Multiple forms of child abuse and neglect: adult retrospective reports

There are few research reports of the experience of multiple forms of child abuse and neglect (multi-type maltreatment). A critical review is presented of 29 studies in which adult retrospective reports of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect, or witnessing family violence) are assessed. Empirical investigations of the extent and impact of multi-type maltreatment are identified. Data on the relationship between the different forms of maltreatment and the adjustment problems associated with each type of maltreatment are critiqued. As well as using dichotomous measures of maltreatment, an important methodological problem was the failure of researchers to assess all child maltreatment types, the relationship between multi-type maltreatment and adjustment, and the role of variables influencing the occurrence or impact of maltreatment. Considerable overlap was found in the occurrence of maltreatment types. The compounding or interacting effects of experiencing multi-type maltreatment were ignored in many studies. Where an assessment was made of the specific impact of multi-type maltreatment, it was associated with greater impairment than single forms of abuse or neglect. A multi-dimensional approach to prevention and treatment of child abuse and neglect is required in which children's vulnerability to multi-type maltreatment is addressed.     

Intervention in child neglect: an applied behavioral perspective

Child maltreatment in the forms of abuse and neglect is a serious social problem, affecting over 1.5 million children in the US annually. Abuse has generally received more public and professional attention than other forms of child maltreatment. Given that more than one type of child maltreatment frequently occurs in families, there are few behavioral studies that have specifically addressed techniques for the reduction of child neglect. Only recently have researchers begun to regard child neglect as a phenomenon that may be conceptually different from other forms of child maltreatment, thereby warranting specific attention. Described here are intervention strategies for parents at-risk for or referred for child neglect. We review these strategies, along with commentary on the difficulties of conducting applied research in this field. Suggestions are offered for improved intervention research in child neglect.     

Child Protection and Psychology Education in Australian Universities

Child maltreatment is a significant problem in Australia. Psychologists in a wide range of occupations play an important role in the identification and prevention of child abuse and neglect, the provision of interventions to children and families, and the development and conduct of research in related areas. Psychology graduates must be adequately prepared to work in this field; however, little is known about the extent to which child abuse and neglect related contents are taught in current university curricula. A purpose‐developed curriculum‐mapping survey was used to examine Australian undergraduate, fourth year, and postgraduate Australian Psychology Accreditation Council‐accredited programmes available in 2008. Results showed that students in the majority of programmes were exposed to child protection‐related content; however, the extent of exposure was limited. Three postgraduate units specifically addressed the prevention, identification, and response to child abuse and neglect. Course coordinators reported that child maltreatment content was mostly integrated into general units throughout the programme, typically within developmental psychology units in the undergraduate curriculum and in ethics, research, or professional issues units in the fourth year and postgraduate programmes. Results suggest the need for child protection content to be included in minimum national standards and accreditation guidelines for universities.     

Preventing Maltreatment with a Community-Based Implementation of Parent–Child Interaction Therapy

The purpose of this study was to examine rates of child abuse and neglect reports following a community implementation of Parent–Child Interaction Therapy (PCIT), an evidence-supported intervention for the prevention of maltreatment. Among a group of families receiving PCIT, predictors of reports were examined including family demographics, course of treatment, changes in clinical measures, and caregiver report for prior maltreatment victimization and perpetration. Participants (n = 120) included families at-risk for future maltreatment with and without prior maltreatment history. Agency case records were linked with state administrative records of child welfare reports. Time to follow-up ranged from 13 to 40 months. Bivariate and multivariate survival analyses were used to model risk for a later report. During the follow-up period, 12.5 % of families had a report for physical abuse or neglect. Reports of prior victimization as a child and prior perpetration as an adult were strong predictors of a report of perpetration after PCIT. Dosage of PCIT and change in clinical measures did not increase risk for a later report. PCIT can be an effective intervention for preventing maltreatment. Family history of child welfare involvement is a prominent factor in assessing risk for future involvement.     

