Identification Of Child Maltreatment Research Articles

School nurse's screening for child maltreatment facilitates disclosure – A Swedish intervention study

Early identification of child maltreatment (CM) is essential for children to receive support. The aim was to develop and evaluate a screening instrument for CM to be used by the school nurse in the health dialogue. The research questions included if victimisation could be disclosed by screening, if disclosure led to support measures, and the pupils' and the school nurses' experiences of the screening. A screening instrument to identify CM was developed. A total of 140 pupils and eleven school nurses participated. Mixed methods were used for analysis. Results showed that 29.7% of the participants disclosed CM victimisation and support was given when needed. Girls disclosed exposure to all types of maltreatment to a greater extent than boys. Pupils expressed the importance of screening and it created a trustful relation with the school nurse. No school nurses or pupils were distressed by the screening. Screening for CM facilitated disclosure.

Does a child maltreatment report source predict differences in immediate and subsequent report outcomes?

BackgroundMandated reporting policies, a core response to the identification of child maltreatment, are widely debated. Currently, there are calls to abolish or scale back these policies to include only certain professionals. These calls warrant evaluation of whether there are any differences in child welfare outcomes based on report source. ObjectiveTo determine if the initial report source predicts immediate and long-term risk of re-referral, substantiation, and placement. Participants and settingWe used yearly National Child Abuse and Neglect Data System (NCANDS) hotline report and placement data. Children (0-14y) with a first ever hotline report in 2012–2014 were followed for three years. The final sample included 2,101,397 children from 32 states. MethodsWe use descriptive and bivariate statistics to show initial report outcomes by reporter source type and logistic regression models to evaluate the effect of report source on immediate and subsequent report outcomes. ResultsProfessional sources varied in levels of substantiation and placement, with law enforcement, medical, and social service sources showing much higher rates. Reports from professional sources have higher odds of initial report substantiation and foster care entry, and slightly lower odds of later re-report than nonprofessional sources. We found no differences between professional and nonprofessional sources in subsequent foster care entry. ConclusionsReports from professional, nonprofessional, and unclassified sources have varying levels of risk in some of their short- and long-term outcomes. To the degree that child protective services embrace a long-term preventative role, reports by nonprofessional report sources may provide opportunities for prevention.

A 40-year study of child maltreatment over the early life course predicting psychiatric morbidity, using linked birth cohort and administrative health data: protocol for the Childhood Adversity and Lifetime Morbidity (CALM) study.

Child maltreatment is a major public health issue worldwide. Retrospective studies show a strong association between self-reported child maltreatment and poor mental and physical health problems. Prospective studies that use reports to statutory agencies are less common, and comparisons of self- and agency-reported abuse in the same cohort even rarer. This project will link state-wide administrative health data with prospective birth cohort data (N = 7223) from Brisbane in Queensland, Australia (including notifications to child protection agencies), to compare psychiatric outcomes in adulthood of agency- and self-reported child maltreatment while minimising attrition bias. We will compare people with all forms of self- and agency-reported child maltreatment to the rest of the cohort, adjusting for confounding in logistic, Cox or multiple regression models based on whether outcomes are categorical or continuous. Outcomes will be hospital admissions, emergency department presentations or community/out-patient contacts for ICD-10 psychiatric diagnoses, suicidal ideation and self-harm as recorded in the relevant administrative databases. This study will track the life course outcomes of adults after having experienced child maltreatment, and so provide an evidence-based understanding of the long-term health and behavioural consequences of child maltreatment. It will also consider health outcomes that are particularly relevant for adolescents and young adults, especially in relation to prospective notifications to statutory agencies. Additionally, it will identify the overlap and differences in outcome for two different sources of child maltreatment identification in the same cohort.

Child Maltreatment Education: Utilizing an Escape Room Activity to Engage Learners on a Sensitive Topic.

Child Maltreatment Education: Utilizing an Escape Room Activity to Engage Learners on a Sensitive Topic.

Evidence-based social work outreach to military leaders to facilitate intimate partner violence and child maltreatment identification and referral: an evaluation

ABSTRACT The effects of family maltreatment on the military are far-reaching and well documented, with implications that include the deterioration of mission readiness and an increase in distractibility for all involved. Congress has mandated each service agency to take steps in preventing partner and child maltreatment, including outreach – enlisting military leaders to identify, respond to, and mitigate risk factors for maltreatment in their active duty (AD) members – but the success and impact of these efforts have gone mostly unexamined. This article explores the implementation and evaluation of a new Air Force (AF) family maltreatment training based on empirical and military-specific evidence of prevalence, risk and protective factors, and the impact on military families. This project sought to optimize and standardize such trainings across bases in an interactive manner. As expected, the training led to significantly greater knowledge about family maltreatment, significantly lower belief in the justification of both IPV and parent–child aggression, significantly lower belief in the effectiveness of parent–child aggression to solve problems, significantly increased self-efficacy to help prevent and address family maltreatment on the base, and marginally significantly more positive beliefs about Family Advocacy Program (FAP). Additionally, satisfaction with the training was very high.

