How child health care physicians struggle from gut feelings to managing suspicions of child abuse

Erik Stolper*, Margje van de Wiel, Simon Kooijman, Frans Feron

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


AIM: We examined how gut feelings of child health care physicians' (CHCPs) contribute to the development of a suspicion of child abuse, how they act upon this suspicion and what barriers they experience in their management. To gain insight into the youth health care chain, we compared the diagnostic reasoning and management regarding this issue by CHCPs and family physicians (FPs).

METHODS: Three focus groups, 20 CHCPs, thematic content analysis.

RESULTS: A gut feeling acted as an early alert to look for the triggering cue(s), by observing more closely and asking relevant questions. CHCPs struggled to distinguish whether the situation involved child abuse or a lack of parenting skills, and how to communicate their concerns with parents. They tried to motivate parents to improve the situation, avoiding the term child abuse and considered involving the Child Abuse Counselling and Reporting Centre (CACRC) a measure of last resort only.

CONCLUSION: As with FPs, gut feelings support CHCPs in becoming attentive to child abuse and to situations which can lead to child abuse. The next step, discussing their suspicion with the parents, is a difficult one, and the CACRC might actually help to make this step easier.

Original languageEnglish
Pages (from-to)1847-1854
Number of pages8
JournalActa Paediatrica
Issue number6
Early online date28 Dec 2020
Publication statusPublished - Jun 2021


  • child abuse suspicion
  • child health care physicians
  • gut feelings
  • communication with parents
  • family physicians

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