Ecological correlates of neglect in infants and toddlers

Infants and toddlers are more likely to be victims of neglect than any other form of maltreatment. Infants and toddlers are at highest risk of fatality because of maltreatment and experience behavioral, social, academic, medical, and cognitive consequences of neglect during their most formative years. Within an ecological framework, this study examines the correlates of the substantiation of neglect in children 0 to 36 months of age. Using an ex post facto design and a random sample of 148 child protective services cases, bivariate analysis revealed significant differences in families who were substantiated for neglect in the areas of child characteristics, home environment, social environment, caregiver, and maltreatment situations. Multivariate analysis found children who were substantiated for neglect were exposed to greater environmental dangers and had caregivers who had poor parenting skills. Implications for practice and future research are discussed.     

Quality of Maternal Parenting among Intimate-Partner Violence Victims Involved with the Child Welfare System

Children are overrepresented in households with intimate-partner violence (IPV), and many suffer the double burden of being the subject of maltreatment and bearing the consequences of abuse to their mothers. Despite this situation, little information exists concerning parenting by women who have been abused by an intimate partner. We examine the relationship between women’s experiences with IPV and the quality of maternal parenting using data from the National Survey of Child and Adolescent Well-Being. The sample consisted of 1,943 female caregivers of children younger than 10 years investigated for child maltreatment. Women who had experienced IPV in the past but were no longer victims of IPV had significantly better parenting scores than women who were currently experiencing IPV, when other risk factors were controlled. This study adds to the evidence that IPV does not necessarily impair maternal parenting. Women abused by an intimate partner deserve a thorough assessment of what services they need: parenting services should be offered as warranted on a case-by-case evaluation of the particular woman’s parenting skills.     

African American Caregivers and Substance Abuse in Child Welfare: Identification of Multiple Risk Profiles

Despite the strong correlation between caregiver substance abuse and child maltreatment, little information exists to understand the typology of African American caregivers with substance abuse problems in the child welfare system. Research shows African American caregivers contend with multiple problems stemming from substance abuse. Unfortunately, we do not yet know how to best tailor resources to be responsive to varying groups of African American caregivers. Using data from the National Survey of Child and Adolescent Well-being (NSCAW), this investigation tested for distinct multivariate profiles among a subset of African American caregivers with substance abuse problems (n=258). Latent Class Analysis (LCA) was used to classify caregivers, and five classes were identified among this high risk sample - each with distinct risk profiles. Based on these findings, we discuss implications for tailored practices to enhance the safety and stability of children involved with child welfare.     

Gender Inequity Associated with Increased Child Physical Abuse and Neglect: a Cross-Country Analysis of Population-Based Surveys and Country-Level Statistics

Gender inequity is proposed as a societal-level risk factor for child maltreatment. However, most cross-national research examining this association is limited to developing countries and has used limited measures of gender inequity and child homicides as a proxy for child maltreatment. To examine the relationship between gender inequity and child maltreatment, we used caregivers’ reported use of severe physical punishment (proxy for physical abuse) and children under 5 left alone or under the care of another child younger than 10 years of age (supervisory neglect) and three indices of gender inequity (the Social and Institutional Gender Index, the Gender Inequality Index, and the Gender Gap Index) from 57 countries, over half of which were developing countries. We found all three gender inequity indices to be significantly associated with physical abuse and two of the three to be significantly associated with neglect, after controlling for country-level development. Based on these findings, efforts to prevent child abuse and neglect might benefit from reducing gender inequity.     

Gatekeeping by Allegations: An Examination of Verified,Unfounded, and Fabricated Allegations of Child Maltreatment Within the Context of Resist and Refusal Dynamics

Allegations of child maltreatment and neglect, including child sexual abuse, in the context of child custody disputes pose particular challenges for child protection services, family law professionals and the courts to identify children at risk of harm, as well as children impacted and exposed to other risk factors. Accurately identifying child maltreatment requires assessing the background, the history and the context of the allegations in order to differentiate confirmed, unfounded, and fabricated allegations. The paper provides a review of the history and current understanding of allegations within the context of child custody disputes by considering the connections of fabricated allegations to the theory of alienation and the role of gatekeeping. The paper then examines the social science literature regarding allegations within child protection investigations (the prevalence, types of maltreatment, reporter of allegations, and case outcomes) and explores the factors that have contributed to the challenges faced by child protection services to investigate and make determinations regarding allegations within the context of child custody disputes. We argue for early assessment protocols for child protection services to screen child custody cases, to differentiate allegations of alienation from other types of harm, to enhance role clarity in these volatile situations, to refrain from “taking sides” and to work collaboratively with the family law community. Lastly, we offer legal implications to improve collaboration between child protection services and the family law field to better respond to these complex cases.     

