Training Parents Reported for or at Risk for Child Abuse and Neglect to Identify and Treat Their Children's Illnesses

Parents at-risk or reported for child abuse or neglect may demonstrate deficits in infant and child health care skills, placing their children at greater risk for health problems. Research assistants, caseworkers, and a nurse provided health care skills training to parents at risk or reported for child abuse or neglect. A health reference guide and other training materials were validated by health care professionals. Training involved teaching parents to follow a series of steps to identify symptoms, use reference and record-keeping materials, determine the best form of treatment, and either treat the illness at home, consult a physician, or seek emergency treatment. Skill acquisition was assessed through observations of parent behavior in simulated health care scenarios. A series of multiple baselines across parents demonstrated effectiveness of this training in the context of these scenarios. Six out of seven parents met the 100% mastery criterion. All parents provided positive ratings of the content of the training program, the training strategies, and the counselors who provided training.     

Treatment of Concurrent Substance Dependence,Child Neglect and Domestic Violence: A Single Case Examination Involving Family Behavior Therapy

Although child neglect and substance abuse co-occur in greater than 60% of child protective service cases, intervention outcome studies are deplorably lacking. Therefore, a home-based Family Behavior Therapy is described in the treatment of a woman evidencing child neglect, substance dependence, domestic violence and other co-occurring problems. Treatment included contingency management, self control, stimulus control, communication and child management skills training exercises, and financial management components. Results indicated improvements in child abuse potential, home hazards, domestic violence, and drug use, which were substantiated by objective urinalysis testing, and tours of her home. Validity checks indicated the participant was being truthful in her responses to standardized questionnaires, and assessors were “blind” to study intent. Limitations (i.e., lack of experimental control and follow-up data collection) of this case example are discussed in light of these results.     

Estimation of stress in child neglect from thymic involution.

It is difficult to evaluate the extent of stress in cases of suspected child abuse/neglect in a medico-legal autopsy. We have previously reported that stress due to abuse/neglect was found to have led to thymic involution. To elucidate the influence upon thymocytes differentiation, we compared the proportion of the thymocyte subpopulation in the thymus of a neglected child with one in an age-matched control obtained from cardiac surgery. We found that the relative number of CD4+ CD8+ double positive (DP) thymocytes decreased in the neglected child. It was presumed that the selective decrease in the number of the immature DP thymocytes with CD3- to low bcl-2low caused the thymic involution in the neglected child. It was suggested that an alteration in the proportion of thymocytes subpopulation might be used as an index of stress in cases of child abuse/neglect.     

Crimes against children in nineteenth-century France

Abuse of children is not entirely a modern phenomenon but the definition and classification of abusive practices has changed. Modern concepts of child abuse date only from the 1880s in France. Child abuse in twentieth-century terms of emotional and physical assault, neglect, abandonment, and sexual molestation was not considered a crime during most of the past century. Prior to the 1880s, only two acts, abortion and infanticide, constituted crimes against children. Child abandonment, rather than a crime, was the state supported, societally acceptable alternative to abortion and infanticide. After abandonment, malnourishment and neglect of these children, even to the point of death, likewise were not crimes. With changes in attitudes of the 1880s, parental neglect, assault, and starvation of children became defined as child abuse as did perceived immoral behavior of the parents such as habitual drunkenness and debauchery. Under these new definitions of abuse, state officials could deprive parents of their legal rights and make the children wards of the state for their own protection. The state becamein loco parentis. This essay explores the changing perceptions of child abuse, and the increasing state intervention for the care of abused children after the 1880s.     

Medical Evidence and Expert Testimony in Child Sexual Abuse

Expert medical testimony in child sexual abuse cases can be critical to the outcome of a legal case. This article will review the development of the medical knowledge and clinical expertise in child sexual abuse. Since the passage of mandatory child abuse reporting laws, the forensic medical examination of a child for evidence of sexual abuse has become standard. Until recently, many myths regarding female genital anatomy existed but were based primarily on dogma and lack of empirical research. Over the past 25 years, many research studies and accumulating clinical evidence have expanded medical knowledge and debunked old myths. Physical evidence, even in cases of alleged genital or anal penetration is rare. Sexually transmitted infections are also uncommon and often require medical interpretation as to their significance in a prepubertal child. Specialized medical knowledge, training, and clinical expertise have developed in order to evaluate children presenting with allegations of sexual abuse. Such medical expertise provides invaluable service to courts. We review criteria for evaluating such expertise in light of current medical practice.     

