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1.
The provision of the most comprehensive funded statewide delivery of diagnostic, protective and treatment services to abused and neglected children and their families in the country has been made possible by the State of Louisiana and its concerned citizenry. The importance of obtaining a legislative mandate establishing and funding the statewide child protection concept by the Louisiana legislature was illustrated.We described how the medical and protective services components cooperate and coordinate at the state and local levels to provide the abused and neglected child and his family with the best possible services available. Throughout our presentation the use of the interdisciplinary team concept was emphasized as the best system known to enhance the reporting, investigation and diagnosis of child abuse and/or neglect cases as well as providing protective and treatment services to the child and his family.The Child Protection Center is the community agency serving as the “core” for the interdisciplinary approach to be successful. The role of each discipline employed by the center was reviewed and how interagency coordination is accomplished through their efforts.The interdisciplinary dispositional conference prior to a child's discharge from the hospital was considered as an excellent method to insure that several disciplines share in the definitive protective and treatment plans for the abused child.Several treatment modalities and their success rates for the child and his family were discussed. The accomplishments of the center were listed.Finally, a review of how the citizenry from the Baton Rouge Community responded overwhelmly by their involvement and commitments in an all out effort to combat a serious social symptom and disease — child abuse and neglect. 相似文献
2.
A study of the initial phase of intensive work with families indicated that whilst outreach techniques had dramatically reduced physical injury there was long-term distortion in the child's relationship with mother (parent) less amenable to change. The most recent phase of work has concentrated on direct treatment for the abused child, using a multidisciplinary team that includes a play specialist and child psychotherapist in addition to the social workers involved. Out of a total number of 66 children seen between April 1977 and December 1979 it was alarming to find that almost all were emotionally disturbed; even if the abuse did not reoccur they remained with considerable problems. The study highlights the degree of emotional disturbance suffered by these abused children and how they can be helped by focusing on their particular treatment needs. It is important to assess all children in the family situation and not to miss the quiet, depressed, withdrawn child who might not have been the subject of the initial referral. In some instances the needs of the child may outweigh those of the family and the focus of treatment must be on the child. 相似文献
3.
Seven deadly sins of childhood: advising parents about difficult developmental phases 总被引：1，自引：0，他引：1
B D Schmitt 《Child abuse & neglect》1987,11(3):421-432
Seven of the more difficult developmental phases for any parent to deal with are colic, awakening at night, separation anxiety, normal exploratory behavior, normal negativism, normal poor appetite, and toilet training resistance. For the child living in a high-risk family, these innocent acts can trigger dangerous or even deadly abuse. The two behaviors most commonly associated with fatal abuse are colic and toilet training. When we recognize a child who is going through a provocative phase, we should be prepared to advise the parents on some practical alternatives to a physical response. Such advice is welcomed by most types of families. Any treatment plan for an abusive family that fails to include this type of problem solving may be inadequate. 相似文献
4.
It is obviously better if child abuse can be prevented in the first place. There are many problems in society which doctors and nurses and other health care professionals can hardly be expected to fix up, but there are many weaknesses in what we do which can and should be repaired. As a group we are weak in our appreciation of the demoralizing strain that an awkward or crying baby can bring upon a household, particularly that of the nuclear family. The media paint a mythical picture of parenthood, possibly unreal, and leading to the isolation of the mother who wants to complain that her child is very trying. As a group, doctors and nurses are more concerned about reassurances that a child is not seriously ill or else will outgrow his particular symptom and are not very good at bending their energies towards providing relief of the symptom. The sanity of many families has been preserved by the judicious use of safe analgesics and sedatives. Many people obtain these in spite of the physician and not through him.To turn to an even earlier phase of infancy, where hospital personnel are intensely involved and could well mend their ways often — in Western countries more and more babies are being born in hospital. Frequently, insufficient efforts are made to ensure that the labour and delivery are pleasant emotional experiences for the mother. In the name of safety, sterility and administrative needs, many of the emotional needs of the parents are unmet. It is now being shown that actual physical attachment between mother and baby in the time — hours and days — after the baby is born can be extremely important in developing the mother/child bond which is the child's greatest protection. In many countries including mine there have to be associations of mothers who want to breast feed their own children, and these mothers often find that their greatest difficulties are with hospital personnel.The very necessary scientific measures required to ensure the safety of low birth weight and premature infants can separate mother from baby even more and this is reflected in the well-known increase in later child abuse among babies who have spent their early weeks in intensive care units. If the hospital personnel really try, they can make the mother and father feel at home in these ultrascientific units. The staff must not merely permit but must actively invite the parents into the special nursery, explain the surroundings and equipment, show how to gown and hand wash, how to open the Humidicrib, touch the baby and take part in the nursing management from the earliest possible time — the second or first day. Explanations appropriate to the parental level of understanding must be given and repeated.Anything which will strengthen the bonds within the family must be welcomed as something that will prevent child abuse. 相似文献
5.
