Research suggests that the dimensions of childhood maltreatment (type, age of onset, duration, frequency and perpetrator) play an important role in determining health and wellbeing outcomes, though little information is available on these dimensions for any care experienced cohorts. This study aimed to determine if any variation in maltreatment dimensions were experienced between two subsets of the nationally representative Australian Child Maltreatment Study, both of which reported childhood maltreatment histories: care-experienced ( = 358) and non-care-experienced ( = 4922). Using a series of independent t-tests and chi-square tests, we compared the two groups on seven dimensions (number of maltreatment types, range of maltreatment items, age of onset, duration, frequency, perpetrator number, and perpetrator type) for the five child maltreatment types (physical, emotional, sexual abuse, neglect, and exposure to domestic violence). Results showed that the care-experienced group reported a higher intensity of maltreatment, being younger when maltreatment first started, experiencing greater variety of maltreatment types, for longer periods, more times and by more perpetrators than maltreated people with no care experience. We conclude that children and young people in out-of-home care experience maltreatment at a higher intensity than the rest of the population, which has implications for effective treatment.

Childhood exposure to domestic violence (CEDV) poses significant risks to children's safety and wellbeing, yet its prevalence and impact on child protection outcomes remains understudied. This study examined administrative data for child protection investigations in Los Angeles County, California between January 2018 and March 2021 to determine the prevalence of CEDV safety concerns, associated case characteristics, and child protection outcomes (case openings and foster care placements). Results indicated that 5.9% of investigations had CEDV concerns and CEDV investigations represented 17.9% of placements. Investigations with CEDV concerns had higher co-occurring indicated safety concerns than investigations without, including substance abuse (31.1%) and mental health (14.2%). Investigation outcomes for those with CEDV concerns included the substantiation of more than one individual (36.6%), while 28.4% resulted in case openings (without placement) and 30.2% resulted in placements. The study underscores the importance of moving beyond punitive frameworks and exploring the use evidence-based service planning to address the complex needs of families affected by CEDV.

Limited research describes approaches for applying a public health lens to fatal child maltreatment classification. Specialized terminology and tools could help improve consistency in classifying deaths resulting from caregiver behavior. A six-criterion classification tool was developed via expert panel review of over 100 child deaths by the Alaska Division of Public Health's Child Death Review (CDR) program. Next, accuracy and acceptability were assessed by inviting staff from other CDRs using a national listserv to classify 21 brief case scenarios with the tool. Among the 47 respondents, sensitivity was 0.87, specificity 0.77, and accuracy 0.84. Variability by tool criterion ranged from 97% to 74% accurate. Most respondents (66%) reported the tool as being helpful for classifying deaths and moderate reliability was found. Study participants found it difficult to consistently apply specific criteria which resulted in a modification of the tool to improve the potential for universal adoption.

Childhood adversity (CA) is associated with increased risk of negative health outcomes. Research implicates brain structure following CA as a key mechanism of this risk, and recent models suggest different forms of adversity differentially impact neural structure as a function of development (accelerated or attenuated development). Employing the Dimensional Model of Adversity and Psychopathology, we examined whether deprivation and threat differentially impact age-related change in cortical thickness, cortical surface area, and subcortical structure volume, using whole-brain and region of interest analyses ( = 135). In youth without CA, age predicted less surface area across adolescence, consistent with normative data. However, for adolescents with more deprivation exposure, as age increased there was attenuated surface area decreases in the orbitofrontal and superior-parietal cortex, regions recruited for higher-order cognition. Further, for those with more threat exposure, as age increased surface area increased in the inferior-temporal and parietal cortex, regions recruited in socio-emotional tasks. These novel findings extend work examining the impact of dimensions of adversity at a single-age and broaden current conceptualizations of how adversity might impact developmental timing.

Many youth serving organizations (YSOs) implement child sexual abuse (CSA) prevention strategies. We examined the potential impact of those strategies by retrospectively estimating the prevalence of CSA and boundary violating behaviors experienced in five broad organizational settings: organized sports, religious organizations, music or arts programs, K-12 schools, and the "Big 6 settings" (i.e., 4-H, Big Brothers Big Sisters of America, Boys and Girls Clubs of America, Boy Scouts of America, Girl Scouts of the USA, and the YMCA of the USA). We compared victimization rates between nationally representative cohorts of younger adults (age 18-22; = 3174) and slightly older adults (age 32-36, = 3237). Across all participants and settings, 3.75% ( 363) experienced CSA in YSOs. Among survivors, younger adults reported experiencing a lower proportion of CSA within Big 6 settings than older adults (29.1% vs. 44.5%; < .05), suggesting that prevention efforts may be having the desired effects in Big 6 settings.

