This is the current release of the guideline.

This guideline updates a previous version: American Academy of Pediatrics: Committee on Child Abuse and Neglect and Committee on Children With Disabilities. Assessment of maltreatment of children with disabilities. Pediatrics 2001 Aug;108(2):508-12.

All clinical reports and policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

Maltreatment of children, including those with disabilities

Note: For purposes of this report, the terms "disability" and "special health care needs" include the full spectrum of physical, mental, and emotional impairment.

Evaluation
Prevention
Risk Assessment
Screening
Treatment

Family Practice
Pediatrics
Preventive Medicine
Psychology

Advanced Practice Nurses
Allied Health Personnel
Nurses
Physician Assistants
Physicians
Social Workers

• To increase awareness and provide education to pediatricians regarding risk factors of child abuse and neglect
• To ensure that children with disabilities are recognized as a population that is also at risk of maltreatment
• To present recommendations for early recognition, intervention, early detection and prevention of child abuse and neglect in this population

Children and adolescents with disabilities, including physical, mental, and emotional impairment

Screening

1. Assessment of:
   • Signs and symptoms of child maltreatment
   • Disabling conditions that can mimic child abuse
   • Family's strengths and need for resources
2. Evaluation of maltreated child for disabilities

Prevention

1. Provision of:
   • Emotional support
   • Needed equipment and resources to children and families
2. Treatment plans and collaborative team approach
3. Advocacy for:
   • Children with disabilities or special health care needs
   • Changes in state and local policies
   • Positive behavioral supports and elimination of aversive techniques
   • Better health care coverage

• Causal factors related to child maltreatment
• Incidence of maltreatment in children with disabilities

Searches of Electronic Databases

Not stated

Not stated

Not stated

Not applicable

Review

Not stated

Not stated

Not applicable

A formal cost analysis was not performed and published cost analyses were not reviewed.

Peer Review

Not stated

1. Be capable of recognizing signs and symptoms of child maltreatment in all children and adolescents, including those with disabilities.
2. Be familiar with disabling conditions that can mimic abuse or pose an increased risk of accidental injury that can be confused with abuse.
3. Because children with disabilities are at increased risk of maltreatment, remain vigilant not only in assessment for indications of abuse but also in offerings of emotional support and provision of equipment and resources to meet the needs of children and families.
4. Ensure that any child in whom maltreatment has been identified is evaluated thoroughly for disabilities.
5. Advocate for all children, especially those who have disabilities or special health care needs, to have a medical home. (Medical Homes Initiatives for Children with Special Needs Advisory Committee & American Academy of Pediatrics, 2002) If a child is hospitalized and does not have a medical home, the inpatient attending physician can help the family secure one before discharge, preferably as early as possible in the hospital course. (Percelay & American Academy of Pediatrics, 2003)
6. Be actively involved with treatment plans developed for children with disabilities and participate in collaborative team approaches.
7. Use health supervision visits as a time to assess a family's strengths and need for resources to counterbalance family stressors and parenting demands.
8. Advocate for changes in state and local policies in which system failures seem to occur regarding the identification, treatment, and prevention of maltreatment of children with disabilities.
9. Advocate for the implementation of positive behavioral supports and elimination of aversive techniques and unnecessary physical restraints in homes, schools, and other educational and therapeutic programs (both public and private), institutions, and settings for children who have disabilities.
10. Advocate for better health care coverage by both private insurers and governmental funding.

None provided

The type of evidence supporting each recommendation is not specifically stated.

Appropriate assessment of maltreatment of children with disabilities may lead to early recognition and intervention of child abuse and neglect, as well as prevention of child maltreatment

Not stated

The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

An implementation strategy was not provided.

Staying Healthy

Effectiveness
Patient-centeredness

Not applicable: The guideline was not adapted from another source.

2001 Aug (revised 2007 May)

American Academy of Pediatrics - Medical Specialty Society

American Academy of Pediatrics (AAP)

Committee on Child Abuse and Neglect
Committee on Children with Disabilities

Committee on Child Abuse and Neglect, 2006-2007: Carole Jenny, MD, MBA, Chairperson; Cindy W. Christian, MD; *Roberta A. Hibbard, MD; Nancy D. Kellogg, MD; Betty S. Spivack, MD; John Stirling, Jr, MD

Liaisons: David L. Corwin, MD, American Academy of Child and Adolescent Psychiatry; James A. Mercy, PhD, Centers for Disease Control and Prevention

Staff: Tammy Hurley

Committee on Children with Disabilities, 2006-2007: Paul H. Lipkin, MD, Chairperson; J. Daniel Cartwright, MD; *Larry W. Desch, MD; John C. Duby, MD; Ellen Roy Elias, MD; Chris Plauché Johnson, MD, Med; Eric B. Levey, MD; Nancy A. Murphy, MD; Scott M. Myers, MD; Ann Henderson Tilton, MD

Liaisons: Beverly Crider, Family Voices; Donald Lollar, EdD, Centers for Disease Control and Prevention; Merle McPherson, MD, MPH, Maternal and Child Health Bureau

Staff: Stephanie Mucha Skipper, MPH

Not stated

This is the current release of the guideline.

This guideline updates a previous version: American Academy of Pediatrics: Committee on Child Abuse and Neglect and Committee on Children With Disabilities. Assessment of maltreatment of children with disabilities. Pediatrics 2001 Aug;108(2):508-12.

All clinical reports and policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

None available

None available

This summary was completed by ECRI on May 7, 2002. The information was verified by the guideline developer on June 11, 2002. This NGC summary was updated by ECRI Institute on September 4, 2007. The updated information was verified by the guideline developer on September 18, 2007.

This National Guideline Clearinghouse summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the Permissions Editor, American Academy of Pediatrics (AAP), 141 Northwest Point Blvd, Elk Grove Village, IL 60007.