Doc­tors on alert for rise in child as­saults

The Irish Times - - Home News - MARK HIL­LIARD

Doc­tors are con­cerned that chil­dren in fam­i­lies un­der in­creased stress due to Covid-19 are at risk of phys­i­cal abuse, a con­sul­tant in pae­di­atric emer­gency medicine has said.

Dr Ciara Mar­tin, of Tal­laght Univer­sity Hos­pi­tal in Dublin, said train­ing among med­i­cal staff in iden­ti­fy­ing signs had been stepped up in the past month.

She was re­spond­ing to a new UK study that iden­ti­fied a “surge in do­mes­tic child abuse dur­ing the pan­demic”.

The study noted a dra­matic in­crease in in­ci­dents recorded at one Bri­tish pae­di­atric hos­pi­tal be­tween March and April, com­pared to the same pe­riod over the pre­vi­ous three years.

This “silent pan­demic”, the fo­cus of a study pub­lished in the Archives of Dis­ease in Child­hood jour­nal, found 10 chil­dren – six boys and four girls aged from 17 days to 13 months – with sus­pected abu­sive head trauma.

Brain swelling

Those fig­ures com­pared to an av­er­age of 0.67 cases a month over the pre­vi­ous three years.

The chil­dren at­tended hos­pi­tal with a va­ri­ety of symp­toms in­clud­ing colic, breath­ing is­sues, loss of con­scious­ness, seizures, ex­ten­sive bruis­ing and swollen scalps.

After ex­am­i­na­tion, cases of sub­du­ral haem­or­rhage, brain swelling and bruis­ing of the tis­sue, as well as skull and other frac­tures were di­ag­nosed.

The re­port’s authors noted a “com­plex in­ter­play be­tween abuse, men­tal health, sub­stance mis­use and so­cio-eco­nomic fac­tors”.

“This sober­ing fig­ure is likely un­der-rep­re­sented due to pub­lic avoid­ance of hos­pi­tals at this time.”

Dr Mar­tin said Ir­ish medics were con­cerned for chil­dren of all ages and that while they had ob­served a small in­crease in chil­dren pre­sent­ing with non-ac­ci­den­tal in­juries, it re­mained too early to as­cer­tain any pat­tern.

Warn­ing signs

“In­tu­itively and know­ing what we know, Ir­ish pae­di­a­tri­cians have been con­cerned that lock­down would put strain on fam­i­lies and that chil­dren would be at risk,” she said. “The risk is as de­scribed: close con­tact with a fam­ily un­der stress, wors­en­ing eco­nomic stress, fear of at­tend­ing hos­pi­tals and less con­tact with wider fam­ily and health­care vis­i­tors who could pick up on warn­ing signs early and pro­vide sup­port to the fam­ily.”

She said doc­tors en­cour­aged any­one with con­cerns to come for­ward and that their role was not to judge but to help peo­ple.

“Child abuse is an ice­berg and what presents is not the whole story. The aim is to recog­nise this more of­ten; and we have ac­tively in­creased train­ing in this area over the past month so that our doc­tors and nurses in the pae­di­atric EDs [emer­gency de­part­ments] have a height­ened aware­ness of non ac­ci­den­tal in­jury and the skills to re­spond to fam­i­lies at risk.”

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