Reliability of routinely collected hospital data for child maltreatment surveillance

Background: Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. Methods: A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. Results: In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most ‘under-coded’ by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability. Conclusion: Given the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting.

Monitoring children's progress using child portfolios

Introduces a method to early childhood professionals of observing children as they are involved in everyday play episodes, record children's development and plan for this, while utilising the knowledge and input of the key players in the partnership, parents and teachers.

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability

Background The relationship between positive parent-child interactions and optimal child development is well established. Families with a child with a disability may face additional challenges to establishing positive parent-child relationships. There are limited studies addressing the effectiveness of interventions which seek to address these issues with parents and young children with a disability. In particular, prior studies of music therapy with this group have been limited by small sample sizes and the use of measures of limited reliability and validity. Objective This study investigates the effectiveness of a short-term group music therapy intervention for parents who have a child with a disability and explores the factors associated with higher outcomes for participating families. Methods The participants were 201 mother-child dyads, where the child had a disability. Pre and post intervention parental questionnaires and clinician observation measures were taken on a range of parental wellbeing, parenting behaviours and child developmental factors. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented. Results Significant improvements pre to post were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence that parents were very satisfied with the program and that it brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education. Conclusions This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas. Whilst several limitations are discussed, the study does address some of the gaps in the music therapy evidence base in this area.

Children of substance-using mothers : child health engagement and child protection outcomes

Aim: Maternal substance use has been associated with a range of child risk factors. The study investigated the relationship between engagement with child health services and child protection outcomes for children of substance using mothers. ----- ----- Methods: A sample of 119 children of mothers who disclosed opiate, amphetamine or methadone use during a maternity admission between 2000 and 2003, as included in a previous matched co-hort study1, were included in the current study. Statutory child protection agency and child health engagement information for the first two years of life, was obtained. The relationship between type of maternal substance use, child health engagement and child protection outcomes was examined. ----- ----- Results: Seventy two percent of study group infants were engaged with child health services during the first two years of life. Chi square analysis showed no significant relationship between child health engagement and child protection reports. Child health engagement was associated with decreased substantiated child protection notifications for children of methadone using mothers, but not for children of illicit substance users. ----- ----- Conclusions: Almost a quarter of identified children of substance using mothers are not accessing standard child health services in their first two years of life. This study provides support for increased attention to the provision of child health services for children of methadone using mothers. Further research into effective intervention strategies for children of illicit substance using mothers is indicated.

Employers and child workers : an institutional approach

This article explores employers' perspectives on the introduction of child employment legislation in Australia through the lens of the three pillars—regulative, normative and cultural-cognitive—of institutional theory. The study extends the traditional industrial relations (IR) focus on regulation to examine how human resource (HR) practices around child employment become legitimised, normalised and socially supported.

Who wants to work in childcare? Pre-service early childhood teachers' consideration of work in the child care sector

Australia is currently witnessing considerable change in conceptualisation of the role of child care. This is a response to the strong evidence from developmental science that demonstrates the lifelong impact of early experiences. The recent commitment made by the Council of Australian Governments (COAG) (Communiqué, December 2009a) to improved qualifications and quality of those working in child care is a manifestation of this shift and highlights the importance of the childcare workforce. This study focused on the considerations of a third year cohort of B.Ed (EC) pre-service teachers (n = 55), about entering the childcare workforce. It examines their willingness to work in child care and identifies barriers and incentives for so doing. Our results indicate that, although attitudes to maternal work and child care were largely positive, few would prefer to work in child care under the current conditions. Key barriers were the pay and work conditions, particularly as they compare to other forms of potential employment. Incentives were the opportunity for leadership, creativity and a commitment to advocate for the rights of children. Those more willing to consider work in child care were distinguished from those less willing by altruism—foregoing personal gain to advocate for improved quality as a child’s right.

Does pornography harm young people?

