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Emalee G Flaherty - One of the best experts on this subject based on the ideXlab platform.
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from suspicion of physical Child Abuse to reporting primary care clinician decision making
2008Co-Authors: Emalee G Flaherty, Robert D Sege, Lori Lyn Price, Eric J Slora, Donna Harris, John L Griffith, Richard C Wasserman, Niramol Dhepyasuwan, D P NortonAbstract:OBJECTIVES. The goals were to determine how frequently primary care clinicians reported suspected physical Child Abuse, the levels of suspicion associated with reporting, and what factors influenced reporting to Child protective services. METHODS. In this prospective observational study, 434 clinicians collected data on 15 003 Child injury visits, including information about the injury, Child, family, likelihood that the injury was caused by Child Abuse (5-point scale), and whether the injury was reported to Child protective services. Data on 327 clinicians indicating some suspicion of Child Abuse for 1683 injuries were analyzed. RESULTS. Clinicians reported 95 (6%) of the 1683 patients to Child protective services. Clinicians did not report 27% of injuries considered likely or very likely caused by Child Abuse and 76% of injuries considered possibly caused by Child Abuse. Reporting rates were increased if the clinician perceived the injury to be inconsistent with the history and if the patient was referred to the clinician for suspected Child Abuse. Patients who had an injury that was not a laceration, who had>1 family risk factor, who had a serious injury, who had a Child risk factor other than an inconsistent injury, who were black, or who were unfamiliar to the clinician were more likely to be reported. Clinicians who had not reported all suspicious injuries during their career or who had lost families as patients because of previous reports were more likely to report suspicious injuries. CONCLUSIONS. Clinicians had some degree of suspicion that approximately 10% of the injuries they evaluated were caused by Child Abuse. Clinicians did not report all suspicious injuries to Child protective services, even if the level of suspicion was high (likely or very likely caused by Child Abuse). Child, family, and injury characteristics and clinician previous experiences influenced decisions to report. Language: en
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clinicians description of factors influencing their reporting of suspected Child Abuse report of the Child Abuse reporting experience study research group
2008Co-Authors: Rise Jones, Emalee G Flaherty, Lori Lyn Price, Katherine Kaufer Christoffel, Helen J Binns, Eric J Slora, Dianna Abney, Donna Harris, Robert D SegeAbstract:OBJECTIVES. Primary care clinicians participating in the Child Abuse Reporting Experience Study did not report all suspected physical Child Abuse to Child protective services. This evaluation of study data seeks (1) to identify factors clinicians weighed when deciding whether to report injuries they suspected might have been caused by Child Abuse; (2) to describe clinicians’ management strategies for Children with injuries from suspected Child Abuse that were not reported; and (3) to describe how clinicians explained not reporting high-suspicion injuries. METHODS. From the 434 pediatric primary care clinicians who participated in the Child Abuse Reporting Experience Study and who indicated they had provided care for a Child with an injury they perceived as suspicious, a subsample of 75 of 81 clinicians completed a telephone interview. Interviewees included 36 clinicians who suspected Child Abuse but did not report the injury to Child protective services (12 with high suspicion and 24 with some suspicion) and 39 who reported the suspicious injury. Interviews were analyzed for major themes and subthemes, including decision-making regarding reporting of suspected physical Child Abuse to Child protective services and alternative management strategies. RESULTS. Four major themes emerged regarding the clinicians’ reporting decisions, that is, familiarity with the family, reference to elements of the case history, use of available resources, and perception of expected outcomes of reporting to Child protective services. When they did not report, clinicians planned alternative management strategies, including active or informal case follow-up management. When interviewed, some clinicians modified their original opinion that an injury was likely or very likely caused by Abuse, to explain why they did not report to Child protective services. CONCLUSIONS. Decisions about reporting to Child protective services are guided by injury circumstances and history, knowledge of and experiences with the family, consultation with others, and previous experiences with Child protective services.
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forty years later inconsistencies in reporting of Child Abuse
2008Co-Authors: Robert D Sege, Emalee G FlahertyAbstract:Forty years have passed since medical professionals in the United States were first required to report all cases of suspected Child Abuse to state Child protective service agencies. Despite the passage of time, many cases of severe Child physical Abuse remain hidden. Healthcare professionals may not recognize common syndromes of Child Abuse, or, has been demonstrated in recent studies, may recognize the possibility of Abuse but decide not to report the case to the state agencies. Rethinking the types of training we provide, the relationship between medical professionals and state agencies, and re-training medical and Child protection professionals may be required to further improve the recognition and care of Abused Children.
