Neighborhoods and child maltreatment: a multi-level study

OBJECTIVE: To better understand how neighborhood and individual factors are related to child maltreatment. METHOD: Using an ecological framework, a multi-level model (Hierarchical Linear Modeling) was used to analyze neighborhood structural conditions and individual risk factors for child abuse and neglect. Parents (n = 400) of children under the age of 18 were systematically selected from 20 randomly selected census-defined block groups with different risk profiles for child maltreatment report rates. Parents were administered the Neighborhood Environment for Children Rating Scales, the Child Abuse Potential Inventory, the Zimet measure of social support, and the Conflict Tactics Scales as a measure of childhood experience with violence. RESULTS: Neighborhood factors of impoverishment and child care burden significantly affect child abuse potential after controlling for individual risk factors. However, neighborhood effects are weaker than they appear to be in aggregate studies of official child maltreatment reports. Variation in child abuse potential within neighborhoods is greater than between neighborhoods. However, adverse neighborhood conditions weakend the effects of known individual risk and protective factors, such as violence in the family of origin. CONCLUSIONS: If individual potential for child maltreatment is more evenly distributed across neighborhoods than reported maltreatment, then neighborhood and community play an important, if as yet unspecified, role in child maltreatment. Multi-level models are a promising research strategy for disentangling the complex interactions of individual and contextual factors in child maltreatment.     

Resilience in child maltreatment victims: a conceptual exploration

While many child maltreatment victims suffer serious negative emotional sequelae, others do surprisingly well. Resilience in children is a relative concept which can change over time and is affected by environment and genetics. Resilience is fostered by protective factors which ameliorate or alter a child's response to the hazards of maltreatment that usually predispose to maladaptive outcome. Personal characteristics or skills that may foster resilience include (1) rapid responsivity to danger; (2) precocious maturity; (3) dissociation of affect; (4) information seeking; (5) formation and utilization of relationships for survival; (6) positive projective anticipation; (7) decisive risk taking; (8) the conviction of being loved; (9) idealization of an aggressor's competence; (10) cognitive restructuring of painful experiences; (11) altruism; and (12) optimism and hope. There are also generic life circumstances, such as having access to good health, educational, and social welfare services, that foster resilience in children regardless of the specific nature of the stressor. Additionally, there may be abuse-specific protective factors in the environment. Examples might include the quick and full acknowledgment of an offender regarding abuse, or timeliness and permanence of legal actions affecting a child's custody. The life stories of three well-known survivors of various forms of child maltreatment illustrate how protective factors contribute to resilience. A caution is noted regarding how personal characteristics developed for survival may become maladaptive if overused and/or not given up when the stressor no longer exists. Characterological problems are most likely to develop when a child's life circumstances fail to change and the environment never becomes secure.     

Academic achievement despite child maltreatment: a longitudinal study

Purpose

Although researchers have concluded that child maltreatment has a negative effect on children's learning and academic achievement, not all children are negatively affected by maltreatment, and some children seem to succeed academically despite being maltreated. Drawing on risk and resilience theory, we examined a broad range of potential risk, promotive, and protective factors within children and their environments along with characteristics of the maltreatment to account for variability in test scores.

Methods

A national longitudinal probability sample of 702 maltreated school-aged children, ages 6-10, and their caregivers was used to predict reading and math scores among maltreated children over three years.

Results

We found that chronic maltreatment, poorer daily living skills, and lower intelligence explained a substantial proportion of the variance in maltreated children's math scores (39%), whereas type of maltreatment, poorer daily living skills and lower intelligence explained a substantial proportion of the variance in reading scores (54%) over time. Contrary to our prediction, having a behavior problem seemed to protect chronically maltreated children from poorer performance in math over time.

Conclusions

To increase academic achievement among maltreated children, it is imperative that we prevent chronic maltreatment and help children increase their competency on daily living skills.     

Measurement of emotional/psychological child maltreatment: a review

Background

Emotional/psychological child maltreatment (ECM) is a major public health problem with serious consequences including emotional and behavioral problems. Nevertheless, ECM is an understudied area.

