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Message ID: 8602
Date: 2010-08-28

Author:Poha Kane

Subject:Re: New bulletin: Updated Trends in Child Maltreatment, 2008

I would hesitate to cite Oprah as an indicator of the tendency of children to report or not report. Her producers round up people that volunteer to be entertaining, and get their fifteen minutes of fame. This wouldn't equate with a random sample of the population for statistical purposes. What I would look at is what workers in the field are finding as they have, for about 3 decades now, dealt with increasingly insular family models in the newly and first generation immigrant families. Not only are views of what abuse is or is not in those families but willingness to expose the family to outside and government intrusion differs from the mainstream considerably. The mainstream itself reacts to spectacles such as Oprah and other media by a pulling in and closing their doors. Perpetrators work harder, in light of these exposures, to ensure the victim does not speak out. Until I see some newer reports I cannot agree that the death rate for CAN related child fatalities is indeed fixed, and not rising. As recently as 2009 a report contained at the web site: http://www.childwelfare.gov/pubs/factsheets/fatality.cfm ... ... reports differently and addresses some of the points I and others are examining. If we are looking at a single year, or even two since then where the rate has not increased the question comes up of whether or not this is a real downturn in abuse related deaths, or the cyclical changes we see in most data collection of CAN. "How Many Children Die Each Year From Abuse or Neglect? The National Child Abuse and Neglect Data System (NCANDS) reported an estimated 1,760 child fatalities in 2007. This translates to a rate of 2.35 children per 100,000 children in the general population. NCANDS defines "child fatality" as the death of a child caused by an injury resulting from abuse or neglect, or where abuse or neglect was a contributing factor. With the exception of FFY 2005, the number and rate of fatalities have been increasing over the past 5 years. The national estimate is influenced by which States report data. For 2007, several States reported increased fatalities compared to FFY 2006, which resulted in a higher national estimate. To some degree, this can be attributed to improved data collection and reporting, but all the causes of the increase are not specifically identifiable. Most data on child fatalities come from State child welfare agencies. However, States may also draw on other data sources, including health departments, vital statistics departments, medical examiners' offices, and fatality review teams. This coordination of data collection contributes to better estimates. Many researchers and practitioners believe child fatalities due to abuse and neglect are still underreported. Studies in Nevada and Colorado have estimated that as many as 50 percent to 60 percent of child deaths resulting from abuse or neglect are not recorded as such (Child Fatality Analysis (Clark County), 2005; Crume, DiGuiseppi, Byers, Sirotnak, & Garrett, 2002). Issues affecting the accuracy and consistency of child fatality data include: * Variation among reporting requirements and definitions of child abuse and neglect and other terms * Variation in death investigative systems and in training for investigations * Variation in State child fatality review processes * The amount of time (as long as a year, in some cases) it may take to establish abuse or neglect as the cause of death * Inaccurate determination of the manner and cause of death, resulting in the miscoding of death certificates; this includes deaths labeled as accidents, sudden infant death syndrome (SIDS), or "manner undetermined" that would have been attributed to abuse or neglect if more comprehensive investigations had been conducted (Hargrove & Bowman, 2007) * Limited coding options for child deaths, especially those due to neglect or negligence, when using the International Classification of Diseases to code death certificates * The ease with which the circumstances surrounding many child maltreatment deaths can be concealed * Lack of coordination or cooperation among different agencies and jurisdictions A number of studies, including some funded by the Centers for Disease Control and Prevention, have suggested that more accurate counts of maltreatment deaths are obtained by linking multiple reporting sources, including death certificates, crime reports, child protective services (CPS) reports, and child death review (CDR) records (Mercy, Barker, & Frazier, 2006). " In other words not much has changed really in the ability to trust the reports. Unless we take greater advantage of our currently available technology for rapid input and analysis of data we'll always labor under these same possible constraints as listed above. As long as policy decisions run 2 to 6 years behind events they are meant to impact we will not be serving community, family, and child needs adequately, effectively, and on addressing the current issues. In the count of abuse incidents in NCANDS data we see that sometimes there is recognition that a child, the same child, is abused more than once. But that is limited to more than once in a