The healthcare industry can play a critical role in preventing child abuse, according to a new study. Providing regular health screenings for children with signs of physical abuse can help protect them from further harm, according to a report published in Pediatrics.
That probably doesn’t come as a huge surprise, but as it currently stands, doctors and nurses are reluctant to summon child protective services unless they see numerous signs of abuse, like lack of eye contact from the child or vague details about the injury from the caregiver. Bruises are also a telltale sign, but as any parent will tell you, kids get bumps and bruises all the time, and sometimes parents really don’t know how the injury occurred.
In an effort to understand if screenings for children with “sentinel injuries,” could better help identify victims of abuse and prevent further harm, researchers dove deeper into past health records of children who were brought in with a sentinel injury. Researchers say sentinel injuries occur more often in children who are abused. Some examples of some of these sentinel injuries include:
- Bruises on children younger than six months
- Limb fractures
- Genital injuries
- Burn injuries
Researchers examined the health records of more 30,000 children who were brought into the clinic with minor sentinel injuries, and they also examined rates of further abuse testing and eventual abuse diagnosis. After looking at the compilation of data, researchers uncovered:
- Among all visits for children younger than 2-years-old, the rate of abuse diagnosis was 0.17 percent, however, rates of abuse diagnosis of children with at least one punitive sentinel injury were much higher.
- For children younger than 12 months of age, the rate of abuse diagnosis for those with burns was 3.5 percent.
- For children younger than 2-years-old, the rate of abuse diagnosis for those with rib fractures was 56.1 percent.
“An alternative, more objective approach would be to routinely screen those children who are found to have injuries most associated with abuse,” the researchers wrote.
Variance in Healthcare Screening Rates
One of the main reasons why researchers wanted to dive deeper into this topic was because abuse testing rates varied so widely from clinic to clinic. When children were admitted to a clinic with a skull fracture, the rate of abuse testing ranged from 20 percent of patients on the low end to 74 percent of patients on the high end.
“Approximately 30% of abusive head trauma and 20% of abusive fractures are missed initially, putting children at risk for ongoing abuse,” the authors wrote.
Additionally, researchers discovered that children’s hospitals called for further abuse testing twice as often as general hospitals when punitive sentinel injuries are present, and abusive fractures are seven times more likely to be missed in general emergency departments than pediatric emergency departments.
Researchers believe the results of the study can lead to the development of a more standardized abuse testing procedure when certain injuries are present so victims don’t continue to slip through the cracks.
“Together, these facts suggest that increased, routine, or protocolized testing for children with these injuries can identify other children with abuse that might otherwise be missed. These results support future trials of protocolized evaluations for children with these putative sentinel injuries,” researchers concluded.
Related source: Medscape