π Key Information Summary
- Child abuse encompasses physical abuse, emotional (psychological) abuse, sexual abuse, and neglect β all of which may coexist.
- In Australia, approximately 1 in 32 children receive child protection services each year; Aboriginal and Torres Strait Islander children are overrepresented at 7 times the rate of non-Indigenous children.
- All Australian states and territories impose mandatory reporting obligations on medical practitioners β thresholds vary by jurisdiction (see state-based summary table).
- Physical abuse indicators include unexplained bruising in non-mobile infants, patterned injuries, injuries inconsistent with the history, and sentinel injuries (e.g., rib fractures, subdural haemorrhage in infants).
- The TEN-4-FACES-P bruising clinical decision rule helps distinguish inflicted from accidental bruising in children aged <4 years.
- Emotional abuse and neglect are the most common forms of maltreatment reported to Australian child protection services but are the most under-recognised in clinical practice.
- Sexual abuse rarely presents with genital injury β behavioural indicators (regression, sexualised behaviour, sleep disturbance) are more common than physical findings.
- When sexual abuse is suspected, a forensic medical examination should only be performed by a trained examiner (Child Protection Unit or Sexual Assault Service); routine GP examination is not required and may compromise forensic evidence.
- Document findings using body maps, direct quotations, and objective clinical language β avoid diagnostic conclusions (e.g., write "patterned bruising" not "non-accidental injury").
- Screen for intimate partner violence and parental substance use as co-factors in presentations suggestive of child maltreatment.
- For urgent child safety concerns, contact the relevant state/territory child protection authority or call 000 if the child is in immediate danger.
- The Child Abuse Helpline (1800 688 009) provides 24/7 advice for health professionals across Australia.
Introduction & Australian Epidemiology
Child abuse and neglect (child maltreatment) is a significant public health issue in Australia and internationally. The World Health Organization estimates that up to 1 billion children aged 2β17 years experience some form of violence annually. In the Australian context, child maltreatment has profound and lasting consequences for physical health, mental health, educational attainment, and social functioning across the lifespan.
General practitioners and paediatricians are uniquely positioned to recognise, respond to, and report suspected child abuse. Early identification and intervention can prevent escalation, reduce harm, and connect families with support services. However, detection remains challenging due to the covert nature of abuse, the reliance on clinical suspicion rather than pathognomonic signs, and the medicolegal complexities of mandatory reporting.
Australian Statistics
- Child protection notifications: In 2022β23, there were approximately 622,986 notifications made to state and territory child protection services nationally (AIHW, 2024).
- Substantiations: Around 60,966 children (8.6 per 1,000) had a substantiation of abuse or neglect.
- Types of substantiated abuse: Emotional abuse (30%), neglect (29%), physical abuse (18%), sexual abuse (12%), and combinations or other (11%).
- Aboriginal and Torres Strait Islander overrepresentation: First Nations children are 7.0 times more likely to be the subject of a substantiation than non-Indigenous children.
- Age distribution: Children aged 0β4 years are the most commonly represented age group in substantiations.
- Repeat victimisation: Approximately 23% of children with a substantiation have a subsequent substantiation within 12 months.
Sentinel injury: Any injury in a pre-ambulatory infant (non-crawler) β including bruising, fractures, or intracranial haemorrhage β should be considered inflicted until proven otherwise. These require urgent paediatric assessment and imaging.
Types of Child Abuse & Facts
The Australian Government's National Framework for Protecting Australia's Children 2021β2031 and state-based child protection legislation define child maltreatment as encompassing four principal categories. These categories frequently overlap β a child may experience multiple forms simultaneously.
| Type | Definition | Examples |
|---|---|---|
| Physical Abuse | Non-accidental physical force by a caregiver that results in, or has the potential to result in, physical injury to a child | Hitting, shaking, burning, biting, throwing, suffocation |
| Emotional (Psychological) Abuse | Persistent patterns of caregiver behaviour that convey to the child they are worthless, flawed, unloved, unwanted, or only valued in meeting another's needs | Verbal abuse, threats, intimidation, rejection, isolation, corruption, witnessing family violence |
| Sexual Abuse | Any act that involves a child in sexual activity beyond their understanding, or to which they cannot give informed consent, or that violates the laws of society | Penetrative and non-penetrative acts, exposure, production of child exploitation material, grooming |
| Neglect | The failure to provide conditions that are essential for the healthy physical and emotional development of a child by a caregiver responsible for the child's care | Failure to provide adequate food, clothing, shelter, hygiene, supervision, medical care, education, or emotional support |
Key Facts
- Most abuse is perpetrated by someone known to the child β parents or caregivers account for the majority of substantiated cases.
