Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19: A review and education material

Polina Martinkevich; Lise Langeland Larsen; Troels Græsholt-Knudsen; Gitte Hesthaven Jørgensen; Michel Bach Hellfritzsch; Karin Kastberg Petersen; Bjarne Møller-Madsen; Jan Hendrik Duedal Rölfing

doi:10.1080/17453674.2020.1782012

Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19: A review and education material

Polina Martinkevich, Lise Langeland Larsen, Troels Græsholt-Knudsen, Gitte Hesthaven Jørgensen, Michel Bach Hellfritzsch, Karin Kastberg Petersen, Bjarne Møller-Madsen, Jan Hendrik Duedal Rölfing

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Abstract

Background and purpose — Physical abuse of children,
i.e., nonaccidental injury (NAI) including abusive head
trauma (AHT) is experienced by up to 20% of children;
however, only 0.1% are diagnosed. Healthcare professionals
issue less than 20% of all reports suspecting NAI to the
responsible authorities. Insufficient knowledge concerning
NAI may partly explain this low percentage. The risk of NAI
is heightened during health and socioeconomic crises such
as COVID-19 and thus demands increased awareness. This
review provides an overview and educational material on
NAI and its clinical presentation.
Methods — We combined a literature review with expert
opinions of the senior authors into an educational paper
aiming to help clinicians to recognize NAI and act appropriately
by referral to multidisciplinary child protection teams
and local authorities.
Results — Despite the increased risk of NAI during the
current COVID-19 crisis, the number of reports suspecting
NAI decreased by 42% during the lockdown of the Danish
society. Healthcare professionals filed only 17% of all reports
of suspected child abuse in 2016.
Interpretation — The key to recognizing and suspecting
NAI upon clinical presentation is to be aware of inconsistencies
in the medical history and suspicious findings on
physical and paraclinical examination. During health and
socioeconomic crises the incidence of NAI is likely to peak.
Recognition of NAI, adequate handling by referral to child
protection teams, and reporting to local authorities are of
paramount importance to prevent mortality and physical and
mental morbidity.

Original language	English
Journal	Acta Orthopaedica
Volume	91
Issue	5
Pages (from-to)	527-533
Number of pages	7
ISSN	1745-3674
DOIs	https://doi.org/10.1080/17453674.2020.1782012
Publication status	Published - Nov 2020

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Acta Orthop - Physical chilad abuse, COVID-19Accepted manuscript, 1.59 MBLicence: CC BY-SA

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Martinkevich, P., Larsen, L. L., Græsholt-Knudsen, T., Jørgensen, G. H., Hellfritzsch, M. B., Petersen, K. K., Møller-Madsen, B., & Rölfing, J. H. D. (2020). Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19: A review and education material. Acta Orthopaedica, 91(5), 527-533. https://doi.org/10.1080/17453674.2020.1782012

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abstract = "Background and purpose — Physical abuse of children,i.e., nonaccidental injury (NAI) including abusive headtrauma (AHT) is experienced by up to 20% of children;however, only 0.1% are diagnosed. Healthcare professionalsissue less than 20% of all reports suspecting NAI to theresponsible authorities. Insufficient knowledge concerningNAI may partly explain this low percentage. The risk of NAIis heightened during health and socioeconomic crises suchas COVID-19 and thus demands increased awareness. Thisreview provides an overview and educational material onNAI and its clinical presentation.Methods — We combined a literature review with expertopinions of the senior authors into an educational paperaiming to help clinicians to recognize NAI and act appropriatelyby referral to multidisciplinary child protection teamsand local authorities.Results — Despite the increased risk of NAI during thecurrent COVID-19 crisis, the number of reports suspectingNAI decreased by 42% during the lockdown of the Danishsociety. Healthcare professionals filed only 17% of all reportsof suspected child abuse in 2016.Interpretation — The key to recognizing and suspectingNAI upon clinical presentation is to be aware of inconsistenciesin the medical history and suspicious findings onphysical and paraclinical examination. During health andsocioeconomic crises the incidence of NAI is likely to peak.Recognition of NAI, adequate handling by referral to childprotection teams, and reporting to local authorities are ofparamount importance to prevent mortality and physical andmental morbidity.",

