Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 119
Appendix D
Background Paper: Major Research
Advances Since the Publication of the 1993
NRC Report Understanding Child Abuse and
Neglect: Highlights from the Literature1
By Rosemary Chalk2
Introduction 120
Definitions and Frameworks 126
Identification, Reporting, and Data Sources 133
Causes 147
Consequences 151
Prevention Efforts 157
Treatment Interventions 167
Services and Systems-Level Issues 175
Social Policy 182
Conclusion 188
References 189
1
This paper was commissioned by the Institute of Medicine (IOM) and National Re-
search Council (NRC) to provide background for the January 30-31 Workshop on Child
Maltreatment Research, Policy, and Practice for the Next Generation, hosted by the IOM-
NRC Board on Children, Youth, and Families. The responsibility for the content of this
article rests with the author and does not necessarily represent the views of the IOM, the
NRC, or their committees and convening bodies.
2
The author wishes to acknowledge the contributions of several individuals who re-
viewed early drafts of this paper, including Lucy Berliner, Mark Chaffin, Lisa Jones,
Melissa Jonson-Reid, John Leventhal, Joy Osofsky, Anne Petersen, Andrea Sedlak, and
Melissa Welch-Ross. Yeonwoo Lebovitz, IOM research associate, provided extensive
bibliographic and research assistance in the preparation of the paper.
119
OCR for page 120
120 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
INTRODUCTION
The problem of child maltreatment has persisted as one of the most
serious threats to child health and safety in the United States. The most
recent National Incidence Study (NIS-4) reported that more than 1.25
million children, involving 1 in 58 children from the general population,
were abused or neglected by a parent during the 2005-2006 survey peri-
od according to the evidence of harm standard (Sedlak et al., 2010b).
When the broader standard of endangerment is applied (which includes
maltreatment by adult caretakers other than parents, or by teenaged care-
takers in the case of sexual abuse), the number of children in substantiat-
ed cases increases to nearly 3 million children, involving 1 in 25
children, according to NIS-4 data.
More recent data, provided in the FY 2010 report Child Maltreat-
ment (HHS, 2011, p. ix), indicates that “the unique victim rate was 9.2
victims per 1,000 children in the population” when considering substan-
tiated reports of child abuse and neglect. The overall rate of child mal-
treatment deaths, the most tragic consequences of abuse and neglect, was
2.07 deaths per 100,000 children, based on estimates provided by state
child welfare agencies (HHS, 2011).
The statistical figures mask a complex picture of child maltreatment,
one that frequently challenges the general public’s perception of the na-
ture of the problem of child abuse and neglect. For example:
Maltreatment is frequently viewed as physical or sexual abuse,
yet child neglect reports consistently account for the large major-
ity of the reported cases in national surveys and official records.
The NISs report that the general incidence of child maltreatment
declined by 19 percent (harm standard) in the 12 years between
the data reported in NIS-3 (which collected data in 1993) and
NIS-4 (Sedlak et al., 2010b). This decline occurred during a pe-
riod of growth in the child population in the United States. When
adjusted to account for such growth, the rate of decline per 1,000
children equals 26 percent, approaching the 1986 incidence level
reported in the NIS-2 estimate.
Most of the rates of decline can be explained by significant de-
creases in reports of physical or sexual abuse of children; the
level of child neglect reported in NIS-4 has remained about the
same as that reported in NIS-3. Finkelhor and Jones (2006) offer
OCR for page 121
121
APPENDIX D
additional explanations for the causes of the reported decline in
child maltreatment rates.
One recent study suggests that the perceived decline in NIS re-
ports of abuse and neglect is not consistent with other data re-
garding trends in hospital admissions for child maltreatment
injuries, which have remained stable from 1997 (Gilbert et al.,
2012). However, their analysis relied on data that are not nation-
ally representative, excluded indicators of sexual abuse, and also
classified as maltreatment cases where injuries in question were
classified as of “undetermined cause” (Personal communication,
L. Jones, University of New Hampshire, February 10, 2012).
Although a relatively small proportion of reported cases of child
abuse and neglect meet legal criteria for substantiation, several
studies have suggested that unsubstantiated cases face equal risks
(Hussey et al., 2005; Kohl et al., 2009).
These changes, as well as persistent trends, need to be considered in light
of the changing demographics of the U.S. child population. Statistics in
the report America’s Children (FIFCFS, 2011), based on data compiled
by the Census Bureau through the Current Population Survey, notes that
more than one in five children now live in poverty (see www.child
stats.gov/americaschildren/eco1.asp). The report states:
The percentage of children in families with incomes below the
poverty threshold (defined as $21,756), which is a significant
risk factor for abuse and neglect, rose from a low of 16 percent
in 2000 and 2001 to 21 percent in 2009.
The wealth disparities that now characterize American society
also affect children: The percentage of children living in families
in extreme poverty (defined as 50 percent of $21,756) rose from
6 percent in 2000 to 9 percent in 2009, which is the highest esti-
mate for related children since 1997.
The percentage of children who lived in families with very high
incomes (600 percent or more of the poverty threshold) remained
unchanged between 2000 and 2009 (13 percent). The rising
number of children living in poverty is particularly noteworthy
among younger children. In 2009, 24 percent of related children
ages 0 to 5 lived in poverty, compared with 18 percent of older
related children.
OCR for page 122
122 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
The reported decline in child maltreatment rates is part of a larger
decline in other forms of violent crime, which began in the early 1990s
and continues today (Blumstein and Wallman, 2006). In recent decades,
however, dramatic shifts have occurred in the American economic arena
as well as the racial and ethnic composition of America’s children. Ac-
cording to data from the 2010 Census that is included in the America’s
Children report, 54 percent of U.S. children were white, non-Hispanic;
23 percent were Hispanic; 14 percent were Black; 4 percent were Asian;
and 5 percent were in the category “all other races” (http://www.
childstats.gov/americaschildren/demo.asp). Rapid increases have been
recorded particularly among the percentage of children who are Hispan-
ic, who made up only 9 percent of the child population in 1980
(http://www.childstats.gov/americaschildren/demo.asp).
In light of these economic trends and shifting demographics, it is im-
portant to consider at this time how the health and safety of children have
changed over the past decade. A particular area of interest is research on
child maltreatment, which focuses on the characteristics and needs of
children and families who experience physical abuse, sexual abuse, emo-
tional maltreatment, and neglect.
