Abuse and disabled children: hidden needs…?

In order to look at current practices in recording the abuse of disabled children, a questionnaire was sent out to the 121 Chairs of the Area Child Protection Committees in the United Kingdom. Of the 73 responders, over 50% claimed to identify the disability of an abused child but only 10% could given an actual figure. The lack of statistical evidence made it impossible to calculate anything except an approximation of the rate of abuse of disabled children. Schedules completed over a period of 1 year in two Social Services Departments for all disabled children who were conferenced for abuse showed that they were less likely to be put on the child protection register than a comparison group of non‐disabled children. Semi‐structured interviews with eight of the key workers for the disabled children revealed that they were concerned that there was a tendency ‘not to see’ the abuse of disabled children and they did not feel there was sufficient training regarding the interface between abuse and disabilities. Taking into account the responses to the study, a number of national and local recommendations were made. Copyright © 2002 John Wiley & Sons, Ltd.     

Parental Discipline and Abuse Potential Affects on Child Depression,Anxiety, and Attributions

The current study investigated differences in children's emotional functioning as a product of their parents' reported disciplinary practices and child abuse potential. Families with no known history of abuse were recruited to ascertain whether depressogenic attributional style and depressive or anxious symptomatology was evident in children of parents who used harsher physical punishment and who had higher abuse potential. Forty‐two New Zealand children ages 8–12 participated with their parents. Child‐report measures of depression, anxiety, and attributional style were compared with parents' responses on physical discipline scenarios and child abuse potential. Children's anxiety symptoms were higher in those children whose parents obtained higher abuse potential scores and had harsher discipline practices. Children's depressive symptoms and some components of maladaptive attributional style were also found in families with higher abuse potential. Results suggest emotional difficulties similar to those of maltreated children even without identifiable abuse.     

Profiles of the parents of adolescent CSA perpetrators attending a voluntary outpatient treatment programme in Ireland

A group of 22 parents of adolescent sexual offenders (PASO) was compared with a group of 19 normal controls (NC) and 10 clinical controls (CC) on demographic, developmental, personal adjustment and family environment variables. The assessment protocol included the General Health Questionnaire‐12, the Culture‐Free Self‐Esteem Inventory, the Child Behaviour Checklist, the Family Assessment Device, the Parent Satisfaction Scale and the Multidimensional Scale of Perceived Social Support. Compared with clinical and normal controls, more parents in the PASO group reported that they had been arrested or charged for a criminal offence; had personally experienced child abuse; and more of their adolescents had experienced child abuse, with emotional abuse being the most common form of abuse for both parents and adolescents. Compared with clinical and normal controls, more adolescents of parents in the PASO group had witnessed parental drug or alcohol abuse and had been placed in care outside their home. While parents in the PASO group did not differ from clinical or normal controls in terms of personal adjustment, their adolescents had significantly more internalizing behaviour problems than normal controls, whereas adolescents of parents in the clinical control group had significantly more externalizing behaviour problems than normal controls. Compared with normal controls, parents in both the PASO and clinical control groups reported more difficulties with general family functioning, roles, affective responsiveness, affective involvement and behaviour control and lower levels of parental satisfaction. However, the groups did not differ significantly in their levels of perceived social support. Copyright © 2003 John Wiley & Sons, Ltd.     

Experiences of Biological Parents and Their Older Children in Out-of-Home Care for the First Time

This article will examine the parenting characteristics and challenges that faced a cohort of families participating in an exploratory qualitative research study. This study sought to describe the experiences and characteristics of parents whose children were placed in the child welfare system in early-to-late adolescence (ages 12–18), thus gaining an understanding of the parenting challenges faced as they were able to maintain their children in their homes for a significant portion of their lives. The families of older youths entering care for the first time described how alcohol and drug abuse impacted their relationships with children, significant others, jobs, and their mental health status. A significant issue that emerged in several of the cases were older children who initiated a report to child welfare themselves.     

Child Maltreatment, Abortion Availability, and Economic Conditions

Child maltreatment is a substantial problem in the U.S. yet has received relatively little attention from economists. This article examines the relationship between abortion availability and economic factors at the time children were conceived and subsequent measures of child maltreatment in the U.S. as well as the influence of contemporaneous economic conditions. Our measures of child maltreatment are state-level rates of child abuse and neglect reports, the fraction of children receiving social services, and child deaths and murders. The results indicate that legalized abortion for each successive cohort led to a decline in total reported incidents of child abuse and neglect of about 10 percent and a negative effect on the fraction of children receiving social services. Child deaths and murders are not related to abortion legalization. Medicaid funding restrictions are associated with an increase in substantiated reports of abuse and an increase in murders by relatives or parents; other post-legalization restrictions are not consistently associated with the various measures of child maltreatment. The effects of welfare benefits, average income, and unemployment rates are mixed.     

