HealthWallonia
Child protection

How is Liège’s Citadelle helping abused children express what words cannot?

Liège’s Citadelle hospital has detailed how its specialist child-abuse unit uses age-appropriate play materials and emotion cards to help children communicate during protected hospital stays.

Belgium Impulse Editorial·25 August 2026·4 min read·
Well established· 1 primary source + 5 official documents + 1 independent reporting source
TopicsCitadelle hospitalLiègeCellule MaltraitanceSOS EnfantsONEchild protection in WalloniaSAJSPJ

In 30 seconds

  • The Citadelle described the use of figurines, cards and illustrated emotion faces on 13 July 2026.
  • The unit receives children aged 0 to 16, generally for hospital stays lasting four to six weeks.
  • ONE recorded 6,522 referrals involving 6,034 children across 14 SOS Enfants teams in 2024.
  • Four beds in Liège’s 16-bed medico-psychosocial unit are designated for intensive maltreatment assessments.

Place

Liège

Walloon city where Citadelle hospital and its specialist inpatient service are located.

Why it matters

Walloon city where Citadelle hospital and its specialist inpatient service are located.

About

Liège is a city and municipality in the Belgian region of Wallonia, and the capital of the eponymous province. The city is situated in the valley of the Meuse, in the east of Belgium, not far from borders with the Netherlands and Germany. In Liège, the Meuse meets the river Ourthe. The city is part of the sillon industriel, the former industrial backbone of Wallonia. It is still the principal economic and cultural centre of the region.

’s Citadelle hospital detailed on 13 July how psychologists in its specialist child-abuse unit use figurines, cards and illustrated faces to help children express emotions and experiences they may be unable to put into words. The hospital says the materials support, rather than compel, communication during multidisciplinary assessments; it has not presented them as a new diagnostic test or disclosed evidence measuring their outcomes.

The explanation offers a rare view inside a Belgian service dealing with exceptionally sensitive cases. According to the Citadelle, its Cellule Maltraitance receives children aged from birth to 16 on mandates from the French-speaking youth-support services, known as SAJ and SPJ. Children can remain in hospital for four to six weeks while doctors, psychologists, educators, social workers, neuropsychologists and psychomotor therapists assess their health, safety and longer-term needs.

For families and professionals in Wallonia, the importance lies less in the objects themselves than in the conditions surrounding their use. A child may not have the vocabulary, confidence or developmental capacity to recount neglect or violence directly. The hospital says play-based supports allow communication to develop at the child’s pace and stresses that the purpose is not to make a child speak “at all costs”. That distinction matters: therapeutic exploration must not be confused with a police interview or treated automatically as proof of an allegation.

The Citadelle describes its dedicated inpatient structure as unique in Belgium. It was established in May 2016 within a child-protection service already operating in the hospital’s paediatric department. Dr Sandra Pannizzotto, the unit’s responsible paediatrician, previously explained that hospitalisation can provide a neutral setting when a child is unsafe outside it and when a psycho-medical-social assessment cannot be completed through outpatient appointments.

The wider French-speaking child-protection system shows the scale of the need, although its figures cannot be read as a prevalence estimate. The Office de la Naissance et de l’Enfance, the public body overseeing the 14 SOS Enfants teams in the Wallonia-Brussels Federation, recorded 6,522 referrals involving 6,034 children in 2024. The ONE explicitly warns that these are situations reaching its teams, not a count of all maltreatment. Its research also identifies Liège as one of only three intra-hospital SOS Enfants locations in the federation and says four beds in its 16-bed medico-psychosocial unit are assigned to intensive maltreatment assessments.

Two professional perspectives meet here without being identical. The Citadelle’s clinical framing prioritises emotional safety, individual development and communication without pressure. The Council of Europe and European Union, by contrast, increasingly frame child-friendly practice through the

policy

Barnahus model

Integrated, child-friendly service model used as a European comparison for multidisciplinary protection.

Why it matters

Integrated, child-friendly service model used as a European comparison for multidisciplinary protection.

, which coordinates health care, welfare and criminal-justice work under one roof. Their May 2026 guidance says this approach should reduce repeated questioning and secondary victimisation while improving the evidential quality of a child’s account. The first perspective is primarily therapeutic; the second also asks how institutions can obtain reliable evidence and deliver justice. Good practice has to protect both objectives without allowing one to overwhelm the other.

Where this is happening

View on map Liège
Liège · 50.640, 5.571 · Open in OpenStreetMap · Source: Wikidata Q3992

That European comparison gives the Liège initiative relevance beyond the province, but it does not turn a local hospital service into an EU programme. The

Organisation

European Commission

EU institution that issued the 2024 recommendation on integrated child-protection systems.

Why it matters

EU institution that issued the 2024 recommendation on integrated child-protection systems.

About

The European Commission (EC) is the executive cabinet of the European Union. It is composed of 27 members of the Commission corresponding to the number of member states, unless the European Council, by unanimous consent, decides to alter this number.

’s 2024 recommendation on integrated child-protection systems calls for coordinated, adequately resourced responses to physical, psychological and sexual violence and neglect. The
Organisation

World Health Organization

International health body providing guidance on professional responses to child maltreatment.

Why it matters

International health body providing guidance on professional responses to child maltreatment.

About

The World Health Organization (WHO) is a specialized agency of the United Nations (UN) which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has six regional offices and 150 field offices worldwide. Only sovereign states are eligible to join, and it is the largest intergovernmental health organization at the international level.

similarly advises professionals to communicate safely and respond empathetically and without judgement when maltreatment is suspected or disclosed. The Citadelle’s multidisciplinary structure and child-adapted materials broadly reflect those principles, although no source reviewed establishes that the unit has been formally certified as a Barnahus service.