Permanent Housing for Child Welfare‐Involved Families: Impact on Child Maltreatment Overview

A longitudinal randomized controlled trial tested whether access to permanent housing reduces child maltreatment among inadequately housed families under investigation for child abuse and neglect. The study followed homeless and child welfare‐involved families randomly assigned to receive a referral for housing subsidies plus housing case management (n = 75, 196 children) or housing case management alone (n = 75, 186 children). Latent growth models examined change in caregiver‐reported frequencies of psychological aggression, physical abuse, and neglect toward children at five time points across 2.5 years. Intent‐to‐treat analyses suggested treatment differences for minor assault and neglect that approached significance; families randomly assigned to permanent housing plus case management exhibited marginally greater declines compared to families referred for housing case management only. Caregiver psychological aggression remained high over time, regardless of treatment condition. No evidence indicated higher risk families benefitted more from permanent housing. Results show some promise of permanent housing and highlight the complex needs of homeless families under investigation for child maltreatment. Findings emphasize the importance of continued involvement from the child welfare system to connect families with important resources.     

Risk Factors for the Occurrence of Child Abuse and Neglect

SUMMARY

A large, nationally representative database of child abuse and neglect cases was analyzed to identify demographic risk factors for the occurrence of different types of abuse and neglect. The analyses used the data collected in the second National Incidence Study of Child Abuse and Neglect (the NIS-2) concerning children who were harmed by abuse or neglect. Multiple-factor logistic models were developed to identify risk factors for the occurrence of abuse or neglect in six categories of maltreatment: physical abuse, sexual abuse, emotional maltreatment, physical neglect, educational neglect, and multiple maltreatment. A key finding was that children in families with incomes under $15,000 per year were at far greater risk in every category of maltreatment. Also, older children were generally at greater risk in every category, and risk was related to family structure, family size, child's sex and race/ethnicity, and metropolitan status of the county. However, these relationships applied to only certain types of abuse or neglect or took different forms in different maltreatment categories. Interactions among risk factors were the rule rather than the exception. Findings emphasize the need for better coordination between human services and income support services to families. The results imply that risk assessment would be appreciably advanced by going beyond simple matrix approaches that independently consider different factors by developing assessment models that include interactions between different risk factors.     

The welcome baby program: A community-based volunteer prevention model of caring,sharing, and support for new parents

Primary prevention is one of the most important components of any community child abuse and neglect program. Welcome Baby is a community-based, volunteer primary prevention program that offers caring, sharing, and support to parents of newborns through hospital visitation and follow-up contacts during the adjustment period that surrounds the birth of a baby. Program goals include personal support for the new mother, prevention of child abuse and neglect by providing support and information for all parents, reinforcement of strengths and support for quality parenting, improving emotional preparation for parenthood, and early identification and intervention for families with the potential for maltreatment. Program rationale and conclusions agree with research findings that early and consistent support and intervention with high-risk families improve the quality of parent-child interaction and significantly reduce the risk of maltreatment. This article outlines the basic philosophy, goals, and operations of this community prevention program.     

Child Maltreatment in Vietnam: Prevalence and Cross-Cultural Comparison

This Vietnam prevalence study on child maltreatment (VPM-2014) was designed to examine the prevalence of child maltreatment in Vietnam and to compare it with the child maltreatment prevalence in the Netherlands using the same measures and procedure. Questionnaires were filled out by 1,851 students aged 12 to 17 years (47.3% were boys). Results indicated that half of the students (49.9%) reported at least 1 event of child maltreatment in the past year. Emotional abuse was most frequently reported (31.8%), followed by physical abuse, neglect, and witnessing parental conflict. Sexual abuse was the least prevalent (2.6%). Compared with the Netherlands, the prevalence rates of most types of child maltreatment were higher in Vietnam: The largest difference was with emotional abuse, followed by neglect, physical abuse, and witnessing parental conflict. Only the past-year sexual abuse prevalence in Vietnam was lower. These findings highlight the alarming problem of child maltreatment in Vietnam.     