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.     

Family Structure and Child Well‐Being: The Significance of Parental Cohabitation

Data from the 1999 National Survey of America's Families (N = 35,938) were used to examine the relationship between family structure and child well‐being. I extended prior research by including children in two‐biological‐parent cohabiting families, as well as cohabiting stepfamilies, in an investigation of the roles of economic and parental resources on behavioral and emotional problems and school engagement. Children living in two‐biological‐parent cohabiting families experience worse outcomes, on average, than those residing with two biological married parents, although among children ages 6–11, economic and parental resources attenuate these differences. Among adolescents ages 12–17, parental cohabitation is negatively associated with well‐being, regardless of the levels of these resources. Child well‐being does not significantly differ among those in cohabiting versus married stepfamilies, two‐biological‐parent cohabiting families versus cohabiting stepfamilies, or either type of cohabiting family versus single‐mother families.     

Describing the context and nature of emotional maltreatment reports in children

The circumstances leading to reports of emotional maltreatment are potentially unique from those of other abuse types. This study utilized data from the National Child Abuse and Neglect Data System (NCANDS), which is a federally sponsored effort requiring the submission of case-level data on all children who were subject to maltreatment investigations by state child welfare agencies. The central aims of this study were to examine case-level characteristics of sole occurrences of emotional maltreatment Child Protective Service (CPS) reports in an effort to address how caregiver and child risk correlates affect the substantiation of these allegations. A cluster analysis was performed to explore how the risk assessment factors grouped together; secondarily, the cluster groupings were examined in a logistic regression model to measure factors associated with substantiation of these abuse reports. Four unique clusters emerged, with one cluster absent any risk assessment factors entirely and another cluster solely composed of domestic violence. Caregiver risk factors with the highest odds of predicting report substantiation included caregiver substance abuse, domestic violence, and caregiver learning disabilities.     

Child-Parent Relationship Therapy with Extra-Familial Abused Children

Sexual abuse by a perpetrator outside of the family is the most prevalent form of child sexual abuse. It is associated with serious consequences for both the child and his family. Surprisingly, however, the issue of extra-familial sexual abuse has received very little research and clinical attention. The purpose of the current study was to explore the effectiveness of Child-Parent Relationship Therapy (CPRT), which uses nondirective play therapy tools, among parents of extra-familial abused children and their parents. In order to do so, data was collected from 51 parents who participated in CPRT, at three points in time: pretreatment stage, at the beginning of the first meeting; and in the post treatment stage. The data included the parents’ reports via three questionnaires: Parenting Stress Inventory (PSI), Compassion Fatigue Self-Test (CFST), Child Behavior Checklist (CBCL). Overall, the results indicated a decrease in internalizing and externalizing symptoms among the children, as well as in parenting stress and in parental secondary trauma symptoms. This study contributes to the literature on interventions with victims of extra-familial child abuse and their parents. Specifically, the results highlight the benefits and importance of involving both parents and children in therapeutic interventions for victims of extra-familial child sexual abuse, with particular emphasis on the benefits of Child-Parent Relationship Therapy.     

Parental mental health as a child protection issue: data from the NSPCC national child protection helpline

Analysis of a sample of 2084 child abuse referrals to the NSPCC Child Protection Helpline showed that in 10% a parent or carer was reported as having a mental health problem. Mothers were the parent affected in the majority of these cases. The mental health sample differed from the other referrals in an increased concern about emotional abuse and less about sexual abuse; greater levels of violence and discord between parents; and more agency involvement. Issues of potential labelling and therapeutic needs are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

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.     

Cross‐examination,sexual abuse and child witness identity

This paper presents extracts from cross‐examinations with child witnesses who are alleged victims of child sexual abuse. The manner in which cross‐examination may present a challenge to the child's identity as child, victim and witness is discussed. Specifically, the child may be portrayed as ‘unchildlike’, for example in their experience of sexual relationships or in their sexual knowledge. They may be portrayed as less than innocent, through references to previous contacts with social services or to other behaviours such as delinquency. Child witnesses may be depicted as instigators rather than victims, seducing the adult or seeking revenge through sexual allegations. Finally, children are easily accused of being poor witnesses, as being confused, untruthful and having fallible memories. The paper considers the dynamics and potential impact of such cross‐examination practice within Finkelhor's framework of four traumagenics of sexual abuse: traumatic sexualization, betrayal, powerlessness and stigmatization. The potential for poorly conducted cross‐examinations to create further problems for child witnesses, particularly in the area of identity, is highlighted, and it is suggested traumagenic factors in such cross‐examinations may resemble those of abuse. The paper discusses practice implications for cross‐examination, judicial intervention and witness support following implementation of the Youth Justice and Criminal Evidence Act 1999 in England and Wales. Copyright © 2002 John Wiley & Sons, Ltd.     

