[Epidemiological study of noted children under 6 years of age in danger in medicosocial services in a French department (Ille et Vilaine)].

An epidemiological study was conducted during 1 year (1989) in a French department (Ille et Vilaine) on children under 6 years of age reported by local medico-social services as being at risk of child abuse or neglect. This involved 786 children, ie an incidence of 1/80 children under 6. Among these children, 282 (35.9%) presented with clinical signs possibly related to abuse; only nine were hospitalized after being reported, showing the limits of the hospital to detect child abuse or neglect. The psycho-social characteristics of the families, the sources and motives of the reports, the criteria used to assess the risks run by the children, the care and protection measures were investigated through multifactor statistical analysis. Alcoholism, violence and parental immaturity were the most worrying factors. Social workers were at the origin of most reports and referrals (78%); most often they were alerted by socio-economic problems and parental immaturity. Physicians were in a better position to signal physical abuse, but they overlooked the situations of neglect. These were 388 children referred to the judiciary; 91 were removed from their families. Removal was ordered by courts in the presence of alcoholism, familial violence, disabled parents, offence records, insanitary housing, physical abuse or neglect, repeated hospitalizations. The perception of the risks was found to be a subjective notion depending upon the assessor's experience and tolerance thresholds, but also the quality of the professionals training and the organization of the services.