Clout or doubt? Perspectives on an infant mental health service for young children placed in foster care due to abuse and neglect

Despite knowledge about the profound effects of child abuse and neglect, we know little about how best to assess whether maltreated children should return home. The effectiveness of the New Orleans Intervention Model (NIM) is being tested in a randomized controlled trial where the comparison is social work ‘services as usual.’ The future trial results will tell us which approach produces the best outcomes for children; meanwhile qualitative process evaluation is generating intriguing findings about the perceived impact of NIM on decision-making about childrens’ futures. Interviews and focus groups were conducted with social workers, foster carers, legal decision-makers and the NIM team (n = 63). Data were analysed thematically. Findings suggest that NIM is seen as bringing greater influence (‘clout’) to decision-making due to its depth of focus, provision of treatment for the family, health professional input and perceived objectivity. Simultaneously, the NIM approach and the detailed information it produces potentially throws judgments into doubt in the legal system. Clout/doubt perceptions permeate opinions about NIM and are inter-related with a historical discourse about ‘health versus social’ models of information gathering, with implications for assessment of child abuse and neglect that extend beyond the study context. The juxtaposition of ‘clout versus doubt’ both highlights and is strengthened by an intense focus among social workers and legal professionals on how evidence will be regarded within legal fora when making decisions about children. There is continuing uncertainty in the child welfare system about the best ways of assessing maltreated children, underscoring a continued need for the trial.     

Utilizing Service Learning in a College-Level Human Sexuality Course

Implementing service learning into college courses has been shown to have positive benefits for both students and community members; however, service learning has not been largely evaluated in the literature on human sexuality courses. Thus, the purpose of the current study was to design, implement, and evaluate a service learning project in a human sexuality class. Students who were enrolled in a human sexuality class designed and delivered two outreach presentations at their university as part of their service learning projects. The presentations were geared toward other college students with specific majors (i.e., future teachers and athletic coaches) and focused on areas related to child and youth sexuality. Overall, the service learning projects garnered positive support from both the students and the attendees at the presentations. Thus, results suggest that service learning is a useful pedagogical tool that college level instructors might consider implementing into their human sexuality courses.     

A new age for child protection--General Comment 13: why it is important, how it was constructed, and what it intends?

Children continue to be subjected to high levels of violence (i.e., physical, psychological and sexual maltreatment) throughout the world. International concern about violence against children has increased significantly during the last decade. A Study on Violence Against Children, encouraged by the UN Committee on the Rights of the Child, conducted under the auspices of the United Nations Secretary General and reported in 2006, has become a rallying call to improve child protection. Child protection practices and systems have been judged to be generally inadequate and, in some cases, destructive. It is widely recognized that business as usual—more of the same—will not do. A General Comment (guide to fulfilling obligations) for Article 19, the central conceptualization of child protection of the UN Convention on the Rights of the Child, has the potential to promote a worldwide reformulation of child protection priorities, policies, and practices by virtue of the infusion of a child rights approach. It can be a mechanism for framing and promoting the transformational change needed – for a genuine paradigm shift. Here, explication is given for the historical context, rationale, centrality of child rights, process of development, holistic nature, and primary elements of General Comment 13 (GC13): The child's right to freedom from all forms of violence. GC13 embodies and champions a child rights approach to child protection entailing strong support for proactive primary prevention, promotion of good child care, and a commitment to secure the rights and well-being of all children. A child rights-based, comprehensive coordinating framework is recommended for the implementation of GC13.     

Forensic child sexual abuse evaluations: assessing subjectivity and bias in professional judgements

Objectives

Evaluators examining the same evidence often arrive at substantially different conclusions in forensic assessments of child sexual abuse (CSA). This study attempts to identify and quantify subjective factors that contribute to such disagreements so that interventions can be devised to improve the reliability of case decisions.

Methods

Participants included 1106 professionals in the field of child maltreatment representing a range of professional positions or job titles and years of experience. Each completed the Child Forensic Attitude Scale (CFAS), a 28-item survey assessing 3 forensic attitudes believed to influence professional judgments about CSA allegations: emphasis-on-sensitivity (i.e., a focus on minimizing false negatives or errors of undercalling abuse); emphasis-on-specificity (i.e., a focus on minimizing false positives or errors of overcalling abuse); and skepticism toward child and adolescent reports of CSA. A subset of 605 professionals also participated in 1 of 3 diverse decision exercises to assess the influence of the 3 forensic attitudes on ratings of case credibility.

