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Evidence insufficient on how to screen for child abuse

Monday June 10, 2013
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The U.S. Preventive Services Task Force has released its final recommendation statement on primary care interventions to prevent child abuse and neglect.

The task force found that although child maltreatment is a very serious problem, there is not enough evidence to determine how primary care practices can prevent abuse or neglect of children who do not show signs or symptoms of maltreatment. Therefore, the task force issued an "I" statement.

"No child should suffer from abuse or neglect," task force member David Grossman, MD, MPH, said in a news release. "We know there are children suffering abuse who donít show obvious signs of mistreatment, and the task force wanted to learn more about what primary care practices can do to help them."

Child maltreatment is harmful actions or threat of these actions toward children, such as physical abuse, sexual abuse, emotional abuse and neglect. It affects more than half a million children each year, according to the news release. In 2011, about 680,000 children in the United States were abused or neglected, and more than 1,500 of these children died. Children ages 5 and younger are at the highest risk for abuse and death from abuse.

The task force reviewed studies released since 2004, the last time the group examined this topic, on how primary care practices can prevent child abuse and neglect. However, little evidence was found about how primary care practices can prevent maltreatment in children who show no obvious signs of abuse or neglect. Due to the lack of evidence, the task force stated it cannot make a specific recommendation for or against providing interventions to prevent maltreatment.

"We critically need more research on how primary care clinicians can prevent maltreatment and protect their young patients when symptoms of abuse or neglect are not apparent," Grossman said.

The task force thus calls on the healthcare community to conduct research to determine how primary care clinicians can effectively intervene to prevent abuse and neglect. Areas where more research is needed include how healthcare professionals can help support families to prevent abuse and neglect, how to identify children who are being mistreated, ways to prevent abuse of older children and whether interventions to prevent child abuse could cause unintended harms.

"It will take action from every part of society, including families, schools and healthcare professionals, to build a future where every child can grow up healthy and safe from abuse and neglect," said task force Chair Virginia Moyer, MD, MPH. "While we learn more about what primary care professionals can do to help children, all healthcare professionals must continue to remain vigilant for signs of abuse and neglect and respond appropriately when they identify problems."

Read the recommendation statement and related links: www.uspreventiveservicestaskforce.org/uspstf/uspsfamv.htm.


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