RT Journal Article
SR Electronic
T1 Child protection medical assessments: why do we do them?
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 336
OP 340
DO 10.1136/adc.2009.160499
VO 95
IS 5
A1 Charlotte B Kirk
A1 Angela Lucas-Herald
A1 Jacqueline Mok
YR 2010
UL http://adc.bmj.com/content/95/5/336.abstract
AB Introduction Child protection guidelines highlight the importance of medical assessments for children suspected of having been abused. Aim To identify how medical assessments might contribute to a diagnosis of child abuse and to the immediate outcome for the child. Method Review of all notes pertaining to medical assessments between January 2002 and March 2006. Results There were 4549 child protection referrals during this period, of which 848 (19%) proceeded to a medical examination. 742 (88%) case notes were reviewed. Of the medical examinations, 383 (52%) were for alleged physical abuse, 267 (36%) for sexual abuse and 20 (3%) for neglect. 258 (67%) of the physical abuse cases were considered to have diagnostic or supportive findings as compared to 61 (23%) of the sexual abuse cases (χ2=146.31, p<0.001). In diagnostic or supportive examinations or where other potentially abusive concerns were identified, 366 (73%) proceeded to further multi-agency investigation and 190 (41%) to case conference. 131 (69%) of these resulted in the registration of the child on the child protection register. Other health concerns were identified in 121 (31%) of physical and 168 (63%) of sexual abuse cases. Conclusion In this case series, 465 (63%) out of 742 examinations showed signs diagnostic or supportive of alleged abuse or highlighted other abusive concerns. This endorses the view that medical examination is an important component in the assessment of child abuse as it provides information to support or refute an allegation and helps to identify the health and welfare needs of vulnerable children.