Perceptions of child maltreatment by parents from the Indian subcontinent: challenging myths about culturally based abusive parenting practices

"Care About us First": Israeli Youths' Perspectives on Child Neglect

Child neglect is considered the most common form of child maltreatment with severe implications for children's development. Nonetheless, there is a dearth of scholarly literature examining child neglect, possibly stemming from a lack of consistent definition. The current qualitative study addresses this gap by aiming to understand the phenomena of child neglect from the direct perspective of youth from the general population, a perspective that has so far barely been considered. Data were collected by 10 focus groups conducted among multicultural youth aged 12 to 15 years in the north of Israel. The qualitative-thematic analysis generated three main themes, each including several subthemes: (a) experience of neglectful behavior (lack of parental care, lack of parental priority, dynamics of blaming the child, rejection, and relinquishment of the child); (b) instrumental characteristics of neglect (lack of material and financial investment in the child, expressions of neglect in providing food and nutrition, poor appearance and hygiene of the child and home); (c) lack of parental involvement (lack of parental guidance, lack of communication and availability, lack of presence in the child's life). The perspectives of the Israeli youth resembled existing conceptualizations of child neglect. The youth also added a new dimension to the conceptualizations in their focus on the emotional context involved in the range of neglectful behaviors they described. This new conceptualization of child neglect is discussed together with some suggestions for how it can inform better professional practice.

Development and effectiveness of parent skills training intervention for Indian families having children with attention-deficit/hyperactivity disorder (ADHD)

OBJECTIVE

Parent skills training interventions (PSTIs) are considered first-line treatment for ADHD. We describe development and effectiveness of a culturally-contextualised PSTI for Indian families.

METHOD

Forty-one families divided into 5 groups, each group with 6-10 families received group PSTI comprising of 10 weekly sessions using multi-point videoconferencing as an adjunct to routine care in the non-randomized pre-post intervention study.

RESULTS

Thirty-six families attended more than 3 sessions. RM ANOVA revealed significant improvements in parent-rated measures of inattention (p < 0.001), hyperactivity/ impulsivity (p = 0.007), conduct problems (p = 0.002), academic performance (p = 0.001) and classroom behavior (p = 0.001). Mixed ANOVA analysis did not reveal significant differences between those who received PSTI with medication and those who received PSTI on any VADPRS domains except depression/ anxiety scores, wherein former group performed better (p = 0.008). More than 60 % parents perceived that PSTI was helpful in increasing awareness, reducing guilt/ blame, improving parent-child relation and decreasing stress. Difficulty in sustaining with the strategies was reported by 50 % of parents.

CONCLUSION

Findings suggest that PSTI is effective and helpful for Indian families dealing with ADHD.

"His body is human, but he has a tiracchāna heart": An ethnographic study of the epigenesis of child abuse in Cambodia

In Cambodia, more than half of all children experience physical, emotional, or sexual abuse. This article examines how Cambodians view the causes and effects of child abuse and analyses its underlying cultural forces. Adopting a conceptual framework originally developed for the cultural context of violence against women, 110 cases of child abuse were ethnographically studied, comprising 61 cases of sexual abuse (50 girls and 11 boys), 26 cases of physical abuse (13 girls and 13 boys), and 23 cases of emotional abuse or neglect (13 girls and 10 boys). The perpetrators included fathers and other close relatives, lay Buddhist officiants and monks, and neighbors. Most informants viewed the sexual or physical abuse of children as stemming from "cultural attractors," including blighted endowment caused by deeds in a previous life, a bad character starting early in life, astrological vulnerability to abuse, preordained entanglement between the child and the abuser (they are "fated" to meet), sexual craving, "entering the road to ruin," and a moral blindness that portrays the abuser as blameless. Although these traits are similar to those identified in the explanations of violence against women, there were notable differences such as the role of the tiracchāna in explaining sexual abuse, including incest. Using these findings, this article identifies a cultural epigenesis of child sexual abuse, and provides a blueprint for developing a culturally responsive plan to prevent child abuse.

Factors associated with perceptions of child sexual abuse and lack of parental knowledge: a community-based cross-sectional study from the Eastern Province of Saudi Arabia

BACKGROUND

Child sexual abuse (CSA) has serious consequences that can affect the physical, social and mental health of a child. In the last two decades, concern about CSA has increased around the world including Saudi Arabia.

OBJECTIVE

Evaluate factors associated with parental perceptions and knowledge of CSA.

DESIGN

Cross-sectional survey.

