Maltreatment Classification System Research Articles

A Systematic Review of Measures of Child Neglect

Purpose: Child neglect is prevalent in children's social work and assessing neglect is complex because it is multifaceted and opaque. This systematic review identifies and evaluates evidence of tools or measures to better assess child neglect. Methods: Informed by Cochrane methodology and adapted to the needs of social work practice, a systematic search and review of measures of child neglect was undertaken. Ten databases were searched, augmented by grey literature, and contact with relevant experts. Results: Only two measures, the Child Neglect Index (CNI) and modifications of the Maltreatment Classification System (MCS), met the inclusion criteria. Neither tool was completely comprehensive for child neglect. Discussion: Our findings indicate (a) a dearth of suitable tools to measure neglect and (b) the need for robust testing of neglect measures in the social work setting. The current evidence based on measuring child neglect is too limited to effectively inform policy and practice.

Latent classes of child neglect types and associated characteristics

BackgroundChildren who experience neglect typically endure multiple types of neglect and abuse during a single maltreatment incident. However, research on the phenomenology and predictors of neglect types has primarily examined neglect types in isolation. ObjectiveTo advance understanding of neglect incidents that more accurately reflect the experiences of children who have been neglected, we examined latent classes of neglect defined by co-occurring neglect types and multiple forms of abuse. To inform efforts to identify families at-risk for particular classes of neglect, associations between child, parent, and family characteristics and latent classes were examined. Participants and setting390 child neglect incidents substantiated at U.S. Army installations. MethodsNeglect types and incident severity were coded using the Modified Maltreatment Classification System. Child, parent, and family characteristics were coded using information drawn from case records. ResultsLatent class analysis yielded 5 classes: exposure to violence, failure to provide, supervisory lapses, substance-related endangerment, and non-specific. The exposure to violence and substance-related endangerment classes were characterized as highly severe. High and low severity classes were associated with distinct child, parent, and family characteristics. The latent classes were also differentiated by distal outcomes, including probability of law enforcement investigation, child removal from home, and offender removal from home. ConclusionsBy identifying the types of neglect and abuse that are likely to occur concomitantly as well as the child, parent, and family characteristics associated with increased risk of latent classes of neglect, results advance knowledge regarding the phenomenology of neglect types and inform prevention efforts.

Child maltreatment and the development of psychopathology: The role of developmental timing and chronicity

BackgroundThe effects of child maltreatment (CM) on psychopathology are well-established, yet the complex effects of timing and chronicity of maltreatment exposure on the development of psychopathology are still unclear. ObjectiveTo elucidate developmental pathways from distinct dimensions of CM (chronicity and timing) to psychopathology during emerging adulthood using data from a longitudinal, multi-method study. Participants and settingChildren with and without maltreatment exposure were recruited at wave 1 (ages 10–12) to participate in a research summer camp. At wave 2, participants were recontacted during emerging adulthood (ages 18–22). The current study includes 391 participants (51.3% female; 77.5% Black, 11.3% white, 7.4% Hispanic, 3.8% other race). MethodsTiming and chronicity of maltreatment exposures were coded from child protective services records using the Maltreatment Classification System. Childhood internalizing and externalizing symptoms were assessed using child- and camp counselor-report. Emerging adults completed self-report questionnaires and were interviewed about their current and past symptoms of psychopathology. Structural equation modeling was used to estimate direct and indirect links between childhood maltreatment dimensions (chronicity and timing) to adult psychopathology via childhood internalizing and externalizing. ResultsChild maltreatment experiences that spanned several developmental periods, including both early and later childhood stages, predicted a cascade of both internalizing and externalizing symptoms in childhood that eventuated in greater symptoms of anxiety, depression, substance use disorder, and antisocial personality disorder in emerging adulthood. ConclusionsResults suggest that chronic childhood maltreatment exposure is associated with multifinality in psychopathology presentations that can be detected in childhood and extend into emerging adulthood. Early prevention and intervention efforts to promote positive and safe parenting are essential to decrease the burden of mental health symptoms conferred by chronic maltreatment exposures on individuals, families, and public health systems.