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pediatrician characteristics associated with Child Abuse identification and reporting results from a national survey of pediatricians
2006Co-Authors: Emalee G Flaherty, Robert D Sege, Lori Lyn Price, Katherine Kaufer Christoffel, D P Norton, Karen G OconnorAbstract:Pediatrician experience with Child protective services (CPS) and factors associated with identifying and reporting suspected Child physical Abuse were examined by a survey of members of the American Academy of Pediatrics (AAP). Respondents provided information about their demographics and experience, attitudes and practices with Child Abuse. They indicated their diagnosis and management of a Child in a purposely ambiguous clinical vignette. Pediatricians who had received recent Child Abuse education were more confident in their ability to identify and manage Child Abuse. High confidence in ability to manage Child Abuse and positive attitude about domestic violence screening and value of anticipatory guidance predicted that pediatricians would have high suspicion that the Child in the vignette was Abused and that they would report the Child to CPS. Future efforts to improve medical intervention in Child Abuse should focus on physician attitudes and experience, as well as cognitive factors.
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barriers to physician identification and reporting of Child Abuse
2005Co-Authors: Emalee G Flaherty, Robert D SegeAbstract:Physicians systematically underidentify and underreport cases of Child Abuse. These medical errors may result in continued Abuse, leading to potentially severe consequences. We have reviewed a number of studies that attempt to explain the reasons for these errors. The findings of these various studies suggest several priorities for improving the identification and reporting of Child maltreatment: Improve continuing education about Child maltreatment. Continuing education should focus not only on the identification of maltreatment but also on management and outcomes. This education should include an explanation of the role of CPS investigator and the physician's role in an investigation. The education should provide physicians with a better understanding of the overall outcome for Children reported to CPS to help physicians gain perspective on the small number of maltreated Children they may care for in their practice. This education should emphasize that the majority of maltreated Children will benefit from CPS involvement. New York is the only state that mandates all physicians, as well as certain other professionals, take a 2-hour course called Identification and Reporting of Child Abuse and Maltreatment prior to licensing. Cited studies in this article suggest that such a mandate might be expected to improve identification and reporting, thereby encouraging other states to adopt similar regulations. Give physicians the opportunity to debrief with a trained professional after detecting and reporting Child Abuse. The concept of Child Abuse and the gravity of the decision to report can be troubling to the reporter. The debriefing could include discussions of uncomfortable feelings physicians may experience related to their own countertransference reactions. Provide resources to assist physicians in making the difficult determination of suspected maltreatment. The role of accessible telephone consultation should be evaluated, along with formalized collaborations with local Emergency Departments with pediatric expertise. Improve the relationship between CPS and medical providers. For example, CPS workers should systematically inform the reporting physician about the progress of their investigation and the outcome for the Child and family. Several past reports have made specific suggestions to improve the working relationship. Warner and Hanson recommended that positive outcomes be programmed into the reporting process. They suggested that CPS have special phone lines staffed by well-trained employees for mandated reporters to call. Finkelhor and Zellman proposed a more radical change to improve the working relationship between CPS and mandated reporters. They suggested that certain professionals, with demonstrated expertise in the recognition and treatment of Child Abuse and registered as such, should have "flexible reporting options." Options include the ability to defer reporting, if there are no immediate threats to a Child, or to make a report in confidence and defer the investigation until necessary. Finkelhor and Zellman emphasized that this model would improve physician-reporting compliance and enhance the role of CPS while reducing the work burden for CPS. Improve interaction with the legal system. Child Abuse pediatric experts who have courtroom experience could provide education and support to physicians who have little preexisting experience with the legal system. Reimbursement for time spent supporting legal proceedings should be equitable and may reduce physician concerns about lost patient revenue. Retrospective studies and vignette analyses provide much information about some of the barriers to Child maltreatment reporting and describe many of the reasons why physicians do not identify and report all Child maltreatment. Future prospective examinations of physician decision-making may further explain the physician's decision-making process and the barriers he or she faces when identifying and reporting Child Abuse.
