Preventing and Addressing Child Abuse During COVID-19

Preventing and Addressing Child Abuse During COVID-19 1024 575 Kristin Crichton, DO, MPH

With schools and daycares closed, stay-at-home orders in effect, and most non-emergency health care visits being conducted via telehealth, reporting and addressing child abuse is more difficult. Dr. Crichton from The Center for Family Safety and Healing shares advice for providers to identify child abuse during telehealth visits.

As concerns about the coronavirus pandemic swept the country, efforts to reduce exposure of both providers and patients led to many pediatric practices rapidly adopting or expanding their telemedicine capabilities over the past few months. Simultaneously, schools and many childcare centers shut down leaving children at home full time with their parents, many of whom are juggling the strain of working from home themselves or financial stress from a lost job.

We know that child abuse increases as family stressors increase and with most children being isolated from mandated reporters, telehealth encounters with medical providers may be a unique opportunity to directly address the stressors that put children more at risk and identify children who are suspected victims of child maltreatment.

Start the Conversation

Providers can start the conversation about family stress by acknowledging that we are all in a difficult situation and ask open-ended questions of parents and children about their stress level and what supports they have available to them: “How are you feeling about being at home?” and “Who are you interacting (including via phone/internet) with while you are at home?”

Offer Strategies and Tips for Coping

For parents and/or children who identify experiencing stress or anxiety, offer tips and strategies to cope with the adjustment and strain, including keeping a consistent daily schedule with meals, physical activity and bedtime occurring around the same time every day. Parents should focus on engaging children in structured activities that can be reasonably accomplished and give them a sense of fulfillment.

Acknowledge Big Feelings

Providers can remind parents that both they and their children need regular, short breaks from assigned tasks. The changes to children’s daily lives that have occurred are going to result in them experiencing big feelings that they may not know how to express very well which may lead to them acting out; providers should encourage parents to give their children attention and ask them to talk about how they feel. When parents can catch their children being good, it helps to reinforce these positive behaviors and minimize more challenging ones. Also, providers should remind parents to engage in self-care themselves.

Reinforce Online Safety

For children who are spending time online either for school or recreational activities, providers should remind parents that all online activities need to be observable to ensure that children, especially those for whom internet activity is new, are in safe places online and interacting with safe people. Parents should talk to children about online safety and help them understand what to do if they encounter someone online making requests that make them feel uncomfortable.

Look for Red Flags

During a telehealth video visit, providers should be mindful of suspicious injuries, unusual body language and/or inappropriate or negative parent-child interactions and report any concern of child maltreatment to their local child protective services.

Helpful Resources:


Image credit: Adobe Stock

About the author

Dr. Kristin Crichton is a child abuse pediatrician at Nationwide Children's Hospital in Columbus, Ohio. She is board-certified in general pediatrics and child abuse pediatrics. Her clinical interests include child sexual abuse, child physical abuse and caring for children in foster care; her research interests include improving early detection of physical abuse. Dr. Crichton has master’s degrees in both public health and experimental psychology. She serves on the Biomedical Ethics Committee at Nationwide Children's. Additionally, Dr. Crichton is a member of the Ray Helfer Society and an active member of the AAP Ohio Chapter Committee on Child Abuse and Neglect.