The expert witness in child abuse and neglect: An interdisciplinary process

The legal system is an important part of a society's response to child abuse and child neglect. Courts need to be guided in their deliberations by experts from many different professions. Consultation and in-court expert testimony is necessary from medicine, psychology, psychiatry, social work and other professions both to prove child abuse and neglect and establish the power of the court to act on behalf of a child but also to guide the court in the intervention strategy most suited to the needs of the child and his family. Non-lawyers often feel uncomfortable in the legal setting. The adversary process is foreign to their training and professional experience. Collaboration with a lawyer greatly improves their effectiveness in court. Lawyers, on the other hand, need to make maximum use of medical and social-psychological experts in the court process in the interests of their clients; but to do so lawyers need a basic understanding of the other professions. With an emphasis on a process of mutual education, the paper presents a framework for collaboration between lawyers and expert witnesses in child abuse and neglect cases. “Expert witness” is defined; informal consultation is encouraged; suggestions for selecting a collaborator are made; initial contracts between lawyer and expert, case conferencing and preparation for trial are discussed; specific advice on direct and cross examination is provided.     

Race,ethnicity, and child maltreatment: An empirical analysis

Using central registry data for Texas for 1975–1977 of validated cases of abuse and of neglect, a study was conducted to investigate empirically the relationship of child maltreatment to ethnicity, addressing methodological issues that merit consideration in such studies.The ethnic composition of the at-risk population was 61% Anglos, 15% Blacks, and 24% Mexican-Americans. The annual rates for all abuse and neglect were 2.87, 3.17, and 3.94 per 1,000 under 18 population for Anglos, Mexican-Americans, and Blacks, respectively. Abuse was more predominant among Anglos, accounting for 33.5% of the validated cases of maltreatment, than among Mexican-Americans and Blacks, accounting for 25.2% and 29.4% of the maltreatment, respectively. Neglect was the major dynamic of maltreatment for Mexican-Americans and Blacks, accounting for 65.6% and 61.2% of the maltreatment, respectively, with Anglos having 55.4% of the maltreatment due to neglect. These relationships were not altered when rural-urban differences were taken into consideration.     

Sexual abuse in the national incidence study of child abuse and neglect: An appraisal

The National Incidence Study of Child Abuse and Neglect was a major, government sponsored effort to collect data on reported and unreported child abuse. It used a systematic representative sample methodology and very precisely developed definitions of child abuse. This paper reviews some of the main limitations of the study in regard to findings on sexual abuse. First, there is probably less “new” data in the study on sexual abuse than on other forms of abuse, since so many of the study cases of sexual abuse were “officially reported” cases. In addition, the study limited its definition of sexual abuse only to cases where a caretaker was the perpetrator, a definition that is much more restrictive than what is used in many treatment programs. Finally, the data on perpetrators has a number of problems that stem from the study's definitions of sexual abuse. The paper makes suggestions for future incidence type studies of sexual abuse.     

Patterns of reported child abuse and neglect

Confirmed reports of abuse and neglect logged in a large state registry file from 1977 to 1984 are analyzed. Boys tend to sustain more frequent and more serious injuries. Victims of male perpetrators tend to sustain more serious injuries. A modest same-sex perpetrator/victim pattern is revealed for physical abuse; males are more likely to physically abuse boys while females are more likely to physically abuse girls. Among younger victims (aged 12 and younger) boys outnumber girls in all reporting categories except sexual abuse. Among adolescent victims, female victims greatly outnumber male victims in all reporting categories. Similarities between adolescent physical abuse and spouse abuse are noted; males are are the predominant perpetrators and females the predominant victims. As expected, victim age emerged as a strong predictor of severity of physical abuse injury. Several other factors including social isolation, mental health problems, lower income, and unemployment of the father are identified as modest predictors of severity.     