In recent debates about the regulation of technologies that deliver pornographic content, the greatest concerns have been about the increasing ease with which young people can access such material. Because of the ethical difficulties in researching this topic, little data has been available on the potential harm done to young people by exposure to pornography. This paper gathers a number of data sources that address this issue indirectly—including the results of our own survey of over 1000 consumers of pornography—to explore this issue. Research shows that healthy sexual development includes natural curiosity about sexuality. Retrospective studies show that accidental exposure to real-life scenes of sexuality does not harm children. Our survey shows that age of first exposure to pornography does not correlate with negative attitudes towards women. Studies with non-explicit representations of sexuality show that young people who seek out sexualised representations tend to be those with a pre-existing interest in sexuality. These studies also suggest that current generations of children are no more sexualised than previous generations, that they are not innocent about sexuality, and that a key negative effect of this knowledge is the requirement for them to feign ignorance in order to satisfy adults’ expectations of them. Research also suggests important differences between pre- and post-pubescent attitudes towards pornography, and that pornography is not addictive.

Out of time: The moral temporality of sex, crime and taboo

This paper discusses the relationship between law and morality. Morality does not necessarily coincide with the law, but it contributes to it. An act may be legal but nevertheless considered to be immoral in a particular society. For example, the use of pornography may be considered by many to be immoral. Nevertheless, the sale and distribution of non-violent, non-child related, sexually explicit material is legal (or regulated) in many jurisdictions. Many laws are informed by, and even created by, morality. This paper examines the historical influence of morality on the law and on society in general. It aims to develop a theoretical framework for examining legal moralism and the social construction of morality and crime as well as the relationship between sex, desire and taboo. Here, we refer to the moral temporality of sex and taboo, which examines the way in which moral judgments about sex and what is considered taboo change over time, and the kinds of justifications that are employed in support of changing moralities. It unpacks the way in which abstract and highly tenuous concepts such as ‘‘desire’’, ‘‘art’’ and ‘‘entertainment’’ may be ‘‘out of time’’ with morality, and how morality shapes laws over time, fabricating justifications from within socially constructed communities of practice. This theoretical framework maps the way in which these concepts have become temporally dominated by heteronormative structures such as the family, marriage, reproduction, and longevity. It is argued that the logic of these structures is inexorably tied to the heterosexual life-path, charting individual lives and relationships through explicit phases of childhood, adolescence and adulthood that, in the twenty-first century, delimit the boundaries of taboo surrounding sex more than any other time in history.

Sex, crime and morality

Over the last few decades, there has been a marked increase in media and debate surrounding a specific group of offences in modern Democratic nations which bear the brunt of the label ‘crimes against morality’. Included within this group are offences related to prostitution and pornography, homosexuality and incest and child sexual abuse. This book examines the nexus between sex, crime and morality from a theoretical perspective. This is the first academic text to offer an examination and analysis of the philosophical underpinnings of sex-related crimes and social attitudes towards them and the historical, anthropological and moral reasons for differentiating these crimes in contemporary western culture. The book is divided into three sections corresponding to three theoretical frameworks: Part 1 examines the moral temporality of sex and taboo as a foundation for legislation governing sex crimes Part 2 focuses on the geography of sex and deviance, specifically notions of public morality and the public private divide Part 3 examines the moral economy of sex and harm, including the social construction of harm. Sex, Crime and Morality will be key reading for students of criminology, criminal justice, gender studies and ethics, and will also be of interest to justice professionals.

Absence of malice: Constructing the female sex offender

It could be argued that all crimes have a general moral basis, condemned as ‘wrong’ or ‘bad’ in the society in which they are proscribed, however, there are a specific group of offences in modern democratic nations which bear the brunt of the label, crimes against morality. Included within this group are offences related to prostitution and pornography, homosexuality and incest, as well as child sexual abuse. While the places where sex and morality meet have shifted over time, these two concepts continue to form the basis of much criminal legislation and associated criminal justice responses. Offenders of sexual mores are positioned as the reviled corruptors of innocent children, the purveyors of disease, an indictment on the breakdown of the family and/or the secularisation of society, and a corruptive force (Davidson 2008, Kincaid 1998). Other types of offending may divide public and political opinion, but the consensus on sex crimes appears constant.

