Risk Factors For Child Maltreatment Research Articles

Pre- and Perinatal Risk Factors for Child Maltreatment in Military Families Across the First Two Years of Life.

Military families are exposed to a unique constellation of risk factors, which may impact maltreatment outcomes. The present study examined prospective relationships between demographic, health, birth-related, and military-specific risk factors identified prior to a child's birth on their risk for maltreatment in the first two years of life. Data from the Millennium Cohort Study, Department of Defense (DoD) operational records and Family Advocacy Program data on met-criteria maltreatment, and Birth and Infant Health Research program data on suspected maltreatment were linked for 9076 service member parents. Discrete time survival analysis showed that preterm birth increased risk of maltreatment while parents' older age, physical health, and service in the Navy or Air Force decreased risk. Building on DoD's New Parent Support Program, findings suggest the need for universal and targeted prevention efforts, beginning during pregnancy, which limit or eliminate risk factors for maltreatment in military families.

ОТБАСЫНДАҒЫ ЗОРЛЫҚ-ЗОМБЫЛЫҚТЫҢ БАЛАЛАРҒА ӘСЕРІ

The article describes the types, causes and risk factors of child abuse in the family. Currently, one of the urgent social problems in society is: the impact of domestic violence on children. We see how brutality, violence is escalating, the situation is escalating. The reason for this was the quarrels of parents in the family, the consequences of alcohol and drugs. There are often factors associated with the abduction of children, their trafficking, placement in hard work or the sale of body parts. All these situations are a problem that cannot be solved in the world. It is obvious that a child who has been abused is terrified, such a crime cannot be prevented because of the concealment of children. In this regard, the article provides a comparative analysis of forms of violence against children in Kazakhstan, Russia and abroad. The results of surveys conducted through social networks were also discussed. The systematization of interpretations of the concept of violence in science, as well as categories of child abuse, is proposed.

Research-based Risk Factors for Child Maltreatment: Do Child Protection Workers Use them in their Case Investigations?

Abstract Risk assessment is an essential aspect of child abuse investigations in order to estimate the risk of future abuse and to develop a risk management and intervention plan. According to the risk–need–responsivity model, intervention and risk monitoring needs to target dynamic risk factors to prevent future child maltreatment. In the current study, we examined whether child protection workers in the Netherlands focus on evidence-based risk factors for child maltreatment. We investigated 192 case files retrospectively for risk factors included in the Child Abuse Risk Evaluation-NL, a structured risk assessment instrument. We expected to find limited information concerning parental risk factors and risk factors related to parent–child interaction, but more information on family and child factors. These hypotheses were confirmed. Because parental and parent–child interaction factors are the most important and proximal risk factors for child abuse, our findings point to a large gap between science and child protection practice. We recommend the use of a structured risk assessment instrument and a risk-focused approach to intervention planning.

Association between maternal perceived capacity in life and physical punishment of teenage children: a longitudinal analysis of a population-based cohort in Tokyo, Japan

ObjectivesPerceived capacity denotes a subjective sense of having resources to cope with strains and hardships, and hence maternal perceived capacity may be protective against risk factors for child maltreatment. This...

Epidemiology of Child Maltreatment during the COVID-19 Pandemic in Saudi Arabia.

Child maltreatment, especially during health crises, is a major public health issue transcending cultural, social, and racial contexts. We assessed the sociodemographic and related risk factors associated with the types and rates of child maltreatment. We also assessed the economic, social, and environmental characteristics of child maltreatment victims and their perpetrators, as they were reported to the Saudi National Family Safety Program (NFSP), with consideration of the COVID-19 pandemic’s impact. A secondary data analysis of a retrospective review was conducted to compare types and rates before and during the COVID-19 outbreak, utilizing descriptive and multivariate analyses on anonymized data from the NFSP. According to a predetermined list of relevant risk factors for child maltreatment outlined by the NFSP, these anonymized data were obtained and analyzed with no exclusion criteria (n = 1304). The findings showed that a child’s age correlated significantly and positively with their odds of being physically maltreated; as a child’s age increased by one year, on average, their corresponding predicted odds of being physically maltreatment tended to rise by a factor equal to 7.6% (p < 0.001). Neglected children, compared to those who had not been previously neglected, were predicted to be almost twice (2.23 times more) as likely to be victims of physical maltreatment on average (p < 0.001). Children were notably more likely to experience sexual abuse during the COVID-19 pandemic than those exposed to abuse during the period before (1.69 times). The COVID-19 pandemic was associated with significantly lower odds of physical child maltreatment (47.7% less). This study found no statistically significant effect of the COVID-19 pandemic on children’s odds of being emotionally maltreated (p = 0.169). These findings support the existence of specific risk factors for child maltreatment for both child victims and perpetrators. They also attest to the significant differences between different types of maltreatment. A systematic, proactive system is needed to screen and document child maltreatment with a higher degree of integration with community reporting systems.

