Risk Factors For Child Maltreatment Research Articles

Study protocol: randomized controlled trial of manualized components in home visitation to reduce mothers\u2019 risk for child maltreatment

BackgroundThis study tests whether home visitation to prevent child maltreatment can be improved by adding manualized program components, targeting four key risk factors for child maltreatment: low parental self-efficacy, high levels of perceived stress, parental anger, and post-traumatic stress symptoms. Home visitation is widely implemented, but effects on child maltreatment risk tend to be modest at best. Home visitation tends to be rather flexible (i.e., professionals decide how to support each family). We will test whether adding manualized program components increases program effectiveness, by ensuring that key risk factors are addressed, while maintaining flexibility. In addition, we will test whether any component effects on reduced child maltreatment risk can be explained (i.e., is mediated) by ameliorated risk factors. Lastly, we will test whether the components are more effective for some mothers (e.g., those at highest child maltreatment risk) than for others.MethodsWe will conduct a randomized controlled trial among 398 mothers enrolled in a Dutch home visiting program targeting families at risk for child maltreatment. Mothers in the experimental group will receive the manualized components in two consecutive home visits, while mothers in the control group will receive regular home visits (care as usual). Mothers will fill out questionnaires at four time points: before and after each of the two home visits. Outcome variables include the four targeted risk factors parental self-efficacy, perceived stress, parental anger, and (recognition of) post-traumatic stress symptoms, as well as parenting practices (e.g., rejection and affection), and risk for child maltreatment.DiscussionThis study aims to determine whether adding manualized program components to a flexible home visiting program increases program effectiveness on risk for child maltreatment. In addition, our test of whether the effects of the components on risk for child maltreatment is explained (i.e., mediated) by amelioration of the targeted risk factors, may contribute to our understanding of the role of these risk factors in child maltreatment. Our tests of which mothers benefit most from adding the components may help move the field towards evidence-based personalized family support.Trial registrationThis trial has been retrospectively registered in the Netherlands Trial Register (NL8005).

Are Children With a Number of Disabilities and Long-Term Illnesses at Increased Risk of Mental Violence, Disciplinary Violence, and Serious Violence?

The focus of this study was on the question of whether or not children with a number of disabilities and long-term illnesses are at increased risk of child maltreatment (mental violence, disciplinary violence, and serious violence). This study was based on the Child Victim Survey of 2013 (FSD2943). The data consist of a nationally representative sample of pupils in Finland in sixth grade (12-13 years of age) and ninth grade (15-16 years of age). The sampling was undertaken as a stratified cluster by province, municipality type, and school size. The total number of respondents was 11,364. According to the logistic regression analyses, the children with at least three disabilities or long-term illnesses had an increased risk of violence compared with children with no disability: The risk of mental violence increased by 2.96 times, the risk of disciplinary violence by 4.30 times, and the risk of serious violence by 3.53 times. The effect of the category of at least three disabilities and illnesses remained statistically significant, although the analysis also accounted for several confounding factors. Thus, a child's multiple morbidity (in the case of three or more disabilities and illnesses) can be categorized as one of the major risk factors for child maltreatment. The study complements the results of previous studies concerning the effect of children's disabilities and long-term illnesses and their impact on child maltreatment. The results underline the importance of employees of health and social care having knowledge of multiple morbidity and its importance as a key factor regarding child maltreatment.

Preventing child abuse risk factors: A study of the ease of French professionals working in early prevention

Research on child abuse prevention has been limited for the last forty years to the experimental field. While we know how home visiting interventions can help limit situations of child abuse, we do not know how these results can be replicated in routine care situations. The objective of this study was to identify, in French public services, how prevention professionals approach child abuse risk factors with families, and with what degree of ease. The results show that, beyond a form of versatility that allows them to discuss a wide range of topics with families, prevention workers are very uncomfortable dealing with topics of family intimacy, psychopathology, or child abuse. The political implications are discussed.

