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<p>  </p> <p>As the default state response to child maltreatment in the U.S., child welfare system (CWS) interventions are delivered to caregivers of 1.3 million children annually (USDHHS, 2021). In theory, CWS interventions aim to reduce risks for child maltreatment by providing services to parents; however, research and anecdotal evidence from stakeholders suggest that many families do not benefit from CWS intervention as intended (Russell et al., 2018). One important feature of CWS interventions is that they differ greatly between families – in ways both intentional and unintentional (Jonson-Reid et al., 2017). As such, exploring how differences in intervention delivery may explain outcomes is of value. For instance, the explanatory potential of parents’ experiences of interventions has been overlooked. The overarching goal of this dissertation was to expand the empirical evidence base related to how focusing on parents’ experiences and well-being during and after CWS interventions can help explain differences in outcomes as traditionally measured (i.e., chronic CWS involvement and ongoing child maltreatment). Paper 1 quantitatively explores levels and trends in parent well-being for three years following a CWS investigation, including how indicators of parent well-being relate to child welfare outcomes. Results suggest that only parents’ mental health remains a consistent predictor of child maltreatment risk after three years, and that no parent well-being indicator predicted CWS re-involvement. Paper 2 expands upon Paper 1 by exploring the role of parents’ experiences with CWS services and caseworkers in shaping trends in parent well-being and child welfare outcomes. Overall, results indicated that no indicators of parents’ experiences predicted odds of CWS re-reports, but that some aspects of parents’ experiences may predict ongoing maltreatment risk. Results also indicated that parents who received or were mandated to a greater number of services overall also reported changes over time in well-being related to mental health, IPV victimization, and drug use-related problems. Findings also suggested that parents from marginalized backgrounds may have different experiences with interventions. Paper 3 qualitatively explored parents’ experiences in a specialized form of CWS intervention (Family Treatment Court), with an emphasis on how parents experience and make sense of the many manifestations of state power during interventions. Together, these three studies offer modest implications for future research and practice related to promoting parent well-being and child safety in the context of the evolving CWS.</p>

Child maltreatment has been linked consistently to the development of aggressive behavior. However, not all maltreated youth later demonstrate increased aggression. The present study examined two avenues of inquiry to explain this observed heterogeneity in a sample of 470 serious juvenile offenders enrolled in a prospective longitudinal study. Official reports of maltreatment history were obtained from the Department of Human Services (DHS) in Philadelphia providing information about the nature and incidence of abuse and neglect in childhood of the study participants. The first line of inquiry explored if particular maltreatment subtypes, including physical abuse, sexual abuse, neglect, and emotional maltreatment, as well as the severity and frequency of these maltreatment types, was related to increased aggression in adolescence. The second line of inquiry used structural equation modeling (SEM) to examine the impact of three mediational factors, namely, emotion regulation, moral disengagement, and emotional callousness, on the maltreatment-aggression relation. I expected that not only would maltreatment in childhood be related to increased aggression in adolescence, but that this relation would be mediated by disruptions in emotional and cognitive development. In addition, I expected that these underlying mechanisms would be specific to particular subtypes of maltreatment. As expected, child maltreatment was related to increased aggression among youth. Physical abuse and emotional maltreatment emerged as the two maltreatment subtypes that best predicted aggression, whereas neglect and sexual abuse were not related to increased aggression. The study findings also suggested that higher severity and frequency of maltreatment contributes to increased aggression. Additionally, physical abuse and emotional maltreatment appeared to have a multiplicative effect, in that the combination of these two maltreatment subtypes resulted in the highest levels of aggression among youth in this study. Finally, as hypothesized, poor self-regulation mediated the relation between physical abuse and aggression, while heightened moral disengagement mediated the relation between emotional maltreatment and aggression. / Psychology

