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Medical and Developmental Histories Of Maltreated Children

Boston Juvenile Court Clinic, New Court House, Room 210, 17 Somerset Street, Boston, MA 02108, Department of Pediatrics, Franciscan Children's Hospital, Brighton, MA, The Children's Hospital, Boston, MA, Harvard Medical School, Boston, MA

Terence Fenton, E.d. D

Department of Biostatistics, Harvard School of Public Health, Boston, MA, Harvard Medical School, Boston, MA

Robert Kinscherff, Ph.D.

Boston Juvenile Court, Department of Mental Health, Boston, MA, The Children's Hospital, Boston, MA, Harvard Medical School, Boston, MA

This paper represents a first attempt at delineating and summarizing the issues in a child's medical and developmental history associated with the probability of suffering abuse. The sample consisted of 96 children between 5 and 10 years of age, 61 of whom had been maltreated and 35 of whom served as controls. There were 22 items about which the medical and developmental histories of the maltreated children revealed a significantly greater risk than those of the controls. A factor analysis revealed that 78% of the variance in these items can be represented by eight independent factors. None of these factors was dominant; rather, each accounted for a significant amount of the variation among the original items. The individual items tended to load on the four strongest factors in a coherent, interpretable manner: Factor 1 represented behavior problems; factor 2, neonatal issues and failure to thrive; factor 3, familial disruption, with the child suffering mental illness and/or head injury; and factor 4, a "difficult" temperament during the first year of life. We conclude there are numerous independent factors in the medical and developmental histories of maltreated children which should be considered by pediatricians involved in cases of child abuse and neglect.

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