Pediatrics Groups Offer Guidance on Caring for Maltreated Children

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

The American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry have released guidance for clinicians caring for children and adolescents who have experienced maltreatment. Among the recommendations, published in Pediatrics:

• Before starting any treatment, a clinician trained in child maltreatment should assess a child.

• For children with a history of maltreatment, care focused on psychosocial interventions instead of medication often has the greatest value and the least amount of risk.

• Clinicians should be alert to signs of ongoing violence and maltreatment.

• Children who have emotional and behavioral difficulties as a result of maltreatment should receive evidence-based psychotherapies. Pediatric clinicians should help bridge the gap until therapy can begin (e.g., providing psychoeducation and relaxation training, and encouraging parent-child communication).

• Maltreated youth should be asked about self-harm and suicidal ideation, even if they don't seem suicidal.

• When considering medication discontinuation, clinicians should follow evidence-based protocols and focus on medications with significant risk, limited evidence, or no obvious improvement.