Understanding Child Abuse and Neglect (1993) / Chapter Skim
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SUMMARY
SUMMARY
Pages 1-37
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From page 1... ...
No specific theories about the causes of child abuse and neglect have been substantially replicated across studies, yet significant progress has been gained in the past few decades in identifying the dimensions of complex phenomena that contribute to the origins of child maltreatment. Furthermore, research in the field of child maltreatment studies is relatively undeveloped when compared with related fields such as child development, social welfare, and criminal violence.
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From page 2... ...
Research in this field is demonstrating that experiences with child abuse and neglect are a major component of many child and adult mental and behavioral disorders, including delayed development, poor academic performance, delinquency, depression, alcoholism, substance abuse, deviant sexual behaviors, and domestic and criminal violence.
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From page 3... ...
Such guidance can evolve from research on the outcomes of alternative responses to reports of child abuse and neglect, results of therapeutic and social service interventions, and costeffectiveness studies.
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Collaborative efforts are also needed to facilitate the integration and application of research on child maltreatment with related areas such as child development, spousal violence, substance abuse, and juvenile delinquency. In contrast to conceptualizing this report in terms of categories of maltreatment or responses of the social system to child maltreatment, the panel presents a child-oriented research agenda that emphasizes the importance of knowing more about the backgrounds and experiences of developing children and their families, within a broader social context that includes their friends, neighborhoods, and communities.
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From page 5... ...
The formulation of research definitions of child maltreatment should be guided by four key principles: consideration of the specific objectives the definition must serve; division into homogeneous subtypes; conceptual clarity; and feasibility in practice. SCOPE OF THE PROBLEM From 1976, when the first national figures for child maltreatment were generated, to 1990, the most recent year covered by the National Child Abuse and Neglect Data System, reports of maltreatment have grown from 416,033 per year (affecting 669,000 children)
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From page 6... ...
evidence suggests that child abuse and neglect is an important, prevalent problem in the United States, with conservative estimates placing the annual number of children affected by this problem at more than 1 million, following an analysis of substantiated rates of reported cases. Child abuse and neglect are particularly important compared with other critical childhood problems because they are often directly associated with adverse physical and mental health consequences in children and families.
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From page 7... ...
The phenomenon of child abuse and neglect has thus been moved away from a theoretical framework of an individual disorder or psychological disturbance, toward a focus on extreme disturbances of childrearing, often part of a context of other serious family problems, such as substance abuse or mental illness. Interactive models suggest that child maltreatment occurs when multiple risk factors outweigh protective, compensatory, and buffering factors.
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From page 8... ...
on children in different social, ethnic, and cultural groups. The relationships among physical discipline, stress, and parental and family dysfunctions that give rise to the emergence of child maltreatment also need to be clarified.
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Socioeconomic conditions have predictive value for explaining child maltreatment rates, yet some neighborhoods have higher or lower child abuse rates than would be expected based on socioeconomic conditions alone. Social isolation has been identified as an important etiological risk factor in child maltreatment, but its role as a consequence or cause of maltreatment is uncertain.
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From page 10... ...
Societal fascination with violence, including violence toward children, has been suggested as a risk factor for child maltreatment, as has the lack of coherent family leave and family support policies, particularly the absence of preventive health care for infants, children, and adolescents at risk for maltreatment. Conclusions Many factors have been identified as contributing to the occurrence of child maltreatment, but single-factor theories of child maltreatment have not been able to identify specific mechanisms that influence the etiology of child maltreatment.
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Research on victims of child sexual abuse suggested that risk factors with respect to perpetrator characteristics, victim characteristics, and sociodemographic variables are far more heterogeneous than they are for physical abuse or neglect victims. As a result, prevention advocates focused on ways to strengthen potential victims of sexual abuse through classroom-based instruction for children of all ages.
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From page 12... ...
In addition to major efforts in child sexual abuse prevention, the panel reviewed two other efforts that may have implications for the prevention of child abuse and neglect. These are community-based antipoverty programs, some of which involve vocational or educational assistance, and the violence prevention programs in the schools designed to educate children, primarily adolescents, about conflict resolution skills.
