1978 Annual Review of Child Abuse and Neglect Research

ATAHOB. Martin ;. Mary Porter; Klaus, Susan L. TITLE 1978Annual Review of Child Abuse and Neglect. Research. iNST/TIITION Berner and Co., iiashingtcn, D.C. SPOSS. AGENCY National Center on Child Atupe and Neglect .1-

(DREVORD),Washingtor,D.C'. . REPORT ,NO DEER-ORDS-79-30168 0 PUB DATE Sep.78. CONTRACT 1054-76-1136 NOTE 99p.;Not available in hare copy due to stall print (

ginsPRICE ' 1-117-$0.83 plus Postage. MC Nct Available from EbBS. DESCRIPTORS Annotated Bibliographies; *Child Abuse; *Definiticnt; -Ecological Pactcrs; Etyircnmental influences; - *Incidence; *Intervention; *Neglected Children; *prevention; Research Revi4zqs (Publications) ; '*Social 4 influences

ABSTRiiCT . - The review of research cn child abuse and neglect presents1:4i.ef abstracts of studies ccllected by the Clearinghouse of the National Center cn Child Abuse and Neglect. Material is organized into five subject areas (sample subtopics in parentheses) : definition ofabuse and neglect; incidence (national and selected gegraphic estimates) ;psychosccial ecology (individual cdpacities, situational factors, and social institutional factors); prevention and treatment ..(primary and secondary prevention) ; and effects/seguelae. The

. annotated lists within each heading include authors name, methodology statement, and a brief review of findings. A 30-page bibliography concludes the document. (CL) .

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**********************************4************************************* * Reproductions supplieeby!DES,are the best that .car be made * * from the original document. * *****I*****it********************0***k********************************* .4, V $ DEPARTMENT OF NEWS EDUCATION &WELFARE Tf"'4 . NATIONAL !INSTITUTE OX k a EDUCATION CZ a . TN/S 00CVX.E NI paAS BEENREPRO . OVCEO EXACTLY AS RECE,YE0FROM . THE PERSON OR OROANiZAT,ONORIGIN AT INC. IT POINTS OP VEtVOP,OPIN.ONS STATED DO NOT NECESSARILY REPRE SENT OCCIC.AL NATONAL..NST,TIJTE Or EOV.AT.ON POS,T,ON OR PO/ 'CV . il 1978ANNUAL REVIEW OF CHILD ABUSE AND NEGLECT RESEARCH

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U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE _ Office of Human Development Servi;:es k.. Adminostration for Children. Youth and Families Children's Bureau DHEW Publocation No. (OHOS) 79.30168 a I ..

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. . , This Publication was prepared by Mary Porter Martin and Susan L. Klaus, Social Research Group, George Washington University for Hemet and Company under Contract Number HEW-105.76-1136, for the National Center on Odd Abuse and Neglect. U.S. Children's Bureau, Administration for Children, Youth and Families, U.S. Department of Health, Education, and Welfare. It is disseminated in the interest of information exchange. No office of the U.Government assumes any liability for its content or the use thereof. .., . . . .

-46 PREFACE

Since the i early 1960s the concerte4j.fforts of researchers, clinicians, 'and practitioners trom a variety of professional disciplines have served to bring to the consciousness and the conscience of our society a problem of tragid proportionsthe abuse and iregJect of our nation's children. With the passage of the Child Abuse Prevention and Treatment At of 1974, the Federal government, through the National Center:on Child Abuse and Neglect (NCCAN), has Worked to heighten'this public awareness and to support efforts directed toward the identification, prevention, and treatment of child abuse and neglect.

As. part of its mandate, the National Centel is directed to compile and publish a summary of recently conducted research in the field of child abuse and,neglect This 1978 Annual Reviets of Child Abuse and Neglect Research presents a broad overview of the status of research using as its data base the abstracts of completed and ongoingresearch studies contained inthe computerized data base of the NCCAN Information ClearinghoLise This Clearinghouse was established by the National Center to collect, process. and disseminate informatum on child abuse and neglect.

Such an overview, using the abstracts as the sole data source, has the advantage of including a large body of material in a format where different methodologies are easily 'apparent and where pertinent topics are dearly tlistingutshedIt also helps identify gaps or overlaps in research. We hope it will be a useful resource docurgent for anyone wishing to select a particular area of research for further examination Unfortunately, mformationettemandeil by the abstract format does not permit an indepth analysis of the material '

This report was written'by Mary Poiter Martin and Susan L Klaus with assistance from Ruttiann Bates Dr Maure Hurt. Jr , directed the work for the Urcial Research Group, The George, WashingtonUtriversity,, Dr DouglasE Bereurigef directed the work on -behalf. of Herne! and Company TEA assistance of Joseph Wechsler, Government Project Officer and Chief of the Ne'CAN Clearinghouse., is gratefully atknowledged

Douglas I asharov Director, National Center on Child Abuse arid Neglect U.S, Children's Bureau

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e 1. TABLE OF CONTENTS 1 I

. . I. INTRODUCTION . i -

ei inio.rmatton Cleannghouse e I Procedures for Selecnon of Abstracts for Inclusion . in the Review t i r II.DEFINITION . . ; .. 2 Summary of Research StudiesRelatedto the Definotton iof Child Atnne and Neglect ..' . . . . 2 Summary of Legal Issues and Opinions Related to the Definsnon of Child Abuse and,Neglecs 2

HI INCIDENCE 4

Estimates of the National Incidence of Abuse . . 4

Estimates of theNationalIncidence of Neglect 1 . 4' Estrmasesof Abuse and Neglect in Selected Geographical Areal . 4 Ongoing Research Studies Exams:tang Incidence ., 7 Sources of Discrepancies in Estimates of Abuse and Neglect . 8

IV. PSYCHOSOCIAl. ECOLOGY 10 .

Individual Capacities 10 Situational Factors A. . 21 1$ Attitudes and Values . 28 Social Institutional Factors 30

V. PREVENTION AND TREATMENT. 38

Pnmary Prevenno- n "`. . 38 Secondary Prevention , . . , 38 Treatment' . . - . .. 39 . .121.- I

1 V..EFFECTS/SEQUELAE 53

____J.APPENDIX

s Abbreviations of Standardized Tells- . . 63

BIBLIOGRAPHY . ... 64

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LIST OF TABLES "----/..., .:. <.r, . . . . , , , Table 1. Comparison of tiational Estimates Of the Ektent: of Abuse, 1962.1975 ,. 5 , 1 . Tab1e.2. t CompartsCin 9f National Estimates of the Extent of Neglitt, 1962.1975 6

-Table 3. 'Annotated List of Ongoing Research Studies' Incidence 47. 7 v

Table 4 Annotated Lisa Of Studies. Individual capacities, . . ... _ ....-v .. 12.

