There is ample evidence indicating that maltreatment has deleterious effects on the development of infants and toddlers. The Child Abuse Prevention and Treatment Act of 2003 requires referrals from child welfare (CW) to IDEA Part C Early Intervention services to provide developmental assessments and services for children younger than three with substantiated cases of child abuse or neglect. Thus, this study aims to examine the effects of Part C services on the well-being of young children and their families in CW. This study used a secondary dataset, the National Survey of Children and Adolescent Well-Being II, to examine the research questions. The study results indicate that Part C services can help to decrease the decline and have greater improvement in the well-being outcomes of young children with and without substantiated cases in CW. Also, Part C services can enhance language and adaptive skills for children who are in need of developmental and learning services. However, the developmental and learning needs of those young children are under-identified and under-addressed by CW professionals. Ample research has emphasized that Part C services can lead to positive outcomes for children who are at risk for developmental delays or dysfunction. If those children and their families are not offered timely and appropriate early interventions, their difficulties can become more severe, which often leads to lifelong consequences. To address the developmental needs of those children as early as possible, this study’s findings indicate an urgent need to enhance CW professionals’ knowledge of early childhood development and intervention as well as to improve their capabilities to identify young children’ developmental needs. State administrators and policymakers should reexamine the existing relationship between CW and Part C to further establish a better referral-making system in response to the mandated referrals under CAPTA of 2003 and IDEA of 2004.

Magister Public Health - MPH / Background: Child abuse is a global public health problem with serious consequences for the victims and society. Most studies on child maltreatment in South Africa have focused on the role of teachers as perpetrators and the prevalence of abuse within schools. Due to their strategic importance in breaking the cycle of abuse, it is important to document teachers‘ knowledge and attitudes towards identifying and reporting suspected cases of child abuse in relation to existing mandatory laws.Aim: To assess teachers‘ knowledge, attitudes and reporting practices of suspected child abuse in independent and public primary schools across all quintile categories in the Midlands education circuit in Pietermaritzburg.Methods: An observational, descriptive cross sectional quantitative study design was used. A self-administered questionnaire was completed by 237 teachers selected by multi-stage stratified proportional random sampling from a total of 2496 primary school teachers. The data were analysed using CDC Epi Info 7 (2012b). A descriptive analysis was done and groups were compared with chi square, ANOVA or Kruska-Wallis tests where appropriate. The level of significance was set as 95%.Results: The teachers were generally knowledgeable about possible indicators of child abuse. There were critical gaps in participants‘ knowledge of reporting procedures and most of the teachers (70.2%) have had no training on child abuse detection and reporting. Previous training on child abuse was associated with an increased likelihood to have detected abuse in the past (OR 4.86, 95%CI 2.64-8.96, p < 0.01). An overwhelming awareness of mandatory reporting law did not translate into knowledge of its provisions or substantial compliance. Hence, while most teachers agreed that all forms of child maltreatment should be reported, they still displayed differential reporting of suspected cases. The decision to report was often influenced by their perceived seriousness of the on-going abuse while uncertainty about on-going abuse was one of the most important barriers to lodging a report of suspected cases. Conclusions and Recommendations: Teachers recognised child abuse as a serious issue and are willing to learn and do more. Teachers, and ultimately the children in their care, would immensely benefit from training repertoire which addresses identified contextual issues shaping teachers‘ child abuse detection and reporting practices.

Each year over half a million children are victims of childhood maltreatment. While a plethora of interdisciplinary research has evaluated the detrimental outcomes of these experiences, few studies have analyzed the effects contextual components of child abuse and neglect can have on the life-course of maltreated youth. Juvenile delinquency has been identified as a prominent outcome of maltreatment, however, a lesser portion of the empirical literature has focused on outcomes among more serious justice-involved juveniles. This study analyzed the effects of childhood maltreatment severity on the recidivism outcomes of 853 blended-sentenced juveniles in a large southern state. Previous studies demonstrated worsened outcomes associated with more severe maltreatment, thus higher recidivism rates were expected for more severely maltreated juveniles. The results indicated only sexual abuse severity impacted recidivism rates, and the direction of the relationship was negative. Implications of the findings and directions for future research are discussed.