Mental health targets in child maltreatment prevention programs: A systematic review of randomized trials

Mental health is an important contributor to child and family well-being. Conversely, mental illness is a well-recognized risk factor for child maltreatment and repeated involvement with child welfare systems. Presently little is known about how primary and secondary maltreatment prevention programs conceptualize mental health, or if changes to mental health are observed across maltreatment prevention studies. To address this gap in knowledge the current study systematically reviewed twenty years of research to identify and describe the mental health outcomes of caregivers and children who were enrolled in primary or secondary maltreatment prevention outcome studies. Studies were eligible for inclusion if the prevention focused on the general population or families exhibiting early risk factors for maltreatment, employed a randomized controlled trial design, included at least one measure of mental health, contained at least one prospective outcome measure of child maltreatment, and was published in English-language in or after the year 2000. A systematic search of MEDLINE, PsycINFO, Embase, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Campbell Library of Systematic Reviews, California Evidence-Based Clearinghouse for Child Welfare (CEBC), Child Welfare Information Gateway, and Social Care Online identified 931 studies, thirty-three of which met the inclusion criteria. Fourteen dimensions of mental health were identified across included studies. Measures of mental illness (n = 95) appeared roughly seven times more often than measures of mental well-being (n = 13). Studies reported treatment group improvements to mental health and maltreatment prevention (n = 10), improvements to mental health but not maltreatment prevention (n = 8), improvements to maltreatment prevention but not mental health (n = 5), or neither improvements to mental health nor maltreatment prevention (n = 10). Across programs reporting changes to mental health, the most commonly reported improvements were to child behavior (n = 8) and parenting stress (n = 6). Results indicate primary and secondary prevention programs more often improve mental health than prevent child maltreatment. Future studies aimed at strengthening the efficacy of child maltreatment prevention in community settings should consider targeting additional indicators of mental health that are commonly encountered in community settings, and strengthen measures of child maltreatment to more frequently include multiple indicators and multiple sources. Future studies should also examine the interaction of socioeconomic and structural contributors to mental health and child maltreatment prevention.

Racism in child welfare: Ethical considerations of harm.

Racism has resulted in significant disproportionality and disparity in the US child welfare system. Being Black is not an inherent risk factor for child abuse and neglect yet Black children are almost twice as likely to be victims of substantiated abuse and neglect claims compared to other racial groups. Addressing the disproportionality within the child welfare system due to systemic racism falls squarely under the purview of bioethics. In this paper, we briefly review the impact of racism on child welfare. We then discuss some ethical considerations that mandatory healthcare reporters should think through when determining whether to report potential abuse and neglect. Specifically, we discuss the need for a broader consideration of what constitutes harm. We then present a hypothetical composite case to illuminate where and how bias can enter the process of referral to child protective services (CPS). We encourage thoughtful reporting with consideration of social and historical context and alternative explanations for worrisome findings. We recommend using evidence, avoiding assumptions by seeking clarification from families and ensuring internal consistency. When contemplating CPS referral, medical providers should feel empowered to ask questions if there is concern for potential bias. The ultimate goal is to protect children from harm. If there are clear safety concerns-they must be addressed. However, in the many cases where the safety concern is less tangible, we need to expand our considerations of the harms that can befall children, especially children of color.

