First-time maltreatment in children ages 2–10 with and without specific birth defects: A population–based study

Children with disabilities are at an increased risk for maltreatment. However, little is known about the risk of maltreatment in children with specific types of birth defects. This study was conducted to determine whether the risk and predictors of maltreatment in children 2 to 10 years of age differ between those without and with specific birth defects: Down syndrome, cleft lip with/without cleft palate, and spina bifida. State administrative and United States Census data were linked to identify study groups, variables of interest, and outcome measures. Kaplan-Meier and multivariate Cox proportional hazard analyses were used to identify study groups and variables associated with an increased risk for maltreatment. The prevalence of substantiated maltreatment was consistently highest among children with cleft lip with/without cleft palate. After adjusting for birth-level factors, children with Down syndrome and cleft lip with/without cleft palate were 34% and 26% more likely to have been maltreated than those without birth defects, respectively. In all three birth defect groups, the risk of medical neglect was higher (relative risks ranged from 3 to 11) than in the unaffected group. The factors associated with increased risk for maltreatment were similar across all groups. Of note, parity, maternal education, and maternal Medicaid use at birth were all associated with greater than 2-fold increased risk for maltreatment. Our findings suggest that the families of children with birth defects may need support services throughout early childhood to help families cope with the needs of their children and reduce the risk of maltreatment.     

Is season of birth related to developmental dyslexia?

Different moderators/mediators of risk are involved in developmental dyslexia (DD), but data are inconsistent. We explored the prevalence of season of birth and its association with gender and age of school entry in an Italian sample of dyslexic children compared to an Italian normal control group. The clinical sample included 498 children (345 boys, mean age 10.3 ± 2.1 years) with DD, the control sample 1,276 children (658 boys, mean age 10.8 ± 2.2 years) from four elementary schools from the same urban area, and with the same socio-economic status level. A prevalence of birth in autumn was found among children with DD compared to controls (34% versus 24%, p < 0.0001). Children with DD were more frequently males (p < 0.0001) and had a lower mean age of school entry (p < 0.0001). Regarding the distribution of ages, 11.4% of children with DD, but none of the subjects in the control group, started school before 5.7 years. Therefore, greater risk of DD was related to age of school entry (OR = 2.72), gender (OR = 2.16), and season of birth (OR = 1.21). Significant interactions between boys with DD born in autumn, and correct school of entry (OR = 2.56) were joint predictors of higher risk of DD. The association between birth in autumn and DD may be explained by the earlier age of school entry, which may be a critical element in the youngest children with DD or at risk to DD. Whether Italian school policy is oriented to anticipate the school entry, a closer detection of early learning disorders and associated risk factors (familial load, specific language disorders, and attention deficit hyperactivity disorder) should be warranted.     

Possible early warning signs of non-accidental injury to children

Describes a retrospective study carried out in the North West of England, during 1976 while the author was a post-graduate student at Liverpool University. The possible ‘at risk’ factors under study were (1) Separation of the mother herself, before 11 years of age, from her mother. (2) Abnormality of pregnancy. (3) Abnormality of labour. (4) Abnormality of puerperium. (5) Low birth weight of baby. (6) Poor ante-natal care. (7) If child placed in special care baby unit. (8.) Consultation with social worker during pregnancy. (9) Apgar score less than nine at ten minutes.Data was collected, from maternal case records of a ten per cent random sample of children on the register of non-accidental injury, and of children born in the same hospital and paired by their sex, their mother's age and parity within a minimum of a year period.The findings revealed that (1) the factors under test, when grouped together, could be reliable predictors of non-accidental injury to children, and (2) that statistical significance was found between the number of possible ‘at risk’ factors in the subject group and the control group of mothers. In -the subject group of mothers 82.98% were found to have one or more factors present, compared to 55.32% in the control group of mothers.The results appear to warrant a more extensive study with a larger size sample and limited only to confirmed cases of non-accidental injury.However, it may be possible for members of the primary care teans to use this information in setting priority criteria for visiting, in attempts to reduce the occurrences of nonaccidental injury.     

