Frequency of injuries in a voluntary program evaluating young children exposed to intimate partner violence

Intimate partner violence (IPV) affects 1 in 4 American women, and physical child abuse is reported to occur in 10-67 % of homes with IPV. Routine evaluation of physical abuse in IPV-exposed children is neither widespread nor informed by clinical guidelines. Thus, the true frequency of detectable injuries in IPV-exposed children remains unknown. The purpose of this study was to examine the frequency of injuries in children <3-years-old reported for IPV to a regional child protective services (CPS) office.

In this prospective observational study, we reviewed encounters of children whose caregivers agreed to an evaluation for injuries (physical exam and imaging, if indicated) from July 2019-June 2022. Children were included if: 1) a CPS investigator referred a child for evaluation for injuries ("non-acute" evaluation) or 2) a child presented immediately after an IPV incident ("acute" evaluation).

Of 326 children <3-years-old reported to the CPS office after IPV exposure, 90 (27.6 %) were evaluated: 81(90 %) presented for a non-acute evaluation, and 21(23 %) were reported to have sustained trauma during the IPV event. Of the 90 children evaluated, 3 (3.3 %, 95 % CI 0.7-9.4) were found to have cutaneous injuries, fractures, and/or intracranial findings. Each was <6-months old and had an "acute" evaluation.

In this study of children reported to CPS for IPV exposure, a small percentage was found to have injuries. A multi-center study that examines the frequency of and factors that increase the risk of abusive injuries in IPV-exposed children may ensure that testing targets children at highest risk.