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.     

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.     

Child deaths attributed to abuse and neglect: An empirical study

This study of 267 child deaths associated with abuse or neglect in Texas during 1975 through 1977 suggests a number of indicators for identifying potential child fatalities. Families where abuse or neglect is implicated in a child fatality are characterized by small family size, young parents, and under-utilization of community support services. Over three-fourths of the families in the study had never come to the attention of the state's child protective services agency. In addition, when fathers were present in the home, they were as likely to be involved in the abuse or neglect as mothers. Neglect was implicated in the death of a child as often as abuse. The study suggests the need for further examination of child fatality profiles associated with abuse and neglect and increased community outreach efforts to provide support to high-risk families, The study also has implications for social policy decisions, particularly in relation to efforts to resist attempts to exclude neglect from child protective service responsibility.     

Child sexual abuse programs: Recommendation for refinement and study

Child assault prevention programs have increasingly been instituted in school systems throughout the country. this paper reviews and summarizes research findings on child abuse, child abuse prevention programs, and evaluations of child abuse prevention programs. In addition, the author presents issues for program developers to consider as they re-examine and refine existing child abuse prevention programs.     

Early indicators of child abuse and neglect: a multi‐professional Delphi study

Through the application of the Delphi technique, this study draws on the expertise of British child protection academics and practitioners from a wide range of disciplines in seeking to develop a consensus opinion on possible early indicators of child abuse and neglect. The search for early indicators is described in the context of a secondary preventative approach to the problem of child maltreatment. A very tentative conclusion arising from the study is that the early indicators of child abuse and neglect that achieved consensus of agreement may help in diagnosing child abuse and neglect at an earlier stage, although they are not necessarily diagnostic. Alternative explanations, differential diagnoses and information‐gathering are paramount, as is a willingness and ability to act on concerns. Although great caution is urged, it is suggested that the findings from the study are credible and of interest to those who are working towards more timely recognition and referral of abused and neglected children. Copyright © 2003 John Wiley & Sons, Ltd.     

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.     

Federal dissemination of child abuse and neglect information

This review examines the recent history of efforts at the federal level to disseminate child abuse and neglect information and describes current challenges to these endeavors. Two dissemination models are defined as are the problems associated with the adaptation of those models. Finally, general principles for transmitting information and the processes involved in such transmission are reviewed.     

A multidimensional inventory for assessment of parental functioning

This paper reports on the psychometric properties of a multidimensional inventory battery for the evaluation of the parenting behavior of participants in family support programs. This inventory was administered to 693 voluntarily enrolled participants in five family support programs aimed at reducing child abuse and neglect. The components of the inventory assess key aspects of parenting behavior as defined by ecological theories of human development. Included are measures of depression, parental knowledge of child developmental milestones, parental attitudes toward childrearing, and social support available to and used by the family unit. Response burden, internal consistency of each measure, and content, criterion, and construct validity are examined. The results show that the inventory can be administered in field settings with minimum disruption of service activities. Two of the four measures achieved satisfactory reliability and convergent validity (i.e., the depression scale and social support scale). Assessment of construct validity yielded results in accord with the ecological model of child development and family function.     

Child abuse and neglect in North Carolina day care programs

A study of child abuse and neglect complaints in child day care programs revealed factors affecting the filing of complaints, as well as problems with the investigation of complaints filed with the North Carolina Office of Child Day Care Licensing. The authors specify the cause of the problems and offer recommendations for improvement.     

Defining child abuse in Hong Kong

Definitions of child abuse are culturally driven. Hong Kong, with a predominantly Chinese population, has managed to eradicate much of the societal abuse that children suffer elsewhere in Asia. Professional and government attention has now shifted to child abuse and neglect within the family. The paper, based on interviews with key professionals. analysis of policy documents and practice records examines traditional Chinese parent-child relationships. the status of parental authority and corporal punishment and changes in contemporary Hong Kong family life. It goes on to outline the development of responses to child abuse in Hong Kong, some of the dilemmas that professionals face in defining abuse and areas for future research.     

Street Children in Nairobi and the African Cultural Ideology of Kin-Based Support System. Change and Challenge

Poverty, rapid urbanization, population growth rate, family instability and the declining role of the extended family system are among the key factors responsible for the prevalence of child abuse and neglect in Nairobi. In this state of flux, cases of children who have been battered, abandoned, abused and neglected by their families or displaced as a result of armed conflict in the region have increased at an astounding pace over the past several years. One out of every three children from poor urban families in Kenya is regularly battered or subjected to other forms of maltreatment by a parent or other family members, the public and the authorities. Basically, there are two levels of abuse and neglect. There is abuse and neglect which children experience at home and which drives them onto the streets. There is also abuse and neglect which street children endure while on the streets. This paper discusses some of the ways in which abuse and neglect affect the lives of street children and families. It also highlights the plight of a sample of street children as exemplified by the kinds of difficulties which they endure while on the street. © 1997 John Wiley & Sons, Ltd.     

