Detection of child abuse in emergency departments: a multi-centre study

Eveline C F M Louwers, Ida J Korfage, Marjo J Affourtit, Dop J H Scheewe, Marjolijn H van de Merwe, Francoise A F S R Vooijs-Moulaert, Claire M C Woltering, Mieke H T M Jongejan, Madelon Ruige, Henriëtte A Moll, Harry J De Koning, Eveline C F M Louwers, Ida J Korfage, Marjo J Affourtit, Dop J H Scheewe, Marjolijn H van de Merwe, Francoise A F S R Vooijs-Moulaert, Claire M C Woltering, Mieke H T M Jongejan, Madelon Ruige, Henriëtte A Moll, Harry J De Koning

Abstract

Objective: This study examines the detection rates of suspected child abuse in the emergency departments of seven Dutch hospitals complying and not complying with screening guidelines for child abuse.

Design: Data on demographics, diagnosis and suspected child abuse were collected for all children aged ≤18 years who visited the emergency departments over a 6-month period. The completion of a checklist of warning signs of child abuse in at least 10% of the emergency department visits was considered to be compliance with screening guidelines.

Results: A total of 24 472 visits were analysed, 54% of which took place in an emergency department complying with screening guidelines. Child abuse was suspected in 52 children (0.2%). In 40 (77%) of these 52 cases, a checklist of warning signs had been completed compared with a completion rate of 19% in the total sample. In hospitals complying with screening guidelines for child abuse, the detection rate was higher (0.3%) than in those not complying (0.1%, p<0.001).

Conclusion: During a 6-month period, emergency department staff suspected child abuse in 0.2% of all children visiting the emergency department of seven Dutch hospitals. The numbers of suspected abuse cases detected were low, but an increase is likely if uniform screening guidelines are widely implemented.

Conflict of interest statement

Competing interests None.

References

    1. Gilbert R, Widom CS, Browne K, et al. Burden and consequences of child maltreatment in high-income countries. Lancet 2009;373:68–81
    1. Guenther E, Knight S, Olson LM, et al. Prediction of child abuse risk from emergency department use. J Pediatr 2009;154:272–7
    1. Spivey MI, Schnitzer PG, Kruse RL, et al. Association of injury visits in children and child maltreatment reports. J Emerg Med 2009;36:207–14
    1. Woodman J, Pitt M, Wentz R, et al. Performance of screening tests for child physical abuse in accident and emergency departments. Health Technol Assess 2008;12:1–95
    1. Tenney-Soeiro R, Wilson C. An update on child abuse and neglect. Curr Opin Pediatr 2004;16:233–7
    1. Gilbert R, Kemp A, Thoburn J, et al. Recognising and responding to child maltreatment. Lancet 2009;373:167–80
    1. Euser EM, van Ijzendoorn MH, Prinzie P, et al. Prevalence of child maltreatment in The Netherlands. Child Maltreat 2010;15:5–17
    1. Lamers-Winkelman F, Slot NW, Bijl B, et al. Scholieren over mishandeling; Resultaten van een landelijk onderzoek naar de omvang van kindermishandeling onder leerlingen van het voortgezet onderwijs. [School Students About Abuse; Results of a National Survey of the Extent of Child Abuse Among Pupils of Secondary School.] Duivendrecht: PI Research, Vrije Universiteit Amsterdam, Faculteit der Psychologie en Pedagogiek, WODC, 2007
    1. MOgroep Jeugdzorg Adviezen en meldingen over kindermishandeling in 2008. [Advice and Reports of Child Abuse in 2008.] Utrecht: MOgroep Jeugdzorg, 2009
    1. Ethier LS, Lemelin JP, Lacharité C. A longitudinal study of the effects of chronic maltreatment on children's behavioral and emotional problems. Child Abuse Negl 2004;28:1265–78
    1. Wet op de Jeugdzorg. [Law on Youth Care.] [(accessed 19 April 2010)].
    1. Louwers EC, Affourtit MJ, Moll HA, et al. Screening for child abuse at emergency departments: a systematic review. Arch Dis Child 2010;95:214–18
    1. Marteau TM, Kinmonth AL. Screening for cardiovascular risk: public health imperative or matter for individual informed choice? BMJ 2002;325:78–80
    1. Wal van der G. Afdeling spoedeisende hulp van ziekenhuizen signaleert kindermishandeling nog onvoldoende: gebroken arm nog te vaak een ongelukje. [Observation of Child Abuse Still Insufficient at Emergency Departments of Hospitals: Broken Arm Is Too Often Just an Accident.] The Hague: Health Care Inspectorate, 2008
    1. Benger JR, Pearce V. Simple intervention to improve detection of child abuse in emergency departments. BMJ 2002;324:780.
    1. Pless IB, Sibald AD, Smith MA, et al. A reappraisal of the frequency of child abuse seen in pediatric emergency rooms. Child Abuse Negl 1987;11:193–200
    1. Sidebotham PD, Pearce AV. Audit of child protection procedures in accident and emergency department to identify children at risk of abuse. BMJ 1997;315:855–6
    1. Kellogg ND. American Academy of Pediatrics Committee on Child Abuse and Neglect. Evaluation of suspected child physical abuse. Pediatrics 2007;119:1232–41
    1. Trocmé N, MacMillan H, Fallon B, et al. Nature and severity of physical harm caused by child abuse and neglect: results from the Canadian Incidence Study. CMAJ 2003;169:911–15

Source: PubMed

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