The relationship between emergency medical services use and social service needs in a pediatric emergency department population

BackgroundEmergency Medical Services (EMS) use for children is correlated with areas of resource deprivation as well as child maltreatment. Households using EMS may have more social needs and be willing to accept services. ObjectiveTo compare social service needs and willingness to accept services in families arriving to a pediatric emergency department (ED) via EMS vs non-EMS, before and during COVID-19. Participants and settingCaregivers of children 0–5 years old in a quaternary pediatric ED, with a 1:1 ratio of EMS vs non-EMS arrivals. MethodsParticipants completed a survey of demographics, social service needs, and willingness to accept services, before and during COVID-19. ResultsOf 220 participants, 84 were enrolled before COVID-19. The EMS group reported less full-time employment (34.6% vs 51.8%, p < 0.05) and more social service needs (2.47 vs 1.76 needs, p < 0.05). Mean score for willingness to accept a service provider in the home was 3.62 for EMS and 3.19 for non-EMS (p = 0.09). Mean score for accepting a phone referral was 3.84 for EMS and 3.40 for non-EMS (p = 0.07). COVID-19 impacted needs for both groups (20.9% EMS vs 30.3% non-EMS). For all subjects presenting to the ED, COVID-19 was associated with decreased food insecurity (28.6% vs 15.4%) and children with a chronic medical condition (31.0% vs 12.5%). ConclusionsThe EMS group had more social service needs. There was no difference in social services acceptance. COVID-19 affected both groups' needs. Future interventions may use EMS systems to mitigate social service needs which may be risk factors for child abuse.

Evaluating child maltreatment and family violence risk during the COVID-19 Pandemic: Using a telehealth home visiting program as a conduit to families.

The COVID‐19 pandemic has affected many child maltreatment risk factors and may have affected maltreatment among vulnerable families. We surveyed 258 certified providers of an evidence‐based home visiting program, SafeCare, about their perception of the impact of the pandemic on the families they serve. We examined if the providers perceived an overall change in child maltreatment and family violence risk among the families with young children they served and factors that may have contributed to changes. Regressions estimated the relationship between providers’ assessment of families’ ability to social distance, emotional struggles, and access to public resources/services with providers’ perception of child maltreatment and family violence risk in the home. Findings indicate that 87% of providers believed maltreatment risk had increased during the pandemic. Providers serving families who were unable to social distance due to employment were more likely to report increased supervisory neglect and material neglect among the families they serve. Providers reporting that families were struggling with elevated frustration levels also reported more family conflict and material neglect among the families they serve. Results from this research can inform strategic decision‐making for policies and programs that address the challenges low‐income families with young children face in emergency situations.

Do macroeconomic shocks in the local labor market lead to child maltreatment and death?: Empirical evidence from Japan

BackgroundJapan is facing a rapid increase in the number of reported child maltreatment cases. Child maltreatment has long-term consequences for the victims, and unemployment rate is considered a strong predictor of it. However, only few studies have analyzed the causal relation between child maltreatment and the unemployment rate—particularly the effects of the latter on the former—in Japan. MethodsUsing prefecture-level longitudinal data from 2005 to 2016, we employed a fixed effects instrumental variable estimation. The estimation included a weighted average of the national unemployment rate across industries by industrial structures in 2005 as an instrument to identify the causal effects. ResultsThe average local unemployment rate changed by approximately 50% from the peak to the bottom in the sample period. A 50% increase in local unemployment rates increased the number of reported child neglect cases and child deaths by 80% and 70% (statistically significant at the 5% level), respectively. Further, it increased cases of death due to external causes, unintentional injuries, and unintentional drowning by 146%, 217%, and 315% (statistically significant at the 5% level), respectively. ConclusionThe local unemployment rate is a risk factor for child maltreatment, resulting in children’s death, especially as a result of unintentional drowning—the common cause of death due to child neglect. When the local unemployment rates rise, governments should allocate more financial and human resources for preventive measures to combat child deaths caused by neglect.

