NCJ Number
227387
Journal
Child Abuse & Neglect Volume: 33 Issue: 5 Dated: May 2009 Pages: 278-281
Date Published
May 2009
Length
4 pages
Annotation
Although the American Academy of Pediatrics (AAP) recommends that skeletal surveys be mandatory for all children less than 2 years old in cases of suspected physical abuse, this study tested the hypothesis that skeletal surveys are less useful in the second year after birth compared to the first year in cases of suspected physical abuse.
Abstract
The study did not support the hypothesis that skeletal surveys conducted in the second year after birth are less useful than those conducted in the first year in evaluating possible child physical abuse. This finding is consistent with previous research and adds strength to the current AAP recommendation for skeletal surveys in cases of suspected physical abuse. The study showed no statistical difference between the utility of skeletal surveys in the first year of life and their utility in the second year of life. As expected, there was statistically significant bias within the study group of child-abuse pediatricians against obtaining skeletal surveys routinely in the second year of life; this likely stemmed from the perception that the skeletal surveys in the second year of life were almost always classified as "No Added Findings" (NAF), indicating they did not add information beyond the presenting complaint. The study identified all children less than 2 years old referred to the child protection team of the Primary Children's Medical Center of the University of Utah Health Sciences Center between January 2002 and November 2006. Those who had a skeletal survey performed and/or read by the pediatric radiologists as part of their work-up for possible physical abuse were eligible for the study, Radiology records and, when necessary, clinical records, were reviewed for all eligible subjects. Age and presenting complaint leading to the child abuse evaluation were recorded. Skeletal surveys were classified as "Added Findings" (AF) when the survey added findings pertinent to the diagnosis of abuse beyond the presenting complaint. Surveys were classified as NAF when they did not add information beyond the presenting complaint. Researchers compared children 0-11 months of age to children 12-23 months of age. 2 tables, 2 figures, and 6 references