Child Protection Measures Research Articles

Collective Impact on Prevention: Let's Talk About Children Service Model and Decrease in Referrals to Child Protection Services.

Background: Families with parental mental health issues often have numerous problems needing multilevel measures to address them. The “Let's Talk about Children Service Model (LT-SM)” is a community-based service approach aiming at collectively impacting population needs regarding child protection services. Three municipalities in the Raahe District (RD) of Finland requested implementation of the LT Service Model. This paper describes the model and first results.Methods: The LT Service Model connects relevant stakeholders with families and their social networks aiming at the shared goal of supporting children's everyday life at home, kindergarten, school, and leisure environments. Parents, teachers, and other caretakers are supported by LT interventions. An infrastructure for collaboration, decision making, monitoring, training, and feedback is established, embracing health, social and educational services, and other stakeholders. Referrals to child protection services were compared with national data before (2009–2013) and after implementation of the LT Service Model (2013–2016). Analyses were conducted using the joinpoint regression method.Results: There was a significant decrease in the underage population referred to child protection services in RD (AAPC = −6.9; p = 0.013) between 2013 and 2016, in contrast with an increased rate nationwide (AAPC = 1.9; p = 0.020).Conclusion: In the LT Service Model, prevention starts in children's everyday life as the uniting, common goal for multiple stakeholders and an integrated service structure is developed to support this effort. The first results are promising, showing an appreciable decrease in referrals to child protection services, although further research with longer follow-up and across other municipalities is needed.

Los Acogimientos en Familia Extensa en Madrid: Análisis del Perfil Familiar y Propuestas de Intervención

Kinship foster care is the most common child protection measure in Spain. This paper defines a profile of these families in three districts of the city of Madrid and proposes lines of intervention. A descriptive methodology is used considering the age of children and caregivers, family relationship, or kind of child protection measure. Results show that the most common kinship caregiver is the maternal grandmother, the most used form of kinship foster care is permanent administrative care and the protection measure mostly agreed upon is guardianship. Intervention should focus on problems related to intergenerational differences, relationship improvement, and the elaboration of children’s life stories.

Widening the Antimafia Net: Child Protection and the Socio-Cultural Transmission of Mafia Behaviours in Calabria

This article explores proceedings by the Youth Tribunal of Reggio Calabria, Southern Italy, aimed at the protection of children in families where one or both parents are investigated for mafia offences. The findings show that preventing the transmission of mafia (‘ ndrangheta) culture in the local context has become an essential part of child protection measures. This article will argue that when discussing child protection in criminal families, it is necessary (a) to question the nature of the bonds of these families with the socio-cultural context, and (b) to concretely assess the way this context wishes to affect the family’s criminality.

New family code of Slovenia (2017): procedural aspect

O direito de família na Eslovênia vivenciou anos de manifesta ebulição: o casamento recebeu nova definição (ou) redefinição, a parentalidade foi revisitada, a adoção tem sido objeto de muita discussão e houve dois referendos relacionados às parcerias entre pessoas do mesmo sexo ... Finalmente, aos 23 de março de 2017, foi recebido o novo Código de Família. Uma de importantes mudanças mais salientes está relacionada à jurisdição nas questões de família, transferida dos órgãos administrativos para os tribunais de modo a tentar aumentar a proteção processual da criança. Ao fazê-lo, o legislador atendeu ao pedido de que a jurisdição para questões semelhantes seja a mesma e a partir daí adoção, assistência social e tutela passam a interessar aos tribunais. Mas há também um sistema de via dupla, no qual questões familiares podem ser tratadas de não-contenciosa. Independentemente do procedimento (administrativo, civil, não-contencioso), o melhor interesse da criança é consideração primordial. Daí que o Código de Família direciona especial atenção às medidas de proteção à criança ante a obrigação do Estado de proteger os melhores interesses delas. O interesse da criança “é padrão legal, cujo valor haverá de ser concretizado de modo a respeitar as circunstâncias do único caso. Para isso, os tribunais devem fornecer garantias processuais adequadas, independentemente do procedimento adotado.

