Medical Definitions

Medical approaches formulated by physicians tend to focus on the psychopathology of abusive parents and the evidence of physical injury, observed directly or with X-rays (O'Toole, Turbett, and Nalepka 1986). Some attention is given to the importance of stress and the intergenerational "cycle of violence." O'Toole and his colleagues note that nursing texts often have a broader perspective on defining child maltreatment than do texts written by physicians, because the former give greater emphasis to child and parental behaviors as indicators of abuse and to the relative importance of family dynamics and the child's behavior. Although some authors, such as justice and Justice (1976), assume that physical abuse is generally the easiest form of maltreatment to define, O'Toole, Turbett, and Nalepka suggest that medical professionals often use vague concepts such as "normal" and "abnormal" injuries to shape the definition of physical abuse and may ignore information from the

family, community, and school, as well as racial, cultural, and socioeconomic factors.

Giovannoni and Becerra (1979) describe the medical approach to child maltreatment as a "diagnostic perspective," characterized by an emphasis on the processes of pathology, symptoms, and cure; medical professionals may use symptoms to categorize cases of child abuse, for the purpose of forming diagnoses and planning interventions. The work of Kempe and Helfer (1977) is cited as an example of a medical definition of child maltreatment; their focus, though broad, is primarily on parental characteristics.