Robert D Sege - One of the best experts on this subject based on the ideXlab platform.
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from suspicion of physical Child Abuse to reporting primary care clinician decision making
2008Co-Authors: Emalee G Flaherty, Robert D Sege, Lori Lyn Price, Eric J Slora, Donna Harris, John L Griffith, Richard C Wasserman, Niramol Dhepyasuwan, D P NortonAbstract:OBJECTIVES. The goals were to determine how frequently primary care clinicians reported suspected physical Child Abuse, the levels of suspicion associated with reporting, and what factors influenced reporting to Child protective services. METHODS. In this prospective observational study, 434 clinicians collected data on 15 003 Child injury visits, including information about the injury, Child, family, likelihood that the injury was caused by Child Abuse (5-point scale), and whether the injury was reported to Child protective services. Data on 327 clinicians indicating some suspicion of Child Abuse for 1683 injuries were analyzed. RESULTS. Clinicians reported 95 (6%) of the 1683 patients to Child protective services. Clinicians did not report 27% of injuries considered likely or very likely caused by Child Abuse and 76% of injuries considered possibly caused by Child Abuse. Reporting rates were increased if the clinician perceived the injury to be inconsistent with the history and if the patient was referred to the clinician for suspected Child Abuse. Patients who had an injury that was not a laceration, who had>1 family risk factor, who had a serious injury, who had a Child risk factor other than an inconsistent injury, who were black, or who were unfamiliar to the clinician were more likely to be reported. Clinicians who had not reported all suspicious injuries during their career or who had lost families as patients because of previous reports were more likely to report suspicious injuries. CONCLUSIONS. Clinicians had some degree of suspicion that approximately 10% of the injuries they evaluated were caused by Child Abuse. Clinicians did not report all suspicious injuries to Child protective services, even if the level of suspicion was high (likely or very likely caused by Child Abuse). Child, family, and injury characteristics and clinician previous experiences influenced decisions to report. Language: en
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clinicians description of factors influencing their reporting of suspected Child Abuse report of the Child Abuse reporting experience study research group
2008Co-Authors: Rise Jones, Emalee G Flaherty, Lori Lyn Price, Katherine Kaufer Christoffel, Helen J Binns, Eric J Slora, Dianna Abney, Donna Harris, Robert D SegeAbstract:OBJECTIVES. Primary care clinicians participating in the Child Abuse Reporting Experience Study did not report all suspected physical Child Abuse to Child protective services. This evaluation of study data seeks (1) to identify factors clinicians weighed when deciding whether to report injuries they suspected might have been caused by Child Abuse; (2) to describe clinicians’ management strategies for Children with injuries from suspected Child Abuse that were not reported; and (3) to describe how clinicians explained not reporting high-suspicion injuries. METHODS. From the 434 pediatric primary care clinicians who participated in the Child Abuse Reporting Experience Study and who indicated they had provided care for a Child with an injury they perceived as suspicious, a subsample of 75 of 81 clinicians completed a telephone interview. Interviewees included 36 clinicians who suspected Child Abuse but did not report the injury to Child protective services (12 with high suspicion and 24 with some suspicion) and 39 who reported the suspicious injury. Interviews were analyzed for major themes and subthemes, including decision-making regarding reporting of suspected physical Child Abuse to Child protective services and alternative management strategies. RESULTS. Four major themes emerged regarding the clinicians’ reporting decisions, that is, familiarity with the family, reference to elements of the case history, use of available resources, and perception of expected outcomes of reporting to Child protective services. When they did not report, clinicians planned alternative management strategies, including active or informal case follow-up management. When interviewed, some clinicians modified their original opinion that an injury was likely or very likely caused by Abuse, to explain why they did not report to Child protective services. CONCLUSIONS. Decisions about reporting to Child protective services are guided by injury circumstances and history, knowledge of and experiences with the family, consultation with others, and previous experiences with Child protective services.
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forty years later inconsistencies in reporting of Child Abuse
2008Co-Authors: Robert D Sege, Emalee G FlahertyAbstract:Forty years have passed since medical professionals in the United States were first required to report all cases of suspected Child Abuse to state Child protective service agencies. Despite the passage of time, many cases of severe Child physical Abuse remain hidden. Healthcare professionals may not recognize common syndromes of Child Abuse, or, has been demonstrated in recent studies, may recognize the possibility of Abuse but decide not to report the case to the state agencies. Rethinking the types of training we provide, the relationship between medical professionals and state agencies, and re-training medical and Child protection professionals may be required to further improve the recognition and care of Abused Children.
