Exploration of the Relationship between Severe and Complex Disabilities and Child Sexual Abuse: A Call for Relevant Research

ABSTRACT

Despite the awareness that children with severe and complex difficulties experience child sexual abuse (CSA), the development of research in this area is still in its infancy. This call for relevant research seeks to identify the main gaps in knowledge in order to inform future debate, potential research questions, and raise issues for practice. Themes are identified relevant to researchers and practitioners globally. These include the complexity and duality of definition: recognition of CSA; barriers to communication with children and between services; diversity of segregated and inclusive settings; interaction of age and gender; adult and peer abuse in institutions; sexuality and disability; and intrusive care and medical practices. Recommendations for future research and practice in creating safe environments are provided.     

Korean American Pastors' Perceptions and Attitudes Toward Child Abuse

Abstract

More than 80 percent of Korean immigrants in the United States attend church on a regular basis. Churches, as informal community organizations, can play a very significant role in protecting children from abuse. This study examines Korean American clerics' knowledge of child abuse, their definition of child abuse, and their familiarity with mandatory child-abuse reporting laws. The study also examines how culture, demographic variables, and individual theological orientation affect their attitudes toward child abuse, mandated child abuse reporting by clergy, and preference of intervention strategies. Major findings include that more than 50 percent of respondents have seen child abuse and neglect among their church members, but the majority who have witnessed child abuse prefer to provide pastoral counseling to the family instead of reporting the case to a child protective agency.     

Abusers gaining custody in family courts: A case series of over turned decisions

Abstract

This article presents findings and recommendations based on an in-depth examination of records from 27 custody cases from across the United States. The goal of this case series was to determine why family courts may place children with a parent that the child alleges abused them rather than with the nonoffending parent. We focused on “turned around cases” involving allegations of child abuse that were at first viewed as false and later judged to be valid. The average time a child spent in the court ordered custody of an abusive parent was 3.2?years. In all cases we uncovered the father was the abusive parent and the mother sought to protect their child. Results revealed that initially courts were highly suspicious of mothers' motives for being concerned with abuse. These mothers were often treated poorly and two-thirds of the mothers were pathologized by the court for advocating for the safety of their children. Judges who initially ordered children into custody or visitation with abusive parents relied mainly on reports by custody evaluators and guardians ad litem who mistakenly accused mothers of attempting to alienate their children from the father or having coached the child to falsely report abuse. As a result, 59% of perpetrators were given sole custody and the rest were given joint custody or unsupervised visitation. After failing to be protected in the first custody determination, 88% of children reported new incidents of abuse. The abuse often became increasingly severe and the children's mental and physical health frequently deteriorated. The main reason that cases turned around was because protective parents were able to present compelling evidence of the abuse and back the evidence up with reports by mental health professionals who had specific expertise in child abuse rather than merely custody assessment.     

Incest and Parental Contact: A Psychologist's Personal Case and Literature Review

ABSTRACT

A psychologist's husband molested their young daughter. Consulting psychologists purported that research indicated it would be developmentally advantageous for their daughter to continue a relationship with the father following the marital separation. The consulting psychologists did not reference the literature, prompting the mother to conduct a literature review herself. The available literature recommending that a child continue the paternal relationship cites research on children of divorce, not research on the treatment of child sex abuse victims. The scant child sex abuse research that addresses contact with the abusing parent actually indicates more harm than benefit occurs to the child.     

Judgments regarding parental alienation when parental hostility or child sexual abuse is alleged

Abstract

Allegations of Parental Alienation (PA), the systematic disparaging of one parent by the other parent aimed at alienating their child’s affections, as a basis for child custody decisions are highly controversial. Claims of parental hostility or allegations of child sexual abuse in custody cases may trigger concerns about PA. Family court professionals (N?=?280) rated young children’s accuracy of report (e.g., suggestibility, honesty) in general and also read three custody scenarios varying as to whether or not they included allegations of parental hostility or child sexual abuse, or no such allegations. For each scenario, the alleged alienating parent’s gender was experimentally varied between subjects. Participants rated the likelihood that each case involved PA. For the scenario that included allegations of child sexual abuse, professionals who viewed young children as more inaccurate reporters or who read about the mother (rather than a father) as the alleged alienator were more likely to rate the scenario as involving PA. For the scenario that described parental hostility but no child sexual abuse allegations, professionals who were older or female were more likely to judge the scenario as involving parental alienation when a mother (rather than a father) was the alleged alienator, whereas there were no significant predictors of responses to the no-allegation scenarios. Findings are discussed in relation to the difficult task of evaluating custody cases for PA when parental hostility or child sexual abuse is alleged.     

