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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Sutures of the Skull01:22

Sutures of the Skull

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The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
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Psychological and Sociocultural Causes of Schizophrenia01:29

Psychological and Sociocultural Causes of Schizophrenia

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Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
450
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  11. Factors Associated With Child Protective Services Referrals In Young Children With Isolated Skull Fractures.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Paediatrics
  9. Infant And Child Health
  11. Factors Associated With Child Protective Services Referrals In Young Children With Isolated Skull Fractures.

Related Experiment Video

A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
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A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)

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Factors Associated With Child Protective Services Referrals in Young Children With Isolated Skull Fractures.

Karli Breeden-Carino1, Joanne N Wood2, Cindy W Christian3

  • 1Division of General Pediatrics (K Breeden-Carino), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa.

Academic Pediatrics
|December 3, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Many young children with skull fractures are referred to child protective services (CPS), even with low abuse likelihood. Factors like psychosocial risks and hospital site influence CPS referrals, showing significant variation across institutions.

Keywords:
CAPNETchild abusechild protective servicesskull fracture

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Area of Science:

  • Pediatric Traumatology
  • Child Abuse Pediatrics
  • Forensic Pediatrics

Background:

  • Young children with isolated skull fractures are often referred to child protective services (CPS).
  • These referrals occur despite assessments indicating a low likelihood of abuse.
  • Significant variation exists in CPS referral practices across different hospitals.

Purpose of the Study:

  • Identify factors associated with CPS referrals in young children with isolated skull fractures.
  • Quantify hospital-level variation in CPS referral rates.
  • Inform guidelines for appropriate CPS referrals in cases of pediatric skull fractures.

Main Methods:

  • Multicenter retrospective cross-sectional study of children under 2 years with skull fractures.
  • Included children with or without intracranial hemorrhage (ICH) and no other injuries, who underwent a child abuse pediatrics (CAP) evaluation.
  • Used multivariable logistic regression and marginal standardization to analyze CPS referral factors and hospital variation.

    • Main Results:

    • Over half (57.4%) of 528 children were referred to CPS, most before CAP consultation (86.5%).
    • Factors associated with CPS referral included psychosocial risk factors, in-person CAP consult, inflicted/no trauma history, absence of ICH, and hospital site.
    • Adjusted CPS referral rates varied significantly across hospitals, ranging from 34.6% to 76.4%.

    Conclusions:

    • A two-fold variation in CPS referrals for pediatric skull fractures exists based on hospital site.
    • The majority of CPS referrals occur before specialist child abuse pediatrics consultation.
    • Findings highlight the need for standardized guidance on indications for CPS referral in these cases.