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.     

Promising practices in understanding and treating child neglect

Child neglect is the most common type of child maltreatment in the United States. However, services provided to families who neglect often fail to address and treat the primary concerns associated with child neglect. The information provided in this paper identifies the primary problems contributing to child neglect, and some promising practices in child welfare casework that address these problems and show positive outcomes for the children and families who experience child neglect. Knowledge pertaining to assessment skills, treatment abilities, and model programmes is provided.     

Addressing common forms of child maltreatment: evidence‐informed interventions and gaps in current knowledge

This paper reviews interventions for preventing the occurrence and recurrence of major types of child maltreatment. We begin with an overview of the challenges of establishing evidence‐based interventions to prevent child abuse and neglect in many countries, and underscore the importance of this need with child maltreatment incidence rates in the USA, and how much each type and subtype contribute to child out‐of‐home placement. Next, we identify the well‐supported, supported and promising interventions for each child maltreatment type and subtype, according to their level of research evidence using an evidence‐based clearing house. The paper closes with a discussion of the implications for practice, evaluation, policy and agency management, including intervention knowledge gaps that showcase areas that need additional practice research.     

Enablers of help‐seeking for deaf and disabled children following abuse and barriers to protection: a qualitative study

Research internationally has highlighted the increased vulnerability of deaf or disabled children to abuse and the frequently inadequate response of services. However, first‐hand accounts of deaf or disabled children have rarely been sought. This paper reports selected findings from one of the first studies exploring experiences of deaf and disabled children regarding help‐seeking following maltreatment. Innovative and sensitive research methods were employed to support 10 deaf or disabled people (children and adults) to take part in guided conversations. The study identifies three enablers of help‐seeking of deaf or disabled children: the capacity of adults to detect abuse and respond to disclosures, supportive relationships or circumstances which facilitate disclosure and for Deaf children, access to registered interpreters. Barriers to protection related to these are also discussed. Recommendations directed at policy makers, practitioners and families include education and awareness raising amongst practitioners, children, parents and carers; addressing isolation of deaf and disabled children; providing comprehensive support services that address the needs of the child holistically; ensuring that the voice of the child is heard; routine access to registered interpreters for Deaf children within mainstream and specialist services and measures to address disablism at local and institutional levels.     

The effectiveness of selected interventions for previous maltreatment: enhancing the well-being of children who live at home

The authors critically assessed reviews of the literature published between 1984 and 2002 to describe the state‐of‐knowledge about the effectiveness of interventions aimed at protecting or improving the welfare of child victims of maltreatment and who remain in the family home. The interventions studied target children, parents or families. They chiefly involve cases of sexual abuse, physical abuse or neglect; very few concern psychological abuse or exposure to violence. For the most part, the intervention effectiveness indicators measure changes in parents’ and children's knowledge (e.g. better knowledge of child development), attitude (e.g. gains in enthusiasm), emotion (e.g. decreased anxiety) and behaviour (e.g. decreased rates of aversive behaviours). Few assessments follow up on participants to determine whether the changes are lasting. The small number of evaluative studies, methodological limitations and disparities in the content and the carrying out of interventions make it difficult to draw sound conclusions about the effectiveness of interventions, even for interventions most often and most favourably assessed, such as behavioural and cognitive‐behavioural interventions with maltreating parents. Implications for practice, research and policy are underlined.     

Attitudes of Palestinian pre‐school teachers from Israel towards reporting of suspected cases of child abuse and neglect

The paper documents a study conducted among 225 Palestinian pre‐school teachers from Israel. Data were collected through a self‐administered questionnaire that examined the teachers’ attitudes towards reporting child abuse and neglect. In general, the participants’ attitudes towards reporting child abuse and neglect to the child protection services (CPS) were more positive than their attitudes towards reporting to the police. Willingness to report suspected cases of child sexual abuse to the police and CPS was higher than willingness to report other types of child abuse and neglect. Inconsistent results were revealed with regard to how awareness of reporting regulations and awareness of signs and risk factors for child maltreatment affect willingness to report to CPS and to the police. A comprehensive discussion of the possible relevance of the participants’ socio‐cultural and sociopolitical values to their attitudes towards reporting child abuse and neglect is presented. The implications of the results for future studies are also discussed.     

