Child abuse in children and youth with special health care needs

Abstract

1. Longitudinal epidemiologic surveillance data indicate that children and youth with special health care needs are a growing population in the United States, secondary to advances in medical technology and improved survival of premature infants. (2) 2. On the basis of strong research evidence, children and youth with special health care needs are at increased risk for child abuse because of increased need for care and additional parental and caregiver stressors. (8)(9)(10) 3. On the basis of some research evidence, as well as consensus, there are unique challenges to the identification of abuse in children with special health care needs, such as the differentiation of abuse from accidental trauma based on risk factors such as osteopenia, spasticity, higher rates of fracture or soft-tissue trauma, and limited mobility that requires transfers by assistive person, as well as recognizing abuse in nonverbal patients. (18)(20)(22) 4. The medical home model provides a framework for preventing abuse in vulnerable children while partnering with the community and families. (26)(28).