    Third Degree (Full Thickness) – Destruction of the entire skin, including nerve fibers.


Calcification – Process in which organic tissue becomes hardened by the deposition of lime salts in the tissues, e.g., the formation of bone.  Seen through x-rays, the amount of calcium deposited indicates the degree of healing of a broken bone or the location of previous healed fractures.  See Callus.

Callus – The hard bone-like substance that forms around the site of fractured bones and gradually fuses with underlying bone as the fracture heals.  It is visible on x-ray about a week after injury.  See Calcification.

Calvaria (Calvarium) – The upper dome-like portion of the skull, composed of the superior portions of the frontal, parietal and occipital bones.

CAPTA – See Child Abuse Prevention and Treatment Act.

Caretaker – In child welfare, a person responsible for a child’s health or welfare.  This may be the child’s parent or guardian, another person within the child’s own home or relative in a relative’s home, foster care home or residential institution.

Cartilage – Hard connective tissue that is not bone.  In the fetus and growing child, cartilage is the forerunner of bone before calcium is deposited to form bone.

Case – In child welfare, refers to both to the process of a child and family through the child welfare agency and to the process of the child and family through court.

Case Management – A systematic approach to social work in which an emphasis is placed on the system in which a client must function, rather than on inner thought processes.  Case management requires identification and coordination of the multiple services required by the client.

Case Plan – In child welfare, a written document which contains at least: (1) a description of the home or institution in which the child is placed; (2) a plan for assuring that the child receives proper care and that services are provided which will reduce risk, promote healthy family functioning or facilitate the child’s return home or to another permanent placement; and (3) the child’s health and education records.

Case Planning – The continuous process engaged in by a child welfare agency in developing and modifying a child’s or family’s case plan.

Case Worker – The staff member of a child welfare agency who is responsible for working with a child or family.

CAT Scan (Computerized Axial Tomography) – a radiological study using x-rays translated by computer to show body cross sections.  See MRI

Cause of Death – The effect or condition that brought about the cessation of life (e.g., trauma, asphyxia or cancer).

Central Registry – The system maintained at the Michigan Department of Human Services that is used to keep a record of all reports filed with the DHS under Child Protection Law in which relevant and accurate evidence of child abuse or neglect is found to exist. 

Cerebral – Pertaining to the brain.

Cerebral Edema – Swelling of the brain due to accumulation of watery material.

Child – Person under 18 years of age.  Synonymous with minor.

Child Abuse – Harm or threatened harm to a child’s health or welfare that occurs through nonaccidental physical or mental injury, sexual abuse, sexual exploitation, or maltreatment, by a parent, a legal guardian, or any other person responsible for the child’s health or welfare or by a teacher, a teacher’s aide, or a member of the clergy.

Child Abuse Prevention and Treatment Act (CAPTA) – An act introduced and promoted in Congress by US Senator Walter Mondale and signed into law on January 31, 1974.  The Act emphasized multidisciplinary approaches to child abuse and neglect.  Codified at 42 USC § 101 et seq.

Child Death Review Case Report – A standardized form required for collecting data on child fatalities meeting the criteria for review by the Child Death Review Teams.

Child Death Review Team (CDRT) – Representatives from the county office of the medical examiner, county Department of Human Services, public health department, office of the prosecuting attorney and law enforcement.  May contain additional membership.

Child Development – Pattern of sequential stages or interrelated physical, psychological and social development in the process of maturation from infancy and total dependence to adulthood and relative independence.

Child Maltreatment – See Child Abuse.

Child Neglect – Harm or threatened harm to a child’s health or welfare by a parent, legal guardian, or any other person responsible for the child’s health or welfare that occurs through either of the following:

(i)        Negligent treatment, including the failure to provide adequate food, clothing, shelter or medical care.

(ii)       Placing a child at an unreasonable risk to the child’s health or welfare by failure of the parent, legal guardian, or other person responsible for the child’s health or welfare to intervene to eliminate that risk when that person is able to do so and has, or should have, knowledge of the risk.

Child Protective Services (CPS) – (Common) The welfare department/social service system designed to protect children.  The entity that receives and investigates reports of suspected child maltreatment and provides services to children and families to ameliorate past maltreatment and prevent future maltreatment. In Michigan, this entity is a part of the Department of Human Services.

Child Welfare and Adoption Assistance Act (Public Law 96-272) – A federal law passed in 1980 intended to prevent multiple foster care placements and increase effective permanency planning for children in foster care.  Case plans, findings of reasonable effort, periodic reviews and dispositional reviews are among its requirements for states wanting a share of money appropriated under the Act.

Child Welfare Court – The court that hears child welfare cases (emergency removal, adjudication, disposition, review, termination or parental rights).  Sates have different names for this court, including family court, juvenile court, and dependency court.

