Safety, Health Care, and Bonding Within an Ecobehavioral Approach to Treating and Preventing Child Abuse and Neglect

This paper describes Project SafeCare, an ecobehavioral research and treatment project with families reported or at risk for child abuse or neglect. Preliminary demographic data are reviewed along with indirect assessment data. Four case studies are described to exemplify the effects of training provided to families. The implications for the current assessment data, treatment, and outcome are discussed.     

Offender Characteristics and Behaviors in NonSexual Child Maltreatment

Data on 552 child maltreatment cases in South Korea involving convictions, including child physical abuse, emotional abuse, and neglect, were analyzed in order to compare 259 offenses committed by male offenders with 293 offenses committed by female offenders. Relative to cases involving female offenders, male offenders both had a higher number of criminal convictions and were more likely to have previously abused their victims. By contrast, female offenders were more likely to have had financial difficulties, while their victims were significantly younger compared to male offenders. Male offenders were more likely to strike the victim, either manually or with an instrument, particularly a blunt instrument, whereas female offenders were more likely to pinch or bite their victims. The findings can aid social workers and medical personnel in recognizing the signs of child maltreatment and identifying at-risk children more effectively, helping to employ timely interventions and prevent the reoccurrence of child maltreatment.     

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.     

A Longitudinal Study of Modifying Influences in the Relationship Between Domestic Violence and Child Maltreatment

The increased risk of child maltreatment in the presence of domestic violence is well documented, but much remains unknown about factors that modify this relationship. This study investigates the roles of risk and protective factors in the relationship between domestic violence and being reported to the Department of Social Services for child maltreatment. Consistent with the literature, we find a significant overlap between domestic violence and maltreatment. Young maternal age, low education, low income, and lack of involvement in a religious community add to the risk for maltreatment associated with domestic violence. Separation between the maternal caregiver and her partner significantly reduces the risk for maltreatment when domestic violence is reported. A significant reduction in the risk for maltreatment is also found with higher levels of support from the maternal caregiver reported by the child in the context of domestic violence.     

Project SafeCare: Improving Health, Safety, and Parenting Skills in Families Reported for, and At-Risk for Child Maltreatment

Project SafeCare was a 4-year, in-home, research and intervention program that provided parent training to families of children at-risk for maltreatment, and families of children who were victims of maltreatment. Parents were trained in treating children's illnesses and maximizing their own health-care skills (Health), positive and effective parent–child interaction skills (Parenting), and maintaining low hazard homes (Safety). The effectiveness of these training components was evaluated as the change in the parents' scores on roleplay situations for child health problems, hazards present in the home, and the frequency and quality of parent–child interactions during activities of daily living. Statistically significant improvements were seen in child health care, home safety, and parent–child interactions.     

Effects of Partner Violence and Physical Child Abuse on Child Behavior: A Study of Abused and Comparison Children

This study tests a model of the effects on child behavioral outcome of the child's exposure to partner violence and child abuse, in children who have experienced the two forms of victimization either separately or together. Recognizing that family contextual factors play an important role in influencing child outcome, an ecological model is proposed that designates family stress as the principal exogenous factor, with effects on child outcome mediated through caretaker distress, partner violence, and child abuse. The sample consists of 100 confirmed cases of physically abused New York City schoolchildren, ages 9 to 12 years, and their families, and 100 nonmaltreated classmates, matched for gender, age, and, as closely as possible, for race, ethnicity, and socioeconomic status, and their families. Child behavioral outcome is assessed by classmates for antisocial, prosocial, and withdrawn behavior and by parents and teachers for externalizing and internalizing problem behavior. Results are generally consistent with the hypothesis that partner violence and caretaker distress, both associated with family stress, increase the risk for child abuse and thereby raise the child's risk for poor outcome. Implications of differences among raters for the model's applicability, and implications of the results for clinical intervention, are discussed.     

Research Foundations of Greenbook Interventions to Address the Co‐Occurrence of Child Maltreatment and Adult Domestic Violence

Twenty years ago the National Council of Juvenile and Family Court Judges published Effective Intervention in Domestic Violence and Child Maltreatment: Guidelines for Policy and Practice, which became known as the Greenbook because of its green cover. This article presents the social science research leading up to the Greenbook and the 20 years beyond the publication of this seminal document, including examination of the effect of co‐occurrence of child maltreatment and exposure to domestic violence on child outcomes, the interventions for families to improve the safety of both child and adult victims, and future directions for research.     

