Child Abuse Cases Research Articles

Meeting the need for independent medico-legal opinions in child abuse cases: Public or private paediatric practice?

Aim: To (i) identify how many child protection paediatricians provide review opinions for alleged child abuse cases outside their own jurisdiction; (ii) identify practices and perspectives about how this work is done.

Dark Pedagogies in Comparative Perspective: Remembering Institutional Child Abuse

This article sketches three cases of institutional child abuse in different historical contexts and places—St. Michael’s Residential School in Alert Bay (Canada), Parramatta Girls’ Home in Sydney (Australia), and the Closed Juvenile Detention Center in Torgau (German Democratic Republic). I propose Katharina Rutschky’s concept of “dark pedagogy” to analyze the striking similarities in the methods and justification of treatment of children, in the experiences that survivors describe, and in the nature of commemoration. This concept can help us see how the extremes of violence and the techniques of control in “care” facilities that were common across the profiled cases are immersed in similar norms governing the social roles of children and adults. My core argument is that institutional child abuse—because of its systemic nature, its embeddedness in the modernist project, and the resulting stigmas—has lead to similar challenges and practices in confronting and memorializing these histories.

Perlindungan Hukum Terhadap Korban Glorifikasi dari Pelaku Tindak Pidana Pencabulan


 Today, children are often victims of sexual abuse. Child molestation is a very disgraceful treatment that damages the future of the child, both physically and psychologically. One of the examples of cases of child abuse is the case that was committed by SJ. After being released from prison, SJ received a lot of applause in the public. The glorification of the SJ case can be seen as normalizing perpetrators of sexual abuse in the public. The purpose of this research is to examine the legal arrangements for the glorification of perpetrators of criminal acts of obscenity and to reveal protection for victims who have experienced crimes of sexual abuse. The type of research used is normative legal research with a statutory approach. Sources of legal materials are primary and secondary legal materials. To get valid data, the researcher used library research techniques, namely taking notes, summarizing, and giving reviews. The results of the study revealed that the regulation of perpetrators of criminal acts of obscenity is regulated in Article 289 of the Criminal Code and for the glorification of perpetrators of criminal acts of obscenity has not been specifically regulated. Protection of victims who have experienced criminal acts of obscenity is regulated in Articles 6, 7 and 7A of Law no. 31 of 2014 concerning Amendments to Law Number 13 of 2006 concerning Protection of Witnesses and Victims.
 ban Glorifikasi Dari Pelaku Tindak Pidana Pencabulan

Early recognition of child abuse through screening indicators at the emergency department: experience of a tertiary urban pediatric hospital

BackgroundEmergency Departments play a pivotal role in detecting cases of child abuse. Despite the efforts made in the past decades on the need for a screening method for the early detection of abuse victims, a unique instrument shared by the international scientific community has not been made. These instruments should be able to help recognizing whether it is necessary to further investigate the child’s condition. The aim of the study is to illustrate the screening indicators in use since 2010 in the Emergency Department of the Bambino Gesù Children’s Hospital to early recognise the victims of abuse and the modifying process of the screening tool undertaken over the years.MethodsWe retrospectively analyzed the process that led to the editing of the indicators of child abuse in use nowadays at the Bambino Gesù Children's Hospital. We codified three clinical pathways to apply in case of suspected abuse. Furthermore, we investigated the medical records of screening-positive accesses in the Paediatric Emergency Department of the Bambino Gesù Children's Hospital from January 2008 to October 2020.ResultsAn estimation of positive screening, regarding the type of abuse suspected, and the number of accessed in ED was made, resulting in a cohort of 956 patients. In 2010 we created a list of 14 items grouped in three clusters: anamnestic declarations or incongruences, carelessness/neglect and evident lesions at physical examination. Positivity to one of the items allows the actuation of the investigating protocol named as clinical pathway.In 2013, after three years of experience, the criteria were edited to increase specificity. The application of screening led to a median number of 82 suspected cases/year from 2013 to 2020.ConclusionA screening tool is essential and productive for the early recognition of victims of abuse. An in-deep analysis of suspected cases through a standardized method, such as the clinical pathway, allowed reaching the diagnosis in a more accurate and precise manner.