Attachment representations of maltreated and non-maltreated pre-schoolers in Korea and its association with abuse type, chronicity, and severity: a comparative study

ABSTRACTThis study aimed to facilitate a better understanding of the psychological characteristics of maltreated children by comparing attachment representations between maltreated and non-maltreated pre-schoolers. Participants included 46 maltreated and 48 non-maltreated (children for whom evidence of maltreatment has not been identified or reported) pre-schoolers. The Attachment Story Completion Task was used to evaluate attachment representation; the Maltreatment Classification System was used to assess abuse type and chronicity. There was a difference in the contents of the attachment representations and distribution of attachment types between the two groups. Secure attachment in maltreated pre-schoolers was significantly lower than that in non-maltreated pre-schoolers whereas insecure-avoidant and disorganized attachment were higher. The likelihood of insecure attachment was higher when the abuse type was complex abuse and the abuse chronicity and severity were high. This study is meaningful as it investigated the developmental psychological consequences of trauma in Korean children.

In-home support or out of home care? Thresholds for intervention with abused and neglected children

The number of children referred to the English child protection system and the numbers receiving home-based intervention or placed in out of home care have been rising in recent years. It is difficult to judge whether these changes indicate that thresholds for intervention are low or high, as we know little about the severity of the maltreatment that draws children into the child protection system in England. This study compared the histories, circumstances and pathways of children receiving quasi-compulsory home-based support (under a child protection plan) to those for children ever placed in out of home care. It collected detailed data from the social workers of 390 children and is the first UK study to include a standardised measure of the severity of maltreatment, the Modified Maltreatment Classification System (MMCS). It found that the vast majority of children had experienced multiple types of maltreatment, including at least one type of high severity, suggesting that thresholds for the use of child protection plans and placement were high. The strongest predictors of placement (as opposed to home-based support) were severity of maltreatment, being unborn or under one year old at referral, being disabled and experiencing physical abuse. Findings are discussed in the context of developments in policy and services under the English government's austerity programme.

Reduced hair cortisol after maltreatment mediates externalizing symptoms in middle childhood and adolescence.

The enduring impact of childhood maltreatment on biological systems and ensuing psychopathology remains incompletely understood. Long-term effects of stress may be reflected in cumulative cortisol secretion over several months, which is now quantifiable via hair cortisol concentrations (HCC). We conducted a first comprehensive investigation utilizing the potential of hair cortisol analysis in a large sample of maltreated and nonmaltreated children and adolescents. Participants included 537 children and adolescents (3-16years; 272 females) with maltreatment (n=245) or without maltreatment histories (n=292). Maltreated subjects were recruited from child protection services (CPS; n=95), youth psychiatric services (n=56), and the community (n=94). Maltreatment was coded using the Maltreatment Classification System drawing on caregiver interviews and complemented with CPS records. Caregivers and teachers reported on child mental health. HCC were assessed in the first 3cm hair segment. Analyses uniformly supported that maltreatment coincides with a gradual and dose-dependent reduction in HCC from 9 to 10years onwards relative to nonmaltreated controls. This pattern emerged consistently from both group comparisons between maltreated and nonmaltreated subjects (27.6% HCC reduction in maltreated 9-16-year-olds) and dimensional analyses within maltreated subjects, with lower HCC related to greater maltreatment chronicity and number of subtypes. Moreover, both group comparisons and dimensional analyses within maltreated youth revealed that relative HCC reduction mediates the effect of maltreatment on externalizing symptoms. From middle childhood onwards, maltreatment coincides with a relative reduction in cortisol secretion, which, in turn, may predispose to externalizing symptoms.