Prediction and prevention of child abuse and neglect

Utilizing an interview, a questionnaire, and observations during labor, delivery, and the postpartum period, a sample of one hundred mothers was identified as at high risk for abnormal parenting practices. These mothers were randomly divided into a “High-Risk Intervene” group (N=50) and a “High-Risk Nonintervene” group (N=50). The “Intervene” group received comprehensive pediatric follow-up by a single physician, a lay health visitor, and/or a public health nurse in the home. The “Non-intervene” group received routine care, although the results of these screening procedures were shared with the physicians and nurses responsible for their ongoing care. Another group of 50 mothers, who delivered during the same time period and who were assessed as low risk in terms of abnormal parenting practices, served as controls. When the children were approximately two years old (mean age 26.8 months), 25 families in each of the three groups were chosen at random for detailed evaluation.     

An alternative to foster care for victims of child abuse/neglect: a university-based program

Two central forces dominated the conception and development of the Parents and Children Together (PACT) project: the need for provision of an in-home alternative to foster care for abuse and/or neglect families and the prevention of further abuse and/or neglect in the family. Wayne State University in Detroit is the site for Parents and Children Together (PACT) project, a contractual service of the Michigan Department of Social Services (DSS). Graduate students provide in-home services to referred families who, due to child abuse or neglect, would otherwise have their child(ren) removed from the home. This family-based work is a one-year cooperative education experience for students interested in professions in the human services. This report discusses the PACT project as a grant operated through the university, the specification of course work associated, and the attraction of students to graduate study with "hands-on" experience. All of these program attributes, as well as the resource of the project for research, make it an important effort for the university. Further, the university has an additional meaningful role with community residents. Beyond university and student opportunities, the DSS and its clients benefit by having broad-based expertise brought into homes on a weekly basis. Annual success rates of keeping children out of foster care are cited along with cost effectiveness. The university's role in levels of prevention in a highly coordinated community effort is indicated.     

An ecological analysis of infant neglect by adolescent mothers

To inform efforts to prevent child neglect, we investigated a wide range of risk factors that have been largely unexamined in relation to infant neglect, the most commonly occurring form of child maltreatment. Using an ecological model of child neglect, we assessed the influence of characteristics at the level of the child, the mother, the family, and broader childrearing contexts on adolescent mothers’ likelihood of being a perpetrator in a substantiated case of neglect against their firstborn infants (n = 383, M = 12 months). Several factors were associated with infant neglect by young mothers: median block income, low infant birth weight, maternal smoking, maternal childhood history of neglect and of positive care, intimate partner violence (IPV) perpetrated by either the mother or her partner, and maternal use of mental health services. In multivariate models, income, a maternal childhood history of positive care, IPV by either a mother or her partner, and mental health service usage made significant contributions to the odds that a mother neglected her infant. Our findings suggest that these factors have particular salience to policymakers’ and practitioners’ efforts to identify high risk families and to intervene during the earliest months of life to prevent child neglect.     

Parents in prison: A child abuse and neglect prevention strategy

Parents in Prison is an innovative family support service housed at the Tennessee State Prison for Men. Developed in response to inmates' recognition of the need for child abuse and neglect prevention services relevant to men who are in prison, the program model has potential for becoming a major service delivery strategy. Leadership for Parents in Prison is provided by an inmate committee which receives consultation and assistance from a community advisory board and an institutional sponsor. Program components--correspondence and classroom courses, monthly events featuring community guest speakers, and family-focused social activities and projects--address family needs during incarceration and upon return to community living. These diverse components and the flexible service delivery format permit widespread inmate participation not readily available in a prison setting. Parents in Prison successes demonstrate that the period of incarceration can be used to improve parental skills and knowledge and to strengthen family relationships. They also demonstrate the viability of a family support service which relies on inmate leadership, community volunteer participation, and institutional support. The future success of this model depends on replication in other prison settings, dissemination of the program products which have been and continue to be developed, and rigorous, systematic examination of the impact that participation has on child abuse and neglect problems associated with a father's incarceration.     

