A History of Child Abuse Pediatrics: Training, Research, and Clinical Diagnosis.

This article provides an historical review of child maltreatment, focusing on the three most common subtypes: physical abuse, sexual abuse, and neglect. The evolution of recognizing, evaluating, and accurately diagnosing child maltreatment is described. Over time, the establishment of multidisciplinary teams, mandatory reporting, and Child Abuse Pediatrics as a subspecialty of pediatrics has improved the training, research, and clinical diagnosis for all forms of child maltreatment. These advancements have set clinical standards to ensure accurate diagnosis, prevent the misdiagnosis of child abuse and neglect, and continually improve the systems meant to protect children. The expansion of knowledge of child maltreatment continues with attention on early detection of children at risk of developing lifelong physical, psychological, and behavioral consequences from trauma associated with all forms of child maltreatment.

Food Insecurity and Child Maltreatment: A Quality Improvement Project.

Food insecurity affects both children and adults in 8% of households in the United States and 12.8% of households in Rhode Island, negatively impacting childhood health and development. Children with a history of child abuse or neglect are at higher risk for food insecurity than other pediatric populations. Patients evaluated at a child protection clinic - which completes evaluations for all forms of suspected child maltreatment - were screened for food insecurity using a validated two-item questionnaire. Data were collected over a four-month period, with three quality improvement cycles. A quality improvement cycle is a planned sequence of systematic and documented activities aimed at improving a process. Prior to the implementation of this protocol, children in the clinic were not screened for food insecurity. With the initiation of food insecurity screening, 8% of all households eligible for screening were found to be food insecure. Pediatric providers should identify food insecurity in their patients, including in subspecialty care clinics, to optimize care for pediatric patients and their families. When food insecurity is identified, referral to resources and support services is important.