PARENTAL REACTION TO THE DISABLED CHILD:

The special needs child demands adept and flexible care. This becomes harder to provide when the child resides in two homes or when the parents are in conflict about the child's diagnosis. To secure effective intervention, parents must become mini-experts in their child's condition, advocating tirelessly to secure necessary educational, financial, and medical assistance. These parents, confronted with the reality of their child's diagnosis, must also face the reality of a different future than the one they had imagined for their child and themselves. This can trigger a complex and fluid grieving process that is different for every parent. Understanding the role of grief in custody proceedings can provide a useful lens for viewing the vastly dissimilar opinions these parents often present. Failing to recognize the distorting effect of grief places family law professionals at a distinct disadvantage in dealing with these complex issues.     

Lethal child neglect

The jurisdiction of the Hannover Institute of Legal Medicine recently experienced an unusually high incidence of lethal child neglect, with three cases in a 5-month period in 1999. Case 1: A girl received an inappropriate and inadequate diet of tea and oatmeal. The child was never breastfed, nor did it ever receive any other formula. The parents report the infant to have been healthy until she suddenly began projectile vomiting at the age of 13 weeks. For the next 3 days the infant was not able to maintain an adequate intake. The mother reports finding the child dead in its bed on the morning of the fourth day. Attempts by medical personnel to revive the child were unsuccessful. Case 2: A mother began spoon-feeding the infant puree on the fourth day of life, which according to the manufacturer's specifications is suitable for children between 4 and 8 months of age. At the age of 5 weeks, the infant was reported to have vomited half the just previously ingested meal, after which she took a nap. Some time later the parents observed the infant to be quite pale, however, assumed this was a result of sleep. When the mother finally did pick her up, the child was lifeless, and the parents brought her to the hospital. Medical personnel could however, only declare the infant dead, documenting a rectal temperature of 30 degrees C. Case 3: A 3.5-year-old girl died after her mother left the locked apartment and did not return for several weeks. The body of the child was found lying dressed on the floor in a state of advanced decay and mummification. Common findings in all three cases include lack of prenatal care, home birth without the help of a midwife, low socioeconomic status or maternal alcohol abuse, body weights below the 3rd percentile, extreme dehydration, fatty hepatic degeneration, thymic atrophy and signs of aspiration.     

Inadvertent clavicular fractures caused by "chiropractic" manipulations in an infant: an unusual form of pseudoabuse

A nine-month-old child was found unresponsive in his crib, five hours after his last feeding. At autopsy, there were no external or internal signs of abuse or neglect, and a few visceral pleural and epicardial petechiae were consistent with the sudden infant death syndrome (SIDS). However, postmortem total body radiographs revealed healing, symmetrical clavicular fractures and a healing left medial humeral epicondyle fracture. The parents had no explanation for these injuries and denied causing any harm to the child. The location and nature of the fractures strongly suggested abusive origin, and the case was reported to the police and the district attorney's office as child abuse. During the investigation, information from the parents indicated that the child had undergone "chiropractic" manipulations by an unlicensed therapist, between three and four weeks prior to death, to correct supposed "shoulder dislocations." This time interval correlated with the histologic age of the injuries, and the history explained their unusual bilateral location and appearance. The parents were exonerated of abuse charges, and the death was ascribed to SIDS.     

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.     

Trial court decision in Houle case

The plaintiffs in this case, a hospital and an attending physician, petitioned the court to exercise its parens patriae authority when the parents of a newborn with multiple birth defects refused to consent to surgery that would permit normal feeding and respiration. Basing his decision on the medical necessity and feasibility of the proposed treatments and setting aside the issue of the infant's quality of life, Justice David G. Roberts of the Superior Court ruled that the parents had no right to withhold care from their child. He authorized the infant's guardian ad litem to consent to surgery and other standard life-preserving measures that were immediately necessary, retaining jurisdiction for the court over future developments in the case.     