Child maltreatment and household dysfunction have long been linked to delinquency, adult criminality, and sexual offending. However, the association between adverse childhood experiences (ACEs), factors related to out-of-home placement, and the onset of maladaptive behaviors has not thoroughly been explored in adolescents who have engaged in sexually abusive behavior. In the present study, we examined archival records of 120 male youths who have received treatment for sexually abusive behavior. As expected, the male adolescents in this sample have experienced higher rates of ACEs than samples of adult males in the community, adult males who committed sexual offenses, and juvenile justice–involved males as reported in the literature. Discrete-time survival analyses yielded increased risks of onset of aggression and sexually abusive behavior during early childhood and mid-to-late childhood, with significant associations between higher ACE scores and a greater number of out-of-home placements. Implications and future directions are discussed.

No description available.

Abstrakt Bakgrund: Barn har rätt att växa upp i trygga förhållanden utan våld eller försummelse. Att barn far illa är ett stort problem idag, vilket är en utmaning för vårdpersonal att identifiera. Det finns många orsaker till att barn far illa och det kan medföra stora konsekvenser för barnet senare i livet. Motiv: Denna studie var viktig att utföra för att sjukvårdspersonal lättare ska kunna identifiera barn som far illa och sätta in tidiga åtgärder för att förhindra att våld mot barn ska ske. Det är viktigt att alla barn identifieras i tid och får hjälp. Syfte: Syftet med studien var att belysa BVC-sjuksköterskors erfarenheter av att motverka att barn far illa. Metod: I denna semistrukturerade intervjustudie har åtta deltagare inkluderats genom bekvämlighetsurval. Intervjuerna transkriberades ordagrant och analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Innehållsanalysen resulterade i två huvudkategorier: “BVC-sjuksköterskors svåra uppgift” och “Att samarbeta med familjer och kollegor”.  Konklusion: BVC-sjuksköterskor saknar tillräckligt med kunskap och utbildning för att identifiera och motverka att barn far illa. Det kan förekomma fler tecken, orsaker samt åtgärder än det författarna tagit upp i denna studie. Författarna anser att resultatet som har framkommit i studien kan användas i klinisk praxis för BVC-sjuksköterskor som ett underlag för att motverka att barn far illa. / Abstract Background: Children have the right to grow up in a safe environment without violence and neglect. Child maltreatment is a big problem, which is a challenge for the child healthcare nurse’s to identify. There are many reasons why children are exposed to violence, which can have consequences. Motive: This study is of great importance to healthcare-staff to take part of to make it easier to identify child maltreatment and take early actions to prevent maltreatment of children. It’s important to identify children early to make sure every child gets the help they need.  Aim: The aim of the study was to illuminate child healthcare nurses’ experiences to counteract maltreated children. Methods: 8 participants were included in this semi structured interview study through a convenience selection. The interviews were transcribed thoroughly and analyzed with qualitative content analysis.  Result: The content analysis resulted in two main categories: The child healthcare nurses’ difficult task” and “To cooperate with families and colleagues”. Conclusion: The child healthcare nurses’ shortage of knowledge and education to identify and counteract child maltreatment was presented in this study. More signs of child maltreatment, reasons and actions towards this issue than what is presented in this study can occur. The result can be used in clinical practice for the child healthcare nurses’ to prevent child maltreatment.

Background: Exposure to greater Adverse Childhood Experiences (ACEs) has been associated with increased likelihood of general and sex offending behaviors. However, few studies consider both the impact of varied ACE exposures and other early experiences on pathways to offending behaviors in adolescents who have engaged in sexually abusive behaviors. Objective: The purpose of this study was to examine the impact of ACEs and sexual boundary problems within the home on the development of delinquent and sexually abusive behavior. Participants & setting: Data were collected from archival records of male adolescents (N = 285) who had received treatment for sexually abusive behavior at a youth facility. Methods: This study investigated the effects of individual adverse experiences on delinquent nonsexual and sexually abusive behaviors through structural equation modeling. Results: Structural equation modeling revealed a three-factor model for ACEs. Direction and significance of paths between ACEs and the onset, persistence, and nature of maladaptive behaviors differed. Household dysfunction was related to an earlier onset (β = 1.19, p = 0.013) and more persistent nonsexual delinquent offending (β = 1.05, p = 0.048) and contact sexual offending (β = 1.19, p = 0.010). Conversely, sexual abuse and exposure to sexual boundary problems were associated with an earlier onset of sexually abusive behavior (β = −1.08, p = 0.038) as well as indicators of adolescent-onset (β = −1.30, p = 0.002), less persistent (β = −1.53, p = 0.001), and nonviolent (β = −1.89, p = 0.001) delinquency. Conclusions: Findings suggest variations in ACE exposures differentially influence the onset, severity, and persistence of delinquent and sexually abusive behaviors among these youths.

