Child Abuse Investigations Research Articles

Sex differences in the roles of nicotine use and puberty on youth C-reactive protein levels: Effects above and beyond adversity

Inflammation likely mediates associations between nicotine use and negative health outcomes. Sex differences have been observed in nicotine use–inflammation links, and physiological processes during puberty might allow for these differences to arise. In this cross-sectional study of 498 youth (ages 8–13, 52% girls, 77% with history of child maltreatment (CM) investigation), sex-differentiated associations between self-reported nicotine use and high-sensitivity C-reactive protein (hs-CRP) were explored. Additionally, self-reported pubertal stage was investigated as a moderator of such nicotine use–hs-CRP links. Hierarchical generalized estimating equation models were adjusted for a wide range of adversity effects: CM investigation history derived from state records, self- and caregiver-report of traumatic life events, adversity-related demographic risk factors (i.e., identification with historically marginalized racial and ethnic groups, household income), and other characteristics that may influence the variables of interest (e.g., medication use, age, body mass index). Nicotine use had a negative main effect on hs-CRP among boys (β = −0.50, p = 0.02), and pubertal stage did not moderate this association (β = 0.06, p = 0.71). In contrast, pubertal stage moderated the association between nicotine use and hs-CRP among girls (β = 0.48, p = 0.02) such that a positive association between nicotine use and hs-CRP levels was stronger at more advanced pubertal stages (β = 0.45, SE = 0.21, 95% CI [0.03, 0.87]). Findings suggest that puberty may influence the effect of nicotine on inflammation in sex-differentiated ways and have implications for timing of prevention and treatment efforts geared toward reducing nicotine use and subsequent inflammation-related health risk among youth.

Home Visiting and Child Welfare Involvement: A Matched Comparison Group Study.

The present study is one of the largest quasi-experimental studies to date on the effects of home visiting on documented child maltreatment during a child's first two years of life. In this matched comparison group study, we compare 8796 families that participated in a home visiting program (HV families) to 8796 similar non-participating families (non-HV families) selected from birth records using Coarsened Exact Matching. Using sequential logistic regression, we identify that HV families have significantly higher odds of experiencing a child maltreatment investigation by their child's second birthday compared to non-HV families; however, among those that were investigated, HV families have significantly lower odds of having their first investigation substantiated for maltreatment. Overall, HV families do not differ significantly from non-HV families in the odds of experiencing a substantiated investigation over 2years. We share implications for considering surveillance bias, and we highlight the importance of including both substantiated and unsubstantiated investigations when studying the effects of home visiting on documented child maltreatment.

A Multilevel Analysis of Individual and Community Factors Associated With Case Dispositions Following Child Maltreatment Investigations.

Understanding service disposition pathways is critical to provide deeper insight into why certain subgroups of the population are at risk for recurrent Child Protective Services (CPS) involvement and may highlight disparities across groups or geographic areas. Using the Decision-Making Ecology Framework as a lens, the present study examines whether service disposition pathways are influenced by risk assessment, safety concerns, child age, maltreatment type, previous CPS involvement, and/or county-level structural vulnerability. We linked administrative data from New Mexico's Department of Children, Youth and Families (DCYF) to data from the American Community Survey. Multilevel models examining associations between case (N = 12,960) and county (N = 33) characteristics revealed that both case (age, maltreatment type, risk/safety assessments, previous CPS involvement) and county-level factors (transportation and housing) were associated with service disposition. Additionally, we observed considerable variation at the county level in both the provision of services and the relationship between risk assessment and service provision. By linking different factors of the decision-making process in child welfare cases to intervention strategies, the analysis reveals that the perception of risk can vary based on geographical context resulting in different outcomes for families who have similar risks but different county-level vulnerabilities.

