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A survey was conducted among professionals expert in the field of child protection to determine which papers or book chapters they felt had been the most influential. From their responses, a list of the 50 most mentioned papers and chapters was compiled. This list was sent to a large group of child protection professionals with the request that they rank the 15 publications which they considered most important. To compare the views of child protection professionals with the number of times these publications had been cited in the literature, a citation search was carried out. Kempe, Silverman, Steele, Droegemuller, and Silver's (1962) paper "The Battered Child Syndrome" and Summit's (1983) paper "The Child Sexual Abuse Accommodation Syndrome" received the highest ranking from the professionals. "The Battered Child Syndrome" also achieved the highest ranking in the citation search. Although there were a number of discrepancies between the professional rankings and the citation search, eight papers appeared in the top 15 rankings achieved by the professional survey and the citation search. Such a review of the influence of child abuse literature has limitations, although it does help to show which papers appear to have had an important and lasting influence. [ABSTRACT FROM AUTHOR]

At the hospital 41 children from 37 families were identified as having had illness induced by a parent who in all but three cases was the mother. Their case records were reviewed. Four patterns of presentation occurred: failure-to-thrive through the active withholding of food; allegation of allergy and withholding of food; allegation and fabrication of medical symptoms; and active interference by poisoning or disrupting medical treatment. Four of the children died, two as a result of the illness induction. In 35% of the families a sibling had been previously subjected to some type of abuse. All the children had been presented with potentially serious symptoms, but post-identification only five were found to have serious medical problems requiring ongoing treatment. There were no specific characteristics of either the child or family associated with each type of presentation. Seventeen children had previously presented with failure-to-thrive, feeding problems or food allergies. All the mothers had suffered at least one of the following: Privation, child abuse, psychiatric illness, or significant loss or bereavement, whereas only half the fathers had grown up in a deprived family situation and/or had earlier or current health difficulties. Forty percent of the parents had serious marital problems. A combined medical/psychosocial team identified the abuse and attempted to understand the family's belief system regarding the illness. The process of Illness Induction was conceptualized as being initiated by the parents perceiving the child to be ill and using this focus on illness as a way of solving major personal, marital, and/or family difficulties. [ABSTRACT FROM AUTHOR]

Child protective services (CPS) case records contain a vast amount of narrative information that is underutilized for estimating risk, conceptualizing family needs, and planning for services. The current study applied a novel method for quantifying family-level severity of maltreatment and non-maltreatment-related adversity types to narrative information reflecting a family's full CPS history. Cases were randomly sampled (N = 100) from two regions of Connecticut that were referred over a specified 6-month period. De-identified data were extracted through comprehensive chart review of electronic and paper case records. The Yale-Vermont Adversity in Childhood Scale (Y-VACS; Holbrook et al., 2015) was used to quantify adversity severity across a range of intrafamilial and extrafamilial experiences. Several family-level adversity severity ratings were associated with administrative data on allegations and investigative outcomes. Poly-victimization (β =.47, p <.001) and poly-deprivation (β =.25, p =.005) significantly predicted total allegation types and total substantiation types (β =.30, p =.002; β =.26, p =.008, respectively) across the case history. Poly-victimization significantly predicted the presence of a new allegation within 12 months of the index report, OR = 1.72, SE =.25, p =.027. Findings support the feasibility of a novel method that uses narrative case record information to quantify severity of maltreatment and non-maltreatment-related adversity types, as well as cumulative measures of threat- and deprivation-based adversities at the family level. Implications for utilizing case record data to inform CPS intervention are discussed. [ABSTRACT FROM AUTHOR]

Estimates suggest that close to 3 million institutionalized children internationally have some family to whom they could go home. A proportion of these children is recruited from their communities under false pretenses and has false documentation that describes them as legal orphans. The orphanages where they live exploit them on the basis of their orphanhood. These children are known as paper orphans. The aim of the current article is to provide a profile of their origins and networks based on current available evidence, from an investigative interviewing perspective. Increased discussion and research of this problem will assist in supporting efforts towards reunification of children with families, investigations by law enforcement into orphanages, and successful prosecution of orphanage trafficking. The article provides an overview of the orphanage trafficking context, followed by a comparison of orphanage trafficking victims with other child trafficking victims from the perspective of investigative needs. Investigative needs are outlined with respect to two primary groups who would interview paper orphans and other involved parties (e.g., birth parents, orphanage staff)–law enforcement and reunification officers. In the final section of the article, we encourage further research on orphanage trafficking and provide initial guidance for interviewing in this unique context. This paper serves as a step to raise further awareness of paper orphans, orphanage trafficking, and the specific characteristics of their cases that affect research and planning into how to identify and interview them and others involved. [ABSTRACT FROM AUTHOR]

Numerous methods are used in the measurement of child maltreatment (CM) exposure. As a science, it is necessary that the field of CM research evaluate its measurement approaches periodically to ensure that the common approaches are the best approaches. A prominent method for measuring CM in research as a predictor variable is to conceptualize CM as a two-level, yes/no binary variable (e.g., 0 = No CM exposure, 1 = CM exposure). While there is no consensus on what method is the best approach for measuring CM, empirical evidence suggests that the binary measurement approach to CM has significant limitations. The current paper sought to progress the field of CM and trauma research forward by reviewing several lines of research demonstrating why the use of a binary yes/no CM measurement approach is problematic. As evidence for why a binary measurement of CM should be halted, this paper reviews research on: why the characteristics or details of CM exposure matter, risk of CM "contamination," and CM's relation with environmental or systemic factors. The ethical and clinical implications of a CM binary measurement approach are also discussed. Several recommendations for the field are provided on how researchers can improve the measurement of CM and ensure accurate and replicable studies are being published. • Child maltreatment research requires an evaluation of its measurement practices. • There are many concerns related to measuring child maltreatment as a binary variable. • Researchers should consider a multidimensional approach to maltreatment measurement. [ABSTRACT FROM AUTHOR]

Organized sexualized and ritual abuse (ORA), a contentious issue since the 1980s, remains a polarizing topic. Although there is much debate about the existence of this phenomenon, a differentiated perspective is lacking, and no representative study has yet addressed the frequency. This paper aims to investigate the frequency of ORA in Germany using two representative datasets. Data were collected from representative samples of the German population (N = 2522, N = 2515). Participants aged 16 to 96 years (50 and 53 % female) were recruited. They were selected by a random route procedure and asked to fill out a paper-pencil-questionnaire. The four aspects of ORA (severe sexual violence, perpetrator networks, commercial exploitation, ideology) were assessed based on the definition provided by an expert group. Additionally, in the second survey, a direct yes/no question about the experience of ORA as well as details on perpetrators and offense characteristics were surveyed. Frequency of ORA was low. The direct question on ORA was affirmed by 0.5 % (n = 13), while according to the criteria of the definition, only 0.2 % or less of individuals experienced organized sexualized abuse, and <0.1 % experienced ritual abuse. Although ORA is discussed thoroughly, frequencies in the German population are low. This may be due to inconsistent terminology and operationalization of definitions with lack of precision. However, an intersection of conspiracy beliefs and the topic of ritual violence sheds another light on this issue that should receive more attention. [ABSTRACT FROM AUTHOR]

