Skip to main content

The Presentation of Child Maltreatment in Healthcare Settings

  • Chapter
  • First Online:
Clinical Handbook of Psychological Consultation in Pediatric Medical Settings

Part of the book series: Issues in Clinical Child Psychology ((ICCP))

  • 1520 Accesses

Abstract

This chapter defines child maltreatment and provides an overview of how maltreatment presents in healthcare settings. Protective and risk factors associated with child maltreatment are identified. Reporting rules for suspected child maltreatment are outlined, as is the role of the consulting psychologist in the hospital setting, child advocacy center, and in the patient-centered medical home. Provision of anticipatory guidance on adverse childhood experiences (ACEs) and toxic stress will be provided as will suggestions for brief intervention on managing common physiological symptoms often associated with trauma. This chapter addresses the role of the consulting psychologist in educating healthcare professionals about the negative effects of child maltreatment including corporal punishment. Evidence-based interventions to address child maltreatment in the outpatient setting are provided. A case example is provided to demonstrate the role of a consulting psychologist in an integrated pediatric primary care setting.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aaron, H., & Burtless, G. (2014). Potential effects of the affordable care act on income inequality. Retrieved from The Brookings Institution website: http://www.brookings.edu/research/papers/2014/01/potential-effects-affordable-care-act-income-inequality-aaron-burtless

  • Bailhache, M., Leroy, V., Pillet, P., & Salmi, L. R. (2013). Is early detection of abused child possible? A systematic review of the diagnostic accuracy of the identification of abused children. BMC Pediatrics. https://doi.org/10.1186/1471-2471-2431-12-202

  • Bender, H. L., Allen, J. P., McElhaney, K. B., Antonishak, J., Moore, C. M., Kelly, H. O., & Davis, S. M. (2007). Use of harsh physical discipline and developmental outcomes in adolescence. Development and Psychopathology, 19, 227–242.

    Article  Google Scholar 

  • Berlin, L. J., Dodge, K. A., & Reznick, S. (2013). Examining pregnant women’s hostile attributions about infants as a predictor of offspring maltreatment. American Medical Association. JAMA Pediatrics, 167, 549. http://archpedi.jamanetwork.com

    Article  Google Scholar 

  • Burkhart, K., Knox, M., & Hunter, K. (2016). Changing healthcare professionals’ positive attitudes toward spanking. Clinical Pediatrics, 55(11), 1005–1011.

    Article  Google Scholar 

  • Casanueva, C., Wilson, E., Smith, K., Dolan, M., Ringeisen, H., & Horne, B. (2012). NSCAW II wave 2 report: Child wELL-being report. OPRE report # 2012-38. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, US Department of Health and Human Services.

    Google Scholar 

  • Child Abuse and Prevention and Treatment ACT (CAPTA) amended by P.L. 111-320, the CAPTA reauthorization act of 2010.

    Google Scholar 

  • Child Maltreatment. (2002). Summary of key study findings. National clearinghouse on child abuse and neglect information: US Department of Health and Human Services Administration for Children and Families. Retrieved from nccanch.acf.hhs.gov/pubs/factsheets/canstats.cfm

  • Child Welfare Information Gateway. (2016). Mandatory reporters of child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

    Google Scholar 

  • Compton, M. T., & Shim, R. S. (2015). The social determinants of mental health. Arlington, VA: American Psychiatric Association.

    Google Scholar 

  • Eckenrode, J., Smith, E. G., McCarthy, M. E., & Dineen, M. (2014). Income inequality and child maltreatment in the United States. Pediatrics, 133(3), 454. Retrieved from http://pediatrics.aappublications.org

    Article  Google Scholar 

  • Farst, K. J., Ambadwar, P. B., King, A. J., Bird, T. M., & Robbins, J. M. (2013). Trends in hospitalization rates and severity of injuries from abuse in young children, 1997-2009. Pediatrics, 131, e1796–e1802.

    Article  Google Scholar 

  • Friedlander, E. Y., Rubin, D. M., Alpern, E. M., Mandell, D. S., et al. (2008). Patterns of health care use that may identify young children who are at risk for maltreatment. Pediatrics, 116, 1303–1308.

    Article  Google Scholar 

  • Garcia, A. R., DeNard, C., Ohene, S., Morones, S. M., & Connaughton, C. (2018). “I am more than past:” parents’ attitudes and perceptions of the Positive Parenting Program in child welfare. Children and Youth Services, 88, 286–297.

    Article  Google Scholar 

  • Gershoff, E. T., Font, S. A., Taylor, C. A., Foster, R. H., Garza, A. B., Olson-Dorff, D., & Spector, L. (2017). Effectiveness of a No Hit Zone policy in reducing staff support for and intervention in physical punishment in a hospital setting. Children and Youth Services Review, 94, 155–162.

    Article  Google Scholar 

  • Gershoff, E. T., & Grogan-Kaylor, A. (2016). Spanking and child outcomes: Old controversies and new meta-analyses. Journal of Family Psychology, 30(4), 453.