Where now for ‘child protection’ in Scotland?

In common with the rest of the UK, child care and protection practice in Scotland has undergone unprecedented change over the last ten years, including a wide‐ranging three‐year Child Protection Reform Programme. In 2006, The University of Dundee's Centre for Child Care and Protection and Barnardo's Scotland Research and Development team were commissioned by the then Scottish Executive to undertake a process review of the Child Protection Reform Programme (Daniel et al., 2007 ). Drawing on findings from the process review, this article considers the impact of the Child Protection Reform Programme. The process review concluded that, in the view of the respondents, the Child Protection Reform Programme made a substantive contribution towards the improvement and delivery of child protection services in Scotland, particularly in terms of raising awareness and increased multi‐agency working. It was beyond the scope of the review to measure outcomes for children as a result of the reforms. Since the completion of the Child Protection Reform Programme, national policy emphasis has broadened from ‘child protection’ towards integrated support for children under the Getting it Right for Every Child reforms of children's services. The paper concludes with a discussion around where ‘child protection’ now fits within this context of universal support for children and argues that there is a need to ensure that the valuable work which was done to improve child protection services in Scotland under the Child Protection Reform Programme is not lost. Copyright © 2010 John Wiley & Sons, Ltd.     

Conscription of children in armed conflict—a form of child abuse. A study of 19 former child soldiers

Armed combat in childhood is a form of child abuse. It may lead to serious consequences, including post‐traumatic stress disorder. The inherent emotional abuse and acts or omissions by caregivers may cause behavioural, cognitive, emotional or mental disorder in the child. Nineteen former child soldiers were interviewed in a rehabilitation centre using a standard questionnaire. Reasons for recruitment included: volunteered (18), hatred of enemy (revenge) (5), virtue of being a freedom fighter (martyrdom) (9), as a means of supporting their family (economic) (3). One child was abducted, 7 joined for fear of the ‘enemy’ abducting them, and in 5 a family member was killed by ‘enemy’ or own group. The children were involved in manual labour (15), guard duty (15), front‐line fighting (7), bomb manufacture (5), setting sea/land mines (5) and radio and communication (2). Fifteen were trained in firearms and 14 in self‐destruction. Twelve children attempted to or did run away and 11 refused to obey orders or argued. This led to various punishments, including kitchen duty, beatings, imprisonment, blackmail or death threats. A majority of the children felt sad and emotionally upset when they remembered their mother and family. Children's involvement in war, whatever the ‘justifications’ may be, should always be considered as forced, as they cannot truly comprehend their action in war. The responsibility must be taken by the adult caregivers. The following definition of the abuse of children in armed conflict is proposed: ‘The involvement of dependent, developmentally immature children and adolescents in armed conflict they do not truly comprehend, to which they are unable to give informed consent, and which adversely affects the child's right to unhindered growth and identity as a child’. Firm international agreement on guidelines for the lower age limit of recruitment of children into armed forces is required. Copyright © 2001 John Wiley & Sons, Ltd.     

Domestic Violence and Intergenerational Rates of Child Sexual Abuse: A Case Record Analysis

Using case review at a shelter for battered women and their children, this exploratory study investigated the association between physical abuse, exposure to domestic violence and intergenerational occurrence of child sexual abuse. The charts of 570 children were reviewed in an attempt to explore the relationship between the children's experiences with sexual abuse and their nonoffending parent's own history of having been sexually abused. Results indicated that a significant percentage of nonoffending parents who reported a history of child sexual abuse also had children who were sexually abused. Additionally, we found that most (93%) of the children studied had been exposed to domestic violence, and while the base rate of sexual abuse was relatively low (11%), the rate of physical abuse of the children was substantial (41%). Logistic regression results indicated that children of sexually abused nonoffending parents may be at heightened risk for sexual abuse. Implications for treatment and intervention are discussed.     

