Etiological patterns of child abuse and neglect

A review of the various etiological possibilities for child abuse and neglect, designed to offer an additional and different possibility. Consideration is first given to problems, namely the lack of universal definition, heterogeneous effects, and retrospective research. The probability of multifactor models is noted, and sexual abuse is given separate consideration, followed by an exploration of the existing models termed ecological, transactional, transitional, and attachment. An interactive aggression model is then offered as the new possibility. Empirical evidence for cultural and/or ethnic predispositions suggests that society can be a supporting or inhibiting factor in terms of promoting or opposing violence.     

Specialist assesstnent services for child abuse and neglect

This paper describes the Child Protection Service, Flinders Medical Centre, South Australia, a specialist assessment service for infants, children and adolescents following allegations of abuse and neglect. The psychosocial and medical services provided for infants, children, adolescents and their families are outlined briefly and the Child Protection Service's view that the assessment process can and needs to be therapeutic is discussed. Data was provided about the age and gender of infants, children and adolescents seen and the number of families referred on for longer-term therapeutic intervention. The unit's philosophical stance, affecting its clinical practice and interagency and consultation service, is described, as is its research focus. The paper also raises a number of issues that warrant further and detailed attention. These include the need for workers to monitor and attend to their emotional responses while working in the area of abuse and the destructive potential of denial that may consequently and subtly impact on professional practice. The tendency for professionals and the wider society to ignore the impact of physical abuse is also raised.     

Child abuse and neglect: Perspectives on a national emergency

Hundreds of thousands of children are being abused and neglected in the United States annually. The structures devised to respond to this abuse and neglect have been unsuccessful. The United States government continues to spend billions of dollars on programs to deal with the effects of these unsuccessful responses. Child abuse and neglect in the United States now represent a national emergency. In this article, we will provide a historical, cultural, and contemporary perspective on child abuse and neglect. This perspective throws light on the complexity of the national emergency and provides a context for further exploration of the issue.     

The context of decision-making in cases of child neglect

This paper explores professional decision-making in cases of child neglect within the context of child protection practice in Britain. The literature on the nature of neglect is reviewed. Difficulties associated with decision-making are then examined within a framework that addresses the social, political and organizational context of child protection practice. It is argued that the current system, which focuses on incidents of abuse rather than the context of children's lives, provides inadequate protection for many children experiencing chronic neglect. Conclusions are drawn with regard to the development of practice that supports vulnerable parents while still remaining the child's welfare as paramount. © 1998 John Wiley & Sons, Ltd.     

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.     

The preoccupation with thresholds in cases of child death or serious injury through abuse and neglect

Thresholds into and between services emerged as a significant theme in the biennial analysis of cases of child death and serious injury through abuse and neglect ‘serious case reviews’ carried out in England for the (then) Department for Education and Skills between 2003–05. The preoccupation with thresholds was one of a number of interacting risk factors and many children's cases were on the boundary of services and levels of intervention. In most cases child protection did not come ‘labelled as such’ which reinforces the need for all practitioners, including those working with adults to be alert to the risks of significant harm. Policy makers should acknowledge that staff working in early intervention are working within the safeguarding continuum and not in a separate sphere of activity. The emotional impact of working with hostility from violent parents and working with resistance from older adolescents impeded engagement, judgement and safeguarding action. In the long term neglect cases that were reviewed, the threshold for formal child protection services was rarely met and some agencies and practitioners coped with feelings of helplessness by adopting the ‘start again syndrome’. Adequate resources are essential but not sufficient to redress the problems. Effective and accessible supervision is crucial to help staff to put into practice the critical thinking required to understand cases holistically, complete analytical assessments, and weigh up interacting risk and protective factors. Copyright © 2008 John Wiley & Sons, Ltd.     

The gender neglect and textual abuse of children in the print media

In recent years the relationship between the media and child abuse has been subjected to closer scrutiny. Research at Monash University into the media portrayal of child abuse has led the researchers to examine the language used by the print media to represent both children who have been abused or neglected and the offences committed against them. This paper presents two findings from this research. The analysis firstly found that a child who has been abused or neglected may be objectified in print media language even when the child’s gender is previously identified. Secondly, the analysis found that the language used to describe the sexual abuse of children may serve to reduce the seriousness of offences. These phenomena, termed ‘gender neglect’ and ‘textual abuse’, are highlighted by examples from UK and Australian print media. The authors argue that ‘critical language awareness’ is important for children, just as it has been identified in research that examines the representation of women in print media. Copyright 2000 John Wiley & Sons, Ltd.     

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.     

