RE: New Lancet Report on Incidence of Child Maltreatment

["Deborah Stone" <dstone@xxxxxxxxxxxxxxxx>]

I'd be interested to know the difference in both reports and subsequent investigations by SES and how this may differ across states. 
Deb

>>> <F.Schultz@xxxxxxxxxxxxxxxxx> 12/08/08 9:05 AM >>>
Peggy,
 
Your description of bias based on the ability of affluent parents to negotiate their way out of the problem has been our experience in my county (I work for Child Welfare Services/CPS).  I know of no place where that is NOT the case.  In spite of our best efforts, affluent parents are very often able to place legal barriers to investigation.  They also are less likely to be reported because even mandated reporters don't want to go up against them as witnesses, in spite of confidentiality assurances.
 
In terms of general incidence among the affluent, among my Stanford classmates of the 60s quite a few had been victims of incest, and in one notable case, the matter even went to trial, but the parents were found not guilty - - by manipulating the child victim and getting him to recant.  At that time, the best the system could offer the victimized child who ran away from home was being housed in a county group receiving facility ("hall"), almost as bad as staying in his home.  This occurred in another California county, not Santa Barbara.
 
In my lifetime, we have had a superior court judge who sexuallly abused his sons, and that one never went to trial .  
 
In my classmate''s family in the case I mentioned above which was prosecuted, the sexual and physical abuse continued through and into mature adulthood, involved all of four children of both sexes, and the mother participated in luring neighborhood children to the home where the father abused them along with his own children.   The family moved frequently with the father's rise in a major firm.  Members kept silence to protect their access to the family's wealth.
 
The father in the family also impregnated the wife of the youngest son and sought sex with the spouses of the other chidren as a matter of right until his death.
 
I did not learn of the full extent of my classmate's abuse until later in life, but other classmates have also revealed similar experience in their own homes, all of them wealthy.
 
I have also served as the District Attorneys Victim/Witness Services Coordinator for a number of years, so my experience is also on the criminal end of things.  My county was very aggressive in prosecuting child abuse criminally where possible with full supports to the victim.  I know first-hand how difficult these cases can be from the prosecution perspective, especially when the children were very, very young and all you could present was physical evidence.
 
Freya
Freya Schultz
Santa Barbara County Child Welfare Services.

________________________________

From: bounce-3367701-6833838@xxxxxxxxxxxxxxxx on behalf of Taylor, Peggy
Sent: Sun 12/7/2008 11:47 AM
To: Child Maltreatment Researchers
Subject: RE: New Lancet Report on Incidence of Child Maltreatment


This study raises interesting questions about the prevailing assumption that the demonstrated relationship between child maltreatment and poverty is evidence that low income parents are more likely to be 'poor' parents and mistreat their children.
 
I would love to see or conduct a study that looks at the differences in outcomes of child protective service investigations and child welfare initial hearings for parents with sufficient resources to have a private attorney and health insurance to cover family services with outcomes in investigations and hearings where parents have none of these resources.  How often are identified mistreated children not served by child welfare agencies because their parents' private attorney proposes a safetly plan that includes family therapy with a therapist of the parents' choice?  
 
Is it possible that the 'demonstrated' associated between poverty and child maltreatment is more of a measure of families' wherewithall to pay for legal and mental health services themselves than it is a measure of the safety of children in families with higher incomes and better insurance?  
 
Peggy Taylor, LMSW
Lawrence, Kansas

________________________________

From: bounce-3366075-6834006@xxxxxxxxxxxxxxxx on behalf of F.Schultz@xxxxxxxxxxxxxxxxx
Sent: Fri 12/5/2008 8:01 PM
To: child-maltreatment-research-l@xxxxxxxxxxxxxxxx
Subject: New Lancet Report on Incidence of Child Maltreatment




 I thought that many might be interested in this new report.


Child Abuse Much More Common Than Official Statistics Indicate

Caroline Cassels
Medscape Medical News 2008. (c) 2008 Medscape
http://www.medscape.com/viewarticle/584817_print

December 5, 2008 - Child abuse in high-income countries is far more
common than official statistics show, with just 10% of suspected cases
investigated and substantiated annually, new research suggests.

Published online December 4 in the Lancet, the study, led by Ruth
Gilbert, MD, from University College London Institute of Child Health,
United Kingdom, is 1 of a series of 4 papers in this issue of the Lancet
that highlight the issue of childhood maltreatment.

According to the study, 4% to 16% of children are physically abused and
1 in 10 is neglected or psychologically abused every year. In addition,
between 5% and 10% of girls and up to 5% of boys are exposed to
penetrative sexual abuse, and up to 3 times this number are exposed to
any type of sexual abuse. However, the investigators note that official
rates for substantiated child maltreatment indicate less than a tenth of
this burden.

The impact of child maltreatment can have devastating and long-lasting
consequences that persist into adulthood. For instance, the authors note
that maltreated children are at increased risk for criminal behavior,
are more likely to engage in risky sexual behavior, and are at
significantly higher risk for drug and alcohol abuse.

"The most tragic manifestation of the burden of child maltreatment is
the thousands of child deaths every year due to murder or neglect," the
authors write.

According to the World Health Organization, worldwide, 155,000 children
younger than 15 years die annually as a result of abuse or neglect.
Biological parents are responsible for 80% of cases and stepparents for
15%.

In the United Kingdom, 35% of child murder victims are younger than 1
year. It is estimated that in the European Union, 4 in every 1 million
children die from homicide or manslaughter every year. In central and
eastern Europe and the Newly Independent States, the rate is 3 times
greater, the authors report.

Abuse Significantly Underreported

A second study, also conducted by Dr. Gilbert and colleagues, shows that
in most settings child abuse is significantly underreported - even by
schools and community-health services that have continuous contact with
children.

However, this phenomenon also extends to professionals in primary care,
mental health, and law enforcement.

Reasons for underreporting, say the authors, include lack of awareness
about the signs of maltreatment and the processes for reporting to
child-protection agencies, and the perception that reporting might do
more harm than good.

However, even when maltreatment is suspected, the authors note,
professionals often do not report the case unless they have a high level
of certainty that maltreatment has occurred.

To illustrate the extent of uncertainty about maltreatment, the
researchers highlight a prospective study from the United States that
showed that doctors suspected about 10% of 15,000 child-injury visits
were due to maltreatment. However, only 6% of cases were reported
(Pediatrics 2008;122:611-619).

"Professionals who have continuous contact with children, such as people
working in schools and community health services, can have a leading
role in recognizing, responding to, and supporting maltreated children.
Their scarce reporting to child-protection agencies is a cause for
concern, and we need to find out whether maltreatment is being
recognized and dealt with in other ways. Doubts are widespread that the
benefits of reporting suspected case of maltreatment to child-protection
services outweigh the harms," the authors conclude.

In an accompanying editorial, Richard Horton, MB, editor of the Lancet,
and senior editor Richard Turner, MD, express hope that this series of
articles will raise awareness about child abuse and will help guide
clinicians and other professionals who come in contact with children who
might be abuse victims.

"It is to clinicians and other professionals responsible for caring for
children that the Lancet's Child Maltreatment Series is aimed, with the
intention of providing them with a rigorous and up-to-date summary of
scientific evidence and conceptual work on this complex and demanding
topic," they write.

The researchers have disclosed no relevant financial relationships.

Lancet. Published online December 4, 2008.

Freya Schultz, Staff Analyst
Santa Barbara County Social Services, Child Welfare Services
234 Camino del Remedio
Santa Barbara, CA 93110
(805) 696-8972

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