Incidence Of Child Abuse Research Articles

Are economic trends associated with child maltreatment? Preliminary results from the recent recession using state level data

The objective of this study is to investigate the effects of the recent economic recession on child maltreatment rates. Specifically, we examine whether unemployment rates, labor force participation, and food stamp usage are associated with aggregate rates of child abuse and neglect (CAN) rates using state-level data. Theory and prior empirical evidence supports the relationship between family and neighborhood poverty and incidence of child maltreatment; however, the relationship between general economic environment and CAN remains unclear. The study uses a multiple case study design at the state level, analyzing administrative child maltreatment and economic data for seven U.S. states. Aggregate numbers for child maltreatment reports and food stamp usage were obtained from state respective agencies and economic data for unemployment and labor force from the Current Population Survey from the Bureau of Labor Statistics. Empirical growth plots and OLS regression were used to examine changes in maltreatment and utilization of economic variables as predictors over time. Bivariate correlations and OLS regression results show a weak and inconsistent relationship between the economic indicators in this study and maltreatment rates. Several possible reasons accounting for these results are explored.

Overrepresentation of New Zealand’s Maori in Presumed Shaken Baby Syndrome – Nature or Nurture?

percentile). That this would occur by chance is less than 3% for each case. Since these are independent events, the chance they would both occur is the product of the two or 3% times 3% - less than one in a thousand. Both also had evidence of increased cerebrospinal fluid spaces. This condition, known by many different names, my preference being craniocerebral disproportion, was noted by Piatt [4] to present a possible “pitfall” in the diagnosis of child abuse and more recently confirmed by Vinchon [5] to be associated with the spontaneous occurrence of subdural and retinal hemorrhage, a combination considered highly suspicious for abuse. Alvarez [6] has noted this condition to be “closely related to benign familial macrocephaly”, a finding confirmed by Karamzadeh [ 7], who reported a non-abusive subdural in one of his 20 cases. Kelly [8] has reported a higher incidence of child abuse in the Maori population, noting that “racial susceptibility to accidental SDH” (nature) has been suggested but labeling 2 articles by neurosurgeons “dubious” and preferring cultural factors (nurture). Kelly grouped the new Zealand

Small Changes Can Have Large Impacts: Health Care Overhaul Should Include Child Maltreatment Prevention in Primary Care

When we think of patient safety, we usually do not immediately think of child maltreatment prevention. Yet the incidence and prevalence of child maltreatment is a significant public health issue in the United States. As we begin to overhaul our health care system, it is a good time to think about child maltreatment prevention. Including child maltreatment prevention as a core component of pediatric care may be less complicated than understanding what child maltreatment is and how it affects children. Anonymous telephone surveys suggest that as many as 10% to 15% of children experience physical and emotional abuse. The abuse is most often long term, acting more like a chronic malady than an acute trauma. Children younger than 3 years of age experience the greatest risks for morbidity and mortality resulting from child abuse and neglect. Although we know that physical abuse is underrecognized and underreported, emotional abuse is even more difficult to identify. Research, such as the Adverse Childhood Experiences study, has shown that there is a direct association between the abuse and neglect suffered during childhood and use of drugs and alcohol, involvement in violence, depression and anxiety, and physical health in adulthood. This study of Kaiser adult enrollees shows dramatic increases in adult mental health and physical illness that are directly related to the number of adverse childhood experiences these enrollees suffered. These data are not new and yet there has been little momentum in health care to focus on prevention of childhood maltreatment. The actual prevention techniques are progressing through clinical trials and are still too early to be definitive, but a number of early studies show promise. Pediatricians see the majority of children younger than 3 years of age numerous times each year. Physicians have recognized that issues related to the child’s psychosocial health are a primary parental concern. This makes sense given that children’s physical health has improved beyond acute issues such as infectious diseases. The “new morbidities” of mental health and developmental issues have become of paramount importance to the pediatric visit. Although parents want pediatricians to help them with these topics, pediatricians often do not feel well equipped to answer questions related to psychosocial health, nor do they know what to do when they recognize family dysfunction. Several psychosocial topics related to maternal health, infancy, and toddlerhood are currently under study by researchers: maternal depression, infant crying, discipline, and toilet training (eg, Practicing Safety). Pediatric identification of and response to these issues can enhance parenting skills and behaviors and ultimately help raise a happy, healthier child and, thus, a healthier adult. Additionally, through its Bright Futures initiative, the American Academy of Pediatrics has assessment instruments and tools for pediatricians to use to identify other psychosocial issues related to the infant, child, and family. Lastly, it is essential that primary care provider sites provide medical homes for infants at risk for maltreatment or developmental delays. Interventions such as Practicing Safety, and perhaps Bright Futures, offer building blocks to primary care pediatrics to use in the development of medical homes for their infant and child patient populations. Incorporating such features into primary care requires a culture of change—a change in long-standing practice patterns. Quality improvement strategies, such as office-based coaching, learning collaboratives, and use of data to track changes, are critical to acceptance and sustainability. Rigorous studies to test child maltreatment prevention interventions are under way. The integration of risk identification, linkages and referral to community resources, and monitoring and follow-up to enhance parenting skills and behavior must undergo rigorous research to determine the treatment effect produced by such focused, proactive office-based approaches. Universal developmental screening has been suggested by the Commonwealth Fund and the American Academy of