It is critical that researchers gather evidence of factors that identify infants at risk of out-of-home placement based on types of substance exposures and demographic characteristics. This study applied a validated medical record data extraction tool on data derived from a multi-site ( = 30) pediatric clinical trials network (ISPCTN) study of Neonatal Opioid Withdrawal (ACT NOW study). Participants included 1808 birthing parent-infant dyads with documented NOWS scoring or prenatal opioid exposure. Non-Hispanic White pregnant persons comprised the largest proportion of the sample (69.8%), followed by Non-Hispanic Black (11.6%), Non-Hispanic Multiracial and Other race (8.5%), and Hispanic (6.2%). Most notably, infant prenatal substance exposure across alcohol, cocaine, meth/amphetamine, and opioids, had the lowest possibility of discharging to parent(s). Additionally, latent class analysis identified distinct classes of substance use during pregnancy that were associated with different probabilities of discharging to parent(s). Specifically, less than half of infants (47%-49%) in the Poly-use and Meth/amphetamine classes were discharged to their parent(s). Severity of infant withdrawal symptoms influenced placement decisions within the Poly-use and Prescription Opioid classes. Findings can inform standard practices for increasing support for pregnant persons and substance-exposed infants including identification, subsequent referrals, communication with Child Protective Services, and plans of safe care.

The Multidisciplinary Pediatric Education and Evaluation Consortium (MPEEC) is a medically directed program that mandates real-time interagency collaboration among child abuse pediatricians (CAPs), child protective services (CPS) investigators, and law enforcement. MPEEC provides consultation resulting in a definitive medical opinion regarding manner of injury when allegations of serious harm involving children less than three years old living in Chicago are reported to Illinois Department of Children and Family Services (DCFS). This study is the first to link data from a medically directed, inter-agency program with CPS investigations data to specifically examine the duration of CPS investigations and the level of concordance between the manner of injury as determined by CAPs and the investigation's outcome when CPS investigators and medical professionals are required to formally collaborate. On average, MPEEC produced a written opinion 16 days from the time of referral and DCFS made a finding 45 days after receiving the MPEEC report for the 690 cases referred to MPEEC over a 3-year period. The concordance level ranged from 75-90%. Our results highlight the need for more analysis of linked data to promote efficiency and proficiency in CPS investigations.

Forensic interviews following child sexual abuse (CSA) are of central importance to the children, their families and all those involved. Moreover, the legal system expects rich, forensically relevant reports from the children. The current study focuses on the impact of children's social affiliation on the richness of their reports, and how question types contribute to rich reports. The sample included 314 forensic interviews conducted in Israel between 2015 and 2018. The findings revealed a relationship between child characteristics (gender), abuse characteristics (perpetrator identity, abuse type, abuse frequency) and social affiliation with report richness. Furthermore, question types (free recall prompts, summaries, directive, option-posing, suggestive) moderated the relationship between the child's characteristics, abuse characteristics, and social affiliation with report richness, when these effects were not equal. The findings emphasized that contextual observation of sexually abused children may promote better services for them and, in addition, stressed the importance of advancing future training and practical guidelines for practitioners.

The objective of this study was to evaluate disparities in skeletal survey (SS) use for pediatric. head injury patients in the emergency department (ED). This was a multi-site retrospective. cohort study of children <24 months with concern for head injury and injury on head CT from. 7/1/12 - 1/1/22. We determined adjusted associations between SS completion and race, ethnicity, language for care, insurance type, and income, with sub-analysis of children <6 months and with complex injury. We evaluated occult fracture prevalence. Two-hundred seventy children met criteria and 88 had SS. No statistical association was found between skeletal survey completion and race or ethnicity, language for care, private insurance, median census tract income, or in sub-analyses. Two of 88 (2.3%) patients had occult fracture; both had risk factors for NAT. In conclusion, no statistical association was found between SS completion and demographics. Occult fracture was uncommon. SS use can likely be decreased in lower risk patients.