    Article  Google Scholar 

  • Gunn, V. L., Hickson, G. B., & Cooper, W. O. (2005). Factors affecting pediatricians’ reporting of suspected child maltreatment. Ambulatory Pediatrics, 5(2), 96–101.

    Article  Google Scholar 

  • Jackson, A. M., Kissoon, N., & Green, C. (2015). Aspects of abuse: Recognizing and responding to child maltreatment. Current Problems in Pediatric and Adolescent Health Care, 45, 58–70.

    Article  Google Scholar 

  • Jenny, C. (Ed.). (2011). Child abuse and neglect diagnosis, treatment, and evidence. St. Louis, MI: Elsevier Saunders.

    Google Scholar 

  • Jenny, C., & Crawford-Jakubiak, S. E. (2013). The evaluation of children in the primary care setting when sexual abuse is suspected. Pediatrics, 132, e558.

    Article  Google Scholar 

  • Jenny, C., Hymel, K. P., Ritzen, A., Reinert, S. E., & Hay, T. C. (1999). Analysis of missed cases of abusive head trauma. JAMA, 281, 621–626.

    Article  Google Scholar 

  • Keenan, H. T., Cook, L. J., Olson, L. M., Bardsley, T., & Campbell, K. A. (2017). Social intuition and social information in physical child abuse evaluation and diagnosis. Pediatrics, 140(5), e20171188. https://doi.org/10.1542/peds.2017-1188

    Article  Google Scholar 

  • Kellogg, N. D. (2007). Evaluation of suspected child physical abuse. Pediatrics, 119(6), 1232–1241.

    Article  Google Scholar 

  • Kenny, M. C., Lopez-Griman, A. M., & Donohue, B. (2017). Development and initial evaluation of a cost-effective, internet-based program to assist professionals in reporting suspected child maltreatment. Journal of Child & Adolescent Trauma, 10(4), 385–393.

    Article  Google Scholar 

  • King, A. J., Farst, K. J., Jaeger, M. W., Onukwube, J. I., & Robbins, J. M. (2015). Maltreatment-related emergency department visits among children 0 to 3 years old in the United States. Child Maltreatment, 20(3), 151–161.

    Article  Google Scholar 

  • Knox, M., Pelletier, H., & Vieth, V. (2013). Educating medical students about adolescent maltreatment. International Journal of Adolescent Medicine and Health, 25, 301–308.

    Article  Google Scholar 

  • Knox, M. S., Pelletier, H., & Vieth, V. (2014). Effects of medical student training in child advocacy and child abuse prevention and intervention. Psychological Trauma: Theory, Research, Practice, and Policy, 6, 129–133.

    Article  Google Scholar 

  • Lane, W. G., et al. (2002). Racial differences in the evaluation of pediatric fractures for physical abuse. JAMA, 288(13), 1603–1609.

    Article  Google Scholar 

  • Laskey, A. L., Stump, T., Perkins, S. M., et al. (2012). Influence of race and socioeconomic status on the diagnosis of child abuse: A randomized study. Journal of Pediatrics, 160(6), 1003–1037.

    Article  Google Scholar 

  • Lawrence, L. L., & Brannen, S. J. (2000). The impact of physician training on child maltreatment reporting: A multi-specialty study. Military Medicine, 165(8), 607–611.

    Article  Google Scholar 

  • Leetch, A. N., Leipsic, J., & Woolridge, D. P. (2015). Evaluation of child maltreatment in the emergency department setting. Child and Adolescent Psychiatric Clinics of North America, 24, 41.

    Article  Google Scholar 

  • Leetch, A. N., & Woolridge, D. (2013). Emergency department evaluation of child abuse. Emergency Medicine Clinics North America, 31, 853–873.

    Article  Google Scholar 

  • Lubell, K. M., Lofton, T., & Singer, H. H. (2008). Promoting health parenting practice across cultural groups: A CDC research brief. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention.

    Google Scholar 

  • Markenson, D., Tunik, M., Cooper, A., Olson, L., Cook, L., et al. (2007). A national assessment of knowledge, attitudes, and confidence of prehospital providers in the assessment and management of child maltreatment. Pediatrics, 119(1), e103. https://doi.org/10.1542/peds.2005-2121

    Article  Google Scholar 

  • Mason, S. M., Schnitzer, P. G., Danilack, V. A., Elston, B., & Savitz, D. A. (2018). Risk factors for maltreatment-related infant hospitalizations in New York City, 1995–2004. Annals of Epidemiology, 28(9), 590–596.

    Article  Google Scholar 

  • Mikton, C., & Butchart, A. (2009). Child maltreatment prevention: A systematic review of reviews. Bulletin World Health Organization, 87, 353–361.

    Article  Google Scholar 

  • Miller-Perrin, C., & Malloy, L. C. (2007). Curriculum guide for instruction in child maltreatment. Section on Child Maltreatment Division, 37.

