Preventing violence against children in schools: Contributions from the Be Safe program in Sri Lanka

Violence against children is a global public health issue with serious social, economic, physical, and emotional impacts. This study evaluates the effectiveness of a school-based program aimed to prevent and respond to physical, sexual, and psychological violence against children in Sri Lanka from the perspective of parents. A cross-sectional retrospective study design was used. A total of 835 parents of children who participated in the program were surveyed across seven districts in Sri Lanka. Dose-response analyses were conducted to assess for correlations between program exposure and perceived prevention of violence against children. Low to moderate correlations were found between exposure to the program and perceived child safety in schools, school policies, and in the community. The findings provide preliminary evidence of program effectiveness; however, more efforts are needed to validate and sustain outcomes. Implications for future violence prevention programming, along with the use of dose-response evaluations, are discussed.     

ICDP approach to awareness-raising about children's rights and preventing violence, child abuse, and neglect

In April 2011, the Committee on the Rights of the Child issued the General Comment No. 13 on the right of the child to freedom from all forms of violence. Its Article 19 declares that "protective measures should, as appropriate, include effective procedures for the establishment of social programs to provide necessary support for the child and for those who have the care of the child." One available social program that focuses on providing support for parents, caregivers and children is the International Child Development Program (ICDP), which is presented in this article. The ICDP is designed to influence and improve the quality of contact and relation between the caregivers, usually parents, and children, through the practical application of the eight themes or guidelines for positive interaction. The Convention on the Rights of the Child is a value-based legal document ratified by most countries in the world. This is a significant achievement and it gives a new basis and legitimization for a more humane treatment of children all over the world. Nevertheless, it is important to understand that there is a big gap between a legal document describing ideal conditions for children at a macro-governmental level and its implementation at the microlevel of families and communities. The ICDP is another expression of the same humanitarian spirit as it is encoded in the convention of children' rights. ICDP can be put in practice in any community to create positive conditions for the fulfillment of fundamental children's rights: the right to be protected from violence and to receive the loving care and guidance from the immediate environment which is required to ensure healthy human development. Introducing children's rights is likely to have a major impact on families (and all levels of authorities) if efforts are also made to activate awareness and deeper bonding to children as persons. Without a deep activation of a more humanized and caring relationship to children, provided by social programs such as ICDP, the advocacy for children's rights may become an empty shell without its basis in human realities.     

Development and initial validation of a scale to measure emotional abuse among school children aged 13-15 years in Sri Lanka

OBJECTIVE: To develop a scale to measure emotional abuse among school children aged 13-15 years in Sri Lanka that can be used in field settings. METHOD: Emotional abuse was defined based on available literature. Review of literature and discussions with a panel identified 85 items indicating abusive behaviors. Content validity and social acceptability were achieved by getting the views of this same panel and parents, respectively. Item analysis and assessment of validity were carried out based on the responses to the draft instrument by 105 children aged 13-15 years attending a school in an urban slum area. The test-retest reliability of the scale was assessed using the responses from 144 students from a different school. Criterion validity was established by comparing the independent assessments of a psychiatrist for the presence or absence of emotional abuse with the respective scores of the children on the scale. RESULTS: The scale developed to assess emotional abuse included 46 items having a Cronbach alpha of .89. The test-retest reliability was .73. A cutoff score of 95 was identified at a sensitivity of 76.9% and a specificity of 51.4%. CONCLUSIONS: A scale that had a satisfactory level of reliability and validity was socially acceptable, which could be used in school settings in Sri Lanka was developed to enable identification of emotional abuse among school children aged 13-15.     

Exposure to domestic violence as abuse and neglect: Constructions of child maltreatment in daily practice

Research finds that exposure to domestic violence can adversely affect the emotional, behavioral, and physical health of children. These effects have led some child advocates and policymakers in the United States to conclude that child exposure to domestic violence (CEDV) is a type of child maltreatment warranting state intervention. However, few states have defined CEDV as a type of maltreatment in statute and little is known about how child welfare agencies respond to allegations of CEDV in the absence of other safety threats. This study considers that CEDV itself might prompt an initial child welfare referral and may be construed by workers as a type of statutory maltreatment. Using a random sample (n = 295) of case records, this study analyzed one large child welfare agency’s response to referrals alleging CEDV between 2011 and 2012. Findings indicate that CEDV itself did trigger investigation. At time of referral, workers used statutory maltreatment typologies to construe alleged CEDV as a type of maltreatment; however, CEDV was not consistently construed as a safety threat and few allegations were substantiated. Instead most families were referred to community-based domestic violence services. Findings indicate that CEDV was not consistently construed as a type of statutory maltreatment and infrequently resulted in ongoing child welfare services. Findings suggest that training is needed to help workers better assess CEDV-related safety threats. Findings also raise questions about what types of interventions are needed to protect children from domestic violence and which types of agencies are best positioned to deliver those interventions.     