Little academic research has been conducted on how people conceptualise 'violence' and 'discipline', especially in humanitarian settings. This may limit the transferability of violence prevention interventions. This paper examines the understanding of violence and discipline concepts among students, teachers, and parents in the Nyarugusu Refugee Camp in Tanzania. A qualitative study was undertaken as part of the larger trial testing the effectiveness of the EmpaTeach intervention to prevent physical violence from teachers to students implemented in 27 schools in Nyarugusu Refugee Camp. Data from baseline and midline surveys in control schools that did not receive the intervention informed this paper where a total of 14 in-depth interviews (eight with students and six teachers) and six focus group discussions (two with teachers and four with parents from the Parent Teacher Association) were analyzed. Both audio recordings from in-depth interviews and focus group discussions were transcribed verbatim, and translated from Kiswahili to English (Congolese) and Kirundi to English (Burundian). Translated data were verified and coded using thematic analysis based on the views of students, teachers, and parents. Participants revealed that the same behavioural acts could be differentially classified as violence or discipline. Violence was understood in relation to the consequences of acts, which could include physical or psychological harm, or other harms which were seen as detrimental to children's futures and life chances, particularly adolescent pregnancy. Sexual acts without consent were also seen as violence. In contrast, discipline was understood according to intent, and perceived acts done towards students to correct bad behaviour. Results imply that education about the harmful consequences of behavioural acts intended as discipline, may be important for violence prevention interventions and that framing interventions in terms of positive child development could help change discipline strategies in schools. [ABSTRACT FROM AUTHOR]

In 2017 the Northern Territory (NT) government re-introduced the Banned Drinker Register (BDR) to address the high rates of alcohol related harm. This paper aims to evaluate whether trends in assault, maltreatment and sentinel injuries in children and adolescents were associated with the re-introduction of the BDR, in the context of other local interventions such as police officers stationed in bottle shops being partially removed, Police Auxiliary Liquor Inspectors, and the introduction of a minimum unit price of alcohol. Interrupted time series analysis was used to assess monthly trends in emergency department presentations and inpatient hospital admissions for assault, maltreatment and sentinel injuries between January 2014 and December 2019 in the regions of Greater Darwin, Alice Springs, and Katherine. A significant step increase after the introduction of the BDR in emergency department presentations for assault and maltreatment was present when examining the three regions combined (β = 7.65, 95 % CI = 2.15, 13.16). However, this was not present at the individual community level. Results across a range of other models pointed towards null effects of the BDR introduction. The current study found that the re-introduction of the BDR had minimal impact on rates of assault, maltreatment, or sentinel injuries in children and adolescents. To ensure long-term harm mitigation from alcohol use, a combination of evidence informed alcohol policies that address the price and availability of alcohol in a comprehensive framework, along with measures which address the underlying social determinants of unregulated drinking and health more broadly will assist in reducing alcohol related harm in both children and adults. [ABSTRACT FROM AUTHOR]

Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use. The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood. Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase. Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs–childhood sexual abuse in particular–was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use. This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities. • Childhood adversity correlates with cannabis use, with more severe ACEs increasing risk of adult cannabis use disorder. • Inconsistent methods of measuring cannabis use and ACEs hinder result comparison, affecting reliability. • Adult primary care screening can identify those needing specialized care due to childhood trauma. • Studying causation and ACEs' impact on cannabis use in diverse groups are curcial for better understanding. [ABSTRACT FROM AUTHOR]

As digitalization has made it easier to produce, copy, and distribute child sexual exploitation material (CSEM), the possession and distribution of child sexual abuse images has become more widespread. Thus, the need to assess the risk of subsequent sex offenses – above all, sexual abuse of children by individuals who have been convicted of CSEM offenses – becomes more and more important. The main objective of this paper is to contribute to the understanding of the respective size of two groups of offenders: first, offenders who commit CSEM offenses without ever crossing the line to sexual abuse of children, and second, so-called crossover offenders, that is, individuals who commit CSEM offenses and engage in child sexual abuse. Identification of differences between these two groups facilitates analyzing the risk that someone convicted of a CSEM offense might in the future sexually assault children. We used data from the German Federal Central Criminal Register (Bundeszentralregister), a data set that includes information about all persons convicted of any criminal offense, including "child pornography" offenses, by a court in Germany. For persons convicted of CSEM offenses only, with no additional concurring sex offenses, the rate of subsequent convictions for child sexual abuse is very low (1.1 % after a six-year follow-up period, adult offenders). This risk is even lower if offenders are older than 30 years of age, and it is slightly higher for offenders with previous offense-specific convictions (i.e., previous sex offenses). The mere existence of a conviction for a CSEM offense is not an indication that the convicted person poses a significant risk of committing child sexual abuse. To pinpoint such a risk more accurately, the following factors should be examined: the existence of offense-specific prior records, the presence of crossover-offending in the form of concurring offenses, and the age of the offender. [ABSTRACT FROM AUTHOR]

Abstract Considering the inherently hazardous nature of some artisanal fishing and farm work in Ghana, there is sometimes a thin line between what is considered child work and child labour. I drew on literature exploring cultural relativism and human rights and the concept of the margin of appreciation in considering whether child labour violates human rights. I aimed to establish parental perceptions of child labour and human rights in rural and urban Ghana amongst 60 government officials, NGO representatives, and both parents whose children were/were not involved in child labour. The average age of participants was 31 years. Semistructured interviews were conducted with parents (10), stakeholders (10), focus groups (30); and participant observation techniques (10) utilised to gather the needed data and purposively sampled across rural areas (Ankaase, Anwiankwanta and Kensere), and urban areas (Jamestown, Korle Gonno and Chorkor) in Ghana. Interviews were recorded, transcribed utilising a framework approach as the main data analysis method. The paper finds that children are engaged in work to teach them work ethics as most parents consider work socialisation as beneficial for children and society. The paper also finds that knowledge of human rights makes parents more committed to children's welfare. Overall, the paper finds that sensitivity to the economic and cultural context is important in understanding the issue of child labour and, more generally, in applying the United Nations Convention on the Rights of the Child (UNCRC) and working out the parenting policies and practices that are in the best interests of the child. [ABSTRACT FROM AUTHOR]

Violence against children (VAC) remains an urgent global dilemma and researchers and policymakers alike continue to work tirelessly to devise strategies aiming to end VAC. However, the perspectives and expertise of children themselves remain underrepresented in the drafting and implementation of these strategies against VAC. This paper draws attention to the marginalization of children living outside of family care and centers their perspective. This study aimed to characterize the forms of violence experienced by children living outside the family setting in Uganda, from the perspective of children themselves. The paper seeks to position the voicing of this perspective as a form of resistance against VAC from a decolonial perspective. Participants and Setting: The participatory research process included a total of 94 participants in various urban study sites in Kampala, Uganda. The research team completed this qualitative study within a youth-driven participatory action research (YPAR) framework. Data collection techniques included interviews, focus groups, participatory visual methods and social cartography. Children living outside of family care experience grave forms of emotional, physical and sexual violence. Child participants present survival strategies that can inform future research and policies on violence prevention practice. The illustration of explicit violence outlined in this study represents a form of resistance children take against their perpetrators. The participatory youth researcher team urges future research and policy addressing VAC in Uganda to center these perspectives and expertise of children and adolescents in both programmatic and research initiatives aiming to end violence against children. • How to center the perspectives of children in decolonial VAC research and prevention practice • Data on types of VAC, including perpetrators and urban contexts of adversity • Suggestions from children for prevention practice that center narratives of child-led resistance [ABSTRACT FROM AUTHOR]

