Skip to main content
SpringerLink
Log in

Child maltreatment identification rates in a child development center: suggestions for improved detection

  • Original Article
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Under-identification of child maltreatment (CM) remains a significant problem. The study aim was to examine rates of CM identification in a child development center (CDC) vs. a community clinic (CC). This was a cross-sectional study, involving study (CDC) and comparison groups (CC) and using administrative data for the period 2011–2015. The study group consisted of children 0–18 years belonging to the Meuhedet Health Maintenance Organization (HMO)—Northern Region, who attended the CDC, including satellite clinics, for assessment/treatment. The CDC employed a multi-disciplinary approach to improve CM identification. The comparison group consisted of children with a disability belonging to the HMO, who attended a CC, but were not known to the CDC. Rates of CM identification, socio-demographic characteristics, and disability severity were compared. CM identification during the study period was 2.1% for the CDC vs. 0.8% for the CC. Children visiting the CDC had five times higher odds to be identified with suspected CM than children in the CC, after adjusting for age, gender, socioeconomic status, ethnicity, and disability severity.

Conclusion: CM identification rates in children with disability were higher in a CDC vs. CC. The approach used in the CDC may significantly improve CM identification in children with disability.

What is Known:

• There is significant under-identification of CM.

What is New:

• By examining child maltreatment identification rates in a child development center vs. the community, the study found that a multi-disciplinary staff approach can significantly improve CM Identification.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CC:

Community clinic

CDC:

Child development center

CM:

Child maltreatment

HMO:

Health Maintenance Organization

SES:

Socioeconomic status

References

  1. Norman RE, Byambaa M, De R et al (2012) The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med 9:e1001349. https://doi.org/10.1371/journal.pmed.1001349

    Article  PubMed  PubMed Central  Google Scholar 

  2. Munro E (2005) What tools do we need to improve identification of child abuse? Child Abus Rev 14:374–388. https://doi.org/10.1002/car.921

    Article  Google Scholar 

  3. Gilbert R, Kemp A, Thoburn J, Sidebotham P, Radford L, Glaser D, MacMillan HL (2009) Recognising and responding to child maltreatment. Lancet 373:167–180. https://doi.org/10.1016/S0140-6736(08)61707-9

    Article  PubMed  Google Scholar 

  4. Louwers ECFM, Korfage IJ, Affourtit MJ, Scheewe DJH, van de Merwe MH, Vooijs-Moulaert AFSR, van den Elzen APM, Jongejan MHTM, Ruige M, Manai BHAN, Looman CWN, Bosschaart AN, Teeuw AH, Moll HA, de Koning HJ (2012) Effects of systematic screening and detection of child abuse in emergency departments. Pediatrics 130(3):457–464. https://doi.org/10.1542/peds.2011-3527

    Article  PubMed  Google Scholar 

  5. Bailhache M, Leroy V, Pillet P, Salmi L-R (2013) Is early detection of abused children possible?: a systematic review of the diagnostic accuracy of the identification of abused children. BMC Pediatr 13:202. https://doi.org/10.1186/1471-2431-13-202

    Article  PubMed  PubMed Central  Google Scholar 

  6. Maclean MJ, Sims S, Bower C, Leonard H, Stanley FJ, O’Donnell M (2017) Maltreatment risk among children with disabilities. Pediatrics 139:e20161817. https://doi.org/10.1542/peds.2016-1817

    Article  PubMed  Google Scholar 

  7. Sullivan PM, Knutson JF (2000) Maltreatment and disabilities: a population-based epidemiological study. Child Abuse Negl 24:1257–1273

    Article  PubMed  CAS  Google Scholar 

  8. Hershkowitz I, Lamb ME, Horowitz D (2007) Victimization of children with disabilities. Am J Orthop 77(4):629–635. https://doi.org/10.1037/0002-9432.77.4.629

    Article  Google Scholar 

  9. Itzhaky H, Zanbar L (2014) In the front line: the impact of specialist training for hospital physicians in children at risk on their collaboration with social workers. Soc Work Health Care 53:617–639. https://doi.org/10.1080/00981389.2014.921267

    Article  PubMed  Google Scholar 

  10. McElvaney R, Culhane M (2017) A retrospective analysis of children’s assessment reports: what helps children tell? Child Abus Rev 26:103–115. https://doi.org/10.1002/car.2390

    Article  Google Scholar 

  11. Victoor A, Delnoij DM, Friele RD, Rademakers JJ (2012) Determinants of patient choice of healthcare providers: a scoping review. BMC Health Serv Res 12:272. https://doi.org/10.1186/1472-6963-12-272

    Article  PubMed  PubMed Central  Google Scholar 

  12. Feng JY, Fetzer S, Chen YW, Yeh L, Huang MC (2010) Multidisciplinary collaboration reporting child abuse: a grounded theory study. Int J Nurs Stud 47:1483–1490. https://doi.org/10.1016/j.ijnurstu.2010.05.007

    Article  PubMed  Google Scholar 

  13. Mctavish JR, Kimber M, Devries K et al (2017) Mandated reporters’ experiences with reporting child maltreatment: a meta-synthesis of qualitative studies. BMJ Open 7:e013942. https://doi.org/10.1136/bmjopen-2016-013942

