What factors increase Dutch child health care professionals’ adherence to a national guideline on preventing child abuse and neglect?

Guidelines to support health care professionals in early detection of, and responses to, suspected Child Abuse and Neglect (CAN) have become increasingly widely available. Yet little is known about professionals’ adherence to these guidelines or the determinants that affect their uptake. This study used a cross-sectional design to assess the adherence of Dutch Child Health Care (CHC) professionals to seven key activities described in a national guideline on preventing CAN. This study also examined the presence and strengths of determinants of guideline adherence. Online questionnaires were filled in between May and July 2013 by 164 CHC professionals. Adherence was defined as the extent to which professionals performed each of seven key activities when they suspected CAN. Thirty-three determinants were measured in relation to the guideline, the health professional, the organisational context and the socio-political context. Bivariate and multivariate regression analyses tested associations between determinants and guideline adherence. Most of the responding CHC professionals were aware of the guideline and its content (83.7%). Self-reported rates of full adherence varied between 19.5% and 42.7%. Stronger habit to use the guideline was the only determinant associated with higher adherence rates in the multivariate analysis. Understanding guideline adherence and associated determinants is essential for developing implementation strategies that can stimulate adherence. Although CHC professionals in this sample were aware of the guideline, they did not always adhere to its key recommended activities. To increase adherence, tailored interventions should primarily focus on enhancing habit strength.     

Professionals’ preferences and experiences with inter-organizational consultation to assess suspicions of child abuse and neglect

This study addresses the following questions in cases of suspected child abuse and neglect (CAN) in children up to four years of age: 1) How many professionals intend to seek inter-organizational consultation? 2) What types of organizations do professionals prefer to consult? and 3) What factors can be identified as facilitator(s) or barrier(s) regarding inter-organizational consultation, based on professionals’ experiences? Professionals working with children in 101 organizations in a medium-sized Dutch city were invited to fill in an online questionnaire. The questionnaire included a vignette about a suspected case. Quantitative, qualitative, and social network analysis approaches were used to analyze the data. Seventy-eight questionnaires were available for analysis. Fifty-five respondents (71%) intended to seek inter-organizational consultation. Ten different organization types were mentioned. The most frequently mentioned organization was preventive child healthcare. In total, 82 text fragments from 39 participants were available to analyze barriers and facilitators to inter-organizational consultation, 60 fragments that entailed a facilitator and 22 fragments that entailed a barrier. The text fragments were subdivided into twelve factors. The three factors that were most often identified as a facilitator were ‘support’, ‘undertaking action’, and ‘regard’. Barriers were found in relation to all twelve factors. No specific barrier(s) stood out. This study demonstrated that most professionals are inclined to seek inter-organizational consultation when they suspect CAN. They are especially likely to seek consultation from preventive child health care organizations. Their experiences mainly revealed facilitators and few barriers. The implications for research and practice are also discussed.     

Therapeutic interventions with child survivors of sibling sexual abuse: The professionals’ perspective

BackgroundSibling sexual abuse (SSA) is a continuum of childhood sexual behaviors that do not fit age-appropriate curiosity. SSA may be the most prevalent, longest lasting form of intrafamilial sexual abuse – and the least reported, studied and treated.ObjectiveThis exploratory qualitative study examined the experience of intervention with SSA survivors from the perspective of mental health professionals, and explored their major therapeutic challenges.Participants and settingThe sample consisted of 20 Jewish Israeli mental health professionals working in private clinics or public social welfare services who had experience with SSA.MethodsSemi-structured interviews focusing on the characteristics of SSA events, perceptions about the effects of abuse, intervention priorities and therapeutic challenges compared to other types of child abuse.ResultsProfessionals working with SSA survivors are preoccupied with the need to provide them with physical and emotional protection, as well as to help them process the abuse narrative. They also find themselves dealing with survivors who do not experience themselves as victims despite external evidence of abuse, or with the need to reconcile their perception of the sexual relationship as mutual, as opposed to the formal requirement to differentiate between “offender” and “victim”. In either case, the reality of these survivors can be just as painful as in other SSA cases.ConclusionsThe complexity of SSA calls for unique intervention skills, including working with survivor narratives that do not fit the victim/offender dichotomy on one hand and that do not minimize the potentially harsh consequences of SSA on the other.     

