Detection of child abuse by Dutch preventive child-healthcare doctors and nurses: Has it changed?

Abstract Objective Child maltreatment (i.e., abuse and neglect) is a major cause of child morbidity and death. It is a principal topic in community child-healthcare services yet little is known about the actual detection of suspected cases. We examined trends in this detection, as well as the characteristics of parents and children associated with higher rates of detection. Methods We obtained data on suspected cases of physical maltreatment, as well as of emotional and sexual abuse, from Dutch national samples for children aged 3 ¾ , 5-6 and 8-12 years, for 1997/98 and 2002/03 (response rates 92% and 84%, respectively, about 4,000 children each), as registered by preventive child-healthcare doctors and nurses. We assessed changes in the detection of suspected cases and also assessed the association of suspicion with the background characteristics of parents and children. Results Rates increased slightly over this 5-years period, from .23% to .41%, due to a quadrupling of suspected emotional abuse cases (from .06% to .24%), but without statistical significance. Suspicion of maltreatment was found to be more likely among boys, older children, and children with low-educated fathers and mothers who were younger than 27 years at the child’s birth. Conclusions Professionals in Dutch preventive child-healthcare services detected fewer cases of child maltreatment than might be expected on the basis of prevalence rates of self-reported maltreatment. Detection of other types of child maltreatment thus still needs further improvement in order to reach the goal of better child health