Predictors of Treatment Engagement for Young Children Exposed to Violence

This study examined factors associated with treatment engagement and child outcomes in 1,365 children receiving community-based services for exposure to violence. Data were collected on children and families who completed an intake interview. Children were categorized into groups based on whether they attended any therapy sessions after the intake, terminated prematurely from therapy, or completed treatment. Results demonstrated that child emotional and behavioral problems at intake, general parent stress, and income did not differ by treatment engagement. Type of violence exposure, parent–child stress, and race differed by category of treatment engagement. Strategies from Safe From the Start service providers to increase treatment engagement are included in the discussion.     

Next Steps in Research on Children Exposed to Domestic Violence

The papers in this special issue of Clinical Child and Family Psychology Review provided an overview of what is known about children's exposure to domestic violence, and include indications of gaps in extant research. These gaps and research needs are summarized in this conclusion. Specifically, there is need for further research in several broad areas: definition and measurement of children's exposure to domestic violence; development of research methods and statistical designs that provide detailed information and provide for evidence of intervention effectiveness; impact of domestic violence on parenting and family functioning; the role of child factors and exposure to violence factors in predicting developmental risk and resilience; medical and health consequences of exposure to violence; and the nature of child-system interaction in response to domestic violence. Research needs in these areas are discussed in greater detail, and specific questions are raised for further development.     

Posttraumatic Response and Children Exposed to Parental Violence

Summary

In this article some of the literature on children's responses to natural and person-created trauma are discussed. In addition, data relevant to children's posttraumatic response as a result of exposure to interparental violence are presented. Using a factor analytic procedure, the study attempted to examine how the DSM-IV symptom clusters for Posttraumatic Stress Disorder come together for this sample of children. General suggestions are made regarding possible intervention with exposed children experiencing posttraumatic symptoms.     

Children Exposed to Domestic Violence and Child Abuse: Terminology and Taxonomy

Three definitional issues regarding children exposed to domestic violence are examined. First, the multiple ways in which a child can be exposed to violence is discussed. A taxonomy of 10 types of exposure is proposed. Nine key characteristics of domestic violence, as they relate to children and children's exposure, are then outlined. The third issue addressed concerns why children who are exposed to domestic violence can be considered victims of child maltreatment. These children, by nature of their experience in the home, are psychologically maltreated and are also at high risk for physical abuse and some risk for sexual abuse. Empirical questions concerning these definitions and taxonomies and their interrelations are discussed.     

Children Exposed to Community Violence: The Rationale for Early Intervention

Children are exposed to violence in their homes and communities at extraordinarily high rates. Given the alarming rates of exposure and its known impact on child developmental outcomes, crisis intervention geared at interrupting the negative effects of violence exposure are increasingly important. This review provides a rationale for the implementation of early and crisis intervention strategies for children exposed to community violence and recommends principles for applying these interventions. These principles are based on the body of research concerning risk and protective factors for children who have been exposed to violence. Relevant factors are reviewed and recommended principles are explicated that correlate to these factors. Issues concerning developmentally informed crisis intervention, support of parental executive functioning, and the need for active community partnership to help ameliorate risk factors are highlighted.     

Reading and Phonological Awareness Skills in Children Exposed to Domestic Violence

This study examined whether children exposed to domestic violence perform worse on tests of reading and phonological awareness than children from nonviolent homes. Forty children, ages 6 to 9 years, were divided into control or domestic violence groups based on their mothers' responses on the revised Conflict Tactics Scales (CTS2). The groups were matched on age, gender, nonverbal IQ, and socioeconomic status. The domestic violence group performed worse than the control group on all measures of reading and phonological awareness. Significantly more children in the domestic violence group were identified as having reading difficulties compared to the control group. The results suggest that domestic violence may negatively impact children's reading skills, and appropriate intervention techniques should be developed.     

Assessment and Intervention for PTSD in Children Exposed to Violence

Summary

Recent research has established that exposure to domestic violence is a major risk factor for posttraumatic stress disorder (PTSD) in children. However, one issue that has been relatively neglected in research conducted to date concerns developmental differences: both in the expression of PTSD symptoms across childhood and adolescence, and in the techniques appropriate for assessing and intervening with PTSD in children at different ages. The available literature is reviewed concerning the conceptualization, measurement, and treatment of PTSD in children, with special attention to the case of children of battered women. Guidelines are provided for developmentally sensitive approaches to assessment and treatment.     

Next Steps in Research on Children Exposed to Community Violence or War/Terrorism

The articles in this special issue of Clinical Child and Family Psychology Review provide an overview of what is known about children's exposure to community violence and war/ terrorism, and indicate significant gaps in extant research. These gaps and research needs are summarized in this conclusion.     