Social history: A qualitative analysis of child abuse pediatricians’ consultation notes

BackgroundChild abuse pediatricians (CAPs) are often consulted for injuries when child physical abuse is suspected or when the etiology of a serious injury is unclear. CAPs carefully evaluate the reported mechanism of the child’s injury and the medical findings in the context of the child’s family and social setting to identify possible risk and protective factors for child abuse and the need for social services. It is unknown what population risk indicators along with other social cues CAPs record in the social history of the consultation notes when assessing families who are being evaluated for child physical abuse.Participants and settingThirty-two CAPs representing 28 US child abuse programs.MethodsParticipants submitted 730 completed cases of inpatient medical consultation notes for three injury types: traumatic brain injury, long bone fracture, and skull fracture in hospitalized children 4 years of age and younger. We defined a priori 12 social cues using known population risk indicators (e.g., single mother) and identified de novo 13 negative (e.g., legal engagement) and ten positive social cues (e.g., competent parenting). Using content analysis, we systematically coded the social history for the social cues.ResultsWe coded 3,543 cues resulting in a median of 7 coded cues per case. One quarter of the cues were population indicators while half of the cues were negative and one quarter positive.ConclusionsCAPs choose a wide variety of information, not always related to known population risk indicators, to include in their social histories.     

Race,social class,and child abuse: Content and strength of medical professionals’ stereotypes

Black and poor children are overrepresented at every stage of the child welfare system, from suspicion of abuse to substantiation. Focusing on stereotypes as a source of bias that leads to these disparities, the current study examines the content and strength of stereotypes relating race and social class to child abuse as viewed by medical professionals. Doctors, nurses, and other medical professionals (Study 1: N = 53; Study 2: N = 40) were recruited in local hospitals and online through snowball sampling. Study 1 identified stereotype content by asking participants to list words associated with the stereotype that either (a) Black or (b) poor children are more likely to be abused by their parents, and responses were organized into construct groups. Study 2 determined stereotype strength by asking participants to rate how strongly the constructs generated in Study 1 related to either the race-abuse or social class-abuse stereotype. The content of stereotypes linking child abuse to Black or poor children are confounded, with approximately half the constructs shared by both stereotypes. Of the 10 shared constructs, only “Stressed” and “Neglect” differed in strength, with both significantly more strongly related to the social class-abuse than race-abuse stereotype, all ts(36–37) ≤ −2.23, ps ≤ .03, Cohen’s ds ≥ .71. This research documents the existence, content, and strength of stereotypes that link race and social class to child abuse. These stereotypes have the potential to lead to medical misdiagnosis of abuse for Black and poor children.     

Association between mothers’ problematic Internet use and maternal recognition of child abuse

BackgroundThere are few studies about mothers’ problematic Internet use (PIU). Mothers’ PIU may lead to inadequate parenting and child abuse.ObjectiveThis cross-sectional study aimed to clarify the association between mothers’ PIU and their recognition of child abuse.Participants and settingWe analyzed data collected of health examinations of children aged 4 months, 1.5 years, and 3 years which were carried out in Matsue City, Shimane Prefecture, Japan between April 2016 and March 2017. The number of the subjects were 1685, 1729, 1674, respectively.MethodsWe used logistic regression analysis to clarify the association between mothers’ PIU (Young’s Diagnostic Questionnaire for Internet Addiction score: ≥5) and their recognition of child abuse (selecting < True of me > for < I sometimes think that I am abusing my child > on a questionnaire survey), which was adjusted for covariates such as maternal age, number of children, daytime caretaker, social support, postpartum depression, and current smoking status of the parents.ResultsBased on the multivariate logistic regression analysis, the mothers’ PIU was significantly correlated with their recognition of child abuse for children aged 4 months, 1.5 years, or 3 years [odds ratio (OR): 13.30, 95% confidence interval (CI): 1.26–139.98, OR: 7.02, 95% CI: 1.28–38.55, and OR: 28.06, 2.48–317.93, respectively].ConclusionThis study revealed the possibility that mothers with PIU recognize child abuse more than mothers without PIU. However, further studies should be conducted to increase reliability and validity.     