Severe interpersonal violence against children in sport: Associated mental health problems and quality of life in adulthood

In a recent large-scale prevalence study of interpersonal violence (IV) against child athletes in the Netherlands and Belgium we found that 9% of adult respondents who participated in organized sports before the age of 18 had experienced severe psychological violence, 8% severe physical violence, and 6% severe sexual violence in various sport settings. While the general literature has repeatedly shown that exposure to IV during childhood is associated with mental health problems in adulthood and to a lesser extent with reduced quality of life (QOL), these relationships have not been demonstrated in (former) athletes. Thus, the current study aims to assess the association of severe childhood IV in sport and adult wellbeing. Depression, anxiety, and somatization were assessed in the same general population sample (N = 4043) using the Brief Symptom Inventory (BSI-18) and QOL with the World Health Organization Quality of Life questionnaire (WHOQOL-Brèf). The association between severe IV in sport and adult wellbeing was investigated using multiple linear regression while controlling for demographics, recent life events, and relatives’ psychological problems. We found severe sexual, physical, and psychological childhood IV in sport to be associated with more adult psychological distress and reduced QOL. Polyvictimization shows the strongest correlation with poorer wellbeing and QOL. Recent life events, relatives’ psychological problems, marital status, and level of education were significant covariates in the psychological symptoms and QOL assessed. We hope that these new insights prompt sport administrators to implement broad spectrum child protection measures and raise the awareness of mental health professionals about the necessity to also screen for adverse childhood experiences in the sport context.

Fundamentos y estrategias socioeducativas en la elaboración de la historia de vida en el acogimiento en familia extensa

El acogimiento en familia extensa es la medida de protección a la infancia más utilizada en nuestro país, que encuentra entre sus mayores dificultades la correcta elaboración de la historia de vida de los niños acogidos. Si esta construcción de la historia vital del niño, que generalmente contiene situaciones dramáticas, no se elabora adecuadamente, puede generar problemas identitarios susceptibles de obstaculizar un adecuado desarrollo. Este artículo analiza la narrativa como una de las principales estrategias socioeducativas para la elaboración de la historia de vida, a partir de los conceptos de experiencia fallida, experiencia imaginaria reactiva y del estadio del espejo, entre otros. Así mismo, propone la utilización de las autobiografías, el libro de vida y la literatura como herramientas para contribuir al desarrollo de la identidad del niño, el fomento de su resiliencia y el conocimiento de su historia de vida de una manera coherente y positiva.

Adolescents hospitalisés dans les services de psychiatrie adulte : une étude descriptive à la lumière des problématiques relevant de la protection de l’enfance

BackgroundAdolescents hospitalized in adult mental health departments are many, and an important part of them benefit from a child welfare system. Many teenagers hospitalized at the adult psychiatric services have symptoms of auto- or hetero-aggressive behaviours. The aim of our study was to describe the population of adolescents supported by these services by analyzing their demographic and psychiatric characteristics and their links with the areas of child protection and disability. MethodsWe performed a retrospective descriptive study based on the analysis of hospital records of teenagers supported by the adult psychiatric services. Criteria for the analysis include sociodemographic, psychiatric morbidity and schooling data, data on the terrain, and those related to child protection or disability. Then subpopulations were analyzed in order to compare the different criteria whether or not within the child welfare system. ResultsSixty teenagers were included in our study. An analysis of the total population shows that these adolescents wer exposed to risk factors for psychiatric disorders: lower socioeconomic conditions, psychiatric family history and traumatic life events. Many were also school-leavers compared to the general population. Furthermore, a majority of the teenagers benefited from a child protection measure (n=33) and were institutionalized. The subpopulation analysis helped realize the particular vulnerability of adolescents under the care of child protection. Indeed, we significantly emphasized among them an increased prevalence of parental isolation (P=0.001), of psychiatric family history (P=0.001) and of having experienced traumatic events (P<0.0001). Concerning psychiatric disorders, we also found by the child welfare system that mild to moderate mental retardation was significantly more frequent among teens (P=0.003). In addition, our results show that these adolescents were significantly more often hospitalized (P=0.013). Finally, still in comparison with the other adolescents, these teens were significantly more school-leavers (P=0.032), mostly in specialized or adapted course of study (P<0.001), and more subject to disability (P<0.001), implying a double care. ConclusionThis study has allowed us to better know the youth population supported by adult psychiatric services. It has also enlightened the specific vulnerability of the teenagers under the child protection care who need psychiatric treatment. It offers interesting discussion topics to develop new modalities of care for these young people.