Social workers’ knowledge about children’s memory and child interviewing

BackgroundThe Child Protective Services (CPS) can be prominent actors in child abuse investigations as they often conduct the first safety assessment upon receiving a report of concern for a child. As part of this assessment, CPS may conduct an interview with the child. However, to date, little is known about how these interviews are conducted. ObjectiveThe present study aimed to shed light on Swedish social workers’ experience with interviewing children and knowledge about children’s memory and witness abilities. Participants and SettingA total of 204 social workers participated in an online survey and answered questions concerning memory functioning and interviewing children about suspected abuse. MethodsResponses were analyzed using qualitative (content analyses) and quantitative (descriptive) approaches. ResultsThe main findings concern a lack of standardized interviewing guidelines, with CPS workers instead using various interviewing techniques with limited empirical support. When asked to elaborate on the challenges they perceived interviewing children, many mentioned the difficulty of asking proper questions. A few expressed feeling unequipped for the task of interviewing children. Further, participants' knowledge regarding children's memory varied. Many expressed awareness that memories can be vulnerable to suggestion and that emotions cannot verify a memory's authenticity. However, participants were more insecure regarding the possibility of repressing and, subsequently, recovering memories. ConclusionsImprovement is required; CPS needs further education and support when conducting interviews with children regarding suspected abuse. Implementing a research-based method can facilitate these interviews and improve children’s right to be heard and legal certainty.

“Just Did The Best That I Could Do”: CPS Social Workers’ Perceptions of Self-Efficacy in Legal Aspects

Child protective services (CPS) social workers assess safety and risk needs during abuse and neglect investigations to determine if legal interventions are needed. However, only 60% of abuse and neglect cases have safety and risk assessed during the investigatory process in North Carolina. This study aimed to explore the perceptions of self-efficacy among rural North Carolina CPS social workers in child abuse and neglect investigations. Understanding CPS social workers’ perceptions of self-efficacy and factors that may influence their self-efficacy is vital to improving job satisfaction, retention, and the legal and investigative processes relating to child abuse and neglect. A purposive sampling approach was used to recruit nine CPS social workers in rural counties in North Carolina. Through a process of open, axial, and selective coding, we conclude that a CPS social worker’s self-efficacy is impacted by factors relating to leadership and legal teams, longevity, previous social work experience, and paperwork and caseload demands.

‘It’s why you get up in the morning’. A Straussian grounded theory study of coping in police officers who investigate rape and child abuse

Policing by its very nature has been widely recognised as being inherently stressful with little that can be done to prevent police officers’ exposure to both primary and secondary trauma. Officers involved in the investigation of child abuse and sexual offences have been further recognised as working in some of the most stressful and demanding roles in policing. However, there has been little research within this high-risk group of officers which seeks to understand how they cope with both the organisational and occupational stressors they are exposed to, as well as which strategies help them to ‘ get up in the morning’. Data were collected through twenty-three (23) semi-structured interviews, with Straussian Grounded Theory used as a framework to develop a model of coping. This study highlighted that although some officers were affected by the traumatic nature of their work, there were other risk factors present which appear to have impacted on them more significantly including ‘burnout’, ’compassion fatigue’ and ‘moral injury’. Protective factors were identified as ‘being in control’, ‘organisational, social and peer support’ as well as ‘having a purpose’ all of which impacted on an officer’s ability to cope with the work they do. The present findings extend our knowledge of key concepts relating to police officer coping which may help officers working in these high-risk roles to cope with challenges they face daily. Recommendations for further research on how to support this group of officers, as well as implications for practice are discussed.

The overrepresentation of parents with disabilities in child protection

BackgroundRacial disproportionality and disparity have long plagued the United States child protection system (CPS). Determining whether disproportionality exists for parents with various disability diagnoses, and the points at which it may occur within CPS, is important to the provision of appropriate assessment and service delivery to children and families. ObjectiveThis study describes the characteristics of parents with different types of disabilities and estimates their representation at various CPS decision-making points. Participants and settingThe sample consists of a longitudinal, population-level cohort of individuals aged 15–21 identified from statewide educational records, whose disability status could be determined. Statewide CPS records were integrated to determine subsequent CPS involvement (as alleged offenders/parents involved in a child maltreatment investigation, and/or as parents of children placed in out-of-home care [OHC], and/or as parents whose parental rights were terminated [TPR]), or lack thereof. MethodsDescriptive statistics, chi-square analysis, disparity indices with decision-point enumeration, and logistic regression analyses were used to answer study questions. ResultsFindings reveal consistent and significant overrepresentation of parents with disabilities at CPS investigation as compared to parents without disabilities. Additionally there is a fairly similar trend across disability diagnoses in the reduction of overrepresentation at OHC, followed by a diagnosis-specific change in representation as parents with disability move into a situation of TPR, with some parents with disabilities being over-represented and others not. ConclusionAttention to practice, policy, and research are necessary to provide fair and equitable services to parents with disabilities and their children in CPS.