Child maltreatment and emotion socialization: Associations with executive function in the preschool years

This study examined executive function (EF) among preschoolers exposed to maltreatment, and tested whether caregiver practices related to emotion socialization (e.g., reactions to children’s emotions; discussion of emotion) moderate the relationship between maltreatment and EF in this period. Participants were (n=107) children aged 4–5 years (M=4.75; SD=0.57; 39% female), with various levels of exposure to maltreatment. Using the Maltreatment Classification System, substantiated reports of maltreatment were coded to produce an index of the multiplicity of abuse subtypes to which children had been exposed. EF was indexed using a composite of scores on three performance-based tests (Happy–Sad Stroop Task; Tapping Test; Dimensional Change Card Sort). Caregivers reported on their use of emotion related socialization behaviors (ERSBs) with the Coping with Children’s Negative Emotions Scale. Exposure to maltreatment and ERSBs were both found to account for unique variance in EF, independent of developmental-ecological factors including children’s receptive language and maternal depression. Significant interactions between maltreatment and ERSBs were also found to suggest that nonsupportive ERSBs (e.g., punitive reactions to negative child emotion) may amplify the risk for poor EF associated with maltreatment, whereas supportive ERPBs (e.g., expressive encouragement) protect against it.

Self-reported and case file maltreatment: Relations to psychosocial outcomes for youth in foster care

The aim of the current study was to explore the relation between maltreatment and psychosocial outcomes for youth in foster care, and how this relation differs according to reporter type (self-report or case file). Participants included 285 children and adolescents and their caregivers who completed self-report questionnaires about lifetime maltreatment and psychosocial adjustment. Youths' case files containing lifetime maltreatment reports were obtained from Division of Social Services (DSS), and were coded for physical and sexual abuse, emotional maltreatment, and neglect using the Modified Maltreatment Classification System (MMCS; English & LONGSCAN Investigators, 1997). Crosstabs analysis was used to summarize proportions of youth whose caregivers reported clinically significant internalizing and externalizing and average to high adaptive functioning within groups of youth who had a) neither self-reported nor case file maltreatment, b) only case file maltreatment, c) only self-reported maltreatment, and d) both case file and self-reported maltreatment for each maltreatment type (physical and sexual abuse, emotional maltreatment, and neglect). Results showed that externalizing symptoms differ according to reporter type for physical and sexual abuse, and that internalizing symptoms differ according to reporter type for sexual abuse. Implications for methodology in maltreatment research are discussed.

Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care

State social service agency case files are a common mechanism for obtaining information about a child's maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child's maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed.

Defining Child Maltreatment Among Lay People and Community Professionals: Exploring Consensus in Ratings of Severity

The way in which laypeople and community professionals define child maltreatment in a family context is essential in decision-making on its referral and assessment. Despite differences found in the perspectives of the two groups, operating definitions are needed, which integrate them. The purpose of this work is to define types of maltreatment, integrating both perspectives (study 1) and to analyse the assessment of the severity of these practices (study 2). In study 1, a consensual qualitative research method was used to analyse 123 interviews of laypeople and 9 annual reports of social and health community services. A joint analysis of 1235 record units allowed us to obtain an integrated definition comprised of 6 types and 20 subtypes of maltreatment. In study 2, with the material gathered in study 1, a scale was created with 4 degrees of severity, based on the Maltreatment Classification System. Next, a sample of 159 interns, from health and social science areas with or without contact with situations of maltreatment, evaluated the severity of the items. An analysis of Kendall’s coefficient of concordance showed a lack of consensus in 9 of the 20 subtypes, with physical abuse and sexual abuse being the most consensual types, as opposed to psychological abuse and neglect. These studies underscore the importance of understanding this phenomenon at a community level, and suggest that public awareness may facilitate the referral of these practices, minimizing the over-reporting and under-reporting of cases, and encouraging early and preventive intervention.

Child deaths with persistent neglected experiences from medico-legal documents in Japan.

Few studies have examined the actual conditions of fatal neglect in Japan. The aims of this study were to investigate persistent neglect among child fatalities using medico-legal documents, and to describe the characteristics of the socio-familial background and biological data. The current study analyzed the documents of all postmortem external examinations and autopsies in children <2 years old carried out in one prefecture in Japan from 2006 to 2011. After examining 59 autopsy cases using modified the Maltreatment Classification System, we identified six children who experienced persistent neglect as study samples. Three children were found in unsanitary rooms and one was left alone inside a car. In two cases, age of mother at delivery was <21 years old. Three victims had 1 year older sibling. With regard to history of use of health services, three mothers missed some prenatal care visits, and two refused to receive neonatal home visits. With regard to biological data the average weight Z score of six children was -2.22 after being adjusted to average weight for age (in months) and sex. Three children had acute or chronic undernutrition. Three victims had thymic involution considered as being due to chronic child maltreatment. The present collaboration between public health and legal medicine has enabled investigation of the background and biological impact of experiences of persistent neglect. A multidisciplinary system of evaluating child death is needed to identify preventable factors in order to intervene in the case of neglected children in a timely manner.