Socioeconomic status and poverty are strongly associated with Child Maltreatment. Multiple studies have described the effects of working tax credits on Child Maltreatment with heterogeneous results. There is yet to be a comprehensive review of this research. This study aims to review all research which explores the effect of working tax credits on child maltreatment. Three databases (Ovid Medline, Scopus and Web of Science) were searched. Title and abstracts were screened according to a set of eligibility criteria. Data were extracted from eligible studies, and risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool. Results were synthesised narratively. Nine studies were included. Of these, five papers investigated overall reports of child maltreatment, with three finding a positive effect of tax credits. Results suggested a protective effect against child neglect, however, no significant effect was found with respect to physical or emotional abuse. Three of four papers found that working tax credits resulted in decreased rates of entry to foster care. Mixed results were found with respect to self-reported child protective services contact. A range of methodological and temporal differences between studies was identified. Overall, some evidence found that in work tax credits are protective against child maltreatment and that they are most effective in reducing neglect. Policymakers can take courage in these results, as they represent an example whereby the "risk factors" of child maltreatment can be countered in order to reduce rates of it. [ABSTRACT FROM AUTHOR]

The research pertaining to racial disparities for Black families in child welfare is relatively limited in Canada. Recent research reveals that the overrepresentation of Black families in Canadian child welfare systems typically begins at the reporting or investigation stage and continues throughout the child welfare service and decision-making continuum. This research is occurring against the backdrop of increasing public acknowledgement of Canada's historic anti-Black policy-making and institutional relationships to Black communities. Though there is increased awareness about anti-Black racism, there has been limited exploration of the connection between anti-Black racism in child welfare legislation and how this policy generates disparities for Black families in both child welfare involvement and outcomes – this paper seeks to fill this gap in knowledge. The objective of this paper is to explore the entrenchment of anti-Black racism within the child welfare system by critically assessing the language and absence of language within the guiding legislative and implementation policies. Utilizing a critical race discourse analysis method, this study explores the entrenchment of anti-Black racism within the Ontario child welfare system by critically assessing the language and absence of language within the guiding legislative policies that shape practice for Black children, youth, and families. The findings revealed that though the legislation does not explicitly address anti-Black racism, there were instances where the legislation indicated that race and culture may be considered in responding to children and families. The lack of specificity, particularly in the Duty to Report, has the potential to contribute to disparate reporting and decision-making for Black families. Policy makers should acknowledge the history of anti-Black racism that informed the development of the legislation in Ontario and move towards tackling systemic injustices that disproportionately affect Black families. More explicit language will shape future policies and practices to ensure that the impact of anti-Black racism is considered across the child welfare continuum. [ABSTRACT FROM AUTHOR]

The Keep Children and Families Safe Act amendment to the Child Abuse Prevention and Treatment Act (CAPTA) of 2003 mandated children under age three who are involved with Child Welfare (CW) to receive a referral to the system for early intervention (EI). While there is strong rationale for providing developmental services to young children and families impacted by maltreatment, the early implementation of this policy brought about many challenges related to interagency coordination and readiness of providers to provide cross-systems care. Currently, as the system and providers within the system recover from the effects of Covid-19, a predicted increase in need of services may exacerbate historical gaps in the provision of services to families involved with CW. This policy-focused paper explores issues impacting CW and EI providers who coordinate care between CW and EI services. This paper provides a historical examination of these challenges and proposes an approach for improving developmental services for families referred from CW, specifically through the lens of addressing resources and supports available to providers. The proposed approach includes an increase and reprioritization of resources to support provider readiness and well-being. By focusing on support for providers, the authors propose a reduction of stress and improvement of services at each level of the "well-being" system. [ABSTRACT FROM AUTHOR]

Exposure to multiple forms of violence is common amongst adolescents from socioeconomically disadvantaged communities in South Africa. Adolescents’ exposure to violence at home, in school and in their communities can lead to detrimental outcomes in education. In particular, adolescents who are more frequently exposed to multiple forms of violence are at risk of school delay. This paper investigates the potential for supportive parenting to protect against adolescents’ school delay in this context. With this aim, this paper applies structural equation modelling to a sample of 503 adolescents exposed to multiple forms of violence from 40 socioeconomically disadvantaged communities. Adolescents’ self-report data on child abuse in the family, school and community, and adolescents’ perceptions of positive parenting, consistent discipline, good monitoring, parental involvement and social support were analyzed. Results showed that perceptions of more positive parenting and consistent discipline moderated the relationship between more frequent exposure to multiple forms of violence and school delay. Our findings suggest that supportive parenting has the potential to protect against school delay for poly-victimized adolescents in South Africa. [ABSTRACT FROM AUTHOR]

Geographical variation exists in violence experienced by children and young people; however, there is limited research applying geospatial techniques to study this variation, and the methodological quality of this body of work is unclear. This study aimed to review the application of geospatial analysis in research on violence against children (VAC) and evaluate how essential methodological aspects are reported. Twelve databases were searched for studies on VAC using geospatial techniques. Two independent reviewers screened the papers for eligibility. Findings were narratively synthesised. Sixty studies were included. Six studies estimated the prevalence of VAC and 54 investigated the associations between VAC and covariates. Most studies were conducted in the US (68 %), and the broad definition of 'child maltreatment' (53 %) was the most common form of violence explored. Most studies (83 %) used administrative data, whereas 23 % used an ecological study design to estimate the associations between risk factors and official reports of VAC. Frequentist modelling approaches were used in 54 % of the studies, and 47 % investigated VAC at census tract level. Model fit metrics were reported in 69 % of studies. Current knowledge of the geographical distribution of VAC is severely limited because of the reliance on administrative data, which vastly underestimates the prevalence of VAC compared with self-reports and poor reporting of quality characteristics. There is a huge opportunity for applying geospatial methods in VAC research in diverse geographic contexts. Future research must adopt rigorous and standardised approaches to model fitting and validation and make better use of self-reported data. [ABSTRACT FROM AUTHOR]

Hazardous child labor in Nepal is a serious concern, particularly in the brick kiln industry. Although a range of interventions have been implemented in Nepal to address hazardous child labor, there is a lack of research to both measure success and shape further development in interventions that integrate sound child protection practices to ensure the wellbeing of all children. This paper provides a review of the literature outlining interventions for children working in brick kilns in Nepal, and presents preliminary case study findings of one current intervention in the Kathmandu Valley. The paper highlights the strength of applying foundational child protection principles and advocates for the development and implementation of future programs underpinned by broad civil society principles within a child rights and protection framework. [ABSTRACT FROM AUTHOR]

This paper explores the well-documented relationship between child maltreatment and aggressive and criminal behavior, specifically examining several dimensions of maltreatment and cumulative child and family risk. Using data from the provincially representative Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), this paper utilizes a developmental lens to examine whether maltreatment dimensions and cumulative risk can differentiate maltreated young people who exhibit aggressive and criminal behaviors and those who do not. A total unweighted sample of 1837 substantiated maltreatment investigations was examined in this analysis using chi-square, t -test, and logistic regression. The findings indicate that 13% of maltreated children and youth served by the Ontario child welfare system exhibited aggression and 6% of maltreated adolescents were involved in the youth justice system. Aggressive children and youth were more likely to experience severe and co-occurring forms of maltreatment and to experience higher levels of cumulative child risk. In adolescence, youth exhibiting aggressive and/or criminal behavior commonly were investigated because of neglect, specifically because their caregivers were no longer willing or able to remain in a caregiving role. Implications for child welfare policy and practice are discussed. [ABSTRACT FROM AUTHOR]