Preschool predictors of dyslexia status in Chinese first graders with high or low familial risk

The present 4-year longitudinal study examined preschool predictors of Grade 1 dyslexia status in a Chinese population in Hong Kong where children started learning to read at the age of three. Seventy-five and 39 Chinese children with high and low familial risk respectively were tested on Chinese word reading, oral language skills, morphological awareness, phonological skills, rapid naming, and print-related skills from age 4 to 6 and a standardized dyslexia test at age 7. Results showed that children of the high risk group performed significantly worse than the low risk group in Chinese literacy, phonological awareness, and orthographic skills at age 7. All the children with dyslexia had word reading difficulties in at least one preschool year. Results of the logistic regression showed that preschool verbal production, syllable deletion, and letter naming were the best predictors of dyslexia outcome at age 7. As in alphabetic languages, preschool oral language skills like verbal production, phonological skills, and print-related skills are the most significant predictors of children’s later reading difficulties.     

Judging who knows best about yourself: developmental change in citing the self across middle childhood

Rosenberg (1979) reported that children under the age of 11 do not recognize that they are the authority on their own self-knowledge, placing authority instead with adults. However, results from Studies 1 and 2, in which 86 and 47 children, respectively, from predominantly White low- to middle-income communities participated, suggest that the shift from reliance on adults to self occurs between the ages of 5 and 10 years. The studies also demonstrate parallel development in judging own and other people's self-knowledge. Study 3, in which 96 children from predominantly White low- to middle-income communities participated, shows the beginnings of sophisticated understanding in children aged 5 to 7 years, who differentiate between information about the self that is best judged by the self and information that can be judged by others. Suggestions are made as to why this aspect of understanding minds develops later than other aspects of psychological understanding.     

A longitudinal study of children's early literacy experiences at home and later literacy development at home and school

Studies of literacy attainment in the early years of school have identified various measures at school entry which predict later attainment. The study reported has sought not only to replicate earlier findings but to investigate significant home factors from a younger age. Literacy experiences of 42 children at ages 3, 5 and 7 were investigated, and the relationship of home factors to literacy development explored. Findings are reported concerning two outcome measures at age 7: children's reading level, as determined by the difficulty level of their school reading book, and whether or not children at age 7 were judged to have literacy difficulties. Significant factors included having favourite books at age 3; letter knowledge and parents reading to children at school entry; and at age 7, access to home computers, and parents’ knowledge of literacy teaching in school. Children with literacy difficulties owned fewer books, were less likely to read to themselves or their parents, and generally had less support for literacy at home. Implications for teachers, highlighting the relevance of home literacy, are discussed. The findings underline the importance of home factors for children's literacy development.     

Developmental effects of social reinforcement on eye‐contact and speech in mildly intellectually handicapped children.

This study investigates the developmental effects of soical reinforcement on the interview behaviour of 58 mildly intellectually handicapped children (CA = 11.8 years; IQ = 75). The subjects were divided into three age groups (8‐10 years, 10‐13 years, 13‐15 years) and categorized as dominant or dependent by teacher ratings. In the experiment, high and low social reinforcement for eye‐contact was given in an interview by one of their teachers. The data were analyzed, for each age group, according to the amount of speech and eye‐contact under the various conditions. Support for the earlier Exline and Messick (1967) findings indicated a feedback rather than reward model in explaining the effects of social reinforcement on eye‐contact. More important, however, for the mildly intellectually handicapped, no evidence was found for significant variations in eye‐contact as a function of age, sex or IQ.     

An analysis of factors related to the attitudes of regular classroom teachers toward mainstreaming mildly handicapped children

A model of factors was developed in order to examine variables that might be associated with the attitudes of regular classroom teachers toward mainstreaming mildly handicapped children. Using multiple linear regression analyses, the following variables were found to be significant predictors of a positive attitude toward mainstreaming: team-teaching, years of teaching experience (negative correlation), course in diagnosing learning and behavior problems, availability of resource teacher, previous special education teaching experience, number of courses taken in special education, number of students in classroom (25–27), and inservice program experience related to exceptional children. An examination of these predictors suggests that they may be used to select those regular educators who are likely candidates for implementing mainstreaming programs and that school systems can inhance their mainstreaming efforts by arranging the integration settings to conform with these predictors of positive attitude.     