Transverse fractures of the femoral shaft are a better predictor of nonaccidental trauma in young children than spiral fractures are.

Certain fracture configurations, especially spiral fractures, are often thought to be indicative of nonaccidental trauma in children. The purpose of this study was to determine whether femoral fracture morphology, as determined by an objective measurement (fracture ratio), was indicative of nonaccidental trauma in young children. Consecutive patients who were three years of age or younger and had a closed, isolated femoral shaft fracture treated at an urban pediatric level-I trauma center between 2005 and 2013 were identified. Anteroposterior and lateral fracture ratios (fracture length/bone diameter) were calculated for each patient by a fellowship-trained pediatric orthopaedic surgeon who was blinded to the patient's clinical history. The presence or absence of a Child Protective Services referral as well as institutional Child Assessment Program evaluations were reviewed. Nonaccidental trauma was deemed to be present, absent, or indeterminate by Child Protective Services or an on-site Child Assessment Program team. To further evaluate and quantify the likelihood of nonaccidental trauma, the criteria of the Modified Maltreatment Classification System were used. Of 122 patients identified, ninety-five met the inclusion criteria for this study. Of these ninety-five, fifty-one (54%) had either a Child Protective Services or a Child Assessment Program consultation because of suspected nonaccidental trauma. Thirteen (25%) were found to have nonaccidental trauma as determined by Child Protective Services or the Child Assessment Program team and seven (14%) had indeterminate Child Protective Services or Child Assessment Program investigations. All thirteen patients with nonaccidental trauma, as well as the seven patients with an indeterminate Child Protective Services or Child Assessment Program investigation, had positive Modified Maltreatment Classification System scores for physical abuse. Patients who had nonaccidental trauma had significantly decreased mean anteroposterior fracture ratios compared with those who had confirmed accidental trauma (p < 0.0001). The fracture ratio can be helpful to determine fracture morphology and can be used as part of the assessment of a child with suspected nonaccidental trauma. While not diagnostic, the presence of a transverse diaphyseal femoral fracture in a young child should raise the index of suspicion for nonaccidental trauma. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Interrelations of maternal expressed emotion, maltreatment, and separation/divorce and links to family conflict and children's externalizing behavior.

Research has documented that maternal expressed emotion-criticism (EE-Crit) from the Five-Minute Speech Sample (FMSS) predicts family conflict and children's externalizing behavior in clinical and community samples. However, studies have not examined EE-Crit in maltreating or separated/divorced families, or whether these family risks exacerbate the links between EE-Crit and family conflict and externalizing behavior. The current study examined the associations between maternal EE-Crit, maltreatment, and separation/divorce, and whether maltreatment and separation/divorce moderated associations between EE-Crit and children's externalizing problems, and EE-Crit and family conflict. Participants included 123 children (M = 8.01 years, SD = 1.58; 64.2 % males) from maltreating (n = 83) or low-income, comparison (n = 40) families, and 123 mothers (n = 48 separated/divorced). Mothers completed the FMSS for EE-Crit and the Family Environment Scale for family conflict. Maltreatment was coded with the Maltreatment Classification System using information from official Child Protection Services (CPS) reports from the Department of Human Services (DHS). Trained summer camp counselors rated children's externalizing behavior. Maltreatment was directly associated with higher externalizing problems, and separation/divorce, but not maltreatment, moderated the association between EE-Crit and externalizing behavior. Analyses pertaining to family conflict were not significant. Findings indicate that maltreatment is a direct risk factor for children's externalizing behavior and separation/divorce is a vulnerability factor for externalizing behavior in family contexts with high maternal EE-Crit. Intervention, prevention, and policy efforts to promote resilience in high-risk families may be effective in targeting maltreating and critical parents, especially those with co-occurring separation/divorce. Key Words: expressed emotion, EE-Crit, Five-Minute Speech Sample; maltreatment, divorce, externalizing behavior.

