Child maltreatment in the “children of the nineties”: A cohort study of risk factors☆
Section snippets
Background
As well as being of direct individual and public concern, child maltreatment places considerable burdens on both health and social services. In the early 1990s in the UK, 27 per 10,000 children were placed on child protection registers each year (Department of Health, 1995). This figure represents those children identified as having been abused or neglected and in whom ongoing risk warrants professional involvement, but underestimates the true prevalence of child maltreatment. At least 100
Parental background
Reviewing the published literature on risk factors in the parents’ background, four features consistently emerge as having strong associations with subsequent maltreatement: young parental age (Brown, Cohen, Johnson, & Salzinger, 1998; Connely & Straus, 1992; Egeland & Brunnquell, 1979; Kinard & Klerman, 1980; Leventhal, Egerter, & Murphy, 1984, Lynch & Roberts, 1977; Smith & Adler, 1991); low educational achievements (Brown et al., 1998; Egeland & Brunquell, 1979; Kotch et al., 1995; Kotch,
Socio-economic environment
The association between poverty and child maltreatment is one of the most consistent observations in the published research, both in relation to individual poverty and to neighborhood characteristics (e.g., Baldwin & Spencer, 1993; Brown et al., 1998; Garbarino & Kostleny, 1992; Kotch et al., 1995, Kotch et al., 1997, Kotch et al., 1999). However, interpretation of this association is not without its problems (Crittenden, 1999, Pelton, 1981). In particular, there is a substantial risk of
Family environment
Among the more proximate factors affecting risk of maltreatment, the structure and dynamics of the family are of prime importance. Children of single mothers have been shown to be at higher risk (Brown et al., 1998; Browne & Saqi, 1988; Egeland & Brunquell, 1979). The presence of a step-parent has also been shown to increase the risk (Browne & Saqi, 1988; Fergusson et al., 1996; Radhakrishna, Bou-Saada, Hunter, Catellier, & Kotch, 2001), particularly in relation to sexual abuse. Family size may
Child characteristics
A number of child characteristics have previously been shown to be associated with risk of maltreatment. Prematurity or low birthweight is frequently reported, although empirical evidence to support this is limited (e.g., Browne & Saqi, 1988; Creighton, 1985; Friedrich & Boriskin, 1976), and other researchers have not found any link (e.g., Brown et al., 1998, Leventhal et al., 1984). Other reported factors in the child include health, behavior or developmental problems, and disability (
Setting
The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large study following a cohort of children born to mothers resident in Avon, UK with expected dates of delivery between 1.4.91 and 31.12.92. The ALSPAC study area has a population of approximately one million and includes the city of Bristol (population 500,000), a mixture of inner city deprivation (7% of Avon children live in poor urban areas), rural areas (15%), suburbs and moderate sized towns. Children living in Avon have
Results
Out of the total 14,256 children in the ALSPAC study, 293 (2.1%) were investigated by social services for suspicion of abuse before their sixth birthday. Of these, 115 were placed on the child protection register (44% of those investigated; 0.8% of the total cohort). The age at registration is given in Table 2. The pattern of registration has been previously reported with 31.7% of registrations being for physical injury, 10.9% for sexual abuse, 25.1% for emotional abuse, 29.0% for neglect and
Discussion
Through a multivariate analysis of data in the parents’ backgrounds, socio-demographic environment, and characteristics of the child and family, we have been able to explore risk factors for child maltreatment within a comprehensive ecological framework. The use of different outcome variables has enabled an exploration of factors affecting reporting of child maltreatment (leading to investigation) or registration (approximating to officially recognized or substantiated maltreatment).
Conclusions
In the assessment and management of child abuse, practitioners in all agencies are being encouraged to take a broad view of the child and the environment within which they are growing (Department for Education and Skills, 2004, Department of Health, 2000). This research provides empirical material to inform such an approach. By combining factors within a comprehensive ecological framework we have demonstrated that the strongest risks are from socio-economic deprivation and from factors in the
Acknowledgments
We are extremely grateful to all the mothers who took part and to the midwives for their cooperation and help in recruitment. The whole ALSPAC Study Team comprises interviewers, computer technicians, laboratory technicians, clerical workers, research scientists, volunteers, and managers who continue to make the study possible.
References (86)
- et al.
Prediction of child abuse: A prospective study of feasibility
Child Abuse & Neglect
(1984) - et al.
