Occult drug exposure in young children evaluated for physical abuse: An opportunity for intervention |
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| Institution: | 1. Medical College of Wisconsin, Milwaukee, WI, United States;2. Children’s Hospital of Wisconsin, Milwaukee, WI, United States;1. Faculty of Psychology, 7th Floor, Borommaratchachonnani Srisattaphat Building, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand;2. School of Psychology, The University of Queensland, Queensland, 4072, Australia;3. Institute for Teaching and Learning Innovation, The University of Queensland, Queensland, 4072, Australia;1. University of Wisconsin-Milwaukee Helen Bader School of Social Welfare, 2400 E. Hartford Avenue, 1165 Enderis Hall, Milwaukee, WI, 53211, USA;2. Tulane University School of Social Work, 127 Elk Place, New Orleans, LA, 70112, USA;1. Departments of Health Technology and Services Research, and Public Administration, Institute of Innovation and Governance Studies, University of Twente, Enschede, the Netherlands;2. Department of Health Technology and Services Research, Institute of Innovation and Governance Studies, University of Twente, Enschede, the Netherlands;3. Department of Preventive Child Healthcare, Municipal Health Service GGD Twente, Enschede, the Netherlands;4. Department of Public Administration, Institute of Innovation and Governance Studies, University of Twente, Enschede, the Netherlands;1. Maastricht University, Netherlands;2. Maastricht University, Netherlands and Catholic University Leuven, Belgium;1. Department of Psychology, University of Maryland, United States;2. Division of Public Health, Michigan State University, United States;3. Department of Psychology, University of Kansas- Cofrin Logan Center for Addiction Research and Treatment;1. Beijing Key Laboratory of Learning and Cognition, Research Center for Child Development, School of Psychology, Capital Normal University, China;2. Research Center for Child Development, College of Elementary Education, Capital Normal University, No.105 Xisan Huan Beilu, Beijing, 100048, China |
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| Abstract: | BackgroundAlthough screening for drug exposure is an important consideration in the evaluation of suspected child maltreatment, limited data are available on the frequency of drug exposure in children with suspected physical abuse.ObjectiveTo examine occult drug and pharmaceutical exposure in young children with suspected physical abuse.Participants and settingChildren ages 2 weeks –59 months evaluated for physical abuse by a tertiary referral center Child Protection Team.MethodsCross-sectional study of young children diagnosed with high, intermediate, or low concern for physical abuse and tested for occult drug exposure from 2013-2017. Chart review was performed to determine adherence to recommended testing and drug test results with comparison between groups.ResultsOccult drug exposures were found in 5.1% (CI 3.6–7.8) of 453 children tested: 6.0% (CI 3.6–10.0) of 232 children with high concern for physical abuse, 5.0% (CI 2.7–9.3) of 179 children with intermediate concern, and 0% of 42 children with low concern. As adherence to protocol-based screening improved during the second half of the study, so did the overall rate of detection of occult drug exposures (7.9%, CI 5.2–11.9) in 252 children with intermediate or high concern for physical abuse. Most exposures were to cocaine, although non-prescribed pharmaceutical exposures were also detected.ConclusionsUp to 7.9% of young children suspected of being physically abused also had an occult drug exposure. Given the adverse health consequences associated with exposure to a drug-endangered environment, screening for occult drug exposure should be considered in the evaluation of young children with intermediate or high concern for physical abuse. |
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| Keywords: | Child physical abuse Drug exposure Drug testing Substance abuse Child safety |
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