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.     

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.     

Comparing Self-Reports and Official Records of Arrests

We compared measures of self-reported arrests and official arrests for 676young adults with a history of child abuse and/or neglect and 520 nonabusedand nonneglected controls matched on age, sex, race, and approximate familysocial class. Findings reveal considerable concurrent validity between thetwo sources overall. But there is also evidence of differences by gender,race/ethnicity, age at time of arrest, conviction status, and type ofoffense. Abused and neglected subjects did not appear to differ from thecontrol group in the extent of underreporting of known offenses, however,the groups did differ in the degree of positive bias—offensesnot found in arrest records. Abused/neglected subjects self-reportedproportionately more offenses not known to police compared to controls. Thisresult suggests that findings from previous studies on the relationshipbetween childhood victimization and later criminality, as measured byarrests, may have underestimated the magnitude of this relationship.     

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.     

PUNCHING THE PARENTING TIME CLOCK: THE APPROXIMATION RULE,SOCIAL SCIENCE,AND THE BASEBALL BAT KIDS*

The American Law Institute proposes that in contested physical custody cases the court should allocate to each parent a proportion of the child's time that approximates the proportion of time each has spent performing caretaking functions in the past. Examined through the lens of child development research, the approximation rule is unlikely to improve on the best interests standard. It is difficult to apply; is perceived as gender‐biased; creates a new focus for disputing parents; renders a poor estimate of parents’ contributions to their child's best interests; overlooks parents’ intangible, yet significant, contributions to their child's well‐being; and miscalculates the essence of how a child experiences the family. A preferable alternative is a better defined, contemporary best interests standard that accommodates new knowledge and reforms that encourage nonadversarial, individualized resolutions of custody disputes.     

THE NEGLECT OF CHILDREN AND CULTURE: RESPONDING TO CHILD MALTREATMENT WITH CULTURAL COMPETENCE AND A REVIEW OF CHILD ABUSE AND CULTURE: WORKING WITH DIVERSE FAMILIES*

This article examines cultural competence in the context of child protective proceedings, underscoring the dangers posed by bias toward particular cultural views, standards, and norms. I look at the racial imbalance within the realm of child maltreatment proceedings and explore the challenge of how children can receive appropriate services, counseling, and representation, given their varying cultural, ethnic, and racial backgrounds. Lastly, I review Child Abuse and Culture: Working with Diverse Families, by Lisa Aronson Fontes.     

Practice tips for managing challenges in parenting capacity assessments in child protection court

Courts frequently rely on parenting capacity assessments to make decisions about visitation and case progress in child protection court. Although these evaluations can provide valuable information to courts, they often involve assessing areas of human behavior that are not clearly defined in the literature. For example, mental health professionals are often tasked with identifying risk and protective factors for child maltreatment while identifying factors that can impede progress towards reunification. Although some of these factors may be easy to identify and assess (e.g., symptoms of mental illness or substance abuse), others may be more challenging. For example, factors such as denial and minimization about risk factors and maltreatment, a parent(s)’ ability to protect their child(ren) from future incidents of maltreatment, the parent(s)’ potential for change, and the consideration of what is in the best interest of the child are hard to assess. This article will provide a summary of the research in these areas, provide tips for managing these areas, and highlight directions for future investigation that will help inform parenting capacity assessments in child protection court.     

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.     

EMPOWERING PARENTS IN CHILD PROTECTION MEDIATION: CHALLENGES AND OPPORTUNITIES

One of the greatest challenges that parents face in child protection mediation (CPM) is to voice their concerns and negotiate on a relatively equal basis with the other mediation participants. This article considers how imbalances of power, limited confidentiality protection, and the personal problems that bring parents into the child protection process can limit a parent's ability to exercise self-determination in mediation and offers guidance for mediators seeking to conduct CPM in a manner that effectively empowers parents to meaningfully and collaboratively participate in mediation.     

Polygamy In Family Court: A Resource For Judges Dealing With An Unfamiliar Family Structure

Cases concerning polygamous households can present difficult challenges for family courts. Though a growing number of Americans practice polygamy, the lifestyle still remains shrouded in mystery. Many polygamists are religious (and sometimes racial) minorities that have suffered from discrimination. The most influential judicial precedents concerning polygamy come from the nineteenth century and are tinged with religious and racial stereotypes, which can make judges uncomfortable with citing those decisions. There is a need for reliable, unprejudiced, and up‐to‐date information about polygamy that judges can cite while maintaining an image of objectivity and impartiality. This Article seeks to provide that resource. It provides information about the evolutionary influences that shape polygamy, how polygamy is practiced in the modern world, and common problems affecting polygamous households that judges should be aware of.     

