Child Neglect

Objective: Childhood abuse and other adverse childhood experiences (ACEs) have historically been studied individually, and relatively little is known about the co-occurrence of these events. The purpose of this study is to examine the degree to which ACEs co-occur as well as the nature of their co-occurrence. Method: We used data from 8,629 adult members of a health plan who completed a survey about 10 ACEs which included: childhood abuse (emotional, physical, and sexual), neglect (emotional and physical), witnessing domestic violence, parental marital discord, and living with substance abusing, mentally ill, or criminal household members. The bivariate relationship between each of these 10 ACEs was assessed, and multivariate linear regression models were used to describe the interrelatedness of ACEs after adjusting for demographic factors. Results: Two-thirds of participants reported at least one ACE; 81%-98% of respondents who had experienced one ACE reported at least one additional ACE (median: 87%). The presence of one ACE significantly increased the prevalence of having additional ACEs, elevating the adjusted odds by 2 to 17.7 times (median: 2.8). The observed number of respondents with high ACE scores was notably higher than the expected number under the assumption of independence of ACEs (p < .0001), confirming the statistical interrelatedness of ACEs. Conclusions: The study provides strong evidence that ACEs are interrelated rather than occurring independently. Therefore, collecting information about exposure to other ACEs is advisable for studies that focus on the ଝ The Adverse Childhood Experiences Study was supported under a cooperative agreement #TS-44-10/11 from the Centers for Disease Control and Prevention through the Association of Teachers of Preventive Medicine and is currently funded by a grant from the Garfield Memorial Fund at Kaiser Permanente. Dr. Dong was supported by cooperative agreement #TS-44-10/11 from the Centers for Disease Control and Prevention through the Association of Teachers of Preventive Medicine.

Objective: This article highlights the manner in which child neglect, the most common form of maltreatment, affects children's development. Method: The review is organized according to three developmental periods (i.e., infancy/preschool, school-aged and younger adolescents, and older adolescents and adults) and major developmental processes (cognitive, social-emotional, and behavioral). Although the focus is on specific and unique effects of various forms of child neglect, particular attention is paid to studies that allow comparisons of neglect and abuse that clarify their similarities and differences. Results: Past as well as very recent findings converge on the conclusion that child neglect can have severe, deleterious short-and long-term effects on children's cognitive, socio-emotional, and behavioral development. Consistent with attachment and related theories, neglect occurring early in life is particularly detrimental to subsequent development. Moreover, neglect is associated with effects that are, in many areas, unique from physical abuse, especially throughout childhood and early adolescence. Relative to physically abused children, neglected children have more severe cognitive and academic deficits, social withdrawal and limited peer interactions, and internalizing (as opposed to externalizing) problems.

Objective: This study is a detailed examination of the association between parental alcohol abuse (mother only, father only, or both parents) and multiple forms of childhood abuse, neglect, and other household dysfunction, known as adverse childhood experiences (ACEs).Method: A questionnaire about ACEs including child abuse, neglect, household dysfunction, and exposure to parental alcohol abuse was completed by 8629 adult HMO

Objective: This study assesses the relationship of childhood sexual abuse (CSA) to nine other categories of Adverse Childhood Experiences (ACEs), including childhood abuse, neglect, and multiple types of household dysfunction. Methods: Retrospective cohort study data were collected from 17,337 adult health plan members who responded to a survey questionnaire. Regression models adjusted for age, race, and education were used to estimate the strength of the association of CSA to each of the other nine ACEs and a graded relationship between measures of the severity of CSA and the number of other ACEs (ACE score). Results: CSA was reported by 25% of women and 16% of men. In comparison with persons who were not exposed to CSA, the likelihood of experiencing each category of ACE increased 2-to 3.4-fold for women and 1.6-to 2.5-fold for men (p < .05). The adjusted mean ACE score showed a significant positive graded relationship to the severity, duration, and frequency of CSA and an inverse relationship to age at first occurrence of CSA (p < .01). Conclusions: CSA is strongly associated with experiencing multiple other forms of ACEs. The strength of this association appears to increase as the measures of severity of the CSA increases. The ଝ The Adverse Childhood Experiences Study was supported under a cooperative agreement #TS-44-10/11 from the Centers for Disease Control and Prevention through the Association of Teachers of Preventive Medicine and is currently funded by a grant from the Garfield Memorial Fund.