An analysis of children and young people's calls to ChildLine about abuse and neglect: a study for the Scottish Child Protection Review

In 2001 a young child, who was known to child protection agencies, was murdered by her stepfather. Following a recommendation of an inquiry into her death, a ministerial multidisciplinary review of child protection across Scotland was carried out. The review aimed to promote the reduction of abuse or neglect of children and to improve the services for children who experience abuse or neglect. It was carried out by a multidisciplinary team and the report made 16 recommendations. The review was informed by a series of sub‐projects. This paper describes one sub‐project that aimed to collect the views of children and young people who might have been abused but might not have had contact with child protection agencies. The study was carried out in conjunction with ChildLine Scotland. Call data for one year were made available for quantitative analysis. Qualitative analysis was carried out on the counsellors' notes on all calls relating to abuse and neglect taken during a 2‐week period. Children described signi?cant levels of abuse and neglect. Many had told no‐one of the abuse and in particular had not contacted child protection agencies. The paper considers the implications of the ?ndings for the child protection system. Copyright © 2004 John Wiley & Sons, Ltd.     

Prevention of child abuse and neglect and improvements in child development

The aim of the study was to evaluate the implementation of a section in the Danish Social Assistance Act which encourages local authorities to offer families services in order to support children at risk of child maltreatment. The specific purpose of the present paper is to answer the question: Will the socio‐psychological development of children known to social services be improved when abuse and neglect are reduced? A sample of 1,138 children was drawn at random from new social services cases starting in 1998. Subsequently, about 80 per cent were evaluated by local caseworkers on the basis of a standardised questionnaire covering a period of four years. The most damaging family conditions seemed to be psychological maltreatment, physical/sexual abuse and neglect. Maltreated children were more often in a depressed state, unhappy, socially isolated, or they had an eating disorder, inadequate or under‐nutrition, suicidal tendencies, lack of concentration, or disturbed behaviour, compared to those children who were not exposed to abuse and neglect. If parental behaviour improved, effects on children's well‐being were also observed and positive changes in children's socio‐psychological development were identified. The questionnaire explored the impact of various interventions, including services geared to strengthen the child's network, but results indicated that the child displayed reduced risk of reactive symptoms only when parental behaviour improved and abuse and neglect were reduced. Copyright © 2009 John Wiley & Sons, Ltd.     

The safety of children and the parent‐worker relationship in cases of child abuse and neglect

Child protection work is complex and demanding and presents both parents and workers with a number of emotional and relationship demands. Although it is recognised that a good working alliance between child protection workers and parents is associated with therapeutic success and service user satisfaction, some current developments, including the growth of an audit culture with its attendant emphasis on targets and performance, appear to undermine the worker's ability to establish good relationships and working alliances. To the extent that poor‐quality working relationships and increased emotional distance reduce the worker's capacity to be empathic, levels of stress for both parents and workers are likely to remain high. Heightened stress reduces the capacity of parents and workers to keep at‐risk children in mind and in focus. This reduces their safety. The paper revisits the value of containment as a way of processing and managing difficult feelings which, along with more recent therapeutic concepts such as mentalisation, encourages workers to keep the parents' feelings in mind as well as hold the child in mind for the parent as a psychological, meaningful and mentalising being. Helping parents think about their feelings and understand, indeed celebrate, their children as burgeoning, independent psychological entities increases understanding, reduces stress and plays a part in helping keep children safe. Copyright © 2010 John Wiley & Sons, Ltd.     

Effects of mandatory notification training on the tendency to report hypothetical cases of child abuse and neglect

The objective of this study was to examine the effect of mandated notification training upon the tendency of individuals to report hypothetical cases of abuse and neglect. A second objective was to investigate the factors that influence the decision to report and to determine whether mandated notification training had an effect on these factors. Comparisons were drawn between a no training and a recent training group (with random allocation). An additional group of participants who had received training some time ago was included. Five hypothetical vignettes were responded to by 41 teachers and school personnel who had recently completed training, 31 people who had not completed training and 73 people who had completed training some years previously. Where the quality of evidence of abuse and thus suspicion of abuse was relatively high, there were no differences in the likelihood of reporting between trained and untrained participants, all of whom were very likely to report. Ambiguous evidence of abuse had a strong negative influence on reporting likelihood, although mandatory reporting training reduced this inhibition. Copyright © 2001 John Wiley & Sons, Ltd.     

Understanding of elder abuse and neglect among health care professionals in Malaysia: An exploratory survey

ABSTRACT

Elder abuse and neglect (EAN) is a hidden public health challenge for Malaysia. This cross-sectional survey studied the awareness of EAN among 148 doctors and nurses from two neighboring states in Malaysia using a self-administered questionnaire exploring their knowledge, perceptions, practices, and experience concerning EAN. Both doctors and nurses demonstrated poor understanding of signs of EAN and exhibited misperceptions on reporting requirements. Both groups perceived EAN as a national burden and reporting it as their responsibility; but most felt they had not been trained to diagnose it. Many were unsure of procedures and whether their own intervention could be effective. Only four (nurses) of 41 participants who suspected abuse during the past year reported the cases. Targeted education and uniform protocols are mandatory to ensure best practice with regards to EAN. Further research is crucial to extend this inquiry into the broader health care workforce.     

The prevalence of elder abuse and neglect in Iran: a systematic review and meta-analysis

ABSTRACT

Objective: The aim of this study was to estimate the prevalence of elder abuse and neglect in Iran.