Discretion and Strategies for Investigating Child Abuse: Social Workers’ Conceptions of Child Abuse Investigations and Police Reporting

Abstract Understanding the capacity of child welfare (CW) organisations to deal with child abuse is complex, and dependent on the specific CW context. Sweden occupies a unique position in trying to balance high demands for CW and protection with a strong family support focus, which carries a risk of overlooking children who need protection. Drawing on an understanding of social service organisations as street-level bureaucracies, this article explores discretion in child abuse cases by examining conditions affecting discretion and strategies for investigating child abuse, including police reporting. Thematic analysis of interviews with Swedish supervising social workers showed that staff’s conceptions of the CW system influenced the exercise of discretion, leading to different strategies for dealing with child abuse. This resulted in different practices and potentially unequal access to child protection and support, highlighting the wide margin of discretion. This article concludes that the interplay between knowledge and governance is central to equal child protection. This article contributes to the discussion of discretion in CW organisations by underlining the importance of being particularly vigilant about discretion when both children and parents are considered clients, as the child risks being lost as a subject with individual needs and rights.

Client characteristics and service use at the first hospital-based Canadian child and youth advocacy center: An analysis of case tracking data

BackgroundThe Child and Youth Advocacy Center (CYAC) model supports a coordinated response for young victims of abuse and their families. The model is prevalent in the United States, with more recent growth across Canada. ObjectiveThis descriptive study summarizes case tracking data to profile the client population, referral characteristics, use of services, and associations between client characteristics and service use in child maltreatment investigations referred to the first hospital-based Canadian CYAC over time. This data illustrates the potential to use CYAC case tracking data in understanding the use of, and client populations served by, this emerging collaborative service model in Canada.Participants and Setting Participants included children and youth served at SeaStar Child and Youth Advocacy Center in Halifax, Nova Scotia (N = 1,364) in its first seven years of operation. MethodsDescriptive statistics were calculated for client and case characteristics. Differences in characteristics between time periods were assessed using Chi-square tests. Risk ratios (RR) with 95% confidence intervals (CI) for the associations between characteristics and the use of specific services were estimated using log-binomial regression. ResultsThe most common indication for referral to this CYAC was sexual assault (53.3 %). Most clients were female (60.9 %), with a median client age of 10.0 years (IQR 6.0 to 13.0 years). In over half of all cases the alleged perpetrator was a family member (56.0 %) and most alleged perpetrators were adults (79.9 %). Medical exams were provided in 13.4 % of referrals and were less likely in children aged > 7 years (age 7–12, RR = 0.38, CI 0.27–0.51; and age > 12, RR = 0.41, CI 0.29–0.58), in referrals for sexual assault compared to physical assault (RR = 0.69, CI 0.52–0.90), and when the alleged perpetrator was an acquaintance rather than a family member (RR = 0.48, CI 0.34–0.67). Child and youth advocate support was provided in 76.1 % of cases and was slightly more likely in sexual assault and ‘other’ types of referrals (RR = 1.14, CI 1.06–1.22; and RR = 1.13, CI 1.02–1.26, respectively). Canine Assisted Intervention (CAI) was offered in 38.6 % of cases and was more likely in referrals for sexual assault (RR = 1.23, CI 1.01–1.50). Of those who had CAI, 41 % had an Accredited Facility Dog present with them during their forensic interview; this accompaniment in interview was more likely for clients who were older (RR = 2.15, CI 1.15–4.01) and female (RR = 2.56, CI 1.34–4.90). There were few differences in client and case characteristics or service use over time. ConclusionsThis study provides descriptive context of child maltreatment investigations referred to a Canadian hospital-based CYAC. Given the recognized variability among CYACs in scope and setting, this profile contributes to a broader understanding of the client population and service uptake at a CYAC which varies from the prototypical US-based model most often represented in the existing literature. This information contributes to a more detailed understanding of the CYAC model in practice in Canada, which can help to inform the growth and development of CYACs in the future.