Cutaneous mimickers of physical child abuse: A brief overview.

Child abuse is one of the medico-legal issues a physician may face during his/her clinical practice. It has devastating effects on both the child and family, especially psychological. If falsely identified as a child abuse case, it could result in detrimental consequences. Therefore, physicians must recognise and be able to rule out child abuse mimickers, which are often conditions that are mistakenly confused with true physical child abuse. Injuries like bruises and burns are common presentations and therefore it is important to consider cutaneous abuse mimics to avoid incorrect diagnosis of child abuse. This review article sheds light on the most common cutaneous conditions that can mimic physical child abuse, where patients present with patterns of various skin lesions that raise a suspicion of child abuse.

Corrigendum to the paper 'Re-evaluation of medical findings in alleged shaken baby syndrome and abusive head trauma in Norwegian courts fails to support abuse diagnoses'.

We recently carried out a retrospective evaluation of 17 child abuse cases in the Norwegian courts and concluded that 16 of those failed to support the evidence provided by expert witnesses of shaken baby syndrome.1 Our paper focussed on the possible mechanisms behind the children's intracranial injuries and unfortunately a couple of findings were missing or incompletely described. In case number 2, we described rib fractures with callus formation. This was true for some, but not all, of the fractures. We did not mention the term ‘flail chest’, which we have now found in the discharge record. This was not mentioned elsewhere on the medical chart, as a finding or medical condition. The same is true for the bilateral rather than unilateral retinal haemorrhages, which again only were described in the discharge records. In case number 6, we described clavicle and rib fractures, but unfortunately, we did not report that there was also a scapula fracture. Stray-Pedersen et al.2 have claimed that we made other errors. We can explain these by stating, as is also described in the article, that we did not have access to all the data at the time of the retrospective analysis. For example, we made a deliberate decision not to view any legal documents, in order to avoid introducing bias. These discrepancies included the fact that we did not mention the bilateral optic nerve sheath haematomas or metaphyseal fractures in case 4 because the medical charts did not contain this information. Furthermore, Stray-Pedersen et al. have stated that there was a rib fracture in case 4. This was suspected during the autopsy but could not be verified by microscopical examination. With regard to case 6, Stray-Pedersen et al stated that ‘the defendant confessed to having repeatedly shaken the child back and forth’. This information was not given in the article, as it was only mentioned in the legal documents and not in the medical records. However, following a reconstruction in the court, two medical experts, including Stray-Pedersen, concluded that the shaking that was demonstrated had insufficient power to cause intracranial findings. In addition, Stray-Pedersen et al. have disagreed with us on a few other cases, where we stand by our interpretations. For example, in case two, they claim that we have overlooked fresh haemorrhagic components in the subdural effusions. We have simply called these chronic subdural hematomas/hygromas, which we believe is reasonable since small rebledings in chronic SDHs are a common finding. Further, in case 4, which involved a one-month-old infant, Stray-Pedersen et al. claim that there was an acute subdural hematoma. We were unable to detect this on the images, it was not described in the medical charts, and we still find it hard to detect this finding. Our assessment of the low-quality computed tomography images for case 6 was that no definite acute, bilateral subdural haematoma was present, contrary to the view expressed by Stray-Pedersen et al. They also claim that the fractures described in case 6 were new. We felt that this was not the case, because callus was observed after another 11 days. In conclusion, we regret any inadvertent errors in our paper. The aim of our study was to analyse the intracranial findings presented by the court experts involved in these 17 cases and to evaluate if they showed evidence of traumatic origin per se. However, while it is important to present data as accurately and objectively as possible, it is also important to acknowledge the difficulties that arise in retrospective studies. We must stress that we are fully aware of the fact that child abuse exists, and of the importance of protecting abused infants. It is further not our conclusion that abuse can be excluded in all cases in this cohort. In the evaluation of these cases, it is self-evident that extracranial injuries such as bruises and different fractures must be taken into consideration. A comprehensive assessment of these was however beyond the scope of this article. That being said, we believe that the findings of our study still hold and that many of the intracranial findings in this cohort of possibly abused infants could be attributed to non-traumatic causes. One important example quoted in our paper was the group with benign external hydrocephalus. While Stray-Pedersen et al have made some valid points about our paper, it is interesting to note that they did not question our main intracranial findings.

