Signs of Child Abuse Opportunities for Prevention & Intervention Discussion no plagiarize, spell check, and check your grammar. Please only use the referen

Signs of Child Abuse Opportunities for Prevention & Intervention Discussion no plagiarize, spell check, and check your grammar. Please only use the reference below. Ask at least one question in response to an original peer post that you would like the author to explore further.

Discussion

The two dysfunctional behaviors that can result from intergenerational abuse are emotional and physical abuse. Emotional abuse may be defined as experiencing a lack of love and emotional support from over significant individuals (Kaplan, Pelcovitz, & Labruna, 1999, p.1214). First, Rick’s father demonstrated emotional abuse toward him by failing to provide him with emotional support, calling him derogatory names, and humiliating him by stating to him that he would never amount to anything in life. His mother also caused emotional abuse to him through her actions. Her actions were to do nothing but allow the father to abuse him without intervening to protect him. In addition, being exposed to emotional abuse as a child had a negative effect on Rick’s relationship with his wife and child. Physical abuse may be defined as an act of physical violence which results in physical injury on another individual (Archana, Don,2019, p.189). Second, Rick was a victim of physical abuse by his father when he attempted to protect his mother from being physically abused by his father. In addition, growing up in this type of environment Rick inflicted physical abuse on his wife and son by slamming her against the wall and violently shaking his son.

As a human service professional, an intervention would need to be implemented for Rick to break the intergenerational abuse cycle. First, it needs to be explained to Rick that emotional and physical abuse are not appropriate behavior that needs to be displayed toward his wife and son. Second, an early prevention of maltreatment program is needed to help Rick to handle his emotional and physical abuse towards his wife and son. The early prevention of maltreatment program is designed to identify and prevent the abuse before it escalates to a level of emotional and physical abuse. This program may be designed to tailor the specific needs of a family (Fallon, Ma, Allan, Pillhofer, Trocme, & Jud, 2013, p.12). Third, a human service professional may help Rick with develop strategies designed to help Rick control his anger, physical and verbal aggression/abuse towards his wife and child. This program will be able to help Rick to express his anger, trust issues, and self-control. Last, Rick needs to attend counseling on marriage and parenting. This will help Rick to improve his relationship with his child, wife, mother, and father, thus, reducing the possibility of a continued cycle of abuse.

References

Archana, K., & Don, K.R. (2019). Physical signs of child abuse. Drug Invention Today, 11(1), 180-192. Retrieved from http://search.ebscohost.com.proxy-library.ashford.edu/login.aspx (Links to an external site.)Links to an external site.?

