Emerg Med J. 2002 Jan;19(1):17-8. doi: 10.1136/emj.19.1.17.

Presentation to accident and emergency with crying or screaming and likelihood of child protection registration.

Emergency medicine journal : EMJ

A K Fletcher, D P Burke

PMID: 11777864 PMCID: PMC1725771 DOI: 10.1136/emj.19.1.17

Abstract

OBJECTIVES: To determine whether children aged less than 2 years who present to accident and emergency (A&E) with crying or screaming as the only complaint, are more likely to be placed on the child protection register in later years than children who do not attend with crying or screaming alone.

METHODS: The Sheffield Children's Hospital A&E database was examined for five years from 1 January 1992. Children who presented at triage with crying or screaming as their sole complaint were identified. Controls were taken from children who presented with any other complaint. Matches were made for sex, postcode and date of birth. All names were checked against against files that contained dates of past or present child protection registration. In January 2000, the children's age ranged from 3 to 10 years. The mean follow up period was six years (SD one year seven months).

RESULTS: From 1 January 1992 until 31 December 1996, 450 children made 462 attendances to A&E with crying or screaming as their only complaint. Of these, 12 had been placed on the child protection register. Ten of the 450 control children had been registered. The odds ratio of subsequent child protection registration if a child presents in Sheffield with crying or screaming alone is 1.21 (95% confidence intervals 0.52 to 2.82).

CONCLUSIONS: Presentation of young children who cry or scream for no clear reason is relatively common. Although child protection registration is not the same as abuse, it is the closest surrogate marker we have. This study shows there is no evidence of increased likelihood of child protection registration for children who present with crying or screaming alone and prejudices against parents of these children, if held, are inappropriate.

References

1. Child Abuse Negl. 1984;8(2):185-202 - PubMed
2. Child Abuse Negl. 1987;11(3):421-32 - PubMed
3. Pediatr Emerg Care. 1992 Jun;8(3):171-2 - PubMed
4. Aust N Z J Psychiatry. 1998 Jun;32(3):370-8 - PubMed
5. Child Abuse Negl. 1994 Mar;18(3):261-9 - PubMed
6. Pediatr Emerg Care. 1999 Oct;15(5):307-9 - PubMed
7. Pediatrics. 1993 Mar;91(3):642-8 - PubMed

MeSH terms

• Child Abuse / diagnosis
• Emergency Service, Hospital*
• Female
• Humans
• Infant
• Male
• United Kingdom

Publication Types

• Journal Article