A reappraisal of the frequency of child abuse seen in pediatric emergency rooms

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Abstract

This study was conducted to determine the frequency of abuse and neglect among infants and preschool children seen in the emergency department of a large children's hospital. A case-finding system was introduced using a checklist (Accident-SCAN) to remind the attending nurse and physician to consider the possibility of maltreatment in the etiology of each apparent accident. Thirty-nine of 2,211 accident patients were evaluated systematically during an 18-week study period and referred to a child protection team for investigation. Twenty-eight (1.3%) were presumed to be victims of abuse or neglect. This figure differs substantially from the widely quoted estimate of 10%. The marked discrepancy between this result and previous findings suggests that either important variations exist in the rates of abuse and neglect in different populations or that the earlier figures are overestimates.

Résumé

L'idée de l'étude présentée ici était de déterminer la fréquence des cas de maltraitance-négligence parmi les nourrissons et les enfant pré-scolaires tels qu'on les voit dans le secteur urgence d'un grand hôpital pour enfants. Pour constituer un collectif on a introduit un formulaire de contrôle (“accident-SCAN”) afin de rappeler à l'infirmière et au médecin de garde travaillant aux urgences qu'il faut considérer la possibilité de maltraitance dans l'étiologie de chaque cas apparemment accidentel. Sur 2,211 patients accidentés 39 furent évalués systématiquement sur une période de 18 semaines et référés à une équipe de protection de l'enfance pour investigations. 28 (1.3% du total) ont été trouvés suspects d'être des victimes de violence ou de négligence. Ce chiffre diffère de façon substantielle de l'estimation très souvent citée de 10%. Cette différence marquée par comparaison avec des rapports antérieurs suggère soit qu'il existe d'importantes variations dans la fréquence de la violence et de la négligence à l'égard d'enfants selon les populations, soit que les chiffres cités jusqu'ici sont largement surestimés

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This is publication No. 87001 of the McGill University-Montreal Children's Hospital Research Institute.

Dr. Pless is a recipient of a National Health Scientist Award from Health and Welfare, Canada. During the period of the survey, Dr. Sibbald was a R

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