Child Abuse: Adherence of Clinical Management to Guidelines for Diagnosis of Physical Maltreatment and Neglect in Emergency Settings

Pierpaolo Di Lorenzo, Claudia Casella, Serena Dei Medici (), Fabio Policino, Emanuele Capasso and Massimo Niola
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Pierpaolo Di Lorenzo: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples “Federico II”, 80131 Naples, Italy
Claudia Casella: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples “Federico II”, 80131 Naples, Italy
Serena Dei Medici: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples “Federico II”, 80131 Naples, Italy
Fabio Policino: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples “Federico II”, 80131 Naples, Italy
Emanuele Capasso: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples “Federico II”, 80131 Naples, Italy
Massimo Niola: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples “Federico II”, 80131 Naples, Italy

IJERPH, 2023, vol. 20, issue 6, 1-15

Abstract: Child maltreatment is a phenomenon of great importance due to the significant socio-health implications related to it. Purpose of the study is assessing compliance child abuse clinical management with guidelines and suggest corrective actions to avoid false negative or false positive judgments. The data come from 34 medical records of child victims of suspected abuse hospitalized in a pediatric clinic. We examined diagnostic and medico-legal management through the analysis of pediatric, dermatological, ophthalmological (including fundus examination), and gynecological (only in some cases) consultations, brain and skeletal imaging, laboratory tests (with reference to the study of hemostasis), and medico-legal advice. Of 34 patients, the average age was 23 months, ranging from 1 month to 8 years. The judgment was positive for abuse for 20 patients and negative for 12 patients; in two cases it was not possible to express a conclusive judgment. Two children died because of the injuries sustained. We underline the need of clinical-diagnostic standardized protocols, coroner in emergency settings, short-distance follow-up, social worker support. We also suggest objectifying in a descriptive way (using a common and repeatable language) and with photographic documentation the results of all the investigations carried out, to evaluate signs of physical maltreatment and neglect.

Keywords: child abuse; physical maltreatment; neglect; guidelines; violence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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