1
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Westphaln KK, Pike NA, Li VR, Spurrier R, Imagawa KK. Pediatric Hospital Admissions with Concern for Neglect: Correlations Between Neglect Types and Other Clinical and Environmental Risk Factors. Matern Child Health J 2024; 28:1539-1550. [PMID: 38904903 DOI: 10.1007/s10995-024-03936-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE Child neglect is a public health concern with negative consequences that impact children, families, and society. While neglect is involved with many pediatric hospitalizations, few studies explore characteristics associated with neglect types, social needs, and post-discharge care. METHODS Data on neglect type, sociodemographics, social needs, inpatient consultations, and post-discharge care were collected from the electronic medical record for children aged 0-5 years who were hospitalized with concern for neglect during 2016-2020. Frequencies and percentages were calculated to determine sample characteristics. The Chi-square Test for Independence was used to evaluate associations between neglect type and other variables. RESULTS The most common neglect types were inadequate nutrition (40%), inability to provide basic care (37%), intrauterine substance exposure (25%), combined types (23%), and inadequate medical care (10%). Common characteristics among neglect types included age less than 1 year, male sex, Hispanic ethnicity, public insurance, past involvement with Child Protective Services, and inpatient consultation services (social work, physical therapy, and occupational therapy), and post-discharge recommendations (primary care, physical therapy, and regional center). Neglect type groups varied by child medical history, social needs, and discharge recommendations. Statistically significant associations supported differences per neglect type. CONCLUSIONS Our findings highlight five specific types of neglect seen in an impoverished and ethnically diverse geographic region. Post-discharge care needs should focus on removing social barriers and optimizing resources, in particular mental health, to mitigate the risk of continued neglect. Future studies should focus on prevention strategies, tailored interventions, and improved resource allocations per neglect type and discharge location.
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Affiliation(s)
- Kristi K Westphaln
- University of California Los Angeles, School of Nursing, 700 Tiverton Ave, Factor Building Room 3-246, Los Angeles, CA, 90095, USA.
- Children's Hospital Los Angeles, Los Angeles, CA, USA.
| | - Nancy A Pike
- University of California Los Angeles, School of Nursing, 700 Tiverton Ave, Factor Building Room 3-246, Los Angeles, CA, 90095, USA
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- University of California Irvine, Sue and Bill Gross School of Nursing, 854 Health Sciences Hall, Office 4515, Irvine, United States
| | - Vincent R Li
- University of Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ryan Spurrier
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Karen Kay Imagawa
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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2
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Tate AR, Fisher-Owens SA, Spiller L, Muhlbauer J, Lukefahr JL. Oral and Dental Aspects of Child Abuse and Neglect: Clinical Report. Pediatrics 2024; 154:e2024068024. [PMID: 39155729 DOI: 10.1542/peds.2024-068024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 08/20/2024] Open
Abstract
In all 50 states, the District of Columbia, and the Commonwealth of Puerto Rico, pediatricians, dental professionals, and other physicians are mandated to report suspected cases of abuse and neglect to social service or law enforcement agencies. The purpose of this clinical report is to review the oral aspects of abuse and dental neglect in children and the role of pediatricians, dental professionals, and other physicians in evaluating such conditions. This clinical report addresses recommendations on the evaluation of bite marks, as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect. Some physicians may have received less education pertaining to oral health, dental injury, and oral disease. These physicians may not detect the mouth and gum findings possibly related to abuse or neglect as readily as abuse injuries involving other areas of the body. Therefore, pediatricians, dental professionals, and other physicians are encouraged to collaborate to increase the prevention, detection, and treatment of these conditions in children.
