Which maltreated children are at greatest risk of aggressive and criminal behavior? An examination of maltreatment dimensions and cumulative risk

This paper explores the well-documented relationship between child maltreatment and aggressive and criminal behavior, specifically examining several dimensions of maltreatment and cumulative child and family risk. Using data from the provincially representative Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), this paper utilizes a developmental lens to examine whether maltreatment dimensions and cumulative risk can differentiate maltreated young people who exhibit aggressive and criminal behaviors and those who do not.A total unweighted sample of 1837 substantiated maltreatment investigations was examined in this analysis using chi-square, t-test, and logistic regression. The findings indicate that 13% of maltreated children and youth served by the Ontario child welfare system exhibited aggression and 6% of maltreated adolescents were involved in the youth justice system. Aggressive children and youth were more likely to experience severe and co-occurring forms of maltreatment and to experience higher levels of cumulative child risk. In adolescence, youth exhibiting aggressive and/or criminal behavior commonly were investigated because of neglect, specifically because their caregivers were no longer willing or able to remain in a caregiving role. Implications for child welfare policy and practice are discussed.     

Optimising implementation of reforms to better prevent and respond to child sexual abuse in institutions: Insights from public health,regulatory theory,and Australia’s Royal Commission

The Australian Royal Commission Into Institutional Responses to Child Sexual Abuse has identified multiple systemic failures to protect children in government and non-government organizations providing educational, religious, welfare, sporting, cultural, arts and recreational activities. Its recommendations for reform will aim to ensure organizations adopt more effective and ethical measures to prevent, identify and respond to child sexual abuse. However, apart from the question of what measures institutions should adopt, an under-explored question is how to implement and regulate those measures. Major challenges confronting reform include the diversity of organizations providing services to children; organizational resistance; and the need for effective oversight. Failure to adopt theoretically sound strategies to overcome implementation barriers will jeopardize reform and compromise reduction of institutional child sexual abuse. This article first explains the nature of the Royal Commission, and focuses on key findings from case studies and data analysis. It then analyzes public health theory and regulatory theory to present a novel analysis of theoretically justified approaches to the implementation of measures to prevent, identify and respond to CSA, while isolating challenges to implementation. The article reviews literature on challenges to reform and compliance, and on prevention of institutional CSA and situational crime prevention, to identify measures which have attracted emerging consensus as recommended practice. Finally, it applies its novel integration of regulatory theory and public health theory to the context of CSA in institutional contexts, to develop a theoretical basis for a model of implementation and regulation, and to indicate the nature and functions of a regulatory body for this context.     

Adverse childhood experiences among youth reported to child welfare: Results from the national survey of child & adolescent wellbeing

The negative influence of adverse childhood experiences (ACEs) on social, emotional, and behavioral (SEB) outcomes are well documented. However, no research to date has examined the effect of ACEs on SEB outcomes in youth who received mental health services after reporting to the child welfare system. This study's analyses of data from the National Survey of Child and Adolescent Well-Being II revealed that the most prevalent ACEs included hospitalization for a medical condition, neglect, and exposures to domestic and community violence. Logistic regression of this data showed that the odds of being diagnosed with internalizing problems increased with age and when sexual abuse was reported. The results also showed that compared to Caucasian youth, Latinos were less likely to be diagnosed with externalizing behaviors, even when sexual abuse had been reported. Contrary to one of this study's hypotheses, mental health service use within the past 18 months increased the odds of being diagnosed with SEB problems. These findings highlight the persistence of SEB problems despite receipt of mental health services. Future research should assess the impact of interventions that aim to mitigate poor SEB outcomes due to ACEs, especially sexual abuse.     

Effectiveness of family group conferencing in preventing repeat referrals to child protective services and out-of-home placements

Rigorous research on the efficacy of family group conferencing is rare. This randomized control trial study used an intent-to-treat approach to examine whether a referral to a family group conference (FGC) was associated with re-referrals, substantiated re-referrals, or out-of-home placements among child welfare-involved families receiving in-home services. We found no significant associations between treatment and control group assignment and the three outcomes for the sample as a whole. However, families with more children had higher odds of a re-referral and a substantiated re-referral, families with more than one parent had higher odds of re-referral, and families where a substance abuse services referral was noted had higher odds of out-of-home placement. In interaction models with race, we found that families with African American mothers who were referred for an FGC were more likely to be re-referred compared to other families, but no differences were identified with respect to their rates of substantiated re-referrals or out-of-home placements. Implications are discussed.     