Patterns of child abuse and neglect associated with chronological age of children living in a midwestern county.

OBJECTIVE: The main objective of the study was to investigate the relationship between age of the very young victim and the type of abuse perpetrated against that victim. A secondary objective was to examine gender and racial differences in child abuse and neglect in children between the ages of birth and 7 years. METHOD: Archived data for all cases of substantiated abuse of children for the years of 1990-1996 inclusive were retrieved from a data bank at a county children services department (N = 876). Chi-square analyses were used to determine age, gender, and racial differences in child abuse and neglect in children 0 to 7 years of age. RESULTS: Neglect was the most common form of primary substantiated abuse recorded for this population of children under the age of 7 years, although the incidence of neglect decreased as chronological age of the child increased. Sexual abuse increased in occurrence as the children got older. Girls were more likely to be victims of sexual abuse than boys. No significant age differences were observed for physical abuse or for emotional abuse, and no racial differences were detected for any of the four types of abuse examined. CONCLUSIONS: Although the findings of this study are in agreement with those of previously published reports, there is some question as to whether archived data are an accurate reflection of actual patterns of maltreatment occurring in very young children or whether they represent the types of abuse that are subjectively identified and reported by authorities.     

Development of an individualized risk calculator for poor functioning in young people victimized during childhood: A longitudinal cohort study

BackgroundChildhood victimization elevates the average risk of developing functional impairment in adulthood. However, not all victimized children demonstrate poor outcomes. Although research has described factors that confer vulnerability or resilience, it is unknown if this knowledge can be translated to accurately identify the most vulnerable victimized children.ObjectiveTo build and internally validate a risk calculator to identify those victimized children who are most at risk of functional impairment at age 18 years.ParticipantsWe utilized data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative birth cohort of 2232 UK children born in 1994–95.MethodsVictimization exposure was assessed repeatedly between ages 5 and 12 years along with a range of individual-, family- and community-level predictors. Functional outcomes were assessed at age 18 years. We developed and evaluated a prediction model for psychosocial disadvantage and economic disadvantage using the Least Absolute Shrinkage and Selection Operator (LASSO) regularized regression with nested 10-fold cross-validation.ResultsThe model predicting psychosocial disadvantage following childhood victimization retained 12 of 22 predictors, had an area under the curve (AUC) of 0.65, and was well-calibrated within the range of 40–70% predicted risk. The model predicting economic disadvantage retained 10 of 22 predictors, achieved excellent discrimination (AUC = 0.80), and a high degree of calibration.ConclusionsPrediction modelling techniques can be applied to estimate individual risk for poor functional outcomes in young adulthood following childhood victimization. Such risk prediction tools could potentially assist practitioners to target interventions, which is particularly useful in a context of scarce resources.     

Conduct disorder and cognitive functioning: testing three causal hypotheses

The sample consisted of black adolescents who were members of the Columbia-Presbyterian chapter of the Collaborative Perinatal Project from birth to age 7. At age 17, subjects and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Results from least-squares and logistic regression analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM III. The results suggested that the relation of cognitive functioning to psychiatric status appears to be specific to conduct disorders. The results were incompatible with a "third" variable hypothesis (third factors included neurological status and environmental disadvantage) and the hypothesis that conduct problems lead to deficits in cognitive functioning. The 3 most (and equally) important factors in accounting for age-17 conduct disorder were cognitive functioning, parent psychopathology, and early aggression. A closer look at the data tentatively suggested that a broad deficiency in acculturational learning, rather than narrowly focused social cognitive differences or native endowment, constitutes a key element in the link between cognitive functioning and conduct disorder. Test bias was ruled out as a possible explanation for the results.     