Although the death of a child client is among the worst work-related events that a child welfare worker can experience, the phenomenon is tremendously understudied concerning how the event impacts the staff involved and how, or if, their employing agencies supported any mental health needs that may have arisen after the death. This study investigates what types of mental health/emotional support was made available to Northeastern Ontario child welfare workers following the death of a child client, and how effective that support was in helping the worker cope with any difficulties related to the death. This study was guided by principles of Constructivist Grounded Theory and semi-structured qualitative telephone interviews were conducted with five (5) participants. My analysis found that the death of a child client can negatively impact both the mental wellbeing of involved workers as well as the organizational climate of an agency. My analysis also found that workers may delay the emotions associated with the grieving process to effectively focus on the administrative requirements resulting from the child’s death, potentially to their detriment. The different ways child welfare organizations supported staff through these events included individual and group psychological debriefings, grief counselling, and providing information regarding additional support options. Only three of the five workers engaged in the strategies provided to them by their agency, and of those three, only one found the services to be helpful with managing emotional difficulties related to the child’s death. What remained true among all five participants was that they each had very personalized ideas as to what they felt would have best helped them through this difficult event. I conclude that based on related literature and the findings of this study, child welfare organizations are recommended to invest in a thorough and embedded agency framework of trauma-management that addresses policy and procedure development as well as support coordination at the pre-trauma, immediate trauma, and post-trauma levels. Additionally, trauma-management should not be a singular standardized response and should be tailored to the individualized needs of each worker. Agencies should be well-versed in delivering different strategies of trauma-management and letting the worker lead in determining what type of support they are looking for and when would be best to receive it. / Thesis / Master of Social Work (MSW)

ABSTRACT INTRODUCTION: Studies on the topic of adverse childhood experiences (ACEs) and childhood obesity collectively indicate an association, but there is a lack of replication in nationally representative sample of children aged 10-17 years. This study aims to expand on the definition of ACEs to include: socio-economic hardship, racial discrimination, witness or victim of neighborhood violence, and bereavement, and to examine their individual and joint association with BMI levels, especially childhood obesity (primary outcome). METHODS: The 2011-2012 National of Children’s Health (NSCH) was used for this study (N=45,309). One child interview weight was produced; hence, the estimates are generalized to all non-institutionalized children 10-17 years of age in the US and each state. Statistical methods used included descriptive statistics and multivariable multinomial logistic regression models. ACEs examined included: (1) Socioeconomic hardship, (2) Parental divorce or separation, (3) Bereavement, (4) Incarcerated family member, (5) Witness to domestic violence, (6) Victim/witness of neighborhood violence, (7) Household mental illness, (8) Household substance abuse, (9) Racial discrimination. BMI for the same sex and age (10-17 years) percentile relative measurement, using growth charts recommended by CDC, among children and teens were used as indicators of BMI. BMI-95th percentile or greater was considered obese. RESULTS: The prevalence of childhood obesity and ACE exposure was higher for boys compared to girls. Controlling for gender, among those who were obese, White-non-Hispanic children had the highest prevalence of obesity compared to other races for both genders. Southern States constituted 80% and 60 % of top 10 states with the highest prevalence of childhood obesity and ACE, respectively. Approximately 25.4 million (89.5%) children aged 10-17 years had experienced 3 or less ACE. The most prevalent ACE category of nine asked about for child was-living with parents who were either divorced or separated after his/her birth (26.77%) and the least prevalent was living with a parent who died (4.84 %). ACEs were not mutually exclusive, and all nine categories of ACEs were interrelated. The adjusted odds ratio of covariates to their reference groups that were only statistically significant for childhood obesity relative to healthy weight encompassed: a) Place of residence in metropolitan statistical area, b) two or more chronic health conditions of 18 asked about, c) Watching TV, videos, or playing video games across categories >1 to≥4 hours, d) family members in the household eat a meal together 7 days of the week, e) and computer, cell phone or electronic device use ≤1 hour. Moreover, the explanatory variables, namely, age, sex, the physical health status of parents, and physical activity, were strongly related to childhood obesity (associated both with higher odds and lower odds of outcome) compared to overweight and underweight BMI categories. CONCLUSIONS: This is the first study to explore the co-occurrence, individual and joint association of ACEs with childhood obesity using nationally representative sample of children aged10-17 years in the U.S. Having childhood obesity, BMI-95th percentile or above was strongly related to ACE dichotomy, ACE score ≥2 and two ACE types (socioeconomic hardship and bereavement) than the probability of overweight, BMI-85th to 94th percentile. Underweight-BMI less than 5th percentile had only statistically significant association with socioeconomic hardship ACE category. Sociodemographic, parental, and childhood related factors were also independently associated with childhood obesity.