重视关键期 发展幼儿的语言能力

幼儿期是发展语言的关键期,加强对幼儿语言表达能力的培养,在幼儿园教育中尤为重要。该文通过创设良好的语言环境、进行词汇教学,游戏中学习语言,以及在日常生活中渗透语言教育等方面来介绍发展幼儿语言的方法。     

The relationship between childhood emotional abuse and chronic pain among people who inject drugs in Vancouver,Canada

BackgroundPeople who inject drugs (PWID) often contend with chronic pain as a result of illness and trauma, and such pain is known to have significant impacts on mental health, quality of life, and substance use behaviours. Although PWID are also known to have high rates of childhood trauma, little is known about how childhood emotional abuse may be associated with chronic pain in this population.ObjectiveWe undertook this study to explore emotional abuse and chronic pain among PWID.Participants and settingThis study comprised a total of 1459 participants in Vancouver, Canada between June 2014 and November 2016.MethodsWe employed multivariable generalized estimating equations with data derived from two prospective cohort studies of community-recruited PWID to examine the relationship between childhood emotional abuse and chronic pain in the past six months.ResultsAmong eligible participants, 591 (40.5%) reported childhood emotional abuse, and 760 (52.1%) reported chronic pain in the previous six months. In a multivariable analysis, experiencing childhood emotional abuse remained independently associated with chronic pain (adjusted odds ratio: 1.25; 95% confidence interval: 1.01–1.53) after adjustment for a range of socio-demographic and drug use confounders.ConclusionsOur findings suggest that childhood emotional abuse may have lasting relationships with chronic pain among PWID, potentially through established physiological and psychological mechanisms. Current chronic pain treatment may benefit from the evaluation of life course vulnerabilities that may be amenable to earlier interventions. Further, increased availability of effective trauma-informed chronic pain treatment is needed among this vulnerable population.     

Childhood poly-victimization and children’s health: A nationally representative study

BackgroundAlthough research on the negative effects of childhood poly-victimization is substantial, few studies have examined the relationship between poly-victimization and younger children’s physical health and diseases.ObjectiveThis study examines the associations between poly-victimization and children’s health problems requiring medical attention.MethodsA national stratified cluster random sampling was used to select and approach 25% of the total primary schools in Taiwan, and 49% of the approached schools agreed to participate in this study. We collected data with a self-report questionnaire from 6233 (4th-grade) students aged 10–11, covering every city and county in Taiwan.ResultsLogistic regression analyses demonstrate a significant dose-response relationship between children’s poly-victimization exposure and their health problems including hospitalization, serious injury, surgery, daily-medication requirements, heart murmurs, asthma, dizziness or fainting, allergies, kidney disease, therapies for special needs, smoking, and alcohol use. The results indicate that children’s risk of having a health problem grew significantly with each increase in the number of victimization types that children experienced.ConclusionsThese research findings underscore the effect of poly-victimization on children’s health problems requiring medical attention, and stress the need for both proper screening methods for children’s exposure to poly-victimization and stronger awareness of poly-victimization’s effects on health conditions in healthcare clinics.     

Action research improves services for child sexual abuse in one Caribbean nation: An example of good practice

BackgroundChild sexual abuse (CSA) is a multi-dimensional problem. The search for best practice must consider the complexities surrounding CSA and its management in any particular society.ObjectiveData previously gathered from service providers on CSA service provision in Trinidad and Tobago identified key deficient issues in policy and practice. In this paper, researchers aimed to bridge the gaps identified, and effect changes to improve services for CSA using an action research methodology.Participants and settingService providers from all sectors in governmental and non-governmental organizations in Trinidad and Tobago, who work with children at risk of CSA were involved in the process.MethodsResearchers led the service providers into an awareness of their own practice through critical discussion of, and reflection on, the key deficient issues. The new knowledge generated, with guided input from evidenced-based best practice, led to the development of guidelines for management. Discussion of the practicability of the guidelines by service providers in multiple sectors generated more new knowledge that refined the management approach.ResultsThe contextual knowledge obtained from service providers resulted in best practice guidelines for service providers that were culturally relevant and context-sensitive, adaptive and implementable, and allowed a seamless multidisciplinary response to CSA in Trinidad and Tobago within prevailing constraints.ConclusionsAction research offers an effective approach to improve services for CSA through mobilization of service providers and changes in policy and practice. It is applicable in any setting and likely to be effective in any socio-cultural context.     

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.