Little Known About How Primary Care Doctors Can Prevent Abuse

What can a primary care physician do if he suspects maltreatment of a child but there are no obvious signs? Not much, according to a statement by the U.S. Preventive Services Task Force.

Without proper research and obvious symptoms in the child, it can be impossible for a doctor to make a decision either for or against action. It takes a village to recognize abuse and get help, so keeping your eyes open for any signs in children of friends, family and neighbors is important. 

Risk Factors for Children Suffering Abuse

The U.S. Preventive Services Task Force is unable to determine whether they recommend primary care physicians intervene on a child’s behalf if he or she suspects maltreatment or abuse. If there is no evidence of abuse, the doctor cannot lawfully make any decisions. The USPSTF does indicate risk factors for children suffering abuse, including the following: 

  • young, single, or non-biologic parents
  • parental lack of understanding of children’s needs, child development, or parenting skills
  • poor parent-child relationships/negative interactions
  • family dysfunction or violence
  • parental history of violence or abuse
  • substance abuse within the family
  • parental stress and distress

The Statistics on Child Maltreatment

According to the U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth, and Families, Children’s Bureau, “In 2011, approximately 680,000 children were confirmed victims of maltreatment, and approximately 1,570 died of such treatment. Approximately 78 percent experienced neglect, 18 percent physical abuse, and 9 percent sexual abuse; many experienced several forms of maltreatment.” Whether doctors can prevent this maltreatment is what is in question. There is little evidence to suggest whether doctor intervention actually helps the child or not. Without adequate research, no recommendation can be made to agree or disagree with a doctor’s conviction in assisting a child. 

Defining Child Maltreatment

According to the Centers for Disease Control and Prevention, child maltreatment can be defined as “any act or series of acts of commission or omission by a parent or other caregiver that result in harm, potential for harm, or threat of harm to a child.” Child abuse (physical, sexual, or psychological) and child neglect also fall under this category. If a doctor suspects maltreatment, the most common first step is a home visitation. This means that a nurse or other licensed professional visits the child and her family at home and/or at school on a regular basis until a determination can be made as to the child’s health. Home visitation services often includeparent education on normal child development, counseling, problem solving, free transportation to health clinic appointments, enhancement of informal support systems, linkage to community services, promotion of positive parent-child interactions, ensuring a source for regular health care, promotion of environmental safety, and classes for preparing for motherhood.” These visitations often take place during young childhood years. 

While physicians are required to report suspected issues of maltreatment to child protective services, not every state has the same guidelines for visitation services and family violence screening is not a requirement. Physicians must take each child on a case-by-case basis, determining whether the child is in need or not. If you suspect maltreatment, visit the USPSTF website or speak to a doctor today.