Predicting maltreatment of children of teenage mothers

Cumulative teen birth rates among girls in foster care at age 17: an analysis of linked birth and child protection records from California

This study used linked foster care and birth records to provide a longitudinal, population-level examination of the incidence of first and repeat births among girls who were in foster care at age 17. Girls in a foster care placement in California at the age of 17 between 2003 and 2007 were identified from statewide child protection records. These records were probabilistically matched to vital birth records spanning the period from 2001 to 2010. Linked data were used to estimate the cumulative percentage of girls who had given birth before age 20. Birth rates and unadjusted risk ratios were generated to characterize foster care experiences correlated with heightened teen birth rates. Between 2003 and 2007 in California, there were 20,222 girls in foster care at age 17. Overall, 11.4% had a first birth before age 18. The cumulative percentage who gave birth before age 20 was 28.1%. Among girls who had a first birth before age 18, 41.2% had a repeat teen birth. Significant variations by race/ethnicity and placement-related characteristics emerged. Expanded data and rigorous research are needed to evaluate prevention efforts and ensure parenting teens are provided with the needed services and supports.

Young mother-father dyads and maternal harsh parenting behavior

OBJECTIVE

This study examined whether the age of parents predicted maternal harsh parenting behavior, specifically whether younger mothers might be at higher risk than older mothers, and which paternal characteristics might be associated with maternal parenting behavior.

METHODOLOGY

This study used data from the Fragile Families and Child Wellbeing (FFCW) study. In the present study, the authors examined a subsample of families for which complete data were available on all variables that were used in the analyses (n=1,597). Based on the parents' age at the time of the child's birth, mother-father age-dyad types were classified, and selected paternal factors were used to examine their association with maternal harsh parenting behavior. Psychological aggression, physical aggression, and self-reports of spanking were used as proxies for maternal harsh parenting behavior.

RESULTS

Multivariate analyses indicated that adolescent mothers, regardless of how old their partners were, were at higher risk for harsh parenting behavior than older adult mothers. Regarding paternal factors, paternal coercion against mother and the fathers' use of spanking were significantly associated with all three proxies for maternal harsh parenting behavior. Fathers' employment was a risk factor for maternal physical aggression.

CONCLUSION

This study supported findings from previous studies that younger mothers may indeed be at greater risk for harsh parenting behavior. It is critical, therefore, that they acquire appropriate parenting behavior and develop a healthy relationship with their children. Additional studies, both cross-sectional and longitudinal, are needed to involve their partners (i.e., their child's father) in order to shed light on ways of preventing harsh parenting behavior and examining the role of fathers in maternal parenting behavior.

PRACTICE IMPLICATIONS

The present study calls for more attention to sex education and intervention programs in school and health care settings as important components of prevention services. Practitioners need to better understand the concept of harsh parenting behavior in order to work with young parents and prevent future physical child abuse. Policy makers should support these efforts and research should be done that engages both mothers and fathers and seeks to enhance and modify existing programs for youths.

Early motherhood and harsh parenting: the role of human, social, and cultural capital

OBJECTIVE

This study examined the role of maternal human, social, and cultural capital in the relationship between early motherhood and harsh parenting behavior.

METHODS

This study used data from the Fragile Families and Child Wellbeing (FFCW) Study. Harsh parenting behaviors by mothers who were 19 years or younger at birth of the focal child (n=598) were compared with that of adult mothers 26 years or older (n=1,363). Measures included: For harsh parenting behavior, three proxies were created from the Parent to Child version of the Conflict Tactics Scales (CTS-PC) and self-reports of maternal spanking. For maternal human capital, education, employment, and depression were used. For maternal social capital, expected-social support, paternal support, and lone caregiver status were included. For maternal cultural capital, religious attendance and attachment to race/ethnic heritage were used.

RESULTS

Multivariate analyses indicated that adolescent motherhood has a significant impact on all three harsh parenting behavior outcomes even after controlling for demographic and maternal capital characteristics. Working since the birth of the focal child, depression scores, paternal support, expected-social support, and attendance at religious services made independent contributions to the prediction of harsh parenting behavior.

CONCLUSIONS

Findings emphasize the importance of the prevention of adolescent motherhood and suggest intervention strategies for reducing the risk of maternal harsh parenting behavior. Further study is necessary to examine the complicated relationships among maternal capital and parenting. One method may be to focus on the development of measures of maternal capital, notably measures of expectations regarding and perceptions of received capital.

PRACTICE IMPLICATIONS

Findings from this study have implications for social work practice, particularly for the prevention of adolescent pregnancy and intervention with adolescent mothers and their children. First, the study calls for more recognition of school social work and intervention programs in school settings as important components of prevention services. Second, the importance of identifying fathers and helping them become involved and connected with their young families are highlighted. Finally, practitioners should become more aware of the role of culture in young families as the effect of cultural capital on parenting behavior becomes better understood.

Adolescent parents and their children - The paediatrician's role

Adolescent parents and their children have a number of health issues that require attention from the health care provider. Both the adolescent and their child have health needs, and the young parent often requires significant support in their parenting role. Paediatricians should be aware of the areas in which problems can develop, including maternal nutrition and emotional health, and infant growth and development. The literature addressing these areas of concern will be reviewed and general recommendations for the care of this patient population will be provided.

The transition to parenthood among young African American and Latino couples: relational predictors of risk for parental dysfunction

This study examined relationship factors associated with parental dysfunction among young African American and Latino couples. Parent dysfunction was defined in terms of parenting stress, child abuse potential, physically punitive behavior, and paternal disengagement. Fathers who reported positive relations with their own parents and partners before childbirth reported more positive adjustments to parenthood at follow-up. The quality of the prebirth partner relationship buffered the impact of a relationship breakup on a young father's adjustment to parenthood. The quality of a mother's relationship with her parents was the best predictor of her adjustment to parenthood. However, mothers who reported large declines in the quality of the partner relationship also reported high levels of parenting stress. Clinical and policy implications of findings are discussed.