History of abuse and neglect in patients with schizophrenia who have a history of violence

Objective

To determine the prevalence of five forms of abuse/neglect during childhood and adolescence in a group of schizophrenic patients with a history of violence.

Methods

Twenty-eight patients hospitalized in a highly secured psychiatric unit were included. Abuse and neglect during patients’ growth were evaluated with the childhood trauma questionnaire (CTQ). History of substance abuse (consumption of cannabis, and/or alcohol, and/or heroin, and/or cocaine during the year that preceded the hospitalization), incarceration, and death of a close parent were also collected.

Results

We found that 46.4% of patients experienced at least 1 form of abuse and/or neglect during childhood and 21.4% of them had experienced more than 2 forms of abuse and/or neglect. The 2 most frequent forms of neglect and abuse were physical abuse (39.3%) and emotional neglect (17.9%). History of substance abuse was found for cannabis (57.1%), alcohol (57.1%), and cocaine and/or heroin (35.7%). We found that 42.8% of patients had 1 close relative who had died during their growth and that 41.6% of these deaths were violent.

Conclusion

It appears important to systematically search for and assess a history of abuse and neglect during growth in schizophrenic patients with a history of violence, in order to offer specific treatments for this group of patients.     

Counseling in the area of child sexual abuse within the family

This paper considers the recent recognition in Ireland of the problem of child sexual abuse. In 1983, the Government Department of Health, for the first time, allocated a separate category for it in its statistics. Treatment to date has been one of localised and ad hoc arrangements.Counseling approaches follow broadly the divisions that exist in the theoretical models that seek to explain the aetiology of abuse. These can be characterised as (1) those programs that derive from the family systems model and that emphasise dysfunctional family dynamics and (2) programs established for the counseling of a wide range of sex offenders, including intrafamily abusers, and which emphasise traits or aspects of individual perpetrator functioning. Both approaches, however, share fundamental prerequisites. These prerequisites are considered.Three issues are of particular relevance during counseling. The first relates to the child victim at the time of the discovery or disclosure of the abuse, and prior to entry into a family counseling program. The second looks at counseling programs that emphasise the family dimension. The third deals with counseling approaches for perpetrators of abuse. Each of these three topics will be discussed.     

斯里兰卡开放大学的质量保证与启示

为应对高等教育发展所带来的挑战,斯里兰卡逐步建立了一个强大且全面的、内外部质量保证相结合的高等教育质量保证体系。在该体系框架下,斯里兰卡开放大学在课程管理、学生管理、师资管理、信息管理等方面采取了一系列质量保证措施,形成了一些基本经验,为我国远程开放教育的质量保证提供了借鉴与启示:遵循统一的国家资格框架、开展内外部质量保证活动、围绕学习者需求开发课程、引入第三方学生评价机制、注重教师的激励与培训、建立有效的信息沟通机制。     

The relationship of exposure to childhood sexual abuse to other forms of abuse,neglect, and household dysfunction during childhood

OBJECTIVE: This study assesses the relationship of childhood sexual abuse (CSA) to nine other categories of Adverse Childhood Experiences (ACEs), including childhood abuse, neglect, and multiple types of household dysfunction. METHODS: Retrospective cohort study data were collected from 17,337 adult health plan members who responded to a survey questionnaire. Regression models adjusted for age, race, and education were used to estimate the strength of the association of CSA to each of the other nine ACEs and a graded relationship between measures of the severity of CSA and the number of other ACEs (ACE score). RESULTS: CSA was reported by 25% of women and 16% of men. In comparison with persons who were not exposed to CSA, the likelihood of experiencing each category of ACE increased 2- to 3.4-fold for women and 1.6- to 2.5-fold for men (p < 0.05). The adjusted mean ACE score showed a significant positive graded relationship to the severity, duration, and frequency of CSA and an inverse relationship to age at first occurrence of CSA (p < 0.01). CONCLUSIONS: CSA is strongly associated with experiencing multiple other forms of ACEs. The strength of this association appears to increase as the measures of severity of the CSA increases. The understanding of the interrelatedness of CSA with multiple ACEs should be considered in the design of studies, treatment, and programs to prevent CSA as well as other forms of ACEs.     

