The evaluation of child maltreatment among child abuse evaluation clinics in Berlin, Germany – A multicenter study

Background

Since child maltreatment can cause severe and lifelong developmental impairment, early evaluation by multidisciplinary child abuse evaluation clinics (CAEC) is recommended. Nevertheless, data on the evaluation outcome is rare to measure and little addressed by existing literature.

Objective

To assess the evaluation outcome clarified (confirmed or excluded abuse or neglect), not clarified (remains indeterminate) of suspected child maltreatment and to find associated predictors related to a respectively high or low clarification rate.

Participants and setting

N = 3056 children between 0 and 17;11 years, who were examined at the six CAEC in Berlin, Germany during 2016–2021, with a total number of N = 4576 assigned suspicions of different types of child maltreatment.

Method

Statistical analysis of differences between suspected types of child maltreatment, and correlations using diagnostic procedures as predictors and clarification as an outcome.

Results

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  In total, 68.7 % of the assigned suspicions of child maltreatment could be either confirmed or excluded, and 31.3 % remained indeterminate.
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  The highest rate for either confirmation or exclusion was found for emotional abuse (76.3 %), the lowest for sexual abuse (65.0 %).
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  Confirmation or exclusion was significantly more likely in children with higher age, and when the medical consultations were of longer duration.
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  Higher age, female gender, emotional abuse and its interaction with medical consultation duration were found to be predictors for a higher rate of confirmation or exclusion.

Conclusions

Overall, CAEC are a useful instrument for the evaluation of the suspicion of different types of child maltreatment. The assessment of suspected child maltreatment requires significant resources and multidisciplinary collaboration, especially concerning sexual abuse.