FALEIROS, J. M. Estudo da prevalência de maus - tratos em crianças matriculadas de 1ª à 4ª série do ensino fundamental em escolas da rede pública e particular da cidade de Ribeirão Preto. 150 p. Dissertação (Mestrado) Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto. 2006. Os maus-tratos na infância têm se revelado um foco de preocupação no meio científico devido às descobertas das graves conseqüências a curto e longo prazo no desenvolvimento da criança. No meio político e social, no entanto, essa questão, e suas graves conseqüências, parece caminhar ainda muito lentamente na direção do estabelecimento de políticas públicas efetivas. A escassez de estatísticas e a ausência de um conhecimento mais aprofundado das diversas situações de maus-tratos fazem com que a problemática receba uma atenção pouca adequada e especializada. A literatura científica aponta a provável existência de um grande número de casos que não se chega a conhecer, para além dos números divulgados por órgãos oficiais de proteção. Com o objetivo de estimar de forma mais precisa o número de casos de maus-tratos domésticos na cidade de Ribeirão Preto, o presente estudo buscou mensurar a prevalência de maus-tratos, por amostragem, em crianças matriculadas de 1ª a 4ª série do ensino fundamental nos estabelecimentos educacionais da rede pública e particular, a partir de informações obtidas junto ao setor da educação. A investigação adotou uma abordagem quantitativa/descritiva, de caráter epidemiológico. O instrumento utilizado foi a artilha Epidemiológica, já testada em nossa realidade em estudo semelhante, em que se focou a faixa etária de 0 a 6 anos. Esta foi elaborada para abordar os profissionais da educação e, no presente, foi utilizada junto a professores responsáveis por salas de 1ª a 4ª série do ensino fundamental do sistema público e particular do município. Além do número de casos e de suas características, a Cartilha também permite investigar os fatores de risco associados e os indicadores comportamentais/emocionais das crianças assinaladas. Respeitando-se o princípio da aleatoriedade, procedeu-se a um sorteio das escolas, por região da cidade, tendo chegado a um número de 151 professores entrevistados responsáveis por 3.885 crianças. Os resultados indicaram uma prevalência de 3,9% que calculada para a população varia entre 3,3% e 4,6% (IC=95%). Os tipos de maus-tratos assinalados, mais freqüentemente, pelos professores foram Maltrato Emocional, Abandono Emocional e Falta de Controle Parental. O Desemprego, (32%), dificuldades econômicas graves (26%) e baixa escolaridade (26%) foram os fatores de risco mais freqüentemente assinalados nas famílias. 75% das crianças assinaladas têm problemas escolares, parecem não ter interesse em aprender (62%) e parecem ter baixa auto-estima (57%). Ainda, os professores relataram que, pelo menos 72% dos casos assinalados não eram conhecidos dos órgãos oficiais de proteção. Isso significa que em cada sala de aula existe pelo menos uma criança que está vivendo uma situação adversa em casa sem receber qualquer tipo de acompanhamento, confirmando as indicações da literatura quanto ao fato de os dados oficiais serem a ponta do iceberg. Além disso, as crianças assinaladas já estão apresentando conseqüências desenvolvimentais importantes. A negligência como tipo mais freqüente merece ser melhor compreendida em estudos posteriores, devido aos graves danos que provoca às crianças. Em relação aos fatores de risco, os professores assinalaram mais freqüentemente o fato de os adultos das famílias estarem desempregados, passando por dificuldades econômicas e de possuírem baixa escolaridade. Contudo, neste âmbito, o fato de os professores terem pouco conhecimento a respeito das famílias sobressai-se em relação ao que sabem, denotando uma enorme distância entre a família e escola, que deveria ser minorada. / FALEIROS, J.M. Prevalence of maltreatment in children from 7 to 10 years old studying in public and private schools in the city of Ribeirão Preto. 150 p. (Másters degree) Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto. 2006. Child maltreatment has become a focus of concern in scientific literature mainly because of the discoveries of the serious outcomes to child development. In social and politician circles, however, this issue and its serious consequences, seems to walk slowly in the direction of the establishment of effective politics. The lack of statistics and the absence of knowledge about the diverse situations of child maltreatment permits that the problematic still receives insignificant adequate and specialized attention. Scientific literature points the probable existence of a great number of cases that is not known despite the numbers showed by protection agencies. The objective of this study is to estimate the prevalence of maltreatment in children (from 7 to 10 years old) in the city of Ribeirão Preto. A representative sample was used