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3 Causality
Pages 69-110

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From page 69... ... Most have reported an association or correlation between a variety of potential risk factors and child abuse and neglect, contributing to the description of the problem, but few have investigated causes. This chapter reviews the literature on the candidate explanatory factors for child abuse and neglect and considers whether it is appropriate to draw causal inferences regarding these associations. Read the entire page →
From page 70... ... Determining whether these studies meet the third criterion -- demonstration of the correct temporal sequence -- is more difficult and complex. One of the major problems with studies using retrospective measures of child abuse and neglect is that the temporal ordering of risk factors and abuse and neglect cannot be established reliably. Read the entire page →
From page 71... ... . Prospective longitudinal designs, ideally beginning before the birth of the child, provide an opportunity to determine the correct temporal order of risk factors and child abuse and neglect, to adjust for social and individual confounding factors as they occur, and to minimize reliance on recall and the selection of participants on the basis of outcomes (Gilbert et al., 2009) Read the entire page →
From page 72... ... risk factors for child abuse and neglect include a history of child abuse and neglect, or intergenerational transmission; early childbearing; and parental psychopathology. History of Childhood Abuse and Neglect (Intergenerational Transmission) Read the entire page →
From page 73... ... conducted a meta-analysis of 155 studies published between 1975 and 2000 in which parents' prior experience of abuse was included. Collectively, these studies examined 39 different risk factors for child physical abuse and 22 for neglect. Read the entire page →
From page 74... ... examined the relationship between mothers' childhood experiences of family violence -- including physical abuse, sexual abuse, neglect, and witnessing domestic violence -- and child abuse and neglect reports to child protective services regarding their children. They found that women with a history of sexual or physical abuse in childhood were three times more likely to have both experiences of adulthood intimate partner violence and allegations of child abuse and neglect toward their own children than (compared with) Read the entire page →
From page 75... ... separately assessed the relative impact of potential risk factors for child physical abuse and neglect in a representative community sample. To assess risk factors for their impact on the initiation of abuse and neglect, the analysis focused on parents who did not report any abuse or neglect in the first wave of the study but reported either physical abuse or neglect in the second wave. Read the entire page →
From page 76... ... In one of the rare longitudinal studies of risk for child abuse and neglect beginning in infancy, Kotch and colleagues (1995) recruited mothers of newborn infants with biomedical and sociodemographic risk factors from community and regional hospitals and local health departments in 42 counties of North and South Carolina. Read the entire page →
From page 77... ... Chaffin and colleagues (1996) found that parents who had a substance abuse disorder at the onset of their study were more than four times as likely as parents without such a disorder to commit physical abuse and more than 2.5 times as likely to have an episode of neglect. Read the entire page →
From page 78... ... TABLE 3-1 Perpetrators Identified in Child Abuse and Neglect Reports by Age, 2010 (Unique Count) 78 6-19 20-29 30-39 40-49 State Number Percent Number Percent Number Percent Number Percent Alabama 848 10.8 2,845 36.1 2,099 26.6 820 10.4 Alaska 82 3.8 823 38.2 690 32.0 376 17.4 Arizona 248 4.0 2,373 38.1 2,198 35.3 991 15.9 Arkansas 1,012 10.1 3,582 35.6 2,859 28.4 1,318 13.1 California 3,141 5.2 20,075 33.5 19,909 33.3 10,923 18.2 Colorado 629 7.3 3,002 35.0 2,812 32.7 1,328 15.5 Connecticut 310 3.8 2,782 34.2 2,571 31.6 1,650 20.3 Delaware 87 5.3 616 37.3 540 32.7 314 19.0 District of Columbia 62 3.1 663 32.8 674 33.3 325 16.1 Florida 1,127 3.0 14,525 39.0 12,241 32.9 6,355 17.1 Georgia* Read the entire page →
