Similar theories of etiology have been postulated for child abuse and nonorganic failure to thriv... more Similar theories of etiology have been postulated for child abuse and nonorganic failure to thrive (FTT). This study compared individual, familial, and environmental conditions in cases of child abuse to cases of FTT. Assessment of the mother's childhood home, supports, current living situation, attitudes toward her child, and child characteristics (such as temperament, social maturity, and complicating medical conditons) showed the groups to be remarkably alike. The major significant difference was that although both groups were poor, the abuse group was even more impoverished and lived in more crowded conditions than the families with a child with FTT. These data suggest a common etiologic context for different pediatric social illnesses and the need for a broad collaborative approach by pediatricians and colleagues in related disciplines.
The document referenced below is part of the NCJRS Library collection. To conduct further searche... more The document referenced below is part of the NCJRS Library collection. To conduct further searches of the collection, visit the NCJRS Abstracts Database. ... THIS COLLECTION OF ESSAYS ON CHILD ABUSE EXAMINES A VARIETY OF TOPICS CONCERNING ANALYTIC ...
In the last 20 years each of the 50 states has developed and refined legislation that mandates pr... more In the last 20 years each of the 50 states has developed and refined legislation that mandates professionals who have contact with or who are responsible for children to report suspected cases of child abuse or neglect. The language in these laws varies markedly, with different states defining their own criteria for intervention. All states have expanded their focus beyond physical abuse and neglect to include psychological and sexual abuse. In view of these differences, this article will examine the most common policies and practices. An important role for professionals has been to identify and report suspected cases of abuse. A requirement of medical screening is that early detection of the problem is beneficial to the patient; diagnosis alone does not justify a screening test. Therefore, it is important that we critically evaluate what happens to the more than I million children and their families who now are being reported to state child protection agencies each year. Before focusing on details of clinical management, it is helpful to identify important recent philosophical approaches. These are central to an appreciation of what underlies specific programs and policies.
Child abuse is an age-old problem for which we have had documentary records for as long as we hav... more Child abuse is an age-old problem for which we have had documentary records for as long as we have had recorded history. This article reviews the ethical dilemmas, diagnosis, interviewing guidelines, physical examination, and treatment for child physical abuse. Also discussed are unusual manifestations and differential diagnosis.
Since the Surgeon General's Workshop on Violence and Public Health (Leesburg, Virginia, October 2... more Since the Surgeon General's Workshop on Violence and Public Health (Leesburg, Virginia, October 27-29, 1985), a substantial literature has developed about the limitations of the health care response to family violence. Many contributions have reflected experiences in limited numbers of practice settings (e.g., a single emergency department or hospital). Until 1990, however, there had been no community-based studies. The Robert Wood Johnson Foundation asked a multidisciplinary team from Education Development Center, Inc. and Children's Hospital (Boston) to investigate the health care responses to family violence in five diverse communities. This qualitative study, comprising more than 480 interviews, provided a vivid picture of the barriers facing physicians and other health care providers in identifying, treating, and referring victims of family violence. It also illuminated the relations of the health care systems in these communities with other key sectors, including agencies and the judiciary. The key findings from the five-city study remain relevant because (1) it is the only large-scale, multi-community-based assessment of the barriers facing physicians; (2) it identified, or in some cases confirmed, both institutional and educational barriers limiting the effectiveness of even the most committed physicians; (3) it identified, or in some cases confirmed, specific areas of knowledge, attitudes, and skills development that should be incorporated in medical education; and (4) its conclusions continue to be reflected in subsequent contributions to the literature. In each of these ways, therefore, it informs the other articles in this supplement.
Bestimmte Symptome von Familienkrisen und traumatischen Kindheitserlebnissen werden arztlich und ... more Bestimmte Symptome von Familienkrisen und traumatischen Kindheitserlebnissen werden arztlich und rechtlich erfast und "Kindesmishandlung" genannt, um dann von einer Reihe von Fachleuten behandelt zu werden, die ihre Legitimitat aus dem Verlauf eben dieser Behandlung ableiten. Es werden fachliche Konflikte und die Auswirkungen eines ganzen Behandlungssystems erortert und Vorschlage zur Verminderung des Machtmisbrauchs dieser Fachleute gemacht.
"Today . . . the important battle continues between the child murderer and the child... more "Today . . . the important battle continues between the child murderer and the child saver" (p. 8). "There must be an acknowledgment by society, immediately, that the problem of child abuse and neglect does exist and is on the increase. Recognition of this syndrome as an index of social and parental delinquency should stimulate community cooperation through the establishment, if not already in existence, of organizations, protective agencies, and courts for better child protection." (p. 38)
The increasing visibility of child abuse and family violence presents for child health profession... more The increasing visibility of child abuse and family violence presents for child health professionals a novel and exciting set of challenges. These include parental requests to examine children for signs of sexual abuse, subpoenas from attorneys to testify in court in conflicts about children's custody, invitations to consult to child care programs about how to protect children from victimization, and telephone calls from school teachers and administrators who have heard new disclosures of sexual abuse from their students. Central' to the health professional's role is the orderly and systematic assessment of allegations and reports of victimization. The task of this article is to describe the principles of practice as they have evolved into the last decade of the century, based on an understanding of the current context offamily violence and a review of the techniques and ethics of communication with parents, children, and other members of the professional community.
