Do Children's Advocacy Centers improve families' experiences of child sexual abuse investigations?

OBJECTIVE: The Children's Advocacy Center (CAC) model of child abuse investigation is designed to be more child and family-friendly than traditional methods, but there have been no rigorous studies of their effect on children's and caregivers' experience. Data collected as part of the Multi-Site Evaluation of Children's Advocacy Centers were used to examine whether CACs improve caregivers' and children's satisfaction with investigations. METHODS: Nonoffending caregiver and child satisfaction were assessed during research interviews, including the administration of a 14-item Investigation Satisfaction Scale (ISS) for caregivers. Two hundred and twenty-nine sexual abuse cases investigated through a CAC were compared to 55 cases investigated in communities with no CAC. RESULTS: Hierarchical linear regression results indicated that caregivers in CAC cases were more satisfied with the investigation than those from comparison sites, even after controlling for a number of relevant variables. There were few differences between CAC and comparison samples on children's satisfaction. Children described moderate to high satisfaction with the investigation, while a minority expressed concerns about their experience. CONCLUSIONS: The CAC model shows promise for improving families' experiences, but to build upon this promise, agencies will need to systematize procedures for refining and adapting the model as new research becomes available.     

Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women

OBJECTIVE: The objective is to describe the prevalence of child sexual abuse (CSA) among women in New Zealand, document ethnic specific rates, and outline the frequency of abuse experienced and the most commonly identified perpetrators. Associations between CSA and later adverse consequences were also explored. METHODS: Retrospective report from a random sample of 2,855 women aged 18-64 years old in two regions in New Zealand. Face-to-face interviews with one randomly selected woman from each household were conducted. RESULTS: The overall prevalence rates for CSA were 23.5% for women from the urban region and 28.2% from the rural region. In both urban and rural regions, Māori women more frequently reported experiences of CSA than women from European and other ethnic groups (urban: 30.5% vs. 17.0% and rural: 35.1% vs. 20.7%). The median age of onset of the abuse was 9 years, and the median estimated age of the abuser was 30 years. Half of those who experienced CSA reported that it occurred once or twice, 27% "a few times," and 23% "multiple times." Sole perpetrators were involved in 83% of cases. The majority of cases were perpetrated by a family member, most frequently male. Compared with non-victims, victims of CSA were twice as likely to experience later intimate partner violence and violence by others. CONCLUSIONS: This study reports on a large, population-based sample in an ethnically diverse population in New Zealand, providing the first ethnic-specific rates of CSA available. Findings suggest important priorities for prevention and intervention activities.     

Child forensic interviewing in Children's Advocacy Centers: empirical data on a practice model

OBJECTIVE: Children's Advocacy Centers (CACs) aim to improve child forensic interviewing following allegations of child abuse by coordinating multiple investigations, providing child-friendly interviewing locations, and limiting redundant interviewing. This analysis presents one of the first rigorous evaluations of CACs' implementation of these methods. METHODS: This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on investigation methods in 1,069 child sexual abuse cases with forensic interviews by reviewing case records from multiple agencies. RESULTS: CAC cases were more likely than comparison cases to feature police involvement in CPS cases (41% vs. 15%), multidisciplinary team (MDT) interviews (28% vs. 6%), case reviews (56% vs. 7%), joint police/child protective services (CPS) investigations (81% vs. 52%) and video/audiotaping of interviews (52% vs. 17%, all these comparisons p<.001). CACs varied in which coordination methods they used, and some comparison communities also used certain coordination methods more than the CAC with which they were paired. Eighty-five percent of CAC interviews took place in child-friendly CAC facilities, while notable proportions of comparison interviews took place at CPS offices (22%), police facilities (18%), home (16%), or school (19%). Ninety-five percent of children had no more than two forensic interviews, and CAC and comparison differences on number of interviews were mostly non-significant. CONCLUSIONS: Relative to the comparison communities, these CACs appear to have increased coordination on investigations and child forensic interviewing. The CAC setting was the location for the vast majority of CAC child interviews, while comparison communities often used settings that many consider undesirable. CACs showed no advantage on reducing the number of forensic interviews, which was consistently small across the sample.     

Decision-making skills and deliberate practice in elite association football referees

We examined sport expertise as a function of role. In study 1, referees were better than players in a video-based decision-making task. This provides evidence that there are role-specific skills within one domain or sport. In study 2, we examined the training activities that could be influential in the development of skills in sports officials. Elite association football (soccer) referees retrospectively reported time spent in and perceptions of training activities for three periods: their first year of formal refereeing, 1998 (before formal training programmes were available), and the current year (2003). This allowed us to examine an area of skill with a limited culture of practice, where performance simulations with direct feedback are usually not feasible. The results showed that referees specialize early and, as they develop, they engage in greater volumes and types of training. Competitive match refereeing is considered a relevant activity for skill acquisition that does not fit Ericsson and colleagues' (1993) original definition of deliberate practice. Our findings indicate that actual performance is a significant activity for skill acquisition and refinement.     