Quelle place pour une école dans un hôpital dans le cadre de soins associés au décrochage scolaire

BackgroundAlthough school dropout is not a psychiatric diagnosis, it is a frequent concern for child psychiatrists, and covers a variety of psychopathological situations. In addition, severe psychopathologies in adolescence also constitute a risk of school dropout, hence undermining the prognosis. Integrating care into the issue of dropping out of school seems like an interesting lead. Since 2008 we have reorganized the partnership between the specialized hospital care system and the detached school group in our hospital to meet these increasing demands. Here we propose to reevaluate the first 50 patients who benefited from this device, to assess their clinical situation at discharge (t1) and at 30 months (t2) and to explore the factors potentially associated with their reinsertion. MethodsSocio-demographic and clinical variables were retrospectively collected at t0 and t1. Regarding evaluation at t2, the data were obtained by telephone call. The retained criteria for reintegration at 30 months are: the resumption of schooling (classical, adapted, or medico-social type) or the existence of a professional activity. ResultsBetween 2008 and 2012, we received 52 subjects (36 boys, 69%) in the hospital's educational system in combination with consultation (n=20) or day hospitalization (n=32). They had miscellaneous psychopathological profiles. In total, 37 were pupils (71%) and the average period of school absence was 6.7 months. The average duration of care in the care plan was 4 months. At age 30 months, 34 subjects (65%) had school rehabilitation with significant overall clinical improvement (30% increase in EGF score). Only the existence of an educational measure at t0 and the clinical severity (CGI-S and EGF) at t1 was significantly associated with poor reinsertion at t2. ConclusionAdolescents at risk of dropping out of school have benefited from the system in terms of psychosocial adjustment and reintegration into school. Although psychopathological profiles were diverse, the only prognostic factor was the existence of a child protection measure.

La protection de l’enfance, une question de société

Child protection is a sector undergoing major changes in which local authorities play a central role. There are several different types of child protection measures covering different needs: monitoring in the home, foster family, placement in a children's home or astay in a mother-and-baby centre for young mothers. For all these children and adolescents, leavingcare is a key moment which requires support.

Profiling perpetrators of interpersonal violence against children in sport based on a victim survey

The current article reports on perpetrator characteristics gathered in the first large-scale prevalence study on interpersonal violence against children in sport in the Netherlands and Belgium. Using retrospective web survey design, 4043 adults answered questions on their experiences in youth sport. The study looks at the number of perpetrators as well as individual descriptive characteristics (sex, age, and role in the sport organization) of perpetrators of psychological, physical and sexual violence as reported retrospectively by victim-respondents. This information was then clustered to provide an overview of the most common perpetrator profiles. Results show that in all types of interpersonal violence in sport, perpetrators are predominantly male peer athletes who frequently operate together in (impromptu) groups. Several differences between the three types of interpersonal violence are highlighted. While incidents of physical violence perpetrated by coaches tend to be less severe compared to those by other perpetrators, acts of sexual violence committed by a coach are significantly more severe. The presented findings shed new light on perpetrators of interpersonal violence in sport, nuancing the predominant belief that the male coach is the main perpetrator while providing nuanced information that can be utilized to improve prevention and child protection measures and other safeguarding initiatives in sport.

Continuity, Engagement and Integration: Early Intervention in Remote Australian Aboriginal Communities

ABSTRACTOver the last decade there has been at best limited implementation of preventive interventions for vulnerable Aboriginal and Torres Strait Islander children and their families in remote communities of northern Australia despite growing involvement in the child protection system. This paper describes challenges for services seeking to engage parents who are subject to child protection measures. Brief case studies from an early intervention program in a remote community illustrate that responsiveness and continuity of engagement of parents over time is a necessary basis for an integrated approach to meeting the needs of vulnerable children and families in very remote settings.

Health Interventions and Child Health in Sub-Saharan Africa: Assessing the Impact of the Millennium Development Goal

The study investigates the role of health interventions on child health in developing Africa for the period 1990-2013 using a dynamic panel approach. Among others, the study examines the effect of millennium development intervention programme on child health outcomes. Our analysis reveals MDG intervention as extremely pertinent in reducing the incidence of child mortality in Africa. It implies that introduction of MDGs culminates into increasing the rate of child survival in Africa. Similarly, maternal literacy, maternal health and other child protective measures adopted were found to be statistically significant in improving child health outcomes. The proportion of under-five mortality (proxy for child health) responds more strongly and negatively to immunization coverage, exclusive breastfeeding and DPT vaccines. On the other hand, the quality of institution contributively impact under-five mortality in Africa. Finally, there is need to strengthen institutional arrangement, ensure compulsory basic education for women and strengthen the health system to achieve full packages of intervention, curtain the rising incidence of child deaths and attain the MDGs.