Wormian Bones: Prevalence, Topography, and Implications.

Wormian bones also known as sutural bones are asymmetrical and shapeless bones occurring in cranial sutures and fontanelle of the skull. Their incidence is reported to vary in population. The exact etiology is debatable, but their formation is under the control of both genetic and environmental factors and has great anthropological and clinical implications related to the cranium. Due to high clinical relevance of Wormian bones, the study was carried out. The aim of the study is to expound the incidence and topography of Wormian bones along with clinical significance in dry adult skulls of Indian origin. The study was conducted in the Department of Anatomy using 200 complete adult dry skulls of unknown age and sex. All the sutures in the skull were inspected for the presence of Wormian bones. The Wormian bones were classified into 10 categories, and associated implications were brought out. The Wormian bones were photographed, and details were compared with the available literature. The Wormian bones were observed in 190 (380 sides) skulls with 186 on the right side and 108 on the left side. The predominance site of sutural bone was lambdoid suture followed by sagittal suture. The least common site of Wormian bone was lambda. The detailed information of precise topography, frequency, and number of Wormian bones is of utmost use for surgeons performing surgery on the skull, anthropologists for identifying races, and forensic scientists for investigating child abuse cases.

A field assessment of child abuse investigators' engagement with a child-avatar to develop interviewing skills

BackgroundChild investigative interviewing is a complex skill requiring specialised training. A critical training element is practice. Simulations with digital avatars are cost-effective options for delivering training. This study of real-world data provides novel insights evaluating a large number of trainees' engagement with LiveSimulation (LiveSim), an online child-avatar that involves a trainee selecting a question (i.e., an option-tree) and the avatar responding with the level of detail appropriate for the question type. While LiveSim has been shown to facilitate learning of open-ended questions, its utility (from a user engagement perspective) remains to be examined. ObjectiveWe evaluated trainees' engagement with LiveSim, focusing on patterns of interaction (e.g., amount), appropriateness of the prompt structure, and the programme's technical compatibility. Participants and settingProfessionals (N = 606, mainly child protection workers and police) being offered the avatar as part of an intensive course on how to interview a child conducted between 2009 and 2018. MethodsFor descriptive analysis, Visual Basic for Applications coding in Excel was applied to evaluate engagement and internal attributes of LiveSim. A compatibility study of the programme was run testing different hardware focusing on access and function. ResultsThe trainees demonstrated good engagement with the programme across a variety of measures, including number and timing of activity completions. Overall, knowing the utility of avatars, our results provide strong support for the notion that a technically simple avatar like LiveSim awake user engagement. This is important knowledge in further development of learning simulations using next-generation technology.

Understanding the roles of the healthcare and child welfare systems in promoting the safety and well-being of children.

The accurate identification and appropriate investigation of child maltreatment is a key priority for promoting the optimal health and development of children. Healthcare providers are often well-positioned professionals to report suspected child abuse and neglect, and, therefore, interact regularly with child welfare workers. Little research has examined the relationship between these two groups of professionals. We interviewed healthcare providers and child welfare workers in order to examine the referral and child welfare investigation processes to understand strengths and identify areas of improvement for future collaboration. Thirteen child welfare workers from child welfare agencies and eight healthcare providers from a pediatric tertiary care hospital in Ontario, Canada were interviewed to meet the study's objectives. Healthcare providers spoke about positive experiences making reports, factors impacting reporting decisions, areas for improvement (e.g., difficulties communicating, lack of collaboration, and disruption of therapeutic alliance), training, and professional roles. For interviews with child welfare workers, identified themes included healthcare professionals' perceived expertise and understanding the role of child welfare. Both groups brought up the need for increased collaboration as well as systemic barriers and legacies of harm. Our core finding was a reported lack of communication between the groups of professionals. Other identified barriers in collaboration included a lack of understanding of each other's roles, hesitation for healthcare providers making reports, as well as legacies of harm and systemic inequities in both institutions. Future research should build on this examination by including the voices of healthcare providers and child welfare workers to identify sustainable solutions for increased collaboration.