Children experiencing maltreatment in the first 3 years of life are at risk for several developmental challenges throughout the lifespan. Researchers and practitioners have emphasized understanding how institutional supports implemented through state governments may support infants and toddlers' development, but less attention has been paid to the potential effects of state policies on maltreatment specifically. We tested whether state-level policies providing economic and family planning support implemented between 2005-2019 were associated with rates of reported and substantiated abuse and neglect among children under three. Two-way fixed effects models indicate that implementing a state Child Tax Credit, expanding contraception access, raising minimum wages, and expanding eligibility for Supplemental Nutrition Assistance Programs were associated with decreased maltreatment according to various indicators among Black, White, and Hispanic children. Implications for future research and policy are discussed.

Child maltreatment can affect multiple children in a family, yet its occurrence and chronicity has been often assessed by focusing on a single child. Although this approach provides valuable insights, considering the experiences of all children in a family may provide a more complete understanding of maltreatment dynamics. Using linked birth and child protection system (CPS) records from California, we analyzed 20 years of data on 194,514 first-time mothers to document the prevalence, timing, and chronicity of maternal CPS reporting across multiple children. Mothers were categorized by the number of live childbirths: one (25.7%), two (36.2%), three (20.9%), and four or more (17.2%). Overall, 33.0% of mothers were reported to CPS, increasing from 18.5% for mothers with one child to 63.1% for those with four or more children. For mothers with two or more children, more than 70% experienced an initial CPS report only after the second child's birth. Our findings have implications for understanding the dynamics of maternal reports to CPS, emphasizing the need for lasting and family-focused interventions.

In cases of alleged child sexual abuse, information about the timing of events is often needed. However, published developmental laboratory research has demonstrated that children struggle to provide accurate and reliable testimony about time and there is currently a lack of field research examining how attorneys actually question child witnesses about time in court. The current study analyzed 130 trial transcripts from cases of alleged child sexual abuse containing a child witness between the ages of 5-17 years old to determine the frequency, style, and content of attorneys' questions and child responses about time. We found that attorneys primarily ask closed-ended temporal location questions (i.e., asking when an event took place using a temporal construct such as day, month, and year) to child witnesses. Additionally, children, of all ages, rarely said "I don't know" or expressed uncertainty in response to temporal questions. These findings are concerning as researchers find that children tend to struggle with temporally locating past events.

The study compared life course models (LCM; accumulation, recency, and sensitive period) of child maltreatment and general psychopathology in a large, national longitudinal data set of 1354 youth ages birth-16 years (657 boys, 53.2% Black, 59.7% <$40K caregiver income). Previous research has supported the accumulation and recency models, albeit with shorter or fewer time periods of outcome measurement. We extend this work by modeling the impact of combined abuse and neglect allegations on a general psychopathology factor (dysregulation profile). Cross-sectional structural equation models were constructed using LCMs and tested across two-year periods from 4-16 years old and compared using Akaike Information Criterion weights. The recency variable generally explained the greatest proportion of variance in psychopathology. Notably, maltreatment more proximal to the time of outcome measurement had the strongest effect, suggesting that more recent maltreatment may have stronger effects on general psychopathology. These results lend support to a recency effect of maltreatment on psychopathology outcomes, although substantive overlaps with the accumulation model are noted.

Housing cost burden is stressful for families, interfering with healthy, positive parenting. The present study uses data from the Future of Families and Child Wellbeing Study to examine the relationship between housing cost burden and aggressive parenting with children age 3 to age 15. Latent growth curve modeling finds that both types of aggressive parenting behaviors decline on average, but that housing cost burden contributes to significant ongoing risk. Results indicate within-time associations between housing cost burden and psychological aggression and associations both within- and across-time between housing cost burden and physical aggression. Housing cost burden poses a significant risk factor for families, and child maltreatment prevention approaches must incorporate strategies for addressing housing cost burden.

This study aimed to investigate the connection between childhood abuse history and cardiovascular health indicators among a nationally representative sample of young adults aged 24-32. Using data from waves three and four of the National Longitudinal Study of Adolescent to Adult Health ( = 4, 164) multivariate logistic regression was employed to investigate childhood trauma (i.e., childhood physical abuse, sexual abuse, and neglect) as predictors for cardiovascular disease, hypertension, high cholesterol, diabetes, and obesity. Results showed that adults who reported history of sexual abuse were 4.3 times more likely to report diagnosis of cardiovascular disease and those who reported childhood physical abuse at wave three had 1.4 times the odds of reporting high cholesterol diagnosis. Although trauma history is often calculated as a composite, some forms of childhood abuse may have greater impacts on cardiovascular risk than others.

