Decision-making in child abuse and neglect

Social attachment theory can be of value in examining the wide variety of abuse and neglect situations that come to the attention of authorities. We consider evaluation of the parent-child relationship as a crucial part of the judicial process. We have suggested parameters that can be used to evaluate the relationship. We have outlined some of the more common distortions in this relationship that have, in our experience, been associated with the mistreatment of children. The use of social attachment theory has been of great help in understanding the emotional reactions of the many children we have seen for evaluation and treatment. The theory also serves as a potential guide for improvements in social policy. If we are more sensitive to the psychological world of these children, we will be better able to truly protect them.     

Mandatory reporting by nurses of child abuse and neglect

Most Australian jurisdictions have mandatory reporting legislation to compel members of selected professional groups, including nurses, to report suspicions that a child has been or is likely to be subjected to abuse or neglect. This article details the legal obligations of nurses in each jurisdiction, and highlights differences between jurisdictions. Problematic features of the laws are identified, including the use of ambiguous concepts like "reasonable" suspicion and "significant" harm. Literature is reviewed to identify what is known about nurses' legal knowledge, actual reporting practice, and the practical problems that arise for nurses in this context. It is concluded that empirical research needs to be conducted, because it is not known if the laws are practically effective, whether nurses have sufficient training in, and knowledge of, their reporting duties, or what factors influence sound reporting. Such research can inform both the development of sound training systems and recommendations for legal reform.     

The correlates of child physical abuse and neglect by adolescent mothers

Theoretical and empirical knowledge about the link between adolescent motherhood and child maltreatment is in an early stage of development. Research has produced contradictory findings as to a relationship between the two and has not focused on identifying correlates. To fill gaps in the knowledge base and generate hypotheses for future tests, this secondary analysis of data on a subset of 119 mothers who gave birth prior to their 18th birthday focused on identifying characteristics that discriminate among low-income adolescent mothers with maltreated children and comparable mothers whose children were not known to be maltreated. Bivariate analyses of 18 characteristics from several theoretically justified domains revealed that 11 were associated with neglect and four with abuse. Step-sise discriminant analysis identified six correlates of neglect that correctly classified 85% of the mothers and four for abuse that correctly classified 79% of the mothers. Discussion focuses on implications for future research and hypothesis generation.     

Knowledge of child abuse and neglect in nursing students: Assessment and perspectives

Misdiagnosis of child abuse and neglect can delay early treatment. Some authors have pointed out that nurses can miss child abuse and neglect diagnoses due to a lack of knowledge. It is unclear whether the lack of knowledge is due to students' insufficient preparation in nursing school and/or a deficiency in continuing education. An 18-item questionnaire was administered to final-year nursing students to assess their degree of knowledge on child abuse and neglect and to evaluate if the lack of knowledge was due to insufficient teaching/training during nursing school. The students were also asked to evaluate themselves by assigning a score to their knowledge. A statistical comparison was performed to define whether sufficient/insufficient results were associated with the following variables: sex, pediatric or general nursing student, attending pediatric lectures, training in pediatric wards/ambulatories, and attending specific lectures on child abuse and neglect. The study population comprised 175 students (154 females, 20 males, 1 unknown). Exactly 66.3% of the participants had ≤9/18 correct answers. Of all students, 77.7% self-evaluated their level of knowledge as ≤5/10. The comparisons yielded statistically significant differences between the groups with sufficient objective knowledge and those unrelated to training in pediatric wards/ambulatories or pediatric nursing students. Overall, there was little objective knowledge on the subject, which may be related to insufficient teaching/training in nursing schools. Useful corrective strategies include further teaching on child abuse and neglect, preferably using a practical approach. Further, common teaching/training programs should be conducted by both pediatric and general nursing schools.     

