Analysis of acute presentations for child protection medical assessments in a large, culturally diverse metropolitan setting

OBJECTIVE: South Western Sydney has a large culturally diverse population with many vulnerable subgroups; little is known about the health and social outcomes following acute child maltreatment assessments. We aimed to describe acute presentations of maltreatment in South Western Sydney—including examination findings of the assessment, determine health and social outcomes for children following medical assessment, to inform service development. DESIGN: We gathered data from the acute child protection database on all children <16 years referred for physical abuse and neglect and/or sexual abuse assessment between 2013 and 2015 to one hospital service. We reviewed clinical records of the children assessed, using the reports to classify findings of the examination. We performed simple descriptive analysis on the data. RESULTS: There were 304 children referred, 279 seen for acute assessment. Most (72%) were female, 204 (73%) referrals were for sexual abuse, 75 (27%) were for physical abuse and neglect. There were age, gender and ethnicity differentials depending on type of maltreatment presentation. Twelve per cent of sexual and 19% of physical abuse cases were found not to be abuse related. Unmet medical, developmental and behavioural concerns were identified in the majority (54%) assessed. Just under half (48%) of all children went home with families with no statutory agency support; those seen for physical abuse were more likely to be placed in care (p<0.001). CONCLUSIONS: Children assessed for child maltreatment had a range of health and social concerns identified, needing further intervention. Comprehensive medical assessments have a critical role to play in child protection assessments.