A 6,, Table 5 Annotated List of Ongoing Research tches Individual Capacities 19

;. Table 6. Annotated List of Studies Situational Factors ...... 4.. 22 . Table.7`'°Annotated List of Ongoing Research Studies Situational Factors .27 Table 8. Annotated List of Studies Attitudes and Values . 29 S Table 9 Annotated Lpt of Ongoing Research Studies Attitudes and Values .30

Table to.; Annotated List of Studies. Social Institutional Factors .32 Table 11' sitAnnotared Lift of Ongoing Research Studies Social Institutional Feelers i§

, Table'12 'Annotated List of Studies Secondafy Prevention ...... 40 b - 'Table 13 Annotated List of Ongoing Research Studies, Secondary Prevention 42 ri

Table 14 Annotatid List of Studies .Yreatment ' . 43

"'Table -15 Annotated List of pirgoing Research Studi, es Treatment 41.

Table 14.Annotated List of Studies .Eltects/Sequelae of Abuse ... . 55

Table 1,7 'Annotated.Listbf Studies. Effects/Sequelae of Neglect .. . 60 ...... cr Table.' 8 Annotated List of Ongoing Research Studies Effects/Sequelae ...... t2 t. ..

iii IINTRODUCTION te

Informadon Cleansighouse Research 2 With the exception of the section on psychosocialecology, any modifications reflect ante NCCAN Information Clearinghouse the availability of matenal in the abstracts! The systematically scans the world's literatuft in order - section on psychosocial ecology has been refined to identify results of research on child abuse and arid enlarged as the result of a symposium on this neglect. These research findings appear in journal subject 3 .articles, books,technicalreports, Klissertations, etc., whichtheClearinghousecollectsand After the initial review and sorting was dqpe,it processes for entry into the Center's computerized became clear that the definition of research used data base The Clearinghousealso ,conducts here excluded legal research, since fegar research semiannual surveys to identify 'going research does not follow the procedures of social science projects in the field. and to collect information research but has its own methods, mimly case about these for its data base The present report is descnption A review of legal abstracts was done, one of several methods used by the tileannghouse those a ruts that dealt with one or more of the to disseminate informationThe abstracts and five subs ative areasand thatwerenot descriptions of projects that are used in this report state-sincifie> but appli4aile to child abuse and were also published by thi National Center in neglect proceedings nationally, were selected and threeeditionsofChildAbuse and .Vegleti included in the review Research Projects and Publichions i The same 4procedure was used in revievilifg ongoing research studies in the NCCAN Procedures for Selection of Research Studies ('leannghouse data bake and selecting studies for for Inclusion snthe, Review inclusion inthis review. Those research studies 4 which were underway as of January, 1978 are' All abstracts includedin the NCCAN includea.'Whde some of these studies fnay now be Clearinghouse data base as of November 1977. complete, no formally published documentation were reviewed to select for further examination ofresearchresults had been includedinthe those which met the criteria for a research study Cleannghouse data base as bf November 1977 For the purposes of this review, research is defined Information concerning ongoing research projects as reported here was obtained from responses to a NCCAN survey questionnaire, and in large measure a systematic examination.investigation,or focuses on research purposes and Inethodologv inquiry which proceeds under a well-defined rathe,er than findings, since many of the studies' procedureormethodology, uses a known wereinthedatacollection phase when the systeht ofmeasurement, and documents questionnatrevsas completed finikrigs based on empirical data The sole source of data for review of completed, A second review ofelliose abstracts which were and ongoing research studies is the abstracts of the designated research studies was then carried out to NC C AN Cleinnghouse Allstudiesarecited categorize the material into five substantive areas according to the "CP". or "CR" identification definition, incidence. psychosocial ecology, number assigned each study when it is entered into prevention otindtreatment. and sequelae This the NCC AN computerized data base. Full citations organizational framework is based on the /97' are given in the bibliography beginning on page Annual Analysis ofChild Abuse and Scelect 64. I

iNatiorial Center tin Child Abu and 'Ni.gle1Child Abuse and Neglect Research Prom" and Pubbcations Spnnglield, Va.National Tethniv t Information Serowe. March 1978 (PP -/77 825), Nuvember 1976 (P13-260 8001. May. 1976 (PB25 I 010). 2Marttn, M.P. 1977 Analysis Claild Abuse ande gle cr Re searchWathington,DSNational (drner fur Child Abuse and Neglect. January 1978 .

3Klaus, Si- The Psychosocial 1-.col,k: of Child Abuse and Nedra uIn prcssr. September 1978)