School-based child sexual abuse prevention programs

Early prevention education training has been advocated by scholars and practitioners to intervene with children and youth who have been or are being sexually abused as well as to prevent sexual abuse from occurring. This study identified and surveyed major school-based child sexual abuse prevention programs in the country. Results obtained from 126 prevention programs indicated that most programs are conducted at a local level; that together they reach hundreds of thousands of students, parents, teachers, and other school staff; and that they offer a prescribed curriculum and resource materials. Nearly two-thirds receive state funding assistance, with less than a third charging the schools. Most were established in the early and mid 1980s and have well-educated staff. Further, most work to meet the needs of disabled students and provide means for disclosure of sexual abuse. Training format, duration, and materials vary.This study was supported by Grant #5083B80014, Womens Educational Equity Act Program, U.S. Department of Education.     

A Primer on Child Abuse and Neglect Law

This article surveys major aspects of child abuse and neglect law encountered by judges, lawyers, child advocates, and child care professionals. The authors, whose casebook, Children and the Law: Doctrine, Policy and Practice (West 4th ed. forthcoming 2010), is required reading in nearly seventy law schools, analyze both statutory and case law.     

Evaluating the Child Abuse and Neglect Institute: Does Training Affect Decision‐Making?

Traditionally, training evaluations have focused on participants' satisfaction and self‐reported knowledge gain. The current study uses a different approach to evaluate the Child Abuse and Neglect Institute (CANI), a training program designed to educate judicial officers on best practices in child abuse and neglect cases. CANI participants were asked to review a case scenario and render decisions about the case before and after the trainings. Findings suggest CANI has several positive impacts on judicial decision‐making, including an increased willingness to engage the father, an increased focus on the child, and increased motivation to comply with the Indian Child Welfare Act.     

STATE CHILD EMOTIONAL ABUSE LAWS: THEIR FAILURE TO PROTECT CHILDREN WITH GENDER IDENTITY DISORDER

Emotional abuse of children with Gender Identity Disorder by parents is very difficult to identify and prevent. State investigators of abuse and neglect often have a hard time determining if the reasons for mental illness and psychological harm in children are due to the actions of their parents, or if they stem from other sources. Once identified, it becomes even harder to prove in court for purposes of ordering services or removing the child from the home if the abuse is severe enough. With children who are gender non‐conforming, this task becomes exponentially more difficult due to the low prevalence rate, discrimination, stereotypes, and a parent's right to bring up their child as they choose. These youth face discrimination and violence in school, work, their communities, and also within their own families. Emotional abuse statutes are too vague to protect youth who are gender non‐conforming. The vague and unclear laws lead to inconsistency in the application of the law and lack of protection of the children because judges and investigators are not aware of how parent's actions harms youth with gender identity disorder. Therefore, states should adopt the model statute within this Note which defines specific actions by parents which would not qualify as abuse when involving gender conforming youth but qualifies as abuse for children with gender identity disorder. Many states already have statutes which define physical abuse, sexual abuse and abandonment by specific actions by parents towards their children. This proposal will enable both the state and the judges to properly identify victims with gender identity disorder of emotional abuse and provide for their protection.     

Social Class, Child Maltreatment, and Delinquent Behavior

The relationship between social class and child maltreatment and between maltreatment and delinquency were examined, particular attention being paid to previous deficiencies in the operationalization of maltreatment and class. Maltreatment was operationalized with subscales for physical abuse, emotional abuse, and neglect, while social class was operationalized with multiple indicators. Survey data from 110 high school freshmen were analyzed and revealed the following: (a) a weak but consistent inverse correlation between social class and all forms of child maltreatment, (b) a stronger relationship between social class and maltreatment when lower-class membership was operationalized in a manner consistent with the concept of an underclass, (c) that emotional abuse and neglect were correlated positively with all forms of delinquent behavior examined, and (d) that physical abuse was not correlated appreciably and positively with any form of delinquency.     

Childhood Maltreatment Experiences and Child Abuse Potential: Temperamental Sensitivity as Moderator?

This study aimed to examine the relationship between negative experiences in childhood (physical-, sexual-, and emotional abuse and emotional neglect) and the risk for an individual to become a perpetrator of child maltreatment in adulthood. Participants were 337 female college students who completed self-report measures of childhood trauma and temperament. Risk for child abuse was assessed with the Child Abuse Potential Inventory. Results showed experiences of emotional neglect significantly predicted higher child abuse potential. Additionally it was shown that experiences of physical abuse significantly predicted higher child abuse potential but only in those individuals with high temperamental orienting sensitivity. These results underline the potentially damaging long-term effects of emotional neglect in childhood and indicate temperamental sensitivity may moderate the relationship between being abused as a child and being at risk for maltreating one’s own offspring.     