Australian undergraduate primary school student‐teachers’ responses to child sexual abuse and its mandatory reporting

This study aims to understand how primary school teachers, as mandatory reporters of child sexual abuse, are responding to child sexual abuse and its mandatory reporting, even though many teachers do not receive a compulsory course in Child Protection and its legal requirements in their pre‐service university training. A cohort of 81 Australian final fourth‐year Bachelor of Education (Primary) student‐teachers was asked about four aspects of it. Qualitative data gathered from these student‐teachers’ questionnaires provide important insights into their knowledge of child sexual abuse; their knowledge of Department of Education policy on it; their professional competence in mandatory reporting of it; and their recommended educational and professional training in it. The results show that all of these student‐teachers feel inadequately prepared to address child sexual abuse and mandatory reporting in schools, being unaware of both knowledge of it and the Department’s policy, even though many recognise the gravity of sexual abuse for the child survivor and the need, and seriousness, of child protection. Finally, these student‐teachers all want better training about these issues during their four‐year degree. In conclusion, these results, and some recommendations, may provide a guide for curriculum planners to design compulsory and appropriate pre‐service university courses to enhance student‐teachers’ knowledge, skills and competencies about child sexual abuse and its mandatory reporting.     

Parents’ perception of child behavior,parenting stress,and child abuse potential: Individual and partner influences

Based on the Social Information Processing model of parenting risk for child abuse, the present study examined the associations between mothers’ and fathers’ perception of child behavior and child abuse potential, as well as whether parenting stress mediates the association between these constructs. Two hundred and fifty-nine mother-father couples raising preschool children answered the Child Behavior Checklist (CBCL), the Parenting Stress Index (PSI), and the Child Abuse Potential Inventory (CAPI). The results of dyadic path analysis showed that perception of child behavior was related to heightened parenting stress and abuse potential in both mothers and fathers. Concerning partner effects, we found that mothers’ perception of child behavior problems was positively associated with fathers’ parenting stress and that the higher the mothers’ distress, the higher the fathers’ risk of physical abuse. Finally, parenting distress partially mediated the association between parents’ perception of child behavior and child abuse potential, with mothers’ perception of their children as problematic showing a significant indirect effect through distress on their own abuse risk and on fathers’ CAP as well. These findings suggest that parental distress may represent a critical mechanism by which parents’ negative views of their children contribute to abuse potential. Moreover, mothers seem to influence fathers’ tendency towards abusive behaviors.     

Emergency management students’ perceptions of the use of WebEOC® to support authentic learning

This study investigates the use of software technology that is used by emergency management professionals to create an authentic learning environment in emergency and disaster management courses in the classroom. Participants were 235 upper-level students enrolled in residential and online emergency and disaster management courses at a mid-sized public university in the southeastern USA. Students participated in simulated disaster exercises that were presented through the software; further, as part of the exercise, students used the software to respond to the simulated disaster. Students then completed a survey to assess their perceptions of whether the exercises and software created an authentic learning environment and enhanced learning.     

Fostering the use of pedagogical practices among teachers to support elementary students’ motivation to write

Based on self-determination theory, this research aimed at evaluating the effectiveness of the CASIS professional development (PD) program for fostering (1) teachers’ use of five recommended pedagogical practices during a writing lesson and (2) students’ motivational resources (intrinsic, identified, and controlled regulations) toward writing. Two quasi-experimental studies with two-time points were conducted among preservice (Study 1, n = 32) and inservice (Study 2, n = 111) elementary teachers and their students (Study 1, n = 559; Study 2, sample 1, n = 1779; sample 2, n = 1471). In both studies, the CASIS PD program appeared to foster the use of two of the five recommended pedagogical practices. For the other three, some effects were observed in one study but were not always reproduced in the other. Although the CASIS PD program fostered greater use of the pedagogical practices, this effect did not always translate directly to the students’ motivational resources. However, some significant differences were observed between students of the CASIS and the control groups on identified and controlled regulations, as a function of the socioeconomic background of the schools in which teachers and students were sampled. The results are discussed in light of past research and relevant theories.     

