Systematic screening for child abuse at emergency departments

Child abuse is a serious problem and has serious consequences for the victim, his or her environment and for society itself. It has been estimated that one in every 30 Dutch children is exposed to child abuse.1 While preventable morbidity and mortality of infectious diseases in childhood is enormously reduced over the past decades, unfortunately this has not been the case for the staggering statistics surrounding child abuse.2 Child abuse includes all forms of physical and emotional maltreatment, sexual abuse and neglect that result in actual or potential harm to the child’s health, development or dignity.3 Child abuse was already addressed as a public health problem in the 19th century by a French forensic expert, Ambroise Tardieu (Born in Paris on March 10, 1818). He was the fi rst physician to acknowledge the appearance of children being mistreated at the hands of their parents, and described the classical features of almost all forms of child abuse and neglect. A century later, in 1962, American physicians wrote a landmark article about child abuse being a pediatric and public health problem, called “The battered childsyndrome”. This was the starting point for further recognition and awareness of child abuse. The increasing awareness of child abuse by health care professionals since 1962 is refl ected in the enormous increase in articles published in the MEDLINE database. In 1963, 12 articles were categorized under the newly added keyword “child abuse” versus 914 in 2011.7 In 1970 the Dutch Association Against Child Abuse was founded.

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