Identification of Domestic Violence in the Community Pediatric Setting

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Abstract
DOMESTIC VIOLENCE is increasingly recognized as a major public health problem that particularly affects women—90% to 95% of domestic violence victims are women.1 More recently, domestic violence, and more specifically, the abuse of women has been recognized as a pediatric issue.2 The battering of women is intricately connected to child health. Child abuse occurs disproportionately in homes where domestic violence exists.3 Moreover, witnessing the battering of their mothers may result in significant psychosocial and developmental sequelae for children.4 This affects a significant proportion of the children in this country, as children who witness family violence far outnumber those who are direct victims of abuse (between 3.3 to 10 million children witness parental violence annually).3 Although most children who witness the battering of their mothers do not become victims or perpetrators of violence as adults, research suggests that up to 75% of men in batterer treatment programs report witnessing the abuse of their mothers or being physically abused themselves as children.5 Other evidence suggests that girls who have been abused or who have witnessed the abuse of their mothers may be more likely to become victims of domestic violence as adults.6 Abused and neglected children are at greater risk for delinquent and criminal behavior.7 Thus, the abuse of women is a pediatric issue and pediatricians are in a unique position to respond. Response to battered women in the pediatric setting poses a particular challenge as interventions need to assess safety of both the mother and her children.

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