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Abusive head trauma: current practice of investigation and management in Taiwan
Frank Leigh Lu1,2, Yen-Ju Chu2,3,4, Meng-Fai Kuo5
1Division of Pediatric Pulmonology and Critical Care Medicine, National Taiwan University Children's Hospital, Taipei, Taiwan.
Insights
Child protection services in Taiwan have improved over the last decade to combat abusive head trauma (AHT). Enhanced networks and training aim to better identify and manage AHT cases in young children.
Area of Science:
- Pediatrics
- Child Protection
- Public Health
Background:
- Abusive head trauma (AHT) is a primary cause of fatal head injuries in children under two years old globally.
- Developing effective child protection medical services is crucial for addressing AHT.
Purpose of the Study:
- To document the development of child protection medical services in Taiwan over the past decade (2013-2022).
- To review the evolution of Taiwan's pediatric protection network and interdisciplinary training programs.
Main Methods:
- Review of recommendations from the Taiwan Pediatric Association regarding AHT prevention and management.
- Analysis of the Medical Professionals Manual of Child Abuse and Neglect.
- Examination of the establishment and function of 10 regional child protection medical service centers.
Main Results:
- Establishment of 10 regional centers to improve identification, recognition, and management of AHT.
- Development of a cross-system child protection network involving healthcare, social welfare, and judicial sectors.
- Facilitation of early detection, management, and appropriate disposition for children with AHT.
Conclusions:
- The child protection network and ongoing training are expected to increase AHT incidence reporting.
- Improved consensus on AHT diagnosis and management has been achieved in Taiwan.
- Continuous efforts are necessary to further protect children from abusive head trauma.
Introduction:
Abusive head trauma (AHT) is a worldwide leading cause of fatal head injuries in children under 2 years. This study aims to present the development of child protection medical service in Taiwan in the past decade.
Materials And Methods:
This study reviews the evolution of the pediatric protection network and the cross-system professional training in Taiwan from 2013 to 2022. The recommendations of Taiwan Pediatric Association on the prevention and management of AHT and the Medical Professionals Manual of Child Abuse and Neglect proposed by the Ministry of Health and Welfare were reviewed.
Results:
Considering the impact of the high incidence of severe sequelae and the mortality caused by of AHT, 10 regional centers for child protection medical service were founded in Taiwan to identify, recognize, and properly manage cases of AHT, which is easily overlooked by the healthcare providers. The child protection network across the healthcare, social welfare administration, and judicial systems facilitate the early detection, management, and proper disposition of the children with AHT.
Conclusion:
An increasing of the incidence of AHT is expected after the setting up of the child protection network and the continuing cross-system professional trainings. There is more consensus of the diagnosis and management of AHT than before in Taiwan. However, there is no end to protecting children from AHT.
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