Pediatric Annals


Child Abuse

Stanford T Shulman, MD


1. Cone TE Jr. History of American Pediatrics. Boston, MA: Little Brown; 1979.…

It seems inconceivable that abuse and neglect of children is widespread in our society. Sadly, of course, this is no surprise to those working in the trenches of pediatrics. Drs. Flaherty and Sege in this issue of Pediatric Annals cite 2002 data from the United States Department of Health and Human Services that 1.8 million US children were reported to child protective services for suspected abuse or neglect in that year. Recently, a child was admitted to our hospital with limited burns that had a distribution highly suspicious for being nonaccidental; the child died several days later of an overwhelming secondary bacterial infection, another likely victim of abuse.

For this issue, our guest editor, Dr. Joe Zenel, has assembled a great set of articles that provide a comprehensive review of this critically important topic. The subject is also covered from another perspective in our sister publication, Psychiatric Annals, with guest editor Dr. Bessel van der Kolk (see page 335 for further information).

You may be surprised to learn (as I was) that in 17th century colonial America, Theophilus Eaton, the first governor of the New Haven colony, described in a letter to Governor John Winthrop Jr. how his second wife had pinched his young daughter "until she was black and blue" and knocked her head against a dresser, causing her a severe nosebleed. Even in the autocracy of colonial America, there is documentation that maltreatment of children occurred.

As recounted by TE Cone Jr., the first organized efforts to protect children from abuse in the US, amazingly enough, developed as an extension of the humane efforts on behalf of animals.1 This is a remarkable story, relatively unknown to the modern pediatric community, I believe. Henry Bergh, founder of the Society for the Prevention of Cruelty to Animals (SPCA) in 1866, petitioned a judge of the New York State Supreme Court in 1874 to issue a warrant to remove "little Mary Ellen," age 8, from her foster parents, who were accused of beating her brutally. The charitable woman who had learned of this child's plight had gone unsuccessfully to several institutions and organizations on her behalf and then appealed to the SPCA. Bergh decided that, "the child being an animal," the ASPCA would offer her protection as well. The foster mother ultimately was convicted of fe- lonious assault and sentenced to a year of hard labor, and Mary Ellen was placed in an institute called the Sheltering Arms.

This episode and the publicity it engendered eventually led to the formation of the Society for the Prevention of Cruelty to Children (SPCC) in 1874. By 1900, there were more than 250 such societies in the US. The first child welfare legislation in the country also resulted from this highly publicized case, with the New York state legislature, in 1876, granting the SPCC a charter giving it broad powers to protect child life. This has served as the basis of all of our subsequent child welfare laws.

Stamps selected for this month include the cartoon from El Salvador ("Child Protection"), the green stamp from Mexico ("For the Children - Prevention First"), the orange stamp from Mexico ("Children's Rights"), and the Belgian stamp ("Abandoned Youth"). All serve as reminders of our role to prevent and report child abuse.


1. Cone TE Jr. History of American Pediatrics. Boston, MA: Little Brown; 1979.


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