Correlates of Substantiated Emotional Maltreatment in the Second Canadian Incidence Study

The objective of this study was to determine the correlates of substantiated psychological maltreatment (PMT) in Canada on functions of maltreatment characteristics, child profile, household profile, and child protection services interventions. This study is based on a secondary analysis of data collected in the second Canadian Incidence Study. PMT investigations were categorized into six groups: emotional abuse, emotional neglect, and other maltreatment as single form, and these same three groups when they co-occurred with another form of maltreatment. Six logistic regressions, comparing all pairs of groups, were carried out. Cases of PMT (single form) were more chronic and associated with greater adverse emotional impact than other forms of maltreatment. Mothers of psychologically maltreated children had more mental health issues. Emotional neglect cases were more complex (e.g., substance abuse, mental health, and social housing). The three co-occurrent groups present more negative factors but more risk factors are observed when PMT are also observed (e.g., emotional harm, alcohol abuse, housing problems, chronicity, and referral to other services).     

Do Social Services Matter for Child Maltreatment Prevention?: Interactions between Social Support and Parent's Knowledge of Available Local Social Services

Despite wide recognition that increased social support is associated with positive parenting behaviors, there is limited understanding regarding the mechanisms through which the neighborhood context can increase or hinder social connections. In a sample of 1,050 parents in Franklin County, OH, this study examines the role of availability of social services in child maltreatment. Through negative binomial regression, the study finds that greater availability of social services is associated with lower levels of child abuse and neglect. Additionally, the availability of social services moderates the relationship between social support and child maltreatment, such that the relationship between social support and child maltreatment is weaker for parents in neighborhoods with greater availability of services. The findings suggest that increasing services and awareness of such services might be an opportunity for child maltreatment prevention.     

Emotional Dysregulation and Negative Affect Mediate the Relationship Between Maternal History of Child Maltreatment and Maternal Child Abuse Potential

Risk for committing child abuse is frequently attributed to an intergenerational “cycle of violence” through which abuse as a child increases risk for committing abuse as a parent. While this hypothesis has support, more research is needed to understand the factors that account for this pattern of risk. Given literature suggesting that adults with a history of child maltreatment have increased risk for a wide range of psychopathology, this study examined the role of two behavioral endophenotypes, emotional dysregulation and negative affect, in the association between maternal experiences of childhood maltreatment and maternal child abuse potential among 83 low-income, primarily African-American mothers of elementary school age children. Results indicate that a mother’s experience of abuse as a child predicts later risk for abusive parenting as measured by child abuse potential scores. However, our data also indicate that the relationship between maternal experience of child abuse and later child abuse potential is mediated by maternal emotional dysregulation and negative affect.     

Maltreatment of handicapped children: A critical review

Despite increased interest in child abuse and neglect in the past decade, little research attention has been focused on maltreatment in handicapped populations. This is surprising given that many handicapped children display characteristics (e.g., chronic and pervasive behavioral disturbances, decreased social initiations with caregivers) that are associated with high risk for assault and neglect in nonhandicapped children. Numerous investigations have found an overrepresentation of handicapped children in maltreated samples, and results of more recent efforts reveal a high incidence of abuse and neglect in handicapped populations. Although these data underscore the high risk for maltreatment in handicapped children, a number of important issues warrant further empirical examination. Moreover, generalizations and interpretations of findings from previous research have been obfuscated by methodological shortcomings. The present paper reviews the literature concerning abuse and neglect of handicapped children. Research strategies and issues are delineated and current problems in this field are discussed. Suggestions for directions future research might take are offered.     

An Evaluation of Hawaii’s Healthy Start Program Using Child Abuse Hospitalization Data

This retrospective study had a twofold focus: (1) to assess the utility of a perinatal screening and assessment protocol for identifying families with an elevated child maltreatment risk and (2) to assess the effectiveness of an intensive home visitation program designed to prevent severe maltreatment. Among 15,864 families screened and assessed for child maltreatment risk, elevated risk was identified in 4,464 families, 1,738 of whom received intensive home visiting services and 2,728 who did not. Subsequently, data on hospitalizations with a child maltreatment diagnosis were used as outcome measures. Among the 1,738 served by home visitors, there were five hospitalized cases of child maltreatment; among the 2,278 families not served, there were 34 cases. The results of chi squared analyses suggest that the screening and assessment protocol successfully differentiates between families with greater and lesser degrees of risk for maltreatment and that hospitalization occurred significantly more often among unserved families (p?=?<.001).     

