Evaluation and follow-up of cases diagnosed as child abuse and neglect at a tertiary hospital in Turkey

Aim: Data on child maltreatment in Turkey would appear to be scarce. This manuscript aims to address the prevalence and severity of child maltreatment in Turkey. Materials and methods: We report on 215 cases at the Ministry of Health’s Ankara Training and Research Hospital that were followed-up by the multidisciplinary Child Protection Team (CPT) between 1 January 2001 and 31 December 2005. The data collected on subjects included characteristics of the victims and the perpetrators, family demographics, maltreatment types, medical findings, mortality rate, and outcomes for the victim and the perpetrator. Results: Age and gender distribution of the victims were 6.8 ± 5.8 years and 58.1% girls. The perpetrators in 53.0% of the cases were the fathers, in 18.6% the mothers, and others in 28.4%. The categories of maltreatment were neglect in 39.5% of cases, physical abuse in 29.8%, psychological abuse in 21.4%, and sexual abuse in 9.3%. One hundred twenty cases (55.3%) were efficiently followed-up by the regional Social Service Agency (SSA). Re-abuse was reported in 8.3% of them. Following initial investigation of the 84 perpetrators, who were reported to the Forensic Medicine Institution by the Police Department, 17.8% were acquitted, 11.9% were convicted, and no legal action was taken for the rest. Conclusion: The knowledge and experience of the physician are extremely important for the diagnosis of child abuse and neglect. This study shows that a team approach to suspected cases of child abuse and neglect improves recognition and the reporting process.

Evaluation and follow-up of cases diagnosed as child abuse and neglect at a tertiary hospital in Turkey

Aim: Data on child maltreatment in Turkey would appear to be scarce. This manuscript aims to address the prevalence and severity of child maltreatment in Turkey. Materials and methods: We report on 215 cases at the Ministry of Health’s Ankara Training and Research Hospital that were followed-up by the multidisciplinary Child Protection Team (CPT) between 1 January 2001 and 31 December 2005. The data collected on subjects included characteristics of the victims and the perpetrators, family demographics, maltreatment types, medical findings, mortality rate, and outcomes for the victim and the perpetrator. Results: Age and gender distribution of the victims were 6.8 ± 5.8 years and 58.1% girls. The perpetrators in 53.0% of the cases were the fathers, in 18.6% the mothers, and others in 28.4%. The categories of maltreatment were neglect in 39.5% of cases, physical abuse in 29.8%, psychological abuse in 21.4%, and sexual abuse in 9.3%. One hundred twenty cases (55.3%) were efficiently followed-up by the regional Social Service Agency (SSA). Re-abuse was reported in 8.3% of them. Following initial investigation of the 84 perpetrators, who were reported to the Forensic Medicine Institution by the Police Department, 17.8% were acquitted, 11.9% were convicted, and no legal action was taken for the rest. Conclusion: The knowledge and experience of the physician are extremely important for the diagnosis of child abuse and neglect. This study shows that a team approach to suspected cases of child abuse and neglect improves recognition and the reporting process.