1993 Academy Study on Child Abuse and Neglect
Nearly two decades ago, the National Research Council (NRC) pub-
lished the report Understanding Child Abuse and Neglect (NRC, 1993).
The report was prepared by a panel of national experts, following a com-
prehensive study and critique of the existing research literature as well as
discussions with hundreds of practitioners from the social services,
healthcare, and legal systems that serve vulnerable children and their
families. The NRC report embraced a developmental and ecological per-
spective in examining the various dimensions of the problem of child
maltreatment, and the study panel offered a general conceptual child-
oriented framework to guide new approaches to child and family ser-
vices as well as to set priorities that could integrate a diverse, fragment-
ed, and interdisciplinary research literature.
The 1993 report included 10 chapters that offered a synthesis of the
key research studies under the designated topics:
1. Introduction
2. Identification and Definitions
3. Scope of the Problem
4. Etiology of Child Maltreatment
OCR for page 123
123
APPENDIX D
5. Prevention
6. Consequences of Child Abuse and Neglect
7. Interventions and Treatment
8. Human Resources, Instrumentation, and Research Infrastructure
9. Ethical and Legal Issues in Child Maltreatment Research
10. Priorities for Child Maltreatment Research
Based on this review, the study panel highlighted 17 research priori-
ties, organized within a research agenda that addressed four objectives:
1. Clarify the nature and scope of child maltreatment;
2. Provide an understanding of the origins and consequences of
child maltreatment in order to improve the quality of future poli-
cy and program efforts;
3. Provide empirical information about the strengths and limitations
of existing interventions as well as guiding the development of
more effective ones; and
4. Develop a science policy for child maltreatment research that
recognizes the importance of national leadership, human and fi-
nancial resources, instrumentation, and appropriate institutional
arrangements.
Since the publication of the 1993 report, the field of child maltreat-
ment studies has continued to expand. While the Office on Child Abuse
and Neglect (formerly the National Center for Child Abuse and Neglect)
within the U.S. Department of Health and Human Services (HHS) con-
tinued to support a modest research portfolio, other federal sponsors in-
vested in child maltreatment studies, including a national consortium on
child neglect research organized by several institutes within the National
Institutes of Health. In the intervening years, a national child abuse pre-
vention initiative within the Doris Duke Charitable Foundation has also
emerged. In addition, a wave of animal and human research studies fo-
cused on stress, trauma, and the regulation of adverse environmental in-
fluences (including threats and violence) has embraced the significance
of child maltreatment as a major influence on health and well-being (see,
e.g., papers produced by the Center on the Developing Child at Harvard
University, http://developingchild.harvard.edu).
The expansion of research in the neurosciences, including the devel-
opment of new tools that are capable of imaging brain structures and
functions, has advanced our understanding of the intricate and complex
OCR for page 124
124 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
processes associated with the regulation of adverse stimuli. Additional
biological studies, focused on other systems such as the immune function
and interactions between genetic structures and the social environment,
are shaping the ways in which researchers view complex interactions
among threats and protective factors in forming the pathways to and con-
sequences of child maltreatment. Research that is focused on selected
childhood injuries, such as head trauma, has also converged with studies
of child maltreatment, especially in highlighting selected stages of devel-
opment (e.g., infancy) or child behaviors (e.g., prolonged crying) that
may be especially vulnerable to particular forms of abuse or trauma
among young children.
Purpose and Scope of This Paper
This paper highlights some of the major research advances since the
publication of the 1993 NRC report, with a particular emphasis on stud-
ies published in the past decade. The objective is to provide an initial
guide to recent research that offers a significant guide for our under-
standing of a multifaceted and disturbing subject, in preparation for a
January 2012 workshop on child abuse and neglect research convened by
the Institute of Medicine (IOM) and the NRC. The paper is designed for
a general audience that may not be acquainted with the full range of rele-
vant studies in the social, behavioral, health, and biological sciences.
This paper cannot offer a comprehensive review of the literature
concerned with child maltreatment or cover all the topics addressed in
the initial 1993 study. Rather, it provides a brief overview of selected
research within most of the nine categories that mirror the chapters of the
original report (the topic of ethical and legal issues is not addressed in
this paper, although there is a brief section on social policy that incorpo-
rates some of this discussion).
In keeping with the original NRC report, the paper has a child orien-
tation rather than a broader review of perpetrator, family, neighborhood,
or cultural characteristics associated with abuse and neglect, which de-
serve further attention in a more comprehensive analysis. Research stud-
ies focused on specific aspects of child welfare, such as the experience
with alternative forms of foster care placements or disproportionality in
the foster care population, are not addressed. Nor is attention directed
toward topics such as the reliability of child testimony, or interventions
in judicial settings for victims of child abuse and neglect. While these
other areas are certainly suitable for a more comprehensive research re-
OCR for page 125
125
APPENDIX D
view, they fell beyond the scope of what was feasible to address in the 3-
month time period for this effort.
Research Methods
The research studies selected for inclusion in this paper were identi-
fied through a search of the bibliographic databases operated by the Web
of Science and a comprehensive library search function of the National
Academy of Sciences, which includes 13 separate databases (e.g., Aca-
demic Search Premier, SCOPUS, and Science Direct). The initial search
focused on the identification of research review papers that received a
significant number of citations in other articles and narrowed the list to
30 from the top-ranking 50 articles. The initial database review was then
supplemented by searches of additional research sources, such as the Na-
tional Criminal Justice Research Service, the Child Abuse and Neglect
Digital Library maintained by Cornell University, and websites main-
tained by selected HHS agencies, including the Administration for Chil-
dren and Families (ACF), Health Resources and Services Administration
(HRSA), Centers for Disease Control and Prevention (CDC), National
Institutes of Health, and Substance Abuse and Mental Health Services
Administration (including the Catalog of Federal Domestic Assistance
and other background materials that describe grants supported by these
agencies). In some cases, reports not archived in the scientific biblio-
graphic databases were identified through searches of websites of select-
ed academic and professional organizations (e.g., the American
Academy of Pediatrics, American Psychological Association, or Mt.