Choking – When the upper airway is blocked by a foreign object.

Chronic – In medicine, developing slowly and persisting for a long period of time.

Citizen Review Panel – A panel established as required by Section 106 of Title I of CAPTA.

Civil Court – Courts established for the adjudication or controversies between individual parties, or the ascertainment, enforcement, and redress of private rights.  The court which hears child welfare cases is a civil court.

Clotting Factor – Material in blood that causes it to coagulate or clot.  Deficiencies in clotting factors can cause profuse internal bleeding and bruising, as in the disease hemophilia.  Bruises or bleeding caused by clotting factor deficiencies may be mistaken for abuse.

Coagulation – The process of clotting.  The body’s process of healing itself when blood is released from an injured vessel.

Coagulation Studies – Blood tests done to diagnose or rule out possible clotting factors diseases.

Coining – A Southeast Asian folk remedy in which the edge of a coin is repeatedly rubbed over the body, generally the upper torso, windpipe and inner arm.  The result is a series of reddish to purple vertical bruises resembling strap marks, which vary in depth and severity.  The bruises are believed to be an indicator for the evil spirits of a disease to exit the body.

Colon – The part of the large intestine that connects the small bowel (ileum) with the rectum.

Colposcope – Optical instrument for low power magnification of the external genitalia as well as the vagina and cervix.  Used for detection of sexual injuries.  Also used for detection of ano-rectal injuries.

Competent Intent – The desire to cause an event to happen by someone with the ability to form that intent (some say a child under the age of 8 does not have the ability to form competent intent).

Concussion – An injury to the brain caused by a violent jarring or shaking, or a blow to the brain.  After a mild concussion there may be a brief loss of consciousness with a headache on awakening.  A severe concussion may cause lengthy unconsciousness and disruption of breathing or other vital functions of the brainstem.

Confidentiality Statement – A standardized form, approved by the jurisdictional authority, which must be signed by all participants in the review process.

Congenital – Those mental or physical traits, malformations, disease, etc., that are present at birth.  May be hereditary or due to some influence during gestation.

Contusion – See Bruise.

Corporal Punishment – Physical punishment inflicted directly upon the body.

Cortex – The outer layer of an organ.

Cranium – The skull.

Crime Scene – The physical site where a crime may have occurred.  See Death Scene. 

Criminal Court – A court designated to hear matters relating to criminal law, this court hears cases involving the crime of child abuse.

Crisis Intervention – In social work, the purposeful activities and involvement of a helping a person at the point that another person or family is caught in acute, disabling distress due to situational events.  The intervention includes rapid response to move the client from emotional disorganization to rational problem solving through time-limited counseling and other services.

Cupping – A folk remedy in which an alcohol-soaked material is ignited in a small cup or jar.  After the flame is extinguished, the cup is placed over the skin and the resulting suction forces the tissue into the mouth of the cup.  The cup is left in place for approximately 20 minutes.  Cupping results in a two-inch circular, unraised, burn.  Wounds usually are produced in symmetrical, vertical rows, in clusters of two and four on the right and left side of the chest, abdomen and back, or in smaller groupings on the forehead.

Custody – In law, the right to care and control of a child and the duty to provide that child’s food, clothing, shelter, ordinary medical care, education and discipline.  Parents are the natural custodians of their child. However, a court may grant temporary custody to someone other than a parent, pending further action or review by the court.

Cutaneous – Pertaining to the skin.

Cyanosis – Purplish or bluish discoloration of the skin and mucous membranes, caused by a lack of oxygen in the blood.


Death – The cessation of life, manifested in people by a loss of heart beat, absence of spontaneous breathing, and the permanent loss of brain function; loss of life.  See Fatality.

Death Certificate – Official document noting the cause and manner of death.  See Cause, Manner and Fetal Death Certificate.

Death Scene Investigation – An attempt by a person functioning in an official capacity to gather information at the site where a fatal illness, injury or event occurred, for the purpose of determining the cause and circumstances of the death.

Defendant – In civil proceedings, the party responding to the complaint brought by the plaintiff.  In criminal proceedings, the person accused of a crime, synonymous with accused.

Dehydration – A large loss of fluid from the body tissues.  It may occur after fever, diarrhea or vomiting.  It may also be a result of neglect.  Dehydration is particularly dangerous in infants and young children.

Depression – In psychology, a mood disorder in which there are extreme feelings of helplessness, hopelessness, inadequacy or sadness.

Dermis – Inner layer of skin.

Diaper Rash – A skin irritation in the diaper area.  Possible causes include yeast infections, bacterial infections, urinary tract infections, parasitic infestations, contact irritation from soaps or diaper wipes, infrequent diaper changes or poor hygiene.

