Missed Cases in the Detection of Child Abuse Based on Parental Characteristics in the Emergency Department (the Hague Protocol)

Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt

“…To start, eligible parents could have been missed at the emergency department. We do not know if this happened in our sample, but in an analysis of the Hague protocol, 8 out of 120 cases (7%) were missed, for various reasons (Diderich et al ). Furthermore, of all eligible families, 8% refused to be examined at the outpatient pediatric department, and another 17% was examined but refused study participation.…”

Nurses’ and physicians’ reported difficulties and enablers to recognising and reporting child abuse in Swiss paediatric emergency and paediatric surgery departments – an observational study

“…Consensus was reached on all items except for the "Typical locations for accidental and non-accidental injuries' item, which the authors decided not to replace with the other suggested items (e.g., TEN-4-FACESp, a validated tool to help screen children under 4 years of age with bruising to differentiate accidental from non-accidental injury [23]). The final ver-sion of the tool comprised six parts (see appendix): 1) six screening questions adapted from the validated ESCAPE instrument [24] to be used in case of suspected CAN or for the implementation of a general screening in the ED, 2) alarming clinical/behavioural findings of abuse/neglect within the context of the history [25], 3) child and 4) family factors that increase vulnerability to CAN, 5) typical locations for accidental and non-accidental injuries [26], and 6) suggested consensus and experience-based example questions for approaching the child and their family for suspected child abuse. We found this especially useful to respond to the expressed (emotional) challenge of approaching the child and their family in case of suspected CAN and to facilitate a possible entry point for the conversation that could save a life.…”

“…(clinical, history, socio-economic factors), screening questions for staff [24], sample questions for facilitated communication with child abuse victims and their families, and a graphical representation of typical locations of accidental and non-accidental injuries in children [26]. We suggest that other resources be added individually (e.g., contact details of the hospital CPS, linkto the local child abuse referral pathway, and relevant local web sites).…”