Substantiation of Spouse and Child Maltreatment Reports as a Function of Referral Source and Maltreatment Type

Substantiation rates for alleged incidents of spouse (N = 33,787) and child (N = 31,986) maltreatment reported to the U.S. Air Force (AF) Family Advocacy Program between 2000 and 2007 were examined. For spouse maltreatment, physical abuse and multiple forms of maltreatment were most likely to be substantiated and neglect was least likely to be substantiated. For child maltreatment, emotional abuse was most likely to be substantiated and physical abuse was least likely to be substantiated. Substantiation rates were higher for referrals by military professionals than for referrals by civilian professionals or nonprofessionals; considerable variation in substantiation rates within each of these categories also was observed. Overall, AF substantiation rates were higher for spouse than for child maltreatment, and substantiation rates for child maltreatment were higher in the AF than in the general U.S. population. Substantiation rates have declined over time in both the AF and the United States.

Using capture-recapture methods to better ascertain the incidence of fatal child maltreatment

Objectives To (1) test the use of capture-recapture methods to estimate the total number of child maltreatment deaths in a single state using information from death certificates, child welfare reports, child death review teams, and uniform crime reports; and to (2) compare these estimates to the number of maltreatment deaths identified through an in-depth “gold standard” review. Methods Child maltreatment deaths were identified in four existing administrative data sources: (1) death reports in our state vital statistics (DC); (2) child death review team reports (CDR); (3) homicide reports filed by our state police agency as uniform crime report (UCR) supplements for the FBI; and (4) abstracted reports of a minor's death from our state child protective services (CPS) agency. Capture-recapture pair-wise and pooled comparisons were then applied to estimate the numbers of abuse and total maltreatment deaths and were compared to the number of cases identified by independent case review. Results There were a total of 194 child maltreatment deaths in Michigan during 2000–2001 with 66 due to physical abuse. Capture-recapture analysis estimated the mean number of total child maltreatment deaths as 101.02 (95%CI = 92.52, 109.53), with abuse deaths of 64.55 (60.85, 68.25). Most pair-wise and pooled comparisons worked equally well for abuse deaths, but estimates for total child maltreatment deaths were low. Conclusions Capture-recapture methods applied to existing administrative datasets produced accurate estimates of child abuse deaths but were not useful in producing reliable estimates of total child maltreatment deaths due to undercounting neglect-related deaths in all existing administrative data sets. The underlying assumptions for capture-recapture methods were not met for neglect deaths. Local and/or state teams conducting ongoing intensive case review may yet remain the best way to identify the total number of child maltreatment deaths. Practice implications Capture-recapture methods allow for more accurate estimation of the true number of child physical abuse deaths than does using single existing sources of child fatality information, but deaths from causes other than abuse are undercounted. Child maltreatment fatality surveillance requires a systematic process and standard criteria for identifying cases of maltreatment, particularly neglect-related child deaths.