One overlooked result in a 1989 paper on the "cycle of violence" was a race-specific increase in risk for arrest for violence among Black maltreated children, but not White maltreated children. We examine whether race differences in the cycle of violence are explained by risk factors traditionally associated with violence. Using a prospective design, maltreated and non-maltreated children were matched on age, sex, race, and approximate family social class and interviewed at mean age 28.7 years ( = 1196). Arrest histories were obtained through age 50.5. Regression analyses included maltreatment, race, self-reported violent behavior, and risk factors (e.g., family, school, neighborhood variables). For arrests for violent crime, race was a significant predictor, whereas childhood maltreatment was not significant. For violent arrests, there was a significant race × maltreatment interaction when the total number of risk factors were included controlling for self-reported violent behaviors. For self-reported violent behaviors, childhood maltreatment remained significant for some risk factors. However, race did predict self-reported violent behaviors. Offending behavior and traditional risk factors did not explain the disproportionate arrests among Black maltreated children. This disparity in the cycle of violence may reflect complex processes influenced by racial bias or structural racism.

Support has been found for the intergenerational transmission of risk from maternal adverse childhood experiences (ACEs) to child outcomes. Less research has focused on longitudinal psychosocial pathways that account for this transmission. In the current study, path analysis examined mediating pathways (i.e., maternal adult attachment insecurity, romantic relationship functioning, and maternal anxiety and depression symptoms) in the association between maternal ACEs and internalizing and externalizing concerns among their child at eight years of age. Participants included 1,994 mother-child dyads from a prospective longitudinal cohort sample. Maternal ACEs were significantly associated directly with child internalizing concerns (β = .06, = .025) and indirectly via both maternal attachment anxiety and avoidance, lower romantic relationship functioning, and depression, (β = .002, = .006; β = .003, = .005, respectively). Maternal ACEs were directly associated with child externalizing concerns (β = .06, = .018) and indirectly via both maternal attachment anxiety and avoidance, lower romantic relationship functioning, and depression, (β = .001, = .008; β = .002, = .010, respectively). This study identified several maternal risk factors that have implications for downstream internalizing and externalizing concerns among their children.

Youth with intellectual and developmental disabilities (IDD) are at significantly higher risk of experiencing multiple types of interpersonal victimization across their lifespan compared to their peers without IDD. Despite the extensive literature on efficacy of prevention education programs for children without IDD, very little is known about comparable programs for children with IDD. In this scoping review, we synthesized the literature on existing programs for children with IDD. We identified thirteen programs which we critically assessed against established best practice criteria for prevention and special education and evaluation. The current literature on prevention education programs for children with IDD exhibits significant limitations, such as weak research designs and poor measurement of outcomes.

Child maltreatment poses serious consequences, while sports participation among adolescents offers a potential avenue for mitigating such consequences. This study, based on self-determination theory (SDT), examines the associations among child maltreatment, sports motivation (intrinsic and extrinsic), and satisfaction or frustration of basic psychological needs (BPNs). This study also investigated the mediating role of sports motivation in the relationship between child maltreatment and psychological adaptation. Adolescents engaged in sports were derived from the first wave of a large two-wave study (wave 1: = 1403; wave 2: = 618) using data on child maltreatment, intrinsic and extrinsic motivation, and satisfaction and frustration of within the sports context. Subsequently, data on psychological adaptation, including self-esteem and satisfaction with life, were collected during the second wave. Path analyses revealed satisfaction and frustration of BPNs as significant mediators in the relationship between child maltreatment and sports motivation. In addition, intrinsic motivation mediated the relationship between child maltreatment and psychological adaptation after 18 months. Specifically, the results indicated that enhancing intrinsic motivation in adolescents with a history of child maltreatment by improving satisfaction of BPNs could be an innovative intervention target.

The present study is one of the largest quasi-experimental studies to date on the effects of home visiting on documented child maltreatment during a child's first two years of life. In this matched comparison group study, we compare 8796 families that participated in a home visiting program (HV families) to 8796 similar non-participating families (non-HV families) selected from birth records using Coarsened Exact Matching. Using sequential logistic regression, we identify that HV families have significantly higher odds of experiencing a child maltreatment investigation by their child's second birthday compared to non-HV families; however, among those that were investigated, HV families have significantly lower odds of having their first investigation substantiated for maltreatment. Overall, HV families do not differ significantly from non-HV families in the odds of experiencing a substantiated investigation over 2 years. We share implications for considering surveillance bias, and we highlight the importance of including both substantiated and unsubstantiated investigations when studying the effects of home visiting on documented child maltreatment.