Risk factors in the mother-child relationship that predispose to the development of early childhood caries

This study focused on the risk factors in mother-child relationship that predispose babies to the development of dental caries. A prospective cohort study with 80 mother-child pairs was conducted. The mothers responded at 12, 18 and 30 months after their children's birth, to questions about variables related to diet, sucking habits, and oral care. Children were clinically examined to verify caries lesions (white spot lesions or cavitation). Data were analysed using Chi squared or Fisher's exact tests. The significance level was set at 5 %. Of the total, 3.75 % showed cavitated lesions after 18 months; 6.25 and 45 % had spot white lesions, respectively, at 18 and 30 months. The cariogenic diet was high at 12 (63.75 %) and 30 (88.75 %) months. Good oral hygiene was present in a minority of children at 12 months (46.25 %), but increased at 30 months (65 %), helping to prevent cavities and white spot lesions over this period (p = 0.0005). The variables of the blocks sucking habits and diet were not associated with caries. The lack of oral care in children was a risk factor for dental caries development.

RP93-395 Liability Insurance and the Family Child Care Provider

Life other small business owners, family child care providers need adequate life, health, and disability insurance to protect their families from the loss of their income. However, child care providers also face unique risks. Perhaps the most important of these risks is the financial loss that would result if the provider were found liable or responsible for the injury or death of a child or a child's parent. If a claim were filed against you as a provider, three different types of financial losses are possible: medical expenses, damages awarded to the victim or his/her family after a lawsuit, and court costs related to your defense. This booklet will help you to: (1) evaluate options for insuring a family child care operation, and (2) evaluate available liability insurance policies.

Psychological and Support Characteristics of Parents of Child Sexual Abuse Victims: Relationship with Child Functioning and Treatment

Child sexual abuse continues to be a prevalent and complex problem in today’s society as it poses serious and pervasive mental health risks to child victims and their non-offending parents. The main objectives of this study were (a) to elucidate the psychological symptoms and support needs of parents of child sexual abuse victims as they present to group treatment, (b) to examine changes in psychological symptoms and support needs and their relationship with child functioning over the course of a parallel group treatment, and (c) to examine the impact of these factors on completion of group treatment. Participants included 104 sexually abused youth and their non-offending parent presenting to Project SAFE Group Intervention, a 12-session cognitive-behavioral group treatment for sexually abused children and their non-offending parents. This project had a unique advantage of utilizing a variety of demographic, parent-, and child-report measures, allowing for a more comprehensive examination of change in symptomatology and needs over the course of treatment. Several significant findings were noted, including the identification of four clusters of youth at pre-treatment, which were maintained at post-treatment; elevations on the CTQ Sexual Abuse scale; parents of youth sexually abused by a non-family member had significantly higher PSI-Restriction of Role subscale scores; parental expectations of a negative impact on their child were worse for older children; several parent characteristics predicted client treatment retention (e.g., older parents, lower SCL-90-R GSI scores); and an early age of onset of abuse also increased treatment retention. Future directions, recommendations, and limitations were discussed.

EMERGENT CONDITIONAL RELATIONS IN A GO/NO-GO PROCEDURE: FIGURE-GROUND AND STIMULUS-POSITION COMPOUND RELATIONS

Past research has demonstrated emergent conditional relations using a go/no-go procedure with pairs of figures displayed side-by-side on a computer screen. The present Study sought to extend applications Of this procedure. In Experiment, 1, we evaluated whether emergent conditional relations Could be demonstrated when two-component stimuli were displayed in figure-ground relationships-abstract figures displayed on backgrounds of different colors. Five normal)), capable adults participated. During training, each two-component stimulus Was presented successively. Responses emitted in the presence of some Stimulus pairs (A1B1, A2B2, A3B3, B1C1, B2C2 and B3C3) were reinforced, whereas responses emitted in the presence of other pairs (A1B2, A1B3, A2B1, A2B3, A3B1, A3B2, B1C2, B1C3, B2C1, B2C3, B3C1 and B3C2) were not. During tests, new configurations (AC and CA) were presented, thus emulating structurally the matching-to-sample tests employed in typical equivalence Studies. All participants showed emergent relations consistent with stimulus equivalence during testing. In Experiment 2, we systematically replicated the procedures with Stimulus compounds consisting Of four figures (A1, A2, C1 and C2) and two locations (left - B1 and right - 132). A,11 6 normally capable adults exhibited emergent stimulus-stimulus relations. Together, these experiments show that the go/no-go procedure is a potentially useful alternative for Studying emergent. conditional relations when matching-to-sample is procedurally cumbersome or impossible to use.