The incidence of child abuse in the contemporary society: a fact or farce?

The study investigated the incidence of child abuse in the contemporary society. It examined the dimension of the incidence whether it is a fact or a farce. 300 participants, from school of Nursing, Mid-wifery and Medical Laboratory of Bishop Shanahan Hospital Nsukka. 285 females and 15 males freely participated. Age range was (20-26) years with a mean age of 23 years. An instrument called Incidence of child Abuse Inventory (ICAI) developed and validated by the researcher was used. The scale has three dimensions, physical, mental and moral dimensions. Results showed that there was significant influence of physical dimension on child abuse. F(1,293)= 207.73 P

Topics of Stress and Abuse in Children’s Literature for Intermediate Readers

Normal.dotm 0 0 1 172 1293 Loyola College 43 23 1516 12.0 0 false 18 pt 18 pt 0 0 false false false /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Wendy M. Smith-D’Arezzo (Corresponding author) Loyola University Maryland 4501 North Charles Street Baltimore, MD 21210 United States wmsmith@loyola.edu 410-617-2194 (o) 410-617-5097 (fax) Susan C. Thompson University of Northern Colorado, Greeley School of Teacher Ed Office McKee Hall 280 Campus box 107 Greeley, CO 80639-0001 United States Susan.thompson@unco.edu 970-351-2070 Abstract Incidents of child abuse and neglect are reported daily in the United States, currently numbering close to 900,000 cases per year. Children are abused/maltreated physically, emotionally and sexually, in addition to being abused through neglect. Introducing this topic in the intermediate grades as a social justice/civil rights issue is one way to open the door to discussions of child abuse with children who may be experiencing abuse in their homes. Included here is an in-depth analysis of thirteen current texts for intermediate readers that contain significant incidents of child maltreatment, comparing the abuse within the books to actual statistics and types of maltreatment currently recognized within the United States. Suggestions and guidelines are given to teachers for using these books with children, although cautions against using bibliotherapy are clear throughout. Key words: Child abuse/maltreatment Children’s literature Intermediate grades Social justice

The Medical Consequences of Child Abuse and Neglect

The remarkably high incidence of child maltreatment in the United States and worldwide is astounding. Estimates have revealed that nearly 3.6 million cases of child abuse and neglect are reported annually in the United States. According to the U.S. Department of Health and Human Services Children’s Bureau (NCANDS), more than 700,000 of these were found to be severe in nature, with nearly 2,000 cases resulting in fatalities in 2007 alone. However, it is important to recognize that many experts in the field consider these figures to be a gross underestimate because childhood maltreatment is often not reported or difficult to confirm. A growing database indicates that early life stress, defined as verbal, physical or sexual abuse, or neglect, including, for example, separation from a primary caregiver, or living with a primary caregiver with severe mental illness, increases the risk of developing psychiatric disorders, including mood disorders, anxiety disorders, attention-deficit hyperactivity disorder (ADHD), substance abuse, and schizophrenia.<sup><a href="EditorPage.aspx?da=core&id=%7bA932AC25-CB6C-41F0-887A-1F74731AC343%7d&ed=FIELD17595849&vs&la=en&fld=%7b0B37FA8E-B2A6-4AE9-8E4F-53651D5CB226%7d&so=%2fsitecore%2fsystem%2fsettings%2fhtml+editor+profiles%2frich+text+healio&di=0&hdl=H17595923&us=sitecore%5cadmin&mo&pe=0#x00485718-20091123-02-bibr1">1–4</a></sup> Moreover, the long-term effects of early-life trauma are not limited to increased vulnerability for syndromal psychiatric disorders but also appear to result in impaired cognitive abilities, increased obesity, and long-term effects on a number of biological systems that result in increased disease burden in adults. It is this subject that comprises the major subject matter of this article, an area previously, to the best of our knowledge, not summarized. Understanding the biological consequences of early-life stress is of paramount importance, not only in advocacy for protection of our youth but also as a pathophysiologic guide to develop novel treatments for this population. As will be described below, multiple biological mechanisms have been demonstrated to be dysregulated in adults who were victims of child abuse and neglect. These include effects on the endocrine, nervous, immune, and cardiovascular systems, all of which are known to be involved in the innate acute stress response. This article is an effort to consolidate the data available involving the long-term medical consequences of childhood trauma.