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pediatrician characteristics associated with Child Abuse identification and reporting results from a national survey of pediatricians
2006Co-Authors: Emalee G Flaherty, Robert D Sege, Lori Lyn Price, Katherine Kaufer Christoffel, D P Norton, Karen G OconnorAbstract:Pediatrician experience with Child protective services (CPS) and factors associated with identifying and reporting suspected Child physical Abuse were examined by a survey of members of the American Academy of Pediatrics (AAP). Respondents provided information about their demographics and experience, attitudes and practices with Child Abuse. They indicated their diagnosis and management of a Child in a purposely ambiguous clinical vignette. Pediatricians who had received recent Child Abuse education were more confident in their ability to identify and manage Child Abuse. High confidence in ability to manage Child Abuse and positive attitude about domestic violence screening and value of anticipatory guidance predicted that pediatricians would have high suspicion that the Child in the vignette was Abused and that they would report the Child to CPS. Future efforts to improve medical intervention in Child Abuse should focus on physician attitudes and experience, as well as cognitive factors.
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barriers to physician identification and reporting of Child Abuse
2005Co-Authors: Emalee G Flaherty, Robert D SegeAbstract:Physicians systematically underidentify and underreport cases of Child Abuse. These medical errors may result in continued Abuse, leading to potentially severe consequences. We have reviewed a number of studies that attempt to explain the reasons for these errors. The findings of these various studies suggest several priorities for improving the identification and reporting of Child maltreatment: Improve continuing education about Child maltreatment. Continuing education should focus not only on the identification of maltreatment but also on management and outcomes. This education should include an explanation of the role of CPS investigator and the physician's role in an investigation. The education should provide physicians with a better understanding of the overall outcome for Children reported to CPS to help physicians gain perspective on the small number of maltreated Children they may care for in their practice. This education should emphasize that the majority of maltreated Children will benefit from CPS involvement. New York is the only state that mandates all physicians, as well as certain other professionals, take a 2-hour course called Identification and Reporting of Child Abuse and Maltreatment prior to licensing. Cited studies in this article suggest that such a mandate might be expected to improve identification and reporting, thereby encouraging other states to adopt similar regulations. Give physicians the opportunity to debrief with a trained professional after detecting and reporting Child Abuse. The concept of Child Abuse and the gravity of the decision to report can be troubling to the reporter. The debriefing could include discussions of uncomfortable feelings physicians may experience related to their own countertransference reactions. Provide resources to assist physicians in making the difficult determination of suspected maltreatment. The role of accessible telephone consultation should be evaluated, along with formalized collaborations with local Emergency Departments with pediatric expertise. Improve the relationship between CPS and medical providers. For example, CPS workers should systematically inform the reporting physician about the progress of their investigation and the outcome for the Child and family. Several past reports have made specific suggestions to improve the working relationship. Warner and Hanson recommended that positive outcomes be programmed into the reporting process. They suggested that CPS have special phone lines staffed by well-trained employees for mandated reporters to call. Finkelhor and Zellman proposed a more radical change to improve the working relationship between CPS and mandated reporters. They suggested that certain professionals, with demonstrated expertise in the recognition and treatment of Child Abuse and registered as such, should have "flexible reporting options." Options include the ability to defer reporting, if there are no immediate threats to a Child, or to make a report in confidence and defer the investigation until necessary. Finkelhor and Zellman emphasized that this model would improve physician-reporting compliance and enhance the role of CPS while reducing the work burden for CPS. Improve interaction with the legal system. Child Abuse pediatric experts who have courtroom experience could provide education and support to physicians who have little preexisting experience with the legal system. Reimbursement for time spent supporting legal proceedings should be equitable and may reduce physician concerns about lost patient revenue. Retrospective studies and vignette analyses provide much information about some of the barriers to Child maltreatment reporting and describe many of the reasons why physicians do not identify and report all Child maltreatment. Future prospective examinations of physician decision-making may further explain the physician's decision-making process and the barriers he or she faces when identifying and reporting Child Abuse.