Hope Family Center). Early drafts of the paper were reviewed by mem-
bers and staff of the IOM-NRC planning committee for the January 2012
workshop as well as by workshop speakers and participants; their sug-
gestions were particularly helpful in highlighting specific areas of em-
phasis and gaps in the literature review.
This paper strives to highlight areas of research that are characterized
by multiple, theory-informed empirical studies with study populations
that include children and families who have experienced abuse and ne-
glect. Where possible, attention is directed toward those interventions
that are the focus of comprehensive research reviews, striving to create a
reliable evidence base to guide policy and practice. The author recogniz-
es that multiple other studies exist that focus on common risk factors for
abuse and neglect (e.g., depressed parents, domestic violence, or sub-
stance abuse). For the most part, these research areas are not included
OCR for page 126
126 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
unless the study specifically addressed child maltreatment issues as a
primary outcome of interest.
DEFINITIONS AND FRAMEWORKS
Child maltreatment studies are consistently challenged by variations
in definitions that characterize the events, behaviors, and experiences
under review. Coulton et al. (2007) highlight the importance of distin-
guishing among the definition, recognition, reporting, and agency admin-
istrative classifications of child maltreatment cases that are recorded by
social services agencies, and the types of child maltreatment behaviors or
experiences that are self-identified by victims or offenders. These differ-
ences are not just semantic; the datasets that support official reports of
child maltreatment may differ in important ways from other types of ad-
ministrative records or self-report data that are obtained through house-
hold or victimization surveys.
The 1993 NRC study described an array of research studies on defi-
nitions of child maltreatment and various principles that could guide ef-
forts to achieve greater consistency in future research studies. Since then,
additional efforts have been made to improve the quality of definitions of
child maltreatment used in both clinical and general population studies.
Most notably, public health agencies and clinicians have made efforts to
identify uniform definitions and data elements, including International
Classification of Disease (ICD) codes, that can be used to classify child
maltreatment injury and related health data and to incorporate these data
into national health information databases, surveillance efforts, and diag-
nostic procedures. For example:
The Child Abuse Prevention and Treatment Act (CAPTA) (42
U.S.C.A. § 5106g), as amended by the CAPTA Reauthorization
Act of 2010, defines child abuse and neglect as, at minimum:
“Any recent act or failure to act on the part of a parent or care-
taker which results in death, serious physical or emotional harm,
sexual abuse or exploitation” or “An act or failure to act which
presents an imminent risk of serious harm.” This definition of
child abuse and neglect refers specifically to parents and other
caregivers. A “child” under this definition generally means a
person who is younger than age 18 or who is not an emancipated
minor. This legislative definition guides federal policy and pro-
grams, and sets minimum standards for states that accept
OCR for page 127
127
APPENDIX D
CAPTA funding. However, each state provides its own defini-
tions of maltreatment within civil and criminal statutes, resulting
in significant variation in terms of the scope of actions (or inac-
tions) that may constitute abuse or neglect (http://www.child
welfare.gov/can/defining/federal.cfm).
The CDC website states that: “A consistent definition is needed
to monitor the incidence of child maltreatment and examine
trends over time. In addition, it helps determine the magnitude of
child maltreatment and compare the problem across jurisdictions.”
(http://www.cdc.gov/violenceprevention/childmaltreatment/defin
itions.html).
In January 2008, the CDC published the report Child Maltreat-
ment Surveillance: Uniform Definitions for Public Health and
Recommended Data Elements, Version 1.0 (Leeb et al., 2008).
The report includes recommendations “designed to promote con-
sistent terminology and data collection related to child maltreat-
ment” that were developed through an extensive expert
consultation process. The 2008 CDC report notes that prior ef-
forts by the research and legal communities to develop consistent
and uniform definitions of child maltreatment were not adequate
for use in public health surveillance because many of the data
sources used by the research and legal communities are not
available to state and local public health officials:
Because no public health-based definitions for child mal-
treatment exist, public health officials continue to use terms
related to child maltreatment in different ways and use dif-
ferent terms to describe the same acts. Not surprising, these
inconsistencies have contributed to varied conclusions about
the incidence and prevalence of child abuse and neglect.
(Leeb et al., 2008, p. 12)
The CDC therefore developed uniform definitions and a set of
recommended data elements to guide surveillance efforts by pub-
lic health agencies. However, the report does not provide specif-
ic instruments for surveillance nor does it offer clinical
information for identifying child maltreatment.
The uniform definition included in the CDC report is: “Child
Maltreatment is any act or series of acts of commission or omis-
sion by a parent or other caregiver that results in harm, potential
OCR for page 128
128 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
for harm, or threat of harm to a child. Additional definitions are
offered for each term in bold with specific examples.”
The 2008 CDC report also describes the use of the ICD 9/10 codes
for child maltreatment, which vary by hospital and region. The ICD
codes provide a standard system for hospitals to code all discharge diag-
noses and are used for reimbursement rates in the United States. These
codes provide an alternative data source for monitoring the scope of
child maltreatment, but it is important to note that many physicians may
or may not use them. In addition to recording information about the na-
ture, severity, and physiological location of injury, the ICD data include
“E-codes” that provide information about the source or cause of the inju-
ry. In the case of child maltreatment, the E-code may identify several
characteristics of the perpetrator, including the person’s relationship to
the child (Leeb et al., 2008). (See Box 3 for further details about the use
of ICD codes in classifying child maltreatment injuries.)
In its first Report to Congress on High Priority Evidence Gaps for
Clinical Preventive Services, the U.S. Preventive Services Task Force
identified “Interventions in Primary Care to Prevent Child Abuse and
Neglect” as one of the high-priority areas in “Behavioral Intervention
Research Topics That Deserve Further Research.”
Approximately 1 million abused children are identified in the United
States each year. Despite the dedication and hard work of people in
many sectors, no one has discovered an effective role for the primary
care system and primary care professionals in preventing child abuse
and neglect. The Task Force recognizes that the solution to this issue
will include many other efforts and hopes that needed research to
find effective interventions initiated in primary care will be conduct-
ed. Early research suggests that clinician referrals to home visitation
by nurses during pregnancy and early childhood may reduce child
abuse and neglect in selected populations, but additional research is
needed. Future research must examine both the potential benefits
and the potential unintended harms of interventions aimed at pre-
venting child abuse and neglect. (Moyer et al., 2011, p. 12; see
http://www.uspreventiveservicestaskforce.org/annlrpt/tfannrpt2011.pdf)
Recent controlled studies have followed this lead and the field has
begun to identify pediatric primary care-based prevention models that
reduce maltreatment reports (Dubowitz et al., 2009).