Impact of a Statewide Collaborative on Strengthening Families Through Early Care and Education

Research Findings: Research suggests that early care and education programs are most effective when they include strong components of family involvement. The Center for the Study of Social Policy recommended that early care and education programs build family-centered practices to strengthen families and reduce the incidence of child abuse and neglect. This article summarizes a statewide effort to implement this strategy, called Strengthening Families through Early Care and Education. We analyzed program self-assessments submitted by 186 early care and education programs. Analyses revealed that Head Start programs had better support systems in place for families than did “mainstream” (non–Head Start, non-accredited) early care and education programs. Results also showed that a small amount of state and local funding provided enough incentive for programs to improve their family-strengthening practices. Commitment and collaboration at the state level led to a sustainable impact by infusing “strengthening families” concepts into the early care and education field statewide.

The Silent Epidemic of Neurodevelopmental Injuries

Childhood maltreatment in the United States was recently recognized as a major public health problem by several influential sources including the World Health Organization and the Institute of Medicine (1,2). An extensive survey conducted by the National Incidence of Child Abuse and Neglect (NIS3) revealed that roughly 1.5 million children were abused or neglected in 1993. This number of documented cases most likely underestimates the true prevalence, given that many cases of maltreatment go unrecognized (2). Moreover, according to the three available NIS reports, the incidence of childhood maltreatment has been steadily increasing over the past 3 decades (see also NIS4 for a good summary of this issue). Although increased reporting might explain some of the data, it is unlikely to explain this alarming trend fully (3). In the absence of effective interventions, maltreated children go on to develop a host of behavioral, emotional, cognitive, and medical sequelae that are chronic and in many cases refractory to treatment (2,4–6). The relationship between early life adversity (ELA) and mental illness has now been documented with both retrospective and prospective studies (reviewed in [2]), and several reports have consistently documented that more than one-half (!) of the individuals with chronic mental illness have been physically, verbally, or sexually abused early in life (7,8). Although most clinicians and researchers will endorse the notion that ELA is associated with increased risk for chronic mental illness, few appreciate the true magnitude of this problem. Better awareness of the burden that exposure to ELA places on adult psychiatric services represents the first step necessary towards transforming current psychiatric interventions. This paradigm shift should substitute the current focus on symptom-reduction with one that focuses on prevention and incorporates a neurodevelopmental framework to diagnose and treat ELA-associated psychopathology. These interventions will require a sound biological understanding of normal neurodevelopment and how ELA interferes with this process.

Child maltreatment in Disney animated feature films: 1937–2006

The 45 fully animated, theatrical release feature films produced by Disney between 1937 and 2006 were analyzed for child maltreatment content. All child and adolescent characters were counted and coded for age, role type and incidents of child maltreatment, following US National Incidence Study of Child Abuse and Neglect (NIS) criteria. A total of 561 incidents of child maltreatment were identified among the 1369 child characters in the films. A total of 26 of the 42 (62%) main child characters were maltreated at least once. Findings are discussed in the context of previous research. Implications of the findings for understanding potential effects on film viewers’ understandings of issues around child maltreatment are outlined.

Child homicide in New South Wales from 1991 to 2005

To examine the circumstances of homicides of children in New South Wales from 1991 to 2005. Retrospective analysis of all identified child homicides in NSW from 1991 to 2005, based on data on offenders and victims obtained from crime statistics, documents located by systematic searches of legal databases and media reports, and medicolegal reports of offenders who committed child homicides during psychotic illness. Demographic characteristics of homicides and a history of prior psychiatric treatment among offenders with psychosis. We located documents describing 165 homicides by 157 offenders. Fifty-nine deaths were a consequence of child abuse, including those of five children who died from methadone overdoses. Both the offenders and the victims in fatal child abuse were significantly younger than in other forms of child homicide. The courts found that 27 child homicides had been committed by 26 offenders during the acute phase of psychotic illness, and 15 of these offenders had never been treated with antipsychotic medication. Earlier identification and treatment of psychotic illness in mothers, and changes in the way methadone is provided to opiate-dependent parents, might result in a small overall reduction in the number of child deaths. More lives could be saved by measures that reduce the incidence of child abuse, including the prohibition of corporal punishment of children.

