Gov. Beshear visits Kosair, signs bill into law requiring Kentucky doctors to take child abuse recognition training

For Insider Louisville
Published: APRIL 30, 2014

By RAE HODGE

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Gov. Steve Beshear signing HB 157 into law at Kosair Children’s Hospital | Photo by Rae Hodge

Kentucky doctors who are likely to see children–including pediatricians, radiologists, family practitioners, and emergency medical specialists–will now be required to complete a one-time, one-hour course on identifying potential signs of abuse. 

Gov. Steve Beshear signed House Bill 157, sponsored by Addia Wuchner, R-Florence, into law Tuesday in a ceremony held at Kosair Children’s Hospital of Louisville.

Data from the U.S. Department of Health & Human Services Child Maltreatment 2012 report shows that in recent years Kentucky has ranked among the worst states for child abuse death rates. According to the report, an average of 29 children die each year from abuse or neglect, and another 30-60 are almost killed.

“I think part of the reason is that we haven’t had this kind of training,” said Beshear. “That will fill in one of these gaps. And we’ve raised the level of awareness about child abuse, and I think that in the long run that will effect our statistics significantly.”

Dr. Melissa Currie, director of Kosair Charities Division of Pediatric Medicine, said she’s been waiting to hear the pushback from her colleagues regarding the burden of additional training the program will place on them. “But I have not heard from one single physician in the state of Kentucky who says that they aren’t proud to be getting this education,” she said. “Everyone wants to do the right thing, but unfortunately, time and time again we were seeing examples where physicians just weren’t armed with the information that they needed in order to pick up on those subtle early warning signs.”

Normal bruising for toddlers and older children usually occurs on the front of the body and over bony areas such as the forehead, elbows, knees and shins. The center of the training is known as the TEN-4 bruising rule. In children 4 years and under, torso, ear, and neck bruising are seen as potential indicators of abuse. 

“Ears do not bruise easily, so when we see a bruise in this location, we know to look carefully for additional trauma to the head. A small bruise on an infant’s stomach could be a liver laceration that has occurred because the child was punched in the stomach,” Currie said in a press release.

When asked what the program’s implementation would cost, Beshear said that “certainly, the medical licensure board is going to require that in the future from physicians,” but that, “The Kentucky Medical Association will work in conjunction with the state to provide that training. And that training is much needed.”

The law goes into effect July 15 of this year. 

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