Child Abuse And Neglect Research Articles

Did Child Neglect Cause Severe Injuries in Nine Children?: Case series from a regional hospital in Oman.

Child abuse and neglect (CAN) is a global phenomenon that takes many forms, with child neglect being the most common. CAN comprises serious incidents with medicolegal implications for the caregivers. The recognition of CAN is still in its early stages in Middle Eastern cultures, including in Oman, where parental authority over children is traditionally sacrosanct. This case series presents nine serious incidents from a regional hospital in Oman from 2020-2021 that appear to fulfil the definition of child neglect. All cases were diagnosed by the Suspected Child Abuse and Neglect (SCAN) team. This article provides evidence that child neglect exists in Oman and has resulted in the death of some children while causing significant physical, psychological and social sequelae in others. It also addresses risk factors and provides recommendations for management. Furthermore, the experience of the SCAN team and limitations of the current Child Protection Services in Oman are highlighted.

Editorial

Two years ago, I used this space to demonstrate that, despiteall the problems and deficits that beleaguer us, the world hasnever been better. That has always been a difficult propositionfor me since I am acutely aware of the pervasive injusticesthat infiltrate every society at all levels. Yet, when wetake the empirical approach, that startling finding is supportedagain and again. This is good news and should provideencouragement and reinforce our determination. However,there are still many problems to conquer and in someareas we are not making the progress needed. Recently Ihave been developing instructional modules for pre-serviceteachers on programs for the prevention of child abuse andneglect, for developing pro-social attitudes and behaviors instudents, and for programs that assist children in selectingmodes of societal participation that are advantageous tothem while rejecting the attraction of the youth street gang.In that research, I found an underbelly of society, often referredto as the American underclass, where many of the assumptionsabout life I take for granted are threatened if notlacking.

Prevalence of suspected child abuse in children with constipation: a case–control study

BackgroundA possible association between child abuse and neglect (CAN) and functional constipation (FC) has been described in adults, however, limited data are available in children. Our objective was to determine...

Knowledge, attitudes, and perceptions regarding child abuse and neglect among dentists in Turkey.

Limited research attention has been paid to Turkish dentists' perceptions of child abuse and neglect (CA/N). This study aimed to examine Turkish dentists' knowledge about, attitudes toward, and perceptions of CA/N. A total of 229 Turkish dentists responded to the self-administered, valid and reliable questionnaire. It consisted of 34 questions that could be classified into the following conceptual categories: a) sociodemographic data, b) knowledge about legal procedures and the orofacial characteristics and findings that are indicative of CA/N, and c) self-efficacy and attitudes toward CA/N. Multivariate analysis of variance was conducted and partial eta squared coefficients were used statistically. Knowledge about legal obligations was associated with occupational experience, highest CA/N education, frequency of child dental treatment. Prior experience with case of suspected CA/N demonstrated the greatest effects. Knowledge about the orofacial characteristics and findings that are indicative of CA/N was associated with prior experience with at least one case of suspected CA/N. The most frequently provided reasons for failure to report cases of suspected CA/N were fear that the child would be harmed. Turkish dentists demonstrated moderate levels of knowledge about their legal obligations and the orofacial characteristics and findings that are indicative of CA/N. Dentists should receive detailed education on CA/N in their undergraduate and postgraduate education. In addition, it is necessary to increase awareness and knowledge about CA/N by providing in-service trainings at the institutions where they work.

Effectiveness of the training provided to healthcare professionals in Turkey to recognise the symptoms and risks of child abuse and neglect.