Persistence of intimate partner violence among families referred to child welfare

The purpose of this study is to examine the longitudinal course of intimate partner violence (IPV) among female caregivers of children receiving child welfare services. Data are derived from the National Survey of Child and Adolescent Well-Being, a national probability study of children investigated for child abuse and neglect in the United States. Caregivers (n = 861) are interviewed about demographic characteristics, mental health, substance use, and physical violence by a partner at the close of the investigation and at an 18-month follow-up. Polychotomous logistic regression examines the associations of severe and minor IPV controlling for caregiver and environmental characteristics. The results suggest that factors related to initial risk for IPV do not affect the continuation of IPV and that patterns of IPV differ for racial and ethnic groups.     

Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation

Child abuse pediatricians often carry the stigma that their sole role is to diagnose maltreatment. In reality, child abuse pediatricians use their clinical experience and current evidence-based medicine to make the best medical diagnoses for the children they evaluate. To better understand the legal conclusion of suspected maltreatment cases with medical examinations, this study sought to: (i) evaluate the percentage of children seen for suspected maltreatment that led to a clinical diagnosis of maltreatment, (ii) determine the number and type of criminal charges associated, and (iii) analyze the legal outcomes of cases as they proceeded through the judicial system. This study retrospectively reviewed the legal outcomes of 1698 children medically evaluated in 2013–2014 as part of an investigation by a multidisciplinary team at a children’s advocacy center in a mid-sized city in Oklahoma. Data were collected from electronic medical records, the district attorney’s office, and a public court docket. Of the original cohort, 477 (28.09%) children yielded a medical diagnosis of at least one type of maltreatment. Further analysis yielded 115 unique court cases involving 138 defendants and 151 children. A total of 286 charges were filed resulting in 190 convictions. While maltreatment allegations yield a high number of children that must be evaluated, a comprehensive medical evaluation helps determine which cases do not have sufficient medical findings for a diagnosis of maltreatment. The findings in this study indicate that a majority of suspected maltreatment cases seen by child abuse pediatricians did not result in criminal court outcomes.     

Long-Term Follow-Up of Young Children Placed in Foster Care: Subsequent Placements and Exposure to Family Violence

This study examined the quality or characteristics of permanent placements at 6 years of age for 254 children who had been removed from their homes prior to attaining 3.5 years of age (mean = 13 months). Although the primary objective when removing children is protection, subsequent permanent placements are prioritized by federal legislation with a stable family environment, especially one with the biological parent(s), being preferred. Three a priori comparisons (i.e., reunified vs. nonreunified, adopted vs. foster care, relative vs. nonrelative foster care) were conducted for caregiver and child reports of exposure to family violence. The results indicate that both reunified children and their parents report more family violence (witnessed and child victimization) than do nonreunified children and their caregivers. Adoptive parents did report that they used more minor violence in disciplining their children than did foster caregivers, but their children reported witnessing significantly less physical violence in the home. Recognizing that the development of children removed from their homes because of maltreatment is likely a function of both the maltreatment as well as the quality of subsequent family experiences (i.e., violence exposure), implications of the findings for determining placements are discussed.     

Single Types of Family Violence Victimization and Externalizing Behaviors Among Children and Adolescents

Prior research has provided substantial evidence that child maltreatment and exposure to physical intimate partner violence (IPV) are associated with increased externalizing behavior problems among children and adolescents. However, little is known about the effects of exposure to psychological IPV and exposure to the physical abuse of a sibling. Using a total sample (N = 2,572) and subsample (n = 441) of children ages 3–18 years old, the purpose of this study was to assess whether cumulative types of family violence lead to higher mean externalizing behavior scores and to examine the effects of single types of indirect and direct family violence on children’s mean externalizing behavior scores. Results confirmed that children who experienced any type of family violence victimization had higher mean externalizing behavior scores compared to children with no history of family violence; however, few differences in externalizing behavior scores were found as the number of family violence types increased. Children who experienced indirect types of family violence (e.g., exposure to the physical abuse of a sibling) had higher externalizing behavior scores than children who experienced direct maltreatment (e.g., child physical abuse). Findings from this study suggest that researchers and service providers should adopt a broader conceptualization of family violence victimization and increase the amount of services provided to children who are indirectly victimized.     

