Identification Of Child Abuse Research Articles

Forensic odontology acquaintance among the students of a dental institution in Mysore City, India

Background: Forensic odontology utilizes the dentist's knowledge to serve the judicial system. It has itself as an important indispensable science in medicolegal matters and in particular in personal identification, gender determination, and age estimation. It plays an important role in mass disasters, child abuse, bioterrorism, etc. Taken together, forensic dentistry has become one of valuable tools worldwide to be used in identification processes.Objective: To evaluate the knowledge about forensic odontology among the students of a dental institution.Methodology: A cross-sectional study was conducted among final year, interns, and postgraduate students of JSS Dental College and Hospital, Mysuru. A self-administered, structured questionnaire written in English and validated through a pilot survey was given to all available and willing student participants. Questionnaire included significance of dental records, dental age estimation, identification of child abuse and individuals bite marks, as a witness in the court, lip prints along with the demographic data.Results: In the present study, 67% of the participants responded that DNA comparison was the most accurate method for person identification. About 27.3% responded tooth dimension and tooth morphology was the most accurate method of dental age estimation in elderly. Moreover, 89.1% reported their present knowledge level/awareness about forensic dentistry was not adequate.Conclusion: Forensic odontology must be introduced into the BDS curriculum effectively as a separate subject so that the students get well acquainted with the required knowledge for handling the medicolegal cases in their future practice.

A critical review of child abuse and its management in Africa.

IntroductionChild abuse in Africa is a major threat to the achievement of the sustainable development goals on the continent and has become increasingly topical with a dramatic increase in recognition and an appreciation of the long term harmful effects on the affected population. The aim of this review was to outline current management of child abuse (especially sexual abuse) and highlight current preventive practice that could be beneficial in a resource-limited environment.MethodsA search of Medline and reference lists of the literature on child abuse in African countries and relevant world literature was conducted in December 2016. The review was written narratively, rather than systematically as a general overview was desired, instead of a focused view of individual aspects of child abuse.RecommendationsOpportunities for early identification of child abuse, as well as research into preventative strategies should be prioritised. Establishing strong institutions and guidance to tackle abuse when it occurs is both beneficial to the survivors and the continent at large.

Hidden Child Abuse Identification in the Emergency Department

Child abuse is a worldwide dilemma. The World Health Organization estimates that in children younger than 15 years, child abuse or neglect accounts for approximately 13% of the 1.2 million deaths due to injury worldwide. [1] Boos SC Endom EE Physical abuse in children: epidemiology and clinical manifestations. http://www.uptodate.com/contents/physical-abuse-in-children-epidemiology-and-clinical-manifestations?source=search_result&search=physical+abuse+in+children+epidemiology+clinical+manifestations&selectedTitle=1~150 Google Scholar The definition of child abuse and neglect varies widely depending on the country and culture. Broadly, child abuse can be defined as injury caused by a parent or caretaker. In the United States, each state is responsible for defining child abuse and neglect within federal guidelines. [1] Boos SC Endom EE Physical abuse in children: epidemiology and clinical manifestations. http://www.uptodate.com/contents/physical-abuse-in-children-epidemiology-and-clinical-manifestations?source=search_result&search=physical+abuse+in+children+epidemiology+clinical+manifestations&selectedTitle=1~150 Google Scholar Federal guidelines are outlined in the Child Abuse Prevention and Treatment Act Reauthorization Act of 2010 (Public Law 111–320), which defines child abuse as any recent act or failure to act that results in death or risk for serious harm that is physical, emotional, exploitation, or sexual abuse; involves children younger than 18 years unless the child protective laws of the state stipulate a younger age; and includes the parent, stepparent, caretaker, employee of a residential facility, and staff providing out-of-home care who are responsible for a child’s care. [1] Boos SC Endom EE Physical abuse in children: epidemiology and clinical manifestations. http://www.uptodate.com/contents/physical-abuse-in-children-epidemiology-and-clinical-manifestations?source=search_result&search=physical+abuse+in+children+epidemiology+clinical+manifestations&selectedTitle=1~150 Google Scholar Patricia A. Normandin, Member, Massachusetts ENA Beacon Chapter, is ED Staff Nurse, Tufts Medical Center, Boston, MA.