Predicting infant maltreatment in low-income families: the interactive effects of maternal attributions and child status at birth

Maternal attributions and child neonatal status at birth were assessed as predictors of infant maltreatment (harsh parenting and safety neglect). The population included low-income, low-education families who were primarily Hispanic. Child maltreatment during the 1st year of life (N = 73) was predicted by neonatal status (low Apgar scores, preterm status), as moderated by mothers' attributions. The highest levels of maltreatment were shown within dyads that included a mother with low perceived power and an at-risk infant. Partial support was found for maternal depressive symptoms as mediators of harsh parenting among at-risk infants. It is suggested that lack of perceived parental power constrains investment in protective relationships and fosters sensitization to potential threat.     

Preface

Abstract

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

Preface

Summary

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

The Impact of Family Unification Housing Vouchers on Child Welfare Outcomes

This study addresses whether providing housing vouchers through the Family Unification Program (FUP) to families involved in the child welfare system reduces child maltreatment and the need for child welfare services. The study uses child welfare administrative data on 326 children in Portland, Oregon, and 502 children in San Diego, California from the point at which their families were referred to the program through 18 months post‐referral. Using a quasi‐experimental waitlist comparison design, probit regressions show little impact of FUP on preventing child removal from home, but some positive impact on reunification among children already placed out of home. Hazard estimations show receipt of FUP speeds up child welfare case closure. Impacts on new reports of abuse and neglect are mixed, but point toward reduced reports. Low rates of removal among intact comparison families and high rates of reunification for children in out‐of‐home care suggest poor targeting of housing resources. Housing vouchers are being given to families not bearing the risks the program is intended to address. The presence of some positive findings suggests that housing vouchers might help reduce child welfare involvement if better targeting were practiced by child welfare agencies.     

Educational needs of school personnel regarding child abuse and/or neglect

From a review of literature a questionnaire was developed to identify problems related to child abuse/neglect in a rural school district. School administrators, regular and special education teachers, and counselors completed the survey to help establish more effective training programs. Analysis indicated that (1) school personnel need further assistance in dealing with problems pertaining to the maltreatment of students. (2) Formal, coordinated, workshop training for child abuse/neglect is needed. (3) Colleges and universities should offer instruction on abuse/neglect for persons preparing to work in schools. (4) School personnel need to be aware of and abide by the laws regarding reporting cases of abuse/neglect. (5) Improved communication among school, community, courts, and social service agencies is required for dealing wtih abuse cases. (6) School personnel should become more aware of what happens after abuse/neglect has been reported. Information from such analysis even for one school district can increase insight into problems.     

Covert Video Surveillance of Parents Suspected of Child Abuse: The British Experience and Alternative Approaches

One million cases of child maltreatment and twelve hundred child deaths due to abuse and neglect occur per year. But since many cases of abuse and neglect remain either unreported or unsubstantiated due to insufficient evidence, the number of children who are abused, neglected, and killed at the hands of family caregivers is probably higher. One approach to combat child abuse in the U.K. has been the employment of hospital-based covert video surveillance (CVS) to monitor parents suspected of Munchausen Syndrome by Proxy (MSBP). The use of CVS, however, raises concerns about voluntary informed consent, research on human subjects, privacy, and the appropriateness of healthcare providers to conduct CVS. More broadly, the use of CVS raises concerns about the ethical life of healthcare institutions and their moral obligations to the families and communities they serve. The U.K. protocol for CVS is examined in light of these concerns. Three alternative CVS protocols and two procedures for selecting a protocol are then proposed for use in the U.S. The paper concludes that any CVS protocol selected for use by hospitals ought to be selected by means of open and democratic processes that permit community input and, subsequently, the possibility of a consensus on the moral status and scope of CVS.     