Antecedents of child neglect in the first two years of life
Journal of Pediatrics
(1992) - et al.
A longitudinal analysis of risk factors for child maltreatment: Findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect
Child Abuse & Neglect
(1998) - et al.
Onset of physical abuse and neglect: Psychiatric, substance abuse and social risk factors from prospective community data
Child Abuse & Neglect
(1996) Neglectful mothers, their mothers and partners: The significance of mutual aid
Child Abuse & Neglect
(1995)Child maltreatment: Testing the social isolation hypothesis
Child Abuse & Neglect
(1996)An epidemiological study of abused children and their families in the United Kingdom between 1977 and 1982
Child Abuse & Neglect
(1985)- et al.
The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction
Child Abuse & Neglect
(2004) - et al.
An at-risk approach to the study of child abuse: Some preliminary findings
Journal of the American Academy of Child Psychiatry
(1979) - et al.
Dissociation as a mediator of child abuse across generations
Child Abuse & Neglect
(1996)
Intergenerational continuity of child physical abuse: How good is the evidence?
Lancet
Child sexual abuse and psychiatric disorders in young adulthood: I. Prevalence of sexual abuse and factors associated with sexual abuse
Journal of the American Academy of Child Psychiatry
Sexual abuse in a national survey of adult men and women: Prevalence, characteristics and risk factors
Child Abuse & Neglect
A study of potential risk factors for sexual abuse in childhood
Child Abuse & Neglect
Child maltreatment as a community problem
Child Abuse & Neglect
Unemployment rates, single parent density, and indices of child poverty: Their relationship to different categories of child abuse and neglect
Child Abuse & Neglect
Absence of males in maltreatment research: A survey of recent literature
Child Abuse & Neglect
Risk factors for family violence: Introduction to the special series
Aggression and Violent Behavior
Cross-cultural perspectives and research directions for the 21st century
Child Abuse & Neglect
Predicting child maltreatment in the first 4 years of life from characteristics assessed in the neonatal period
Child Abuse & Neglect
Stress, social support, and substantiated maltreatment in the second and third years of life
Child Abuse & Neglect
Risk of child abuse or neglect in a cohort of low-income children
Child Abuse & Neglect
Research strategies and methodologic standards in studies of risk factors for child abuse
Child Abuse & Neglect
Epidemiology of sexual abuse of children: Old problems, new directions
Child Abuse & Neglect
The predictive impact of domestic violence on three types of child maltreatment
Child Abuse & Neglect
Research on intergenerational transmission of violence: The next generation
Lancet
Intergenerational transmission of abuse: A two-generational prospective study of an at-risk sample
Child Abuse & Neglect
A simulation study of the number of events per variable in logistic regression analysis
Journal of Clinical Epidemiology
A critical evaluation of the research methodology employed in the investigation of causative factors of child abuse and neglect
Child Abuse & Neglect
Identified spouse abuse as a risk factor for child abuse
Child Abuse & Neglect
Child maltreatment in the ‘children of the nineties’: A longitudinal study of parental risk factors
Child Abuse & Neglect
Child maltreatment in the ‘children of the nineties’: The role of the child
Child Abuse & Neglect
Child maltreatment in the ‘children of the nineties’: Deprivation, class and social networks in a UK sample
Child Abuse & Neglect
Children hospitalized with child abuse and neglect: A case control study
Child Abuse & Neglect
Community characteristics and ethnicity in the prediction of child maltreatment rates
Child Abuse & Neglect
Maltreatment and disabilities: A population-based epidemiological study
Child Abuse & Neglect
The relative importance of wife abuse as a risk factor for violence against children
Child Abuse & Neglect
Diagnosed intellectual and emotional impairment among parents who seriously maltreat their children
Child Abuse & Neglect
Deprivation and child abuse: Implications for strategic planning in children's services
Children and Society
Child maltreatment. An Ecological integration
American Psychologist
Etiology of child maltreatment: A developmental-ecological analysis
Psychological Bulletin
The ecology of human development
Approaches to screening for child abuse & neglect
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This study could not have been undertaken without the financial support of the Medical Research Council, the Department of Health, the Department of the Environment, the Wellcome Trust and other funders including the NHS executive, South West, Research and Development Directorate. The ALSPAC study is part of the WHO initiated European Longitudinal Study of Pregnancy and Childhood.