Child abuse as a complex and wicked problem: Reflecting on policy developments in the United Kingdom in working with children and families with multiple problems

In spite of significant public concern, professional efforts and financial expenditure, there has been a perceived lack of progress in reducing the incidence of child abuse, and in improving the outcomes for children in both the short and longer term. In this article the authors reflect on recent policy developments in the United Kingdom relating to children and families experiencing multiple adversities, and argue that the current conceptualisation of child abuse is flawed. In adopting a rational technical approach to the management of child abuse, there is a tendency to focus on shorter term outcomes for the child, such as immediate safety, that primarily reflect the outputs of the child protection system. However, by viewing child abuse as a wicked problem, that is complex and less amenable to being solved, then child welfare professionals can be supported to focus on achieving longer term outcomes for children that are more likely to meet their needs. The authors argue for an earlier identification of and intervention with children who are experiencing multiple adversity, such as those living with parents misusing substances and exposed to intimate partner violence.

Child Maltreatment in Remote Aboriginal Communities and the Northern Territory Emergency Response: A Complex Issue

Forty years after the 1967 Referendum and 10 years after the Bringing Them Home inquiry published its report into the Stolen Generations, in June 2007 the Howard Federal Government launched an Emergency Response intervention in the Northern Territory, having recognised the urgent need to reduce the incidence of child maltreatment in remote Aboriginal communities. This intervention was developed in response to the Northern Territory Government report on child sexual abuse in Indigenous children that described the urgency of the situation. In the present review of the literature, the complexity of the issue of child maltreatment, in particular child sexual abuse, in Indigenous Australia is explored. The Northern Territory Emergency Response1 is examined in the light of research evidence, detailed in numerous government reports, that reducing child maltreatment in Aboriginal communities necessitates both Aboriginal self-determination and extensive consultation between Indigenous and non-Indigenous people working in the field. The extent to which the Emergency Response is evidence based and the complexity of making a report about child maltreatment, in particular child sexual abuse, in a remote Aboriginal communities are explored. Implications for policy and practice are also discussed. 1The current Rudd Federal Government has adopted most of the policies involved in the Northern Territory Emergency Response and has called for a comprehensive and independent review to be completed by 30 September 2008.

Intimate partner violence, maternal stress, nativity, and risk for maternal maltreatment of young children.

We examined the associations of intimate partner violence (IPV) and maternal risk factors with maternal child maltreatment risk within a diverse sample of mothers. We derived the study sample (N=2508) from the Fragile Families and Child Well-Being Study. We conducted regression analyses to examine associations between IPV, parenting stress, major depression, key covariates, and 4 proxy variables for maternal child maltreatment. Mothers reported an average of 25 acts of psychological aggression and 17 acts of physical aggression against their 3-year-old children in the year before the study, 11% reported some act of neglect toward their children during the same period, and 55% had spanked their children during the previous month. About 40% of mothers had experienced IPV by their current partner. IPV and maternal parenting stress were both consistent risk factors for all 4 maltreatment proxy variables. Although foreign-born mothers reported fewer incidents of child maltreatment, the IPV relative risk for child maltreatment was greater for foreign-born than for US-born mothers. Further integration of IPV and child maltreatment prevention and intervention efforts is warranted; such efforts must carefully balance the needs of adult and child victims.