Syntax of social life in postpartum depression: Mother-child interaction

Purpose: Understand the difficulties and experienced of individuals suffering from postpartum depression, related to mood disturbances, the mother-child bond and its repercussions in the meanings established for the experience of being a mother. Methods: Forty-one patients were interviewed, with ages ranging from 20 to 49 years, from a total of 106 attended at the Primary Care Unit, in the interior of the state of Parahiba, Brazil. A sample of 21 women was selected, presenting an inclusion profile, propitious to mapping postpartum depression. The eligible patients were referred by two PSF (Health Family) teams (one each from the urban and rural zones), aimed at diagnosing the psychic disturbance of the perperium. They were accompanied by a psychologist and all signed an informed consent form. A field diary supported the information recorded. Beck's Depression Inventory complemented the inclusion and follow-up of the patients. The data were analyzed statistically. Results: We confirmed the findings of the most recent studies that infant abandonment in the postpartum period occurs in situations where multiple and serious factors add up, such as misery (86.7%), little schooling (67%), lack of a support network (36.5%), estrangement of the mother's family relations (12%) and lack of paternal involvement (91.5%). Conclusion: The feeling of psyching pain and suffering, resulting from postpartum depression, is the most emphasized by women (87%) because it triggers the greatest discomfort, due to the difficulty in overcoming it.

Technical innovations for the diagnosis and the rehabilitation of motor and perceptive impairments of the child with Cerebral Palsy