Teachers’ responses to student misbehavior: the role of expertise

In a quasi-experimental study, we investigated whether preservice and inservice teachers differed in their responses to minor student misbehavior. The participants’ task was to estimate how likely they would be to apply various predefined intervention strategies, while we simultaneously assessed response latencies. Results indicated that preservice teachers were more likely to choose harsh interventions such as school suspension, whereas inservice teachers were more likely to use mild strategies such as ignoring and nonverbal responses. The response latencies showed that the application of mild strategies seemed to belong to the behavioral routines of inservice teachers and were less likely to belong to those of preservice teachers. However, neither the ratings nor the response latencies of the two groups of teachers differed when it came to the application of moderately harsh strategies. The results are discussed with respect to teacher development and teacher education.     

Acing the test: an examination of teachers’ perceptions of and responses to the threat of state takeover

Educational Assessment, Evaluation and Accountability - With the passage of the Every Student Succeeds Act, states have increased latitude over school improvement and accountability policies. At...     

Primary care pediatricians’ experience,comfort and competence in the evaluation and management of child maltreatment: Do we need child abuse experts?

ObjectiveWe assessed the self-reported experience, comfort and competence of primary care pediatricians in evaluating and managing child maltreatment (CM), in rendering opinions regarding the likelihood of CM, and in providing court testimony. We examined pediatricians’ need for expert consultation when evaluating possible maltreatment.MethodsA questionnaire was mailed to 520 randomly selected AAP members. Pediatricians were asked how frequently they evaluated and reported children for suspected maltreatment, and whether child abuse pediatricians were available to and used by them. Pediatricians were asked to rate their knowledge, comfort and competence in the management of CM. Demographic information was also gathered. Pediatricians’ experience with CM, their comfort, self-reported competence, and need for expert assistance is described. Logistic regression was used to assess factors that predicted pediatricians’ sense of competence while controlling for covariates found to be significant in bivariate analyses.ResultsOne hundred forty-seven questionnaires were eligible for analysis. The majority of respondents had little experience evaluating and reporting suspected CM, and was interested in having expert consultation. While pediatricians often felt competent in conducting medical exams for suspected maltreatment, they felt less competent in rendering a definitive opinion, and did not generally feel competent to testify in court. Sense of competence was particularly low for sexual abuse. Increased practice experience and more courses in CM led to increased sense of competence in some areas.ConclusionsPediatricians acknowledged many limitations to providing care to maltreated children, and expressed interest in subspecialist input.Practice implicationsThese findings add additional support to the American Board of Pediatrics’ decision to create a Child Abuse Pediatrics subspecialty. The findings also indicate a need to ensure funding for fellowship training programs in this field.     

Checking,highlighting, adding and ticking off: Year 6 students’ understandings of and responses to the use of goals in the New Zealand writing classroom

Understanding the goals for learning is fundamental to students’ success as writers. We investigated how Year 6 students in New Zealand experienced, understood and responded to goals during a writing unit. The study took place over seven weeks. Data were gathered through interviews with two teachers and six student participants; field notes from lesson observations; informal chats with students; and the collection of teacher documents, resources and student artefacts. Student selected goals, success criteria and rubric statements served as points of reference for a number of writing experiences. Findings indicated that the discourses underpinning students’ goals and the way they were framed resulted in the checking, highlighting, adding and ticking off of elements of persuasive writing. It was concluded if writing is to be understood and practised as an art rather than a technical activity, goals for learning need to address the more substantive aspects of the genre and the writing process.     

High school teachers use of writing to support students’ learning: a national survey

A random sample of language arts, social studies, science, and math high school teachers from across the United States were surveyed about their use of writing to support student learning. Four out of every five teachers reported they used writing to support student learning, applying on average 24 different writing activities across the school year, with nine activities applied by at least one-half of the teachers once a month or more often. Teachers’ responses, however, raised several concerns. One, a majority of teachers indicted they did not receive adequate preservice or inservice preparation on how to use writing to support learning (this issue was especially acute for science and math teachers). Two, many of the nine most commonly applied writing to learn activities involved little or no analysis, interpretation, or personalization of information to be learned. Three, use of writing activities involving the use of digital tools, report writing, and written arguments were infrequent. Such activities are stressed by the Common Core State Standards. Four, when respondents taught students how to apply writing to learn activities, they only used effective teaching practices slightly more than one half of the time (math teachers did this even less often). We further found that use of writing to support learning was related to teachers’ preparation to apply such strategies, perceptions of capabilities to teach and use these tools, and percent of below average students in the class.     