Implementation of evidence-based practices (EBP) in child welfare is a complex process that is often fraught with unanticipated events, conflicts, and resolutions. To some extent, the nature of the process, problems, and solutions may be dependent on the perspectives and experiences of a given stakeholder group. In order to better understand the implementation process in the child-welfare system, we interviewed comprehensive home-based services (CHBS) case managers who were actively engaged in implementing an EBP to reduce child neglect in a state youth services system. Six primary factors were identified as critical determinants of EBP implementation: (1) Acceptability of the EBP to the caseworker and to the family, (2) Suitability of the EBP to the needs of the family, (3) Caseworker motivations for using the EBP, (4) Experiences with being trained in the EBP, (5) Extent of organizational support for EBP implementation, and (6) Impact of EBP on process and outcome of services. These factors reflect two broader themes of attitudes toward or assessments of the EBP itself and experiences with learning and delivering the EBP. Eventual implementation is viewed as the consequence of perseverance, experience, and flexibility.

This article describes the development and psychometric properties of the Multidimensional Neglectful Behavior Scale-Child Report (MNBS-CR). The measure is broadly conceptualized to tap child neglect across four core domains: cognitive, emotional, physical and supervisory neglect, and it assesses exposure to violence, alcohol-related neglect, abandonment, and children's appraisals of parenting. Features include pictorial items, audio computer-assisted testing, and programming by age and gender of the child and caregiver. A clinical sample of 144 children, age 6 to 15 years, and a comparison sample of 87 children were tested. Results showed that the MNBS-CR has high reliability, with higher reliability found for older children (alpha = .94) than for younger children (alpha = .66). Among older children, the MNBS-CR Supervisory scale was significantly associated with the Child Behavior Check List (CBCL), and total MNBS-CR scores were significantly associated with clinician reports of behavioral disorders. Younger and older neglected children scored significantly higher on the MNBS-CR than community children.

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children’s services system. The study took place in the context of a statewide regionally randomized effectiveness trial of an evidence-based intervention designed to reduce child neglect. Twenty-one teams consisting of 153 home-based service providers were followed over a 29 month period. Survival analyses revealed greater staff retention in the condition where the evidence-based practice was implemented along with ongoing fidelity monitoring presented to staff as supportive consultation. These results should help to allay concerns about staff retention when implementing evidence-based practices where there is good values-innovation fit and when fidelity monitoring is designed as an aid and support to service providers in providing a high standard of care for children and families.

Objective: To examine the significance of neonatal risk factors from the individual, family, social, and parenting behavior domains of the ecological model of child maltreatment in predicting maltreatment reports in the first 4 years of life, and to examine the extent to which the interactions of life event stress and social support modify those risk factors.Method: Mothers of 708 predominantly at-risk infants were interviewed in their homes soon after their infants’ discharge from the hospital. State child abuse and neglect central registry data were tracked every 6 months until the infants reached their fourth birthdays.Results: The incidence of maltreatment reports was higher in households where the mothers were depressed, complained of psychosomatic symptoms, had not graduated from high school, consumed alcohol, participated in public income support programs, cared for more than one dependent child, or were separated from their own mothers at age 14 years (p < .1). In interaction models including these seven predisposing variables, there were significant interactions (p < .01) between social support, as measured by the social well-being index after the birth of the index child, and depression, and between social well-being and stress, as measured by an increase in total life events.Conclusion: Some predisposing risk factors measured soon after birth continue to be significant predictors of child maltreatment reports through the fourth year of life. In general, families with low levels of social support had a higher risk of a maltreatment report. For families with lower levels of maternal depression and/or life event stress, low social support significantly increased the risk of a maltreatment report by as much as a factor of four.Spanish abstract not available at time of publication.Objectif: Examiner l’importance des facteurs de risque néonatals au niveau individuel, social, familial et du comportement parental, dans une perspective écologique de la maltraitance. Ceci pour aider à prédire s’il y aura maltraitance au cours des quatre premières années de la vie, et pour examiner dans quelle mesure les interactions qui se déroulent dans le contexte des événements stressants de la vie et les appuis sociaux peuvent modifier ces facteurs de risque.Méthode: On a interviewé 708 mères dont les enfants étaient considérés à risque élevé. Les entrevues ont eu lieu au foyer, peu après la rentrée de l’hôpital. On a suivi les registres de mauvais traitements et de négligence à tous les six mois jusqu’à ce que les enfants aient atteint l’âge de quatre ans.Résultats: L’incidence des signalements de mauvais traitements étaient plus élevée dans les foyers où la mère était déprimée, se plaignait de symptômes psychosomatiques, n’avait pas complété l’école secondaire, prenait de l’alcool, faisait partie d’un groupe d’appui financé par l’état, avait plus d’un enfant à sa charge ou avait été séparée de sa propre mère à l’âge de 14 ans. Une analyse de ces sept variables indiquent des liens importants entre, d’une part, l’appui social (tel que mesuré selon l’indice de bien-être après la naissance) et la dépression; puis entre le bien être et le stress, ceci à la suite d’une hausse des événements quotidiens stressants.Conclusions: Certains facteurs de risque notés peu après la naissance demeurent des facteurs importants capables de prédire les mauvais traitements au cours des quatre années qui suivront. En général, les familles qui jouissent de peu d’appuis sociaux sont les plus souvent signalées aux autorités pour cause de maltraitance. Pour les familles qui ont des niveaux de dépression maternelle inférieure et/ou qui connaissent peu de stress dans leur vie, l’absence d’appuis sociaux augmente jusqu’à quatre fois le risque d’un signalement.

