How neighborhoods influence child maltreatment: a review of the literature and alternative pathways

OBJECTIVE: To review the literature on the relationships between neighborhoods and child maltreatment and identify future directions for research in this area. METHOD: A search of electronic databases and a survey of experts yielded a list of 25 studies on the influence of geographically defined neighborhoods on child maltreatment. These studies were then critically reviewed by an interdisciplinary research team. RESULTS: Numerous studies demonstrate that child maltreatment cases are concentrated in disadvantaged areas. A number of socio-economic characteristics of neighborhoods have been shown to correlate with child maltreatment rates as measured by official reports to child protective service agencies. Only a few studies examine direct measures of parenting behaviors associated with maltreatment, and these show a weaker relationship with neighborhood disadvantage. Moreover, the processes that link neighborhood conditions to either maltreatment reports or parenting behaviors are not yet confirmed by the research literature. Selection bias, neighborhood definitions and spatial influences are largely uncontrolled in the existing research. CONCLUSIONS: We propose a framework for pursuing further study of neighborhoods and child maltreatment that addresses the gaps in the current literature. Neighborhood-based strategies to prevent and reduce child maltreatment will be enhanced by research that provides a better understanding of how neighborhood conditions act as stressors or supports for families at risk of child maltreatment.     

Enhancing law enforcement identification and investigation of child maltreatment

OBJECTIVE: Data from two independent studies is presented, representing the investigators' ongoing work with faculty from a state criminal justice academy to analyze existing knowledge and skill levels among veteran law enforcement officers and recruits, as well as to enhance future training. METHOD: Through an anonymous questionnaire, the first of these studies examined officers' perceptions of maltreatment, including those factors that do and do not influence a determination of whether a particular act constitutes child maltreatment and assessments of whether particular acts constitute abuse or neglect. The second study also utilized an anonymous questionnaire to examine officers' knowledge of the developmental strengths and limitations of children relative to their ability to provide accurate information in suspected cases of child maltreatment. RESULTS: As hypothesized, several gaps both in law enforcement officers' knowledge of certain characteristics that can serve to denote a case of maltreatment and their knowledge of fundamental developmental issues and interview techniques that could assist them in the performance of their professional duties are identified. CONCLUSIONS: Suggestions for enhanced law enforcement training programs are presented and discussed.     

Public opinion and knowledge about childhood sexual abuse in a rural community.

OBJECTIVES: To explore the knowledge and attitudes of the general public about child sexual abuse (CSA) through a population-based survey. METHOD: A survey was completed by 246 respondents living in Klamath Falls, a small city in rural eastern Oregon. Specific areas of inquiry included who respondents believed were likely perpetrators of CSA, when a child was most likely to disclose sexual abuse, whether respondents believed that children would be truthful, reasons a child might not acknowledge that they had been sexually abused, what respondents knew about how CSA could be diagnosed, and what attitudes respondents thought that a sexually abused child might have towards the perpetrators of their abuse. Finally, respondents were asked how they would report a suspected case of CSA and about their receptivity to personal safety training to prevent CSA. RESULTS: While significant proportions of respondents were fairly knowledgeable about CSA, gaps in knowledge were found in all age groups and ethnic groups. Groups with the most significant knowledge deficits about CSA included men, unmarried respondents, respondents who had not had children, respondents in younger age groups, respondents of Latino descent, and respondents with low incomes or low education. Respondents were most likely to report CSA to their physician or the police. There is community interest in training about CSA and its prevention. CONCLUSION: These data indicate that significant deficits as well as strengths in knowledge about CSA exist in this rural community, and identify populations to which community education about CSA could be directed.     

Best Practices for Interviewing Children with Intellectual Disabilities in Maltreatment Cases

Globally, children with intellectual disabilities are at an increased risk of being victims of maltreatment compared to those without disabilities. Among the children who do disclose the abuse, limitations with communication and working memory can result in their allegation being perceived as not credible. There are several evidence-based interviewing methods available to interviewers for improving the accuracy and amount of detail in children’s testimonies, such as free-recall and cognitive load questioning. In general, these interviewing methods have been developed and tested with typically developing populations, and do not take into consideration the needs of children with intellectual disabilities. Further, there is very little empirical work to guide forensic interviews with intellectually disabled populations, despite there being a great need for such strategies. To address this notable gap in the literature, the current article reviews the contemporary literature on forensic interviewing to identify the best methods for questioning children with intellectual disabilities in maltreatment cases. Adaptations to the commonly used forensic interviewing techniques, including verbal, nonverbal, and repeated questioning strategies, are proposed that address the unique developmental, social, and emotional needs of this population. Furthermore, a series of recommendations are provided to enhance the limited forensic interviewing research with this population.     

