Factors affecting clinical referral of young children with a subdural haemorrhage to child protection agencies

Abstract

AbstractThe research on which this paper is based aimed to identify the social and legal consequences when young children sustain a suspected non‐accidental subdural haemorrhage; and to examine the clinical and social factors that impact on clinical referral decisions. Data were collected from medical, social services, police and court files for information on the management of children with these injuries by various agencies in the South West of England and South Wales. Data were collected on the case management of young children from time of presentation to hospital through to referral to police and social services. The paper shows that children who are most at risk of shaking injuries are likely to be very young babies between 3 and 5 months of age. They are most likely to come from deprived households where parental stability is weak and where social support for the carers is limited. Referral of children by paediatricians to child protection agencies is not always carried out in cases where coexisting signs indicate a strong reason for referral. It is recommended that paediatricians and other clinicians involved in the care of young children should embark on a multidisciplinary process of assessment and training in the identification of non‐accidental head injury in very young children and babies, to reduce their risk of future harm. Copyright © 2003 John Wiley & Sons, Ltd.