Pediatric Injury Resulting From Family Violence

Family violence is defined as the violence between two or more household

members (parents, relatives, intimate partners, close family friends, etc.). In 1993,
there were more than one million children who were victims of substantiated
maltreatment. Each year, approximately two million women are severely assaulted
by their male partners. This type of abuse affects the physical and emotional well
being of all family members who witness it. In fact, children who witness family
violence have more behavioral problems, poor adaptive and social skills, increased
aggression and are at higher risk for physical injury.
The aim of this study was to describe the causes, types and patterns of
pediatric injuries that result from such family violence from 1984 to 1994.
159 medical records (MRs) of children seen in the emergency department
(ED) at the Childrens Hospital in Philadelphia were taken from the Child Protective
Services (CPS). Every medical record was about a child who had injuries that
resulted from familial violence. However, an important thing to note is that children
who were victims of direct abuse were not studied. There were 159 MRs total; 139
(87.4%) of them could be used for the study. The data taken from the MRs included:
(1) Demographics, (2) date of the initial visit and age of the child, (3) adult
accompanying the child to the ED, (4) individuals involved in the fight, (5) individual
who had injured the child, (6) the use of drugs/alcohol by the adults involved, (7)
history of events leading to the childs injury, (8) the location, type and severity of
the injury, (9) mechanism of injury, (10) treatment that was required for the injury,
and (11) the disposition of the child. The resulting injuries from these familial
violence cases were categorized as mild, moderate or severe.
The person most often involved in the abuse was the mother of the child.
This happened 81% of the time. The most common type of fight that caused the
child injury involved the mother and father (57%). 83% of the time, the person who
injured the child was identified. Most of the time, the father or mothers boyfriend
inflicted the injury on the child. Substance abuse was present in 27% of the cases
studied. 29% of these injuries were caused by being dropped or hit (the parent was
held in individuals arms). In 24%, the child was injured while attempting to
intervene, 78% of those who did try being adolescents. 9% of the children were
injured by another mechanism such as burns or penetrating wounds. Children who
were less than five years old were more likely to have head or facial injuries.
Children older than four years of age had more extremity trauma than those who
were younger. Half of the cases were contusions, 29% of the children suffered
lacerations or abrasions, four children had fractured bones, and four children
suffered from burns. When studying for the severity of the injuries received by the
children; 57% were minor, 40% were moderate, 9% required hospital admission,
and 2% required surgery. Of all the cases, 73% of the children were discharged from
the hospital to their original homes, while 27% were discharged to alternative
homes.
In conclusion, children sustained mostly minor injuries. But, children are at
risk for sustaining a wide variety of injuries as a result of family violence.
Interfamilial violence is also believed to extent beyond parents to extended family
and even friends of childrens parents. Overall, this study proved that children are at
risk for sustaining a wide variety of injuries as a result of family violence.