This paper examines the realities and perspectives of a sample of 60 children born of wartime rape within the Lord’s Resistance Army (LRA), and currently living in northern Uganda. These children were born to mothers who were abducted by the LRA, held captive for extended periods of time, repeatedly raped and impregnated. The paper explores the multiple challenges that these children face in the post-war period including, rejection, stigma, violence, socio-economic marginalization, and issues of identity and belonging. Participants underscored the profound violence and deprivation that they experienced while in LRA captivity. However, because of post-war marginalization, participants individually and collectively articulated that wartime was better than peacetime. Multiple systems of support are needed to ensure the rights and protection of these children and importantly, to address and reverse young people’s perceptions that “war is better than peace”. [ABSTRACT FROM AUTHOR]

Objective Research on child protection recurrence has found consistent child, family, and case characteristics associated with repeated involvement with the child protection system. Despite the considerable body of empirical research, knowledge about why recurrence occurs, and what can be done to reduce it, is limited. Method This paper reviews the empirical literature and analyses the approaches of prior recurrence research. Four related conceptual challenges are identified: (1) a tendency to conflate child protection recurrence with repeated child maltreatment; (2) uncertainty about how best to operationalize and measure child protection recurrence in research; (3) inconsistency between prevailing explanations for the most frequently observed patterns of recurrence; and (4) difficulty in developing coherent strategies to address child protection recurrence based on research. Results Addressing these challenges requires a greater consideration of the effects of decision-making in the child protection system on recurrence. This paper proposes a methodology based in systems theory and drawing on existing administrative data to examine the characteristics of the child protection system that may also produce recurrence. [ABSTRACT FROM AUTHOR]

Research efforts are measuring various forms of online sexual abuse. There is a need to incorporate such measures of online sexual abuse into the calculation of overall prevalence rates for child sexual abuse. A sample of 2639 respondents aged 18-to-28 was recruited from a nationally representative online panel. Using an online questionnaire, respondents were assessed via self-report about 9 types of online sexual abuse in childhood and were also assessed with 2 questions that have been used to assess generic child sexual abuse prevalence in previous surveys. The addition of the online abuse to the generic questions about child sexual abuse raised the overall prevalence rate from 13.5 % to 21.7 %. The rate for females increased from 19.8 % to 31.6 % and for males from 6.2 % to 10.8 %. The largest independent contribution to the overall combined increase were the offenses involving non-consensual image sharing and voluntary online sexual interactions with an impermissibly older adult partner. The inclusion of the online sexual abuse exposures also increased the ability to identify the survivors with the highest levels of current psychological distress. The study highlights the importance of counting and including online sexual abuse in efforts to estimate the overall prevalence of childhood sexual abuse. The paper proposes 2 or 3 questions that could be added to sexual abuse questionnaires to assess these online offenses efficiently. [ABSTRACT FROM AUTHOR]

Researchers and policymakers have identified adverse childhood experiences (ACEs) like abuse, neglect, and household dysfunction as a contributing factor to poor mental health outcomes for children. Positive childhood experiences (PCEs) like open family communication styles, having the ability to live and play in a safe, stable, and protective environment, having constructive opportunities for social engagement, and receiving mentorship from adults have been found to improve the mental health of children. This paper explores the role of ACEs and PCEs on the mental health outcomes of children. A sample of 22,628 children ages 6–17 from the National Survey of Children's Health (2017–2020) was used to explore the relationship between PCEs and ACEs and the mental health of children. Logistic regression analysis is used to model the effect of PCEs and ACEs on the odds of child mental health diagnoses. Findings indicate that with each additional ACE, there was a significant increase in the odds of reporting a MH condition (OR = 1.25, 95 % CI 1.09–1.43). Conversely, with each additional PCE, there is a significant decrease in the odds or reporting a MH condition (OR = 0.76, 95 % CI 0.68–0.84). There was also evidence that PCEs moderate the relationship between ACEs and reports of mental health conditions. When counts of ACEs are low, PCEs provide a protective effect on reports of mental health. But when the count of ACEs are high, children with higher numbers of PCEs have similar reports of mental health conditions. This study provides information about the moderating effect of PCEs on the relationship between ACEs and child mental health diagnosis with the goal of informing policies and interventions focused on ameliorating the growing crisis of children's negative mental health and well-being. Adverse childhood events (ACEs) like abuse, neglect and household dysfunction are known to negatively impact the mental health and well-being of children. Positive childhood experiences (PCEs), on the other hand, can positively influence the mental health and well-being of children. This study examines the association between adverse and positive childhood experiences to understand how they impact the mental health outcomes of children ages 6–17. Findings indicate that when ACEs are lower, the impact of PCEs are positive, but when ACEs are higher, PCEs do not make much difference in reports of mental health problems. [ABSTRACT FROM AUTHOR]

Placement stability is an important indicator of the functioning of an out-of-home care system. Previous research suggests that frequent placement changes have a negative impact on the outcomes for children and young people in out-of-home care. This paper examines the association between placement stability in out-of-home care and children's socio-emotional, cognitive and physical health outcomes. The Pathways of Care Longitudinal Study (POCLS) is the first large-scale prospective longitudinal study of children in out-of-home care in Australia. The sample consists of any study child who participated in any of the first three waves of the POCLS interview. Unweighted data from the first three waves of the POCLS interview and administrative data was used. A measure of placement stability was developed that accounted for both number of placements and length of time in care. Mixed effect modelling was used to examine the link between placement stability and children's developmental outcomes. Placement stability was found to have a significant association with socio-emotional, cognitive (non-verbal) and physical health (gross and fine motor skill) development. A number of other factors were also found to be associated with positive development. The findings support the existing evidence that placement stability is an important factor for children's development. Other factors including placement type, carer wellbeing and carer support are also important for positive development. Appropriate policy and practice intervention to support children and families to improve placement stability is fundamental to achieving positive developmental outcomes for children in out-of-home care. [ABSTRACT FROM AUTHOR]

The Aotearoa New Zealand child protection system consistently fails Māori (Aotearoa New Zealand's Indigenous peoples), with recent reports calling for fundamental changes. Those longer-term shifts are necessary, but short-term changes are also needed. One such change is a shift in the way child protection decisions are made, and the ways in which tamariki (children) and whānau (families) are involved in those processes. This research sought to explore the views of a small group of Māori people with experience of the child protection system on one overarching question, "how should decisions about the safety and wellbeing of tamariki Māori be made, and what role should whānau and tamariki themselves play in that process?" Eight semi-structured interviews were conducted, seven of which were in person and one of which took place online. All participants were Māori, and all of them had involvement with the child protection system in either a personal or a professional capacity. Two of the participants were young people themselves. Three overarching themes were identified: that the voices of tamariki, whānau and kaimahi (professionals) all have a place, but the current system doesn't strike the right balance, that the value of tikanga (Māori cultural values and practices) cannot be understated, but care is needed for whānau who may not know that tikanga, and that the challenges experienced by whānau in this context are often intergenerational. The paper concludes with a discussion of implications for law and policy. [ABSTRACT FROM AUTHOR]