Overview Of Criminology And Criminal Law Concerning The Criminal Act Of Abuse Performed By Parents Against This Bird Children (Study Of The Decision Of The State Court Tulung Agung Number 179/Pid.Sus/2012/PN. Ta)

The Indonesian nation is known as a nation that loves children. Turns out this is just a myth. Many cases of physical violence or cases of child abuse in their own families are not taken seriously by law enforcement. This situation causes the dark number to be high because it is not reported. Though the impact of the perpetrator tends to damage the mental even the victim is mentally retarded. This is certainly the main idea and responsibility of the government and society as observers of the nation's children who are the next generation of the nation's ideals. Why abuse among children is increasing, how does our positive law issue policies to deal with cases of violence experienced by children, and what other efforts can be taken to overcome violence experienced by children into the formulation of the problem of this thesis. The approach method used in this research is normative juridical, which is a deductive research that begins with an analysis of the articles in the laws and regulations governing thesis problems. Normative nature means legal research that aims to obtain normative knowledge about the relationship between one regulation and another and its application in practice (decision study). The factors that cause the occurrence of criminal acts of abuse or violence against children by their own parents are classified into two parts, namely internal factors and external factors. In dealing with cases of abuse experienced by children, it consists of criminal law policies such as the application of criminal sanctions and the application of legal protection for children. In addition, in tackling the crime of child abuse, there are several efforts that can be taken, namely preventive efforts, repressive efforts and reformative efforts.

Newspapers' Treatment of Child Abuse Cases in Lahore

According to research, the careless use of words in news coverage on child abuse has been brought to light. It was discovered that the language used in the crime story has a significant impact on reducing the severity of the crime and, as a result, has a substantial impact on how the readers perceive the nature of such crimes. The purpose of this research was to conduct a detailed investigation on how incidences of child abuse are reported in Pakistani media. Its primary emphasis is on understanding how news articles about child abuse are framed and promoted in the media. The reports of child sexual abuse that appeared in four daily newspapers (two English and two Urdu) between January 2016 and January 2018 were studied for the frames and language used to convey the events. A summary of the results was presented in the form of graphs and tables. To get an accurate count, we surveyed a total of 2718 people across both English-language and Urdu-language newspapers. According to this study, a total of 706 cases of child sexual abuse were reported in Lahore during the years (2016-2010) and 355 cases of CSA (Child Sexual Abuse) were reported in Lahore during the years (2010-2010). How the newspapers covered the news about child abuse did and does have a sound impact in underlining the importance of this matter on both the governmental and public scale. Sensitized coverage is problematic because it tends to portray child abuse more as a political issue than as a grim reality, affecting everyone across society. It is time to strictly implement anti-child abuse laws so that crimes against children could be effectively prevented.

Screening Tools for Child Abuse Used by Healthcare Providers: A Systematic Review.

The early detection of child abuse is essential for children at risk. Healthcare professionals working at hospitals and in the community are often the first to encounter suspected cases of child abuse. Therefore, an accurate identification of child abuse is critical for intervention. However, there is no consensus on the best method to screen for child abuse. This systematic review was designed to evaluate the relevant psychometric properties and critically appraise the methodological quality of child abuse screening tools used by healthcare providers with children less than 18 years old. We searched the Cochrane Library, MEDLINE, Embase, CINAHL, Education Resources Information Center, PubMed, Airiti Library, and OpenGray databases for studies on screening tools used to identify abuse in children published through October 2019 in English or Chinese. Information regarding populations, assessment methods, and accuracy parameters were extracted. Study quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist and Grading of Recommendation, Assessment, Development, and Evaluation criteria. Nine hundred thirty-nine abstracts and 23 full-text articles were reviewed for eligibility, and 15 screening tools for child abuse used by healthcare providers were identified. Screening tools often assess the presence of more than one form of abuse, but no single tool covered all forms. Of these, 10 tools screened for a single, discrete type of abuse, including nine physical abuse screening tools (three abusive head trauma tools) and one sexual abuse tool. Eighty percent (n = 12) of the screening tools had a moderate-to-high quality of evidence based on the Grading of Recommendation, Assessment, Development, and Evaluation criteria. However, none of these screening tools achieved an adequate level of evidence based on the COnsensus-based Standards for the selection of health Measurement INstruments checklist. In this systematic literature review, 15 assessment tools of child abuse used by healthcare providers were identified, of which nine screened for physical abuse. Screening tools must be valid, succinct, user-friendly, and amenable for use with children at every point of care in the healthcare system. Because of the paucity of informative and practical studies in the literature, findings related to the quality of child abuse screening tools were inconclusive. Therefore, future research should focus on the use of screening tools in the healthcare system to identify effective screening interventions that may help healthcare providers identify child abuse cases as early as possible.

