Child abuse and neglect: Preventable causes of mental retardation

Retrospective case study analysis was done to determine the number of persons retarded due to child abuse and neglect. Analysis was made of 436 cases of mental retardation diagnosed between 1957 and 1973 by a multiprofessional team in Anchorage, Alaska. Independent analysis was made by the two authors using predetermined criteria of maltreatment and reliability of data. Sixty-five of 436 (14.9) cases had evidence of abuse and neglect prior to identification of their retardation. Higher rates of abuse and neglect were found among native Alaskans (Aleuts, Eskimos, and Indians) than Caucasians. Higher rates of abuse and neglect were found among females than males of the mentally retarded population.Paucity of reported studies of abuse and neglect as causes of mental retardation is discussed. It is concluded that abuse and neglect are preventable, but underappreciated, causes of mental retardation.     

Predictors of placement for children who initially remained in their homes after an investigation for abuse or neglect

Objective

To examine the frequency and predictors of out-of-home placement in a 30-month follow-up for a nationally representative sample of children investigated for a report of maltreatment who remained in their homes following the index child welfare report.

Methods

Data came from the National Survey of Child and Adolescent Well-being (NSCAW), a 3-year longitudinal study of 5,501 youth 0-14 years old referred to child welfare agencies for potential maltreatment between 10/1999 and 12/2000. These analyses focused on the children who had not been placed out-of-home at the baseline interview and examined child, family and case characteristics as predictors of subsequent out-of-home placement. Weighted logistic regression models were used to determine which baseline characteristics were related to out-of-home placement in the follow-up.

Results

For the total study sample, predictors of placement in the 30-month follow-up period included elevated Conflict Tactics Scale scores, prior history of child welfare involvement, high family risk scores and caseworkers’ assessment of likelihood of re-report without receipt of services. Higher family income was protective. For children without any prior child welfare history (incident cases), younger children, low family income and a high family risk score were strongly related to subsequent placement but receipt of services and case workers’ assessments were not.

Conclusions/practice implications

Family risk variables are strongly related to out-of-home placement in a 30-month follow-up, but receipt of child welfare services is not related to further placements. Considering family risk factors and income, 25% of the children who lived in poor families, with high family risk scores, were subsequently placed out-of-home, even among children in families who received child welfare services. Given that relevant evidence-based interventions are available for these families, more widespread tests of their use should be explored to understand whether their use could make a substantial difference in the lives of vulnerable children.     

Dynamics of forensic interviews with suspected abuse victims who do not disclose abuse

OBJECTIVES: The present study was designed to explore structural differences between forensic interviews in which children made allegations and those in which children did not make allegations. METHODOLOGY: Fifty forensic interviews of 4- to 13-year-old suspected victims of abuse who did not disclose abuse during the interview were compared with the same number of forensic interviews of alleged victims who made allegations of sexual or physical abuse. Only cases in which there was substantial reason to believe that abuse had taken place were included in the study. Audiotapes of the interviews were examined with a focus on interviewer utterances and children's responses during the pre-substantive rapport-building, episodic memory training, and 'getting the allegation' phases of the interviews, which all employed the NICHD Investigative Interview Guide. FINDINGS: Forensic interviews which yielded allegations of child abuse were characterized by quite different dynamics than interviews with children who did not make allegations. When interviewing non-disclosers, interviewers made less frequent use of free recall prompts and offered fewer supportive comments than when interviewing children who made allegations of abuse. Children who did not disclose abuse were somewhat uncooperative, offered fewer details, and gave more uninformative responses, even at the very beginning of the interview, before the interviewers focused on substantive issues and before the interviewers themselves began to behave differently. CONCLUSIONS: A premature focus on substantive issues may prevent children who are not responsive in the episodic memory training phase from disclosing abuse. Identifying reluctant disclosers and making more extensive efforts to build rapport before substantive issues are broached, or interviewing such children in more than one session, may help suspected victims disclose their experiences.     

Sexual abuse and exploitation of children and adults with mental retardation and other handicaps

There is growing recognition that children, adolescents, and adults who are mentally retarded are particularly vulnerable to sexual abuse and exploitation and are in need of intervention services. These people are especially vulnerable due to ther often life-long dependence on caregivers, relatively powerless position in society, emotional and social insecurities, and lack of education regarding sexuality and sexual abuse. In addition the mental health functioning and emotional development of individuals who are mentally retarded are not well understood, and many professionals remain uneducated about their mental health needs. To work effectively with this population, mental health professionals and educators must be alert to what is known about the sexual abuse and exploitation of persons with mental retardation. Furthermore, they need to become educated about the rights of these persons to special legal protection from abuse and neglect and to appropriate and effective mental health interventions. The challenge for mental health professionals and educators is to protect persons who are mentally retarded from sexual abuse and exploitation, to provide appropriate psychotherapeutic interventions when abuse occurs, to respect their right to developmentally appropriate knowledge about sexuality and sexual abuse, and to allow for the fulfillment of their sexuality.     