THE PREVALENCE AND TYPES OF CHILD ABUSE AMONG TEACHERS AND ITS RELATIONSHIP WITH THEIR DEMOGRAPHIC CHARACTERISTICS AND GENERAL HEALTH IN PRIMARY SCHOOLS

Introduction Teachers are one of the groups that in addition to teaching the students can have a role in control and identification of child abuse and violence in schools. Certainly, before doing any action and choose an approach to reduce misbehavior, we should be aware of situation, how and prevalence of child abuse in schools. The present study aims to investigate the prevalence and types of child abuse among teachers and its relationship with demographic characteristics and general health in teachers whom teaching in primary schools. Materials and Methods This was a cross-sectional study on 350 female and male students and 82 teachers that performed with a multi-stage sampling method. The tools for data gathering included: questionnaire of teachers' personal and job characteristics (12 questions), General Health Questionnaire (GHQ) (28 questions), and standard questionnaire of Conflict Tactics Scale. Data were analyzed by the statistical tests of independent t-test, Mann–Whitney, chi-square, one-way analysis of variance (ANOVA), with SPSS version 16. Results Results of statistical analysis revealed that there wasn’t a significant association between general health and physical abuse. But there was a significant association between general health, emotional abuse and neglect. So that their general health score was higher (more score was not associated with better general health), the emotional abuse and neglect were also higher. Conclusions According to the results, it is suggested to design and implement some programs for prevention and reduction of violence in schools of our country and education of violence prevention methods should be part of school curriculum.

Dental Graduates Awareness of Child Abuse and Neglect (CAN)

Aims: To assess the knowledge and attitude of dental graduates regarding identification of child abuse and neglect (CAN). Study Design : This study included Dental graduates from Krishna and West Godavari districts of Andhra Pradesh, India. A questionnaire with 15 questions about Dentists’ attitudes, Dentists’ knowledge on “Child Abuse and Neglect” was made. Two hundred randomly selected de ntists who have minimum five years of clinical experience were selected from Indian Dental Association data base and questionnaire was sent to them by post with return postage paid.

Barriers to Child Abuse Identification and Reporting

Barriers to Child Abuse Identification and Reporting

Mandatory Reporting Laws and Identification of Child Abuse and Neglect: Consideration of Differential Maltreatment Types, and a Cross-Jurisdictional Analysis of Child Sexual Abuse Reports

Mandatory reporting laws have been created in many jurisdictions as a way of identifying cases of severe child maltreatment on the basis that cases will otherwise remain hidden. These laws usually apply to all four maltreatment types. Other jurisdictions have narrower approaches supplemented by differential response systems, and others still have chosen not to enact mandatory reporting laws for any type of maltreatment. In scholarly research and normative debates about mandatory reporting laws and their effects, the four major forms of child maltreatment—physical abuse, sexual abuse, emotional abuse, and neglect—are often grouped together as if they are homogenous in nature, cause, and consequence. Yet, the heterogeneity of maltreatment types, and different reporting practices regarding them, must be acknowledged and explored when considering what legal and policy frameworks are best suited to identify and respond to cases. A related question which is often conjectured upon but seldom empirically explored, is whether reporting laws make a difference in case identification. This article first considers different types of child abuse and neglect, before exploring the nature and operation of mandatory reporting laws in different contexts. It then posits a differentiation thesis, arguing that different patterns of reporting between both reporter groups and maltreatment types must be acknowledged and analysed, and should inform discussions and assessments of optimal approaches in law, policy and practice. Finally, to contribute to the evidence base required to inform discussion, this article conducts an empirical cross-jurisdictional comparison of the reporting and identification of child sexual abuse in jurisdictions with and without mandatory reporting, and concludes that mandatory reporting laws appear to be associated with better case identification.

Knowledge, attitudes, and experience of dentists living in Saudi Arabia toward child abuse and neglect.