Children’s food and activity patterns following a six-month child weight management program

Objective To describe the impact of a parent-led, family focused child weight management program on the food intake and activity patterns of pre-pubertal children. Methods n assessor-blinded, randomized controlled trial involving 111 (64% female) overweight, pre-pubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Study outcomes were assessed at baseline, 6 months, and 12 months. This paper presents data on food intake assessed via a validated 54-item parent completed dietary questionnaire and activity behaviours assessed via a parent-report 20-item activity questionnaire. Results Intake of energy-dense nutrient poor foods was lower in both intervention groups at 6 months (mean difference, P+DA -1.5 serves [CI -2.0;-1.0]; P -1.0 serves [-2.0;-0.5]) and 12 months (mean difference P+DA -1.0 serves [CI -2.0;-0.5]; P -1.0 serves [-1.5; 0.0]) compared to baseline. Intake of vegetables, fruit, breads and cereals, meat and alternatives and dairy foods remained unchanged. Regardless of study group there were significant reductions over time in the reported time spent engaged in small screen activities and an increase in the time reported spent in active play. Conclusion Child weight management intervention that promotes food intake in line with national dietary guidelines achieves a reduction in children’s intake of energy dense, nutrient poor foods. This was achieved without compromising intake of nutrient-rich food and changes in were maintained even once the intervention ceased.

Why a child needs a critical eye, and why the art classroom is central in developing it

It is a common acceptance that contemporary schoolchildren live in a world that is intensely visual and commercially motivated, where what is imagined and what is experienced intermingle. Because of this, contemporary education should encourage a child to make reference to, and connection with their ‘out-of-school’ life. The core critical underpinnings of curriculum based arts appreciation and theory hinge on educators and students taking a historical look at the ways artists have engaged with, and made comment upon, their contemporary societies. My article uses this premise to argue for the need to persist with pushing for critique of/through the visual, that it be delivered as an active process via the arts classroom rather than as visual literacy, here regarded as a more passive process for interpreting and understanding visual material. The article asserts that visual arts lessons are best placed to provide fully students with such critique because they help students to develop a ’critical eye’, an interpretive lens often used by artists to view, analyse and independently navigate and respond to contemporary society.

Mother and child sharing through drawing: Intergenerational collaborative processes for making artworks

This paper presents a preliminary study into collaborated processes for art-making, undertaken by a young child and an adult. The study explores collaborative drawing in the context of sociocultural research into early childhood education. The study particularly examines whether childhood techniques for making marks, creative processing and art-making could be ‘re-learned’ by the adult, while new opportunities for expanding on extant repertoire could be available to the child. In this context the child teaches and learns from the adult, and the adult teaches and learns from the child. The study utilised video-data-recording to facilitate microanalysis of the researchers in action, enabling the adult researcher to present a discourse into the dynamics of how the visual, mark-making repertoires of an adult and child can be co-developed. Preliminary findings help contribute to the various discourses available into sociocultural research that supports processes for exploring and making art, and which allows a challenge to the role of the adult educator as a provider or director of what is learned.

Parents’ views about child sexual abuse prevention education : a systematic review

This paper presents the results of a systematic review of literature on the topic of parents’ views about child sexual abuse prevention education. It describes: i) what parents know about child sexual abuse prevention education; ii) what child sexual abuse prevention messages parents provide to their children and what topics they discuss; iii) what parents’ attitudes are towards child sexual abuse prevention education in schools; and iv) their preferences for content. Electronic database searches were conducted to identify relevant literature published in English relating to child sexual abuse prevention programs and parent’s views. A total of 429 papers were evaluated with 13 studies identified as meeting the study’s inclusion criteria. Worldwide, empirical research on parents’ views about child sexual abuse prevention programs is limited and more research is needed in Australia. Implications for future research and practice are outlined.