Foster children's attachment behavior and representation: Influence of children's pre-placement experiences and foster caregiver's sensitivity

Although the majority of foster children have been exposed to early adversity in their biological families and have experienced one or more disruptions of attachment relationships, most studies surprisingly found foster children to be as securely attached as children in low-risk samples. However, attention has been paid almost exclusively to attachment formation in young children up to two years of age, and the majority of studies solely investigated attachment behavior whereas few is known about foster children's representations about attachment relationships. To extend findings on attachment in foster children and its predictors, our study examined both attachment behavior and representations in foster children aged between 3 and 8 years. Diverse potential predictors including child variables, birth parents’ variables, pre-placement experiences, and foster caregiver's behavior were included in the analyses. Results revealed that foster children showed both lower attachment security and higher disorganization scores than children in low-risk samples. Attachment behavior and representation were found to be widely independent from each other. Different factors contributed to attachment behavior and representation: whereas foster children's attachment behavior was mainly influenced by foster parents’ behavior, pre-placement experiences did predict hyperactivation and disorganization on the representational level. The results indicate that, when intervening with foster families, it seems crucial to focus not exclusively on the promotion of secure attachment behavior but also to develop interventions enhancing secure and organized attachment representations.     

Predicting child maltreatment in the first 4 years of life from characteristics assessed in the neonatal period.

OBJECTIVE: To examine the significance of neonatal risk factors from the individual, family, social, and parenting behavior domains of the ecological model of child maltreatment in predicting maltreatment reports in the first 4 years of life, and to examine the extent to which the interactions of life event stress and social support modify those risk factors. METHOD: Mothers of 708 predominantly at-risk infants were interviewed in their homes soon after their infants' discharge from the hospital. State child abuse and neglect central registry data were tracked every 6 months until the infants reached their fourth birthdays. RESULTS: The incidence of maltreatment reports was higher in households where the mothers were depressed, complained of psychosomatic symptoms, had not graduated from high school, consumed alcohol, participated in public income support programs, cared for more than one dependent child, or were separated from their own mothers at age 14 years (p < .1). In interaction models including these seven predisposing variables, there were significant interactions (p < .01) between social support, as measured by the social well-being index after the birth of the index child, and depression, and between social well-being and stress, as measured by an increase in total life events. CONCLUSION: Some predisposing risk factors measured soon after birth continue to be significant predictors of child maltreatment reports through the fourth year of life. In general, families with low levels of social support had a higher risk of a maltreatment report. For families with lower levels of maternal depression and/or life event stress, low social support significantly increased the risk of a maltreatment report by as much as a factor of four.     

Risk factors for infant maltreatment: a population-based study

CONTEXT: Of the approximately 900,000 children who were determined to be victims of abuse or neglect by US child protective services in 2002, the birth-to-3 age group had the highest rate of victimization (1.6%) and children younger than 1 accounted for the largest percentage of victims (9.6%). OBJECTIVE: To identify perinatal and sociodemographic risk factors associated with maltreatment of infants up to 1 year of age. DESIGN AND SETTING: Observational cohort study. PARTICIPANTS: 189,055 children born in 1996 in Florida. MAIN OUTCOME MEASURE: Infant maltreatment, defined as a verified report of abuse, neglect, or threatened harm that occurred between day 3 of life and 1 year. RESULTS: 1,602 children (.85%) of the 1996 birth cohort had verified instances of maltreatment by age 1. Of 15 perinatal and sociodemographic variables studied, 11 were found to be significantly related to infant maltreatment. Five factors had adjusted relative risks (RR) of two or greater: Mother smoked during pregnancy (RR 2.8); more than two siblings (RR 2.7); Medicaid beneficiary (RR 2.1); unmarried marital status (RR 2.0); low birth weight infant (RR 2.0). Infants who had four of these five risk factors had a maltreatment rate seven times higher than the population average. CONCLUSIONS: Data on nearly all risk factors found to be significantly associated with infant maltreatment are available on the birth certificate. Such information can be incorporated into a population-based risk-assessment tool that could identify subpopulations at highest risk for infant maltreatment. Because resources are limited, these groups should be given priority for enrollment in child abuse prevention programs.     