Characteristics of child welfare investigations reported by healthcare professionals in Ontario: secondary analysis of a regional database

ObjectivesThis study examines the characteristics and outcomes of child welfare investigations reported by hospital-based and community-based healthcare professionals.MethodsA sample of 7590 child maltreatment-related investigations from the Ontario Incidence Study of...

Identification of Child and Youth Maltreatment as Experienced by Prehospital Emergency Care Providers

This mixed method study explores 200 prehospital emergency care providers’ experiences of identifying child and youth maltreatment. The data were collected in Finland in 2019–2020 using an online survey tool and analysed using SPSS statistics and inductive content analysis. Respondents had encountered signs of physical and psychosocial maltreatment, and family challenges, contexts, and economic and social problems indicative of maltreatment. It is important for the early intervention and prevention of long-term mental health problems that prehospital emergency care providers receive continuing education on the identification of child maltreatment.

Identifying and Responding to Child Neglect within Schools: Differing Perspectives and the Implications for Inter-Agency Practice

Child neglect is the most common reason for a child to be placed on the child protection register in Wales. Due to their central position within the community, schools provide opportunities for staff to observe children’s interactions with peers and family members, five days a week, over an extended period of time and development. Although literature acknowledges schools as pivotal sites for the identification of child maltreatment, little is known about the manner in which school staff recognise and respond to child neglect in their roles. This paper brings new understanding about the way in which child neglect is identified by school staff in Wales. The mixed method research design comprises two phases: quantitative social work case file analysis, qualitative semi-structured interviews and non-participant observation. This paper presents two key findings from the thirty interviews with staff in mainstream schools undertaken within the second phase of the study. Findings emphasise the presence of differing professional perspectives between school staff and social services: firstly the identification of child neglect within the boundaries of the school, and secondly the interprofessional challenges which exist for school staff when responding to child neglect. Findings have important implications for future policy and practice in the delivery of school-based service provision, and broader messages for the development of effective inter-professional relationships between staff in all universal services and statutory services when supporting and protecting children who are suspected of living with neglect.

What We Can Learn From Failure: An EHR-Based Child Protection Alert System.

This study aimed to evaluate the efficacy of a newly implemented Child Protection Alert System (CPAS) that utilizes triggering diagnoses to identify children who have been confirmed/strongly suspected as maltreated. We retrospectively reviewed electronic health records (EHRs) of 666 patients evaluated by our institution's child protection team between 2009 and 2014. We examined each EHR for the presence of a pop-up alert, a persistent text-based visual alert, and diagnoses denoting child maltreatment. Diagnostic accuracy of the CPAS for child maltreatment identification was assessed. Of 323 patients for whom child maltreatment was confirmed/strongly suspected, 21.7% (70/323) had a qualifying longitudinal diagnosis listed. The pop-up alert fired in 14% of cases (45/323) with a sensitivity and specificity of 13.9% (95% CI [10.4%, 18.2%]) and 100% (95% CI [98.9%, 100.0%]), respectively. The text-based visual alert displayed in 44 of 45 cases. The CPAS is a novel simple way to support clinical decision-making to identify and protect children at risk of (re)abuse. This study highlights multiple barriers that must be overcome to effectively design and implement a CPAS to protect at-risk children.

Qualitative analysis of clinician experience in utilising the BuRN Tool (Burns Risk assessment for Neglect or abuse Tool) in clinical practice

IntroductionThe BuRN-Tool (Burns Risk assessment for Neglect or abuse Tool) is a clinical prediction tool (CPT) aiding the identification of child maltreatment in children with burn injuries. The tool has been derived from systematic reviews and epidemiological studies, validated and is under-going an implementation evaluation. Clinician opinion on the use of this CPT is a key part of its evaluation. ObjectivesTo explore the experience of emergency clinicians use of the BuRN-Tool in an emergency department (ED). MethodsThree focus groups were conducted over a six-week period by the research team in the ED in the University Hospital of Wales; 25 emergency clinicians attended. A semi-structured approach was taken with pre-determined open-ended questions asked followed by a series of case vignettes to which the CPT was applied. The focus groups were recorded and transcribed verbatim. Thematic analysis was conducted for identification of pre-set and emergent themes. All data were double-coded. ResultsAll participants said that it was acceptable to use the BuRN-Tool to aid in the decision-making process surrounding child maltreatment. All participants said that the BuRN-Tool was helpful and straight forward to use. All participants said that the tool was clinically beneficial, particularly for junior staff and those who do not always work in a paediatric environment.The clinical vignettes identified subjectivity in interpretation questions around adequate supervision, previous social care involvement and full thickness burns. This resulted in some variation in scoring. ConclusionsThis study confirms that the BuRN-Tool is acceptable in an ED setting. The focus groups demonstrated a homogenous and positive attitude regarding the layout, benefits and use of the BuRN-Tool. The subjective interpretation of some variables accounts for the non-uniformity in the scores generated. Clarification of questions will be made.

