Brief screening spots domestic abuse

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It takes only a few minutes and a couple of questions to spot many hidden cases of domestic abuse in adults accompanying children to their pediatricians, new research shows.

Investigators found that asking parents to answer a few questions while waiting for their children to be seen by the doctor spotted 24 cases of home violence over a three-month period. In contrast, during the same three-month period in the previous year, clinicians uncovered only five cases of domestic abuse.

"That’s kind of how we know it works,” study author Doris Sisk told Reuters Health.

Sisk added that it is important to screen adults who accompany children to the doctors’ office because research shows that where there is domestic abuse, there is often child abuse as well.

She and her colleagues screened mothers “with the hope that we could be preventing some child abuse if we intervene with the mom,” she said.

According to the report, approximately 10 million children are exposed to domestic violence every year in the U.S. alone. Up to 30 percent of women may experience domestic violence at least once over the course of their lives.

During the experiment, Sisk and her colleagues asked every parent bringing a child to an out-patient pediatric clinic to complete a short questionnaire about domestic violence while waiting to see the doctor. Questionnaires were designed differently for children of different ages, and the longest included 12 questions.

Questions included whether a parent had been or was currently in a relationship where they were hit, kicked, slapped or punched; whether they were physically hurt by anyone during pregnancy; and whether their partner was verbally abusive.

During the first three months that Sisk’s team distributed the questionnaire, 1,622 children visited the pediatric clinic, the authors report in the journal BMC Medicine.

Sisk and her colleagues at the University of Arizona found that the questionnaire increased the odds of identifying instances of current domestic abuse by more than three-fold.

In an interview, Sisk said that this is the first time clinicians have tried to administer a screening tool for domestic abuse in a pediatric clinic. She noted that the goal is to reach out to mothers, but that the tool would likely work best if offered to every adult that brings a child to the pediatrician.

She explained that research has shown that women do not necessarily volunteer the fact that they are experiencing home violence, but will often admit it if they are asked.

She added that when women say they are being abused, doctors and social workers will often meet with them in private, and discuss what services can help them deal with their current situation, such as shelters or counseling.

They will also often ask mothers if they have noticed any changes in their children’s behavior, such as acting out or depression, which can be related to the domestic abuse, Sisk noted.

She added that she is obligated to report if a child is being abused, but she will often include the child’s mother in that process to ensure she realizes that the purpose is to protect the child, and not punish the mother for reporting the problem.

SOURCE: BMC Medicine, June 30, 2004.

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