Fallon, B., Ma, J., Allan, K., Pillhofer, M., Trocme, N., & Jud, A. (2013). Opportunities for prevention and intervention with young children: Lessons from the Canadian Incidence Study of Reported Child Abuse and Neglect. Child & Adolescent Psychiatry & Mental Health, 7(1): 1-13.doi:10.1186/1753-2000-7-4 Fallon et al. Child and Adolescent Psychiatry and Mental Health 2013, 7:4
http://www.capmh.com/content/7/1/4
RESEARCH
Open Access
Opportunities for prevention and intervention
with young children: lessons from the Canadian
incidence study of reported child abuse and
neglect
Barbara Fallon1*, Jennifer Ma1, Kate Allan1, Melanie Pillhofer2, Nico Trocmé3 and Andreas Jud3
Abstract
Background: The most effective way to provide support to caregivers with infants in order to promote good
health, social, emotional and developmental outcomes is the subject of numerous debates in the literature. In
Canada, each province adopts a different approach which range from universal to targeted programs. Nonetheless,
each year a group of vulnerable infants is identified to the child welfare system with concerns about their wellbeing and safety. This study examines maltreatment-related investigations in Canada involving children under the
age of one year to identify which factors determine service provision at the conclusion of the investigation.
Methods: A secondary analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect CIS-2008
(PHAC, 2010) dataset was conducted. Multivariate analyses were conducted to understand the profile of
investigations involving infants (n=1,203) and which predictors were significant in the decision to transfer a case to
ongoing services at the conclusion of the investigation. Logistic Regression and Classification and Regression Trees
(CART) were conducted to examine the relationship between the outcome and predictors.
Results: The results suggest that there are three main sources that refer infants to the Canadian child welfare
system: hospital, police, and non-professionals. Infant maltreatment-related investigations involve young caregivers
who struggle with poverty, single-parenthood, drug/solvent and alcohol abuse, mental health issues, lack of social
supports, and intimate partner violence. Across the three referral sources, primary caregiver risk factors are the
strongest predictor of the decision to transfer a case to ongoing services.
Conclusions: Multivariate analyses indicate that the presence of infant concerns does not predict ongoing service
provision, except when the infant is identified with positive toxicology at birth. The opportunity for early
intervention and the need to tailor interventions for specific caregiver risk factors is discussed.
Keywords: Child welfare, Child maltreatment, Infants, Young parents, Referral source, Decision-making, Ongoing services
Introduction and Background
The most effective way to provide support to caregivers
with infants in order to promote good health, social,
emotional and developmental outcomes is the subject
of numerous debates in the empirical literature. Each
province/territory in Canada adopts a different approach which range from universal to targeted programs.
* Correspondence: barbara.fallon@utoronto.ca
1
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor
Street W, Toronto, Ontario M5S 1V4, Canada
Full list of author information is available at the end of the article
Nonetheless, each year a group of vulnerable infants is
identified to the Canadian child welfare system with
concerns about their well-being and safety.
In Canada, both non-professionals and professionals
who have concerns about child maltreatment can make
a referral to a child welfare agency. The child welfare
agency determines whether or not an initial investigation
will occur after they receive the referral. If there is an initial investigation, child welfare workers typically determine
whether or not maltreatment has occurred, and whether
or not the family will receive voluntary or non-voluntary
© 2013 Fallon et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Fallon et al. Child and Adolescent Psychiatry and Mental Health 2013, 7:4
http://www.capmh.com/content/7/1/4
child welfare services. Workers may decide to provide
ongoing child welfare services at the conclusion of the
investigation, meaning that the child and/or family will
have an open case file with the child welfare agency, and
will maintain ongoing contact with an agency employee
until it is determined that supportive services are no
longer necessary.
The primary objectives of this paper are (1) to examine
the decision to provide ongoing child welfare services to
infants identified to the child welfare system using a
Canadian national dataset, (2) to understand the clinical
factors that influence the decision to provide ongoing
child welfare services to infants and their caregivers, and
(3) to situate the findings in a public health context and
understand opportunities for prevention and intervention
in families struggling with maltreatment-related issues.
Infants are the most vulnerable subset of children
involved with the child welfare system given their dependency on a caregiver to take care of their daily needs,
and their inability to protect themselves from any form
of harm [1,2]. In 2008, children under the age of one
were the most likely to be the subject of maltreatmentrelated investigations in Canada with rates of investigations decreasing with age [3]. This pattern was also
observed in 1998 and 2003 [3]. Given the high incidence
of investigations involving infants, understanding the
factors that impact child welfare service delivery to
infants and their families is important.
The rate of infant maltreatment related investigations
in Canada in 2008 was 51.81 per 1,000 children, a nonsignificant increase from the 2003 rate of investigation
[3]. A dramatic increase in the rate of infant investigation occurred earlier, between 1998 and 2003 when the
rate increased from 17.23 to 49.54 [3]. This increase was
consistent with an overall increase in the rate of all child
maltreatment investigations in Canada [3]. Various factors may have contributed to this increase in investigations including changes in detection, reporting and
investigation practices [3]. Furthermore, legislative changes
introduced provincially expanded reporting criteria to
include cases where a child had not yet been harmed,
but where a risk of future maltreatment was evident [4].
Differential service response models have been recently
introduced in several Canadian jurisdictions, which permit
workers to conduct family needs assessments as opposed