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Affiliation(s)
- Anupama Rao Tate
- Division of Oral Health, Children's National Hospital, and Department of Pediatrics, George Washington Medical School, Washington, District of Columbia
| | - Susan A Fisher-Owens
- Departments of Pediatrics and Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California
| | - Lora Spiller
- Division of Child Abuse Pediatrics, Department of Pediatrics, University of Texas Health San Antonio, San Antonio, Texas
| | | | - James L Lukefahr
- Division of Child Abuse Pediatrics, Department of Pediatrics, University of Texas Health San Antonio, San Antonio, Texas
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3
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Stirling J, Gavril A, Brennan B, Sege RD, Dubowitz H. The Pediatrician's Role in Preventing Child Maltreatment: Clinical Report. Pediatrics 2024; 154:e2024067608. [PMID: 39034825 DOI: 10.1542/peds.2024-067608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 07/23/2024] Open
Abstract
Pediatricians have always seen the value of preventing health harms; this should be no less true for child maltreatment than for disease or unintentional injuries. Research continues to demonstrate that maltreatment can be prevented, underscoring the vital roles of both the family and society in healthy childhood development and the importance of strong, stable, nurturing relationships in preventing maltreatment and building the child's resilience to adversity. This clinical report elaborates the pediatrician's multitiered role in supporting relational health from infancy through adolescence, from universal interventions assessing for maltreatment risks and protective factors to targeted interventions addressing identified needs and building on strengths. When maltreatment has already occurred, interventions can prevent further victimization and mitigate long-term sequelae. Advice is provided on engaging community resources, including those that provide food, shelter, or financial support for families in need.
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Affiliation(s)
| | - Amy Gavril
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Brian Brennan
- The Armed Forces Center for Child Protection, Walter Reed National Military Medical Center, Bethesda, Maryland. The views expressed in this presentation are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government
| | - Robert D Sege
- Departments of Medicine and Pediatrics, Tufts University School of Medicine, Center for Community Engaged Medicine, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Howard Dubowitz
- Division of Child Protection, Center for Families, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
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4
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Ozcevik Subasi D, Akca Sumengen A, Semerci R, Cakir GN. Effectiveness of school-based interventions on child sexual abuse knowledge in children with disabilities: Systematic review and meta-analysis. J Pediatr Nurs 2024:S0882-5963(24)00252-5. [PMID: 38955613 DOI: 10.1016/j.pedn.2024.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/24/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Children with disabilities (CWDs) constitute a substantial segment of the population who encounter abuse, emphasizing the need to comprehend the influence of school-based interventions on this susceptible group. AIM This systematic review and meta-analysis aimed to identify and evaluate the effectiveness of school-based interventions in enhancing child sexual abuse (CSA) knowledge among CWDs. PARTICIPANTS This meta-analysis incorporated seven published studies, encompassing 387 CWDs. METHODS Our study synthesizes findings from seven experimental and quasi-experimental studies, adhering to the PRISMA guidelines. The study was registered in PROSPERO. The literature search, conducted between September 25, 2023, and October 2, 2023, employed various databases and keywords relevant to the study's scope. The research question and articles' eligibility were assessed using the Population, Intervention, Comparison, Outcomes, and Study type (PICOs). The meta-analysis was conducted using the Comprehensive Meta-Analysis (CMA) software. RESULTS The school-based intervention greatly impacted CWDs' CSA knowledge scores (Hedges's g = 1.026 [95% CI: 0.845; 1.208], z = 11.074, p = 0.000). The findings of this meta-analysis demonstrate that Questionnaire/scale-based knowledge measurement (Hedges's g = 2.586 [95% CI: 0.920; 4.252], z = 3.043, P = 0.002) and Vignette-based knowledge measurement (Hedges's g = 1.065 [95% CI: 0.655; 1.474], z = 5.100, p = 0.000) are effective in assessing CWDs' knowledge of CSA. CONCLUSION This systematic review and meta-analysis of seven randomized controlled studies and quasi-experimental studies provide robust evidence supporting the effectiveness of school-based interventions in significantly enhancing CSA knowledge among CWDs. IMPLICATIONS TO PRACTICE These findings are potentially significant evidence for education professionals, including educators and school health nurses.