Healthcare professionals have a significant role to play in the early diagnosis of child abuse and neglect (CAN), which is important in terms of protecting children's health. The study aimed to measure the change in the participants' level of diagnosing the risks and symptoms of CAN before and after the training by providing a training program to healthcare professionals including the signs of CAN, symptoms and procedures to be followed in this case. All healthcare professionals working in a State Hospital and Family Health Centers in Tunceli, Turkey, and who volunteered to participate in the study were included in the study (n=125). The data were collected before and after the training by using the Personal Information Form and The Diagnosis Scale of the Risks and Symptoms of Child Abuse and Neglect (DSRSCAN). 39 participants (31.2%) reported that they had previously suspected CAN, and 35 (28%) stated that they had encountered CAN before. The mean DSRSCAN score of the healthcare professionals included in the study before the training was 3.38 (lowest =2.37, highest =3.55), while after the training, it went up to 3.60 (lowest =2.76, highest =5.00), and the difference between the pre-training and post-training DSRSCAN scores was determined to be statistically significant (p<0.001). It was determined that when healthcare professionals were trained on CAN, their awareness could be further strengthened. Hence, training programs for healthcare professionals on diagnosing and reporting CAN should be updated and increased.

Pediatric emergency department visits due to child abuse and neglect following COVID-19 public health emergency declaration in the Southeastern United States

BackgroundThe ongoing worldwide COVID-19 pandemic has heightened several risk factors for child abuse and neglect (CAN). We study whether COVID-19 and the public health response to it affected CAN-related pediatric emergency department (ED) visits in the southeastern United States (US).MethodsWe performed a retrospective chart review on medical records of ED visits from a level I pediatric hospital system serving one of the largest metropolitan areas in the southeastern US from January through June 2018–2020. We used multivariate Poisson regression and linear regression to compare professionally identified CAN-related ED visits before and after a COVID-19 public health emergency declaration in 2020, relative to trends over the same period in 2018 and 2019.ResultsAlthough the number of both overall pediatric ED visits and CAN-related ED visits declined, the number of CAN-related ED visits due to neglect from inadequate adult supervision increased by 62 % (p < 0.01). The number of CAN visits per 1,000 pediatric ED visits also increased by 97 % (p < 0.01). Finally, the proportion of CAN-related ED visits due to neglect from inadequate supervision increased by 100 % (p < 0.01).ConclusionsPhysicians should be aware that patients who present with injuries during a pandemic may be victims of neglect due to changes in social structures in their households. In particular, maltreatment presenting to the ED shifted toward treating injuries and abuse resulting from inadequate supervision. Policymakers should consider the impacts of stay-at-home orders on child well-being when determining appropriate public health responses in the midst of a pandemic.Trial RegistrationNot applicable.

Sexual Violence and Child Poverty: Lived Experiences of Child Sexual Violence Survivors in Nigeria

Existing literature has documented strong associations between families’ socio-economic conditions and children’s experiences of child abuse and neglect (CAN), including physical, sexual and emotional abuse. Even though the broader approach to family poverty and child poverty may overlap, they do not always have the same indices, implying that the established relationships between family poverty and CAN cannot be unequivocally applied to child poverty. Specifically, inadequate attention has been given to developing an evidence base for understanding the relationship between CAN and child poverty, especially in Nigeria. Even in developed countries, reports on the extent of child poverty have rarely included information about child abuse. Using the hermeneutic phenomenological approach, this study explored lived experiences of 19 female adolescent survivors of child sexual violence (CSV) (Mage ≈ 16, SD = 0.36) in Nigeria. Data was gathered through interviews and victims’ experiences were aggregated using content analysis. The major findings were summarized under the following themes: (1) linkage of CSV with child poverty outcomes (2) implications of poor services for CSV survivors, (3) alternate resources for provision of CSV services, (4), survivors’ suggestions on CSV reduction and proper intervention. The study recommended a multi-sectorial and multi-stakeholder approach to implementing strategies to curb CSV in Nigeria. Future studies should build on the thematic structures evolved to further investigate the links between CSV and child poverty.

Knowledge Levels and Educational Experiences among Dental Graduates in Saudi Arabia Regarding Child Abuse and Neglect: A National Study.