Parent-Child Agreement on Parent-to-Child Maltreatment

Parent-child agreement on child maltreatment was examined in a multigenerational study. Questionnaires on perpetrated and experienced child maltreatment were completed by 138 parent-child pairs. Multi-level analyses were conducted to explore whether parents and children agreed about levels of parent-to-child maltreatment (convergence), and to examine whether parents and children reported equal levels of child maltreatment (absolute differences). Direct and moderating effects of age and gender were examined as potential factors explaining differences between parent and child report. The associations between parent- and child-reported maltreatment were significant for all subtypes, but the strength of the associations was low to moderate. Moreover, children reported more parent-to-child neglect than parents did. Older participants reported more experienced maltreatment than younger participants, without evidence for differences in actual exposure. These findings support the value of multi-informant assessment of child maltreatment to improve accuracy, but also reveal the divergent perspectives of parents and children on child maltreatment.     

Case study: Forensic analysis of a Samsung digital video recorder

In May 2007, a case of potential child abuse was reported to the hospital where the victim was under observation. The child had been in the hospital for several months and there was hope that a digital video recorder (DVR) may have recorded the maltreatment of a hospitalized child. Unfortunately the recordings could not be found on the device by hospital security employees. The DVR was given to digital forensic examiners in an effort to recover footage. This article details how the system was examined, describing the steps that were taken to obtain information and how the information was interpreted. The methods described in this article can be applied to other similar devices.     

Parental problem-solving skills and child behavior problems: A comparison of physically abusive,neglectful, clinic,and community families

Failure to solve problems related to parenting and other aspects of daily living is hypothesized to result in frustration or inability to cope, and lead to deviant parental behavior such as aggression or neglect. The present investigation provided support for a procedure for measuring parental problem-solving skill and compared the problem-solving abilities and child behavior problems of maltreating and nonmaltreating parents. Subjects were 40 parents with at least one child between the ages of three and twelve. Subjects were assigned to one of four groups: (a) physically abusive parents (n = 9); (b) neglectful parents (n = 9); (c) nonmaltreating clinic parents seeking help for child behavior problems (n = 11); and (d) nonmaltreating, non-help-seeking community parents (n = 11). Abusive and neglectful parents were deficient in problem-solving skill as compared to clinic and community parents, yet there were many similarities in parental reports of child behavior problems for maltreating and nonmaltreating parents. Parental problem-solving skill did not correlate significantly with parental ratings of child behavior problems.     

STATEWIDE SPECIAL EDUCATION SURROGATE PARENT PROGRAMS: ENSURING QUALITY ADVOCACY TO ALL FOSTER CHILDREN WITH SPECIAL EDUCATION NEEDS

The Individuals with Disabilities Education Improvement Act (IDEIA) protects foster children's rights to have a special education decision maker. For foster children who do not have a natural or adoptive parent or a responsible adult in their life to take on this role, IDEIA requires that a special education surrogate parent be appointed by appropriate procedures. Under IDEIA, these procedures are delegated to the states. Each state must ensure that local education agencies (LEAs) delineate methods for recruiting and maintaining a pool of available special education surrogate parents. Due to differing state laws and LEA procedures, there are many discrepancies in the quality and availability of special education surrogate parents. To combat these problems, this Note proposes principles for administrative regulations establishing statewide special education surrogate parent programs by examining existing statewide programs. Administered through a state's Department of Education in collaboration with child welfare agencies, statewide special education surrogate parent programs guarantee well‐qualified decision makers who will advocate for all children eligible for special education services.     

Parental Alienation Syndrome in Italian legal judgments: an exploratory study

The present study highlights the characteristics of separated families in Italy for whom Parental Alienation Syndrome (PAS) has been diagnosed during court custody evaluations. The study analyzed the psychological reports of 12 court-appointed expert evaluations of families for whom PAS had been diagnosed. Twelve evaluations that did not receive the PAS diagnosis served as a control group. A specific coding system was used for data analysis. The results indicated that the alienating parents were always the parents who had custody of the children. Children who were diagnosed with PAS were predominantly the only child in the family, had identity problems and manifested manipulative behavior. The consultant in these cases suggested individual psychotherapy for the children and recommended foster care to the Social Services agency.     

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.     

