The Tip of the Iceberg for Child Abuse: The Critical Roles of the Pediatric Trauma Service and its Registry

Chang, David C.; Knight, Vinita Misra; Ziegfeld, Susan; Haider, Adil H.; Warfield, Dawn; Paidas, Charles N.

doi:10.1097/01.ta.0000145076.05111.e1

Cited by 76 publications

(79 citation statements)

References 6 publications

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“…In total, 2.3% of all children in the TARNlet study were recorded as injured because of physical abuse, but this rose to 23.5% for infants ( Table 8). 75 Similar trends were reported by Chang et al 98 In summary, we found no direct evidence that age is predictive of physical abuse in all injured children attending A&E, but admission with severe injury in infancy was moderately predictive of abuse.…”

Section: Review Resultssupporting

confidence: 77%

“…Only one study, 101 conducted in Hawaii, was based on all injured children attending A&E. Two other studies 75,98 were based on a subset of children admitted with severe injuries.…”

Section: Review Resultsmentioning

confidence: 99%

“…infants or children under 2 years), fractures or head injury in young children, 22 Several potentially important characteristics were not evaluated because of a lack of UK data. These include presentation during night-time hours, 98,99 parental mental illness and drug abuse, and domestic violence, all of which are factors evaluated by the community liaison nurse (Ben Lloyd, January 2006, personal communication).…”

Section: Characteristics Of Children Attending Aande For Injurymentioning

confidence: 99%

“…The timing of attendance at A&E (night-time) and the severity of the injury are both associated with physical abuse and warrant further investigation. 75,98,99 Bruising to the head or face may also offer a feasible screening test without requiring a fully undressed examination, but its performance needs to be assessed in the A&E population. 19 We could not evaluate direct questioning of schoolage children as we found no relevant studies, despite the recommendation by Lord Laming that children with suspected abuse be questioned about the injury.…”

Section: Key Findingsmentioning

confidence: 99%

See 3 more Smart Citations

Performance of screening tests for child physical abuse in accident and emergency departments

Woodman¹,

Pitt²,

Wentz³

et al. 2008

Health Technol Assess

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How to obtain copies of this and other HTA Programme reports. An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable CD-ROM is also available (see below).Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) Programme, part of the National Institute for HealthResearch (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in t...

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Section: Review Resultssupporting

confidence: 77%

“…Only one study, 101 conducted in Hawaii, was based on all injured children attending A&E. Two other studies 75,98 were based on a subset of children admitted with severe injuries.…”

Section: Review Resultsmentioning

confidence: 99%

Section: Characteristics Of Children Attending Aande For Injurymentioning

confidence: 99%

Section: Key Findingsmentioning

confidence: 99%

See 2 more Smart Citations

Performance of screening tests for child physical abuse in accident and emergency departments

Woodman¹,

Pitt²,

Wentz³

et al. 2008

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…4,19 Hospital discharge databases using ICD-9 codes allow the use of E-codes for assault to better identify cases of inflicted injury and injury severity scoring to judge the seriousness of the child' s abuse. 12,13,24 Our study population was limited to children 0 through 3 years of age because this represents the age group most likely to require hospitalization for injury from abuse. 18,19 Limiting the study population to the youngest age group also minimizes the potential confounder of an E-code for assault representing peer on peer violence in older age groups instead of injury perpetrated by a person responsible for the child' s care although serious injury can occur to young children by their siblings.…”

Section: Discussionmentioning

confidence: 99%

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Farst

Ambadwar²,

King³

et al. 2013

Pediatrics

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OBJECTIVES: To examine trends in incidence of hospitalizations for injury from abuse in young children from 1997 through 2009 and to examine injury severity trends. METHODS: Cases were identified in the National Inpatient Sample database of the Healthcare Cost and Utilization Project by using International Classification of Diseases, Ninth Revision, Clinical Modification codes for child maltreatment and external cause of injury for assault in children aged 0 through 3 years. Incidence was calculated by age, gender, and region. Trends in incidence of hospitalization and injury severity were calculated over time. RESULTS: Hospitalization rates for injury from abuse showed no significant change over the study period, ranging from a low of 2.10 per 10 000 children in 1998 to a high of 3.01 per 10 000 children in 2005 (P = .755). Children aged <1 had significantly higher hospitalization rates for injury from abuse (6.01 vs 1.12, P <.001) and higher mean injury severity scores compared with children aged 1 to 3 years (12.50, SD = 0.14 vs 8.56, SD = 0.21, P <.001). Injury severity scores increased significantly over the study period. CONCLUSIONS: No significant change in hospitalization rates for injury from abuse among young children was observed from 1997 to 2009. These results coincide with other reports of stable or modestly increasing rates of serious physical abuse or death in young children but not with reports from child welfare data showing declines in physical abuse during the same period. Diverse sources of data may provide important complementary methods to track child abuse.

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Association of Friday School Report Card Release With Saturday Incidence Rates of Agency-Verified Physical Child Abuse

et al. 2019

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IMPORTANCE Corporal punishment is a leading risk factor for physical abuse. Strong anecdotal evidence from physicians and other professionals working in child protection suggest that punishment-initiated physical abuse for school-aged children increases after release of report cards. However, no empirical examination of this association has occurred. OBJECTIVE To examine the temporal association between school report card release and incidence rates (IRs) of physical abuse. DESIGN, SETTING, AND PARTICIPANTS This retrospective study reviewed calls to a state child abuse hotline and school report card release dates across a single academic year in Florida. Data were collected in a 265-day window from September 8, 2015, to May 30, 2016, in the 64 of 67 Florida counties with report card release dates available (16 960 days). Participants included all children aged 5 to 11 years for whom calls were made. A total of 1943 verified cases of physical abuse were reported in the study period in the 64 counties. Data were analyzed from October 2017 through May 2018. EXPOSURES School report cards release across a single academic year, measured daily by county. MAIN OUTCOMES AND MEASURES Daily counts of calls to a child abuse hotline that later resulted in agency-verified incidents of child physical abuse across a single academic year by county. RESULTS During the academic year, 167 906 calls came in to the child abuse hotline for children aged 5 to 11 years; 17.8% (n = 29 887) of these calls were suspected incidents of physical abuse, and 2017 (6.7%) of these suspected incidents were later verified as cases of physical abuse before excluding the 3 counties with no release dates available. Among the 1943 cases included in the analysis (58.9% males [n = 1145]; mean [SD] age, 7.69 [1.92] years), calls resulting in verified reports of child physical abuse occurred at a higher rate on Saturdays after a Friday report card release compared with Saturdays that do not follow a Friday report card release (IR ratio, 3.75; 95% CI, 1.21-11.63; P = .02). No significant association of report card release with IRs was found for any other days of the week. CONCLUSION AND RELEVANCE This association of school report card release and physical abuse appears to illustrate a unique systems-based opportunity for prevention.

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The Tip of the Iceberg for Child Abuse: The Critical Roles of the Pediatric Trauma Service and its Registry

Cited by 76 publications

References 6 publications

Performance of screening tests for child physical abuse in accident and emergency departments

Performance of screening tests for child physical abuse in accident and emergency departments

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Association of Friday School Report Card Release With Saturday Incidence Rates of Agency-Verified Physical Child Abuse

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