Cutaneous mimickers of child abuse: a primer for pediatricians

The annual incidence of child abuse was estimated to be 2.8 million by the national incidence study conducted in the USA in 1993, which is a two-fold increase compared to 1986. Awareness of child abuse has been increasing since the 1960s. Although most victims of child abuse present with cutaneous lesions, many genuine skin diseases may appear as non-accidental injuries which, if not recognized, may lead to misdiagnosis of child abuse. Here, we review the most common cutaneous mimickers of child abuse in order to increase awareness of these disorders and reduce erroneous diagnosis of child abuse.

Child Abuse in a semi-urban community in south-south Nigeria: The case of a 12 Year Old Girl Accused of Witchcraft

In spite of the passage of the 2003 Child Right Act in Nigeria, and the signing and ratification of several international legal instruments that dealt with child abuse, the incidence of child abuse in Nigeria is still very high. We report the deprivation, physical and psychological abuse suffered by a 12 year old girl accused of witchcraft by members of her family, in Egbema, a semi-urban, oil bearing community in the Niger Delta region of Nigeria. This case is reported to highlight the increasing number of children accused of witchcraft by charismatic religious groups; and to emphasize the need for doctors to seek out such abuses, and act to protect the abused children.Nigerian Hospital Practice Vol. 2 (1) 2008: pp. 10-13

Child Protection in the United States: An Examination of Mandated Reporting of Child Maltreatment

Child protection is one of the key indicators of a society’s health. In the U.S. all states have enacted laws which require certain professionals who regularly come into contact with children to report suspected maltreatment. Passage of these laws has resulted in an unprecedented increase in the number of reports of child maltreatment made to U.S. child protective services (CPS), yet this increase has not been systematically studied to determine whether this increase in reports is actually reducing the incidence of child maltreatment. This paper describes and compares the reporting practices of four mandated reporting groups in the U.S. over a 3-year period. Data from the National Child Abuse and Neglect Dataset (NCANDS) were analyzed. NCANDS is a national database created by the US Department of Health and Human Services (DHHS) of reports of maltreatment made to child protective services agencies (CPS) in the US. Results indicate that each reporter group has a somewhat unique profile of reports and responses from the child protection agencies to which they report. Significant differences were found related to the type of maltreatment reported and the rate of report substantiation by CPS. While some differences can be easily explained, others require more research and have broad implications for the professional education and training of mandated reporters.

Child Maltreatment and Substance Abuse Among U.S. Army Soldiers

Although substance abuse has consistently been linked to child maltreatment, no study to date has described the extent of substance abuse among child maltreatment offenders within the military. Analysis of U.S. Army data on all substantiated incidents of parental child maltreatment committed between 2000 and 2004 by active duty soldiers found that 13% of offenders were noted to have been abusing alcohol or illicit drugs at the time of their child maltreatment incident. The odds of substance abuse were increased for offenders who committed child neglect or emotional abuse, but were reduced for child physical abuse. The odds of offender substance abuse nearly tripled in child maltreatment incidents that also involved co-occurring spouse abuse. Findings include a lack of association between offender substance abuse and child maltreatment recurrence, possibly because of the increased likelihood of removal of offenders from the home when either substance abuse or spouse abuse were documented.

Selected Socio-demographic Factors as a Correlates of Child Abuse and Neglect among Parents in Ibadan, Oyo State

This study examined four socio-demographic factors associated with child abuse among parents in Ibadan metropolis which include: economic status, large family size, parent's upbringing and single parenthood. The descriptive survey research design was used. Simple random sampling techniques was used to select two thousand and sixty three subjects from the five metropolitan local government areas in Ibadan viz: Ibadan North, Ibadan North East, Ibadan North West, Ibadan South East, Ibadan South West. Chi-square was used to test the four hypotheses set at 0.05 alpha level. The findings of the study established that factors examined contributed significantly to the incidence of child abuse among parents in various degrees. It was recommended that government at all levels should pursue their poverty reduction and eradication programmes with vigour to stop child abuse due to poverty; population and family life education is necessary for all citizens to create awareness on the need to control family size for improved quality life; religious institutions should concentrate attention on premarital counseling and organize conferences, seminars and workshops focused on acquisition of parenting skills so as to stop or at least reduce the cases of child abuse associated with poor patterns of child rearing.