This study evaluated the relative efficacy of two promising treatments of child abuse and child neglect: parent training and multisystemic therapy. Subjects included 18 abusive families and 15 neglectful families who were randomly assigned to the treatment conditions. Self-report and observational measures were used to evaluate the effects of treatment at three levels that have been associated with child maltreatment: individual functioning, family relations, and stress/social support. Statistical analyses revealed that families who received either treatment showed decreased parental psychiatric symptomology, reduced overall stress, and a reduction in the severity of identified problems.

Objective: To review the current research literature on resilience to maltreatment in childhood and adolescence. Method: First, this paper addresses the methodological issues applicable to this area of research. Second, it reviews the empirical literature on the protective factors believed to contribute to resilience to maltreatment and offers commentary on specific issues raised in each study. Results: The current findings are summarized and an integrated descriptive picture, based on the extant literature of the processes and factors contributing to the development of resilience to childhood maltreatment is outlined. Conclusion: Based on this extensive review and critique of the current empirical literature on resilience to maltreatment, suggestions for future investigations in this area are recommended.

Objective: The development of substance use disorder (SUD) was prospectively investigated in 66 boys having fathers with SUD and 104 boys having fathers with no adult Axis I or II psychiatric disorder. Evaluations were conducted to determine the context in which neurobehavior disinhibition in relation to parental SUD, parental neglect of the child and child's social maladjustment culminated in a DSM-III-R diagnosis of SUD. Methods: A neurobehavior disinhibition latent trait was derived using indicators of behavior undercontrol, affect dysregulation and executive cognitive functioning in the boys when they were 10-12 and again at 16 years of age. These latter characteristics have been frequently observed in individuals who have a prefrontal cortex disturbance. The data were analyzed to determine whether the score on the neurobehavior disinhibition construct mediates the association between father's and mother's SUD and son's SUD. Results: SUD in the mother and father predicted neurobehavior disinhibition in the son. The neurobehavior disinhibition score in the sons predicted SUD between ages 10-12 and 19. Neurobehavior disinhibition, in conjunction with social maladjustment and drug use frequency, mediated the association between paternal and maternal SUD and son's SUD. Neurobehavior disinhibition was unrelated to neglect of the child by either the father or mother; however, paternal but not maternal neglect at age 10-12 predicted SUD at age 19. Conclusions: The association of neurobehavior disinhibition in childhood and SUD by young adulthood suggests that a prefrontal cortex dysfunction contributes to SUD liability. The results extend previous findings demonstrating that neurobehavior disinhibition is an important component of the liability to SUD.

The empirical literature pertaining to the prevalence, origins, and consequences of neglectful parenting as it relates to substance abuse is critically reviewed. Available evidence indicates that children who experience parental neglect, with or without parental alcohol or drug abuse, are at high risk for substance use disorder (SUD). The effects of parental substance abuse on substance abuse outcome of their children appear to be partly mediated by their neglectful parenting. The discussion concludes with presentation of a developmental multifactorial model in which neglect, in conjunction with other individual and environmental factors, can be integratively investigated to quantify the child's overall liability across successive stages of development as well as to map the trajectory toward good and poor outcomes. D

We compared measures of self-reported arrests and official arrests for 676 young adults with a history of child abuse and͞or neglect and 520 nonabused and nonneglected controls matched on age, sex, race, and approximate family social class. Findings reveal considerable concurrent validity between the two sources overall. But there is also evidence of differences by gender, race͞ethnicity, age at time of arrest, conviction status, and type of offense. Abused and neglected subjects did not appear to differ from the control group in the extent of underreporting of known offenses, however, the groups did differ in the degree of ''positive bias''offenses not found in arrest records. Abused͞neglected subjects self-reported proportionately more offenses not known to police compared to controls. This result suggests that findings from previous studies on the relationship between childhood victimization and later criminality, as measured by arrests, may have underestimated the magnitude of this relationship.