The treatment of the Cerebral Palsy (CP) is considered as the “core problem” for the whole field of the pediatric rehabilitation. The reason why this pathology has such a primary role, can be ascribed to two main aspects. First of all CP is the form of disability most frequent in childhood (one new case per 500 birth alive, (1)), secondarily the functional recovery of the “spastic” child is, historically, the clinical field in which the majority of the therapeutic methods and techniques (physiotherapy, orthotic, pharmacologic, orthopedic-surgical, neurosurgical) were first applied and tested. The currently accepted definition of CP – Group of disorders of the development of movement and posture causing activity limitation (2) – is the result of a recent update by the World Health Organization to the language of the International Classification of Functioning Disability and Health, from the original proposal of Ingram – A persistent but not unchangeable disorder of posture and movement – dated 1955 (3). This definition considers CP as a permanent ailment, i.e. a “fixed” condition, that however can be modified both functionally and structurally by means of child spontaneous evolution and treatments carried out during childhood. The lesion that causes the palsy, happens in a structurally immature brain in the pre-, peri- or post-birth period (but only during the firsts months of life). The most frequent causes of CP are: prematurity, insufficient cerebral perfusion, arterial haemorrhage, venous infarction, hypoxia caused by various origin (for example from the ingestion of amniotic liquid), malnutrition, infection and maternal or fetal poisoning. In addition to these causes, traumas and malformations have to be included. The lesion, whether focused or spread over the nervous system, impairs the whole functioning of the Central Nervous System (CNS). As a consequence, they affect the construction of the adaptive functions (4), first of all posture control, locomotion and manipulation. The palsy itself does not vary over time, however it assumes an unavoidable “evolutionary” feature when during growth the child is requested to meet new and different needs through the construction of new and different functions. It is essential to consider that clinically CP is not only a direct expression of structural impairment, that is of etiology, pathogenesis and lesion timing, but it is mainly the manifestation of the path followed by the CNS to “re”-construct the adaptive functions “despite” the presence of the damage. “Palsy” is “the form of the function that is implemented by an individual whose CNS has been damaged in order to satisfy the demands coming from the environment” (4). Therefore it is only possible to establish general relations between lesion site, nature and size, and palsy and recovery processes. It is quite common to observe that children with very similar neuroimaging can have very different clinical manifestations of CP and, on the other hand, children with very similar motor behaviors can have completely different lesion histories. A very clear example of this is represented by hemiplegic forms, which show bilateral hemispheric lesions in a high percentage of cases. The first section of this thesis is aimed at guiding the interpretation of CP. First of all the issue of the detection of the palsy is treated from historical viewpoint. Consequently, an extended analysis of the current definition of CP, as internationally accepted, is provided. The definition is then outlined in terms of a space dimension and then of a time dimension, hence it is highlighted where this definition is unacceptably lacking. The last part of the first section further stresses the importance of shifting from the traditional concept of CP as a palsy of development (defect analysis) towards the notion of development of palsy, i.e., as the product of the relationship that the individual however tries to dynamically build with the surrounding environment (resource semeiotics) starting and growing from a different availability of resources, needs, dreams, rights and duties (4). In the scientific and clinic community no common classification system of CP has so far been universally accepted. Besides, no standard operative method or technique have been acknowledged to effectively assess the different disabilities and impairments exhibited by children with CP. CP is still “an artificial concept, comprising several causes and clinical syndromes that have been grouped together for a convenience of management” (5). The lack of standard and common protocols able to effectively diagnose the palsy, and as a consequence to establish specific treatments and prognosis, is mainly because of the difficulty to elevate this field to a level based on scientific evidence. A solution aimed at overcoming the current incomplete treatment of CP children is represented by the clinical systematic adoption of objective tools able to measure motor defects and movement impairments. A widespread application of reliable instruments and techniques able to objectively evaluate both the form of the palsy (diagnosis) and the efficacy of the treatments provided (prognosis), constitutes a valuable method able to validate care protocols, establish the efficacy of classification systems and assess the validity of definitions. Since the ‘80s, instruments specifically oriented to the analysis of the human movement have been advantageously designed and applied in the context of CP with the aim of measuring motor deficits and, especially, gait deviations. The gait analysis (GA) technique has been increasingly used over the years to assess, analyze, classify, and support the process of clinical decisions making, allowing for a complete investigation of gait with an increased temporal and spatial resolution. GA has provided a basis for improving the outcome of surgical and nonsurgical treatments and for introducing a new modus operandi in the identification of defects and functional adaptations to the musculoskeletal disorders. Historically, the first laboratories set up for gait analysis developed their own protocol (set of procedures for data collection and for data reduction) independently, according to performances of the technologies available at that time. In particular, the stereophotogrammetric systems mainly based on optoelectronic technology, soon became a gold-standard for motion analysis. They have been successfully applied especially for scientific purposes. Nowadays the optoelectronic systems have significantly improved their performances in term of spatial and temporal resolution, however many laboratories continue to use the protocols designed on the technology available in the ‘70s and now out-of-date. Furthermore, these protocols are not coherent both for the biomechanical models and for the adopted collection procedures. In spite of these differences, GA data are shared, exchanged and interpreted irrespectively to the adopted protocol without a full awareness to what extent these protocols are compatible and comparable with each other. Following the extraordinary advances in computer science and electronics, new systems for GA no longer based on optoelectronic technology, are now becoming available. They are the Inertial and Magnetic Measurement Systems (IMMSs), based on miniature MEMS (Microelectromechanical systems) inertial sensor technology. These systems are cost effective, wearable and fully portable motion analysis systems, these features gives IMMSs the potential to be used both outside specialized laboratories and to consecutive collect series of tens of gait cycles. The recognition and selection of the most representative gait cycle is then easier and more reliable especially in CP children, considering their relevant gait cycle variability. The second section of this thesis is focused on GA. In particular, it is firstly aimed at examining the differences among five most representative GA protocols in order to assess the state of the art with respect to the inter-protocol variability. The design of a new protocol is then proposed and presented with the aim of achieving gait analysis on CP children by means of IMMS. The protocol, named ‘Outwalk’, contains original and innovative solutions oriented at obtaining joint kinematic with calibration procedures extremely comfortable for the patients. The results of a first in-vivo validation of Outwalk on healthy subjects are then provided. In particular, this study was carried out by comparing Outwalk used in combination with an IMMS with respect to a reference protocol and an optoelectronic system. In order to set a more accurate and precise comparison of the systems and the protocols, ad hoc methods were designed and an original formulation of the statistical parameter coefficient of multiple correlation was developed and effectively applied. On the basis of the experimental design proposed for the validation on healthy subjects, a first assessment of Outwalk, together with an IMMS, was also carried out on CP children. The third section of this thesis is dedicated to the treatment of walking in CP children. Commonly prescribed treatments in addressing gait abnormalities in CP children include physical therapy, surgery (orthopedic and rhizotomy), and orthoses. The orthotic approach is conservative, being reversible, and widespread in many therapeutic regimes. Orthoses are used to improve the gait of children with CP, by preventing deformities, controlling joint position, and offering an effective lever for the ankle joint. Orthoses are prescribed for the additional aims of increasing walking speed, improving stability, preventing stumbling, and decreasing muscular fatigue. The ankle-foot orthosis (AFO), with a rigid ankle, are primarily designed to prevent equinus and other foot deformities with a positive effect also on more proximal joints. However, AFOs prevent the natural excursion of the tibio-tarsic joint during the second rocker, hence hampering the natural leaning progression of the whole body under the effect of the inertia (6). A new modular (submalleolar) astragalus-calcanear orthosis, named OMAC, has recently been proposed with the intention of substituting the prescription of AFOs in those CP children exhibiting a flat and valgus-pronated foot. The aim of this section is thus to present the mechanical and technical features of the OMAC by means of an accurate description of the device. In particular, the integral document of the deposited Italian patent, is provided. A preliminary validation of OMAC with respect to AFO is also reported as resulted from an experimental campaign on diplegic CP children, during a three month period, aimed at quantitatively assessing the benefit provided by the two orthoses on walking and at qualitatively evaluating the changes in the quality of life and motor abilities. As already stated, CP is universally considered as a persistent but not unchangeable disorder of posture and movement. Conversely to this definition, some clinicians (4) have recently pointed out that movement disorders may be primarily caused by the presence of perceptive disorders, where perception is not merely the acquisition of sensory information, but an active process aimed at guiding the execution of movements through the integration of sensory information properly representing the state of one’s body and of the environment. Children with perceptive impairments show an overall fear of moving and the onset of strongly unnatural walking schemes directly caused by the presence of perceptive system disorders. The fourth section of the thesis thus deals with accurately defining the perceptive impairment exhibited by diplegic CP children. A detailed description of the clinical signs revealing the presence of the perceptive impairment, and a classification scheme of the clinical aspects of perceptual disorders is provided. In the end, a functional reaching test is proposed as an instrumental test able to disclosure the perceptive impairment. References 1. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002 Set;44(9):633-640. 2. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005 Ago;47(8):571-576. 3. Ingram TT. A study of cerebral palsy in the childhood population of Edinburgh. Arch. Dis. Child. 1955 Apr;30(150):85-98. 4. Ferrari A, Cioni G. The spastic forms of cerebral palsy : a guide to the assessment of adaptive functions. Milan: Springer; 2009. 5. Olney SJ, Wright MJ. Cerebral Palsy. Campbell S et al. Physical Therapy for Children. 2nd Ed. Philadelphia: Saunders. 2000;:533-570. 6. Desloovere K, Molenaers G, Van Gestel L, Huenaerts C, Van Campenhout A, Callewaert B, et al. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study. Gait Posture. 2006 Ott;24(2):142-151.