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Although school-based violence prevention programs are a promising development, no firm conclusions can be drawn at this time regarding their effectiveness or generalizability for the prevention of child abuse, and it is not known if participants will be less likely to be perpetrators of family violence. Media representatives can become important participants in public education about prevention in child abuse and neglect.
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From page 14... ...
Conclusions Evaluations of home visitation programs, school-based programs for the prevention of sexual abuse and violence, and other community-based child maltreatment prevention programs are quite limited. Many evaluations are compromised by serious methodological problems, and many promising preventive interventions do not systematically include child maltreatment as a program outcome.
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From page 15... ...
Until recently, research on the consequences of physical and sexual child abuse and neglect has been limited by delays between the child's experience and official identification of maltreatment. Maltreatment often occurs in the presence of multiple problems within a family or social environment, including poverty, violence, substance abuse, and unemployment.
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From page 16... ...
The consequences of childhood maltreatment vary by demographic, background, and clinical variables such as the child's gender, the family's socioeconomic status, and the level of marital and family violence. Individual characteristics, such as high intelligence, certain kinds of temperament, the cognitive appraisal of victimization experiences, a relationship with a significant person, and out-of-home placement experiences protect some childhood victims.
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INTERVENTIONS AND TREATMENT Research on interventions in child maltreatment is complicated by ethical, legal, and logistical problems, as well as difficulties in isolating factors specifically associated with child abuse and neglect in programs that often include families with multiple problems. Interventions include the assessment and investigation of child abuse reports by state child protection agencies, clinical treatment of physical injuries, legal action against the perpetrator, family and individual counseling, self-help services, and informal provision of goods and services (e.g., homemaker and respite care)
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From page 18... ...
Many adult survivors of child abuse do not identify themselves as such, and most treatment programs or studies for adult survivors focus on child sexual abuse rather than other forms of child maltreatment. Research on the treatment of adult survivors is submerged in the literature on adult psychological disorders such as addiction, eating disorders, borderline personality disorders, and sexual dysfunction.
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From page 19... ...
A lack of consensus exists regarding the effectiveness of a wide range of treatment services for maltreating families, including parental enhancement programs, family systems treatment, home-based services, and family support programs. Outcome studies have indicated positive behavioral and attitudinal changes as a result of family or parent treatment, but few studies have examined the effects of such interventions on subsequent reports of child abuse and neglect beyond one year.
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Studies suggest, however, that many health professionals may not be sufficiently trained to detect or validate signs of abuse or to deal with the emotional, technical, and legal aspects of evaluating maltreated children, particularly sexually abused children. Child Protective Services Child protection agencies receive and screen initial reports of child abuse and neglect from educators, health personnel, police, members of the public (e.g., neighbors, family friends)
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From page 21... ...
Recent clinical reports of child abuse cases suggest that many cases are closed immediately after services have been initiated and, in some instances, even prior to actual service delivery. Child Welfare Services The decision to allow a maltreated child to remain with family members or relatives during treatment is a critical and controversial aspect of the case management process.
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From page 22... ...
Conclusions Medical, psychological, social, and legal interventions in child maltreatment cases seek to reduce the negative physical, behavioral, and emotional consequences of child abuse and neglect, foster attitudes and behaviors that improve the quality of parent-child interactions, and limit or eradicate recurrences of maltreatment. Interventions have been developed in response to public, professional, legal, and budgetary pressures that often have competing and sometimes contradictory policies and objectives.
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From page 23... ...
The Research Community A variety of disciplines and subject areas contributes to studies of child maltreatment, including medicine (especially pediatrics and psychiatry, psychology, social work, criminal justice, law, sociology, public health, nursing, anthropology, demography, statistics, and education. Few systematic efforts have been made to integrate research on child maltreatment with the knowledge that has evolved from recent studies of normal child development, family systems, adult and child sexual behavior, family violence, community violence, substance abuse, poverty, and injuries.
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From page 24... ...
