Screening Parents

The American Association of Pediatricians has stated that “Abuse of women is a pediatric issue”. They urge pediatricians to assess the home situation by screening parents for abuse at newborn and well child visits.

Read Ethics & Privacy prior to interview.

How to ask, respond, counsel and refer regarding possible parental domestic abuse can be found at our domestic abuse companion website. If needed, the adult hospital social services department is 3-5091.

Make sure that there is privacy during the discussion, including privacy from children age three or older, and that a family member is not used as an interpreter.

If you are suspicious of domestic abuse due to behavior of the child, a good way to indirectly lead into this topic is to ask the parent whether there is anything going on at home that might be a reason for either the child’s behavior, or for the child to be showing signs of stress (see video). 

The one major difference about domestic abuse in a pediatric setting is that the child is the patient. A pediatrician is a mandated reporter for children. If a parent discloses abuse and has otherwise reportable injuries to herself or himself from abuse, the pediatrician is not required to report. For Family Practitioners, this may be a grey area if both the child and the parent are patients.

Pediatric domestic abuse screening 
(4:44 min.)

Video clip courtesy of Family Violence Prevention Fund ©2003, all rights reserved. For a free 30 minute CD of 5 clinical interactions titled "Screen to End Abuse" contact FVPF.

Counseling abused parent about effects on children

Be non-judgmental and supportive. These situations are often complicated, and there may be complex reasons why a parent doesn't "just leave".

  • How does the parent explain the situation to the child?
  • Does parenting style change if abuser is there or not, such as punishing more so that the abuser won't do so more harshly?
  • How does the child cope with the family atmosphere?
    • This may be gender related:
      • girls - internalizing with low self esteem, depression, anxiety
      • boys - externalizing with conduct disorder, anger, impulsiveness
  • How does the child cope during violence?
  • Educate about effects of abuse on children - one of the three main reasons an abused woman decides to accept an intervention is because of the effects on children
  • Encourage parent to develop a safety plan with children for violent episodes
    • teach children to stay out of the way
    • identify a safe place for children to go in or outside of the home
    • decide on a code word and means for child to safely call 911
  • Discuss need for counseling for child
  • Make follow up appointment


Parent Handout 
Created by the Santa Clara County Domestic Violence Council, these non-judgmental handouts help parents realize how yelling, abuse and violence in the home affect their children. Included are recommended books, hotlines and websites.