gathering children from public and private schools. Teachers were interviewed answering The Cartilha Epidemiológica already tested in our reality in a similar study for children from 0 to 6 years old. Besides the number of cases and its characteristics, the Cartilha allows investigating the risk factors associated to the child maltreatment and behavioral/emotional problems of the children refereed by teachers. A descriptive/quantitative approach was used to analyze data. 151 teachers who were responsible for 3885 children answered the Cartilha. The results pointed a prevalence of 3,9% (3,3% and 4,6% ,IC=95%). The most frequently types of child maltreatment were: ?Emotional Maltreatment, Emotional Abandonment and Lack of Parental Supervision. The unemployment, (32%), serious economic difficulties (26%) and low level of education (26%) had been the risk factors more frequently in the childrens families. With respect to the behavioral/emocional problems, 75% of children had school problems, 62% had no interest in learning and 57% had low self-esteem. Teachers pointed as well that at least 72% of the maltreated children didn`t receive any attention of protective services. This means that in each classroom exist at least on child suffering form maltreatment without receive any help. These results also confirm the indications of literature with respect to the fact that official data is just the tip of iceberg. Moreover, all these children are presenting important desenvolvimentais outcomes. The negligence as the most frequent form of maltreatment deserves to be better understood in posterior studies. In relation to the risk factors, teachers frequently pointed the unemployment of the adults of the families passing thru economic difficulties and low rates of education. However, is important to consider the fact that teachers have insignificant knowledge about the families denoting an enormous distance between family and school that should be reduced.

Bakgrund: Hälso- och sjukvårdspersonal i Sverige har en lagstadgad skyldighet att göra orosanmälan till Socialtjänsten vid misstanke om att barn far illa. Anmälningsplikten infördes redan under 1920-talet och regleras i socialtjänstlagen. Statistik över inkomna orosanmälningar i Sverige visar att endast cirka 10 procent av anmälningarna kommer från hälso- och sjukvården. Sjuksköterskan spelar en viktig roll när det kommer till att identifiera riskfaktorer för barn som far illa men forskning visar att det av olika anledningar ibland råder osäkerhet och tveksamhet när det kommer till att göra orosanmälningar till Socialtjänsten. Syfte: Syftet var att utforska vad sjuksköterskor på beroendemottagningar har för erfarenheter av och hur de upplever att göra orosanmälan om barn som far illa till Socialtjänsten. Metod: En kvalitativ explorativ design valdes där datainsamling gjordes med semistrukturerade intervjuer. För att bearbeta materialet användes en kvalitativ innehållsanalys med induktiv ansats. Resultat: Analysen resulterade i tre kategorier, ett medvetet förhållningssätt, konsekvenser av handling samt det professionella samarbetets betydelse med sammanlagt sex underkategorier.  Diskussionen fördes utifrån Sigridur Halldórsdóttirs teori om caring and uncaring samt tidigare relevant forskning och litteratur. Slutsats: Att ha barnperspektivet underlättar för sjuksköterskor i beslutsfattandet av att göra orosanmälan för barn som far illa och kan även vara ett stöd i kommunikationen med patienten. / Background: Healthcare professionals in Sweden have a statutory obligation to report suspected child maltreatment to the Social Services. The notification requirement was introduced already in the 1920: s and is regulated in the Social Services Act. Statistics on incoming reports in Sweden show that only about 10% of the notifications come from the healthcare system. Nurses play an important role when it comes to identifying risk factors for child maltreatment, but research shows that for various reasons, there is sometimes uncertainty and doubt when it comes to making reports to the Social Services. Aim: The aim of this study was to explore nurses experience of reporting suspected child maltreatment to the Social Services. Method: A qualitative explorative design was chosen where data collection was done with semistructured interviews. A qualitative content analysis with inductive approach was used to analyze the collected material. Results: The analysis resulted in three categories, a conscious approach, consequences of action and the importance of professional cooperation with a total of six subcategories. The discussion was based on Sigridur Halldórsdóttir's theory of caring and uncaring, as well as previous relevant research and literature. Conclusions: Having the child perspective makes it easier for nurses to make the decision to report concern for child maltreatment and can also support the communication with the patient.