Factors influencing help-seeking behavior among battered Korean women in intimate relationships

In total, 123 battered Korean women who used domestic violence agencies were asked where they had turned for assistance in response to intimate partner violence. This study examined the factors related to use of formal and informal resources by these women. Formal resources included police, medical, legal, and shelter; informal were family or neighbors. Findings revealed that (a) the women studied used a variety of resources and that (b) income, violence-related injuries, and partner child abuse were related to whether they contacted police. Injury and partner child abuse were related to contacting a medical doctor/medical facility. Income, relationship status, and partner child abuse were related to approaching family or neighbors. The key finding was that partner child abuse increased the likelihood of battered Korean women seeking help from formal service resources and informal networks. This suggests the need for integrative services that link women's and children's protective services in order to meet the needs of both victims and children.     

Child abuse and chronic pain in a community survey of women

This study examined the relationship between a self-reported history of child physical and sexual abuse and chronic pain among women (N = 3,381) in a provincewide community sample. Chronic pain was significantly associated with physical abuse, education, and age of the respondents and was unrelated to child sexual abuse alone or in combination with physical abuse, mental disorder (anxiety, depression, or substance abuse), or low income. Number of health problems and mental health disorders did not mediate the relationship between physical abuse and chronic pain. Despite considerable evidence from the clinical literature linking exposure to child maltreatment and chronic pain in adulthood, this may well be the first population-based study to investigate this relationship for child physical and sexual abuse independently. The significant association between childhood history of physical abuse and pain in adulthood calls for a greater awareness of the potential for chronic pain problems associated with this type of maltreatment. Further research is needed to understand the mechanism for this complex relationship.     

Biology, childhood trauma, and murder: rethinking justice

This article reviews recent findings in the developmental neurophysiology of children subjected to psychological trauma. Studies link extreme neglect and abuse with long-term changes in the nervous and endocrine systems. A growing body of research literature indicates that individuals with severe trauma histories are at higher risk of behaving violently than those without such histories. This article links these two research areas by discussing how severe and protracted child abuse and/or neglect can lead to biological changes, putting these individuals at greater risk for committing homicide and other forms of violence than those without child maltreatment histories. The implications of these biological findings for forensic evaluations are discussed. Based on new understanding of the effects of child maltreatment, the authors invite law and mental health professionals to rethink their notions of justice and offender accountability, and they challenge policymakers to allocate funds for research into effective treatment and for service delivery.     

Examination of the Relationship Between Parental Satisfaction and Child Maltreatment Potential While Considering Social Desirability

Parental dissatisfaction with children appears to be associated with child maltreatment. However, little is known regarding the specific domains of parental dissatisfaction that may increase child maltreatment potential, particularly in perpetrators of child maltreatment where substance abuse is present. In this study, responses to the Child Abuse Potential Inventory (CAPI) and a scale measuring parental satisfaction in 11 domains were examined in a sample of 82 mothers who were referred for treatment of substance abuse and child neglect by the local child protective service agency. Results indicated that mothers were relatively most satisfied with their children overall, and least satisfied in domains that were relevant to discipline (i.e., following house rules, compliance, reaction to redirection and punishment, completion of chores). Five of the 11 areas of parental satisfaction that were assessed evidenced negative correlations with child abuse potential, indicating that as satisfaction increased, abuse potential decreased. However, when correlation analyses excluded participants with elevated CAPI Lie scale scores (a measure of social desirability), only overall happiness demonstrated a significant negative correlation with child abuse potential. These results suggest that while associations are present among measures of parental satisfaction and child abuse potential, these associations are moderated to some extent by social desirability, which may help explain some of the inconsistencies reported in prior studies of parental satisfaction and child maltreatment potential.     

Poor parenting and antisocial behavior among homeless young adults: links to dating violence perpetration and victimization

Though research has examined risk factors associated with street victimization among homeless young people, little is known about dating violence experiences among this group. Given homeless youths' elevated rates of child maltreatment, it is likely that they are at high risk for dating violence. As such, the current study examined the association between child maltreatment and parental warmth with dating violence perpetration and victimization through substance use and delinquency among a sample of 172 homeless males and females. Results from path analysis revealed that physical abuse, sexual abuse, and neglect were all significant correlates of both substance use and delinquency, whereas lack of parental warmth was only associated with substance use. Neglect and substance use had direct effects on dating violence and substance use and was found to mediate the relationship between physical abuse and dating violence. Finally, females, older youth, and non-Whites had significantly higher levels of dating violence compared with their counterparts.