Neighborhood Risks and Child Maltreatment Investigations: A Comparison Across Urban and Rural Contexts

Neighborhood Risks and Child Maltreatment Investigations: A Comparison Across Urban and Rural Contexts

Childcare Subsidy Enrollment Income Generosity and Child Maltreatment.

In the United States, childcare subsidies are available to low-income working parents to assist with the cost of childcare. The subsidies are provided as block grants to states, which allows for a great deal of flexibility in the specific policies guiding their distribution. Prior research has found a protective link between childcare subsidies and child maltreatment, but the variations in policies have been much less explored. The current study used longitudinal administrative child welfare data from 10 years (2009-2019) linked with state policies regarding the income eligibility requirements of states to examine the impact of these policies on child abuse and neglect among young children (0-5); early school-age children (6-12), and older children (13-17). Using multiple regression and controlling for state demographic characteristics, the study found that more generous policies surrounding income eligibility were related to lower rates of child abuse and neglect investigations at the state level.

Development of the Checklist of Service Needs and Barriers (C-SNAB) Measure for Caregivers Involved in Child Maltreatment Investigations

Caregivers involved in child welfare report receiving fewer services than they anticipated or desired. To date, service needs and barriers research has focused on mental health care, though this pattern of unmet needs likely extends to other critically important areas (i.e., physical health, basic needs, school, social support). Further, there is lack of a standardized measure that captures these constructs. The current study developed a self-report measure of needs, use, and barriers across a wide range of service areas. Participants were caregivers of children involved in child abuse or neglect investigations (N = 32, 59% Latino, 50% alleged perpetrator) and were recruited as part of a larger study evaluating a multidisciplinary response to allegations in a metropolitan U.S. county. Items were generated based on existing needs assessments and consultation from researchers and caseworkers. The C-SNAB appeared to have adequate coverage of the breadth of services needed (33 items) and barriers faced (19) and had good predictive validity. About 93% of caregivers endorsed at least 1 unmet service need. Caregivers experienced an average of 4 unmet needs and 7 barriers to accessing services. The current study provides an approach to practically and comprehensively assessing service needs, use and barriers within this population.

Hoping for the best but unprepared for the worst? Explorative analysis of police students’ encounter with child abuse investigation

Child abuse investigation can include complex stressors increasing the risk of secondary trauma among police professionals. This study explores the preparedness of police students about to engage in child abuse investigation tasks during their recruit period. We did semi-structured interviews with 19 police students to explore the students’ expectations and resources they relied on to cope with stress. Through thematic analysis, five themes emerged: 1) a worthy challenge and a valuable experience; 2) absence of concern about the burdens of “a job to be done”; 3) “Gotta’ work it out!”—physical activity as the default coping mechanism; 4) seeking social support—the importance of talking to someone; 5) education on stress management is limited to operational stress. The results support increasing students’ preparedness for child abuse investigation through knowledge about potential risks, normal reaction to adverse situations, and a focus on effective coping strategies beyond physical activity. The results call for improved and more diverse stress management education in the police, with an emphasis on evidence based coping strategies and reducing stigma associated with mental health help seeking.

Investigators Obstacles in Child Molestation Cases

Abstract: The purpose of this research is to identify the types of obstacles that investigators face when investigating child abuse. Empirical research approach was applied in this study. This study employs a qualitative methodology, purposive sampling, and descriptive qualitative analytic approaches. According to the findings of this study, the investigator's restrictions in processing instances of criminal acts of sexual abuse against minors are both internal and external. The internal barrier consists of people resources from investigators, the system, and the cultural side. Meanwhile, there are no witnesses to see, the victims are still minors, fees, and parents' inexperience of legal procedures. The execution of law enforcement investigations must boost confidence so that all types of hurdles to conducting investigations may be rapidly overcome. As a result, the inquiry is progressing as we all hoped. The investigation should be conducted in line with the appropriate legal procedure, particularly when dealing with cases of child abuse and updating legal knowledge for investigators, particularly those whose education is still insufficient.