From page 79... ... Nevada 122 3.2 1,465 38.7 1,304 34.5 654 17.3 New Hampshire 65 8.8 262 35.4 225 30.4 138 18.6 New Jersey 258 3.7 2,203 31.8 2,194 31.6 1,383 19.9 New Mexico 191 4.2 1,639 36.2 1,396 30.8 539 11.9 New York 2,117 3.4 18,998 30.7 20,985 33.9 14,015 22.6 North Carolina 167 3.6 1,663 35.9 1,606 34.7 825 17.8 North Dakota 26 3.4 223 29.4 210 27.7 120 15.8 Ohio 2,566 10.1 9,292 36.4 7,008 27.5 2,993 11.7 Oklahoma 393 5.6 2,988 42.4 2,145 30.5 888 12.6 Oregon* Pennsylvania 447 12.4 1,011 28.1 973 27.1 714 19.8 Puerto Rico 162 2.5 1,192 18.2 1,248 19.1 579 8.9 Rhode Island 186 7.1 981 37.6 862 33.1 424 16.3 South Carolina 261 3.0 3,318 37.7 3,237 36.8 1,456 16.5 South Dakota 34 3.7 436 47.0 284 30.6 126 13.6 Tennessee 795 15.1 2,028 38.5 1,364 25.9 586 11.1 Texas 4,765 9.3 22,179 43.1 15,254 29.7 6,198 12.1 Utah 1,026 11.3 3,220 35.6 3,016 33.3 1,263 14.0 Vermont 116 21.0 152 27.5 148 26.8 75 13.6 Virginia 236 4.4 1,859 34.7 1,558 29.1 901 16.8 Washington 136 2.4 2,023 36.1 1,978 35.3 940 16.8 West Virginia 118 3.4 1,354 38.7 1,185 33.9 430 12.3 Wisconsin 286 7.4 1,154 29.8 955 24.7 451 11.7 Wyoming 26 4.8 223 40.8 182 33.3 65 11.9 Total 30,814 185,547 162,598 82,155 Percent 6.0 36.3 31.8 16.1 States Reporting 50 50 50 50 continued 79 Read the entire page →
From page 80... ... TABLE 3-1 Continued 80 50-59 60-69 70-75 Unknown Total Unique State Number Percent Number Percent Number Percent Number Percent Perpetrators Alabama 289 3.7 79 1.0 906 11.5 7,886 Alaska 94 4.4 23 1.1 11 0.5 58 2.7 2,157 Arizona 292 4.7 64 1.0 7 0.1 49 0.8 6,222 Arkansas 447 4.4 172 1.7 36 0.4 635 6.3 10,061 California 3,137 5.2 785 1.3 292 0.5 1,596 2.7 59,858 Colorado 387 4.5 99 1.2 18 0.2 312 3.6 8,587 Connecticut 473 5.8 104 1.3 29 0.4 219 2.7 8,138 Delaware 71 4.3 19 1.2 4 0.2 1,651 District of Columbia 115 5.7 23 1.1 2 0.1 158 7.8 2,022 Florida 2,147 5.8 601 1.6 145 0.4 71 0.2 37,212 Georgia* Hawaii 89 6.4 28 2.0 7 0.5 27 1.9 1,395 Idaho 44 3.3 15 1.1 3 0.2 1,335 Illinois 797 4.2 173 0.9 65 0.3 238 1.2 19,159 Indiana 655 3.7 172 1.0 67 0.4 944 5.4 17,564 Iowa 377 3.9 76 0.8 18 0.2 253 2.6 9,743 Kansas 48 4.0 19 1.6 4 0.3 32 2.6 1,212 Kentucky 468 4.0 110 0.9 45 0.4 224 1.9 11,629 Louisiana 224 3.6 75 1.2 53 0.9 1 0.0 6,138 Maine 108 3.6 28 0.9 5 0.2 83 2.7 3,035 Maryland 606 6.6 173 1.9 29 0.3 365 4.0 9,183 Massachusetts 1,085 5.5 199 1.0 59 0.3 630 3.2 19,889 Michigan 1,082 4.3 290 1.2 64 0.3 5 0.0 25,111 Minnesota 152 4.4 45 1.3 12 0.3 1 0.0 3,467 Mississippi 311 5.4 100 1.7 24 0.4 19 0.3 5,806 Missouri 270 5.7 92 2.0 22 0.5 224 4.8 4,711 Montana 43 4.2 13 1.3 3 0.3 55 5.4 1,017 Nebraska 109 3.4 33 1.0 6 0.2 31 1.0 3,180 Read the entire page →
From page 81... ... Nevada 201 5.3 29 0.8 10 0.3 3,785 New Hampshire 32 4.3 11 1.5 2 0.3 6 0.8 741 New Jersey 374 5.4 93 1.3 385 5.6 45 0.6 6,935 New Mexico 156 3.4 37 0.8 13 0.3 559 12.3 4,530 New York 4,353 7.0 1,044 1.7 282 0.5 92 0.1 61,886 North Carolina 265 5.7 70 1.5 36 0.8 1 0.0 4,633 North Dakota 25 3.3 3 0.4 151 19.9 758 Ohio 956 3.7 248 1.0 2,426 9.5 5 0.0 25,494 Oklahoma 300 4.3 103 1.5 38 0.5 189 2.7 7,044 Oregon* Pennsylvania 255 7.1 117 3.3 36 1.0 44 1.2 3,597 Puerto Rico 175 2.7 48 0.7 20 0.3 3,112 47.6 6,536 Rhode Island 100 3.8 21 0.8 7 0.3 26 1.0 2,607 South Carolina 386 4.4 102 1.2 30 0.3 18 0.2 8,808 South Dakota 25 2.7 3 0.3 1 0.1 18 1.9 927 Tennessee 227 4.3 71 1.3 25 0.5 175 3.3 5,271 Texas 2,128 4.1 643 1.3 209 0.4 52 0.1 51,428 Utah 386 4.3 94 1.0 19 0.2 25 0.3 9,049 Vermont 35 6.3 12 2.2 6 1.1 8 1.4 552 Virginia 267 5.0 86 1.6 33 0.6 412 7.7 5,352 Washington 277 4.9 74 1.3 14 0.2 167 3.0 5,609 West Virginia 131 3.7 39 1.1 8 0.2 233 6.7 3,498 Wisconsin 106 2.7 24 0.6 13 0.3 881 22.8 3,870 Wyoming 22 4.0 6 1.1 22 4.0 546 Total 25,102 6,588 5,549 12,471 510,824 Percent 4.9 1.3 1.1 2.4 100.0 States Reporting 50 50 48 46 50 NOTE: Fifty states reported case-level data about perpetrators. Read the entire page →
From page 82... ... who were followed over a 10-year period, Dubowitz and colleagues (2011) found that maternal drug use was one of five risk factors that significantly predicted a subsequent report to child protective services for abuse and neglect. Read the entire page →
From page 83... ... Under the harm standard, children with documented disabilities had significantly lower rates of physical abuse and moderate harm from abuse and neglect compared with children without disabilities, but significantly higher rates of emotional neglect and serious injury or harm. Under the endangerment standard, children with disabilities had lower rates of abuse overall and of sexual abuse, neglect, physical neglect, and emotional neglect. Read the entire page →