Parental substance use disorder and child abuse: risk factors for child maltreatment?

Although the literature consistently shows an association between parental substance use disorders (SUDs) and child abuse, it is unknown what factors discern non-abusive and abusive parents with SUDs. This study aims to investigate which specific risk factors are associated with child abuse in clinically treated parents with SUDs in the Netherlands. It examines two groups of parents with SUDs in a clinical setting, with and without known instances of child abuse. These groups were compared on SUD-related factors such as the type and severity of the SUDs, and variables addressing psychological disability such as comorbid diagnoses and quality of life. Other than a marginally significant difference in severity of addiction and a lower mean age of the parents in the child abuse group, no significant differences were found. The small sample size and the inherent difficulty of studying SUDs in a clinical sample is likely to have affected the results.

Adverse Childhood Experiences and Outcomes among At-Risk Spanish-Speaking Latino Families

This study examined the relationship between ACE score and substance use, mental health, and parenting competence among a sample of Latino caregivers at-risk for child maltreatment. This study sought to increase our understanding of ACEs and outcomes among Latino caregivers that had at least two risk factors for child maltreatment. Surveys were administered to caregivers with children between 0 and 5 years of age who enrolled in child maltreatment prevention programs and completed by N= 417 Spanish-speaking Latino caregivers before or shortly after beginning the prevention program. Results suggest that ACE scores are positively associated with mental health issues and substance use, but the relationship between ACE scores and parenting competence is more complex. Furthermore, foreign-born caregivers fared better in terms of mental health and parenting competence than their U.S.-born counterparts among this sample of Spanish-speaking at-risk Latino caregivers. Implications for future research include incorporating other measures of more current exposure to adversity, such as immigration trauma, when working with recent immigrants. Furthermore, practitioners should be aware of policies related to immigration and how these might impact potential service usage and overall wellbeing among Spanish-speaking clients. More research is needed to better understand other factors that might impact parenting, mental health, and substance use associated with ACEs among Latino families.

Do surprisingly low child maltreatment rates in rural southern counties reflect lower rates of substantiation?

This study aims to help explain surprisingly low official child maltreatment rates in rural southern U.S. counties with many child maltreatment risk factors. It investigates whether comparatively lower child maltreatment rates in rural, majority African-American counties are due to lower rates of substantiation. County-level data from the National Child Abuse and Neglect Data System (NCANDS) were linked with demographic and poverty data from the U.S. Census. Fractional response probit regression models assessed whether substantiation rates were associated with county racial composition, rurality, and poverty rate. Substantiation rates in rural, majority African-American counties were similar to those of other counties in the region, even when accounting for the county poverty rate. The findings clarify that lower maltreatment rates in rural, majority African-American counties in the South are a consequence of lower maltreatment report rates, and not also a consequence of substantiation decisions. The discussion addresses some implications of low levels of formal child welfare intervention in high risk, low resource counties with histories of marginalization.

Child abuse in ethnic regions: Evidence from 2899 girls in Southwest China

ObjectiveChina has 55 ethnic minorities with 114 million population. As a piece of the worldwide picture of child abuse in ethnicity, the study on child abuse in Chinese ethnic regions is significant but insufficient currently. Therefore, this study examined the prevalence, negative effects, and risk factors of child abuse involving girls in Chinese ethnic regions. MethodA multi-stage cluster sampling procedure and paper-and-pencil questionnaire survey were used to conduct the study in 126 classes in three counties of Southwest China, which includes a total sample of 2899 girls. ResultsThe rates of physical abuse, emotional abuse, and neglect to girls in ethnic minority areas were significantly higher than those in the Han areas. Moreover, all types of child abuse negatively affected girls' mental health at different levels. However, the effects of abuse were more severe for girls in Han than for ethnic minorities with similar abuse severity. In addition, academic performance and parent-child relationship were correlated with child abuse for girls in the ethnic regions, and the risk was especially higher for girls in rural towns and those of younger age. ConclusionFindings from this study indicated that the prevalence of child abuse of girls in ethnic regions was high. Although with lower prevalence of child abuse, girls in Han should be intervened for their more severe mental health problems with abuse than the peers in ethnic minority areas. Great attention should be paid to girls in ethnic regions with poor academic performance, bad parent-child relationship, especially in rural towns and in young age, to prevent the risk of child abuse.