Objectives

The aims of this review are to identify measures of ECM and to evaluate their psychometric properties and utilities. We provide a summary of ECM measures that have been tested for their reliability and validity, evaluate the quality of these assessments and suggest directions for future research.

Methods

We searched PsycINFO and Medline databases from 2000 to 2010 in addition to a hand search of retrieved references; 2344 were identified and the abstracts reviewed independently by two authors to identify relevant articles. Using pre-established criteria, 144 of those articles were selected and reviewed in full to assess whether the instruments included a separate measure of ECM and its psychometric properties.

Results

Forty-five articles examining 33 measures met the inclusion criteria and were selected for further review. The majority of measures demonstrated acceptable reliability; fewer measures had evaluated one or more types of validity.

Conclusion

Both reliability and validity testing are required in order to establish more accurate measures of ECM.

Practice implications

Reliable and valid measures are necessary to enhance our limited knowledge about the distribution, determinants and consequences of ECM.     

Unintended pregnancy as a predictor of child maltreatment

Whereas child maltreatment research has developed considerable evidence on post-natal risk-factors, pre-natal circumstances have been largely overlooked. The circumstances surrounding a pregnancy may considerably impact the environment in which later parenting behaviors occur. This study examines one of the earliest potentially identifiable risk-factors for child maltreatment: the intentions of a pregnancy. Utilizing both mother and father reports, this study focuses on maltreatment risk, as it relates with both parents’ perspectives of the pregnancy's intention. Drawing upon data from the Fragile Families and Child Well Being study, a longitudinal, birth cohort study, survey questions were used that asked parents, at the time of the birth, whether they considered abortion for the child. Unintended pregnancy demonstrates predictive value as one of the earliest identifiable risk-factors for child maltreatment. Regardless of whether the mother or father reported the unintended pregnancy, the relationship with maltreating behavior is largely the same, although for different maltreatment types. Mothers’ reports of unintended pregnancy are associated with psychological aggression, and neglect. Fathers’ reports of unintended pregnancy are associated with physical aggression. Fathers’ perspectives regarding pregnancy intentions matter just as much as mothers,’ and accounting for their perspectives could be important in understanding the maltreating behaviors of both parents. Identifiable in the earliest stages of caregiving, unintended pregnancy may be an important risk-factor in predicting and understanding child maltreatment.     

Social support and child maltreatment: a review of the evidence

Parents who maltreat their children have long been thought to lack support from informal and social networks. Recent writers have taken the position that this relationship is a proven, causal one, with social isolation seen as a necessary antecedent condition for the occurrence of child abuse. Concurrently, initial enthusiasm for social support as a powerful explanatory variable in other areas of psychological and health research is giving way to cautious reevaluation of the evidence. The present review was undertaken to bring into sharper focus what is now known regarding the relationship between child maltreatment and parental isolation from informal helping networks. Existing research is fraught with both conceptual and methodological problems. There is, at present, little research evidence that lack of social support plays a significant role in the etiology of physical abuse. Stronger evidence exists that neglectful parents are socially isolated, but the data are consistent with the hypothesis that this is one manifestation of the character problems of these parents. Future research must give closer attention to clearly defining social support and using reliable and valid instruments to measure it, while exploring multivariate models of child maltreatment.     

Community interaction and child maltreatment

The way in which parents interact with their environment may have implications for their likelihood of abuse and neglect. This study examines the parent–environment relationship through community involvement and perception, using social disorganization theory. We hypothesize mothers who participate in their communities and have positive perceptions of them may be less likely to maltreat their children because of the potential protective capacity of neighborhood supports. Using information from the 5 year Fragile Families and Child Wellbeing Study (n = 2991), the mother's self-reported acts of psychological and physical maltreatment and neglect are measured. A mother's community involvement index is the number of community activities a mother was involved in, and community perception is measured by two five-item Likert scales assessing perception of community collective efficacy. We analyze the relationship between community variables and each of mother's maltreatment behaviors as well as the interaction between community factors using a series of nested logistic regressions. Higher levels of community involvement are associated with lower levels of psychological aggression. More positive perception of community social control is associated with lower levels of physical assault. A moderation effect of community perception suggests that a mother's perception of her community changes the relationship between community involvement and psychological child abuse. The results provide important policy and empirical implications to build positive and supportive communities as a protective factor in child maltreatment. Getting parents involved in their communities can improve the environment in which children and families develop, and decrease the likelihood that maltreatment will occur.     

