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1.
BackgroundEvidence suggests intimate partner violence (IPV), substance use, and depression adversely affect the disciplinary practices of caregivers involved with child welfare; however, it remains uncertain whether the combined effects of these conditions are syndemic.ObjectiveThe purpose of this study was to examine the (1) associations between IPV, problematic drug use, problematic alcohol use, and depressive symptoms and self-reported disciplinary practices among a sample of mothers with child welfare contact; and (2) effect of co-occurrence of these conditions on child disciplinary practices.Participants and settingWe used data from the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II). The analysis focused on 965 biological mothers with children who were subjects of child abuse/neglect investigations between February 2008 and April 2009 in the United States.MethodWe conducted multiple linear regression analyses.ResultsOur findings showed that IPV (B = .28; 95% CI = [.04, .53]) and depressive symptoms (B = .27; 95% CI = [.03, .52]) were independently associated with psychologically aggressive disciplinary practices. Also, IPV was independently associated with physically aggressive disciplinary practices (B = .64; 95% CI = [.18, 1.11]); and IPV (B = .21; 95% CI = [.06, .35]) and depressive symptoms (B = .22; 95% CI = [.07, .37]) were independently associated with neglectful parenting strategies. A significant effect was found for the interaction between problematic drug use and depressive symptoms with physically aggressive practices as the outcome. As the number of conditions caregivers had increased, so did their propensity for self-reporting each of the disciplinary practices (p < .05).ConclusionsThe findings highlight the need for using a more holistic/multidisciplinary approach to child maltreatment prevention research, policy, and intervention. 相似文献
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BackgroundFew studies have examined the effects of the Child Protection Act on child maltreatment in Taiwan.ObjectiveThis study estimated the secular trends in the incidence rate of physical abuse of children requiring hospitalization between 1996 and 2013, and the subsequent in-hospital death proportion before and after implementation of the Act in 2003.Participants and settingThe cases were children younger than 12 years old who were hospitalized due to child abuse, shaken-baby syndrome, neglect, or homicide between 1996 and 2013. A comparison group consisted of children requiring hospitalization for other reasons. We used the National Health Insurance database to identify patients.MethodsThe Joinpoint Regression Program was used to estimate temporal trends in the standardized incidence rates.ResultsBetween 1996 and 2013, 2050 children required hospitalization for physical abuse. Before 2005, the annual percent change increased by 9.40 [95% confidence interval (CI), 4.98–14.00] per year, and after 2005 the annual percent change was –4.80 (95% CI, –9.53–0.17) per year. Among the 2050 physically abused children requiring hospitalization, 83 (4%) died in hospital. The in-hospital death proportion was 2.62% before 2003 and 4.90% after 2003, and the ratio of these two proportions was 1.43 (95% CI, 0.80–2.58).ConclusionsThe trend in the incidence of hospitalization of children due to physical-abuse-related injuries started to decline 2 years after implementation of the Child Protection Act. However, the proportion of children who died in hospital as a result of physical abuse requiring hospitalization did not change. 相似文献
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The objective of this study is to determine the prevalence and correlates of obesity among youth investigated for maltreatment in the United States. Participants were drawn from the National Survey of Child and Adolescent Well-Being II, a national probability study of 5,873 children aged birth to 17 years under investigation for maltreatment in 2008. From child weight reported by caregivers, we estimated obesity (weight-for-age ≥95th percentile) prevalence among children aged 2 through 17 (n = 2,948). Sex-specific logistic regression models by developmental age were used to identify obesity risk factors, including child age, race/ethnicity, and maltreatment type. Obesity prevalence was 25.4% and was higher among boys than girls (30.0% vs. 20.8%). African American adolescent boys had a lower risk for obesity than white boys (OR = 0.28, 95% CI [0.08, 0.94]). Compared with girls aged 2–5 with a neglect allegation, girls with a sexual abuse allegation were at greater risk for obesity (OR = 3.54, 95% CI [1.01, 12.41]). Compared with adolescent boys with a neglect allegation, boys with a physical abuse allegation had a lower risk for obesity (OR = 0.24, 95% CI [0.06, 0.99]). Adolescent girls with a prior family history of investigation were at greater risk for obesity than those without a history of investigation (OR = 3.97, 95% CI [1.58, 10.02]). Youth investigated for maltreatment have high obesity rates compared with national peers. Opportunities to modify and evaluate related child welfare policies and health care practices should be pursued. 相似文献
4.
