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Abusive head trauma (AHT) is a criminal offence that is prosecuted ex officio, following report to the police from physicians or child protection services. The aim of this study was to assess whether the judicial outcome (dismissal vs indictment) was influenced by the quality of the medical documentation and/or the time span between AHT diagnosis and reporting child abuse to the police. The cohort was divided in two groups: 13/23 dismissals (57%) and 10/23 indictments (43%). The diagnostic probability of the AHT cases was certain for both groups. Nonetheless, in fraction of dismissed cases, alternative explanations for the observed lesions seemed plausible to the public prosecutor. Legal files of only 3/12 dismissed cases had a forensic report, while 6/10 cases that were indicted included a forensic report. Further, the legal file of several dismissed cases entirely lacked medical documentation (3/12), which was not the cases for indicted cases. The period between AHT diagnosis and reporting to the police was not different for dismissals (29 ± 19 days) and indictments (7 ± 4 days) (p = 0.32). Physicians filed reports more rapidly (6 ± 1 days) compared to childhood protection service (70 ± 46 days) (p = 0.01) and that may increase the rate of indictments (9/18) compared to reporting via the childhood protection service (1/5). Despite diagnostic certainty, other causes for the lesions were considered as plausible alternative explanations to judicial professionals in several dismissed cases. These seemed to have less medical documentation and forensic evaluations. In addition, more rapid reporting to the police by physicians seems to increase the likelihood of indictments., (© 2024. The Author(s).)

Neglect of children and adolescents is the most common form of abuse and occurs when their basic needs are not met. The negative impact on physical and mental health can be significant. Early detection by primary care physicians and support for parents and the community, in collaboration with the social and health network, are essential to ensure that minors have an environment conducive to their healthy development. Recognizing the needs of children and teenagers is an important issue in social and preventive medicine, as is defending their interests and rights., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

During the semi-confinement period linked to the COVID-19 pandemic, the CHUV's Child Abuse and Neglect Team observed a decrease in cases of child abuse. Has confinement made it easier for families to avoid violence or, on the contrary, to hide it? Within the framework of this second hypothesis, we propose that the relaxation of the measures be an opportunity for professionals to explore in families the possible occurrence of domestic abuse., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Adolescents who are confronted to violence rarely consult health services about this problem. Family maltreatment is the origin of most violence against adolescents, but remains very often hidden from the eyes of professionals. The "assault and battery" reports produced by emergency services are largely about community violence situations. The medical consultation following an assault requires a global evaluation of the teenager confronted to violence. This evaluation will have to take into account not only the adolescent's requests (such as confidentiality), but also professional duties to prevent recidivism.