Child abuse,child protection and disabled children: a review of recent research

This paper reports the results of a scoping study that reviewed research about child abuse, child protection and disabled children published in academic journals between 1996 and 2009. The review was conducted using a five stage method for scoping studies. Several studies have revealed a strong association between disability and child maltreatment, indicating that disabled children are significantly more likely to experience abuse than their non‐disabled peers. Those with particular impairments are at increased risk. There is evidence that the interaction of age, gender and/or socio‐cultural factors with impairment results in different patterns of abuse to those found among non‐disabled children although the reasons for this require further examination. It appears that therapeutic services and criminal justice systems often fail to take account of disabled children's needs and heightened vulnerability. In Britain, little is known about what happens to disabled children who have been abused and how well safeguarding services address their needs. Very few studies have sought disabled children's own accounts of abuse or safeguarding. Considerable development is required, at both policy and practice level, to ensure that disabled children's right to protection is upheld. The paper concludes by identifying a number of aspects of the topic requiring further investigation. Copyright © 2010 John Wiley & Sons, Ltd.     

Why should child welfare pay more attention to emotional maltreatment?

A significant body of research indicates that emotional maltreatment (EMT) is harmful to children, resulting in long-term negative impacts on emotional and behavioral development. The child welfare system's focus on physical abuse, physical neglect, and sexual abuse has led a relative lack of attention to EMT. Reported rates of EMT vary widely across states – ranging from 0.2% to 44.9% in a recent national report on child maltreatment – indicating that it is not being measured consistently. This paper uses data collected by the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to (1) describe the nature and characteristics of emotional maltreatment experienced by 846 LONGSCAN youth across time, and (2) describe the relation between four subtypes of emotional maltreatment (psychological safety and security, acceptance and self-esteem, autonomy, and restriction) and child trauma symptoms and risk behaviors at age 18. Exposure to EMT was related to increased trauma symptoms and risky behaviors. EMT is common, identifiable, harmful, and potentially preventable; and a better understanding of it will help to inform the provision of effective child welfare and mental health services to children and their families. Findings suggest a need for greater understanding of parental behaviors, and the motivations behind them, that result in emotionally harmful outcomes for children, as well as a better understanding of appropriate interventions for children who experience various types of EMT.     

Child care burden and the risk of child maltreatment among low-income working families

Studies suggest that a substantial proportion of low-income working mothers experience work disruptions and parental stress related to child care, which may lead to increases in the risk of physical and psychological abuse and neglect of children. However, little research has examined the relationship between child care burden and the risk of child maltreatment among low-income working families. Using the Fragile Families and Child Wellbeing Study 3-year data, this study explores how child care burden is associated with the risk of child maltreatment (physical aggression, psychological aggression, and neglectful behavior) among low-income working mothers. We find that instability in child care arrangements is likely to increase mothers' physical and psychological aggression, while not having someone reliable for emergency child care is likely to increase mothers' neglectful behaviors. Findings also show that the risk of child maltreatment related to child care burden measures is more significant for single mothers than married mothers. Potential policy implications are discussed.     

Parental substance misuse and statutory child protection in England: Risk factors and outcomes

Parental substance misuse is a significant child welfare issue and associated with increased risk of child maltreatment. The aim of the present study was to understand what social care outcomes children who live with parental substance misuse have, and to assess factors associated with those social care outcomes over a two-year period. The paper reports on a retrospective longitudinal study of 299 children all living with parental substance misuse and referred to one local authority in England. Data were collected from children's social work case files about procedural social care outcomes and factors which may be associated with those outcomes. Using cluster analysis, a new typology of children's longitudinal trajectories through the children's social care system was developed, consisting of five distinct types. Analysis indicated that some children received too little intervention from children's social care despite ongoing concerns, while other children were potentially unnecessarily caught up in the social care system. Factors associated with children having the poorest outcomes were: caregiver instability resulting from substance misuse, parenting capacity and household instability. The study's findings indicate that some children who live with parental substance misuse are at significant risk of harm, but others are not and may be better supported through non-statutory services such as early help.     

Adolescents Caught in Parental Loyalty Conflicts

A group of 220 13- to 16-year old Catholic high school boys were administered a questionnaire regarding their exposure to parental loyalty conflict behaviors, physical abuse, sexual abuse, psychological maltreatment, depression, and rule-breaking behaviors. Results revealed high rates of exposure to parental loyalty conflict—especially in divorced families—as well as statistically significant associations with psychological maltreatment and depression. These data build on and extend earlier findings documenting the prevalence of children's involvement in parental conflict and the negative effects of that experience.     

