Alex Kemper, M.D., M.P.H., M.S. 

USPSTF: Interventions to Prevent Child Maltreatment Interview with:

Alex Kemper, M.D., M.P.H., M.S. 

Dr. Kemper

Alex Kemper, M.D., M.P.H., M.S. 

Dr. Kemper is a board-certified pediatrician and chief of the Division of Ambulatory Pediatrics at Nationwide Children’s Hospital. He is also the deputy editor of Pediatrics. What is the background for this recommendation statement? What are the main findings and recommendations? 

Response: Child maltreatment, which includes abuse and neglect, is a serious health problem that affects too many children in the United States.  Abuse and neglect can have devastating health consequences, including long-term disabilities, depression, physical injury, and even death. In 2016, approximately 676,000 children were subjected to maltreatment, and more than 1,700 children died as a result.

Because this is such an important public health issue, the U.S. Preventive Services Task Force looked at the most recent evidence on whether primary care clinicians can help prevent child maltreatment and its negative consequences.

We found that, unfortunately, there is not enough evidence to recommend for or against these interventions. The Task Force is calling for more research on this important subject so that we can help prevent children from being abused and neglected. What should readers take away from your recommendation statement? 

Response: This is not a recommendation for or against primary care interventions to prevent child maltreatment. More research into the role that primary care clinicians can play in preventing abuse and neglect will help us better protect all children. Until then, clinicians should use their best medical judgment when making decisions about interventions that may protect children, as well as continuing to look out for children who are already experiencing abuse and neglect.

Response: What recommendations do you have for future research as a result of this evidence review? 

Response: More evidence is needed on accurate tools to identify children at increased risk for maltreatment. Current studies have different designs and different ways of measuring outcomes, so it is difficult to determine whether interventions are successful or not.

We also need more studies including diverse populations and settings. This includes families with known risk factors for child maltreatment—such as history of substance misuse in the home—and settings with limited access to social services. Is there anything else you would like to add?

Response: Importantly, this recommendation statement only applies to children who do not show signs or symptoms of maltreatment. All clinicians must remain vigilant for signs of abuse and neglect—which can include frequent injuries, signs of poor hygiene, unexplained changes in behavior, and being excessively withdrawn or fearful. Clinicians should always ensure children get the help they need, as no child should suffer from maltreatment.


US Preventive Services Task Force. Interventions to Prevent Child MaltreatmentUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(20):2122–2128. doi:10.1001/jama.2018.17772

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Last Updated on November 28, 2018 by Marie Benz MD FAAD