Developing Assessments for Child Exposure to Intimate Partner Violence in Switzerland – a Study of Medico-Legal Reports in Clinical Settings

Abstract

Purpose: Evidence to inform assessment of needs of children exposed to intimate partner violence (IPV) in health settings is limited. A Swiss hospital-based medico-legal consultation for adult victims of violence also detects children's exposure to IPV and refers cases to the Pediatrics Child Abuse and Neglect Team. Based on a conceptual ecological framework, this study examined the nature and circumstances of children's exposure to IPV described in accounts collected by nurses in consultations with adult IPV victims. Methods: From 2011-2014, 438 parents (88% female) of 668 children aged 0 to 18 sought medico-legal care from the Violence Medical Unit in Lausanne Switzerland, following assaults by intimate partners (85% male). As part of the consultation, nurses completed a semi-structured questionnaire CHILDREN'S EXPOSURE TO IPV IN SWITZERLAND 2 with victimized parents, recording their answers in the patient file. Victims' statements about the abuse, their personal, family and social contexts, and their children's exposure to IPV were analyzed. Descriptive statistics and qualitative thematic content analyses were conducted to identify, from the victimized parents' accounts, elements useful to understand the nature and circumstances of children's exposure and involvement during violent events. Results: Parent statements on specific violent events described children being present in 75% of the cases. Children were said to be exposed to, and responded to, severe physical violence, serious threats and insults, in the context of repeated assaults and coercive control. Families, especially mothers, were often coping with additional socioeconomic vulnerabilities. Conclusions: Implications for further developing assessments of children living with IPV, especially in health settings were identified.

Suffering and Care of 0–12 Year-Old Children Exposed to Intimate Partner Violence: Making Clinical Forensic Data Talk

“…Protective factors can also play a moderating role in the child's individual response to IPV, as discussed above. Moreover, several studies point to the influence of co-occurring forms of socioeconomic vulnerabilities ( 25 , 40 ) or maltreatment ( 16 , 17 ), such as direct physical abuse, which can also complicate the analysis of the direct impact of IPV.…”

“…The results presented in this paper emerged in the context of the first author's medical thesis, which was carried out between September 2018 and September 2020 ( 24 ). The thesis itself was a component of a larger study on children's exposure to IPV ( 25 ).…”

“…Only one year's data were analyzed because of the thesis's time constraints. The year 2014 was selected since this was the most recent dataset available already extracted in the context of the larger study that examined data from 2011 through 2014 ( 25 ). The rationale for focusing on 0–12 year-old children was that this was the age group most represented in the main study.…”

“…The results presented in this paper emerged in the context of the first author's medical thesis ( 24 ). The thesis itself was a component of a larger study on children's exposure to IPV ( 25 ). We are grateful to the patients whose interviews constituted the basis for the study.…”

How the Current Management of Intimate Partner Violence Can Endanger Victimized Mothers and Their Children

“…Beyond putting children at risk of immediate physical harm during an assault (De Puy et al, 2019), children's experience of IPV can have detrimental consequences on their health, development and well-being (Carlson et al, 2019;Gardner et al, 2019;Vu et al, 2016;Wolfe et al, 2003). In addition, these children are at greater risk of experiencing neglect, physical or sexual abuse (Hamby et al, 2010;Holt et al, 2008).…”