1 7 II DEFINITION

One of the central issues in the field of child protective agency than did the members of other abuse and neglect is that of defining the.problem. occupations The ambiguities that surround the definition of this particular social problem touch every aspect Inan ongoing study, Gelles (CD-00060) is of the field. For example. the way in which one examining the labeling and classification proesses defines abuse and neglect Affects what 4s reported employed by individuals dealing with suspected and how many reports are made, which in turn cases of child abustin an attempt to determine a affects .the .iffort to assess an incidence rate Using cqrnmon definitionof abuseThe opinions of a broad defmition, abuse and neglect include all physicians, social workers, and elementary.school acts that .interfere with the optimal development counselors were ascertained through of children. This definition leaves open the issue of questionnaires and in-depth interviews. what is the optimal development of a child and what acts. interfere Ikith this development, At the other extreme. abuse and neglect include only Summary of Legal Issues and Opinions Related thoseacts that resultinobservable injures, a to the Definition of Child Abuse and Neglect defiratidn that excludes an' uncomfortably large number of children who do not exhibit observable Twenty-five studies report on legal issues that injuries, yet are abused and neglected Prevention areinvolvedinthedevelopmentofalegal and treatment programs are also influenced by the definitionofchildabuseandneglect.An inclusion or exclusion of certain behaviors within appropriate legal definition of child aliuse and the definition of abusf and neglectFinally, in neglect is necessaryo avoid confusion in reporting magy cases comparability across research findings andtoallow foreffectivebut appropriately is not possible because of the use of different limited intervention. definitions in studies The majority of these studies deal with -the Thefollowingdiscussionwillreviewthe problem of competing interelts of thechild, available research on the definition of child abuse fariuly, and state in those instances in which legal and neglectIn addition, this section will discuss action is taken` by the state. A second group deals some of the legal issues and opinions related to the. with the specifics, of court procedures, while a problem ofdefining abuse andneglectFull thirdanalyzes the effect ofa, broad' versus a citations for all references can be found in the narrow statutory'definition of child abuse and bi6liography beginning on page64 neglect r Competinjutterests of child, family, and state Summary of Research Studies Related to Legal opinions continue to reflect differences oh the Dinitton of Child Abuse and Neglect how best to resolve competing interests of the child, family, and state in cases of child abuse and Only one completed research study deals with neglectCourts have traditionally held that the theissueof defining 'child abdse and neglect naturalor biological parents have an inherent and Boehm (CD00103, CD-01415i surveyed 1400 supenor nght to the custody and control of their members cif representative community leadership child (CD-00075), at the same time they have groups by ,questionnaire in order to assess the recognized thatParens patriaemay be exercised extent of Consensus for protective intervention in withtheunderstandingthatthestateisthe vanous types of abusive and neglectful situations ultimate keeper of the child's welfare(CD01698). There was strong consensus for protective action Currentlawemphasizesfamilyprivacyand in situations involving physical hazard to the child, presumed parental fitness although the nghts of but a large majority opposed protective action in parents are ndt absolute (CD-014731. Traditionally cases ofem?tionalneglect Nosignificant children hav%the nght to be cared for by their relationship was found between occupation anal parents; or, in the absence of such care:091e state the perceived need for protective inte6ention, would benevolently provide for them (C 01006). thus indicating that social work resptindents were substantially,inagreementwiththeattitudes At present. theprima facieassumption that expressed by other community groups and did not eithertheparentsorthestatenecessanly assign peat& latitudeor pponsibility to the represents the interests of the child is questioned

2 (CD-01006). A Bill of Rights for Children has been CD-00218,CD-00548, CD-00808, CD-00826, proposed which declares that children 'are People CD-01030, CD-01162, CD-01231) and that they are entitled to assert individual ...., interests m their own nght,tohaveafair Statutory definition of abuse and neglect. Many consideration given to theirclaims,and to have states have enacted legislation which defines abuse their best interests judged in terms of pragmatic and neglect broadly and permits extensive judicial consequences(CD-01172) Onbalance,the intervention. Expenence has shown that many of protectionof individualnghts has notbeen thesestatuteshavefallenshortofa good appliedasevenlytochildrenastoparents operational definition." The major flaw in most (CD-01698). i -. statutes is a vagueness that permits intervention in \-- 1 theparent-childrelationshiP in thebasis of An important legal decision pertaining to the subjectivenormsratherth onspecified, issue of children's nghts versus parents' rights was objective standards delineated by the legislature made in the case of Wyman vJames,when the (CD-01831) Supreme Court ruled on the legality of the state's veil to visit welfare mothers, as a kecunty for .the It is felt by some that a limited definition of rights of children involved. For the first time, an child abuse 'and neglect encourages the use of issue of contradiction between the child's nghts protective services and other nonjudicial and the mother's nghts was presented (CD-00l55. approaches to the problemACD-01473). There has CD-00266,.CD-00267 1 been support from vanous involved professional groups for the proposition that parents charged 1 with neglect and abuse are entitled to remedial and Court procedures Discussionsofcourt supportive services designed to ameliorate the proceduresfocus on the need forprocedural conditions constituting neglect and abuse rather safeguards fur parents and children in the legal than the quasi - punitive response of removing the process The issues include neqd for due process child(CD-01006).Thechallenge, remains to protectic.a,' thechild'snght"-tocounsel,the develop a definition that allows Mr intervention in parent's nght to counsel if indigent, confrontation those instances where children need protection, andcross-examinationofwitnesses.cnminal particidarly when parents refuse assistance, but liability of parents of delinquent children, and thatprotectsindividualsfromarbitraryor various evidentiary problems (CD -001l 2, inappropnate.enterventionl by the state P I

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, III. INCIDENCE

t Attempts to measure the rate at which new Esnmates of the Nanonal Incidence ofNeglect cases of abuse and neglect occur in the United States dunng a specified time period (incidence). Perhaps the one statement on neglect for which. or the number of cases.of abuse and neglect in there is universal agreement is that it occurs with existence at a particular point in time (prevalence 1. more frequency, than abuse. Although a variety of have been unsuccessful for a number of reasons ratios is presented in the literature, a4.1or 51 The sources of information have been biased to ratio of neglect to abuse sums ways only partially understood and the resulTant figuresarenot yetstatisticallycontrollable. The actual numbers of neglected 'children are definittonaldifferences acrossstates .and even even more difficult to derive than those of abused within studies have made statistical projections to children,becausesofewreportingsystems larger populations inaccurate, increased public and separate abuse fromneglectThe category of professional awarengss of the problem, along with abuse,which includesneglect,is generally increased enforcement of reporting mandates, have recorded made trendanalysisunreliable. and the very pnvate nature of the actions under study and their Table 2. which follows, presents a comparison simdanty to accidental injuryor to cunilitions of national estimates of the extent of neglect, found in an impoverished environment have made 1,962-1975 detection very difficult Therearetwo otherpotentialsourcesof This section will review those research studies information on the extent of neglect in the United that report on the incidence of child abuse and States,mveatlecourt ,jtatistics(CD-01309. neglect, or that report the results of efforts to CD-01848, CD-01849) anstatistics on neglected ascertain the sources of discrepancies in estimates children living in institutions that receive federal of abuse and neglect To date. most studies have funds (CD-01946). Data in. these studies are not measured incidence rates. though prevalence may national estimates. since they refer only to those well be the better measure of neglect (Polansky et neglectedchildren who come into the court al, 1975)4 For this reason, only incidence rates system enwho are institutionaliz.ed. Further, the are under consideration hers lull citations for all juvenile courtgures inclede dependency as well referencescanbefoundinthebibliography as neglect casel, however, they do provide some beginning on Rage 64 information on the relative increase in reported neglect cases.

