Physical abuse re-reporting during the COVID-19 pandemic: The kids are not okay

Child physical abuse (PA) is a significant societal concern with limited research into predictors of re-reports.

Our research explores correlations between sociodemographic variables and re-reported PA. Our aim was to characterize populations at higher risk and identify changes in presentation during the COVID-19 pandemic.

This retrospective descriptive study focused on 238 patients with re-reports of PA made by a pediatric hospital from January 2019 through April 2021.

We analyzed sociodemographic information and details of reports made to child protective services (CPS) obtained from the electronic health record.

Females were 2.5 years older than males (mean 11.0 and 8.5 years, respectively) (p < .001, 95%CI 1.21-3.76). Males were more likely to have observable injuries (OR 2.61, p < .001) and a CPS response (OR = 2.70, p = .003). Patients categorized as "Other" races were less likely to have observable injuries (OR = 0.32, p = .006). Presentation changed during the pandemic: a quadrupling of re-reports by behavioral health clinicians caused the percentage of reports made by them to increase significantly (OR = 3.46, p < .001) and the mean age increased by 2.0 years (8.2 years before, 10.2 years during) (p = .009, 95%CI 0.5-3.5), though females remained approximately 2.2 years older than males (p = .003, 95%CI 0.8-3.7).

Males experienced higher rates of re-reported PA and were younger at the time of re-report. Changes to presentation during the pandemic suggest an increase in PA among older children. Future research should further explore differences in sex/race, while current prevention efforts should focus on children receiving behavioral health care.