Rich cultural and traditional practices make interpersonal relationships vital for American Indian (AI) youth. Social relations and multigenerational networks (i.e., peer, family, kinship, and community) remain a salient fixture of AI culture, survival and thriving in reservation communities. Research in other populations has demonstrated how social networks impact youth risk and resilience, but data are lacking on AI adolescent networks. Intergenerational trauma from settler colonialism leads some AI youth to early initiation of substance use and subsequent substance misuse, along with disproportionately high risk for suicide and vulnerability to witnessing and experiencing violence. Using network data to develop prevention strategies among this population is a promising new avenue of research. In this study protocol paper, we describe the rationale and methodology of an exploratory study to be conducted with American Indian 9th and 10th graders at three schools on a Northern Plains reservation. This mixed methods study will collect quantitative social network surveys (N = 300) and qualitative interviews (n = 30). The study will examine the extent to which existing social network theories and data metrics adequately characterize AI youth networks or how they may need to be expanded for this population. Associations of network characteristics with risk and protective factors for substance use, exposure to violence, and suicide will also be examined. This innovative methodological approach holds promise for informing the development of effective preventive approaches to address co-occurring risks for substance use, violence and suicide among AI adolescents. Understanding processes that impact social networks among AI adolescents can promote culturally resonant social relationships that may support better outcomes for youth. [ABSTRACT FROM AUTHOR]

Simulation models are an important tool used in health care and other disciplines to support operational research and decision-making. In the child protection literature, simulation models are an under-utilized source of research evidence. In this paper, we describe the rationale for and the development of an agent-based simulation of a child protection system in the US. Using the investigation, prevention service, and placement histories of 600,000 children served in an urban child welfare system, we walk the reader through the development of a prototype known as OSPEDALE. The governing equations built into OSPEDALE probabilistically simulate the onset of investigations. Then, drawing from empirical survival distributions, the governing equations trace the probability of subsequent interactions with the system (recurrence of maltreatment, service referrals, and placement) conditional on the characteristics of children, their assessed risk level, and prior child protection system involvement. As an initial test of OSPEDALE 's utility, we compare empirical admission counts with counts generated from OSPEDALE. Though the verification step is admittedly simple, the comparison shows that OSPEDALE replicates the empirical count of new admissions closely enough to justify further investment in OSPEDALE. Management of public child protection systems is increasingly research evidence-dependent. The emphasis on research evidence as a decision-support tool has elevated evidence acquired through randomized clinical trials. Though important, the evidence from clinical trials represents only one type of research evidence. Properly specified, simulation models are another source of evidence with real-world relevance. [ABSTRACT FROM AUTHOR]

Increases in child welfare investigations involving children's exposure to intimate partner violence (IPV) in Ontario are likely the result of three factors: 1) changes to legislation, policy, and assessment instruments; 2) increased awareness of the risks of exposure to IPV for children, and 3) referrals from professionals (e.g., police). Using data from 6 cycles of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) (1993, 1998, 2003, 2008, 2013, and 2018), this paper will examine the changes of the incidence rates of IPV exposure, providing important context for a type of investigation that is not well understood in Ontario. The incidence of investigations where the primary concern of the investigating worker is IPV was derived and compared across OIS cycles. Investigation were compared across cycles using incidence counts. After the nearly 2-fold increase of investigations for all maltreatment types in Ontario between 1998 and 2003, IPV investigations are the only type that continue to increase. There is a growing gap between these investigations and substantiating child maltreatment. Rates of placement have not changed over time, remaining low. Rates of transfers and referrals have increased but not significantly. The continued growth in the rate of child welfare investigations involving exposure to IPV as well as the overwhelming endorsement of substantiated exposure to IPV, while maintaining the same proportion of transfers to ongoing child welfare services and low placement rates, is a significant concern for Ontario. [ABSTRACT FROM AUTHOR]

During the past decade, there have been increased efforts to implement evidence-based practices into child welfare systems to improve outcomes for children in foster care and their families. In this paper, the implementation and evaluation of a policy-driven large system-initiated reform is described. Over 250 caseworkers and supervisors were trained and supported to implement two evidence-based parent focused interventions in five private agencies serving over 2,000 children and families. At the request of child welfare system leaders, a third intervention was developed and implemented to train the social work workforce to use evidence-based principles in everyday interactions with caregivers (including foster, relative, adoptive, and biological parents). In this paper, we describe the policy context and the targeted outcomes of the reform. We discuss the theory of the interventions and the logistics of how they were linked to create consistency and synergy. Training and ongoing consultation strategies used are described as are some of the barriers and opportunities that arose during the implementation. The strategy for creating a path to sustainability is also discussed. The reform effort was evaluated using both qualitative and quantitative methods; the evaluation design, research questions and preliminary results are provided. [ABSTRACT FROM AUTHOR]

A series of papers using data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) explored the influence of clinical and organizational characteristics on the decision to place Aboriginal children in out-of-home placements at the conclusion of child maltreatment investigations. The purpose of this paper is to further explore a consistent finding of the previous analyses: the proportion of investigations involving Aboriginal children at a child welfare agency is associated with placement for all children in that agency. CIS-2008 data were used in the analysis, which allowed for inclusion of previously unavailable organizational and contextual variables. Multi-level statistical models were developed to analyze the influence of clinical and organizational variables on the placement decision. Final models revealed that the proportion of investigations conducted by the child welfare agency involving Aboriginal children was again a key agency-level predictor of the placement decision for any child served by the agency. Specifically, the higher the proportion of investigations of Aboriginal children, the more likely placement was to occur for any child. Further, this analysis demonstrated that structure of governance, an organizational-level variable not available in previous cycles of the CIS, is an important agency-level predictor of out-of-home placement. Further analysis is needed to fully understand individual and organizational level variables that may influence decisions regarding placement of Aboriginal children. [ABSTRACT FROM AUTHOR]

While the low educational attainment of out-of-home care youth (OHC youth) has been well established, less is known about the role mental health problems play in shaping their educational pathways. This paper examines how mental health problems influence OHC youths' educational pathways and how this influence can be understood. The paper draws on a mixed-methods longitudinal study of OHC youth in Denmark. Sequence and cluster analyses and logistic regressions of survey data (n = 525) and administrative registries were used and combined with narrative analyses of two qualitative cases. We identified four educational pathways: 1) the typical academic pathway, 2) the typical vocational pathway, 3) the disrupted pathway, and 4) the non-completion pathway. Moreover, mental health problems were found to be an essential predicting factor of entrance into the disrupted pathway (3) or the non-completion pathway (4). For youths who entered the disrupted pathway (3), mental health problems appeared to be the key predicting factor. Even though mental health problems also played a fundamental role in entrance into the non-completion pathway (4), we also found a more complex intersection of predictive factors, such as care history, lack of social support, and other social problems, such as cannabis abuse and homelessness. The findings showed a need for a stronger focus on how mental health problems among OHC youths impact their educational pathways. Mental health problems played a key role in OHC youths' transition to independent adulthood and, consequently, their chances for a better life. [ABSTRACT FROM AUTHOR]

Despite contested definitions, trauma is often conceptualized as an event that shocks or overloads human systems, shaping memory and meanings as the body and mind attempt to cope and survive. Adoption is often the presumed redress for childhood trauma. Thus, few scholars have examined how, or if, some conditions of adoption or the status itself might involve unique traumas or adversities. In this paper, I argue that the condition of being transracially adopted can represent intersectional minoritized statuses, which in turn activate potentially distinct formations of epistemic trauma— structurally and relationally transmitted harms to a person as a knower and to their capacities for claiming, making sense of, and healing through their lived experiences. I draw from my personal and professional standpoints as a black, mixed-race, woman who was transracially adopted from public foster care as an infant, became a child welfare caseworker and later, a child welfare scholar. Using a critical and reflexive autoethnographic method I ask how theories of epistemic injustice might help to highlight conditions tied to the status "transracial adoptee" that distinguish adoption-specific trauma. By reflexively analyzing my experiences in the context of extant theory and research, this paper brings theories of epistemic injustice into conversation with an emic perspective on adoption. In my experience, "transracial adoptee" and "mixed race" operated as statuses that occasioned epistemic injustices. I propose these conditions can become traumatic when they chronically and structurally disenfranchise claiming and cultivating folkways essential to one's healing and resilience across the life course. This paper is a call to invest in advancing epistemologies of adoption and theories of trauma that are anchored within diverse adoption experiences. I also invite future scholarship to explore epistemic injustice in adoption as trauma, and to identify and disrupt the many spaces in which it may be enacted culturally, relationally, familially, and in a society through its laws, policies, practices, and scientific knowledge. [ABSTRACT FROM AUTHOR]