Widespread efforts are being made to increase awareness and provide education to pediatricians regarding risk factors of child abuse and neglect. The purpose of this clinical report is to ensure that children with disabilities are recognized as a population that is also at risk of maltreatment. Some conditions related to a disability can be confused with maltreatment. The need for early recognition and intervention of child abuse and neglect in this population, as well as the ways that a medical home can facilitate the prevention and early detection of child maltreatment, are the subject of this report.

OBJECTIVES. We explored whether breastfeeding was protective against maternally perpetrated child maltreatment. METHODS. A total of 7223 Australian mother-infant pairs were monitored prospectively over 15 years. In 6621 (91.7%) cases, the duration of breastfeeding was analyzed with respect to child maltreatment (including neglect, physical abuse, and emotional abuse), on the basis of substantiated child protection agency reports. Multinomial logistic regression was used to compare no maltreatment with nonmaternal and maternally perpetrated maltreatment and to adjust for confounding in 5890 cases with complete data (81.5%). Potential confounders included sociodemographic factors, pregnancy wantedness, substance abuse during pregnancy, postpartum employment, attitudes regarding infant caregiving, and symptoms of anxiety or depression. RESULTS. Of 512 children with substantiated maltreatment reports, &gt;60% experienced ≥1 episode of maternally perpetrated abuse or neglect (4.3% of the...

Although child neglect is the most common form of child maltreatment, considerable confusion remains regarding its definition. A conceptual definition of neglect is presented based on an ecological model of child maltreatment. The definition focuses on the basic needs of children that are not met, rather than on the intentions or behavior of parents. The replacement of parental culpability by a shared responsibility including parents, families, the community, and society is suggested. Neglect is seen as a heterogeneous phenomenon that varies by type, severity, and chronicity. In addition, neglect is understood as existing on a continuum ranging from optimal to grossly inadequate care. The context within which neglect occurs, including parents&#39; understanding of children&#39;s needs, religious and cultural beliefs, and poverty, influences the approaches of clinicians, researchers, and policymakers toward the problem of child neglect.

The aim of our study is to report the relation between pathological care and impairment in social interaction, communication, language development, and stereotypical behaviors. Fifteen cases (9 boys, 6 girls) who have the symptoms listed above and who were misdiagnosed with pervasive developmental disorder (PDD), were referred to our clinic for evaluation and treatment. After the cases were evaluated by a semi-structured interview, symptoms related to pathological care were fortified; maternal depressive symptoms associated with child neglect and overexposure to television viewing. The cases and the mothers/primary caretakers were treated in a standardized psycho-educational program of 3 months. After this period improvements were observed in all of the symptom clusters. Twelve cases (80%) had improvements in eye contact. Eleven cases (73.3%) began to engage in reciprocal play and ten cases (66.6%) showed social imitative behaviors. Six cases (40%) began to form sentences. Stereotypic behaviors diminished in six cases (40%) and disappeared in nine cases (60%). According to our findings, although the symptoms of PDD and reactive attachment disorder (RAD) resemble each other, presence of pathological care and good response to treatment in RAD can be important for the differential diagnosis with PDD.

a b s t r a c t One hanging question in child welfare policy and research is whether there is an artificial overrepresentation of the poor in child welfare caseloads or whether this reflects the co-occurrence of poverty and need. In order to address this question, this study uses data from child welfare (report, assessment, service and re-report), income maintenance, special education, hospitals, juvenile court, public mental health treatment, and census data. Poor children reported to child welfare are compared to non-poor children reported to child welfare and also to poor children not reported to child welfare. Poor children reported for maltreatment had greater risk factors at the parent and neighborhood levels and higher rates of negative outcomes than children in either comparison group. Among children reported for maltreatment, poor children have worse outcomes, both within child welfare (e.g., recurrence) and outside of child welfare (e.g. juvenile court, hospitalization for violence) than non-poor children. These data suggest that the overrepresentation of poor children is driven largely by the presence of increased risk among the poor children that come to the attention of child welfare rather than high levels of systemic class bias.

Background. Limited longitudinal research has been conducted on the impact of neglect on children&#x27;s health and well-being. There is a need to consider the impact of specific subtypes of neglect on children&#x27;s functioning. In addition, there is interest in examining the ...