Estimates of the National Incidence of Abuse Estimates of Abuse and Neglect in Various methods have been used to asses the Selected GeographiCal Areas national incidence rate of abuseFor example. DeFrattcis (CD-01511i studied eases reported in There have been numerous studies of the extent newspapers in 1,962. Gil (CD-011.87) conducted a ofabuse,orabuseorneglectinspecific national surveyaswellasasurvey, of every geographical areasThese cover compilations of incident reported through legal chanhels. Nagi data on the incidence of the problem in states. (CD-00704) surveyed agencies related to abuse and regions, counties, cities, and foreign nations. neglect for his estimate figures A comparison of nationalestimatesoftheextentofabuse, The literature includes many studies on the 1962-1975, shown an Table 1, reveals that these extent of abuse And neglectin states, including estimates vary as widely in actual numbers as they Alaska (('D- 01089, CD-01114, CD-01433), do in methodology Arizona(CD-01452),California(CD:01447),

4Polansky. N.A., Willy .(And Polan,kyN IProfile el/ikekrt A Surrey of the State of Knowledge of CbildNeglect Washington, D(', Community Service, Adminustwison, Social and Rehabilitation Services, PHI W. 1975

4 0 IIP ivt .4. . - '' TABLE 1

' COMPARISON OF NATIONAL ESTIMATES e OFnigEXTENT OF OUSE. 1962.1975

Measurement Estimute of Origin of Bata Reference Criteria i Incidence . . . Abuse, not further 662 Newspaper accounts, DeFrancis (14) specified - data' (CD-0151I) . . Abuse.not further 302 71 hospitals, 1962 data Kempe qt al (1962) specified (Reported in CO-00560) . . 4 Abuse, not further 44'7 77 district attorneys, Kempe et al. (1962) specified 1962 data (Reported in CD-00560)

Abuse that resulted in 2,500,000-4.070,000 National survey, 1965 Gd (1970) some degree of injury data (Reported in (4D-01187)

'Abuse that resulted in 200,000.500.000 Reanalysis of Gd's 1965 Light (1973) some degree of injury data (CD-00613) e Senous injury by , 10,000-15.000 1966 data, no source Helfer and Pollack (1968) nonaccidental means given (CD-0040 ) , ... Abuse that resulted in Centralregistries, nation- Gd(1970) , 6,617 some degree of injury wide.1968 data (Reported in CD011'87) . , Reported abuse 60.000 Additiveestimate,based Kerive and Helfer (1972) on cases reported in (CD00559) Denver and New York City. 1972 data ts keportcd abuse 41.104 .' Official reporting CohenandSussman' (1975) . systems from 10 iargest (CD01136) states. 1973 data

Reported abuse .'167.000 .* Agency survey, 1972- Nag) (1975) 1973 data (CD00704)

Abuse not reported 93 ,000 Difference betwcen pro- Nagi (1975) sections from rate of re- (CD-00704) 258,b00 (total) 'ports in Florida and rate from agency survey, ob. i 1972.1973 data Parenito-child I,400.000-1,900,000 - Household survey. 197,5 Gelles (1977 )* violence data

14available from the NCC AN Clc.inligliouse when ifir. table waPTePared

. l 5 .1I s' 1. a. TABLE 2 1

COMPARISON OF NATIONAL ESTIMATES OF THE EXTENT OF NEGLECT, 1%2-1975

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, Measurement Estimate of Origin of Data Reference Criteria Incidence ...... ' a . . Reported neglect 432.000 Agency purvey, 1972. Nagi (11375) 1973 data IC D00704.) . , (.., 4 Neglect, 1191 renorteI 234,000 Difference- between pro- Naga(1975) Y. Jections from rate of re- (CD-00704) . I. . 666.000(total pous in Flonda and rate from agency survey, L972-1,973 data

Neglect and other maltreat. 465.000' of Gil's 1965 Light (1973) ' relent incidents excluding V . data - (CD-00613) abuse . .

Hawaii (CD-00446, CD-00447, CD-00448), Illinois study of suspected child abuse cases reported in (CD -00$06, CD-012741, Iowa tCD-01670). Kansas the southeastern 'states over a five-year period (CD-01608), Kentucky t CD-00563), Massachusetts (CD-011526.) was conducted to (1) deteirmine major (CD-00726), New York (CD-01261, CD-0161A demographic chpractensties of abused children, North Carolina (CD-01263), Pennsylvania families,andperpetrators,(2)analyzethese (CD-01281). Texas (CD-01583), and Wisconsin characteristics in terms of case dispositions, (3) (CD-01293) These reports usually include deternitne the extent of reporting and utility of information on the rate of increase or decrease in statelegislationand programs, and (4). find . the repdrted cases, some descriptive information relevant associations between selected variables. onthechildabusingpopulation.orsome Another studied state legislation and programs in information'onhow cases were Theseese the ,Southeast (CD-01219). A third study focused 'studies are, however, dissimilarilar in a number .of on the effectiveness of reporting laws, rate of 1 ways. For example, their scope the statistics reports,,and perSons involved in 'reporting systems

for Iowa inclpde only' child abuse cases while those child abuse forcases in Newt 'fork, California, for Kansas include both abuse and neglect cases Colorado, and West Virginia (C D-01480 ). The methods of measuring incidence also are not P... uniform, Alatka estimated its statistics in units of A few docurnerits have pebbshed results of physically abused children per 100,000 children studies of the extent of abuse and neglect in riderthe age of 16, while Pennsylvania merely particular cities and counties. If) Denver unted all the cases reported to the state. Sources (CD-01153), the Department of Welfare analyzed o information are different, a New York study 1972 data on 143 battered children served by the (CD701612) relied pn reports from the state's child Child Protection Program and compared these to abuse register, but the Massachusetts study used 1971 figures, this study also estimated that 2,400 agencyreports,asurveyofphysiciansand to 2,600 children come to the attention of the hospitals; and projections 'based on nunreply ing program each year. An epiderrnologic study of physicians. The years covered by these studies also sexualabuseinchildrenwas performed by varied, ranging from a one-year estimate for 1970 reviewingMinneapolisPoliceDepartment case inMastachusetts and for 1975 in Iowa, to a records from 1964 to 1971 (CD- 01674), about multi-yin study, 1972 to 1975. in Kansas 300 cases, were seen each yeir, and 85% of thtie involved indecent exposure or iecent liberties. A Three studies examined child abuse reporting five-year review of data on elm and Ramsey practices in more than one state A 4. omprehensive Counties, Minnesota, sill.; at1,285 cases of a

