Injury‐Related Healthcare Use and Risk of Filicide Victimization: A Population‐Based Case–Control Study

Research on child‐related risk factors for filicide is scant. We investigated whether prior healthcare use for injury (including poisoning) influences filicide risk. Victims (0–14 years; n = 71) were identified in a national autopsy database for the years 1994–2012 and compared to matched, general population controls (n = 355). Healthcare use data were retrieved from a national patient registry. Risks were estimated using odds ratios (ORs) and 95% confidence intervals (CIs). For females, prior inpatient care for injury conferred a statistically significant sevenfold risk (OR = 6.67 [95% CI: 1.49–29.79]), and any prior injury‐related healthcare use conferred a statistically significant fourfold risk (OR = 3.57 [95% CI: 1.13–11.25]), of filicide victimization. No statistically significant risks were found for males. Healthcare personnel should be aware that children treated for injuries, especially females, may be at an elevated risk of filicide victimization. Nevertheless, the filicide base rate remains low, and parents may be stigmatized by unfounded alerts; thus, prudent reflection should precede reports to the authorities.     

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Traumatic cardiac ventricular ruptures in children are rare. Only a single case of left ventricular rupture due to child abuse has been reported. We report a child who sustained a fatal left ventricular apical rupture. It appeared to have resulted from hydrostatic forces resulting from abusive blunt thoracic injury. That he was being abused was previously missed when he was presented to the emergency department with facial pyoderma. It was not noted that he also had lip and oral mucosal injury, sites not affected by staph toxins. As a result, his underlying, abusive and secondarily infected, facial flow type scald burn was not appreciated. Within a week thereafter his fatal injury occurred, accompanied by extensive and obvious associated abusive injuries. Postmortem high‐detail whole body computed tomography scanning aided the autopsy. Although rare, ventricular rupture from abusive blunt thoracic injury can occur.     

‘Working’ the international child protection case: a snapshot of local authorities’ experiences within an evolving legal context

Child protection proceedings often concern children with international connections. In recent years, the courts of England and Wales have handed down a number of significant judgments examining the application of international legal instruments (in particular Brussels IIa) to care proceedings. This article considers the impact of court judgments on the practical ‘working’ by Local Authorities of international child protection cases. A case study was conducted, oriented by socio-legal theory, consisting of a small number of qualitative interviews with Local Authority lawyers and social workers. The article concludes that some judgments have acted as a catalyst to change working practices for Local Authorities. However, international child protection cases present a variety of challenges for Local Authorities, and judgments provide an imperfect site for the provision of procedural and substantive guidance in this complex area. Further, there was often a tension between the need to conscientiously adhere to such guidance, and the welfare needs of the children with whom the Local Authority was concerned.     

Previous judicial detection and paedophilic sexual interest partially predict psychological distress in a non-forensic sample of help-seeking men feeling inclined to sexually offend against children

Little is known about overall psychological distress in paedophiles who are not formally involved with the criminal justice system. Since knowledge in this context could help to optimise intervention efforts, this study aimed to examine the association between distress as measured with the Brief Symptom Inventory (BSI) and preference- and offence-related variables in a sample of N?=?455 men self-reporting sexual interest in children, of whom 402 were diagnosed as paedophiles. Results showed that 59% reported clinically relevant levels of distress, with paedophiles being significantly more distressed than teleiophiles. A regression analysis revealed that a paedophilic preference and prior detection were relevant predictors for distress. However, past offending behaviour had no impact and the major part of variance could not be explained. The results suggest that paedophilia is associated with distress, but other factors influence whether a paedophilic man is distressed on a clinically significant level.     

Mother–infant separations in prison. A systematic attachment-focused policy review

Abstract

Mothers in prison separated from their young children are an overlooked group. Attachment theory could provide a useful model to underpin interventions and better support women affected by separation from their infants. Current policy draws on a limited body of evidence and research has developed considerably since its first design. This review systematically searched all relevant UK prison policy and government documents with regards to mother and child separation in prison and analysed the extent to which these documents draw on attachment theory. Following initial searches, 58 documents were thematically analysed. Attachment was implicitly referred to in most documents but only explicitly mentioned in four. Global themes identified included ‘separation as trauma’. However, document groups varied in focusing either on the mother or the child and there were no joint perspectives. Developing and researching specific attachment-informed interventions might be one way forward as would further attachment-based research in this area.     

The relation between interviewers’ personal characteristics and investigative interview performance in a child sexual abuse context

Despite important progress in knowledge about interview ‘best practice’ with child victims, few studies had yet evaluated the impact of interviewers’ personal characteristics on adherence to these ‘best practice’. This study was designed to determine whether interviewers’ personal characteristics are associated with adherence to a structured interview protocol (National Institute of Child and Human Development), the use of open-ended questions and the amount of details provided in children’s responses during investigative interviews with alleged victims of child sexual abuse. 114 interviews were scored from 13 police investigators after they followed a one-week training program. Results showed that experience, emotional intelligence, Extraversion, Agreeableness, Conscientiousness and Neuroticism were related with adherence to the protocol and ratio of open-ended questions. Cognitive abilities were related to the amount of details obtained from the child. Generalized estimating equations were used to compare relative contribution of each variable. These findings raise questions about how investigative interviewers are selected and trained.     

Fatal acute intracranial injury, subdural hematoma, and retinal hemorrhages caused by stairway fall

We describe an infant with an acute subdural hematoma, a fatal head injury, and severe hemorrhagic retinopathy caused by a stairway fall. His cerebral and ocular findings are considered diagnostic of abusive head trauma by many authors. Our literature search of serious injuries or fatalities from stairway or low-height falls involving young children yielded 19 articles of primary data. These articles are discrepant, making the classification of a young child's death following a reported short fall problematic. This case report contradicts the prevalent belief of many physicians dealing with suspected child abuse that low-height falls by young children are without exception benign occurrences and cannot cause fatal intracranial injuries and severe retinal hemorrhages. The irreparable harm to a caregiver facing an erroneous allegation of child abuse requires physicians to thoroughly investigate and correctly classify pediatric accidental head injuries.