Maltreatment and disabilities: a population-based epidemiological study

OBJECTIVES: To assess the prevalence of abuse and neglect among a population of children identified as a function of an existing disability, relate specific types of disabilities to specific types of abuse, and to determine the effect of abuse and neglect on academic achievement and attendance rates for children with and without disabilities. METHOD: An electronic merger of school records with Central Registry, Foster Care Review Board, and police databases was followed by a detailed record review of the circumstances of maltreatment. RESULTS: Analyses of the circumstances of maltreatment and the presence of disabilities established a 9% prevalence rate of maltreatment for nondisabled children and a 31% prevalence rate for the disabled children. Thus, the study established a significant association between the presence of an educationally relevant disability and maltreatment. CONCLUSIONS: Children with disabilities are 3.4 times more likely to be maltreated than nondisabled peers. School professionals need to be cognizant of the high base rate of maltreatment among the children they serve. Disability status needs to be considered in national incidence studies of maltreatment.     

An exploratory study of Special Educational Needs Co‐ordinators' knowledge and experience of working with children who have sustained a brain injury

This research aimed to measure Special Educational Needs Co‐ordinators' knowledge of the educational implications of acquired brain injury in children and young people and whether experience of working with pupils with a brain injury or additional training impacts upon this knowledge. Data was collected within one local authority in England using an online survey. The results indicated that the respondents had high levels of uncertainty regarding the impact of a brain injury although they were more confident in those areas which related most closely to their practice. The responses suggested that experience of working with a pupil with a brain injury promoted greater knowledge than receiving training; the results, however, showed that only a minority of SENCos had received any training and those who had tended to have undertaken this independently. This suggests that there is a need for SENCos to be provided with specialist training in order to increase their understanding of the impact of acquired brain injury in children and young people.     

Reported maltreatment in children with multiple disabilities

This study examined a population of children with multiple disabilities to investigate whether functional, developmental, or perinatal factors could differentiate children reported and substantiated as maltreated from those not so reported. Data were collected from medical records of a cohort of 500 children evaluated between 1973 and 1984 at the Kennedy Institute in Baltimore, Maryland. Maltreatment reporting was documented through the State of Maryland Abuse Registry and the counties of residence of all study children. Results indicated that the profiles of demographic and family characteristics associated with child maltreatment reporting in this population are consistent with the literature, but child functional and developmental characteristics were not confirmed as risk factors for substantiated maltreatment reports. Indeed, contrary to investigator expectations, the more severely disabled children, in terms of functioning, appeared at less risk of maltreatment than did disabled children functioning at more age-appropriate levels.     

A survey of pediatricians' attitudes and experiences with court in cases of child maltreatment

OBJECTIVES: To explore pediatricians' attitudes and experiences with the court system in child maltreatment cases. DESIGN: An anonymous, cross-sectional survey of a random sample of pediatricians registered with the North Carolina Medical Board. RESULTS: The response rate of the study was 60% (N=270). Few pediatricians (10%) reported that they had "ever" suspected maltreatment but decided not to report it. Pediatricians were equally likely to recall positive and negative experiences in court for child abuse cases. Pediatricians with negative court experiences were more likely to view reporting as time-consuming and were more than twice as likely not to report suspected cases of maltreatment (OR 2.4, 95% CI 1.04, 6.0). Seventy-five percent of pediatricians felt that court is harmful or distressing for children. CONCLUSIONS: The majority of pediatricians report suspected cases of child maltreatment. Pediatrician's court experiences play a role in the response to child maltreatment cases, influencing attitudes towards the legal system and the process of caring for maltreated children. Future research efforts should address physicians' concerns about the impact of court on children, ways to improve the working relationship between the legal system and physicians, and the training needs of physicians in child maltreatment, including testifying and understanding the court process.     

