Can Public Child Welfare Help to Prevent Child Maltreatment? Promising Findings from Los Angeles

This article describes promising findings from the Los Angeles County Prevention Initiative Demonstration Project, a systems change approach to developing relationships between public child welfare, allied public agencies, and community-based networks that offer family-centered services, economic assistance and capacity building to support all kinds of families. It describes the conceptual underpinnings and unique structure of the initiative, the evaluation methods used to assess results, and a pattern of promising results.

Barriers to reporting child maltreatment: do emergency medical services professionals fully understand their role as mandatory reporters?

BACKGROUND: Child maltreatment is underreported in the United States and in North Carolina. In North Carolina and other states, mandatory reporting laws require various professionals to make reports, thereby helping to reduce underreporting of child maltreatment. This study aims to understand why emergency medical services (EMS) professionals may fail to report suspicions of maltreatment despite mandatory reporting policies. METHODS: A web-based, anonymous, voluntary survey of EMS professionals in North Carolina was used to assess knowledge of their agency's written protocols and potential reasons for underreporting suspicion of maltreatment (n=444). Results were based on descriptive statistics. Responses of line staff and leadership personnel were compared using chi-square analysis. RESULTS: Thirty-eight percent of respondents were unaware of their agency's written protocols regarding reporting of child maltreatment. Additionally, 25% of EMS professionals who knew of their agency's protocol incorrectly believed that the report should be filed by someone other than the person with firsthand knowledge of the suspected maltreatment. Leadership personnel generally understood reporting requirements better than did line staff. Respondents indicated that peers may fail to report maltreatment for several reasons: they believe another authority would file the report, including the hospital (52.3%) or law enforcement (27.7%); they are uncertain whether they had witnessed abuse (47.7%); and they are uncertain about what should be reported (41.4%). LIMITATIONS: This survey may not generalize to all EMS professionals in North Carolina. CONCLUSIONS: Training opportunities for EMS professionals that address proper identification and reporting of child maltreatment, as well as cross-agency information sharing, are warranted.

Asociación de las violencias física, sexual y comunitaria con el embarazo en adolescentes: análisis multinivel

Objetivos Determinar si existe asociación entre la exposición a violencia, experimentada a nivel individual o municipal, y el embarazo adolescente en mujeres Colombianas entre 13 y 19 años de edad que contestaron la Encuesta de Demografía y Salud en el año 2010. Métodos Estudio de corte transversal, nacional y multinivel. Se tomaron datos de dos niveles jerárquicos: Nivel- 1: Datos individuales de una muestra representativa de 13.313 mujeres entre 13 y 19 años de edad provenientes de La Encuesta Nacional de Demografía y Salud del año 2010 y Nivel- 2: Datos municipales de 258 municipios provenientes de las estadísticas vitales del DANE. Resultados La prevalencia del embarazo adolescente fue del 16.8% IC 95% [16.2-17.4]. El análisis mostró que la asociación entre embarazo adolescente y violencia tanto individual, representada como violencia sexual [OR= 6.99 IC99% 4.80-10.10] y violencia física [OR= 1.74 IC99% 1.47-2.05] así como la violencia municipal medida con tasas de homicidios altas [OR= 1.99 IC99% 1.29-3.07] y muy altas [OR= 2.10 IC99% 1.21-3.61] se mantuvo estadísticamente significativa después de ajustar por las variables: Edad [OR= 1.81 IC99% 1.71-1.91], ocupación [OR= 1.62 IC99% 1.37-1.93], educación primaria o sin educación [OR= 2.20 IC99% 1.47-3.30], educación secundaria [OR= 1.70 IC99% 1.24-2.32], asistir al colegio [OR= 0.18 IC99% 0.15-0.21], conocimiento en la fisiología reproductiva [OR= 1.28 IC99% 1.06-1.54], el índice de riqueza Q1, Q2, Q3 [OR= 2.18 IC99% 1.42-3.34], [OR= 2.00 IC99% 1.39-2.28], [OR= 1.82 IC99% 1.92-2.25] y alto porcentaje de Necesidades básicas insatisfechas a nivel municipal [OR= 2.34 IC99% 1.55-3.52]. Conclusiones Este estudio mostró una relación significativamente estadística entre la violencia sexual y física con el inicio de relaciones sexuales y embarazo adolescente después de controlar por factores sociodemográficos y conocimientos en reproducción sexual en mujeres colombianas de 13 a 19 años en el año 2010. Esta asociación debe continuar siendo estudiada para lograr optimizar las estrategias de prevención y disminuir la tasa actual de embarazos adolescentes en el país y sus consecuencias.

