Updating and expanding systematic reviews and meta-analyses on the effects of school-wide positive behavior interventions and supports

School-wide positive behavior interventions and supports (SWPBIS) is a multitiered support framework for preventing problem behaviors and increasing prosocial behaviors. There has been an increasing number of experimental group design research studies focused on the impacts of SWPBIS. Therefore, we conducted a systematic review to update and extend prior reviews by including both published and unpublished studies and conducting a robust variance estimation meta-analysis to examine the magnitude of the effect of SWPBIS on all available school-level outcomes. A total of 29 studies were identified across the United States and Europe, including seven randomized controlled trials and 22 quasi-experimental group design studies. Overall, statistically significant reductions in school discipline and increased academic achievement were found. Effect sizes were small to medium. Limitations and implications are discussed.     

A scoping review of evidence-based interventions available to parents of maltreated children ages 0-5 involved with child welfare services

Parents referred to child welfare services for child maltreatment often struggle against chronic risk factors including violence, substance abuse, mental health concerns, and poverty, which impinge upon their ability to be sensitive caregivers. The first line of intervention within the child welfare context is to modify parenting behavior. This scoping review comprehensively surveyed all available literature to map the extent and range of research activity around the types of interventions available within a child welfare context to parents of infants and toddlers (0–5 years of age), to identify the facilitators and/or barriers to the uptake of interventions, and to check that interventions match the risk factors faced by parents. This scoping review engaged in stringent screening of studies based upon inclusion/exclusion criteria. Sixty-five articles involving forty-two interventions met inclusion criteria. Interventions generally aimed to improve parenting practices, the relationship between parent and child, and/or attachment security, along with reducing child abuse and/or neglect. A notable finding of this scoping review is that at present, interventions for parents of children ages 0–5 involved with the child welfare system are most frequently measured via case study and quasi-experimental designs, with randomized control trials making up 26.2% of included study designs.     

A systematic review and meta‐analysis of the effectiveness of information and communication technology (ICT) on the teaching of spelling

Recent Government policy in England and Wales on Information and Communication Technology (ICT) in schools is heavily influenced by a series of non‐randomised controlled studies. The evidence from these evaluations is equivocal with respect to the effect of ICT on literacy. In order to ascertain whether there is any effect of ICT on one small area of literacy, spelling, a systematic review of all randomised controlled trials (RCTs) was undertaken. Relevant electronic databases (including BEI, ERIC, Web of Science, PsycINFO, The Cochrane Library) were searched. Seven relevant RCTs were identified and included in the review. When six of the seven studies were pooled in a meta‐analysis there was an effect, not statistically significant, in favour of computer interventions (Effect size = 0.37, 95% confidence interval =–0.02 to 0.77, p = 0.06). Sensitivity and sub‐group analyses of the results did not materially alter findings. This review suggests that the teaching of spelling by using computer software may be as effective as conventional teaching of spelling, although the possibility of computer‐taught spelling being inferior or superior cannot be confidently excluded due to the relatively small sample sizes of the identified studies. Ideally, large pragmatic randomised controlled trials need to be undertaken.     

Examining the effectiveness of home-based parent aide services to reduce risk for physical child abuse and neglect: Six-month findings from a randomized clinical trial

Objective

This study set out to carry out a feasible, real-world, randomized clinical trial to examine the benefits of home-based paraprofessional parent aide services in reducing physical abuse and neglect risk in high-risk parents.

Methods

Families were randomly assigned to receive either parent aide plus case management services (n = 73) or case management services only (n = 65), collecting in-home data on physical child abuse and neglect and proximal risk and protective factors, just prior to service initiation, and again after six months of services.

Results

Mothers receiving parent aide and case management services reported significant improvements from baseline to six-month follow-up in self-reported indicators of physical child abuse risk, as well as improvements on parental stress, mastery, depression, and anxiety, whereas mothers receiving only case management services did not. The slopes of such observed changes across groups, however, were not found to be statistically significantly different. No discernable improvements were found with regard to indicators of risk for child neglect.

Conclusions

As the first randomized clinical trial examining the effectiveness of parent aide services, this study provides the first controlled evidence examining the potential benefits of this service modality. This study suggests promising trends regarding the benefit of parent aide services with respect to physical child abuse risk reduction and related predictors, but evidence does not appear to suggest that such services, as they are presently delivered, reduce child neglect.

Practice implications

These findings support the continued use of parent aide services in cases of physical child abuse and also suggest careful consideration of the ways such services may be better configured to extend their impact, particularly with respect to child neglect risk.     

