The use of multiple informants to assess children's maltreatment experiences

Most researchers rely exclusively on the reports of protective service workers to determine children's abuse history. In this report, information about children's maltreatment experiences is obtained from protective service workers and three supplementary sources of data: parents, medical records, and clinical observations. Fifty-six children from 34 families receiving protective services for verified reports of physical abuse, neglect, sexual abuse, and/or emotional maltreatment participated in the study, with most children known to have experienced more than one type of abuse. The supplementary data provided important information about the range and severity of children's maltreatment experiences. Review of the parent and medical record data led to identification of 28 children who had additional types of maltreatment experiences that were not reported by their protective services workers—nine cases of physical abuse, two cases of neglect, five cases of sexual abuse, and 12 cases of emotional maltreatment. Supplementary data also revealed information about incidents of specific types of abuse that were more severe than those reported by the children's protective service workers in an additional 24 cases. A method was devised to synthesize information provided from the different sources of data examined in this report to derive 0–4 point ratings of four categories of maltreatment experiences: (1) physical abuse, (3) neglect, (3) sexual abuse, and (4) emotional maltreatment. The Kappa reliability coefficients for each of these scales were .88, .73, .83, and .90, respectively. Data demonstrating the relationship between these maltreatment ratings and various indices of the children's socioemotional and cognitive functioning were also presented to provide preliminary support for the validity of these scales. The findings from this study suggest that multiple sources of data should be examined in order to obtain accurate assessments of children's maltreatment experiences, and that independent raters can synthesize discrepant data to obtain reliable and valid estimates of children's abuse history. Clinical and methodological issues relevant to the improved assessment of children's maltreatment experiences are also discussed.     

Methodological Issues in Assessing the Effects of Maltreatment Characteristics on Behavioral Adjustment in Maltreated Children

This paper explored methodological issues in examining the impact of maltreatment characteristics on behavioral adjustment in a sample of maltreated school-age children. Different approaches to assessing the effects of maltreatment type were used to determine whether maltreatment characteristics differed by type of maltreatment and whether relationships between maltreatment characteristics and child behavioral functioning differed according to type of maltreatment. Results revealed several differences among the three types of maltreatment subgroups (physical abuse, neglect, and sexual abuse) on characteristics of maltreatment experiences. Correlations between maltreatment characteristics and outcome measures for the sample as a whole obscured findings that relationships were often specific to particular types of maltreatment. Developing generic definitions for maltreatment characteristics applicable to all forms of maltreatment is difficult because of differences in meaning across maltreatment types. Findings suggest that the role of maltreatment characteristics in children's behavioral functioning should be examined separately for each form of maltreatment.     

Is Domestic Violence Learned? The Contribution of Five Forms of Child Maltreatment to Men's Violence and Adjustment

On the basis of a learning-theory approach to the intergenerational transmission of violence, researchers have focused almost exclusively on violent men's childhood experiences of physical abuse and witnessing family violence. Little consideration has been given to the coexistence of other forms of child maltreatment or the role of family dysfunction in contributing to violence. This study shows the relationships between the level of child maltreatment (physical abuse, psychological maltreatment, sexual abuse, neglect, and witnessing family violence), childhood family characteristics, current alcohol abuse, trauma symptomatology, and the level of physical and psychological spouse abuse perpetrated by 36 men with a history of perpetrating domestic violence who had attended counseling. As hypothesized, a high degree of overlap between risk factors was found. Child maltreatment, low family cohesion and adaptability, and alcohol abuse was significantly associated with frequency of physical spouse abuse and trauma symptomatology scores, but not psychological spouse abuse. Rather than physical abuse or witnessing family violence, childhood neglect uniquely predicted the level of physical spouse abuse. Witnessing family violence (but not physical abuse) was found to have a unique association with psychological spouse abuse and trauma symptomatology. These results present a challenge to the understanding of domestic violence obtained from learning theory.     

Classifying Type of Child Maltreatment: Does the Source of Information Make a Difference?

To determine whether antecedents or consequences of maltreatment differ by type of maltreatment, researchers must address the question of how to classify type of maltreatment. However, maltreatment rarely occurs in the pure forms desirable for research. Children often experience multiple forms of maltreatment at one time or experience different types of maltreatment at different times. This paper examines six different methods for classifying type of maltreatment in a sample of cases reported to a state protective service agency. The greatest shifts in type of maltreatment group membership occurred when the definition was expanded from a single maltreatment report to include prior history of maltreatment for the study child and present and prior maltreatment for siblings. Multiple forms of maltreatment increased as more maltreatment history was taken into account. Regardless of the classification source, the most frequent multiple type was the combination of physical abuse and neglect.     

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.     

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).     

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.     

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).     

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.     