No sign of harm: issues for disabled children communicating about abuse

While all children may be the victims of abuse, disabled children are particularly vulnerable. This paper explores the views of professionals working with children using alternative/augmented communication systems on the issues relating to communication about abuse. Interviews were carried out with 20 staff from eight establishments for disabled children across Scotland. It describes the range of alternative/augmented communication systems used and the barriers to communication about abuse. Staff generally accepted the importance of providing the appropriate vocabulary in augmented communication systems, but systems that provide such vocabulary were not widely used. Staff considered that a major difficulty concerned the level of understanding disabled children might have about concepts of abuse. They were unsure how the appropriate vocabulary could be introduced in a natural way and how links could be made between the signs and their meanings. Staff saw themselves as those most able to protect the children, but it was felt that discovery of abuse was more likely to come from them noticing physical signs, behaviour or mood changes than from the child communicating explicitly about abuse. The need for appropriate training and increased coordination between social work, health and education is highlighted. Copyright © 2001 John Wiley & Sons, Ltd.     

Gender Differences in the Characteristics and Outcomes of Sexually Abused Preschoolers

ABSTRACT

This study examined whether sexually abused preschool boys and girls (ages 2–5) differed in terms of abuse characteristics or psychological outcomes. A retrospective chart review of 74 cases of sexually abused children (29 boys and 45 girls) treated at an urban mental health clinic in Maryland was conducted. Information was collected on: (1) demographics; (2) abuse characteristics (victim's age, type of sexual abuse, relationship to perpetrator); (3) abuse discovery pattern (accidental vs. purposeful); (4) children's symptomatology; and (5) child and familial factors. No differences were found between boys and girls in terms of the victim's age at the time of abuse, perpetrator's age, or the identity of the perpetrator. However, boys and girls experienced different forms of abuse; boys were more likely to experience fondling, oral and anal intercourse. The majority of boys and girls were abused by males, typically someone they knew (biological parent/parent figure or relative). No differences were evident in the type of disclosure; however, older children were more likely to self-disclose than younger children. Results indicated that boys exhibited more developmental delays and aggressive symptoms than girls. Clinical implications of these findings are discussed as well as recommendations for future research.     

Evaluating Allegations of Child Sexual Abuse Within Complex Child Custody Cases

SUMMARY

This article provides a framework for identifying and assembling the interdependent elements of a child custody evaluation with allegations of child sexual abuse. The identification of several myths regarding child sexual abuse (CSA) introduces the subject matter of this article. A forensic evaluation model (Heilbrun, 2001) is then used to organize the custody evaluator's tasks into the following sequential classifications: (a) preparation; (b) data collection; (c) data interpretation; and (d) communication of results. Through this model, the entwined tasks of evaluating the child's needs and the parents' capacities to meet the child's needs, while simultaneously examining the question of child sexual abuse, are addressed.     

Knowledge,Attitude and Practice of Child Sexual Abuse Prevention among Parents of Children with Hearing Loss: A Pilot Study in Beijing and Hebei Province,China

ABSTRACT

This study aimed to examine the knowledge, attitude, and practice (KAP) of child sexual abuse (CSA) prevention among parents of children with hearing loss. The study involved 127 pairs of parents with deaf and hard of hearing children from three special education schools in Beijing and Hebei province, China. The findings revealed that the parents lacked knowledge about CSA prevention, such as the character of perpetrators and child victims. Parents were supportive about potential CSA prevention education in schools. Most parents told children much about personal safety, but topics on CSA prevention were still insufficient. The study also found that education level was significantly associated with knowledge and attitude. Elder parents knew more and talked more about CSA prevention. Mothers and girls’ parents were more willing to communicate with children about CSA prevention. The conclusion of the study was that parents appeared to have gained a positive attitude, but poor knowledge and practice. Their knowledge and skills of effective communication should be strengthened to promote CSA prevention practice.     

Children’s Knowledge of Genital Anatomy and Its Relationship With Children’s Use of the Word “Inside” During Questioning About Possible Sexual Abuse

ABSTRACT

This study was designed to examine the relationship between children’s understanding of their genital anatomy and their use of the word “inside” in response to questions about genital touch during a forensic medical examination. This study involved a secondary data analysis of 674 records of children at a sexual abuse clinic in a large city in a southern state. Data were analyzed using contingency table, binary logistic, and multinomial logistic regression analysis methods. An association between children’s understanding of genital anatomy and their use of the word “inside” to describe genital touch was found. Children’s age and development contributes to their overall understanding of genital anatomy, and their knowledge of genital anatomy appears to influence how they answer questions regarding genital touch. This finding could play an important role in sexual abuse cases in states where the definition of rape includes penetration of any bodily opening, including labial penetration.     