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).     

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.     

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.     

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.     

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.     

NEGLECTED INFANTS IN FAMILY COURT

This paper applies the science of early childhood development to the question of neglect in infancy to offer best practice guidance to family law and child protection professionals charged with acting in their best interest. The paper discusses the challenges of presenting cases of infant neglect, particularly emotional neglect, to the court. Current science on the implications of neglect for brain development, and long term mental health are discussed. Recommendations for assessment, intervention and questions that should be addressed in court deliberations are outlined.     

Obesity,Body Mass Index,and Homicide

The body mass indexes (BMIs) of 100 randomly selected homicide cases from the files of Forensic Science SA were compared to the Australian and South Australian populations. There were 70 males and 30 females (M:F = 2.3:1; age range 18–84 years; mean 42.3 years). There was a substantially lower proportion of obese individuals in the homicide population compared to the general Australian and South Australian populations (19% [vs.] 27.9% and 30%, respectively). A second group of 144 randomly selected autopsy cases where the BMI was ≥40 kg/m² was analyzed. There were 77 males and 67 females (M:F = 1.2:1; age range 23–78 years; mean 46.7 years). The majority of deaths were natural (N = 108), with no homicides. A negative association between obesity and homicide has, therefore, been demonstrated. Reasons for the lower numbers of obese/morbidly obese individuals among homicide victims are unclear, but may include physical protection afforded by fat padding from sharp force injuries, and relative sociodemographic isolation.     

ARE WE REALLY LOOKING OUT FOR THE BEST INTERESTS OF THE CHILD? APPLYING THE NEW ZEALAND MODEL OF FAMILY GROUP CONFERENCES TO CASES OF CHILD NEGLECT IN THE UNITED STATES

This Note advocates for state laws to be amended to implement family group conferencing (FGC) as the first step in cases of alleged child neglect. FGC was developed in New Zealand nearly twenty years ago and have since become a realistic method of balancing the best interests of the children, families, agencies, courts, and communities involved in the child welfare system. A FGC is a meeting among family members and professionals that is conducted in order to develop a plan for a child who is the victim of neglect. FGC places the family at the center of the welfare proceedings and empowers them to reach a solution without having to resort to the often lengthy and expensive adversarial court system. If FGC is incorporated into the child welfare systems throughout the United States, communication between the parents, social services, and the courts could increase, helping families adequately address the problem of neglect and getting the children out of the child welfare system quickly and more efficiently.     

ADVOCATING FOR COMPREHENSIVE ASSESSMENTS IN DOMESTIC VIOLENCE CASES

Many jurisdictions handle domestic violence cases on a one‐size‐fits‐all basis, with a presumption in favor of a finding of child neglect and removal when children are exposed to domestic violence. Such a standard fails to recognize that not all domestic violence is the same and not all families are equally affected. The impact of domestic violence depends on several factors such as the different types of domestic violence the frequency and intensity of the violence, the frequency and extent of the child's exposure, and each family member's unique experiences and characteristics. This view takes the position that parents’ capacity to participate in counseling and services promoting the health and safety of their children varies, as does the appropriateness of children being removed from the home as a result of exposure to domestic violence. Therefore, this Note proposes that states develop a standard for both courts and child protective agencies that carefully examines each domestic violence case using an individualized factual analysis and attempt to mitigate the effects of a child's exposure to domestic violence by means other than a presumption for or against removal (temporary or permanent) in every case.     

VARIETIES OF VIOLENT BEHAVIOR

There is an implicit assumption of homogeneity across violent behaviors and offenders in the criminology literature. Arguing against this assumption, I draw on three distinct literatures [child abuse and neglect (CAN) and violence, violence and post‐traumatic stress disorder (PTSD), and CAN and PTSD] to provide a rationale for an examination of varieties of violent behaviors. I use data from my prospective cohort design study of the long‐term consequences of CAN to define three varieties of violent offenders using age of documented cases of CAN, onset of PTSD, and first violent arrest in a temporally correct manner [CAN → to violence, CAN → PTSD → violence (PTSD first), and CAN → violence → PTSD (violence first)], and a fourth variety, violence only. The results illustrate meaningful heterogeneity in violent behavior and different developmental patterns and characteristics. There are three major implications: First, programs and policies that target violence need to recognize the heterogeneity and move away from a “one‐size‐fits‐all” approach. Second, violence prevention policies and programs that target abused and neglected children are warranted, given the prominent role of CAN in the backgrounds of these violent offenders. Third, criminologists and others interested in violence need to attend to the role of PTSD, which is present in about one fifth (21 percent) of these violent offenders, and not relegate the study of these offenders to the psychiatric and psychological literatures.