In summary, the Circle House Residential Treatment Program for abusive families did meet its goals of protection of the child without separation from the family. The program was also effective in making and executing permanent plans for children in a relatively short period of time, but at huge financial cost.Residential care tor abusive families may be feasible if planned for 12–18 families at a time, thus utilizing staff fully. Also, in the Circle House program the single-parent families were clearly able to utilize the program to deal with their child-care techniques. Because the program was primarily geared to improving child-rearing patterns, some fathers in two-parent families, who viewed themselves as only occasional disciplinarians, never really participated in the program. Some were successful in learning new techniques, others were not.Residential care may also be more feasible if utilized as a diagnostic and prognostic facility with enhanced opportunity for long-term relationships to be formed, rather than as a primarily treatment facility, with the expectation of improvement and “cure.” Treatment of abusive families then becomes long-term supportive care no matter how intense the initial intervention. Even with the multitude of services of Circle House at the beginning phase of diagnosis and treatment of a family, this does not reduce or remove the need for ongoing long-term services. The true results of present intervention will be measured in future generations. 相似文献
6.
7.
Research suggests that perinatal screening and early intervention may reduce the incidence of maltreatment and improve the parenting in at-risk families. The question of whether families with different sets of entry-level characteristics differ in the way that they respond to intervention is asked in this paper. We investigated whether entry-level family functioning and family problems had an impact on length of time in treatment and the improvement or deterioration of family functioning over time. In our analyses, we used entry-level characteristics to classify families into five homogeneous groups--situationally stressed, chronically stressed, emotionally stressed, multirisk, and violent multirisk--and we found that treatment duration and rate of change in family functioning over time differed in clinically important ways across these groups. Our findings suggest that treatment is likely to be successful in stabilizing and slowly improving the family functioning of the majority of families at risk of child maltreatment. 相似文献
8.
Helen McCabe R. Eric Barnes 《International Journal of Disability, Development & Education》2012,59(2):197-207
Having a child with autism in China raises challenges for families. Some are similar to those of families in western countries, but others are unique. This study sought to understand one aspect—the dilemmas of having a second child in a country where having only one child is the norm, and where social welfare services are not developed. This study examined the experiences of one family from the time when the family were considering having a second child through to the time when the younger child was a teenager. The most salient issues were the changing perspectives on the sibling’s role, and the responsibility and future burden of the sibling due to this responsibility. We use three ethical theories as a framework for analysis. The data suggested several benefits of having a second child and the possibilities for promoting opportunities and well-being, and not just responsibility and worry, in the second child. Areas of future research to expand this study are considered. 相似文献
9.