To analyze the experience and knowledge of dental practitioners in Saudi Arabia regarding the identification of child abuse and neglect (CAN), to identify barriers that prevent the reporting of suspected cases of child maltreatment by dental practitioners, and to assess the need for training dentists in child protection. A self-administered, web-based questionnaire was emailed to all of the members of the Saudi Dental Society (n=7352) in 2012. The respondents (n=122) demonstrated good knowledge of the forms and indicators of CAN. Moreover, a large proportion (59%) had experienced a case of child abuse or neglect in their practice over the previous five years. However, only about 10% of these respondents made a report. Fear of family reprisal, lack of certainty about the diagnosis of child maltreatment, and uncertainty about case management were critical barriers to the reporting of the suspected child maltreatment. In addition, only 20.9% of the respondents reported having knowledge of a child protection policy in their workplace. Based on the results of this survey, it appears that the level of knowledge among the respondents regarding the forms and indicators of CAN is good. However, a large proportion of respondents did not take action regarding suspected cases of CAN in their practice over the past five years. Therefore, additional resources and training are needed to support the identification and management of cases of child maltreatment by dental practitioners.

Child abuse: perception and management of the Brazilian endodontists

In Brazil, dentists have a legal, moral, and ethical obligation to notify competent authorities of suspected cases of maltreatment. Studies conducted in several countries reported the difficulties of dentists in the diagnosis, documentation, and reporting of suspected abuse cases to authorities. Objective: The aim of this study was to investigate the perception, diagnosis and attitudes of Brazilian endodontists towards child abuse. Material and methods:Data were collected from 56 questionnaires, considering a total of 248 sent by mail (response rate = 23%) to the endodontists (female = 73%). Results: Forty-one percent (n = 23) of the professionals answered that they were able to identify cases of abuse, while 59% (n = 33) answered that they were unable. Considering their graduation years, 93% (n = 52) stated that they had received little information on this issue, and only 5% (n = 3) attended seminars on this subject during the year before the questionnaire’s application. Although 61% (n = 34) of the professionals affirmed that suspicious cases must be reported, only 30% (n = 17) knew to whom. Eighteen percent (n = 10) of the endodontists reported they had alreadytreated suspicious cases, although only 3.5% (n = 2) reported the case to the authorities. The most cited signs of abuse were: bodybruises (48%; n = 27), change in behavior (48%; n = 27) and burn marks (12.5%; n = 7). Lesions presented in the face, mouth, and teeth were reported by 27% (n = 15) of the professionals. There were no statistically differences regarding the number of notifications in relation to either the number of years since graduation or the workplace. Conclusion: It was concluded that it is necessary to improve endodontists’ formation concerning to child abuse identification, in order to modify their behavior, therefore, increasing the number of suspicious cases’ notifications.

Medical students' child oral‐health‐related knowledge, practices and attitudes

This study evaluated medical interns' oral health knowledge, and other factors influencing their ability and willingness to perform oral-health-related practices for high-caries-risk children. A 15-item survey was emailed to all eligible graduating fifth-year medical students at King Khalid University Hospital to address these areas of interest. Chi-square statistics and logistic regression models were used to analyse data. One-hundred and twenty-one (49%) usable surveys were returned from two mailings. On questions regarding comfort levels when performing oral-health-related practices on children under age 3, physicians noted high levels of comfort with all specified oral health practices. Regarding satisfaction of students with medical training, the majority of respondents (87.5%) rated their medical training as fair or poor in preparing them for oral health assessments compared to only 35%, 29% and 7% of respondents giving fair or poor ratings to child abuse identification, caring for special needs patients and primary care paediatric practice, respectively. Additionally, although 90% of respondents noted that the role of primary physicians in counselling/referring children with oral health was important, 60% did not agree with the AAPD and AAP guidelines that state that all children should be referred to a dentist by 12 months of age. Multivariate logistic regression analyses revealed several statistically significant variables that predict the likelihood of performing various oral-health-related practices. The choice of public-health-oriented future clinical goals, the level of oral health knowledge, how interns rated their oral health training in medical school and the average number of children seen per week, all--to varying degrees--proved important predicator variables for the likelihood of performing them once in practice. More oral-health-related training of medical students seems warranted and could improve their interest in providing oral-health-related screening and referrals in practice. Increasing student exposure to child patients and increasing exposures to oral health knowledge and problems could be targeted towards students interested in primary care and public health to use resources most efficiently in the effort to combat the growing caries levels amongst young children in Saudi Arabia.