Impact of substance abuse and child maltreatment training on service utilization in a rural setting

Substance abuse and child maltreatment have been recognized as co-morbid problems encountered in families presenting in the child protective services (CPS) system. Nonetheless, utilization rates of substance abuse treatment services have generally lagged well behind what the research would suggest are prevalence rates for substance abuse disorders in this population, suggesting problems in recognition and referral practices among CPS workers. In response to this, 25 training programs were funded by the National Center on Child Abuse and Neglect. This study reports data from one program. Trainees indicated a high level of satisfaction and demonstrated significant knowledge gains. More importantly, utilization of substance abuse services increased significantly across time in a multi-county region receiving training relative to a comparison region receiving none. The gain was limited, suggesting that while increased knowledge may translate into increased service utilization, additional barriers to accessing needed services must also be addressed.     

Relationships between Parental Maltreatment and Adolescents’ School Adjustment: Mediating Roles of Self-Esteem and Peer Attachment

Parental maltreatment of children has been steadily increasing in Korea despite national efforts to curb it. Children and adolescents who experience maltreatment develop psychological and social maladjustment. Therefore, mediating variables alleviating the negative effects of parental maltreatment on child development should be investigated to develop effective intervention programs. We identified the direct effects of parental abuse and neglect on adolescents’ school adjustment and the mediating effects of adolescents’ self-esteem and peer attachment on the relationships between parental abuse and neglect and their school adjustment. We used data from 2351 middle school students who participated in the Korean Children and Youth Panel Survey. Structural equation modeling revealed the following: child neglect directly and negatively related with adolescents’ school adjustment, whereas child abuse did not. Further, while adolescents’ self-esteem and peer attachment mediated the relationship between child neglect and school adjustment, adolescents’ self-esteem alone mediated the relationship between child abuse and school adjustment. These findings imply that there is a need to develop different intervention programs based on child maltreatment types. Finally, we suggested that the negative effects of parental neglect on adolescents’ school adjustment could be alleviated by adolescents’ self-esteem recovery resulting from peer support. On the other hand, in the case of adolescents experiencing parental abuse, self-esteem recovery through education and counseling provided by teachers or respected adults could be prioritized.     

Parental satisfaction in child abuse and neglect: A review of standardized measures

Low levels of parental satisfaction have been implicated in parents' utilization of harsh disciplining strategies and perpetration of child abuse and neglect. Although measures of parental satisfaction have been present for more than 3 decades, the employment of these instruments in child maltreatment populations has been limited, perhaps due to a lack of empirical evaluation. This paper reviews extant studies that demonstrate the need to examine the relationship between parental satisfaction and child maltreatment, and provides a critical examination of existing measures of parental satisfaction, including their psychometric support and application to child maltreatment. Recommendations are offered regarding the utility of these measures in child maltreatment.     

The role of the environment in the etiology of child maltreatment

The role of the environment in the etiology of child maltreatment has long been debated. Child protection activities have typically focused on the character of alleged perpetrators to the virtual exclusion of the broad social context in which abuse and neglect occurs. Evidence of the stressful effects of environmental circumstance on adults in disadvantaged families is substantial. Overwhelming social forces that act on parents with few resources or skills with which to cope and adapt can produce violent tendencies that lead to the mistreatment of their children. There is established theory to guide the design and implementation of programs sensitive to the potentially strong environmental influence of the behavior of abusive and neglectful family members.     

Parent,child, and contextual predictors of childhood physical punishment

Data gathered over the course of an 18‐year longitudinal study of 1025 New Zealand children were used to: (a) develop a profile of the maternal, child, and contextual factors associated with differing levels of exposure to maternal physical punishment, and (b) identify the key predictors of maternal physical punishment as reported by young people at age 18. Results revealed the presence of clear linear associations between the extent of young people's reported exposure to physical punishment and a wide range of maternal, child, and contextual factors. The key predictors of physical punishment suggested that the psychosocial profile of those mothers at greatest risk of physically punishing or mistreating their child was that of a young woman with a personal history of strict parenting who entered motherhood at an early age, and who was attempting to parent a behaviourally difficult child within a dysfunctional family environment characterized by elevated rates of inter‐parental violence and childhood sexual abuse. These findings were consistent with a cumulative risk factor model in which increasing risk factor exposure is associated with increasing levels of child physical punishment/maltreatment. Copyright © 2002 John Wiley & Sons, Ltd.