Fatal child neglect in West Germany 1 January 1985 to 2 October 1990. Results of a multicenter study]

Up to now reliable data were available on cases of lethal child neglect in the area of the Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period from 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany. RESULTS: The study center received information on 19 cases of lethal child neglect. Extrapolated to all institutes of legal medicine, this corresponds to 20 cases and thus 3.5 cases a year in the whole of West Germany in the period studied. There is to be added a dark-field which cannot be limited more precisely. However, the cases of fatal child neglect might have occurred much more seldom than fatal child abuse caused by use of physical violence. Slightly more than half the victims were younger than 1 year, the oldest one was 7 10/12 years old. Most frequently the children died of starvation and thirst. Mostly the mothers/nursing mothers killed the child alone or together with the victim's father/stepfather. In the majority of the cases there was not a close affection between parents and child. Nearly 30% female/male perpetrators suffered from chronic alcohol abuse. Only 15 (= 56%) of 27 female/male perpetrators were sentenced to imprisonment (period between 7 months on probation and 10 years). Mitigation circumstances existed for nearly half the persons sentenced to imprisonment. It is true that child neglect is a rarer crime, but the experts of legal medicine always have to indicate errors made during the external inspection of the corpse (among others failures to see indications of neglect).     

A Primer on Criminal Child Abuse and Neglect Law

This article surveys major aspects of criminal child abuse and neglect law encountered by judges, prosecutors and defense lawyers, child advocates, and child care professionals. The author, whose casebook, Children and the Law: Doctrine, Policy and Practice (West 4th ed. 2010) (with Sarah H. Ramsey), is required reading in law schools throughout the United States, analyzes both constitutional and statutory law.     

A 25-year retrospective review of deaths due to pediatric neglect

Neglect, defined as the failure of a caregiver to adequately provide safety, food, clothing, shelter, education, protection, medical/dental care, and supervision for a child in his/her care, is a relatively uncommon but important cause of child mortality. A retrospective review of pediatric deaths (age 18 years or less) referred to the Medical University of South Carolina Forensic Pathology Office for autopsy over the past 25 years revealed 16 deaths due to some type of pediatric neglect. Cases were analyzed as to age, sex, race, cause and manner of death, autopsy findings, ancillary studies, past medical history, social/family history, and caregiver. Six cases of malnutrition/starvation and/or dehydration were identified, composing the most common cause of death in the neglect cases identified and the majority of the homicides due to neglect. Other deaths in which neglect contributed significantly included toxic ingestions (2 cases), hyper-/hypothermia (2 cases), unusual drowning/aspiration (4 cases), electrocution (1 case), and delayed/absent medical therapy (2 cases, including one of the previously mentioned ingestions). Of these additional cases, 7 were certified as accidental manner, 2 as natural, and 1 as a homicide. Cases which fell into a "gray zone" in which the appropriateness of invoking neglect was a matter of opinion or societal convention were excluded from the review; examples included conventional accidental drowning, choking on food or aspiration of foreign body, overlying/wedging during sleep, accidental hanging, and motor-vehicle traffic accidents (pedestrians, unrestrained passengers). The findings of this review reinforce the fact that malnutrition/starvation and dehydration compose the most common form of lethal pediatric neglect while highlighting less common forms of neglect and the difficulty of determining manner of death in cases in which neglect plays a more questionable role than in seemingly clear-cut malnutrition/starvation and dehydration cases. We demonstrate the typical victim and scenario that investigators will encounter in cases of fatal pediatric neglect, often a child under the age of 1 year who has been deprived of food and/or drink for some time, or an older, more independently mobile child who has not been adequately supervised. These children may or may not have a demonstrable prior history of maltreatment or (nonfatal) neglect, and review of medical records is an important part of the investigation. We additionally discuss key gross autopsy findings, appropriate specimen collection, helpful ancillary studies, microscopic findings of significance, potential mimickers of neglect, and other special considerations in cases of pediatric neglect.     