Katherine Kaufer Christoffel - One of the best experts on this subject based on the ideXlab platform.
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clinicians description of factors influencing their reporting of suspected Child Abuse report of the Child Abuse reporting experience study research group
2008Co-Authors: Rise Jones, Emalee G Flaherty, Lori Lyn Price, Katherine Kaufer Christoffel, Helen J Binns, Eric J Slora, Dianna Abney, Donna Harris, Robert D SegeAbstract:OBJECTIVES. Primary care clinicians participating in the Child Abuse Reporting Experience Study did not report all suspected physical Child Abuse to Child protective services. This evaluation of study data seeks (1) to identify factors clinicians weighed when deciding whether to report injuries they suspected might have been caused by Child Abuse; (2) to describe clinicians’ management strategies for Children with injuries from suspected Child Abuse that were not reported; and (3) to describe how clinicians explained not reporting high-suspicion injuries. METHODS. From the 434 pediatric primary care clinicians who participated in the Child Abuse Reporting Experience Study and who indicated they had provided care for a Child with an injury they perceived as suspicious, a subsample of 75 of 81 clinicians completed a telephone interview. Interviewees included 36 clinicians who suspected Child Abuse but did not report the injury to Child protective services (12 with high suspicion and 24 with some suspicion) and 39 who reported the suspicious injury. Interviews were analyzed for major themes and subthemes, including decision-making regarding reporting of suspected physical Child Abuse to Child protective services and alternative management strategies. RESULTS. Four major themes emerged regarding the clinicians’ reporting decisions, that is, familiarity with the family, reference to elements of the case history, use of available resources, and perception of expected outcomes of reporting to Child protective services. When they did not report, clinicians planned alternative management strategies, including active or informal case follow-up management. When interviewed, some clinicians modified their original opinion that an injury was likely or very likely caused by Abuse, to explain why they did not report to Child protective services. CONCLUSIONS. Decisions about reporting to Child protective services are guided by injury circumstances and history, knowledge of and experiences with the family, consultation with others, and previous experiences with Child protective services.
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pediatrician characteristics associated with Child Abuse identification and reporting results from a national survey of pediatricians
2006Co-Authors: Emalee G Flaherty, Robert D Sege, Lori Lyn Price, Katherine Kaufer Christoffel, D P Norton, Karen G OconnorAbstract:Pediatrician experience with Child protective services (CPS) and factors associated with identifying and reporting suspected Child physical Abuse were examined by a survey of members of the American Academy of Pediatrics (AAP). Respondents provided information about their demographics and experience, attitudes and practices with Child Abuse. They indicated their diagnosis and management of a Child in a purposely ambiguous clinical vignette. Pediatricians who had received recent Child Abuse education were more confident in their ability to identify and manage Child Abuse. High confidence in ability to manage Child Abuse and positive attitude about domestic violence screening and value of anticipatory guidance predicted that pediatricians would have high suspicion that the Child in the vignette was Abused and that they would report the Child to CPS. Future efforts to improve medical intervention in Child Abuse should focus on physician attitudes and experience, as well as cognitive factors.
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health care providers experience reporting Child Abuse in the primary care setting
2000Co-Authors: Emalee G Flaherty, Robert D Sege, Helen J Binns, Christine L Mattson, Katherine Kaufer ChristoffelAbstract:Objectives To describe (1) primary care providers' experiences identifying and reporting suspected Child Abuse to Child protective services (CPS) and (2) variables affecting providers' reporting behavior. Design and Methods Health care providers (76 physicians, 8 nurse practitioners, and 1 physician assistant) in a regional practice-based network completed written surveys that collected information about the demographic characteristics of each provider and practice; the provider's career experience with Child Abuse; and the provider's previous year's experience identifying and reporting suspected Child Abuse, including experience with CPS. Results All providers (N=85) in 17 participating practices completed the survey. In the preceding 1 year, 48 respondents (56%) indicated that they had treated a Child they suspected was Abused, for an estimated total of 152 Abused Children. Seven (8%) of 85 providers did not report a total of 7 Children with suspected Abuse (5% of all suspected cases). A majority of providers (63%; n=29) believed that Children who were reported had not benefited from CPS intervention, and 21 (49%) indicated that their experience with CPS made them less willing to report future cases of suspected Abuse. Providers who had some formal education in Child Abuse after residency were 10 times more likely to report all Abuse than were providers who had none. Conclusions Primary care providers report most, but not all, cases of suspected Child Abuse that they identify. Past negative experience with CPS and perceived lack of benefit to the Child were common reasons given by providers for not reporting. Education increases the probability that providers will report suspected Abuse.
