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Child Maltreatment: How Concerned Should We Be for the Siblings? :

April 14, 2021

When a child experiences any type of maltreatment (e.g., physical, sexual, emotional abuse), what is the risk for other siblings having been the victim of maltreatment or for future risk of maltreatment? Kisely et al (10.1542/peds.2020-036004) evaluated these risks in a remarkable and concerning study being early released this month in our journal. The authors started with a population-based birth cohort gathered over three years (1981-1984) and identified 520 sibling pairs, who were followed over 21 years. The authors identified 44 pairs with child protection notification. There was a 60-fold increase in a second sibling being identified as a victim of abuse if the first was. In addition, if one sibling reported that they had been sexually abused, the other sibling also did so 58% of the time. The authors identify factors associated with a higher risk of both siblings experiencing abuse, including maternal age less than 20 years, maternal depression, and other factors that you can learn about by reading the study,

This study is important because it reminds us of the importance of monitoring for signs of abuse in siblings. To emphasize this point, we asked Dr. Suzanne Haney from the University of Nebraska (10.1542/peds.2021-049930), specialist in the prevention of child abuse, to share her thoughts about this study in an accompanying commentary. She notes that the current AAP policy statement on sexual abuse does not mention siblings, and as a result of this study, should do so with the next policy revision. Dr. Haney also offers suggestions on how best to monitor for abuse in siblings, including imaging siblings who are infants and toddlers who may not be able to report that they had been physically abused. Sexual abuse victims should also be asked about sibling abuse, especially if some of the risk factors identified in the Kisely et al study are noted. Finally, home visits for young mothers might be an important strategy to prevent abuse. Link to both articles and learn more.

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