Violence against children who have left home,lived on the street and been domestic workers — A study of reintegrated children in Kagera Region,Tanzania

Children all over the world experience physical, emotional and sexual violence. Children leaving home for street or domestic work are especially vulnerable. Strategies for facilitating reintegration for these children are advocated, but enough is still not known about the outcome of such reintegration in terms of violence and abuse. The study aimed at examining the extent of violence against children who have left home in Kagera Region, Tanzania as well as in different stages of their trajectory of life, i.e. before leaving home, on the street, as domestic workers, and after reintegration. A cross-sectional study was conducted with 214 participants aged 13–24, who had earlier left their homes and had now been reintegrated into the local community for at least one year. The study also examined the residual violence still taking place after reintegration and its potential impact on their psychological quality of life. This study, first of its kind in the country measuring level of violence for children who have left home as well as after reintegration, offered a unique opportunity to compare level of violence with other nationally conducted studies on violence against children recruited from the home setting. The result showed a significantly higher overall prevalence of violence against the children who left home compared to the national average. After reintegration, the overall prevalence of violence had declined significantly (p-value < 0.001) and to the same level as the national average, showing that reintegration can be successful.The group still facing violence showed lower psychological quality of life, which emphasises the need for continued preventive work to reduce the overall violence against children in society, with special emphasis on orphans and other vulnerable children most at risk of leaving their homes.     

Independent Living: gender, violence and the threat of violence

In what ways is independent living for young adults with disabilities compromised by violence and its threat? A qualitative study of 42 young adults with severe physical disabilities explored their perceptions and concerns about independent living, access to services and the meeting of needs. Young women especially experienced difficulties about leaving home, because of their own and their parents' fears about vulnerability; some who did leave home experienced highly restricted social lives because of anxiety about neighbourhood violence. Few had established partnerships, but violence and sexual abuse from partners emerged as an issue for which there is little policy. Control and abuse within caring relationships are serious issues for those who need personal care. Violence and lack of protection may undermine independent living, especially for women.     

Physical abuse of older adults in nursing homes: a random sample survey of adults with an elderly family member in a nursing home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

Physical Abuse of Older Adults in Nursing Homes: A Random Sample Survey of Adults With an Elderly Family Member in a Nursing Home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

The prevalence and nature of abuse and neglect in children under four: a national survey

This paper reports the results from a Danish national survey of child abuse and neglect. Data were obtained by a written questionnaire sent to all home health visitors. All newborn Danish children receive visits by a home health visitor several times during their first year of life. For children in need of special care for social reasons the visits may continue until school age (at 6 or 7 years). The questionnaire included four checklists of signs of abuse and neglect. The home health visitors were asked to record what they had actually observed visiting the children in their homes. Eighty‐three per cent (covering about 80% of all newborns) answered the questionnaire. The objective was to establish a scientific based framework that could be used to guide preventive efforts. Ten per cent of all children under 1 year of age may be characterized as children in need of special care for social reasons, the most frequent single reason being reliance on social assistance, alcohol abuse or violence against the mother. A minimum of 4% of infants are subjected to broadly defined abuse or neglect from one or more of the four categories: physical abuse, physical neglect, emotional abuse and emotional neglect, physical and emotional neglect being the most frequent and physical maltreatment the most rare. Copyright © 1999 John Wiley & Sons, Ltd.     

Children Living Away from Home

SUMMARY. Millions of children across the world live away from home; many because of wars, famines, dictatorships and poverty. Children live away from home in Britain because of family breakdown, neglect, abuse and other disadvantages, but also through parental choice and educational need. There is inadequate information about numbers, reasons and outcomes. Three main alternatives to living at home in Britain are boarding schools, residential homes and foster care. Traditional barriers between education and welfare and policies of care placements based on inadequate data have resulted in damaging gaps in services and poor placement decisions for many children living away from home. The early 1990s have brought about a national consensus based on new legislation and a group of Inquiries which provides the opportunity for major changes and improvements in services. International deliberations and action could and should be part of these changes.     

