Medical Evaluations in Rhode Island for Suspected Child Abuse and Neglect Prior to and During the COVID-19 Pandemic.

During the COVID-19 pandemic, there was an increase in several risk factors for child maltreatment. There was also a sudden decrease in the systems available to identify and support at risk children and families. This study aims to describe the number of children presenting to specialized medical care for suspected child abuse and neglect during the first seven months of the COVID-19 pandemic compared to the three previous years. This was a retrospective chart review of all cases evaluated by the child abuse team in Rhode Island from March 1st until September 30th of 2017, 2018, 2019 and 2020. During the first seven months of the COVID-19 pandemic, there were 10% fewer children evaluated by the child abuse team with the most significant decrease (35%) in the number of children evaluated for physical abuse. With the known increased risk factors for physical abuse due to COVID-19, the decrease in the number of children evaluated for physical abuse is unlikely due to a decrease in the incidence of physical abuse. This decrease is most likely due to physical abuse not being identified or children not being referred to specialized medical care. Without the ability to see and interact with children in person, professionals' ability to identify child victims of abuse is limited. Professionals working with children and families at risk should develop strategies to be able to continue to provide in-person services in the future if another pandemic or natural disaster occurs.