Recurrent concerns for child abuse: Repeated consultations by a subspecialty child abuse team

Martindale, Jennifer; Swenson, Alice D.; Coffman, Jamye; Newton, Alice W.; Lindberg, Daniel M.

doi:10.1016/j.chiabu.2014.03.007

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…26 A previous study revealed that the incidence of death was 4% in individuals who had been evaluated previously and 3% in those with single visits. 27 This was concordant with our results that 3.79% were found with single-visit children and 1.85% in repeated cases. Most of death cases in our study were occurred in children less than 1 year of age (the youngest case was 13 days old).…”

Section: Types Of Abusesupporting

confidence: 93%

Identifying children at high risk for recurrence child abuse

Wongcharoenwatana

Tarugsa

Kaewpornsawan

et al. 2021

J Orthop Surg (Hong Kong)

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Purpose: To evaluate the characteristics of abused children, families and abusive event and to identify risk factors associated with recurrence of child abuse. Methods: Retrospective data from 133 children aged between 2 months to 15 years old who were diagnosed as abuse between year 2002 and 2017. Thirteen items related to characteristics of the child, families, abusive event were selected. These factors were analyzed by multivariate logistic regression model for association with repeated child abuse. Results: Total of 133 subjects with average age of 5.25 ± 4.65 years old. There were 54 cases (40.60%) reported of repeated abuse. Majority of repeated abuse type in this study was physical abuse (73.68%). Most perpetrators were child’s own parents (45.10%). Factors associated with increased risk of repeated abuse were child age 1–5 years old (AOR = 4.95/95%CI = 1.06–23.05), 6–10 years old (AOR = 6.80/95%CI = 1.22–37.91) and perpetrator was child’s own parent (AOR = 21.34/95%CI = 3.51–129.72). Three cases of mortality were found with single-visit children and one case in recurrence. Most of death cases were children less than 1-year-old with average age of 7 months. Causes of death were subdural hematoma with skull and ribs fracture. Conclusions: Identifying risk factors for repeated child abuse help in recognizing child at risk to provide prompt intervention. This study found two factors associated with higher risk of abuse recurrence: child age 1–10 years old and abusive parents. Children who presented with these risk factors should be recognized and intensively monitored.

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Section: Types Of Abusesupporting

confidence: 93%

Identifying children at high risk for recurrence child abuse

Wongcharoenwatana

Tarugsa

Kaewpornsawan

et al. 2021

J Orthop Surg (Hong Kong)

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“…Previous secondary analyses of the ExSTRA data have used either a narrow score range of 6–7 (Dorfman et al, 2018; Greiner et al, 2013; Metz et al, 2014) or a broader score range of 5–7 (Martindale et al, 2014; Pawlik et al, 2016) to indicate a “higher likelihood of abuse”. The present study used the broader definition (i.e., 5–7) in order to guard against potential bias of overestimating the proportion of cases deemed low likelihood of abuse (thereby defined as a score of 1–4).…”

Section: Methodsmentioning

confidence: 99%

Child Abuse Pediatricians Assess a Low Likelihood of Abuse in Half of 2890 Physical Abuse Consults

et al. 2021

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The aim of this study was to examine the frequency with which child abuse pediatricians (CAPs) assess consultations as low versus high likelihood of abuse. In this retrospective secondary analysis of data from the Examining Siblings to Recognize Abuse (ExSTRA) study, the likelihood of abuse score for 2890 consultations at 20 medical centers was collected. Descriptive statistics were used to examine the percentage of cases representing low versus high likelihood of abuse (i.e., score of 1–4 vs. 5–7 on a 7-point scale). Linear and logistic regression analyses were used to examine score variability between medical centers. Overall, fifty-three percent of cases were assessed as low likelihood of abuse, suggesting that CAPs were equally as likely to assess a high versus low likelihood of abuse. The percentage of cases representing low likelihood of abuse differed significantly ( P < .001) between medical centers after controlling for patient age, sex, race/ethnicity, twin/triplet status, injury types, and injury severity. The variability between CAP assessments at different medical centers is discussed, along with potential contributors to this variability and directions for future work.

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“…Also, presentation of more blunt injuries might be attributed to accessibility of blunt objects at home. Several studies commented that superficial injuries and bruising were found in abused children [51][52][53]. Injury from abuse is often located at the head region due to child's small stature which makes the head the closest part to an adult's hand, followed by the skin, which is perceived as a lesser vital organ to harm.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Child Injury Database and Registry in Identifying Children Who are Potentially at Risk of Abuse: A Systematic Review

Jamaludin¹

2019

PNBOA

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Background: Child injury is a major cause of morbidity and mortality. The aim of this study is to systematically review trauma and injury databases and/or Child Protection Registries available globally that include children ≤18 years and to determine their effectiveness in identifying children potentially at risk of abuse within the community. Methods: Four high-yield electronic databases were searched, they were PubMed, EMBASE, PsychInfo and ProQuest to retrieve articles studying child injury databases. Full articles published in English from 2006 to 2016 that met the inclusion criteria were chosen. The included articles were appraised and evaluated by three reviewers independently. Results: Overall, 12 articles that studied child injury databases were selected. The articles were then categorized into five themes: 1) risk factors; 2) characteristics of abused children; 3) repeated admission; 4) concordance with other databases; and 5) presentation at the emergency department. The effectiveness of each theme in identifying children who are potentially at risk of abuse was then evaluated. Injury databases that used characteristics of abused children as a theme in identifying abuse cases were shown to be the most effective, followed by risk factors (fairly effective), repeated admission (fairly effective) and concordance with other databases (fairly effective). Presentation at the emergency department was shown to be not effective in predicting child abuse. Conclusion: Existing studies showed that there are still limitations in databases for identifying children at risk of abuse. The setup of an integrated database with linkage to other databases will increase efficiency in detection and assist in early identification of children potentially at risk of abuse in the emergency setting.

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Recurrent concerns for child abuse: Repeated consultations by a subspecialty child abuse team

Cited by 5 publications

References 23 publications

Identifying children at high risk for recurrence child abuse

Identifying children at high risk for recurrence child abuse

Child Abuse Pediatricians Assess a Low Likelihood of Abuse in Half of 2890 Physical Abuse Consults

The Effectiveness of Child Injury Database and Registry in Identifying Children Who are Potentially at Risk of Abuse: A Systematic Review

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