reporting year. That same child may have been abused, unreported, and not receiving services for a decade or more. As long as we report as few incidents as possible, rather than the full scope that reflects the real need of the child and the family the risk of public apathy will grow. I do not suggest any figures should be padded or presented in ways that misrepresent real needs for services, but I do suggest that all that should be reported must be. A child with years of abuse should be recorded and posted with each incident to those years data and that longitudinal data reported to policy makers. It reflects what we have not done, what we missed that might have been driven by past policy decisions shortfalls, and what must be done and the increase in kinds of services these very children will likely need over the child victim of a single incident of CA or N. Poha On 8/28/10, Chaffin, Mark J. (HSC) wrote: > Ben, > > I recall these findings. Excellent work. Its always good to have population > based data. I think we can FINALLY put to rest the notion that somehow > kids are more reluctant to report now than they were in the past. In fact, > it is the opposite. As anyone who watches Oprah could attest! If anything, > this finding would tend to mask declines, not vice versa. > > The age findings are particularly interesting. There has always been a > surge in risk for sexual assault of girls around age 12, and some > corresponding changes in who (relationally speaking) is assaulting them, as > quite a number of peer-on-peer events come into the picture. The overall > epidemiology of sexual assault over age and time is complex. These declines > are modest, but still are declines, and are not inconsistent with the CPS > findings, given that CPS often is not involved in peer-on-peer type > incidents, although law enforcement is and that more, not less, are being > reported now than before. > > I would like to briefly comment on some other points mentioned by others. > First, the idea that there is a disconnect between the reality of front-line > practice and the declines observed in the data. As mentioned, front line > practice observes only the numerator, and never the denominator, so this is > not surprising. The second observation is that there are horrible cases out > there, and that CPS does not always respond to them. I've been working in > the child abuse field, including on the front lines, for around 30 years. > Let me tell you--there have ALWAYS been horrible cases, plenty of them, and > people have been complaining about frightening CPS rule-outs forever. > People always believe that cases are getting worse--I've never met a > practitioner who believed otherwise about anything--its like a badge of > honor. So, I think we need hard data on this one, and I'm not sure that > impressions are trustworthy, given the difficulty human beings have with > these current vs. old days contrasts. > > Most of all, I would like to comment on the recurrent idea that if indeed > rates are going down, that this takes the wind out of our advocacy sails. > If this is the case, I strongly recommend that we get new sails. After all, > the main alternative conclusion is that our efforts have been disastrous > failures. I think if we tie our advocacy to the rather thin notion that > "our intervention and prevention efforts are wonderful and effective, but > its all hidden and we can never trust good news, so its really a crisis and > getting worse by the day" that this is an unsustainable contradiction. > > Mark > > ________________________________________ > From: Ben Saunders [saunders@musc.edu] > Sent: Friday, August 27, 2010 1:14 PM > Subject: Re: New bulletin: Updated Trends in Child Maltreatment, 2008 > > Just to add a bit more complication to this discussion, I presented a paper > at the San Diego Conference in January looking at results of lifetime sexual > assault prevalence reported by teenagers assessed in the National Survey of > Adolescents (N=3,907), which we conducted in 1995, and the National Survey > of Adolescents-Replication (N=3,614), the first wave of which was conducted > in 2005. These two surveys separated by 10 years examined two different > cohorts of adolescents (ages 12-17) living in U.S. households with > telephones. The samples were sampled and recruited using the same methods. > Self-reported lifetime prevalence of sexual assault was assessed with the > two samples using the same screening questions. So, comparison of the > results of the two surveys gives us snapshots of self-reported sexual > assault prevalence among teenagers in 1995 and 2005. However, it tells us > nothing about the trends in the interim. Here is a summary of the > findings... > > 1. No statistically significant differences between SA prevalence among > boys (3.5% - 3.8%) or girls (13.2% - 11.5%), though the trend for girls was > a decline. > > 2. No significant differences in SA prevalence within racial/ethnic groups, > though there was a trend for decline among African Americans (13.1% - 9.8%). > > 3. A significant decline in SA prevalence among the 12 year old cohort > (3.7% - 1.6%). No significant differences among any of the other age > cohorts. > > 4. Average age at first sexual assault increased fro 11.8 years to 14.9 > years. > > 5. The reporting to