Critical Elements to Recognize Child Abuse
Recently, a panel of child abuse experts released critical elements that can be used to identify physical child abuse medically.
Details about the Elements to Recognize Child Abuse
On June 22nd, child abuse experts published findings on child abuse protocols in “Pediatrics”, according to MedScape.
Often times diagnosing child abuse deals with a lot of uncertainty. It is usually a method of excluding alternative diagnoses, which is a loosely defined process with little resolution. The study claimed that without guidelines health professionals would have to “pick and choose” among options, developing a bias and lowering chance of diagnosis credibility.
The child abuse panel consisted of 28 child abuse pediatricians (CAP), all of who were asked to participate in the Delphi Process, with intention of defining key elements for child abuse in various medical cases. These cases include intracranial hemorrhage, long bone fracture, and skull fracture among children aged 0 to 60 months.
At the end of the study, the product was that the diagnosis could be built on the following aspects; need for an extended medical history including the source of said history, the caregiver being present at the time of injury as well as their response to the symptoms, and any changes or discrepancies in the history provided.
Exclusions to the Elements to Recognize Child Abuse
While this research identifies signs that indicate child abuse, it also acknowledges that its defined diagnosis method may be limiting.
The authors of the published research study wrote, “…CAPs recognize the potential misalignment of caregiver and physician goals in reaching the ‘correct’ diagnosis for a child. Broad inclusion of elements from the medical, developmental, and family history reflect the wide differential diagnosis entertained in cases of suspected abuse”.
Psychological elements required in the evaluation are what make the study considerably different from other published guidelines. A description of child care setting, related to intracranial hemorrhage or skull fracture, and a prior history of abuse, skull fracture, were deemed “required” or most “highly recommended” elements of abuse or violence in home.
However, these elements exclude the mental health of the caregiver, substance abuse, pregnancy planning, and perceptions of the child’s temperament by the parents.
The authors of this report acknowledge that their findings do not represent the CAP community as a whole and the opinion of the scientific truth behind these findings may alter over time.
In conclusion the authors state, “Additional research is required to determine whether these consensus guidelines can reduce previously described variability, decrease potential bias, and/or improve reliability in the evaluation and diagnosis of child physical abuse”.
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