6 4 physical-and ,sexual abuse were repotted found that three times is many cases were referred 1971, 396 of- lvtirch were reported in 1995 alone in 1970 than in 1968 (CD-01 123) Theain't) study (CD01926)iAstudyin Douglas County, estimateddhat then s may be about 11,000 cases of Nebraska, found that 2,570 cases of child abuse iniufies to children to England every and neglect had been reported to the -county's year by .extrapolatingOom the 1970 and 1971 Child protective 'service agency between August statistics of the Emergency Department of Preston 1967 and December 1973, with 634 of these Woyal Infirmary(CO-00167).thisstudyalso reported in1973 (CD-00049). Like the studies estimated that 500 to 600 children of this annual

:done on the incidence of abuse and neglect in total will die , various states, these county and city analyses also anadian differasto measurement criteria; methods of 'Two studie'sare concerned with measuring incidence. sources of statistics. and time statisticspnchild abuseandneglect One spans covered examined eases triyolving battered 'and emotionally depnved cluldrexin Nova Scotia (CD01144), but ;There are five studies of the extent of abuse, or,, was based on records of only 59 cases in the five of abuse and neglect in' foreign countries, and one years between 1966 and 1970 The other Canadian of child abuse and neglect in U.S Army families study analyzed murder statistics between 1964 stationed in Europe (CD-01315) Compansons of and 1968, finding that the victims were under 16 years of age in 115 of the cases (CD-00853) the rate of abuse and neglect in Army families 4 with the reported rate in Denver and New York revealed a significantly hightr rate ir the Army population "Ongolig Research Studies 4xannuing Incidence Three of the foreign studies concern child atruse and neglect irt4ogland One examined the cases of The following table summanzes information on 24 enfants admitted to a British hospital during four ongoing research studies investigating various three-year period and pr9)ected that one child in aspect of the problems related to determining the 1,000 would be hospitalized due to' battering in incidence of abuse and neglectTwo of these infancy IC D-00831) ,Another study analyzed the studies are concerned with means of identifying cases referred to England's National Society for abuse and two attempt to measure incidericein the Prevention of Cruelty to ( hddren. this study specific populations

TABLE 3 ANNOTATED LIST OF ONGOING RESEARCH srufnEs INCIDENCE

Reference Research Purpose Methodology

Ford, R.J. I stahfish a general policy as guideline for Survey of hiophotographers in 64 chi!. Smistek B photographing mums of child abuse, dren hospitals LegalinterPretations ICR-00053) I ducat hospital personnel in following being studiedRiAontact of biophoto- graphers 2 years later guideline tit (Arne, I S investigate incidence. ty pology , and L(ini- Various to:Rogues from care supervision 4( R-001041 mutiny manageinent ut adolescent abuse to collectiorpof aggregate data and pro- ,Sy anti Deglet.1 vision fortfritovative service components - Sample 250 children

kilts, I Review lemur fractures ininfants and 40 children who suffered femur fractures U R-00449) their relationship to mechanisms utin to be riNiewedI xplanaiions givn..by iury parents compared with type of fracture

-W1.ston, J rIPW,k. RA} \ of data 40411child Rettospecjive survey Data collected from 4( R-00155i thusc deaths in one state and on Indian untie investigations, postmortem exams reservations and autopsies, and andillaryxams.

7 Sources of Discrepancies in Estimates of Several research studies examine the Abuse and Neglect relationshipsofprofessional awareness tothe .reported rate of abuse,and neglect. One examined : The wide discrepancy in estimates of abuseand immunity far reporters as an.effectiVe stimulus for neglect may be attnbuted to a number of reasons, reporting and for gaining full cocreration by child abuse reporters (CD -0j337). lontof which stem from the types of data sources - used for estimating incidence rates: (1) mandated reports,either dtoa, centralregisters or - child Otherstudiesfocusonthe 'physicians' protective agency, and (2) household surveys. knowledge df.and attitudes toward child abuse and Each has certain inherent ,charkctenstics which neglect and their role in reporting it. One study of account in part for the problems encountered in over 1,200 cases reported by hospitals found that assessing the true extent of abuse and neglect. rhavatephysicians .had reported onlyII, and attnbuted this to inadequate education in medical One of the most obvious reasons foil the wide' school and insufficient in-service training discrepancy. in estimates isthat incidence data (CD-00517). Similar deficiencies in education or collectedthroughmandatory reportingare training' were reported in other studies (CD-00458, ipaccurate.In general, itis thought that rates CD-00925, CD-02052), and wide variations in based on a ,reporting system underestimate the familiarity with abuse and neglect also have been true number of cases of abuse and neglect while at ,reported (CD-01459, CD-00902). the. same time failing to distinguish abuse from neglect and' substantiatedfr /m unsubstantiated Sixstudiesfocus ontheschool'srolein OM Furthermore: it is known that such a,systern, reporting child abuse and neglect. Four note the of data collection is affected by (1) accuracy of failure of the system to fulfil its responsibility by 4 detection, (2) public and professional awareness. organizing standard procedures and ensuring that (3) degree of enforcement, (4') certain reporting personnel are awareof the ,Rroblern andthe biases, (5) lack of comparability in statutes, and procedures available tothemtCD-00277, (6) availability of resources. CD-00635, CD-01544, CD-01945). One study 4 simply surveyed 33 schools in a metropolitan area Accuracy of detection Certain children simply and noted that school personnel did in fact report are not brought to the attention of authorities, numerous cases of abuse and neglect (CD-01294). either because they do not receive any medical This was borne out by an,analyn of complainants attention, because their parents use a different nd complaints im a, public iTtotective services hospitaleachtime,or because they are not ,setting which reported that theAreatest number of diagnosed as abused when they are seen by a acceptable complaintscam?) from schools doctor of hospital personnel Four research Oldies (CD-01855). examine some awect of the problem of diagnosing child abuse or neglect. A study of 45 randomly Studies of public awareness concentrate on selected children seen in the casualty departments surveying public knowledge of and attitudes of two London hospitals found that in none of the toward the problem of child abuse and where to . nine cases' subsequently diagnosed as abused or report it, or on measuring, by statistical reports, neglectedhadthisdiagnosisbeenseriously calls to a hotline. One surrey sought information considered (CD-0I851). A follow-ep study of 33 from a sample of resIdepts of Newark, New Jersey, children hospitalized with bone .fractures reported -an area reporting the highest /incidence of child that, at the time of the injury, 10 families (five abuse in the state (CD01202) and found that involving abuse, two' not involving abuse, and three nearly 70% of the respondents had heard about questionable) had not been questioned regarding theproblem of child abuse. Another studied the possibility of child abuse, and two nonabusive nonwhites in Tacoma-Pierce County, Washington families had erroneously peen accused of abuse. and found that a majority were aware of .child (CD-00291)Indicatorsofsuspicionthatthe abuse agencies (CD-01471). A third discovered injurywasintentionalincludeunreliableor that residents of Puebla County, Colorado were Inconsistenthistory(CD-01453), delayinre- awareof child abuse as a problem, but their porting by parents with inadequate explanations, knowledge of helpful agencies in the community and failure to appear for follow-up examinations. wasconfused (CD-01371). The impact ofa (CD-00515) coordinatedinformationcampaigninFlonda (('D-01842) and of the Care-Line, a 24-hourper-day, 7day-per-week statewide child abuseprevention and information . servicein Public-and professional awareness The number Connecticut(eD-01489, CD.01490) has been of 'child abuse cases reported each year is dearly studied. The tremendous increase in calls to these affected by the extent of public and professional systems from year to year suggests that the public awarenessandhowwellthisawarenessis is increasingly aware of the problem and where to translated into actual reporting repprt it

