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The Essential Tools for Positive Behavior Change is a behavioral parenting curriculum that is currently being disseminated throughout the state and Florida and is now being utilized in Texas to teach parents who are at risk or are founded of abuse and neglect. Research on the curriculum thus far has focused on large scale outcomes, skill acquisition of caregivers during analog role-play assessments, and scores on a written quiz. Little research has focused on generalization of classroom performance to the home. The measurement systems that have been used to evaluate positive outcomes also were in need of improvement. The current study was designed to determine whether teaching a component (Stay Close) to typical parents resulted in immediate improvements in written exam scores and on a role-play assessment and if those skills could be seen in a home setting. The results indicated that small improvements were seen across quiz scores in all but one family and some improvements across behavior was seen in both the role-play and home observations. Additionally, a reliable measurement system was created that captured both home observations and role-play assessment data.

Child maltreatment affects 900 thousand children in the U.S. every year and impacts all areas of daily functioning. Behavioral parent training (BPT) programs have effectively taught parenting and demonstrated externally valid outcomes (i.e., lower recidivism rates). Skill maintenance assessments for BPTs have mixed results. The Behavior Management and Parenting Services (BMAPS) program has shown effective skill training for court-mandated families. This study assessed skill maintenance and performance factors that may have impaired parents using an ABAB single-case research design in Phase 1 & external validity with a survey in Phase 2. Results for Phase 1 found that most BMAPS parents acquired all parenting tools to criteria, dropped below criteria at the 3 month probe, then fully demonstrated their regained skills after a brief review. Psychological and classroom factors do not appear to have systematically influenced performance at any time, although homework completion was associated with better scores at the end of class. Phase 2 results found a 91% reunification rate and a 0% recidivism rate over 1-3 years. All limitations aside, it appears that the BMAPS program is able to effectively train skills to criteria and these skills can be sustained with a booster session. The vast majority of parents we contacted were reunified with their children and none were involved with additional charges of child maltreatment.

Structural equation modeling was used to examine how childhood sexual abuse (and other associated variables, such as family functioning and experiencing multiple forms of abuse) relates to revictimization and psychological distress. Participants were women who participated in Project HOW: Health Outcomes of Women interviews, a longitudinal study that spanned six waves of interviews. Only women with a history of childhood sexual abuse were included in the present study (n=178). Experiencing nonsexual child maltreatment in addition to childhood sexual abuse appears directly related to adult sexual and physical revictimization and indirectly related to psychological distress. Childhood sexual abuse alone was not predictive of revictimization or psychological abuse. This suggests that other mediating factors may explain the relation between CSA and revictimization found in other research. Clinical implications based on the results of the present study emphasize the importance of identifying children who have experienced multiple forms of abuse as particularly at risk for future victimization. In addition, providing interventions with a focus on education and empowerment might decrease risk for future violence and subsequent emotional maladjustment. Potential future research could examine the treatment outcomes and efficacy of these interventions as well as identify those mediating factors that increase the risk for adult revictimization for those individuals who experience only childhood sexual abuse.

This study investigated the nature and impact of the sexual abuse of children ages birth through 6 years. The purpose was to enhance knowledge about this understudied population through examination of: (1) characteristics of the abuse; (2) socioemotional developmental outcomes of young victims; and (3) potential moderating effects of family dynamics. An ecological-developmental theoretical framework was applied. Secondary data analysis was conducted using data collected from the consortium Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). A sample of 250 children was drawn from LONGSCAN data, including children who were sexually abused (n=125) and their nonabused counterparts (n=125), matched on demographic variables. Results revealed that young victims of sexual abuse were disproportionately female (91 girls; 73%). The sexual abuse committed against these youngsters was severe in nature, with 111 children (89%) experiencing contact offenses ranging from fondling to forcible rape. Sixty-two percent of child victims demonstrated borderline, clinical, or less than adequate functioning on normative, expected socioemotional outcomes. Child victims reported low degrees of perceived competence and satisfaction in the social environment. When compared with their nonabused counterparts, child victims demonstrated significantly poorer socioemotional functioning, as evidenced by aggressive behaviors, attention and thought problems. Sexually abused youngsters also reported lower self-perceptions of cognitive and physical competence and maternal acceptance. Family dynamic factors did not significantly moderate the relationships between abuse and socioemotional outcomes, with one exception. The caregivers’ degree of empathy for their children had a significant moderating effect on the children’s social problems. This study contributes to an otherwise scant body of literature on the sexual abuse of preschoolers. Findings provide implications for social work practice, especially in the development of assessment and prevention strategies.

