Doctors have identified a set of warning signs that could increase an abused child’s risk of further abuse.

The findings are based on evidence drawn from a trawl of electronic databases, relevant print journals, and bibliography supplied by experts in the field, and published ahead of print in the Archives of Disease in Childhood.

Of 89 potentially eligible studies, 16 met the criteria for descriptions of substantiated maltreatment and recurring problems in children under the age of 18. Maltreatment included neglect and emotional, sexual, and physical abuse.

An analysis of these studies revealed that previous episodes of maltreatment; neglect rather than other forms of abuse; parental conflicts, including domestic violence; and parental mental health problems all strongly predicted further maltreatment.

Children who had endured a previous episode of maltreatment were six times more likely to be abused again, particularly within the next month. The risk appeared to level out after two years.

Other factors also seemed to have a role in the risk of further maltreatment, although less consistently so. They included drugs and alcohol misuse, “family stress,” inadequate social support, families with younger children, and already being known to child protection services.

The authors conclude that their findings underscore the different factors at play in child abuse and neglect, which suggests that the matter can only effectively be dealt with if different professionals in health and social care cooperate closely with one another.

British Medical Journal