G14b

PHYSICAL ABUSE OF SCHOOL-AGED CHILDREN

Presenter: Sue Skinner

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Description:   

Analyzing data regarding children ages 5-14 who were diagnosed with physical abuse, to identify commonalities and characteristics of this population.

Abstract:

Objective

The goal of this study was to analyze data regarding children ages 5-14 who were diagnosed with physical abuse, to identify commonalities and characteristics of this population.

Methods

7,928 children were seen as outpatients from 2001-2006 at CARES Northwest, a medical child abuse assessment center in Portland, Oregon. 5,313 of those seen  were between the ages of 5-14.  481 (9%) of the school-age children seen at the center were diagnosed as victims of physical abuse.  Data sheets were completed on each child and the information was analyzed.  In-depth chart reviews were completed on the 147 children seen in 2005 and 2006. Chart review included the case history, the text of the child's videotaped interview, and the final report. 

Results

Physical abuse diagnoses comprise 9% of the total patients in the 5-14 age group seen at this outpatient clinic.  32% of the children seen  were boys; however, boys comprised 49% of those physically abused.  In comparison, only 20% of children with a diagnosis of sexual abuse were boys.  Adult caretakers were the offenders in 81% of the children diagnosed with physical abuse as compared to 39% of the total sample size. A child is less likely to make the first disclosure of physical abuse to their adult caretaker (22% vs 42%), and more likely to make the first disclosure of physical abuse in school (18% vs 8%). Children with a diagnosis of physical abuse have a higher percentage of exposure to drugs and alcohol (68% vs. 56%) and to domestic violence (74% vs 56%). The incidence of disabilities remains the same in the larger sample size as well as those physically abused.

62% of the children report that more than one part of their body was hit, and 35% of the children are hit with more than one object or body part. 39% of the children do not know why they are hit. 54% state they have been hit with different objects in the past. 36% say there are other adults in the home who hit, and 56% report that other children in the home are hit.  In 2/3 of cases, past concerns regarding physical abuse in the family have been reported to children’s protective services.

Conclusions

School-aged children who are physically abused are an equal mix of boys and girls. The abuser is an adult caretaker of the child four out of five times. Schools provide a safe place for children to disclose abuse. The child victim often lives in a culture of violence:  one third of the time other adults hit, and more than half of the time other children are hit. The child has a high incidence of being exposed to drugs/alcohol and domestic violence. Children are hit with multiple objects, and often they've been hit before. Consistent screening in pediatric offices as well as optimal support in schools will help identify cases of physical abuse. Additionally, it is recommended that all concerns of physical abuse reported to children’s protective services be thoroughly assessed.