- Children under 5 years are most vulnerable to physical abuse and neglect due to their complete dependency on caregivers.
- Adolescents are at higher risk of sexual exploitation and emotional abuse.
- Family and domestic violence is a major co-factor β children living in households with intimate partner violence are at significantly higher risk of direct maltreatment.
- Risk factors include parental substance misuse, parental mental illness, social isolation, poverty, prior child protection history, and young parental age.
- Children with disability are at least 2β3 times more likely to experience abuse than their non-disabled peers (Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2023).
Clinical pearl: Consider the "ICE" triad β Injury inconsistent with mechanism, Child's developmental stage, Explanation changing or implausible β when evaluating a child's presentation.
Physical Abuse Indicators
Physical abuse accounts for approximately 18% of substantiated child protection cases in Australia. Clinical recognition depends on pattern recognition, anatomical knowledge, developmental assessment, and a thorough, documented history.
The TEN-4-FACES-P Clinical Decision Rule
This validated tool (Pierce et al., 2010) identifies bruising patterns that are more commonly associated with inflicted injury in children <4 years of age:
- T β Trunk bruising
- E β Ear bruising
- N β Neck bruising
- 4 β Any bruising in a child <4 years AND any bruising in a non-ambulatory infant (any age)
- F β Frenulum injury
- A β Angulated/Patterned bruising (e.g., loop marks, belt buckle, handprint)
- C β Clusters of bruising (β₯3 separate bruises)
- E β Ecchymoses (non-dependent, β₯5 separate bruises)
- S β Subconjunctival haemorrhage (in absence of birth/haematological cause)
- P β Petechiae (non-dependent, unrelated to coagulopathy)
Red-Flag Injury Patterns
| Finding | Significance | Action |
|---|---|---|
| Rib fractures in infants | Highly specific for inflicted injury; rarely accidental in non-ambulatory children | Skeletal survey + urgent paediatric admission |
| Subdural haemorrhage in infants | Considered sentinel β shaken baby/abusive head trauma | CT brain, retinal examination by ophthalmologist, skeletal survey, neurosurgical consult |
| Metaphyseal ("corner" or "chip") fractures | Highly specific for twisting/traction forces | Skeletal survey, skeletal follow-up at 10β14 days |
| Burns β immersion pattern (glove/stocking or "tideline") | Suggestive of deliberate immersion in hot liquid | Photograph, body map, report, paediatric assessment |
| Posterior rib fractures / scapular fractures | Require high-force mechanisms; very rarely accidental | Full skeletal survey, ophthalmology, haematology screen |
| Bruising over bony prominences in non-mobile infant | Infants who cannot cruise/walk rarely generate sufficient force to bruise | Full assessment, skeletal survey, mandatory notification |
Differential Diagnosis Considerations
Not all unexplained bruising is inflicted. Consider the following differentials, but do not allow them to delay reporting if clinical suspicion persists:
- Mongolian spots (congenital dermal melanocytosis) β blue-grey patches over the sacrum/buttocks in infants with darker skin; confirmed by history and dermatological assessment
- Henoch-SchΓΆnlein purpura (IgA vasculitis) β palpable purpura in dependent areas
- Coagulation disorders (haemophilia, von Willebrand disease, ITP) β require haematological workup
- Cultural practices (e.g., coining, cupping, cautery) β documented in Southeast Asian and African communities; still require full assessment and reporting if injury exceeds cultural scope
Documentation Standards
1
Photograph injuries
Use a ruler for scale; include patient identification in frame; date and time stamp. Store in secure clinical record.
2
Use body maps
Mark anatomical location, size (cm), shape, and colour of each injury on standardised body map diagram.
3
Record direct quotes
Document verbatim what the child and caregiver say, using quotation marks. Note who provided the history.
4
Use objective language
Describe findings only β "patterned bruising consistent with belt buckle" rather than "non-accidental injury."
Do not delay reporting. If you suspect physical abuse, do not wait for confirmatory investigations or specialist review before making a mandatory notification. Report, then investigate.
Emotional Abuse & Neglect
Emotional abuse and neglect are the most commonly substantiated forms of child maltreatment in Australia (together comprising ~59% of substantiations) yet remain the most under-recognised by health professionals. They are chronic, cumulative in effect, and frequently co-occur with other forms of abuse.