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Affiliation(s)
| | - Aylin Akca Sumengen
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL, United States of America
| | - Remziye Semerci
- Department of Child Health and Disease Nursing, School of Nursing, Koç University, Istanbul, Turkey
| | - Gokce Naz Cakir
- Department of Nursing, School of Nursing, Yeditepe University, Istanbul, Turkey
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5
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Barreca J, Swiggum M. Trauma-Informed Care in Pediatric Physical Therapy as a Standard Precaution: The Time Is Here. Pediatr Phys Ther 2024; 36:278-284. [PMID: 38568276 DOI: 10.1097/pep.0000000000001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
In this special communication, an overview of the research on trauma, resilience, and action items for the pediatric physical therapist (PT) is addressed. The experiences of early childhood, positive and negative, impact overall development and well-being throughout the lifespan. Childhood trauma can include exposure to abuse, neglect, violence, racism, or medical procedures. These adverse childhood experiences are associated with poor physical and mental health outcomes that can extend into adulthood and can appear in the pediatric rehabilitative realm as caregivers who become labeled noncompliant. Trauma is common and impacts all children; however, some populations, such as children with disabilities, have greater risk for experiencing adversity. An individual's trauma history is not always visible, necessitating a standard approach. Pediatric PTs must take an intentional approach to address the detrimental effects of trauma on those we serve. Many organizations recommend adopting trauma-informed care as the standard of care for all populations.
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Affiliation(s)
- Jessica Barreca
- Center for Interprofessional Education and Research (Dr Barreca), Saint Louis University, Saint Louis, Missouri; Doctor of Physical Therapy Program (Dr Swiggum), Wingate University, Wingate, North Carolina
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6
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Loomis AM, McLaughlin RX, Lyon M, Mitchell J. Infant and early childhood teleconsultation and training: Program description and feasibility outcomes from a statewide implementation. Infant Ment Health J 2024; 45:185-200. [PMID: 38230980 DOI: 10.1002/imhj.22101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.
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Affiliation(s)
- Alysse M Loomis
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Rose X McLaughlin
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - McCall Lyon
- The Children's Center Utah, West Valley City, Utah, USA
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7
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Bressler CJ, Malthaner L, Pondel N, Letson MM, Kline D, Leonard JC. Identifying Children at Risk for Maltreatment Using Emergency Medical Services' Data: An Exploratory Study. CHILD MALTREATMENT 2024; 29:37-46. [PMID: 36205182 DOI: 10.1177/10775595221127925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The objective of this study was to use natural language processing to query Emergency Medical Services (EMS) electronic health records (EHRs) to identify variables associated with child maltreatment. We hypothesized the variables identified would show an association between the Emergency Medical Services encounter and risk of a children maltreatment report. This study is a retrospective cohort study of children with an EMS encounter from 1/1/11-12/31/18. NLP of EMS EHRs was conducted to generate single words, bigrams and trigrams. Clinically plausible risk factors for child maltreatment were established, where presence of the word(s) indicated presence of the hypothesized risk factor. The EMS encounters were probabilistically linked to child maltreatment reports. Univariable associations were assessed, and a multivariable logistic regression was conducted to determine a final set of predictors. 11 variables showed an association in the multivariable modeling. Sexual, abuse, chronic condition, developmental delay, unconscious on arrival, criminal activity/police, ingestion/inhalation/exposure, and <2 years old showed positive associations with child maltreatment reports. Refusal and DOA/PEA/asystole held negative associations. This study demonstrated that through EMS EHRs, risk factors for child maltreatment can be identified. A future direction of this work include developing a tool that screens EMS EHRs for households at risk for maltreatment.
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Affiliation(s)
- Colleen J Bressler
- Division of Child and Family Advocacy, Nationwide Children's Hospital, Columbus, OH, USA
- Nationwide Children's Hospital Section of Emergency Medicine, Columbus, OH, USA
| | - Lauren Malthaner
- Nationwide Children's Hospital Center for Injury Research and Policy at the Research Institute, Columbus, OH, USA
| | - Nicholas Pondel
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Megan M Letson
- Division of Child and Family Advocacy, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine
| | - David Kline
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine
| | - Julie C Leonard
- Nationwide Children's Hospital Section of Emergency Medicine, Columbus, OH, USA
- Nationwide Children's Hospital Center for Injury Research and Policy at the Research Institute, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine
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8
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Tolliver DG, He Y, Kistin CJ. Child Maltreatment. Pediatr Clin North Am 2023; 70:1143-1152. [PMID: 37865436 DOI: 10.1016/j.pcl.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Child maltreatment is associated with significant morbidity, and prevention is a public health priority. Given evidence of interpersonal and structural racism in child protective service assessment and response, equity must be prioritized for both acute interventions and preventive initiatives aimed at supporting children and their families. Clinicians who care for children are well positioned to support families, and the patient-centered medical home, in collaboration with community-based services, has unique potential as a locus for maltreatment prevention services. Clinicians can advocate for policies that support families and decrease the risk of child maltreatment.