Background: Child abuse and neglect (CAN) is considered a serious problem worldwide. Dentists have a significant role in recognizing and reporting CAN cases. Aim: The aim of this study was to assess the CAN-related knowledge and educational experiences among Saudi dental graduates. Design: Self-administered questionnaires were distributed to dental graduates from all dental schools in Saudi Arabia (n = 1552). Bivariate and multivariate logistic regression analyses were performed to assess the associations between knowledge level and different predictors. Results: A total of 988 dental graduates completed the questionnaire. The majority of them were dissatisfied with the amount of education they had received in their school (56.4%). Around 60% of the participants had inadequate knowledge regarding CAN. Graduates from government schools who received dental education about CAN and female participants had significantly higher odds of having adequate knowledge scores than others (odds ratio = 2.0, 3.1, and 1.7, respectively). Only 39.5% of the participants felt confident in their ability to identify CAN cases, and only 9.7% knew how to report such cases. Conclusions: Graduate dental students have insufficient knowledge about CAN. More time should be dedicated to educating students about this important topic in dental curricula.

Differences in late adolescent psychopathology among youth with histories of co-occurring abuse and neglect experiences

BackgroundKnowledge about the impacts of child abuse and neglect (CAN) experiences on late adolescent psychopathology has been limited by a failure to consider the frequent co-occurrence of CAN types and potential unique impacts of specific combinations. ObjectiveUsing person-centered analyses, we aimed to identify unobserved groups of youth with similar patterns of lifetime CAN experiences before age 16 and differences in psychopathology symptom counts between groups two years later. Participants and settingParticipants were 919 adolescent-caregiver dyads (56% female; 56% Black, 7% Latina/o, 13% mixed/other). MethodsProspective, multi-informant data, including child protective services records and caregiver and youth reports were collected, and youth completed a diagnostic interview at age 18. ResultsLatent Class Analyses classified adolescents into four distinct groups based on patterns of physical neglect, supervisory neglect, and physical, sexual, and psychological abuse: “Low-Risk” (37%), “Neglect” (19%), “Abuse” (11%), and “Multi-type CAN” (33%). The Multi-type CAN class had significantly more major depressive, generalized anxiety, and nicotine use symptoms than the Low-Risk class, and more post-traumatic stress, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Abuse class had significantly more generalized anxiety and attention deficit/hyperactivity symptoms than the Low-Risk class, and more major depressive, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Neglect class did not have elevated psychopathology symptoms. ConclusionFindings highlight important differences in the associations between lifetime CAN experience patterns and psychopathology. Researchers should explore mechanisms underlying psychopathology that are impacted by different CAN experience patterns.

Calculating the impact of COVID-19 pandemic on child abuse and neglect in the U.S.

BackgroundCOVID-19 has had a major impact on child abuse and neglect (CAN) in the U.S. leading to a change in the number of reported screened-in CAN investigations, missed prevention cases, and missed CAN cases. ObjectivesTo estimate the deficit number of CAN investigations and resultant estimated number of missed prevention and CAN cases due to the COVID-19 pandemic in the U.S. from March 2020 to December 2020. MethodsSecondary data analyses of administrative child welfare data from January 2013 to December 2020 from New York City, Florida, New Jersey and Wisconsin were conducted. Spline regression modeling controlling for autocorrelation was utilized to explore any significant changes once the pandemic began in March 2020 in the number of screened-in CAN investigations. The seven-year monthly average of screen-in CAN investigations for March through December from 2013 to 2019 was calculated and compared to the numbers of CAN investigations for March 2020 to December 2020. The resultant number of missed prevention cases and CAN cases was estimated for the four jurisdictions and used to approximate the number of missed prevention cases and CAN cases in the U.S., as well as the projected estimation of national lifetime economic costs. ResultsPrior to the pandemic, there were insignificant monthly increases of 0.7 CAN investigations in NYC and 6.2 CAN investigations in Florida, a significant monthly increase 4.2 CAN investigations in New Jersey and an insignificant monthly decrease in 0.6 CAN investigations in Wisconsin. Once the pandemic began, there were significant monthly decreases (p < .001) in each of the four jurisdictions, including 1425.6 fewer CAN investigations in NYC, 3548.0 fewer CAN investigations in Florida, 963.0 fewer CAN investigations in New Jersey and 529.1 fewer CAN investigations in Wisconsin. There were an estimated 60,791 fewer CAN investigations in these four jurisdictions from March 2020 to December 2020 of which there were approximately 18,540 missed prevention and CAN cases suggesting up to $4.2 billion in lifetime economic costs. It was estimated that were 623,137 children not investigated for CAN in the U.S. during the same 10-month period. This suggests that there were an estimated 85,993 children were missed for prevention services and about 104,040 children were missed for CAN with a potential lifetime economic impact of up to $48.1 billion in the U.S. ConclusionsThe COVID-19 pandemic has led to a precipitous drop in CAN investigations where almost 200,000 children are estimated to have been missed for prevention services and CAN in a 10-month period. There are opportunities for the child welfare jurisdictions to work with partner education, public health, social service and other providers to strategically approach this very grave issue in order to mitigate its impact on this very vulnerable population.

