Kristine A Campbell, Antoinette L Laskey, Daniel M Lindberg, M Katherine Henry, Porcia Vaughn, James D Anderst, Megan M Letson, Angela N Bachim, Nancy S Harper, Carmen M Coombs, Lori D Frasier, Joanne N Wood
{"title":"儿童虐待后儿童安置的变化儿科咨询怀疑身体虐待。","authors":"Kristine A Campbell, Antoinette L Laskey, Daniel M Lindberg, M Katherine Henry, Porcia Vaughn, James D Anderst, Megan M Letson, Angela N Bachim, Nancy S Harper, Carmen M Coombs, Lori D Frasier, Joanne N Wood","doi":"10.1016/j.chiabu.2025.107608","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The association between child abuse pediatric (CAP) assessments and child welfare outcomes is unknown.</p><p><strong>Objective: </strong>To determine the association between a CAP determination of the likelihood of physical abuse and change in child placement. We hypothesized that child race would be associated with CAP determination of abuse likelihood and child welfare outcomes.</p><p><strong>Participants and setting: </strong>Children under age ten years with in-person CAP consultation and referral to child protective services for suspected physical abuse at a U.S. pediatric referral center participating in CAPNET, a CAP research network, from 02/2021 to 01/2023.</p><p><strong>Methods: </strong>We created a series of generalized estimating equations clustered by site, adding covariate blocks representing child characteristics, clinical case factors, and social risk indicators to understand the probability of placement change after CAP consultation.</p><p><strong>Results: </strong>Of 3732 eligible children, 950 (25.5 %) experienced a placement change around a CAP consultation for physical abuse. Adjusting for site, placement change was 28.7 % (25.7-31.8 %) more likely for children with a CAP determination of a high v. lower likelihood of abuse and 6.7 % (3.1-10.4 %) more likely for children of Black/Indigenous v. other race (p < 0.001). These differences persisted with attenuation in fully adjusted models. There was no significant association between CAP determination and child race.</p><p><strong>Conclusions: </strong>CAP assessment of physical abuse likelihood is strongly associated with the probability of change in child placement. While not associated with CAP assessment of abuse likelihood, Black or Indigenous race is associated with increased probability of placement change even after adjusting for child, case, and social risk factors.</p>","PeriodicalId":51343,"journal":{"name":"Child Abuse & Neglect","volume":"167 ","pages":"107608"},"PeriodicalIF":3.4000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427961/pdf/","citationCount":"0","resultStr":"{\"title\":\"Changes in child placement after child abuse pediatrics consultation for suspected physical abuse.\",\"authors\":\"Kristine A Campbell, Antoinette L Laskey, Daniel M Lindberg, M Katherine Henry, Porcia Vaughn, James D Anderst, Megan M Letson, Angela N Bachim, Nancy S Harper, Carmen M Coombs, Lori D Frasier, Joanne N Wood\",\"doi\":\"10.1016/j.chiabu.2025.107608\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The association between child abuse pediatric (CAP) assessments and child welfare outcomes is unknown.</p><p><strong>Objective: </strong>To determine the association between a CAP determination of the likelihood of physical abuse and change in child placement. We hypothesized that child race would be associated with CAP determination of abuse likelihood and child welfare outcomes.</p><p><strong>Participants and setting: </strong>Children under age ten years with in-person CAP consultation and referral to child protective services for suspected physical abuse at a U.S. pediatric referral center participating in CAPNET, a CAP research network, from 02/2021 to 01/2023.</p><p><strong>Methods: </strong>We created a series of generalized estimating equations clustered by site, adding covariate blocks representing child characteristics, clinical case factors, and social risk indicators to understand the probability of placement change after CAP consultation.</p><p><strong>Results: </strong>Of 3732 eligible children, 950 (25.5 %) experienced a placement change around a CAP consultation for physical abuse. Adjusting for site, placement change was 28.7 % (25.7-31.8 %) more likely for children with a CAP determination of a high v. lower likelihood of abuse and 6.7 % (3.1-10.4 %) more likely for children of Black/Indigenous v. other race (p < 0.001). These differences persisted with attenuation in fully adjusted models. There was no significant association between CAP determination and child race.</p><p><strong>Conclusions: </strong>CAP assessment of physical abuse likelihood is strongly associated with the probability of change in child placement. While not associated with CAP assessment of abuse likelihood, Black or Indigenous race is associated with increased probability of placement change even after adjusting for child, case, and social risk factors.</p>\",\"PeriodicalId\":51343,\"journal\":{\"name\":\"Child Abuse & Neglect\",\"volume\":\"167 \",\"pages\":\"107608\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427961/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Child Abuse & Neglect\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1016/j.chiabu.2025.107608\",\"RegionNum\":2,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"FAMILY STUDIES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child Abuse & Neglect","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1016/j.chiabu.2025.107608","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"FAMILY STUDIES","Score":null,"Total":0}
Changes in child placement after child abuse pediatrics consultation for suspected physical abuse.
Background: The association between child abuse pediatric (CAP) assessments and child welfare outcomes is unknown.
Objective: To determine the association between a CAP determination of the likelihood of physical abuse and change in child placement. We hypothesized that child race would be associated with CAP determination of abuse likelihood and child welfare outcomes.
Participants and setting: Children under age ten years with in-person CAP consultation and referral to child protective services for suspected physical abuse at a U.S. pediatric referral center participating in CAPNET, a CAP research network, from 02/2021 to 01/2023.
Methods: We created a series of generalized estimating equations clustered by site, adding covariate blocks representing child characteristics, clinical case factors, and social risk indicators to understand the probability of placement change after CAP consultation.
Results: Of 3732 eligible children, 950 (25.5 %) experienced a placement change around a CAP consultation for physical abuse. Adjusting for site, placement change was 28.7 % (25.7-31.8 %) more likely for children with a CAP determination of a high v. lower likelihood of abuse and 6.7 % (3.1-10.4 %) more likely for children of Black/Indigenous v. other race (p < 0.001). These differences persisted with attenuation in fully adjusted models. There was no significant association between CAP determination and child race.
Conclusions: CAP assessment of physical abuse likelihood is strongly associated with the probability of change in child placement. While not associated with CAP assessment of abuse likelihood, Black or Indigenous race is associated with increased probability of placement change even after adjusting for child, case, and social risk factors.
期刊介绍:
Official Publication of the International Society for Prevention of Child Abuse and Neglect. Child Abuse & Neglect The International Journal, provides an international, multidisciplinary forum on all aspects of child abuse and neglect, with special emphasis on prevention and treatment; the scope extends further to all those aspects of life which either favor or hinder child development. While contributions will primarily be from the fields of psychology, psychiatry, social work, medicine, nursing, law enforcement, legislature, education, and anthropology, the Journal encourages the concerned lay individual and child-oriented advocate organizations to contribute.