authorities rate for first sexual assaults doubled from > 14% to 29%. > > These results suggest that changes in gross statistics like number of > reports to CPS likely mask the more interesting underlying trends in gender, > age, racial/ethnic, and other subgroups. These data indicated that declines > are being seen in the younger age cohorts (0-12) and perhaps among certain > ethnic groups (AA). However, other groups report similar results in 1995 > and 2005. So, worrying about global trends may be less revealing than > better understanding which subgroups are exhibiting which trends and then > trying to understand why. > > Articles describing the comparison data for CSA, physical abuse, DV > exposure, and community violence exposures from the 1995 NSA and 2005 NSA-R > will be appearing in the literature over the next year. Several are in > press now. I am happy to send a handout from the San Diego paper to anyone > that wants it. Contact me back channel at > saunders@musc.edu. > > Ben > > > Basically, there were > > On 8/27/2010 9:41 AM, Chaffin, Mark J. (HSC) wrote: > Re: decreases in physical and sexual abuse rates. > > In studies using law enforcement data, I’ve observed similar declines in > child sexual abuse cases involving nonfamilial and unrelated perpetrators. > These cases don’t involve CPS policies, and don’t involve family pressures > to retain a breadwinner during hard times. The trajectory of the decline in > these separate data sets and different kinds of reports (often non-CPS > cases) over the past decade and a half parallels what was seen in the CPS > report data. > > In my career in child abuse research, I can’t recall seeing very many > research findings that seem to evoke such skepticism as research suggesting > that abuse rates are declining. I firmly believe that skepticism about > research findings is a good thing, but I’m intrigued about why so much > skepticism about this now almost two decade long finding. As a > psychologist, the really interesting research question to me is becoming the > reaction of our field to this finding, more than any more examination on the > finding itself! I recall recently sharing this finding with a person from a > rural child advocacy center (who had never heard anything about it) and she > was almost in tears with distress. > > Mark > > -- > Benjamin E. Saunders, Ph.D. > Professor and Associate Director > National Crime Victims Research & Treatment Center > Department of Psychiatry and Behavioral Sciences > Medical University of South Carolina > 67 President Street, MSC 861 > Charleston, SC 29425 > 843-792-2945 Phone 843-792-7146 Fax > www.musc.edu/ncvc > > Learn about Project BEST > > Take our free Web-based training courses: > TF-CBTWeb CPTWeb > > > >

I would hesitate to cite Oprah as an indicator of the tendency of children to report or not report. Her producers round up people that volunteer to be entertaining, and get their fifteen minutes of fame. This wouldn't equate with a random sample of the population for statistical purposes. What I would look at is what workers in the field are finding as they have, for about 3 decades now, dealt with increasingly insular family models in the newly and first generation immigrant families. Not only are views of what abuse is or is not in those families but willingness to expose the family to outside and government intrusion differs from the mainstream considerably. The mainstream itself reacts to spectacles such as Oprah and other media by a pulling in and closing their doors. Perpetrators work harder, in light of these exposures, to ensure the victim does not speak out. Until I see some newer reports I cannot agree that the death rate for CAN related child fatalities is indeed fixed, and not rising. As recently as 2009 a report contained at the web site: http://www.childwelfare.gov/pubs/factsheets/fatality.cfm ... ... reports differently and addresses some of the points I and others are examining. If we are looking at a single year, or even two since then where the rate has not increased the question comes up of whether or not this is a real downturn in abuse related deaths, or the cyclical changes we see in most data collection of CAN. "How Many Children Die Each Year From Abuse or Neglect? The National Child Abuse and Neglect Data System (NCANDS) reported an estimated 1,760 child fatalities in 2007. This translates to a rate of 2.35 children per 100,000 children in the general population. NCANDS defines "child fatality" as the death of a child caused by an injury resulting from abuse or neglect, or where abuse or neglect was a contributing factor. With the exception of FFY 2005, the number and rate of fatalities have been increasing over the past 5 years. The national estimate is influenced by which States report data. For 2007, several States reported increased fatalities compared to FFY 2006, which resulted in a higher national estimate. To some degree, this can be attributed to improved data collection and reporting, but all the causes of the increase are not specifically identifiable. Most data on child fatalities come from State child welfare agencies. However, States may also draw on other data sources, including health departments, vital statistics departments, medical examiners' offices, and fatality review teams. This coordination