There were 60 child deaths in 2024 deemed abuse cases and another 82 incidents in which children were seriously injured due to abuse.

The number of abuse deaths was up slightly compared to the prior year, while the number of near-fatal abuse cases was down significantly.

In 2023, there were 57 substantiated child abuse deaths and 119 near-fatal abuse cases.

One of the biggest changes in the 2024 data was a drop in the number of deaths and near-fatal cases involving accidental ingestion of drugs.

The number of abuse deaths linked to accidental overdoses of drugs was down almost 75% compared to 2023 and it was the fewest number of overdose-related abuse deaths since 2019.

Accidental overdose abuse cases by year:

– 2024 — 4 deaths, 6% of abuse deaths; 21 near-fatal cases, 19% of total

– 2023 — 15 deaths, 21% of abuse deaths; 47 near-fatal cases, 28% of total

– 2022 — 14 deaths, 22% of abuse deaths; 52 near-fatal cases, 38% of total

– 2021 — 12 deaths, 21% of abuse deaths; 52 near-fatal cases, 38% of total

– 2020 — 11 deaths, 12% of abuse deaths; 45 near-fatal cases, 33% of total

– 2019 — 3 deaths, 6% of abuse deaths; 21 near-fatal cases, 21% of total

Brandon Cwalina, a spokesman for the Department of Human Services, said agency officials have no immediate explanation for the drop.

“DHS is reviewing this most recent data, along with other data on child abuse fatalities and near fatalities, in order to identify trends and contributing factors,” Cwalina said.

Hospitals are required to notify the state when moms give birth to babies who have drugs in their system.

These notifications are typically made through the ChildLine abuse reporting hotline but they are not counted as reports of abuse.

The number of reports of babies with drugs in their system was also down in 2024 compared to 2023, he said.

The agency has convened a Child Abuse and Neglect Fatalities and Near-Fatalities Workgroup to make recommendations for changes to improve the way the child protection system helps families and avoid crisis situations.

“The goal of the workgroup is to recommend potential changes to statute and/or OCYF policy, identify prevention approaches, and communicate data trends and prevention practices across the Commonwealth,” he said.

Not enough information

Under state law, the agency releases an annual report with child abuse data as well as individual reports detailing reviews of the way county caseworkers and others responded to cases of fatal or near-fatal abuse. But those reports are routinely sealed from public view at the request of county prosecutors while their offices investigate for possible criminal charges.

But advocates continue to be frustrated by how difficult it is to get timely and clear information about abuse cases and how they were handled.

“Even with all of these data points, publications we still struggle to have reliability in what is the actual scope of lethal and near lethal incidents reported to ChildLine and later substantiated (or not) as child abuse or neglect,” Cathleen Palm, co-founder of the Center for Children’s Justice said in an email. “We rarely talk about how similar incidents (e.g., ingestions, lack of supervision) can look very much the same in terms of the circumstances and even outcome (fatality or near fatality) but not then have the same disposition by child welfare officials — some can be substantiated and some can be unfounded.”

There were 94 child deaths reported as cases of possible abuse in 2024. That was the lowest total number of deaths reported in the last five years, according to DHS data.

But there’s too little information readily available about what led officials to determine that 34 of those deaths should not be classified as abuse, she said.

Palm pointed to a review of the circumstances in several abuse cases illustrating some of the complicated factors that child protection officials must consider when trying to pinpoint whether children’s injuries should have been prevented.

One case centered on the near-death of an almost 2-year-old child in Northampton County in February 2024. The toddler’s mother entered a room and saw the child with a medication bottle, according to the DHS report on the incident. The mother took the baby to the hospital and brought the prescription pill bottle with her.

Doctors determined the child had ingested Buprenorphine, medication used to treat opioid use disorder. The baby received medical treatment and survived. A caseworker visited the home and noted that the family had baby gates in place and locks on cabinets within reach of the toddler. The caseworker gave the family a lockbox to store their medication.

Ultimately, child protective services determined the mom had not acted recklessly and there was no abuse finding.

In a Crawford County incident, a 1-year-old nearly died after ingesting Wellbutrin, an anti-depressant. In that case, the mom saw the child enter the kitchen. When the mom turned the corner to enter the kitchen, she saw the baby with a pill in her mouth. The mom told investigators she thought the child could have ingested between 2-15 pills. After the child began to have a seizure, the mom called 911 and the child was taken to the hospital by helicopter.

County caseworkers met with the family and provided them with a safety plan but found no justification to classify the incident as abuse.

On the other hand, the nearly fatal heroin overdose of a 3-year-old in Wayne County was deemed a case of abuse.

In that case, the child was taken to the hospital after going limp while at his father’s house.

“It was unknown how the [victim] came into contact with the drugs; however, the father’s home is known for overdoses of heroin and other drugs. The father and paternal grandmother are known drug users,” according to the DHS report on the incident.

“As there are concerns that the PGM and father had allowed the VC to come to their home while having opiates in the home, and potentially distributing them, they meet the standards of culpability in that they have acted knowingly and recklessly,” according to the report.