From page 84... ... Unfortunately, no data were available on the age at first diagnosis of disability, making it impossible to determine whether the disabilities occurred before or after the child abuse and neglect. Thus the authors conclude: "Because the present data do not really address questions regarding cause and effect, future maltreatment research should consider the role of disabilities as either a risk factor or an outcome" (p. Read the entire page →
From page 85... ... . Other literature documents the risk of abuse and neglect for children living in single-parent households, households with nonbiological parents, and chaotic families. Read the entire page →
From page 86... ... data, the highest rates of child sexual abuse occurred among single parents who had a cohabiting partner; children living in these households had a rate of abuse 10 times higher than that of children living with married biological parents (Sedlak et al., 2010) Read the entire page →
From page 87... ... Overall, more research is needed in this area to identify the specific constructs of parenting that are most relevant to child abuse and neglect for the purposes of understanding the phenomenon, identifying at-risk families, and designing and implementing effective prevention and treatment efforts. Still, while these characteristics may be markers or risk factors for child abuse and neglect, further research is needed to determine causality. Read the entire page →
From page 88... ... Thus, these findings from studies in different cultural contexts regarding the role of community isolation in relation to child abuse and neglect suggest similarities to the earlier findings from studies with Anglo-Saxon families and perhaps generalizability of the phenomenon. Summary In sum, several characteristics of complex families, as well as deficient parenting in general, intimate partner violence, and social isolation, are associated with risk for child abuse and neglect. Read the entire page →
From page 89... ... Poverty, Unemployment, and Low Socioeconomic Status Poverty, unemployment, and low socioeconomic status have been reported as risk factors for child abuse and neglect (Berger, 2004; Chaffin et al., 1996; Fryer and Miyoshi, 1996; Kotch et al., 1997; Slack et al., 2003, 2004) Read the entire page →
From page 90... ... Parents of children under the age of 18 were selected systematically from 20 randomly selected census-defined block groups with different risk profiles for child maltreatment report rates" and were administered a variety of questionnaires designed to assess characteristics of the environment and the potential for child abuse. The authors found that neighborhood poverty and child care burden affected the potential for child abuse after controlling for individual risk factors. Read the entire page →
From page 91... ... Macrosystem Factors Social attitudes, such as attitudes toward violence or beliefs about discipline and corporal punishment, have been examined as risk factors for child abuse and neglect (Bower-Russa et al., 2001) Read the entire page →
From page 92... ... In one longitudinal analysis of potential risk factors for child physical abuse, sexual abuse, and neglect, for example, Brown and colleagues (1998) collected data on abuse and neglect from both retrospective self-report surveys and official New York state records and considered a broad array of demographic, familial, child, and parenting factors as predictors of risk for child abuse and neglect. Read the entire page →
From page 93... ... Together, these findings suggest that children being raised in families with multiple risk factors are at considerably higher risk for abuse and neglect than children not raised in such families. However, the complex interaction of multiple risk factors is not clearly understood, especially in conjunction with protective factors and resilience (discussed on p. Read the entire page →
From page 94... ... Finding: Of the forms of parental (primarily maternal) psychopathol ogy examined as risk factors for child abuse and neglect, the strongest evidence suggests that substance abuse and maternal depression play an important role in the perpetration of child abuse and neglect by parents. Read the entire page →
