Identification of Child Abuse in the Art and Play Products of the Pediatric Burn Patients

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Abstract
This article deals with the identification of child abuse and neglect in a burn center setting utilizing art and play therapy (APT) as a projective base, a diagnostic and investigative tool, and a treatment modality. APT is a blend of the psychotherapeutic technique and creative process. Providing developmentally appropriate materials and techniques facilitates the communication necessary for the child to tell how he/she was burned. Consistent and repetitive themes of hurting and sadism in the play are combined with observations from the medical team, and give indications as to how the child had been abused. Conflicting versions of how the injury was sustained provoke suspicion, and often inappropriate family interaction may be observed. When a pervasive play theme indicating abuse emerges, appropriate steps are taken to notify the attending physician, the medical social worker, and child protective services. The therapist, after locating the problem area, moves from non-directive play to a structured play (release therapy) modality. This article is based upon nine years of looking at art and play products and extrapolating recurring, pervasive themes that are often used as legal, admissable evidence in child abuse cases.

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