Background: Parent behaviours have a long-lasting impact on the health, education, and behaviour of the young people in their care. Group-based parenting interventions are a promising approach to improve parenting, as well as to prevent and reduce physical and emotional maltreatment of children. While a billion of adolescents live in low- and middle- income countries, few evaluations have examined parenting approaches for families with adolescents in these countries. Objectives: This study was nested within a randomised controlled trial of Sinovuyo Teen, a parenting programme for families with adolescents. The trial took place in rural South Africa in 2015-2016 with 552 families in 40 study clusters. Primary intervention outcomes included parenting and child maltreatment. This dissertation aims to: (1) describe the implementation (attendance, engagement, and fidelity) of the intervention delivered within the evaluation, (2) examine if participant characteristics affected attendance and engagement in the intervention, (3) examine if implementation characteristics affected programme results, and (4) examine if participant characteristics affected programme results. Methods: Programme implementation was assessed through observations of all programme group sessions and the records of the implementing organisation. The analyses also draw on participant self-report data from three time-points (baseline, immediate post-test, and follow-up). The data were analysed using a series of correlation and multilevel regression analyses, presented in three papers. Findings: Attendance levels in the intervention were somewhat lower than in previous similar studies, perhaps due to the role of home visits. Generally, more disadvantaged families participated at similar rates as families with more material and social resources. However, a number of factors affected attendance on individual and family levels, e.g. an overcrowded household, and at the community level, e.g. funeral and grant receipt days. Intervention fidelity was similar to the levels reported in high-income countries, thus suggesting that high implementation quality is feasible in a low-resource setting. There was no consistent impact of the variation in participation and implementation on participant outcomes. Baseline risks did not consistently affect variation in treatment effects, confirming recent findings that families at-risk can benefit from parenting support as much or more than less at-risk families.

Child maltreatment is a worldwide concern. In the Commonwealth of Virginia, social workers are mandated reporters. When there is reasonable suspicion, they are required by law to report suspected child maltreatment to the appropriate Child Protective Services office. In this study, the research problem was the underreporting of child maltreatment, even when reasonable suspicion existed. The purpose of this study, as reflected in the research questions, was to understand social workers' perceptions of their role as mandated reporters, to explore how their perceptions impacted reporting, and to develop recommendations that could be implemented to help ensure appropriate reporting. An action research study was conducted with master's level social workers in southern Virginia. Symbolic interaction theory was used in researching the social workers' role and their perceptions as mandated reporters interacting with clients. Qualitative data were collected from a focus group of 6 social workers and analyzed using specific coding protocols. Six themes emerged: (a) importance of the role of social worker as a mandated reporter, (b) role conflict, (c) negative consequences, (d) feelings, (e) increased knowledge of child abuse laws, and (f) education of clients. The findings of this study may be used by regulators and agency personnel to design education, training, and supervision to help ensure social workers are prepared to appropriately respond to mandated reporting requirements.