Children's response to the medical visit for allegations of sexual abuse: maternal perceptions and predicting variables

This study examined maternal perceptions of their child's response to the medical evaluation for alleged sexual abuse. A total of 50 mothers were interviewed 6 months after a visit to a Child Protection Clinic for a medical evaluation of alleged sexual abuse. The mothers answered a questionnaire on their child's reactions to the medical visit. More than 60% of children were perceived as being reassured about physical integrity. The degree of psychological distress was independent of perpetrator's identity and severity of the abuse. Mothers considered that a hypothetical second visit would generate in their child a level of anxiety that increased with perceived intensity of fear of the examination and decreased with perceived kindness of the physician. These results suggest that the physician's behaviour during the medical evaluation for alleged sexual abuse has an influence on the child's degree of distress that is independent of type and severity of abuse. Copyright © 2001 John Wiley & Sons, Ltd.     

The Role of Early Maladaptive Schemas in the Appearance of Psychological Symptomatology in Adult Women Victims of Child Abuse

ABSTRACT

Child abuse affects people’s ways of thinking, feeling, and observing the world, resulting in dysfunctional beliefs and maladaptive schemas. Thus, consequences of child abuse may persist during adulthood. Therefore, the aim of this study was to analyze the psychological consequences (anxiety, phobic anxiety, depression, and hopelessness) of different types of maltreatment (physical, sexual, and emotional abuse and physical and emotional neglect) and to study the role of early maladaptive schemas in the onset of symptomatology in adult female victims of child abuse. The sample consisted of 75 women referred by associations for treatment of abuse and maltreatment in childhood. Sexual abuse was the type of maltreatment that was most strongly related to most dysfunctional symptomatology, followed by emotional abuse and physical abuse, whereas physical neglect was the least related. Also, early maladaptive schemas were found to correlate with child abuse and dysfunctional symptomatology. Finally, early maladaptive schemas mediated the relationship between sexual abuse and dysfunctional symptomatology when the effect of other types of abuse was controlled. These results may provide important guidance for clinical intervention.     

Parental Depression and Child Outcomes: The Mediating Effects of Abuse and Neglect

Using longitudinal data on 1,813 children and parents from a nationally representative child‐welfare sample, National Survey of Child and Adolescent Well‐Being (NSCAW), this study investigated physically abusive and neglectful parenting as mediating the effects of parent depression on child mental health by developmental stage. Findings from latent growth models indicated that parental depression had a significant impact on child outcomes for all youths, but of the 2 types of parenting behaviors, only neglectful parenting mediated the relationship for preschool and school‐aged children. Neither parenting behavior mediated the effects of parental depression for adolescents.     

Family Characteristics and Structure as Determinants of Sexual Abuse Among Female Secondary School Students in Nigeria: A Brief Report

ABSTRACT

Child sexual abuse is associated with factors that enhance the vulnerability of the child, raising physical and mental health complications in adulthood. Three hundred and fifty students participated in this cross-sectional study. Important determinants of sexual abuse were parents not living together, not living with parents, family type, and current parents’ marital status (p < 0.05). Respondents living with both parents were two times less likely to experience sexual abuse (OR = 0.5, CI: 0.3, 0.9) than respondents living with their guardians. Respondents whose parents were living together were about two times less likely to experience sexual abuse (OR = 0.6, CI: 0.3–0.9) than respondents whose parents were not living together. Respondents whose parents were either divorced or separated were about six times more likely to experience sexual abuse (OR = 5.6, CI: 1.1–27.2) than respondents with widowed parents. The study showed that parental togetherness protected against child vulnerability and risk of being sexually abused.     

An Overview of a Hospital-Based Child Advocacy Center’s Experience from Turkey

The purpose of the present study was to investigate sociodemographic variables, features of sexual abuse (SA), and first psychiatric evaluation results of abused children, and to analyze the relation of the psychiatric evaluation results to the children’s age and gender, type and duration of abuse, abuser–child relationship, and marital status of the children’s parents, at one of the most experienced Child Advocacy Centers (CACs) in Turkey. All data were obtained from reports prepared by child and adolescent psychiatrists. The sample of this study consists of 436 child sexual abuse (CSA) cases who admitted ?zmir CAC between April 2014 and November 2015. The statistical analyses yielded significant relations between psychiatric symptoms and chronic abuse, the gender of the children, and type of abuse. Suicidal ideation and behaviors due to sexual abuse (SA) were also examined. According to our results, it is fair to say that children exposed to SA benefit from immediate psychiatric help because of their vulnerability for psychiatric disorders due to abuse. In this context, CACs are very important multidisciplinary establishments to determine children’s multiple needs to ease their trauma with collaborative teamwork. Psychiatric evaluation should be part of this multidisciplinary context.