Intervention with infants at risk for abuse or neglect

The need for direct services to infants at risk for abuse or neglect is addressed, with an emphasis on the advantages to the child of the integration of various modalities of treatment. The expertise of professionals who work with infants and young children in therapeutic and stimulation programs is required. Their experience also underscores the need for direct intervention in the parent-child interaction process. The developmental line of mastery and competence is reviewed with highlights of how this may be derailed in the at-risk infant. Finally, two suggestions are developed: that empathy might be taught to parents through an educational mode and that surrogate parenting, part-time, might be implemented routinely with mistreated children, at-risk infants, and perhaps for all infants.     

A treatment and education program for parents and children who are at-risk of abuse and neglect

A treatment program for families at-risk of abusive or neglectful parenting was described and evaluated. The program combined intervention strategies and concepts based on research on abuse, early intervention, education and social service. Treatment and education for the parent and child were provided in the three services of the program: Home-Based, Family School, and Neighborhood Peer Support Groups. At-risk families were identified by a high-risk stress index. Program evaluation was based on 46 families and their 74 preschool-age children. Data collected were: incidence of child abuse or neglect, family stresses, observations of parent-child interactions, family goal measurement, and developmental testing of the children. A significant reduction occurred in the number of children abused or neglected as compared to a similar high-risk, nonintervention sample. The family stresses were reduced, parent-child interactions improved, and the intellectual decline of the children was prevented. Families who participated in all three services gained the most from the program.     

Disentangling the mental health impact of childhood abuse and neglect

It is unclear whether maltreatment types exert common or specific effects on mental health. In the current study, we aimed to systematically characterize the unique, shared and cumulative effects of maltreatment types on psychiatric symptoms, using data drawn from a community sample of high-risk youth (n = 204, M = 18.85). Analyses controlled for a range of potentially confounding variables, including socio-demographic variables, neighbourhood deprivation and levels of community violence exposure. Outcome measures included multi-informant reports of internalizing difficulties, as well as data on externalizing problems and trauma-related symptoms. We found that (i) consistent with previous studies, maltreatment types were highly interrelated and frequently co-occurred; (ii) symptom severity linearly increased with the number of maltreatment types experienced (more so for self-report vs informant ratings); and (iii) while most forms of maltreatment were significantly associated with mental health outcomes when examined individually, few unique effects were observed when modelling maltreatment types simultaneously, pointing to an important role of shared variance in driving maltreatment effects on mental health. Emotional abuse emerged as the main independent predictor of psychiatric symptomatology – over and above other maltreatment types – and this effect was comparable for males and females (i.e. no significant interaction with sex). Findings contribute to a better understanding of heterogeneity in individual responses to maltreatment.     

Navajo child abuse and neglect study: A comparison group examination of abuse and neglect of navajo children

The presence of vastly different cultural influences on child rearing and family life in Native Americans than are found in the general population offers an opportunity to examine the issue of child abuse and neglect in a different cultural context. A study was conducted to obtain baseline data and to isolate types and circumstances associated with maltreatment of Navajo children under 9 years of age. Records from tribal and state courts, the Bureau of Indian Affairs (BIA), state social services and a sample of ambulatory pediatric cases were reviewed to elicit abuse or neglect status data for calendar year 1975. Data on 365 abuse or neglect cases were compared with 867 nonabused or nonneglected children (comparison group). A double blind case numbering system was employed to ensure confidentiality of data obtained. Abuse cases were dichotomized according to litigation status (e.g., adjudicated versus documented by clinical findings). Neglect cases were categorized by perceived parental control over circumstances leading to the neglect (e.g., voluntary versus involuntary neglect). Reliability sub-studies were conducted by study staff and Navajo volunteers to assess the degree of agreement in the classification of study case status. Tribal census data for 1975 provided baseline information from which the incidence of abuse or neglect involving Navajo children was established. Extrapolated study data suggests up to 8.6% of the reservation resident Navajo children under age 9 to have been abused or neglected. Various sociode-mographic characteristics differentiating the abusive and neglectful families from those of the nonabused or nonneglected children in the comparison group are reported.     

Child abuse and neglect re-report rates for young children with developmental delays

The study objective was to examine the likelihood and magnitude of child abuse and neglect (CAN) re-reports for young children (0–71 months) with delays in cognitive, language, and adaptive development, compared to typically developing children. The National Survey of Child and Adolescent Well-Being (NSCAW II), a nationally representative and longitudinal survey, was used to examine CAN re-reports at two follow-up waves, 18- and 36-months post baseline assessments. Logistic regression models were employed to determine the correlation between number of developmental delays and a CAN re-report at waves 2 and 3. Results indicate that children with three or more domains of delays had odds 4.73 times higher than children without developmental delays of re-report to CPS at wave 2 but not at wave 3. In this study, children with multiple developmental delays have elevated rates of CAN re-reports when compared to typically developing children. Allocation of child welfare resources should include strategies for preventing maltreatment risk among children with developmental delays.     

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.     

