Should Children Be in the Room When the Mother Is Screened for Partner Violence?

Conclusions

The development of evidence-based guidelines for screening women for intimate partner violence in clinical practice is critical. Failure to screen because of feasibility issues in a busy practice means that the family continues to live with violence and abuse without intervention. Screening in a manner that puts the victim at further risk for violence (eg, screening in front of a child who is aligned with the abuser) risks retaliation for both the mother and her children. Screening in a manner that allows the child to hear details about the violence may further victimize the child and support his already inappropriate role in the family. Therefore, despite the clear need for future research, we make the following recommendations for current practice:

1. The AMA-formatted questions should be used in the presence of children younger than 2 or 3 years.
2. Screening of a mother in front of older children should be done only with her prior permission. For example, clinicians can say: “I have some routine questions about violence in the home; may I ask them in front of Suzy?”
3. Physicians should educate patients about intimate partner violence and distribute resource materials and crisis phone numbers. This can be done routinely even when screening is not possible; offices should have pamphlets and posters in the examination room or bathroom.
4. When either child abuse or intimate partner violence is identified, the other should be screened for and considered.

Acknowledgments

Thanks to Jennifer L. Gossett and Susan L. Rosenthal for their assistance, and to the participants in our interviews and focus groups.