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Army Child Abuse, Neglect Cases Under-Reported

By U.S. Medicine

By Annette M. Boyle

PHILADELPHIA—Abuse and neglect of children of Army personnel appears to be under-reported, according to a new report which also suggests a breakdown of communication between civilian child protective services and the military.

The report, published in the journal Child Abuse & Neglect, noted that only 20 percent of medically-diagnosed child abuse and neglect cases in U.S. Army dependent children between 2004 and 2007 were found to have a substantiated report with the Army’s Family Advocacy Program (FAP)—the agency responsible for the investigation and treatment of child abuse.

PolicyLab, an advocacy and research group associated with Children’s Hospital of Philadelphia Research Institute, which conducted the study with the Army’s FAP, noted that the reported rate was less than half the rate, 44%, of medically-diagnosed child abuse cases confirmed by community Child Protective Services (CPS) agencies.

That disparity, according to researchers, raised questions about the Army-reported rates of child abuse. They question whether the problem is under-reporting of abuse cases by medical providers and/or a breakdown in communication between civilian CPS and established military services.

The number of medically-diagnosed abuse cases with corresponding substantiated Army FAP reports was lowest for children cared for at civilian treatment facilities, 9.2% but also low for children receiving care from military healthcare providers, 24.2%.

“For many years, the U.S. Army has reported rates of child abuse well below that of the civilian population. This study calls those reports into question,” explained Dave Rubin, MD, MSCE, director of PolicyLab at Children’s Hospital of Philadelphia (CHOP), pediatrician at CHOP and a presidential appointee to the federal Commission to Eliminate Child Abuse & Neglect Fatalities. “Yet, the U.S. Army can only report cases they know about, and our findings suggest that they may not be aware of the majority of their cases.”

Looking at 2004 to 2007, researchers employed medical claims data to identify 0- to 17-year-old child dependents of soldiers who received a medical diagnosis of child maltreatment, calculating linkage rates of maltreatment medical diagnoses with corresponding substantiated FAP reports.


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