Untangling the relative contribution of maltreatment severity and frequency to type of behavioral outcome in foster youth

Within maltreatment research, type, frequency, and severity of abuse are often confounded and not always specifically documented. The result is samples that are often heterogeneous in regard to maltreatment experience, and the role of the different components of maltreatment in predicting outcome is unclear. The purpose of the present study was to identify and test the potential unique role of type, frequency, and severity of maltreatment to elucidate each variable's role in predicting outcome behavior. Data from 309 youth in foster care (ages 8–22) and their caregivers were collected using the Modified Maltreatment Classification System and the Behavioral Assessment System for Children, 2nd Edition (BASC2), to measure maltreatment exposure and behavioral outcome respectively. A measurement model of the BASC2 was completed to determine model fit within the sample data. A second confirmatory factor analysis (CFA) was completed to determine the unique contributions of frequency and severity of maltreatment across four types of abuse to externalizing, internalizing, and adaptive behavior. The result of the CFA determined good fit of the BASC2 to the sample data after a few modifications. The result of the second CFA indicated that the paths from severity to externalizing behavior and adaptive behavior (reverse loading) were significant. Paths from frequency of abuse were not predictive of behavioral outcome. Maltreatment is a complex construct and researchers are encouraged to examine components of abuse that may be differentially related to outcome behavior for youth. Untangling the multifaceted nature of abuse is important and may have implications for identifying specific outcomes for youth exposed to maltreatment.

Relations Between Minnesota Multiphasic Personality Inventory–A Scales and Rorschach Variables With the Scope and Severity of Maltreatment Among Adolescents

This study examined preexisting Rorschach (Exner, 2001) and Minnesota Multiphasic Personality Inventory–A (MMPI–A; Butcher et al., 1992) profiles to determine if selected MMPI–A scales and Rorschach variables would jointly associate with the number and severity of maltreatment subtypes (physical abuse, sexual abuse, neglect, and emotional maltreatment) of 157 adolescents (ages 14–17) with documented maltreatment histories. The Maltreatment Classification System was used to systematically code the maltreatment attributes. Six Rorschach variables (MOR, PER, Afr, SumY, SumC’, Human Content) were significantly correlated with the number of maltreatment subtypes, but none of the anticipated MMPI–A scales were related. MMPI–A Scale 7 and Rorschach variables Ego, MOR, and PER were jointly associated with physical abuse severity. MMPI–A Scale 0 and Rorschach variables MOR, PER, SumY, SumC’, PTI, Human Content, and Texture jointly associated with sexual abuse severity. This study supports the potential for certain MMPI–A scales and Rorschach variables to reflect the impact of adolescents’ maltreatment experiences in terms of the number and severity of types of maltreatment experienced. Because both instruments captured different aspects of adolescents’ maltreatment experiences, clinicians should consider using both when evaluating the impact of maltreatment on adolescents.

Emotional abuse in a sample of multiply maltreated, urban young adolescents: Issues of definition and identification