Social isolation from communities and child maltreatment: a cross-cultural comparison

OBJECTIVE: The aim of this study is to determine: (1) the differences between Spanish and Colombian cultures in relation to community social support variables, and (2) the relationships between community social support variables and child maltreatment in both cultures. METHOD: The study was based on 670 nonabusive families and 166 abusive families. The parents were asked to complete the Community Social Support Questionnaire. This instrument measures community social support in terms of Community Integration and Satisfaction, membership in voluntary organizations and community participation, and use of Community Resources of Social Support. RESULTS: Differences between both cultures were found in the pattern of community social support for the nonabusive groups. However, the relationships between community social support and child maltreatment were similar cross-culturally. Our results indicate that in both cultures abusive parents show lower levels of community integration, participation in community social activities and use of formal and informal organizations than the parents that provide adequate care. CONCLUSIONS: The results largely support the literature that has repeatedly reported the link between social isolation and child maltreatment and they confirm this relation within two cultural contexts, Colombian and Spanish, quite different from the Anglo-Saxon context, where most of the previous studies have been carried out.     

Measuring child maltreatment risk in communities: a life table approach

OBJECTIVE: The purpose of this article is to: (1) illustrate the application of life table methodology to child abuse and neglect report data and (2) demonstrate the use of indicators derived from the life tables for monitoring the risk of child maltreatment within a community. METHOD: Computerized records of child maltreatment reports from a large, urban county in Ohio are cumulated for 11 years and linked for each child. Life table methods are used to estimate the probability that children from birth to age 10 will be reported victims of maltreatment by age, race, and urban or suburban residence. RESULTS: Using life tables, the estimates in the county of this study are that 33.4% of African American children and 11.8% of White children will appear in substantiated or indicated child abuse or neglect report(s) by their 10th birthday. The age-specific probability of a maltreatment report is highest in the first year of life for both groups. The probability of a child being reported for a substantiated or indicated incident of maltreatment before his or her 10th birthday is more than three times higher for city dwellers than for suburbanites in the urban county studied here. CONCLUSIONS: Life table methodology is useful for creating child well-being indicators for communities. Such indicators reveal that a larger portion of the child population is affected by maltreatment reports than would be concluded from examining cross-sectional rates and can be used to identify racial or geographic disparities.     

Trends in child maltreatment literature

INTRODUCTION: To identify possible gaps in the child maltreatment literature the present study examined the development of the child maltreatment literature over a 22-year period, including temporal trends for child maltreatment types, the characteristics of the research participants, and sources of participant recruitment. METHOD: Child maltreatment articles (N=2090) published from 1977 to 1998 (inclusive) in six specialty journals were coded on type of article, type of child maltreatment, gender and parental status of participants, abuse role of participants, and recruitment source of participants. RESULTS: Across the period studied the annual percentage of quantitative articles (articles with inferential statistics) increased, whereas the annual percentage of theoretical articles decreased. The annual percentage of articles examining child physical abuse (CPA) decreased, whereas the annual percentage of articles examining child sexual abuse (CSA) increased. The percentages of articles examining child neglect (CN) or child emotional abuse (CEA) remained consistently low. Distinguishing child maltreatment types in research articles increased. Males were underrepresented in CPA perpetration and CPA adult victimization articles, but adequately represented in CSA perpetration and CPA child victimization articles. Females were adequately represented in CPA perpetration and CSA child and adult victimization articles. Recruitment from universities and outpatient mental health facilities increased; recruitment from medical settings decreased. CONCLUSIONS: CN and CEA literatures need to be developed first by theoretical, then by quantitative works. In addition, the publication of more research on male subjects for CPA perpetration and adult CPA victimization is needed.     