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ben-Arieh A, Haj-Yahia MM (2006) The “geography” of child maltreatment in Israel: findings from a national data set of cases reported to the social services. Child Abuse Negl 30:991–1003

    Article  PubMed  Google Scholar 

  15. Stith SM, Liu T, Davies LC, Boykin EL, Alder MC, Harris JM, Som A, McPherson M, Dees JEMEG (2009) Risk factors in child maltreatment: a meta-analytic review of the literature. Aggress Violent Behav 14:13–29

    Article  Google Scholar 

  16. Wildeman C, Emanuel N, Leventhal JM, Putnam-Hornstein E, Waldfogel J, Lee H (2014) The prevalence of confirmed maltreatment among US children, 2004 to 2011. JAMA Pediatr 168(8):706–713. https://doi.org/10.1001/jamapediatrics.2014.410

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lev-Wiesel R, Eisikovits Z, First M et al (2013) Prevalence of child maltreatment in Israel: a national epidemiological study. J Child Adolesc Trauma:1–10

  18. Lynne EG, Gifford EJ, Evans KE, Rosch JB (2015) Barriers to reporting child maltreatment: do emergency medical services professionals fully understand their role as mandatory reporters? N C Med J 76:13–18

    PubMed  Google Scholar 

  19. Vrolijk-Bosschaart TF, Brilleslijper-Kater SN, Widdershoven GA, Teeuw AH, Verlinden E, Voskes Y, van Duin EM, Verhoeff AP, Benninga MA, Lindauer RJL (2017) Physical symptoms in very young children assessed for sexual abuse: a mixed method analysis from the ASAC study. Eur J Pediatr 176:1365–1374. https://doi.org/10.1007/s00431-017-2996-7

    Article  PubMed  PubMed Central  Google Scholar 

  20. Alvarez KM, Kenny MC, Donohue B, Carpin KM (2004) Why are professionals failing to initiate mandated reports of child maltreatment, and are there any empirically based training programs to assist professionals in the reporting process? Aggress Violent Behav 9:563–578. https://doi.org/10.1016/j.avb.2003.07.001

    Article  Google Scholar 

  21. Sittig JS, Uiterwaal CSPM, Moons KGM, Russel IMB, Nievelstein RAJ, Nieuwenhuis EES, van de Putte EM (2016) Value of systematic detection of physical child abuse at emergency rooms: a cross-sectional diagnostic accuracy study. BMJ Open 6:e010788. https://doi.org/10.1136/bmjopen-2015-010788

    Article  PubMed  PubMed Central  Google Scholar 

  22. Starling SP, Heisler KW, Paulson JF, Youmans E (2009) Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors. Pediatrics 123:e595–e602. https://doi.org/10.1542/peds.2008-2938

    Article  PubMed  Google Scholar 

  23. Berry AD, Garzon DL, Mack P, Kanwischer KZ, Beck DG (2014) Implementing an early childhood developmental screening and surveillance program in primary care settings: lessons learned from a project in Illinois. J Pediatr Healthc 28:516–525 10p. https://doi.org/10.1016/j.pedhc.2014.04.008

    Article  Google Scholar 

  24. Kohl PL, Jonson-Reid M, Drake B (2009) Time to leave substantiation behind: findings from a national probability study. Child Maltreat 14:17–26. https://doi.org/10.1177/1077559508326030

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We are most grateful to Shira Barak, Naama Eldar, Pazit Klein-Bardugo, and Anat Toledano for data collection.

Funding source

Meuhedet supported this project internally.

Author information

Authors and Affiliations

  1. Child Development and Pediatric Neurology Service, Meuhedet-Northern Region, Simtat Atlit 6, 33501, Haifa, Israel

    Mitchell Schertz & Yael Karni-Visel

  2. Faculty of Health and Welfare, Haifa University, Haifa, Israel

    Yael Karni-Visel & Irit Hershkowitz

  3. Social Work Service, Meuhedet, Northern Region, Haifa, Israel

    Michal Flaisher

  4. Clinical Quality Department, Meuhedet, Tel Aviv, Israel

    Fabienne Hershkowitz

Authors
  1. Mitchell Schertz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yael Karni-Visel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Irit Hershkowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michal Flaisher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fabienne Hershkowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Dr. M. Schertz conceptualized and designed the study, performed data interpretation, drafted the initial manuscript, and reviewed and revised the manuscript.

Dr. Y. Karni-Visel conceptualized and designed the study, performed data interpretation, supervised data collection, and reviewed and revised the manuscript.

Professor I. Hershkowitz performed data interpretation and reviewed and revised the manuscript.

Mrs. M. Flaisher coordinated data collection and reviewed and revised the manuscript.

Dr. F. Hershkowitz performed data analyses and interpretation and reviewed and revised the manuscript.

All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Mitchell Schertz.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

As data was obtained retrospectively and given the risk to identified children and parents not necessarily informed about the report, we received an exemption from having to obtain parental consent.

Additional information

Communicated by Mario Bianchetti

Communicated by Mario Bianchetti

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schertz, M., Karni-Visel, Y., Hershkowitz, I. et al. Child maltreatment identification rates in a child development center: suggestions for improved detection. Eur J Pediatr 177, 1081–1087 (2018). https://doi.org/10.1007/s00431-018-3163-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-018-3163-5

Keywords

Search

Navigation