Risk factors for child maltreatment in South Korea: An investigation of a nationally representative sample

AbstractThis study investigated the risk factors associated with the occurrence of child physical and psychological abuse in South Korea based on the ecological theory of child maltreatment. A subsample of 3‐ to 18‐year‐old children from “A Study on the Current State of Child Abuse and Neglect,” a nationally representative study on child abuse and neglect, was utilized for secondary data analysis. The sample was divided into two age groups (third graders in elementary school and below and fourth graders and above). We utilized hierarchical logistic regression for each age group separately to analyze the data. The variables at each level of the system (i.e., ontogenic development, microsystem, and exosystem) were entered into the model in sequential order. The results showed the common risk factors for both age groups are the caregiver's experience of abuse in childhood, the child's problem behavior, exposure to domestic violence, community size, and informal social control. The child's age was also significant in both groups but in the opposite direction. Social support was a significant predictor for the younger age group only, while the caregiver's level of education was significant for the older age group only. Implications for future research and practice are discussed based on the study results.

Paternity establishment at birth and early maltreatment: Risk and protective effects by maternal race and ethnicity

BackgroundMinority race/ethnicity, low socioeconomic status, and lack of established paternity have been identified in previous research as risk factors for child maltreatment. However, given vastly different patterns of income distribution, single parenting and co-parenting across racial and ethnic populations, it is difficult to know which of these factors contribute most to maltreatment risk. ObjectiveThe current study explores whether the odds of maltreatment differ across race/ethnicity when paternity is not established at birth after controlling for maternal socioeconomic status. MethodsUsing merged birth certificate and child protective services records for children born between 2009 and 2011 in Texas (N = 1,175,804), we conducted multiple logistic regression analyses testing the main effects of maternal race and lack of established paternity, as well as the interaction of the two, on substantiated maltreatment. ResultsResults show that children of black mothers were less likely to have established paternity and more likely to experience maltreatment compared with other groups. However, the odds of maltreatment were lower for children of black mothers without established paternity compared to children of white mothers without established paternity (OR = .71, 95% CI [0.67,0.75]). Alternatively, the odds of maltreatment were higher when paternity was not established at birth for Hispanic mothers (OR = 1.13, 95% CI [1.08,1.18]) and mothers of other race/ethnicities (OR = 1.35, 95% CI [1.11,1.65]) compared to white mothers. ConclusionResearch and prevention programming must consider that the processes and pathways linking paternity establishment and maltreatment may differ within and between racial/ethnic groups.

National Risk Factors for Child Maltreatment after Trauma: Failure to Prevent

The purpose of this study was to identify the risk factors for hospital readmission for child maltreatment after trauma, including admissions across different hospitals nationwide. The Nationwide Readmissions Database for 2010-2014 was queried for all patients younger than 18 years admitted for trauma. The primary outcome was readmission for child maltreatment. The secondary outcome was readmission for maltreatment presenting to a hospital different than the index admission hospital. A subgroup analysis was performed on patients without a diagnosis of maltreatment during the index admission. Multivariable logistic regression was performed for each outcome. There were 608,744 admissions identified and 44,569 (7.32%) involved maltreatment at the index admission. Readmission for maltreatment was found in 1,948 (0.32%) patients and 368 (18.89%) presented to a different hospital. The highest risk for readmission for maltreatment was found in patients with maltreatment identified at the index admission (odds ratios (OR) 9.48 [8.35-10.76]). The strongest risk factor for presentation to a different hospital was found with the lowest median household income quartile (OR 3.50 [2.63-4.67]). The subgroup analysis identified 647 (0.11%) children with readmission for maltreatment that was missed during the index admission. The strongest risk factor for this outcome was Injury Severity Score > 15 (OR 3.29 [2.68-4.03]). This study demonstrates that a significant portion of admissions for trauma in children and teenagers could be misrepresented as not involving maltreatment. These index admissions could be the only chance for intervention for child maltreatment. Identifying these at-risk individuals is critical to prevention efforts.