Applying the Social Work Health Impact Model to Child Maltreatment: Implications for Social Work Education

ABSTRACT Child abuse and neglect (CAN) is a significant and growing public health problem, yet public health approaches to eliminating CAN have not been widely embraced in the United States or in social work education. Public health approaches require a large multidisciplinary infrastructure to scale evidence-based primary prevention strategies through multiple systems. The rapid growth in the workforce projected for the next decade, combined with the increasing ubiquity of social workers across family-serving systems, position social work to be a key mechanism to implement public health approaches to CAN prevention. This article presents a rationale for expanding CAN training in social work education. We then describe the Social Work in Health Impact Model (SWHIM), an orientation to social work practice that underscores the importance of prevention and population health, and subsequently apply the SWHIM to the problem of CAN. The SWHIM suggests that social work’s multilevel capacities can be enhanced, not by abandoning clinical practice but by infusing wide-lens approaches, harnessing the power of prevention, linking practice across levels, and addressing the social determinants of health. The article concludes with recommendations for U.S.-based social work education and training in CAN prevention.

Child maltreatment in Dubai and the Northern United Arab Emirates: dental hygienists and assistants' knowledge.

Dental assistants (DAs) and hygienists (DHs) should play an active role in the detection and reporting of child abuse and neglect (CAN). We aimed to investigate CAN knowledge of DAs and DHs in the United Arab Emirates (UAE) and some of the inhibiting factors to the process of CAN reporting. A cross-sectional study design was utilized. We surveyed 186 DAs and DHs using a previously validated self-administered anonymous CAN knowledge questionnaire. Statistical analysis was performed using χ2-square, Fisher's exact test, t test/Mann-Whitney, and a ROC curve (p < 0.05). Among 186 DAs and DHs surveyed, satisfactory knowledge of CAN was demonstrated by 50.5%. DAs scored a significantly higher score of knowledge compared to DHs (p = 0.03). The most reported CAN referral inhibiting factor was "being afraid to get in trouble with parents". The recognition of a child with special needs and parents missing multiple appointments as risk factors for CAN was significantly higher in the DAs compared to DHs (p = 0.04, p = 0.024, respectively). Awareness of local laws was related to CAN knowledge in DAs (p = 0.012) and DHs (p = 0.008). The lack of appropriate knowledge regarding CAN necessitates a clear reporting process and better education for DAs and DHs in the UAE.

A National Study on Child Abuse and Neglect in Rural China: Does Gender Matter?

Does gender affect the risk of child abuse and neglect (CAN) in rural China? This study aims to answer this question through a national gender-balanced survey. An empirical investigation of 4943 children (Mage = 12.08, 48.7% male) in eight provinces was finished in December 2019. The descriptive statistics, a mean analysis, and a linear regression are used to discuss the data. Two important findings can be summarized as follows. First, the risk of CAN in rural China differs across genders. The prevalence and severity of the physical and emotional abuse are higher among boys than among girls, while girls are more likely to suffer emotional neglect. Second, the risk factors for CAN also differ across genders. Girls are more likely than boys to be affected deeply by factors such as the experience of maternal intimate partner violence (IPV), parental educational attainment, children’s age and academic performance, while boys are more associated with parental alcohol dependence than girls. The findings indicate that the prevalence of, severity of and risk factors for CAN differ significantly across genders, primarily because of gender inequality and the residual child welfare system.