Child maltreatment is a pervasive social and public health problem in the United States. The negative effects of child maltreatment can include poor mental and relational health outcomes. The experience of discrimination has been shown to have many of the same mental and relational health difficulties. Child maltreatment and discrimination are both social health problems that disproportionately affect the most marginalized people in our society (people of color, people with disabilities, LGBT individuals). Complex trauma, or the experience of multiple traumas, has been shown to have worse mental and relational health outcomes then experiencing one type of trauma alone. Feminist theory is a useful framework for studying how those with marginalized identities experience the effects of child maltreatment. Feminist theory argues that it is essential to incorporate an analysis of power to truly capture the experience of complex trauma for people with marginalized identities. The effects of child maltreatment and discrimination have been studied individually, however little is known about the effects of experiencing both. Data from the National Survey of Midlife Development in the United States (MIDUS) biomarker project was used to examine the effect of experiencing both child maltreatment and discrimination. Latent profile analysis was used to create distinct profiles of trauma out of child maltreatment variables and discrimination. A four profile solution was determined to be the best fitting model. The profiles were Low Trauma, Child Maltreatment/Discrimination, Child Maltreatment and Child Maltreatment/ Discrimination High. Analysis of co-variance was then used to determine how each profile of trauma was related to anxiety, depression, family support and family strain. Differences were found among the profiles and the mental health and relational outcomes. Results and clinical implications are discussed.

The purpose of this study was to understand why so few notifications of concern regarding children are made from sports clubs to social services, the organisation charged with managing such concerns. To be able to understand this phenomenon organisational factors and sport coaches knowledge of warning signs of child maltreatment was studied. There was also an interest to study this further regarding the facts that the United Nations Convention on the Rights of the Children, UNCRC, will be incorporated in the Swedish law January 2020. To answer these questions a qualitative method was used where six sport coaches, independent from each other, were interviewed using semi structured questions. The coaches represent different sports of which three are team sports, two are individual and one is both. The interviews were conducted in personal and were recorded. The analysing method used on the empirical data was coding and thematisation. The empirical data was analysed using relevant theoretical perspectives, namely ethics and organisational theory and an overview of relevant information on the subject. The results of this study showed that as well as there is a gap within the sport clubs regarding information, there is also a gap of information from the bigger organizations to the smaller local clubs. The findings also point towards the struggle coaches have when it comes to the ethical dilemmas that they encounter. How they choose to try and solve situations are directly related to the lack of knowledge - what happens in the process after one makes a referral of concern regarding a child and the fear of making the child's situation worse. One of the conclusions of this study is that if the coaches were given the right information and knowledge enabling them to have a good foundation to stand on, it is likely that more coaches would feel more confident regarding these dilemmas. This would help them know what to do if they notice that a child may be maltreated or abused. Each sports club also needs an existing updated child protection policy outlining how a coach should react when faced with concerns about welfare and protection. The thesis concludes by discussing whether sports clubs should have a duty to report child welfare concerns in the same way, for example, as teachers do.

Barn runt om i världen far illa och utsätts för fysiskt-, psykisk- och sexuellt våld samt vanvård och försummelse. Sjuksköterskor möter barn och vuxna i sitt omvårdnadsarbete, där barn har farit illa eller riskerar att fara illa. Sjuksköterskor har anmälningsplikt vid misstanke om att barn far illa. Dock finns olika omständigheter som påverkar sjuksköterskor att inte göra en orosanmälan vid misstanke att barn far illa, trots att anmälningsskyldighet och etiska koder finns. Syftet med litteraturstudien var att undersöka vilket stöd sjuksköterskor behöver för att göra en orosanmälan vid misstanke om att barn far illa. I litteraturstudien framkom det att sjuksköterskor behöver stöd i form av emotionellt-, informativt- och instrumentellt stöd för att göra en orosanmälan. Sjuksköterskor efterfrågar stöd genom kunskap vilket kan erhållas via utbildning, för att kunna identifiera barn som far illa. Ett organisatoriskt stöd och en god sammanhållning inom teamet är av stor vikt för att främja sjuksköterskors hantering av orosanmälan, där alla inom hälso- och sjukvård får reflektera och dela kunskaper med varandra. Sjuksköterskors individuella förutsättningar gällande normer och värderingar av en vuxen- och barnrelation har en inverkan på anmälningsprocessen. Därmed behöver sjuksköterskor stöd för att samtliga sjuksköterskor utgår från samma värderingar och plikter mot barnet och förövaren. / Children around the world suffer from abuse such as physical, psychological and sexual violence and neglect. Nurses meet children and adults in families in their work where children have been harmed or are at risk of harm. Nurses have an ethical responsibility and duty to report when children are at risk of harm in a report of concern. Although there are ethical codes and an obligation to report, there are circumstances that affect nurses to not always make a report when a child is at risk. The aim of this literature study was to investigate what support nurses need to make a proper report of concern, when there is a suspicion of a child at risk. The study revealed that nurses need emotional, informative and instrumental support to make a complaint. Nurses demand support through knowledge, which can be obtained through education, in order to identify children who are at risk of harm. In addition, organizational support and a good cohesion within a multidisciplinary team is of great importance in promoting nurses' handling of a report of concern, where everyone in healthcare can reflect and share knowledge with each other. Nurses' own upbringing and individual judgement of norms and values have an impact in their decision of what is acceptable in an adult / child relationship, which affect the application process. As a result, nurses need support so that they share the same base of values and duties towards the child and the offender.

