Child Abuse Pediatrics

In the United States over the past 5 years, approximately 660,000 children per year were confirmed victims of child maltreatment after reports to Child Protective Services (CPS). As cited by The American Academy of Pediatrics, 1 in 4 children experience some form of child abuse or neglect in their lifetimes; 1 in 7 have experienced maltreatment in the past year. These child victims often present for medical care amongst the approximately 9.2 million children who present to emergency departments with unintentional injuries each year. Discerning which injuries are concerning for child maltreatment can be difficult, particularly in a high volume, high acuity setting.

The Child At Risk Evaluation (CARE) Team at Children’s Hospital of Michigan was created specifically for this purpose. As specially trained medical providers, our CARE team is able to obtain additional critical details regarding a child’s injury/condition via clinical consultation or case review. The assessments often address developmental capabilities and feasibility of injury, additional history details obtained from caregivers, proximity of the caregivers at the time of the incident, and duration a child may/may not have been left unsupervised. With these comprehensive evaluations, we are able to more appropriately provide diagnoses of child maltreatment while also decreasing unnecessary reports to CPS for injuries/conditions that are accidental or reasonably explained by a medical condition.