CDC study: Is the pandemic keeping abused children out of the ER?

Researchers find drop in number seeking care for neglect, abuse

CDC study: Is the pandemic keeping abused children out of the ER?

BOSTON — At face-value, it sounds like real progress: Fewer kids heading to U.S. emergency rooms because of child abuse or neglect.

Unfortunately, there’s a backstory to the headline. Make that a back-study.

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The Centers for Disease Control and Prevention reports that since the pandemic began surging last March, prompting declaration of a national emergency, hospital emergency departments have seen an overall 53 percent drop in visits from children and adolescents needing medical attention for abuse or neglect when compared with the same period in 2019.

And yet, the study, published in the agency’s Morbidity and Mortality Weekly Report (MMWR), also found those who did come in for those complaints were more likely to require hospitalization than similar patients the year before.

And even though the actual number of patients coming in for abuse and neglect decreased -- the proportion of emergency department patients with those complaints increased.

Which would suggest child abuse and neglect went somewhere during the pandemic -- just not, in droves, to emergency departments.

“People are suffering behind closed doors,” said Jaclyn Winer, a licensed social worker in Holliston. “To hear that we’re seeing an under-reporting of abuse and neglect in families, in children in particular, is incredibly distressing as a behavioral health provider, but not at all shocking.”

Winer suggested the pandemic is a breeding ground for abuse and neglect -- with insecurities over housing, health and nutrition creating levels of stress for families they’ve perhaps never had to deal with before.

“All of those things are where abuse and neglect really thrive,” Winer said. “And so it’s really important that these kids feel safe, that they have a trusted adult to go to. And that we’re recognizing the signs so we can get that family the help that they need.”

The CDC study notes another factor likely contributing to the decline in ED visits: Child abuse reporting during the pandemic has dropped 20 to 70 percent because COVID restrictions on schools and sports have limited the time children are spending with adults designated as ‘mandatory reporters’ -- coaches, teachers and others who, by law, are required to inform authorities of even a suspicion of child abuse.

That’s something that can be difficult enough to discern in person... let alone remotely.

“It’s just not the same when you’re working with a child through Zoom through the screen,” Winer said. “You can’t pick up on the subtleties that sometimes present.”

Because abuse doesn’t always present as a bruise or a broken bone.

Sometimes the manifestation is something silent and unseen, such as a broken spirit.

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