Child abuse: a five-year follow-up of early case finding in the emergency department.

One hundred and fifty-six children under 6 years of age seen for injuries in an emergency department had been previously studied and their injuries were judged by the investigators to represent unreported "suspected abuse," "gross neglect," or an "accident." Five years later, all cases of "suspected abuse" and "neglect," and a random sample of "accidents," were included in a study involving interview of parents and a survey of medical facilities for subsequent contact with these children. Seventy-five percent (41 of 54) of this sample were located and available for study. At the time of follow-up, it was found that children judged to have experienced "accidents" had a lower incidence of subsequent injuries, their siblings had fewer injuries, their relationship to their mother was judged to be better, and there were fewer emotional and social problems in their families. These differences did not reach statistical significance except in a single instance, though by all of these measurements the children from the "suspected abuse" and "gross neglect" groups did not do as well as the children judged to have experienced "accidents." In addition, the two children identified as having experienced abuse during the follow-up period were both initially in the "suspected abuse" category; each of these children also had a sibling involved in abuse during this same period.