Knowledge, Attitude, and Practice Regarding Child Abuse and Neglect among Dental Practitioners

Background: Child abuse and neglect (CAN) is a prevalent and growing public health problem. Dentistsare in a strategic position to identify and report cases of CAN as common signs of child abuse are in theorofacial region. Proper knowledge and awareness are required for early identification and intervention toprevent untoward consequences.Methodology: A cross-sectional observational study using a predesigned three parts questionnaire wasconducted among general and specialty practitioners in branches of dentistry of Dakshina Kannada district,Karnataka to assess the knowledge, awareness, and behavioral practice towards child abuse and neglect. Thedata extracted were tabulated, statistically analyzed and results calculated based on percentages using SPSS.Result: The participants in the current study demonstrated sufficient knowledge of the signs and symptomsof child physical abuse, actions that should be taken in suspected cases, circumstances in which to reportsuch cases, and the legal authorities to which they should be reported. Most of the participants desired forfurther training such as courses or workshops on examining, diagnosing, and reporting cases of child abuse.Conclusion: - The study suggests that dental practitioners need an effective education to increase theirknowledge and awareness on CAN for its precocious identification and diagnosis as an assay for earlyintervention.

Perceived child abuse and neglect in hospitalized children with special health care needs in Iran

Background:Child Abuse and Neglect (CAN) is an important public health concern. Nurses play a key role in caring for the children and keeping them safe from abuse and neglect. The aim of this study was to determine the rate of perceived CAN in Hospitalized Children with Special Health Care Needs (CSHCN) as well as the relationship between the rate and some effective factors.Materials and Methods:This is a descriptive cross-sectional study on 199 CSHCN aged 6–18 years old, admitted to the pediatric wards in an educational hospital, in Isfahan, Iran, in 2018. Children were selected through convenience sampling method and assessed for CAN through a child abuse questionnaire. The Pearson correlation coefficient and Kruskal–Wallis and Mann–Whitney U tests were used to analyze the data. The p values smaller than 0.05 were regarded as significant.Results:According to the findings, 173 children (86.93%) had perceived CAN, the average total score of which was 9.36 contributing commonly to malnutrition 3.01 (2.36) followed by psycho-emotional abuse 2.71 (1.76), neglect 1.62 (1.23), and physical 1.52 (1.08) and sexual 0.54 (0.31) abuse based on mean (SD). Statistical analysis indicated a significant effect of child's age, economic situation of the family, mother's education and occupation, and parents' illness on the total score of perceived CAN (p < 0.05).Conclusions:Malnutrition was found to be the most common type of perceived CAN. Therefore, parents and the health system are advised to prioritize nutritional needs when planning their nutrition.

Documentation of Child Maltreatment by Emergency Medical Services in a National Database

Background Child abuse and neglect (CAN) has an estimated annual incidence of 1.46% among those ≤3 years old. Prehospital providers (PHPs) report difficulties identifying CAN and the frequency in which PHPs document CAN during prehospital encounters of young children is not known. Objective To report the percentage of CAN documentation by PHPs during encounters among children ≤3 years in a national dataset and describe the characteristics of this population. Methods This is an analysis of concurrent cases in the 2017–18 National Emergency Medical Services Information System database. We identified children ≤3 years old with ICD-10-CM codes specific for CAN including codes for physical and sexual abuse as well as neglect. We examined patient demographics including race, gender, Emergency Medical Services (EMS) primary and secondary impression, associated symptoms, anatomic location of chief complaint, and cause of injury. Our primary outcome is the percentage of CAN reported as an EMS primary or secondary impression; secondary outcomes include proportion of children with each subtype of abuse, the description of patients by demographic information, anatomic location of injury, and associated symptoms. Results There were 498,555 for children ≤3 years old, of which 522 had an impression of CAN (0.10%). Within our cohort, 43% were <1 year of age, 51% were male. The most common anatomic location of injury was general/global (29.7%), followed by head (23.5%) and extremity (14%). The most common symptoms reported by PHPs are those associated with injury including codes for injury, burn, fracture, cutaneous findings, hemorrhage, or pain (n = 244, 63%). Pain is the most commonly reported symptom (n = 110, 21%). Few encounters specified vomiting, seizure, or disordered breathing as symptoms (1%, 1%, and 5.4%, respectively). Interestingly, 28.2% (27/124) of cases in our cohort were related to sexual abuse. Conclusions The percentage of PHP documentation of CAN among children ≤3 years of age is very low. Among those with an EMS primary impression of CAN, documentation is primarily associated with findings of injury whereas documentation of nonspecific symptoms such as vomiting and seizure is infrequent. These findings suggest that recognition of abuse primarily occurs in young patients with overt signs of trauma.