    Google Scholar 

  • Olds, D. L., Kitzman, H., Knudtson, M., et al. (2014). Effect of home visiting by nurses on maternal and child mortality results of two-decade follow-up of a randomized clinical trial. JAMA Pediatrics, 168(9), 800–806.

    Article  Google Scholar 

  • Pelletier, H., & Knox, M. (2016). Incorporating child maltreatment training into medical school curricula. Journal of Child & Adolescent Trauma, 10, 267–274.

    Article  Google Scholar 

  • Pulido, M. L., Dauber, S., Tully, B. A., Hamilton, P., Smith, M. J., & Freeman, K. (2015). Knowledge gains following a child sexual abuse prevention program among urban students: A cluster-randomized evaluation. American Journal of Public Health, 105(7), 1344–1352.

    Article  Google Scholar 

  • Raney, L. E. (Ed.). (2015). Integrated care. Arlington, VA: American Psychiatric Association.

    Google Scholar 

  • Regalado, M., Sareen, H., Inkelas, M., Wissow, L. S., & Halfon, N. (2004). Parents’ discipline of young children: Results from the National Survey of Early Childhood Health. Pediatrics, 113, 1952–1958.

    Article  Google Scholar 

  • Schaeffer, P., Leventhal, J. M., & Asnes, G. (2011). Children’s disclosures of sexual abuse: Learning from direct inquiry. Child Abuse & Neglect: The International Journal, 35(5), 343–352.

    Article  Google Scholar 

  • Schmitt, B. D. (1987). Seven deadly signs of childhood: Advising parents about difficult developmental phases. Child Abuse and Neglect, 11(3), 421–432.

    Article  Google Scholar 

  • Scholer, S., Brokish, P. A., Mukherjee, M. D., et al. (2008). A violence prevention program helps teach medical students and pediatric residents about childhood aggression. Clinical Pediatrics, 47(9), 891–900.

    Article  Google Scholar 

  • Sedlak, A. J., Mettenburg, J., Basena, M., Petta, I., McPherson, K., Creene, A., & Li, S. (2010). Fourth National Incidence Study of Child Abuse and Neglect (NIS-4). Washington, DC: US Department of Health and Human Services. Retrieved from http://www.acf.hhs.gov/programs.opre/research/project/national-incidence-study-of-child-abuse-and-neglect-nis-4-2004-2009

  • Sege, R. D., Hatmaker-Flanigan, E., De Vos, E., Levin-Goodman, R., & Spivak, H. (2006). Anticipatory guidance and violence prevention: Results from family and pediatrician focus groups. Pediatrics, 117(2), 455–463.

    Article  Google Scholar 

  • Sheets, L. K., Leach, M. E., Koszewski, I. J., Lessmeier, A. M., Nugent, M., & Simpson, P. (2013). Sentinel injuries in infants evaluated for child physical abuse. Pediatrics, 131(4), 701–707.

    Article  Google Scholar 

  • Sidebothan, P., & Heron, J. (2006). Child maltreatment in the “children of the nineties:” A cohort study of risk factors. Child Abuse & Neglect, 30(5), 497–522.

    Article  Google Scholar 

  • Silva, J. (2011). ACT facilitator manual: ACT raising safe kids program. Washington, DC: American Psychological Association.

    Google Scholar 

  • Straus, M. A., & Stewart, J. H. (1999). Corporal punishment by American parents: National data on prevalence, chronicity, and duration, in relation to child and family characteristics. Clinical Child and Family Psychology Review, 2, 55–70.

    Article  Google Scholar 

  • Sullivan, P. M., & Knutson, J. F. (1998). The association between child maltreatment and disabilities in a hospital-based epidemiological study. Child Abuse and Neglect, 22(4), 271–288.

    Article  Google Scholar 

  • The Centers for Disease Control and Prevention. (2014). Retrieved from https://www.cdc.gov

  • The National Child Traumatic Stress Network. (n.d.). Retrieved from https://www.nctsn.org

  • Vieth, V. I. (2006). Unto the third generation: A call to end child abuse in the United States within 120 years (revised and expanded). Hamline Journal of Public Law and Policy, 28, 1.

    Google Scholar 

  • Webster-Stratton, C., & Reid, J. (2010). Adapting the incredible years an evidence-based parenting programme for families involved in the child welfare system. Journal of Children’s Services, 5(1), 25–42.

    Article  Google Scholar 

  • World Health Organization. (2018, October 10). Child maltreatment. Retrieved from http://www.who.int/news-room/fact-sheets/detail/child-maltreatment

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kimberly Burkhart .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Burkhart, K., Knox, M. (2020). The Presentation of Child Maltreatment in Healthcare Settings. In: Carter, B.D., Kullgren, K.A. (eds) Clinical Handbook of Psychological Consultation in Pediatric Medical Settings. Issues in Clinical Child Psychology. Springer, Cham. https://doi.org/10.1007/978-3-030-35598-2_34

Download citation

Publish with us

Policies and ethics