Concerns about allegations of child sexual abuse against teachers and the teaching environment.

OBJECTIVE: The major objective was to determine teachers' awareness of the potential for child abuse allegations against themselves and the effects on the teaching environment. METHOD: Of 3,000 questionnaires sent out to a random sample of New York state teachers, 515 were returned. The responding teachers were similar to New York state teachers in terms of gender, age, and racial/ethnic distribution. RESULTS: A large percent of the respondents (56%) were aware of false allegations made against a teacher in their school district. About a third (36.5%) expressed concern that a child abuse allegation could be made against them. In response to a vignette, forty-two (42%) advised a new teacher against being alone in a room with a student; 62% advised against casual touching; 70% advised against hugging or putting an arm around a student. Males more than female teachers, especially those teaching upper grades, advised against such contact. The more teachers expressed concern about abuse allegations against themselves, the more teachers advised against contact. CONCLUSIONS: Fear of abuse allegations are salient for teachers. Fears may cause teachers to limit contact with students with potentially adverse consequences for students and the teaching environment.     

Improving credibility assessment in child sexual abuse allegations: the role of the NICHD investigative interview protocol

OBJECTIVES: The study was designed to explore whether the credibility of children's statements regarding their alleged experiences of child sexual abuse could be assessed in a more valid and reliable way when investigative interviews were conducted using the NICHD protocol rather than in an unstructured manner. METHODS: Forty-two experienced Israeli youth investigators each assessed the credibility of allegations of sexual abuse made by alleged victims of sexual abuse when interviewed either with or without the protocol. Half of the alleged incidents were judged likely to have happened ("plausible") on the basis of independent evidence, while half were deemed unlikely to have happened ("implausible"). RESULTS: More non-protocol than protocol interviews were rated as "No judgment possible" rather than either credible or incredible. Allegations made in protocol interviews were more accurately rated as credible or incredible when they were either plausible or implausible, respectively, than those made in non-protocol statements. Levels of inter-rater reliability were also higher when protocol interviews were rated. The differences were significant only for plausible cases, however. CONCLUSIONS: The use of the NICHD protocol facilitated the assessment of credibility by child investigators although incredible allegations (those describing incidents that were unlikely to have happened) remained difficult to detect, even when the protocol was used.     

Maternal use of physical punishment in response to child misbehavior: implications for child abuse prevention

OBJECTIVE: The objective was to examine the roles of cognition and affect in maternal use of physical punishment. METHOD: Through a review of the literature, distal and proximal predictors (cognitive and affective) of physical punishment use were identified. One hundred and ten mothers of 3-year-old children were interviewed regarding two disciplinary situations that occurred during the previous 2-week period that elicited their strongest reactions: one which resulted in the use of physical punishment (if this occurred) and one which did not. The individual and combined contributions of the predictors of physical punishment use were analyzed through logistic regression. RESULTS: The predictors of physical punishment following individual analyses were: maternal attitude toward physical punishment, maternal perception of the seriousness and intent of the child misbehavior, and maternal anger in response to the child misbehavior. Through multivariate analysis 54% of the variance in physical punishment use was explained. CONCLUSIONS: Both cognitive and affective factors affect the decision to use physical punishment with children. These findings can be useful in establishing parenting educational programming that is directed at decreasing the rates of physical punishment and subsequently child physical abuse.     

Substantiation of reported child abuse or neglect: predictors and implications.

Underreporting and overreporting of suspected child abuse and neglect cases reduce the efficiency of child protection services. We used all the reports in South Australia for 1988-1989 (N = 3,228) to study the determinants of the decision by child protection workers to register a reported incident as being one of child abuse and neglect. Logistic regression showed that registration (substantiation) was predictable from two variables: the age of the alleged victim and the caseworker's estimate of severity. This latter variable needs investigation, as despite its crucial role we have no information on how caseworkers form a judgment about severity.     

Fatal child abuse in Georgia: the epidemiology of severe physical child abuse

Decisions about the occurrence of child abuse are increasingly difficult to make because concepts of what qualifies as reportable child abuse may be broadening. We examined this question by comparing 51 fatal child abuse cases occurring in Georgia between July 1975 and December 1979 to non-fatal cases and to the Georgia population. Overall rates of fatal child abuse were higher for male perpetrators compared with female and black perpetrators compared with white. However, the latter finding varied with economic and geographic status. The highest child abuse fatality rates were found in poor, rural, white families (3.3/100,000 children) and in poor, urban, black families (2.4/100,000 children). Risk factors for fatal abuse included early childhood (RR 6:1), parental teenage childbearing (RR 4:1), and low socioeconomic status. These characteristics were similar to those of the severe child abuse cases noted in the early child abuse literature. Non-fatal cases did not clearly share these risk factors. Severe abuse, here represented by fatal cases, is a distinct subset of reported child abuse, but characteristics associated with it are frequently attributed to all reportable child abuse. Medical personnel should be aware that they cannot rely on the presence or absence of these characteristics in screening for risk of reportable child abuse. Child abuse research should use restricted, stated case definitions. When intervention and prevention programs are being organized, they should not generalize research findings to all forms of child abuse.     