Differential Diagnosis – The determination of which two or more diseases with similar symptoms is the one from which the patient is suffering.  For example, osteogenesis is a differential diagnosis for child abuse.

Discipline – Behavior that educates and corrects or punishes.

Disposition – In Child Protective Services, the finding of the validity of a report of child maltreatment that is made by the caseworker after investigation.

Disposition Hearing – In child welfare court cases, a court hearing which determines whether a child needs or requires the court’s assistance, guidance, treatment or rehabilitation and, if so, the nature of that assistance, guidance, treatment or rehabilitation.

Disposition Review – In a child welfare court case, a hearing in which the court reviews the child’s case to ensure that a permanency plan is being implemented in the child’s best interest.

Distal – The parts of the body, limbs, or organs, that are farthest from the trunk or point of origin.

Due Process of Law – The right of persons under the 5th and 14th Amendments to the U.S. Constitution to procedural and substantive fairness in situations in which the government would deprive the person of life, liberty or property.

Dura Mater – The tough fibrous membrane covering the brain and the spinal cord.


Ecchymosis – See Bruise.

Ecological - In the behavioral and social sciences, refers to the consideration of the interaction of personal, physical, behavioral, social, cultural, medical, economic, environmental and systemic determinants when analyzing the behavior of individuals, families, groups and systems.

Edema – Swelling caused by an excess of fluid in the body tissues.

Emergency Medical Services – The complete chain of human physical resources that provide patient care in cases of sudden illness or injury.

Emergency Medical Technician (EMT) – A professional provider of emergency care.  An EMT receives formal training and certification.  There are three levels of emergency medical technicians.

·  EMT Basic – Can administer oxygen and initiate defibrillation but is not allowed to perform any type of invasive care.

·    EMT Intermediate – Has passed specific training programs in order to provide some level of advanced life support, for example, the initiation of intravenous lines and administration of some medications.

·  EMT Paramedic – Has successfully completed paramedic training and has received appropriate certification.  EMT paramedics can generally perform relatively invasive field care including insertion of endotracheal tubes, initiation of intravenous lines, administration of medications, interpretation of electrocardiograms and cardiac defibrillation.

Emergency Removal Hearing – An immediate hearing held by the child welfare court which determines whether to continue emergency out-of-home placement for an allegedly maltreated child. 

Environmental – Pertaining to all of the many factors that affect the life of a person, including physical and psychological.

Epidemiology – The study of the spread, prevention, and control of disease in a community or a group of persons.

Epidermis – The outer most skin layer.

Epiphysis – The rounded ends of a long bone. 

Evidence – In law, something that makes another thing evident or tends to prove that a fact at issue is true.

·     Circumstantial – Evidence of a fact from which another fact can reasonably be inferred.

·  Direct – Evidence which is presented in the testimony of a witness who has direct knowledge of the fact being proved.

·    Hearsay – An out of court statement intended to prove the truth of the matter being asserted.  Hearsay evidence is usually excluded from court proceedings because it is considered unreliable and because the person making the original statement cannot be cross-examined.

·    Opinion – Witnesses are ordinarily not permitted to testify as to their personal beliefs or opinions, being restricted instead to reporting what they actually saw or heard.  However, a witness can give an opinion if qualified as an expert.  See Expert Witness.

·    Physical – Any tangible piece of proof.  Physical evidence usually must be authenticated by a witness who testifies to the connection of the evidence (called an exhibit) with other facts of the case.

·    Prima Facie – Evidence that will suffice as proof of the fact in issue until its effect is overcome by other evidence.

Examination – In law, the questioning of a witness.

Expert Witness – Someone the court determines to have expertise on a subject (does not necessarily require any graduate degree).  The witness may qualify as an expert through experience, training or education.  Only an expert witness may testify in the form of opinion. 

Expungement – Destruction of records.  In child welfare, expungement means the removal from the Central Registry of certain reports of abuse or neglect. 

Extremity – Portion of the body that is not a part of the trunk (e.g., arms, legs). 


Failure to Thrive – A medical condition seen in young children where a child does not gain weight.  It may be associated with a decrease in the rate of growth or in a growth rate that is significantly below norm.  The cause may be organic (natural) or non-organic, such as poor nutrition, inadequate food intake, or inappropriate formula preparation. 

Family Court – Court designated to hear matters pertaining to family law (e.g., divorce and child custody). See Child Welfare Court. 

Family Dynamics – Interrelationships between and among individual family members.  The evaluation of family dynamics is an important factor in the identification, diagnosis and treatment of child abuse and neglect. 

Family Dysfunction – Ineffective functioning of the family as a unit or of individual family members in their family roles because of the physical, mental or situational problems of one or more family members. 