Results

Exploratory factor analysis identified 4 factors or attitude subscales that corresponded closely with the original CFAS scales: 2 subscales for emphasis-on-sensitivity and 1 each for emphasis-on-specificity and skepticism. Attitude subscale scores differed significantly by sample source (in-state trainings vs. national conferences), gender, years of experience, and professional position, with Child Protective Service workers unexpectedly more concerned about overcalling abuse and more skeptical of child disclosures than other professionals—a pattern of scores associated with an increased probability of disbelieving CSA allegations. The 3 decision exercises offered validation of the attitude subscales as predictors of professional ratings of case credibility, with adjusted R²s for the three exercises ranging from .06 to .24, suggesting highly variable effect sizes.

Conclusions

Evaluator disagreements about CSA allegations can be explained, in part, by individual differences in 3 attitudes related to forensic decision-making: emphasis-on-sensitivity, emphasis-on-specificity, and skepticism toward child reports of abuse. These attitudes operate as predispositions or biases toward viewing CSA allegations as likely true or likely false. Several strategies for curbing the influence of subjective factors are highlighted including self-awareness of personal biases and team approaches to assessment.     

How to deal with emotional abuse and neglect: further development of a conceptual framework (FRAMEA)

Objective

To develop further the understanding of emotional abuse and neglect.

Methods

Building on previous work, this paper describes the further development of a conceptual framework for the recognition and management of emotional abuse and neglect. Training in this framework is currently being evaluated. The paper also briefly reviews more recent work on aspects of the definition, harm caused by emotional abuse and neglect and threshold.

Results

The paper arrives at a working definition as ‘persistent, non-physical, harmful interactions with the child by the caregiver, which include both commission and omission.’ There are many forms of harmful caregiver-child interactions, which can be placed in five categories, each category reflecting the fulfillment of one of the child's basic psycho-social needs and requiring a different therapeutic approach for its alleviation. The caregiver-child relationship is embedded within a psycho-social context. It is suggested that greater clarity can be gained about the child and family when information is sorted into the appropriate tiers of concerns: Tier 0 – Social & environmental factors, Tier I – Caregiver risk factors, Tier II – Caregiver-child interactions and Tier III – Child's functioning. It is further suggested that while intervention is required, this is directed towards protection, rather than providing immediate protection of the child. The work takes the form of a time-limited trial of therapeutic work to gauge the capacity of the caregivers to change. This initial work focuses Tiers 0–II. Statutory steps might be required in order to encourage the caregivers to engage. If insufficient progress is achieved, active child protection may be required which might include placing the child in an alternative family. However, some, usually older, children will remain in the emotionally abusive environment and they will require ongoing help and support.

Conclusion

While a greater understanding of emotional abuse and neglect is now possible, further evaluation of the utility of this framework is suggested.     

Emotion recognition in fathers and mothers at high-risk for child physical abuse

Objective

The present study was designed to determine whether parents at high risk for physical child abuse, in comparison with parents at low risk, show deficits in emotion recognition, as well as to examine the moderator effect of gender and stress on the relationship between risk for physical child abuse and emotion recognition.

Methods

Based on their scores on the Abuse Scale of the CAP Inventory (Milner, 1986), 64 parents at high risk (24 fathers and 40 mothers) and 80 parents at low risk (40 fathers and 40 mothers) for physical child abuse were selected. The Subtle Expression Training Tool/Micro Expression Training Tool ( [Ekman, 2004a] and [Ekman, 2004b]) and the Diagnostic Analysis of Nonverbal Accuracy II (Nowicki & Carton, 1993) were used to assess emotion recognition.

Results

As expected, parents at high risk, in contrast to parents at low risk, showed deficits in emotion recognition. However, differences between high- and low-risk participants were observed only for fathers, but not for mothers. Whereas fathers at high risk for physical child abuse made more errors than mothers at high risk, no differences between mothers at low risk and fathers at low risk were found. No interaction between stress, gender, and risk status was observed for errors in emotion recognition.

Conclusions and practice implications

The present findings, if confirmed with physical abusers, could be helpful to further our understanding of deficits in processing information of physically abusive parents and to develop treatment strategies specifically focused on emotion recognition. Moreover, if gender differences can be confirmed, the findings could be helpful to develop specific treatment programs for abusive fathers.