No Belgian ministerial or EU response to the hospital’s July communication was identified, and the Citadelle has not published a budget, supplier, evaluation protocol or expansion timetable for the tools. The next meaningful questions are therefore practical: how children’s feedback is incorporated, how staff avoid suggestive questioning, what happens after discharge, and whether outcomes are independently evaluated. For now, the confirmed development is modest but significant—a Belgian hospital has shown how carefully chosen play materials can give vulnerable children another route toward being heard.

Who’s affectedchildren facing suspected abuse or serious neglectfamilies and caregivers in WalloniaLiège healthcare professionalsSAJ and SPJ caseworkersSOS Enfants teamsFrench-speaking Community youth-protection authorities
Context & what happens next

What to do

For families, the report does not create a new entitlement, application procedure or charge. Children reach the specialist service through established protection pathways, including SAJ and SPJ mandates, rather than by treating the publicity as a direct booking offer. A referred child may face a protected hospital stay of four to six weeks, so caregivers should ask the responsible service who can visit, how schooling and consent are handled, and how findings will be shared. Professionals should not treat the materials as proof or use them independently as investigative tools: Citadelle has published no evaluation establishing their effectiveness.

Impact

Regional — The service gives Wallonia’s youth-support authorities access to a specialised inpatient assessment setting in Liège. Its significance extends across the French-speaking Community because children arrive through SAJ and SPJ mandates, not solely through city services.

Evidence
Well established · 1 primary source + 5 official documents + 1 independent reporting source
Explore evidence
Citadelle — Des outils adaptés pour aider les enfants de la Cellule Maltraitance à s’exprimer
Published:
13 Jul 2026, 02:00
Retrieved by ODIN:
25 Aug 2026
Read original
La DH — Des outils pour aider les enfants maltraités à exprimer leurs émotions
Published:
15 Jul 2026, 02:00
Retrieved by ODIN:
25 Aug 2026
Read original
ONE — ONE en chiffres 2024
Publication date unavailable
Retrieved by ODIN:
25 Aug 2026
Read original
ONE — Recherche sur l’éthos des équipes SOS Enfants
Publication date unavailable
Retrieved by ODIN:
25 Aug 2026
Read original
Council of Europe — Guidance supporting Barnahus model reforms
Published:
21 May 2026, 02:00
Retrieved by ODIN:
25 Aug 2026
Read original
World Health Organization — Responding to child maltreatment
Published:
4 Aug 2022, 02:00
Retrieved by ODIN:
25 Aug 2026
Read original
European Commission — Recommendation on integrated child-protection systems
Published:
23 Apr 2024, 02:00
Retrieved by ODIN:
25 Aug 2026
Read original

Voices & reactions

What the main actors are doing

Reported positions, summarised — not direct quotations

Citadelle’s therapeutic perspective

The Citadelle says the priority is to offer children developmentally appropriate ways to express feelings and experiences without forcing them to speak. The materials belong within a broader clinical and psychosocial assessment and are not presented as proof of abuse.

European child-friendly justice perspective

The Council of Europe and EU-backed Barnahus approach also emphasises safety and multidisciplinary care, but adds an institutional objective: coordinating welfare and criminal investigations to avoid repeated questioning and improve the evidential validity of children’s testimony.

The story, connected

Explore the people, places and ideas in this story

Go beyond the headline. Open a card for sourced context, maps, official links and the other subjects connected to this report.

Places

Liège

Walloon city where Citadelle hospital and its specialist inpatient service are located.

In this story

Walloon city where Citadelle hospital and its specialist inpatient service are located.

Background

Liège is a city and municipality in the Belgian region of Wallonia, and the capital of the eponymous province. The city is situated in the valley of the Meuse, in the east of Belgium, not far from borders with the Netherlands and Germany. In Liège, the Meuse meets the river Ourthe. The city is part of the sillon industriel, the former industrial backbone of Wallonia. It is still the principal economic and cultural centre of the region.

Concepts

Barnahus model

Integrated, child-friendly service model used as a European comparison for multidisciplinary protection.

In this story

Integrated, child-friendly service model used as a European comparison for multidisciplinary protection.

Organisations

World Health Organization

International health body providing guidance on professional responses to child maltreatment.

In this story

International health body providing guidance on professional responses to child maltreatment.

Background

The World Health Organization (WHO) is a specialized agency of the United Nations (UN) which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has six regional offices and 150 field offices worldwide. Only sovereign states are eligible to join, and it is the largest intergovernmental health organization at the international level.

Organisations

European Commission

EU institution that issued the 2024 recommendation on integrated child-protection systems.

In this story

EU institution that issued the 2024 recommendation on integrated child-protection systems.

Background

The European Commission (EC) is the executive cabinet of the European Union. It is composed of 27 members of the Commission corresponding to the number of member states, unless the European Council, by unanimous consent, decides to alter this number.

Concepts

Commission Recommendation (EU) 2024/1238

European Commission recommendation providing a policy benchmark for integrated child-protection systems.

In this story

European Commission recommendation providing a policy benchmark for integrated child-protection systems.

Organisations

La DH

Belgian news outlet reporting on Citadelle’s use of tools to help abused children express emotions.

In this story

Belgian news outlet reporting on Citadelle’s use of tools to help abused children express emotions.

Background

La Dhuys station is a station on Line 11 of the Paris Metro. It is situated in the communes of Montreuil and Rosny-sous-Bois.

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