Objective: The aim of this study is twofold: First, to investigate whether cognitive functions can contribute to differentiating neglected children with or without physical abuse compared to comparison participants; second, to demonstrate the detrimental impact of children being victimized by a combination of different types of maltreatment. Methodology: Seventy-nine children aged 6-12 years and currently receiving Child Protection Services because of one of two types of maltreatment (neglect with physical abuse, n = 56; neglect without physical abuse, n = 28) were compared with a control group of 53 children matched for age, gender, and annual family income. The neuropsychological assessment focused on motor performance, attention, memory and learning, visual-motor integration, language, frontal/executive functions, and intelligence. Results: Discriminant analysis identified auditory attention and response set, and visual-motor integration (Function 1), and problem solving, abstraction, and planning (Function 2) as the two sets of variables that most distinguished the groups. Discriminant analysis predicted group membership in 80% of the cases. Children who were neglected with physical abuse showed cognitive deficits in auditory attention and response set, and visual-motor integration (Function 1) and problem solving, abstraction, and planning (Function 2). Children who were neglected without physical abuse differed from the control group in that they obtained lower scores in auditory attention and response set, and visual-motor integration (Function 1). Surprisingly, these same children demonstrated a greater capacity for problem solving, abstraction, and planning (Function 2) than the physically abused neglected and control children.

Objectives: This research sought to determine if the language delay (LD) of severely neglected children under 3 years old was better explained by a cumulative risk model or by the specificity of risk factors. The objective was also to identify the risk factors with the strongest impact on LD among various biological, psychological, and environmental factors. Methods: Sixty-eight severely neglected children and their mothers participated in this cross-sectional study. Children were between 2 and 36 months of age. Data included information about the child's language development and biological, psychological, and environmental risk factors. Results: Prevalence of LD is significantly higher in this subgroup of children than in the population as a whole. Although we observed that the risk of LD significantly increased with an increase in the cumulative count of the presence of the child's biological-psychological risk factors, the one-by-one analysis of the individual factors revealed that the cumulative effect mainly reflected the specific impact of the child's cognitive development. When we considered also the environmental risk factors, multivariate logistic regression established that cognitive development, the mother's own physical and emotional abuse experience as a child, and the mother's low acceptability level towards her child are linked to LD in severely neglected children. Conclusions: Language development is the result of a complex interaction between risk factors. LD in severely neglected children is better explained by the specificity of risk factors than by the cumulative risk model. Practice implications: Most prevention and early intervention programs promote and target an increase in the quantity and quality of language stimulation offered to the child. Our results suggest that particular attention should be given to other environmental factors, specifically the mother's psychological availability and her sensitivity towards the child. It is essential to suggest interventions targeting various ecological dimensions of neglectful mothers to help break the intergenerational neglect transmission cycle. It is also important to develop government policies and ensure that efforts among the various response networks are concerted since in-depth changes to neglect situations can only come about when all interested parties become involved.

Objective: To present key findings from the Canadian Incidence Study of Reported Child Maltreatment (CIS) in sufficient detail to provide a basis for international comparisons in terms of forms and severity of maltreatment and the age and sex of victims. Method: A survey conducted in a random sample of 51 child welfare service areas across Canada tracked child maltreatment investigations conducted during the months of October to December 1998, produced a national sample of 7,672 child maltreatment investigations. Information was collected directly from investigating workers on child and family background, perpetrator characteristics, severity and types of maltreatment and service and court outcomes of investigations. Results: Forty-five percent of investigations were substantiated and in a further 22% of investigations maltreatment remained suspected. Primary reasons for investigation were physical abuse (31%), sexual abuse (11%), neglect (40%), and emotional maltreatment (19%). A larger proportion of physical abuse cases are isolated incidents involving older children and are more likely to lead to injuries. Sexual abuse, neglect and emotional maltreatment involve more chronic situations with children showing signs of emotional harm. Rates of investigated and substantiated maltreatment are lower in Canada compared to the United States, but are higher than rates reported in Australia.

