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Pediatric Resource Center Recognizes “TEN-4” Day on October 4 to Raise Awareness of Potential Warning Signs of Abuse

Posted on September 24, 2025
TEN-4-FACESp is a screening tool to improve the recognition of potentially abused children. If bruising in any of the three components (Regions, Infants, Patterns) is present on a child under 4 without a reasonable explanation, strongly consider evaluating for child abuse and/or consulting with an expert in child abuse. TEN is an acronym for torso, ears, neck. 4 refers to any bruise anywhere on a child 4 months and younger. FACES stands for Frenulum, Angle of Jaw, Cheeks (fleshy part), Eyelids, Subconjunctivae. P refers to Patterned bruising like slap, grab or loop marks.
© Ann & Robert H. Lurie Children’s Hospital of Chicago; luriechildrens.org/ten-4-facesp

On October 4, the Pediatric Resource Center (PRC) joins healthcare providers and child advocates nationwide to highlight TEN-4 Day, an awareness effort to help caregivers, teachers, and medical professionals recognize when bruising and other injuries in young children may be a sign of child abuse. Awareness is particularly important because 1 in 4 children will experience physical abuse during their life with younger children being particularly vulnerable.

The “TEN-4-FACESp” rule is an evidence-based clinical decision tool that guides providers in identifying bruises that are potentially non-accidental and more concerning for possible physical abuse, including injuries of children under 4 years of age.

Pediatric Resource Center Recognizes TEN-4 Day Awareness event on October 4

“TEN-4-FACES” reminds adults to look closely at bruises found in specific areas:

  • Torso
  • Ears
  • Neck
  • Frenulum – tissue connecting lips and gum or tongue
  • Angle of the jaw
  • Cheeks
  • Eyelids
  • Subconjunctivae – white part of the eye

Additionally, any bruise on an infant 4 months or younger, as well as patterned bruises (such as marks shaped like a hand, belt, or object), are red flags that require further evaluation. The lowercase p in “TEN-4-FACESp” represents unexplained patterned bruising.

“Most bruises in active children are from normal play,” said Stephanie Johnson, Executive Director of the Pediatric Resource Center. “But bruises in the TEN-4-FACESp locations, especially in very young infants, should never be ignored. This tool helps frontline providers and caregivers know when a child needs immediate medical evaluation.”

“TEN-4” Day on October 4 is a reminder to community members to “See the Signs” by learning and sharing the TEN-4-FACESp rule. Parents, daycare providers, and anyone who works with children can help save lives simply by knowing when to be concerned.

If you suspect abuse:

  • Call the DCFS Hotline at 1-800-25-ABUSE
  • Contact the Pediatric Resource Center at (309) 624-9595
  • In emergencies, dial 911

Established in 1993, the Pediatric Resource Center serves as a vital community service program within the University of Illinois College of Medicine at Peoria. It specializes in providing child-centered, specialized medical evaluations and social services to children who may have experienced abuse or neglect. The Pediatric Resource Center evaluates more than 600 central Illinois children from over 40 counties each year.

To make a donation to support PRC services: go to https://go.uic.edu/PRCGiving

For more information about the Pediatric Resource Center, please visit pediatricresourcecenter.org

Contact:  Stephanie Johnson, Executive Director at 309-624-9595, saj@uic.edu

Modified on October 31, 2025