Child abuse & neglect
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Child abuse & neglect · Dec 2013
Randomized Controlled TrialEffectiveness of specific factors in community-based intervention for child-witnesses of interparental violence: a randomized trial.
A community-based intervention with specific factors for children and parents exposed to interparental violence (IPV) was compared with a control intervention based on non-specific factors. We hypothesized that participation in an intervention with specific factors, focused on IPV, parenting and coping, would be associated with better recovery. IPV exposed children and parents were group randomized over a specific factors- and control intervention. ⋯ Treatment differentiation was assessed and both programs were significantly different on hypothesized effective factors. Higher treatment adherence in both programs did not result in a larger difference in recovery. IPV exposed children improve over the course and after participating in a community-based child- and parent program, but specific factors in intervention may not carry additional benefits when implemented in community settings.
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Child abuse & neglect · Dec 2013
A new protocol for screening adults presenting with their own medical problems at the Emergency Department to identify children at high risk for maltreatment.
Identifying child abuse and neglect solely on the grounds of child characteristics leaves many children undetected. We developed a new approach (Hague protocol) based on characteristics of parents who attend the Emergency Department (ED) because they have the following problems: (1) intimate partner violence, (2) substance abuse, or (3) suicide attempt or other serious psychiatric problems. The goal of this protocol is to enable the Reporting Center for Child Abuse and Neglect (RCCAN) to rapidly assess family problems and offer voluntary community based support to these parents. ⋯ The protocol has a high positive predictive value of 91% and can substantially increase the detection rate of child abuse in an ED setting. Parental characteristics are strong predictors of child abuse. Implementing guidelines to detect child abuse based on parental characteristics of parents attending the adult section of the ED can increase the detection rate of child abuse and neglect allowing appropriate aid to be initiated for these families.
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The rate of multiple births has increased over the last two decades. In 1982, an increased frequency of injuries among this patient population was noted, but few studies have evaluated the increased incidence of maltreatment in twins. The study aim was to evaluate the features of all multiple-birth children with substantiated physical abuse and/or neglect over a four-year period at a major children's hospital. ⋯ Siblings of maltreated, multiple-gestation children often, but not always, were abused. In sets with two maltreated children, children usually shared the same modes of maltreatment. Multiples are significantly more likely than singletons to be younger and experience fractures and abdominal trauma. The findings support the current standard practice of evaluating all children in a multiple set when one is found to be abused or neglected.