Child protection in Tanzania: A dream or nightmare

Tanzania has been, especially in the past decade, crucially involved in the mission for child protection through various legislations and institutional arrangements, for instance the Law of the Child Act of 2009. This study examined how effective child protection measures have been in alleviating all forms of violations against children. The current study employed a cross sectional descriptive design to compare the prevalence of violations such as sexual, physical, and emotional violence experienced by the children between 2010/2011 and 2012/2013. Findings of the study show that violations against the children have increased almost 3 times between 2011/12 (n=54) and 2012/2013 (n=150). The majority of the victims of violence in both years were female children. In addition, most of the victims had both parents alive, but this increased from 56% in year 2011/2012 to 91% in 2012/2013. The study also identified poverty as a major contributing factor for violations in both years of the study (48% in 2011/12 and 36% in 2012/13). Most of the incidences of violations were a long term and an ongoing problem, and they frequently took place at home in both years. Despite the limitations, the findings suggest important implications for policy and practice.

Epidemiology and classification of dog bite injuries to the face: A prospective study of 108 patients

Dog bites are considered to be septic injuries, and their location on the face, with its highly symbolic topography and important social functions, is particularly pertinent. In addition to specific medical aspects, such as their psychological impact, they are also of relevance in terms of child protection measures. In light of the far-reaching importance of this subject, we were prompted to carry out a prospective study, over 13 years, to identify risk factors. Our results highlight specific risk factors, and they may hence assist with the implementation of concrete primary prevention measures against dog bites. An information sheet was prepared and filled out during the intake of patients who had been bitten on the face. Data analysis was performed using Epi Info Version 6.04dfr software to find a correlation between the factors studied and the dog bite to the face. Dog bites to the face represented 0.83% of the emergency admissions to our service. A considerable majority of these involved children, with 68.5% of patients <16 years of age, and 33.3% of patients aged between 2 and 5 years. The wounds were multiple and of variable severity. The type of dog involved was frequently a German Shepherd. Strikingly, 91.3% of bites had occurred in a single-parent environment. Our study has determined that the fundamental factors that increase the probability of a dog bite to the face are as follows: the child being 2-5 years old, a single-parent context, and involvement of a German Shepherd-type dog.

Public Health Measures and Child Health in Sub-Saharan Africa: Accessing the Impact of the Millennium Development Goal

The study investigates the role of public health measures on child health in developing Africa for the period 1990-2013 using a dynamic panel approach. Among others, the study examines the effect of millennium development intervention programme on child health outcomes. Our analysis reveals MDG intervention as extremely pertinent in reducing the incidence of child mortality in Africa. It implies that introduction of MDGs culminates into increasing the rate of child survival in Africa. Similarly, maternal literacy, maternal health and other child protective measures adopted were found to be statistically significant in improving child health outcomes. The proportion of under-five mortality (proxy for child health) responds more strongly and negatively to immunization coverage, exclusive breastfeeding and DPT vaccines. On the other hand, the quality of institution contributively impact under-five mortality in Africa. Finally, there is need to strengthen institutional arrangement, ensure compulsory basic education for women and strengthen the health system to achieve full packages of intervention, curtain the rising incidence of child deaths and attain the MDGs.

Lives at risk: Uncovering factors associated with fatal child maltreatment

Awareness of cases of fatal child maltreatment has risen significantly in recent years suggesting the presence of a serious threat to young children despite extensive child welfare, clinical and legal responses to the issue. The purpose of this study was to identify differences between high risk child maltreatment and fatal risk cases and associated child protective service factors. For this study, 50 cases of fatal and near fatal child maltreatment were compared to a random sample of 50 moderate to severe maltreatment cases to determine predictors of group affiliation using a transactional model of child maltreatment to guide model development. Results indicate that recognition of having a male perpetrator, in cases of physical abuse, in families with approximately two children living in more rural environments notably improved the odds of predicting fatal risk cases. Prior referrals to Adult Protective Services, less out of home care and poor utilization of in-home services were also noted differences in the service records of the groups. Implications regarding early intervention and child protection measures that could be utilized to reduce risk are offered.