Mothers' experiences, resources and needs: The context for reunification

This paper extends prior scholarship regarding the characteristics of mothers involved with the child welfare system. In-person interviews were conducted with a statewide sample of 747 mothers, 318 with children remaining in home and 429 with children in care, to examine their socio-demographic and psychosocial characteristics as well as service needs. Mothers were mostly impoverished, struggling to meet basic needs, and coping with early trauma, mental health problems, substance abuse and domestic violence. Almost half reported an annual income of less than $10,000 and 70% were unemployed, but few received public benefits with the exception of food stamps. Mothers with children in care experienced greater economic hardship than mothers whose children remained in home. The implications of the findings are discussed.     

Resident-to-Resident Abuse in Nursing Homes as Reported by Nurse Aides

Information on the scale and scope of resident-to-resident abuse, including verbal, physical, material, psychological, and sexual abuse, is presented. Nursing homes (n = 249) from ten states were used, with a total of 4,451 nurse aides in these facilities returning the questionnaire. Most nursing homes experienced verbal, physical, material, and psychological abuse, but sexual abuse was less common. Our findings clearly show that both the scale and scope of resident-to-resident abuse is high in nursing homes. Resident-to-resident abuse is common enough to be considered an issue of concern impacting the quality of life and safety of many residents.     

Out‐of‐Home Placement of Children Exposed to Violence

There is growing concern about the increasing number of children in the USA who are exposed to community violence and the need to remove some of them from their families. This study examines risk factors for out‐of‐home placement among a large pool of children and adolescents who were referred for general clinical assessment following exposure to violence and/or psychological trauma in their communities or homes. Children with greater familial and environmental support and children exposed to incidents involving a non‐parental personal threat were associated with a significantly lower risk of out‐of‐home placement. A greater likelihood of being placed out of home was associated with older age (adolescents), history of mental health service use, involvement with law enforcement agencies, higher clinical ratings of depression or impaired thought processes, lower clinical functioning and greater exposure to traumatic events. Evidence of maltreatment and a threat to life was associated with 13.6 times greater likelihood of being placed out of the home. This study raises an important issue in respect to the children's past use of mental health service and current symptoms. It is not just the risk of violence but also evidence of psychiatric problem that trigger out‐of‐home placement. Further studies are needed to assess the quality and effectiveness of mental health services provided to children exposed to violence. © 2007 The Author(s). Journal compilation © 2007 National Children's Bureau.     

Fallen apples

Children today often have to cope with living in fractured family systems in which multigenerational dysfunction and abuse is passed on to them. As a result, they often make decisions that lead them into unsafe, and possibly disastrous situations. Some children and adolescents cannot see beyond today. They are prone to giving up because they feel nothing can change. Growing up in physically violent homes can create children who are unable to control their own violent rages. While hospitalized, they often seek the struggle and emotional release that accompanies physical management. Physical management allows the children to be out of control and safe at the same time.     

Do Foster Parents and Care Workers Recognize the Needs of Youth in Family Foster Care with a History of Sexual Abuse?

Children in family foster care have the right to participate in decisions regarding their life, however, adults often advocate on behalf of children. This Q methodological study explored whether shared perspectives among foster parents and care workers resemble shared perspectives of youth regarding the psychosocial needs experienced by youth with a history of sexual abuse. Participants sorted a set of statement cards according to what they thought was most important for youth. By-person factor analyses examined how the Q sorts of foster parents and care workers related to those of youth. The results showed that foster parents mostly recognized the group of youth who value an instrumental relationship with their carers, while care workers mostly recognized the group of youth who value support of both foster and birth parents with regard to their preparation for independent living. The two youth groups characterized by ambivalence and autonomy were barely recognized. Results are discussed in light of the expected roles of foster parents and care workers, and youth’s contact with birth parents. Lastly, this study highlights the importance of youth participation, because youth offer unique and varying perspectives about their needs.     