Major findings from the Canadian incidence study of reported child abuse and neglect 总被引：1，自引：0，他引：1
OBJECTIVE: To present key findings from the Canadian Incidence Study of Reported Child Maltreatment (CIS) in sufficient detail to provide a basis for international comparisons in terms of forms and severity of maltreatment and the age and sex of victims. METHOD: A survey conducted in a random sample of 51 child welfare service areas across Canada tracked child maltreatment investigations conducted during the months of October to December 1998, produced a national sample of 7672 child maltreatment investigations. Information was collected directly from investigating workers on child and family background, perpetrator characteristics, severity and types of maltreatment and service and court outcomes of investigations. RESULTS: Forty-five percent of investigations were substantiated and in a further 22% of investigations maltreatment remained suspected. Primary reasons for investigation were physical abuse (31%), sexual abuse (11%), neglect (40%), and emotional maltreatment (19%). A larger proportion of physical abuse cases are isolated incidents involving older children and are more likely to lead to injuries. Sexual abuse, neglect and emotional maltreatment involve more chronic situations with children showing signs of emotional harm. Rates of investigated and substantiated maltreatment are lower in Canada compared to the United States, but are higher than rates reported in Australia. CONCLUSIONS: The CIS provides much needed information for developing a better understanding of the profile and needs of children and families investigated by child welfare authorities in Canada. The study also serves as a point from which international comparisons can be made. 相似文献
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BackgroundWhile there are national studies on the overrepresentation of First Nations children in the Canadian child protection system, there is a dearth of provincial/territorial studies.ObjectiveThe objectives are to: 1) estimate the rate of overrepresentation of First Nations children and youth involved in child welfare investigations in the Ontario child welfare system and, 2) determine which factors drive the overrepresentation of First Nations children in child welfare at the investigation stage compared to White children.Participants and SettingChild welfare workers completed a three-page data collection form at the conclusion of a child protection investigation.MethodsA secondary analysis of the Ontario Incidence Study 2013 was conducted. Incidence rates were calculated and bivariate analyses were conducted, comparing investigations involving First Nations children to investigations involving White children.ResultsFirst Nations children represent 2.5% of the child population; however, they represent 7.4% of child maltreatment related investigations in Ontario. The rate of investigations for First Nations children was approximately three times higher than the rate for White children. Overrepresentation was most pronounced for investigations of neglect and exposure to intimate partner violence. Rates of substantiation, ongoing child welfare services, child welfare court, and placement in care were higher for the First Nations child population.ConclusionsThe findings provide a foundation for further research and analyses examining the compounding of disparities across the investigation process. Research is needed to disentangle factors that influence decision-making in the child welfare system and how these vary based on a child’s race. 相似文献
7.
A child welfare system is responsible for making difficult decisions. Child welfare workers are charged with assessing and determining when a child is in need of protection, including when it is necessary to intervene on behalf of children when their caregivers’ abilities and/or situation is deemed to put them at risk of abuse or neglect. Although the child welfare workforce in Ontario attended to an estimated 125,281 child maltreatment investigations in 2013, little is known about the skills, education, and experiences of these investigating workers. Notwithstanding assumptions about the qualifications and characteristics necessary for effective child welfare practice, few studies explicitly link the specific characteristics of workers to children, youth, and families achieving positive case outcomes. These assumptions have been shaped by a multitude of factors including knowledge of human resources, professional standards, and educational requriements. This study examined data from five cycles over twenty years of Ontario Incidence Studies (-1993, -1998, -2003, -2008, -2013) to provide a profile of child welfare workers. This is the first study to examine the changing profile of child welfare workers in any province in Canada and provides a foundation for developing effective recruitment and professional development strategies, and promoting a positive work environment. Policy and practice implications for the changing needs of these families are discussed. 相似文献
8.
