Impact of abuse and neglect on the health and wellbeing of children:Child sexual abuse

During the past 30 years, the focus on the extent and nature of child abuse and neglect has been coupled with an increasing interest in the impact on children’s development, health and mental wellbeing. Child maltreatment is both a human rights violation and a complex public health issue, likely caused by a myriad of factors that involve the individual, the family, and the community. Child abuse includes any type of maltreatment or harm inflicted upon children and young people in interactions between adults (or older adolescents). Such maltreatment is likely to cause enduring harm to the child.
The different forms of abuse and neglect often occur together in one family and can affect one or more children. These include, in deceasing level of frequency: neglect; physical abuse and non-accidental injury; emotional abuse; and sexual abuse (Cawson et al, 2000; 2002). Recently, bullying and domestic violence have been included as forms of abuse of children.
There is a sizeable body of literature on the relationship between types of child maltreatment and a variety of negative health and mental health consequences. These include biological, psychological, and social deficits (for reviews, see Crittenden, 1998; Kendall-Tackett, 2001; 2003). Aside from the serious physical and health consequences of child maltreatment, several emotional and behavioural consequences for children have been noted in the literature.

Child Poverty in Northern Ireland: Results from the Poverty and Social Exclusion Study

- There is general agreement that the measurement of child poverty is based on both low income and deprivation.

- Adjusting incomes for different household types, measuring before or after housing costs, and the selection of deprivation items all have an impact on poverty rates.

- The consensual poverty method, which takes account of what the population considers to be basic necessities, is described. The study found a high level of agreement on the basic necessities for children.

- The study found that only a few children lacked very basic necessities such as three meals a day and adequate clothing, but a third of all children (150,000) were deprived of an annual holiday and 75,000 children are growing up in cold and damp homes.

- Overall, the study found that 24% or 106,000 children are living in low income households and are deprived of four or more items.

- The study found those who had a ‘high experience’ of the conflict were significantly more deprived than those with no conflict experience and that a fifth of all children are living with an adult/s who have ‘high experience’.

Child Maltreatment and High Risk Families: Protecting children and young people

Most child maltreatment occurs within the context of high risk families. There are ethical, economic and ecological reasons why physical abuse in such families should be a major concern. Physical abuse is a significant issue throughout the UK. Yet, while neglect and other forms of abuse are receiving focused attention, physical abuse may languish under the misconceptions that it is no longer a problem, is addressed elsewhere, or is just too overwhelming an issue.
The physical abuse of children can involve regular, violent treatment at the hands of parents or carers over a number of years. Its physical effects may last for days and may result in actual physical injury. It is not accidental. Although physical abuse can occur in any family, it is prevalent in particular sectors of society, where families may be vulnerable to a combination of complex risk factors such as domestic abuse, alcohol and drug (mis)use, and mental health issues. These factors are present in 34% of Serious Case Reviews (SCRs).
The authors provide an increased understanding of risk, analysis, impact, learning and the current landscape of service delivery in relation to the physical abuse of children living in high risk families for professional, postgraduate and policy-making audiences.

Use of the child health utility and strengths and difficulties outcome measures in economic evaluations of school-based interventions: data from a cluster-randomised controlled trial in Northern Ireland

Background There is growing evidence linking early social and emotional wellbeing to later academic performance and various health outcomes including mental health. An economic evaluation was designed alongside the Roots of Empathy cluster-randomised trial evaluation, which is a school-based intervention for improving pupils’ social and emotional wellbeing. Exploration of the relevance of the Strengths and Diffi culties Questionnaire (SDQ) and Child Health Utility 9D (CHU9D) in school-based health economic evaluations is warranted. The SDQ is a behavioural screening questionnaire for 4–17-year-old children, consisting of a total diffi culties score, and also prosocial behaviour,
which aims to identify positive aspects of behaviour. The CHU9D is a generic preference-based health-related quality of life instrument for 7–17-year-old children.