Mental age and syntactic development in the intellectually handicapped

Language samples from five mildly intellectually handicapped subjects with chronological ages ranging from 11 years 0 months to 11 years 8 months, and mental ages ranging from 6 years 2 months to 10 years 1 month were analysed syntactically. The results indicated problems in identifying the relationship between mental age and indices of linguistic sophistication. Most correlations were not significant, and the results suggested that these eleven year old mildly intellectually handicapped children may not show syntactic differences as great as those of mental age. At this age, differences exhibited in language may be due more to variables of individual experience, and especially the teaching strategies they experience. The results do not support the documented hypothesis that language development is closely related to mental age.     

Predictors of word‐reading ability in 7‐year‐olds: analysis of data from a U.K. cohort study

Previous U.K. population‐based studies have found associations amongst early speech and language difficulties, socioeconomic disadvantage and children's word‐reading ability later on. We examine the strength of these associations in a recent U.K. population‐based birth cohort. Analyses were based on 13,680 participants. Linear regression models were fitted to identify factors that were associated with word‐reading score at the age of 7 years. Path analysis models were fitted to examine phonological skills as a mediator of the relationships. We found that male gender, preterm birth, naming vocabulary at age five, concerns about speech and language, maternal education, type of housing tenure, lone parenting, parent attachment and frequency of reading to the child were all independently associated with word reading. For each of these predictors, there was evidence suggesting that a substantial proportion of the effect may be mediated by phonological skills (ranging from 52 to 89%). Despite policy intervention, many of the same risk factors identified in previous studies still predict children's word‐reading ability in the United Kingdom. Results support the phonological model, with phonological skills on the pathway to word reading.

What is already known about this topic?

• A range of studies has implicated poor socioeconomic background and disadvantaged family circumstances as risks for children's poor word reading.
• Good early development of language skills is firmly established as a pathway to promoting reading ability.
• Not all poor readers show deficits in phonological skills, although such deficits correlate highly with reading difficulties.

What this paper adds

• This is an original analysis of factors in a recent cohort of U.K. children, using stratified sampling to be representative of the U.K. population as a whole.
• A range of child‐specific, family socioeconomic and family relationship factors were independently associated with word‐reading ability when children were age seven.
• For each of the predictors, there was evidence suggesting that a substantial proportion of the effect, if causal, may be mediated by phonological skills (ranging from 52 to 89%).

Implications for theory, policy or practice

• Despite policy intervention, many of the same risk factors identified in older studies still predict children's word‐reading ability in the United Kingdom.
• Results lend weight to the phonological model, where deficits in phonological skills are on the pathway to word reading.

     

Credibility assessment in child sexual abuse investigations: A descriptive analysis

A major challenge in cases of child sexual abuse (CSA) is determining the credibility of children's reports. Consequently cases may be misclassified as false or deemed ‘no judgment possible’. Based on a large national sample of reports of CSA made in Israel in 2014, the study examines child and event characteristics contributing to the probability that reports of abuse would be judged credible. National data files of all children aged 3–14, who were referred for investigation following suspected victimization of sexual abuse, and had disclosed sexual abuse, were analyzed. Cases were classified as either ‘credible’ or ‘no judgment possible’. The probability of reaching a ‘credible’ judgment was examined in relation to characteristics of the child (age, gender, cognitive delay, marital status of the parents,) and of the abusive event (abuse severity, frequency, perpetrator–victim relationship, perpetrator's use of grooming, and perpetrator's use of coercion), controlling for investigator's identity at the cluster level of the analysis. Of 1563 cases analyzed, 57.9% were assessed as credible. The most powerful predictors of a credible judgment were older age and absence of a cognitive delay. Reports of children to married parents, who experienced a single abusive event that involved perpetrator's use of grooming, were also more likely to be judged as credible. Rates of credible judgments found are lower than expected suggesting under-identification of truthful reports of CSA. In particular, those cases of severe and multiple abuse involving younger and cognitively delayed children are the ones with the lowest chances of being assessed as credible.     