Measuring the severity of child maltreatment

OBJECTIVE: The purpose was to identify different operational definitions of maltreatment severity, and then to examine their predictive validity. METHOD: Children and their primary caregivers participating in a consortium of ongoing longitudinal studies were interviewed when they were approximately 4 and 8 years of age to assess behavior problems, and developmental and psychological functioning. Four different severity definitions were identified and applied to 519 children who were reported for alleged maltreatment between Birth and the Age 8 interview. A taxonomy for defining maltreatment characteristics (Barnett, Manly, & Cicchetti, 1993) was applied to Child Protective Service records to define severity as (a) Maximum Severity within each of five maltreatment types, (b) Overall Maximum Severity across the five types, (c) Total Severity or the sum of the maximum severity for each of five types, and (d) Mean Severity or the average severity for those types of maltreatment alleged, during each of two time periods-Birth to Age 4, and Age 4 to Age 8. RESULTS: Regression analyses that controlled for socio-demographic factors, early maltreatment (Birth to Age 4), prior functioning (Age 4), and site revealed that (a) all four severity definitions for maltreatment reports between Age 4 and Age 8 predicted Age 8 behavior problems, (b) Maximum Severity by Type and Mean Severity predicted adaptive functioning at Age 8, and (c) only Maximum Severity by Type was related to anger, at Age 8. Follow-up regression analyses indicated that only Maximum Severity by Type, specifically physical abuse, accounted for outcomes, beyond maltreatment occurrence versus non-occurrence. CONCLUSION: The results suggest that maltreatment severity definitions that preserve ratings within types of maltreatment may be the optimal approach to measure the severity of children's experiences.     

Longitudinal association of child maltreatment and cognitive functioning: Implications for child development

Although research investigating associations among child maltreatment, cognitive functioning, and academic achievement has grown in recent years, important questions remain. In particular, assessing the influence of maltreatment apart from that of other co-occurring and confounding factors remains difficult. This study was developed to further the field’s understanding by investigating cognitive functioning in association with time-variant maltreatment patterns. Using multiple time-variant linear mixed models, we investigated the relationships between maltreatment timing and three domains of cognitive functioning (i.e., knowledge, comprehension, and analysis). In general, the cognitive functioning of students who experienced maltreatment was lower than that of their peers who had yet to experience maltreatment at the time of testing. Results of LMM indicated that the cognitive functioning of students who experienced maltreatment concurrent with the testing year fluctuated over time whereas the cognitive functioning of students who experienced maltreatment prior to or after the testing year remained stable. Students who experienced concurrent maltreatment showed the lowest functioning of any group. While maltreatment timing was a significant predictor of cognitive functioning over time, the addition of poverty into the model resulted in a non-significant effect of maltreatment timing. Additional research is needed to disentangle the longitudinal effect of maltreatment on cognitive functioning and address the interacting role of poverty and chronic maltreatment.     

Risk terrain modeling predicts child maltreatment

As indicated by research on the long-term effects of adverse childhood experiences (ACEs), maltreatment has far-reaching consequences for affected children. Effective prevention measures have been elusive, partly due to difficulty in identifying vulnerable children before they are harmed. This study employs Risk Terrain Modeling (RTM), an analysis of the cumulative effect of environmental factors thought to be conducive for child maltreatment, to create a highly accurate prediction model for future substantiated child maltreatment cases in the City of Fort Worth, Texas. The model is superior to commonly used hotspot predictions and more beneficial in aiding prevention efforts in a number of ways: 1) it identifies the highest risk areas for future instances of child maltreatment with improved precision and accuracy; 2) it aids the prioritization of risk-mitigating efforts by informing about the relative importance of the most significant contributing risk factors; 3) since predictions are modeled as a function of easily obtainable data, practitioners do not have to undergo the difficult process of obtaining official child maltreatment data to apply it; 4) the inclusion of a multitude of environmental risk factors creates a more robust model with higher predictive validity; and, 5) the model does not rely on a retrospective examination of past instances of child maltreatment, but adapts predictions to changing environmental conditions. The present study introduces and examines the predictive power of this new tool to aid prevention efforts seeking to improve the safety, health, and wellbeing of vulnerable children.     