Emotional Abuse β Indicators
Child Behavioural Indicators
- Withdrawal, excessive compliance, or "frozen watchfulness"
- Low self-esteem, self-blame, persistent negative self-talk
- Aggression, oppositional behaviour, cruelty to animals
- Sleep disturbance, nightmares, enuresis
- Age-inappropriate sexualised behaviour
- Regression (e.g., thumb-sucking, baby talk in older children)
- Speech and language delay (in the absence of organic cause)
CaregiverβChild Interaction Indicators
- Caregiver consistently belittles, blames, or scapegoats the child
- Caregiver is persistently hostile, rejecting, or indifferent
- Child treated as a "mini-adult" with inappropriate responsibilities
- Child used as a confidant or emotional support for the parent
- Caregiver exposes child to family violence, substance abuse, or criminal behaviour
- Severe or persistent criticism disproportionate to child's behaviour
Neglect β Types & Indicators
| Type of Neglect | Clinical Indicators |
|---|---|
| Physical neglect | Persistent hunger, poor hygiene, inappropriate clothing for weather, unattended medical/dental needs, untreated infections |
| Medical neglect | Failure to attend for immunisation, untreated dental caries, missed specialist appointments, non-compliance with essential medications (e.g., insulin, anticonvulsants) |
| Supervisory neglect | Repeated unintentional injuries, child left unsupervised, repeated presentations for ingestion/injury, history consistent with inadequate supervision for age |
| Educational neglect | Chronic non-attendance (β₯15% absence rate), child not enrolled in school, unidentified learning difficulties |
| Emotional neglect | Failure to provide affection, stimulation, or emotional support; indifference to child's emotional needs |
Growth and Development
Neglect may present as failure to thrive (non-organic). Key assessment features include:
- Weight dropping across percentiles without organic cause β monitor on growth charts
- Developmental delay disproportionate to any identified neurological condition
- "Rumination" or food-hoarding behaviour in the context of inconsistent feeding
- Persistent nappy rash, untreated skin infections, and parasitic infestations
- Consider referral for paediatric developmental assessment (MBS Item 110 β referral to specialist paediatrician)
Poverty β neglect: Distinguish between families experiencing socioeconomic disadvantage who are actively seeking help and families where caregiver disengagement is the primary driver of unmet needs. The threshold for reporting is when the child's safety and developmental needs are being persistently unmet despite available support.
Sexual Abuse: Clinical Indicators & Clinical Approach
Child sexual abuse (CSA) accounts for approximately 12% of substantiated child protection cases in Australia, though prevalence studies suggest the true rate is substantially higher. The median age at disclosure is 10β13 years, with a significant delay between abuse onset and disclosure. General practitioners are often the first health professional a child or adolescent may tell.
Physical Indicators
- Genital findings: Genital pain, itching, discharge, bleeding, bruising, or lacerations (note: the majority of sexually abused children have normal genital examination findings)
- Anal findings: Perianal bruising, fissures (consider constipation as differential), scarring, laxity
- Sexually transmitted infections (STIs): Gonorrhoea, chlamydia, syphilis, trichomoniasis, HIV, HPV (genital warts in pre-pubertal children) β any STI in a pre-pubertal child is suspicious for sexual abuse unless vertically transmitted
- Pregnancy in a child or early adolescent
- Recurrent urinary tract infections without anatomical explanation
Behavioural Indicators
- Age-inappropriate sexual knowledge or sexualised behaviour (e.g., detailed knowledge of sexual acts, inserting objects into self/others, soliciting sexual contact)
- Regression (enuresis, encopresis, thumb-sucking)
- Sudden school refusal, declining academic performance
- Self-harm, suicidal ideation, or eating disorders in the absence of other identified triggers
- Fear of specific individuals, reluctance to be alone with a particular person
- Nightmares, sleep disturbance, hypervigilance
- Disclosure β direct or indirect ("Something happenedβ¦", "A secret I can't tell")
Clinical Approach When Sexual Abuse Is Suspected
Critical guidance for GPs: Do NOT perform a genital examination on a child in a general practice setting. A forensic medical examination should only be undertaken by a trained examiner at a designated Child Protection Unit or Sexual Assault Service. Untrained examination may compromise forensic evidence and cause additional trauma.