Multi-victim sexual assault : a case study in rural Australia

Objective: There is a paucity of information regarding cases of multi-victim sexual assault of children. The reported incidence suggests that these cases are rare. The aim of this paper is to provide practitioners with information about effective intervention strategies arising out of the direct experience of managing a case of multi-victim sexual assault in an Australian rural community. --------- Method: A descriptive, case-report methodology summarizing the investigation and intervention in a case of multi-victim sexual assault is reported. A community based intervention arising out of the disclosures of 21 male children is described. The intervention occurred at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. ---------- Results: The coordination of police and welfare services increased the communication flow to victims, their families, and the community. The case also demonstrated the utility in regularly briefing political and bureaucratic authorities as well as local officials about emergent issues. Coordinating political and bureaucratic responses was essential in obtaining ongoing support and sufficient researching to enable the effective delivery of services. ---------- Conclusions: Interventions were focused at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. This provided a choice of services which were sensitive to the case setting. Recommendations are offered for practitioners who are confronted with similar events. While this paper describes an approach for intervening in a case of multi-victim sexual assault, further empirical research is needed to enable service deliverers to efficaciously target interventions which offer choice to victims and their families.

Patterns of reporting to child protection services in Canada by healthcare and nonhealthcare professionals

Background: All Canadian jurisdictions require certain professionals to report suspected or observed child maltreatment. This study examined the types of maltreatment, level of harm and child functioning issues, controlling for family socioeconomic status, age and gender of the child reported by healthcare and non-healthcare professionals. Methods: We conducted chi-square analyses and logistic regression on a national child welfare sample from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003) and compared the differences in professional reporting with its previous cycle (CIS-1998) using Bonferroni-corrected confidence intervals. Results: Our analysis of CIS-2003 data revealed that the majority of substantiated child maltreatment is reported to service agencies by non-healthcare professionals (57%), followed by non-professionals (33%) and healthcare professionals (10%). The number of professional reports increased 2.5 times between CIS-1998 and CIS-2003, while non-professionals’ increased 1.7 times. Of the total investigations, professional reports represented 59% in CIS-1998 and 67% in CIS-2003 (p<0.001). Compared to non-healthcare professionals, healthcare professionals more often reported younger children, children who experienced neglect and emotional maltreatment and those assessed as suffering harm and child functioning issues, but less often exposure to domestic violence. Conclusion: The results indicate that healthcare professionals played an important role in identifying children in need of protection considering harm and other child functioning issues. The authors discuss the reasons why underreporting is likely to remain an issue.

Critical review of Queensland's Crime and Misconduct Commission Inquiry into abuse of children in foster care : social work's contribution to reform

This paper profiles Queensland's recent Crime and Misconduct Commission Inquiry into the abuse of children in foster care. The authors welcome the outcome as an opportunity to highlight the problems encountered by child protection jurisdictions in Australia and internationally, and they applaud some of the Inquiry's findings. However, the paper argues that the path to reform is hampered by insufficient accountability by government and management, and an inadequate challenge to the ideologies underpinning contemporary child protection policy and practice. The authors conclude with a call to value and assert social work's contribution to child protection systems so as to vastly improve outcomes for children and families.