Confirmed, unconfirmed, and false allegations of abuse made by adults with mental retardation who are members of a class action lawsuit

OBJECTIVE: The purpose is to explore differences in confirmed, unconfirmed, and false allegations of abuse made by consumers with mental retardation in regards to type of abuse and perpetrator. METHOD: Interviews were conducted with 1,220 people with mental retardation who were part of a class action lawsuit in North Carolina. A content analysis of abuse allegations was performed. Frequencies of responses and subgroup differences are reported for type of abuse allegation and perpetrator. RESULTS: Unconfirmed claims are the most frequent. Females made more allegations of abuse than males in general, and more allegations of rape. There are no significant differences among the subgroups (confirmed, unconfirmed, and false allegations) by type of abuse allegation. There are significant differences among the subgroups in regard to the alleged perpetrator. Other consumers with mental retardation are most frequently accused of confirmed assaults. Staff members are most frequently accused in false allegations. CONCLUSION: Ability of the alleged victim to report information and timing of the investigation are important factors in substantiating abuse. Awareness of consumer-to-consumer violence and prevalence of false accusations against staff necessitates increased safeguards for both consumers and staff.     

The role of gestures in the mathematical practices of those who do not see with their eyes

In this paper, we aim to contribute to the discussion of the role of the human body and of the concrete artefacts and signs created by humankind in the constitution of meanings for mathematical practices. We argue that cognition is both embodied and situated in the activities through which it occurs and that mathematics learning involves the appropriation of practices associated with the sets of artefacts that have historically come to represent the body of knowledge we call mathematics. This process of appropriation involves a coordination of a variety of the semiotic resources??spoken and written languages, mathematical representation systems, drawings, gestures and the like??through which mathematical objects and relationships might be experienced and expressed. To highlight the connections between perceptual activities and cultural concepts in the meanings associated with this process, we concentrate on learners who do not have access to the visual field. More specifically, we present three examples of gesture use in the practices of blind mathematics students??all involving the exploration of geometrical objects and relationships. On the basis of our analysis of these examples, we argue that gestures are illustrative of imagined reenactions of previously experienced activities and that they emerge in instructional situations as embodied abstractions, serving a central role in the sense-making practices associated with the appropriation of mathematical meanings.     

Treatment of parents who abuse their children: A literature review and implications for professionals

This article contains a review of the current treatment approaches to child abuse in terms of the following models: psychopathological, sociological, social-situational, family systems and social learning. The psychopathological model of child abuse emphasizes direct services. The services provided may consist of individual, group and lay treatment, volunteer companions, and self-help groups. The sociological model's approach to intervention emphasizes the need for wide-ranging changes in social values and structures. The socio-situational model's approach to treatment is based upon the assumption that the cause of child abuse lies not in the individual, but in the social situation, which may, in turn, be maintaining abusive patterns of behavior. The family systems approach to treatment resembles that of the socio-situational model in that it too emphasizes changing the family's pattern of interaction and behaviors. Finally, the social learning approach to treatment involves the identification of behavioral goals, specific techniques for achieving these goals, and the use of social reinforcers to facilitate this process. Data indicate that parents who abuse their children face multiple social and psychological difficulties. It has been suggested that the reason why treatment programs have not prodoced significant results in treating parents who abuse their children is that they focus on only one of the factors that operate to produce child abuse, i.e., lack of child management skills, marital dissatisfaction, or vocation or interpersonal skills dissatisfaction. It is logical that a treatment approach to abuse must view the problem as multi-determined and services should be structured in such a manner. Thus, the comprehensive treatment program should consist of the following; (1) Child Management Program; (2) Marital Enrichment Program; (3) Vocational Skills Enrichment Program; (4) Interpersonal Skills Enrichment Program. Programs to accomplish the acquisition of requisite skills in each of the four areas of emphasis are chosen from the technology of applied behavioral analysis. Each of the four program components is reviewed along with the rationale for a comprehensive program delivered through a behavioral group work approach. The article concludes with a discussion of the implementation and evaluation of the program.     

培智数学课堂教学社区化的实践

数学是一门逻辑思维比较强，内容比较广泛、抽象的学科。智障儿童的思维肤浅．各方面的思维活动大大落后于正常的同龄孩子，对他们来说，学习数学是一件很不容易的事。特别是重度智障学生，经过多年的课堂教学．最简单、最基础的数学知识也很难习得。在教师的千遍万遍教学之下，有些学生好不容易学会的点滴知识却不会运用于现实的生活之中，[第一段]     

Why children with ADHD do not have low IQs

The major cognitive deficit of children with attention-deficit/hyperactivity disorder (ADHD) is impaired executive function (EF), a cognitive component that some theorists believe to be the primary substrate for the general intelligence (g) factor. We review the constructs of g and EF and the relevant research findings on ADHD. We then analyze the results of a battery of diverse tests, including measures of EF, administered to 123 boys with ADHD. The correlations among the EF measures, two well-accepted measures of IQ, and the g factor extracted from the entire battery are trivial at best. These results are discussed in the context of collateral evidence supporting the independence of g and EF and its clinical and theoretical implications.