By Billy Hammond (Copyright AELS)

December 17, 2019

TEN-4 Rule of Pediatric Bruising

In the US in most states, medical professionals are required to report suspected child abuse.

One of the rules that is taught in recognizing child abuse is the TEN-4 Rule.

TEN stands for Torso, Ears and Neck and the 4 refers to children younger than 4 years old. The Torso, Ears and Neck are markers for child abuse in children in that age range. Bruising on the head, knees and arms would be considered within the realm of possible play injuries.

For children 4 months old or younger, any bruising on any part of the body is considered suspect.




TENとはT = Torso()E = Ears(耳)N = Neck (首)を意味する。4とは4歳より若い子供。そのいずれの個所の打撲傷があれば、虐待を疑う。但し、その年齢の膝、肘や腕の打撲傷は通常の遊びで出来る怪我範囲内のものが多い。




English novels by Billy Hammond published by AELS



I. Majoh Gakuin and Hikari Juku – Japanese Witch Schools Trilogy

1. Majoh Gakuin & Hikari Juku – Japanese Witch Schools

2. Lost Witch (The second book)

3. Fate & Magic (The final book in the trilogy)

II. Brindle – Scryer Extraordinaire Trilogy

1. Brindle – Scryer Extraordinaire

2. Brindle – Scryer Extraordinaire – Returns

3. Brindle – Scryer Extraordinaire – Challenges (The final book in the trilogy)

III. Fantasy fiction set in Japan

1. 21st Century Ninja

2. Regressed

3. Japanese Woman

IV. Fantasy fiction set outside of Japan

1. Dimension Jumpers