OCR for page 129
129
APPENDIX D
BOX 3
Use of ICD Codes for Child Maltreatment Injuries
and Mortality Data
The World Health Organization prepares and publishes International
Classification of Diseases (ICD) codes that guide cross-national compar-
isons of disease, injury, and mortality trends (WHO, 1999, 2003). At pres-
ent, the U.S. health care system uses the ICD-9-CM (Clinical Modifica-
tion) codes for hospital data and the ICD-10 codes for child death cases
(CDC and NCHS, 2009; Leventhal et al., 2012). In 2013 the United
States is changing to ICD-10-CM for hospital data; the ICD-10 codes are
already in use by most countries.
The ICD-9 codes for “child maltreatment syndrome” are 995.50,
.54, .55, or .59, which include abuse, emotional/psychological
abuse, nutritional neglect, sexual abuse, physical abuse, shaken
infant syndrome, and other child abuse and neglect.
The ICD codes that classify fatalities from child maltreatment are
“external cause of death: homicide” (ICD-9 E960-969) and “as-
sault” (ICD-10 X85-Y09). The E-code E967 in ICD-9 (or Y07 in
ICD-10) includes “external cause of death: child battering” and
identifies the perpetrator of the abuse. In the United States, the
ICD-10 codes are currently used on death certificate data only.
The ICD-9 code for child neglect is E968.4, “Assault by other and
unspecified means–criminal neglect, which includes the aban-
donment of child, infant, or other helpless person with intent to
injure or kill.”
Other ICD-9 codes for homicide and injury purposely inflicted by
other persons can sometimes be used to identify cases of mal-
treatment if it is possible to describe the age of the child, the
perpetrator is designated as a caregiver, and the assault occurs
within a home.
Separate ICD-10 codes for child maltreatment have also been creat-
ed, but are not yet in common use in the United States. These include
the “Y-codes” for specific acts, such as sexual assault by bodily force;
neglect and abandonment by parent, by acquaintance or friend, or by a
specified or unspecified person. They also include “other maltreatment
syndromes” by parent, by acquaintance or friend, by official authorities,
or by other specified or unspecified person (WHO, 2003).
OCR for page 194
194 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
Dubowitz, H., R. R. Newton, A. J. Litrownik, T. Lewis, E. C. Briggs, R.
Thompson, D. English, L.-C. Lee, and M. M. Feerick. 2005. Examination of
a conceptual model of child neglect. Child Maltreatment 10(2):173-189.
Dubowitz, H., S. Feigelman, W. Lane, and J. Kim. 2009. Pediatric primary care
to help prevent child maltreatment: The Safe Environment for Every Kid
(SEEK) model. Pediatrics 123(3):858-864.
Egeland, B., D. Jacobvitz, and L. A. Sroufe. 1988. Breaking the cycle of abuse.
Child Development 59(4):1080-1088.
Egeland, B., T. Yates, K. Appleyard, and M. van Dulmen. 2002. The long-term
consequences of maltreatment in the early years: A developmental pathway
model to antisocial behavior. Children's Services 5(4):249-260.
Ertem, I. O., J. M. Leventhal, and S. Dobbs. 2000. Intergenerational continuity
of child physical abuse: How good is the evidence? Lancet 356(9232):814-
819.
Fallon, B., N. Trocmé, J. Fluke, B. MacLaurin, L. Tonmyr, and Y.-Y. Yuan.
2010. Methodological challenges in measuring child maltreatment. Child
Abuse & Neglect 34(1):70-79.
Farrington, D. 2011. Families and crime. In Crime and public policy, edited by
J. Wilson and J. Petersilia. New York: Oxford University Press. Pp. 130-157.
FIFCFS (Federal Interagency Forum on Child and Family Statistics). 2011.
America’s children: Key national indicators of well-being, 2011.
Washington, DC: U.S. Goverment Printing Office.
Finkelhor, D. 2007. Developmental victimology: The comprehensive study of
childhood victimizations. In Victims of crime, 3rd ed., edited by R. C. Davis,
A. J. Lurigio, and S. Herman. Thousand Oaks, CA: Sage Publications. Pp. 9-
34.
Finkelhor, D. 2008. Childhood victimization: Violence, crime, and abuse in the
lives of young people. New York: Oxford University Press.
Finkelhor, D., and L. Jones. 2006. Why have child maltreatment and child
victimization declined? Journal of Social Issues 62(4):685-716.
Finkelhor, D., R. K. Ormrod, H. A. Turner, and S. L. Hamby. 2005. Measuring
poly-victimization using the Juvenile Victimization Questionnaire. Child
Abuse & Neglect 29(11):1297-1312.
Flynn, B., J. Furtado, T. Orbach, and J. Scott. 2011. Designing and
implementing differential response systems in child protective services: A
three state case study. Boston, MA: Department of Urban and
Environmental Policy and Planning, Tufts University.
Fraser, M. W., E. Walton, R. E. Lewis, P. J. Pecora, and W. K. Walton. 1996.
An experiment in family reunification: Correlates of outcomes at one-year
follow-up. Children and Youth Services Review 18(4-5):335-361.
Garner, A. S., J. P. Shonkoff, B. S. Siegel, M. I. Dobbins, M. F. Earls, L.
McGuinn, J. Pascoe, and D. L. Wood. 2012. Early childhood adversity, toxic
stress, and the role of the pediatrician: Translating developmental science
into lifelong health. Pediatrics 129(1):e224-e231.
OCR for page 195
195
APPENDIX D
Gilbert, R., J. Fluke, M. O’Donnell, A. Gonzalez-Izquierdo, M. Brownell, P.
Gulliver, S. Janson, and P. Sidebotham. 2012. Child maltreatment: Variation
in trends and policies in six developed countries. Lancet 379(9817):758-772.
Gunnar, M. R., P. A. Fisher, and the Early Experience, Stress, and Prevention
Science Network.2006. Bringing basic research on early experience and
stress neurobiology to bear on preventive interventions for neglected and
maltreated children. Development and Psychopathology 18(3):651-677.