The incidence of infant physical abuse in Alaska

OBJECTIVES: To determine the incidence of and risk factors associated with infant (< 1 year of age) physical abuse in Alaska. METHODS: A population-based retrospective cohort study for the 1994-2000 resident birth cohort was conducted by linking data from birth certificates, Child Protective Services, a statewide hospital-based trauma registry, hospital discharge data, and the Alaska Infant Mortality Review (including death certificates). The main outcome measures were the incidences of overall physical abuse and abuse resulting in hospitalization or death. A case of child abuse was defined as an instance of substantiated physical abuse to an infant identified in the Child Protective Services database or an infant death with homicide identified on the death certificate as the manner of death. RESULTS: During the 7-year study period, there were 70,842 births and 325 cases of physical abuse including 72 that led to hospitalization (n = 58), death (n = 4), or both (n = 10); respective incidences for all abuse and abuse leading to hospitalization or death were 4.6 and 1.0 per 1000 live births. Following multivariate analyses, the risk factors with the highest population attributable risks were maternal or paternal education < or = 12 years, unmarried mother, and maternal prenatal substance use. To determine if the study methodology was likely to have missed cases of severe abuse, we examined information for all 216 infants hospitalized for trauma during the study period who did not have identification of abuse in one of the study databases; of these, at least 39 had injuries inconsistent with the reported mechanism (a long bone or skull fracture that reportedly resulted from a fall of less than 3 feet or from a caretaker's arms or for which the caretaker denied a history of trauma). Conclusions: Alaska has one of the highest documented infant physical abuse incidences reported in the literature and abuse is associated with potentially modifiable-primarily social-risk factors. Despite this high incidence, substantial under-reporting of hospitalized cases likely occurs.     

Modeling the Early Paths of Phonological Awareness and Factors Supporting its Development in Children With and Without Familial Risk of Dyslexia

The development of phonological awareness (PA) before school age was modeled in association with the development of vocabulary and letter knowledge, home literacy environment (HLE), children's reading interest, and beginning reading skill in children with and without familial risk of dyslexia. A total of 186 children were followed from birth to the age of 6.5 years. Of these children, about half had a familial background of reading difficulties (the at-risk group), and the other half came from families without such background (the control group). The data from several measures and assessment time points were analyzed within an SEM framework, and a latent analysis of growth curves was employed. Vocabulary and letter knowledge were found to predict PA development, and vice versa, PA predicted them. The effect of HLE on PA was mediated by vocabulary skills, and of the HLE variables, the only variable predicting vocabulary development was shared reading. In spite of the difference in level, favoring the controls, the pattern of effects of vocabulary and letter knowledge on PA development was highly similar in children with and without familial risk for dyslexia. However, in the at-risk group, the HLE variables and children's reading interest had stronger associations with each other and with skill development than in the control group, and vocabulary predicted parental reports on children's reading interest in the at-risk group only.     

The development of children at familial risk for dyslexia: Birth to early school age

Children at risk for familial dyslexia (n = 107) and their controls (n = 93) have been followed from birth to school entry in the Jyvaskyla Longitudinal study of Dyslexia (JLD) on developmental factors linked to reading and dyslexia. At the point of school entry, the majority of the at-risk children displayed decoding ability that fell at least 1 SD below the mean of the control group. Measures of speech processing were the earliest indices to show both group differences in infancy and also significant predictive associations with reading acquisition. A number of measures of language, including phonological and morphological skill collected repeatedly from age three, revealed group differences and predictive correlations. Both the group differences and the predictive associations to later language and reading ability strengthened as a function of increasing age. The predictions, however, tend to be stronger and the spectrum of significant correlations wider in the at-risk group. These results are crucial to early identification and intervention of dyslexia in at-risk children.