Newton Alice W, Vandeven Andrea M
Department of Pediatrics, Harvard Medical School, USA.
Curr Opin Pediatr. 2007 Apr;19(2):223-9. doi: 10.1097/MOP.0b013e32809f9543.
Recent literature regarding assessment, management and prevention of child maltreatment will be considered. Unexplained infant and child death will also be reviewed.
Controversies in the evaluation of unexpected infant death and inflicted traumatic brain injury are ongoing. Evidence continues to accumulate describing the serious long-term sequelae of child maltreatment. Studies have examined the earliest beginnings of these adverse outcomes commencing in childhood. Despite sustained efforts to develop a variety of training and intervention programs, the deployment of these efforts has been hampered by the lack of evidence that they make any difference in improving recognition of child abuse or in preventing recurrent maltreatment. There is a great need in the child abuse field for more formal, rigorous assessment of all manner of intervention programs.
Efforts to improve the recognition of and management of child abuse need to be sustained. As our understanding of child maltreatment continues to grow, evidence-based interventions will likely improve outcomes for abused children and their families. General pediatricians are often the first to notice signs and symptoms of possible child maltreatment; collaboration with hospital-based Child Protection Teams is critical when considering the possibility of abuse or neglect.
探讨近期有关儿童虐待评估、管理及预防的文献。同时也将对不明原因的婴幼儿死亡进行回顾。
意外婴儿死亡和外伤性脑损伤评估方面的争议仍在持续。有关儿童虐待严重长期后果的证据不断积累。研究已经考察了这些不良后果从童年早期就开始出现的情况。尽管持续努力开展了各种培训和干预项目,但由于缺乏证据表明这些项目在提高对儿童虐待的识别或预防反复虐待方面有任何作用,这些努力的实施受到了阻碍。在儿童虐待领域,非常需要对各种干预项目进行更正式、严格的评估。
需要持续努力提高对儿童虐待的识别和管理。随着我们对儿童虐待的理解不断加深,基于证据的干预措施可能会改善受虐儿童及其家庭的结局。普通儿科医生往往是最先注意到可能存在儿童虐待迹象和症状的人;在考虑存在虐待或忽视可能性时,与医院儿童保护团队合作至关重要。