美国虐童防控对策研究

虐童是全球的普遍现象,美国儿童也深受其害.美国的虐童现状堪忧,原因错综复杂.虐童不仅会造成孩子身体上的伤害,还会对孩子造成心理上的伤害,这种伤害要持续很长时间甚至一生.针对此,美国形成了应对虐童的综合性防控体系,有着严格的法律保障、系统的组织保障和充足的资金保障,形成了主动先发的前瞻性预防模式,把虐童预防的重点放在了整个社会的综合预防.实践证明,美国的这种综合性防控虐童对策具有良好的防控效果.     

The effects of adult and peer social initiations on the social behavior of withdrawn and aggressive maltreated preschool children

The effects of programmed peer- and adult-mediated play initiations were compared for socially dysfunctional, maltreated preschool children. An N = 1, alternating treatments design was used to compare these strategies. Two withdrawn nonmaltreated (control), two withdrawn maltreated, and three aggressive maltreated children served as subjects. Dyadic play sessions were videotaped and rated at the completion of the study by naive raters according to an 18-category observation system. Overall, the control children showed no difference in levels of interaction between peer and adult conditions. The withdrawn maltreated children showed a clear preference for interaction with the peer over the adult. The aggressive maltreated children showed a clear preference for interaction with the peer over the adult. The aggressive maltreated children showed a clear preference for interaction with the adult. They also demonstrated a decrease of positive behavior and increase in negative behavior in response to the programmed initiations. Implications of these differential responses were discussed.     

Maltreatment and Family Dysfunction in Childhood and the Subsequent Adjustment of Children and Adults

The adjustment problems associated with sexual abuse, physical abuse, psychological maltreatment, neglect, and witnessing family violence during childhood were examined in three studies. Study 1 demonstrated significant overlap between maltreatment types in parent reports (N = 50) of maltreatment experiences of their child aged 5–12 years. Parental sexual punitiveness, traditionality, family adaptability and family cohesion significantly predicted scores on 4 maltreatment scales and children's externalizing behavior problems. Level of maltreatment predicted internalizing, externalizing, and sexual behavior problems. In Study 2, significant overlap was found between adults' retrospective reports (N = 138) of all 5 types of maltreating behaviors. Parental sexual punitiveness, traditionality, family adaptability, and family cohesion during childhood predicted the level of maltreatment and current psychopathology. Although child maltreatment scores predicted psychopathology, childhood family variables were better predictors of adjustment. Study 3 demonstrated that child maltreatment scores predicted positive aspects of adult adaptive functioning (N = 95).     

Patterns of reported parent-child abuse and police response

The present study examines the level and patterns of parent-child abuse incidents that come to the attention of the police. It also addresses the response of law enforcement to such incidents in an attempt to discover the determinants of official intervention. The findings indicate that both family status and gender influence the patterns of parent-child abuse reported to the police. Multivariate analysis revealed that the arrest decision was influenced most strongly by the seriousness of the incident, as measured by offense severity and extent of injury to the victim. The likelihood of arrest was also affected by the race of the offender, but the influence of this variable was mediated by the seriousness of the offense. The study highlights the role that the value system surrounding the family plays in the reporting of parent-child abuse incidents and in the police decision to intervene.     

Child Sexual Abuse in Turkey: An Analysis of 1002 Cases

This study investigated the characteristics of abuse suffered by children, the dimensions of the psychiatric effects associated with abuse, and the factors affecting these. One thousand two cases aged under 18, exposed to sexual abuse, and referred over a 7‐year period were assessed. Girls represented 80.8% of cases, and the numbers rose with age. The aggressors were all male, and 88.2% were known to their victim. Approximately half the children were exposed to sexual abuse involving penetration. Psychological pathology was identified in 62.1%. Female gender, the presence of penetration, physical violence, and incest significantly increased the development of psychological pathology. Levels of awareness in people close to and trusted by the child must be raised to minimize the adverse effects of trauma in the long term, preventive measures must be taken, and medical and social support units from which victims can receive assistance need to be established.     

Sexual exploitation of children in europe: Child pornography

Abstract

Summary: This article is taken from a report entitled: Rhetorics and Realities: Sexual Exploitation of Children in Europe, of a study funded by the European Commission under the STOP Programme. It begins by re-visiting the knowledge base of child pornography and addresses a range of issues including: children's access to pornography; law enforcement and European policy. The article concludes with a number of pertinent questions which need both attention and answers.     

Child Abuse Potential: A Comparison of Subtypes of Maritally Violent Men and Nonviolent Men

Researchers have demonstrated an overlap between husband-to-wife violence and child abuse, but we know little about which maritally violent men are at greatest risk for engaging in child abuse. This study examined child abuse potential across 4 subtypes of maritally violent men (i.e., family only, low level antisocial, borderline/dysphoric, and generally violent/antisocial; Holtzworth-Munroe et al., and 2 comparison groups of nonviolent men (i.e., maritally distressed or not), using the Child Abuse Potential Inventory (CAP; J. S. Milner [1986])). The results revealed that the borderline/dysphoric batterer subtype had significantly higher child abuse potential scores than all of the other violent subtypes and the nonviolent comparison groups. Theoretical and clinical implications are briefly discussed.     