The parenting skill development and education service: Telehealth support for families at risk of child maltreatment during the COVID‐19 pandemic

AbstractChildren are at heightened risk of maltreatment during community wide crises. The Parenting Skill Development and Education (PSDE) Service is a 6‐week telehealth intervention designed and implemented during the COVID‐19 pandemic to support families with young children in Australia at risk of child maltreatment. This study aimed to conduct a formative review of the PSDE service to (a) describe families accessing the PSDE during the pandemic, (b) determine parent and referrers' satisfaction of the service and (c) explore clinicians' experiences of service delivery. A mixed‐method study design incorporating the analysis of routinely collected data, and qualitative interviews with clinicians was conducted. Participants were 11 families displaying child maltreatment risk and 11 clinicians. Parents accessing the service were experiencing considerable risk factors for child maltreatment. The service was deemed acceptable by parents and referrers; however, several challenges in telehealth delivery were documented including parent engagement, technology difficulties and assessing child safety. Our findings highlighted the importance of ensuring adequate support and monitoring of families where there is child maltreatment risk during the COVID‐19 pandemic. In addition, these findings highlight the acceptability of telehealth services to support families at risk of child maltreatment for families, clinicians, and referrers.

Characteristics of Pregnant Women and New Mothers Identified as Being At-Risk for Child Maltreatment in Early Pregnancy

Pregnant women and new mothers who have risk factors of child maltreatment are “at high risk for future child maltreatment.” Early detection of them is crucial to prevent it. This community-based, retrospective, cross-sectional, observational study aimed to identify the characteristics of pregnant women, and those in their postpartum period, identified as at-risk cases for child maltreatment. We used data from the municipal pregnancy registration system in City A and analyzed 206 cases identified as “at-risk for child maltreatment” from 1 April 2017 to 31 March 2018. They were categorized into two groups: a pregnancy group (131 cases, 63.6%) and a postpartum group (75 cases, 36.4%). Logistic regression analysis revealed that women who reported having poor relationships with their parents and participated in the interview in their early stages of their pregnancy were less likely to be registered as at-risk cases for child maltreatment after delivery. The results suggest that public health nurses (PHNs) can conduct interviews with pregnant women during the early stages of pregnancy to prevent child maltreatment in community settings. Additionally, to ensure safe delivery and childrearing environments, PHNs need to assess the family support capacity of each registered case and provide assistance to those without parental support.

The threat of coronavirus perceived by the mother and her experiences related to the pandemic versus her relationship with the child

Introduction: The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus, has significantly changed people’s everyday lives, threatening the quality and even durability of intra-family relationships. The relationship between mother and child is particularly vulnerable to the disruptive impact of the pandemic. The article examines the relationship between mothers’ perceived threat of coronavirus and their pandemic experiences, and their relationships with their children. The analyses took into account the mediating role of parental stress and the following indicators of the mother-child relationship: mother’s perceived closeness with her child and mother-reported increase in the use of harsh parenting related to the pandemic. Method: The perceived threat of coronavirus and the pandemic experiences were assessed using scales based on the Coronavirus Experiences and Impacts Questionnaire (Conway, Woodard, &amp; Zubrod, 2020). Parental stress was tested using the Polish version of The Parental Stress Scale (Berry &amp; Jones, 1995), while the mother’s relationship with the child was measured using the Polish version of the scales developed by Chung, Lanier, and Wong (2020). The study involved 155 mothers who are in a relationship and have at least one child up to 12 years of age. Statistical analyses were performed using SEM structural equation modeling. Results: It was found that during the pandemic, mothers’ negative experiences related to the pandemic had a significant effect on mother-child relationships, which was associated with a greater increase in the use of harsh parenting as reported by mothers and a decrease in their perceived closeness with their children. This effect was mediated by parental stress. There was no significant correlation between the perceived threat of coronavirus and mother-child relations. Conclusions: The pandemic and the related difficult situations constitute a significant risk factor for child abuse and neglect in the group of mothers. This indicates the need to support mothers.