Early abuse experiences and subsequent gender differences in couple adjustment

The main purpose of the current study was to evaluate the relationship between early abusive experiences (sexual abuse, parental violence, and witnessing parental violence) and subsequent couple adjustment with a theoretical model that incorporates attachment and psychological distress as mediator variables. We specifically examined the variability in long-term psychosocial characteristics of child abuse survivors across women and men. A representative sample of French-Canadian couples composed of 632 men and women completed measures of child abuse, attachment, psychological distress, and dyadic adjustment. Structural equation analyses showed that, for both women and men, sexual abuse was related to dyadic adjustment through anxiety about abandonment and psychological distress. For men, experiencing physical or psychological violence was associated with dyadic adjustment through psychological distress. For women, there was an indirect relationship between witnessing physical violence and dyadic adjustment through abandonment anxiety. Differences between men and women in the long-term adjustment to childhood sexual abuse were small and not consistent with a gender-specific model of psychosocial repercussions.     

The Effect of Care Setting on Elder Abuse: Results from a Michigan Survey

This study compares abuse rates for elders age 60 and older in three care settings: nursing home, paid home care, and assisted living. The results are based on a 2005 random-digit dial survey of relatives of, or those responsible for, a person in long-term care. Nursing homes have the highest rates of all types of abuse, although paid home care has a relatively high rate of verbal abuse and assisted living has an unexpected high rate of neglect. Even when adjusting for health conditions, care setting is a significant factor in both caretaking and neglect abuses. Moving from paid home care to nursing homes is shown to more than triple the odds of neglect. Furthermore, when computing abuse rates by care setting for persons with specified health conditions, nursing homes no longer have the highest abuse rates.     

Male-initiated partner abuse during marital separation prior to divorce

The purpose of this study was to assess predictors of male-initiated psychological and physical partner abuse during the separation process prior to divorce among a sample of 80 divorced fathers who reported no physical violence during their marriages. The predictor variables examined were male gender-role identity, female-initiated divorces, dependence on one's former wife, depression, anxiety, and coparental conflict. Through ordinary least square (OLS) regression techniques, it was found that male gender-role identity was positively related to male-initiated psychological abuse during separation. Logistic regression analyses revealed that male-initiated psychological abuse, anxiety level, coparental conflict, and dependence on one's former spouse increased the odds of a man engaging in physical abuse. However, depression decreased the odds of separation physical abuse. The models predicting both male-initiated psychological abuse (F = 2.20, p < .05, R2 = .15) and physical violence during the separation process were significant (Model chi2 = 35.00, df= 7, p < .001).     

Sexual abuse,family violence,and female delinquency: findings from a longitudinal study

The current study examines the effects of three forms of childhood victimization on self-reported delinquency and aggression in adolescent girls. These analyses are based on a longitudinal sample of 141 mother-daughter pairs participating in a study about marital violence and child development. When the children were school aged, mothers and children provided reports describing (a) child exposure to marital violence, (b) escalated physical abuse against the child, and (c) child sexual abuse. Children were followed up into adolescence and re-interviewed. Self-reports of delinquency (violent and nonviolent), running away, and violence against parents were collected. Results indicate that out of the three forms of victimization, child sexual abuse emerged as the strongest predictor of girls' violent and nonviolent criminal behavior. Girls with a history of physical abuse in childhood were most likely to assault their parents. Witnessing marital violence failed to contribute further to delinquency, beyond the adverse association with childhood sexual abuse. Findings highlight a unique avenue for delinquency in girls via childhood sexual exploitation.     

Signs of resilience in sexually abused adolescent girls in the foster care system

In a sample of 99 sexually abused adolescent girls in the foster care system (64% in congregate living situations and 36% in family/foster care homes), nearly half were psychologically functioning well despite having experienced moderate-to-severe emotional, physical, and sexual abuse. It was hypothesized that these girls with resilient trajectories would differ from the currently symptomatic girls on several protective factors: education, future orientation, family support, peer influence, and religion. The results revealed that the girls with resilient trajectories were significantly more certain of their educational plans and optimistic about their future and had more positive peer influences.     