SETTINGS

Primary health care clinic.

SUBJECTS AND METHODS

Simple random sampling was used to select participants. The main tool for data collection was a self-administered questionnaire.

MAIN OUTCOME MEASURES

Factors associated with knowledge and perceptions of CSA.

SAMPLE SIZE

400.

RESULTS

Most respondents (69%) had good knowledge of the signs of sexual abuse in children. For perception scores, statistically significant variables were age (P=.004), educational level (P=.005), income (P less than .001), number of wives (P=.004), number of male children (P=.021), and number of female children (P=.027). For knowledge scores, statistically significant variables were income (P=.008), number of wives (P less than .005), number of male children (P=.003) and number of female chil.dren (P less than .003). Logistic regression showed that the older age group was significantly associated with a good perception score (P less than .046).

CONCLUSIONS

Risk factors for parental lack of knowledge and poor perception associated with CSA are poverty and low education. Protective factors included the older parent age, size of the family and families with more than one wife. Education should be designed for parents and the community to increase the knowledge and perception of CSA.

LIMITATIONS

Single-center study and short study period.

CONFLICT OF INTEREST

None.

Change and consistency in descriptions of child maltreatment: A comparison of caregivers' perspectives 20 years apart

Although approximately one-fifth of child maltreatment reports originate with family members, friends, neighbors, or community members, their efforts to identify and report child maltreatment are still not well understood. Nor is it well understood how these individuals' perceptions of what constitutes maltreatment may change over time. This study examined descriptions of behavior perceived as maltreatment by caregivers of minors in Cleveland, Ohio, USA neighborhoods. Data were obtained from two neighborhood-based cross-sectional surveys of caregivers of minors: one conducted in 1995-1996 and the other in 2014-2015. The sample consisted of 400 caregivers living in 20 census tracts with varying profiles of maltreatment risk in the 1995-1996 study, and 400 caregivers living in the same 20 census tracts surveyed in 2014-2015. Each time point, participants were asked to provide three examples of behaviors they considered to be child abuse and neglect. All responses were categorized using the 1995-1996 coding scheme. Logistic regression analyses including all 800 participants, adjusted for individual and neighborhood characteristics, and accounting for residential clustering in neighborhoods, showed that participating in the 2014-2015 survey was associated with 51% increased odds of mentioning an act of neglect and a 39% decreased odds of mentioning an act of physical abuse. No significant temporal changes were observed for inadequate supervision, emotional or verbal abuse, sexual abuse, and parental misbehavior. Associations between specific types of maltreatment and individual and neighborhood characteristics were observed. Potential practice implications and future research directions include seeking greater familiarity with caregivers' perceptions of maltreating behaviors to better understand how these perceptions might "translate" into child maltreatment reports and investigations.

Redrawing the line: An exploration of how lay people construct child neglect

While there has been an increasing professional and political focus on the prevalence and harmfulness of child neglect, little has been done to explore what child neglect means outside child protection circles. This qualitative study explores lay constructions of child neglect by thematically analyzing focus group discussions between 46 self-defined 'lay' people in England. Participants viewed neglect as extremely damaging for children and as arising when children's physical, emotional, training and supervisory needs were unmet due to abnormal parental behavior. Children with unmet needs were positioned as deprived, unloved, uncontrolled and escaping. They were only positioned as neglected when failure to meet their needs was attributable to a lack of parental knowledge and skill (clueless parents), a lack of appropriate parental disposition (underinvested parents) or both (unsuitable parents). 'Normal' parents - those with the appropriate parental disposition, skills and knowledge - who failed to meet their children's needs were not seen as neglectful but rather as overburdened. As 'normal parenting' has fragmented in late modernity, society wide consensus on child neglect was felt by participants to have retreated to child protection definitions, alienating lay understandings. If child neglect really is 'everybody's business', then it is important that lay people are included in forging new definitions of and responses to meeting the needs of children.

Relationship between body mass index and family functioning, family communication, family type and parenting style among African migrant parents and children in Victoria, Australia: a parent-child dyad study

Background

Although childhood obesity prevalence is stabilised in developed countries including Australia, it is continuing to rise among migrants and socially disadvantaged groups in these countries. African migrants and refugees in particular, are at high risk of obesity due to changes in their family dynamics. The aim of this study was to examine the difference between children and parental perception of family functioning, family communication, family type and parenting styles and their relationship with body mass index.