Hanson, R. F., S. Self-Brown, A. E. Fricker-Elhai, D. G. Kilpatrick, B. E.
Saunders, and H. S. Resnick. 2006. The relations between family
environment and violence exposure among youth: Findings from the
National Survey of Adolescents. Child Maltreatment 11(1):3-15.
Harris, W. W., F. W. Putnam, and J. A. Fairbank. 2004. Mobilizing trauma
resources for children. Paper presented at Johnson and Johnson Pediatric
Institute: Shaping the Future of Children’s Health, San Juan, Puerto Rico,
February 12-16.
Hembree-Kigin, T. L., and C. B. McNeil. 1995. Parent-child interaction
therapy. New York: Plenum Press.
Herrenkohl, R., and T. Herrenkohl. 2009. Assessing a child’s experience of
multiple maltreatment types: Some unfinished business. Journal of Family
Violence 24(7):485-496.
HHS (U.S. Department of Health and Human Services). 2011. Child
maltreatment 2010. Washington, DC: HHS.
Hicks, B. M., S. C. South, A. C. DiRago, W. G. Iacono, and M. McGue. 2009.
Environmental adversity and increasing genetic risk for externalizing
disorders. Archives of General Psychiatry 66(6):640-648.
Horwitz, S., M. Hurlburt, and J. Zhang. 2010. Patterns and predictors of mental
health services use by children in contact with the child welfare system. In
Child welfare and child well-being, edited by M. Webb, K. Dowd, B.
Harden, J. Landsverk, and M. Testa. New York: Oxford University Press.
Pp. 279-329.
Hunter, W., and E. Knight. 1998. LONGSCAN research briefs, volume 1.
Chapel Hill, NC: LONGSCAN Coordinating Center.
Huntington, C. 2006. Rights myopia in child welfare. UCLA Law Review
53:637-700.
Hussey, J. M., J. M. Marshall, D. J. English, E. D. Knight, A. S. Lau, H.
Dubowitz, and J. B. Kotch. 2005. Defining maltreatment according to
substantiation: Distinction without a difference? Child Abuse & Neglect
29(5):479-492.
IOM (Institute of Medicine). 2001. Crossing the quality chasm: A new health
system for the 21st century. Washington, DC: National Academy Press.
IOM. 2002. Confronting chronic neglect: The education and training of health
professionals on family violence. Washington, DC: National Academy Press.
Isaacs, J. B. 2007. Cost-effective investments in children. Washington, DC:
Brookings Institution.
OCR for page 196
196 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
Jaffee, S. R., A. Caspi, T. E. Moffitt, M. Polo-Tomás, and A. Taylor. 2007.
Individual, family, and neighborhood factors distinguish resilient from non-
resilient maltreated children: A cumulative stressors model. Child Abuse &
Neglect 31(3):231-253.
Jonson-Reid, M., and R. P. Barth. 2000. From maltreatment report to juvenile
incarceration: The role of child welfare services. Child Abuse & Neglect
24(4):505-520.
Jonson-Reid, M., and B. Drake. 2008. Multisector longitudinal administrative
databases. Child Maltreatment 13(4):392-399.
Jonson-Reid, M., N. Presnall, B. Drake, L. Fox, L. Bierut, W. Reich, P. Kane, R.
D. Todd, and J. N. Constantino. 2010. Effects of child maltreatment and
inherited liability on antisocial development: An official records study.
Journal of the American Academy of Child & Adolescent Psychiatry
49(4):321-332.
Jonson-Reid, M., P. Kohl, and B. Drake. 2012. Child and adult outcomes of
chronic child maltreatment. Pediatrics. Published online before print April
23, 2012. http://pediatrics.aappublications.org/content/129/5/X5.short (accessed
May 24, 2012).
Kauffman Best Practices Project. 2004. Closing the quality chasm in child abuse
treatment: Identifying and disseminating best practices, the findings of the
Kauffman Best Practices Project to help children heal from child abuse. San
Diego, CA: Chadwick Center for Children and Families, Children’s
Hospital-San Diego and the National Call to Action.
Kaufman, J., B. Birmaher, J. Perel, R. E. Dahl, P. Moreci, B. Nelson, W. Wells,
and N. D. Ryan. 1997. The corticotropin-releasing hormone challenge in
depressed abused, depressed nonabused, and normal control children.
Biological Psychiatry 42(8):669-679.
Kaufman, J., P. M. Plotsky, C. B. Nemeroff, and D. S. Charney. 2000. Effects of
early adverse experiences on brain structure and function: Clinical
implications. Biological Psychiatry 48(8):778-790.
Kempe, C. H., F. N. Silverman, B. F. Steele, W. Droegemueller, and H. K.
Silver. 1962. The battered-child syndrome. Journal of the American Medical
Association 181(1):17-24.
Kilpatrick, D. G., and B. E. Saunders. 1999. Prevalence and consequences of
child victimization: Results from the National Survey of Adolescents, final
report. Charleston, SC: National Crime Victims Research and Treatment
Center, Department of Psychiatry and Behavioral Sciences, Medical
University of South Carolina.
Kilpatrick, D. G., and B. E. Saunders. 2009. National Survey of Adolescents in
the United States, 1995. Ann Arbor, MI: Inter-university Consortium for
Political and Social Research.
Kilpatrick, D. G., K. J. Ruggiero, R. Acierno, B. E. Saunders, H. S. Resnick, and
C. L. Best. 2003. Violence and risk of PTSD, major depression, substance
OCR for page 197
197
APPENDIX D
abuse/dependence, and comorbidity: Results from the National Survey of
Adolescents. Journal of Consulting and Clinical Psychology 71(4):692-700.
Knopf, D., M. J. Park, and T. P. Mulye. 2008. The mental health of adolescents:
A national profile, 2008. San Francisco, CA: National Adolescent Health
Information Center, University of California, San Francisco.
Kohl, P. L., M. Jonson-Reid, and B. Drake. 2009. Time to leave substantiation
behind. Child Maltreatment 14(1):17-26.
Kolko, D. J., and C. C. Swenson. 2002. Assessing and treating physically
abused children and their families: A cognitive-behavioral approach.
Thousand Oaks, CA: Sage Publications.