Central Issues in Jurisprudence

Law schools have been criticised as being behind the times in predominantly adhering to the traditional lecture format combined with the casebook method. In so far as these techniques simply transmit prescribed content to students, this comes at the expense of teaching the skill crucial for success in examinations and in legal practice: problem solving. Active teaching and learning techniques seem likely to better foster the development of this skill. However, in an environment where transmission-based lectures are the norm, and students are anxious to absorb content in the (mis)belief that this holds the key to success, would they welcome such active learning or resist it? To assess this, I delivered three lectures to second year undergraduate students in the same cohort of the Law of Contract, each of which used varying degrees of active learning techniques: the first, the maximum amount practicable, the second a combination of active learning techniques and techniques traditionally used in law school lectures, and the third no active learning techniques at all. By asking students to comment on the extent to which they were engaged in the lectures and how the use of time enabled them to learn, to understand contract law, and to develop their own problem-solving skills, I aimed to see how they would react to the different techniques. Supported by the qualitative results of this pilot study, the article suggests that (1) the incorporation of active learning exercises – including those based on problems – into large lectures is perceived by students as beneficial for their learning, and even preferred over passive methods; and (2) in the typical law school environment, law teachers could also consciously mitigate the relentless pressures affecting law students by making classes more conversational, relaxed and entertaining.     

A case of panhypogammaglobulinemia masquerading as child abuse

A case of panhypogammaglobulinemia in a 15-month old boy is presented. The child was followed at a local university teaching hospital for pneumonia, failure to thrive, and possible child abuse/neglect. Following minor trauma to the face, massive sepsis developed in the child. The mother was afraid to seek medical care because she was fearful of legal action against her. Upon the child's demise at home, police and medical examiner involvement ensued. The correct diagnosis was established at autopsy.     

日本法科大学院教育制度及其特征

法科大学院是日本的新型法律人才培养机构。这一制度借鉴了美国法学院教育模式,招收具有多样专业知识背景的学生,开展研究生层次的职业化教育。建立法科大学院制度是日本在司法改革的大背景下,在扩大法律职业数量和确保法律职业培养质量的目标下,做出的制度选择。日本通过了相关法律,并派遣在职法官、检察官任教,以保证法科大学院具有充分的师资,保证法科大学院教育的质量。     

School liability for student injury from school violence: comparison between South Korea and the USA

This paper examines school liability for school violence-related student injury in South Korea and the US. The study found that the US courts considered only violence-related behaviors of the perpetrator when judging whether violence can be foreseen; thus drug abuse or verbal abuse by the perpetrator were not considered as a part of his/her violent history. On the other hand, the Korean courts considered perpetrators’ nonviolent behavior, such as low academic achievement or negative attitudes toward academic work, as indicators of violent history. Regarding the extent of school liability, while in Korea, schools were not held responsible for injuries to non-school-related persons caused by their students’ violent acts in public, in the US, the court required schools to take legal responsibility for such cases happening during field trips. These findings help to reconsider school liability for school violence and generate suggestions for more reasonable and universal legal standards.     

中外合作办学问题的法律解读

中外合作办学是我国教育走向国际化而出现的一种新的办学形式,在我国的教育事业中占有重要地位。基于《中外合作办学条例》等相关法律进行分析,应当认为,培养人才与取得回报是中外合作办学的重要目标,举办项目与设立机构是中外合作办学的基本形式,立足本土与引进外源是中外合作办学的教育内容,继承传统与改革创新是中外合作办学的发展要求,政府监管与社会制约是中外合作办学的调控力量。     

Stereotypes and attitudes about child sexual abusers: A comparison of experienced and inexperienced professionals in sex offender treatment

Purpose . The danger of stereotyping child sex offenders is that such stereotypes allow suspected abusers to avoid detection. The current study investigated whether professionals involved in the treatment of sex offenders endorsed less stereotypes of sex offenders than an ‘inexperienced’ group of teachers. Method . Sixty professionals involved with sex offenders and 71 school teachers completed three questionnaires: the Stereotypes of Sex Offenders Questionnaire; Attitudes Towards Sex Offenders Scale ( Hogue, 1993 ) and Knowledge of Child Abuse Questionnaire (created for the present study). Mediation analyses were then conducted on the relationships between the scores. Results . Experienced professionals endorsed negative stereotypes less, had more positive attitudes towards sex offenders and expressed more knowledge of child abuse than the inexperienced group. Further, attitudes towards child sexual offenders were significantly mediated by the effect of knowledge of child abuse on group (experienced, inexperienced). However, there was no significant mediation for the effect of knowledge on child abuse on the relationship between group (experienced, inexperienced) and stereotype consistent scores. Conclusions . The less knowledge of child abuse, the more stereotypical one may be about potential child sex offenders. Thus, it may be useful to increase knowledge on child abuse in inexperienced groups to counter stereotyping and allow greater detection of offenders.