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.     

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 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.     

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.     

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.     

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.     

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.     

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.     

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.     

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.     

Child maltreatment in China: An ecological review of the literature

This article presents findings of a systematic review of empirical studies on child maltreatment in China that were published in either English or Chinese. The review uses Bronfenbrenner's ecological systems theory as a lens to examine risk and protective factors of child maltreatment within micro-, meso-, exo-, macro-, and chrono- system levels. A search of 5 electronic bibliographic databases and websites identified 24 outcome studies on child maltreatment in China, which included studies that examined physical/emotional/sexual abuse, and neglect. The most direct influences of child maltreatment in the micro-level system include the parent-child relationship and intergenerational transmission of abuse. At the macro-system level, maltreatment is explained by cultural values such as filial piety and familism. In essence, different factors are found within the various system levels that indicate the complexities of the factors that influence child maltreatment. Throughout the article, we highlight the need to understand the cultural dynamics, values, and mores of Chinese families. The discussion includes practical suggestions and implications for intervention with children, parents, and grandparents that school teachers, social workers, policy makers, and researchers can utilize.     

Emotional harm and neglect: the legal response

This paper reports on a study of the extent to which child protection applications brought to the Melbourne Children's Court in Victoria, Australia, were based on emotional/psychological harm or neglect of a child and what factors were presented as evidence of harm or neglect. The study examined records of 208 court‐ordered pre‐trial conferences heard in the court between February and July 2002. What was found was that, although cases involving emotional abuse have increased in terms of child protection applications, they remain cases that are difficult to decide. While in 1998/9 emotional harm was a ground in 25.7% of child protection matters completed in the Family Division of the Children's Court of Victoria, legal decision‐makers are reluctant to make a finding of child abuse in these cases because there is less accuracy in the determination of emotional harm and negligible legal criteria available to guide decision‐making. Copyright © 2006 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.     

Family characteristics of children in cases of alleged abuse and neglect

Information is presented about the family composition, structure and significant relationships of 2069 children referred to an English social services department for suspected abuse and neglect. Of these children, 373 (18%) were subsequently placed on the child abuse register. Very few members of extended families were recorded as being significant in the lives of these children. Contrary to earlier research, less than one‐third of children lived with a lone or unmarried mother. However, children whose parents were married and living together were less likely to be registered. Nearly half of the mothers and one‐fifth of the fathers of registered children were aged 21 or less at their child's birth. Compared to all those referred, a significantly larger number of children registered were conceived by younger or older men. Two in five of the siblings of registered children were under 6, and the younger the siblings, the more likely the child was to be registered. Children with two or more siblings were also more likely to be registered. Copyright © 1999 John Wiley & Sons, Ltd.     

Multi‐type maltreatment and the long‐term adjustment of adults

Multi‐type maltreatment refers to the experience of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence). Researchers have largely ignored the presence of other types of child abuse and neglect when examining the adjustment problems associated with a particular form of maltreatment. The association between ‘multi‐type maltreatment’ and adjustment was explored in the current study. Retrospective data were obtained on (a) the degree to which maltreatment types co‐occurred, (b) childhood family characteristics and (c) adjustment problems in adulthood in an Australian self‐selected community sample (N=175). As hypothesized, a large degree of overlap was reported in the experience of the five types of maltreatment. Family characteristics—particularly family cohesion and adaptability—discriminated between respondents reporting single‐type and multi‐type maltreatment. Greater adjustment problems were associated with reports of a larger number of different maltreatment types. Multi‐type maltreatment should be recognized as a crucial aspect of the nature and impact of child maltreatment and considered in the development of programmes for the prevention and treatment of child abuse and neglect. Copyright © 2000 John Wiley & Sons, Ltd.     

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.     

Profiles of adult survivors of severe sexual,physical and emotional institutional abuse in Ireland

Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for Disorders of the Diagnostic and Statistical Manual of Mental Disorders IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups that described severe sexual (N = 60), physical (N = 102), or emotional (N = 85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterised by higher rates of all forms of child maltreatment and higher rates of post‐traumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms and life problems. Survivors of severe emotional abuse were better adjusted than the other two groups. The profile of survivors of severe physical abuse occupied an intermediate position between the other two groups. A thorough assessment of abuse history and current functioning should be conducted when providing services to adult survivors of institutional abuse, since this may have important implications for the intensity of services required. Survivors of severe sexual abuse may require more intensive services. Copyright © 2009 John Wiley & Sons, Ltd.     

Development of a framework for classifying threat and neglect in childhood: A qualitative study

Quantification of childhood adversity has typically involved a cumulative risk approach in which total number of discrete adversities serves as an index of overall risk. However, this approach fails to account for the growing evidence of differential outcomes following exposure to childhood adversities. An alternative approach adopts a dimensional perspective, with growing evidence for distinct developmental impacts associated with exposure to threat (violence/abuse) and deprivation (neglect). This study developed a framework for the classification of these dimensions through a thematic analysis of health practitioners' views and accounts of different forms of childhood adversity. Ten health practitioners experienced in working with children with challenging behaviours and neurodevelopmental disorders participated in semi-structured interviews regarding definitions and examples of six categories of adversity: physical/emotional/sexual abuse, physical/emotional neglect, and domestic and family violence. The qualitative analysis identified 23 themes across the six categories of adversity, along with two overarching themes regarding ambiguity of classifying exposures and non-specific outcomes of exposures. Themes were integrated to provide a framework and checklist for classifying indicators of exposure to threat and deprivation. The findings offer a framework and checklist for the assessment of threat and deprivation that will allow for further testing of the dimensional risk model.