Korbin, J. E., C. J. Coulton, S. Chard, C. Platt-Houston, and M. Su. 1998.
Impoverishment and child maltreatment in African American and European
American neighborhoods. Development and Psychopathology 10(02):215-
233.
Kotch, J. B., D. C. Browne, C. L. Ringwalt, V. Dufort, E. Ruina, P. W. Stewart,
and J.-W. Jung. 1997. Stress, social support, and substantiated maltreatment
in the second and third years of life. Child Abuse & Neglect 21(11):1025-
1037.
Langford, J. 2007. Strengthening families through early care and education.
Washington, DC: Center for the Study of Social Policy.
Lanier, P., M. Jonson-Reid, M. J. Stahlschmidt, B. Drake, and J. Constantino.
2010. Child maltreatment and pediatric health outcomes: A longitudinal
study of low-income children. Journal of Pediatric Psychology 35(5):511-
522.
Leeb, R. T., L. J. Paulozzi, C. Melanson, T. R. Simon, and I. Arias. 2008. Child
maltreatment surveillance uniform definitions for public health and
recommended data elements, version 1.0. Atlanta, GA: Centers for Disease
Control and Prevention.
Leventhal, J. M., K. D. Martin, and J. R. Gaither. 2012. Using U.S. data to
estimate the incidence of serious physical abuse in children. Pediatrics.
Published online before print February 6, 2012, doi: 10.1542/peds.2011-
1277. http://pediatrics.aappublications.org/content/early/2012/02/01/peds.2011-
1277.abstract.
Litrownik, A. J., A. Lau, D. J. English, E. Briggs, R. R. Newton, S. Romney,
and H. Dubowitz. 2005. Measuring the severity of child maltreatment. Child
Abuse & Neglect 29(5):553-573.
Lott, D. 2011. National Child Traumatic Stress Network: Changing the course
of children’s lives. Rockville, MD: U.S. Department of Health and Human
Services.
Lutzker, J. R., A. J. Tymchuk, and K. M. Bigelow. 2001. Applied research in
child maltreatment: Practicalities and pitfalls. Children’s Services 4(3):141-
156.
OCR for page 198
198 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
Lyons-Ruth, K. 2003. Dissociation and the parent-infant dialogue: A
longitudinal perspective from attachment research. Journal of the American
Psychoanalytic Association 51(3):883-911.
MacMillan, H. L., B. H. Thomas, E. Jamieson, H. A. Walsh, M. H. Boyle, H. S.
Shannon, and A. Gafni. 2005. Effectiveness of home visitation by public-
health nurses in prevention of the recurrence of child physical abuse and
neglect: A randomised controlled trial. Lancet 365(9473):1786-1793.
Manly, J. T., J. E. Kim, F. Rogosch, and D. Cicchetti. 2001. Dimensions of child
maltreatment and children’s adjustment: Contributions of developmental
timing and subtype. Development and Psychopathology 13(04):759-782.
McCrory, E., S. A. De Brito, and E. Viding. 2010. Research review: The
neurobiology and genetics of maltreatment and adversity. Journal of Child
Psychology and Psychiatry 51(10):1079-1095.
McEwen, B. S. 2000. Effects of adverse experiences for brain structure and
function. Biological Psychiatry 48(8):721-731.
McMillen, J. C., B. T. Zima, L. D. Scott, Jr., W. F. Auslander, M. R. Munson,
M. T. Ollie, and E. L. Spitznagel. 2005. Prevalence of psychiatric disorders
among older youths in the foster care system. Journal of the American
Academy of Child & Adolescent Psychiatry 44(1):88-95.
Melton, G. B., and B. Holaday. 2008. Strong communities as safe havens for
children. In Family and community health, edited by G. B. Melton and B.
Holaday. Vol. 31, no. 2. Hagerstown, MD: Wolters Kluwer Health,
Lippincott Williams & Wilkins.
Mihalic, S., A. Fagan, K. Irwin, D. Ballard, and D. Elliott. 2001. Blueprints for
violence prevention. Washington, DC: Office of Juvenile Justice and
Delinquency Prevention.
Miller, M. 2011. Family team decision-making: Does it reduce racial
disproportionality in Washington’s child welfare system? Olympia, WA:
Washington Institute for Public Policy.
Moyer, V., M. LeFevre, and A. Siu. 2011. First annual report to Congress on
high-priority evidence gaps for clinical preventive services. Rockville, MD:
U.S. Preventive Services Task Force.
Nelson, C. A., C. H. Zeanah, N. A. Fox, P. J. Marshall, A. T. Smyke, and D.
Guthrie. 2007. Cognitive recovery in socially deprived young children: The
Bucharest Early Intervention Project. Science 318(5858):1937-1940.
Noonan, K. G., C. F. Sabel, and W. H. Simon. 2009. Legal accountability in the
service-based welfare state: Lessons from child welfare reform. Law &
Social Inquiry 34(3):523-568.
NQIC (National Quality Improvement Center on Differential Response in Child
Protective Services). 2009. Differential response in child protective services:
A literature review. http://www.differentialresponseqic.org/assets/docs/qic-
dr-lit-review-sept-09.pdf (accessed May 24, 2012).
OCR for page 199
199
APPENDIX D
NQIC. 2010. Differential response approach in child protective services: An
analysis of state legislative provisions. http://www.differentialresponseqic.
org/assets/docs/differential-response.pdf (accessed May 24, 2012).
NRC (National Research Council). 1993. Understanding child abuse and
neglect. Washington, DC: National Academy Press.
Olds, D. L., J. Eckenrode, C. R. Henderson, H. Kitzman, J. Powers, R. Cole, K.
Sidora, P. Morris, L. M. Pettitt, and D. Luckey. 1997. Long-term effects of
home visitation on maternal life course and child abuse and neglect. Journal
of the American Medical Association 278(8):637-643.
Olds, D. L., C.R. Henderson, Jr., H. J. Kitzman, J. J. Eckenrode, R. E. Cole, and
R. C. Tatelbaum. 1999. Prenatal and infancy home visitation by nurses:
Recent findings. The Future of Children 9(1):44-65.
O’Reilly, R., L. Wilkes, L. Luck, and D. Jackson. 2010. The efficacy of family
support and family preservation services on reducing child abuse and
neglect: What the literature reveals. Journal of Child Health Care 14(1):82-
94.
