Changing incidence of non-accidental injury to children in South Glamorgan.

We examined details of all referrals during 1982-5 in which non-accidental injury had been diagnosed. The procedure for child abuse in South Glamorgan requires that all children who are suspected of having suffered non-accidental injury are medically examined. All children with suspected or proved injury are admitted to hospital. Within 72 hours after referral there is a case conference, which is attended by a senior paediatrician. After considering medical reports and contributions from other agencies those at the case conference decide whether a diagnosis of non-accidental injury can be upheld. This process of reaching a diagnosis of non-accidental injury has not changed appreciably during the past 15 years. The data for this report were taken from the minutes of the case conferences; copies of all these minutes are received and monitored centrally by the child abuse coordinator (JJ) for South Glamorgan Social Services. The age range of the children was 0-15 years. Injuries were divided into two groups: severe injuries, which included all fractures, internal injuries, -and intracranial bleeding, and moderate injuries, which included all soft tissue injuries. The figure shows a rapid increase in the number of children referred with moderate injuries after 1973. In 1974 there was a ninefold increase in the number of children aged 0-4 years who were referred with moderate injuries; subsequently an average of 22 children in this age group were referred each year. The number of children aged 5-9 who were referred with moderate injuries increased from four in 1974 to 18 in 1975; after 1974 there was an average of 15 referrals each year. The referral of children aged 10-15 with moderate injuries was a later phenomenon: during 1970-7 the average number ofcases referred each year was 1-9 but after1977 the average number of referrals increased to 13, showing that child abuse is no longer a syndrome affecting only infants.