According to a recent study, child abuse is significantly underreported by primary health care providers. Researchers from Boston University School of Medicine and Boston Medical Center used a subsample of injuries drawn from the national Child Abuse Reporting and Experience Study, which included over 15000 child injury cases. Researchers interviewed primary care providers (PCPs) about 111 cases involving injured children, six weeks and six months after they treated the children. The cases were also reviewed by five child abuse experts.
Of the cases that were reviewed, the researchers found that the PCP did not report 21 percent of injuries that the experts said they would have reported to child protective services. This finding is substantial because in 81 percent of the physical injury cases, the primary health care providers and experts agreed about the suspicion of abuse. So while PCPs are trained in how to identify child abuse injuries, they need to be educated on why they need to report, how to report, and what information they need to provide.
The researchers explained that identifying an injury caused by child abuse can be difficult and that only the responsible person and the child witness the event. In addition, they note various reasons why PCP’s may not report including questioning their own judgment of whether an injury is enough to meet the standard of reasonable suspicion for abuse, bond with the parent/caregiver, and awareness of the overwhelmed and overburdened Department of Social Services. The findings suggest that PCPs require better training in the diagnosis and management of child abuse, and as a result, they are working with the American Academy of Pediatrics and others to get more training for pediatricians.
Under the CAPTA Reauthorization Act of 2010 (P.L. 111-320), the Department of Health and Human Services is now required to maintain and disseminate information on the medical diagnosis and treatment of child maltreatment. The law also provides new support for research that focuses on effective practices in medical diagnosis of child abuse and neglect as well as effective collaborations between child protective services and medical providers.