Effects of family violence on psychopathology symptoms in children previously exposed to maltreatment

Although many studies suggest that family violence is associated with child psychopathology, multiple features of the home environment might account for this association, such as poverty and caregiver psychopathology. Studies are needed examining how change in psychopathology symptoms is affected by home violence, controlling for children's own developmental symptom histories and other predictors of psychopathology. This study used latent difference score structural equation modeling to test if witnessing home violence and/or experiencing harsh physical discipline predicted changes in psychopathology symptoms among 2,925 youth aged 5-16 years previously exposed to violence. Results demonstrated that harsh physical discipline predicted child-specific changes in externalizing symptoms, whereas witnessing violence predicted child-specific changes in internalizing symptoms across time. Implications for research and policy are discussed.     

The prevalence and context of family violence against children in Finland

The prevalence and context of violence against children in their families was surveyed as part of a study on the sexual abuse of children. A random sample of 409 comprehensive school classes with approximately 9,000 15-year-olds was asked to anonymously fill out questionnaires. The majority filled out the questionnaires in the privacy of the school nurse's office, the rest in their classrooms. Of the selected classes, 88.8% participated in the survey, and the response rate of the students in those classes was 96%. Mild violence (slapping, pushing, etc.) was reported by 72% of the respondents, and severe violence (hitting with a fist, kicking, use of weapons) was reported by 8%. Violence was committed by the parents sometime before the children reached age 14. Incidents of violence during the year preceding the survey were reported by 19% and 5%, mild and severe, respectively. Mild violence was committed slightly more often by mothers than fathers. Severe violence was perpetrated more frequently by fathers. Girls reported mild abuse more often than boys. Severe violence was experienced equally often by both sexes. Children living with single mothers reported less-than-average mild violence, but more frequent severe violence. The highest incidence of severe violence was found among youth living in families with a stepfather. Unemployment in a family tended to increase both mild and severe violence. Violence was reported least often by children living in farming families or Swedish speaking families (which make up about 6% of Finnish population). Overall the frequency of violence toward children in Finland is significantly lower than in the U.S. Comparison to Sweden seems to show an identical level of child abuse, although different study methods make comparisons difficult.     

Child abuse and neglect in infancy: sources of hostility within the parent-infant dyad and disorders of attachment in infancy

The human infant is prepared during fetal life and arrives on the scene ready to participate actively as a partner with the parent in structuring his own development. Parents are normally prepared for this participant activity by achieving a high degree of sensitivity to the signals of distress of and by the infant's affective engagement with them. The meaning of ordinary distress signals is in instances of child abuse and neglect determined by an unconscious mythology which the parent has about the infant, and also by what the parent finds unacceptable in oneself and projects onto the infant. The recent research on mother-infant attachment is reviewed. Landmarks for normal attachment behaviors from birth to age 3 are defined within seven different age groupings, and the psychiatric syndrome, "Reactive Attachment Disorder of Infancy," is described and is found almost universally in failure to thrive without organic cause babies. The diagnosis of Reactive Attachment Disorder is preferable because it leads to appropriate preventive and interventive action.     

Oral health in children investigated by Social services on suspicion of child abuse and neglect

Child abuse and neglect (CAN) are likely to have negative consequences on health; however, for oral health, studies on associated outcomes are sparse. The purpose of this study was to assess oral health and oral health behaviors in relation to suspected CAN among children being investigated by the Swedish Social Services. The material comprised data from the Social Services and dental records; the sample, 86 children and 172 matched controls. The children in the study group had a higher prevalence of dental caries than the control group; in addition, levels of non-attendance and dental avoidance were high, as was parental failure to promote good oral health. We found four factors that, taken together, indicated a high probability of being investigated because of suspected CAN: prevalence of dental caries in primary teeth, fillings in permanent teeth, dental health service avoidance, and referral to specialist pediatric dentistry clinics. If all four factors were present, the cumulative probability of being investigated was 0.918. In conclusion, there is a high prevalence of dental caries, irregular attendance, and a need for referral a pediatric dental clinic among Swedish children under investigation due to suspected CAN. Social context is an important factor in assessing the risk of developing dental caries, the inclination to follow treatment plans, and the prerequisites for cooperation during treatment. Routinely requesting dental records during an investigation would provide important information for social workers on parental skills and abilities to fulfill the basic needs of children.