Child abuse & neglect
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Child abuse & neglect · Jul 2018
The impact of a statewide trauma-informed child welfare initiative on children's permanency and maltreatment outcomes.
This article presents findings of a state-wide trauma informed child-welfare initiative with the goal of improving well-being, permanency and maltreatment outcomes for traumatized children. The Massachuetts Child Trauma Project (MCTP), funded by the Administration of Children and Families, Children's Bureau was a multi-year project implementing trauma-informed care into child welfare service delivery. The project's implementation design included training and consultation for mental health providers in three evidence-based treatments and training of the child-welfare workforce in trauma-informed case work practice. ⋯ However, children in the intervention group had more maltreatment reports (substantiated or not) and total out-of-home placements than did their counterparts in the comparison group. Assignment to MCTP, however, was not associated with an increase in kinship care or adoption. Overall, the results are promising in reinforcing the importance of mobilizing communities toward improvements in child-welfare service delivery.
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Child abuse & neglect · Jul 2018
Acceptability of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals.
The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom. ⋯ Interpretations regarding which percentages equate to 'low', 'medium' or 'high' likelihood of AHT varied; participants preferred a precise % probability over these general terms. Participants would use PredAHT with provisos: if they received multi-agency training to define accepted risk thresholds for consistent interpretation; with knowledge of its development; if it was accepted by colleagues. PredAHT may therefore increase professionals' confidence in their decision-making when investigating suspected AHT, but may be of less value in court.
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Child abuse & neglect · Jul 2018
Adverse childhood experiences: Evidence for screening beyond preventive visits.
Primary efforts to screen for adverse childhood experiences (ACE/ACEs) are often focused on the well child/adolescent visit. The purpose of this study was to examine relationships between ACEs and youth likelihood of receiving preventive care. Data are from 126,868 students in the 8th, 9th, and 11th grades who participated in the 2016 Minnesota Student Survey, an anonymous, self-report questionnaire examining youth behaviors, experiences, and perceptions. ⋯ Associations with food insecurity were of greatest magnitude, associated with 0.32 [CI: 0.64-0.72] to 0.54 [CI: 0.44-0.49] decreased odds of receiving care. Each one point increase in the total ACE score was associated with 0.07 [CI: 0.92-0.94] to 0.15 [CI: 0.84-0.86] decreased odds of having had a preventive care visit in the last year. Findings add to the growing literature documenting significant relationships between ACEs and health, in this case, youth missing opportunities to receive recommended surveillance and anticipatory guidance.