October 4th Proclaimed as TEN-4 Day in Illinois to Honor the Importance of Recognizing, Reporting, and Preventing Child Abuse

October 01, 2021

Ann & Robert H. Lurie Children’s Hospital of Chicago announces today that Governor JB Pritzker has proclaimed October 4th as TEN-4 Day in Illinois. TEN-4 Day will honor the importance of recognizing bruises and injuries on young children and emphasize the importance of training adults to recognize, report, and prevent child abuse.  

TEN-4-FACESp is a useful acronym to help screen children with bruising and identify when a bruise is more likely to be caused by abuse in children under 4 years of age. TEN-4-FACESp stands for bruising to the Torso, Ears, Neck, Frenulum, Angle of the jaw, Cheeks, Eyelids or Subconjunctivae, “4” represents infants 4 months and younger with any bruise, anywhere, and “p” represents the presence of patterned bruising (“TEN-4-FACESp”).

“Paying attention to bruising is important because bruising is the most common and most visible sign of physical abuse. While bruising in toddlers and pre-school aged children is common from accidental injury, the location of the bruise can be helpful in distinguishing physical abuse from accidental injury,” said Mary Clyde Pierce, MD, Division of Emergency Medicine. “The bruising clinical decision rule known as TEN-4-FACESp calls attention to the key findings where bruising is more likely to be present from abuse than accidental injury.” 

TEN-4-FACESp is a bruising clinical decision rule developed and validated by Dr. Mary Clyde Pierce and colleagues. The rule and associated research findings were recently published in the peer-reviewed medical literature and they are available for FREE download: 

Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics 

Nationally, there are at least 115,000 victims of child physical abuse each year, with 6,000 cases in Illinois.  In 2019, physical abuse led to at least 700 child deaths in the United States and more than 100 in the state of Illinois. Attention to bruising is an actionable step that we can take to help identify children at risk of physical abuse and potentially improve the outcomes of these young children.

Lurie Children’s has providers with the expertise to identify and treat children who are victims of abuse and neglect.

Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 220,000 children from 48 states and 49 countries.