No description available.

Psychological stress is a major risk factor for cardiovascular diseases. While the relevance of early life stress, such as that which is due to child maltreatment (CM), is well known to impact individual stress responses in the long-term, and data on the interplay between CM and stressful events in adulthood on cardiovascular health are sparse. Here, we aimed to assess how stressful life events in adulthood are associated with cardiovascular health infarction in later life and whether this association is independent of CM. In a cross-sectional design, a probability sample of the German population above the age of 14 was drawn using different sampling steps. The final sample included 2510 persons (53.3% women, mean age: 48.4 years). Participants were asked about sociodemographic factors, adult life events, CM, and health conditions in adulthood. Results indicate that the number of experienced adverse life events in adulthood is associated with significantly increased odds for obesity (Odds Ration (OR)women = 1.6 [1.3; 2.0], ORmen = 1.4 [1.1; 1.9]), diabetes (ORwomen = 1.5 [1.1; 2.1], ORmen = 1.5 [1.1; 2.3]) and myocardial infarction (ORwomen = 2.1 [1.0; 4.3], ORmen = 1.8 [1.1; 2.8]). This association is not moderated by the experience of CM, which is associated with cardiovascular problems independently. Taken together, adult stressful life events and CM are significantly and independently associated with cardiovascular health in men and women in the German population in a dose-dependent manner. General practitioners, cardiologists and health policy-makers should be aware of this association between psychosocial stressors during childhood and adulthood and cardiovascular health.

La somatisation est la manifestation de symptômes physiques en réponse à une détresse psychologique. Chez les enfants victimes d’agression sexuelle (AS), la somatisation et les facteurs associés sont peu documentés dans la littérature. Puisque la somatisation peut diminuer la qualité de vie, il est important d’identifier les facteurs qui seraient des cibles d’interventions. L'étude a pour objectif d’examiner les caractéristiques de l’AS, ainsi que les facteurs personnels, familiaux et environnementaux associés aux symptômes somatiques dans cette population. L'échantillon comprend 655 enfants (68,9 % de filles; M = 8,96, SD = 1,87) ayant dévoilé une AS. Des modèles de régression linéaire hiérarchique ont été utilisés pour étudier les associations entre les caractéristiques de l'AS, les facteurs personnels, familiaux et environnementaux et les symptômes somatiques. Les interactions avec le sexe ont été testées. La majorité (80 %) des enfants avaient au moins un symptôme somatique. En contrôlant pour le sexe et l'âge, le stress lié au dévoilement de l’AS (B = 0,17, IC à 95 % [0,10, 0,25], la détresse parentale (B = 0,22, IC à 95 % [0,14, 0,29]), le nombre d’évènements de vie stressants (B = 0,15, IC à 95 % [0,08, 0,23]) et la défavorisation sociale du quartier (B = 0,25, IC à 95 % [0,05, 0,45]), étaient indépendamment associés à plus de symptômes. Des interventions axées sur le contexte familial et environnemental peuvent être considérées pour atténuer les conséquences de l’AS sur les plaintes somatiques. / Somatization is the manifestation of physical symptoms as a response to psychological distress. In children victims of sexual abuse (SA), somatization and the associated risk and protective factors are understudied. Given that somatic symptoms can lead to functional impairment and decreased health-related quality of life, identifying areas of intervention at all levels of the child’s environment is essential. The study aimed to identify SA characteristics, personal, family, and environmental factors associated with somatic complaints among child victims of sexual abuse. The sample included 655 children (68.9% girls; M = 8.96 years, SD = 1.87) seeking services after SA disclosure. Hierarchical linear regression models were used to investigate the associations between SA characteristics, personal, family, and environmental factors, and somatic symptoms. Interactions with sex were systematically tested. In the sample, 80% of children reported at least one somatic symptom. After controlling for sex and age, stress related to the SA disclosure (B = 0.17, 95% CI [0.10, 0.25], parental distress (B = 0.22, 95% CI [0.14, 0.29]), the number of stressful life events (B = 0.15, 95% CI [0.08, 0.23]) and neighborhood social deprivation (B = 0.25, 95% CI [0.05, 0.45]), were independently associated with increasing somatic complaints. Children therefore depend on the support of adults around them and on their entire social environment to mitigate the consequences of SA on somatic complaints. Interventions focused on family and environmental factors should be considered to support this vulnerable population.