Language teachers’ responses to educational research: addressing the ‘crisis’ of representation

ABSTRACT

While teachers are being called upon to turn to educational research and find evidence of ‘what works’, critics argue that research often suffers from a crisis of representation. They contend that research reports fail to sufficiently capture the lived experiences of research participants. In this article, I present insights gleaned from 12 in-service teachers who read and responded to a research-based article published in a peer-reviewed journal. Data were collected from the participants’ threaded discussions on a wiki discussion board and individual in-depth interviews. The analysis of data suggests that the participants viewed the research article as both a means of representation and a potential obstacle to it. Contrary to the crisis rhetoric, the majority of participants were not too concerned about the issue of representation. They interpreted the theoretical knowledge presented in the article in light of their past experiences and socio-material contexts of work. I use the concept of recognition to illustrate their interpretive readings of the research article. I conclude the article with a discussion of how a recognitive approach to representation may help us re-conceptualize the dissemination and utilization of educational research in the current climate of evidence-based practice.     

Review of serious events in cases of (suspected) child abuse and/or neglect: A RoSE by any other name?

Child abuse and neglect (CAN) cases presenting to health-services may be complex; when things go seriously wrong such as a child death or near miss, cases are reviewed and health-services and professionals subject to intense scrutiny. While there are a variety of mechanisms to review critical incidents in health-services no formal process for the review of cases where child protection is the primary concern exists in Australia. We aimed to develop a systematic process to review serious events in cases of suspected CAN across two health districts in Sydney, so that shared learnings could fuel system change. Drawing upon mapping, case review, literature findings and using quality improvement methodology, we developed a model named Review of Serious Events (RoSE), in suspected cases of CAN. The RoSE model has the key features of: being child focused; seeking to examine care over a period of time; using child protection staff as lead reviewers; involving health professionals/services in the review who have been involved with the child; and actioning systems change at local levels. The RoSE model was trialled through 2014–2015. Eight cases were reviewed using RoSE; cases were similar to those reviewed prior to having a model. Participant feedback from RoSE group processes was overwhelmingly positive; outputs were transparent and accessible to key stakeholders, there was mixed progress with implementation. The RoSE model is a serious case review process that is strongly child-focused, is both investigative and reflective, led by child protection experts; and can be adapted to other settings and systems.     

Decisions and attitudes concerning child sexual abuse: does the gender of the perpetrator make a difference to child protection professionals?

Objective: An investigation was conducted into whether child protection investigators, specifically social workers and the police, are as likely to take seriously a case of child sexual abuse if it had been perpetrated by a female rather than a male. Also, to examine whether the decisions relating to female-perpetrated abuse were predicted by participants’ sex role perceptions of women and their attitudes concerning women’s sexualized behavior towards children.Method: Participants advocated decisions in response to four hypothetical case of child sexual abuse in which the perpetrator was either male or female. The female perpetrators were then rated on femininity and masculinity characteristics and attitudes concerning women’s sexualized behavior toward children were assessed.Results: Following male—rather than female—perpetrated sexual abuse, case registration and imprisonment of the perpetrator was considered more appropriate by all participant groups; male social workers also considered social services involvement and investigation as more appropriate. A substantial number of decisions concerning female perpetrated abuse were predicted by participants’ attitudes.Conclusion: While child protection professionals considered child sexual abuse perpetrated by females to be a serious issue warranting intervention, a number of advocated decisions suggested that they did not consider female-perpetrated abuse to be as serious as male-perpetrated abuse. The implication is that victims of sexual abuse perpetrated by a woman may be less likely to receive the protection afforded victims of male-perpetrated abuse. Furthermore, professionals’ practices may be inadvertently perpetuating the view that female child sexual abuse is rare or less harmful than abuse carried out by males.Spanish abstract was not available at time of publication.