Predictive model for intra-familial child maltreatment re-reports and recurrence in South Korea: Analysis of national child protection services case records

BackgroundChild maltreatment recurrence has a significant negative impact on child well-being and may indicate low effectiveness of child protection services (CPS). In South Korea, 10.4% of child maltreatment cases in 2016 had previous CPS involvement. Identifying and understanding significant predictors of child maltreatment re-reports and recurrence has been a critical task in maltreatment research. However, this task has rarely been attempted in South Korea. ObjectiveThis study aimed to examine child maltreatment re-reports and recurrence among children involved in CPS in Korea, identify correlates of child maltreatment re-reports and recurrence with predictors, and explore the consistency or inconsistency of correlates between re-reports and recurrence. MethodsThe present study analyzed 5349 case records from the National Child Maltreatment Data System, which included information collected by Korean CPS regarding maltreatment, child, parent or perpetrator, and service characteristics. ResultsResults showed that the recurrence rate was 5.9% over the two-year period. In contrast to previous studies, neglect was not found to be a significant predictor of recurrence. Perpetrators' problem-solving skills and survival stress, as well as children's disability status, were significant predictors of recurrence. Receiving welfare assistance was a significant predictor of re-reports (AOL = 1.42, p < 0.01) but not a significant predictor of recurrence. ConclusionCompared to other empirical studies conducted in several countries, we found similarities and differences regarding predictors of child maltreatment re-reports and recurrences. The results reiterate the importance of family intervention to prevent maltreatment recurrence.

I Know How It Feels: Empathy and Reluctance to Mobilize Legal Authorities

Abstract Why do people hesitate to summon state authorities to address concerns? Previous research has focused on cultural orientations about law enforcement, such as legal cynicism. In addition, people are often in a position to turn others in, requiring attention to how potential reporters understand the meaning and consequences of implicating others. This article identifies empathy as an underexamined lens through which marginalized groups view state intervention. I argue that amid shared social roles with those potentially reported to authorities, individuals invoke empathy in disavowing reporting. I advance this argument using the case of child abuse and neglect reporting, analyzing in-depth interviews with 74 low-income mothers in Rhode Island. Respondents disavowed or expressed ambivalence about reporting other families to child protection authorities, often justifying their non-reporting by empathizing with mothers they might report. Drawing on their own experiences of scrutinized and precarious motherhood, respondents imagined how they would feel if reported and balked at calling on child protective services, understanding reporting as an act of judging and jeopardizing another’s motherhood. The findings challenge conceptions of non-reporting as necessarily indicating social disorganization. Rather, hesitation to mobilize authorities can constitute an expression of care, kinship, and solidarity.

Understanding Factors That Hinder Child Abuse Cases from Being Reported to Officials in Households with Alcoholic Parents: Case Study of Mashonaland West, Zimbabwe

Background: This article discusses reasons why child abuse victims and witness may not disclose child maltreatment. Methods: For primary data collection of this article, a sample of church pastors, community members and social workers from Mashonaland West in Zimbabwe were interviewed. Primary data from a qualitative research methodology was used to explore why child abuse victims and witnesses do not always report child abuse when they come across it. Aim: The purpose for this article is to promote awareness of what hinders people from reporting child abuse so that childcare professionals and families can work together in removing barriers that hinders the revelation of horrid secret such as child abuse. Results: Inefficient systems for reporting child abuse can hinder victims and witness from disclosing child abuse cases. Conclusion: To prevent and reduce child abuse, there is a need to have effective procedures of protecting and encouraging child abuse victims and witnesses to disclose suspected child abuse cases.