Evaluating the risk of child abuse: the Child Abuse Risk Assessment Scale (CARAS)

The present study developed the Child Abuse Risk Assessment Scale (CARAS), an actuarial instrument for the assessment of the risk of physical child abuse. Data of 2,363 Chinese parents (47.7% male) living in Hong Kong were used in the analyses. Participants were individually interviewed with a questionnaire assessing their perpetration of child abuse and some theoretically or empirically tested factors associated with child abuse. Using the split-half validation procedure, the 5-factor, 64-item CARAS was created and validated. When applying to the second half of the split sample, the CARAS had a sensitivity of 81.9%, a specificity of 77.8%, and an overall accuracy of 78.1%. The area under the receiver operating characteristic curve (AUC) was .91. Overall, our findings showed that the CARAS is a simple, systematic and validated instrument identifying at-risk population of child maltreatment in Chinese societies.     

A NEW LOOK AT AN OLD ISSUE:

In 1997, the Office of Child Support Enforcement initiated the State Child Access and Visitation (AV) Grant Program, which involves annual awards of $10 million to states to promote the development of programs to alleviate access problems. Telephone interviews with 970 parents who used mediation, parent education, and supervised visitation programs funded by AV grants in nine states revealed that the programs are reaching diverse groups of parents including many low-income, non-White, and unmarried parents who receive no other type of access assistance. The programs also appear to be achieving the major objectives posited for them by the federal government. One-third to one-half of noncustodial parents in every program type reported that parent–child contact increased following program participation, with supervised visitation users who typically had the lowest levels of parent–child contact reporting a significant increase in the number of days of contact. A review of child support records for 173 program users in three states revealed that child support payments increased among participants following program participation, especially for never-married parents who paid a significantly higher proportion of what they owed. These findings are similar to results reported in a five-state study of mediation programs funded by AV grants that was conducted by the Office of the Inspector General. However, both studies have some serious limitations, including low response rates and the absence of a nontreatment comparison group.     

The Co-occurrence of Child and Intimate Partner Maltreatment in the Family: Characteristics of the Violent Perpetrators

This study considers the characteristics associated with mothers and fathers who maltreat their child and each other in comparison to parents who only maltreat their child. One hundred and sixty-two parents who had allegations of child maltreatment made against them were considered. The sample consisted of 43 fathers (Paternal Family—PF) and 23 mothers (Maternal Family—MF) who perpetrated both partner and child maltreatment, together with 23 fathers (Paternal Child—PC) and 26 mothers (Maternal Child—MC) who perpetrated child maltreatment only. In addition, 2 fathers (Paternal Victim—PV) and 23 mothers (Maternal Victim—MV) were victims of intimate partner maltreatment and perpetrators of child maltreatment and 7 fathers (Paternal Non-abusive Carer—PNC) and 15 mothers (Maternal Non-abusive Carer—MNC) did not maltreat the child but lived with an individual who did. Within their family unit, 40.7% of parents perpetrated both intimate partner and child maltreatment. However, fathers were significantly more likely to maltreat both their partner and child than mothers and mothers were significantly more likely to be victims of intimate partner violence than fathers. PF fathers conducted the highest amount of physical and/or sexual child maltreatment while MC and MV mothers perpetrated the highest amount of child neglect. Few significant differences between mothers were found. PF fathers had significantly more factors associated with development of a criminogenic lifestyle than PC fathers. Marked sex differences were demonstrated with PF fathers demonstrating significantly more antisocial characteristics, less mental health problems and fewer feelings of isolation than MF mothers. MC mothers had significantly more childhood abuse, mental health problems, parenting risk factors and were significantly more likely to be biologically related to the child than PC fathers. This study suggests that violent families should be assessed and treated in a holistic manner, considering the effects of partner violence upon all family members, rather than exclusively intervening with the violent man. Requests for reprints should be sent to Louise Dixon, Center for Forensic and Family Psychology, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.     