Ouellet-Morin, I., C. L. Odgers, A. Danese, L. Bowes, S. Shakoor, A. S.
Papadopoulos, A. Caspi, T. E. Moffitt, and L. Arseneault. 2011. Blunted
cortisol responses to stress signal social and behavioral problems among
maltreated/bullied 12-year-old children. Biological Psychiatry 70(11):1016-
1023.
Palusci, V. J. 2011. Risk factors and services for child maltreatment among
infants and young children. Children and Youth Services Review 33:1374-
1382.
Paolucci, E. O., M. L. Genuis, and C. Violato. 2001. A meta-analysis of the
published research on the effects of child sexual abuse. Journal of
Psychology 135(1):17.
Patterson, G. R., J. B. Reid, and J. M. Eddy. 2002. A brief history of the Oregon
model. In Antisocial behavior in children and adolescents: A developmental
analysis and model for intervention, edited by J. B. Reid, G. R. Patterson,
and J. J. Snyder. Washington, DC: American Psychological Association. Pp.
3-20.
Paulsell, D., S. Avellar, E. Sama Martin, and P. Del Grosso. 2010. Home visiting
evidence of effectiveness review: Executive summary. Washington, DC: U.S.
Department of Health and Human Services.
Paxson, C., and R. Haskins. 2009. Introducing the issue. The Future of Children
19(2):3-17.
Pecora, P. J., J. K. Whittaker, A. N. Maluccio, R. P. Barth, and R. D. Plotnick.
2009. The child welfare challenge: Policy, practice, and research. New
Brunswick, NJ: Aldine Transaction.
Prinz, R. J. 2009. Toward a population-based paradigm for parenting
intervention, prevention of child maltreatment, and promotion of child well-
being. In Preventing child maltreatment: Community approaches, edited by
K. Dodge and D. Coleman. New York: Guilford Press. Pp. 55-67.
OCR for page 200
200 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
Prinz, R. J., and M. R. Sanders. 2006. Testing effects on parenting at a broad
scale: The U.S. Triple P system population trial. In Familien starken:
Evidenz-basierte anstze zur unterstutzung der psychischen gesundheit von
kindern (Strengthening families: Evidence-based approaches to support
child mental health), edited by N. Heinrichs, K. Hahlweg, and M. Dopfner.
Munster, Germany: Verlag fur Psychotherapie. Pp. 483-511.
Prinz, R. J., and M. R. Sanders. 2007. Adopting a population-level approach to
parenting and family support interventions. Clinical Psychology Review
27(6):739-749.
Prinz, R., M. Sanders, C. Shapiro, D. Whitaker, and J. Lutzker. 2009.
Population-based prevention of child maltreatment: The U.S. Triple P
system population trial. Prevention Science 10(1):1-12.
Riggins-Caspers, K. M., R. J. Cadoret, J. F. Knutson, and D. Langbehn. 2003.
Biology-environment interaction and evocative biology-environment
correlation: Contributions of harsh discipline and parental psychopathology
to problem adolescent behaviors. Behavior Genetics 33(3):205-220.
Ryan, J. P., and M. F. Testa. 2005. Child maltreatment and juvenile
delinquency: Investigating the role of placement and placement instability.
Children and Youth Services Review 27(3):227-249.
Rycus, J. S., and R. C. Hughes. 2003. Issues in risk assessment in child
protective services. Columbus, OH: Center for Child Welfare Policy, North
American Resource Center for Child Welfare.
Sanders, M. R. 1999. Triple P-Positive Parenting Program: Towards an
empirically validated multilevel parenting and family support strategy for the
prevention of behavior and emotional problems in children. Clinical Child
and Family Psychology Review 2(2):71-90.
Sanders, M. R., C. Markie-Dadds, and K. M. T. Turner. 2003. Theoretical,
scientific and clinical foundations of the Triple P-Positive Parenting
Program: A population approach to the promotion of parenting competence,
Parenting research and practice monograph no. 1. Brisbane, Queensland,
Australia: The Parenting and Family Support Centre.
Saunders, B. E., L. Berliner, and R. F. Hanson (eds.). 2004. Child physical and
sexual abuse: Guidelines for treatment (revised report: April 26, 2004).
Charleston, SC: National Crime Victims Research and Treatment Center.
Sawyer, R., and S. Lohrbach. 2005. Differential response in child protection:
Selecting a pathway. Protecting Children: A Professional Publication of
American Humane 20(2&3):44-54.
Schnitzer, P. G., P. L. Slusher, R. L. Kruse, and M. M. Tarleton. 2011.
Identification of ICD codes suggestive of child maltreatment. Child Abuse &
Neglect 35(1):3-17.
Seckl, J. R. 1998. Physiologic programming of the fetus. Clinics in Perinatology
25(4):939-962, vii.
OCR for page 201
201
APPENDIX D
Sedlak, A. J., K. McPherson, and B. Das. 2010a. Supplementary analyses of
race differences in child maltreatment rates in the NIS-4. Washington, DC:
U.S. Department of Health and Human Services.
Sedlak, A. J., J. Mettenburg, M. Basena, I. Petta, K. McPherson, A. Greene, and
S. Li. 2010b. Fourth National Incidence Study of child abuse and neglect
(NIS-4): Report to Congress. Washington, DC: U.S. Department of Health
and Human Services, Administration for Children and Families.
Shenk, C. E., J. G. Noll, F. W. Putnam, and P. K. Trickett. 2010. A prospective
examination of the role of childhood sexual abuse and physiological
asymmetry in the development of psychopathology. Child Abuse & Neglect
34(10):752-761.
Shields, A., and D. Cicchetti. 1998. Reactive aggression among maltreated
children: The contributions of attention and emotion. Journal of Clinical
Child Psychology 27(4):381.
Shipman, K. L., and J. Zeman. 2001. Socialization of children’s emotion
regulation in mother–child dyads: A developmental psychopathology
perspective. Development and Psychopathology 13(02):317-336.