Child Abuse

Introduction: Child abuse is an increasing social problem with serious lifetime impact. Almost half of the violence cases affect the head-and-neck region, so dentists can play a proactive role in identifying and reporting possible cases of child abuse. Aim: This study aims to assess the knowledge and attitude about physical and social indicators, legal aspects, and barriers in reporting mechanisms toward child abuse among dentists in Ludhiana city. Methodology: With prior consent, a self-administered structured questionnaire comprising 21 questions was distributed to 100 state-registered dentists of Ludhiana city. The data collected were descriptively analyzed using Pearson Chi-square test. Results: A total of 92 dentists responded to the questionnaire, with a response rate of 92%. Among them, 43% were females, while males were 57% and 64.4% of dentists were specialists, out of which 21% were pedodontists. A moderate proportion of the dentists (68%) had knowledge about indicators. The knowledge of indicators was more among pedodontists. However, no significant difference was seen between other respondents and pedodontists. Almost 79% knew their legal duty to report the suspected case. Forty percent of the dentist had encountered with child abuse cases with a significant difference among pedodontists when compared to other respondents, but only 23% reported a case. Fear of litigation, lack of referral knowledge, and uncertainty of diagnosis were major barriers in reporting. Ninety-two percent showed a positive attitude for further training in identification and reporting mechanisms for suspected cases. Conclusion: The respondent dentists had moderate knowledge regarding child abuse, positive attitude toward dealing with child abuse, but they were diffident and unaware of the appropriate authority to report. Considering this fact, a systematic educational program in diagnosis and reporting of child abuse is advised to provide adequate knowledge than lecture-based learning.

A descriptive study on child sexual abuse act in India.

ABSTRACTBackground:Child sexual abuse (CSA) is a significant public health problem. Health care professionals can play an important role in the identification and reporting of such cases. This study was conducted to assess the awareness level among doctors working in a medical Institute about CSA.Materials and Methods:This is a cross-sectional descriptive study. Data was collected using a closed-ended structured questionnaire. Descriptive analysis was done to compute percentages and frequencies. Respondents’ educational qualification, as well as the relationship between their level of education and their awareness of child abuse, was also assessed.Results:Nearly 70% of respondents came across child abuse cases, wherein sexual abuse was found to be the commonest (58%), followed by physical abuse (28%). Nearly 40% of child abuse cases were reported in the hospital where they worked, while 15% of child abuse cases occurred in other hospital areas. The study also revealed that 81% of respondents had knowledge about child sexual abuse. However, only 34% were aware of the repercussions of non-reporting of a child abuse case. Nearly 64% of respondents had an idea about an online complaint system for child abuse, and 70% were aware of the availability of a one-stop centre at a respondent’s hospital. The majority (68%) were aware of the POCSO (Protection of Children from Sexual Offences) Act on sexual abuse. On seeking information regarding evidence of anal sexual abuse among children and adolescents, 36% were completely aware, and 13% were partly aware of it.Conclusion:There is a need for continued education and advancement of all health care professionals to improve the diagnosis and reporting of CSA.

A life threatening case of a physical child abuse- The importance of diagnosing and reporting

A life threatening case of a physical child abuse- The importance of diagnosing and reporting