Family Preservation Services – Services provided which support the principle that a child should be maintained in the family if the child’s safety can be ensured. 

Family Reunification Services – Services which support the principle that the preferred permanency plan for a child in foster care is the return to the family if the child’s safety can be ensured. 

Fatality ‑ Loss of life.  See Death. 

Felony – Generally, any criminal offence for which the penalty is imprisonment for more than one year. Murder, rape and armed robbery are crimes usually considered felonies. 

Felony Murder – See Homicide. 

Fetal Alcohol Syndrome – A congenital syndrome caused by intrauterine exposure to alcohol.  Characteristics include intra and extrauterine growth retardation, microcephaly (small head) and mental retardation. 

Fetal Death ‑ (Common) Death of pregnancy after approximately 20 weeks. 

Fetal Death Certificate ‑ Official document noting the death of a fetus (note ‑ does not include a space for manner of death.) See Manner of Death. 

Fontanelle (Fontanel) – The two soft areas (“soft spots”) on the head of an infant where the bones are not yet joined.  One soft spot disappears at about two months and the other at about eighteen months of age. A bulging fontanelle may indicate increased pressure in the skull.  A sunken fontanelle may indicate dehydration. 

Forensic – Having to do with the study of criminal acts. 

Forensic Pathologist – A pathologist with training in criminal pathology.  See Board Certified. 

Foster Care – Placement for children under dependency court jurisdiction (note ‑  this includes single family homes, group homes with no more than six children or institutions with many children).  Includes continuous 24-hour care and supportive services provided for a child while the child needs substitute care outside of the child’s family. 

Foster Family Home – A type of foster care that is provided in a family setting. 

Fracture – Any break or crack in bone or cartilage.

·    Basilar Skull – A fracture to the base of the skull which will often result in spinal fluid leaking from the nose or ear.

·    Bucket Handle Tears – Total fracture of a long bone so that it is floating loose.

·  Chip – A small piece of bone is separated from the main body of the bone; avulsion fracture.

·    Comminuted – A bone broken into a number of pieces.

·    Compound – A broken bone that protrudes through the skin.

·    Egg Shell – A fracture of the skull that looks like a broken egg on an x-ray.

·  Greenstick – The bone is bent and there is an incomplete fracture in the convex side of the curve.  Common among young children.

·    Incomplete – The line of the fracture does not include the entire bone.

·    Occult – A fracture that is not visible on x-ray.

·    Pathologic – A fracture occurring at a site weakened by a preexisting disease, as seen in osteogenesis imperfecta, tumors or Gaucher’s Disease.

·    Simple – A break in a bone without displacement of the bone pieces.

·  Spiral – A break in a long bone which is spiral shape, resulting from twisting of the extremity.


Gaucher’s Disease – A rare, familial disease in infants, which may cause fractures.  Gaucher’s Disease is a differential diagnosis for child abuse. 

Gross Examination – In medicine, a physical examination without the aid of radiologic instruments or surgical entry. 

Group Home – A type of foster care in which care is provided in a small group setting. 

Guardian – An adult who is legally responsible for a child.  A guardian has almost all the rights and powers of a parent, but the legal relationship is subject to termination and change.  A guardian may also have physical custody of the child. 

Guardian ad litem – A lawyer or non-lawyer who represents the best interest of a child in a child welfare court proceeding.


Hematemesis – Vomiting of bright red blood, often resulting from internal injury. 

Hematoma  Swelling caused by the accumulation of blood in the body tissues.

·    Intramural of the Duodenum – A hematoma occurring in the wall of the duodenum.  Occurs only from trauma.

Hemophilia – An inherited disorder of the blood in which there is a defect in its ability to clot, resulting in a tendency to hemorrhage. 

Hemorrhage – Bleeding.

·    Intra-abdominal – bleeding within the abdomen.

·    Intracerebral – Bleeding within the brain.

·    Intracranial – Bleeding within the skull.

·    Intradermal – Bleeding within the skin.  See Bruise.

·   Retinal – Bleeding into the inner lining of the eye, hallmark of whiplash and Shaken Baby Syndrome.

Hemostaiss Screen – A laboratory study performed to determine whether or not a child has a bleeding or bruising tendency. 

Hepatic – Pertaining to the liver. 

Homicide –  Death caused by another with the intent to kill or severely injure.

· Murder – The unlawful killing of a human being with malice aforethought.  Malice aforethought requires premeditated intent plus an element of hatred.

·   Felony Murder The unintentional killing of a human being during the commission of a felony.

·    Manslaughter – An unlawful killing of a human being without malice aforethought.

·   Voluntary Manslaughter – An intentional killing committed under circumstances which, although they do not justify the homicide, mitigate it.