1
Receive the disclosure calmly
Remain calm. Do not express shock or disbelief. Use open-ended, non-leading questions. Reassure the child they are not in trouble. Do not promise confidentiality β explain you may need to tell someone who can help keep them safe.
2
Document verbatim
Write down the child's exact words using quotation marks. Note the time, date, location, and who was present. Record any spontaneous statements. Do not interrogate.
3
General physical examination
Perform a general physical examination (growth parameters, general inspection). Document any injuries found using body maps and photography. Do not perform a genital or anal examination.
4
Arrange specialist referral
Contact the nearest Child Protection Unit, Sexual Assault Service, or paediatrician with child protection expertise. In acute presentations (<72 hours), the child may require emergency forensic examination β contact your state Sexual Assault Crisis Line.
5
Make a mandatory notification
Report to your state/territory child protection authority (see table below). In all states, sexual abuse triggers a mandatory reporting obligation. Also consider reporting to police if the perpetrator has access to other children.
6
Safety planning
If the alleged perpetrator is a household member, ensure the child's immediate safety. Provide contact for counselling services (e.g., Bravehearts: 1800 272 831; 1800RESPECT: 1800 737 732). Arrange follow-up.
STI Screening in Suspected CSA
STI screening is indicated when sexual abuse is suspected. The approach depends on the child's age and pubertal status:
- Pre-pubertal children: Self-collected urine NAAT for chlamydia and gonorrhoea (if the child can void voluntarily), plus serology for syphilis, HIV, and hepatitis B. Examination and swabs should only be taken by a trained forensic examiner.
- Adolescents: As for adults β self-collected vaginal swabs or first-void urine for chlamydia/gonorrhoea NAAT, plus full sexual health serology. Offer emergency contraception if presentation is within 120 hours and pregnancy is possible.
- HPV vaccination status should be checked; provide catch-up vaccination if not yet completed (funded under the National Immunisation Program for ages 12β25).
Grooming behaviour: Be aware that perpetrators may present to the consultation as concerned caregivers, seeking to control the narrative. Document interactions with caregivers carefully and remain independently objective in your assessment.
Clinical Assessment & Differential Considerations
A comprehensive clinical assessment for suspected child maltreatment requires a systematic approach that balances diagnostic thoroughness with the child's emotional wellbeing and medicolegal obligations.
History-Taking Framework
| Domain | Key Questions |
|---|---|
| History of presenting complaint | When did the injury/concern occur? What was the mechanism? Who was present? Has the story changed over time? |
| Developmental history | Is the child ambulatory? Can they cruise, crawl, pull to stand? Is the reported mechanism consistent with their developmental stage? |
| Past medical history | Previous injuries? Emergency department visits? History of child protection involvement? Bleeding disorder? |
| Family & psychosocial history | Domestic violence, substance use, mental health, social isolation, housing instability, custody disputes |
| Child's own account | Speak to the child separately (if developmentally appropriate). Use open questions. Document verbatim. |
Investigations β When Indicated
Essential
Skeletal survey (full body X-ray)
For children <2 years with suspected physical abuse. Performed at paediatric centre. Follow-up skeletal survey at 10β14 days to detect healing fractures.
Essential
CT brain (non-contrast)
For infants with suspected abusive head trauma β seizures, altered consciousness, retinal haemorrhages, or unexplained neurological signs.
Specialist
Ophthalmological examination (dilated fundoscopy)
By a paediatric ophthalmologist for suspected abusive head trauma β retinal haemorrhages are characteristic.
Available
Full blood count, coagulation profile (APTT, PT, vWF, Factor VIII, IX)
To exclude coagulopathy as a cause of bruising. Do not delay reporting while awaiting results if clinical suspicion is high.
Available
STI screening (urine NAAT, serology)
When sexual abuse is suspected. Self-collected urine in pre-pubertal children; refer for forensic examination for genital swabs.
Available
Liver function, lipase, amylase
For children with abdominal trauma β consider occult intra-abdominal injury in the context of non-accidental injury.
Mandatory Reporting β Australian Legislation
In all Australian states and territories, medical practitioners are mandatory reporters of suspected child abuse and neglect. Failure to report is a criminal offence in most jurisdictions. The specific thresholds, timing requirements, and reporting mechanisms vary by state and territory.
Key principle: You do NOT need to be certain that abuse has occurred. The threshold is suspicion on reasonable grounds that a child has suffered, or is at risk of suffering, significant harm. Do not delay reporting to gather additional evidence.