Multisystemic Therapy for Child Abuse and Neglect: Do Parents Show Improvement in Parental Mental Health Problems and Parental Stress?

Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) is an evidence-based program for families with children who experience maltreatment. This clinical trial is the first evaluation of MST-CAN in a German-speaking area. Parental psychological problems and parental stress have been shown to be risk factors for child abuse and neglect. By the end of treatment, parents reported significantly less psychological distress than before the start of MST-CAN. Six months after treatment, this reduction was still evident. However, parents did not report any significant reduction of parental stress at any of the three time points. MST-CAN is an effective intervention for child maltreatment that not only combats child abuse and neglect but also has the potential to alleviate parental psychological distress.     

Differential response in child protection: How much is too much?

Recurring maltreatment can have devastating, lifelong consequences for children who are victims of abuse and neglect. The primary mission of child protection services (CPS) agencies is to prevent the recurrence of child maltreatment by offering families services designed to prevent future maltreatment. In order for these services to be effective, however, families must actually engage in them. This study focuses on how differential response programs impact families' successful engagement in services as indicated by long-term child safety outcomes.Differential response refers to a dual track system that allows public CPS agencies to respond to accepted reports of child abuse or neglect with either a traditional investigative response (TR) or an alternative response (AR). The AR is designed to be a less authoritative and less adversarial approach to families presenting a low- to moderate-risk of maltreatment. The AR involves collaboration with the family in a comprehensive assessment of the family's needs, risks and strengths and a referral to services on a voluntary basis. States implementing DR systems statewide vary greatly in the percentage of accepted reports that are assigned to the AR track. The goal of this study is to determine what rate of AR utilization is most effective in reducing subsequent reports of abuse and neglect for cases assigned to the AR.This study compares child safety outcomes for children assigned to the AR and those assigned to the TR within each of the fourteen states which implemented DR statewide between 2000–2012. The analysis uses Cox proportional hazards regression. Data for this observational study are drawn from the 2000–2012 data in the National Child Abuse and Neglect Data System (NCANDS) child files. Child safety is measured by re-reporting of the child to CPS.The theoretical model underpinning the study is McCurdy and Daro's (2001) Integrated Theory of Participant Involvement (ITPI) which outlines a conceptual model of parental engagement in services. This study hypothesizes that AR utilization rates affect the risk level of cases assigned to the AR. The ITPI model offers a possible explanation as to why higher risk cases may not be as responsive to the AR approach which depends upon the family's voluntary participation in services.The key finding of this study is that, in states assigning > 33% of reports to the AR, children on the AR track are being re-reported at equal or higher rates than those on the TR track. Only in those states utilizing the AR track for < 33% of the cases are AR cases being consistently re-reported at lower rates than those on the TR track. This article explores ways to improve the accuracy of track assignment decisions to prevent the assignment of higher risk families to the alternative response.     

Parent gender and child removal in physical abuse and neglect cases

Criminal justice research frequently investigates relationships between punishment decisions and demographic characteristics of the accused, such as gender, race, and age. While there are many similarities between criminal justice and child welfare cases, research on child maltreatment has yet to examine potential demographic influences on case outcomes. The current study examines relationships between parent gender, type of maltreatment, and child removal among agency responses to child maltreatment cases. Using data collected by the National Data Archive on Child Abuse and Neglect Data System (NCANDS), we identify differences in the likelihood of child removal from the parental home across type of maltreatment and perpetrator gender. Our results indicate that mother perpetrators of physical abuse not only face significantly higher likelihood of removal than mother perpetrators of neglect, but are more at risk for losing their children than father perpetrators of both physical abuse and neglect. Findings suggest that gendered attributions and stereotypes regarding parenting can shape assessments of parents' blameworthiness, dangerousness, and rehabilitative potential. We propose that future research on child maltreatment cases adapt and apply justice concepts and frameworks to uncover potential unwarranted demographic disparities in agency decision-making.     

