Jonathan Thackeray, MD, FAAP

The Academy recently published a clinical report on the effects of intimate partner violence (IPV) on children, which will be examined October 5 in a plenary session presentation, "Opening Pandora's Box: Why Pediatricians Should Consider Screening for Intimate Partner Violence" (P4047).

"We are going to talk about the current national recommendations on screening for IPV, the gaps in the research and how we fill them to guide us in our future decision-making," said session presenter Jonathan Thackeray, MD, clinical director of the Center for Child and Family Advocacy at Nationwide Children's Hospital, Columbus, Ohio.

The session will also address the medical, behavioral and mental health effects on children reared in homes where there is IPV, said Dr Thackeray, who also is the associate program director of the Pediatric Residency Program at Nationwide.

"We will discuss the significant effects of IPV on the child and use this as justification for pediatricians to at least consider why it is important to address the issue of IPV, in spite of the scarcity of published evidence to do so," he said.

Among recommendations that will be reviewed are those of the U.S. Preventive Services Task Force, under the U.S. Department of Health and Human Services, which released a statement in 2004 that there is no evidence to support screening for intimate partner violence.

"The recommendations force us to examine what ‘screening' truly means, and they point out the paucity of evidence showing why and how screening is beneficial," Dr Thackeray said. "With intimate partner violence, the research is clear — when we screen for it, we find it. What is missing is evidence reflecting good interventions for both women and children experiencing IPV."

In the past several years, though, research has begun to focus on potential interventions to help women who are victims of IPV. As a result, some programs to help these victims have been developed, but more data are needed, he said.

"The future of research in the field is to continue to measure the effects on children and to see what we can offer in terms of counseling — behavioral services to improve their outcomes, for example," Dr Thackeray said.

Much of the plenary will focus on what is known — that children exposed to IPV develop differently from children reared in homes without violence.

"From birth, these children start to have different medical problems than other children — they are more irritable, they are less consolable, and they tend to be hyper-aroused and anxious," Dr Thackeray said.

As these children age, they are more likely to suffer from other health conditions, such as obesity. As teens, they are more likely to have high-risk sexual behaviors and early pregnancies, he said.

"In terms of mental health and behavioral issues, these children may have a higher incidence of bullying," Dr Thackeray said. "They tend to be more aggressive and have more symptoms of withdrawal and depression. They have trouble establishing and sustaining relationships with peers, and they have greater academic difficulties than other children."

The Academy's paper on the subject, "Intimate Partner Violence: The Role of the Pediatrician," was published in April and is available on the AAP website at www.pediatrics.org/cgi/content/full/125/5/1094.