IntroductionEstimating the national prevalence of child sexual abuse (CSA) and its association with health and developmental outcomes is the first step in developing prevention strategies. While such data are available from many countries, less is known about the epidemiology of CSA in Japan.MethodsFor this systematic review, we searched English databases: Embase, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), Ovid OLDMEDLINE(R), PsycINFO, and Japanese databases: Cinii, J-Stage, Children’s Rainbow Center Japan, Japan Child and Family Research Institute, Japanese Journal of Child Abuse and Neglect to identify articles published before July 2015 examining the lifetime prevalence of CSA in Japan using non-clinical samples. Data were extracted from published reports.ResultsWe initially identified 606 citations and after abstract review, retrieved 120 publications. Six studies that met the selection criteria and additional two relevant studies were reviewed. The range of contact CSA for females was 10.4%–60.7%, and the prevalence of this type of CSA for males was 4.1%. The range of penetrative CSA for females was 1.3%–8.3% and that for males was 0.5%–1.3%. A number of methodological issues were identified, including a lack of validated measures of CSA, and low response rates.ConclusionIn contrast to a lower prevalence of penetrative CSA, the prevalence of contact CSA among Japanese females may be comparable or higher in relation to international estimates. Future research on children's perceptions of and exposure to sexual abuse, crime and exploitation in Japan is discussed. 相似文献
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BackgroundLike many middle-income countries, knowledge about child sexual abuse (CSA) is limited in Indonesia. The national government has stated a commitment to protect children from the worst forms of abuse, yet the sensitivity of CSA along with the complexity of culture and law, present substantial challenges.ObjectiveThis article reviews current knowledge about CSA in Indonesia, in the context of existing laws and policies that influence CSA prevention and intervention.MethodA systematic review of this research was conducted in the following manner: a review of scholarly literature and grey literature in English (19 papers) and in Bahasa Indonesian (11 papers), and a review of CSA-related Indonesian laws (4 documents) and policies (5 documents).ResultsThis review finds that knowledge about CSA in Indonesia is still limited. The taboos on discussing sexual matters were identified as factors that impede reporting of CSA. Poverty also leads to increasing children’s risk of sexual abuse. There was less attention to CSA occurring within family contexts and focus was more upon its occurrence outside of the family. The study identified that contradictory definitions of children within the law add to children’s vulnerability to CSA; this is especially the case for girls. Current child protection strategies in prevention and intervention lack specific focus on CSA.ConclusionFurther research is needed to enable the development of evidence-based approaches to better harmonize the development of law and policy with contemporary knowledge about CSA. 相似文献
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Educational neglect is an understudied phenomenon that is difficult to define and also to address. While it is clear that attending to children’s academic needs is important to child development, few studies focus on educational neglect and therefore little is known about its associated risk factors and the outcomes following this form of maltreatment. The purpose of this research was to (a) determine the rate at which child welfare service providers investigate educational neglect in Canada and identify any trends in rates over time, (b) better understand educational neglect and its distinction from other types of neglect and truancy, and (c) understand how child welfare services respond to allegations of educational neglect. Data from five cycles of the Ontario Incidence Studies of Reported Child Abuse and Neglect were examined. A trend analysis was conducted followed by a mixed-method examination of educational neglect investigations. Results indicate that rates of investigated educational neglect in Ontario have been consistently low over time. However, these investigations are significantly more likely to be substantiated and to be transferred to ongoing child welfare services compared to investigations of other subtypes of neglect. Educational neglect investigations involving younger children are more likely to note risk factors for caregivers whereas those involving adolescents are more likely to note functioning issues for youth. The findings are discussed in relation to international trends in educational neglect and policy and practice implications are explored. 相似文献
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BackgroundPublic health surveillance is essential to inform programs that aim to eradicate child maltreatment (CM) and to provide services to children and families. However, collection of CM data imposes a burden on child welfare workers (CWWs). This study assesses the feasibility of hiring coders to abstract the required information from administrative records and case narratives.MethodsBased on a convenience sample of child welfare data from Manitoba, Canada, two coders abstracted information on 181 alleged CM cases. The coders completed a short web-based questionnaire for each case to identify which of five types of CM had been investigated, level of substantiation for each type, and risk of future CM. The CWWs responsible for each case completed the same questionnaire. Percentages of the occurrence of CM by the three sources were compared. The validity of the coders’ classifications was assessed by calculating sensitivity, specificity, and positive and negative predictive values, against the CWWs’ classifications as the “gold standard.” Cohen’s kappa was also calculated.ResultsThe coders’ classifications of physical abuse, sexual abuse and neglect generally matched those of CWWs; for exposure to intimate partner violence, agreement was weak for one coder. Coding of emotional maltreatment and risk investigations could not be evaluated.ConclusionResults were promising. Abstraction was not time-consuming. Differences between coders and CWWs can be largely explained by the administrative data system, child welfare practice, and legislation. Further investigation is required to determine if additional training could improve coders’ classifications of CM. 相似文献