Intervention for Children Exposed to Interparental Violence (IPV): Assessment of Needs and Research Priorities

In this paper we review the development of interventions for children who have been exposed to interparental violence (IPV), assess current needs in the evaluation of interventions, and provide suggestions for research priorities in this area. Interventions for negative outcomes associated with exposure to IPV only recently have been carefully designed and evaluated, thus knowledge regarding program effectiveness is minimal. Three of the most comprehensive interventions that have been evaluated are presented. Each has demonstrated effectiveness, and focuses on children with different levels of symptoms and distress. However, many questions remain regarding which interventions are beneficial for diverse children with different kinds and intensities of problems. A number of research priorities and suggestions for further improvements in the evaluation of effectiveness of interventions are identified.     

Youth Exposed to Violence: Stability, Co-occurrence, and Context

With considerable literature establishing how separate types of violence disrupt the lives of children, there is emerging interest in examining violence across multiple interpersonal domains. This article examines four commonly occurring and frequently researched domains of violence exposure: marital physical aggression, mother-to-youth aggression, father-to-youth aggression, and community violence. A community-based sample of 103 parents and youth provided three waves of data at annual intervals beginning when the youth were aged 9–10. We explored stability of exposure, co-occurrence across different types of violence exposure, and associations with co-occurring risk factors. Approximately 30–45% of youth reported intermittent exposure over the 3 years. In addition to overlap among types of violence exposure within the family, we found overlap between parent-to-youth aggression and community violence, an association that was exacerbated in families where fathers reported high levels of global distress symptoms. Mother-to-youth, father-to-youth, and community violence related to youth behavior problems beyond the contextual risk factors of low income, stressful life events, and parents’ global distress symptoms. These results highlight the importance of examining violence longitudinally, across multiple types, and with attention to contextual factors.     

Legal and Policy Responses to Children Exposed to Domestic Violence: The Need to Evaluate Intended and Unintended Consequences

Greater training and specialization in working with children exposed to domestic violence has resulted in new policies, interagency protocols, and legislation in many states. This paper examines court-related responses in criminal, child protection, and family court custody proceedings, which highlight legislative changes and resulting systemic change. Although this legislation originated with the best of intentions to assist and protect children, some of the most striking outcomes have been negative and unintended. Laws that mandate reporting of children exposed to domestic violence can clash with inadequate training and resources, or inadvertently revictimize abused women. Similarly, child custody legislation that raises a rebuttable presumption that a violent spouse will not receive custody or joint custody of children after parental separation has resulted in greater skepticism about abuse allegations. We propose that efforts at law reform can be enhanced by a more thoughtful analysis of potential intended and unintended consequences, and should be accompanied by a comprehensive evaluation plan to monitor implementation effects.     

Fostering Social Competence in Preschool Children Exposed to Intimate Partner Violence: Evaluating the Preschool Kids' Club Intervention

This study assessed whether participation in an intervention program enhanced social competence in 113 preschool-aged children who were exposed to intimate partner violence. Change in competence was evaluated from baseline to approximately five weeks postbaseline and compared preschool children who did and did not receive intervention services. Protective factors, such as exposure to less severe violence, were identified that predicted change in competence scores. Results indicated that children with the highest social competence pre-intervention exhibited a significant increase in their postintervention scores, if they participated in the program. The extent of this change was predicted by a higher preintervention score and exposure to less severe violence. This study indicates that even short-term intervention could result in meaningful change in key aspects of child functioning.     

Violence Exposure Among Children with Disabilities

The focus of this paper is children with disabilities exposed to a broad range of violence types including child maltreatment, domestic violence, community violence, and war and terrorism. Because disability research must be interpreted on the basis of the definitional paradigm employed, definitions of disability status and current prevalence estimates as a function of a given paradigm are initially considered. These disability paradigms include those used in federal, education, juvenile justice, and health care arenas. Current prevalence estimates of childhood disability in the U.S. are presented within the frameworks of these varying definitions of disability status in childhood. Summaries of research from 2000 to 2008 on the four types of violence victimization addressed among children with disabilities are presented and directions for future research suggested.     

Understanding Children with War-Zone Traumatic Stress Exposed to the World's Violent Environments

This article discusses the common and unique configurations of stress responses of children to traumatizing experience in the world's warzones like Bosnia-Herzegovina, Croatia, Rwanda, Liberia, Mozambique, El Salvador, the Middle East, and other nations caught up in the throes of declared and undeclared wars. Children are the most vulnerable, and suffer the greatest. The new concepts of warzone traumatic stress (WZTrS) and warzone traumatherapy (WZTrT) are presented to expand the discussion of the treatment of warzone children beyond today's exclusive focus either on intrapsychic factors alone or on material-resource replenishing alone. These terms are an alternative to current approaches to treatment in which a discrete stressor has been identified as the responsible toxic agent that produced the child's symptoms. Most warzone children have experienced a multiplicity of stressors—a virtual matrix of violent war stressors. The WZTrT model recognizes that the mental, social, and cultural needs of traumatized children change over time—from the time they are exposed to raging toxic war stressors to the time when war hostilities end. Thus warzone traumatherapy attempts to address the child's needs on a continuum based upon a time-referenced intervention model. The model presented here acknowledges the child's adaptational strengths, and the multitheoretical employing of psychodynamic, cognitive, and behavioral techniques grounded in cultural/racial sensitivity and indigenous folk medicine as indispensable tools in warzone therapy for children. Additionally, the model takes into account the special features of relevant international policies of the United Nations (UN) and Non-Governmental Organizations (NGOs) geared to assist in the recovery and integration of warzone traumatized children. WZTrT embraces Western models of interventions integratively and flexibly employed with the personal, cultural, social, spiritual, and economic factors existing in the world of the traumatized child. Hopefully, the article will contribute to creating innovative ways of conceptualizing the mental, physical, social, cultural, and economic needs of warzone children in order to advance conceptual, technical, scientific, and practical aspects of child-relevant warzone interventions.     