State & Territory Child Protection Contact Details
| Jurisdiction | Threshold | Contact |
|---|---|---|
| NSW | Suspicion on reasonable grounds that child is at risk of significant harm (ROSH) | DCJ Child Protection Helpline: 132 111 (24/7) |
| VIC | Belief on reasonable grounds that child has suffered, or is at risk of, significant harm from physical injury or sexual abuse | Child Protection: 1300 360 391 (24/7) |
| QLD | Reasonable suspicion that child has suffered, or is at risk of, significant harm | Child Safety: 13 74 68 (24/7) |
| WA | Belief on reasonable grounds that child has been, or is being, sexually abused; or has suffered, or is at risk of, physical abuse | CPFS: 1800 708 704 (24/7) |
| SA | Belief on reasonable grounds that child has been, or is being, abused or neglected and the child protection notification threshold is met | Child Abuse Report Line: 13 14 78 (24/7) |
| TAS | Reasonable belief that child has suffered, or is at risk of, significant harm | Strong Families Safe Kids: 1800 000 123 (24/7) |
| ACT | Reasonable suspicion that child has suffered, or is at risk of, abuse or neglect | Child and Youth Protection Services: 1300 556 729 (24/7) |
| NT | Reasonable belief that child has suffered, or is at risk of, harm | Child Protection Hotline: 1800 700 250 (24/7) |
What Happens After Reporting?
- The child protection authority assesses the notification and determines the response (investigation, referral to family support services, or no further action).
- You may be asked to provide a written report and/or attend a case conference.
- In some jurisdictions, you will receive feedback on the outcome of your notification.
- Continue to provide medical care and follow-up to the child and family.
- Do not inform the family that a notification has been made if doing so could place the child at further risk. The child protection authority will decide when and how to inform the family.
Legal protection: Mandatory reporters are protected from civil and criminal liability when making a notification in good faith. Good-faith reporting is a defence against defamation in all Australian jurisdictions.
Special Populations
Paediatrics
Infants <12 months
Highest risk age group. Any injury in a non-ambulatory infant is suspicious. Skeletal survey mandatory for suspected physical abuse. Abusive head trauma peaks at 2β4 months of age.
Pre-schoolers (1β4 years)
Apply TEN-4-FACES-P rule for bruising assessment. Developmental stage must match reported mechanism of injury. Consider neglect in the context of recurrent presentations.
School-age children
Behavioural indicators become more prominent. School refusal, declining performance, and withdrawal may signal abuse. Speak to the child alone when safe to do so.
Adolescents
Higher risk of sexual exploitation, self-harm, and emotional abuse. May disclose to GP before anyone else. Consider Gillick competence when adolescents request confidential care. Balance privacy with mandatory reporting obligations.
Pregnancy & Perinatal
Antenatal detection
Domestic violence screening is recommended at antenatal booking. Substance use in pregnancy may indicate child protection risk. Fetal alcohol spectrum disorder (FASD) is itself a consequence of in-utero exposure.
Newborn period
Hospital-based child protection teams may flag at-risk families. Neonatal withdrawal, unexplained bruising at birth, or inconsistent parental engagement are warning signs.
Children with Disability
Increased vulnerability
Children with intellectual disability, autism spectrum disorder, or communication impairment are at 2β3Γ higher risk. May not be able to disclose. Behavioural changes may be the only indicator. Caregiver burden and respite gaps contribute to risk.
Assessment considerations
Use augmented communication tools. Engage disability-informed child protection specialists. Avoid attributing all behavioural changes to the disability itself.
Children in Out-of-Home Care
Foster and kinship care
Children in OOHC are a high-risk population with complex health needs. Ensure comprehensive health assessments (MBS Item 733/735 equivalents in state programs). Any new injury requires careful documentation and reporting to the OOHC agency.
Children with Pre-existing Medical Conditions
Bleeding disorders
Children with known coagulopathies (haemophilia, von Willebrand disease) may present with bruising that mimics abuse. Involve the child's haematologist. A coagulopathy does NOT exclude abuse β both may coexist.
Osteogenesis imperfecta
May cause unexplained fractures. Genetic testing and skeletal survey interpretation should involve a paediatric metabolic bone specialist.
