Concerns about child maltreatment in hospitalized children

Area of Science:

• Pediatric healthcare
• Child welfare
• Clinical social work

Background:

• Child abuse and neglect are significant public health concerns.
• Understanding factors influencing clinician reporting is crucial for child protection.
• Previous research highlights socioeconomic disparities in child maltreatment reports.

Purpose of the Study:

• To identify factors associated with clinicians' concerns about child abuse and neglect.
• To examine predictors of reporting hospitalized children to Child Protective Services (CPS).
• To investigate the influence of socioeconomic status, family structure, and illness severity on reporting.

Main Methods:

• Cross-sectional chart review of pediatric hospitalizations (n=5,446) across three cities.
• Data collected on clinician concerns for abuse/neglect, CPS reports, family income, ethnicity, family structure, child's age, and illness severity.
• Statistical analysis to determine independent associations between variables.

Main Results:

• Concerns for abuse (2.5%) and neglect (3.1%) were noted; 2.9% of children were reported to CPS.
• Younger child age, low income, and single-parent families were linked to increased concerns and reports.
• Low income correlated with neglect concerns, while illness severity impacted abuse concerns in head trauma and neglect concerns in meningitis cases.

Conclusions:

• Confirms associations between neglect, poverty, and single-parent families in hospitalized children.
• Increasing illness severity may prompt clinicians to consider delayed care and potential neglect.
• Findings underscore the need for targeted interventions and support for vulnerable families in pediatric settings.