Preservice Teachers’ Sources of Information on Mandatory Reporting of Child Sexual Abuse

Teachers in many countries are mandated by law, professional codes, or education authorities to report child abuse and neglect, including child sexual abuse. However, teachers may not receive adequate preparation for such sensitive interventions, as preservice teacher education degrees provide very few or no compulsory courses on child protection and crucially related, lifelong health and well-being issues. So, where do preservice teachers source their information regarding the mandatory reporting of such abuse? This research examines preservice teachers’ professional university education for their sources of information about mandatory reporting and child sexual abuse. A sample cohort of 56 final 4th-year university bachelor of education (primary school) student teachers in Australia identified the sources they used regarding 10 important aspects of child protection. The results suggest that most did not learn about mandatory reporting or child sexual abuse, and others cited sparse and sporadic public media as their primary information source. These findings, building on previous evidence about inadequate or nonexistent preservice mandatory intervention courses in primary teacher education, may guide the design of appropriate training responses enhancing educational professionals’ knowledge, competencies, skills, and efficacies as mandatory reporters of child sexual abuse.     

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

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

Understanding "elder abuse and neglect": a critique of assumptions underpinning responses to the mistreatment and neglect of older people

This article provides an overview of the ways in which the mistreatment and neglect of older people have come to be understood as a social problem, one which is underpinned by a variety of substantive and theoretical assumptions. It connects the process of conceptualizing elder abuse and neglect to political-economic and social evolution. The authors draw on a review of the literature, government sources, interest group websites, and their own research to provide a critical commentary illustrating how these understandings have become manifest in legislation, policies, and programs pertaining to "elder abuse and neglect" in Canada. Suggestions are provided for changes in direction for policies, programs, and research.     

Fatal child neglect

This study examined the circumstances associated with fatal child neglect in one state to differentiate fatal child neglect from fatal physical abuse and from other types of neglect that are not life-threatening. The typical neglect fatality was a male child, younger than three, living with his mother and two or three siblings. The fatalities from physical abuse were characterized by deliberate, hostile acts on the part of a caregiver, but in the vast majority of fatalities from neglect, a caregiver was simply not there at a critical moment.     

Pathways Linking Childhood Maltreatment and Adolescent Sexual Risk Behaviors: The Role of Attachment Security

Previous research has shown an association between child maltreatment (sexual abuse, physical abuse, neglect, or witnessing interparental violence) and adolescent sexual risk behaviors (SRBs). The mechanisms explaining this association are not well understood, but attachment theory could provide further insight into them. This study examined the relationships between child maltreatment and SRBs and investigated anxious and avoidant attachment as mediators. The sample comprised 1,900 sexually active adolescents (13 to 17 years old; 60.8% girls) attending Quebec high schools. The results of path analyses indicated that neglect was associated with a higher number of sexual partners, casual sexual behavior, and being younger at first intercourse. Anxious attachment mediated the relation between neglect and number of sexual partners, whereas avoidant attachment explained the relation between neglect and number of sexual partners, casual sexual behavior, and age at first intercourse (for boys only). Sexual abuse was directly associated with all three SRBs. Neither anxious attachment nor avoidant attachment mediated these associations. Youth with a history of neglect and sexual abuse represent a vulnerable population that is likely to engage in SRBs. Interventions designed to induce a positive change in attachment security may reduce SRBs among victims of neglect.     

Can child fatalities,end product of child abuse,be prevented?

Study of a sample of child abuse/neglect families where a child fatality has occurred suggests several indicators for identifying potential child fatalities. In contrast to families where child abuse is not followed by a child fatality, child abuse cases where a fatality does occur are characterized by abuse of more than one child in the family, a more chaotic family constellation, the mother as perpetrator of the abuse, and high levels of both human and milieu stress. The study also identifies gaps in services to sample families and suggests changes.     

Computerizing protective services intake expertise: Preliminary research

Decision making at child welfare intake has been the subject of considerable investigation for the last thirty years. Previous reserach on the dynamics of abuse and neglect resulted in complexity and inconsistency to the extent that research moved away from determining the relevant information for creating a more structured decision making process. Recent developments in knowledge engineering and computerized expert systems provide new tools for examining protective services intake decision making. These tools are appropriate for organizing the vast amount of information workers use during decision making, extracting decisions from that information, and presenting the decisions and their supporting logic. This research examines existing expertise with a small sample of child welfare experts to determine the feasibility of developing an expert system for supporting intake decisions.     

Using benefit-cost analysis to assess child abuse prevention and intervention programs.

Benefits and costs are discussed when child abuse prevention and intervention programs are proposed and evaluated, but systemic benefit-cost analysis as developed by economists has not been applied to such programs. This article presents the case for using benefit-cost analysis to structure evaluations of child abuse prevention and intervention programs. It presents the basic concept of benefit-cost analysis, its application in the context of assessing these types of child welfare programs, and limitations on its application to social service programs.