Beatrice Crofts Yorker

To Grandmother's House We Go... and Stay: CHILDREN RAISED IN INTERGENERATIONAL FAMILIES

An increased incidence in child abuse and neglect has resulted in a dramatic rise in the number of grandparents raising grandchildren and great-grandchildren. Grandchildren raised by grandparents often suffer from emotional and behavioral problems due to prior abuse, neglect, and abandonment. Grandparent caregivers experience increased health problems, psychological distress, and social isolation related to their roles as primary caregivers of children. Grandparents who become caregivers of grandchildren face increased financial responsibilities at a time in their lives, close to or at retirement, when income is dramatically decreased.

Fears of Medical Events Among School-Age Children with Emotional Disorders, Parents, and Health Care Providers

The purpose of this comparative study was to describe the reports of fears of medical events among school-age children with emotional disorders and compare their reports with those of parents and health care providers. A secondary purpose was to determine the reliability of the Child Medical Fear Scale (CMFS) with this population. Thirty children, parents, and health care providers (N = 90) completed the CMFS; the parents and health care providers also completed demographic instruments. The internal consistency reliability was acceptable (alpha = .75) for the CMFS with this population. Overall, the children reported lower fear scores of medical events than in previous research studies. Boys reported lower fear scores (p = .03) than girls. There was a statistical difference (p = .006) between the mean scores of the children and those of the parents and health care providers, with the children reporting less fear. The CMFS is useful among children with emotional disorders both in the clinical setting and in research.

The Role of Nonphysician Health Care Providers in the Physical Assessment and Diagnosis of Suspected Child Maltreatment: Results of a National Survey

The physical diagnosis and treatment of child abuse and neglect have traditionally fallen in the domain of physicians; however, nurse practitioners (NPs), registered nurses (RNs), and physician assistants (PAs) are assuming increasing roles in the evaluation and treatment of maltreated children. The role of nonphysician health care providers in evaluating cases of suspected child maltreatment (CM) is not without controversy and deserves close attention for several reasons. First and foremost, a diagnosis of suspected CM has serious civil and criminal legal ramifications. A “false positive” evaluation—concluding that abuse occurred when it has not occurred—could result in the wrongful removal of a child from his or her family, or criminal prosecution and conviction of an innocent individual, or both. On the other hand, a “false negative” finding—failing to diagnose suspected abuse when in fact it has occurred—could result in subjecting a child to subsequent abuse, resulting in increased physical and psychological harm. Because cases of CM often rely heavily on physical findings and laboratory evidence, examiners must be adequately prepared to perform such examinations. Expert testimony also plays a critical role in child abuse litigation. According to federal law, before a professional may testify as an expert witness, the judge must be convinced that the professional possesses sufficient “knowledge, skill, experience, training, or education” to qualify as an expert. Do RNs, NPs, and PAs possess the credentials necessary to qualify as expert witnesses in cases of CM? The purpose of this article is to describe the roles, responsibilities, and qualifications of NPs, RNs, and PAs working in the field of CM. More specifically, the results of a national survey of NPs, RNs, and PAs who perform physical assessments in cases of suspected child physical abuse, neglect, and sexual abuse will be presented.