Understanding Child Abuse and Neglect (1993) / Chapter Skim
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3 SCOPE OF THE PROBLEM
3 SCOPE OF THE PROBLEM
Pages 78-105
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From page 78... ...
The alarming rise in the number of reported cases of child maltreatment is a significant development, but the full dimensions of its meaning are not yet clear. A significant number of cases reported to child protective services (CPS)
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From page 79... ...
was asked to determine the feasibility of a national study of child maltreatment reports and, until 1987, AHA collected reports on various types of maltreatment from child protective services personnel in cooperating states. Data were collected in summary form (e.g., the number of cases of physical abuse in a calendar year)
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From page 80... ...
States and territories voluntarily participated in the project and, over the years, the participants changed (American Humane Association, 1979, 1981; American Association for Protecting Children, 1986, 1987; NCCAN, 1981, 1988, 1992~. National Incidence Studies Recognizing the need to estimate the true occurrence of child maltreatment rather than simply relying on reported cases, in 1976 NCCAN contracted with Westat to design and implement a study of the incidence and severity of child abuse and neglect.
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From page 81... ...
When data from other community agencies are added to the data from child protective services, the incidence increased to 10.5 per 1,000 children per year. The second National Incidence Study (NIS-2)
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From page 82... ...
In all, there were 1.7 million reports of maltreatment involving 2.7 million children. Forty-five percent of the reports were of neglect, 47 percent of the reports were of abuse: 25 percent of physical abuse, 16 percent of sexual abuse, 6 percent of emotional abuse.
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From page 83... ...
The work is limited by its attention only to physical abuse and verbal forms of emotional maltreatment. Sexual Abuse Studies of the incidence and prevalence of sexual abuse, while initiated early in this century (Hamilton, 1929)
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From page 84... ...
. Prevalence of Abuse and Neglect in Disabled Children Although early work in child maltreatment research pointed to a link between disabilities and maltreatment, studies in this area are limited.
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From page 85... ...
Analyses of these data indicate that child homicide is more common in the United States than in comparison countries for every age group (Williams and Kotch, 1990; Division of Injury Control, 1990~. METHODOLOGICAL ISSUES This review of the research on the scope of child maltreatment reveals important methodological problems that limit the usefulness of these data for drawing conclusions about both the dimensions of the problem and the factors that cause it.
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From page 86... ...
The 1975 National Family Violence Survey, for example, found a prevalence rate for physical abuse of 140 per 1,000 children per year, which is 21 times greater than the 6.8 per 1,000 for cases reported to child protective services in the United States, and also many times greater than the rates from the National Incidence Studies of cases known to all human service professionals (Straus and Gelles, 1986~. Many severely abused children are brought to emergency rooms by parents or relatives who blame injuries on accidents that, in reality, never occurred.
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From page 87... ...
The two National Incidence Studies did not find a significant relationship between races and the incidence, type, or severity of child maltreatment (NCCAN, 1981, 1988~. Some studies have reported that ethnic minorities are disproportionately reported for child
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From page 88... ...
Cultural and ethnic groups that are at the greatest risk of poverty, then, appear to have disproportionate incidence and prevalence rates of child maltreatment. Convincing evidence that disaggregates socioeconomic status and cultural or ethnic identity in rates of reported child abuse and neglect has not been developed, although socioeconomic status may be strongly associated with some forms of child maltreatment.
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From page 89... ...
Changes in the proportion of child maltreatment reports that are substantiated may provide evidence as to whether the increased reported incidence involves changes in the rate of occurrence as well. One study conducted by Eckenrode and colleagues (1988a,b)
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From page 90... ...
Although cohort studies are being conducted in this area, key factors of the ideal design, such as ascertainment of representative samples of cases of abuse and neglect, are missing due to reliance on administrative data for cases. Incidents of child maltreatment may also remain undetected and unreported if subgroups of the population at risk for abuse and neglect are not recruited into longitudinal studies.
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From page 91... ...
As part of the informed consent procedure required in federally supported studies, participants in most child maltreatment studies should be informed of their rights and duties as research subjects (see Chapter 9 for a full discussion of ethical issues in child maltreatment research)
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From page 92... ...
For example, some potential research subjects may decide not to participate in the research project because of mandatory reporting requirements, while others may falsify or distort responses revealing reportable child maltreatment activity (Sieber, 19921. The interests and safety of the child are obviously paramount to any research objectives.
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From page 93... ...
· Neglect is more common than any individual type of child maltreatment and has consistently accounted for approximately half of the cases of maltreatment (NCCAN, 1992~. Although reports of physical or sexual abuse of childhood significantly increased between 1980 and 1986, reports of child neglect still account for a large majority (63 percent)
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From page 94... ...
. Sexual abuse reported to child protective services has shown the largest reported increase of any form of abuse or neglect, rising from 0.7 per 1,000 children to 2.2 per 1,000 children per year in the National Incidence Studies (1980-1986)
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From page 95... ...
Effort is needed on a national level to: . mandate state compliance with data acquisition and reporting efforts as in other federal efforts like Medicaid and Medicare; develop uniform case definitions with measurable criteria; generate risk assessment tools that are sensitive to complex professional and ethical problems to guide protective services workers' decisions; · identify potential sources of bias in current procedures for reporting and investigation of reported cases; redesign state data processing systems so that uniform individuallevel data are available and unduplicated counts of children affected by abuse and neglect are easily obtainable; · establish an expert panel to periodically review the data system, establish quality indicators, and identify key areas for services systems investigation; .
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From page 96... ...
Currently, little information is gathered about child abuse or neglect in many national surveys (such as the National Health Interview Survey on Child Health, the National Survey of Children, and the Child Supplement to the National Longitudinal Survey of Youthful. Although the inclusion of questions on child maltreatment may raise issues of cost and administrative burdens, past surveys and secondary analyses of existing data sets represent research opportunities that could provide further insights into the nature and frequency of child abuse and neglect.
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From page 97... ...
· mandated to use multiple data sources to verify reports of abuse and neglect, particularly when parents report either medically attended injuries or social services interventions as a result of the maltreatment. These strategies would serve not only as case ascertainment but would also allow the development of realistic indicators of what portion of these problems are brought to the attention of child protective services.
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From page 98... ...
. Differences in estimates between the incidence of emotional maltreatment in the National Incidence Study (which suggests that 435,000 children were victims of child maltreatment)
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From page 99... ...
American Association for Protecting Children 1986 Highlights of Official Child Neglect and Abuse Reporting, 1984. Englewood, Colorado: American Humane Association.
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Doris 1987 Unreliable Child Maltreatment Reports: Variations Among Professional and Nonprofessional Reporters. Washington, DC: National Center on Child Abuse and Neglect.
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From page 101... ...
Emery 1989 Methodological issues in child sexual abuse research. Child Abuse and Neglect 13:89-100.
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1992 Child Maltreatment: Emerging Perspectives. Dix Hills, NY: General Hall, Inc.
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From page 103... ...
In D Finkelhor, ea., A Sourcebook on Child Sexual Abuse.
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Wolock, I., and B Horowitz 1979 Child maltreatment and material deprivation among AFDC-recipient families.
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From page 105... ...
Journal of Child Sexual Abuse 48(4) (Summer)
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