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RE: New Lancet Report on Incidence of Child Maltreatment
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<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Sheri-<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Your last sentence is priceless and while
on a serious level is not funny – after 35 + years in the field (child
protective services)<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>I am laughing in appreciation – you definitely
hit one of the many nails on the head!<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Alice F. Koenig<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Hanover County Department of Social
Services<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Virginia<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
bounce-3372975-8508769@list.cornell.edu
[mailto:bounce-3372975-8508769@list.cornell.edu] <b><span style='font-weight:
bold'>On Behalf Of </span></b>D F MCMAHON<br>
<b><span style='font-weight:bold'>Sent:</span></b> Monday, December 08, 2008
10:56 AM<br>
<b><span style='font-weight:bold'>To:</span></b> Child Maltreatment Researchers<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: New Lancet Report on
Incidence of Child Maltreatment</span></font><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>I believe it is a generally well-established legal
principle that children are not to be found legally deprived when the primary
issue is financial, and in my state that principle is also established by
statute. However, it is easy to narrow the definition and disconnect issues
families face from a purely financial interpretation. "Reasonable
efforts" seems to be used as a throwaway line--again, referring only to
legal proceedings, which are at least technically separate from investigations
and/or substantiation of abuse or neglect. <br>
<br>
There is the study from the 1980's that examined children receiving ER services
in <st1:State w:st="on">Massachusetts</st1:State> (<st1:City w:st="on"><st1:place
w:st="on">Boston</st1:place></st1:City>?) and linked CA/N reporting to the use
of MA as a payment means. There was a bit of a twist, in that if the presenting
issue was a chronic illness, more affluent families were more likely to be
reported, apparently based on assumptions that poor people had less resources
to address chronic illness while affluent parents did not have that
"excuse."<br>
<br>
Although I am not a professional statistician and also do not have the data
access many of the list participants have, I do have some statistical
background (very abstract levels though) and have tried out simple correlation
hypotheses using public data. On the macro level, correlations are elusive;
realizing the degree to which states and local jurisdictions use their own
definitions and standards (with sometimes startling inconsistencies) makes me
wonder how useful "macro" analyses are even likely to be. <br>
<br>
It does seem to me that a child is most likely to enter foster care if one
lives in a state settled by white Scandinavians within the last 130 years
(particularly, of course, if one is Native American). <br>
<br>
Sheri McMahon<o:p></o:p></span></font></p>
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<p class=MsoNormal style='margin-bottom:12.0pt'><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'>From: murray.straus@unh.edu<br>
To: child-maltreatment-research-l@list.cornell.edu<br>
Subject: RE: New Lancet Report on Incidence of Child Maltreatment<br>
Date: Sun, 7 Dec 2008 21:20:55 -0500<o:p></o:p></span></font></p>
<div>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Although differences
in resources available to higher socioeconomic (SES) parents, and also
stereotypes by professionals about the behavior of parents of different SES
levels, are part of the explanation of the higher rate child maltreatment by
low SES parents, in my opinion they are only a part of explanation.
Other parts of the explanation include more children and fewer resources,
greater occurrence of many other life stresses, lower education and less
understanding of normal child development, more use of corporal punishment
etc. </span></font><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'> </span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'> The National
Family Violence Surveys in 1975, 1985, and 1995 other studies used
anonymous interviews with parents to measure child physical and
psychological abuse on the basis of the behavior of parents as reported by
parents. These studies have found that the lower the SES, the higher the
rate of child maltreatment. See for example:</span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'> </span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.5in'><font size=2
face=Arial><span style='font-size:11.0pt;font-family:Arial'>Straus, M. A.,
Gelles, R. J., & Steinmetz, S. K. (1980 (2006)). <i><span style='font-style:
italic'>Behind closed doors: Violence in the American family </span></i><st1:State
w:st="on"><st1:place w:st="on">New York</st1:place></st1:State>:
Doubleday/Anchor Books (Re-issued Transaction Publications, 2006 with a new
forward by Richard J. Gelles and Murray A. Straus).</span></font><font size=2
face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.5in'><font size=2
face=Arial><span style='font-size:11.0pt;font-family:Arial'> </span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.5in'><font size=2
face=Arial><span style='font-size:11.0pt;font-family:Arial'>Wauchope, B. A.,
& Straus, M. A. (1990). Physical punishment and physical abuse of American
children: Incidence rates by age, gender, and occupational class. In M. A.
