Characteristics of cases submitted to a statewide system of child abuse experts. (August 2016)

• Record Type: Journal Article
• Authors: Girardet, Rebecca; Lahoti, Sheela; Bolton, Kelly; Kellogg, Nancy
• Is Part Of: Children and youth services review. Volume 67(2016:Aug.)
• Page Start: 198
• Page End: 202
• Publication Date: 2016-08
• Subjects: Child maltreatment -- Epidemiology -- Public health; Social work with children -- Periodicals; Social work with youth -- Periodicals; Adolescent -- Periodicals; Child Welfare -- Periodicals; Social Work -- Periodicals; Service social aux enfants -- Périodiques; Service social à la jeunesse -- Périodiques; Electronic journals; 362.705
• DOI: 10.1016/j.childyouth.2016.06.007
• Languages: English
• ISSNs: 0190-7409

Abstract

Abstract: Background: The Texas Department of Family and Protective Services (DFPS) created a statewide network of child abuse pediatricians working at 6 academic centers in 2006. Methods: Case data for the period 9/1/2012–8/31/2014 were reviewed for child demographics, risk factors, physician determinations, injury descriptors, and information made available to the physician. Results: 8061 of 410, 315 DFPS cases (2%) were referred during the period. Network utilization rates ranged from 7.5% in counties served by San Antonio to 1.4% in Austin-served counties. Cases from outlying counties were less likely to involve older children. African American children were over-represented in referrals, and Caucasian and Asian children were underrepresented. Prevalent risk factors included prior DFPS history, single parent-household, mental illness, substance abuse, and domestic violence. Network providers found no or only nonspecific evidence for maltreatment in 45% of cases. Determinations were hindered by poor quality photographs in 188 cases and inadequate skeletal surveys in 121. Insufficient information precluded case completion for 65 cases of children < 2 years. Conclusions: Our data indicate that child abuse centers in Texas are underutilized, and there are practice differences with respect to medical referrals across different regions. Our findings concerning ethnic differences and risk factors are consistent with national trends. The problems of inadequate photographs and case information may improve with better training of workers; the issue of poor quality skeletal surveys requires further study. Standard DFPS criteria for referrals to child abuse pediatricians should mitigate some of the problems identified by this study. Highlights: Voluntary utilization of child abuse experts results in system under-utilization. Voluntary utilization of child abuse experts results in referral age and ethnicity disparities. Statewide child abuse network data supports the development of standard referral criteria. Child maltreatment determinations are often limited by inadequate case information. Statewide networks afford the opportunity to address child maltreatment service disparities.