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  • Theodore AD, Runyan DK. A medical research agenda for child maltreatment: negotiating the nextsteps, Pediatrics 1999; 104: 168-77.
  • Robin M. The social construction of child abuse and false
  • Youssef RM, Attia MS, Kamel MI. Children experiencing violence: parental use of corporal punishment. Child Abuse & Neglect, 1998; 22: 959-73.
  • Kim DH et al. Children’s experience of violence in China and Korea: a transcultural study. Child Abuse & Neglect, 2000; 24: 1163-73.
  • Finkelhor D. The international epidemiology of child sexual abuse. Child Abuse & Neglect, 1994; 18: 409-17.
  • Youssef RM, Attia MS, Kamel MI. Children experiencing violence: parental use of corporal punishment. Child Abuse & Neglect, 1998; 22: 959-73.
  • Conners-Burrow NA, Johnson B, Whiteside-Mansell L. Maternal substance abuse and children's exposure to violence. J Pediatr Nurs 2009; 24: 360-8.
  • Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high- income countries. Lancet 2009; 373: 68-81.
  • Takayama JI, Wolfe E, Coulter KP. Relationship between reason for placement and medical findings among children in foster care. Pediatrics, 1998; 101: 201-7.
  • Pasqualone GA, Fitzgerald SM. Munchausen by Proxy syndrome: the forensic challenge of recognition, diagnosis, and reporting. Crit Care Nurs., 1999; 22: 52-64; quiz 90-1.
  • National Research Council. Washington, DC, National Academy of Sciences Press, 1993.
  • Hurme T, Alanko S, Anttila P, Juven T, Svedström E. Risk factors for physical child abuse in infants and toddlers. Eur J Pediatr Surg., 2008; 18: 387-91.
  • Berkowitz CD. Fatal child neglect. Adv Pediatr., 2001; 48: 331- 61.
  • Zimmermann S, Makoroff K, Care M, Thomas A, Shapiro R. Utility of follow-up skeletal surveys in suspected child physical abuse evaluations. Child Abuse Negl, 2005; 29: 1073-4.
  • Kemp AM, Dunstan F, Harrison S, Morris S, Mann M, Rolfe K, Datta S, Thomas DP, Sibert JR, Maguire S. Patterns of skeletal fractures in child abuse: systematic review. BMJ., 2008; 337: a1518.
  • Straus MA, Hamby SL. Measuring physical and psychological maltreatment of children with the Conflict Tactics Scales. In: Kantor K et al., (eds.) Out of the darkness: contemporary perspectives on family violence. Thousand Oaks, CA, Sage, 1997; 119-135.
  • Hunter WM et al. Risk factors for severe child discipline practices in rural India. Journal of Pediatric Psychology, 2000; 25: 435-447.
  • Tang CS. The rate of child abuse in Chinese families: a community survey in Hong Kong. Child Abuse & Neglect, 1998; 22: 381-391.
  • Madu SN, Peltzer K. Risk factors and child sexual abuse among secondary students in the Northern Province (South Africa). Child Abuse & Neglect, 2000; 24: 259-68.
  • Finkelhor D. The international epidemiology of child sexual abuse. Child Abuse & Neglect, 1994; 18: 409-417.
  • Bergen HA, Martin G, Richardson AS, Allison S, Roeger L. Sexual abuse and suicidal behavior: a model constructed from a large community sample of adolescents. J Am Acad Child Adolesc Psychiatry, 2003; 42: 1301-9.
  • Ozbaran B, Erermis S, Bukusoglu N, Bildik T, Tamar M, Ercan ES, Aydin C, Cetin SK. Social and Emotional Outcomes of Child Sexual Abuse: A Clinical Sample in Turkey. J Interpers Violence, 2008 Sep 15. [Epub ahead of print]
  • Küçüker H. Analysis of 268 child and adolescent victims of sexual assault and the legal outcome. Turk J Pediatr, 2008; 50: 313-6.
  • Voros, Osvath P, Fekete S. Gender differences in suicidal behavior. Neuropsychopharmacol Hung, 2004; 6: 65-71.
  • Straus MA, Hamby SL. Measuring physical and psychological maltreatment of children with the Conflict Tactics Scales. In: Kantor K et al., (eds.) Out of the darkness: contemporary perspectives on family violence. Thousand Oaks, CA, Sage, 1997; 119-135.
  • Suicide and suicide attempts in adolescents. Committee on Adolescents. American Academy of Pediatrics. Pediatrics, 2000; 105: 871-4. Pagura J, Cox BJ, Sareen J, Enns MW. Factors associated with multiple versus single episode suicide attempts in the 1990-1992 and 2001-2003 United States national comorbidity surveys. J Nerv Ment Dis, 2008; 196: 806-13.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Molecular typing of methicillin-resistant Staphylococcus aureus isolated from bloodstream infections in a university hospital

Gülay YETKİN

The predictive role of AST level, prothrombin time, and platelet count in the detection of liver fibrosis in patients with chronic hepatitis C

Bahar TAŞDELEN, Güliz SARAÇOĞLU, Özlem KANDEMİR, Gürbüz POLAT

Imaging liver transplantation candidates using gadolinium enhanced MDCT angiography

Ragibe KANTARCI, Cihan DURAN, Selim DOĞANAY, K. Yalçın POLAT, S. Selçuk ATAMANALP, Mecit KANTARCI, Hayri OĞUL, Bülent AYDINLI, Durur Irmak SUBAŞI

Cytotoxic effects of caffeic acid phenethyl ester (CAPE) on the human multiple myeloma cell line

Özgür KORU

Does L-carnitine increase serum TNF -α and IGF-1 during liver regeneration in the rat?

Mevlüt PEHLİVAN

General anesthesia for cesarean delivery followed by anterior and posterior spinal cord decompression of a parturient with symptomatic spinemetastasis due to breast cancer

Berrin GÜNAYDIN

The relationship of serum CEA and CA 19-9 levels to liver metastasis and pancreatic invasion in esophageal cancer

Atila EROĞLU, Atila TÜRKYILMAZ, Yener AYDIN, Nurettin KARAOĞLANOĞLU

Fetal malnutrition in infants of smokers and passive smokers assessed by clinical assessment of nutritional status scoring

Ayşen Kutan FENERCİOĞLU

Does L-carnitine increase serum TNF -α and IGF-1 during liver regeneration in the rat?

Tevfik YAVUZ, Arif ARSLANER, Mevlüt PEHLİVAN, Abdurrahman COŞKUN, Ahmet ZENGİN

Use of the shock index to diagnose acute hypovolemia

Polat DURUKAN