Child maltreatment identification rates in a child development center: suggestions for improved detection

CM identification rates in children with disability were higher in a CDC vs. CC. The approach used in the CDC may significantly improve CM identification in children with disability. What is Known: • There is significant under-identification of CM. What is New: • By examining child maltreatment identification rates in a child development center vs. the community, the study found that a multi-disciplinary staff approach can significantly improve CM Identification.

Child Maltreatment Screening and Anticipatory Guidance: A Description of Pediatric Nurse Practitioner Practice Behaviors

IntroductionGiven the number of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. The purpose of this study was to describe pediatric nurse practitioner (PNP) practice behaviors related to screening and providing anticipatory guidance for child maltreatment and its psychosocial risk factors. MethodThe Risk Assessment Survey was developed for this study by 12 PNPs, all of whom were members of NAPNAP's Child Maltreatment Special Interest Group to ensure face validity; all 12 PNPs were content experts in child maltreatment. The content of the survey was derived from key characteristics from the evidence on child maltreatment. The survey was emailed to the more than 8500 NAPNAP members. ResultsTwo hundred forty-three PNPs responded to the survey, which represents a response rate of 3%. Approximately half of the participants (n = 121; 51%) stated that they never/rarely ask parents questions about domestic violence, more than one-fourth (n = 71; 30%) reported that they never/rarely ask parents questions about discipline, and half of the responding PNPs (n = 120; 50%) reported that they perform an ano-genital exam at well visits. DiscussionThis study demonstrates that a significant number of PNPs do not routinely screen for child maltreatment and psychosocial risk factors. This is especially true in regards to sexual abuse screening and anticipatory guidance.

Pediatric Inpatient Nurses' Perceptions of Child Maltreatment

PurposeThe purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. Design and MethodsA cross-sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. ResultsMany nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. ConclusionsDue to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. Practice ImplicationsThere is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses.

Does changing mandated reporting laws improve child maltreatment reporting in large U.S. counties?

The effects of changes in mandated child maltreatment reporting laws have not been systematically evaluated. To better understand the effects of these changes, the objectives of the present study are: (1) to assess the relationships between report rates and state universal and clergy reporting laws in 2010; (2) to compare the changes in total, confirmed, and maltreatment type report rates and with changes in reporting laws from 2000 to 2010, and (3) to examine whether there is any relationship with report rates and the nature of the mandated reporting law change. We used county-level data from the U.S. National Child Abuse and Neglect Data System for the years 2000 and 2010 to evaluate changes in reporting rates for total reports, confirmed reports, and confirmed maltreatment types while controlling for concurrent changes in child and community variables. We found that trends in 2010 for increased total and confirmed reports were similar to 2000 for counties with universal and/or clergy reporting requirements, which significantly contributed to report rates even after controlling for child and community factors. Universal reporting was associated with higher report rates for physical and sexual abuse, and clergy reporting requirements were associated with more sexual abuse, medical neglect and psychological maltreatment confirmed reports. However, while counties in states that changed their clergy reporting laws had higher increases in total reports, they had fewer confirmed physical and sexual abuse, neglect, and psychological maltreatment reports. More pronounced changes were noted in a state that made more pronounced changes in its clergy reporting laws. Policymakers should consider whether changing requirements for mandated reporting meaningfully improves child maltreatment identification.

Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt

To improve identification of child maltreatment, a new policy (‘Hague protocol’) was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol (‘Amsterdam protocol’) was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment.

Identification of child maltreatment in Iranian children with the parent-child conflict tactics scale.

