Citation

Bright MA, Lynne SD, Masyn KE, Waldman MR, Graber J, Alexander R. JAMA Pediatr. 2019; 173(2): 176-182.

Affiliation

Division of Child Protection and Forensic Pediatrics, Department of Pediatrics, University of Florida, Jacksonville.

Copyright

(Copyright © 2019, American Medical Association)

DOI

10.1001/jamapediatrics.2018.4346

PMID

30556830

Abstract

IMPORTANCE: Corporal punishment is a leading risk factor for physical abuse. Strong anecdotal evidence from physicians and other professionals working in child protection suggest that punishment-initiated physical abuse for school-aged children increases after release of report cards. However, no empirical examination of this association has occurred.

OBJECTIVE: To examine the temporal association between school report card release and incidence rates (IRs) of physical abuse.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective study reviewed calls to a state child abuse hotline and school report card release dates across a single academic year in Florida. Data were collected in a 265-day window from September 8, 2015, to May 30, 2016, in the 64 of 67 Florida counties with report card release dates available (16 960 days). Participants included all children aged 5 to 11 years for whom calls were made. A total of 1943 verified cases of physical abuse were reported in the study period in the 64 counties. Data were analyzed from October 2017 through May 2018.

EXPOSURES: School report cards release across a single academic year, measured daily by county.

MAIN OUTCOMES AND MEASURES: Daily counts of calls to a child abuse hotline that later resulted in agency-verified incidents of child physical abuse across a single academic year by county.

RESULTS: During the academic year, 167 906 calls came in to the child abuse hotline for children aged 5 to 11 years; 17.8% (n = 29 887) of these calls were suspected incidents of physical abuse, and 2017 (6.7%) of these suspected incidents were later verified as cases of physical abuse before excluding the 3 counties with no release dates available. Among the 1943 cases included in the analysis (58.9% males [n = 1145]; mean [SD] age, 7.69 [1.92] years), calls resulting in verified reports of child physical abuse occurred at a higher rate on Saturdays after a Friday report card release compared with Saturdays that do not follow a Friday report card release (IR ratio, 3.75; 95% CI, 1.21-11.63; P = .02). No significant association of report card release with IRs was found for any other days of the week.

CONCLUSION AND RELEVANCE: This association of school report card release and physical abuse appears to illustrate a unique systems-based opportunity for prevention.

Language: en