Significant harm and children's experiences of domestic violence

This is the first of two papers concerning children and domestic violence, both of which draw on findings from a Department of Health commissioned study of children suffering or likely to suffer significant harm. This paper discusses the ways in which children appear to be harmed by witnessing violence between their parents or parental figures. A brief review is offered of the literature concerning the developmental and behavioural effects on children who have lived with domestic violence. Selected findings from the research study are then discussed. Out of a cohort of 105 maltreated or neglected children, 49 were discovered to be regularly witnessing violence between parents at home. The emotional, social and behavioural effects on 28 children who were studied in detail are presented, through three case studies. Examples are offered of the way in which professionals overlook, discount or downgrade the harm to the child from this hostility. The emotional impact on the child of living with domestic violence rarely forms part of the assessment of significant harm made at the child protection conference; nor does it feature in subsequent plans to protect the child.     

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

This paper presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within thirteen urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this paper focuses on parent reports of child oppositional behavior and parenting stress over time. MFG is a flexible, protocol-driven approach designed to address the most common reason for referral to outpatient child mental health clinics, childhood behavioral difficulties. The MFG also aims to enhance family-level engagement and retention in ongoing care. Further, the service delivery model was collaboratively developed with intensive input from parents rearing children with conduct difficulties, parent advocates, community-based child mental health providers and services research staff in order to ultimately expand the number of effective service models that can be situated within "real world," urban child mental health settings.     

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns

ABSTRACT

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.     

The Psychobiology of Maltreatment in Childhood

The varied maladaptive behavioral, social, medical, and psychiatric outcomes associated with maltreatment in childhood have been extensively documented in the extant empirical literature. In this review, we examine the adverse impact of the stress associated with child maltreatment on the regulation of the neurobiological stress systems, alterations in brain maturation, and neuropsychological outcomes in the developing child. Further, we provide a detailed discussion of the pathway between the psychobiological consequences of trauma and subsequent cognitive, language, and academic deficits that often have a deleterious impact on global functioning. We review neuroimaging techniques and the empirical results of studies utilizing such techniques to examine brain maturation in maltreated children and individuals with posttraumatic stress disorder. We address the practice, research, and policy implications of the psychobiological sequelae of child maltreatment and offer future directions for research.     

The relationship between maternal depression and child outcomes in a child welfare sample: implications for treatment and policy

Maternal depression is an extremely important parenting variable in relation to child general health. This investigation addressed the issue of maternal depression as it relates to the lives of children seen by child welfare authorities. Maternal depression was investigated in the context of the increasing rate of children coming to the attention of the London and Middlesex Children's Aid Society. A variety of child outcomes including those of particular relevance to child welfare, specifically disorders of attachment and neglect and physical abuse, school‐related variables, conduct disorder and psychological distress, were investigated. The relative contribution of maternal depression along with measures of socioeconomic status and social isolation to childhood risk was examined. Results indicated that the rate of maternal depression doubled during the years 1995–2001. Maternal depression was related to children entering care through wardship. Additional poor child outcomes such as attention deficit disorder, conduct disorder and emotional adjustment were also related to maternal depression. The findings are discussed in terms of treatment and policies that can lower the risk to children through effective intervention with depressed mothers.     

The importance of clinician courtroom testimony for children exposed to domestic violence

Children exposed to domestic violence account for as many as a third of all children in the United States. Many of these children will seek mental health treatment for symptoms of trauma. The clinicians who provide their treatment are often called as witnesses in family law proceedings, especially child protection and custody cases. Clinicians are often anxious when they receive subpoenas to testify and prefer to avoid testimony. Training about court proceedings, subpoenas and how to prepare for testimony would be beneficial for clinicians and will help clinicians be more confident in the courtroom. Additionally, becoming designated as expert witnesses can only help mental health clinicians provide a greater understanding of the issues encountered by children experiencing domestic violence, and these clinicians can provide recommendations that will take into account child safety without exacerbating trauma symptoms.     

Equipping child protection practitioners to intervene to protect children from cumulative harm: legislation and policy in Victoria,Australia

Many children are repeatedly reported to statutory child protection services, but do not receive the protection they need. Many such children are suffering chronic maltreatment, which is likely to result in cumulative harm. Chronic maltreatment encompasses emotional abuse and chronic neglect. As a result, children can experience a range of cognitive, emotional, and behavioural problems that are more serious than those associated with other abuse types. This paper focuses on the Victorian statutory child protection system, and considers why cumulative harm is not receiving the attention the legislation intends. Under the Victorian legislation cumulative harm must be proven on grounds of emotional abuse and/or neglect. However, it is difficult for child protection practitioners to place before the court the necessary evidence to establish these grounds. The paper concludes that the legal definitions of emotional abuse and neglect should not require evidence of a link between the abusive actions of the parent and the poor outcomes for the child. The evidentiary focus should be on the actions of the parent. Furthermore, legislation should focus on abusive parental behaviours that are likely to result in cumulative harm, which are more concrete and measureable than emotional abuse and neglect, such as intimate partner violence and parental illicit drug use.     

