Child Protection and Practice最新文献

Background

Child welfare-involved families have diverse and multi-faceted needs. Families who experience poverty and are investigated by the child protection system may represent a particularly vulnerable group.

Objective

This study aims to understand the unique profiles of need that exist for families who experience poverty and are investigated by the Ontario child protection system.

Participants and setting

Data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 (OIS-2018) was used. The OIS-2018 is a cross-sectional study which collected information on investigations conducted in Ontario, Canada in 2018.

Methods

A latent class analysis was conducted to identify and describe distinct classes of adversity among a representative sample of child protection investigations. Indicators of child, caregiver and economic adversity were used.

Results

This study found evidence for eight distinct classes of adversity. With the exception of a low adversity class which emerged, the identified classes were characterized by distinct profiles of cooccurring adversities and there were several classes where indicators of poverty were probable. Investigation dispositions varied greatly by class.

Conclusions

The findings highlight the importance of ensuring an optimal fit between the distinct needs of investigated families and the child welfare interventions provided. Services and supports that are tailored to the specific constellations of cooccurring adversities that families face may be more effective in reducing the need for future child welfare involvement and/or more intrusive child protection responses. It is likely that investigated families who experience poverty would benefit from a range of economic and concrete supports.

Background

The association of adverse childhood experiences (ACEs) with young adult social outcomes is poorly understood.

Objective

To examine the relationship between ACEs and young adult household income, education, and partnered status.

Participants

13,767 respondents (population-weighted estimate N = 13,191,291) aged 30–39 completed the optional ACES module in the 2019 Behavioral Risk Factor Surveillance System (BRFSS) from 17 states.

Methods

The 2019 BRFSS was used to analyze the significance of ACE scores for the likelihood of reporting household income greater than $75,000, a college or postgraduate degree, and living with a partner among respondents aged 30–39. Poisson regression analyses controlled for sociodemographic, health status, and behavioral risk characteristics.

Results

As compared to those with zero ACEs, respondents reporting four or more ACE exposures (20.2% of respondents) were marginally less likely to report high income (IRR: 0.87, 95% CI: 0.79–0.97) and one-third less likely to report a college degree (IRR: 0.68, 95% CI: 0.61–0.76), with no significant difference in partnered status.

Conclusions

Young adult social status may be shaped by social-emotional effects of ACEs that go beyond demographic and health status differences. Enhancing resilience to childhood adversity can benefit from a trauma-informed approach in health care, education, and employment.

Over the last 50 years, the global community has forged consensus on child rights and, thereby, laid the basis for defining child protection in terms of three cornerstones: (1) the protection from all forms of violence in all settings and contexts and for all children, without discrimination; (2) the provision of supports within governments, to families, and children for the promotion of child health when failures to child protection occurs; (3) and the participation of child and youth voices to value their lived experience and developmentally-based understanding of adult decisions impacting their rights. As such, child protection has historically been internationally focused, broad-based, with accountability structures within countries and internationally. When we survey some current contexts, the implementation of child rights seems to have been met with a blockage in realizing child protection, within child welfare system settings, but more graphically within conflict settings. This discussion serves as an introduction to the needed discourse on standards in responding to child rights violations, and the urgent need to formulate preventive, protective strategies to uphold the law-based consensus of global child rights and global child health goals. The United Nations Convention on the Rights of the Child, and its Optional Protocols, continues to be the leading guidepost for country-level and international efforts to protect children and promote their well-being, and informs the Sustainable Development Goals integrating the protection from violence with child health, as benefiting the public health and global health targets. With seemingly shifting alliances among countries, the central focus on child rights as foundational and the driving force to child protection needs to remain as a cross-cutting, sustained commitment. Duty of care precedes the standards of care, and such standards are uppermost in need in our current socio-economic-political landscape.

Background

The Canadian child protection system is a network of provincial, territorial, and federal systems. Each province and territory has unique child protection legislation and service delivery practices. There is significant variation between the legislations and processes which inevitably determines which children and families are investigated.

Objective

This study examines the clinical case characteristics to understand the drivers related to the significant difference in child protection investigation rates occurring in Ontario and Quebec, Canada. Relevant legislations and policies are also examined.