Provision for Children with Speech and Language Difficulties in Tanzania

Knowledge about paediatric speech and language difficulties, training for and contact with children with such problems and views on service developments were explored using a written questionnaire, completed by 84 Tanzanian health and education professionals. Additionally, two sets of interviews were carried out, one with a subset of questionnaire respondents and another with a group of 14 health/education planners and administrators. Results showed that whilst only 41 % of respondents had received training about speech and language difficulties, 68% considered themselves to be responsible for assisting children with such problems. Levels of knowledge were significantly higher in the special education group, but were not significantly related to training, exposure to speech and language therapists, or professional responsibility. However, knowledge levels were significantly related to daily contact with children with speech and language difficulties. No evidence of research or planning for children with such difficulties was discovered. Views on service provision favoured educational over health‐based provision. Qualitative information on attitudes and beliefs about speech and language difficulties did not contradict previous data on disabilities. The implications for Tanzania and other similar countries are discussed. Improvements to the questionnaire are discussed. More data are needed in order to facilitate appropriate service development.     

Disability and Counselor Education

Mainstreaming legislation is an impetus for social change in relation to treatment of individuals with disabilities. This change requires that counselor educators include content areas related to aspects of disability to prepare counselors to serve clients with disabilities. The author makes recommendations for curricular change for experiential and didactic training to increase a counselor trainee's sensitivity, skills, and knowledge regarding disability. Also, counselor educators are urged to team trainees from school and rehabilitation counseling training programs so that these professionals can work cooperatively for the benefit of the client with a disability.     

SERVICE PROVIDERS’ KNOWLEDGE AND MISCONCEPTIONS ABOUT OLD AGE: COMPARISON OF THREE SERVICE NETWORKS

We report on knowledge about old age among social service providers from three service networks. Data are based on a survey of 245 respondents from Washington State's developmental disabilities, aging, and generic service networks. Palmore's Facts on Aging Quiz (FAQ; 1977, 1988) was used to measure the level of knowledge about old age. Key findings are as follows: (a) Overall, the respondents averaged 64% correct on the FAQ. (b) Developmental disabilities service providers scored lower than either aging service providers or generic service providers. (c) The content areas in which items were most often missed were the psychological aspects aging, the demographic trends of the aging population, and the socioeconomic status of the elderly. Implications of the results for training service providers are discussed.     

Disciplinary choices of mothers of deaf children and mothers of normally hearing children

OBJECTIVE: To assess the disciplinary preferences of mothers of profoundly deaf children and normally hearing children in a test of the hypothesized link between child disabilities and punitive parenting. METHOD: Disciplinary preferences of mothers seeking a cochlear implant for their profoundly deaf child (n=57), mothers not seeking an implant for their deaf child (n=22), and mothers of normally hearing children (n=27) were assessed using an analog task in which subjects select discipline in response to slide images of children engaging in normative or frankly deviant behaviors that are potentially irritating. RESULTS: Results indicated that mothers of children with profound hearing impairments were more likely to select physical discipline in response to depicted child transgressions and more likely to escalate to physical discipline when the depicted child was described as persisting in the transgression. Additionally, escalation was more probable in response to scenes depicting children engaged in dangerous and destructive acts than in rule-violating acts. CONCLUSIONS: Findings were consistent with the hypothesized link between childhood disabilities and child maltreatment as well as the hypothesis that children with disabilities associated with communication problems could be at risk of physical abuse.     

Current parental stress in maltreating and nonmaltreating families of children with multiple disabilities.

Questionnaires were mailed to families of children with multiple disabilities to investigate whether differences in parental perception of stress and burden of care could be identified in those families who had previously been reported and substantiated as abusive or neglectful as compared to those families who had not been so reported. Two hundred and fifty-seven parents completed Friedrich's revised version of Holroyd's Questionnaire on Resources and Stress (QRS-F), an instrument designed to measure stress and burden of care in families of children with disabilities. Twenty-five (9.7%) had previously substantiated maltreatment reports. Results suggest that a history of maltreatment is not related to the family's currently perceived stress levels as measured by the Friedrich scale. Implications of the results are discussed.     

