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Accuracy of a Screening Instrument to Identify Potential Child Abuse in Emergency Departments

NCJ Number
Child Abuse and Neglect Volume: 38 Issue: 7 Dated: July 2014 Pages: 1275-1281
Eveline C.F.M. Louwers; Ida J. Korfage; Marjo J. Affourtit; Madelon Ruige; Annette P.M. van den Elzen; Harry J. de Koning; Henriëtte A. Moll
Date Published
July 2014
7 pages
This study measured the accuracy of a newly developed screening instrument for use in emergency departments to determine the presence of child abuse.
This study on the accuracy of a newly developed screening instrument, ESCAPE, to determine the presence of child abuse found that the completed screening instrument had a specificity level of 0.98 and a sensitivity level of 0.80. Of the 18,275 cases where an ESCAPE instrument was completed, 2.3 percent, or 420 of the instruments were positive for potential child abuse. In addition, 89 of the 18,275 cases were referred by the attending emergency room physician to child abuse teams. Univariate logistic regression analysis of the completed instruments found that potentially abused children were significantly more likely to have an aberrant or outlying answer to at least one of the items on the screening instrument. Data for the study were obtained from review of medical records over an 18-month period from three Dutch hospitals where the ESCAPE instrument was implemented for use in screening children age 18 and younger who presented for injuries and were potentially at high risk for physical abuse. The Escape screening instrument is a 6-item checklist that addresses risk factors for child abuse and which may be predictive for child abuse in any child. Analysis of the data revealed that most of the children in the study who were at high risk for child abuse were detected through use of the screening instrument. These findings suggest that the Escape instrument is a useful tool for emergency department staff looking to support the identification of those at high risk for child abuse. Study limitations are discussed. Tables, figures, references, and appendix