A review of the relationship between poverty and child abuse and neglect: Insights from scoping reviews,systematic reviews and meta-analyses

An up-to-date and accurate picture of the evidence on the impact of poverty is a necessary element of the debate about the future direction of children's social care services internationally. The purpose of this paper is to update evidence about the relationship between poverty and child abuse and neglect (CAN) published since a previous report in 2016 (Bywaters et al., 2016). A systematic search was conducted, identifying seven reviews. Poverty was found to be consistently and strongly associated with maltreatment, be that in terms of familial or community-level poverty, or in terms of economic security. Findings demonstrated that both the type and the quantity of economic insecurities impacted child maltreatment. Certain economic insecurities – income losses, cumulative material hardship and housing hardship – reliably predicted future child maltreatment. Likewise, as families experienced more material hardship, the risk for maltreatment intensified. In some studies, the relationship between poverty and maltreatment differed by abuse type. Future reviews need to investigate individual papers and their findings across different CAN measures, definitions, samples, abuse types and conceptualisations of poverty to provide a comprehensive understanding of the current research base and the directions which need to be taken to further understand and prevent CAN.     

Is prior parental criminal justice involvement associated with child maltreatment? A systematic review

Parental criminal justice involvement is prevalent in the United States and potentially associated with a range of negative outcomes for children including child abuse and neglect. However, the association between prior parental criminal justice involvement and child maltreatment is not well understood. This paper reviewed the existing literature regarding maltreatment victimization among children of parents with prior criminal justice involvement. Results from ten reviewed studies demonstrated an association between prior parental criminal justice involvement and child maltreatment, but did not provide sufficient evidence to determine whether parental criminal justice involvement is an independent risk factor for child maltreatment or of the specific mechanisms through which this association occurs. Recommendations for future research include use of multivariate analysis methods that account for variations in the type and timing of parental criminal justice involvement and child maltreatment. Implications for practice include the development of strategies to address the adverse family contexts commonly found among these parents and children.     

Neglected voices: Lessons from forensic investigation following neglect

In the field of child maltreatment research, it is known that child neglect is a relatively neglected phenomenon. The current study addresses children's perceptions of neglect and the importance of taking into account the processes that children undergo while providing their perceptions. This qualitative study used thematic analyses of forensic investigations of children with external evidence suggesting high probability of neglect. The aim of the study is to characterize the manner in which children narrate their experiences and perceptions following neglect and what lessons can be learned from these narratives. Forensic investigations were carried out with fifteen children, five girls and ten boys, aged seven to twelve years. All of the suspects were the children's biological parents, nine mothers and six fathers. The narrative analysis of the children's interviews generated five themes. These predominant themes represent the children's experiences regarding the maternal or paternal neglect: (1) Difficulties identifying neglect; (2) neglect revealed as the narrative of family life unfolds; (3) loyalty to parents; (4) collective view (siblings and me); and (5) prominent feelings (hope for the future, fear, and sadness). This study has implications to understanding children's testimonies in cases of neglect and for welfare practices. The inability of children to verbalize the neglect they underwent in the initial interview contributes to the understanding of the importance of allocating resources to families and community services and not only relying on report-response strategies.     

Caseworkers' perspective on risk factors in the family environment influencing mothers' difficulties in meeting children's needs

ObjectivesThis study examines, from the caseworkers' point of view, which needs of children are the most difficult for parents in neglectful contexts to respond to and which risk factors make this response more difficult.MethodA sample of 55 parents being followed by child protection services for neglect or high risk of neglect accepted to participate in the study. Their caseworker filled out a grid regarding the response provided to the children's needs and the risk factors in the family environment.ResultsThe results indicate that the children's age is related to the difficulties of responding to their needs. The caseworkers are particularly concerned about guidance and boundaries provided to preschool-age children, but less so about that provided to school-age children. When the children's age is controlled for, parents' mental health problems explains a significant proportion of the variance in parents' response to their children's need for stimulation, emotional warmth, and guidance and boundaries. Caseworkers' worries about drug and alcohol misuse also explain a significant proportion of their concerns about the mothers' ability to ensure their child's safety.ConclusionCaseworkers are more worried about the parental response offered to preschool children than to school-age ones. However, a constant and coherent response to growing children is still important for their developmental trajectories. Moreover, mental health and substance abuse explain caseworkers' concerns about mothers' engagement toward their child. These data raise questions about which type of services to offer, because intervening in families where parents deal with personal issues while addressing child neglect is complex.     

