Parenting Support Needs Assessment: Screening for Child Maltreatment Risk in Young Families

ObjectivesThe objective of the study was to examine the Parenting Support Needs Assessment (PSNA) for content validity, internal consistency reliability, and clinical usefulness. The PSNA was designed for use by primary care clinicians who care for young children and their families, to identify families with risk factors for child maltreatment.MethodsPhase I of the study consisted of the content validity assessment by child maltreatment experts, and phase II was a pilot test of the PSNA and referral algorithm by nurse practitioners (NPs) for clinical usefulness. Data obtained during the pilot testing were used to examine individual PSNA items, establishing an estimate of internal consistency reliability and identify the instrument's clinical usefulness.ResultsThe PSNA instrument and referral algorithm was found to have content validity and clinical usefulness. The number of referrals to family support social service agencies increased from 4 to 22 over the pre-PSNA use (with different children) and the instrument exceeded the internal consistency reliability threshold of .80.ConclusionsThe PSNA instrument was found to be valid, reliable, and clinically useful in the primary care setting. The PSNA represents a significant step forward in screening for child maltreatment risk in families of young children during routine primary care.     

Neighborhood Characteristics, Child Maltreatment, and Child Injuries

The study reported here aimed to advance research methods by demonstrating the utility of observational rating scale to measure neighborhood physical and social characteristics. In a related vein, the study clearly points to the need for additional, focused research on neighborhood effects on child safety. The need to identify or develop the best possible indicators of child well-being, especially at small areas of geography is one of the more pressing challenges for indicators research.

Responding to Child Maltreatment: a Framework for Mapping Child Protection Agencies

While there is a growing number of international population surveys about rates of child maltreatment there is much less data on legal, health and social services responses to maltreatment. Agency surveys are a cost effective method for assessing this response in countries where there is limited administrative data available about child maltreatment reports, investigations and services. The first step in conducting such survey is to map out the network of agencies and organizations tasked with responding to child maltreatment, as part of a multi-stage sampling strategy to identify a representative sample of child maltreatment reports and investigations. This endeavor can be complex as a diverse universe of agencies are involved in protecting victimized children and supporting their families—government-run child protective services, child protection teams at hospitals, not-for-profit helplines, psychotherapists at private practices, and community-based child welfare organizations, to name a few examples. This paper offers a framework for mapping child protection along the dimensions of levels of authority, functions and processes. Beyond high-income countries with well-established child protection systems, it gives special consideration to informal structures such as councils of community leaders and non-governmental organizations’ consortiums in low-income countries.     

Child Maltreatment and Cannabis: Intersection in Pediatric Emergency Department Visits

Cannabis is the most commonly used illicit drug in the world. The use of cannabis continues to evolve, as it is available in a growing variety of forms and changing potencies. At the time of this writing, eleven states and the District of Columbia have legalized recreational cannabis use for adults. Studies of pediatric cannabis exposure after legalization have demonstrated an increase in related emergency department visits. Here we review some of the ways that pediatric cannabis exposure may present to the emergency care clinician, including accidental exposure, intentional exposure, drug facilitated sexual assault, commercial sexual exploitation of children, and caregiver use and impairment. We also review the ways in which substance abuse and child maltreatment intersect and illustrate how these examples of pediatric cannabis exposure should prompt consideration of child maltreatment.     

Child Protection in the United States: An Examination of Mandated Reporting of Child Maltreatment

Child protection is one of the key indicators of a society’s health. In the U.S. all states have enacted laws which require certain professionals who regularly come into contact with children to report suspected maltreatment. Passage of these laws has resulted in an unprecedented increase in the number of reports of child maltreatment made to U.S. child protective services (CPS), yet this increase has not been systematically studied to determine whether this increase in reports is actually reducing the incidence of child maltreatment. This paper describes and compares the reporting practices of four mandated reporting groups in the U.S. over a 3-year period. Data from the National Child Abuse and Neglect Dataset (NCANDS) were analyzed. NCANDS is a national database created by the US Department of Health and Human Services (DHHS) of reports of maltreatment made to child protective services agencies (CPS) in the US. Results indicate that each reporter group has a somewhat unique profile of reports and responses from the child protection agencies to which they report. Significant differences were found related to the type of maltreatment reported and the rate of report substantiation by CPS. While some differences can be easily explained, others require more research and have broad implications for the professional education and training of mandated reporters.     

Measuring Economic Hardship in Child Maltreatment Research: Evidence from Canada

Poverty is a frequently cited risk factor for child maltreatment. This review critically assesses how Canadian research on child maltreatment has operationalized economic hardship to improve understanding of the relationship between the two concepts. The review includes 16 studies between 1986 and 2011 using data reported by individuals, child protection workers, and third party sources such as Statistics Canada. Variables used to measure economic hardship included income, income source, perceived ability of income to meet needs, employment status, education achievements, and variables related to shelter such as number of moves and home ownership. Operationalizing economic hardship with these variables shows differing results—both in direction and magnitude—depending on the outcome variable. The knowledge base would be improved with more precise measurement of economic hardship variables.