Screening tool for parents

The child check is based on The Hague Protocol

This protocol was implemented in a region around the city of The Hague in 2007. Subsequently, it has been introduced in a large number of hospitals in the Netherlands. It aims to stop child abuse and offer voluntary community-based support to families.

The aim of this study is to assess whether this protocol for screening adults presenting for at an emergency department can identify children at high risk for maltreatment. A before and after study was conducted at nine emergency departments in three Dutch regions (one intervention region and two control regions). From January 2006 to November 2007, prior to the introduction of The Hague Protocol, four parents from a total of 385,626 ED patients in the intervention region (1 per 100,000) were referred to the RCCAN.

In the period after introduction of the protocol (December 2007 to December 2011), the number rose to 565 parents from a total of 885,301 ED patients (64 per 100,000). In the control regions, where the protocol was not implemented, these figures were two per 163,628 (1 per 100,000) and ten per 371,616 (3 per 100,000) respectively (OR = 28.0 (95 CI 4.6–170.7)). At assessment, child abuse was confirmed in 91% of referred cases.

The protocol has a high positive predictive value of 91% and can substantially increase the detection rate of child abuse in an ED setting. Parental characteristics are strong predictors of child abuse. Implementing guidelines to detect child abuse based on parental characteristics of parents attending the adult section of the ED can increase the detection rate of child abuse and neglect allowing appropriate aid to be initiated for these families.