to full investigations in cases where the risk level is found
to be low to moderate, including British Columbia [5],
Alberta [6], and Ontario [7]. Cases involving infants,
however, are generally considered high-risk due to the
vulnerability of this population [2]. A study found that
caregivers of infants were more likely to have a drug,
alcohol, learning or medical problem and to be experiencing domestic violence compared to caregivers of
older children involved with the child welfare system [8].
Page 2 of 13
Federally-mandated developmental screening in the United
States suggests that children who become involved with
the child welfare system in infancy present developmental
delays more often than children in the general population
[9]). In the 2003 Canadian Incidence Study of Reported
Child Abuse and Neglect, workers noted few developmental
concerns and positive toxicology at birth or substance abuse
birth defects in 93% of investigations involving infants [10].
However, several studies suggest that children involved
with the child welfare system may be under-identified for
developmental difficulties [9,11,12].
Currently, at the point at which infants come into contact with the child welfare system, there is at minimum
risk factors present that could potentially impact the
child’s social, emotional, cognitive, intellectual or physical development [3]. In Canada, infants are most often
brought to the attention of the child welfare system by
health professionals and second most often by police,
often while law enforcement is responding to an incident
of domestic violence [2]. Preventive programs, which
may begin prenatally, may help to support parents and
mitigate risk factors for maltreatment prior to the birth
of the child (e.g., Nurse Family Partnership Program)
[13,14].
It is important to understand the clinical profile of
families with risk factors for maltreatment, as this may
assist in preventing harm to children, supporting wellbeing, and preventing intrusive child welfare intervention. Early prevention of maltreatment is a public health
issue, and programs that are tailored and responsive to
the needs of at-risk families are necessary. Preventing
maltreatment will in turn help to prevent the consequences of maltreatment, such as childhood injury and
developmental difficulties, and it will also lessen the case
volume at child protection agencies. Overall, investing in
early identification and prevention is beneficial for individuals and families as well as society as a whole, with
efforts in the early years producing excellent economic
returns and other positive outcomes [15].
Methods
A secondary analysis of the Canadian Incidence Study of
Reported Child Abuse and Neglect CIS-2008 [16] dataset
was conducted. Ethics approval for this study was provided by University of Toronto, McGill University and
University of Calgary. Please refer to Chapter 2 in the
CIS-2008 Major Findings Report for more detailed information about methods [3]. The CIS-2008 dataset contains information about key clinical factors collected
during routine child maltreatment investigations [3]. A
multi-stage sampling design was employed to first obtain
a representative sample of 112 child welfare agencies
selected from 412 child welfare service areas in Canada,
and then to sample cases within these agencies [3].
Fallon et al. Child and Adolescent Psychiatry and Mental Health 2013, 7:4
http://www.capmh.com/content/7/1/4
Maltreatment-related cases opened for investigation at
the agencies between October 1st and December 31sta
were eligible for inclusion [3]. Three months was considered to be the optimal period for participation and compliance with study procedures. The final sample selection
stage involved identifying children who had been investigated due to concerns related to possible maltreatment.
Maltreatment-related investigations included situations
where there were concerns that a child may have already
been abused or neglected as well as situations where there
was no specific concern about past maltreatment but
where the risk of future maltreatment was being assessed.
A maltreatment investigation occurred when there was an
allegation made about a known or suspected past incident
of abuse or neglect. Risk investigations were conducted
when there were no allegations or suspicions of past abuse
or neglect, but rather the concern was the risk of future
maltreatment. Together, maltreatment and risk investigations are referred to as “maltreatment-related investigations” throughout this paper.
In most jurisdictions cases were counted as families,
so procedures were developed to determine which specific children in each family had been investigated for
maltreatment-related concerns. In jurisdictions outside of Québec, children were eligible for inclusion in
the final study sample if the worker investigated a
maltreatment-related concern (i.e., investigation of
possible past incident(s) of maltreatment or assessment
of risk of future maltreatment). In Québec, children
were eligible for inclusion in the final study sample
if the case was “retained”b with maltreatment-related
classification codes.
Data collection instruments
Workers in the sampled child welfare agencies completed the three-page data collection instrument at the
conclusion of their initial maltreatment-related investigation. The CIS-2008 data collection instrument was
based on the instrument used in previous cycles of the
CIS. In preparation for the CIS-2008, the instrument
was revised and validated through a case file validation
study, validation focus groups, and a reliability study
(please see Trocmé et al., 2010 for details). The data collection instrument included clinical information that
workers would have collected as part of their initial investigation. Workers were trained on completing the instrument, and were asked to use their clinical judgment
to respond to the questions. Data collected included: referral source; type of investigation (maltreatment or risk
only); type of abuse and neglect investigated; level of
substantiation; functioning concerns for the children
and risk factors for their caregivers; income source;
housing information; and information about short-term
service dispositions. Key clinical variables were included
Page 3 of 13
in the analysis in order to reflect an ecological model
and to determine the relative contribution of clinical
variables to the decision to provide ongoing services
(please see Table 1). Completion rates were over 98% on
most items; this high item completion rate can be attributed to the design of the instrument and the verification
procedures [3].