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BackgroundNearly a third of adults report childhood trauma in their youth and approximately 700,000 cases of child maltreatment were reported in 2016. Both history of childhood trauma and current trauma symptoms in adults are linked to child maltreatment, although many trauma-exposed individuals are warm and nurturing parents. Identifying resiliency factors in adults with risk factors for harsh parenting may illuminate new pathways to sensitive parenting. Mindfulness is reported to improve trauma and mental health symptoms but the relationship between mindfulness, trauma, and child abuse potential is not yet understood.ObjectiveThis cross-sectional study investigated the relationship between mindfulness, childhood trauma experiences, trauma symptoms and child abuse potential.Participants and settingOur participants were 102 expectant parents recruiting from obstetric clinics and agencies Detroit, MI (58.8% African American, 27.5% Caucasian).MethodBivariate correlations were examined using validated, self-report questionnaires. Significant variables were included in a hierarchical linear regression to identify predicting factors that contribute to child abuse potential scores.ResultsSignificant correlations between child abuse potential with current trauma symptoms (r = .53, p < .01) and mindfulness (r = −.32, p < .01) were found, but no link with past childhood trauma experiences and child abuse potential were identified. The model significantly predicts child abuse potential (ΔR2 = .10, F(5, 96), = 12.48, p < .001). Trauma symptoms (B = .09, p < .001, 95% confidence interval [CI][−.40, −.07]) and mindfulness nonreactivity (B = −.24, p < .01, 95% CI[.05, .14]) predicted higher potential for child abuse scores.ConclusionFindings suggest increased mindfulness, especially nonreactivity to one’s own thoughts, may be an important factor to protect against child abuse potential. Interventions to increase parental mindfulness may reduce child abuse potential and improve child well-being, but further mechanistic research is needed to determine this. 相似文献
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Despite the substantial body of literature on racial disparities in child welfare involvement in the Unites States, there is relatively little research on such differences for Canadian children and families. This study begins to address this gap by examining decision-making among workers investigating Black and White families investigated for child protection concerns in Ontario, Canada. Using provincially representative data, the study assessed whether Black children were more likely than White children to be investigated by child welfare, if there was disparate decision-making by race throughout the investigation, and how the characteristics of Black and White children contribute to the decision to transfer to ongoing services. The results indicate that Black children were more likely to be investigated than White children, but there was little evidence to suggest that workers in Ontario child welfare agencies made the decision to substantiate, transfer to ongoing services, or place the child in out-of-home care based on race alone. Black and White children differed significantly with respect to child characteristics, characteristics of the investigation, caregiver risk factors, and socioeconomic circumstances. When adjusting for these characteristics, Black families had 33% greater odds (OR = 1.33; 95% CI: 1.26, 1.40; p = <0.001) of being transferred to ongoing services compared to White families. Among Black families, the assessed quality of the parent-child relationship and severe economic hardship were the most significant and substantial contributors to the decision to provide child welfare services. Implications for practice, policy, and research are discussed. 相似文献
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BackgroundDespite the importance of child sexual abuse (CSA) prevention, there are few recent randomized controlled trials of school-based CSA prevention programs.Objectives(1) To evaluate the effects of the Second Step Child Protection Unit (CPU) on students’ CSA prevention concept knowledge, ability to recognize, report, and refuse unsafe touches, and perceptions of teacher-student relations and (2) investigate the moderating role of age and gender on program effectiveness.Participants and settingEight elementary schools in a large suburban school district in the northeast United States were randomly assigned to the intervention or control condition, with analyses conducted on a total of 2172 students.MethodsStudents in intervention schools received the 6-week CPU and those in the control schools were exposed to business as usual. Students were administered assessments at baseline and then at post-test.ResultsUnivariate Analyses of Covariance revealed that students in the intervention schools had significantly higher scores on all outcomes than students in the control schools at post-test, even after controlling for baseline scores. Children in younger grades made greater gains from the program, and girls scored higher than boys in CSA knowledge and ability to recognize, refuse, and report unsafe touches, but both boys and girls made significant gains.ConclusionsResults support the importance of beginning early with school-based CSA prevention efforts. Although boys are still at a relative disadvantage in terms of their knowledge and ability in this area, they are able to make gains at the same rate as girls. 相似文献
15.