Mock (simulated) interviews can be used as a safe context for trainee interviewers to learn and practice questioning skills. When mock interviews are designed to reflect the body of scientific evidence on how questioning skills are best learned, research has demonstrated that interviewers acquire relevant and enduring skills. Despite the importance of this exercise in learning interview skill and its prevalence as a learning tool in other fields such as medicine and allied health, there has been relatively little discussion about mock interviews from an educational perspective in investigative interview training. This paper addresses that gap by providing the first comprehensive overview of the way mock interviews have been used in training interviewers of children. We describe the research that supports their utility, and the various ways they can be implemented in training: providing insight to learners; allowing opportunities for practice, feedback, and discussion; and as a standardized way to assess skill change over time. The paper also includes an overview of the cutting-edge use of avatars in mock interviews to enhance efficiency, provide unique learning experiences, and ultimately reduce training costs. We explain why avatars may be particularly useful in basic training, freeing up human trainers to facilitate mock interviews around advanced topics and discussion. [ABSTRACT FROM AUTHOR]

According to the "differential vulnerability hypothesis," individuals in adverse socioeconomic circumstances as less mentally resilient to stressful events. However, several recent papers radically challenged this hypothesis based on the accumulated literature on stress inoculation and presented cases in which lower-SES adolescents appear to be less vulnerable to suicidal ideation in the face of interpersonal aggression. We re-examine the link between psychological vulnerability to acute stressors and SES using yearly longitudinal public survey data from South Korea. This is a secondary data analysis of a multi-year public health panel dataset on South Korean adolescents. Logistic regression is used to examine the association between suicidal ideation and a range of predictor variables, with a particular focus on the interaction between bullying victimhood and log family income. These variables and the sample were chosen for consistency with recent revisionist research. We reaffirm the well-established finding that bullying victimhood strongly and consistently increases the odds of suicidal ideation (OR = 1.859, p < 0.01). However, we find no evidence in favor of the traditional "differential vulnerability hypothesis" or the recently proposed counterhypothesis. A subsample analysis from the latest wave (W4–W5) did produce results that are consistent with recent revisionist findings, but we suggest this is likely a false positive. There appears to be no systematic association between SES and vulnerability to suicidal ideation in the face of peer aggression among South Korean adolescents. The claim that lower-SES adolescents may be more resilient to stressful events stands on limited empirical support. • Bullying victimhood is an important acute stressor of adolescent suicidal ideation. • Recent studies reported that higher SES raises vulnerability to suicidal ideation. • We conduct confirmatory analysis of the recent proposal with data from S. Korea. • We fail to find evidence that the effect of bullying victimhood varies by SES. • The idea that lower-SES adolescents are tougher stands on weak empirical support. [ABSTRACT FROM AUTHOR]

A history of childhood emotional abuse (CEA) is prevalent among adults with affective disorders; therefore, a comprehensive measure of it is vital. The Rating of Emotional Abuse in Childhood Questionnaire (REACH) was developed to assess history of CEA in relation to parental behaviours of threat, ignoring, humiliation/denigration, scapegoating, antipathy, and overcontrol/conditionality in a single measure. This paper investigated the psychometric properties of REACH in a community sample and proposes values for classifying individuals as high-risk for CEA. A convenience sample of N = 483 adults (Female, 78.3%) was recruited to complete questionnaires that included the REACH alongside measures of mental health, insecure attachment, emotion regulation, and childhood abuse. A subset of participants (n = 198) completed the REACH 7 days later. Factor analysis indicated a 2-factor model provided a good fit. Factors were named 'threatening' and 'devaluing'. A total scale score of CEA was also recommended. The threatening, devaluing, and total scales demonstrated strong psychometric properties with high internal consistency, test-retest reliability, and convergent validity, while cutoff values for identifying a high-risk CEA group demonstrated good discriminant utility. The results support REACH as a valid measure and suggest a history of CEA should be measured in relation to threatening and devaluing CEA as they represent unique dimensions of CEA even though they often co-occur. • A reliable measure of history of childhood emotional abuse (CEA) is vital. • The Rating of Emotional Abuse in Childhood (REACH) questionnaire retrospectively assesses different CEA experiences. • REACH is a brief reliable measure of threatening, devaluing, and overall CEA experiences. [ABSTRACT FROM AUTHOR]

Negative life events in early life have a cumulative effect on health trajectory changes in middle and old age, and some scholars have used life course theory as a guide to empirically explore the effect of childhood adversity or adverse experiences on depression in the elderly, but few study focuses on violence within the family. To explore the influence mechanism of domestic violence experience on depression in later life in middle-aged and elderly people, and to provide academic support for the whole society to pay attention to good family function and intergenerational interaction, and to propose whole-life health promotion strategies. This paper selects the 2014 life course survey data and 2018 cross-sectional data of the China Health and Elderly Care Longitudinal Survey for analysis, and the research objects are middle-aged and elderly people aged 45 and above. Based on a retrospective survey of 3008 middle-aged and elderly people, this study analyzed the influence path of domestic violence on depression level in childhood by using multiple mediation models, and used the Bootstrap method to test the significance of indirect effects. Based on controlling for gender, age, age square, household registration, marital status, community environment and education level, childhood domestic violence had a direct positive effect on depression level in the elderly (P < 0.001), and childhood domestic violence also had an indirect effect on the depression level of the elderly through childhood health status, income logarithm and IADL (P < 0.05). As a life experience in early life, childhood domestic violence has a cumulative effect on depression in middle-aged and elderly people, is an important risk factor for depression, and has an important impact on mental health in later life. [ABSTRACT FROM AUTHOR]