·  Involuntary Manslaughter – Criminally negligent homicide, such as a death resulting from the negligent operation of a motor vehicle. 

Homicide Detective (Investigator) – A police or sheriff department investigator with an expertise in homicide investigations. 

Hospital Shopping – The use by a person or family of different medical facilities so that each individual medical facility’s sole contact with the person or family is a single presenting injury.  This is often done in an attempt to hide a pattern of abusive injuries.  

Hydrocephalus – “Water on the Brain,” in infants, an accumulation of fluid in the subarachnoid or subdural spaces of the brain. 

Hyperactive – More active than normal.  The term becomes synonymous with Attention Deficit Disorder with Hyperactivity (ADDH or ADHD or ADD), that is characterized by inattention, impulsivity, and hyperactivity. 

Hyperthermia – High body temperature. 

Hyphema – Hemorrhaging into the anterior chamber of the eye, often appearing as a bloodshot eye.  Blows to the head or violent shaking are two possible causes.  See Hemorrhage-Retinal. 

Hypothermia – Low body temperature. 

Hypothalamus – The portion of the brain which controls and integrates functions such as general regulation of water balance, body temperature, sleep, food intake, and the development of secondary sex characteristics.


Identification with the Aggressor – In psychology, a defense mechanism consisting of imitation of the aggressor. 

Impassivity – A state of not feeling or showing emotion. 

Incest – Sexual intercourse between persons who are closely related by blood.  While incest between parent and child or siblings is almost universally forbidden, various cultures may extend the boundaries to prohibit intercourse with other relatives.  In the U.S., the prohibition against incest is specified by state laws as well as by cultural tradition.   

Incidence – In epidemiology, the extent to which a problem occurs in a given population. 

Independent Living – A possible permanency plan for a child in foster care in which the goal is self-sufficiency after discharge from foster care. 

Indian Child Welfare Act (ICWA) – A federal law which specifies the manner in which child welfare agencies and child welfare courts must handle cases involving Native American and Alaska Native Children. 

Infant – Child under one year of age.  See Neonate. 

Infanticide – The killing of an infant. 

Injury – Refers to any force, whether it be physical, chemical, thermal or electrical, that results in harm or death. 

Intentional Injury Death – Public health term used to define death caused by another with the intent to cause harm.  See Competent Intent. 

Intern Student trainee, also refers to a physician’s first year of work after medical school. 

Intraocular – Within the eye. 

Intravenous – Within a vein. 


Judgment – The court’s final decision. 

Jurisdiction – A court’s or other entity’s authority over a case.


Kinship Care (Relative Placement) – Residential care giving provided to children by non-parental relatives. Kinship care may be full-time or part-time, temporary or permanent, and may be initiated by private family agreement or under the custodial supervision of the Department of Human Services. 


Laceration – A torn or jagged wound caused causing a splitting or tearing in the external skin surface in addition to the deep tissue. 

Lateral – Occurring on, or pertaining to, the side. 

Lesion – Any injury to any part of the body from any cause that results in damage or loss of structure or function of the body tissue involved.  A lesion may be caused by poison, infection, dysfunction or violence, and may be either intentional or unintentional. 

Lethargy – A state marked by loss of energy, inactivity, sluggishness or excessive drowsiness. 

Leukemia – A malignant disease of blood forming elements.  Children suffering from leukemia may present petechiae or bleeding which should be considered in the differential diagnosis of children who bruise easily. 

Long Bones – Bones of the arms (ulna, radius, humerus) and legs (femur, tibia, fibula).


Malnutrition – A condition caused by inadequate nourishment. 

Maltreatment – See Child Abuse and Neglect. 

Mandated Reporters – Persons designated by state law who are legally responsible for reporting suspected child abuse and neglect to the mandated agency within their state.  Mandated reporters vary according to state law, but are primarily professionals, such as doctors, nurses, school personnel, and social workers who have frequent contact with children and families. 

Mandible – The bone of the lower jaw. 

Manner of Death – The legal classification, whether natural, suicide, homicide, accidental or undetermined. 

Manslaughter – See Homicide. 

Mechanism of Death – The physical reason for a death (e.g., head trauma caused brain swelling which caused decreased brain function which caused the heart and/or lungs to stop functioning). 

Medial – Towards the middle or mid-line. 

Medical Cause – Refers to death resulting from a natural cause. 

Medical Examiner – An official whose duty it is to investigate sudden, suspicious or violent death to determine the cause.  

Medical Examiner Investigator – An official investigator for the county medical examiner, to assist in the investigation of a case to determine cause and manner of death. 

Medical Neglect – Generally, the repeated failure of parents or caretakers to comply with recommendations from medical professionals for the treatment of a child’s condition.  

