The current study used the Trauma Symptom Checklist-40 (TSC-40) to index both childhood sexual abuse (CSA) and childhood physical abuse (CPA) in a college student sample of both men and women (N = 441). Although the TSC-40 was designed as a measure of CSA trauma, this study concludes the measure is appropriately reliable for indexing the traumatic sequelae of CPA as well as CSA in nonclinical samples. The current study also explored the effects of gender and abuse severity on resulting symptomatology, finding that women and severely abused individuals report the most negative sequelae. Both CSA and CPA emerged as significant explanatory variables in TSC-40 scale scores beyond gender, supporting its validity for indexing traumatic sequelae in nonclinical samples.

Children often present to the emergency department (ED) for treatment of abuse-related injuries. ED healthcare providers (HCPs) do not consistently screen children for physical abuse, which may allow abuse to go undetected and increases the risk for re-injury and death. ED HCPs frequently cite lack of knowledge or confidence in screening for and detecting child physical abuse.

The purpose of this evidence-based quality improvement project was to implement a comprehensive screening program that included ED HCP education on child physical abuse, a systematic screening protocol, and use of the validated Escape Instrument. After a 20-minute educational session, there was a significant increase in ED HCP knowledge and confidence scores for child physical abuse screening and recognition (p < .001). There was no difference in diagnostic coding of child physical abuse by ED HCPs when evaluating a 30-day period before and after implementation of the screening protocol.

In a follow-up survey, the Escape Instrument and educational session were the most reported screening facilitators, while transition to a new electronic health system was the most reported barrier. The results of this project support comprehensive ED screening programs as a method of improving HCP knowledge and confidence in screening for and recognizing child physical abuse. Future research should focus on the impact of screening on the diagnosis and treatment of child physical abuse. Efforts should also be made to standardize child abuse screening programs throughout all EDs, with the potential for spread to other settings.