Non-Accidental Injury (NAI)
Definition
Physical harm inflicted deliberately or through gross neglect rather than by accident. The term is preferred over 'child abuse' in clinical documentation because it describes what is observed without asserting intent, which is a legal determination.
- Preferred over
- "Child abuse" in clinical documentation
- Reason
- Describes observation, not legal intent
- Determination of intent
- Reserved for a court, not the clinician
Common questions
Why do clinicians prefer non-accidental injury over abuse in a medical record?+
A clinical note is meant to document objective findings and their likely mechanism, and intent is a legal question decided by a court, not a diagnosis. Using NAI keeps the record within the clinician's competence and avoids prejudging the legal outcome.
Does an NAI finding automatically trigger a criminal investigation?+
It typically triggers a child-protection referral and often a police notification under mandatory-reporting rules, but whether charges follow depends on a separate investigative and prosecutorial assessment of intent and circumstance.
Related terms
- Abusive Head Trauma (AHT)
- Intracranial injury resulting from violent shaking, with or without impact. Findings include subdural haematoma, subarachnoid haemorrhage, diffuse axonal injury, and retinal haemorrhages....
- Child Advocacy Centre (CAC)
- A child-focused facility that houses the medical, investigative, and support functions of a child abuse case in one location. The multidisciplinary team...
- Metaphyseal Corner Fracture
- A fracture through the metaphyseal collar of a long bone, producing a triangular or bucket-handle fragment. Caused by traction and torsion forces...
- Posterior Rib Fracture
- A fracture at the posterior rib near the costotransverse junction. Produced by forceful anteroposterior chest compression (as in squeezing), not by simple...
- Skeletal Survey
- A full radiographic series of the skeleton (AP skull, lateral skull, chest, spine, pelvis, and all long bones) performed in suspected NAI...