Identification of child maltreatment using prospective and self-report methodologies: a comparison of maltreatment incidence and relation to later psychopathology

OBJECTIVES: One of the greatest methodological problems in the study of childhood maltreatment is the discrepancy in methods by which cases of child maltreatment are identified. The current study compared incidents of maltreatment identified prospectively, retrospectively, or through a combination of both methods. METHOD: Within a cohort of 170 participants followed from birth to age 19, incidents of maltreatment which occurred prior to age 17.5 were identified via prospective case review and interviewer ratings of retrospective self-reports. Multi-informant measures of behavior problems were obtained at age 16, and diagnostic assessments of psychopathology were completed at age 17.5. RESULTS: While the maximal number of maltreatment cases was identified by using a combination of all available identification methods, the prospective method was the single most comprehensive method for identifying the most cases of childhood physical abuse, sexual abuse, and neglect. Those who were identified as maltreated by a combination of both prospective and self-report methods experienced the greatest number of incidences of maltreatment (i.e., 49% of this group experienced more than one type of maltreatment) and displayed the most emotional and behavioral problems in late adolescence (i.e., 74% met diagnostic criteria for a clinical disorder). CONCLUSIONS: This study emphasizes the variability in the incidence rates of maltreatment and the psychological outcomes that result from utilizing different methods of identification. The most severe cases of maltreatment are likely to be identified by both prospective and retrospective methods; however, cases that are identified solely through retrospective self-report may have unique relations to psychopathology in late adolescence. PRACTICE IMPLICATIONS: Reliance on a single method to identify childhood maltreatment incidents often overlooks many cases. Comparing both prospective case reviews and retrospective self-reports in late adolescence, the most severe cases of multiple incidents of abuse were most likely to be identified by both methodologies. The less severe maltreatment incidents were more likely to be missed, either by prospective methods or, more frequently, by self-report methods. Practitioners must be continually sensitive to possible abuse histories among their clients, seeking out information from multiple sources whenever feasible. Additionally, the potential effects of abuse disclosure on pre-existing or developing psychopathology should be considered.     

Parental substance abuse as a predictor of child maltreatment re-reports

This longitudinal study of child abuse and neglect cases closed after investigation examined the impact of parental substance abuse on family functioning and on subsequent referrals to child protective services. The findings support the hypothesis that parental substance abuse would have a negative impact on family functioning, which, in turn, would result in a higher rate of re-reports. As expected, substance abuse also had a direct impact on re-reports. It is critical that the child welfare system recognize and respond to parental substance abuse problems in these families through expanded and improved voluntary, and perhaps, mandatory services.     

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.     

Adolescent risk factors for child maltreatment

We investigate adolescent risk factors, measured at both early and late adolescence, for involvement in child maltreatment during adulthood. Comprehensive assessments of risk factors for maltreatment that use representative samples with longitudinal data are scarce and can inform multilevel prevention. We use data from the Rochester Youth Development Study, a longitudinal study begun in 1988 with a sample of 1,000 seventh and eighth graders. Participants have been interviewed 14 times and, at the last assessment (age 31), 80% were retained. Risk factors represent 10 developmental domains: area characteristics, family background/structure, parent stressors, exposure to family violence, parent–child relationships, education, peer relationships, adolescent stressors, antisocial behaviors, and precocious transitions to adulthood. Maltreatment is measured by substantiated reports from Child Protective Services records. Many individual risk factors (20 at early adolescence and 14 at later adolescence) are significantly, albeit moderately, predictive of maltreatment. Several developmental domains stand out, including family background/structure, education, antisocial behaviors, and precocious transitions. In addition, there is a pronounced impact of cumulative risk on the likelihood of maltreatment. For example, only 3% of the youth with no risk domains in their background at early adolescence were involved in later maltreatment, but for those with risk in 9 developmental domains the rate was 45%. Prevention programs targeting youth at high risk for engaging in maltreatment should begin during early adolescence when risk factors are already at play. These programs need to be comprehensive, capable of addressing the multiple and interwoven nature of risk that is associated with maltreatment.