The role of stress in the commission of subsequent acts of child abuse and neglect

Data from 1874 clients, who were reported to authorities and treated for abuse and neglect, were examined to determine the role of stress in the commission of subsequent acts. Several case, client, and family characteristics were examined. It was hypothesized that the contribution of stressful events in clients' lives would have a greater effect than all other factors assessed. Results indicated that stress, while contributing to the explanation of subsequent acts of child maltreatment, explains only 9% of the variance over that already explained by other factors. In fact, stressful events, along with seriousness of initial assault, contributed significantly to the explanation of the commission of subsequent acts of child maltreatment.     

Parent and child reports of animal cruelty and their correlations with parent and child reports of child delinquency

ABSTRACT

The purpose of this study was to determine whether child and parent reports of animal cruelty in children correlated with child- and parent-reported delinquency in these same children. A group of 3397 children (1778 boys and 1619 girls; age?=?9 years) from the Fragile Families and Child Wellbeing sample [FFCW: Reichman, Teitler, Garfinkel, & McLanahan (2001). Fragile families: Sample and design. Children & Youth Services Review, 23, 303–326] served as participants in this study. The prevalence of animal cruelty as reported by the child (4.7%) and parent (3.0%) were both low and the zero-order correlation between the two estimates was non-significant, suggesting that they were measuring different constructs. A two-equation multiple regression analysis was conducted, controlling for child gender, domestic violence within the home, mother hitting/spanking, and father hitting/spanking. Findings indicated that parent-reported animal cruelty correlated significantly with child-reported delinquency, controlling for child reports of animal cruelty and the four control variables. Child-reported animal cruelty, however, failed to correlate with parent-reported delinquency, controlling for parental reports of animal cruelty and the four control variables. These results suggest that parental reports of animal cruelty may be more useful as indicators of delinquent involvement than child reports. Possible reasons for these findings are discussed.     

An integrated understanding of elder abuse and neglect

In the past three decades, society has developed interest in what has come to be called elder abuse. Since interest initially appeared, concern about elder abuse has gone through different cycles regarding the conceptualization of the problem, appropriate responses, and explanations. A recent trend has witnessed a call for an interdisciplinary and integrated understanding of, and response to, elder abuse. This article describes what is meant by an integrated response to elder abuse. Ways to promote a broader response to the problem are suggested.     

Characteristics of child abuse by anteroposterior manual compression versus cardiopulmonary resuscitation: case reports

Lethal and sublethal injuries to infants caused by anteroposterior manual compression can be accompanied by lateral rib fractures, hemorrhage into the viscera, and when severe, rupture of large vessels and solid organs. Abusers may claim that these injuries were sustained in an attempt to perform cardiopulmonary resuscitation (CPR). The difference between injuries caused by CPR and injuries caused by inflicted anteroposterior compression is examined in one sublethal and two lethal cases.     

Factors associated with contact child sexual abuse in a sample of indecent image offenders

Abstract

This study explored a sample of 244 UK adult male offenders convicted of offences involving indecent images of children (IIOC): 120 had a previous contact child sexual offence (defined as dual offenders) and 124 had no evidence of an offence against a child (defined as non-contact offenders). Offender groups were compared regarding their socio-demographic characteristics, previous convictions and IIOC possession. Key discriminatory factors that differentiated dual offenders were: access to children, previous offence history, sexual grooming and possession of IIOC that depicts similar-aged victims. In contrast, non-contact offenders could be identified from their greater amount and wider range of IIOC possession. The results suggest a homology between Internet behaviours, IIOC possession and victim selection. Implications for law enforcement agencies are discussed in terms of assisting investigative prioritisation by identifying those most at risk of committing sexual abuse against children.     