The predictive value of a child abuse screening instrument on unselected populations is illustrat... more The predictive value of a child abuse screening instrument on unselected populations is illustrated for varying hypothesized levels of child abuse prevalence in order to demonstrate outcome of a hypothetical national screening program. At any level of application, the prediction of false positives and false negatives suggests a low practical utility for an unacceptably high social cost.
Families of child abuse and accident victims were evaluated in a study of 402 families with child... more Families of child abuse and accident victims were evaluated in a study of 402 families with children up to four years of age. Children were matched on a one-to-one basis with a control according to race, socioeconomic status, and age. Socioeconomic factors that play a significant role in imposing undue stress upon many families are identified, and implications for prevention and for practice are offered.
... Record Details - EJ190619. Title: Knowledge and Epidemiology of Child Abuse: A Critical Revie... more ... Record Details - EJ190619. Title: Knowledge and Epidemiology of Child Abuse: A Critical Review of Concepts. ... Click on any of the links below to perform a new search. Title: Knowledge and Epidemiology of Child Abuse: A Critical Review of Concepts. ...
Journal of the American Academy of Child Psychiatry, Jul 1, 1983
The significance of ecological stress factors in the etiology of failure to thrive (FTT) was expl... more The significance of ecological stress factors in the etiology of failure to thrive (FTT) was explored through structured interviews with mothers of 42 infants who were failing to thrive and 42 matched controls. Three factors distinguished the FTT families from the controls. They had a more sickly child, were more isolated from neighborhood and family support, and had a larger discrepancy in parents' education. Demographic, pregnancy, contemporaneous stress factors were not significant. The data suggest that the usual assumption that FTT is due to inadequate mothering needs to be reassessed.
Children under four years of age hospitalized for child abuse, domestic accidents, failure to thr... more Children under four years of age hospitalized for child abuse, domestic accidents, failure to thrive, and ingestions were matched with controls admitted for comparably acute medical conditions. A structured parental interview yielded significant case-control differences. Discriminant analysis suggested interrelationships among the case groups and cluster analysis identified three cohesive groups in terms of severity of symptoms. This reformulation provides a matrix for organizing data and an alternative to the present manifestational classification system.
Similar theories of etiology have been postulated for child abuse and nonorganic failure to thriv... more Similar theories of etiology have been postulated for child abuse and nonorganic failure to thrive (FTT). This study compared individual, familial, and environmental conditions in cases of child abuse to cases of FTT. Assessment of the mother's childhood home, supports, current living situation, attitudes toward her child, and child characteristics (such as temperament, social maturity, and complicating medical conditons) showed the groups to be remarkably alike. The major significant difference was that although both groups were poor, the abuse group was even more impoverished and lived in more crowded conditions than the families with a child with FTT. These data suggest a common etiologic context for different pediatric social illnesses and the need for a broad collaborative approach by pediatricians and colleagues in related disciplines.
The document referenced below is part of the NCJRS Library collection. To conduct further searche... more The document referenced below is part of the NCJRS Library collection. To conduct further searches of the collection, visit the NCJRS Abstracts Database. ... THIS COLLECTION OF ESSAYS ON CHILD ABUSE EXAMINES A VARIETY OF TOPICS CONCERNING ANALYTIC ...
In the last 20 years each of the 50 states has developed and refined legislation that mandates pr... more In the last 20 years each of the 50 states has developed and refined legislation that mandates professionals who have contact with or who are responsible for children to report suspected cases of child abuse or neglect. The language in these laws varies markedly, with different states defining their own criteria for intervention. All states have expanded their focus beyond physical abuse and neglect to include psychological and sexual abuse. In view of these differences, this article will examine the most common policies and practices. An important role for professionals has been to identify and report suspected cases of abuse. A requirement of medical screening is that early detection of the problem is beneficial to the patient; diagnosis alone does not justify a screening test. Therefore, it is important that we critically evaluate what happens to the more than I million children and their families who now are being reported to state child protection agencies each year. Before focusing on details of clinical management, it is helpful to identify important recent philosophical approaches. These are central to an appreciation of what underlies specific programs and policies.
Child abuse is an age-old problem for which we have had documentary records for as long as we hav... more Child abuse is an age-old problem for which we have had documentary records for as long as we have had recorded history. This article reviews the ethical dilemmas, diagnosis, interviewing guidelines, physical examination, and treatment for child physical abuse. Also discussed are unusual manifestations and differential diagnosis.