Objective The main purpose of this paper is to use the Brassard and Donovan [Brassard, M. R. & Donovan, K. L. (2006). Defining psychological maltreatment. In M. M. Freerick, J. F. Knutson, P. K. Trickett, & S. M. Flanzer (Eds.), Child abuse and neglect: Definitions, classifications, and a framework for research (pp. 151–197). Baltimore, MD: Paul H. Brookers Publishing Co., Inc.] framework to examine and describe the nature of emotional abuse experienced by a sample of urban, ethnically diverse male and female youth ( N = 303) identified as maltreated by a very large public child welfare agency. Methods Case record abstraction was conducted on the DCFS records of these maltreated youth using the Maltreatment Case Record Abstraction Instrument (MCRAI) which was based on the work of Barnett et al. [Barnett, D., Manly, J. T., & Cicchetti, D. (1993). Defining child maltreatment: The interface between policy and research. In D. Cicchetti & S. L. Toth (Eds.), Advances in applied developmental psychology: Child abuse, child development and social policy (pp. 7–73). Norwood, NJ: Ablex Publishing Corp.] as modified by English and LONGSCAN [English, D. J., & the LONGSCAN Investigators. (1997). Modified maltreatment classification system (MMCS). Retrieved from http://www.iprc.unc.edu/longscan/]. Fifteen items of parental behavior deemed emotionally abusive were coded and organized into four subtypes of emotional abuse ( spurning, terrorizing, isolating, exploiting/corrupting) using the Brassard and Donovan (2006) framework. Results Using this coding system, almost 50% of the sample were found to have experienced emotional abuse in contrast to 9% identified at the time of referral by DCFS. Most of the emotionally abused youth also experienced physical abuse (63%) and/or neglect (76%) as well. The most frequent subtype of emotional abuse experienced was terrorizing. Most youth experienced more than one subtype. Conclusions Emotional abuse, while frequent, was seldom the focus of the child protection services investigation. The nature of this abuse was not minor, but rather likely to be dangerous to the mental health and well-being of these children. Further more emotional abuse, in this sample of young adolescents, at least, was likely to be accompanied by other forms of maltreatment, especially physical abuse and/or neglect. These findings have important implications for practice and the direction of future research. Practice implications All those who interact with child welfare clients must recognize the prevalence of emotional abuse in maltreated children so that appropriate interventions are instituted. Screening for emotional abuse should be part of all intake referrals and when confirmed should be noted in official records. When children are placed, foster parents (both kin and non-kin) need training on the prevalence and consequences of emotional abuse, and strategies to help their foster children recover from the aftermath. When children remain with maltreating parents, emotional abuse should be a focus of the interventions designed to help maltreating parents with more effective parenting strategies and also should be a focus of the interventions designed to help the child recover from the consequences of maltreatment.

Defining child neglect based on child protective services data

Objectives: To compare neglect defined by Child Protective Services official codes with neglect defined by a review of CPS narrative data, and to examine the validity of the different neglect measures using children's functioning at age 8 years. Methods: Data are from 740 children participating in a consortium of longitudinal studies on child abuse and neglect; 481 had at least one CPS report prior to age 8. CPS records were reviewed to ascertain both broad CPS types of neglect as well as specific subtypes of neglect using a modified version of the Maltreatment Classification System (MMCS). Frequencies of, and correlations among, the types and subtypes of neglect were examined. The validity of the neglect measures was evaluated by examining their relationships with children's functioning at age 8. Results: The CPS neglect types and MMCS subtypes were moderately correlated, as were the MMCS subtypes of neglect. In general, neglect was only modestly associated with children's functioning at age 8 ( r 2 = 1–4%), with few differences between the CPS neglect types and the MMCS subtypes. There were significant associations with children's total and externalizing behavior problems, impaired socialization, and impaired daily living skills. Among the specific subtypes, neglect of children's medical needs was related to externalizing behavior problems, impaired socialization, and impaired daily living skills. Neglect of children's hygiene needs was related to impaired socialization. Conclusion: The moderate correlations among CPS and MMCS types and subtypes of neglect and their similar associations with children's functioning suggest that the considerable effort involved in coding neglect subtypes from CPS narrative data may yield limited incremental knowledge regarding the types of neglect children experience and their sequelae. However, the MMCS does offer useful descriptive information on the nature of neglect children experience, and may guide future research and practice on optimal ways to conceptualize neglect.

Describing maltreatment: do child protective service reports and research definitions agree?