Shonkoff, J. P., A. S. Garner, the Committee on Psychosocial Aspects of Child
and Family Health, Committee on Early Childhood Adoption, and
Dependent Care, and Section on Developmental and Behavioral Pediatrics,
B. S. Siegel, M. I. Dobbins, M. F. Earls, A. S. Garner, L. McGuinn, J.
Pascoe, and D. L. Wood. 2012. The lifelong effects of early childhood
adversity and stress. Pediatrics, published online before print December 26,
2011. http://pediatrics.aappublications.org/content/129/1/e232.abstract (accessed
May 24, 2012).
Slack, K.S., J. L. Holl, M. McDaniel, J. Yoo, and K. Bolger. 2004.
Understanding the risks of child neglect: An exploration of poverty and
parenting characteristics. Child Maltreatment 9(4):395-408.
Stahmer, A. C., L. K. Leslie, M. Hurlburt, R. P. Barth, M. B. Webb, J.
Landsverk, and J. Zhang. 2005. Developmental and behavioral needs and
service use for young children in child welfare. Pediatrics 116(4):891-900.
Stevenson, J. 1999. The treatment of the long-term sequelae of child abuse.
Journal of Child Psychology and Psychiatry and Allied Disciplines 40(1):89-
111.
Strathearn, L., P. H. Gray, M. J. O’Callaghan, and D. O. Wood. 2001.
Childhood neglect and cognitive development in extremely low birth weight
infants: A prospective study. Pediatrics 108(1):142-151.
Stroufe, L. A., B. Egeland, E. A. Carlson, and W. A. Collins. 2005. The
development of the person: The Minnesota study of risk and adaptation from
birth to adulthood. New York: The Guilford Press.
Sullivan, P. M., and J. F. Knutson. 2000. Maltreatment and disabilities: A
population-based epidemiological study. Child Abuse & Neglect
24(10):1257-1273.
OCR for page 202
202 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE
Suomi, S. J. 1997. Early determinants of behaviour: Evidence from primate
studies. British Medical Bulletin 53(1):170-184.
Taylor, A., and J. Kim-Cohen. 2007. Meta-analysis of gene–environment
interactions in developmental psychopathology. Development and
Psychopathology 19(04):1029-1037.
Teicher, M. H., S. L. Andersen, A. Polcari, C. M. Anderson, C. P. Navalta, and
D. M. Kim. 2003. The neurobiological consequences of early stress and
childhood maltreatment. Neuroscience and Biobehavioral Reviews 27(1-
2):33-44.
Thomas, D., C. Leicht, C. Hughes, A. Madigan, and K. Dowell. 2003. Emerging
practices in the prevention of child abuse and neglect. Washington, DC:
U.S. Department of Health and Human Services.
Trickett, P. K., L. Allen, C. J. Schellenbach, and E. F. Zigler. 1998. Violence
against children in the family and the community. In Violence against
children in the family and the community, edited by P. K. Trickett and C. J.
Schellenbach. Washington, DC: American Psychological Association. Pp.
419-437.
Urquiza, A. J., and C. B. McNeil. 1996. Parent-child interaction therapy: An
intensive dyadic intervention for physically abusive families. Child
Maltreatment 1(2):134-144.
U.S. Advisory Board on Child Abuse and Neglect. 1990. Child abuse and
neglect: Critical first steps in response to a national emergency.
Washington, DC: U.S. Department of Health and Human Services.
USPHS (U.S. Public Health Service). 2001. Youth violence: A report of the
Surgeon General. Rockville, MD: USPHS, Office of the Surgeon General.
Waldfogel, J. 1998. Rethinking the paradigm for child protection. The Future of
Children 8(1):104-119.
Waldrop, A. E., R. F. Hanson, H. S. Resnick, D. G. Kilpatrick, A. E. Naugle,
and B. E. Saunders. 2007. Risk factors for suicidal behavior among a
national sample of adolescents: Implications for prevention. Journal of
Traumatic Stress 20(5):869-879.
Webster-Stratton, C. 1998. Parent training with low-income families: Promoting
parental engagement through a collaborative approach. In Handbook of child
abuse research and treatment, edited by J. R. Lutzker. New York: Plenum
Press. Pp. 183-212.
Webster-Stratton, C., and M. J. Reid. 2003. Treating conduct problems and
strengthening social and emotional competence in young children. Journal of
Emotional and Behavioral Disorders 11(3):130-143.
Weder, N., B. Z. Yang, H. Douglas-Palumberi, J. Massey, J. H. Krystal, J.
Gelernter, and J. Kaufman. 2009. Maoa genotype, maltreatment, and
aggressive behavior: The changing impact of genotype at varying levels of
trauma. Biological Psychiatry 65(5):417-424.
WHO (World Health Organization). 1999. International statistical classification
of diseases, 9th revision. Geneva, Switzerland: WHO.
OCR for page 203
203
APPENDIX D
WHO. 2003. International statistical classification of diseases and related
problems, 10th revision. Geneva, Switzerland: WHO.
Widom, C. S. 1989. Does violence beget violence? A critical examination of the
literature. Psychological Bulletin 106(1):3-28.
Widom, C. S. 1999. Posttraumatic stress disorder in abused and neglected
children grown up. American Journal of Psychiatry 156(8):1223-1229.
Widom, C. S., and L. M. Brzustowicz. 2006. MAOA and the “cycle of
violence”: Childhood abuse and neglect, MAOA genotype, and risk for
violent and antisocial behavior. Biological Psychiatry 60(7):684-689.
Widom, C. S., K. DuMont, and S. J. Czaja. 2007. A prospective investigation of
major depressive disorder and comorbidity in abused and neglected children
grown up. Archives of General Psychiatry 64(1):49-56.
Wulczyn, F. 2009. Epidemiological perspectives on maltreatment prevention.
The Future of Children 19(2):39-66.
Yanos, P., S. Czaja, and C. Widom. 2010. A prospective examination of service
use by abused and neglected children followed up into adulthood.
Psychiatric Services 61:796-802.
Zeanah, C., C. Nelson, N. Fox, A. Smyke, P. Marshall, S. Parker, and S. Koga.
2003. Designing research to study the effects of institutionalization on brain
and behavioral development: The Bucharest early intervention project.
Development and Psychopathology 15(04):885-907.
Zeanah, C. H., A. T. Smyke, S. F. Koga, E. Carlson, and The Bucharest Early
Intervention Project Core Group. 2005. Attachment in institutionalized and
community children in Romania. Child Development 76(5):1015-1028.
OCR for page 204