Menkes Kinky Hair Syndrome – A rare, genetic disorder which blocks absorption of copper in the gastrointestinal system, causing brittle bones and eventual death.  It is a differential diagnosis for child abuse. 

Mesentery – Membranes which cover abdominal organs and attach the bowel to the abdominal wall.  The mesentery may be injured in interabdominal trauma or inflames, as with peritonitis. 

Minor – Synonymous with Child. 

Misdemeanor – Criminal offenses that are less severe than felonies and generally punished by lesser fines or by jail terms which do not exceed a year. 

Mongolian Spot – A type of birthmark that appears most frequently on a child’s lower back or buttocks, most frequently in people of color.  These dark pigmented areas usually fade by age five.  They are sometimes confused with bruises. 

Multidisciplinary Team – In child welfare, a group of professionals representing various disciplines who meet to coordinate their efforts in diagnosing and treating specific cases of child abuse and neglect.  A multidisciplinary team may also address the general problem of child abuse and neglect in their community.  See Local Child Death Review Team. 

Munchausen's Syndrome by Proxy – A pattern of abuse in which the perpetrator, usually a parent, will fabricate medical histories, inflict physical findings, alter laboratory specimens and induce disorders in a child to give the appearance that the child is ill.  The perpetrator gets reinforcement for this behavior in the attention of the medical staff who attempt to diagnose and treat the child.

Murder – See Homicide.


Natural Cause – Death resulting from inherent, existing conditions.  Natural causes include congenital anomalies, perinatal conditions, infectious disease and other medical causes. 

Neglect – See Child Neglect. 

Negligence – In the law, doing something that a person of ordinary prudence would not do, or the failure to do something that a person of ordinary prudence would do, under given circumstances.

Neonate – Infant under one month of age. 

Neurologic Sequelae – A diseased condition of the nervous system resulting from previous disease.  In abused children, the condition may result from previous abuse.


Occipital – Back of the head. 

Ossification – The process during which immature or new bone or cartilage is converted into bone.

Osteogenesis Imperfecta – A genetic condition which causes bone to be brittle and prone to fracture.  It is a differential diagnosis for child abuse.


Paramedic – See EMT-Paramedic. 

Pathognomonic – Specifically distinctive or characteristic of a disease or pathologic condition; a sign or symptom on which a diagnosis can be made. 

Pathologist ‑ Physician with residency training in pathology.  See Forensic Pathologist, Pediatric Pathologist and Forensic Pediatric Pathologist. 

Pediatrician – Physician who has completed residency training in pediatrics.

Pediatric Pathologist – Physician with special training in pediatrics and pathology.  See Board Certified. 

Perinatal – The period of time from around the twenty-eighth week of gestation through the first seven days after delivery. 

Perineum – Region of the body between the anus and the genitals. 

Periodic Review – In child welfare, the six-month review of cases of children in out-of-home care required by Public Law 96-272 and state law. 

Periosteal Elevation (Hemorrhage) – The tearing away or lifting up of the bone's covering, from the hemorrhaging that occurs when a bone is broken or there has been bleeding under the periosteum.  This is not necessarily indicative of child abuse, as it can be due to leukemia or infiltrative disease such as tumors or inflammation.  It may be present at birth from a difficult delivery. 

Periosteum – The outer covering of bones that is essential for bone formation and healing.

Peritoneum – The lining of the abdomen. 

Peritonitis – Inflammation of the membranous lining of the abdominal cavity. 

Perjury – Knowingly and willfully giving false testimony under oath. 

Permanency Plan – In child welfare, a plan for implementing the most permanent long-term living situation possible for a child, consistent with the child’s best interest.  This plan specifies where and with whom a foster care child shall live, and the proposed legal relationship between the child and the permanent caretaker or caretakers. 

Permanency Planning – The process by which a welfare agency with responsibility for the child in foster care develops a permanency plan for a child.

Perpetrator – In child welfare, a person(s) who committed an act that resulted in the injury or death of a child. 

Petechiae – See Hemorrhage – Intradermal. 

Petition – In the law, a formal, written request to the court that it do something.  The petition is a pleading that begins a court case.  It contains the facts and circumstances upon which a court is asked to provide certain relief as well as the relief being sought. 

Physical Abuse – See Child Abuse. 

Pia Mater – The fine vascular membrane that envelopes the brain and spinal cord.  It is located below the arachnoid and the dura mater. 

Plaintiff – In a civil case, the person who files a lawsuit. 

Pleadings – In the law, formal allegations of the claim and defenses raised by the parties to the court case. 

Posterior – In human anatomy, the back surface of the body. 

Postpartum Depression – Depression which may occur after child birth.

Premature Infant – An infant born before thirty-eight weeks gestation. 

Prenatal – Occurring before birth. 

