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Screening Adult Patients in Emergency Departments (EDs) for Risk Factors of Child Maltreatment. A Swedish Pilot Study

Dovik C, Cattell J, Jönsson L, Rantala A, Lundqvist P, Laurell L

Acta paediatrica (Oslo, Norway : 1992), 2026

131 participants · 1 citation

Abstract

AIM

Swedish healthcare staff are obliged to immediately report suspected child maltreatment (CM) to child protection services (CPS), but often fail this duty. The use of screening instruments in EDs increases detection of adults with risk factors for CM. Such instruments have previously not been available in Sweden. The aim of the present study was to pilot test a Swedish version of the Dutch 'child-check' instrument, and evaluate a retrospective case series.

METHODS

Our study was performed in an ED at Skåne University Hospital. The original Dutch instrument was translated with adaptation to national medico-legal context; face validity was obtained by a multidisciplinary expert panel, and it was piloted by a multiprofessional ED team. Following implementation, retrospective data was collected 2021-2022 from registries at the hospital ED and one municipal CPS.

RESULTS

The screening instrument identified 295 adult care-seekers with risk factors for CM. Subsequent reports of concern included 131 children, among which 62 (47%) were not known to CPS.

CONCLUSION

Our study suggests that the Swedish version of the instrument, 'child-check adult', could play an important role for ED personnel in identifying adults with risk factors for CM. We therefore aim to implement it in all Swedish regions.

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 131 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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