Role of the dental hospital-based paediatric liaison nurse in safeguarding children.

Aim Service evaluation of our dental hospital paediatric liaison nursing (DH-PLN) service which provides an additional route for information sharing about safeguarding concerns via an agreed pathway for two-way communication with public health nurses.Method Retrospective analysis of clinical records of all children referred by DH teams to PLN in the three months October-December 2016.Results One hundred and four children were referred; mean age was 6.2 years, 89.4% from Index of Multiple Deprivation (IMD) quintiles 4 and 5, and 70.2% were attending for dental general anaesthesia. The most common referral reason was dental neglect in 66.3%, followed by missed appointments in 50.0%. The PLN checked child health databases and shared information with health visitors and school nurses (46.2% and 53.8% respectively). Feedback retrieved included known child maltreatment risk factors in 7.7%. This prompted additional child protection referrals to children's social services for seven children (6.7%). Dental outcomes six months later were: treatment complete in 50.0%, treatment ongoing 28.8%, discharged to original referrer with treatment incomplete in 21.1%.Conclusion This DH-PLN service promotes integrated multidisciplinary working, helping overcome barriers to dentistry's involvement in safeguarding. It facilitates more accurate assessments of risk of harm to children receiving dental care and prompts additional child protection referrals to social services.

Perception on risk factors of child maltreatment in China: a qualitative study among health professionals

ObjectivesThe aim of this study was to explore health professionals’ perception of risk factors related to child maltreatment in China.DesignQualitative research.SettingThe study was conducted in November and December 2014 in...

Exploring the association between parenting stress and a child's exposure to adverse childhood experiences (ACEs)

Nearly half of U.S. children age 0–17 have been exposed to adverse childhood experiences (ACEs), accounting for over 34 million of children nationwide. Parenting stress (negative feelings related to the demands of parenting) is a primary risk factor for child maltreatment and neglect; yet has been an overlooked factor for ACEs. Understanding the degree of parenting stress and its subsequent associations with ACEs will facilitate future designations of relevant interventions to keep children safe. We analyzed 2016 data from the National Survey of Children's Health to examine whether increased levels of parenting stress are associated with higher counts of ACEs among children. About 4.4% of caregivers reported “high parenting stress” and children living with them were three times more likely (OR: 3.05; 95% CI: 2.23–4.15) to experience four or more ACEs by the age of 18. Lowering parenting stress through parenting interventions could decrease the level of childhood trauma experienced by a child or may lessen one type of stress in a home where many other stressors exist.

Child welfare workers’ knowledge of risk factors for child maltreatment fatalities: a second multi-state assessment

ABSTRACT This paper reports results from a second study which examines the knowledge and training of child welfare professionals with regard to risk factors for fatal child maltreatment. This multi-state, online study (n = 619) shows that workers have gaps in their knowledge of risk factors for maltreatment-related deaths. The majority of workers had received training, but it had little impact on worker knowledge. Workers reported receiving a variety of trainings on risks for fatalities, with different sources, length of training, and foci. Workers who received training that focused on research-based risk factors had higher levels of knowledge than other workers.