A Critical Examination of Child Protection Initiatives in Sport Contexts

With the broadening of focus on child maltreatment beyond intra-familial settings, there is growing awareness of occurrences of maltreatment within the sport context. Millions of children participate in organized sport annually, and despite a tendency to view sport as a context by which to enhance the overall health and development of children, it is also a context in which children are vulnerable to experiences of maltreatment. The well-documented power ascribed to coaches, the unregulated nature of sport and a “win-at-all-costs” approach contribute to a setting that many propose is conducive to maltreatment. A number of high profile cases of sexual abuse of athletes across several countries in the 1990s prompted sport organizations to respond with the development of child protection measures. This study examined seven child protection in sport initiatives in terms of the extent to which they originated from research, had content that was consistent with scholarly work and were evaluated empirically. The findings indicated that these initiatives were not empirically derived nor evaluated. Recommendations are made to more closely align research with these initiatives in order to protect children and to promote a safe and growth-enhancing experience for young participants in sport.

G36(P) Evaluation of current practice guidelines and follow-up of outcomes among emergency department visits for head injuries in a cohort of infants less than 6 months of age

BackgroundThe incidence of abusive head injury in children is highest in infancy with nearly 80% of abusive head trauma occurring in children by 2 years. Physical abuse represents a leading...

Dental neglect as a marker of broader neglect: a qualitative investigation of public health nurses' assessments of oral health in preschool children.

BackgroundChild neglect is a pernicious child protection issue with adverse consequences that extend to adulthood. Simultaneously, though it remains prevalent, childhood dental caries is a preventable disease. Public health nurses play a pivotal role in assessing oral health in children as part of general health surveillance. However, little is known about how they assess dental neglect or what their thresholds are for initiating targeted support or instigating child protection measures. Understanding these factors is important to allow improvements to be made in care pathways.MethodsWe investigated public health nurses’ assessment of oral health in preschool children in relation to dental neglect and any associations they make with child neglect more broadly. A qualitative study was conducted in Scotland during 2011/12. Sixteen public health nurses were recruited purposively from one health region. Individual, semi-structured interviews were undertaken and data were analyzed inductively using a framework approach. Categories were subsequently mapped to the research questions.ResultsPublic health nurses assess oral health through proxy measures, opportunistic observation and through discussion with parents. Dental neglect is rarely an isolated issue that leads on its own to child protection referral. It tends to be other presenting issues that initiate a response. Threshold levels for targeted support were based on two broad indicators: social issues and concerns about child (and parental) dental health. Thresholds for child protection intervention were untreated dental caries or significant dental pain. Barriers to intervention are that dental neglect may be ‘unseen’ and ‘unspoken’. The study revealed a communication gap in the care pathway for children where a significant dental problem is identified.ConclusionsPublic health nurses take their child protection role seriously, but rarely make a link between dental caries and child neglect. Clear guidance on oral health assessment is required for public health nurses. Establishing formal communication pathways between child dental care providers and public health nurses may help close gaps in care pathways. However, further research is required into how these communication mechanisms can be improved.

The impact of heat waves on children’s health: a systematic review

Young children are thought to be particularly sensitive to heat waves, but relatively less research attention has been paid to this field to date. A systematic review was conducted to elucidate the relationship between heat waves and children's health. Literature published up to August 2012 were identified using the following MeSH terms and keywords: "heatwave", "heat wave", "child health", "morbidity", "hospital admission", "emergency department visit", "family practice", "primary health care", "death" and "mortality". Of the 628 publications identified, 12 met the selection criteria. The existing literature does not consistently suggest that mortality among children increases significantly during heat waves, even though infants were associated with more heat-related deaths. Exposure to heat waves in the perinatal period may pose a threat to children's health. Pediatric diseases or conditions associated with heat waves include renal disease, respiratory disease, electrolyte imbalance and fever. Future research should focus on how to develop a consistent definition of a heat wave from a children's health perspective, identifying the best measure of children's exposure to heat waves, exploring sensitive outcome measures to quantify the impact of heat waves on children, evaluating the possible impacts of heat waves on children's birth outcomes, and understanding the differences in vulnerability to heat waves among children of different ages and from different income countries. Projection of the children's disease burden caused by heat waves under climate change scenarios, and development of effective heat wave mitigation and adaptation strategies that incorporate other child protective health measures, are also strongly recommended.