Child maltreatment, parents & the emergency department

The research described in this thesis focuses on the evaluation of several methods of screening for child maltreatment at the emergency department, with an emphasis on screening based on parental risk factors (‘child check’). The use of a screening checklist (mandatory in all Dutch emergency departments), a complete physical examination and the child check are discussed. Furthermore, the wellbeing of a family is assessed when a parent visits the emergency department due to intimate partner violence, substance abuse or a suicide attempt. We conclude that, although all Dutch emergency departments (are mandated to) use a screening checklist in attending children, study results about the effects are controversial. Another screening method, a complete physical examination, is not effective to use as a universal screening method for child maltreatment at the emergency department. When parents attend the emergency department because of intimate partner violence, substance abuse or a suicide attempt, their children are at high risk for child maltreatment, but do not experience more psychological problems than community children. The Amsterdam protocol of referring these families to the outpatient pediatric department seems to be a useful method. Finally, participating parents are predominantly positive and accepting of child maltreatment screening.
Further research aimed to improve the effectiveness of interventions and services for families after child maltreatment detection is encouraged. We hope that the results of this research will be useful in assisting with decision-making about child maltreatment screening in practice.