11. g 1 4 Comparability' of statutes State reporting laws ( D-00275, CD-00343, CD-00666, CD-00777, also vary as to the definitions of abuse and neglect, reported CD-00778, CD01479, CD01540) penal sanctions, who must report, and reporting However, these surveys reveal that standardization procedures Suchvanationsresultinlimited of provisions is occurring as junsclictions broaden comparability among states' data on child abuse their definitions of abuse and neglect, expand the and neglect reports SeveraLstudies from the field classes of persons r9uiTed...to report, expand the of legal research have compared the provisions of provisionsforconfidenti4Ltyofrecords,, and mandatory repdrtipg statutes an,* state central authonze'the operation of central Tomes. registries (CD-00149, also reported in CD-00141, '

9 ti

IV. PSYCHOSOCIAL ECOLOGY

The following section revlfws the research on In this review, individual capacities related to the psychosocial ecologyofchild abuse and child abuse, and neglect aredivided into three neglect. A companion reportsdescribesthe major groups ft mortality characteristics, personal psychosocial ecological approach, and presents a attributes, and Life experiences. framework, for 'identifyingand analyzingall aspects related to individuals and their environment which seem relevant to the problem Pecsonatity characteristics include of child abuse and neglect. This psychosocial 4emperameht, motivation, ego strength, capacity onentation of the framework shows a concern for for self-discipline, and capacity to give and receive {actors related to individuals ankfamilies, affection.. Theyare. shapedbythepotential is for the cultural and social environment in which esialllishedbyheredity, bythe devel pthental they exist,whileits "ecologicalapproach process of growth and motivation, anby the emphasizes .the importance of ,the residue of memories and exp,enences which are the interrelationships of these factors and the ways in lessons of life. Certain characteristics "represent which-they affect each other.. enduring aspects of personality Nhich persist tkroulhout aperson'slife,but \personahty The major sets of factors that are thought tb characteristics also develop and evolve as a person contribute to or mitigate against the occurrence of interacts with his physical and social environment. *child abuse and neglect include (1) individual capacities, (2) situational factors, (3) attitildes and Personalattributer includebothphysical values, and (4) social institutional factors: These capacitiessuch as general health, handicaps caused factors affect family dynamics both negatively, by bygenetic., errorsorbydisease, and motor creating stresses for the' family, and positively, by coordination and- dexterity and cognitive providingsuppoitsthatcan . enhancefamily capacities,including innateintellectual ability, functioning. it is some particular combination of abilitytouse language, perceptualskills, and these factors at particular times thatthought to abstract thinking and problem-solving abilities. be associated wi,th"childabuse and neglect. Some of these attributesarepermanent conditions. For example, congenital blindness or Each of these factors is reviewed separately in deafness resulting from a childhood disease are the following section. Each study that reported more or less constant factors'which affect other findings related to one of these fact acincluded . areas of an individual's growth and development. once in the ,review In many inncesa studyNormal capaCities develop and change overttime, reported findings on both &ridivitiucape ies and some through the natural maturation process and situational factors. In some cases, atti es and others through learning and life expenences. .values were also reported. The decision to review a study in a particular Action was based on the Life experiences importantly affect personality majonty of findings it presented. formationandtheexpressionof personality 't throughbehavior,whileatthesametime personality characteristics and personal attributes Individual Capacities! play a significant part of determining some of the experiencewhich 'onemeetsinlife.Life experiences involving parent-child interaction in Individualcapacitiesareperhaps the most particular have a profound Nnfluence on an adult's critical determinants of.behavior,//hest own parenting ability. If abuse and neglect were charactgnsticsdefine one's individuality. They experienced as a child, itis possible that under determine the ways in which an individual adjusts stress,thesefamiliarandac...essible responses .to his environment and affect the ways in which whichhavebecomeintegratedintoone's he deals with himself and others. & 'personality structure may emerge.

- sttlaus. S.L. The Psychotocial Ecology if CAIN Abuse and Neglect. Unpress. September 197E4..

