Skip to main content

Child Maltreatment Fatality Review: Purposes, Processes, Outcomes, and Challenges

McCarroll, J.E., Fisher, J.E., Cozza, S.J., & Whalen, T.J. (2021).

Trauma, Violence, & Abuse , 22(5), 1032 – 1041.


The purpose of this article is to facilitate understanding of child maltreatment fatality review processes and their outcomes.


Expanded Abstract:
The World Health Organization estimated that 57,000 worldwide deaths of children under 15 years old occurred as a result of homicide in the year 2000. The rate of child abuse fatalities varies by age, sex, and geographical region. For children under 5 years of age living in high-income countries, the rate of fatal abuse is 2.2/100,000 for boys and 1.8/100,000 for girls. In low-to- middle-income countries, the rates are 2 to 3 times higher, 6.1/100,000 for boys and 5.1/100,000 for girls (Krug et al., 2002). In the United States, in 2017, an estimated 1,720 children died of abuse and neglect at a rate of 2.32 per 100,000 children (U.S. Department of Health and Human Services, 2019).
Better understanding of the causes and circumstances of maltreatment deaths of children is needed to prevent this preventable tragedy. The purpose of this article is to facilitate understanding of the child maltreatment fatality review processes and their outcomes. A literature review was conducted, finding165 publications on this topic; they were reviewed and 55 were selected for inclusion in this paper. Papers were from the United States, England, Ireland, Northern Ireland, Netherlands, France, Canada, Australia, South Africa, Switzerland, Saudi Arabia, Japan, and China. Papers were included if they described fatality review goals, authority, procedures, and outcomes. 
Improvement of fatality review requires diligence by individuals and organizations that provide information to the reviewers. Among challenges to the review process are varying criteria for review, misclassifications of the manner of death, inadequate or incomplete forensic and medical investigations, lack of information about the perpetrator, diversity of the community, concealment of the cause of death by parents or other caregivers, and disagreement among reviewers about the results of their inquiries. 
Institutional challenges are also present, which include the need for funding, privacy issues on obtaining information, updating reviewer training, lack of follow-up by institutional authorities on the recommendations of the reviews, and research facilitating the review of maltreatment fatalities.
(The expanded abstract is excerpted and adapted from the article cited above).