Objective: The National Research Council identified inadequate research definitions for abuse and neglect as barriers to research in child maltreatment. We examine the concordance between child protective services (CPS) classifications of maltreatment type with the determinations of type from two research coding systems. We contrast the two coding systems and the CPS classification, in their ability to predict subsequent difficulties in the psychological functioning of maltreated children at age 8. Method: The sample included 545 children who were enrolled in Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) with a report of child maltreatment, had data collected at approximately 4 and 8 years of age, and had a lifetime review of CPS records to age 8. CPS Maltreatment reports were coded using LONGSCAN's modification of the Maltreatment Classification System (MMCS) and the Second National Incidence Study maltreatment coding system (NIS-2). The first analyses used reports as the unit of analysis to examine agreement between CPS and research determinations of allegation type. Validation analyses examined outcomes for each type of maltreatment experienced after age 4 under each coding system using the Child Behavior Checklist (CBCL), Trauma Symptom Checklist-Alternative form, and the Vineland Screener as the measures of outcome. Control variables were the CBCL and Battelle Developmental Screener, measured at age 4. Results: There were a total of 1980 reports of maltreatment for 545 study children although only 1593 CPS reports specified at least one type of maltreatment. There were differences between the type of maltreatment recorded in child protective service records and the conclusions reached by either research classification system. CPS classifications were most discordant with the research systems for emotional abuse and neglect. Nearly 10% of physical and sexual abuse reports, as determined by the MMCS, were classified as neglect by the child protective service agencies. The NIS-2 system and the MMCS had very high Kappa statistics for agreement for physical and sexual abuse. The validity of the research definitions for physical and sexual abuse was demonstrated in models predicting children's functioning at age 8. Prediction of child functioning was significantly but modestly improved in several domains compared to the CPS classifications. Conclusion: Both research classification systems moderately improved on the prediction of the adverse effects of maltreatment compared to the characterization of a maltreatment exposure as recorded by CPS.

Do allegations of emotional maltreatment predict developmental outcomes beyond that of other forms of maltreatment?

Objectives: To understand the features of child abuse/neglect (CA/N) allegations in cases with emotional maltreatment (EMT) allegations, as well as the features of the EMT allegations themselves, and to describe any associations of EMT with distinct impairments of children's behavior, emotion and functioning. Method: The sample consisted of 806 high-risk children, 545 with one or more maltreatment reports to CPS. The Maltreatment Classification System was used to record the number and severity levels of maltreatment allegations, which compared cases with and without EMT. Multiple regression analyses were conducted using 10 outcome scales from the Child Behavior Checklist, Vineland Screener, and Trauma Symptom Checklist. Successive blocks of predictor variables included demographics, maltreatment classification variables, maternal and family characteristics, and study site. Results: When there were allegations of EMT as well as CA/N in a CPS case-record (by age 8), the CA/N allegations tended to be either more frequent or less severe than those kinds of allegations in cases without EMT. When neglect was alleged to occur with EMT, neglect allegations outnumbered allegations of EMT. However, when sexual abuse allegations were accompanied by EMT allegations, there were more EMT allegations than sexual abuse allegations in the cases. Higher severity ratings for EMT allegations than for physical abuse occurred when cases included any abuse. Distinctive effects of EMT subtypes were found between problems of safety/restriction and self-reported anger symptoms, and between problems of self-esteem/autonomy and posttraumatic stress. Conclusion: Differences exist between the CA/N allegations in cases with and without EMT. Having few cases containing only EMT allegations made it difficult to assess distinctive harm associated with EMT. Certain types of EMT allegations were associated with increases in children's anger and posttraumatic stress.

Estimation of three-dimensional joint angles using qualysis position sensors

The aim of the current study was to explore the relation between maltreatment and psychosocial outcomes for youth in foster care, and how this relation differs according to reporter type (self-report or case file). Participants included 285 children and adolescents and their caregivers who completed self-report questionnaires about lifetime maltreatment and psychosocial adjustment. Youths' case files containing lifetime maltreatment reports were obtained from Division of Social Services (DSS), and were coded for physical and sexual abuse, emotional maltreatment, and neglect using the Modified Maltreatment Classification System (MMCS; English & LONGSCAN Investigators, 1997). Crosstabs analysis was used to summarize proportions of youth whose caregivers reported clinically significant internalizing and externalizing and average to high adaptive functioning within groups of youth who had a) neither self-reported nor case file maltreatment, b) only case file maltreatment, c) only self-reported maltreatment, and d) both case file and self-reported maltreatment for each maltreatment type (physical and sexual abuse, emotional maltreatment, and neglect). Results showed that externalizing symptoms differ according to reporter type for physical and sexual abuse, and that internalizing symptoms differ according to reporter type for sexual abuse. Implications for methodology in maltreatment research are discussed.