Differential child maltreatment risk across deployment periods of US Army Soldiers

Objectives. We described the risk for maltreatment among toddlers of US Army soldiers over different deployment cycles to develop a systematic response within the US Army to provide families appropriate supports. Methods. We conducted a person-time analysis of substantiated maltreatment reports and medical diagnoses among children of 112 325 deployed US Army soldiers between 2001 and 2007. Results. Risk of maltreatment was elevated after deployment for children of soldiers deployed once but not for children of soldiers deployed twice. During the 6 months after deployment, children of soldiers deployed once had 4.43 substantiated maltreatment reports and 4.96 medical diagnoses per 10 000 child-months. The highest maltreatment rate among children of soldiers deployed twice occurred during the second deployment for substantiated maltreatment (4.83 episodes per 10 000 child-months) and before the first deployment for medical diagnoses of maltreatment (3.78 episodes per 10 000 childmonths). Conclusions. We confirmed an elevated risk for child maltreatment during deployment but also found a previously unidentified high-risk period during the 6 months following deployment, indicating elevated stress within families of deployed and returning soldiers. These findings can inform efforts by the military to initiate and standardize support and preparation to families during periods of elevated risk.