Child care subsidy and child maltreatment

This study examined the relationship between receipt of child care subsidies and child maltreatment investigations in a sample of low‐income mothers in Illinois. We expected that receiving child care subsidies would have a protective effect on child maltreatment risk and therefore decrease the likelihood of child protective services investigations. Using structural equation modelling, we tested the direct and indirect paths of the receipt of child care subsidies to physical abuse or neglect. We found only direct effects of receiving child care subsidies on both physical abuse and neglect investigations. The findings suggest an important protective role of child care subsidies in the lives of low‐income families.     

Research Review: Child protection referrals and minority ethnic children and families

This paper reviews the research on the referral of minority ethnic children to child and family social work teams because of child protection concerns. Specifically, it focuses on those studies that have researched the referral stage of the child ‘in need’ and child protection systems, and explored differences in patterns of referral between the main ethnic groups that make up the UK population.     

Patterns and correlates of co‐occurrence among multiple types of child maltreatment

This study examined the patterns and correlates of the types of maltreatment experienced by adolescents aged 9–12, participating in an ongoing longitudinal study on the impact of neglect on children's development. Using case record abstraction, the study compared the child protection classification and findings from the case record abstraction with regard to the rates of four types of maltreatment (i.e. physical, sexual, emotional abuse and neglect) as well as co‐occurrence across multiple types of maltreatment. Next, the study examined the frequently observed patterns of child maltreatment. Finally, the study investigated whether aspects of caretaker functioning and the detailed incident characteristics in the cases of neglect differed by the number of different types of maltreatment the children experienced. Results showed significant discrepancies between the Child Protective Service classification and case record abstraction. Child Protective Service classification considerably underestimated the rate of co‐occurrence across multiple types of maltreatment. Neglect accompanied by physical and emotional abuse was the most common form. Some of the caretaker functioning variables distinguished the number of types of maltreatment. Based on the findings, future‐research directions and practice implication were discussed.     

Understanding child,family, environmental and agency risk factors: findings from an analysis of significant case reviews in Scotland

This paper presents the findings from an analysis of 56 significant case reviews (SCRs) in Scotland. In contrast to England and Wales where national analyses have been undertaken for many years, until this study was undertaken, the findings from SCRs had not previously been collated nationally. The paper discusses child, parent, environmental and agency factors that were identified in the SCRs and, whilst noting that the pathways to death or harm will be unique in individual cases, tries to further our understanding of the ways in which these different factors may interact to result in death or harm. A significant finding was the high number of SCRs that relate to the care and protection of children living in families whose lives are dominated by drug use and the associated issues this brings, including criminality and neighbourhood problems. Another challenging finding was the lack of suitable resources for the placement and support of troubled teenagers. Finally, a number of SCRs involved long‐term neglect and/or sexual abuse of school or nursery age children who had been known to statutory services for many years.     

Noticing and helping the neglected child: towards an international research agenda

This systematic review examined the evidence on the extent to which practitioners are equipped to recognize and respond to the indications that a child's needs are likely to be, or are being neglected. This paper examines the methodological issues arising from the review. A systematic process of progressive filtering yielded 112 papers representing primary studies that inform the international research agenda for child neglect. A final dataset of 63 studies was of sufficient quality and usefulness for inclusion. The review raised a number of methodological issues of relevance for research in child protection in general, and on neglect in particular. Researchers and practitioners can benefit from an enhanced understanding of the issues that make neglect difficult to understand. Common issues were identified to inform future research. For example, there was a tendency for studies to use a range of proxy measures rather than direct observation of the outcome of interest, and a wide range of different outcome measures was used. Many of the studies were small scale or retrospective in design. Many studies conflated neglect and other forms of maltreatment, and it was often difficult to extract specific messages for neglect.     

