Child abuse and neglect in a pediatric emergency department: epidemiology and outcome

Area of Science:

• Pediatric Emergency Medicine
• Child Protection Services
• Social Work in Healthcare

Background:

• Managing child abuse and neglect in pediatric emergency departments (PEDs) presents significant challenges due to complex screening and lengthy care processes.
• Assessing and intervening in cases of child abuse and neglect within PEDs is a critical but often difficult aspect of pediatric care.

Purpose of the Study:

• To quantify the child protection activities undertaken within a pediatric emergency department.
• To evaluate the scope and nature of social evaluations and interventions for children presenting with abuse or neglect concerns.

Main Methods:

• A retrospective, single-center study was conducted at Lille University Hospital's PED between September 2017 and February 2019.
• Included patients required social evaluation by PED staff; data analyzed included patient demographics, reasons for visit, length of stay, and protective actions taken.
• Primary endpoint was the rate of patients needing social management; secondary endpoints included length of stay, reports to child protective services, and reports to a judge.

Main Results:

• The study included 245 patients (0.6% of PED visits), with a median age of 5 years.
• Leading reasons for visits included somatic complaints (31%), sexual assault (23%), and behavioral disorders (20%).
• Key interventions involved reports to child protective services (34%) and to a judge (24%), with 51% requiring post-discharge actions.

Conclusions:

• Child abuse management in PEDs is a substantial and time-intensive undertaking.
• Establishing a specialized hospital child protection team is vital for optimal initial care and sustained monitoring of child abuse victims.