Young Adult Outcomes of Juvenile Court–Involved Girls

ABSTRACT

The recent increase in the number of girls involved in the juvenile justice system has resulted in increased academic and public attention. Thus far, this attention has focused on entry into the juvenile justice system rather than longer-term consequences. This research helps fill this gap by examining a sample of 700 maltreated and/or impoverished juvenile court–involved females. Competing risks models were used to control for time from juvenile-court entry to adult outcomes: criminal justice system involvement, use of public mental health or substance use services, and income maintenance use. Results indicate that there are distinct predictors associated with the different outcomes, although learning disability and adolescent parenthood were associated with higher risk of both mental health/substance use services and income maintenance. Individualized services for juvenile court–involved girls are suggested. Prospective, longitudinal research is needed to investigate intrapsychic and behavioral dynamics associated with females' young adult outcomes.     

Children and Violence: Nurturing Social-Emotional Development to Promote Mental Health

The absence of violence against children is a fundamental children's right and a major milestone of civilized society. Similarly, reports on incidences of violence by children and youth, including severe cases with devastating consequences, speak to the need that the trauma of exposure to violence in childhood needs to be addressed. While violence and its risk factors are generally understood, what is less clear are the essential protective factors, how we can identify those as early as possible, and how we can use them to prevent and address the trauma of violence exposure in children and youth. In this report, I review pathways of child and youth violence through the lens of social-emotional development as a central protective factor. Negative emotions of frustration and anger can underlie violence and aggression. Kind emotions, such as caring and our ability to connect with others emotionally, can serve as social-emotional protective factors. A brief review of the central social-emotional processes and their development is provided, including the human capacity to feel with others and express empathy, be emotionally aware and care about the effects of one's own actions on others, and be able to regulate the self and their emotions. Given the negative widespread and long-term impact of exposure to violence, I describe research-informed attempts to prevent violence exposure across development. Taking a humanistic, strength-based perspective, the focus is on social-emotional protective factors to address violence and nurture mental health in every child. I conclude with recommendations for practice and policy.     

A Leadership Training Group for at Risk Fifth & Seventh Graders: Results from A Brief Strength-Based Group Program

ABSTRACT

An increasing number of youth are exhibiting social, emotional, and behavioral problems that hinder their ability to function at grade level. Subsequently, school mental health services have not been able to address the need for services particularly among students who are minority and poor. A mixed methodology study was conducted to determine the treatment outcomes from a brief strength-based leadership training group for primarily students who are African American and poor. Pre–post scores on three scales and focus group data revealed significant positive changes in regard to internal areas of functioning and social skills, anger management skills, and school attitude. Gender and age significantly impacted outcomes.     

Parental mental health: disruptions to parenting and outcomes for children

The association between parental mental health problems and negative outcomes for children has been long known. This paper addresses three issues in relation to this. First, the scale of the problem is outlined, in terms of both the prevalence of mental health problems in parents and the likelihood of children exhibiting negative outcomes in these circumstances. Secondly, the specificity, or lack of it, of particular outcomes in the child in relation to different parental mental health problems is explored. Thirdly, the paper focuses on the importance of disruptions to parenting as a mechanism in the transmission of mental health problems to negative impacts on the child. Examples are given of how parenting is disrupted in non‐clinical community populations, and the subsequent impacts on the child. The case is made for the preventative importance of parenting and family support in mediating between parental mental health problems and negative impacts on the child.     

Domestic violence and child protection: towards a collaborative approach across the two service sectors

Domestic violence continues to be one of the most significant aspects of child abuse and neglect in Australia. However, the children are not well served by either child protection or domestic violence service sectors, which continue to operate as segregated, tertiary response systems. This paper reports on research that examined bridges and barriers to effective collaboration between child protection and domestic violence services in responding to children affected by domestic violence. The differing conceptions and responses of the workers from each service sector, in relation to children and families affected by domestic violence, is discussed in the light of gaps in service provision in both sectors. In doing so, areas of common ground for more effective collaboration between these service sectors are identified, including the prioritizing of emotional and psychological abuse, supporting and empowering abused mothers, strengthening the mother–child relationship, and supporting children and families across a continuum of service provision, particularly in the medium‐ to long‐term. Understanding each other and finding common ground across the two service sectors is paramount to improving how each responds to children and families affected by domestic violence.     

Positive Connections: a programme for children who have a parent with a mental illness

Mental health professionals working with parents who suffer from a mental illness often overlook the children within the family. Children whose parents are mentally ill face numerous obstacles to their own emotional development and these children are at higher risk for developing mental illnesses than other children. These risks can be decreased if protective or positive interventions are available for the children. This article will describe the development and implementation of Positive Connections, an effective intervention programme specifically designed for children whose parents have been diagnosed with a mental disorder. The effectiveness of this programme has been evaluated using both qualitative and quantitative research strategies, and the results are presented.     