Mandatory Child Abuse Reporting Laws: Issues and Implications for Policy

Child maltreatment has been deemed a national emergency, with more than 2.5 million cases of abuse and neglect reported each year. Social policies designed to address child maltreatment include state statutes requiring professionals to report suspected child maltreatment to authorities. Mandatory reporting laws, while of potential benefit in the identification of abused and neglected children, can often result in higher or lower rates of reporting of abuse. The present paper reviews the functions of mandatory reporting statutes in professional contexts. Factors related to both low and high rates of reporting are discussed. In addition, suggestions for social policy are reviewed.     

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.     

The Neglect of Elder Neglect as a White-Collar Crime: Distinguishing Patient Neglect from Physical Abuse and the Criminal Justice System’s Response

While research on elder maltreatment has increased dramatically over the past three decades, few studies have considered elder neglect. Even fewer studies have addressed cases of patient neglect committed while older adults are receiving long-term care. In this study, we analyzed 252 cases of elder maltreatment to increase understanding about elder patient neglect and the way that patient neglect can be distinguished from patient abuse. The criminal justice system’s response to these crimes is also addressed. The results show that offenders in elder patient abuse and patient neglect cases receive similar sentences. However, the dynamics surrounding the offenses are different in important ways. Patient neglect cases are more likely than patient abuse cases to (1) involve multiple victims, (2) be committed in groups, (3) be white-collar crimes rather than occupational crimes, and (4) result in more serious consequences for victims. Implications for policy, theory, and research are provided.     

Risk Factors Associated with the Chronicity of High Potential for Child Abuse and Neglect

The present 4-year follow-up study involves 56 mothers who were evaluated by social agencies as being abusive and neglectful or at high risk for child abuse and neglect. The aim of the study is to analyze the relationship between psychosocial risk factors (relating to the history and current situation of the mothers) that were present at the time the families were initially recruited and the fact that some of the mothers continue to show a high potential for child abuse and neglect (chronic abuse and neglect), whereas others were able to overcome the problem (transitory abuse and neglect). Results indicate that the following variables are particularly associated with situations involving chronic problems of abuse and neglect: initial level of severity of potential for abuse and neglect; dual-parent status; a large number of children at the time of intervention (3.13 times more risk of chronicity for large families); the fact that as a child the mother herself had been placed in a foster home (3.7 times more risk); that she had been sexually abused (3.5 times more risk); and that as an adolescent she had run away from home (3.02 times more risk). Our results indicate that mothers who have a combination of more than eight risk factors are four times more likely to be in the chronic group.     

Predictors of Child Abuse Potential Among Military Parents: Comparing Mothers and Fathers

The present study examines the predictors of child abuse potential for at-risk fathers and mothers serving as active duty Army members and their spouses. Although fathers are perpetrators of child physical abuse and neglect in a substantial portion of reported cases, what is known about factors associated with child maltreatment comes almost exclusively from studies of perpetrating mothers. Thus, the inclusion of a large sample of fathers in the present study makes a significant contribution to the extant literature. Participants were 175 fathers (93% active-duty) and 590 mothers (16% active duty) of young children enrolled in an Army-sponsored home visitation program. Regression analyses indicated that there were both common and unique predictors of child abuse potential for mothers and fathers. Common predictors included depression, parental distress, and family conflict. Low family expressiveness was predictive only for fathers, whereas marital dissatisfaction, low social support, and low family cohesion were predictive only for mothers. Possible reasons for these gender differences and the implications of these results for child maltreatment interventions are discussed.     

Personality Disorders in a Sample of Parents Accused of Physical Abuse or Neglect

The objective of this study was to provide a psychological profile of parents who have been formally accused of child maltreatment. A clinical group of 16 parents accused of physical abuse and 22 parents accused of neglect were compared with 18 parents from a control group. The MCMI-III was administered individually for each parent. Both groups of maltreatment showed significant differences on different scales of the MCMI-III. No difference was seen between the parents of both groups of child maltreatment. Many parents of both child maltreatment groups reported at least one form of abuse during their childhood, suggesting that a childhood marked by abuse or neglect on the part of a parent could result in personality disorders and that these disorders may have something to do with the intergenerational transmission of abuse.     

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.     

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.     

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.     

The Impact of Child Abuse Potential on Adaptive Functioning: Early Identification of Risk

Previous research has investigated the deleterious effects of child maltreatment on child development; however, little research has examined the development of children who live with caregivers who are at risk of maltreatment on child development outcomes. This study utilized self-report data from caregivers that included the Child Abuse Potential Inventory (CAPI), Parenting Stress Inventory-Short Form (PSI/SF), and Adaptive Behavior Assessment System-2nd Edition (ABAS-II) for 116 children ages 3-12 from a rural, Appalachian community. Caregivers with lower child abuse potential, children who used fewer school services, older children, and caregivers with lower household income had better total adaptive skills. Caregivers with lower child abuse potential, children who used fewer school services and older children had better functioning on the academic skills subscale. Children who used fewer school services, were older, and had lower family income had greater self-care skills. Finally, children who used fewer school services had greater communication skills. Parent-child dysfunction was not related to child development outcomes. The findings demonstrate that educators are in a unique position to intervene and support children at risk of maltreatment.     

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.