MORPHO-HISTOLOGICAL CHARACTERISTICS OF BRUISES WITH DIFFERENT AGE - QUALITATIVE STUDY

Bruises are common skin lesions that occur&nbsp;as&nbsp;the&nbsp;force hits the skin, but integrity of the skin is not impaired. Their significance is&nbsp;important&nbsp;in&nbsp;forensic expert reports in determining the time of death in many cases of domestic violence or child abuse. The aim of this study was to present the differences between bruises with different time of origin by evaluation of their morpho-histological characteristics.&nbsp; The study included 60 human skin samples divided into control and experimental groups&nbsp;A, B, C, D.&nbsp;The experimental group A included bruised human skin samples with &lt;1day&nbsp;old bruises, experimental group B included bruised human skin samples with 1-3 days old bruises, experimental group C included bruised human skin samples with 3-7 days old bruises and experimental group D included bruised human skin samples&nbsp;with 7-14 days old bruises. Paraffin sections of the skin were stained with&nbsp;Hematoxylin-eosin, Giemsa, Perl’s Prussian Blue, Masson-Goldner methods of staining and application of&nbsp;anti-HO-1 antibody. All paraffin sections were evaluated by light microscopy and&nbsp;photodocumented. Our results have shown changes in color in bruises with different age due to infiltration with different immune cells and metabolism of extracellular hemoglobin. &nbsp;Granulocyte infiltration is seen shortly after the initiation of the bruise, while&nbsp;after&nbsp;few&nbsp;days of initiation, usually 1-3, there is macrophage infiltration in the field of bleeding. Presence of macrophages in the field of bleeding increases as bruises age. These histological characteristics appear in direction of healing the bruise, together with phagocytosis of the erythrocytes and removing the tissue debris.&nbsp; Keywords: bruises, time of origin, morpho-histological characteristics, microscopic analysis&nbsp;

Homeschooling Reconsidered

Homeschooling was occasionally a subject of popular interest pre-COVID, when media reported horrific cases of child abuse under the guise of homeschooling, or when controversies erupted over efforts in state legislatures or local school boards to introduce very modest oversight measures. COVID made homeschooling something nearly every parent considered as a long-term educational option for their children, and something arguably – depending on one’s definition of homeschooling – nearly all experienced. This article extracts from the societal experience of forced remote learning, challenging theoretical questions about the distinction between homeschooling and “regular schooling”; the wisdom of traditional brick-and-mortar, multi-service schooling; and the appropriateness of state officials passing judgement on any private form of schooling.

Symposium

Brief bio data of proposer: Currently working as Professor and Head of Department of Psychiatry, Kasturba Medical College, Manipal. Mostly work with adult psychiatry and addiction patients, and coordinator of Clinical Research Center for Neuromodulation in Psychiatry.Subtopics:Lithium-associated thyroid abnormalities: An overview – Dr Suma T. Udupa, Assistant Professor, Dept. of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, IndiaLithium-associated hypothyroidism: Case-based discussion – Dr Shahul Ameen,Consultant Psychiatrist, St Thomas Hospital, Chenganacherry, KeralaLithium-associated hyperthyroidism: Case-based discussion - Dr. Samir Kumar Praharaj, Professor and Head, Dept. of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, IndiaLearning objectives:1. To understand the thyroid abnormalities associated with long term lithium use.2. To understand the clinical presentations of hypo- and hyperthyroidism associated with long term lithium use and their managementBrief description of symposiumLithium is the gold standard mood stabilizer for bipolar disorder. It not only prevents mood episodes, but also has antisuicidal and neuroprotective effects. Despite its efficacy, its use is limited because of the adverse effects associated with long term use. Early identification and management of such adverse effects is the need of hour to increase acceptability among patients as well as physicians. In this symposium we focus on a less discussed topic, i.e. thyroid abnormalities associated with long term lithium use.Dr Suma T Udupa will give an overview of thyroid abnormalities associated with long term lithium use, which will include the type of abnormalities, their incidence and prevalence, and, risk factors. She will also discuss the probable mechanisms briefly. Dr Shahul Ameen and Dr Samir K. Praharaj will discuss the clinical presentations and management of lithium associated hypothyroidism and hyperthyroidism, respectively. They will use case vignettes to facilitate interactive discussion on the early presenting features, differential diagnoses and approaches to management.Protection of / prevention from violence against children: the role of educational system.The experience of violence in childhood impacts lifelong on mental health and well-being. The National Crime Records Bureau 2019 data tells us that every hour, 6 cases of child abuse occur, 57 percent of cases of sexual abuse are perpetrated by close family members. Globally, it is estimated that upto 1 billion children aged 2-7 years, have experienced physical, sexual or emotional violence or neglect (UNICEF,2020). The protection of child against violence and prevention mechanisms in our country is in very nascent stage and is currently struggling to adapt child-friendly procedure and inculcating various awareness building programes in different service sectors . There is tremendous need to inculcate new programes in educational sector to develop social and emotional skills to handle such problems at the very base level. It is the time to stop the harmful system to breed further. The study comes at a crucial time when a good number of people are showing interest to know more about the mechanisms meant for preventing and protecting children from abuse and violence. In this study some evidence based mechanisms i.e. ‘respectful relationship education’ (Australia) and ‘ happiness curriculum’(India) will be discussed. The discussion will throw some light of how social emotional learning(SEL) helps to develop skills of understanding the right communication, to identify wrong attitude, behavior, act etc and handling the signals of various situations breeding violence before it occurs.Authours : Dr. Sampa SinhaPsychiatric Social Worker, Dept. of PSW, IHBAS, DelhiDr. Deepak KumarProfessor & Head Dept. of Psychiatry, IHBAS, DelhiCorrespondence e-mail: sinhasampa25@rediffmail.com/sampa_in2000@yahoo.co.in