Cultural issues in child maltreatment

Waves of immigration from the latter half of the 20th century have changed the cultural and ethnic mix of major regions of the world. Dynamic multicultural societies now are a reality across the Western world. The relationship and influence of these diverse cultures to the understanding and identification of child abuse and neglect is challenging and complex. Health professionals working with children from culturally and linguistically diverse groups often find themselves with the challenge of exploring and resolving the tension between definitions of harm in child protection practice and various cultural and child-rearing practices. In this paper, we set out ways of thinking about the influence of culture when approaching and dealing with the suspicion of child maltreatment. We will explore how culture shapes the experiences of childhood, child-rearing practices, and identify common barriers in working with children and families from culturally diverse backgrounds when presenting with child maltreatment. We will use case examples from Europe and Australia to illustrate the real life challenges of working in the area of child maltreatment across cultures. We will review the scientific literature exploring the nexus between culture and child maltreatment, identifying the gaps in the literature and highlight areas for future research. We suggest a model for dealing with cultural issues in child maltreatment that is culturally competent and respectful. The model for cultural competency in child health and child protective services incorporates four domains for advocacy and action - individual, professional, organisational and systemic.

The Efficacy of Hair and Urine Toxicology Screening on the Detection of Child Abuse by Burning

Abuse by burning is estimated to occur in 1 to 25% of children admitted with burn injuries annually. Hair and urine toxicology for illicit drug exposure may provide additional confirmatory evidence for abuse. To determine the impact of hair and urine toxicology on the identification of child abuse, we performed a retrospective chart review of all pediatric patients admitted to our burn unit. The medical records of 263 children aged 0 to 16 years of age who were admitted to our burn unit from January 2002 to December 2007 were reviewed. Sixty-five children had suspected abuse. Of those with suspected abuse, 33 were confirmed by the Department of Health and Human Services and comprised the study group. Each of the 33 cases was randomly matched to three pediatric (0-16 years of age) control patients (99). The average annual incidence of abuse in pediatric burn patients was 13.7+/-8.4% of total annual pediatric admissions (range, 0-25.6%). Age younger than 5 years, hot tap water cause, bilateral, and posterior location of injury were significantly associated with nonaccidental burn injury on multivariate analysis. Thirteen (39.4%) abused children had positive ancillary tests. These included four (16%) skeletal surveys positive for fractures and 10 (45%) hair samples positive for drugs of abuse (one patient had a fracture and a positive hair screen). In three (9.1%) patients who were not initially suspected of abuse but later confirmed, positive hair test for illicit drugs was the only indicator of abuse. Nonaccidental injury can be difficult to confirm. Although inconsistent injury history and burn injury pattern remain central to the diagnosis of abuse by burning, hair and urine toxicology offers a further means to facilitate confirmation of abuse.

Abuso infantile e disturbi psichiatrici: rassegna

Background Child abuse is a worldwide and often unrecognized social problem. In recent years, there has been an increasing interest in the impact of child abuse on mental health and in the relation between psychiatric disorders and early traumatic experiences. Objectives To summarize the research literature that documents the link between child abuse and subsequent development of psychopathology. Materials and methods Using the PubMed database, the search terms “child abuse” (with a specific DSM IV-TR psychiatric disorder) identified 65 studies published during the period 1988–2005 in North-American, European and Australian journals. Publications included in the review are prospective studies, retrospective studies, meta-analysis and other reviews. Results Many psychiatric disorders, particularly those characterized by problems with self-esteem (depression, BN, substance abuse) estrangement from self (dissociative disorders, PD, PTSD), self-destructive behavior (BPD, BN), disturbances in sense of self (schizophrenia, BPD) and in modulation of mood (depression) are related to a history of abuse in early life. In other disorders (schizophrenia, BD), a positive link between child abuse and a worse course of the illness has been demonstrated. Conclusions The main problem of these studies is that the identification of child abuse has been made retrospectively, when the psychiatric disorder had already developed. Moreover the studies considered were methodologically limited and definitions of sexual abuse varied widely. The possible link to a history of abuse at an infantile age was not investigated in equal measure regarding different psychiatric disorders. There are still only a small number of well-designed studies, controlling for possible confounding variables, with large and representative samples (more community-based and not only clinical studies). We suggest clearer and unequivocal definition of “abuse”, improved sampling, more rigorous data collection and more sophisticated data analyses. The study of the existing relation between child abuse and psychiatric disorders is still at the early stages and requires more research to evaluate and integrate the theories that have recently been proposed.