Child sexual abuse and incest: community-based intervention

OBJECTIVE: The primary aim of this article is to determine the effectiveness of community intervention in the case of child sexual abuse. The article describes and analyses an actual case in a small urban community in Israel. METHOD: After several incidents of child sexual abuse, much of it incestuous, were brought to light in the community, they were discussed openly, contained, and punished. A community campaign, in which community activists as well as all the service providers were involved, was organized by community social workers. Individual, group, and community interventions were used. RESULTS: The continuation of the abuse has been checked, and, so far, there is no evidence to suggest its resurgence. Community apathy to child sexual abuse seems to have been halted and reversed. The involvement of community residents, particularly the activists, has increased, and this appears to be the major factor in changed community norms toward child sexual abuse. CONCLUSION: Implications of the individual, group, and community interventions are discussed. An integrated program of intervention practices is advocated to contain and prevent the incidence of child sexual abuse and incest.     

Accumulating evidence for parent-child interaction therapy in the prevention of child maltreatment

In a randomized controlled trial, the effectiveness of Parent-Child Interaction Therapy (PCIT) and correlates of maltreatment outcomes were examined. Mothers (N = 150) had a history or were at high risk of maltreating their children. After 12 weeks and compared to waitlist, PCIT mothers were observed to have improved parent-child interactions and reported better child behavior and decreased stress. At PCIT completion, improvements continued and mothers reported less child abuse potential and had improved maternal sensitivity. Also, PCIT completers were less likely to be notified to child welfare than noncompleters. Finally, those families not notified post-PCIT showed greater reductions in child abuse potential and improvements in observed sensitivity during treatment. Implications for theory and practice are discussed.     

Pediatric response to a large-scale child protection intervention

Objective

In a rural area of the US state of Texas, in April 2008, the Texas Department of Family and Protective Services (DFPS) responded to evidence of widespread child abuse in an isolated religious compound by removing 463 individuals into state custody. This mass child protection intervention is the largest such action that has ever occurred in the United States. The objective of this paper is to characterize the burdens placed on the area's community resources, healthcare providers, and legal system, the limitations encountered by the forensic and public health professionals, and how these might be minimized in future large-scale child protection interventions.

Methods

Drawing on publicly available information, this article describes the child abuse investigation, legal outcomes, experiences of pediatric healthcare providers directly affected by the mass removal, and the roles of regional child abuse pediatric specialists.

Results

Because the compound's residents refused to cooperate with the investigation and the population of the compound was eight times higher than expected, law enforcement and child protection resources were insufficient to conduct standard child abuse investigations. Local medical and public health resources were also quickly overwhelmed. Consulting child abuse pediatricians were asked to recommend laboratory and radiologic studies that could assist in identifying signs of child abuse, but the lack of cooperation from patients and parents, inadequate medical histories, and limited physical examinations precluded full implementation of the recommendations.

Conclusions

Although most children in danger of abuse were removed from the high-risk environment for several months and some suspected abusers were found guilty in criminal trials, the overall success of the child protection intervention was reduced by the limitations imposed by insufficient resources and lack of cooperation from the compound's residents.

Practice implications

Recommendations for community and child abuse pediatricians who may become involved in future large child-protection interventions are presented.     

The utility and challenges of using ICD codes in child maltreatment research: A review of existing literature

ObjectiveThe objectives of this article are to explore the extent to which the International Statistical Classification of Diseases and Related Health Problems (ICD) has been used in child abuse research, to describe how the ICD system has been applied, and to assess factors affecting the reliability of ICD coded data in child abuse research.MethodsPubMed, CINAHL, PsychInfo and Google Scholar were searched for peer reviewed articles written since 1989 that used ICD as the classification system to identify cases and research child abuse using health databases. Snowballing strategies were also employed by searching the bibliographies of retrieved references to identify relevant associated articles. The papers identified through the search were independently screened by two authors for inclusion, resulting in 47 studies selected for the review. Due to heterogeneity of studies meta-analysis was not performed.ResultsThis paper highlights both utility and limitations of ICD coded data. ICD codes have been widely used to conduct research into child maltreatment in health data systems. The codes appear to be used primarily to determine child maltreatment patterns within identified diagnoses or to identify child maltreatment cases for research.ConclusionsA significant impediment to the use of ICD codes in child maltreatment research is the under ascertainment of child maltreatment by using coded data alone. This is most clearly identified and, to some degree, quantified, in research where data linkage is used.Practice implicationsThe importance of improved child maltreatment identification will assist in identifying risk factors and creating programs that can prevent and treat child maltreatment and assist in meeting reporting obligations under the CRC.     