Childhood maltreatment (CM) has been associated with diminished executive functioning in children and adults; however, there is a relative paucity of study of executive function in adolescents exposed to CM. Yet, executive dysfunction in adolescence may have important adverse consequences including increased vulnerability to risky behaviors and impaired school functioning. This study investigates the relationship between self-reported CM and an executive function, cognitive flexibility, in adolescents without identified psychiatric disorders. Effects of physical and emotional, abuse and neglect, maltreatment subtypes were explored. Thirty adolescents ages 12-17 years, 50% females, completed the retrospective self-report Childhood Trauma Questionnaire (CTQ) and were administered the Wisconsin Card Sorting Test (WCST). Correlational analyses assessed the relationship between WCST perseverative error scores normreferenced for age and education with CTQ total scores. The relationship with non-perseverative errors, as well as with physical and emotional abuse and neglect CM subscores, were explored. Total CTQ scores showed significant associations with perseverative errors on the WCST, but not with non-perseverative errors. Significant associations with perseverative errors were seen for physical abuse and physical neglect among the CTQ subscales. The results suggest both physical abuse and physical neglect are associated with diminished cognitive flexibility in adolescents. These effects were detected in adolescents without identified psychiatric diagnoses suggesting the importance of considering executive dysfunction in adolescents exposed to CM who may not meet diagnostic criteria for an Axis I disorder and that tests of perseverative errors, such as those of the WCST, may be sensitive indicators of this dysfunction.

Family Connections was a demonstration program specifically designed to prevent child neglect. This article describes the development of prevention strategies and the assessment of outcomes for families who received two versions of the intervention. The sample included 154 families (473 children) in a poor, urban neighborhood who met risk criteria for child neglect and who were randomly assigned to receive either a 3- or 9-month intervention. Self-report and observational data were analyzed using analyses of variance (ANOVA) with repeated measures. Results for the entire sample indicated positive changes in protective factors (parenting attitudes, parenting competence, social support); diminished risk factors (parental depressive symptoms, parenting stress, life stress); and improved child safety (physical and psychological care of children) and behavior (decreased externalizing and internalizing behavior). Results further reflected no advantage of the 9-month intervention for impro...

Child maltreatment researchers have often suggested that experiences with child neglect have long-term, negative effects. Child neglect is thought to have particularly adverse effects on self-control, peer relations, and delinquency. In this research, we examine the relationship of child neglect with adolescent violence via self-control and peer rejection. Using prospective, longitudinal data from a community sample, we find that child neglect adversely affects peer rejection and violence. Neglected children were more likely to be rejected by their peers in early adolescence and were more likely to be violent later in adolescence. Contrary to theoretical predictions, child neglect was not a significant predictor of self-control. Implications for delinquency and child maltreatment researchers are discussed.

Child abuse Child neglect Alcohol abuse College students Drinking motives Although the relationship between child maltreatment and alcohol use and drinking problems is well established, the mechanisms involved in this relationship remain largely unknown and research has focused primarily on women. Using the Modified Drinking Motives Questionnaire-Revised (M-DMQ-R; , drinking motives were examined as mediators in the relationship between childhood maltreatment and alcohol consumption and consequences among male and female college student drinkers (N = 218, 60.6% women). Participants completed questionnaires assessing child maltreatment, drinking motives, alcohol consumption and alcohol consequences. Enhancement motives in particular mediated the relationship between childhood abuse and alcohol consequences for men, whereas coping-depression motives mediated this relationship for women. Implications of these findings for alcohol interventions and future research are discussed, along with limitations of the present study.

This article reviews recent findings in the developmental neurophysiology of children subjected to psychological trauma. Studies link extreme neglect and abuse with long-term changes in the nervous and endocrine systems. A growing body of research literature indicates that individuals with severe trauma histories are at higher risk of behaving violently than those without such histories. This article links these two research areas by discussing how severe and protracted child abuse and/or neglect can lead to biological changes, putting these individuals at greater risk for committing homicide and other forms of violence than those without child maltreatment histories. The implications of these biological findings for forensic evaluations are discussed. Based on new understanding of the effects of child maltreatment, the authors invite law and mental health professionals to rethink their notions of justice and offender accountability, and they challenge policymakers to allocate funds for research into effective treatment and for service delivery.

ObjectiveTo determine whether child maltreatment is associated with obesity in preschool children.MethodsData were obtained from the Fragile Families and Child Wellbeing Study, a birth cohort study of 4898 children born between 1998 and 2000 in 20 large US cities. At 3 years of age, 2412 of these children had their height and weight measured, and mothers answered items on the Parent-Child Conflict Tactics Scales about three types of child maltreatment—neglect, corporal punishment, and psychological aggression. The frequency of each type of maltreatment behavior in the prior year was analyzed using categories—ever/never for neglect and quintiles for the other 2 types of maltreatment. Child obesity was defined as measured body mass index (kg/m2) ≥ 95th percentile.ResultsEighteen percent of the children were obese, and the prevalence of any episode of neglect, corporal punishment, and psychological aggression was 11%, 84%, and 93%, respectively. The odds of obesity were increased in children who had experienced neglect (odds ratio 1.56, 95% confidence interval, 1.14-2.14), after controlling for the income and number of children in the household, the mothers’ race/ethnicity, education, marital status, body mass index, prenatal smoking, and age, and the children’s sex and birth weight. Neither the frequency of corporal punishment nor psychological aggression was associated with an increased risk of obesity.ConclusionsIn a sample of preschool children from 20 large US cities, maternal self-report of neglectful behavior was associated with an increased risk of childhood obesity, after controlling for birth weight, maternal obesity, and multiple socioeconomic factors.

