Related Experiment Video
Updated: Jul 27, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Referrals to a hospital-based child abuse committee: a comparison of the 1960s and 1990s
D E Thomas1, J M Leventhal, E Friedlaender
1Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8064, USA.
Insights
Referrals for child abuse and neglect increased significantly, with a shift towards newborns and less severe injuries. This reflects broader definitions and earlier recognition of at-risk families.
Area of Science:
- Pediatrics
- Child Welfare
- Public Health
Background:
- Child maltreatment reports have risen annually since 1976.
- Limited data exist on the evolving characteristics of reported children.
- Understanding these changes is crucial for effective intervention.
Purpose of the Study:
- To analyze changes in the characteristics of children referred for maltreatment over time.
- To compare child abuse committee referrals from the late 1960s to the early 1990s.
Main Methods:
- Retrospective review of medical records and child abuse committee logs.
- Comparison of 101 children from 1968-1969 (early group) with 107 children from 1990-1991 (late group).
- Exclusion of sexual abuse cases; focus on nonsexual abuse, neglect, and at-risk classifications.
Main Results:
- Nonsexual abuse referrals more than doubled from the early to the late group.
- The late group had a significant increase in newborn referrals (1% vs. 52%).
- Fewer children in the late group sustained physical injuries (49% vs. 71%), with a rise in 'at-risk' classifications.
Conclusions:
- Referrals to child abuse committees have substantially changed, with a notable increase in high-risk newborns and cases involving minimal injuries.
- This shift suggests broader definitions of maltreatment and earlier identification of at-risk families.
- The findings highlight evolving patterns in child maltreatment reporting within a medical setting.
Objective:
Although reports of child maltreatment have increased yearly since national data were first collected in 1976, little information is available about changes in the characteristics of children reported. Therefore, to examine changes over time in recognition and reporting in a medical setting, we compared referrals to a hospital-based child abuse committee in the late 1960s and early 1990s.
Design:
Retrospective, cross-sectional review of medical records and logs of the hospital's child abuse committee.
Settings:
Ambulatory, emergency, and inpatient services at Yale-New Haven Hospital.
Patients:
Medical records were reviewed for 101 of the 165 children referred to the child abuse committee in 1968-1969 (early group) and 107 of the 843 children referred in 1990-1991 (late group). Cases of sexual abuse were excluded.
Results:
Referrals for nonsexual abuse cases increased from 80 children per year in the early group to 181.5 per year in the late group; the late group was characterized by a larger number of newborn referrals (1% vs. 52%, p < .001). When non-newborns were compared, the two groups were similar with respect to gender and race, but the late group had fewer patients with private insurance (31% vs. 12%, p < .05). The late group also had more female-headed households (32% vs. 67%, p < .05) and more parents with a history of substance abuse (4% vs. 49%, p < .001). Excluding newborns, who were all classified as "at-risk," the types of problems were classified as abuse (41% early vs. 29% late), neglect (41% vs. 35%), and "at-risk" (16% vs. 35%). Although the types of injuries were similar: superficial injuries (20% vs. 16%), burns (9% vs. 8%), and fractures (6% vs. 4%), fewer maltreated children suffered physical injuries in the late group (71% vs. 49%, p < .05).
Conclusions:
A substantial change has occurred in referrals to the hospital's child abuse committee for abuse or neglect. Most referrals have become socially high-risk newborns and children or children with minimal injuries. This shift is likely due to broader definitions of maltreatment and earlier recognition of troubled families.
Related Concept Videos
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:17Healthcare Agencies II
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources, and lay...
01:21Types of Reports II: Incident or Occurrence Report
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
01:22Standards of Care I
01:19Standards of Care II