Preventable Death – A child’s death is considered to be preventable if the community (through legislation, education, etc.) or an individual (through reasonable precaution, supervision or action) could have done something which could have changed the circumstances that led to the death. 

Probable Cause – In the law, a requisite element of a valid search and seizure or of an arrest, which consists of the existence of facts and circumstances within one’s knowledge, that are sufficient to warrant the belief that a crime has been committed (in the context of an arrest) or that property subject to seizure is at a designated location (in the context of a search and seizure).  Whether probable cause exists depends on the independent judgment of a “detached magistrate.” 

Prosecution – The act of pursuing a lawsuit or criminal trial; also, the party initiating a criminal suit. 

Proximal – Those parts of the body, or portions of the bone, that are closest to the trunk or to the point of origin. 

Psychosis – In psychology, a mental disorder causing gross impairment of a person’s mental capacity, affecting response and capacity to recognize reality. 

Public Law 96-272 – See Child Welfare and Adoption Assistance Act. 

Purpura – See Hemorrhage – Intradermal.


Radiolucent – In medicine, a part of a body or object which permits the passage of x-rays without leaving a shadow on the film.  Soft tissues are radiolucent, bones are not. 

Rarefaction – Loss of density; on an x-ray, an area of bone which appears lighter than normal is in a state of rarefaction indicating a loss of calcium. 

Rationalization – In psychology, attempting to prove that one’s behavior is “rational” and justifiable, and thus worthy of self and social approval.

Reaction Formation – In psychology, the substitution of behavior, thoughts, or feelings which are diametrically opposed to the person’s own unacceptable ones.  For example, a parent feels guilty about lack of bonding with the child and instead overindulges the child. 

Reasonable Effort – In child welfare, the ordinary diligence and care by a child welfare agency to identify child protection problems and provide services to solve those problems so as to prevent out-of-home placement or promote family reunification. 

Reconsideration – In child welfare, the process of periodically reassessing and redeveloping the permanency and case plans. 

Recurrent Otitis Media – Repeated inflammation of the middle ear.  It is the leading cause of hearing loss in children. 

Regression – In psychology, retreating to an earlier developmental level involving less mature responses and, usually, a lower level of aspiration. 

Regulation – For a governmental agency, directions for the operation of the agency, developed by the agency to implement its statutory responsibilities.  Regulations have the force and effect of law when issued following notice to the public and an opportunity for the public comment. 

Relative Placement – See Kinship Care. 

Repression – In psychology, a defense mechanism in which the person is unable to remember disturbing feelings, thoughts, or experiences. 

Resident In medicine, a post-intern trainee in an official training program (e.g., pediatrics). 

Retinal hemorrhage – Bleeding in the retina of the eye. 

Risk Assessment – A structured gathering and evaluation of information related to factors in a child’s family, home environment, temperament and conditions, to determine the presence, level and type of risk(s) to the child’s current and future safety and welfare.  As relevant factors change, risk assessment must therefore be conducted over the life of a case.  Also refers to the form used in this process. 

Risk Factors – Refers to a person, thing, event, etc., that put an individual at an increased likelihood of incurring injury, disability or death. 

Rubella – An infectious viral disease with particular effects on fetuses (possibly causing abnormalities) or newborn infants.  One of the early manifestations may be petechiae or easy bruising.  There also may be associated bone lesions that may be confused with child abuse. 

Rupture – The break of an organ or other soft part.


Sacral Area – Lower part of the back. 

Sclera – The rough white outer layer of the eyeball. 

Search Warrant – An order issued by a judge and directing certain law enforcement officers to conduct a search of specified premises for specified things or persons, and to bring them before the court.  Use of a search warrant is required by the 4th and 14th Amendments to the U.S. Constitution. 

Secondary Infection – Infection by a microorganism following an infection by another microorganism.

Seizure – Involuntary muscular contraction and relaxation originating from the “short circuit” of the central nervous system.  Seizures vary in pattern, length and intensity.  Causes include fever, tumors, injuries or epilepsy. 

Sequelae – The aftereffects of an injury or disease process.  In child abuse, this term usually refers to the psychological or physical outcomes which result from being abused or neglected. 

Serology – The study of blood serum for evidence of infection. 

Sexual Abuse See Child Sexual Abuse. 

Sexually Transmitted Disease (Infection) (STD or STI) – Disease transmitted by sexual contact, including chlamydia, trichomonas, gonorrhea, syphilis, hepatitis B, and HIV.  The presence of a STD in a child is an indicator of possible sexual abuse.  However, some STDs are passed on to the fetus during pregnancy or at birth. 

