What factors affect the identification and reporting of child abuse-related fractures?
JournalClinical Orthopaedics and Related Research
PublisherLippincott Williams and Wilkins
MetadataShow full item record
AbstractChild abuse is a serious problem in the United States. Because orthopaedic surgeons are responsible for identifying and reporting suspicious fractures to child protective services, we asked two primary questions: (1) How skilled are orthopaedists in distinguishing abuse-related from noninflicted fractures and making appropriate child protective services reports?; and (2) Are decisions influenced by orthopaedist training or by the race or socioeconomic status of injured children? We developed and mailed a questionnaire containing 10 case vignettes to 974 US orthopaedists. Respondents assessed the likelihood of abuse and need to report to child protective services. Two versions of the questionnaire differed by the race and socioeconomic status of vignette families. Average respondent scores were 79% for correct diagnoses and 73% for correct reporting decisions. Pediatric orthopaedists had higher adjusted scores for identifying abuse-related versus noninflicted injuries (82% versus 73%) and for appropriately reporting to child protective services (76% versus 66%) compared with general orthopaedists. Both groups had difficulty distinguishing abuse-related from noninflicted long-bone fractures in infants and toddlers. We found no differences in appropriate identification or reporting of fractures by race but did find differences by social class. Additional training in identifying abuse-related long-bone fractures appears necessary. Orthopaedists should consider the potential for bias when assessing children with fractures for possible abuse. Copyright 2007 Lippincott Williams & Wilkins, Inc.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-34548364217&doi=10.1097%2fBLO.0b013e31805c0849&partnerID=40&md5=abef34e0cf997a80e4baf9a148c2b43b; http://hdl.handle.net/10713/11880
- Clinicians' description of factors influencing their reporting of suspected child abuse: report of the Child Abuse Reporting Experience Study Research Group.
- Authors: Jones R, Flaherty EG, Binns HJ, Price LL, Slora E, Abney D, Harris DL, Christoffel KK, Sege RD, Child Abuse Reporting Experience Study Research Group.
- Issue date: 2008 Aug
- Delayed identification of pediatric abuse-related fractures.
- Authors: Ravichandiran N, Schuh S, Bejuk M, Al-Harthy N, Shouldice M, Au H, Boutis K
- Issue date: 2010 Jan
- Pediatrician characteristics associated with child abuse identification and reporting: results from a national survey of pediatricians.
- Authors: Flaherty EG, Sege R, Price LL, Christoffel KK, Norton DP, O'Connor KG
- Issue date: 2006 Nov
- From suspicion of physical child abuse to reporting: primary care clinician decision-making.
- Authors: Flaherty EG, Sege RD, Griffith J, Price LL, Wasserman R, Slora E, Dhepyasuwan N, Harris D, Norton D, Angelilli ML, Abney D, Binns HJ, PROS network., NMAPedsNet.
- Issue date: 2008 Sep
- Reasonable suspicion: a study of Pennsylvania pediatricians regarding child abuse.
- Authors: Levi BH, Brown G
- Issue date: 2005 Jul