Pediatric emergency department visits due to child abuse and neglect following COVID-19 public health emergency declaration in the Southeastern United States

BackgroundThe ongoing worldwide COVID-19 pandemic has heightened several risk factors for child abuse and neglect (CAN). We study whether COVID-19 and the public health response to it affected CAN-related pediatric emergency department (ED) visits in the southeastern United States (US).MethodsWe performed a retrospective chart review on medical records of ED visits from a level I pediatric hospital system serving one of the largest metropolitan areas in the southeastern US from January through June 2018–2020. We used multivariate Poisson regression and linear regression to compare professionally identified CAN-related ED visits before and after a COVID-19 public health emergency declaration in 2020, relative to trends over the same period in 2018 and 2019.ResultsAlthough the number of both overall pediatric ED visits and CAN-related ED visits declined, the number of CAN-related ED visits due to neglect from inadequate adult supervision increased by 62 % (p < 0.01). The number of CAN visits per 1,000 pediatric ED visits also increased by 97 % (p < 0.01). Finally, the proportion of CAN-related ED visits due to neglect from inadequate supervision increased by 100 % (p < 0.01).ConclusionsPhysicians should be aware that patients who present with injuries during a pandemic may be victims of neglect due to changes in social structures in their households. In particular, maltreatment presenting to the ED shifted toward treating injuries and abuse resulting from inadequate supervision. Policymakers should consider the impacts of stay-at-home orders on child well-being when determining appropriate public health responses in the midst of a pandemic.Trial RegistrationNot applicable.

SPN 2021 Poster Abstract Awards

SPN 2021 Poster Abstract Awards

The experience of the COVID-19 pandemic for families of infants involved with Child Protection Services for maltreatment concerns.

The COVID‐19 pandemic and associated physical distancing restrictions have exacerbated social, economic and health disadvantage within our communities. With increases in mental health difficulties and family violence already being seen, there is concern that the risk of child maltreatment risk may also be increased. The current study aimed to explore the experience of the COVID‐19 pandemic for families identified to be at risk of child maltreatment in Victoria, Australia. Understanding the experiences of the pandemic for families already at risk is essential in identifying how to best support vulnerable parents and young children during this challenging time. Interviews were conducted with 11 parents currently involved with Child Protection Services, and nine clinicians working within a child and family health services, supporting clients with child protection involvement. Parents and clinicians described a range of pandemic related stressors including employment and financial stress, worry about infection and changes to service access. In addition, parents with children in out of home care discussed decreased access to their children resulting from physical distancing restrictions. Parents and clinicians perceived the pandemic to be having a negative impact on parent mental health, parenting stress and isolation. Although parents raised minimal concerns about the impact of the pandemic on child well‐being, clinicians expressed concerns about the rise in risk factors for child maltreatment. Parents discussed a range of coping strategies which they perceived to be helpful during the pandemic, and clinicians and parents described the need for additional mental health support and support to access basic needs. The study highlights the importance of ensuring at risk families have access to parenting and mental health support throughout the pandemic and the importance of ensuring children within at‐risk families are sighted and their safety assessed.

Spanish Adaptation of the Inventory Brief Child Abuse Potential and the Protective Factors Survey.

Child maltreatment is a public health problem with different consequences depending on the form of abuse. Measuring risk and protective factors has been a fertile ground for research, without involving instruments with sufficient evidence of validity. The aim of the study was to gather evidence of validity and reliability of the Inventory Brief Child Abuse Potential (IBCAP) and Protective Factors Survey (PFS) in the Mexican population. The instruments were translated into Spanish. In a non-probabilistic sample of 200 participants, the 7-factor model for the IBCAP [comparative fit index (CFI) = 0.984; root mean square error of approximation (RMSEA) = 0.067] and the 4-factor model for the PFS (CFI = 0.974; RMSEA = 0.061) were confirmed, showing adequate fit indices. Reliability was estimated and evidence of convergent, divergent, and discriminant validity was collected, controlling for effects of social desirability. We also report interpretability statistics of the scores. We achieved solid progress in the development of instrumentation that allows determining the presence or absence of protective and risk factors for child abuse.

Exploring Clusters of Risk and Association With Child Maltreatment in North Carolina Counties.

