Child abuse, comparative analysis of national and European models and case studies

Child Abuse is described as a major public health problem, requiring a standardized and multidisciplinary approach.

The aim of the study is to evaluate the application of the operative protocols that have been used in the management of suspected cases of child abuse, provided by PDTA (Diagnostic-Therapeutic Care Pathway) of Palermo, and their conformity to the scientific literature ("Royal College of Pediatrics and Child Health" and "Adams's classification").

The study was conducted on a clinical-legal database of 55 patients, which have been followed from 2013 until 2025, evaluating demographic variables, modality of the abuse and the mode of access (urgent vs scheduled).

We proceeded with a process of data normalization, terminological cleaning and removal of outliers to ensure consistency in the analysis and the validity of statistical analyses and epidemiological interpretations.

The explorative analyses of the database highlighted a significant prevalence in the female gender (62,2%), of intra-familial cases (where the most frequent perpetrator is the father), of recurrent cases, and a bimodal distribution of the age with two peaks (3-6, 11-14 years with mean age 8.3 years). The 79,5% of the consultations were carried out on a scheduled basis, suggesting delays in activating the diagnostic-therapeutic pathway; in fact, a greater clinical-legal plausibility of abuse was observed in cases assessed urgently (p = 0.38).

Most cases were managed on a scheduled basis despite higher clinical-legal plausibility in urgent assessments; cases predominated in females, showed bimodal age peaks (3-6 and 11-14 years), and were largely intra-familial with fathers most frequently implicated. Findings support earlier activation of the pathway and standardized data capture across services.