A mindfulness parent well-being course: evaluation of outcomes for parents of children with autism and related disabilities recruited through special schools

Parents of children with intellectual disabilities and/or autism have been shown to experience higher levels of distress than other parents. Despite such data having been available for several decades, the evidence base for psychological interventions to support parental well-being is small. Recent data suggest that both mindfulness and acceptance processes are associated with decreased psychological distress for parents of children with intellectual disability and/or autism. In addition, some controlled evaluations of mindfulness-based interventions for these parents have resulted in positive outcomes for mothers in particular. In the present study 18 mothers and 3 fathers were recruited via special schools who then attended a Mindfulness Based Well-Being for Parents (MBW-P) group over eight weeks. Parents completed questionnaire measures before and at the end of the course. Statistical analysis showed significant reported increases in mindfulness and self-compassion, and reduced general stress. Parents also reported reductions in anxiety and depression, although these changes were not statistically significant. No significant reductions in their child’s behaviour problems or increases in the child’s prosocial behaviour were found. Parents also reported high levels of satisfaction with the course. These preliminary data suggest that further research studies testing the effectiveness of the MBW-P course are warranted.     

L'aide sociale peut-elle induire les mauvais traitements a l'enfant?

The authors report a case where the interference of a health worker led to child abuse in a family for which he had charge. They examine the interactions existing between the concerned team and the high-risk family. They notice that violent situations are often maintained by the higher number of psychosocial interventions and by the intrusive and rigid attitudes of the health workers. A real change in the parental situation can only be obtained by a systematic approach to the families involved, centered not only on the interactions between the child and its parents but also on the interactions between the health system and the family.     

Group coping skills program for parents of children with dyslexia and other learning disabilities

Abstract

Fifty seven mothers of children aged 6 to 12 with dyslexia or other learning disabilities were randomly allocated to a group coping skills program (n = 32) or a wait‐list control group (n = 25). Parents completed pre‐ and post‐intervention measures of parenting competence, stress, coping skills, and child behaviour/emotional problems. Prior to the program mothers reported high stress levels associated with child and school factors. After the program significant reductions were found for stress, isolation, self‐blame, and greater emotional closeness (attachment) to the child was reported. Significant reductions in child behaviour problems (externalizing behaviours) and moodiness were also found. Child internalizing behaviours remained high with nearly half the parents reporting child emotional problems (withdrawn, somatic complaints, anxiety/depression). Future interventions with families and schools are recommended to prevent children with learning disabilities and their parents experiencing high levels of emotional distress.     

Stressed parents with infants: reassessing physical abuse risk factors.

OBJECTIVE: This study aimed to examine the relationship between a range of potentially adverse psychosocial and demographic characteristics identified in the immediate postpartum period and child physical abuse potential at 7 months. METHOD: Data collected as part of a randomized controlled trial of a nurse home visiting programme for vulnerable families with newborns was used. Women (181) were recruited in the immediate postpartum period. At 7 months, 151 participants were available for evaluation. Potential for child physical abuse was assessed using the Child Abuse Potential (CAP) Inventory. RESULTS: Significant risk indicators identified by univariate analysis were financial stress, elevated Edinburgh Postnatal Depression Scale (EPDS) scores, education level less than 10 years, concern regarding the provision of housing, and domestic violence characterized by verbal and social abuse. There was no association between child abuse potential and sole parenthood, poverty, young maternal age, history of childhood abuse, or psychiatric history. Two variables were found to be of independent significance using a logistic regression model; elevated EPDS and perceived difficulty "making ends meet." CONCLUSIONS: The findings indicate that perceived stress relating to finances, accommodation and relationships in the immediate postpartum period are associated with heightened child physical abuse potential at 7 months. Elevated EPDS in the early postpartum period is also a risk indicator. The outcome of this study suggests that perinatal assessment of child abuse risk is possible and simple and is related to perceived stressors at the time surrounding delivery. This is independent of a range of demographic variables traditionally thought to predict high risk.     

The impacts of institutional child sexual abuse: A rapid review of the evidence

While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.     

Applications of Temperament: A Review of Caregiver-Focused Temperament-Driven Interventions

Research Findings: Temperament, often defined in terms of reactive and regulatory tendencies, has been shown to predict child outcomes over and above other risk factors and represents a critical aspect of social-emotional development. The present article is a systematic review of temperament-based interventions targeting caregivers, wherein the aim is to inform caregivers about temperament in an effort to influence a variety of outcomes, such as goodness of fit, parenting stress, achievement, and behavior problems. In total, 13 randomized and nonrandomized trials were reviewed, with promising outcomes. Temperament-driven interventions have demonstrated the capacity to increase parental knowledge of temperament, reduce behavior problems, improve math and reading achievement, create more positive teacher–child relationships, and reduce numbers of medical visits. Caregivers report satisfaction with and usefulness of the interventions, which suggests promise for future application of temperament-based approaches. Temperament-driven interventions can be leveraged to improve multiple developmental outcomes, especially in early childhood, and are useful for both teachers and parents. Practice or Policy: Implications of temperament-based interventions for early childhood educators are discussed, as are limitations and future directions.     