From page 95... ... Finding: Research suggests that children being raised in families with multiple risk factors are at considerably higher risk for abuse and ne glect than children not raised in such families. However, the complex interaction of multiple risk factors is not clearly understood, espe cially in conjunction with protective factors and with demographic characteristics. Read the entire page →
From page 96... ... Finding: Relatively little is known about factors that protect at-risk children from being abused or neglected. Some research suggests that social support, in the form of secure, supportive relationships, may play a significant role in protecting against the risk factors for child abuse and neglect. Read the entire page →
From page 97... ... As risk factors, parental substance abuse, a history of child abuse and neglect, and depression appear to have the strongest support in the literature. However, it is important to acknowledge that all of these factors simply describe elevated risk, and none of them has been shown to "cause" child abuse and neglect. Read the entire page →
From page 98... ... Such designs are rare in this field because they take time and are expensive. The best designs will take multiple factors into account, such as the candidate risk factors described here, and will involve large enough sample sizes to make it possible to determine what predicts abusive and neglectful behavior, under what conditions, and with which children. Read the entire page →
From page 99... ... : To document the "natural history" of child maltreatment and to under stand how environmental, child, and parent characteristics influence occur rences of child maltreatment and subsequent child development, large-scale prospective longitudinal research, such as the NCS, is required…. The ability to identify early markers of problematic parent-child interactions and factors that contribute to the likelihood of child maltreatment across different stages in children's and families' lives will provide invaluable information for the timing and delivery of cost-effective services to pre vent child maltreatment…. Read the entire page →
From page 100... ... Although children often experience multiple forms of abuse and/or neglect over their lifetimes, little is known about risk factors for specific types of abuse or neglect. That is, are the causes of physical abuse similar to the causes of neglect? Read the entire page →
From page 101... ... 2004. Income, family structure, and child maltreatment risk. Read the entire page →
From page 102... ... 1996. Onset of physical abuse and neglect: Psy chiatric, substance abuse, and social risk factors from prospective community data. Read the entire page →
From page 103... ... 2005. Risk factors of parents abused as children: A mediational analysis of the intergenerational continuity of child maltreatment (Part I) Read the entire page →
From page 104... ... 1995. Mobility as a mediator of the effects of child maltreatment on academic performance. Read the entire page →
From page 105... ... 2003. Social isolation from communities and child maltreatment: A cross-cultural comparison. Read the entire page →
From page 106... ... 2008. Risk factors for paternal physical child abuse. Read the entire page →
From page 107... ... 2011. Identifying risk factors for child maltreatment in Alaska:  A population-based approach. Read the entire page →
From page 108... ... 2001. Child maltreatment in the "children of the nineties." A longitudinal study of parental risk factors. Read the entire page →
From page 109... ... 1999. Prevalence and risk factors for childhood sexual abuse in women: National survey findings. Read the entire page →
From page 110... ... 2007. Intimate partner violence and child maltreatment: Overlapping risk. Read the entire page →

From page 69...

... Most have reported an association or correlation between a variety of potential risk factors and child abuse and neglect, contributing to the description of the problem, but few have investigated causes. This chapter reviews the literature on the candidate explanatory factors for child abuse and neglect and considers whether it is appropriate to draw causal inferences regarding these associations.

3 Causality Pages 69-110

3 Causality
Pages 69-110