Abuse in the investigation and treatment of intrafamilial child sexual abuse

This paper examines the effects of current practice in the investigation and treatment of documented incest abusers on the offenders and families involved. Fifteen offenders attending the Utah Parents United group completed a questionnaire on the sequence of events in the investigation and prosecution of their cases and the concomitant results of the investigation on their job status, living and financial situations, family and social relationships, and media reporting of the abuse. Results indicate that there is great variability in the investigation and prosecution of incest cases and the public announcement of abuse convictions. The consequences of the abuse investigation are devastating for offender and his family in terms of job loss; need for public assistance; family disbandonment through removal of the offender, victim, or both from the family, marital separation, and foster care for nonabused siblings; changes of residence, and the public announcement of the abuse in the media. Results also show that offenders receive little, if any, social support from family or friends. Changes in the current approach to the investigation and prosecution of incest offenders are proposed and include the following: (1) banning the publication of convictions for child abuse; (2) streamlining the legal process so that it is consistent from case to case; and (3) developing diversion programs as alternatives to prison for offenders. Suggested are self-help, court-ordered therapeutic programs, such as Parents United, that are designed for the treatment of families involved in child sexual abuse and incest. The desired outcomes of such a diversion program are low offender recidivism, avoidance of the offender's family being placed on welfare, less reliance on foster care placement for the offender's children, involvement of the offender's family in moving toward reunion when feasible, and the use of existing half-way houses in lieu of incarceration when necessary.     

The development and evaluation of a training program for school-based professionals dealing with child abuse: The University of Toronto interfaculty child abuse prevention project 1978–1979

This paper reports on a child protection training program for teachers, social workers, and nurses. The training format consisted of two 5-day workshops, one for preprofessional students and the other for practicing professionals, and two one-day workshops for students. The evaluation employed a pre-test/post-test design. Data were obtained from a total of 254 workshop participants who were randomly selected from a group of 400 volunteers. The training program was designed to provide information and experience in the areas of identification, family dynamics, legislation, intervention, and team responses. Curriculum effects were the dependent variables; group characteristics were the independent variables. The general finding was that the program was an effective means of accomplishing its objectives. Some of the specific findings were that professionals wanted more content in contrast to students who were satisfied with experiences which simulated practice. Both social work professionals and students were more confident in their ability to deal with the problem of child abuse before and after the program than teachers and nurses. In contrast, teachers began and ended the program with relatively low confidence and information levels. Overall, nurses had the highest level of entry and exit knowledge at the beginning and the end of the program. While the results indicate that the three groups profited from shared training experiences they also suggest that certain areas of training may best be realized by specialized workshops.     

Three models of child abuse consultations: A qualitative study of inpatient child abuse consultation notes

Child abuse pediatricians have multiple roles in caring for abused children, including prevention, diagnosis, treatment, and, when needed, expert legal opinion. The child physical abuse consultation differs from the traditional medical consultation in that it has medical, investigative and legal audiences, all of whom have different information needs. How child abuse pediatricians approach their cases and how they document their initial inpatient consultations that will be used by such a diverse audience is currently unexplored. We used content analysis to examine 37 child physical abuse consultation notes from a national sample of child abuse pediatricians in order to understand physicians’ approaches to these consultations. Three commonly used models of child physical abuse consultation were identified in the data that we named the base model, the investigative model, and the family-dynamic model. While model types overlap, each is distinguished by key features including the approach used to gather information, the information recorded, and the language used in documentation. The base model most closely mirrors the traditional medical approach; the investigative model concentrates on triangulation of sources of information; and, the family-dynamic model concentrates on physician perceptions of family relationships. The three models of consultations for child physical abuse mirror the areas of child abuse pediatrics: diagnostic, forensic and therapeutic. These models are considered in relationship to best practice from other medical specialties with forensic components.     

Child development in developing countries: child rights and policy implications

The Multiple Indicator Cluster Survey was used to provide information on feeding practices, caregiving, discipline and violence, and the home environment for young children across 28 countries. The findings from the series of studies in this Special Section are the first of their kind because they provide information on the most proximal context for development of the youngest children in the majority world using one of the only data sets to study these contexts across countries. Using the framework of the Convention on the Rights of the Child, in particular the Rights to Survival, Development and Protection, findings are explained with implications for international and national-level social policies. Implications are also discussed, with respect to policy makers and the larger international community, who have the obligation to uphold these rights.     

