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.
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.
’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 , 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 →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 ’s 2024 recommendation on integrated child-protection systems calls for coordinated, adequately resourced responses to physical, psychological and sexual violence and neglect. The 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.
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.
EvidenceWell established · 1 primary source + 5 official documents + 1 independent reporting sourceExplore evidence →Hide evidence ↑
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- 13 Jul 2026, 02:00
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Voices & reactions
What the main actors are doing
Reported positions, summarised — not direct quotationsCitadelle’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.
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