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Factors Associated With Reports to Child Protective Services Following Unintentional Ingestions in Children Younger

Nicole Irgens-Moller1,2, Carly Shea3, Sundes Kazmir4

  • 1Section of Pediatric Emergency Medicine, Departments of Pediatrics and Emergency Medicine, Yale University School of Medicine, New Haven, CT.

Pediatric Emergency Care
|June 2, 2026
PubMed

Insights

In children with unintentional ingestions, social work or Child Protective Services (CPS) involvement depended on clinical severity and substance type, not race or insurance. These factors influenced decisions in emergency department (ED) cases.

Area of Science:

  • Pediatric Emergency Medicine
  • Social Work in Healthcare
  • Child Protective Services

Background:

  • Unintentional ingestions are common pediatric emergency department (ED) chief complaints.
  • Provider discretion guides decisions for social work consultation or Child Protective Services (CPS) reporting.
  • The influence of patient race or insurance status on these decisions is not well understood.

Purpose of the Study:

  • To investigate the association between a child's race or insurance status and decisions to consult social work or report to CPS.
  • To identify factors influencing social work and CPS involvement in pediatric unintentional ingestion cases.

Main Methods:

  • Retrospective cross-sectional study of children under 6 years old with poisoning or accidental ingestion.
  • Data collected from 6 Yale New Haven Health system hospitals (2013-2021).
  • Multivariable logistic regression analyzed factors associated with social work and CPS consults.

Main Results:

  • Social work consulted in 23% of cases; CPS reports in 6.7%.
  • Factors associated with social work/CPS consults included clinical severity (e.g., altered mental status, inpatient/PICU admission) and substance type (prescription/illicit drugs).
  • Race and insurance status were not associated with social work or CPS involvement.

Conclusions:

  • Clinical severity and the type of substance ingested are key factors in decisions for social work or CPS involvement.
  • Provider decisions regarding social work and CPS consults for pediatric unintentional ingestions are not influenced by patient race or insurance status.
  • These findings highlight the importance of objective clinical criteria in these sensitive decisions.
Abstract

Keywords:
child protective servicesingestionpediatric emergency departmentpoisoningsocial work

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