QUESTIONS TO IDENTIFY AND PREVENT SEXUAL VIOLENCE AGAINST CHILDREN

One of the problems of modern society is child abuse, including sexual abuse. Peculiarities of the psyche of children and their behavior require a special approach in identifying and preventing violence against them. The article discusses the factors that make it difficult to identify actions of a sexual nature with regard to children and ways to overcome these difficulties. Attention is also drawn to factors that may help in identifying violent acts. The problems faced by the child during the investigation and legal proceedings are considered. Factors of increased risk of child abuse are described. Criteria are proposed according to which at the level of school psychologists it is possible to form groups of minors who are at increased risk of becoming victims of sexual violence. Suggestions have been made for the timely prevention of possible sexual offenses. The proposed activities that may be carried out in educational institutions and centers of healthy lifestyle, to prevent such crimes. The classification of persons who are aggressive towards children is given. Signs that are used for classification, summarized in visual form in the tables. The motivation, the criteria for choosing the victim and the methods of manifestation of aggression in each group of the classification presented are described in detail. Profiles of men and women who have committed child abuse or have this propensity are presented. Their profiles describe characterological features, biography features and their lifestyle. Psychiatric criteria of sexual disorders according to the international classification of diseases of the 10th revision and alternative classification of mental disorders are considered. Article materials may be useful for detecting and preventing sexual abuse. A scientific approach to the classification of perpetrators of violence in describing and recognizing their character traits may make it possible to identify those who are prone to violence. This will prevent crimes of a sexual nature against minors by referring such a person to a psychotherapist or psychiatrist in a timely manner to diagnose and prescribe the necessary treatment. Keywords: sexual abuse, abuser profile, pedophilia, abuser classification, risk factors for child abuse.

Maternal unwanted and intrusive thoughts of infant-related harm, obsessive-compulsive disorder and depression in the perinatal period: study protocol

BackgroundUnwanted, intrusive thoughts of harm-related to the infant are reported by the vast majority of new mothers, with half of all new mothers reporting unwanted, intrusive thoughts of harming their infant on purpose. Thoughts of intentional harm, in particular, are distressing to women, their partners and the people who care for them. While maternal, unwanted and intrusive thoughts of infant-related harm are known to be associated with obsessive compulsive disorder (OCD) and depression, preliminary evidence suggests that they are not associated with an increased risk of harm to infants. Perinatal care providers and policy makers, as well as new mothers and their partners require evidence-based information in order to respond appropriately to these types of thoughts. The purpose of this research is to address important gaps regarding the (a) prevalence and characteristics of intrusive, unwanted thoughts of baby-related harm, (b) their association (or lack thereof) with child abuse, and (c) the prevalence and course of obsessive-compulsive disorder and depression in the perinatal period.MethodsParticipant were 763 English-speaking women and recruited during pregnancy. In this province-wide study in British Columbia, participants were recruited proportionally from hospitals, city centers and rural communities between January 23, 2014 and September 09, 2016. Participants were administered online questionnaires and diagnostic interviews over the phone at 33-weeks gestation, 7-weeks postpartum and 4-months postpartum. The study assessed intrusive and unwanted thoughts of harm related to the infant, obsessive-compulsive disorder (OCD) and major depressive episode (MDE) disorders and symptomatology, sleep, medical outcomes, parenting attitudes, and infant abuse.DiscussionThere is a scarcity of literature concerning maternal unwanted, intrusive, postpartum thoughts of infant-related harm and their relationship to child harming behaviors, OCD and depression. This longitudinal cohort study was designed to build on the existing research base to ensure that policy developers, child protection workers and health-care providers have the guidance they need to respond appropriately to the disclosure of infant-related harm thoughts. Thus, its main goals will be to investigate whether intrusive postpartum thoughts of infant-related harm are a risk factor for child abuse or the development of OCD.

Lack of education or abuse?

Child abuse is a significant public health problem nowadays. The case is here presented of an unemployed stepfather, with significant risk factors for child abuse, who caused physical abuse to a child with hot water as a result of incorrect toilet training. In this case, the mother tried to hide the event and as a result of the history taken from the child and findings of lesions in the physical examination, it was learned that these had been made by the stepfather because of urine incontinence. In similar situations to this case, healthcare personnel establishing close communication with the child must pay attention in respect of child abuse, and must inform the authorities in all suspicious cases.

