16 Dec Child Abuse By Members of Military May Be Grossly Underreported
MedicalResearch.com Interview with:
Dr. Joanne Wood
Joanne N. Wood, MD, MSHP
Assistant Professor of Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Research Director, SafePlace
Faculty, PolicyLab
The Children’s Hospital of Philadelphia
MedicalResearch.com: What is the background for this study?
Response: Each year the U.S. Army Family Advocacy program (FAP) investigates between 6000 to 9000 reports of alleged abuse or neglect involving children of Army service members. In approximately 48% of reported cases FAP determines a child was a victim of maltreatment, substantiates the report, and collaborates with local civilian child protection service (CPS) agencies in providing services and ensuring safety. Thus, FAP plays a key role in supporting Army families and protecting children. But FAP can only investigate and respond to cases of child abuse and neglect about which they are aware.
MedicalResearch.com: What are the main findings?
Response: Our study found that only 20% of medically diagnosed child maltreatment cases in U.S. Army dependent children between 2004 and 2007 had a substantiated report with FAP. It is unlikely that the observed 20% linkage rate can be solely attributed to reports not being substantiated by FAP. These findings raise concern that cases of medically diagnosed child maltreatment are not being consistently reported to FAP. The percentage of medically diagnosed maltreatment cases with corresponding substantiated FAP reports was particularly low for children cared for at civilian medical facilities, 9.2 percent. This is not surprising as civilian medical providers unfamiliar with the FAP program may be making reports to civilian CPS agencies but not making an additional report to FAP. In some locations agreements between civilian CPS agencies and FAP allow for sharing of information about reported cases but we don’t know how frequently this is occurring.
MedicalResearch.com: What should readers take away from your report?
Response: The observed low rate of linkage of medical diagnoses of child abuse and neglect to substantiated FAP reports raises concern that many cases of child abuse and neglect involving children of Army service members may not be reported to FAP, the Army agency responsible for investigating and responding to child abuse and neglect. Thus, vulnerable children and families may not be receiving needed FAP services. These results also suggest that prior estimates of child abuse and neglect among Army children based on substantiated FAP reports may underestimate the true magnitude of the problem.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research incorporating unsubstantiated FAP reports and civilian CPS data is needed to understand the identified gap in linkage of medically diagnosed cases of child maltreatment to substantiated FAP reports. Also, we need understand the facilitators and barriers to successful reporting of child abuse and neglect to FAP by medical providers and effective communication between civilian child protective service agencies and FAP. This information will be critical for informing the development of programs and policies that improve reporting to FAP and better support children and families.
MedicalResearch.com: Is there anything else you would like to add?
Response: Ensuring that at-risk Army children and families are supported and protected will require collaboration and communication between medical providers, the Army FAP program and civilian CPS agencies.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Wood, J. N., et al. Under-ascertainment from healthcare settings of child abuse events among children of soldiers by the U.S. Army Family Advocacy Program. Child Abuse & Neglect (2016), http://dx.doi.org/10.1016/j.chiabu.2016.11.007
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Last Updated on December 16, 2016 by Marie Benz MD FAAD