1 0 1 G 7 The "'following. pagespresentanannotate() getteral 'pOpulation :asa whole.Psychological hsting of 57 conipletedand eight ongoing research testingpredominated as a methodofdata studies' of indivithial capacities related to child collection'. reviewofcaserecordswasalso abuse and neglect These' Itudies were selected for frequently used Eight studiesinterviewed inclusion in this section for -one of the following subjects. three studies included home or hospital reasons7I) the purpose of the study was to observations of parent-child interatlion, and one t investigatethe relationship of a particular used videotape .t individual to ,child abuse and neglect; or (2). regardless. of studyfocus, a substantial proportionoffindingsdealt' withindividual t capacities.Thesestudiei are listed alphabetically Review of studiesMostof the completed by author andfullcitations.' are Oven in the studies focuson thepersonalitydisorders of 'bibliographywhichbegins on, page64 The parents rather than children. Intelligence, mental methodology of each study is described in as much illness or psychosis, alcoholism, afratiie, and low detailaspossible.including "samplesiteand self'.concept frequently charactented abusive and . characteristics,controlor comparison group if ne ctful parents. mentioned, and' means of data collecticin, where ., knowp Inajldition, 411relevant information tudy findings related to children descnbed proviaed by the abstract on individual capacities, personal attnbutes, which made the abusing or canbe found undtrtheheading -Review of neglectful parent perceive the child as different Studies Studs findings are noted where as,ailable, Congenital defects andotherhandicapping if no findings are indicated in "the abstract, the conditions, prematunty, and infant and other individual capacities dealt with in the study are earlychildhood illnesseswere most frequently reported mentioned x

i Pindings related to life euenences fe ,Jl inte"two major catergorts.i41lthe conditions surrounding MethodologyThe sample seize. in 32 of the the birth exigrience and mother-infant bowling, completedstudies was between20anJ140 and (2) parental life .experiences and backgrounil subjects, six studies had subject populations over 200 study populations wen abused or neglected Ongoing research studiesTwo of the eight children or their parents in almost every study studies consider the relationships of child abuse The exceptions viere five studies which focused on and substance abuse The majority of studies are mothcr-infint pairs and six studiesev.hich used as attempting to identify characteristics of parents or their subjects white welfare mothers, children that may lead to poor interaction patterns disadvantaged children ,with low Vitamin-A levrls, and abuse or neglect One study considers the role 'genaparous mothers,puur ru,41 families, women that failure to thrive may play in the susceptibility seen at a planned parenthood progro. and the to later abuse or neglect

e t

'Abbreviations for .i.ind.ukluo.i.J psychuloinedi tests were used wherever possible, a kc; to these abbreviations can be' found on pare 63 e 9 r

TABLE 4

ANNOTATED LIST OF STUDIES INDIVIDUAL CAPACITIES.

.1 Reference Methodology . Review of Studies

1 Birrell. R.G., 42 Maltreated children Mental illness or subnormality of,parents Boren, .I.H W, Admittedtohpspital. 31-monthcase alcoholism.distutbedparental back- (CD-00093) follow-up ground. and congenital -abnormalities in child reported ° - , , 2 ,Bich op, F I. 70 cases of child mistreatment At-nsk factors in child abise 'cases in- (CI)-00094) Hospital population cluded premature babies, coDienital mal- formations,' conception durtg depressive illness in mother.,

3 Boisvert, M J 20 cases of child abuse 1 Developed typology of abusive parents ,(CD-00104) including psychotic parents; parents with irresponsible, immature, impulsive.' ,passive aggressive, sadistic, and cold compulsive personalities.

4 Borgman, R D 34 rural low income mothers referred to Neglectful mothers large numper moder- (CD:001091 welfareagency forchronicchild ately retarded, lack of intellec ual .capaci- ,4** neglect ty at root of mothenng inadequacy Contrast group of 16 pothers referred for evaluation of fitness, for employment Standardized test (WAUS) ,

V Brant, R S T 52 cases of possible sexu,11 misuse from Sexual abuse usually a manifestation of Tisza, V 8 . casts in pediatric emergency room family pathology (C D.01425)

6 Brazelton, T B , 12 mother-infantpairs duringfirs' t .5 By 3 weeks of age, newborns demon- Tronick F months of infant,life 4 strated expectancy for interaction with Adamson, L Videotape 1." caregiver lAttentionar cycling may be Als II diagnostic Vf optimal mother-infant inter- Vine. S actions and seems not to be present in (CD101426) more disturbed interactions.

7 Browning, D H , 14 cases of incest ('lironic depression in mother. alcoholism Boatman, B. Referred to psychiatric clinic in father, handicapped or retarded chil- *(CD-0143,5) dren 0 ,8 Children's Hospital Cases of abnormal ingestion, failure to Problem areasthat distinguished cases Medical Center thnve, and child abuse and neglect fromcontrolsincludedproblemsin (CD-01467) Tape recorded interviews mother-childrelationship, problems in mother's life history, and child health problems

Cohen, M 1 1401 neglecting parents Assessedinterpersonalrelations, prob Mulford, R M lern-solvingskills,oopingskills,sell' Philbnck evaluation regarding success-failure, emo- (CD-00210) tional patterns, perception of reality.

". 'A 'i1 ti. TABLE 4 (Continued) ANNOTATED LIST OF STUDIES: INDIVIDUALCAPACITIES - .

Reference Review of Studies

10, De Chateau, P , Pnquparous mothers and thkir infants at Significantdifferencesinstudy grottp Wiberg, B 36 hours post partum and'at 3 months who were allowed15.20 minutes of ,. (CD-01509) post partum suckling and skin-to-skin contact during 1st 'hourafterdelivery.Differences greater for boys than girls. Study mothers spent more timelooking en face- at k infants and infants cried less and smiled more.

11 ._ Delsordo, J D 80 cases of physical abuse Patientsclassifiedbe 'causes of abuse (CD002641 includingparental mental illness, alcoholism, parental frustration, irresponsi bility and anomie, and brain damage in the child

12 Dorman, S. 69 child abuse cases randomly selected Severalpersonalitytraitsaccountfor (CD-01'158) from135reportedtoChildren's parental behavior' narcissism, immatun- . Hospital National Medical Center ty.poor ego development, poorself concept.Physicallyor psychologically -I. deviant children singled out for abuse. 4t . .. 13 Elmer, E -Companson of abusive and nonabusive Abusive mothersrated medical stress (CD-002941 mothers more severely Abused' babies less Hospital population healthy with higher rate of prematurity

40 14. Fanaroff, A A , 146 infants confined to intensive care 2 of 111 mothers in Group 1exhibited Kenna, J H. nurseryfor longer than 14 neonatal disorders in mothering, 9 of 38 in Gr,oup Kraus, M H, days 2 exhibited such disorders (CD00304) Divided into two groupsMothers who visited more than 3 times in 2 weeks (Group 11, mothers who visited fewer than 3 times in 2 weeks (Group 21 Follow-upfor 6-23 months afterdis- charge 1 15 'Floyd, L M 12 abusing and 12 neglecting mothers No difference in abusing and neglecting (CD01566 ) 32 control mothers t mothers on measures of dependency frus- Compared on8personalitymeasures tration,nurturance,interpersonalself- (TAT/ esteem Abusing and neglecting scored higher on TAT need aggression; lower on tb fantily adjustment and interpersonal self - 41 'esteem