A spatiotemporal analysis of the impact of COVID-19 on child abuse and neglect in the city of Los Angeles, California

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) has created an urgent need to identify child abuse and neglect (CAN) and efficiently allocate resources to improve the coordination of responses during a public health crisis. ObjectiveTo provide unique insights into the spatial and temporal distribution of CAN in relation to COVID-19 outcomes and identify areas where CAN has increased or decreased during the pandemic. ParticipantsChildren under 18 years old reported to the Los Angeles Police Department for CAN. SettingCAN incidents in the city of Los Angeles. MethodsNegative binomial regression was used to explore associations between the implementation of social distancing protocols and reported CAN during COVID-19. Spatiotemporal analysis identified locations of emerging hot and cold spots during the pandemic. Associations between neighborhood structural factors (e.g., school absenteeism, poverty, unemployment, housing insecurity and birth assets) and hot and cold spot patterns were explored. ResultsThere was a statistically significant decline in reports of CAN during the COVID-19 pandemic but no significant trends following the implementation of social distancing measures (e.g. safer at home orders, school closures). Compared to consecutive cold spots, severe housing burden, the number of assets children have at birth, poverty, school absenteeism and labor force participation were significantly associated with new and intensifying hotspots of CAN during the COVID-19 pandemic. ConclusionsOur findings reinforce the utility of developing intervention strategies that minimize harm to children by targeting resources to specific challenges facing families enduring the COVID-19 experience.

The social and economic origins of child abuse and neglect

AbstractThis commentary aims to start a debate about various dimensions of social disadvantage and the relationship to child abuse and neglect (CAN). These dimensions include poverty, educational attainment, employment status, sub-standard housing, disadvantaged neighbourhoods and social isolation from family. Other aspects such as mental health issues, domestic violence and substance misuse are compounding factors that are critical influences on the relationship between disadvantage and CAN. New South Wales is used as the exemplar Australian state.

Health and public health approach to ending child abuse and neglect

The 30th anniversary of the United Nations Convention on the Rights of the Child provides an opportunity to reflect on whether the approaches to date in dealing with child abuse and neglect (CAN) have been successful. Initial responsibility in most countries to address CAN has been given to Child Protective Services Agencies. Recently, there have been calls for CPS to take a Public Health Approach in their practice. This paper discusses the potential positive and unintended problems that such a shift in approach might entail.

Paediatric Dentist's Proactiveness in Understanding and Managing Child Abuse and Neglect (CAN)

Child abuse and Neglect (CAN), is now a centre of public attention after prolonged neglect by both society and medical professionals. Child neglect is a form of child maltreatment. There is evidence in the literature that 50% of all injuries involve the head and neck region, which places dentists particularly paediatric dentist at the forefront of abuse detection. Based on available records, the majority of dentists confirm that they can recognize abuse, strangely, a great number of them shows reluctance in reporting to appropriate authorities. The reporting is required not only for ethical reasons but also Section 21(1) of the Protection of Children from Sexual Offences (POCSO) Act, 2012 has made it compulsory to inform about and incidents of child sexual abuse to the law enforcement jurisdiction. This applies to everyone including parents, medical professionals, and school authorities. If suspicion of abuse occurs, all valid information must be documented with radiographs, photographs and impressions. A comprehensive report should be made in the dental chart concerning the presence, site, severity and distribution of the injuries