The Trial of the Expert Witness

This article reports on forensic letters written by physicians specializing in identifying children who have experienced maltreatment. These writers face an extraordinary exigence in that they must provide an opinion as to whether a child has experienced abuse without specifically diagnosing abuse and thus crossing into a legal domain. Their credibility was also at issue because, in this jurisdiction, child abuse identification was not recognized as a medical subspecialty and because the status of expert witnesses is currently being challenged. Through an analysis of 72 forensic letters combined with interview data from six letter writers and five letter readers, we determined that these writers used linguistic and rhetorical strategies that allowed these letters to function as boundary objects or objects that traverse several communities of practice. The most salient strategy was the use of evaluative lexis—adjectives and adverbs which allowed for a range of interpretations and constrained those interpretations at the same time.

Randomized Prospective Study to Evaluate Child Abuse Documentation in the Emergency Department

The objective was to determine whether an educational intervention for health care providers would result in improved documentation of cases of possible physical child abuse in children <36 months old treated in the emergency department (ED) setting. This study had a statewide group-randomized prospective trial design. Participating EDs were randomized to one of three intervention groups: no intervention, partial intervention, or full intervention. Medical records for children <36 months of age were abstracted before, during, and after the intervention periods for specific documentation elements. The main outcome measure was the change in documentation from baseline. Generalized estimating equations (GEEs) were used to test for intervention effect. A total of 1,575 charts from 14 hospitals EDs were abstracted. Hospital and demographic characteristics were similar across intervention groups. There were 922 (59%) injury visits and 653 (41%) noninjury visits. For each specific documentation element, a GEE model gave p-values of >0.2 in independent tests, indicating no evidence of significant change in documentation after the intervention. Even among the 26 charts in which the possibility of physical abuse was noted, documentation remained variable. The educational interventions studied did not improve ED documentation of cases of possible physical child abuse. The need for improved health care provider education in child abuse identification and documentation remains. Future innovative educational studies to improve recognition of abuse are warranted.

Child Abuse and Neglect: A System That Still Needs Pediatric Leadership

Four decades ago, a group of pediatricians published landmark research that substantiated abuse and neglect as an issue worthy of society's attention, providing the catalyst for cultural change and milestone legislation.1 Although a generation of child advocates has made remarkable progress, children remain at risk, and pediatricians must remain leaders in protecting vulnerable children. Every year in the United States, an estimated 900000 children are determined to be victims of child maltreatment, and more than 1500 die secondary to abuse and neglect. To ensure their safety, every year 800000 American children spend time in foster care. In addition, although the $100 billion annual cost of child abuse and neglect to US society is insignificant when compared with the measure of human suffering, it is not a trivial sum. Included in the August and September issues of Pediatrics are 2 articles about the child abuse identification and reporting behaviors of pediatricians.2,3 The Child Abuse Reporting Experience Study (CARES), conducted by the American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) Network, has provided evidence-based confirmation of the perceptions of professionals who have spent entire careers evaluating cases of suspected abuse and neglect. CARES investigators found that health care providers do not report all cases of suspected abuse, in large part because of concerns over best outcomes, given a system perceived as dysfunctional. Previous research has suggested that the results of the CARES, although certainly unsettling for pediatricians, seem to be part of a larger and consistent picture of child abuse reporting (or the lack thereof) by professionals who are mandated to report it. For example, in 1994, Tilden et al4 surveyed a wider variety of … Address correspondence to Edward Bailey, MD, NSMC/North Shore Children's, 57 Highland Ave, Salem, MA 01970. E-mail: enbailey{at}partners.org

Children's advocacy centers: Do they lead to positive case outcomes?