Although many universities offer graduate courses in child abuse and neglect, less than half a dozen universities now sponsor graduate or postgraduate training programs in this field. Graduate training programs have achieved consensus regarding the general body of information necessary in the field of child maltreatment, but considerable variability exists in the length of the programs, student eligibility requirements, time requirements for classroom instruction and practical experience, and the availability of financial support.
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From page 25... ...
The forms of federal research support are diverse, including large research center program awards, individual research awards, data collection efforts, individual training grants, and evaluations of demonstration projects. With the exception of the National Center for Child Abuse and Neglect, which has a research program focused explicitly on studies of child maltreatment, most federal agencies support child maltreatment research in the context of other scientific objectives and program responsibilities, such as research on violence, maternal and child health care, family support, mental health, and criminal justice.
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From page 26... ...
Adopting a comprehensive view of research on child maltreatment presents certain difficulties of identification, organization, and taxonomy. Efforts to prevent child abuse and neglect and improve child welfare are dispersed among a wide range of federal programs within the U.S.
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Conclusions Support for child maltreatment research has developed in a haphazard, piecemeal fashion, reflecting the absence of a national plan for providing research, educational, and professional support for studies of child abuse and neglect. Governmental roles in this area have been complicated by
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From page 28... ...
Given the current status and evolution of child maltreatment studies, a broad diversity of parallel efforts should be maintained. Top-down or centralized approaches should be avoided that may discourage or fail to recognize the significance of emerging theoretical paradigms, instrumentation research, and other approaches that seek to extend the boundaries of current knowledge about the origins, scope, and consequences of child abuse and neglect.
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From page 29... ...
Research on children's sexual development is one of the most unexamined areas in all of social science, impeded by a variety of social taboos, political sensitivities, and ethical ambiguities in general and discussions of sexual behavior with children in particular. Conclusions Researchers who seek to foster valid and creative research projects must address fundamental ethical issues in the recruitment of research subjects; the process of obtaining informed consent; the assignment of subjects; debriefing, dehoaxing, and desensitizing subjects when deception or stress
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Develop a science policy for child maltreatment research that recognizes the importance of developing national leadership, human resources, instrumentation, financial resources, and appropriate institutional arrangements for child maltreatment research. Each chapter in this report includes key research recommendations within the topic under review.
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From page 31... ...
Research Priority 1. A consensus on research definitions needs to be established for each form of child abuse and neglect.
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From page 32... ...
Research Priority 7: Research is needed to clarify the effects of multiple forms of child victimization that often occur in the social context of child maltreatment. The consequences of child maltreatment may be significantly influenced by a combination of risk factors that have not been well described or understood.
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From page 33... ...
Evaluation research is particularly important in the following areas: · Evaluation studies of specific program interventions, such as foster care, family preservation services, and self-help programs that examine the conditions and circumstances under which selected programs are beneficial or detrimental to the child are needed. · Empirical research is also needed to determine the degrees to which criminal sanctions deter child abuse and the degree to which removal of offenders or children from the home protects the child from abuse.
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From page 34... ...
Variations in state definitions of child abuse and neglect as well as differences in verification procedures result in significant unevenness in the quality of research data on child maltreatment reports.
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From page 35... ...
Research Priority 13: Federal agencies concerned with child maltreatment research need to formulate a national research plan and provide leadership for child maltreatment research. Existing fragmentation in the federal research effort focused on child maltreatment requires immediate attention.
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From page 36... ...
The National Center on Child Abuse and Neglect should encourage the development of a state consortium that can serve as a documentation and research support center, allowing the states to collaborate in sponsoring child maltreatment studies and facilitating the dissemination of significant research findings to state officials. Research Priority 17: Researchers should design methods, procedures, and resources that can resolve ethical problems associated with recruitment of research subjects; informed consent; privacy, confidentiality, and autonomy; assignment of experimental and control research participants; and debriefings.
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From page 37... ...
Chicago: National Committee for Prevention of Child Abuse. General Accounting Office 1991 Child Abuse Prevention: Status of the Challenge Grant Program.
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