A Survey on the Knowledge of Clinical Signs of Child Maltreatment among Preschool and Primary School Teachers

Abstract

Background

Child abuse and neglect are critical health issues with far-reaching physical, psychological, and social consequences. Teachers are uniquely positioned to identify signs of abuse due to their daily interactions with children. However, limited knowledge and training often impede effective identification and reporting of abuse. This study assesses the knowledge of preschool and primary school teachers in Flanders, Belgium, regarding the clinical signs of child abuse.

Methods

A prospective study was conducted using an online survey comprising 16 hypothetical cases. The cases, validated by pediatric and forensic experts, included both suggestive and non-suggestive scenarios of child abuse and neglect. Participants rated their level of suspicion using a Likert scale. Statistical analysis explored the relationship between socio-demographic factors and participants' ability to correctly identify cases.

Results

A total of 155 completed surveys were analyzed. Participants achieved a median accuracy of 75% overall, performing better on suggestive cases (87.5%) than on non-suggestive (62.5%). Sensitivity in identifying abuse was higher than specificity, with significant variability observed in non-suggestive case results. Prior training did not significantly improve scores, likely due to the superficial nature of existing training programs. Years of experience and prior exposure to suspected abuse cases also showed no significant correlation with performance.

Conclusion

While teachers demonstrated reasonable knowledge of child abuse and neglect, they sometimes struggle in recognizing non-suggestive cases and distinguishing abuse from mimickers. Further research is needed to evaluate the impact of standardized training programs on improving teachers' ability to detect and report child abuse and neglect effectively.