How pediatricians can support patients exposed to intimate partner violence

How pediatricians can support patients exposed to intimate partner violence | Image Credit: © VadimGuzhva - © VadimGuzhva - stock.adobe.com.

The American Academy of Pediatrics (AAP) has released tips and recommendations for pediatricians to support children exposed to intimate partner violence (IPV), since approximately 1 in 4 children are exposed in their lifetime. These children can face short- and long-term impacts on physical and mental well-being.

For children exposed to IPV, 30% grow up to “perpetuate abusive behaviors toward others,” according to the AAP, which references the clinical report “Intimate Partner Violence: Role of the Pediatrician.” Witnessing IPV increases risk of depression, anxiety, and could result in outward behaviors (attention problems, aggression, and rule-breaking behaviors.)

IPV is defined as “physical violence, sexual violence, stalking and psychological aggression (including coercive tactics) by a current or former intimate partner,” according to the AAP. Intimidation and control are other aspects of IPV, including financial and immigration-related abuse.

“Patients and families may be reluctant to share concerns about violence or other forms of abuse in the home, either out of fear, embarrassment or other reasons,” said Jonathan Thackeray, MD, FAAP, and lead author of the report (written by AAP Council on Child Abuse and Neglect and AAP Council on Violence, Injury, and Poison Prevention). “We know that pediatricians can help by providing education upfront, supporting children and their caregivers, offering community resources and creating safe and healing spaces.”

“Pediatricians are well positioned to provide vital resources to families experiencing intimate partner violence,” said Nina Livingston, MD, FAAP, coauthor of the report. “By connecting caregivers to community domestic violence advocacy services, addressing the needs of the child, and taking a strengths-based approach to supporting resilience, we can help these children thrive.”

To help IPV-affected children, the AAP recommends the following for pediatricians:

• To address IPV, endorse a “universal education” approach. Pediatricians can provide brief but routine education and resources amid office visits, compared to a traditional screening model. “Conversations about intimate partner violence are normalized and an environment is established in which a parent or caregiver has the opportunity to disclose violence only if he or she feels safe and comfortable doing so,” the AAP states.
• Pediatricians should discuss the unique barriers for patients that have experienced IPV and oppression or inequity, including “immigrants, people of color, individuals living in poverty, and survivors who identify as LGBTQ+. Consider policies and practices rooted in racism and fear that have significantly impacted patients’ comfort in accessing resources, treatment, and interactions with the legal system.”
• To maximize opportunities for impact, the AAP recommends that pediatricians engage with culturally specific agencies and programs.
• Be sure that children exposed to (or at risk for) IPV receive developmental screenings using established guidelines.
• For learners of all levels, identify opportunities to improve IPV education.
• Validate the lived experiences of survivors and maximize safety for the child and caregiver by intervening in a “sensitive and skilled manner.”

For more from the “Intimate Partner Violence: Role of the Pediatrician” report published in Pediatrics, click here.

Reference:

American Academy of Pediatrics issues recommendations for supporting children, family members exposed to intimate partner violence. June 20, 2023. Accessed June 26, 2023. https://www.aap.org/en/news-room/news-releases/aap/2023/american-academy-of-pediatrics-issues-recommendations-for-supporting-children-family-members-exposed-to-intimate-partner-violence/