Shared and unique characteristics of school,cyber and family victimization among school-aged children in Hong Kong

Victimizations from online and offline violence, such as sibling violence, school violence and witness of family violence, both have negative associations with victims' mental health and may share similar individual and family characteristics. This study aims to explore the common and differentiated characteristics in the prediction of school, cyber and family victimization and whether there are unique associations within these victimization types. We employed a two-stage stratified sampling method to collect a representative sample of 5567 children aged 3–17 from a cross-sectional, school-based survey in Hong Kong. Results showed that all types of child victimization, including sibling, school and cyberbullying, as well as the witness of violence at home, were positively correlated with each other. Children's age was positively related to the occurrence and cooccurrence of all types of child victimization. Frequent family residential mobility and parents' higher education level were positively related to all types of children's victimization. The scores of all aspects of children's paediatric quality of life were found negatively related to children's school victimization. This study provides insight into the unique and shared elements of children's online and offline victimization. Knowledge of the distinguished familial gradients of child victimization at home and beyond could benefit the development of child victimization prevention.     

Impact of child care arrangements on Australian children's cognitive outcome: moderation effects of parental factors

This study examines the effects of child care arrangements on children's cognitive outcomes. It is a secondary analysis, using data on 5107 children born in 2004 and their families from Growing Up in Australia: The Longitudinal Study of Australian Children. Data were collected in 2004 (Wave One), in 2006 (Wave Two) and in 2008 (Wave Three). This study asks (i) Do children receiving non‐parental child care have different cognitive developmental outcomes at ages 4–5, compared with those who never had non‐parental child care during the first 3 years of life? Do parental factors affect these associations?; and (ii) among children with non‐parental child care, do child care characteristics such as types of care, quantity, entry age and stability of child care affect child outcomes? Do parental factors affect child outcomes? The study's findings suggest that children in non‐parental child care had higher Peabody Picture Vocabulary Test scores at age 5. Among children in non‐parental child care arrangements, quantity and entry age of non‐parental child care affected children's cognitive developmental outcomes. Along with child care arrangements, parental mental health was associated with children's cognitive outcomes.     

Parenting and child experiences in shelter: A qualitative study exploring the effect of homelessness on the parent–child relationship

Depending on the data source, between half a million and 2.48 million children in families experience homelessness each year in the United States. Recent data suggest that approximately half of all homeless children are under the age of 6. A considerable body of quantitative research has documented the occurrence of poor outcomes associated with childhood homelessness in the domains of social–emotional development, physical and behavioral health, academic achievement, and family stability. This qualitative study presents results from 19 interviewers with formerly homeless parents reflecting upon how the experience of being homeless affected their young children and their ability to parent. Findings are contextualized within an attachment perspective. Parental reported effects included confusion, sadness, anxiety or depression, withdrawal, lack of appetite, aggression, and disregard for authority. Parents also talked about the disempowering experience of parenting while in shelter. Unexpectedly, parents of infants said their children were not affected by homelessness, and few parents identified the need for mental health services for their children. The experiences of parents with whom we spoke provide invaluable insight into what shelter staff, social service agencies, philanthropy, policymakers, and researchers can do to support and respect the parent–child relationship in families who are experiencing homelessness.     

Physical Abuse, Cognitive and Emotional Processes, and Aggressive/Disruptive Behavior Problems

Cognitive and emotional processes were examined in maltreated children with a history of physical abuse (n = 76), children with a history of maltreatment other than physical abuse (i.e., sexual abuse, physical neglect, and emotional maltreatment; n = 91), and a group of non‐maltreated comparison children (N = 100). Physical abuse was associated with errors in cue interpretation, easy access to aggressive responses to conflict, and poor emotion regulation. In turn, maladaptive cognitive and emotional processes made unique contributions to explaining the relationship between physical abuse and peer nominations of aggression and disruptive behavior. Maltreated children who had not been physically abused evidenced a trend toward cognitive and emotional maladaptation, but only poor emotion regulation accounted for aggression and disruptive behavior in these children. The findings emphasize the importance of considering multiple domains of development in efforts to understand how varying forms of child maltreatment contribute to later maladjustment.     

The Psychological Consequences of Abuse for the Child

The consequences of child abuse for the emotional health and development of the child have been largely disregarded in theory, in practice, and in research. The few studies which have investigated this aspect of the child abuse problem report detrimental psychological consequences. These research findings combined with more general psychological theory and research on personality development provide a basis for predicting the psychological consequences of abuse for children. Documentation of deficits in the emotional development of abused children has important policy and practice implications for intervention and treatment.