Earlier this year, Safe Passage for Children of Minnesota sponsored a bill that would require daycares to display a poster educating parents, caregivers, and daycare employees about possible signs of abuse.
While bruises are often considered a normal part of childhood, not all bruising is typical. In children younger than 4 years old, certain bruising patterns can be an early warning sign of physical abuse and warrant consultation with a medical professional.
One important tool for recognizing concerning bruising is the TEN-4-FACESp clinical decision rule, developed and validated by Dr. Mary Clyde Pierce. The TEN-4-FACESp graphic was a part of the proposed bill.
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TEN refers to bruising on the Torso, Ears, and Neck.
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FACES refers to bruising on the Frenulum, Angle of the jaw, Cheeks, Eyelids, and Subconjunctivae.
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4 means that any bruise on an infant 4 months of age or younger warrants serious concern.
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The p reminds adults to look for patterned bruising, such as marks that may resemble a slap, grab, or loop
At Safe Passage, we believe that providing timely, meaningful education to parents and caregivers can make a significant difference in how child abuse is recognized, discussed, and prevented. Our bill was heard and passed through the House Children and Families Finance and Policy Committee, though in a challenging legislative session, was not part of the final legislation. We plan to advocate for its passage this coming session as it represents an important first step toward increasing awareness of what to watch for and when to seek help.