Ronald S. Fischler 《Child abuse & neglect》1984,8(3):361-368
The pediatric role in the management of child abuse and neglect has been largely limited to detecting and reporting cases, with little involvement in long-term treatment and follow-up. A review of published clinical experience indicates that customary protective services' “treatment” strategies are all too often ineffective at preventing reabuse, improving child health and developmental status, and improving family functioning. When foster care is used as a treatment modality, children run the added risk of never returning home, nor being freed for adoption, and they may suffer the emotional harm of repeated foster placements. This situation is likely to worsen, in the light of recent cutbacks in social service programs, at a time of rising reports of maltreatment. The pediatrician is widely recognized as an expert in children's health and development, and he can effectively use his position to influence the management of cases and thereby the outcome, by actively participating in treatment decision making and providing close follow-up in a limited but important way. In order to do this, he must first become acquainted with the effects of maltreatment upon children's health and development and with the general principles and available modalities of treatment. He must be sympathetic and supportive of the difficult role of the protective service worker who must make treatment decisions. His role is to assist the worker by making medical resources available in order to adequately define the child's needs and the capacity of the family to meet those needs. Essential to answering these questions is the availability of a child development clinic and mental health resources. After ensuring that the child and family are thoroughly assessed and the treatment plan tailored to the child's and family's needs, the pediatrician provides continual longitudinal follow-up, monitoring the child's health and developmental status. If the child is placed in foster care, the physician observes the child's adjustment and provides advice and consultative assistance when needed to help foster parents manage health, developmental or behavior problems. Periodically he also meets with the natural family to keep them informed about their children's health and development and to ensure they are making good use of treatment. Finally, he communicates closely with the child protective service worker and participates in interdisciplinary staff meetings to review and evaluate treatment progress in the hopes of shortening the time needed to make decisions regarding placement. 相似文献
10.
Abused children admitted to a pediatric in-patient service in Switzerland: a ten-year experience and follow-up evaluation 总被引：2，自引：0，他引：2
In a period of 10 years (1974-1983) 82 children were admitted to our pediatric in-patient service because of child abuse or neglect. In 1984 the records of these children were examined to obtain a follow-up of 34 children who were less than 10 years of age at the time of their admission for non-accidental trauma. Thirty-eight percent of these children were less than 2 years old at the time of abuse, 30% from 2-3 years (68% less than 3 years) and 32% between 3-10 years. The lesions were as described in the literature. There was a greater proportion of children of foreign origin than would be expected from the general population of Geneva. At the time of hospital admission the majority of the parents were legally married and the majority of the children were cared for at home by a parent or relative. The perpetrator in most situations remained unknown; universal denial was the rule and therapeutic treatment of the family difficult to establish. The general policy of the protective services in Geneva is to maintain the abused child with his biological family. Over time, however, there is a tendency for abused children to be either removed from their homes and placed in foster care or to receive stricter supervision within their families. A large proportion of the study children were experiencing school difficulties and attended special classes. A relatively large number had left the country, either with or without their parents. Risk factors recorded in the literature were identified. 相似文献
11.
OBJECTIVE: The aim of this study was to demonstrate the usefulness of cerebral MRI to detect possible child abuse in children with unexplained neurologic findings. METHOD: Between 1990 and 1997, 208 children were referred for suspected physical child abuse to the Child Protection Clinic of Ste-Justine Hospital, a tertiary care pediatric hospital. Among them, 39 children presented initially with neurological findings. For 27 of them, the CT Scan results prompted the diagnosis of child abuse. However, in 12 children, even if a CT-Scan was performed, the diagnosis and/or the mechanisms of the neurologic distress remained obscure. Investigation was completed with MRI study in those 12 cases. RESULTS: MRI findings were diagnostic for physical abuse in eight cases. A diagnosis of child abuse was made in two more cases by a combination of MRI and skeletal survey findings. In one case, MRI was suggestive but the diagnosis of child abuse could not be confirmed. One case was misinterpreted as normal. CONCLUSIONS: MRI is the test of choice to rule out child abuse when faced with a child presenting unexplained neurologic signs lasting for few days. The fact that MRI can better differentiate collections of different ages makes this imaging test particularly useful in identifying cases of child abuse. These results, however, always have to be integrated in a well conducted multidisciplinary clinical approach. 相似文献
12.
