Background Abuse and neglect cause long-term damage to a child’s health and wellbeing. Emerging evidence highlights the dual role of statutory child protection medical assessments (CPMA) as being an opportunity to identify co-morbid medical concerns in children, alongside examination of forensic markers in cases of alleged abuse.
Aims To identify any health conditions reported during the CPMA of children presenting to a community paediatric unit over a one-year period. A sub-study exampled the extent to which these are treated through follow-up in children’s healthcare services.
Methods Medical reports of all children examined during a CPMA between June 2011–June 2012 were retrospectively reviewed. Only those referred by social care to the area’s community paediatric base were reviewed. Allegations of sexual abuse were not included.
Main outcome measures were untreated or newly diagnosed health concerns documented by the examining doctor; these are defined as unmet health needs (UHN). Searching the community paediatrics records database determined whether the UHNs of a sample group were treated within 6 months of discovery.
Results 210 reports were reviewed. 146 children (69.5%) had at least one unmet health need; 323 individual concerns were identified. The largest UHN category was physical conditions (n = 196, 60.7%), with immunisation concerns most frequently recorded (n = 38). Developmental concerns accounted for 38 (11.7%) of UHNs, including 18 cases of speech and language delay. 89 (27.6%) cases of psychological concerns were found; behavioural issues were the most prominent unmet developmental need (n = 48). In the sub-study sample (n = 20), 51% of UHNs were followed up within 6 months.
Conclusions This study found a large number of children presenting to a child protection medical assessment had unmet health needs. The sub-study confirmed that only 51% were met in follow-up. The child protection medical assessment is a key opportunity to review a child’s wellbeing. Additional work to provide comparable data is warranted. Future research should also address barriers that prevent needs being met.
Kirk, C. B., A. Lucas-Herald, et al. “Child protection medical assessments: why do we do them?” Archives of Disease in Childhood 2009;95(5):336–340.