Trocmé N Fallon B Maclaurin B Chamberland C Chabot M Esposito T 《Child abuse & neglect》2011,35(10):831-840
Objective
Although there is growing evidence that the emotional dimensions of child maltreatment are particularly damaging, the feasibility and appropriateness of including emotional maltreatment (EM) in child welfare statutes continues to be questioned. Unlike physical and sexual abuse where investigations focus on discreet incidents of maltreatment, EM is not as easily defined and delimited. Through a review of legislation and child welfare investigation practices in Canada, this paper examines (1) whether Canadian child welfare services respond to EM with the same level of perseverance as with other forms of maltreatment and (2) the extent to which the introduction in 2008 of a more specific EM taxonomy distinguishes between EM and family problems that could lead to EM.Method
Following an analysis of the legislative framework for EM across Canada, investigations practices in Canada are examined using data from the 1998, 2003 and 2008 cycles of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS). Using data from the 2008 cycle, EM investigations are compared to other maltreatment investigations for all of Canada (N = 15,980). Changes in EM investigations over time are then compared using data from the three cycles of the study, excluding Québec because of limited data availability in 2003 (N = 5,360 in 1998, 11,562 in 2003 and 14,050 in 2008).Results
EM is included as a form of reportable maltreatment in all provincial and territorial statutes in Canada. Over 11,000 cases of EM were substantiated in Canada in 2008, at a rate of 1.86 cases per 1,000 children. While EM investigations were substantiated at a lower rate as other forms of maltreatment, a higher proportion of EM cases were referred for specialized services, kept open for on-going child welfare services, lead to an out of home placement, and lead to an application to child welfare court. Using a broad definition of EM the number of investigations classified as EM in Canada, excluding Québec, nearly tripled from 1998 to 2003. In 2008, using more specific definitions focusing on caregiver definitions, the number of investigations classified as EM nearly returned to their 1998 level, with nearly twice as many cases being classified as risk of future maltreatment.Conclusion
EM is a well established category for child welfare intervention in Canada, however, more emphasis should be given to distinguishing between EM and family problems that place children at risk of EM. 相似文献16.