This study examined the relationship between child experiences identified conceptually as “neglectful” prior to age 4 and child outcomes at age 4. This was done using measures from two sites collected as part of LONGSCAN. Child needs were included within categories of physical and psychological safety and security. Problems with residence safety or cleanliness and untreated behavioral problems predicted child impairments in language. CPS reports of failure to provide shelter predicted impairments in several developmental outcomes. A stimulating home environment predicted less impairment in cognitive development. Multiple changes in residence predicted externalizing behavior problems. Exposure to verbally aggressive discipline predicted more behavioral problems overall. Conversely, some indicators (such as caregiver transitions and lack of medical care) predicted less developmental impairment or fewer behavior problems in certain domains. The approach supports a conceptualization of ...

The persecution of children as witches has received widespread reportage in the international mass media. In recent years, hundreds of children have been killed, maimed and abandoned across Africa based on individual and village-level accusations of witchcraft. Despite the media focus, to date, very little systematic study has investigated the phenomenon. In this case study, the persecution of child witches in Ghana is studied to explore the nature and patterns of witch hunts against children in the West African nation.There are no reliable national data on child abuse related to witchcraft accusations in Ghana. For this study, 13 cases of child witch hunts appearing in the local media during 1994–2009 were analyzed. Case summaries were constructed for each incident to help identify the socio-demographic characteristics of assailants and victims, victim-offender relationships, the methods of attacks, the spatial characteristics, as well as the motivations for the attacks.Children branded as witches ranged in age from 1-month-old to 17-years-old, were primarily from poor backgrounds, and lived in rural areas of the country. Accusations of witchcraft and witch assaults were lodged by close family members often through the encouragement of, or in concert with Christian clergymen and fetish priests. Accused witches were physically brutalized, tortured, neglected, and in two cases, murdered. For school-aged children, imputations of witchcraft contributed to stigmatization in both the community and at school, resulting in dropping out. The most frequently expressed reason for persecution of the child was suspicion that the child had used witchcraft to cause the death or illness of family relations or someone in the community. Another reason was suspicion that the child was responsible for the business failure or financial difficulties of a perceived victim.The results of this research are consistent with findings in the witchcraft literature suggesting that seemingly inexplicable illnesses, untimely deaths, and financial hardships tend to be the major causal forces generating witch hunts. Additional research is necessary to further shed light on child witch hunts in Ghana and other countries.To reduce the incidence of such abuse, there is a need for increased advocacy and protections for children in the society. The government must also increase the penalties for child abuse. This will serve as a deterrent to potential offenders. Additionally, through public service campaigns, educating citizens about the causes and trajectories of diseases, will lead to a significant diminution of witchcraft accusations and the associated violence.

The purpose of the present study was to investigate the prevalence of types of child maltreatment and co-occurring risks in an entire county population of children in public education and to examine the unique relations of the child maltreatment types and timing on children's early academic success while accounting for the children's multiple-risk context. A cohort of 11,835 second grade students who were born in the county and attended the public school district served as participants. Information on first reported experiences of substantiated physical abuse, neglect, unsubstantiated child maltreatment reports, health, maternal, and social risks, and academic and behavioral outcomes was obtained and linked through a county-wide integrated data system. Results indicated that after controlling for demographics and the set of other risks, substantiated child neglect and unsubstantiated reports were associated with poorer outcomes than physical abuse. Also, first substantiated child maltreatment and unsubstantiated reports prior to kindergarten were related to a more comprehensive set of poor outcomes than post-kindergarten first reports. The differential patterns that emerged for the association between age of first reported maltreatment by type and educational outcomes were discussed with implications for future research and policy.

Objective: The dynamics of interactions between evidence-based intervention (EBI) developers and trainers and organizations and providers that deliver the EBI was examined in two case studies, a statewide randomized effectiveness trial of an EBI to reduce child neglect and a randomized trial of EBIs for depression, anxiety, and conduct problems in children and adolescents. Methods: Data were collected using ethnographic methods of participant observation and semistructured interviews and analyzed using grounded theory analytic methods. Results: Formal and informal interactions between EBI propagators and end users provide access to resources and exchange of global and local knowledge of service delivery. Productive interactions require accessibility, mutual respect, a shared language, and a willingness to engage in negotiation and compromise to resolve differences in demands imposed by organizational culture, the need for EBI fidelity, and client characteristics. Conclusion: A cultural exchange characterized by information sharing and behavioral change through a process of negotiation and compromise is central to evidence-based practice in youth serving systems of care.