Since the Surgeon General's Workshop on Violence and Public Health (Leesburg, Virginia, October 2... more Since the Surgeon General's Workshop on Violence and Public Health (Leesburg, Virginia, October 27-29, 1985), a substantial literature has developed about the limitations of the health care response to family violence. Many contributions have reflected experiences in limited numbers of practice settings (e.g., a single emergency department or hospital). Until 1990, however, there had been no community-based studies. The Robert Wood Johnson Foundation asked a multidisciplinary team from Education Development Center, Inc. and Children's Hospital (Boston) to investigate the health care responses to family violence in five diverse communities. This qualitative study, comprising more than 480 interviews, provided a vivid picture of the barriers facing physicians and other health care providers in identifying, treating, and referring victims of family violence. It also illuminated the relations of the health care systems in these communities with other key sectors, including agencies and the judiciary. The key findings from the five-city study remain relevant because (1) it is the only large-scale, multi-community-based assessment of the barriers facing physicians; (2) it identified, or in some cases confirmed, both institutional and educational barriers limiting the effectiveness of even the most committed physicians; (3) it identified, or in some cases confirmed, specific areas of knowledge, attitudes, and skills development that should be incorporated in medical education; and (4) its conclusions continue to be reflected in subsequent contributions to the literature. In each of these ways, therefore, it informs the other articles in this supplement.
Bestimmte Symptome von Familienkrisen und traumatischen Kindheitserlebnissen werden arztlich und ... more Bestimmte Symptome von Familienkrisen und traumatischen Kindheitserlebnissen werden arztlich und rechtlich erfast und "Kindesmishandlung" genannt, um dann von einer Reihe von Fachleuten behandelt zu werden, die ihre Legitimitat aus dem Verlauf eben dieser Behandlung ableiten. Es werden fachliche Konflikte und die Auswirkungen eines ganzen Behandlungssystems erortert und Vorschlage zur Verminderung des Machtmisbrauchs dieser Fachleute gemacht.
"Today . . . the important battle continues between the child murderer and the child... more "Today . . . the important battle continues between the child murderer and the child saver" (p. 8). "There must be an acknowledgment by society, immediately, that the problem of child abuse and neglect does exist and is on the increase. Recognition of this syndrome as an index of social and parental delinquency should stimulate community cooperation through the establishment, if not already in existence, of organizations, protective agencies, and courts for better child protection." (p. 38)
The increasing visibility of child abuse and family violence presents for child health profession... more The increasing visibility of child abuse and family violence presents for child health professionals a novel and exciting set of challenges. These include parental requests to examine children for signs of sexual abuse, subpoenas from attorneys to testify in court in conflicts about children's custody, invitations to consult to child care programs about how to protect children from victimization, and telephone calls from school teachers and administrators who have heard new disclosures of sexual abuse from their students. Central' to the health professional's role is the orderly and systematic assessment of allegations and reports of victimization. The task of this article is to describe the principles of practice as they have evolved into the last decade of the century, based on an understanding of the current context offamily violence and a review of the techniques and ethics of communication with parents, children, and other members of the professional community.
The predictive value of a child abuse screening instrument on unselected populations is illustrat... more The predictive value of a child abuse screening instrument on unselected populations is illustrated for varying hypothesized levels of child abuse prevalence in order to demonstrate outcome of a hypothetical national screening program. At any level of application, the prediction of false positives and false negatives suggests a low practical utility for an unacceptably high social cost.
Families of child abuse and accident victims were evaluated in a study of 402 families with child... more Families of child abuse and accident victims were evaluated in a study of 402 families with children up to four years of age. Children were matched on a one-to-one basis with a control according to race, socioeconomic status, and age. Socioeconomic factors that play a significant role in imposing undue stress upon many families are identified, and implications for prevention and for practice are offered.
... Record Details - EJ190619. Title: Knowledge and Epidemiology of Child Abuse: A Critical Revie... more ... Record Details - EJ190619. Title: Knowledge and Epidemiology of Child Abuse: A Critical Review of Concepts. ... Click on any of the links below to perform a new search. Title: Knowledge and Epidemiology of Child Abuse: A Critical Review of Concepts. ...
Journal of the American Academy of Child Psychiatry, Jul 1, 1983
The significance of ecological stress factors in the etiology of failure to thrive (FTT) was expl... more The significance of ecological stress factors in the etiology of failure to thrive (FTT) was explored through structured interviews with mothers of 42 infants who were failing to thrive and 42 matched controls. Three factors distinguished the FTT families from the controls. They had a more sickly child, were more isolated from neighborhood and family support, and had a larger discrepancy in parents' education. Demographic, pregnancy, contemporaneous stress factors were not significant. The data suggest that the usual assumption that FTT is due to inadequate mothering needs to be reassessed.
Children under four years of age hospitalized for child abuse, domestic accidents, failure to thr... more Children under four years of age hospitalized for child abuse, domestic accidents, failure to thrive, and ingestions were matched with controls admitted for comparably acute medical conditions. A structured parental interview yielded significant case-control differences. Discriminant analysis suggested interrelationships among the case groups and cluster analysis identified three cohesive groups in terms of severity of symptoms. This reformulation provides a matrix for organizing data and an alternative to the present manifestational classification system.
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