Jui Ying Feng - One of the best experts on this subject based on the ideXlab platform.
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contextual effects on kindergarten teachers intention to report Child Abuse
2012Co-Authors: Jui Ying Feng, Susan J Fetzer, Hsin Yi ChangAbstract:Child Abuse is underreported for Children with socioeconomic inequalities. The impact of geographic location combined with sociocultural characteristics on teachers’ reports of Child Abuse remains unclear. A national survey of 572 kindergarten teachers from 79 schools in Taiwan used hierarchical linear modeling to investigate the contribution of individual factors, environmental factors, and training on kindergarten teachers’ intention to report Child Abuse. In-service training had the most influence on teachers’ intention to report in eastern Taiwan, the poorest and least-educated region. Training programs should be designed based on socioeconomic and cultural contextual needs.
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multidisciplinary collaboration reporting Child Abuse a grounded theory study
2010Co-Authors: Jui Ying Feng, Susan J Fetzer, Yi Wen Chen, Lily Yeh, Mei Chih HuangAbstract:Abstract Background The complexity of reporting Child Abuse requires multidisciplinary collaboration. The dynamics of a mulidisciplinary team in reporting Child Abuse which begins the process of Child protection remains unclear. Objective To explore the experiences and perspectives of professionals working with other disciplines when reporting Child Abuse. Design A qualitative study with grounded theory was used. Setting Participants were recruited from hospitals, the Department of Child Welfare, and schools in Taiwan. Participants Twenty-one professionals from four disciplines agreed to participate. The purposive sample included 5 physicians, 5 nurses, 6 social workers, and 5 teachers. Method Individual interviews were conducted to explore the experiences in reporting Child Abuse of a purposive sample of 21 professionals including physicians, nurses, social workers, and teachers. Transcripts were analyzed using a grounded theory approach. Categorical themes were developed that reflected reporters' experiences and perspectives in reporting Child Abuse. Results The professionals involved in reported Child Abuse are described as participants in a relay race. Four themes emerged from the interviews: running the relay race of Child protection; reporters as runners with expectations of runners' characteristics and the order of runners; carrying the baton of a mandatory report described using baton characteristics while running in space and time; and team chemistry including trust of and communication with teammates. Systems that encourage and promote team building and collaboration among Child Abuse reporters are needed. Conclusion Success in the race to report Child Abuse across professional disciplines includes runners' skills, speed, a light and easy to carry baton, and team chemistry. As a team of Child Abuse reporters, when performance is enhanced by practice, the team's success will be measured as victories in Child protection. The paradigm of individual disciplines developing their own goals, designing their own training, and practicing within their own regimen needs to be reframed.
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kindergarten teachers experience with reporting Child Abuse in taiwan
2010Co-Authors: Jui Ying Feng, Tzu Yi Huang, Chi Jen WangAbstract:Abstract Objective The objectives were to examine factors associated with reporting Child Abuse among kindergarten teachers in Taiwan based on the Theory of Planned Behavior (TPB). Method A stratified quota sampling technique was used to randomly select kindergarten teachers in Taiwan. The Child Abuse Intention Report Scale, which includes demographics, attitudes about Child discipline, punishment for perpetrators, and professional responsibility for reporting, subjective norms regarding support for reporting from the general and specific important persons, perceived behavioral control, and vignettes of Child Abuse, was used to collect data. A total of 598 kindergarten teachers (return rate 47%) provided data. Results While 97% of teachers reported having no experience with reporting a Child Abuse case, 11% indicated they had failed to report a suspected case of Child Abuse. Multiple regression revealed that, except for social norms, attitudes toward Child discipline, punishments for perpetrators, and professional responsibility as well as perceived behavioral control explained 22.4% of variance of kindergarten teachers’ intention to report Child Abuse. Conclusions With the exception of the subjective norms, the findings of this study supported the TPB that kindergarten teachers’ intention to report Child Abuse is associated with attitudes toward Child discipline, punishment for perpetrators, professional responsibility, and perceived behavioral controls over reporting. This study revealed the problem of underreporting Child Abuse among kindergarten teachers in Taiwan, and highlighted the discrepancy between Child Abuse training and expected reporting outcomes suggesting an insufficiency in the current training programs on Child Abuse. Practice implications There is a need to scrutinize the current training in Child Abuse and develop standardized training and clear reporting guidelines that will increase kindergarten teachers’ confidence when confronted with suspected victims and perpetrators of Child Abuse in Taiwan.