Studies about fathers and child neglect are scarce. Current research, which tends to focus on mothers, does not allow to fully understand the influence of all parental figures on child protection. This research aims to compare socio-demographic characteristics and personal problems of mothers to those of fathers in 1266 neglecting families. The data, from the Canadian Incidence Study of Reported Child Abuse and Neglect -2003, was collected by workers in a representative sample of 63 child welfare service areas. The findings suggest that parental situations vary greatly according to gender and family structures. Mothers (biological and surrogates) face more issues than fathers (biological and surrogates). For example, they face more mental health issues. Biological mothers are in worse position than surrogate mothers but, inversely, surrogate fathers are in worse position than biological fathers. Parental characteristics and problems also differ according to family structures but the way those issues affect mothers could explain most of those differences. Overall, single female-headed families seem particularly vulnerable and fathers present better socio-demographic characteristics and struggle with less personal problems than mothers. Implications for research and action with mothers and fathers will be discussed. Crown

Previous research has suggested that child maltreatment is associated with poor school performance. However, previous studies have largely been cross-sectional or, if longitudinal, have had small sample sizes, short follow-up periods, or have not adequately controlled for confounders. The objective of this study is to determine the relationship between child maltreatment and school performance in a cohort of children at risk of maltreatment and followed since birth. This prospective study followed children born at risk for maltreatment with semi-annual reviews of the North Carolina Central Registry of Child Abuse and Neglect. At ages six and eight years, children&#39;s teachers were surveyed using the Achenbach Teacher Report Form and project-developed questions regarding peer status. This information, along with control variables from maternal interviews, was used in logistic regression models to determine the impact of maltreatment on academic performance, peer status, and adaptiv...

Objective: To assess the cost-effectiveness of two alternate forms of Family Connections (FC), a child neglect prevention program, in relation to changes in risk and protective factors and improvements in child safety and behavioral outcomes. Methods: In the original FC study, a sample of 154 families (473 children) in a poor, urban neighborhood, who met risk criteria for child neglect, were randomly assigned to receive either a 3-or 9-month intervention. CPS reports and self-report and observational data on risk and protective factors, safety, and behavioral outcomes were collected prior to, at the end of, and 6-months post intervention. The current study compared the costs of delivering the 3or 9-month intervention in relation to reported improvements in risk and protective factors, safety, and behavioral outcomes for each group. Results: The 3-month intervention was more cost effective than the 9-month intervention in relation to positive changes in risk and protective factors and child safety. However, cost-effectiveness analysis indicated that the 9month intervention was more cost effective (CE ratio = $276) than the 3-month intervention (CE ratio = $337) in relation to improved unit changes in the child's behavior between baseline and 6 months after service closure. Conclusions: This study successfully explored the cost-effectiveness of the FC intervention in relation to its intended outcomes. More extensive cost analyses are currently being conducted in the replication of this program in multiple jurisdictions across the United States.

Objective: The purpose of this study was to examine the relationships between childhood abuse/neglect experiences (sexual abuse, physical abuse, emotional abuse, and child neglect) and adult life functioning among Methadone Maintenance Treatment Program (MMTP) drop-outs. Method: 432 subjects who dropped out of MMTP were recruited in New York City in 1997-1999. Adult life functioning was measured by HIV drug and sex risk behaviors, Addiction Severity Index (ASI) composite scores, and depression. The 2 tests, t tests, correlation, and multiple logistic regressions were performed to examine the relationships between abuse experiences and adult life functioning. Results: The prevalence of child abuse/neglect history was high among MMTP drop-outs: sexual abuse-36%; physical abuse-60%; emotional abuse-57%; child physical neglect-66%; all four experiences-25%. As assessed via ASI composite scores, those who had been abused in childhood had significantly more medical, legal, relationship, and psychological problems than those who had not. Overall, several significant associations were found between the abuse experiences and HIV risk behaviors. Those who had experienced child neglect were more likely to be HIV positive. In multivariate analyses, childhood physical abuse was a significant predictor of having multiple sex partners while depression was significantly related to injection drug use in adulthood (p < .05). There were trends for the relationships between childhood sexual abuse and HIV sex risk behavior (p < .10) and between gender and injection drug use (p < .10).