Study sample
The CIS-2008 sampling procedures yielded a final sample
of 15,980 children investigated because of maltreatmentrelated concerns (i.e., incident of maltreatment or risk
assessment). This analysis focused on investigations involving children under the age of one year (n=1,203),
examining whether the case was transferred to ongoing
services at the conclusion of the investigation. The sample
was further divided into three categories of referral sources:
hospital referrals; police referrals; and non-professional
referrals. The categories were selected for practical reasons,
because the majority of infant investigations were referred
by one of these referral sources. Almost one quarter of
investigations involving infants were referred by hospital
personnel (23%). Approximately 22% of infant investigations were referred by the police. Non-professional referral
sources comprised 23% of investigations involving infants.
This implies that approximately 68% of all infant investigations were referred to by hospital personnel, police, or
non-professionals. The remaining infant investigations
were referred by other professional sources (e.g., community or social services, day care centre, etc.; please see
Table 1 for complete list). Workers could list multiple
referral sources, if there were multiple independent contacts with the child welfare agency.
Two sets of weights were applied to the data to derive
national annual estimates. First, results were annualized
to estimate the volume of cases investigated by each
study site over the entire year. To account for the nonproportional sampling design, regional weights were
then applied to reflect the size of each site relative to
the child population in the region from which the site
was sampled. Annualization weights are based on service statistics from the study sites; these service statistics include an unknown number of “duplicate” cases,
or in other words, children or families reported and
opened for investigation two or more times during the
year. Although each investigation represents a new
maltreatment-related concern, confusion arises if these
investigations are interpreted to represent an “unduplicated” count of children. To avoid this confusion, the
CIS-2008 uses the term “child investigations” rather
than “investigated children” [3]. The final weighted
sample for child maltreatment investigations involving
infants was 17,339.
Fallon et al. Child and Adolescent Psychiatry and Mental Health 2013, 7:4
http://www.capmh.com/content/7/1/4
Page 4 of 13
Table 1 Variable definitions
Outcome Variable
Transferred to Ongoing Service
Measurement
Dichotomous variable
Transfer to ongoing service(1)
Close case (0)
Description
Workers were asked to indicate
whether the investigation would
be opened for ongoing child
welfare services at the conclusion
of the investigation.
Predictor Variables
Primary Caregiver Age
Categorical variable
18 years and under (1)
Workers were asked to indicate
the age category of the primary
caregiver.
19 to 21 years (2)
22 to 30 years (3)
31 to 40 years (4)
41 years and up (5)
Primary Caregiver Risk Factors
Nine dichotomous variables
Suspected or confirmed concern (1)
No or unknown (0)
Child Functioning
Six dichotomous variables
Suspected or confirmed concern (1)
No or unknown (0)
No Second Caregiver in the Home
Dichotomous variable
No Second caregiver in the home (1)
Second caregiver in the home (0)
Primary Income
Categorical variable
Full time employment (1)
Workers could note up to nine risk
factors for the primary caregiver.
Risk factors were: alcohol abuse,
drug/solvent abuse, cognitive
impairment, mental health issues,
physical health issues, few social
supports, victim of domestic
violence, perpetrator of domestic
violence, and history of foster
care/group home.
Workers could note up to eighteen
functioning concerns for the
investigated child, indicating whether
the concern had been confirmed,
suspected, was not present or it was
unknown to the worker. This analysis
examined six age-appropriate
concerns, including: attachment issues,
intellectual/developmental disability,
failure to meet developmental milestones,
Fetal Alcohol Syndrone/Fetal Alcohol
Effects (FAS/FAE), positive toxicology at
birth, and physical disability.
Workers were asked to describe up
to two caregivers in the home.
If there was only one caregiver
described there was no second
caregiver in the home.
Workers were asked to indicate the
primary source of the primary
caregiver’s income.
Part time/seasonal employment (2)
Other benefits/ unemployment (3)
No income (4)
Household Hazards
Dichotomous variable
At least one household hazard (1)
No household hazards (0)
Household Regularly Runs Out of Money
Dichotomous variable
Noted (1)
Not Noted (0)
Workers were asked to note if the
following hazards were present in
the home at the time of the
investigation: accessible weapons,
accessible drugs, production/trafficking
of drugs, chemicals/solvents used in
drug production, other home injury
hazards, and other home health hazards.
Workers were asked to note if the
household regularly runs out of money.
Fallon et al. Child and Adolescent Psychiatry and Mental Health 2013, 7:4
http://www.capmh.com/content/7/1/4
Page 5 of 13
Table 1 Variable definitions (Continued)
Number of Moves
Categorical variable
Number of moves reflects the number of
moves the household had experienced
in the past six months.
No moves (0)
One move (1)
Two or more moves (2)
Type of Investigation
Maltreatment investigation (1)
Risk-only investigation (2)
Workers were asked to indicate whether
the investigation was for an incident
of maltreatment or if it was a risk
investigation only.
Referral Source
Source of Allegation/ Referral
Nine dichotomous variables
Noted (1)
Not Noted (0)
Measures
Outcome variable: transferred to ongoing services
Workers were asked to indicate whether the case would
be opened for ongoing child welfare services at the conclusion of the investigation. The decision to transfer a
case to ongoing services is a dichotomous variable.
Predictor variables
Key clinical variables representing an ecological model
of child maltreatment were examined to determine the
relative contribution of clinical variables. Clinical variables were chosen based on empirical literature of factors related to child maltreatment or risk of child
maltreatment. These included child functioning concerns, caregiver risk factors, and household characteristics. The operational definitions and codes used in the
analysis are provided in Table 1.
Analysis plan
All analyses were conducted using SPSS, …
Purchase answer to see full
attachment