Child Abuse: Early Case Finding in the Emergency Department

In a 2-week survey of all children under 6 years of age seen in an emergency department for accidents, 7 of 69 cases were suspected of having injuries due to maltreatment. These judgments were made by the investigators systematically reviewing the medical records of these children and their parents. In a second 2-week survey conducted 6 months later, a similar incidence (7 of 87) of abuse was suspected by the investigators. These latter families also were evaluated by a home visit, and an additional 3 accidents were judged to reflect abuse and 10 further cases were thought to reflect gross neglect. Empirically, certain types of injuries were found to be most commonly associated with childhood abuse. These findings are discussed in terms of the preventive function and role of an emergency department.