Methods

A cross-sectional parent-child dyad study was conducted among 284 African families from migrant and refugee backgrounds living in metropolitan Melbourne, Australia. Bilingual workers were trained to collect demographic, anthropometric and questionnaire data on family functioning, parenting, family type and family communication.

Results

Parents and children reported different levels of family dynamics. Children reported a higher prevalence of poor family functioning (61.5 %, 95 % CI: 55.6, 67.2 versus 56.8 %, 95 % CI: 49.7, 61.6) and protective family type (29 %, 95 % CI: 23.9, 34.5 vs. 13.4 %, 95 % CI: 9.9, 17.9), but a lower prevalence of authoritative parenting style (51.6 %, 95 % CI: 45.7, 57.5 vs. 63 %, 95 % CI: 57.5, 68.8) than parents. There was a positive relationship between poor family functioning and child BMI both before (β = 1.28; 95 % CI: 0.14, 2.41; p < 0.05) and after (β = 1.73; 95 % CI: 0.53, 2.94; p < 0.001) controlling for confounders, and an inverse relationship between consensual family type and child BMI after adjustment (β = −1.92; 95 % CI: −3.59, −0.24; p < 0.05). There was no significant relationship between parental BMI and family functioning, communication, family type or parenting style.

Conclusion

Children’s perception of poor family functioning was associated with childhood obesity. Family interventions to reduce childhood obesity need to adopt an intergenerational approach to promote a clear understanding of family dynamics between children and parents. Unless these intergenerational challenges associated with family dynamics are clearly addressed in obesity interventions, current obesity prevention initiatives will continue to widen the childhood obesity gap in Australia.

Review of child maltreatment in immigrant and refugee families

OBJECTIVES

Study results on child maltreatment based on general population samples cannot be extrapolated with confidence to vulnerable immigrant or refugee families because of the specific characteristics and needs of these families. The aims of this paper are 1) to conduct an evidence review of the prevalence, risk factors and protective factors for child maltreatment in immigrant and refugee populations, and 2) to integrate the evidence in an analytical ecosystemic framework that would guide future research.

METHODS

We used a 14-step process based on guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Canadian Collaboration for Immigrant and Refugee Health. We searched major databases from "the oldest date available to July 2014". The eligibility criteria for paper selection included qualitative or quantitative methodologies; papers written in English or French; papers that describe, assess or review prevalence, risk and protection factors for child maltreatment; and a studied population of immigrants or refugees.

SYNTHESIS

Twenty-four articles met the criteria for eligibility. The results do not provide evidence that immigrant or refugee children are at higher risk of child maltreatment. However, recently settled immigrants and refugees experience specific risk factors related to their immigration status and to the challenges of settlement in a new country, which may result in high risk of maltreatment.

CONCLUSION

Future research must incorporate more immigrant and refugee samples as well as examine, within an ecosystemic framework, the interaction between migratory and cultural factors with regard to the prevalence, consequences and treatment of child maltreatment for the targeted groups.

Cultural considerations and child maltreatment: in search of universal principles

Cultural diversity poses challenges within the health care setting, particularly regarding the question of how health professionals can resolve the tension between respecting cultural norms or child-rearing practices and the importance of determining what constitutes harm and child maltreatment. Cultural competency and respect for cultural diversity does not imply universal tolerance of all practices. The United Nations provides a standard of universal child rights, protecting them from harmful practices. Pediatric providers must respect cross-cultural differences while maintaining legal and ethical standards of safety and wellbeing for children, promoting evidence-based prevention of maltreatment, and advocating for child wellness across all cultures.

Words that hurt: a qualitative study of s parental verbal abuse in the Philippines

This article investigated opinions on what constitute parental abuse with interviews of 30 high school students, 30 parents, and 28 counselors. Despite increased reported cases of emotional abuses and child maltreatments in the Philippines, few empirical studies have explored the exact nature of parental verbal abuses in this country. This study is designed to address this gap in the literature. The results revealed nine categories of parental verbal abuses namely: (a) Put downs and shaming, (b) Rejection, (c) Blaming, (d) Fault Exaggerating, (e) Threat, (f) Invoking harm, (g) Regrets, (h) Unfair comparison, and (i) Negative prediction. Implications for research and practice were discussed.

