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Historical and social features of intentional scalds

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


Historical and social features

(These were confirmed in studies of intentional scalds, and in some cases the corollary was found in non-abusive data also. This is indicated in each reference list)


  • Lack of parental concern Intentional alone 4,11
  • Unrelated adult presenting the child for medical attention Intentional alone 1
  • The presence of domestic violence Comparative study 1
  • Differing accounts of the cause of the injury Intentional alone 2,3,14
  • History of prior abuse of this child Comparative study 1,2 Intentional alone 2,7
  • A trigger event such as soiling, enuresis or minor misbehaviour by the child was frequently recorded immediately prior to the scald Comparative study 2 Intentional alone 2,4,6,7,9,10,12,13
  • Child or family already known to social services Comparative study 2 Intentional alone 4 Unintentional alone 1
  • Scald commonly attributed to a sibling Comparative study 3,5 Intentional alone 2,3,5,14
  • Numerous prior accidental injuries noted in the intentionally scalded child Comparative study 1 Intentional alone 2,5,8,9,11 Unintentional alone 1. One comapartive study found no difference in prior injuries in maltreated and non-maltreated children 4

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Comparative study:

  1. Ayoub C, Pfeifer D. Burns as a manifestation of child abuse and neglect. American Journal of Diseases in Children. 1979;133(9):910-914 [Pubmed]
  2. Bajanowski T, Verhoff MA, Wingenfeld L, Püschel K. Forensische Pädopathologie – Tod nach Verbrühung. Drei Fälle mit sehr unterschiedlichen Kausalbedingungen [German] [Forensic paedopathology – death by scalding. Three cases with very different causal conditions]. Rechtsmedizin. 2007;17(4):218-222 [Abstract from SpringerLink]
  3. Hobbs CJ. When are burns not accidental? Archives of Disease in Childhood. 1986;61(4):357-361 [Pubmed]
  4. Wibbenmeyer L, Liao J, Heard J, Kealey L, Kealey G, Oral R. Factors related to child maltreatment in children presenting with burn injuries. Journal of Burn Care & Research. 2014;35(5):374-381 [Pubmed]

  5. Yeoh C, Nixon JW, Dickson W, Kemp A, Sibert JR. Patterns of scald injuries. Archives of Disease in Childhood. 1994;71(2):156-158 [Pubmed]

Intentional alone studies:

  1. Brinkmann B, Banaschak S. Verbrühungen bei einem Kleinkind: Unfall oder Kindesmißhandlung? Monatsschrift für Kinderheilkunde. 1998;146(12):1186-1191 [Abstract from SpringerLink]
  2. Daria S, Sugar NF, Feldman KW, Boos SC, Benton SA, Ornstein A. Into hot water head first: distribution of intentional and unintentional immersion burns. Pediatric Emergency Care. 2004;20(5):302-310 [Pubmed]
  3. Grosfeld JL, Ballantine TVN. Surgical aspects of child abuse (trauma-X). Pediatric Annals. 1976;5(10):106-120 [Pubmed citation only]
  4. Hashimoto I, Nakanishi H, Nagae H, Yamano M, Takeuchi N, Nameda Y, Arase S, Nii M, Taguchi Y, Kuroda Y. Child abuse-related burns: Two cases of severe burns related to child abuse syndrome. Japanese Journal of Plastic and Reconstructive Surgery. 1995;38:149-154
  5. Heaton PA. The pattern of burn injuries in childhood. New Zealand Medical Journal. 1989;102(879):584-586 [Pubmed]
  6. Heredea LS. Diagnostic problems of burns produced by physical abuse towards children. Archives of the Balkan Medical Union. 2008;43(3):171-176 [Abstract from Archives of the Balkan Medical Union]
  7. Holter JC, Friedman SB. Etiology and management of severely burned children. American Journal of Diseases in Children. 1969;118(5):680-686 [Pubmed citation only]
  8. Leonardi DF, Vedovato JW, Werlang PM, Torres OM. Child burn: accident, neglect or abuse. A case report. Burns. 1999;25(1):69-71 [Pubmed]
  9. Lung RJ, Miller SH, Davis TS, Graham WPI. Recognizing burn injuries as child abuse. American Family Physician. 1977;15(4):134-135 [Pubmed citation only]
  10. Patscheider H. Zwei ungewöhnliche Fälle von tödlicher Kindesmißhandlung [German] [Two unusual cases of fatal child abuse]. Archiv für Kriminologie.1975;155(1):19-27 [Pubmed citation only]
  11. Phillips PS, Pickrell E, Morse TS. Intentional burning: a severe form of child abuse. Journal of the American College of Emergency Physicians. 1974;3(6):388-390 [Abstract from ScienceDirect]
  12. Russo S, Taff ML, Mirchandani HG, Monforte JR, Spitz WU. Scald burns complicated by isopropyl alcohol intoxication: a case of fatal child abuse. The American Journal of Forensic Medicine and Pathology. 1986;7(1):81-83 [Pubmed]
  13. Schlievert R. Child abuse or mimic? Is there a medical explanation? Consultant. 2004;44:1160-1161
  14. Stratman E, Melski J. Scald abuse. Archives of Dermatology. 2002;138(3):318-320 [Pubmed citation only]

Unintentional alone studies:

  1. Titus MO, Baxter AL, Starling SP. Accidental scald burns in sinks. Pediatrics. 2003;111(2):e191-e194 [Pubmed]


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