I have just picked up on this case from Monday.
It goes to the nub of one of the legal arguments in child protection. There are fractures that can be diagnosed as Classic Metaphyseal Lesions from X-rays.
I have a report from the College of Radiologists that confirms that noone knows what proportion of children who have Metaphyseal fractures have obtained them through abuse.
There is a difficulty in that X-raying a child has some risk so you cannot just go around x-raying everyone.
However, a high proportion of children who have been abused (particularly fatally) have CMLs.
Let us assume for them moment that 90% of children with CMLs have them through abuse.
That means that 10% of children diagnosed with abuse haven't actually been abused.
They, however, are removed from their parents. Furthermore any other children that the parents have are removed from their parents.
There is an additional problem in that the 90% figure could be 40% and 60% of children who are removed from their parents for this reason (alone) would be removed wrongly.
The College of Radiologists say furthermore:
The diagnosis of child abuse is rarely made on the basis of a single metaphyseal fracture, and it is important that all the clinical, radiological and social aspects are taken into account before arriving at the diagnosis.
Every effort has to be made prior to this to ascertain from the parents/ carers of any possible mechanism, accidental or unintentional, that could account for the injury. Clearly one has to be certain that the observation truly represents a metaphyseal injury.
Child abuse by its very nature makes the performance of controlled studies very difficult.
It must be stressed that child abuse is a significant problem and failure to diagnose abuse may result in further abuse and possibly the death of the infant.
The problem is that the system starts grinding as soon as CMLs are diagnosed.
All the cogs then turn in their usual manner.
45% of prostitutes were in care. Can people not recognise that it is a good idea to keep children out of care.
(again, however, this statistic does not properly justify what quantative conclusions can be drawn as to the long term effect of being taken into care.)
It goes to the nub of one of the legal arguments in child protection. There are fractures that can be diagnosed as Classic Metaphyseal Lesions from X-rays.
I have a report from the College of Radiologists that confirms that noone knows what proportion of children who have Metaphyseal fractures have obtained them through abuse.
There is a difficulty in that X-raying a child has some risk so you cannot just go around x-raying everyone.
However, a high proportion of children who have been abused (particularly fatally) have CMLs.
Let us assume for them moment that 90% of children with CMLs have them through abuse.
That means that 10% of children diagnosed with abuse haven't actually been abused.
They, however, are removed from their parents. Furthermore any other children that the parents have are removed from their parents.
There is an additional problem in that the 90% figure could be 40% and 60% of children who are removed from their parents for this reason (alone) would be removed wrongly.
The College of Radiologists say furthermore:
The diagnosis of child abuse is rarely made on the basis of a single metaphyseal fracture, and it is important that all the clinical, radiological and social aspects are taken into account before arriving at the diagnosis.
Every effort has to be made prior to this to ascertain from the parents/ carers of any possible mechanism, accidental or unintentional, that could account for the injury. Clearly one has to be certain that the observation truly represents a metaphyseal injury.
Child abuse by its very nature makes the performance of controlled studies very difficult.
It must be stressed that child abuse is a significant problem and failure to diagnose abuse may result in further abuse and possibly the death of the infant.
The problem is that the system starts grinding as soon as CMLs are diagnosed.
All the cogs then turn in their usual manner.
45% of prostitutes were in care. Can people not recognise that it is a good idea to keep children out of care.
(again, however, this statistic does not properly justify what quantative conclusions can be drawn as to the long term effect of being taken into care.)
Comments
That is the tragedy.
In one of my first jobs in teaching, a senior colleague who dealt regularly with Social Services, quietly checked with me that I got on well enough with certain (15/16 y.o.) kids for there to be no problems. His concern was that since that most children in care were destined for a life of prostitution or thieving, they should be kept out of potential problem situations, providing social workers with reasons to take them into care. In fact, I ended up "baby sitting" quite a few because of personality clashes between them and other members of staff.
In the early 1980s, all the school's senior management went to great lengths to keep children out of the hands of the social workers. I fear times have changed.
I have heard similar tales from the primary sector.