Development of a Screening Instrument for Exposure to Violence in Children: The KID-SAVE

The present study provided psychometric data on the KID-SAVE, an empirically based measure of children's exposure to community violence. The KID-SAVE was administered to 470 inner-city children in the third through seventh grades and demonstrated excellent reliability. Factor analysis yielded three subscales: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. Initial investigation of construct validity suggested that the KID-SAVE successfully discriminated between groups of children reporting high and low levels of traumatic symptoms. The KID-SAVE appears to be a promising assessment tool and allows for quantification of the severity of violence exposure.     

Behavioral Inhibition and Risk for Posttraumatic Stress Symptoms in Latino Children Exposed to Violence

Latino children in urban contexts marked by poverty are at high risk of being exposed to violence and developing posttraumatic stress disorder (PTSD). Nonetheless, there is great variability in individual responses to violence exposure. This study examines risk for developing re-experiencing, avoidance, and arousal symptoms of PTSD as a function of individual differences in behavioral inhibition and exposure to community violence. Participants were 148 Latino students (M age =11.43 years, SD?=?0.69; 55 % girls) living in an area marked by poverty and crime. Children completed self-report measures of behavioral inhibition and posttraumatic stress symptoms during a baseline assessment. During a follow-up interview 6 months later, children completed self-report measures of exposure to community violence since the baseline assessment and posttraumatic stress symptoms. Structural equation models revealed that behavioral inhibition at baseline was positively associated with PTSD avoidance and arousal symptoms at follow-up, after controlling for symptoms at baseline. Furthermore, behavioral inhibition moderated the association between violence exposure and symptoms such that violence was more strongly associated with the development of PTSD avoidance symptoms as behavioral inhibition increased. Results suggest that individual differences in behavioral inhibition contribute to risk for specific PTSD symptoms and are important for understanding variation in responses to trauma exposure. By examining diathesis-­stress models within a disorder, we may be better able to elucidate the etiology of a disorder and translate this improved understanding into personalized intervention approaches that maximize effectiveness.     

From Violence to Hope

Since the Columbine horror in Colorado, the problem of violence in our society and its roots in human evolution have evoked deep soul-searching in sensitive people. We in the behavioral sciences and theology are asking what we can do to slow or stop the downward spiral of killing and brutality. How inevitable is it? What new factors impinge on this age-old problem of our species? What help is available from research in criminology, child-development, brain studies and modern psychiatry? There are scientifically established ways of reinforcing in the human subject the reality of empathic love which Chistianity has so long proclaimed to be God's answer to our human dilemma. This paper speaks to these issues.     

Children and Political Violence from a Social Ecological Perspective: Implications from Research on Children and Families in Northern Ireland

The effects on children of political violence are matters of international concern, with many negative effects well-documented. At the same time, relations between war, terrorism, or other forms of political violence and child development do not occur in a vacuum. The impact can be understood as related to changes in the communities, families and other social contexts in which children live, and in the psychological processes engaged by these social ecologies. To advance this process-oriented perspective, a social ecological model for the effects of political violence on children is advanced. This approach is illustrated by findings and methods from an ongoing research project on political violence and children in Northern Ireland. Aims of this project include both greater insight into this particular context for political violence and the provision of a template for study of the impact of children’s exposure to violence in other regions of the world. Accordingly, the applicability of this approach is considered for other social contexts, including (a) another area in the world with histories of political violence and (b) a context of community violence in the US.     

Lay Definitions of Violence among Swedish Children,Teenagers, and Adults

Definitions of violence vary and are almost always operationalized by the researcher. Perceptions of violence often determine levels of tolerance of violence. Little research has focused on lay definitions. A total of 309 Swedes (78 children, 85 teenagers, 99 younger adults, and 47 adults (30+); 48% male) were interviewed using a specially developed interview protocol. Content analysis was used to assign definitional categories. A folk taxonomy emerged. Immediate physical violence accounted for 73% of all assigned categories. Hit was the word that occurred most frequently. If global physical violence was included, physical violence accounted for 89% of 780 assigned categories. Immediate non-physical violence accounted for 9% and vicarious violence (including media violence) accounted for 2%. Distributions of categories by respondents' gender, age, and participant role in incidents of violence showed the underlying definitions of violence to be extremely stable. The conclusion is that ordinary Swedes share a robust lay definition of violence as a behavior that is immediate, done in close quarters, and physical.