Risk and Protective Factors for Child Maltreatment: a Review

Austin, Anna E.; Lesak, Alexandria M.; Shanahan, Meghan

doi:10.1007/s40471-020-00252-3

Cited by 115 publications

(69 citation statements)

References 83 publications

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“…It is also worth noting that, although there was some evidence of overlap among the risk factor “parental mental illness” and the reported issue of “carer – mental health” (specifically, around 70 per cent of children whose child protection reports were tagged with the reported issue of “carer – mental health” had evidence of parental mental illness diagnoses in their parent’s health records), the reduction in effect sizes (in multivariable models) for associations between SHCN and this reported issue was negligible. In general, these findings are consistent with the body of literature, which have demonstrated the influence of a range of adversities (i.e., sociodemographic, perinatal and parental factors) and risk of maltreatment (Stith et al 2009; O'Donnell et al 2010; AIHW 2020; Austin et al 2020; Whitten et al 2020). It is therefore essential that future studies consider these factors, along with other potentially important environmental factors not available for inclusion in this study (e.g., social cohesion, community supports).…”

Section: Discussionsupporting

confidence: 89%

“…While the group of children with broad SHCN based on AEDC data have been shown to be vulnerable to poor educational and health outcomes (Howell‐Meurs et al 2014; O'Connor et al 2017; O'Connor et al 2019; O’Connor et al 2020), their contact with child protection services has yet to be explored. These children may also be exposed to other risk factors known to be associated with child maltreatment, such as sociodemographic disadvantage (including being of Aboriginal or Torres Strait Islander descent), perinatal factors (such as the age of the mother at the child’s birth, maternal smoking during pregnancy), and parental mental illness or criminal justice contacts (Stith et al 2009; O'Donnell et al 2010; AIHW 2020; Austin et al 2020; Whitten et al 2020). This information is important so that child protection workers are aware and attentive to the needs of children with broad SHCN.…”

Section: Introductionmentioning

confidence: 99%

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Child protection services for children with special healthcare needs: A population record linkage study

Hindmarsh

Laurens

Katz

et al. 2020

Aust J Social Issues

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Children with disabilities are known to have high rates of contact with child protection services. However, little is known about child protection contacts for a broader group of children with special healthcare needs (SHCN; i.e., special needs or other impairments of concern that affect learning). This study examined the characteristics of contact with child protection services (prior to the age of 6 years) for children with SHCN identified at school entry using the 2009 Australian Early Development Census, using administrative data from more than 65,000 children in the New South Wales Child Development Study. Child protection contacts prior to age 6 years were more prevalent among children with SHCN compared with those without; in particular, children with SHCN had higher odds of a history of exposure to neglect and physical abuse, and higher odds of being placed in out‐of‐home care, compared with their typically developing peers. Understanding the characteristics of child protection contacts among children with SHCN, with consideration of factors that may influence their patterns of contact with these and other human services agencies, will inform the development of appropriate social policy initiatives to fulfil Australia’s obligations under the United Nations Convention on the Rights of the Child.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Child protection services for children with special healthcare needs: A population record linkage study

Hindmarsh

Laurens

Katz

et al. 2020

Aust J Social Issues

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“…Interventions to prevent child maltreatment can target a range of risk factors [5,6] at the child, parent or family, and neighborhood or county level [7]. Child-level risk factors include those such as child demographics, school attendance, and medical insurance coverage [8]. Parent and family factors include parent mental health; family structure, such as single-parent households; and substance misuse [9][10][11].…”

Section: Original Articlementioning

confidence: 99%

“…For example, foster care entry rates have significantly increased in states where high levels of parental opioid misuse are observed [12]. Neighborhood factors include economic distress indicators, such as unemployment and household income, housing and food insecurity, and rurality [8,13].…”

Section: Original Articlementioning

confidence: 99%

“…Moderate-risk counties especially may benefit from community-wide drug misuse prevention and treatment efforts, and mental health supports such as increased access to high-quality care. The high-risk profile may not have had the highest rate of predicted child maltreatment due to unmeasured protective factors that lead to lower rates of child maltreatment, such as social support [8]. Alternatively, as discussed in the limitations section, underreporting and low substantiation rates could also influence estimated rates.…”

Section: Policy and Research Implications: Drug Overdosesmentioning

confidence: 99%

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Exploring Clusters of Risk and Association With Child Maltreatment in North Carolina Counties