Child murder committed by severely mentally III mothers: an examination of mothers found not guilty by reason of insanity. 2005 Honorable Mention/Richard Rosner Award for the best paper by a fellow in forensic psychiatry or forensic psychology

Forensic hospital records of 39 severely mentally ill mothers adjudicated Not Guilty by Reason of Insanity for filicide (child murder by parents) were analyzed to describe characteristics preceding this tragedy and to suggest prevention strategies. Almost three-quarters of the mothers (72%) had previous mental health treatment. Over two thirds (69%) of the mothers were experiencing auditory hallucinations, most frequently command hallucinations, and half (49%) were depressed at the time of the offense. Over one third (38%) of the filicides occurred during pregnancy or the postpartum period, and many had a history of postpartum psychosis. Almost three-quarters (72%) of the mothers had experienced considerable developmental stressors, such as death of their own mother or incest. Maternal motives for filicide were predominantly "altruistic" (meaning murder out of love) or "acutely psychotic" (occurring in the throes of psychosis, without rational motive). Psychiatrists should perform careful risk assessments for filicide in mothers with mental illnesses.     

Who should pay for bad genes?

Parents have long been able to influence the genetic composition of their children through their choice of a reproductive partner, if only very approximately. They are, however, increasingly able to determine the genetic make-up of their children in other, more precise ways, such as by selecting a particular gamete or embryo or by genetically modifying an embryo prior to artificial implantation. This Article discusses parents' obligations to their children and other members of the community stemming from their children's genes. In a just state, it argues, parents would be responsible for redressing any genetic disadvantage their children suffer as a result of parents' voluntary actions. Within the context of a liberal egalitarian account of distributive justice, this responsibility might most fairly be discharged through a compulsory insurance plan that provides compensation to genetically disadvantaged children when they might have had non-disadvantaged children instead would in some circumstances incur greater liability, because they could not fairly push the cost of their choices off on other members of the insurance pool. The Article also asks whether parents wrong a child by allowing it to be born with a genetic impairment when, had they taken steps to remove the impairment, the unimpaired child they had would have been a different person from the genetically disadvantaged child because the better-off child's capacities and experiences differed considerably from those that the disadvantaged child would have had. Contrary to many people's moral intuitions, the Article argues that parents do not wrong such a child. Nevertheless, parents remain morally obligated to bear any added costs occasioned by the child's impairment. Any other approach would allow them unjustly to shift the burden of their choices to other parents. Finally, the Article takes up the much debated question of whether parents harm a child by allowing it to be born with a life not worth living when they could have prevented its birth. It suggests that the answer to this question should be irrelevant to parents' legal liability. Acting on behalf of the parental insurance pool, the state may nonetheless adopt a variety of measures to help potential parents avoid giving birth to such children, which one can assume virtually all would prefer.     

Revisiting the legal standards that govern requests to sterilize profoundly incompetent children: in light of the "Ashley Treatment," is a new standard appropriate?

This Note discusses the recent controversy surrounding a six-year-old girl named Ashley, whose parents chose to purposefully stunt her growth and remove her reproductive organs for nonmedical reasons. A federal investigation determined that Ashley's rights had been violated because doctors performed the procedure, now referred to as the "Ashley Treatment," without first obtaining a court order. However, the investigation did not make any conclusions regarding whether the "Ashley Treatment" could present a legally permissible treatment option in the future. After discussing the constitutional rights that the "Ashley Treatment" implicates and the current legal standards in place, this Note examines how courts have applied these legal standards to cases involving extreme requests. Drawing upon legal commentators, this Note concludes that a court could approve a request for the "Ashley Treatment" in appropriate and limited cases where the parents have presented clear and convincing evidence before a court that the benefits that the "Ashley Treatment" would provide to the child and her family outweigh the risks associated with the procedure. This Note argues that those benefits may include extrinsic considerations, but courts should remain cautious when considering such evidence and be sure that the evidence as a whole supports their conclusions.     