Two sides of the same neighborhood? Multilevel analysis of residents' and child-welfare workers' perspectives on neighborhood social disorder and collective efficacy.

Neighborhood processes have been shown to influence child maltreatment rates, and accordingly neighborhood-based strategies have been suggested as helpful in intervening in and preventing child maltreatment. Although child-welfare workers are at the forefront of child maltreatment work, little is known about the extent to which their perspectives on neighborhood processes related to child maltreatment align with those of neighborhood residents. The current study examined the views of neighborhood residents (n = 400) and neighborhood-based child-welfare workers (n = 260) on 2 neighborhood process measures: social disorder and collective efficacy. Because social disorder is viewed as a risk factor for child maltreatment and collective efficacy is viewed as a protective factor, child-welfare workers and residents of neighborhoods need to reach a common understanding of these factors in order to reach agreement on the safety of children in these neighborhoods. The samples of neighborhood residents and child-welfare workers were nested within 20 neighborhoods in Cleveland, Ohio. Multilevel modeling taking into account individual and neighborhood characteristics indicated that child-welfare workers consistently tended to perceive higher social disorder and lower collective efficacy compared to residents. Neighborhood characteristics were associated with residents' and child-welfare workers' perspectives on social disorder in different ways. Differences between residents and child-welfare workers concerning perceptions of neighborhood processes have implications for better understanding the context and improving the effectiveness of neighborhood-based interventions to prevent child maltreatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Risk factors for child maltreatment by the utilization of medical service and socioeconomic environment in Taiwan.

Child maltreatment is complicated by cultural, welfare, and socioeconomic factors. However, the relationship between child maltreatment and socioeconomic factors has not been completely understood. We investigated risk factors for child abuse and neglect in Taiwan.The data in our study was obtained from Taiwan National Statistics at county level from 2004 to 2015. We included 4 areas (eastern, western, southern, northern) involving 20 cities and counties. The trends of child maltreatment rate based on different years and different areas were surveyed. In addition, panel data analysis was used to analyze the links between child maltreatment rate and socioeconomic factors.An increasing trend of child maltreatment rate in Taiwan was observed. During the past decade, child maltreatment rate increased from 14.5 in 2004 to 23.4 cases per 10000 children in 2014. The peak, which was 43 cases per 10000 children, occurred in 2012. Significant geographical differences were observed, and the highest child maltreatment rate was seen in eastern Taiwan. Panel data analysis revealed a lag effect of the unemployment rate on child maltreatment rate at the county level: the child maltreatment rate increased by 7 percent, while the prior unemployment rate increased by one percent. In addition, the medical personnel density was related to the child maltreatment rate within the county.Previous unemployment rate had a lag impact on child maltreatment occurrence. Unemployment rate has not only a direct impact on the economy but also sequential effects on child maltreatment.

Factor analysis and predictive validity of the Early Risks of Physical Abuse and Neglect Scale (ERPANS): A prospective study in Dutch public youth healthcare.

Early detection of child abuse risk factors in families of new-born babies is an important task of the public youth health care system in the Netherlands. The Early Risks of Physical Abuse and Neglect Scale (ERPANS) was originally developed in Belgium as an observation scale for public child healthcare nurses. The present longitudinal study is an independent prospective validation of the ERPANS in a Dutch community sample (N = 1257) of families with a new-born. Results showed a commonality of underlying subsets of items belonging to the 'Disturbed parent-child relationship' and 'Psychological problems' factors, but the factor 'Communication problems' of the original ERPANS could not be replicated. We found that parental psychological problems were a significant predictor of family problems, including involvement of child protection authorities, at an average follow-up of 22 months. Parents who reported feeling unloved by their own parents were at higher risk of reports of serious concern to child protection authorities at 22 months after birth. These findings support the utility of at least a subset of the ERPANS items as a screening tool for child abuse risk in preventive public youth health care for new-born babies. Our research adds to a growing body of evidence which points to the importance of parental mental health problems and adverse childhood experiences as precursors to child abuse risk.