Aboriginal and Torres Strait Islander Health Considerations
Aboriginal and Torres Strait Islander Health
Aboriginal and Torres Strait Islander children are vastly overrepresented in the Australian child protection system. In 2022β23, First Nations children were 7.0 times more likely to be the subject of a child protection substantiation and 10.4 times more likely to be in out-of-home care than non-Indigenous children (AIHW, 2024). Addressing this requires a nuanced understanding of historical context, culturally safe practice, and community-led approaches.
Contextual Factors
- Intergenerational trauma: The legacy of the Stolen Generations β forced removal of Aboriginal and Torres Strait Islander children from their families β has created deep, multigenerational trauma that contributes to family disruption, loss of parenting knowledge, and distrust of government services.
- Social determinants: Higher rates of poverty, overcrowded housing, food insecurity, parental incarceration, and substance use are driven by systemic disadvantage, not by cultural factors.
- Child-rearing practices: Aboriginal and Torres Strait Islander families often practise shared caregiving (extended family involvement), which may be misunderstood by non-Indigenous clinicians as a lack of parental supervision. Seek cultural guidance before making assumptions.
- Cultural skin practices: Traditional practices such as cautery, scarification, and marking may be misidentified as physical abuse. Seek advice from Aboriginal health workers or community elders before drawing conclusions.
Caution β over-reporting bias: Aboriginal and Torres Strait Islander families experience disproportionately high rates of child protection notifications relative to actual harm. Ensure your assessment is based on clinical evidence, not bias. Consult with Aboriginal Health Workers or Liaison Officers (AHWLOs) where available. Reflect on whether the same presentation in a non-Indigenous family would trigger the same response.
Clinician Self-Care & Support
Managing cases of child abuse and neglect is emotionally demanding. Clinicians should recognise the impact of vicarious trauma and seek appropriate support.
- Debrief with a colleague, supervisor, or clinical lead after difficult cases.
- Access Employee Assistance Programs (EAPs) or professional support through your medical defence organisation.
- Recognise symptoms of vicarious trauma β intrusive thoughts, hypervigilance, emotional numbing, sleep disturbance.
- Use reflective practice and supervision to maintain clinical objectivity.
- The Drs4Drs helpline (1300 374 377) provides confidential support for doctors across Australia.
π References
- 1. Australian Institute of Health and Welfare (AIHW). Child protection Australia 2022β23. Canberra: AIHW; 2024. Available from: https://www.aihw.gov.au/reports/child-protection
- 2. Pierce MC, Kaczor K, Aldridge S, O'Flynn J, Lorenz DJ. Bruising patterns in abusive and accidental injury: a prospective validation study of the TEN-4 clinical decision rule. Pediatrics. 2010;125(4):e750βe757.
- 3. Royal Australian College of General Practitioners (RACGP). Abuse and violence: working with our patients in general practice (White Book). 4th ed. Melbourne: RACGP; 2023.
- 4. Australian Government Department of Social Services. National Framework for Protecting Australia's Children 2021β2031. Canberra: Commonwealth of Australia; 2021.
- 5. Royal Commission into Institutional Responses to Child Sexual Abuse. Final Report. Sydney: Commonwealth of Australia; 2017.
- 6. Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. Final Report: Violence, Abuse, Neglect and Exploitation of People with Disability. Canberra: Commonwealth of Australia; 2023.
- 7. Mathews B. Mandatory reporting laws for child sexual abuse in Australia: legislative obligations, professional and personal conflicts, and the need for reform. University of New South Wales Law Journal. 2017;40(2):791β840.
- 8. Christian CW; Committee on Child Abuse and Neglect. The evaluation of suspected child physical abuse. Pediatrics. 2015;135(5):e1337βe1354.
- 9. Royal Children's Hospital Melbourne. Child Protection Clinical Practice Guidelines. Melbourne: RCH; 2024. Available from: https://www.rch.org.au/clinicalguide/
- 10. Heale P, Hamilton G. Recognising child sexual abuse in general practice. Australian Journal of General Practice. 2020;49(9):570β575.
- 11. Royal Australasian College of Physicians (RACP). Child Abuse and Neglect: A Clinician's Handbook. Sydney: RACP; 2022.
- 12. Aboriginal and Torres Strait Islander Healing Foundation. Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice. 2nd ed. Canberra: Commonwealth of Australia; 2014.
- 13. Australian Centre for Child Protection (University of South Australia). National Research Centre for the Prevention of Child Abuse: Evidence Reviews. Adelaide: University of South Australia; 2023.
- 14. Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Medicine. 2012;9(11):e1001349.