Recognition of neglect and early response: overview of a systematic review of the literature

This paper summarizes the key findings from a systematic literature review that sought to identify existing evidence about the ways in which the needs of neglected children and their parents are signalled and the response to those needs. Using systematic review guidelines, 14 databases were searched for primary research studies published in English from 1995 to 2005. An initial 20 480 items were systematically filtered down to 63 papers for inclusion. The evidence suggests that, while there is little evidence about how needs for help are directly signalled, there is considerable evidence about how needs are indirectly signalled. There is evidence that professionals can identify signs of neglect, but are not always clear about the best response. There remain gaps in evidence about how best to respond to neglected needs, especially within schools.     

Responding to child maltreatment: Comparison between the USA and China

A recent study estimated that over one‐fourth of Chinese children have suffered maltreatment (Fang et al., 2015 ). However, the current child welfare policy in China is limited to orphans, abandoned children, and children with disabilities. Also, there is very little comparative research in China on Chinese and other countries’ child welfare systems. The purpose of this study was to analyze applicable US and Chinese child welfare policies, identify gaps in Chinese policy regarding child maltreatment, and make recommendations for a policy agenda for improving child welfare in China based on cultural values and existing policy structures. Results show that China has considerable capacity to make improvements in child protective services, foster care, and adoption policies. Based on the results of this study, several implications are provided to develop China's child maltreatment policy to increase children's outcomes of well‐being, safety, and permanency. Key Practitioner Message: ? To understand the background and system of current Chinese child maltreatment policy; ? To review US child maltreatment policy and its implementation to identify gaps in the Chinese child maltreatment system; ? To provide policy suggestions to develop Chinese child maltreatment policy and provide recommendations for social work education and practice in China.     

Emotional abuse and neglect: a time for reappraisal

This paper explores, from a UK perspective, issues surrounding policy and practice in cases of neglect, which inevitably involves emotional abuse. It does not address cases of emotional abuse in which neglect does not occur. The paper argues that there is a sufficient body of knowledge on the necessary conditions for healthy child development and factors associated with psychological/ emotional disorders in childhood for social workers to be more proactive in work with such cases. There is, however, a need for this evidence to be assembled and organized in ways which will be useful to social workers. Nonetheless, intervention in such cases is unlikely to become more effective unless some of the reasons for the'neglect of neglecf are better understood and addressed. In the second part of the paper, a range of factors influencing such work is considered, related to the professional, organizational and legal context within which social workers in the UK operate.
The paper draws on an ESRC funded project, which ended in 1995, of social workers' judgements in cases of child sexual abuse and neglect     

Assessment of the psychometric properties of the Graded Care Profile version 2 (GCP2) tool for measuring child neglect

Child neglect is highly prevalent, with extensive effects on children's development and often long‐lasting consequences. It is a complex issue, and the identification and assessment of neglect presents particular difficulties for professionals. The Graded Care Profile (GCP) is a tool that can help practitioners to assess neglect, but the updated version of this tool (GCP2) requires psychometric testing. We sought to test the GCP2 with qualified social work practitioners in the United Kingdom. Interrater reliability was assessed by comparing GCP2 scores between 3 pairs of practitioners following assessments of 30 children. Concurrent validity was assessed by comparing GCP2 scores to scores obtained using 2 other validated measures with 15 children. Professionals were surveyed concerning face validity. There was a substantial level of interrater agreement for 2 domains and a moderate level of agreement for the other 2 domains. There were strong correlations between the GCP2 and the other tools across all domains, and face validity results were positive. In conclusion, although this was a small sample, our findings provide preliminary evidence that the GCP2 has adequate psychometric properties pending further rigorous psychometric testing. It is thus likely to be a useful tool in aiding professionals in the assessment of child neglect.     

