Photographing Injuries

Prior to photographing the injuries, the investigator should identify the suspected child abuse victim by completing an identification sheet and/or taking a full-face picture of the child that also displays the child's name. Separate rolls of film should be used for each case to avoid losing or mixing up evidence, which could result in dismissal of the case. Although time-consuming, it is helpful to place an identifying sign, including name or initials, date of birth, date and time of photographs, case number, and the photographer's name or initials, in front of the victim's injury for each picture. In addition, many 35mm cameras contain databack attachments that imprint the time, date, and an identifying code on each film frame.

In addition, the investigator can use a medical photography form as a tool for highlighting injury sites, description of injuries, time and date of photographs, the victim's identification or case number, and the number of photographs taken and by whom. The form is then included in the finished photo envelope as relevant to the chain of evidence. A sample form is included as figure 1.

Tips for Photographing a Suspected Victim of Child Abuse

• Take two pictures of every view and angle, one for the file and one for court.



• Photograph the injury with an anatomic landmark. The inclusion of an elbow, knee, belly button, or other body part identifies the location of the wound.



• Include two pictures of each wound or other injury — one that identifies a landmark and one that provides a closeup (fills the film frame) of the wound.



• Position the camera so that the film surface or plane is parallel to or directly facing the injury.



• Vary the perspective of the picture by taking various shots from different angles and distances. This is particularly important since the flash may produce unpredictable reflections. Darker complexions can cause flash reflections and loss of definition. If unsure about correct exposures, take pictures at the camera's recommended exposure and one slightly lighter and one slightly darker (bracketing). To do this, adjust the lens aperture by one-half to one full f-stop on either side of the recommended exposure. Bracketing will ensure proper color balance and brightness when documenting victims with very light or very dark skin tones.



• Place a measuring device such as an adhesive metric scale directly above or below the injury to ensure accurate representation of the size and depth of the injury. A standardized color bar may be placed in the photographic plane for comparison with the color of the injury. This ensures that if color is distorted in the film developing process, adequate color comparisons can still be made.

Methods for Photographing Specific Injuries

Punctures, slashes, rope burns, or pressure injuries

When documenting these types of injuries, take photographs straight on and at a slight angle. Photographing the injury straight on provides an overall view of the surface and extent of the injury, while shooting from a slight angle provides depth and texture to a picture.

Bite marks

Forensic bite mark photography is a specialized field of medical photography and is interpreted best by a forensic dentist or pathologist. Bite marks can be recorded by following the method described above for punctures, slashes, and so forth, but the size, shape, color, depth of indentations, and three-dimensional contours also need to be documented. Multiple views from various perspectives are important in delineating texture and shape. Parallel or direct views best depict shape and size, while slanted or indirect views and lighting highlight texture.

Bruises

Bruising goes through several stages of development — a bruise discovered several hours after abuse will become more pronounced as time goes on, and additional photographs will be needed to document the injury. If a second or third series of pictures is required, the investigator should reproduce the angles and positions that were used to photograph the first series. If a child shows evidence of having old and new bruises, repeated abuse may be suspected. Both old and new bruises should be photographed. Areas of swelling (edema) sometimes exhibit a strong reflection that is caused by the flash bouncing off the swollen/rounded injury site. This effect may obscure the photograph. To help minimize the reflections, take photographs from several different angles, then do a followup series when the swelling has gone down.

Burns

In cases of burns or severe scalding, take pictures from all angles before (especially before any creams or oils are applied) and after treatment. Accidental burns usually exhibit splash marks or indiscriminate patterns of injury. Intentional submersions show distinct lines or well-defined areas of damaged skin compared with healthy skin.

Facial injuries

If an injury is inside the mouth, use a plastic or wooden tongue depressor to keep the mouth open and the injury visible. If there is an eye injury, use a pocket flashlight or toy to distract the child's gaze in different directions to show the extent of the damage to the eye area.

Amputation

In cases where abuse involves the amputation of a body part, photograph the dismembered part alone and then in relation to the body as a whole. Closeups should also be taken of the skin's torn edges, which may help verify the method of amputation in court.

Neglect

When there is suspected child neglect, the child's general appearance should be photographed, including any signs such as splinters in the soles of the feet, hair loss, extreme diaper rash, wrinkled or wasted buttocks, prominent ribs, and/or a swollen belly.

Sexual abuse

If sexual abuse is suspected, the child and his or her injuries should be approached as follows:

• Photograph the child in the presence of a trusted relative or guardian.



• Inform the child of what will be involved in taking the pictures.



• Remember to consider the child's level of development when speaking to him or her.



• Do not make quick moves toward the child, as these may be frightening.



• Make eye contact with the child to make him or her feel more comfortable.



• Keep a supply of toys or coloring books as a reward for being helpful.



• Allow time for the child to become accustomed to the photographer before being photographed. Do not surprise the child. Tell him or her what parts of the body need to be photographed.



• Let the child undress himself or herself or have the parent or guardian help.



• Photograph sexual organs, including an overall view and closeups of the injury. This may require that the labia (vaginal lips) be spread apart for closer photography or that the child kneel down on all four limbs to allow the anus to be photographed.



• In general, photographing a sexual abuse injury is best done by a medical specialist in the field of child abuse, with appropriate equipment such as a colposcope.