Background:Child abuse and neglect is a worldwide problem and varies across many sociodemographic characteristics.Aim:The aim of this study was to examine the prevalence of different types of child maltreatment in Iranian kids according to the reports of their caregivers.Subjects and Methods:In this cross-sectional study, 562 mothers with the last child aged between 1 and 12 years were recruited based on purposeful sampling method in one pediatric referent Mazandaran province, Iran. Child maltreatment among eligible participants was assessed by a validated version of conflict tactics scale for parent and child. Data were analyzed using Pearson Correlation coefficient and one-way ANOVA.Results:Prevalence of emotional assault, physical assault, and child neglect were respectively 90.6% (509/562), 82.9% (466/562) and 78.8% (443/562), which were more frequent in preschool age children. Furthermore, different kinds of child maltreatments were correlated with each other (P < 0.001).Conclusion:Assessment of all forms of child maltreatment should be an important focus of evaluation in cases with one kind of child maltreatment. This is an important issue in preschool age children. Furthermore, this paper has some implications for health care providers in order to check some simple items to identify child abuse.

Child Maltreatment: Screening and Anticipatory Guidance

Child maltreatment is a problem of epidemic proportions in the United States. Given the numbers of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. Despite support of the implementation and development of protocols for child maltreatment screening by professional organizations such as the National Association of Pediatric Nurse Practitioners and American Academy of Pediatrics, little is available in the literature regarding the screening practices of pediatric nurse practitioners and other pediatric health care providers. This Continuing Education article will help pediatric nurse practitioners incorporate this vital screening intervention into their practice. Practical examples of when and how to incorporate screening questions and anticipatory guidance for discipline practices, crying, intimate partner violence (domestic violence), physical abuse, and sexual abuse will be discussed.

Paediatric nurses’ identification of violence against children

This paper is a report of an evaluation of paediatric nurses' assessment and diagnostic skills and interventions used for child maltreatment. The use of violence against children occurs in all environments worldwide. Therefore, broader theoretical and practical knowledge related to this issue is needed in health care to facilitate more accurate identification of child maltreatment in order to instigate implementation of appropriate care for these children. The study was based on cross-sectional data obtained with a convenience sample of 160 Registered Nurses employed at paediatric wards at two large cities in Poland (response rate 80%). Data collection took place between December 2005 and March 2006. The research tool was a questionnaire form designed on the basis of international literature concerning battered child syndrome. Battered child syndrome seems to be a relatively common phenomenon, as a great majority of participants (86·25%) had encountered it in their practice. The form of child maltreatment which was most often mentioned (by 30·00% of participants) was neglect. Almost three-quarters of the nurses (61·25%; n = 98) said that they had been involved in providing care for a maltreated child. Nurses should work with maltreated children on an individualized basis, combined with interdisciplinary cooperation with specialists from related disciplines concerned with the issue. There appears to be a need for specialized training for nurses to increase their competence in working with maltreated children and their families.

Protecting children through supporting parents

All parents need social and emotional support to ensure optimal outcomes for children. For the majority of families, this support comes through family and social networks and the institutions of education and health. The challenge for society is to protect and assist parents and children when things are going wrong. Although there are known indicators for risk, it can be hard to be sure of when and how to intervene in family life to protect children and support parents. Such interventions may have to be made in relation to episodic events, for example a recurrence of a depression in one of the parents, and in the face of continuing difficulties, for example poverty or social exclusion.This paper examines two, quite different, challenges for professionals trying to support parents. First, it makes some suggestions about how it is that professionals can fail to recognise signs of child maltreatment. The identification of child maltreatment is critical in taking appropriate steps to protect children. Second, it considers the complexity of the task of supporting parents, including whether support should be based on the parents views about services that they would like, or on professional and policy‐makers judgements about how to meet the parents' needs.

The utility and challenges of using ICD codes in child maltreatment research: A review of existing literature

Objective The objectives of this article are to explore the extent to which the International Statistical Classification of Diseases and Related Health Problems (ICD) has been used in child abuse research, to describe how the ICD system has been applied, and to assess factors affecting the reliability of ICD coded data in child abuse research. Methods PubMed, CINAHL, PsychInfo and Google Scholar were searched for peer reviewed articles written since 1989 that used ICD as the classification system to identify cases and research child abuse using health databases. Snowballing strategies were also employed by searching the bibliographies of retrieved references to identify relevant associated articles. The papers identified through the search were independently screened by two authors for inclusion, resulting in 47 studies selected for the review. Due to heterogeneity of studies meta-analysis was not performed. Results This paper highlights both utility and limitations of ICD coded data. ICD codes have been widely used to conduct research into child maltreatment in health data systems. The codes appear to be used primarily to determine child maltreatment patterns within identified diagnoses or to identify child maltreatment cases for research. Conclusions A significant impediment to the use of ICD codes in child maltreatment research is the under ascertainment of child maltreatment by using coded data alone. This is most clearly identified and, to some degree, quantified, in research where data linkage is used. Practice implications The importance of improved child maltreatment identification will assist in identifying risk factors and creating programs that can prevent and treat child maltreatment and assist in meeting reporting obligations under the CRC.