Abused children admitted to a pediatric in-patient service in Switzerland: a ten-year experience and follow-up evaluation.

In a period of 10 years (1974-1983) 82 children were admitted to our pediatric in-patient service because of child abuse or neglect. In 1984 the records of these children were examined to obtain a follow-up of 34 children who were less than 10 years of age at the time of their admission for non-accidental trauma. Thirty-eight percent of these children were less than 2 years old at the time of abuse, 30% from 2-3 years (68% less than 3 years) and 32% between 3-10 years. The lesions were as described in the literature. There was a greater proportion of children of foreign origin than would be expected from the general population of Geneva. At the time of hospital admission the majority of the parents were legally married and the majority of the children were cared for at home by a parent or relative. The perpetrator in most situations remained unknown; universal denial was the rule and therapeutic treatment of the family difficult to establish. The general policy of the protective services in Geneva is to maintain the abused child with his biological family. Over time, however, there is a tendency for abused children to be either removed from their homes and placed in foster care or to receive stricter supervision within their families. A large proportion of the study children were experiencing school difficulties and attended special classes. A relatively large number had left the country, either with or without their parents. Risk factors recorded in the literature were identified.