Amy L. Damashek

Fatal child maltreatment: characteristics of deaths from physical abuse versus neglect.

This study examined victim, family, and alleged perpetrator characteristics associated with fatal child maltreatment (FCM) in 685 cases identified by child welfare services in the state of Oklahoma over a 21-year period. Analyses also examined differences in child, family, and alleged perpetrator characteristics of deaths from abuse versus neglect. Case information was drawn from child welfare investigation records for all FCM cases identified by the state Department of Human Services. Fatal neglect accounted for the majority (51%) of deaths. Children were primarily younger than age 5, and parents were most frequently the alleged perpetrators. Moreover, most victims had not been the subject of a child welfare report prior to their death. A greater number of children in the home and previous family involvement with child welfare increased childrens likelihood of dying from neglect, rather than physical abuse. In addition, alleged perpetrators of neglect were more likely to be female and biologically related to the victim. These results indicate that there are unique family risk factors for death from neglect (versus physical abuse) that may be important to consider when selecting or developing prevention efforts.

Foster Care Youth Share Stories of Trauma Before, During, and After Placement: Youth Voices for Building Trauma-Informed Systems of Care

Many research studies address child trauma experiences that take place before foster care placement. However, few studies focus on the types and patterns of trauma experiences that reportedly take place during and after foster care placement; that is, after entry into adult living. This study examined the testimony of 43 foster care youth who spoke to a listening panel comprised of state legislators, child welfare professionals, and university educators. Qualitative analyses of transcribed text data revealed 3 main themes. First, the youth reported experiencing trauma before, during, and after placement. Second, the youth described trauma events and situations that were chronic (i.e., intense, composite, or cumulative). Third, youth offered suggestions for reducing traumatic experiences for foster care youth. They recommended earlier family interventions, access to people who listen and care, improved parenting skills for foster parents, continuity of relationships, and opportunities for leadership for foster youth. Foster youth voices offer important suggestions for building, strengthening, and evaluating trauma-informed systems of care.

Child Maltreatment Fatalities Related to Inadequate Caregiver Supervision

More than 1,500 children died in the United States in 2011 due to child maltreatment. A substantial portion of these deaths were due to neglect. Previous research has found that a large percentage of child neglect cases involve supervisory neglect; however, the role of inadequate caregiver supervision (ICS) in child maltreatment deaths is unknown. The present study reviewed files from the Child Death Review Board in the state of Oklahoma for the years 2000 to 2003 to examine (a) how many deaths were due to inadequate caregiver supervision and (b) which child, caregiver, family, alleged perpetrator, and incident characteristics predicted risk for death related to ICS. Results indicated that almost half of the child maltreatment deaths were related to ICS. Older children and those living in homes with greater numbers of children were more likely to die from causes related to ICS. In addition, the alleged perpetrators of deaths related to ICS were more likely to be biological parents than alleged perpetrators of non-ICS-related deaths. These findings suggest that interventions to assist caregivers in providing appropriate levels of supervision for their children may be important for reducing children’s risk for death.

Training competent psychologists in the field of child maltreatment

Child maltreatment is a serious threat to childrens physical and psychological well-being; therefore, it is critically important to develop high-quality educational programs to train psychologists in effectively addressing child abuse and neglect. Various health care disciplines and areas within the field of psychology have established competencies as a guide for student training curricula; however, none have been established for the area of child maltreatment. The present article presents training competencies for the field of child maltreatment that have been developed from a program designed to train psychology graduate students to practice and conduct research in child maltreatment. The competencies have been divided into eight core areas including assessment, treatment, multidisciplinary collaboration, advocacy, ethics, research, research ethics, and professional development.

The role of proximal circumstances and child behaviour in toddlers' risk for minor unintentional injuries.