Child Aggression in a Post-Communist Country: Race and Gender Aspects in a Cross-Cultural Comparison

Gypsies represent approximately 2.5% of the Czech population, but are considerably over-represented among the unemployed, prisoners, schooldropouts, neglected children, etc. Together with racist attitudes on the part of the majority, this causes strong inter-ethnic tension and obviouseconomic, moral and political problems. This research studied the way in which this situation is reflected in peer relations between Gypsy andmajority children in schools. Six samples of children (totalling 2974 children aged 7-15, of whom 15% were Gypsies) were studied through peernomination, teacher assessment and self-reporting. Gypsy/non-Gypsy and gender dichotomies were correlated with measures of aggression,victimisation and acceptance/rejection. The results showed that Gypsy children, both boys and girls, were more likely to nominate their Gypsy peers as aggressors than they nominatemajority children, implying that they tend to direct their rejection toward their own kind. The number of Gypsy children in a class was also animportant factor with Gypsies being more likely to be accepted and less likely to appear aggressive when they were only one or two in a class, thanin a class where there was a greater number of Gypsy pupils. When whole classes were taken as the unit of analysis, Gypsy children were seen asmore likely to behave aggressively in class by their Gypsy and non-Gypsy counterparts as well as by their teachers. At the same time they aremuch less likely to become victims of aggression than are non-Gypsy children, both boys and girls. Mr. Rican also found that the acceptance/rejection patterns of Gypsy children betray their unsatisfactory socialisation. Among their peers, Gypsyor non-Gypsy, they tend to prefer aggressors or children who teachers describe as showing little discipline or effort to succeed at school. Partialcorrelation to assess the influence of seniority on aggressiveness provided a warning that the recent lengthening of compulsory school attendance islikely to bring an increase in aggressiveness. He believes that Gypsy ethnic identity has lost many of its important positive aspects, making itsnegative aspects more prominent and more dangerous. He does however find some possible ways for teachers to reinforce the positive aspects ofGypsy children's identities in order to support their socialisation at schools.

Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study

STUDY OBJECTIVE: The objective of this study was to investigate the impact of two different socioeconomic status (SES) measures on child and adolescent self reported health related quality of life (HRQoL). The European KIDSCREEN project aims at simultaneous developing, testing, and implementing a generic HRQoL instrument. DESIGN AND SETTING: The pilot version of the questionnaire was applied in school surveys to students from 8 to 18 years of age, as well as to their parents, together with such determinants of health status as two SES indicators, the parental educational status and the number of material goods in the family (FAS, family affluence scale). PARTICIPANTS: Students from seven European countries: 754 children (39.8%; mean: 9.8 years), and 1142 adolescents (60.2 %; mean: 14.1 years), as well as their respective parents. MAIN RESULTS: In children, a higher parental educational status was found to have a significant positive impact on the KIDSCREEN dimensions: physical wellbeing, psychological wellbeing, moods and emotions, bullying and perceived financial resources. Increased risk of low HRQoL was detected for adolescents in connection with their physical wellbeing. Family wealth plays a part for children's physical wellbeing, parent relations and home life, and perceived financial resources. For adolescents, family wealth furthermore predicts HRQoL on all KIDSCREEN dimensions. CONCLUSIONS: There is evidence to suggest that exposure to low parental educational status may result in a decreased HRQoL in childhood, whereas reduced access to material (and thereby social) resources may lead to a lower HRQoL especially in adolescence.

Strengthening Families: Parents' Voices on Discipline and Child Rearing

This qualitative study conducted semi-structured, multi-session focus groups and interviews with twenty-seven participants to explore in-depth, participant constructs of child discipline and punishment methods and reasons for the continuing support for corporal punishment of U.S. children. The research assumed that parents want to parent well and utilized the strengths perspective as the instrument to listen to participants' voices. Narratives revealed that participants were thoughtful about discipline and parenting strategies and viewed their parent role as a serious commitment. Non-violent discipline strategies, particularly communication, were often used. However, parents generally framed use of physical punishment as “when children need spanking” versus articulating the view that corporal punishment is a choice. Parents were unfamiliar with risks associated with physical punishment and only three parents, as a result of their foster parent training, had ever heard, “Do not spank.” Participants enumerated services and recommendations that would support and inform their own parenting, as well as, benefit children and the eighty percent of women and men in the United States who become mothers and fathers. Recommendations included: creation of a national campaign to build on parent strengths and the intentionality of effective parenting; child development education and increased public awareness of positive discipline methods; parenting supports, including respite and venues for dialogue and discourse about parenting. Recommendations are intended to inform child welfare practice and policy, particularly child abuse prevention. Creating, funding, and implementing a national campaign as described would challenge the dominant child welfare paradigm from one currently perceived as punitive and focused on parents' deficits to a strengths-based paradigm that provides supports and assistance to parents and children.

The Weekly Adjustment Indicators Checklist: An Application in the Child Welfare Field

Research on the effectiveness of various home-based interventions implemented in the 1980s and 1990s indicates that results have been equivocal. Because of the unique and complex behavioral challenges presented by each family and the need for individualized treatments and long-term interventions for these families, group research and evaluation designs are often insufficient in assessing effectiveness of home-based interventions. Alternative evaluation strategies are needed. The purpose of this exploratory study was two-fold: (a) to investigate the applicability and acceptability of the Weekly Adjustment Indicators Checklist (WAIC) in monitoring adult and child behaviors and (b) to monitor, on an on-going basis, the progress of a family referred to an urban family preservation and reunification program. The target family on whom data were collected consisted of a 13-year old girl and her foster parent who was her maternal aunt. The findings of this study indicate that the WAIC is applicable in monitoring the progress of children and adults in care and that it has the endorsement of its user, namely, the direct care provider. Other results of the study, limitations of the study, and future research needs are discussed.

