Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 18;48(1):32.
doi: 10.1186/s13052-022-01214-9.

Early recognition of child abuse through screening indicators at the emergency department: experience of a tertiary urban pediatric hospital

Caterina Offidani  1 , Alberto Villani  2 , Antonino Reale  2 , Maria Rosaria Marchili  3 , Lelia Rotondi Aufiero  2 , Patrizio Moras  4   5 , Maria Lodise  1 , Umberto Raucci  2 , Maria Antonietta Barbieri  2 , Massimiliano Raponi  6
Affiliations

Early recognition of child abuse through screening indicators at the emergency department: experience of a tertiary urban pediatric hospital

Caterina Offidani et al. Ital J Pediatr. .

Abstract

Background: Emergency Departments play a pivotal role in detecting cases of child abuse. Despite the efforts made in the past decades on the need for a screening method for the early detection of abuse victims, a unique instrument shared by the international scientific community has not been made. These instruments should be able to help recognizing whether it is necessary to further investigate the child's condition. The aim of the study is to illustrate the screening indicators in use since 2010 in the Emergency Department of the Bambino Gesù Children's Hospital to early recognise the victims of abuse and the modifying process of the screening tool undertaken over the years.

Methods: We retrospectively analyzed the process that led to the editing of the indicators of child abuse in use nowadays at the Bambino Gesù Children's Hospital. We codified three clinical pathways to apply in case of suspected abuse. Furthermore, we investigated the medical records of screening-positive accesses in the Paediatric Emergency Department of the Bambino Gesù Children's Hospital from January 2008 to October 2020.

Results: An estimation of positive screening, regarding the type of abuse suspected, and the number of accessed in ED was made, resulting in a cohort of 956 patients. In 2010 we created a list of 14 items grouped in three clusters: anamnestic declarations or incongruences, carelessness/neglect and evident lesions at physical examination. Positivity to one of the items allows the actuation of the investigating protocol named as clinical pathway.In 2013, after three years of experience, the criteria were edited to increase specificity. The application of screening led to a median number of 82 suspected cases/year from 2013 to 2020.

Conclusion: A screening tool is essential and productive for the early recognition of victims of abuse. An in-deep analysis of suspected cases through a standardized method, such as the clinical pathway, allowed reaching the diagnosis in a more accurate and precise manner.

Keywords: Child abuse; Maltreatment; Neglect; Screening; Sexual abuse.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow-chart of the clinical pathways
Fig. 2
Fig. 2
Total positive ED screening cases from 2010 to 2020
See this image and copyright information in PMC

References

    1. Al Odhayani A, Watson WJ, Watson L. Behavioural consequences of child abuse. Can Fam Physician. 2013;59(8):831–836. - PMC - PubMed
    1. Currie J, Widom CS. Child maltreatment 2010 best article award: long-term consequences of child abuse and neglect on adult economic well-being. Child Maltreat. 2011;16(3):233. doi: 10.1177/1077559511418799. - DOI - PubMed
    1. Jackson AM, Kissoon N, Greene C. Aspects of abuse: recognizing and responding to child maltreatment. Curr Probl Pediatr Adolesc Health Care. 2015;45(3):58–70. doi: 10.1016/j.cppeds.2015.02.001. - DOI - PubMed
    1. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006;256(3):174–86. doi: 10.1007/s00406-005-0624-4. - DOI - PMC - PubMed
    1. Levi BH, Brown G, Erb C. Reasonable suspicion: a pilot study of pediatric residents. Child Abuse Negl. 2006;30(4):345–356. doi: 10.1016/j.chiabu.2005.05.004. - DOI - PubMed