Child Abuse Experts Often Fail to Screen for Domestic Violence

Although child abuse and intimate partner abuse are often linked, pediatricians who specialize in child abuse often do not screen the parents for signs of abuse when they suspect abuse of the child, according to data presented today at the Pediatric Academic Societies annual meeting in San Francisco.

The American Academy of Pediatrics already recommends that pediatricians screen female caretakers for intimate partner violence, but pediatricians are often reluctant to do so. The link between partner violence and child abuse is strong. About 1 in 6 children evaluated for child abuse have a caretaker who was previously subject to severe violence by the child's father, according to the data.
The data also suggests a possible association between parental custody battles and a history of domestic violence.

"Even child abuse specialists do not routinely screen for domestic violence," said Jocelyn Brown, MD, MPH, director of the Child Advocacy Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian Hospital, and an associate professor of clinical pediatrics at Columbia University Medical Center, who conducted the study. "This shows how much more education we need to do, even among experts, to understand the known links between violence of the child and the parent."

The study was done in multiple parts with a survey of 57 pediatricians who specialize in child abuse and a questionnaire filled out by 732 caretakers who brought their children to the Child Advocacy Center of Morgan Stanley Children's Hospital of NewYork-Presbyterian. The Child Advocacy Center provides counseling and links to services for parents and children who are victims of domestic violence.

In the caretaker survey, 542 were mothers and 7.1 percent reported a prevalence of severe physical assault with their current partner and 14.9 percent with the child's father. Families presenting with a history of custody battle were four times more likely to have a history of severe physical assault with the child's father.

"Although this information is not conclusive, it suggests that clinicians evaluating children in the context of a custody battle should screen for intimate partner violence," Dr. Brown said.

The Pediatric Academic Societies (PAS) Annual Meeting is the largest international meeting that focuses on research in child health. The PAS consists of the American Academy of Pediatrics, Ambulatory Pediatric Association, American Pediatric Society, and Society for Pediatric Research.