Background Much of the research on child injury risk has focused on trait-like factors (eg, hyperactivity, child gender) that influence injury risk rather than state-like factors (eg, environmental circumstances, child behaviour). Additional research is needed to better identify the proximal risk factors for childrens risk for unintentional injury. Objectives The present study examined the antecedents to minor unintentional injury events and whether unusual circumstances and child behaviour predicted injury risk. Methods The study used archival data that were collected via biweekly in-person interviews with 170 mothers of toddlers (15–36 months) for 6 months. A case crossover design was used to predict childrens risk for injury from proximal risk factors. Results Children were at a higher risk for injury when circumstances were unusual and when they were engaging in an unusual behaviour. When a child was engaging in an unusual behaviour, higher levels of maternal supervision predicted lower injury risk. Children were more likely to be injured in a new environment, in an environment with animals or other people, in an environment with hazards or when engaging in a new activity or in a familiar activity performed in an unfamiliar way. Conclusions The results indicate that toddlers may be at a greater risk for minor unintentional injury when environmental circumstances are outside of the norm or when a child is engaging in unusual behaviours. The findings also indicate that higher levels of caregiver supervision may be especially beneficial when children are engaging in new or unfamiliar activities.

The role of environmental hazard in mothers' beliefs about appropriate supervision

Understanding factors that influence mothers’ beliefs about appropriate levels of supervision for their children may assist in efforts to reduce child injury rates. This study examined the interaction of child (i.e. age, gender, and injury risk behavior) and maternal perception of environmental hazard (i.e. hazard level, injury likelihood, and potential injury severity) variables in predicting mothers’ beliefs about appropriate levels of supervision for their children. Participants were 58 mothers of 2- to 8-year-old community children who were interviewed about their beliefs regarding child injury risk and appropriate supervision. Results indicated that perceived environmental hazard level interacted with child age, gender, and injury risk behavior to predict mothers’ beliefs about supervision. Perceived injury likelihood also interacted with child injury risk behavior to predict beliefs about supervision. Findings underscore the complexity of factors influencing mothers’ beliefs about appropriate supervision and indicate the importance of environmental hazard level in such beliefs.

Computerized Behavioral Activation Treatment for Maternal Depression Delivered in an Obstetric Clinic: A Case Study

Purpose Depression affects a significant number of pregnant and postpartum mothers, especially low-income women. The presence of depressive symptoms during and immediately after pregnancy has been found to negatively affect both mothers and their children. Effective and accessible psychosocial treatment alternatives to antidepressant medications are needed to accommodate patient preferences and avoid potential risks to infant development. However, low-income depressed mothers face many barriers to accessing care. Computer-based treatment delivered in obstetric clinics may bypass some of these barriers and allow depressed pregnant and postpartum mothers greater access to effective treatment. Methods Presented is the clinical case of a low-income 22-year-old pregnant woman experiencing depressive symptoms. The patient successfully completed a 10-session computerized behavioral activation treatment program that was delivered in her obstetric clinic. Results Clinical outcomes revealed a decrease in depressive symptoms and an increase in quality of life. These gains were present at the end of treatment and were maintained at the three-month follow-up. Additionally, the patient responded positively to the treatment program and reported a high level of satisfaction. Conclusion These results suggest that computerized treatments delivered in familiar medical settings could accommodate patient preferences, remove some barriers to care, and allow for a streamlined referral process from physicians to mental health care providers, thus improving the accessibility of treatment for low-income mothers suffering from depression.

116 Reducing unintentional child injuries: pilot test of a home-based behavioural training program

Background Unintentional injury is the leading killer of children in the United States, and nonfatal injuries result in significant physical and emotional injury. Few interventions to reduce child injuries have been effective, potentially due to their primarily didactic nature. Behaviorally focused interventions are needed. SafeCare is a behavioural intervention that is effective for treating child abuse and neglect. It contains a home hazard reduction module that is likely to be effective in reducing child injuries; however, its effect on injuries has not been examined. Objectives This pilot study used an RCT design to examine whether the home safety module of SafeCare reduced home hazards and unintentional injuries among at-risk children ages 1–3. Methods SafeCare was compared to Services as Usual among 20 families receiving home visiting services from a consortium. Self-reports of minor injuries and observations of home hazards were conducted at pre-test, post-test, and 4 week follow-up. Preliminary Results Preliminary results among this low-income sample have found high numbers of hazards at pre-test (average of 55.3 hazards per family). Pre-test rates of minor unintentional injuries have been moderate (average of 2.14 per 2 week period). ANCOVA analyses will compare post-test and follow-up frequencies of hazards and child injuries for the control versus treatment group. Conclusions Study results will indicate whether a home-based behavioural skills parent training can reduce unintentional injuries among low-income and at-risk children.