1 in 30 children are victims of child abuse

It is important in the case of child abuse to treat the situation as objectively as possible

Child abuse is not always visible. However, it happens to 1 in 30 children in the Netherlands. During the week against child abuse, pediatricians draw attention to this topic. “Make it negotiable, no matter how difficult it is.”

Pediatricians Patricia Boyman and Margo Afortet work with Erasmus MC Sophia’s “Jovi Team” to identify all forms of child abuse.

Boyman: Children are referred to us for injuries, but sometimes child abuse is discovered accidentally during a physical examination. For example, unusual bruising or children who end up in ICK with a cerebral hemorrhage which later turns out to be due to abuse. We are invited to consider the case as a team of pediatricians, psychologists, and medical social workers and advise. Forensic physicians and the etiquette squad are often also implicated in sexual assault.

Suspected child abuse is being reported to Erasmus MC Sophia by various authorities such as the GP and the safe house. Our area has approximately 120 children each year for sexual abuse and 30 for physical violence in the emergency room, Goofy outpatient clinic, or on the ward. The ages of children range from a child to a teenager. Erasmus MC is also part of the National Child Abuse Experience Center which is a center for sexual violence against children under 16 years of age.

Boyman says that in the case of child abuse, it is important to approach the situation as objectively as possible. As a doctor in training you learn that the parents’ story is the truth. But the situation is different with child abuse and the story is not always reliable. That’s why you should be vigilant and ask yourself if the injury or complaint fits with the patient’s story. A bruise should never be accepted on children, for example, and an injury without treatment or children who have waited too long to seek medical help can be a signal. To support professionals in their identification, we have formulated four screening questions that are now used as a standard in the emergency department.

behind the front door
The biggest problem with child abuse is that it happens behind the front door. It is by no means always visible, but in the Netherlands one child from each class is a victim. Most emotional neglect. Most forms of child abuse that we see in our center are physical and sexual abuse. Since children often cannot tell themselves, this is not always acknowledged and it is difficult for professionals to make the right decision and refer them to our team or safe house.

Boyman believes that accusations should never be based on suspected child abuse. When children end up in our emergency room, it often turns out that there are also more concerns, such as financial problems or stress from relationship problems. I always try to ask open-ended questions; How did your child get this bruise? Can you explain exactly what happened again? How are things at home with you? I always try to shoot it as a movie and understand what happened.

not thin
No matter how difficult it is, it is important to discuss child abuse. It can also be nice to the people themselves if the need for help is revealed within the family. That’s why I think Child Abuse Prevention Week is also important to raise awareness. If you see something different, ask honestly, if it doesn’t feel right, think about why, if in doubt, consult a professional, and always think from the point of view of the safety and care of the child and family.

For more information, visit the Week Against Child Abuse website.

What can you do in case of suspicion?

  1. Don’t look away
  2. Make it negotiable no matter how difficult it is
  3. Stay away from accusatory atmosphere, but ask open questions and keep asking questions
  4. Always think from the point of view of the care and safety of the child and the family
  5. For advice and support, please contact the Goofy team, LECK or Safe at Home

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