Straus & R. J. Gelles (Eds.), <i><span style='font-style:italic'>Physical
violence in American families: Risk factors and adaptations to violence in
8,145 families</span></i> (pp. 133-148). <st1:place w:st="on"><st1:City w:st="on">New
Brunswick</st1:City>, <st1:State w:st="on">NJ</st1:State></st1:place>:
Transaction Books.</span></font><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.5in'><font size=2
face=Arial><span style='font-size:11.0pt;font-family:Arial'> </span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<div>
<p class=MsoNormal><st1:City w:st="on"><st1:place w:st="on"><font size=2
color="#1f497d" face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:#1F497D'>Murray</span></font></st1:place></st1:City><font size=2
color="#1f497d" face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:#1F497D'> A. Straus<br>
Professor of Sociology and Co-Director<br>
Family Research Laboratory<br>
<st1:PlaceType w:st="on">University</st1:PlaceType> of <st1:PlaceName w:st="on">New
Hampshire</st1:PlaceName>, <st1:place w:st="on"><st1:City w:st="on">Durham</st1:City>,
<st1:State w:st="on">NH</st1:State> <st1:PostalCode w:st="on">03824</st1:PostalCode></st1:place><br>
603-862-2594 Fax: 603-862-1122 murray.straus@unh.edu</span></font><font size=2
color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:Calibri;
color:#1F497D'> <br>
</span></font><font size=2 color="#1f497d" face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:#1F497D'> </span></font><font size=2
color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:Calibri;
color:#1F497D'> <br>
</span></font><font size=2 color="#1f497d" face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:#1F497D'>Copies of many of my papers and some
out-of-print books can be downloaded from my website
http://pubpages.unh.edu/~mas2. For information about the Family Research
Laboratory, conferences, and bibliographies of publications by members of the
laboratory log into www.unh.edu/frl.</span></font><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:#1F497D'> </span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:#1F497D'> </span></font><font
size=2 color="#1f497d" face=Arial><span style='font-size:11.0pt;font-family:
Arial;color:#1F497D'> </span></font><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'> </span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
bounce-3368048-6832504@list.cornell.edu [mailto:bounce-3368048-6832504@list.cornell.edu]
<b><span style='font-weight:bold'>On Behalf Of </span></b>Many, Michele<br>
<b><span style='font-weight:bold'>Sent:</span></b> 2008-12-07 17:58<br>
<b><span style='font-weight:bold'>To:</span></b> Child Maltreatment
Researchers; Child Maltreatment Researchers<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: New Lancet Report on
Incidence of Child Maltreatment</span></font><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'><o:p></o:p></span></font></p>
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<p class=MsoNormal><font size=2 face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'> <o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-bottom:12.0pt'><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'>Here, here. Also, how much
is the association between child maltreatment and poverty impacted by the
additional insulation from child protective services via passive (or active)
intimidation of babysitters, nannies, teachers, doctors, etc., and the ability
for higher SES clients to control access to collateral sources of information
prior to any chance of reporting?<br>
<br>
<br>
Michele M. Many, MSW, LCSW, BACS<br>
Assistant Professor<br>
LSU Department of Psychiatry<br>
<br>
<br>
<br>
-----Original Message-----<br>
From: bounce-3367701-9198871@list.cornell.edu on behalf of Taylor, Peggy<br>
Sent: Sun 12/7/2008 1:47 PM<br>
To: Child Maltreatment Researchers<br>
Subject: RE: New Lancet Report on Incidence of Child Maltreatment<br>
<br>
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.<br>
<br>
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? <br>
<br>
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? <br>
<br>
Peggy Taylor, LMSW<br>
<st1:place w:st="on"><st1:City w:st="on">Lawrence</st1:City>, <st1:State w:st="on">Kansas</st1:State></st1:place><br>
<br>
_____ <br>
<br>
From: bounce-3366075-6834006@list.cornell.edu on behalf of
F.Schultz@SBCSocialServ.org<br>
Sent: Fri 12/5/2008 8:01 PM<br>
To: child-maltreatment-research-l@list.cornell.edu<br>
Subject: New Lancet Report on Incidence of Child Maltreatment<br>
<br>
<br>
<br>
<br>
I thought that many might be interested in this new report.<br>
<br>
<br>
Child Abuse Much More Common Than Official Statistics Indicate<br>
<br>
Caroline Cassels<br>
Medscape Medical News 2008. (c) 2008 Medscape<br>
http://www.medscape.com/viewarticle/584817_print<br>
<br>