Economic predictors of child maltreatment in an Australian population-based birth cohort

A correlation between socioeconomic disadvantage and child maltreatment has long been observed, but the drivers of this association are poorly understood. We sought to estimate the effects of economic factors on risk of child maltreatment after adjusting for other known influences using the Australian Temperament Project, a population-based birth cohort of 2443 individuals and their parents. We used logistic regression to estimate associations of childhood economic factors (parental education, occupation, and unemployment; type of housing; and retrospective perception of poverty) with retrospective reports of perceived child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and witnessing of domestic violence), controlling for demographic factors, parental mental health and substance use, and child health. We then used these estimates to approximate the proportions of child maltreatment—population attributable fractions—that are theoretically preventable by addressing childhood economic disadvantage. Economic factors were associated with all types of child maltreatment. For the most part, these associations diminished only partially when controlling for noneconomic confounders, supporting hypotheses of causal relationships. Jointly, economic factors were significant predictors of physical abuse, sexual abuse, and witnessing of domestic violence but not of emotional abuse or neglect. Retrospective perceptions of childhood poverty were, in particular, strongly associated with most forms of child maltreatment but not with sexual abuse after accounting for other economic factors. We estimated that 27% of all child maltreatment was jointly attributable to economic factors. These findings suggest that strategies that reduce economic disadvantage are likely to hold significant potential to reduce the prevalence of child maltreatment.     

Socioeconomic Resource Environments in Biological and Alternative Family Care and Children's Cognitive Performance*

We examined social and economic resources in the environments of children involved with child protective services and their associations with children's cognitive performance. We used a national dataset of child protection investigations (children aged 6–16 at Wave 1). Using latent class analysis, we constructed profiles of the financial resources, parental education and employment, and family structure and size. We then examined within‐ and across‐time associations between resource environment profiles and children's math and reading scores and tested whether associations differed by family care type. Our latent class analysis identified four distinct family resource environments: educated middle class, single earner, large working class, and severely disadvantaged. Family resource environment profiles predicted current cognitive performance and changes in performance over time, but associations were more consistent for children in biological family care. Children who remain in home following maltreatment allegations may benefit from services that target social as well as economic resources.     

Multi‐type maltreatment and the long‐term adjustment of adults

Multi‐type maltreatment refers to the experience of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence). Researchers have largely ignored the presence of other types of child abuse and neglect when examining the adjustment problems associated with a particular form of maltreatment. The association between ‘multi‐type maltreatment’ and adjustment was explored in the current study. Retrospective data were obtained on (a) the degree to which maltreatment types co‐occurred, (b) childhood family characteristics and (c) adjustment problems in adulthood in an Australian self‐selected community sample (N=175). As hypothesized, a large degree of overlap was reported in the experience of the five types of maltreatment. Family characteristics—particularly family cohesion and adaptability—discriminated between respondents reporting single‐type and multi‐type maltreatment. Greater adjustment problems were associated with reports of a larger number of different maltreatment types. Multi‐type maltreatment should be recognized as a crucial aspect of the nature and impact of child maltreatment and considered in the development of programmes for the prevention and treatment of child abuse and neglect. Copyright © 2000 John Wiley & Sons, Ltd.     

An evaluation of the effects of an integrated services program for multi-service use families on child welfare and educational outcomes of children

The purpose of the study was to evaluate a program that provides integrative case management for families dependent on at least two government services (e.g., child welfare, disability, chemical dependency, vocational rehabilitation). In the current study, we focused on effects of services on children's educational and child welfare outcomes two years after program exit. Children enrolled in the program were compared to a community comparison sample through propensity score matching. None of the group differences was significant. However, outcomes related to child maltreatment (number of child maltreatment reports accepted by Child Protective Services and out-of-home placements) improved dramatically within two years after exit. Outcomes in the education area were less uniformly positive. On the one hand, children's attendance was high and school mobility was low. In addition, there was a significant reduction in the number of children receiving special education services two years after exit. Nevertheless, a third of the children were still receiving special education services two years after exit, and their academic performance on standardized reading and math tests was quite poor. Thus, the intensive case management model was related to successful outcomes in an area directly targeted by the program (child maltreatment), but the gains did not generalize to another domain that was not an explicit focus of the program (academic achievement).     