Educational program on evaluation of alleged sexual abuse victims

Increased awareness of the problem of child sexual abuse has resulted in increasing numbers of children presenting to professionals for the evaluation of possible sexual victimization. A multidisciplinary project to develop professionals' knowledge and skills in the identification and evaluation of possible victims is described. The program focused on the child as a victim and emphasized developmental perspectives with regard to identification, interviewing children, the medical examination, and children in the legal system. Fifty-one medical and social work professionals from ten Indiana counties attended the program and responded to questionnaires about their experience and knowledge. Of 40 (78%) respondents, 63% had had no previous training in the medical evaluation for child sexual abuse. Child protective workers referred alleged victims primarily to the child's regular physician (37%) or emergency room (31%) for medical examination. Knowledge about child sexual abuse improved significantly at two weeks postsymposium (p = .001) and remained improved at six months postsymposium (p less than .02). These original participants have subsequently organized similar multidisciplinary programs in their local communities for medical, social, law enforcement, and legal professionals; thus, they have been "seeds" for further educational and cooperative efforts throughout the state.     

Reviewing the Variability-Overuse Injury Hypothesis: Does Movement Variability Relate to Landing Injuries?

Purpose: Overuse injuries are common in sport, but complete understanding of injury risk factors remains incomplete. Although biomechanical studies frequently examine musculoskeletal injury mechanisms, human movement variability studies aim to better understand neuromotor functioning, with proposed connections between overuse injury mechanisms and changes in motor variability. Method: In a narrative review, we discuss the variability-overuse injury hypothesis, which suggests repeated load application leads to mechanical tissue breakdown and subsequent injury when exceeding the rate of physiological adaptation. Due to the multidisciplinary nature of this hypothesis, we incorporate concepts from motor control, neurophysiology, biomechanics, as well as research design and data analysis. We therefore summarize multiple perspectives while proposing theoretical relationships between movement variability and lower extremity overuse injuries. Results: Experimental data are presented and summarized from published experiments examining interactions between experimental task demands and movement variability in the context of drop landing movements, along with comparisons to previous movement variability studies. Conclusion: We provide a conceptual framework for sports medicine researchers interested in predicting and preventing sports injuries. Under performance conditions with greater task demands, we predict reduced trial-to-trial movement variability that could increase the likelihood of overuse injuries.     

A new footwear technology to promote non-heelstrike landing and enhance running performance: Fact or fad?

This study sought to compare the kinetics and kinematics data in a group of habitual shod runners when running in traditional running shoes and newly designed minimalist shoes with lug platform. This novel footwear design claims to simulate barefoot running and reduce energy loss during impact. We compared footstrike angle (FSA), vertical average (VALR) and instantaneous (VILR) loading rates, energy loss and initial vertical stiffness between two shoe conditions. Runners demonstrated a decreased FSA while running in minimalist shoes with lug platform than traditional shoes (P = 0.003; Cohen’s d = 0.918). However, we did not observe a landing pattern transition. VALR and VILR between two footwear conditions showed no significant difference (P = 0.191–0.258; Cohen’s d = 0.304–0.460). Initial vertical stiffness (P = 0.032; Cohen’s d = 0.671) and energy loss (P = 0.044; Cohen’s d = 0.578) were greater when running in minimalist shoes with lug platform. The results show that minimalist shoes with lug platform reduce the FSA but may not lead to a landing pattern switch or lower vertical loading rates. Interestingly, the new shoe design leads to a greater energy loss than traditional running shoes, which could be explained by a higher initial vertical stiffness.     

Contextual influences on baseball ball-strike decisions in umpires, players, and controls

Baseball umpires, players, and control participants with no baseball experience were asked to call balls and strikes for video clips. In a basic judgement task, umpires and players were significantly better at calling pitches than controls. In a direct information task, borderline pitches were presented following clips of definite balls and definite strikes. Participants called target pitches closer to the strike end of the scale when viewed after definite balls than when they followed definite strikes. Similarly, when borderline pitches were shown in different pitch counts, participants called pitches more towards the strike end of the scale when there were three balls in the count (3-0, 3-2). These findings indicate that the standard for evaluation changes based on the context in which stimuli are processed. Moreover, the strength of the contextual factors is illustrated in that the effects were shown in observers with and without experience in the task. Overall, however, umpires had a greater tendency to call strikes, indicating that they may use a norm of "hastening the game".