{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:46:17Z","timestamp":1788453977763,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,6]]},"abstract":"\n Objective<\/jats:title>\n Head trauma is the most common cause of death from child abuse, and each encounter for recurrent abuse is associated with greater morbidity. Isolated skull fractures (ISF) are often treated conservatively in the emergency department (ED). We determined patterns of physical abuse screening in a children's hospital ED for children with ISF.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective review was performed for children aged 3 years and younger who presented to the ED with ISF from January 1, 2015 to December 31, 2019. Children were stratified by age (<12 mo, \u226512 mo) and witnessed versus unwitnessed injury. Primary outcome was social work (SW) assessment to prescreen for abuse. Secondary outcomes were suspicion for abuse based on Child Protective Services (CPS) referral and subsequent ED encounters within 1 year.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Sixty-six ISF patients were identified. Of unwitnessed injury patients aged younger than 12 months (n = 17\/22), 88.2% (n = 15\/17) underwent SW assessment and 47.1% (n = 8\/17) required CPS referral. Of witnessed injury patients aged younger than 12 months (n = 23\/44), 60.9% (n = 14\/23) underwent SW assessment, with no CPS referrals. Overall, 18.2% (n = 4\/22) unwitnessed and 20.5% (n = 9\/44) witnessed injury patients returned to our ED: 2 were aged younger than 12 months and had recurrent trauma.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n To decrease risk of missed physical abuse, SW consultation should be considered for all ISF patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000002823","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T17:04:43Z","timestamp":1661533483000},"page":"374-377","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Screening for Child Abuse in Children With Isolated Skull Fractures"],"prefix":"10.1097","volume":"39","author":[{"given":"Stephanie Y.","family":"Chen","sequence":"first","affiliation":[{"name":"Divisions of Pediatric Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leland","family":"Gao","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Kay","family":"Imagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric R.","family":"Roseman","sequence":"additional","affiliation":[{"name":"Department of Social Work, Children's Hospital Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy E.","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene S.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan G.","family":"Spurrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s00247-018-4128-6","article-title":"Occult head injury is common in children with concern for physical abuse","volume":"48","year":"2018","journal-title":"Pediatr Radiol"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.chiabu.2013.08.014","article-title":"Child maltreatment deaths in the U.S. National Child Death Review Case Reporting System","volume":"38","year":"2014","journal-title":"Child Abuse Negl"},{"key":"bib3-20250504","first-page":"e1337","article-title":"The evaluation of suspected child physical 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