Children with burn injuries--assessment of trauma, neglect, violence and abuse

Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electrical, chemical and intentional injury. Mechanisms of injury are often unique to children and involve exploratory behavior without the requisite comprehension of the dangers in their environment. Assessment of the burnt child includes airway, breathing and circulation stabilization, followed by assessment of the extent of the burn and head to toe examination. The standard rule of 9s for estimating total body surface area (TBSA) of the burn is inaccurate for the pediatric population and modifications include utilizing the Lund and Browder chart, or the child's palm to represent 1% TBSA. Further monitoring may include cardiac assessment, indwelling catheter insertion and evaluation of inhalation injury with or without intubation depending on the context of the injury. Risk factors and features of intentional injury should be known and sought and vital clues can be found in the history, physical examination and common patterns of presentation. Contemporary burn management is underscored by several decades of advancing medical and surgical care however, common to all injuries, it is in the area of prevention that the greatest potential to reduce the burden of these devastating occurrences exists.     

Predicting multiple victim versus single victim sexual abuse: an examination of distal factors and proximal factors associated with the first abuse incident

Abstract

Official and confidential self-report data on 83 convicted adult male sexual abusers were analysed to examine whether sexual offending progression can be better predicted from distal antecedents, or from proximal antecedents and outcomes associated with the first sexual abuse incident. Fifty-six offenders who sexually abused more than one victim (multiple victim offenders; MVOs) were compared to 27 offenders who sexually abused a single victim only (single victim offenders; SVOs). MVOs were younger at the time of their first sexual abuse incident, and were more likely to first abuse male and non-familial children. With the exception of sexual attraction to male children, no differences were found between the two groups on distal antecedents. Proximal antecedents and outcomes associated with the first sexual abuse incident were significantly related to multiple victim offending. Logistic regression analysis identified the presence of sexual difficulties in the month prior to the first abuse incident, and sexual excitement immediately preceding the first incident, as significant unique predictors. Implications for risk assessment and risk management are discussed, and future research directions proposed.     

Childhood history of abuse and adult child abuse potential

The experience of aversive interactions within the family of origin is believed to increase the probability of parental physical child abuse. To test this hypothesis, 375 subjects were given a Childhood History Questionnaire (CHQ) and the Child Abuse Potential (CAP) Inventory. The CHQ contained a series of questions about the presence and frequency of various abusive behaviors and associated sequelae that were received and/or observed before and/or after puberty. The CAP Inventory was used to measure adult physical child abuse potential. As expected, a childhood history of physical abuse was significantly related to adult physical child abuse potential; and, as chronicity increased, so did abuse potential. The experience of physical abuse prior to puberty produced higher abuse scores than the experience of physical abuse after puberty. The study provides preliminary data indicating the childhood experience of a caring adult and / or caring friend moderates adult child abuse potential.     

Elder abuse and neglect cases reviewed by appellate courts

With increasing attention focused on abuse and neglect of the elderly in domestic and institutional settings, nearly every state has passed legislation to protect these vulnerable adults. While the legal system has become involved at the trial court level, the appellate courts have not yet been very active. Only ten reported cases in the United States during 1981–1993 were appealed to a higher court. This article documents these few cases and explores the reasons for their ultimate dispositions.     

Intergenerational child abuse and coping

Many studies have investigated the consequences of child sexual abuse (CSA) but few have examined the intergenerational effects of poly- victimization and maladaptive coping. The purpose of this investigation was to examine patterns of maltreatment and maladaptive coping among second-generation CSA survivors. It is hypothesized that: (a) maternal CSA history would be associated with a higher incidence of poly-victimization and maladaptive coping and (b) experiencing more forms of abuse would mediate the relation between maternal CSA history and maladaptive coping behaviors. The method used was a chart review of 139 sexually abused females aged 12 to 17, examining maternal abuse history, maladaptive coping behaviors, and child maltreatment. The results showed that poly-victimization differed as a function of maternal CSA history but maladaptive coping did not. Experiencing more types of abuse was associated with both self-injurious behaviors and substance use. In conclusion, results support the hypothesis that second generation CSA survivors are more likely to experience poly-victimization. Future research should address how intergenerational patterns of abuse might affect presenting symptomatology and treatment outcome.