Primary prevention of child abuse and neglect: Identification of high-risk adolescents

Based on the result of the study, the following conclusions are made:

1. 1. The parenting inventory developed has adequate levels of content validity, construct validity, internal reliability, and stability over time.

2. 2. Approximately 13% (150) of the adolescents responding to the inventory had factor scores -1 or more standard deviations below the group mean. It is concluded that the further the score deviates below the mean, the greater the risk the adolescent becomes for practicing abusive parenting behaviors.

3. 3. Abused adolescents have significantly lower mean scores than non-identified abused adolescents, suggesting that abused adolescents espress attitudes towards parenting and child-rearing which are similar to the parenting and child-rearing practices of abusive parents.

4. 4. Female adolescents, whether members of the abused or non-identified abused group, have higher mean scores than abused or non-identified abused male adolescents. The results suggest that male adolescents of both groups express more abusive parenting attitudes than females of both groups.

5. 5. Each of the four group parenting constructs can effectively be used to discriminate between abused and non-identified abused adolescents. Construct B:

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, however, had the greatest discriminatory capability.

The results of the study have indicated the utility of the inventory in assessing the parenting attitudes of adolescents and in discriminating between adolescents identified as abused and those non-identified as abused. In its present stage of development, the inventory may only be validly used to identify adolescents' attitudes towards child-rearing and parenting. Before the inventory is employed to identify potential child abusers for treatment purposes, it is recommended that longitudinal research be concluded. Such research should be designed to provide data relative to the predictive validity of the inventory.     

Essential elements of successful child abuse and neglect treatment

Not all child abuse is preventable. Society faces an ongoing need to support programs that treat the members of families in which abuse occurs. There is little systeamatically generated knowledge on the most efficient and effective ways to assist parents and children faced with abuse. The purpose of our 40-month study of eleven child abuse and neglect demonstration service programs in the United States was to expand the knowledge base in this area by determining, through evaluative research, the essential elements of successful treatment programs. This paper highlights our findings that pertain to more effective delivery of services to abusive and neglectful parents.     

Three views of child neglect: expanding visions of preventive intervention

The failure to address child neglect prevention efforts from a system viewpoint is presented as a major impediment to the generation of truly preventive interventions. Child neglect prevention is discussed at three levels: at the level of the individual, at the level of social systems and at the level of fundamental beliefs and cultural agreements. A process of component selection and placement is suggested with component selection based on components drawn from recent research and clinical work. Interventions would be geared to meet the particular needs of individual settings and at the same time be constructed so that each component would mesh with and build on previous components. An outline of a preventive child neglect intervention strategy is presented. Practices of government, the impact of business and technology and economic theory and practice are shown as plausible areas for preventive intervention. Core beliefs upon which social systems are built are challenged. It is stated that too narrow a view of child neglect often limits problem definition and encourages placement of blame at the family level. This decreases the effectiveness of the clinician who is coping with an individual problem as well as the researcher who is exploring the basic issues.     

Post-traumatic stress disorder: a reaction to state-supported child abuse and neglect

The policy of apartheid not only fosters conditions conducive to child abuse and neglect, but is in itself abusive. Apartheid policies have led to civil unrest and high levels of violence in South Africa's black townships. Many youth are thus exposed to multiple trauma including witnessing death, being arrested, being beaten, being in exile, and being separated from family and friends. This had led many to develop Post Traumatic Stress Syndrome (PTSD) although this term is a misnomer in the South African context as traumatic stress is not historic but is current. Treatment programs have thus to be modified to accommodate the impossibility of guaranteeing even the physical safety of patients. They have also to be modified to accommodate the fact that most black youth are totally unfamiliar with the notion of the "talking cure." This paper describes a modified treatment program for PTSD which was developed in working with a group of 60 township refugees. Systematic follow up studies of its effectiveness were impossible as many of those treated have gone into hiding to escape the continuing violence in their communities, a violence facilitated by the ultimate guardian of the child, the State. However there are indications that the program was successful in providing immediate relief.