Design and evaluation of the parent education component of a comprehensive violence prevention project in middle schools

Low parental monitoring is related to youth risk behaviors such as delinquency and aggression. The purpose of this dissertation was to describe the development and evaluation of a parent education intervention to increase parental monitoring in Hispanic parents of middle school children.^ The first study described the process of intervention mapping as used to develop Padres Trabajando por la Paz, a newsletter intervention for parents. Using theory, empirical literature, and information from the target population, performance objectives and determinants for monitoring were defined. Learning objectives were specified and a staged social-cognitive approach was used to develop methods and strategies delivered through newsletters.^ The second study examined the outcomes of a randomized trial of the newsletter intervention. Outcome measures consisted of a general measure of monitoring, parent and child reports of monitoring behaviors targeted by the intervention, and psychosocial determinants of monitoring (self-efficacy, norms, outcome expectancies, knowledge, and beliefs). Seventy-seven parents completed the randomized trial, half of which received four newsletters over an eight-week period. Results revealed a significant interaction effect for baseline and treatment for parent's reports of norms for monitoring (p =.009). Parents in the experimental condition who scored low at baseline reported increased norms for monitoring at follow-up. A significant interaction effect for child reports of parental monitoring behaviors (p =.04) reflected an small increase across baseline levels in the experimental condition and decreases for the control condition at higher baseline scores. Both groups of parents reported increased levels of monitoring at follow-up. No other outcome measures varied significantly by condition.^ The third study examined the relationship between the psychosocial determinants of parental monitoring and parental monitoring behaviors in the study population. Weak evidence for a relationship between outcome expectancies and parental monitoring behaviors suggests further research in the area utilizing stronger empirical models such as longitudinal design and structural equation modeling.^ The low-cost, minimal newsletter intervention showed promise for changing norms among Hispanic parents for parental monitoring. In light of the importance of parental monitoring as a protective factor for youth health risk behaviors, more research needs to be done to develop and evaluate interventions to increase parental monitoring. ^

Newborn screening for cystic fibrosis - The parent perspective.

BACKGROUND Newborn screening for CF started 01/2011 in Switzerland. We investigated the parents' opinions about the information received, their feelings, and overall approval of the screening. METHODS This is a prospective questionnaire survey of all parents of positively screened children. Parents were phoned by CF-centres and invited for diagnostic investigations. They completed a questionnaire after the visit to the CF-centre. RESULTS From 2011-2013, 246 families received the questionnaire and 138 (56%) replied. Of these 77 (60%) found the information received at birth satisfactory; 124 (91%) found the information provided in the CF-centre satisfactory. Most parents (n=98, 78%) felt troubled or anxious when the CF-centre called, 51 (38%) remained anxious after the visit. Most parents (n=122; 88%) were satisfied with the screening, 4 (3%) were not, and 12 (9%) were unsure. CONCLUSIONS The smooth organisation of the screening process, with personal information by a CF specialist and short delays between this information and the final diagnostic testing, might have contributed to reduce anxiety among parents. Most families were grateful that their child had been screened, and are happy with the process.

Parental substance abuse as a risk factor for physical child abuse and neglect: A systematic review of the literature

Case control and retrospective studies have identified parental substance abuse as a risk factor for physical child abuse and neglect (Dore, Doris, & Wright, 1995, May; S. R. Dube et al., 2001; Guterman & Lee, 2005, May; Walsh, MacMillan, & Jamieson, 2003). The purpose of this paper is to present the findings of a systematic review of prospective studies from 1975 through 2005 that include parental substance abuse as a risk factor for physical child abuse or neglect. Characteristics of each study such as the research question, sample information, data collection methods and results, including the parent assessed and definitions of substance abuse and physical child abuse and neglect, are discussed. Five studies were identified that met the search criteria. Four of five studies found that parental substance abuse was a significant variable in predicting physical child abuse and neglect.^