CHILD SUPPORT IN THE UNITED STATES

This article reports on the results of a telephone survey conducted with a random sample of households screened for eligibility to receive child support in the state of Colorado. Despite the recent enactment of ambitious child legislation at the state and federal levels, the accounts of 731 custodial parents reveal a massive level of unmet need, with child support problems being most extreme for those never married to the chilďs other parent. These mothers typically lack an order establishing a legal obligation to pay child support and have incomes that fall below the poverty level. Overall, women of Colorado with child support orders received only about half of the support they were due, and 73 per cent of all women due support reported that they had experienced problems in collecting support either currently or in the past. The average amount of back due child support owed to the 60 per cent of women in the sample who reported an arrearage was $12,000. Analysis revealed that payment behaviour tracked with the length of time since separation with payment patterns worsening over time and irregular visitation and/or the presence of problems around child access. Female obligors exhibited the same payment patterns as their male counterparts but were more apt to maintain visitation. The article documents the dramatic, negative economic consequences of irregular or missing child support payments for custodial parents, and discusses the additional legal and financial commitments needed to improve the situation. The efficacy of private child support transfers to achieve an adequate standard of living for all children is called into question.     

CHILD‐FOCUSED AND CHILD‐INCLUSIVE DIVORCE MEDIATION: COMPARATIVE OUTCOMES FROM A PROSPECTIVE STUDY OF POSTSEPARATION ADJUSTMENT

This study compared outcomes over 1 year for two groups of separated parents, who attended two different forms of brief therapeutic mediation for entrenched parenting disputes. The two interventions each targeted psychological resolution of parental conflict, enhanced parental reflective function, and associated reduction of distress for their children. The child‐focused (CF) intervention actively supported parents to consider the needs of their children, but without any direct involvement of the children, while the child‐inclusive (CI) intervention incorporated separate consultation by a specialist with the children in each family, and consideration of their concerns with parents in the mediation forum. Repeated measures at baseline, 3 months, and 1 year postintervention explored changes over time and across treatments in conflict management, subjective distress, and relationship quality for all family members. Enduring reduction in levels of conflict and improved management of disputes, as reported by parents and children, occurred for both treatment groups in the year after mediation. The CI intervention had several impacts not evident in the other treatment group, related to relationship improvements and psychological well‐being. These effects were strongest for fathers and children. Agreements reached by the CI group were significantly more durable, and the parents in this group were half as likely to instigate new litigation over parenting matters in the year after mediation as were the CF parents. The article explores the potential of CI divorce mediation to not only safely include many children in family law matters related to them, but also to promote their developmental recovery from high‐conflict separation, through enhanced emotional availability of their parents.     

Associations between Parent and Child Reports Of Interparental Conflict/Violence And Child Difficulties in A Family Mediation Setting*

We examined the association between parents’ (N = 52 mothers and 52 fathers) and children's (N = 27) reports of interparental conflict and child difficulties in a family mediation setting. Parents’ reports of conflict were moderately associated with children's reports of exposure to parental conflict, but only fathers’ reports of conflict were associated with children's reports of negative responses to parent conflict. While mothers and fathers agreed on their child's difficulties, only mothers’, not fathers’, report of child difficulties were moderately related to child reports of child difficulties. Mothers’ and fathers’ reports of conflict generally were not strongly associated with reports of child difficulties. In contrast to parent reports, children's reports of exposure to parents’ conflict were moderately and significantly related to self‐reported child difficulties and moderately related to parents’ reports of child academic difficulties. The magnitude of the association between the child's report of interparental conflict and self‐report of difficulties was stronger than the association between parent report of conflict and parent report of child difficulties, suggesting that parents may not fully understand their child's exposure to parent conflict/violence or the problems their child is experiencing.

Key Points for the Family Court Community:
• Family law stakeholders prioritize the creation of parenting arrangements that are in the best interest of the child; however, it is unclear how to gather information about the child and the child's perspective in order to inform such arrangements.
• The study results suggest that parents may not agree with each other or with the child about important family issues, such as parent conflict and child difficulties. For example, parents may not fully understand their child's exposure to parental conflict/violence when in the midst of custody negotiations.
• More research is needed to determine the best method for gathering information about the child during custody proceedings. In the meantime, it is important to gather information from multiple sources and to consider the agreement and differences across such sources of information.