of data collection contributes to better estimates. Many researchers and practitioners believe child fatalities due to abuse and neglect are still underreported. Studies in Nevada and Colorado have estimated that as many as 50 percent to 60 percent of child deaths resulting from abuse or neglect are not recorded as such (Child Fatality Analysis (Clark County), 2005; Crume, DiGuiseppi, Byers, Sirotnak, & Garrett, 2002). Issues affecting the accuracy and consistency of child fatality data include: * Variation among reporting requirements and definitions of child abuse and neglect and other terms * Variation in death investigative systems and in training for investigations * Variation in State child fatality review processes * The amount of time (as long as a year, in some cases) it may take to establish abuse or neglect as the cause of death * Inaccurate determination of the manner and cause of death, resulting in the miscoding of death certificates; this includes deaths labeled as accidents, sudden infant death syndrome (SIDS), or "manner undetermined" that would have been attributed to abuse or neglect if more comprehensive investigations had been conducted (Hargrove & Bowman, 2007) * Limited coding options for child deaths, especially those due to neglect or negligence, when using the International Classification of Diseases to code death certificates * The ease with which the circumstances surrounding many child maltreatment deaths can be concealed * Lack of coordination or cooperation among different agencies and jurisdictions A number of studies, including some funded by the Centers for Disease Control and Prevention, have suggested that more accurate counts of maltreatment deaths are obtained by linking multiple reporting sources, including death certificates, crime reports, child protective services (CPS) reports, and child death review (CDR) records (Mercy, Barker, & Frazier, 2006). " In other words not much has changed really in the ability to trust the reports. Unless we take greater advantage of our currently available technology for rapid input and analysis of data we'll always labor under these same possible constraints as listed above. As long as policy decisions run 2 to 6 years behind events they are meant to impact we will not be serving community, family, and child needs adequately, effectively, and on addressing the current issues. In the count of abuse incidents in NCANDS data we see that sometimes there is recognition that a child, the same child, is abused more than once. But that is limited to more than once in a reporting year. That same child may have been abused, unreported, and not receiving services for a decade or more. As long as we report as few incidents as possible, rather than the full scope that reflects the real need of the child and the family the risk of public apathy will grow. I do not suggest any figures should be padded or presented in ways that misrepresent real needs for services, but I do suggest that all that should be reported must be. A child with years of abuse should be recorded and posted with each incident to those years data and that longitudinal data reported to policy makers. It reflects what we have not done, what we missed that might have been driven by past policy decisions shortfalls, and what must be done and the increase in kinds of services these very children will likely need over the child victim of a single incident of CA or N. Poha On 8/28/10, Chaffin, Mark J. (HSC) wrote: > Ben, > > I recall these findings. Excellent work. Its always good to have population > based data. I think we can FINALLY put to rest the notion that somehow > kids are more reluctant to report now than they were in the past. In fact, > it is the opposite. As anyone who watches Oprah could attest! If anything, > this finding would tend to mask declines, not vice versa. > > The age findings are particularly interesting. There has always been a > surge in risk for sexual assault of girls around age 12, and some > corresponding changes in who (relationally speaking) is assaulting them, as > quite a number of peer-on-peer events come into the picture. The overall > epidemiology of sexual assault over age and time is complex. These declines > are modest, but still are declines, and are not inconsistent with the CPS > findings, given that CPS often is not involved in peer-on-peer type > incidents, although law enforcement is and that more, not less, are being > reported now than before. > > I would like to briefly comment on some other points mentioned by others. > First, the idea that there is a disconnect between the reality of front-line > practice and the declines observed in the data. As mentioned, front line > practice observes only the numerator, and never the denominator, so this is > not surprising. The second observation is that there are horrible cases out > there, and that CPS does not always respond to them. I've been working in > the child abuse field, including on the front lines, for around 30 years. > Let me tell you--there have ALWAYS been horrible cases, plenty of them, and > people have been complaining about frightening CPS rule-outs forever. > People always believe that cases are getting worse--I've never met a > practitioner who believed otherwise about anything--its like a badge of > honor. So, I think we need hard data on this one, and I'm not sure that > impressions are trustworthy, given the difficulty human beings have with > these current vs. old days contrasts. > > Most of all, I would like to comment on the recurrent idea that if indeed > rates are going down, that this takes the wind out of our advocacy sails. > If this is the case, I strongly recommend that we get new sails. After all, > the main alternative conclusion is that our efforts have been disastrous > failures. I think if we tie our advocacy to the rather thin notion that > "our intervention and prevention efforts are wonderful and effective, but > its all hidden and we can never trust good news, so its really a crisis and > getting worse by the day" that this is an unsustainable contradiction. > > Mark > > ________________________________________ > From: Ben Saunders [saundersmusc.edu] > Sent: Friday, August 27, 2010 1:14 PM > Subject: Re: New bulletin: Updated Trends in Child Maltreatment, 2008 > > Just to add a bit more complication to this discussion, I presented a paper > at the San Diego Conference in January looking at results of lifetime sexual > assault prevalence reported by teenagers assessed in the National Survey of > Adolescents (N=3,907), which we conducted in 1995, and the National Survey > of Adolescents-Replication (N=3,614), the first wave of which was conducted > in 2005. These two surveys separated by 10 years examined two different > cohorts of adolescents (ages 12-17) living in U.S. households with > telephones. The samples were sampled and recruited using the same methods. > Self-reported lifetime prevalence of sexual assault was assessed with the > two samples using the same screening questions. So, comparison of the > results of the two surveys gives us snapshots of self-reported sexual > assault prevalence among teenagers in 1995 and 2005. However, it tells us > nothing about the trends in the interim. Here is a summary of the > findings... > > 1. No statistically significant differences between SA prevalence among > boys (3.5% - 3.8%) or girls (13.2% - 11.5%), though the trend for girls was > a decline. > > 2. No significant differences in SA prevalence within racial/ethnic groups, > though there was a trend for decline among African Americans (13.1% - 9.8%). > > 3. A significant decline in SA prevalence among the 12 year old cohort > (3.7% - 1.6%). No significant differences among any of the other age > cohorts. > > 4. Average age at first sexual assault increased fro 11.8 years to 14.9 > years. > > 5. The reporting to authorities rate for first sexual assaults doubled from > 14% to 29%. > > These results suggest that changes in gross statistics like number of > reports to CPS likely mask the more interesting underlying trends in gender, > age, racial/ethnic, and other subgroups. These data indicated that declines > are being seen in the younger age cohorts (0-12) and perhaps among certain > ethnic groups (AA). However, other groups report similar results in 1995 > and 2005. So, worrying about global trends may be less revealing than > better understanding which subgroups are exhibiting which trends and then > trying to understand why. > > Articles describing the comparison data for CSA, physical abuse, DV > exposure, and community violence exposures from the 1995 NSA and 2005 NSA-R > will be appearing in the literature over the next year. Several are in > press now. I am happy to send a handout from the San Diego paper to anyone > that wants it. Contact me back channel at > saundersmusc.edu. > > Ben > > > Basically, there were > > On 8/27/2010 9:41 AM, Chaffin, Mark J. (HSC) wrote: > Re: decreases in physical and sexual abuse rates. > > In studies using law enforcement data, I’ve observed similar declines in > child sexual abuse cases involving nonfamilial and unrelated perpetrators. > These cases don’t involve CPS policies, and don’t involve family pressures > to retain a breadwinner during hard times. The trajectory of the decline in > these separate data sets and different kinds of reports (often non-CPS > cases) over the past decade and a half parallels what was seen in the CPS > report data. > > In my career in child abuse research, I can’t recall seeing very many > research findings that seem to evoke such skepticism as research suggesting > that abuse rates are declining. I firmly believe that skepticism about > research findings is a good thing, but I’m intrigued about why so much > skepticism about this now almost two decade long finding. As a > psychologist, the really interesting research question to me is becoming the > reaction of our field to this finding, more than any more examination on the > finding itself! I recall recently sharing this finding with a person from a > rural child advocacy center (who had never heard anything about it) and she > was almost in tears with distress. > > Mark > > -- > Benjamin E. Saunders, Ph.D. > Professor and Associate Director > National Crime Victims Research & Treatment Center > Department of Psychiatry and Behavioral Sciences > Medical University of South Carolina > 67 President Street, MSC 861 > Charleston, SC 29425 > 843-792-2945 Phone 843-792-7146 Fax > www.musc.edu/ncvc > > Learn about Project BEST > > Take our free Web-based training courses: > TF-CBTWeb CPTWeb > > > >