Child abuse potential in at-risk African American mothers: the role of life experience variables

The effects of life experience variables on child abuse potential were evaluated in 95 prospectively recruited African American mothers 1 month postpartum. All participants had used opiates or cocaine during pregnancy and were considered high risk for child maltreatment. Abuse potential was assessed with the Child Abuse Potential Inventory, a widely used and psychometrically sound measure with demonstrated predictive validity. Conceptually relevant measures of life experiences and demographic data were obtained from hospital records, maternal self-report, and clinician-administered interviews. Hierarchical multiple regression analysis indicated that exposure to violence in the family of origin and lifetime use of illicit substances made significant independent contributions to the prediction of child physical abuse potential, even after maternal age and current socioeconomic status were controlled for.

A comparison of the psychological resources of adolescents at low and high risk of mistreating their children

OBJECTIVE

Our objective was to compare the psychological resources of pregnant teenagers who are at low and high risk for mistreating their children.

METHOD

We studied 71 participants in a comprehensive, adolescent-oriented maternity program. During the prenatal period, the Family Stress Checklist was used to quantify child abuse potential, with scores > or =25 defining high risk. Information about the social context of the pregnancy and maternal psychological resources was obtained with self-administered questionnaires. A composite psychological resource variable was computed by summing the z scores for intelligence, mental health, and mastery, with scores < or =0 defining the low-resource group.

RESULTS

Of the 71 teenagers, 26 (36.6%) were classified as high risk for child abuse and neglect. Compared with low-risk teens, high-risk teens had more behavioral problems, lower psychological resource scores (mean +/- SD of z score: -0.98 +/- 2.02 compared with 0.39 +/- 1.79; P =.004), and were more likely to have low psychological resources (69.2% compared with 44.4%; P =.04).

CONCLUSIONS

Pregnant teenagers who are at risk for child abuse and neglect exhibit fewer psychological resources than their low-risk peers do, and may therefore benefit preferentially from intensive, in-home intervention.

Adolescents at risk for mistreating their children. Part I: Prenatal identification

OBJECTIVE

To determine if the Family Stress Checklist helps prenatal care providers identify adolescents who are at risk for mistreating their children.

METHODS

We studied 262 participants in a comprehensive, adolescent-oriented maternity program. During the prenatal period, the Family Stress Checklist was used to quantify abuse potential, with scores >25 defining high risk. Information about the social context of the pregnancy and the pattern of health care utilization was obtained with a self-administered questionnaire, and by reviewing the medical records. Major disruption of primary care giving by the adolescent mother was classified hierarchically as abuse, neglect, and abandonment.

RESULTS

Family Stress Checklist scores ranged from 0 to 65 (mean + SD = 20.1 + 1.4); 113 (43%) of the 262 teenagers were classified as high risk. High and low risk adolescent mothers made an equivalent number of health maintenance and Emergency Department visits, but the high risk group initiated significantly more acute care visits (6.0 + 4.1 compared to 3.9 + 3.3; p < .0001). After controlling for pre-existing sociodemographic differences, high risk 1-year-olds were 8.41 (95% CI: 1.77-40.01) times and high risk 2-year-olds 5.19 (95% CI: 1.99-13.60) times more likely to have been mistreated than their low risk counterparts.

CONCLUSIONS

Prenatal care providers can use the Family Stress Checklist to systematically identify a subgroup of adolescent mother whose excessive use of the acute medical care services and propensity for mistreating their children suggests the need for additional support services.

Adolescents at risk for mistreating their children. Part II: A home- and clinic-based prevention program

OBJECTIVE

To determine if adding an intensive home visitation component to a comprehensive adolescent-oriented maternity program prevents child abuse and neglect.

METHODS

We studied 171 participants in a comprehensive, adolescent-oriented maternity program who were deemed to be at high risk for child abuse and neglect. Half were randomly assigned to receive in-home parenting instruction. Major disruptions of primary care-giving by the adolescent mother were classified hierarchically as abuse, neglect, and abandonment.

RESULTS

Compliance with home visits varied in relation to the support the teenage mothers received from their families and the fathers of their babies (p < .0001). There were no significant treatment group differences in the pattern of health care utilization, the rate of postpartum school return, repeat pregnancies, or child abuse and neglect. The incidence of maltreatment rose in tandem with the predicted risk status of the mother. Ultimately, 19% of the children were removed from their mother's custody.

CONCLUSIONS

Prediction efforts were effective in identifying at-risk infants, but this intensive home- and clinic-based intervention did not alter the incidence of child maltreatment or maternal life course development. A parenting program that was more inclusive of the support network might be more popular with teenagers and therefore more effective. Our findings also emphasize the importance of including counseling specifically designed to prevent teenagers from abandoning their children.

Incorporating health and behavioral consequences of child abuse in prevention programs targeting female adolescents

A study examining the health and behavioral consequences of child abuse was conducted among 263 parenting and 257 never-pregnant teens attending a reproductive health clinic. Both groups of teens identified the following major consequences: suicide, prostitution, school drop-out, crime and substance abuse. However, only parenting teens expressed interest in prevention programs that would address these consequences. Traditional child abuse prevention programs are focused on parenting issues and rarely address health and behavioral consequences of abuse. These health and behavioral consequences of abuse may make adolescents vulnerable to abuse their own children as well as interfere with their psychosocial development. Therefore, the authors recommend integrating health and behavioral issues into child abuse prevention programs.