Trends in physical abuse and neglect referrals to a child abuse pediatrics program in Toronto, Canada during COVID: a time series analysis.

BACKGROUND

Reported trends in child maltreatment encounters throughout the pandemic were varying, with few studies examining referrals to child abuse pediatrics programs in non-acute settings.

OBJECTIVES

This study investigated the trend over time of physical abuse and neglect referrals for medical evaluation to a child abuse pediatrics program in Toronto, Ontario, Canada.

METHODS

This single-center, cross-sectional study used retrospective chart review data from electronic medical records of patients referred between June 1, 2018, and March 31, 2022. An interrupted time series analysis was conducted to assess variations in referrals before, during, and post-pandemic (mass school and daycare reopening).

RESULTS

2039 cases were referred for physical abuse and neglect concerns. Pandemic-related closures resulted in an immediate 25% decrease (IRR 0.75, 95% CI 0.60-0.93) in physical abuse referrals, followed by an increasing trend of 2% per month (IRR 1.02, 95% CI 1.003-1.04), largely due to increasing referrals for school-age children. School and daycare reopening was associated with an immediate decrease of 31% (IRR 0.69, 95% CI 0.49-0.98). Referrals for neglect and other forms of abuse increased during the pandemic (IRR 1.05, 95% CI 1.00-1.10), followed by a decreasing trend of referrals post-pandemic by 20% per month (IRR 0.80, 95% CI: 0.68-0.92).

CONCLUSION

Referrals to a child abuse program showed an increasing trend of physical abuse and neglect cases during the pandemic followed by a decrease with mass school and daycare reopening. The increasing physical abuse cases were largely driven by school-age children.