Recent developments in institutional elder care in China: changing concepts and attitudes

This study examines recent developments in institutional care for Chinese elders and attitudinal changes toward institutional care in Tianjin, China. Based on studies in 12 elder home sites and survey interviews with 265 older residents, this study compares institutional differences between government and non-government-owned elder homes, and examines elders' evaluations of elder homes' quality and their level of willingness to stay in elder homes. Findings suggest that government-owned elder homes still enjoy institutional and bureaucratic privileges in funding, staffing, and insurance. Elders' overall evaluation of elder home quality was high. Elders' former living arrangement and financial ability were related to their willingness to stay in the elder home. The unfair competition between governmental and non-governmental elder homes is likely to hinder the development of elder home industry in the free-market system and foster a growing gap between the rich and poor elders in their capability and decisions in elder home care. As adult children become increasingly unavailable due to the one-child policy and geographic mobility, institutional care for aging parents is likely to become one of the major options for parent care.     

Community-based organizations for vulnerable children in South Africa: Reach,psychosocial correlates,and potential mechanisms

Community-based organizations (CBOs) have the potential to provide high quality services for orphaned and vulnerable children in resource-limited settings. However, evidence is lacking as to whether CBOs are reaching those who are most vulnerable, whether attending these organizations is associated with greater psychosocial wellbeing, and how they might work. This study addressed these three questions using cross-sectional data from 1848 South African children aged 9–13. Data were obtained from the Young Carers and Child Community Care studies, which both investigated child wellbeing in South Africa using standardized self-report measures. Children from the Child Community Care study were all CBO attenders, whereas children from Young Carers were not receiving any CBO services, thereby serving as a comparison group. Multivariable regression analyses were used to test whether children attending CBOs were more deprived on socio-demographic variables (e.g., housing), and whether CBO attendance was in turn associated with better psychosocial outcomes (e.g., child depression). Mediation analysis was conducted to test whether more positive home environments mediated the association between CBO attendance and significantly higher psychological wellbeing. Overall, children attending CBOs did show greater vulnerability on most socio-demographic variables. For example, compared to children not attending any CBO, CBO-attending children tended to live in more crowded households (OR 1.22) and have been exposed to more community violence (OR 2.06). Despite their heightened vulnerability, however, children attending CBOs tended to perform better on psychosocial measures: for instance, showing fewer depressive symptoms (B = − 0.33) and lower odds of experiencing physical (OR 0.07) or emotional abuse (OR 0.22). Indirect effects of CBO attendance on significantly better child psychological wellbeing (lower depressive symptoms) was observed via lower rates of child abuse (B = − 0.07) and domestic conflict/violence (B = − 0.03) and higher rates of parental praise (B = − 0.03). Null associations were observed between CBO attendance and severe psychopathology (e.g., suicidality). These cross-sectional results provide promising evidence regarding the potential success of CBO reach and impact but also highlight areas for improvement.     

Injustice and conflict in nursing homes: toward advocacy and exchange

This article examines the relational dynamics and patterns of conflict exhibited in the two interdependent parties in America's nursing homes. In the framework of the social exchange theory of structural power, it explains how the asymmetrical structure of dependence and control in nursing homes eliminates the possibility of fair bargaining—normal conflict—between staff and patients. In the absence of any opportunity for reciprocal rewards and punishment, patients tend to adopt submissive influence strategies, whereas staff members tend to neglect, exploit, or abuse difficult or resistant patients. The author examines the exchange dynamics of adversarial tactics and the prevalence of third-party conflict in the nursing home, and shows that a partisan, patient-directed ally could rebalance power and eliminate inequities in the nursing home environment.     

Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey

This study examines the prevalence and correlates of psychological abuse and physical abuse against women and men aged 70 or older. Self-report data from 2,185 respondents in the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were used to create weighted estimates for past-year experiences of abuse. Correlates were then examined using survey logistic regression models. More than 1 in 10 adults who are 70 years of age or older (14.0%) have experienced some form of abuse in the past year, with 12.1% experiencing psychological abuse and 1.7% experiencing physical abuse. One in five victims (20.8%) were abused by both intimate and nonintimate partners. Health care insecurity was the strongest correlate of past-year abuse. The odds of experiencing abuse were 4.53 times greater for those who experienced health care insecurity than for those who did not. This presents a significant challenge for identifying and helping victims of abuse.