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Affiliation(s)
- Destiny G Tolliver
- Department of Pediatrics, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 801 Albany Street, Boston, MA 02119, USA
| | - Yuan He
- Division of General Pediatrics, Children's Hospital of Philadelphia, 4865 Market Street, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Caroline J Kistin
- Division of Health Services, Policy, and Practice, Hassenfeld Child Health and Innovation Institute, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
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9
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Calvert ML, Korgaonkar S, Ramachandran S, Sarver DE. Follow-Up Care After Maltreatment: Sociodemographic Associations With Timeliness in a Southern State. CHILD MALTREATMENT 2023; 28:634-647. [PMID: 36281769 DOI: 10.1177/10775595221134155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Children who experience maltreatment are at elevated risk of developing mental health difficulties. Even so, they often do not receive timely, evidenced-based mental health treatment, which may exacerbate the risk of poor outcomes. This study aims to describe the receipt of timely follow-up care after maltreatment in a southern state with known treatment shortages and aims to identify factors associated with timely follow-up care. We utilized a retrospective cohort design using 2014 Mississippi Medicaid administrative claims data for youth 0-18 years. Prevalence estimates and associations with definite and probable maltreatment (based on recorded age/injury combinations) during inpatient and outpatient healthcare encounters were evaluated. Rates of 30-day maltreatment follow-up with any medical or behavioral health provider were also assessed. Prevalence estimates of definite and probable maltreatment in the eligible study population (N = 324,752) were 0.53% and 3.8%, respectively. Only one-third of identified children received 30-day follow-up. Black and older children as well as children diagnosed with anxiety or depression were more likely to receive 30-day follow-up than younger children, white children, and children without anxiety or depression. Low rates of timely follow-up indicate the need for intentional workflow practices to increase the likelihood of follow-up.
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Affiliation(s)
- Maegan L Calvert
- Department of Psychiatry, Brain Imaging Research Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Siddhi Korgaonkar
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, Oxford, MS, USA
| | - Sujith Ramachandran
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, Oxford, MS, USA
| | - Dustin E Sarver
- Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
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10
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Ortega DP, Walsh K, Bődi CB, Hawkins LB, Bright MA. School-based prevention education for children and youth with intellectual developmental disabilities. CHILD ABUSE & NEGLECT 2023; 145:106397. [PMID: 37591048 DOI: 10.1016/j.chiabu.2023.106397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
Children with intellectual developmental disabilities (IDD) are at a heightened risk of experiencing child maltreatment (CM) when compared to their peers without IDD. Despite expanding evidence supporting the efficacy of school-based CM prevention programs, there are limited programs that tailor their lessons to the unique needs of children with IDD. This discussion first presents information regarding the prevalence and risk factors of CM among children with IDD. We then present existing peer-reviewed CM programs that have been developed for children with IDD. Finally, based on the latest research of CM prevention and special education, we present our considerations for a comprehensive school-based CM prevention program for children with IDD. Prevention programs for children with IDD may increase risk awareness among children with IDD and their parents, equip children with IDD with the protective skills necessary to navigate unsafe situations, and decrease the overall incidence of CM against this population.
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Affiliation(s)
| | - Kerryann Walsh
- Faculty of Creative Industries, Education & Social Justice, Queensland University of Technology, Australia
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11
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Samuel D, O'Malley F, Brink FW, Crichton KG, Duffy B, Letson MM, Michaels NL. Characterizing child maltreatment fatalities among child victims with disabilities in the United States, 2010-2019. CHILD ABUSE & NEGLECT 2023; 144:106354. [PMID: 37517210 DOI: 10.1016/j.chiabu.2023.106354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND There has been little research on child maltreatment-related fatalities among children with disabilities. Despite being a minority of children in the United States, children with disabilities experience higher rates of victimization. OBJECTIVE To characterize fatalities due to child maltreatment among children with disabilities in the United States. METHODS Data from the National Violent Death Reporting System from 2010 to 2019 were analyzed to describe child maltreatment-related deaths among children with disabilities aged birth to 17 years. RESULTS There were 106 fatalities meeting the study criteria. The average age of the victims was 5.9 years old and 74.6 % were male. The most frequent suspected perpetrators of maltreatment-related fatalities were biological mothers (35.2 %), and most perpetrators were White (55.7 %). Analyses showed a statistically significant relationship between fatalities caused by neglect and diagnoses of attention deficit hyperactivity disorder, autism spectrum disorder, cerebral palsy, and/or traumatic brain injury. Overall, physical abuse and/or neglect resulting in a fatality among children with disabilities were significantly correlated with the relationship of the perpetrator to the victim. CONCLUSIONS Children with disabilities who died as a result of abuse were more likely to have autism spectrum disorder, a developmental disability, or other physical impairment, with physical abuse being the most prevalent type of abuse that resulted in death. To decrease the likelihood of abuse of disabled children, healthcare practitioners and caseworkers should work together to create strategies to help caregivers cope with the financial, mental, and physical stress that comes with raising children with disabilities.