Improving outcomes for children in out‐of‐home care: the role of therapeutic foster care

How best to support children and young people in foster care remains a challenge for child welfare. There has been little Australian research on the outcomes for children and young people placed in therapeutic foster care (TFC). This article aims to address this knowledge gap, presenting the evaluation of a state‐wide model of TFC known as the Circle Program operating in Victoria, Australia. Data sources for the study were case assessment analysis; surveys of foster carers, program workers and other stakeholders in the sector; and both focus groups and individual interviews with foster care workers. The evaluation found that the Circle Program lessened the number of unplanned exits of children from foster placements compared with generalist foster care. Another important finding was that the Circle Program positively influenced foster carers' decisions to stay in the carer role. Key components perceived as contributing to outcomes of the Circle Program included enhanced training of foster carers, intensive carer support, specialist therapeutic support to the child and carer, therapeutic service to family members and a network of services to provide support to the child.     

A Comparison of Child Fatalities by Physical Abuse Versus Neglect: Child,Family, Service,and Worker Characteristics

ABSTRACT

In the field of child welfare, attention has been given to risk factors for child maltreatment fatalities with little attention to the difference between children who die from abuse versus neglect. As part of a larger study, child welfare workers (n = 104) from 14 different states responded to an anonymous online survey that described the child, family, and case characteristics before death and worker characteristics/experiences before and after death. Results supported that prior to death, neglectful families presented with less risk than abusive families, in the areas of parent–child attachment, child behavior problems, and changes in household composition while reporting that they received more services. With regard to child welfare practice, workers did not report any differences in how they handled cases before death nor did they report differences in their posttraumatic stress symptoms at the time of the survey. These findings can be used as a springboard for future research that focuses on fatal maltreatment.     

A Quantitative Evaluation of the Multi-Disciplinary Approach to Prevention Services (MAPS) Program to Protect Children and Strengthen Families

This article presents the results from an evaluation of a state-funded, prevention-based, pilot program called the Multi-Disciplinary Approach to Prevention Services that was designed to reduce the potential for child abuse and neglect. The program served 64 families of various races and ethnicities over two years. A quantitative pretest–posttest design was used to analyze existing program data related to client outcomes including parenting skills, parenting satisfaction, and the use of non-family resources to assist in improving skills and satisfaction. Means comparisons were used to assess the relationship between three standardized instruments (the Parenting Scale, the Eyberg Child Behavior Inventory and the Kansas Parental Satisfaction Scale). Findings indicated a statistically significant improvement regarding resource engagement by families, parenting behaviors and perceptions, and involvement with Child Protective Services. The results from this study offer insight into how to improve parenting behaviors and increase child protective factors for youth who are at risk of maltreatment. In addition, these findings contribute to strengthen the legitimacy of Weiner's Attribution Theory while providing the social work profession with additional data in areas of research targeting the intersection of financially viable prevention programs, family stability, parental education, resources engagement, and the reduction of child abuse and neglect. If additional research supports the efficacy of prevention programs such as MAPS, funding similar programs could lead to improved parenting and decreases in child maltreatment.     

Key decisions in child protection services in cases of domestic violence: maintaining services and out‐of‐home placement

This paper looks at the response of the child protection services (CPS) system in cases where exposure to domestic violence occurs alone or together with abuse or neglect, focusing on the factors involved in decisions to maintain the case open for ongoing services or remove children from the home. The study is based on an analysis of clinical and administrative data from the files on children reported to a CPS agency in Montreal, Canada. A total of 1 071 substantiated reports were documented, including 337 cases of co‐occurrence (32%). Analysis of the data shows that domestic violence does not by itself constitute a factor liable to lead to more intrusive intervention. The CPS response appears to be influenced more by the existence of other forms of maltreatment and risk factors. Additionally, while domestic violence may be associated with more severe individual and family problems, it does not influence the decision to keep the case open because the child still need services. The lack of any connection between domestic violence and this decision is a cause for concern, as results indicate that such families need help. Knowing how to respond to their needs therefore remains a major challenge.