Participant and setting

The study uses data from four provincial Incidences Studies: 1) the Ontario Incidence Study of Reported Child Abuse and Neglect-2013 (OIS-2013), 2) the Quebec Incidence Study on Investigations of Child Protection-2014 (EIQ-2014); 3) OIS-2018); and 4) EIQ-2019. These studies are cross-sectional and collect de-identified information on child protection investigations which occurred in the relative province and year.

Methods

Descriptive tests were conducted to examine differences between clinical case characteristics of the four Incidence Studies. Incidence rates were calculated using Statistics Canada Census data. Confidence intervals were conducted to test for significant differences.

Results

There is a statistically significant difference in the investigation rates between OIS-2013 and EIQ-2014, and OIS-2018 and EIQ-2019. There is no statistically significant difference in the substantiation rates between OIS-2013 and EIQ-2014, and no clinical difference in the substantiation rates between OIS-2018 and EIQ-2019.

Conclusions

It is a critical time to examine screening procedures and tools to ensure resources are used effectively and reduce negative impacts on children and families unnecessarily investigated. Keywords: child welfare, policy, provincial comparisons, incidence rates.

The adoption and implementation of the UNCRC across the globe has taken many forms in various countries, as some develop legislations, national policies, and amend current provisions to work towards eliminating all forms of child violence by 2030, as outlined by SDG 16. Systemic disparities pertaining to international conflicts, power dynamics, and resource limitations hinder the progress of achieving SDG 16. This frequently restrains reporting standards, organization development, and just aid to maltreated children. In terms of the Canadian landscape, Canada acts as a pathfinder country in the adoption of the UNCRC, as it has implemented numerous studies and initiatives in an attempt to end child maltreatment. However, systemic racism, overrepresentation of marginalized communities, and a lack of support for youth as they age-out of care persists in the Canadian child welfare system. While the Ontario child welfare system shares similar struggles, they have made strides in the fields of child maltreatment reporting and data collection, as well as trends and problem identification through the Ontario Incidence Study of Reported Child Abuse and Neglect. First, we present considerations related to the global mandate for child protection, and the challenges that persist amongst marginalized communities. Subsequently, we focus on Canada and, in particular, the Ontario example: the trends from the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS). This child welfare epidemiological project has highlighted the need for greater intersectional adjustments to best protect children, where the iterative research-policy cycle has most effectively been seen with a formal system for the inclusion of lived experience, as in the case of Indigenous peoples. This introduction to the OIS research papers emphasizes that adaptive models for cost-sharing and collaboration are needed to increase the relevance, efficiency and effectiveness of the child welfare system. Continued evaluation to respond to and challenge policy is a critical function of sustained surveillance systems.

Background

In adults with a history of childhood adversity such as abuse, neglect, and household dysfunction there is greater risk of depression, PTSD, alcoholism, suicide, cancer, heart disease, and more. The field of positive psychology aims to improve well-being, which can buffer against stressors and build resources and resilience to cope with adversity. Positive psychology interventions show promise in clinical populations, so may be effective in changing the life-course for adults affected by childhood adversity.

Objective

To review the empirical literature on positive psychological variables that may moderate or mediate the relationships between childhood adversity and various outcomes for young adults, mostly university students.

Participants and setting

This review included a total of 9938 participants, from mostly university student samples (average mean age = 21.19, SD = 2.41) in USA, China, and Turkey.

Methods

PsycINFO, CINAHL, and ERIC were searched in accord with PRISMA guidelines. Studies that explored positive factors and whether they moderated or mediated the relationship between childhood adversity and various outcomes were included. 162 records were screened, and 11 were selected for inclusion.

Results

Eight factors mediated or moderated the relationship between adverse childhood experiences and various deleterious outcomes: self-compassion, optimism, positive perception, meaning in life, positive emotions, mindset, subjective well-being, and psychological suzhi.

Conclusions

Approaches that aim to support recovery from the challenges connected with childhood adversity should aim to integrate the promotion of these positive factors into interventions and treatments. Specifically, subjective wellbeing seems to have high value and can be reliably developed using positive psychology interventions.