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Affiliation(s)
- Devona Samuel
- Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN 37208, United States of America
| | - Fiona O'Malley
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
| | - Farah W Brink
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Kristin G Crichton
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Bridget Duffy
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
| | - Megan M Letson
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Nichole L Michaels
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America.
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12
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Daigneault I, Paquette G, De La Sablonnière-Griffin M, Dion J. Childhood Sexual Abuse, Intellectual Disability, and Subsequent Physical and Mental Health Disorders: A Matched Cohort Study. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:134-144. [PMID: 36807477 DOI: 10.1352/1944-7558-128.2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/28/2022] [Indexed: 06/18/2023]
Abstract
This study assesses whether children with intellectual disability (ID) are more at risk of sexual abuse and whether they have similar consultation rates for physical and mental health disorders than children without ID. The matched-cohort design study uses administrative databases of children who had a sexual abuse report corroborated by a child protection agency and a matched group from the general population. Children with ID were 3.5 times more likely to have a corroborated sexual abuse report when compared to their peers without ID and a higher post-abuse number of medical consultations for physical and mental health disorders. Children with ID are more at risk of sexual abuse and physical and mental health disorders and may also be more vulnerable to the effects of abuse.
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Affiliation(s)
- Isabelle Daigneault
- Isabelle Daigneault, Université de Montréal, Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS), Équipe violence sexuelle et santé (ÉVISSA), Canadian Consortium on Child and Youth Trauma
| | - Geneviève Paquette
- Geneviève Paquette, Université de Sherbrooke, Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS)
| | - Mireille De La Sablonnière-Griffin
- Mireille De La Sablonnière-Griffin, Institut national de la recherche scientifique (INRS), Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS)
| | - Jacinthe Dion
- Jacinthe Dion, Université du Québec à Chicoutimi, Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS), Équipe violence sexuelle et santé (ÉVISSA)
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13
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Noritz G, Davidson L, Steingass K. Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy. Pediatrics 2022; 150:e2022060055. [PMID: 36404756 DOI: 10.1542/peds.2022-060055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cerebral palsy (CP) is the most common motor disorder of childhood, with prevalence estimates ranging from 1.5 to 4 in 1000 live births. This clinical report seeks to provide primary care physicians with guidance to detect children with CP; collaborate with specialists in treating the patient; manage associated medical, developmental, and behavioral problems; and provide general medical care to their patients with CP.