Dacia M. McCoy Julie Q. Morrison Dave W. Barnett Hilary D. Kalra Lauren K. Donovan 《Psychology in the schools》2017,54(8):821-836
As technology becomes more accessible and acceptable in the preschool setting, teachers need effective strategies of incorporating it to address challenging behaviors. A nonconcurrent delayed multiple baseline design in combination with an alternating treatment design was utilized to investigate the effects of using iPad tablets to display video self‐modeling and activity photos for three preschoolers during circle time. During baseline, all three children demonstrated low levels of engagement and high levels of off‐task behavior compared to peers. The intervention phase consisted of alternating between showing the child the self‐video and photos prior to circle time. A child preference phase was conducted whereby each child self‐selected the video or photo prior to circle time. For all three children both videos and photos led to increased engagement and decreased off‐task behaviors. During the child preference phase, all three children selected the video most frequently. Social validity data demonstrated teacher and child preference for the video self‐modeling condition. 相似文献
13.
《Early childhood research quarterly》2003,18(3):294-309
Versions of the HOME Inventory for use in family child care homes are described. The Infant/Toddler version is designed for use when children are less than 3 years old; the Early Childhood version for children ages 3–6. Psychometric characteristics of the child care versions of HOME are similar to the psychometric characteristics found for the original HOME used to measure the family environment. Child Care HOME scores were strongly related to intensive observational measures of behavior among child care providers and to measures of physical and organizational aspects of the environment. Because the inventories take less time and training to administer than most current measures of family child care, they may provide a way for licensing workers and others responsible for maintaining quality in child care to obtain useful information about this widely used but minimally monitored form of non-parental care. 相似文献
14.
In recent years attempts to improve the management of cases of child abuse have concentrated on structural procedures for achieving better coordination between agencies, at the expense of attention to less tangible factors which may impede treatment. This paper, based on a small study which analysed retrospectively cases which had resulted in the serious injury or death of a child, identifies some of these factors. The evidence suggests that the manifest level of concern for the safety of the child changes markedly in treatment, but does not correspond with the objective reality portrayed in the case material. Some underlying factors influencing this lack of congruence are: (1) formulation of the presenting problem creates a bias which becomes more pronounced through time; (2) focus on strengths and progress conceals areas of malfunctioning in the family; (3) attention to an individual masks risk to siblings; (4) concentration of attention on one adult as possible aggressor obscures contribution of others; (5) influence of any changes in family composition is not sufficiently considered. The paper discusses these findings and suggests the hypothesis that the use of a properly constructed “Index of Concern” could provide a means of counterbalancing such factors. 相似文献
15.
J G Jones H L Butler B Hamilton J D Perdue H P Stern R C Woody 《Child abuse & neglect》1986,10(1):33-40
Munchausen syndrome by proxy is a form of child abuse in which a disorder of the child is fabricated by a parent. Although often considered rare, it may have been overlooked frequently in the past. The reported cases of children with Munchausen syndrome by proxy range in age from infancy to 8 years. Their "illnesses" consist of fabricated histories, inflicted physical findings, altered laboratory specimens, and induced disorders. The perpetrator usually is the child's mother, who may have Munchausen syndrome. Consequences of the syndrome may include painful tests, frequent hospitalizations, potentially harmful treatment, and death. The diagnosis can be made when medical and social histories are characteristic of the syndrome and clinical findings are absent, suggestive of induced illness, or resolve upon separation of the child and parent. Suspicion of the syndrome should be discussed with the family once the safety of the child is insured, and the case should be reported under the child abuse reporting law of the state. Social, family, and medical histories must be obtained and verified, and court intervention should be considered. Four patients who illustrate typical features of the syndrome are described. 相似文献
16.
