Are dual and single exposures differently associated with clinical levels of trauma symptoms? Examining physical abuse and witnessing intimate partner violence among young children

A significant portion of children living in the United States have experienced trauma. Informed by the developmental traumatology model, we explored the effects of physical abuse and witnessing intimate partner violence (IPV) on childhood trauma symptoms. This study utilizes a convenience sample of 580 high- risk children between 3 and 12 years who received services from one- child advocacy centre during a 12- month period. We performed a series of binary logistic regression analyses to examine if physical abuse, exposure to IPV, and dual exposure (i.e., both physical abuse and IPV) are distinctly associated with six trauma symptoms, including anxiety, depression, posttraumatic stress (PTS), dissociation, anger, and sexual concerns. The results indicated that dual exposure was predictive of all trauma symptoms, except for dissociation. Additionally, physical abuse was associated with PTS, anger, and sexual concerns, whereas exposure to IPV was associated with depression, PTS, and sexual concerns. Research and implications for practitioners working with young children are discussed.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154965/1/cfs12700.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154965/2/cfs12700_am.pd

Child Advocacy Center Multidisciplinary Team Decision and Its Association to Child Protective Services Outcomes

Limited studies exist evaluating the multidisciplinary team (MDT) decision-making process and its outcomes. This study evaluates the MDT determination of the likelihood of child sexual abuse (CSA) and its association to the outcome of the child protective services (CPS) disposition. A retrospective cohort study of CSA patients was conducted. The MDT utilized an a priori Likert rating scale to determine the likelihood of abuse. Subjects were dichotomized into high versus low/intermediate likelihood of CSA as determined by the MDT. Clinical and demographic characteristics were compared based upon MDT and CPS decisions. Fourteen hundred twenty-two patients were identified. A high likelihood for abuse was determined in 997 cases (70%). CPS substantiated or indicated the allegation of CSA in 789 cases (79%, Kappa 0.54). Any CSA disclosure, particularly moderate risk disclosure (AOR 59.3, 95% CI 26.50–132.80) or increasing total number of CSA disclosures (AOR 1.3, 95% CI 1.11–1.57), was independently associated with a high likelihood for abuse determination. Specific clinical features associated with discordant cases in which MDT determined high likelihood for abuse and CPS did not substantiate or indicate CSA included being white or providing a low risk CSA disclosure or other non-CSA disclosure. MDT determination regarding likelihood of abuse demonstrated moderate agreement to CPS disposition outcome. CSA disclosure is predictive of the MDT determination for high likelihood of CSA. Agreement between MDT determination and CPS protection decisions appear to be driven by the type of disclosures, highlighting the importance of the forensic interview in ensuring appropriate child protection plans

The Behavioral Cost of Care: Changes in Maintenance Behavior during Equine-Assisted Interventions

This study examined human–animal symbiosis in an animal-assisted intervention through observations of animal maintenance behaviors. The rise of psychotherapy, learning, and recreation incorporating animals warrants exploration of the welfare of the animals involved in these interventions. The analysis of welfare in multispecies engagements can be discussed in terms of symbiosis. Regarding an intervention’s animal provider (e.g., therapy horse) and human recipient (psychotherapy client), the balance of cost and benefit is important. Research describing human and animal interactive behavior during interventions is limited, whether focusing on client outcomes or animal welfare. The present study adapted ethological methods to study humans and animals in an equine-assisted intervention, observing equine maintenance behaviors and equid–human interactive behavior. Maintenance behaviors were recorded before, during, and after equine-assisted (psychosocial) learning sessions with youth, providing 1600 observations. Equine alertness, eating behavior, and ambulation varied significantly before, during, and after the equine-assisted sessions. Such interruptions of typical behavior are an important aspect of welfare and unit of analysis when examining symbiotic relationships. A total of 267 sequences of equid–human approach–response behavior were also recorded, indicating that human–animal interaction was predominantly from humans toward equids. Equids’ dominant response to human approach was no response, followed by avoidance, while humans’ dominant response to equid approach was reciprocation. The findings are discussed in terms of symbiosis and animal welfare

Child Advocacy Center Multidisciplinary Team Decision and Its Association to Child Protective Services Outcomes

Limited studies exist evaluating the multidisciplinary team (MDT) decision-making process and its outcomes. This study evaluates the MDT determination of the likelihood of child sexual abuse (CSA) and its association to the outcome of the child protective services (CPS) disposition. A retrospective cohort study of CSA patients was conducted. The MDT utilized an a priori Likert rating scale to determine the likelihood of abuse. Subjects were dichotomized into high versus low/intermediate likelihood of CSA as determined by the MDT. Clinical and demographic characteristics were compared based upon MDT and CPS decisions. Fourteen hundred twenty-two patients were identified. A high likelihood for abuse was determined in 997 cases (70%). CPS substantiated or indicated the allegation of CSA in 789 cases (79%, Kappa 0.54). Any CSA disclosure, particularly moderate risk disclosure (AOR 59.3, 95% CI 26.50–132.80) or increasing total number of CSA disclosures (AOR 1.3, 95% CI 1.11–1.57), was independently associated with a high likelihood for abuse determination. Specific clinical features associated with discordant cases in which MDT determined high likelihood for abuse and CPS did not substantiate or indicate CSA included being white or providing a low risk CSA disclosure or other non-CSA disclosure. MDT determination regarding likelihood of abuse demonstrated moderate agreement to CPS disposition outcome. CSA disclosure is predictive of the MDT determination for high likelihood of CSA. Agreement between MDT determination and CPS protection decisions appear to be driven by the type of disclosures, highlighting the importance of the forensic interview in ensuring appropriate child protection plans

Supplemental Material - <b>Identifying Children at Risk for Maltreatment Using Emergency Medical Services’ Data: An Exploratory Study</b>

Supplemental Material for Identifying Children at Risk for Maltreatment Using Emergency Medical Services’ Data: An Exploratory Study by Colleen J. Bressler, MD, Lauren Malthaner, MPH, Nicholas Pondel, MPH, Megan M. Letson, MD, MEd, David Kline, PhD, and Julie C. Leonard, MD, MPH in Child Maltreatment.</p