Developmental effects of child abuse: A review

Most research investigating the effects of physical child abuse on children's development has been based on uncontrolled or poorly controlled studies having small samples, no long-term follow-up, and weak instrumentation. These studies, as well as some which have been more carefully designed, have generally suggested seriously detrimental developmental consequences in physical, intellectual, behavioral, and emotional areas. Some recent controlled follow-up studies challenge such a negative picture of abuse. In particular, a study by Elmer, which is probably the most carefully conducted study yet done, found that the harmful effects of abuse dissipated years after the abusive incident and that socioeconomic status (SES) and related factors may be more important than abuse in determining the course of child development. To improve the quality and clarity of future research on developmental effects of child abuse, this paper discusses, in four major areas, problems which plague the research. Definition: The extent, type, and frequency of abuse should be more carefully defined to allow studies to be compared. The types and amounts of social service interventions should also be specified. Generalization: Research should include more middle and upper SES children, more of the mildly and moderately abused, and more neglected children to allow generalization to the total population of maltreated children. Causality: Since developmental deficits may be the cause as well as the effects of abuse and because outside factors such as SES may lead to both the abuse and the deficits, there is a need for large-scale longitudinal studies which can untangle the cause and effect web of abuse by following children from birth and measuring many factors which might affect development (e.g., SES, birth abnormalities, abuse). Statistical Analysis: Future studies should always use statistical analysis and should obtain larger samples and utilize outcome and classification measures with demonstrated reliability and validity to increase statistical power.     

A retrospective study with ICAST-R (ispcan child abuse screening tools-retrospective) questionnaire for determination of child abuse in first year medical students in Turkish population

Child Abuse and Neglect (CAN) is an important problem both in Turkey and worldwide. Unfortunately, we still don’t have enough and reliable data on this important subject. In this study, we aimed to investigate the prevalence of childhood maltreatment in a population of first year medical students in a Turkish university using the retrospective version of the ISPCAN Child Abuse Screening Tool (ICAST-R). One hundred seventy three first year medical students, aged between 18 and 24 years, who agreed to complete the ICAST-R questionnaire, were recruited in our study. Of 173 students who completed the survey, 51.4% are found to be subjected to at least one type of child abuse (physical, emotional or sexual). The prevalence is higher in male gender and the difference is statistically significant. Physical, emotional and sexual abuse exposure rates are found to be 23.1%, 40.5% and 11% respectively. Physical and emotional abuse rates are higher in male gender and the difference is statistically significant. We did not find any statistically significant association between gender and sexual abuse. Efforts to prevent child abuse and neglect are growing in our country, as they are worldwide. However, child abuse is still common and a problematic issue. It is important to determine the prevalence of child abuse in order to raise awareness. We need further studies investigating not only prevalence but also risk factors to have reliable data for our country.     

Fatal child neglect: Characteristics,causation, and strategies for prevention

Research in child fatalities because of abuse and neglect has continued to increase, yet the mechanisms of the death incident and risk factors for these deaths remain unclear. The purpose of this study was to systematically examine the types of neglect that resulted in children's deaths as determined by child welfare and a child death review board. This case review study reviewed 22 years of data (n = 372) of child fatalities attributed solely to neglect taken from a larger sample (N = 754) of abuse and neglect death cases spanning the years 1987–2008. The file information reviewed was provided by the Oklahoma Child Death Review Board (CDRB) and the Oklahoma Department of Human Services (DHS) Division of Children and Family Services. Variables of interest were child age, ethnicity, and birth order; parental age and ethnicity; cause of death as determined by child protective services (CPS); and involvement with DHS at the time of the fatal event. Three categories of fatal neglect – supervisory neglect, deprivation of needs, and medical neglect – were identified and analyzed. Results found an overwhelming presence of supervisory neglect in child neglect fatalities and indicated no significant differences between children living in rural and urban settings. Young children and male children comprised the majority of fatalities, and African American and Native American children were over-represented in the sample when compared to the state population. This study underscores the critical need for prevention and educational programming related to appropriate adult supervision and adequate safety measures to prevent a child's death because of neglect.