Identified spouse abuse as a risk factor for child abuse

CONTEXT: There are limited data on the extent to which spouse abuse in a family is a risk factor for child abuse. OBJECTIVE: To estimate the subsequent relative risk of child abuse in families with a report of spouse abuse compared with other families. DESIGN: Cohort study. SETTING: Analysis of a centralized US Army database PARTICIPANTS: Married couples with children with at least one spouse on active duty in the US Army during 1989-95. MAIN OUTCOME MEASURES: The US Army Family Advocacy Program's Central Database was used to identify child and spouse abuse. The exposure was an episode of identified spouse abuse and the main outcome was a substantiated episode of subsequent child abuse.RESULTS: During the study period of an estimated 2,019,949 person years, 14,270 incident child abuse cases were substantiated. Families with an incident case of spouse abuse identified during the study period were twice as likely to have a substantiated report of child abuse compaired with other military families, rate ratio, 2.0, (95% confidence interval [CI] 1.9-2.1). Young parental age had the highest rate ratio, 4.9 (95% CI 4.5-5.3) in the subgroup analysis controlling for rank. Identified spouse abuse was associated with physical abuse of a child, rate ratio 2.4 (95% CI 2.2-2.5), and with sexual abuse of a child, rate ratio 1.5 (95% CI 1.3-1.7). Identified spouse abuse was not associated with child neglect or maltreatment, rate ratio, 1.0 95% CI 0.9-1.1) CONCLUSION: An identified episode of spouse abuse in a family appears to be associated with an increased risk of subsequent child abuse and serves as an independent risk factor. Therefore. care providers should consider the potential risk to children when dealing with spouse abuse.     

Introduction to the development of the ISPCAN child abuse screening tools

The World Report on Children and Violence, (Pinheiro, 2006) was produced at the request of the UN Secretary General and the UN General Assembly. This report recommended improvement in research on child abuse. ISPCAN representatives took this charge and developed 3 new instruments. We describe this background and introduce three new measures designed to assess the incidence and prevalence of child abuse and neglect.     

Stability of retrospective self-reports of child abuse and neglect before and after therapy for child abuse issues

OBJECTIVE: This study is a follow-up to a previously reported outcome study evaluating the efficacy of an emotionally focused therapy for adult survivors of childhood abuse. The present purpose was to evaluate the stability of self-reports of child maltreatment in the context of reduced psychopathology after therapy. The Childhood Trauma Questionnaire (CTQ; Bernstein et al., 1994) was used to measure the extent of child abuse and neglect. METHOD: The CTQ and measures of symptomatology, abuse resolution, and self-esteem were administered at pretreatment to 44 clients and after 6 months of therapy to 33 therapy completers. Post-treatment interviews also assessed changes in clients' perceptions of self and abusive and neglectful others. Analyses examined change on dependent measures, in interviews, and on the CTQ, as well as the test-retest and alpha reliabilities of CTQ factor scales, and the relationship of CTQ factor scales with pretreatment measures of distress. RESULTS: Analyses revealed significant reductions in psychopathology on all dependent measures and reduced self-blame, negatively biased memories, avoidance, and minimization of the abuse after therapy. Reports of abuse and physical neglect on the CTQ remained stable from pre- to post-therapy. All CTQ dimensions demonstrated good internal consistency and convergent validity with trauma-specific measures of distress. CONCLUSIONS: The stability of the CTQ in the context of significantly reduced psychopathology contributes to evidence supporting the accuracy of retrospective self-reports of childhood abuse.     

Reporting child abuse: pediatricians' experiences with the child protection system

OBJECTIVE: To explore pediatricians' reluctance to adhere to a legal mandate to report suspected child abuse and to compare their perspectives with those described in other jurisdictions in studies informed by different theories and employing diverse methodologies. METHOD: An anonymous survey questionnaire was distributed to all pediatricians with admitting privileges to B.C. Children's Hospital which has a specialized Child Protection Services Unit. Physicians were asked about their own prior reporting experience and the influence of that experience upon future reporting decisions. They were also asked why they think other physicians might be reluctant to report (N = 26). RESULTS: While respondents were generally positive about their experience in filing a report to Child Protective Services, they were less positive about the dearth of feedback they received and they were undecided as to whether there was a positive outcome to their report. Their perceptions of the reasons colleagues might fail to report emphasized dissatisfaction with CPS, concern with loss of relationship with the child's parents, and a desire to avoid court proceedings. CONCLUSIONS: Physicians' noncompliance or at least dissatisfaction with their child abuse reporting mandate is an international problem that can not be addressed by institutional protocols alone. Confusions about the limitations on confidentiality and information sharing might be better addressed through more shared training and opportunities for collaboration than by legal mandates and institutional protocols alone. Organizational theory and exchange theory might inform future research about the conditions under which collaboration is enhanced in the service of protecting children.