Child Maltreatment最新文献

Children often enter foster care (FC) with mental health (MH) concerns. Failure or delay in initiating treatment may result in overreliance on acute MH services. This report leverages 2010-2019 linked administrative child welfare and healthcare claims data for 13,562 Wisconsin children entering FC at ages 3-16 years to describe patterns of MH services during FC and examine how MH service use varies by demographic characteristics and maltreatment, FC, and MH histories. Two-thirds of children received MH assessment or treatment during FC, of whom 61% initiated services within 3 months of entry. Younger age, kinship care, and absence of MH history were negatively associated with onset of assessment and treatment. One in 7 children used acute MH services, with higher rates for Black children, adolescents, and youth in non-family settings. Timely MH assessment and treatment is important for foster children's wellbeing, but current guidelines may lack accountability and monitoring mechanisms.

This study drew on the biological sensitivity to context model (Ellis & Boyce, 2008) and polyvagal theory (Porges, 2007) to evaluate the moderating influence of children's autonomic nervous system (ANS) regulation on pathways from child emotional abuse (CEA) and child physical abuse (CPA) to later dissociative symptoms in adolescence. Participants were 232 youth (50.2% assigned female at birth, 45.9% Latine) who reported on their experiences of CEA and CPA at ages 6, 8, and 10 years. Resting cardiography measures of respiratory sinus arrythmia (RSA) and pre-ejection period (PEP) assessed children's parasympathetic and sympathetic activation, respectively, at these same ages. Youth reported on their dissociative symptoms at age 17. Parasympathetic activation qualified predictions from CEA to dissociative symptoms with relatively high RSA sensitizing children to CEA effects. Sympathetic activation qualified interactive predictions from both CEA and CPA to dissociative symptoms, but in different directions depending on the level of CPA. These findings suggest that resting ANS regulation may sensitize children to the effects of CEA and/or CPA on later dissociative symptoms in adolescence.

The Child Abuse Potential Inventory (CAPI) is a measure widely used to assess caregivers' likelihood of physically abusing their child. Its psychometric properties require further assessment, specifically among highest-risk caregivers known to child protective services. This systematic review aimed to evaluate the criterion validity, construct validity, and responsiveness of the CAPI Abuse scale among child-welfare system involved caregivers of children aged 0-12. We searched PsycINFO, PubMed and Web of Science for articles published in English between 1986 and January 2023 that reported data on CAPI psychometric properties among child-welfare system involved caregiver samples. Articles were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for systematic reviews of patient reported outcome measures. Twenty-eight articles reported on CAPI Abuse scale construct validity (i.e., convergent, and known-groups validity), criterion validity and/or responsiveness. Study quality was overall very good. CAPI validity and responsiveness were rated sufficient. CAPI was responsive to post-treatment changes as well as intervention group differences for several tertiary interventions. Despite methodological limitations in the evidence, this review found that the overall strength of CAPI Abuse scale validity and responsiveness evidence was moderate. These findings support further evaluation and CAPI use in clinical and research settings.

The present study examined profiles of service needs among caregivers with child welfare involvement. Participants were 589 caregivers of children 12-36 months old at baseline from the second National Survey of Child and Adolescent Well-Being. Latent class analysis was used to profile unique characteristics of and changes in caregivers' needs across an 18-month period. Four classes of caregiver needs were identified with differential risks for maltreatment. Compared to caregivers with "No Needs" (25%), caregivers with "Chronic Multi-Type" needs (25%) and "Parenting Only" needs (26%) were both significantly more likely to engage in psychological aggression, physical abuse, and neglect. Caregivers with "Changing Needs" (24%) were significantly more likely to engage in psychological aggression and neglect. Involvement with child welfare services represents a critical opportunity to offer support to families, especially among those with multiple chronic needs, needing parenting skills, and those with needs that are unstable over time.

Childhood physical and/or sexual abuse are associated with negative physical and mental health outcomes in adulthood. Protective factors may contribute to resilience and reduce the risk of these adult health outcomes. This study aims to determine if the presence of a protective adult can mitigate the association between childhood abuse and negative adult health outcomes. Data were obtained from the 2021 and 2022 Behavioral Risk Factor Surveillance System (n = 83,495). Binary logistic regression was used to compare the odds of health outcomes in adults who experienced abuse before age 18 compared to those who did not, adjusting for the presence of a protective adult and socio-demographic, socioeconomic, and health behavior factors. Childhood physical and/or sexual abuse were associated with higher odds of physical and mental health conditions in adulthood. Adjusting for the presence of a protective adult partially attenuated the odds of many adult health outcomes. Understanding protective factors associated with childhood abuse may improve targeted outreach and provide helpful direction for the development of effective programs for children experiencing abuse.

