Disabling Conditions and Registration for Child Abuse and Neglect: A Population-Based Study

OBJECTIVE: To study the relationship between disabling conditions and registration for child abuse and neglect in a 19-year whole-population birth cohort. SETTING: West Sussex area of the United Kingdom. STUDY DESIGN: Retrospective whole-population cohort. MAIN OUTCOMES: Child-protection registration, physical abuse, sexual abuse, emotional abuse, and neglect. POPULATION AND PARTICIPANTS: Infants born in West Sussex (119729) between January 1983 and December 2001 with complete data including birth weight, gestational age, maternal age, and postal code. RESULTS: Cerebral palsy, speech and language disorder, learning difficulties, conduct disorders, and nonconduct psychological disorders were all significantly associated with child-protection registration before adjustment, and all but cerebral palsy retained significance after adjustment for birth weight, gestational age, and socioeconomic status. Autism and sensory disabilities (vision and hearing) were not associated with an increased risk of child-protection registration. Conduct disorders and moderate/severe learning difficulty were associated with registration in each of the 4 categories after adjustment for socioeconomic status, birth weight, and gestational age. Children with speech and language disorders and mild learning difficulties were at increased risk of physical abuse, emotional abuse, and neglect. Nonconduct psychological disorders were associated with all categories except neglect, and cerebral palsy was associated with all categories except physical abuse and neglect. CONCLUSIONS: Children with disabling conditions seem to be at increased risk of registration for child abuse and neglect, although the pattern of registration varies with the specific disabling condition. The strong association with registration noted for conditions such as conduct disorder and learning difficulties is likely to arise, in part, because these conditions share a common etiologic pathway with child abuse and neglect.