BackgroundChild sexual abuse (CSA) is a complex public health problem that has lifelong implications for children’s wellbeing. Interventions may provide children strategies to protect themselves against CSA, but few have been studied in Latin America.ObjectiveEvaluate the immediate and medium-term impact of a 10-week educational program on children’s knowledge of CSA self-protection strategies in Ecuador.Participants and settingsChildren aged 7–12 years from six public elementary schools in Ecuador were cluster-randomized to either receive the intervention between October and November 2016 (Group 1, k = 4) or between March and April 2017 (Group 2, k = 2).MethodsTo assess CSA knowledge, a random sample of students completed a questionnaire at three time points: 1) initial: before any group received the intervention, 2) intermediate: immediately after Group 1 completed the program but before Group 2 started it, and 3) final: after Group 2 completed the program. We evaluated changes in scores using mixed linear regression models with school as a clustering variable and adjusted degrees of freedom (df = 4).ResultsPre-post effect estimates at program completion adjusted for age, sex and clustering by school were 6.5% (95% CI: 2.9, 10.0) and 6.8% (95% CI 3.0, 10.7) for Groups 1 and 2, respectively. Scores did not change among children who had not yet received the intervention at intermediate evaluation (0.94%, 95%CI: −6.0, 7.9). Children in Group 1 maintained the scores six months after the program ended.ConclusionsThe self-protection program increased and maintained CSA knowledge six months after the intervention finished. 相似文献
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BackgroundDespite reporting legislation, healthcare providers (HCPs) do not always report and collaborate in cases of suspected child abuse. Recognizing this leaves children at risk, the Wisconsin Child Abuse Network (WI CAN) sought to understand barriers to mandated reporting and collaboration with child abuse investigators.ObjectiveThe purpose of the study was to investigate barriers for professionals in providing and obtaining high-quality medical information in child abuse investigations.Participants and settingParticipants included five discipline-specific focus groups: HCPs, child protective services (CPS), law enforcement, lawyers, and judges. All professionals had been directly involved in Wisconsin child abuse cases.MethodsThis qualitative study consisted of discipline-specific focus groups, directed by open-ended interview questions. Data analysis was completed through the narrative inquiry methodology.ResultsBarriers to providing and obtaining high-quality medical information in child abuse investigations were both discipline-specific and universal amongst all groups. Discipline-specific barriers included: HCPs’ discomfort with uncertainty; CPS’ perception of disrespect and mistrust by HCPs; law enforcement’s concerns with HCPs’ overstepping professional boundaries; lawyers’ concern of HCPs’ discomfort with court proceedings; and judges’ perception of a lack of understanding between all disciplines. Universal barriers included: value of high-quality medical information in child abuse investigations, burden of time and money; unequal resources between counties; a need for protocols, and a need for interdisciplinary collaboration.ConclusionFindings from this study suggest several ways to address identified barriers. Possible interventions include equalizing resources between urban and rural counties (specifically financial resources and access to child abuse experts); protocolizing reporting and investigations; and, increasing interprofessional education. 相似文献
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BackgroundEnsuring the safety of American children is one of the chief mandates of the U.S. Child Welfare System. Yet system differences, including privatization remain an area of concern for whether safety of children is achieved.ObjectiveThis study examined the effect of privatization policy on the performance of state child welfare systems in terms of achieving national safety outcome standards.Participants and SettingN1 = 10 states systems (5 privatized and 5 public systems) with N2 = 118,761 foster care cases located throughout the U.S.MethodUsing data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), safety outcome performance measures were assessed, as were child-/case factors to predict the likelihood of the system types meeting the national safety outcome standards.ResultsLogistic regression models of child, case, and system factors predicting the likelihood state systems met national safety outcome performance standards were statistically significant. Private systems, compared to non-private systems, were found to have lower odds of meeting the safety outcome 1 standard (OR = 0.41, 95% CI = 0.40–0.42), but greater odds of meeting the safety outcome 2 standard (OR = 6.79, 95% CI = 6.56–7.02).ConclusionsThe implementation of privatization policy in state child welfare/foster care service delivery was found to have mixed results in terms of the national safety outcome standards. 相似文献
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This paper explores the well-documented relationship between child maltreatment and aggressive and criminal behavior, specifically examining several dimensions of maltreatment and cumulative child and family risk. Using data from the provincially representative Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), this paper utilizes a developmental lens to examine whether maltreatment dimensions and cumulative risk can differentiate maltreated young people who exhibit aggressive and criminal behaviors and those who do not.A total unweighted sample of 1837 substantiated maltreatment investigations was examined in this analysis using chi-square, t-test, and logistic regression. The findings indicate that 13% of maltreated children and youth served by the Ontario child welfare system exhibited aggression and 6% of maltreated adolescents were involved in the youth justice system. Aggressive children and youth were more likely to experience severe and co-occurring forms of maltreatment and to experience higher levels of cumulative child risk. In adolescence, youth exhibiting aggressive and/or criminal behavior commonly were investigated because of neglect, specifically because their caregivers were no longer willing or able to remain in a caregiving role. Implications for child welfare policy and practice are discussed. 相似文献