The responsibility of local authorities in England to provide children in care with stable, local placements has become increasingly difficult due to the rising number of children in need of care and a shortage of available placements. It is unclear if the trend of outsourcing children's social care to private companies has exacerbated this challenge. This paper examines how the outsourcing of children's social care to the private market has influenced placement locality and long-term stability over time. We created a novel dataset of multiple administrative data sources on the outsourcing, placement locality and stability, and characteristics of children in care between 2011 and 2022. We conducted time-series fixed-effects regression analysis of the impact of for-profit outsourcing on placement locality and stability from 2011 to 2022. Our fully adjusted models demonstrate that for-profit outsourcing is consistently associated with more children being placed outside their home local authority and greater placement instability. We found that an increase of 1 % point of for-profit outsourcing was associated with an average increase of 0.10 % points (95 % CI 0.02–0.17; p = 0.01) more children experiencing placement disruption, and 0.23 % points (95 % CI 0.15–0.30; p < 0.001) more children being placed outside their home local authority. We estimate that an additional 17,001 (95 % CI 9015–24,987) out-of-area placements can be attributed to increases in for-profit provision. Our analyses show that placement stability and distance have deteriorated or stagnated over the last decade, and that the local authorities that rely most on outsourcing have the highest rates of placement disruptions and out-of-area placements. • Social care services struggle to find children suitably located and stable care. • England's services are frequently, and increasingly, outsourced to for-profits. • For-profit outsourcing is linked with more placements away from the child's home. • For-profit outsourcing is linked with more unstable, short-term placements. • Further outsourcing to for-profits may not improve quality of care for children. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Current research suggests that effective psychotherapies for Self Injurious Behavior (SIB) in the context of Borderline Personality Disorder (BPD) contain generic common elements which are responsible for their success. Because of the links between BPD, SIB, and child abuse, it is likely that these common elements can also be applied to the psychotherapy of survivors of child abuse who engage in SIB. This article will reviews several common elements which recent literature has suggested are important and suggest techniques by which community practitioners can incorporate these elements into their practice with adult survivors of child abuse who engage in SIB. Methods: This article summarizes recent key articles on common elements in psychotherapy for BPD. It refers to the treatment manuals for the specialized psychotherapies as well as General Psychiatric Management (GPM), a novel and more accessible approach, to further elaborate on these common elements and their potential usefulness in the community. Results: This paper identifies seven common elements which appear both in the recent literature and in GPM: a coherent model to understand SIB, an active therapeutic stance, validation balanced with change-oriented techniques, encouragement of self-agency, establishment of a connection between actions and feelings, a method for assessing lethality, and access to supervision. By referring to current treatment strategies for BPD, this paper suggests methods by which these common elements can be incorporated into practice by community practitioners working with adult survivors of child abuse who engage in SIB. Conclusions: Despite a lack of access to intensive training or the resources required for multimodal treatments, there are many strategies from established treatments for BPD which can be used by community practitioners to address SIB. Because treatments for BPD often focus on addressing SIB, and because adult survivors of child abuse often engage in SIB, whether or not they have BPD, it is likely that these techniques are applicable to practice with adult survivors. Further research is, however, necessary to empirically examine these common elements and their potential utility. [Copyright &y& Elsevier]

Abstract: Objective: This paper builds upon the analyses presented in two companion papers (Fluke et al., 2010; Fallon et al., 2013) using data from the 1998 and 2003 cycles of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-1998 and CIS-2003) to examine the influence of clinical and organizational characteristics on the decision to place a child in out-of-home care at the conclusion of a child maltreatment investigation. This paper explores various model specifications to explain the effect of an agency-level factor, proportion of Aboriginal reports, which emerged as a stable and significant factor through the two data collection cycles. It addresses the issue of data comparability between the two cycles and explores various re-specifications and descriptive analyses of reported models to evaluate their solidity with regards to the sampling schemes and the precise contribution of a multi-level specification. Methods: The decision to place a child in out-of-home care was examined using data from the CIS-2003. This child welfare dataset collected information about the results of nearly 12,000 child maltreatment investigations as well as a description of the characteristics of the workers and organization responsible for conducting those investigations. Multi-level statistical models were developed using MPlus software, which can accommodate dichotomous outcome variables and are more reflective of decision-making in child welfare. The models are thus multi-level binary logistic regressions. Results: Final models revealed that two agency-level variables, ‘Education degree of majority of workers’ and ‘Degree of centralization in the agency’ clarify the nature of the effect of ‘Proportion of Aboriginal reports’, a stable, key second level predictor of the placement decision. The comparability of the effect of this agency-level variable across the 1998 and 2003 cycles becomes further evident through this analysis. By using a unified database including both cycles and various specifications of models, the comparability was found to be robust, in addition to clarifying the precise contribution of a multi-level specification. Conclusions: This third paper in a series establishes the ‘Proportion of Aboriginal reports’ received by the child welfare agency as an important agency level predictor associated with a child''s likelihood of being placed in the Canadian child protection system. While the more complex models give support to the notion that unequal resources subtend those results, more analyses are needed to confirm this hypothesis. Unequal resources for agencies with larger Aboriginal caseloads may explain the persistence of the results. These findings suggest that specific resource constraints related to worker education may be explanatory. [Copyright &y& Elsevier]

Abstract: Objectives: This article reviews the available evidence regarding the efficacy, effectiveness, ethics, and sustainability of approaches to strengthen systems to care for and protect children living outside family care in low- and middle-income countries. Method: For trafficked children, children of and on the street, children of conflict/disaster, and institutionalized children, a systems framework approach was used to organize the topic of sustainable approaches in low- and middle-income countries and addresses the following: legislation, policies, and regulations; system structures and functions (formal and informal); and continuum of care and services. The article draws on the findings of a focal group convened by the U.S. Government Evidence Summit: Protecting Children Outside of Family Care (December 12–13, 2011, Washington, DC), tasked with reviewing the literature on systems, strategies, and interventions for sustainable long-term care and protection of children with a history of living outside of family care in low- and middle-income country contexts. The specific methodology for the review is described in the commentary paper (Higgs, Zlidar, & Balster, 2012) that accompanies these papers. Results: For the most part, the evidence base in support of sustainable long-term care for the populations of interest is relatively weak, with some stronger but unreplicated studies. Some populations have been studied more thoroughly than others, and there are many gaps. Most of the existing studies identify population characteristics, needs, and consequences of a lack of systemic services to promote family-like care. There is some evidence of the effectiveness of laws and policies, as well as some evidence of service effectiveness, in improving outcomes for children outside of family care. Conclusions: Despite the weaknesses and gaps of the existing research, there is a foundation of research for going forward, which should focus on developing and implementing systems for these most vulnerable children. The evidence reviewed indicates that child protection systems should aim for appropriate, permanent family care (including reunification, adoption, kinship care, or kafalah) for children in order to secure the best environment for a child''s developmental prospects. Evidence also suggests that the quality and duration of care, including both permanent family care and alternative care, are important regardless of setting. The diversity of political, socioeconomic, historical, regional, community, and cultural contexts in which child protection systems operate need to be taken into account during programming and research design. [Copyright &y& Elsevier]

Abstract: Methodologies to identify and enumerate children outside of family care vary as do the vulnerability categories of the children themselves. Children outside of family care is a broad term encompassing children absent of permanent family care, e.g., institutionalized children, children on/of the street, child-headed households, separated or unaccompanied children, trafficked children, children working in exploitive labor situations, etc. This paper reviews the various methodologies applied to identify and enumerate these often hidden and/or mobile populations. Methodologies that identify and enumerate children outside of family strive to meet two objectives: (1) to estimate the number and characteristics of a specific vulnerability category and (2) to determine eligibility to receive services. The paper reviews eight methodologies; six are categorized as survey sample methods (time-location sampling, capture recapture sampling, respondent driven sampling, the neighborhood method, household surveys, and establishment surveys) while two were labeled as data management systems (child labor management system, and databases of institutions). Each review includes a concise description of the methodology, its strengths and limitations, the most appropriate population it is suited to identify and/or enumerate, and any necessary conditions. Conclusions from these reviews advocate for tailoring a methodology (or a combination of methodologies) to the specific circumstances under which it is meant to identify or enumerate children outside of family care. In addition, further research and validation studies are needed to identify the conditions under which the strategies described here can be used and to develop appropriate protocols for utilization [Copyright &y& Elsevier]

Abstract: Recognizing the need for evidence to inform policies, strategies, and programs to care for vulnerable children, the U.S. Government convened an Evidence Summit on Protecting Children Outside of Family Care on December 12–13, 2011, in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used to achieve the goals of the Summit. A multistep process was undertaken to identify the appropriate evidence for review. It began by identifying crucial focal questions intended to inform low and middle income governments and the U.S. Government about effective systems for protecting children outside family care. This was followed by a systematic attempt to gather relevant peer reviewed and gray literature that would inform these focal questions. The search processes, methods used for screening and quality reviews are described. In addition, members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliographies. These teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. This was the first U.S. Government Evidence Summit originating in the U.S. Agency for International Development Global Health Bureau and valuable lessons were learned on the identification and assessment of evidence informing complex development challenges. [Copyright &y& Elsevier]

Adverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ). In this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity. Four hundred and ten adolescents (age 10–16 years old) from Malawi. The adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI). Taken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi =.20, p < 0,01; across subdomains (phi =.10, p < 0,01); partial agreement among children with the same caregiver (ICC =.43, p <.001) and correlation between ACE and depression (predictive validity; r =.35, p <.001); (c) information on the timing of the adversities ("last year" in addition to "ever") modestly improved the predictive value of the ACE-IQ in models of depression (from R 2 =.12 to.15, p <.001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r =.25, p < 0,01). Our findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context. [ABSTRACT FROM AUTHOR]

Abstract Background Child maltreatment research involves modeling complex relationships between multiple interrelated variables. Directed acyclic graphs (DAGs) are one tool child maltreatment researchers can use to think through relationships among the variables operative in a causal research question and to make decisions about the optimal analytic strategy to minimize potential sources of bias. Objective The purpose of this paper is to highlight the utility of DAGs for child maltreatment research and to provide a practical resource to facilitate and support the use of DAGs in child maltreatment research. Results We first provide an overview of DAG terminology and concepts relevant to child maltreatment research. We describe DAG construction and define specific types of variables within the context of DAGs including confounders, mediators, and colliders, detailing the manner in which each type of variable can be used to inform study design and analysis. We then describe four specific scenarios in which DAGs may yield valuable insights for child maltreatment research: (1) identifying covariates to include in multivariable models to adjust for confounding; (2) identifying unintended effects of adjusting for a mediator; (3) identifying unintended effects of adjusting for multiple types of maltreatment; and (4) identifying potential selection bias in data specific to children involved in the child welfare system. Conclusions Overall, DAGs have the potential to help strengthen and advance the child maltreatment research and practice agenda by increasing transparency about assumptions, illuminating potential sources of bias, and enhancing the interpretability of results for translation to evidence-based practice. [ABSTRACT FROM AUTHOR]

Abstract Background Child sexual abuse (CSA) rates have been declining since the 1990s (Dunne et al., 2003; Finkelhor & Jones, 2004, 2012; Jones et al., 2001). Discrepancies in contexts and measures complicate comparing CSA rates across jurisdictions and studies, and there is limited literature about trends in CSA in Canada. Objective Using data from the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS), the only source of provincially aggregated data in Ontario, Canada, that describes child welfare investigations, this paper provides information on reported and investigated CSA over the past 20 years. Participants and setting The OIS uses a file review methodology; information is collected directly from investigating child welfare workers. Methods A sample of child welfare agencies is selected for the study, and data are collected over a three-month period. Weights are applied to produce annual provincial estimates. Results The rates of investigated CSA in Ontario decreased between 1993 and 2013, from 5.20 (95% CI [3.94, 6.47]) to 1.81 (95% CI [0.97, 2.66]) children per 1000. During this time, the rate of all child maltreatment-related investigations doubled, from 21.41 (95% CI [18.38, 24.42]) to 53.32 ([29.61, 77.03]) children per 1000. Conclusions Unlike other forms of child maltreatment, the incidence of investigated CSA in Ontario declined since 1993. Substantiation rates for CSA investigations decreased more dramatically than the rate of all CSA investigations, which could indicate a true decline in rate or an inability to accurately identify cases of CSA. [ABSTRACT FROM AUTHOR]

Abstract Background Child sexual abuse (CSA) is a multi-dimensional problem. The search for best practice must consider the complexities surrounding CSA and its management in any particular society. Objective Data previously gathered from service providers on CSA service provision in Trinidad and Tobago identified key deficient issues in policy and practice. In this paper, researchers aimed to bridge the gaps identified, and effect changes to improve services for CSA using an action research methodology. Participants and setting Service providers from all sectors in governmental and non-governmental organizations in Trinidad and Tobago, who work with children at risk of CSA were involved in the process. Methods Researchers led the service providers into an awareness of their own practice through critical discussion of, and reflection on, the key deficient issues. The new knowledge generated, with guided input from evidenced-based best practice, led to the development of guidelines for management. Discussion of the practicability of the guidelines by service providers in multiple sectors generated more new knowledge that refined the management approach. Results The contextual knowledge obtained from service providers resulted in best practice guidelines for service providers that were culturally relevant and context-sensitive, adaptive and implementable, and allowed a seamless multidisciplinary response to CSA in Trinidad and Tobago within prevailing constraints. Conclusions Action research offers an effective approach to improve services for CSA through mobilization of service providers and changes in policy and practice. It is applicable in any setting and likely to be effective in any socio-cultural context. [ABSTRACT FROM AUTHOR]

Abstract Child maltreatment research varies considerably in how maltreatment is measured. Although researchers have advocated for improvements in maltreatment assessment, a first step is a clear understanding of the status on how the field operationalizes maltreatment. The current paper sought to achieve this goal through reviewing research on child maltreatment over a recent 10-year span to identify trends in maltreatment assessment and operationalization. Information on maltreatment measurement was extracted from 338 articles across three major journals devoted to publishing research on child maltreatment. Among the various definitional dimensions of maltreatment, type was the most common way maltreatment was operationalized, followed by severity, frequency, and chronicity, a stable trend across the 10-year span of review. The results indicated that the majority of studies measured maltreatment as consisting of multiple types, although some studies focused on one type of maltreatment as the indicator of child maltreatment. Further, the most common assessment method was the administration of a questionnaire or the combination of two questionnaires with the second most common being summaries from case file review. Recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Objectives: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings. Methods: In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). Case study findings: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized. Practice implications: Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social–political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective mobilization of an effective assessment able to inform programming. [Copyright &y& Elsevier]

Objective: To develop further the understanding of emotional abuse and neglect. Methods: Building on previous work, this paper describes the further development of a conceptual framework for the recognition and management of emotional abuse and neglect. Training in this framework is currently being evaluated. The paper also briefly reviews more recent work on aspects of the definition, harm caused by emotional abuse and neglect and threshold. Results: The paper arrives at a working definition as ‘persistent, non-physical, harmful interactions with the child by the caregiver, which include both commission and omission.’ There are many forms of harmful caregiver-child interactions, which can be placed in five categories, each category reflecting the fulfillment of one of the child's basic psycho-social needs and requiring a different therapeutic approach for its alleviation. The caregiver-child relationship is embedded within a psycho-social context. It is suggested that greater clarity can be gained about the child and family when information is sorted into the appropriate tiers of concerns: Tier 0 – Social & environmental factors, Tier I – Caregiver risk factors, Tier II – Caregiver-child interactions and Tier III – Child's functioning. It is further suggested that while intervention is required, this is directed towards protection, rather than providing immediate protection of the child. The work takes the form of a time-limited trial of therapeutic work to gauge the capacity of the caregivers to change. This initial work focuses Tiers 0–II. Statutory steps might be required in order to encourage the caregivers to engage. If insufficient progress is achieved, active child protection may be required which might include placing the child in an alternative family. However, some, usually older, children will remain in the emotionally abusive environment and they will require ongoing help and support. Conclusion: While a greater understanding of emotional abuse and neglect is now possible, further evaluation of the utility of this framework is suggested. [Copyright &y& Elsevier]