Inclusion of students with emotional and behavioural disorders in general education settings: a scoping review of research in the US

ABSTRACT

Inclusion of students with disabilities in general education settings has been an international focus for over two decades. In the US, federal laws [e.g. Individuals with Disabilities Education Improvement Act (IDEIA). 2004. H.R. 1350, 108th Congress] mandate access to the general education curriculum for all students, including those with disabilities. These mandates codify a philosophical orientation of least restrictive environment, within a free appropriate public education, while explicitly requiring evidence-based practices. The policies support and protect inclusive practices for individuals with emotional and behavioural disabilities, yet the state of the empirical literature is unknown. A review is needed to provide an overview of the research and reveal the breadth of the literature. To this end, scoping review methodology was used to map the state of the literature. This particular approach is recommended for topics with myriad and complex definitions and issues, as is the case with inclusive education. Results map six themes (professional and student experience, strategy effectiveness, policy and programmes, perception of influencing factors, teacher training, teacher knowledge) and reveal several gaps in the literature. Recommendations are made for systematic review, meta-analyses, and individual studies to address the gaps in the literature.     

Culture and child maltreatment: cultural competence and beyond

OBJECTIVE: The objective of this article is to comment on current issues in the relationship between culture and child maltreatment. METHOD: A review of the literature on culture and child maltreatment is the basis of the article. RESULTS AND CONCLUSION: While attention has been directed to the relationship between culture and maltreatment for more than 20 years, there is a need for further development in this area. Efforts need to be made to "unpack" culture, to promote understanding culture in context, and to enhance research on child maltreatment and culture.     

The impact of patterns of trauma exposure among low income children with and without histories of child maltreatment

Previous research has revealed a large prevalence of trauma experienced by children, creating high risk for the development of psychopathology. Research investigating the negative impacts of child maltreatment and other traumas has typically examined these experiences individually, controlling for co-occurring traumas, or has combined these experiences into a general variable of risk, thereby obscuring the complex relationships among environmental traumas and maltreatment. The current study expands on previous research by elucidating relationships between multiple contexts of overlapping traumas and maltreatment experienced by children, and by categorizing how these experiences join together to impact internalizing and externalizing symptomatology. Participants included 316 maltreated children and 269 nonmaltreated children (M age = 9.4, SD = 0.88) who attended a summer day camp research program for low-income children. Latent Class Analysis (LCA) identified three differential patterns of trauma exposure across children: 1) community violence and loss; 2) pervasive trauma; and 3) low trauma. Covariate analyses demonstrated that child maltreatment was significantly associated with class membership, suggesting that maltreated children were more likely to experience diverse traumas extending beyond their maltreatment experiences (pervasive trauma class). A two-way analysis of variance also demonstrated that trauma latent class membership and child maltreatment each represented unique predictors of internalizing and externalizing symptoms, with each having an independent effect on symptomatology. This investigation provides unique insight into the differential impact of patterns of trauma exposure and child maltreatment, providing support for further research and clinical practice addressing multiple levels of a child’s ecology.     

Instruction in early childhood special education: "seeing through a glass darkly ... knowing in part".

This article discusses what is not known about instruction of preschoolers with disabilities. Knowledge gaps exist in four areas: the content of the curriculum, the procedures used to individualize instruction, the instructional procedures designed to ensure acquisition, and the strategies used to ensure skill use or generalization. Barriers to generating such knowledge include the fragmentation that results from specialization, the inadequacy of the data base, and the lack of training in instruction and research design and analysis. Solutions include training programs for early childhood special educators in the analysis, application, and design of research in instruction and curriculum, as well as the publication of multiple replications and refinements of instructional strategies.     

江西省75例孤独症儿童的现状调查

本研究对75例江西籍孤独症儿童进行调查,分析其在基本信息与家庭情况、求医诊断、治疗康复、生活学习等方面的现状,调查结果表明:(1)本次调查的孤独症儿童城镇比例大、男童远多于女童,父母职业较稳定,文化程度相对较高,家庭收入情况多数不佳。(2)孤独症儿童家长自身建设待加强,康复训练的及时性与持续性不足。(3)教育系统配套措施与满足孤独症儿童入学需求尚存差距。(4)社会支持系统对孤独症问题介入不足。对此提出普及孤独症及相关发育障碍知识、提高家长自身素质、将孤独症教育落到实处、为成年孤独症人士建立社区精神康复机构、构建完善的社会支持系统等建议。