Medical Management of children with suspected physical abuse

Epidemiological data indicates that physical abuse is the most common form of maltreatment in young ages. Physically abused children can be examined by health care professionals of any specialty and present evident medical findings. Physical abuse can be life-threatening and it is a fact that early intervention could act as a shield for the whole family.

Since there is a shortage of physicians specialized in the area of child abuse in Greece, ELIZA formed a multilevel partnership with the 2nd Department of Pediatrics (N.K.U.A) to address this significant deficiency.

The partnership is based on the following strategic pillars:

A.Creation of the first nationwide network of physicians dedicated to protecting children from physical abuse and training of first line health professionals

Having sought guidance and advice from experts in child abuse and neglect from the US Universities of Yale and Iowa, we developed an educational curriculum on Child Physical Abuse for a group of physicians from all the pediatric departments of all the medical schools in Greece. The educational curriculum was adapted to provide a 6-hour workshop on Child Physical Abuse. Eight workshops were conducted in seven cities of Greece with 1.220 participants, mostly physicians.

 B. Retrospective research on child physical abuse

A key element of this initiative was a retrospective study focusing on children hospitalized at the “P. & A. Kyriakou” Children’s Hospital during a 2-year period (2014 & 2015). Among 35.273 admissions, the medical records of 161 children with social problems and/or an acute serious injury were selected and analysed.

Main findings:

  • The average age of children with possible physical abuse was 7.7 years, in contrast to U.S. child abuse data, where the majority of reported cases of physical abuse are under the age of 3 years.
  • In this sample, infants were at greater risk of physical abuse, consistent with existing international literature that highlights the vulnerability of infants to physical abuse.
  • 1 in 3 cases of burns could have been prevented with improved parent/caregiver education and child supervision.

 C. Protocol for the recognition and management of suspected child physical abuse

In the context of the program, a Protocol i.e. a user-friendly standardized procedure was developed for the assessment of suspected physical abuse, which can be applied at all Greek hospitals. The Protocol could contribute in:

  • Increasing the index of suspicion and timely detection of child physical abuse among health care professionals
  • Optimizing and standardizing the laboratory workup and management of suspected physical abuse with prompt notification of child protection services
  • Empowering physicians to recognize abuse prior to irreversible physical and emotional trauma
  • Supporting and maintaining family unity, whilst avoiding institutionalization of children

The Protocol has already been adopted by 5 Hospitals in Greece, and our aim is its induction in all hospitals throughout Greece, during the next 5 years.

In the near future, the educational curriculum will be further enriched with Training Courses related to the management of cases of child sexual abuse.

The Board of Directors of ELIZA, along with its scientific team express their sincerest gratitude to the companies and organizations, which believing in the potential of this Program right from the start, actively supported it through the first year it took place.

Main Sponsor – OTE Group

Sponsor – Embassy of the United States of America, in Greece

Supporters – Aegean Airlines, Microsoft Hellas, The Fulbright Foundation in Greece