Shaken Baby Syndrome – Characterization of head injuries to a young child caused by shaking.  Injury to an infant or child resulting from violent, repetitive shaking.  Pathognomonic findings include intracranial hemorrhaging, retinal hemorrhaging, and no cutaneous manifestations of injury.  Survivors are frequently left with profound neurologic sequelae, e.g., blindness, deafness, mental retardation, cerebral palsy, and seizures.

Shaken Impact Syndrome – Characterization of head injuries to a young child occurring with both shaking and impact. 

Shelter Hearing – See Emergency Removal Hearing. 

Skeletal Survey – A series of x-rays taken of all the bones of the body. 

Smothering – Specifically refers to asphyxiation of the nose and mouth usually by a hand or soft object. Mechanical asphyxia resulting from external pressure on the body preventing chest movement and breathing.

Somatization – In psychology, a pathology in which a person becomes preoccupied with physical symptoms disproportionate to any actual physical disturbance.  May be seen in victims of abuse. 

Spooning – A folk remedy from Southeast Asia for pain relief.  The middle knuckle of the index finger or a spoon is firmly rubbed along the surface of the skin in any area of an ill person’s body, especially along the spine, behind the knees, in the bend of both arms and on the chest from just above the nipple to mid-clavicle.  

Standard of Proof – An amount of probability necessary for a court to render a decision regarding the evidence presented to it.  There are three different standards of proof.

·   Beyond a Reasonable Doubt – The amount of probability required to find a criminal defendant guilty.  The proof must be so conclusive and complete that the ordinary person could not reasonably deny it.

·   Clear and Convincing Evidence – An amount of probability less than beyond a reasonable doubt but more than probable cause.  It is used in some civil cases, including termination of parental rights cases.  The proof must produce a firm belief of truth to the trier of the fact.

·   Preponderance of Evidence – The amount of proof required in most civil cases, including child welfare cases (except for termination of parental rights).  The proof must be more likely than not.

State Child Death Review Team – A multiagency, multidisciplinary advisory committee to identify and make recommendations on policy and statutory changes pertaining to child fatalities and to guide statewide prevention, education and training efforts. 

Statute – A law passed by a legislative body.

Sternum – The bone that runs down the front part of the chest; the breast bone. 

Stillborn – Potentially viable fetus delivered dead. 

Strangulation – Asphyxia caused by external pressure applied to the neck either by the use of hands or a ligature (rope). 

Subarachnoid Bleeding – Bleeding that occurs between the pia and the arachnoid membrane of the central nervous system.

Subcutaneous – Beneath the skin. 

Subdural Hematoma – Bleeding between the internal lining of the skull and the brain. 

Subgaleal – The inner lining of the scalp.  A site of hemorrhage frequently secondary to hair pulling. 

Subpoena – In the law, a command to appear at a certain time and place, on a certain date, to give testimony on a certain matter. 

Sudden Infant Death Syndrome (SIDS) – The sudden death of an infant under one year of age which remains unexplained after completion of a complete autopsy, examination of the death scene and review of the baby’s health history. 

Suffocation – Asphyxia caused by a general deprivation of oxygen, either from obstruction of external airways or lack of breathable gas in the environment. 

Suicide – Intentionally causing one’s own death. 

Syndrome – A group of signs and symptoms that occur together and are typical of a particular disorder or disease.


Termination of Parental Rights – A legal process that severs the legal relationship between parents and child and vests authority in the child welfare agency.  The order places the child in the guardianship of the child welfare agency and gives the agency the right to consent to adoption or any care short of adoption. 

Testimony – Evidence given by a competent witness under oath or affirmation, as distinguished from evidence derived from written or other sources. 

Thorax – Chest area including the heart, lungs and ribs.

Torsion – Twisting, as of a limb. 

Trauma – An injury or wound brought about by an outside force.  Trauma may be caused unintentionally, or, as in physical abuse, intentionally.  Trauma also refers to physiological discomfort or symptoms resulting from an emotional shock or painful experience. 

Trend – In child death surveillance, refers to the changes occurring in the number and distribution of child deaths.


Undetermined Death – Death where the cause and/or manner of death is not clear. 

Unintentional Injury Death – Public health term to replace accidental death.


Vascular – Pertaining to or containing blood vessels. 

Venue – Related to the locality of the court or courts which possess jurisdiction. 

Vesicle – Blister containing fluid. 

Viable Fetus – A fetus that would be able to live outside the uterus if born as defined by experts.

Visceral – Pertaining to the internal organs. 

Vital Signs – Blood pressure, heart rate, respiratory rate and temperature. 

Vitreous – The material that encloses the major portion of the eye, which is normally clear. 


Witness – A person who has first-hand knowledge of the illness/injury/event leading to injury, disability or death.  A person inflicting injury on a child or identified as a perpetrator is not considered a witness.  First-hand knowledge usually includes seeing or hearing the illness/injury/event occur.