Mother of a 5 year old female child is extremely concerned about the discoloration on her daughter's teeth. The mother gives a history of the patient suffering from recurrent and multiple illnesses and various food allergies. The patient is on multiple medications for recurrent fever, diarrhea and infections. The intraoral finding reveals proximal caries between the maxillary incisors and mandibular canines. Mother is insisting on taking an X-ray with these teeth. What type of abuse is this patient most likely suffering from?
Medical child abuse:
Perhaps the most difficult form of child maltreatment to identify and treat is a factitious disorder. Initially called Munchausen syndrome by proxy, and then pediatric condition falsification, the problem is one of child abuse in the medical setting. It occurs when a perpetrator (usually the mother) fabricates or exaggerates signs and/or symptoms of illness, or induces illness or signs and/or symptoms of illnesses in the child, causing unnecessary and harmful or potentially harmful testing, procedures, and treatments to be performed on the child. This form of abuse is different from all other forms of child maltreatment in that the medical community is unwittingly a part of the abuse. Because health care providers are often dependent on the parental history of the child’s illness, it takes some time for the practitioner to realize the inconsistencies and possibly fabricated or exaggerated nature of the complaints. These children often present with persistent and recurrent illnesses that cannot be explained and signs and symptoms that do not clinically make sense. The  motivation of the perpetrators of this form of abuse can be multifactorial (e.g., to gain medical attention, as a result of parental psychosis, or to obtain money or services) but is not considered in the making of a diagnosis of medical child abuse. The bizarre nature of many of these cases makes them almost unbelievable to the professionals involved, which can unfortunately lead to failure to protect the child.
Emotional abuse
Psychological abuse
Medical abuse
Neglect