Follow-up of children “at risk” of child abuse: Effect of support on emotional and intellectual development

This study is a follow-up of 47 children previously reported, who were referred to one paediatric unit and found to be “at risk” of child abuse. They were classified as “Satisfactory” (12), “Unsatisfactory” (18), and “Uncertain” (17), on the basis of breakdown of natural parenting, growth failure, developmental delay, behaviour disturbance and nonaccidental injury. Three years later, of 6 “unsatisfactory” children still with natural parents, 3 were unchanged and 3 had deteriorated. Of 10 fostered children from this group, 4 were considered normal and 5 had improved. Of 17 children in the “Uncertain” group, 3 are reclassified as “Satisfactory,” 3 are now “Unsatisfactory” and in 3 significant organic disease makes attribution of disability difficult. Ten out of 12 children in the “Satisfactory” group have remained in this category. These findings point to the conclusion that in those families where child rearing practices are so poor as to produce emotional and developmental impairment, the usual social work support and other conventional methods are not able to reverse the harm and in some cases to prevent further deterioration.