December 5, 2008 - Child abuse in high-income countries is far more<br>
common than official statistics show, with just 10% of suspected cases<br>
investigated and substantiated annually, new research suggests.<br>
<br>
Published online December 4 in the Lancet, the study, led by Ruth<br>
Gilbert, MD, from University College London Institute of Child Health,<br>
<st1:country-region w:st="on"><st1:place w:st="on">United Kingdom</st1:place></st1:country-region>,
is 1 of a series of 4 papers in this issue of the Lancet<br>
that highlight the issue of childhood maltreatment.<br>
<br>
According to the study, 4% to 16% of children are physically abused and<br>
1 in 10 is neglected or psychologically abused every year. In addition,<br>
between 5% and 10% of girls and up to 5% of boys are exposed to<br>
penetrative sexual abuse, and up to 3 times this number are exposed to<br>
any type of sexual abuse. However, the investigators note that official<br>
rates for substantiated child maltreatment indicate less than a tenth of<br>
this burden.<br>
<br>
The impact of child maltreatment can have devastating and long-lasting<br>
consequences that persist into adulthood. For instance, the authors note<br>
that maltreated children are at increased risk for criminal behavior,<br>
are more likely to engage in risky sexual behavior, and are at<br>
significantly higher risk for drug and alcohol abuse.<br>
<br>
"The most tragic manifestation of the burden of child maltreatment is<br>
the thousands of child deaths every year due to murder or neglect," the<br>
authors write.<br>
<br>
According to the World Health Organization, worldwide, 155,000 children<br>
younger than 15 years die annually as a result of abuse or neglect.<br>
Biological parents are responsible for 80% of cases and stepparents for<br>
15%.<br>
<br>
In the <st1:country-region w:st="on"><st1:place w:st="on">United Kingdom</st1:place></st1:country-region>,
35% of child murder victims are younger than 1<br>
year. It is estimated that in the European Union, 4 in every 1 million<br>
children die from homicide or manslaughter every year. In central and<br>
eastern Europe and the Newly Independent States, the rate is 3 times<br>
greater, the authors report.<br>
<br>
Abuse Significantly Underreported<br>
<br>
A second study, also conducted by Dr. Gilbert and colleagues, shows that<br>
in most settings child abuse is significantly underreported - even by<br>
schools and community-health services that have continuous contact with<br>
children.<br>
<br>
However, this phenomenon also extends to professionals in primary care,<br>
mental health, and law enforcement.<br>
<br>
Reasons for underreporting, say the authors, include lack of awareness<br>
about the signs of maltreatment and the processes for reporting to<br>
child-protection agencies, and the perception that reporting might do<br>
more harm than good.<br>
<br>
However, even when maltreatment is suspected, the authors note,<br>
professionals often do not report the case unless they have a high level<br>
of certainty that maltreatment has occurred.<br>
<br>
To illustrate the extent of uncertainty about maltreatment, the<br>
researchers highlight a prospective study from the United States that<br>
showed that doctors suspected about 10% of 15,000 child-injury visits<br>
were due to maltreatment. However, only 6% of cases were reported<br>
(Pediatrics 2008;122:611-619).<br>
<br>
"Professionals who have continuous contact with children, such as people<br>
working in schools and community health services, can have a leading<br>
role in recognizing, responding to, and supporting maltreated children.<br>
Their scarce reporting to child-protection agencies is a cause for<br>
concern, and we need to find out whether maltreatment is being<br>
recognized and dealt with in other ways. Doubts are widespread that the<br>
benefits of reporting suspected case of maltreatment to child-protection<br>
services outweigh the harms," the authors conclude.<br>
<br>
In an accompanying editorial, Richard Horton, MB, editor of the Lancet,<br>
and senior editor Richard Turner, MD, express hope that this series of<br>
articles will raise awareness about child abuse and will help guide<br>
clinicians and other professionals who come in contact with children who<br>
might be abuse victims.<br>
<br>
"It is to clinicians and other professionals responsible for caring for<br>
children that the Lancet's Child Maltreatment Series is aimed, with the<br>
intention of providing them with a rigorous and up-to-date summary of<br>
scientific evidence and conceptual work on this complex and demanding<br>
topic," they write.<br>
<br>
The researchers have disclosed no relevant financial relationships.<br>
<br>
Lancet. Published online December 4, 2008.<br>
<br>
Freya Schultz, Staff Analyst<br>
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