Background

Child protection statutes are designed to protect children from harm, yet there is surprisingly limited information available about injuries or other forms of harm documented in cases of reported child maltreatment.

Objective

To examine trends in the rate of substantiated child maltreatment investigations in Canada involving physical harm over a twenty-year period.

Participants and Setting

The Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) is a cyclical study which uses a file review methodology to collect information about child maltreatment-related investigations from child protection workers across Canada.

Methods

We conducted secondary analysis of data from three cycles of the CIS (1998, 2008, and 2019). Because information on physical harm was not available from Quebec during the 2019 cycle, we limited the analyses to the rest of Canada, excluding Quebec.

Findings

The rate of child maltreatment-related investigations has more than doubled between 1998 and 2019 from 24.53 to 56.03 investigations per 1000 children. Rates of substantiated maltreatment have also increased (from 10.21 to 17.56 investigations per 1000 children), while the rate of substantiated investigations involving documented physical harm has decreased (from 1.81 to 0.79 investigations per 1000 children).

Conclusion

Child protection agencies in Canada are identifying less physical harm than they were two decades ago although the overall rate of investigations has increased in the same time period. A better understanding of the scope of injuries and the profile of children and families investigated is essential to understanding the extent to which child protection systems are effectively meeting their duty to protect.

Background

There is limited evidence regarding the associations between disability, childhood experiences of violence, and associated health outcomes in humanitarian settings.

Objective

We examined the prevalence of childhood sexual, physical, and emotional violence by disability status, explored associations between childhood violence and type of disability (limitation), perpetrator types, and the negative health outcomes associated with experiencing childhood violence by disability status.

Participant and Setting

Participants included 1338 females and 927 males aged 13–24 years living in refugee settings in Uganda.

Methods

Data were from a cross-sectional Humanitarian Violence against Children and Youth Survey (HVACS) conducted between March and April 2022 in Uganda. Analysis entailed cross-tabulation with a chi-square test and estimation of bivariate and multivariate logistic regression models.

Results

For both females and males, the prevalence of sexual violence in childhood was higher among those with disabilities compared to those without disabilities (23.2% vs. 11.5% for females; and 15.7% vs. 7.6% for males). The odds of experiencing sexual violence were higher among females with physical limitations (self-care [AOR:2.1; 95%CI-1.0-4.3] and task performance [AOR:2.5; 95%CI = 1.3–5.2]) and males with both physical [AOR:4.4; 95%CI = 1.4–13.7] and communication [AOR:4.1; 95%CI = 1.3–12.9] limitations compared to those without such limitations. Experiencing violence and having disabilities increased the odds of reporting negative health outcomes including severe mental distress and symptoms or being diagnosed with STI among females by three times.

Conclusion

In Uganda's refugee settings, the prevalence of childhood violence is higher among children and youth with disabilities compared to those without disabilities. Females with disabilities and who had experienced childhood violence were considerably more susceptible to negative health outcomes. These findings underscore the need for targeted child protection and response interventions to address the vulnerabilities of children and youth, and particularly for those with disabilities and female children.

Childhood sexual violence is a global problem that has far-reaching impacts on children, families and communities. Whilst there has been significant commitment and action to tackle this issue, research with young people consistently draws attention to gaps and limitations. Emerging research, and practice-based evidence, tells us that young survivors of childhood sexual violence hold essential knowledge and expertise about the impacts of, and solutions for addressing, this form of violence. Yet, despite widespread recognition that children and young people have a right to ‘be heard’, in practice there are limited examples where young survivors come together collectively to collaborate with professionals to inform and influence research, policy or practice interventions in this field. This discussion paper begins by reflecting on barriers to, and opportunities for, participatory engagement with young survivors. The article draws on a decade long international programme of work and shares three key elements that have helped ‘scaffold’ our participatory work with young survivors: forming the right partnerships; weighing up the potential risks and benefits of engagement; and putting in place support for all involved. In conclusion, we present potential ways forward, underscoring the importance of addressing structural barriers, the need for creativity, and the significance of support and training for those accompanying young people and facilitating their engagement in the future.