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Martinkevich, P, Larsen, LL, Græsholt-Knudsen, T , Jørgensen, GH , Hellfritzsch, MB, Petersen, KK, Møller-Madsen, B & Rölfing, JHD 2020, 'Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19: A review and education material', Acta Orthopaedica, vol. 91, no. 5, pp. 527-533. https://doi.org/10.1080/17453674.2020.1782012

Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19: A review and education material. / Martinkevich, Polina; Larsen, Lise Langeland; Græsholt-Knudsen, Troels et al.
In: Acta Orthopaedica, Vol. 91, No. 5, 11.2020, p. 527-533.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Review › Research › peer-review

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T1 - Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19

T2 - A review and education material

AU - Martinkevich, Polina

AU - Larsen, Lise Langeland

AU - Græsholt-Knudsen, Troels

AU - Jørgensen, Gitte Hesthaven

AU - Hellfritzsch, Michel Bach

AU - Petersen, Karin Kastberg

AU - Møller-Madsen, Bjarne

AU - Rölfing, Jan Hendrik Duedal

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N2 - Background and purpose — Physical abuse of children,i.e., nonaccidental injury (NAI) including abusive headtrauma (AHT) is experienced by up to 20% of children;however, only 0.1% are diagnosed. Healthcare professionalsissue less than 20% of all reports suspecting NAI to theresponsible authorities. Insufficient knowledge concerningNAI may partly explain this low percentage. The risk of NAIis heightened during health and socioeconomic crises suchas COVID-19 and thus demands increased awareness. Thisreview provides an overview and educational material onNAI and its clinical presentation.Methods — We combined a literature review with expertopinions of the senior authors into an educational paperaiming to help clinicians to recognize NAI and act appropriatelyby referral to multidisciplinary child protection teamsand local authorities.Results — Despite the increased risk of NAI during thecurrent COVID-19 crisis, the number of reports suspectingNAI decreased by 42% during the lockdown of the Danishsociety. Healthcare professionals filed only 17% of all reportsof suspected child abuse in 2016.Interpretation — The key to recognizing and suspectingNAI upon clinical presentation is to be aware of inconsistenciesin the medical history and suspicious findings onphysical and paraclinical examination. During health andsocioeconomic crises the incidence of NAI is likely to peak.Recognition of NAI, adequate handling by referral to childprotection teams, and reporting to local authorities are ofparamount importance to prevent mortality and physical andmental morbidity.

AB - Background and purpose — Physical abuse of children,i.e., nonaccidental injury (NAI) including abusive headtrauma (AHT) is experienced by up to 20% of children;however, only 0.1% are diagnosed. Healthcare professionalsissue less than 20% of all reports suspecting NAI to theresponsible authorities. Insufficient knowledge concerningNAI may partly explain this low percentage. The risk of NAIis heightened during health and socioeconomic crises suchas COVID-19 and thus demands increased awareness. Thisreview provides an overview and educational material onNAI and its clinical presentation.Methods — We combined a literature review with expertopinions of the senior authors into an educational paperaiming to help clinicians to recognize NAI and act appropriatelyby referral to multidisciplinary child protection teamsand local authorities.Results — Despite the increased risk of NAI during thecurrent COVID-19 crisis, the number of reports suspectingNAI decreased by 42% during the lockdown of the Danishsociety. Healthcare professionals filed only 17% of all reportsof suspected child abuse in 2016.Interpretation — The key to recognizing and suspectingNAI upon clinical presentation is to be aware of inconsistenciesin the medical history and suspicious findings onphysical and paraclinical examination. During health andsocioeconomic crises the incidence of NAI is likely to peak.Recognition of NAI, adequate handling by referral to childprotection teams, and reporting to local authorities are ofparamount importance to prevent mortality and physical andmental morbidity.

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DO - 10.1080/17453674.2020.1782012

M3 - Review

C2 - 32573297

SN - 1745-3674

VL - 91

SP - 527

EP - 533

JO - Acta Orthopaedica

JF - Acta Orthopaedica

IS - 5

ER -

Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19: A review and education material

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