A regional multidisciplinary network enhances child abuse case management

We previously reported an inadequate response to intracranial hemorrhage (ICH) cases under 24 months of age in Yokohama from 2011 to 2013. Hence, it is very important to evaluate how the establishment of a regional multidisciplinary network for child abuse affects the response to ICH cases in medical institutions. We conducted a questionnaire survey of ICH cases under 24 months of age from 2014 to 2016 using a regional multidisciplinary network for child abuse established in Yokohama in September 2013. We investigated the patients' characteristics, examinations to identify inflicted injury, and reports made to the hospital-based child protection team (CPT) or regional child protective service (CPS), and compared the results of a previous study and the current study, which corresponds to before and after the establishment of the regional network, respectively. The total number of ICH cases was 50 in 3 years. The number of cases surveyed for covert fracture and fundus hemorrhage increased significantly after the establishment of the regional network (P = 0.0001 and P = 0.0182, respectively). The number of cases reported as suspected child abuse was 41 (82%) to the hospital-based CPTs and 27 (54%) to the regional CPSs. There were significant differences between before and after the establishment of the regional network regarding CPT (P = 0.0062) and CPS (P = 0.0215) reports. A regional multidisciplinary network can enhance response and cooperation to address child abuse. It deepens our understanding of such care and improves awareness by hospital personnel of child abuse.

Research on Laws and Systems Related to the Prevention of Child Abuse: Focusing on the Comparison of Laws and Institutions within Various Cultures

아동학대는 피해아동이 성인으로 성장한 후에도 부정적인 영향을 지속적으로 미친다는 점에서 반드시 예방되어야 할 사회적 문제이다. 그러나 우리나라의 아동학대 발생건수와 피해아동의 사망자 수는 지속적으로 증가추세에 있고 아동학대에 관한 법과 제도는 적극적이지 못한 측면이 있다. 이에 본 연구에서는 다양한 문화 안에서 법과 제도 사례로서 아동보호 및 학대예방의 역사가 비교적 오래된 미국이나 영국, 일본, 독일 스웨덴 등의 사례를 분석하고 아시아 국가들의 가해자에 대한 처벌내용을 검토하여 우리나라 아동학대 예방 정책에 참고할 수 있는 내용을 제안하였다. 아동학대 예방을 위한 법률개정에 반영할 수 있는 내용은 미국의 사례처럼 아동학대사건의 폭력 및 학대 범위를 세분화하여 공권력이 개입할 수 있는 방안을 구체화할 것, 독일의 사례처럼 위험성 평가를 통해 아동의 사전보호조치, 경찰의 물리력 적용 등에 관한 세부사항들의 제도화, 가해자 처벌에 관한 양형기준을 마련, 모든 성인의 아동학대 신고의무자화 등으로 요약할 수 있다.Child abuse is a social problem that must be prevented in that it continues to have a negative effect even after the victim grows up to be an adult. However, although the number of child abuse cases and the number of deaths of victims of child abuse in Korea continues to increase, laws and systems on child abuse are not active. Therefore, this study analyzed the cases of the United States, the United Kingdom, Japan, Germany, Sweden which have a relatively long history of child protection. Also the contents of punishment for perpetrators of abuse prevention within Asian various cultures suggested references to improve Korea s child abuse prevention policy. What can be reflected in the revision of the law to prevent child abuse can be summarized as in the United States to refine the scope of violence and abuse in child abuse cases, institutionalize details of child protection measures as in Germany, police physical force, establishment of sentencing standards for punishment of perpetrators, and obligate all adults child abuse reports.