Child maltreatment among Asian Americans: characteristics and explanatory framework

This article systematically reviews the characteristics of child maltreatment among Asian Americans and provides a theoretical explanatory framework. The reported rate of child maltreatment among Asian Americans is disproportionately low. A high rate of physical abuse and low rates of neglect and sexual abuse are found among Asian American victims. Some protective factors (e.g., the emphasis on family harmony and reputation and the indulgence to infants and toddlers) may lead to low probability of child maltreatment among Asian Americans. Some others (e.g., parental authority and beliefs in physical punishment) may be risk factors of child maltreatment, especially physical abuse. Meanwhile, many other coexisting factors (e.g., children's obedience to parents and families' invisibility to authorities) may prohibit child maltreatment from being disclosed. Therefore, the overall low reported rate of child maltreatment among Asian Americans may be a combination of low incidence and underreporting. Implications for practice and research are discussed.

Child welfare recommendations to improve mental health services for children who have experienced abuse and neglect: a national perspective

This study uses a key informant approach to understand the nature, extent, and quality of outpatient mental health services for children in the child welfare system (CWS) in the United States. We interviewed 89 county child welfare administrators to determine the status of outpatient mental health services and provide recommendations for enhancing care and service delivery. Developed for this study (Caring for Children in Child Welfare), the interview was incorporated in the second formal data collection wave (i.e., 18 months after study baseline assessment) of the National Survey of Child and Adolescent Well-Being. The results highlighted general variability in the degree to which these agencies used evidence-based interventions within outpatient services, demonstrated clinical expertise with this population, and met the needs of their families. Community agency use of evidence-based interventions was found to predict their effectiveness in improving clients' mental health problems. Proposed suggestions for service improvement varied across domains and reflected the need for more communication/coordination, service access, options and resources, and practice refinements to accommodate families' needs. We discuss the implications of these recommendations from CWS stakeholders for enhancing the service delivery system.

Methods of Punishment Used by Turkish Mothers of Preschoolers

The goal of this study was to describe the punishments that Turkish mothers use with their preschool-aged children. 129 mothers with children between 3 and 6 years old were included in the study. Mothers completed a data collection form prepared by the researcher. Punishments mothers applied and mothers' age and education and children's age and sex were examined by chi-squared analysis. Mothers used various punishments with children. Some punishments were used with high frequency. Mothers' age and education and children's age and sex were not related to types of punishment used.

Prevention of child sexual abuse in China: knowledge, attitudes, and communication practices of parents of elementary school children

OBJECTIVE

Active involvement by parents may contribute substantially to the success of school-based programs to prevent child sexual abuse (CSA). In China, little is known about parental understanding of CSA. This study investigated Chinese parents' knowledge, attitudes, and communication practices with their children about CSA.

METHOD

Six hundred and fifty-two parents of Grade 3 pupils of seven elementary schools in Jingzhou city, Hubei province (central China), completed an anonymous questionnaire (response rate=81%).

RESULTS

More than 95% of respondents agreed that elementary schools should provide programs to prevent CSA and were willing to have their children participate in such programs. Although nearly all parents talked with their children about stranger danger, they were much less likely to talk specifically about sexual abuse. Many parents personally lacked basic knowledge about characteristics of perpetrators, the sexual abuse of boys, and nonphysical consequences of CSA. About half (46.8%) expressed some concern that CSA preventive education could cause their children to know "too much about sex." Contrary to expectations from research in western nations, parents who talked with their children about CSA did not have better knowledge or more supportive attitudes to CSA prevention than did parents who said they never discussed CSA with their children.

CONCLUSION

This study confirms and extends two recent surveys indicating strong support for the concept of school-based CSA prevention in China. However, given the apparently low levels of knowledge about CSA, even among those who talk about this problem with their children, future prevention programs should include community-wide efforts to educate adults to ensure that parental advice is accurate and hopefully, effective.

Racial variation in self-labeled child abuse and associated internalizing symptoms among adolescents who are high risk

One thousand and ten Non-Hispanic White, African American, Hispanic, and Asian Pacific Islander youth who were high risk and receiving public sector services were interviewed regarding history of child emotional and physical abuse and current internalizing symptoms. The study examined whether race moderated the association between adolescents' reports of specific parent behaviors and their self-labeling as victims of abuse. The study also examined whether reports of parental behaviors or self-labeled abuse better predicted internalizing symptoms, and whether these associations differed by race. When reporting punitive parent behavior, Non-Hispanic White youth were more likely to describe themselves as abused compared to Asian Pacific Islanders. Reported punitive parental behaviors accounted for more variance in internalizing symptoms than did self-labeled abuse. Reports of parent behaviors were more strongly related to concurrent internalizing symptoms among ethnic minority youth than among Non-Hispanic White youth. Results are discussed in the context of cultural competence in identification of child abuse.