Parenting stress and child maltreatment: The buffering effect of neighborhood social service availability and accessibility

The current study examines the relationship between aspects of social service availability and child maltreatment. Specifically, the study uses negative binomial regression to estimate whether service availability, accessibility, and receipt are associated with physical child abuse and neglect. Relying on Social Cognitive Theory and Stress and Coping Theory, the moderating effect of the service variables was tested on the relationship between parenting stress and maltreatment. The sample is comprised of 1053 parents who completed a survey in July of 2014. The findings suggest that service availability has a potential protective effect against physical abuse and neglect, and that service accessibility has an additional protective effect above and beyond sheer availability of services for child neglect. Further, the availability of services has a significant moderating effect – it decreased the relationship between parent stress and abuse and neglect. Service receipt had a paradoxical effect — although one might expect receiving social services to reduce maltreatment, there was a positive correlation between the two such that parents reporting receipt of a greater number of services tended to have higher levels of abuse and neglect. Further, service receipt moderated the relationship between parenting stress and neglect, such that the relationship was stronger. The study suggests that efforts to increase service availability and accessibility may prevent child maltreatment.     

An innovative child welfare pilot initiative: Results and outcomes

Successful family reunification is achieved only about 50% of the time when children are in foster care. Parents' ability to access and complete court ordered services are paramount in determining whether the family can achieve reunification. However, the research on how to best facilitate service access and utilization are sparse. A matched sample of 100 families with no prior child welfare involvement and at least one child in out of home care were selected from Department of Children and Family closed administrative case files. This study compared 48 families who received traditional child welfare services to 48 families who received a Family First model intervention (PFFP) from a large urban public child welfare agency. The independent variables were the elements that distinguished the Family First model from traditional child welfare services and included the number of caseworkers for the life of the case, caseload size, and service needs met through community partnerships. The dependent variables were the stability of the children's out of home placement, the time to reunification, the length of agency involvement, the stability of reunification at one year follow up, subsequent substantiated child maltreatment reports one year after the cases were closed, the distance a placement location was from the home of the family at intake, the match between identified needs and the timely access of services. Hierarchal regression and survival models were constructed to examine elements of the intervention for their impact on family outcomes. The results suggested that a community partnership model that incorporated family engagement, enhanced service provider accessibility, reduced caseloads, one caseworker for each family, are associated with successful reunification outcomes. Moreover, the intervention families were more likely to have their needs met with clinical or economic services, experienced fewer days in out-of-home placement, shorter involvement with the agency, reduced placement moves and were more likely to be reunified sooner compared to the group who received standard child welfare services. At one year follow up, the intervention families also had fewer substantiated child maltreatment reports and children were more likely to be living in the parental home. Implications for policy, research and practice are presented.     

Risk assessment in child sexual abuse cases

Despite continuing improvements in risk assessment for child protective services (CPS) and movement toward actuarial prediction of child maltreatment, current models have not adequately addressed child sexual abuse. Sexual abuse cases present unique and ambiguous indicators to the investigating professional, and risk factors differ from those related to physical abuse and neglect. Incorporation of research on risk factors specifically related to sexual offender recidivism into existing CPS risk assessment models may improve the ability to assess the risk of future sexual maltreatment to children. This article reviews the literature on risk factors for sexual offense recidivism and discusses their relevance and application to CPS assessment models. An evidence-based model for assessing risk in child sexual abuse cases is proposed.     

Public attitudes toward child maltreatment in Israel: Implications for policy

Objective

The public view of the severity of social problems and their perceptions of how effectively they are being addressed have a major impact on public policies and resource allocation. The present study focuses on public attitudes toward child maltreatment. It examines perceptions of child maltreatment as a social problem, and attitudes toward prevention and treatment strategies in cases of child abuse and neglect.

Methods

A survey was conducted among a representative sample of 812 Israeli adults: 688 Jews, and 124 Arabs. Fifty additional Ultra-Orthodox Jews were added for comparisons among Jewish participants.

Results

The participants tend to view violence and alcohol consumption among youth as a more serious problem than parental maltreatment of children. Low-income participants tend to view child maltreatment as a more serious problem than did high-income participants. Jewish participants (except for ultra-Orthodox Jews) view child maltreatment as a significantly more serious problem than did Arabs and Ultra-Orthodox Jews. Most of the participants believe that parents who maltreat their children should be punished, but they should be taught how to refrain from maltreatment, and learn to change their behavior. Many participants believe that the courts do not sufficiently punish parents who maltreat their children. In their assessments of the quality of professional work, the highest evaluations are given to services provided by physicians and social workers, whereas the lowest evaluations are given to judges and police. Most of the participants (70%) believed that social workers play an important role in protecting children.

Conclusions

The survey findings have implications for enhancing public awareness of child maltreatment as well for policy making in the area of child abuse and neglect. The differences in the perceptions of participants based on their religious, cultural and economic background toward child maltreatment should be further studied and addressed in policy and interventions in this area.