Katie A Mclaughlin - One of the best experts on this subject based on the ideXlab platform.
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Child Abuse neural structure and adolescent psychopathology a longitudinal study
2017Co-Authors: Daniel S Busso, Katie A Mclaughlin, Stephanie Brueck, Matthew Peverill, Andrea L Gold, Margaret A SheridanAbstract:Objective Child Abuse exerts a deleterious impact on a broad array of mental health outcomes. However, the neurobiological mechanisms that mediate this association remain poorly characterized. Here, we use a longitudinal design to prospectively identify neural mediators of the association between Child Abuse and psychiatric disorders in a community sample of adolescents. Method Structural magnetic resonance imaging (MRI) data and assessments of mental health were acquired for 51 adolescents (aged 13-20; M=16.96; SD=1.51), 19 of whom were exposed to physical or sexual Abuse. Participants were assessed for Abuse exposure (time 1), participated in MRI scanning and a diagnostic structured interview (time 2), and 2 years later were followed-up to assess psychopathology (time 3). We examined associations between Child Abuse and neural structure, and identified whether Abuse-related differences in neural structure prospectively predicted psychiatric symptoms. Results Abuse was associated with reduced cortical thickness in medial and lateral prefrontal and temporal lobe regions. Thickness of the left and right parahippocampal gyrus predicted antisocial behavior symptoms, and thickness of the middle temporal gyrus predicted symptoms of generalized anxiety disorder. Thickness of the left parahippocampal gyrus mediated the longitudinal association of Abuse with antisocial behavior. Conclusion Child Abuse is associated with widespread disruptions in cortical structure, and these disruptions are selectively associated with increased vulnerability to internalizing and externalizing psychopathology. Identifying predictive biomarkers of vulnerability following Childhood maltreatment may uncover neurodevelopmental mechanisms linking environmental experience with the onset of psychopathology.
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Child Abuse resting blood pressure and blood pressure reactivity to psychosocial stress
2016Co-Authors: Holly C Gooding, Carly E Milliren, Bryn S Austin, Margaret A Sheridan, Katie A MclaughlinAbstract:OBJECTIVE: Childhood trauma is associated with hypertension in adults. It is unknown whether Childhood trauma predicts elevated blood pressure earlier in development. We investigated whether the trauma of Child Abuse was associated with blood pressure in adolescents. METHODS: The sample included 145 adolescents aged 13-17 years, 40% with exposure to Child Abuse. The mean age of participants was 14.93 years (SD = 1.33); 58% were female. The majority self-identified as non-Hispanic White (43%), with the remainder identifying as non-Hispanic Black (17%), Hispanic (17%), or other/mixed race (23%). We used established age/sex/height-specific cutoffs to determine the prevalence of prehypertension and hypertension in the sample. We used two-sample t tests to examine associations of Abuse with resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) and blood pressure reactivity to the Trier Social Stress Test and a frustration task. We used linear regression to adjust for potential confounders including sociodemographic variables, body mass index, smoking, and psychopathology. RESULTS: Mean resting SBP and DBP were 114.07 mmHg and 61.35 mmHg in those with a history of Abuse and 111.39 mmHg and 56.89 mmHg in those without a history of Abuse. This difference was significant for DBP only. Twelve percent of participants met criteria for prehypertension or hypertension based on resting blood pressure values; this did not differ between those with and without an Abuse history. Child Abuse was associated with lower DBP and SBP reactivity to laboratory stress tasks and reduced DBP reactivity to frustration. These associations were robust to adjustment for potential confounders. CONCLUSIONS: Child Abuse is associated with higher resting DBP and blunted DBP and SBP reactivity to laboratory stress in adolescence. These findings suggest a potential pathway by which Child Abuse leads to hypertension. Language: en