Decision makers face challenges in estimating local risk for child maltreatment and how best to prioritize which factors to intervene upon. Using US Census and survey data for all US counties (N = 3141), we derived US county profiles characterized by the severity of child maltreatment risk factors observed at the county level, such as parental health, health care access, and economic distress. We estimated how five child maltreatment outcomes would vary across the profiles for North Carolina counties (n = 100): total maltreatment reports (including unsubstantiated and substantiated), substantiated neglect, substantiated abuse, whether services were received, and reported child's race/ethnicity. We derived three profiles of county-level child maltreatment risk: high, moderate, and low risk, denoting that predicted risk factors means within profiles were all high, moderate, or low levels compared to counties in other profiles. One risk factor did not follow this pattern: the drug overdose death rate. It was highest in the moderate-risk profile instead of the high-risk profile, as would have been consistent with other factor levels. Moderate-risk counties had the highest predicted rate of child maltreatment reports, with over 20 more reports per 10,000 residents compared to low-risk counties (95% CI, 1.38, 38.86). We included only factors for which aggregate, county-level estimates were available, thus limiting inclusion of all relevant factors. Results suggest the need for increased family-based services and interventions that reduce risk factors such as economic distress and drug overdose deaths. We discuss the implications for tailoring county efforts to prevent child maltreatment.

“Who maltreats? Distinct pathways of intergenerational (dis)continuity of child maltreatment”

BackgroundMaltreatment victimization history is an established risk factor for child maltreatment across generations. However, many parents with a victimization history do not maltreat, and many parents with no victimization history do have victimized children. ObjectivesTo understand differences in demographic and maltreatment risk factors across the following intergenerational patterns of maltreatment: cycle maintainers, cycle breakers, cycle initiators, and a comparison group (no maltreatment). Participants and settingData were drawn from a large population-based cohort in Queensland, Australia and included 32,574 biological parents and their children. Maltreatment experiences as a victim or person responsible for harm towards a child were obtained from the Queensland Child Protection System. MethodsMultinomial regression was completed with the full sample to compare the three maltreatment groups with the comparison group. Logistic regressions were conducted on all pairwise combinations of maltreatment groups. Models accounted for several demographic and maltreatment factors. ResultsCompared with breakers, maintainers were more likely to be Indigenous (OR = 1.86), never married (OR = 0.34), younger at first birth (OR = 0.87), have ≥3 children (OR = 1.99), be younger at first—and older at last—maltreatment victimization (ORs = 0.97 and 1.07, respectively), and experience a higher frequency of victimization (OR = 1.05). Amongst maltreaters, males were significantly more likely to be initiators while females were more likely to be maintainers (OR = .62). There were few other differences between initiators and maintainers. ConclusionsMeaningful differences among the three maltreatment groups were revealed suggesting that research should focus on the intergenerational discontinuity of maltreatment.

Physical health and emotional and behavioral problems in maltreated children according to family economic status: Health problems of maltreated children in Korea.

Low family income is a risk factor for child maltreatment. However, there has been no comparative study on the association between child maltreatment and family income. The objective of this study was to investigate the physical health and emotional and behavioral problems of maltreated children according to the economic status of their family.Cross-sectional nationwide studyData from 2012 to 2014 was extracted from the Korean National Child Abuse Registry (age <18 years) operated by the National Child Protection Agency (NCPA). Demographic characteristics and 34 physical health and emotional/behavioral problems of maltreated children were compared by family economic status. Family economic status was classified into 2 groups: families receiving the National Basic Livelihood Guarantee (NBLG) and those not receiving the guarantee (non-NBLG group).A total of 17,128 children were registered in the system. Mean age was 9.3 years (SD 4.8 years), 44.4% were females, and 29.2% were in the NBLG group. Poor hygiene, anxiety, and attention deficit were frequently reported physical and emotional health problems. Common behavioral problems included running away, rebelliousness/impulsivity/aggressiveness, maladjustment in school, learning problems at school, and frequent unauthorized absenteeism and truancy. Physical health problems (7 of 8 items) occurred more often in the NBLG group, and behavioral problems (6 of 17 items) occurred more often in the non-NBLG group.Children in Korea who are maltreated have different physical health, emotional, and behavioral problems depending on their family income level. These results can be useful in approaching the recognition of and interventions for child maltreatment.