The contribution of a hospital child protection team in determining suspected child abuse and neglect: Analysis of referrals of children aged 0-9

Background: Hospital professionals have a unique opportunity to identify victims of child abuse and neglect (CAN). The hospital multi-disciplinary Child Protection Team (CPT) offers a means for optimizing procedures, maximizing caution and enhancing decision-making. Objective: The current study describes cases of children aged 0-9 years referred to the CPT, to identify the contribution of the CPT to the assessment process in determining reasonable suspicion of child abuse or neglect. Methods: The files of all 990 cases of children aged 0-9 referred to the CPT from 1991 thru 2006 were abstracted. Results: Nearly equal rates of boys and girls were referred to the CPT, and the average age was 2.4. years (SD 2.6), with over two-thirds aged 0-2. Half of the cases arrived at the hospital due to accident or trauma, and nearly one-third due to illness. Eighty-five neonates were referred due to parental risk factors identified at birth. The most common reasons prompting referral to the CPT were medical indication and parent behavior, with parents most often the suspected source of danger. Over half of the cases (566) were reported to authorities. Nearly half of those reported were cases of suspected physical neglect, 21.5% were suspected of physical abuse, and 7.6% of sexual abuse. There were significant differences in the patterns of reporting and types of suspicion both for the various age groups (p <0.001) and the genders (p <0.001), as well as by age-gender groups (shown in the first figure). Conclusions: The current findings illuminate the various factors and steps involved in the hospital CPT's assessment of preliminary suspicions of CAN raised by front-line clinicians. It is recommended that standardized criteria be developed based on current state-of-knowledge.