Abusive head trauma in Japan.

Abusive head trauma (AHT) is a serious cause of morbidity and mortality in the pediatric population, especially in young infants. This review of the literature aimed to understand the characteristics of AHT in Japan. PubMed and the Japanese database Ichuushi were searched to understand the differences in AHT between Japan and other countries. Shaking was identified as an uncommon cause of injury, while mothers were the most common perpetrator of pediatric AHT in Japan. Although uncommon in other countries, infantile subdural hematoma caused by an accidental slight head injury was reported in Japan. As in other countries, AHT is a major condition which pediatric neurosurgeons face in Japan. The mechanisms of injury and perpetrators of AHT seemed to differ slightly between western countries and Japan. Additionally, non-accidental infantile acute subdural hematoma was reported mainly in Japan. Therefore, further care and fair judgment is necessary when investigating child abuse in Japan.

Impact of a universal perinatal home-visiting program on reduction in race disparities in maternal and child health: Two randomised controlled trials and a field quasi-experiment

Public health interventions must become accountable for reduction of race disparities, particularly among Black, Hispanic, and Non-Hispanic White families in the United States. Family Connects (FC) is a universal perinatal home-visiting program that assesses family-specific needs, offers support, and provides connections to community resources to address identified needs. Two previously-published randomised controlled trials and a field quasi-experiment have shown positive impact on maternal mental health, infant emergency medical care utilization, and government investigations for child maltreatment; however, these reports have not tested impact on reducing race disparities in these outcomes. The current report examined three questions in these trials: 1) the extent of race disparities in maternal and infant health and well-being, absent intervention; 2) whether intervention can be implemented with high reach and fidelity among all race groups; and 3) whether assignment to intervention reduces race disparities in important outcomes. Data were re-examined from: 1) a randomised controlled trial of 4777 birthing families in Durham, NC, USA; 2) a replication randomised controlled trial of 923 birthing families in Durham, NC, USA; and 3) a quasi-experiment of 988 birthing families in rural NC, USA. Families were classified as Black, Hispanic, Non-Hispanic White, or Other. Disparity reduction was tested by the interaction effect between treatment assignment and race. 1) In the absence of intervention, large and statistically significant differences between Black familes and Non-Hispanic White families were found in maternal anxiety, maternal depression, father non-support, child emergency medical care, and child maltreatment investigations. Few differences were found between Non-Hispanic White familes and Hispanic families.2) High rates of participation in treatment were found for each race group.3) Across studies, assignment to FC was associated with statistically significant reductions in 7 of 12 disparities, in maternal anxiety and depression, father non-support, infant emergency medical care, and child maltreatment investigations. This study provides a method, metric, and mandate to prioritise testing of whether public health interventions reduce race disparities in family outcomes. This research was supported by grant R01HD069981 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and a grant from The Duke Endowment.

Child maltreatment investigations: Comparing children, families, and reasons for referral in three European countries

BackgroundAlmost all countries have developed measures to ensure that children do not suffer from violence in their families. However, the legal framework, definitions of maltreatment, and institutional structures differ. Whereas in other areas of social policy comparative research is very common, child protection research falls behind. Research questionsThe article examines the differences between cases referred to local child and youth welfare authorities due to concerns about abuse or neglect in Germany, England and the Netherlands, comparing the characteristics of the child, the family, the person reporting the suspected maltreatment, and the type of maltreatment. Method1207 case files on children investigated due to suspected child maltreatment from the Netherlands, England, and Germany were analyzed using a standardized coding scheme. ResultsThe family backgrounds of the children reported differed substantially, with more lone parents in England and more children living in two households in the Netherlands. The persons and institutions reporting their concerns to the local child and youth welfare authorities also differed, with more reports from children and family members in Germany and more from health services in England. In England, physical abuse, sexual abuse, and sexual exploitation were more frequently the reason for referral than in the Netherlands and Germany. DiscussionDifferences between countries can partially be explained based on differences in policies and relations of other systems to the child protection system.