Teacher reporting questionnaire : Queensland Government Schools

This instrument was used in the project entitled Teachers Reporting Child Sexual Abuse: Towards Evidence-based Reform of Law, Policy and Practice (ARC DP0664847)

Teacher reporting questionnaire : New South Wales Non-Government Schools

This instrument was used in the project named Teachers Reporting Child Sexual Abuse: Towards Evidence-based Reform of Law, Policy and Practice (ARC DP0664847)

Child welfare policy and practice on children’s exposure to domestic violence

There are emerging movements in several countries to improve policy and practice to protect children from exposure to domestic violence. These movements have resulted in the collection of new data on EDV and the design and implementation of new child welfare policies and practices. To assist with the development of child welfare practice, this article summarizes current knowledge on the prevalence of EDV, and on child welfare services policies and practices that may hold promise for reducing the frequency and impact of EDV on children. We focus on Australia, Canada, and the United States, as these countries share a similar socio-legal context, a long history of enacting and expanding legislation about reporting of maltreatment, debates regarding the application of reporting laws to EDV, and new child welfare practices that show promise for responding more effectively to EDV.

Quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations

Background While child maltreatment is recognised as a global problem, solid epidemiological data on the prevalence of child maltreatment and risk factors associated with child maltreatment is lacking in Australia and internationally. There have been recent calls for action to improve the evidence-base capturing and describing child abuse, particularly those data captured within the health sector. This paper describes the quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations in Queensland, Australia. Methods This study involved a retrospective medical record review, text extraction and coding methodology to assess the quantity of documentation of risk factors and the subsequent utility of data in hospital records for describing child maltreatment and data linkage to Child Protection Service (CPS). Results There were 433 children in the maltreatment group and 462 in the unintentional injury group for whom medical records could be reviewed. Almost 93% of the any maltreatment code sample, but only 11% of the unintentional injury sample had documentation identified indicating the presence of any of 20 risk factors. In the maltreatment group the most commonly documented risk factor was history of abuse (41%). In those with an unintentional injury, the most commonly documented risk factor was alcohol abuse of the child or family (3%). More than 93% of the maltreatment sample also linked to a child protection record. Of concern are the 16% of those children who linked to child protection who did not have documented risk factors in the medical record. Conclusion Given the importance of the medical record as a source of information about children presenting to hospital for treatment and as a potential source of evidence for legal action the lack of documentation is of concern. The details surrounding the injury admission and consideration of any maltreatment related risk factors, both identifying their presence and ruling them out are required for each and every case. This highlights the need for additional training for clinicians to understand the importance of their documentation in child injury cases.

The battered child syndrome : changes in the law and child advocacy

In 1962, Dr C. Henry Kempe and his colleagues published the single most important article written to date about child maltreatment: The Battered-Child Syndrome. This chapter analyses the threefold nature of what these authors achieved: clearly identifing the medical evidence of severe child physical abuse and naming it as a syndrome; identifying the medical profession's resistance to its identification; and then translating their scholarship into advocacy for social and legal change. The chapter also traces some of the effects of Kempe's work, including the nature and effect of the subsequent introduction of mandatory reporting laws in the USA and internationally.

Mandatory reporting laws: Their origin, nature, and development over time

Dozens of countries have enacted mandatory reporting laws in various forms to respond to child abuse and neglect. Other countries including England are currently considering whether to introduce them, and if so in what form. It is important for policymakers, practitioners and researchers to understand these laws’ background, nature and purpose. This chapter outlines the origins and provenance of the first mandatory reporting laws; discusses their nature; describes major developments over time; and identifies some major effects and their consequences. It is shown that the laws are a heterogeneous, organic, flexible mechanism enabling social intervention where otherwise such intervention is severely compromised or impossible. Their primary function is to comprise but one aspect of a multifaceted child welfare system by identifying cases of serious maltreatment which would not otherwise come to light: sexual abuse and severe physical abuse are paradigm examples. The essential role of these laws is therefore primarily a tertiary aspect of a public health model, rather than a purely preventative strategy. Mandatory reporting laws are made by each specific jurisdiction according to its preferred design and function within its socio-political system. There is a spectrum of different approaches from which a jurisdiction can choose: they can apply to a broad or a narrow range of reporter groups, a broad or a narrow range of types of maltreatment, and a broad or a narrow range of instances where abuse or neglect occurs.