We examined profiles of young people who have been referred to a state child serving agency concerned with identifying commercial sexual exploitation of children (CSE) in the Northeast of the United States before and since the onset of the COVID-19 pandemic. Using comprehensive data from this state child serving agency, our study used latent class analyses and regression analyses to explore changing profiles of young people referred for concerns of CSE since the pandemic. A profile of referred minors whose social settings included CSE-involved people was significantly less common since the onset of the pandemic compared to before the onset of the pandemic. Conversely, a profile of young people with risky online experiences (e.g., sharing sexually explicit media) was significantly more common among CSE referrals since the pandemic began. While extant literature warns of CSE risk in online settings, fewer cases of CSE were identified since the onset of the pandemic. Given the growing importance of online settings and experiences during childhood, supplemental screening practices are needed to better assess the risk of CSE among young people in online settings.

Child maltreatment is a pervasive problem in the United States with significant economic, health, and human capital consequences. Children under age one experience the highest rates of child abuse and neglect and the greatest likelihood of fatality from maltreatment, including shaken baby syndrome. Publicly-funded paid family leave (PFL) programs in the U.S. have been found to improve risk factors for maltreatment including increased parental time investments in children, better maternal and child health, and household income protection in the months surrounding a birth. We examine whether state PFL programs in the U.S. affect infant maltreatment. Using administrative data on child maltreatment reports to Child Protective Services (CPS), we compare reports of infants under age 1 in PFL states to reports of infants in non-PFL states before and after PFL was implemented. We find that PFL reduced reports of infant maltreatment by about 14 percent, and home removals by about 46 percent. We also observe fewer substantiated reports by about 22 percent. These results imply PFL has spillovers to the child welfare system that should be accounted for.

Research on sibling separation in foster care often focuses on cases where all siblings are removed. However, separation can also occur when only some children are placed in care, a scenario that is underexplored. This study investigates: the frequency of partial sibling placements; differences between placed and non-placed siblings, as well as split versus intact sibling groups; and the risk of re-report and future placement for non-placed children in split groups compared to those in intact groups. US child maltreatment report (CMR) and foster care caseload data are accessed from National Child Abuse and Neglect Data System (NCANDS) and Adoption and Foster Care Reporting System (AFCARS). Sibling groups are assigned based on shared CMR in 2018. At least 27.4% of sibling groups, where at least one child is placed, are split. These groups have wide age ranges between children. Children in split groups left at home are at higher risk of placement than children in non-split groups.

Autistic youth experience disproportionately high rates of child maltreatment and a wide range of other traumatic and stressful events, such as peer victimization. Very little empirical work has evaluated trauma-focused supports for Autistic youth, despite high rates of posttraumatic stress disorder (PTSD) and other trauma-related symptoms. The current study is a pilot proof-of-concept evaluation of telehealth-based trauma-focused cognitive behavioral therapy (TF-CBT) for Autistic youth (N = 17, ages 10-17) and their caregivers. Youth PTSD symptoms significantly declined from the beginning to end of the program across youth self-report, caregiver report, and clinician interview, and effects were maintained at the 1-month follow-up with large effect sizes. Youth self-reported significant declines in anxiety. Caregivers reported significant improvements in all co-occurring youth mental health symptoms and some caregiver-level outcomes. Youth and caregivers rated the program and telehealth delivery favorably overall. Future larger-scale randomized evaluations of TF-CBT for Autistic youth are needed.

This field study investigated the use and efficacy of main and cued invitations in eliciting forensically relevant information from a national sample of forensic interviews conducted with preschool-aged (2- to 6-year-old) alleged victims of abuse. Among 1065 invitations posed by the interviewers, 43 (4%) were classified as main invitations, while 1022 (96%) were identified as cued invitations. Both subtypes of invitations were equally effective in eliciting event-specific, forensically relevant information from the children. Nearly 70% of main invitations yielded forensically relevant information, compared to 83% for cued invitations. Interviewers typically presented only one invitation before resorting to other prompts, predominantly directive, option-posing, and suggestive questions. The effectiveness of invitations increased significantly when posed later in the interviews, suggesting a decline in children's productive responses as the interview progressed. This study highlights potential barriers to the effective use of invitations and discusses implications for developing tailored training programs for interviewers working with preschool-aged alleged victims.