Methods: We searched PubMed, Embase, Scopus, and PsycINFO by the end of 2017. The prevalence was calculated based on the percentage or the amount reported in the studies. Heterogeneity was assessed by the I² statistic, and the data were combined using random effects model. The results were reported as the pooled estimates and the 95% confidence intervals (CIs). The review protocol was registered in PROSPERO (CRD42017070744).

Results: A total of 16 studies involving 6,461 participants aged 60 years and over were included. The pooled prevalence for overall elder abuse was 45.7% (95% CI: 27.3–64.1, p < .001).

Discussion: The prevalence of elder abuse and neglect is substantial in the Iranian population aged 60 years and over. More research is needed to investigate the actual prevalence of elder abuse at the national level.     

Validity in an evaluation of Healthy Families Florida—A program to prevent child abuse and neglect

Evidence-based continuums have become a guide for identifying the level of evidence in evaluations of home visiting programs conducted to determine their effectiveness in preventing child abuse and neglect. While randomized controlled trials are required for the highest levels of evidence, quasi-experimental designs have also been specified as an appropriate alternative. Using a quasi-experimental evaluation of a home visiting program to prevent child abuse and neglect that adheres to the Healthy Families America model, this paper describes and illustrates how types of validity can be improved. More specifically, we address how threats to internal validity can be identified and reduced through statistical techniques; how construct validity may be strengthened using state records to measure the outcomes; and how external validity is affected by including or excluding study participants. After applying a variety of statistical adjustments to reduce selection bias, we found that the outcomes favored the home visiting program and increased after accounting for covariates that contributed to child abuse and neglect. This was true across the statistical techniques (traditional covariate and propensity score adjustment) used. For evaluations using quasi-experimental designs, recommendations relevant to the illustrations in the paper are also presented.     

Street children and crime in the UK: a case of abuse and neglect

It is claimed that many incidences of children running away from home and residential care involve issues around violence, bullying and child abuse and neglect. Surveys show that between 14 and 20% of children run away from home for at least one night and that 2% run away 10 times or more from home or a care setting. The potential reasons for running away are discussed together with the increased possibility for further victimization, delinquency and criminal behaviour. Four ‘streetwork projects’ that provide information and support to young runaways in the UK are described and their limitations discussed. It is proposed that counselling should be a part of intervention with street children and that trained counsellors/psychotherapists should be available free to these young people with social and emotional difficulties outside the usual health/social service provision. © 1998 John Wiley & Sons, Ltd.     

Maintaining a focus on the child? First impressions of the Framework for the Assessment of Children in Need and their Families in cases of child neglect

The Framework for the Assessment of Children in Need and their Families is guidance introduced by the Department of Health in England to improve assessment practice and promote better outcomes for children and their families. This paper considers ways in which the Assessment Framework can improve assessment practice in cases of child neglect. However, as with any national guidance, its effectiveness is dependent on local approaches to implementation. The author has undertaken practice development work around implementation with senior managers and frontline staff in area child protection committees (ACPCs) and social services departments. These experiences are used to explore the local issues and tensions encountered by both practitioners and managers responsible for implementing the Assessment Framework. An argument is made that these issues and tensions if not addressed can result in distorted assessments that lose the focus on the child. Copyright © 2002 John Wiley & Sons, Ltd.     

Implications of Overwork and Overload for the Quality of Men's Family Relationships

This study examined the implications of men's long work hours and role overload for the quality of their relationships with their wives and their firstborn (M= 15 years) and secondborn adolescent offspring (M= 12.5 years) in a sample of 190 dual‐earner families. Holding constant men's occupational self‐direction and level of education, long hours were related to less time spent with the wife but were unrelated to spouses' love, perspective‐taking, or conflict; high levels of role overload consistently predicted less positive marital relationships. In contrast, the combination of long hours and high overload was consistently associated with less positive father‐adolescent relationships, a pattern that was similar for older and younger adolescents and for sons and daughters.     

The feasibility of goal attainment scaling to measure case resolution in elder abuse and neglect adult protective services intervention

Objectives: This pilot study describes implementation procedures of goal attainment scaling (GAS) and examines the feasibility of using GAS to measure the multifarious intervention outcome of case resolution in elder mistreatment (EM) adult protective services (APS).

Methods: Substantiated EM victims (n = 27) were recruited prospectively from the State of Maine APS. An adapted GAS approach was implemented involving development of a pre-populated goal scale menu and web-based GAS application.

Results: The GAS menu comprised 18 goals and corresponding scales spanning several domains of case resolution: social support, service access, health/functioning, enhancing independence, and protective measures. The overall GAS process had mean length 33.8 min per case. The mean GAS summary t-score (54.3) aligned with theoretical expectations.

Discussion: Without a measure of case resolution, research cannot compare the effectiveness of different EM intervention models. Findings suggest that GAS is a feasible, client-centered strategy to measure the multifarious EM intervention case resolution outcome.