Effects of Family Violence on Child Behavior and Health During Early Childhood

Looking at families where children have been abused/neglected in early childhood, this study examined measures of child behavior and health to see if they tended to be worse when domestic violence is or has been present in a family. Further, caregiver and family characteristics as well as other case factors were examined, as possible moderators or mediators of the effects of domestic violence. Results indicate that domestic violence, of the type and severity occurring in our sample, does not have a direct effect on child outcomes by Age 6, when other associated variables are taken into account, but has considerable indirect effects. There is a pronounced impact of domestic violence on family functioning, the caregiver's general health and well being, and the quality of the caregiver's interaction with the child, which in turn are significantly associated with decrements of child functioning related to behavior problems and health. Some implications of this study for research in the area of domestic violence and child maltreatment are discussed.     

Consideration of Risk and Protective Factors for Families at Risk for Child Maltreatment: An Intervention Approach

Child maltreatment is associated with a complex interplay of risk and protective factors. Intervention service decisions for child maltreatment need an empirically-supported approach integrating targeted risk and protective factors. A literature review led to the proposed approach to address the interplay between risk (intimate partner violence; IPV and depression) and protective factors (social support and family resources) to help guide decision-making in home-based prevention services for vulnerable families. This approach suggests that social support and family resources are two pivotal protective factors in buffering against child maltreatment potential, while addressing core risk factors. This approach is consistent with research suggesting that home-based parenting programs should target central risk and protective factors in child maltreatment. Application of this approach can guide training of providers delivering home-based services and support decision-making. Future research is warranted to test this approach in empirically-supported interventions.     

Using Video to Reduce Home Safety Hazards with Parents Reported for Child Abuse and Neglect

Safety hazards are frequent in the homes of families reported for child abuse and neglect. The effectiveness of a videotape intervention with two families involved with child abuse and neglect was examined, using a replicated multiple probe design across settings. Data were collected using the Home Accident Prevention Inventory — Revised, and the Checklist for the Video-Trained Parent's Behavior. Social validation and expert validation data are also presented.     

An Investigation of a Community-based Intervention for Socially Isolated Parents with a History of Child Maltreatment

A randomized field trial was conducted to test the effectiveness of a community-based intervention to enhance the prosocial interaction and psychological well-being of urban, Head Start parents with a history of child maltreatment. One-hundred and sixteen socially isolated parents participated. Forty of these parents had a history of child maltreatment. Maltreatment and non-maltreatment parents were assigned randomly to intervention and control conditions. The intervention involved 10 group-training sessions focusing on the relationship between stress and social support. Analyses revealed a significant main effect for the intervention group with intervention parents reporting lower levels of stress and higher levels of social activity than controls. No main effects for maltreatment status or maltreatment by intervention group interactions were found. Implications for community-based treatment were discussed.     

Physical Violence Between Young Adults and Their Parents: Associations with a History of Child Maltreatment

This study investigated the relationship between maltreatment during childhood, parental conflict tactics and the tactics employed by young adults during a disagreement with their parents. Four hundred and sixty nine university students completed the Conflict Tactic Scale and a Childhood History Questionnaire giving details on tactics employed during the previous year and information about their childhood respectively. Overall, 14.5% of students reported using violent tactics with their mother and/or father and 3.8% of them admitted to being severely violent to one or both of their parents. The conflict tactics used by the respondent were found to be significantly related to the reported tactics of their parents and the experience of being maltreated by parents in earlier years.     

Trichobezoar in Vagina: Assessment for Child Sexual Abuse and Diagnostic Result of Forensic Science

Vaginal discharge and bleeding in children require a through and thoughtful evaluation to diagnose the underlying problem including infections, sexual abuse, and vaginal foreign bodies. We report a 6‐year‐old girl presenting with bloody vaginal discharge, carefully evaluated for sexual abuse, and finally diagnosed as a vaginal foreign body after vaginoscopy. A rolling hair ball was extracted from the vagina and was diagnosed as trichobezoar pathologically without any endo–ecto‐mesodermal residual tissue. The hair ball was genetically detected and diagnosed to belong herself by containing no foreign structure. Child sexual abuse was ruled out by forensic interview at CAC and report of forensic science that reported genetic structure belonging to the child. Medicolegal assessment helped in final diagnosis to exclude child sexual abuse.