G W Brown 《Child abuse & neglect》1983,7(1):123-126
An eighteen-month-old Alaskan girl suffered transient coma with multiple superficial contusions when injured by her multiple personality disturbed caretaker. The relative disinterest in multiple personality disorder as a psychiatric diagnosis among American trained practitioners is reflected in the great difficulty encountered by child protection workers while seeking psychotherapy for this disturbed family. The public health nurse, pediatrician, and social workers of the child protection team were unsuccessful in attempting to secure psychiatric therapy for this child batterer. Multiple factors, other than psychiatric community disinterest in multiple personality disorders, influenced these unsuccessful attempts. Legal process delays, strongly punitive community attitudes, tired and nearly "burned out" child protection workers, and conflicting psychological and psychiatric consultant opinions are described. A brief review of multiple personality disorder traits is given with emphasis on the common childhood exposure to abuse and violence among reported multiple personality subjects. Despite the obvious hope by the eighteen-month-old child's parents for effective help to reconstitute her family, the multiple factors described show institutional neglect and abuse which has made such recovery impossible to date. A plea is made to all persons involved with child abuse and neglect to more accurately diagnose and treat multiple personality disorders in abusive parents. 相似文献
17.
Colleen A. Capper 《International journal of qualitative studies in education》2013,26(6):693-698
We examined the lived experiences of a Cypriot family with a young child with autism. Semi‐structured interviews with parents, siblings, and extended family members across three generations and observations of the family’s daily activities were the primary data‐generating methods. Critical events related to the disability diagnosis, the mother’s decision to undertake a significant role in the child’s education following negative interactions with professionals, and the family’s daily accommodations to the child’s needs emerged in narratives of multiple participants. Family narratives reflect the polyphony of experiences and responses shared by participants. The study illuminates the complexities of this experience and offers opportunities to rethink the interplay of disability, family, and culture in the context of research and practice. 相似文献
18.
Variables associated with disrupted placement in a select sample of abused and neglected children 总被引：1，自引：0，他引：1
The purpose of this study was to examine the placement history of 172 abused and/or neglected children who had been placed in a residential home for maltreated children. Data were collected on the child's placement history (i.e., number of placements, time in transition, and placement rate) and also on child and family characteristics. Pearson correlation coefficients were run between child and family variables and each of the three placement history variables. In addition, t-tests were also used as a method of analysis. Results indicated that children with the following characteristics or life circumstances experienced the more disruptive experience while in foster care: children having severe behavior problems; children who were very young when first removed from their natural home; and children having drug addicted and/or alcoholic parents. Implications of these findings indicate social workers and judges need to be alert to the potential for system abuse of children in foster placement, responsible long-term planning for any child in foster care is critical, and those involved in therapeutic treatment for abused/neglected children should be attentive to the child's placement history. 相似文献
19.
Ira S. Lourie M.D. 《Child abuse & neglect》1979,3(3-4)
The phenomenon of adolescent abuse is presented and abusive patterns are discussed. A developmental phase specific model of child abuse is constructed. From this discussion, the utility of abuse in the family is also discussed. 相似文献
20.
Christine Adams-Tucker 《Child abuse & neglect》1981,5(3):361-367
A retrospective overview of 28 sexually-abused children evaluated at a university-based child guidance clinic is reported. These 28 cases are scrutinized and empirical data are culled on the following sociodemographic and clinical variables: age, gender, race, family composition, referral source, presenting complaints, type of referral, psychiatric history of the child and family, diagnosis, disposition, type and duration of treatment, and a severity rating (done by parents) of the child's behavioral maladjustment. Historical information about the sexual abuse is presented: molester, type of abuse, duration of abuse and recency of sex abuse. The sociodemographic findings reveal the sex-abused child prototype to be a white girl, 9 years old, from a working class family headed by both parents or by mother alone. She was abused by an adult male relative. If a boy, abuse was by a male age-mate. Genital abuse was the most frequent type with sexual intercourse of very high frequency for children of all ages. Many psychiatric difficulties were reported in the families of these children. Some children had more than one molester. The clinical findings show psychic suffering among all studied children—most of moderate levels, behavior reactions. All but 3 children had therapy recommended to them. Presenting difficulties were for sexual abuse per se and/or for a wide-ranging variety of symptom complaints. The socioclinical overview of sexually molested children compells researchers to look closer at broader, extra-familial, cultural and socio-economic issues in the lives of these children and not just at psychopathologies of individual molesters and family units. 相似文献