Effects of Clergy Reporting Laws on Child Maltreatment Report Rates

Child maltreatment (CM) reporting laws and policies have an important role in the identification, treatment, and prevention of CM in the United States (U.S. Department of Health and Human Services [US DHHS], 2012). Abuse by a member of the clergy “is not only a personal and emotional betrayal, but [also] a spiritual betrayal, with secrecy amplified by the unprecedented and systemic cover-up committed by the Church hierarchy” (Coyne, 2011, p. 15). Recent controversies have resulted in the consideration of changes in mandated U.S. reporting laws that include increasing requirements for clergy and extension to additional professions (Freeh, Sporkin, & Sullivan, 2012; Loviglio, 2012). Many professionals and policymakers have expected that these changes will result in better identification and response to CM, but the effects of such changes on reporting rates have not yet been systematically evaluated. When the categories of professionals required to report suspected child sexual assault in New South Wales, Australia, for example, were extended to include teachers and other school professionals, there was a significant increase in the number of reports received from teachers but no change in the quality of their reports as measured by the percentage of reports that were verified (Lamond, 1989). When we looked at the association of universal reporting laws with total and confirmed CM reports, there were higher report rates in large counties with universal reporting, but most of the additional confirmed reports were for neglect (Palusci & Vandervort, 2014). It is important to take current specific laws and child and community factors into account if we are to understand the full effects of their implementation on the accurate reporting and identification of CM

Reviewer\u27s Note

Review of Child Abuse & the Law by Jennifer N Fishe and Frederick L. Moffat III

Response to: How Should We Respond to Pregnancy and Substance Use?

We begin our reply by asking the reader to consider this typical case taken from Professor Vandervort’s current practice. It is one of several similar cases currently being handled by the clinic he works in and similar to many dozens—perhaps hundreds—of cases handled over the past 30 years

To Protect and Provide for Children, Prenatal Substance Use Must be Considered Abuse.

The use of drugs and alcohol during pregnancy is harmful to the developing child. When children are born having been exposed to these substances, children’s protective services should uniformly substantiate child maltreatment in order to ensure that the child’s parent(s) and the child receive the treatment and services necessary to address the child’s immediate safety, protect the government’s compelling interest in the child’s welfare, and ensure the best long-term outcome for the child

Preventing intimate partner violence among foreign-born Latinx mothers through relationship education during nurse home visiting

Aims This study aimed to examine the effectiveness of an augmented home visiting programme in preventing intimate partner violence among Latinx mothers by nativity. Background Intimate partner violence diminishes home visit programmes' effectiveness. Immigrant Latinx mothers are especially vulnerable and need culturally tailored prevention. Methods We performed secondary analyses of 33 US-born and 86 foreign-born Latinx mothers at baseline and 1- and 2-year follow-up in a longitudinal randomized controlled trial of the Nurse-Family Partnership programme augmented with nurse-delivered Within My Reach relationship education curriculum and violence screening and referrals in Oregon. We estimated proportional odds models via generalized estimating equations on total physical and sexual victimization and/or perpetration forms (an ordinal variable), adjusting for intervention, wave, age and education. Results The intervention&ndash;nativity interaction was not significant (p&thinsp;=&thinsp;.953). Foreign-born status was associated with lower reported violence at baseline (adjusted odds ratio: 0.29, 95% confidence interval: 0.13&ndash;0.67, p&thinsp;=&thinsp;.004). This association was marginally significant at 1-year follow-up (0.43, 0.17&ndash;1.08, p&thinsp;=&thinsp;.072) and not significant at 2-year follow-up (0.75, 0.33&ndash;1.67, p&thinsp;=&thinsp;.475). Conclusions This augmented programme was not effective for Latinx mothers by nativity. Their nativity gap diminished over time. Implications for Nursing Management Nursing leaders should support culturally tailored home visiting programmes to detect and prevent intimate partner violence affecting Latinx immigrants. Clinical Trial Registration: This study is registered at www.clinicaltrials.gov NCT01811719. The full trial protocol can be accessed at https://clinicaltrials.gov/ct2/show/NCT01811719. &nbsp;</p

Consensus statement on abusive head trauma in infants and young children

Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic-ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature

Risk factors and services for child maltreatment among infants and young children

Objectives Child maltreatment (CM) causes injury in large numbers of U.S. children. This study uses a large, multi-state dataset of child protective services reports for infants and young children under five years of age to examine risk factors and the effects of services in confirmed maltreatment investigations and recurrence over five years.Methods The Child Files of the National Child Abuse and Neglect Data System (NCANDS) for 2003-2007 were used to study confirmed CM reports to child protective services (CPS) using regression models and survival analysis among a cohort of children first reported during 2003.Results There were 1.2 million confirmed maltreatment reports to state child protective services agencies in 22 states during 2003-2007 in NCANDS, including 177,568 infants and young children under five years. 19.3% had a second confirmed CM report within 5 years. White race, inadequate housing and receiving public assistance were associated with significantly increased risk of CM recurrence. Infants and young children received more services and had less recurrence than did older children.Conclusions Infants and young children have different risk factors and receive different services than do older children in the CPS system. We need additional research to further assess and better target services for the special needs of infants, young children and their families if we are to protect them and reduce future child maltreatment.Child maltreatment Recurrence Infants Young children Services Prevention

\u27Of Sound Mind and Body\u27: A Call for Universal Drug Screening for All Newborns

Substance abuse is a major medical and social problem. Estimates suggest that each year some 15 percent of the 4 million babies born in the United States are exposed to drugs or alcohol. Research demonstrates that exposure to these substances is harmful to the children in both the short term and across their developmental trajectory. This chapter summarizes the harms that might result from such prenatal exposure and considers the ways that both federal and state law respond to this. The chapter argues for universal drug testing of newborns in an effort to ascertain whether they have been prenatally exposed to such substances so that treatment and other services can be provide

\u27Of Sound Mind and Body\u27: A Call for Universal Drug Screening for All Newborns

Substance abuse is a major medical and social problem. Estimates suggest that each year some 15 percent of the 4 million babies born in the United States are exposed to drugs or alcohol. Research demonstrates that exposure to these substances is harmful to the children in both the short term and across their developmental trajectory. This chapter summarizes the harms that might result from such prenatal exposure and considers the ways that both federal and state law respond to this. The chapter argues for universal drug testing of newborns in an effort to ascertain whether they have been prenatally exposed to such substances so that treatment and other services can be provide