Child maltreatment

This domain includes indicators of child maltreatment (CM). CM refers to any act of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child.

All indicators Child maltreatment Intimate partner violence High-risk presentation of child maltreatment Parental mental health problems Parental substance misuse Adverse family environments

• 1
  Overview
• 2
  Definition
• 3
  Clinical Codelist
• 4
  Implementation
• 5
  Publications

1 Overview

Domain / Phenotype

Child maltreatment

Sex

Both

Age Range

Prenatal – 18 years

Individual

Parent Child

Coding System

READ SNOMED CT ICD-10 ICD-9 HES-APC HES-AE Speciality

Data Sources

CPRD Aurum CPRD GOLD HES-APC HES-AE

2 Definition

Any recorded act of commission or omission by a parent or caregiver resulting in harm, the potential for harm or threat of child harm, including neglect, psychological, physical, sexual and emotional abuse. Harm does not need to be intended.

In the UK, statutory guidelines of CM include child exposure to intimate partner violence (IPV), and maternal evidence for omission or commission during pregnancy such as Neonatal Abstinence Syndrome (NAS) and Fetal Alcohol Syndrome (FAS). It includes indicators such as neglect (pre- and post-birth), child protection recordings, or out-of-home placements by social care services.

Suspected CM: Includes any maltreatment-related indicator with codes describing presentations likely to refer to CM, but without mentioning the underlying cause (e.g., harm caused by non-specified person), safeguarding procedures, or social interventions. E.g., "Victim of sexual abuse", "Assault in the home".

3 Clinical Codelist

Download (.txt)

Access the complete set of 2877 clinical codes mapped to the CM domain. See the Control documentation for code processing rules.

Indicator Structure & Taxonomy

Domain	Indicator Code	Indicator Description
CM	CM1	Child protection/safeguarding
CM	CM2	CM NOS, incl. physical or sexual abuse
CM	CM3	Neglect (incl. NAS/FASD) and emotional abuse
CM	CM4	Social service involved
CM	CM5	Child in care
CM	CM6	Suspected CM NOS
CM	CM7	Child assaulted NOS

Browse & Search Clinical Codelist (Preview)

CM1 - CM7 - Child maltreatment | ALL CODING SYSTEMS

PUBLISHED

Code	Description	Coding System	Indicator
1620023	Child protection register	READ	CM1
SN532100	Victim of child abuse	SNOMED CT	CM2
Z04.0	Observation following suspected neglect	ICD-10	CM3
1L13.	Looked after child	READ	CM5
SN992144	Assault in the home	SNOMED CT	CM7
T74.2	Sexual abuse, suspected	ICD-10	CM6
1622...	On child protection register	READ	CM1
SN884100	Child emotional abuse	SNOMED CT	CM3
Y07.9	Other maltreatment syndromes	ICD-10	CM2
13HM.	Social services involvement	READ	CM4
SN112200	Fetal alcohol syndrome	SNOMED CT	CM3
Z04.5	Observation following suspected assault	ICD-10	CM6

4 Implementation

Certain specific indicators within this domain require rule-based algorithms to prevent misclassification. Expand the sections below to view the R script logic.

Rule CM, Female Genital Mutilation (FGM)

Apply codes mentioning circumcision to female children only (e.g. "54314 - routine or ritual circumcision"). Code list includes markers for rule inclusion.

cm_fgm <- merged_data %>% 
  filter(Domain=="CM" & individual=="4" & gender=="female")

5 Publications

Core research outputs associated with this specific ACE domain.

Family adversity and health characteristics associated with intimate partner violence in children and parents presenting to health care: a population-based birth cohort study in England.

Syed S, Gilbert R, Feder G, Howe LD, Powell C, Howarth E, Deighton J, Lacey RE. The Lancet Public Health. 2023.

Identifying adverse childhood experiences with electronic health records of linked mothers and children in England: a multistage development and validation study.

Syed S, Gonzalez-Izquierdo A, Allister J, Feder G, Li L, Gilbert R. The Lancet Digital Health. 2022.

Child maltreatment: variation in trends and policies in six developed countries.

Gilbert R, Fluke J, O'Donnell M, et al. The Lancet. 2012. View Code List

Health service use in families where children enter public care: a nested case control study using the General Practice Research Database.

Simkiss DE, Spencer NJ, Stallard N, Thorogood M. BMC Health Services Research. 2012.

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