title: Presentation to accident and emergency with crying or screaming and likelihood of child protection registration.
abstract: OBJECTIVE
  To determine whether children aged less than 2 years who present to accident and emergency (A&E) with crying or screaming as the only complaint, are more likely to be placed on the child protection register in later years than children who do not attend with crying or screaming alone.
  
  
  METHODS
  The Sheffield Children's Hospital A&E database was examined for five years from 1 January 1992. Children who presented at triage with crying or screaming as their sole complaint were identified. Controls were taken from children who presented with any other complaint. Matches were made for sex, postcode and date of birth. All names were checked against against files that contained dates of past or present child protection registration. In January 2000, the children's age ranged from 3 to 10 years. The mean follow up period was six years (SD one year seven months).
  
  
  RESULTS
  From 1 January 1992 until 31 December 1996, 450 children made 462 attendances to A&E with crying or screaming as their only complaint. Of these, 12 had been placed on the child protection register. Ten of the 450 control children had been registered. The odds ratio of subsequent child protection registration if a child presents in Sheffield with crying or screaming alone is 1.21 (95% confidence intervals 0.52 to 2.82).
  
  
  CONCLUSIONS
  Presentation of young children who cry or scream for no clear reason is relatively common. Although child protection registration is not the same as abuse, it is the closest surrogate marker we have. This study shows there is no evidence of increased likelihood of child protection registration for children who present with crying or screaming alone and prejudices against parents of these children, if held, are inappropriate.
authors.affiliation: Department of Accident and Emergency, Sheffield Children's Hospital, Sheffield, UK.
authors.forename: A K
authors.initials: AK
authors.lastname: Fletcher
authors.forename: D P
authors.initials: DP
authors.lastname: Burke
mesh_terms: D002649:Child Abuse / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D006113:United Kingdom