Barn runt om i världen far illa och utsätts för fysiskt-, psykisk- och sexuellt våld samt vanvård och försummelse. Sjuksköterskor möter barn och vuxna i sitt omvårdnadsarbete, där barn har farit illa eller riskerar att fara illa. Sjuksköterskor har anmälningsplikt vid misstanke om att barn far illa. Dock finns olika omständigheter som påverkar sjuksköterskor att inte göra en orosanmälan vid misstanke att barn far illa, trots att anmälningsskyldighet och etiska koder finns. Syftet med litteraturstudien var att undersöka vilket stöd sjuksköterskor behöver för att göra en orosanmälan vid misstanke om att barn far illa. I litteraturstudien framkom det att sjuksköterskor behöver stöd i form av emotionellt-, informativt- och instrumentellt stöd för att göra en orosanmälan. Sjuksköterskor efterfrågar stöd genom kunskap vilket kan erhållas via utbildning, för att kunna identifiera barn som far illa. Ett organisatoriskt stöd och en god sammanhållning inom teamet är av stor vikt för att främja sjuksköterskors hantering av orosanmälan, där alla inom hälso- och sjukvård får reflektera och dela kunskaper med varandra. Sjuksköterskors individuella förutsättningar gällande normer och värderingar av en vuxen- och barnrelation har en inverkan på anmälningsprocessen. Därmed behöver sjuksköterskor stöd för att samtliga sjuksköterskor utgår från samma värderingar och plikter mot barnet och förövaren. / Children around the world suffer from abuse such as physical, psychological and sexual violence and neglect. Nurses meet children and adults in families in their work where children have been harmed or are at risk of harm. Nurses have an ethical responsibility and duty to report when children are at risk of harm in a report of concern. Although there are ethical codes and an obligation to report, there are circumstances that affect nurses to not always make a report when a child is at risk. The aim of this literature study was to investigate what support nurses need to make a proper report of concern, when there is a suspicion of a child at risk. The study revealed that nurses need emotional, informative and instrumental support to make a complaint. Nurses demand support through knowledge, which can be obtained through education, in order to identify children who are at risk of harm. In addition, organizational support and a good cohesion within a multidisciplinary team is of great importance in promoting nurses' handling of a report of concern, where everyone in healthcare can reflect and share knowledge with each other. Nurses' own upbringing and individual judgement of norms and values have an impact in their decision of what is acceptable in an adult / child relationship, which affect the application process. As a result, nurses need support so that they share the same base of values and duties towards the child and the offender.

Background: Children living in low- and middle-income countries (LMICs) experience alarmingly high rates of maltreatment, frequently at the hands of caregivers. Group-based parenting programmes show promise for reducing and preventing child maltreatment, as well as for improving positive parenting, child behaviour problems, and caregiver mental health. However, parenting programmes can only benefit families if caregivers participate in them. Using secondary data, this study thus aimed to 1) identify factors that affect attendance and 2) investigate the impact of attendance on outcomes within two randomised controlled trials of Parenting for Lifelong Health (PLH) for Young Children for caregivers of children aged 2-9 years in Thailand (N = 120) and 2-6 years in the Philippines (N = 120). The interventions were delivered within existing service delivery systems in both countries, over eight weekly sessions (Thailand) or 12 sessions every second week (Philippines). Method: To address the first aim of this study, multivariable logistic regression models with robust sandwich estimators were used to examine family baseline characteristic as predictors of caregiver attendance in sessions. An exploratory approach was taken to test a range of factors that have previously been linked to attendance in parenting programmes, including economic and educational, social and health, parenting and child behaviour, and sociodemographic characteristics. To address the second aim, caregiver self-reports and observational assessments (Thailand only) from baseline, post-test, and follow-up were analysed using complier average causal effect (CACE) analyses to test the impact of attendance variability on the primary outcomes of child maltreatment, as well as secondary outcomes of positive parenting, dysfunctional parenting, child behaviour problems, and caregiver mental health. Results: Caregivers in Thailand attended 82.3% of sessions while those in the Philippines attended 61.8%. Overall, few baseline factors were significantly associated with attendance. In Thailand, caregivers who were less educated and those who were older were significantly more likely to attend sessions. In the Philippines, caregivers who were less healthy, those that who used more emotional abuse, and those who had boys rather than girls were significantly more likely to attend. Notably, caregivers who experienced higher rates of intimate partner violence significantly attended 8% fewer sessions in the Philippines. A comparison of CACE estimates to intention-to-treat estimates at post-test and at follow-up showed greater benefits of the intervention amongst caregivers who attended more sessions. Specifically, the strongest intervention effects were found for caregivers who attended at least 75% of the programme. Conclusion: This study showed no evidence that disadvantages related to lower socio-economic status were associated with attendance, suggesting that it is possible for vulnerable families in LMICs to attend parenting programmes. However, developing retention strategies that target subgroups who are at greater risk of missing sessions is especially important as higher attendance at sessions is positively related to greater improvements in caregiver and child outcomes.