The success of the child protection process is dependent on rapid actions by healthcare professionals who encounter a child in possible need of protection and make appropriate referrals to statutory agencies. Clear rules that promote inter-professional working among health professionals is necessary to enhance child protection.To explore the internal factors leading to bystander attitude towards reporting of suspected physical abuse amongst Ghanaian radiographers.Twenty radiographers across Ghana who have encountered suspected child physical abuse during practice interviewed. Data was collected using qualitative methodology using semi-structured interviews. Participants were radiographers who were selected using purposive sampling. Data was thematically analysed and managed with NVivo version 10. Themes developed formed the basis of the discussion.Participants reported barriers such as training deficits, lack of knowledge in reporting regulations, and the absence of a framework or structures in place to guide suspected physical abuse (SPA) management. The results showed that the majority of participants were ignorant of the role of the social worker in identified cases of SPA. Additionally, there was no teamwork in the majority of the hospitals in the management of suspected physical abuse.Participants’ behaviour towards child protection was congruent with the situation where an individual would assess the consequences of an action. Fear, lack of direction and collaboration characterised the management of suspected physical abuse.The timely identification of child abuse is key to providing the necessary intervention for the child. However, the mere identification of abuse would be of no use to the child when no action was taken by radiographers handling the case as a result of impediments on their way.

Web-based training in child maltreatment for future mandated reporters

Objective The purpose of this study was to determine the effectiveness of providing Web-based information about child maltreatment to undergraduate education and graduate counseling students. The goal was to determine, via an objective test, whether students would gain information about abuse signs and symptoms and reporting laws. Methods One hundred and five education and counseling students enrolled in a large, urban, ethnically diverse, university participated in the Web-based training tutorial. Their participation was part of their course requirements. They logged into the Web site using their university identification number and password. The pre and post-tests could only be taken once. Completion of the tutorial took on average 1 hour. Results Findings indicated that students’ post-test scores were significantly higher than pretest scores on an examination measuring knowledge of child maltreatment signs, symptoms, and reporting procedures. Participants rated their knowledge of child maltreatment significantly higher after taking the tutorial and reported enjoying the self-paced learning of the Web format. Conclusion Overall, this study demonstrated the effectiveness of a brief on-line tutorial to disseminate information related to child abuse identification and reporting to future mandated reporters. In approximately 1 hour of on line training, participants gained an increase in knowledge of reporting procedures. Utilization of Web-based training is proposed as an effective and convenient method of instruction particularly for child abuse issues.

Pediatrician Characteristics Associated With Child Abuse Identification and Reporting: Results From a National Survey of Pediatricians

Pediatrician experience with child protective services (CPS) and factors associated with identifying and reporting suspected child physical abuse were examined by a survey of members of the American Academy of Pediatrics (AAP). Respondents provided information about their demographics and experience, attitudes and practices with child abuse. They indicated their diagnosis and management of a child in a purposely ambiguous clinical vignette. Pediatricians who had received recent child abuse education were more confident in their ability to identify and manage child abuse. High confidence in ability to manage child abuse and positive attitude about domestic violence screening and value of anticipatory guidance predicted that pediatricians would have high suspicion that the child in the vignette was abused and that they would report the child to CPS. Future efforts to improve medical intervention in child abuse should focus on physician attitudes and experience, as well as cognitive factors.

Racial Variation in Self-Labeled Child Abuse and Associated Internalizing Symptoms Among Adolescents Who Are High Risk

One thousand and ten Non-Hispanic White, African American, Hispanic, and Asian Pacific Islander youth who were high risk and receiving public sector services were interviewed regarding history of child emotional and physical abuse and current internalizing symptoms. The study examined whether race moderated the association between adolescents' reports of specific parent behaviors and their self-labeling as victims of abuse. The study also examined whether reports of parental behaviors or self-labeled abuse better predicted internalizing symptoms, and whether these associations differed by race. When reporting punitive parent behavior, Non-Hispanic White youth were more likely to describe themselves as abused compared to Asian Pacific Islanders. Reported punitive parental behaviors accounted for more variance in internalizing symptoms than did self-labeled abuse. Reports of parent behaviors were more strongly related to concurrent internalizing symptoms among ethnic minority youth than among Non-Hispanic White youth. Results are discussed in the context of cultural competence in identification of child abuse.