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

Background: Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey.

Methods: The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data.

Results: Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001).

Conclusions: Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.     

Best Practices in the Treatment of Substance-Abusing Women in the Child Welfare System

ABSTRACT

This paper reviews the literature on women's chemical dependency and its effects on their children. Many risk factors (e.g., a history of traumatic exposure) and consequences (interference with parenting) of substance abuse are unique for women, giving rise to special treatment needs of substance-abusing women with children. Substance-abusing mothers also experience unique barriers to receiving the services they need to recover, such as absence of child care and lack of gender-specific treatment in their communities. Model programs are described and recommendations are offered for best treatment practices for women with chemical dependency who present in the child welfare system.     

Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Psychological Symptoms in a Sample of Latino Abused Children

SUMMARY

This study compared Latino children who were victims of child abuse with similar children who were not abused on measures of depression, anxiety, behavior problems, and dissociation. Abused children were found to have higher levels of symptoms on the majority of symptom measures. There were differences in the evaluation of distress levels on the self report versus parent/guardian report measures. Mean scores of the abused children on the self report measures were not in the clinical range, although a substantial number of children had high levels of distress. In contrast, the results of the parent/guardian measures revealed mean scores in the clinical range of problems. Implications for research and practice are included.     

Blaming the messenger: The media,social workers and child abuse

Abstract

This paper explores the agenda-setting role of the media in child abuse, citing local and international examples. The author argues that much media coverage of child abuse promotes a conservative, pro-family political agenda, offering a narrow individualistic/legalistic view of child abuse as opposed to a broader structural definition. This conservative agenda is particularly reflected in media hostility to social workers involved in child abuse cases. Attention is drawn to the major manifestations of this criticism, and to some of the reasons why social workers experience disproportionate media censure. Suggestions are then made regarding the potential for a more effective and pro-active social work response.     

Protecting Older Americans: A History of Federal Action on Elder Abuse,Neglect, and Exploitation

ABSTRACT

Congressional hearings on elder abuse began over a quarter century ago. However, federal legislative and departmental activity for addressing the problem has been slow and lacks coordination and comprehensiveness. In addition, federal funding to combat elder abuse represents only a small percentage of that spent on such other abused populations as children and women. The barriers and challenges to addressing elder abuse are identified along with existing programs at the federal level. The article concludes with a discussion of state and local initiatives which show promise for effectively preventing or treating this problem.     

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

Considering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.     

Registered nurses' communication about abused children: rules,responsibilities and resistance

This paper provides an ethnomethodological perspective on registered nurses' communication about abused children. During the study, data were gathered in four ways. Nine hundred and ?fty South Australian hospital records of children were examined for nurses' documentation related to child abuse. Eleven paediatric department and emergency department registered nurses then responded to vignettes of suspected child abuse and were subsequently interviewed. Researcher journal entries about contextual issues served as the fourth stage of data collection. Data were analysed using Gar?nkel's documentary method of interpretation. The ?ndings included: nurses' use of codes of communication; denial and acts of resistance; and systematic malpractice. Copyright © 2004 John Wiley & Sons, Ltd.     

Deaf Families’ Unique Experiences and Obstacles

ABSTRACT

This article focuses on deaf children of deaf parents who grew up using American Sign Language (ASL) in deaf culture. Deaf children of deaf parents described their unique experiences of struggling with obstacles, including quality of education, low expectations from professionals, unwanted sympathy, mental health therapists’ lack of cultural competency, and not being asked for valuable perspectives or advice. The advice from deaf children of deaf parents is included in the article. By bringing greater attention to this population, mental health, school, and other professionals can increase their awareness of deaf families’ unique needs in their work environment.     

Abuse and deaf children: Some factors to consider

Deaf children are uniquely disadvantaged in terms of access to information on safety and abuse. This is often due to misunderstood linguistic and cultural needs which relate to the deaf community. Consequently, a greater number of children who are deaf are placed in potentially abusive situations when compared to their non-deaf peer group. A high percentage of deaf children have also acquired negative self-concepts. This is often due to external influences such as educational experiences and family communication. Many deaf children believe that abuse is part of their being deaf. The implications of this are that deaf children are at risk of neglect and abuse as well as long-term damage to their emotional development and self-esteem. A number of survivors of physical and sexual abuse have been referred to the National Centre for Mental Health and Deafness, Preston. Some of these referrals have been inappropriate and due to a dearth of local resources. Extremely little support is available for deaf people who have been or are being abused. There are few appropriately trained counsellors equipped with the necessary skills in communicating with deaf people and even fewer trained in deaf awareness. A number of risk factors have been identified and are illustrated in this article. Three case studies are described to highlight the issues involved.