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Affiliation(s)
- Garey Noritz
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
| | - Lynn Davidson
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Katherine Steingass
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
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14
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Lillvis DF, Sheehan KM, Yu J, Noyes K, Bass KD, Kuo DZ. Characterizing physical trauma in children and youth with special health care needs. J Trauma Acute Care Surg 2022; 93:299-306. [PMID: 35293370 DOI: 10.1097/ta.0000000000003608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Children and youth with special health care needs (CYSHCN) have or are at an increased risk for a chronic condition necessitating medical and related services beyond what children usually require. While evidence suggests that CYSHCN are at an increased risk of injury, little is known about this population within the trauma system. This study describes CYSHCN within the pediatric trauma system and examines patterns of injury risk (i.e., intent, place of injury, trauma type, and mechanism of injury) based on special health care need (SHCN) status. METHODS For this cross-sectional study, we used data from the 2018 National Trauma Data Bank to identify pediatric encounters (1-18 years, N = 115,578) and compare demographics (sex, race/ethnicity, insurance status, and age) by CYSHCN status using χ 2 and t tests. Children and youth with special health care needs encounters were compared with non-SHCN encounters using multinomial logistic regression models, controlling for demographics. RESULTS Overall, 16.7% pediatric encounters reported an SHCN. Children and youth with special health care needs encounters are older, and a higher proportion is publicly insured than non-SHCN encounters ( p < 0.001). Furthermore, CYSHCN encounters have a higher risk of assault (relative risk, 1.331) and self-inflicted (relative risk, 4.208) injuries relative to unintentional injury ( p < 0.001), as well as a higher relative risk of traumatic injury occurring in a private residence ( p < 0.01) than other locations such as school (relative risk, 0.894). Younger CYSHCN encounters have a higher risk of assault relative to unintentional injury when compared with non-SHCN encounters ( p < 0.01). Pediatric trauma encounters reporting mental health and alcohol/substance use disorder SHCN have a higher probability of self-inflicted and assault injuries than non-SHCN encounters ( p < 0.001). CONCLUSIONS These findings suggest that CYSHCN have different traumatic injury patterns than their non-SHCN peers, particularly in terms of intentional and private residence injury, and deserve a special focus for traumatic injury prevention. LEVEL OF EVIDENCE Prognostic/epidemiologic, level III.
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Affiliation(s)
- Denise F Lillvis
- From the Department of Pediatric Surgery (D.F.L., K.D.B.), John R. Oishei Children's Hospital, Buffalo, New York; Department of Surgery (D.F.L., K.D.B.), Jacobs School of Medicine and Biomedical Sciences; Department of Epidemiology and Environmental Health (D.F.L., K.N.), School of Public Health and Health Professions, University at Buffalo, Buffalo, New York; Department of Pediatrics (K.M.S.), Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Biostatistics (J.Y.), School of Public Health and Health Professions, University at Buffalo, Buffalo, New York; and Department of Pediatrics (D.Z.K.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
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Kim K, Moss C, Park JJ, Wekerle C. Child Maltreatment and the Child Welfare System as Environmental Factors in the International Classification of Functioning. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:710629. [PMID: 36188868 PMCID: PMC9397842 DOI: 10.3389/fresc.2021.710629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022]
Abstract
The WHO defines child maltreatment as any form of neglect, exploitation, and physical, emotional, or sexual abuse, committed against children under the age of 18. Youth involved in the child welfare system report more maltreatment experiences and environmental turbulence (e.g., number of moves, caseworkers), placing them at greater risk for poorer physical and mental health. The International Classification of Functioning, Disability, and Health (ICF) provides a framework to describe health conditions and severity of disabilities for an individual and/or group in the context of environmental factors. The Maltreatment and Adolescent Pathways (MAP) study is a longitudinal study, assessing self-reports on variables (e.g., child maltreatment history, trauma symptoms, dating violence, and substance use) of youth in an urban child protection service system. This study focuses on 11 of the 24 MAP publications that pertain to health and functioning, which can be considered applicable to the ICF framework, following established linking rules. The purpose of this study is to analyze these MAP sub-studies, with maltreatment and involvement in the child welfare system as environmental factors that impact the functioning of child welfare-involved youth. Findings indicate significant relationships across environmental factors (i.e., child maltreatment histories, child welfare system involvement), health conditions (i.e., trauma symptomatology, psychological distress, intellectual disabilities), and functioning problems (i.e., substance use, adolescent dating violence, sexual risk-taking, coping motives, sleep problems). The interrelated nature of these factors in the MAP sub-studies suggests the value of the ICF model to a holistic health view of use to practitioners supporting system-involved youth, clarifying unattended environmental factors in guiding service provision for foster care and/or maltreated youth.
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Affiliation(s)
- Katherine Kim
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Corinne Moss
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Slomine BS, Copeland-Linder N. Early-Life Adversity and Executive Functioning-Highlighting an Urgent Need for Identification, Prevention, and Intervention in Childhood. JAMA Pediatr 2021; 175:e212517. [PMID: 34309640 DOI: 10.1001/jamapediatrics.2021.2517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Beth S Slomine
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland.,Office for Health, Equity, Inclusion, and Diversity, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nikeea Copeland-Linder
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland.,Office for Health, Equity, Inclusion, and Diversity, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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