Cruden

Brown

Lanier

et al. 2021

North Carolina Medical Journal

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background Decision makers face challenges in estimating local risk for child maltreatment and how best to prioritize which factors to intervene upon. methods Using US Census and survey data for all US counties (N = 3141), we derived US county profiles characterized by the severity of child maltreatment risk factors observed at the county level, such as parental health, health care access, and economic distress. We estimated how five child maltreatment outcomes would vary across the profiles for North Carolina counties (n = 100): total maltreatment reports (including unsubstantiated and substantiated), substantiated neglect, substantiated abuse, whether services were received, and reported child's race/ethnicity. results We derived three profiles of county-level child maltreatment risk: high, moderate, and low risk, denoting that predicted risk factors means within profiles were all high, moderate, or low levels compared to counties in other profiles. One risk factor did not follow this pattern: the drug overdose death rate. It was highest in the moderate-risk profile instead of the high-risk profile, as would have been consistent with other factor levels. Moderate-risk counties had the highest predicted rate of child maltreatment reports, with over 20 more reports per 10,000 residents compared to low-risk counties (95% CI, 1.38, 38.86). limitations We included only factors for which aggregate, county-level estimates were available, thus limiting inclusion of all relevant factors. conclusions Results suggest the need for increased family-based services and interventions that reduce risk factors such as economic distress and drug overdose deaths. We discuss the implications for tailoring county efforts to prevent child maltreatment.

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Racial and Ethnic Disparities in Child Abuse Identification and Inpatient Treatment

Salimi-Jazi,

Liang,

Huang

et al. 2024

JAMA Netw Open

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ImportanceChild abuse is a leading cause of morbidity in early childhood. Accurate detection remains challenging.ObjectiveTo describe racial and ethnic disproportionalities in suspicion for child abuse (SCA) in pediatric patients admitted after traumatic injury.Design, Setting, and ParticipantsThis retrospective, multicenter cross-sectional study performed between 2022 and 2024 examined a representative national sample of children and adolescents (aged &lt;18 years) admitted for pediatric trauma indications from 2006 to 2019. Data were from the Kids’ Inpatient Database (KID), the largest publicly available all-payer pediatric inpatient care database. Patient demographics, injury severity, and hospitalization characteristics were classified by race and ethnicity and compared using univariate and multivariate regression. Statistical analysis was performed between March 2022 and October 2024.ExposureThe SCA subgroup was identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes corresponding to child and adolescent maltreatment.Main Outcome and MeasureThe primary outcome was the racial and ethnic composition of pediatric patients admitted after traumatic injury with SCA vs those without SCA.ResultsAmong the weighted total of 634 309 pediatric patients with complete data included in the study, 13 579 patients had injuries attributable to SCA (SCA subgroup; mean [SD] age, 1.70 [0.04] years; 7650 male [56.3%]; 2868 Black [21.1%], 2293, Hispanic [16.9%], and 5675 White [41.8%]) and 620 730 patients did not (non-SCA subgroup; mean [SD] age, 9.70 [0.01] years; 395 158 male [63.7%]; 86 376 Black [13.9%], 108 406 Hispanic [17.5%], and 298 748 White [48.1%]). The racial and ethnic distribution of the non-SCA subgroup was similar to that of the 2010 US Census. In the SCA subgroup, Black patients (odds ratio [OR], 1.75; 95% CI, 1.65-1.85; P &lt; .001) and Hispanic patients were overrepresented (OR, 1.11; 95% CI, 1.05-1.18; P &lt; .001) and White patients were underrepresented compared with the Census. After controlling for socioeconomic factors and hospital characteristics among 504 365 (weighted) observations in White, Black, and Hispanic patients (493 530 patients without and 10 835 patients with SCA), Black race remained an independent risk factor associated with SCA (OR, 1.10; 95% CI, 1.03-1.17; P = .004), whereas Hispanic race was found to be a protective factor associated with decreased odds of SCA (OR, 0.71; 95% CI, 0.67-0.76; P &lt; .001). Compared with White patients in the SCA subgroup, Black patients had a 26.5% (95% CI, 11.0%-44.3%) longer length of stay (P &lt; .001) for mild to moderate injuries and a 40.1% (95% CI, 16.4%-68.5%) longer length of stay (P &lt; .001) for serious injury.Conclusion and RelevanceIn this study, Black children and adolescents were suspected to have experienced child abuse at higher rates than children and adolescents of other racial and ethnic backgrounds. More research is necessary to understand the origins of these disparities to reduce them in child abuse identification.

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Risk and Protective Factors for Child Maltreatment: a Review

Cited by 115 publications

References 83 publications

Child protection services for children with special healthcare needs: A population record linkage study

Child protection services for children with special healthcare needs: A population record linkage study

Exploring Clusters of Risk and Association With Child Maltreatment in North Carolina Counties

Racial and Ethnic Disparities in Child Abuse Identification and Inpatient Treatment

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