Screening Injured Children Could Identify Physical Abuse Earlier


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Early symptoms of child abuse are often missed by children’s health care providers, which can result in increasing and more severe injuries. An abstract titled, “Testing for Abuse in Children With Sentinel Injuries,” published in the November 2015 edition of Pediatrics, explains that researchers investigated whether routinely screening all children with certain “sentinel” injuries for child abuse would identify more children in time to protect them from further harm. For example, although bruises are very common in children who crawl and walk, they are strongly associated with abuse in children younger than 6 months of age.

Researchers analyzed a database of children who were treated in the emergency department or inpatient wards of leading children’s hospitals. Rates of abuse diagnosis varied considerably among hospitals, but overall rates were high among young children found to have certain sentinel injuries without having been in a motor vehicle collision.

Children under age 2 with rib fractures were diagnosed with abuse in more than 56 percent of cases.

Intracranial hemorrhage (bleeding in the brain) and abdominal injury were associated with abuse in more than 20 percent of cases.

Study authors concluded that increased and routine testing of children with sentinel injuries would identify other children with abuse who might otherwise be missed.

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