16 Fomufod, A K , Cases of child abuse seen aetropolitan Hypothesissupportedthatearlyand ' Smkford, S M , hospital over I year prolonged neonatal hospitalization inter- Long, V E feres with the development of natural (CD-01 POI maternal- infantbonding andsetsthe scene for greater 'distortions at later date

. , s ,/ 17 Friedrich, W N , 357 children Parental stress derived from handicapped Bonskin, J.A Reported to county welfare as physically .4..liddren a factor in child abuse (CD-01584) . abused ; Analysts of case reports

lib .. 13 9 a. 4

. ABLE4 {Continued)

I ANI4044. EC, LIST OF STUDIES. INDIVIDUAL CAPACITIES 1,

Reference Methodology Review of Studies 4

18 Gakiston, R 60 abused children (mostly 6.18 months Role reversal in parents, history- of un- (C D-00350) cild) pleasant childhood experiences observed -Hospital population .. .67

, 19 Giovannoni, J M . 186,neglectful mothers Past socialandfamilialsituationof Billingsley, A Lome, black, white, or Spanish- mother did nut differentiate neglektful (CD-003781 -,speaking from'adequate mothers. Neglectful Interviews mothers showed lower degrees of nurturance toward children and lower prefer ence foryounger,more dependent children 20 Goldsoil,Ii 114 children from neighborhood health 25% had low birth weights as compared ,Cadol. R.V programwith diagnoses of nonacci- with only l4% of children born in the Fitch, 1,J , dental trauma. failuretothrive, or hospital during that period Umlaut, H.1 , Jr both 6 weeks to 8 years of age (CD01t06)

21 Gdrdon. R Mothers in pcnnatal period Factors isolated in study to determine (CD-01609) potentialchild abuseflctors included mental dullness, too many pregnancies too close together, late attendance (Or antenatal care or default

Green. A 11 60 abusing mothers Child abuse a dysfunction of parenting in (C D-00396, Corm)! gray of 30 neglectful Mothers, which parent misperceives child due to CD-01192; 30 mothers of pediatric outpatients his ownfrustrating chddhood experi- CD-01614) Structuredinterviewsandreviewof ences. Parents reliedonchildfor agency records gratification of dependency needs, had impairedimpulsecontrol,poorself- concept, disturbances in identity forma- 4. bon

23 Gregg. S , I li,accidentally injured or abused Abused childrendevelopmental retarda- Elmer, E ;Ann (30'abused) non. 'ratability as infants (CD-00406) Observations of children and families

24 Gnswold, B B 40 white, welfare mothers Testscores 'indicatedpsychoticten- Billingsley, A Psychological testing (MMPI, WAIS, dencies among abusive mothers and sig- '(C D- 00407) Bahon's Ego Strength Scale) nificantly lower, self-controlNeglectful Interviews mothers neurotic tendencies, deficiencies inall areas of socialization, lower self- fat esteem

25 .Hepner,111_, 38 urban disadvantaged children with low Strong correlations found between mal- Maiden, N serum VitaminA nutritionindicators andqiiality of (CD-00471) Pairmatched for age. race. neighborhood, mothering sex, school, with children with normal Vitamin-A (LLS

Hyman, C A Abusive fandies Abused child scored lower on intelligence (CD-00500. Matched control group nornial parents and developmental tests, abusing parents CD-01661) Psychological. intelligence, and develop- scored higher on practicalintelligence mental testing titan verbal intelligence, abusing mothers

14 t 4

TABLE 4 (Continued) ANNOTATEDIIST OF STUDIES. INDIVIDUAL. CAPACITIn

Reference Methodology Itevaew of Studies AIN -, 26. (Continued) (Stanford-Binet,Bayley -Scales,Bent- scored fottr(ori capacity for character Anthony Family RelationsTest, integrkii)n and matuniy of personality, WAIS, Cattell's 16 PP) abusing fathers showed defective personality.antegration and were more intro- verted.

27 Justice. B , 35 abusing parents Abusers report moderate life, cnsis in the Duncan, D F 35 matched nonabusing parents having . yeatPrior toabusive event, competed (CD-01688) difficulties with their children with other parent and children for the Social Readjustment...-- Rating Scale role Obeing cared for 28 Kennel]. J, Primiparousmothersgivenprolonged Measurable differences lasting for as long lerauld,'R contact with baby as 1 year were noted supporting theory of Wolfe, H. Control group had contact with baby special attachment period shortly after Chester, D . consistent with normal hospital rou,birth Kreger. ti C tine (CD-01'710) Structured interviews, physical examina- tionofbabies. time-lapsefilms of feedings

29 Klaus, M H ; Mothers and newborn infants Mothersdenied physical contactwith Kennel', J S Observations made up to one month after their infants until 20 days after delivery r(' D-00569 discharge . showed less coddling arcd less eye contact with the infants than a group of mothers allowed contact after 5 days

30 Klein, 1.1 SIcases of abused children seen at a 12% were low birthweight infants com- Stern, I. hospital pared with expected rate of 7.8% in (C 0.005701 general population Associated with abuse was a high degree of isolation and separa- tionofinfantsfromparentsduring neonatal period and high incidence of majorneonatalproblem),including psychomotor retardation"

31 Korrusaruk, R 65-cases of child abuse referred to county High dumber of parents with IQ under r(13,0579) court 75, undiagnosed m en ta 1illness, psychic Parent interviews traumata in their own childhood, dependent, immature, and narcissistic personalities 1

32 Laii.gshaw, W ( 29 children identified as abused In 14 cases, history of mental illness or (CD-00589] psychiatric treatment in adult Immaturi- ty low frustration threshold, ambivalence or rejection of child, depression, ngid, compulsive, and passive dependent personalities,' absence of remorse common findings. 5 children had physical or intellectual handicaps.

33 Lukanowict, N 20 women who had attempted infanticide Mothersproduct of an unhappy trau- (CD00632) lase study matic childhood,personality disorders and psychiatnc disorders observed

4 15 v.

( TABLE 4 (Continued) ea ANNOTATED LIST OF STUDIES INDIVIDUAL CAPACITIES

Reference Metho d ttle011Y Review of Studies t

34. Lynch, M.A 25 abused children Factors identifiedwith abused group (CD-01234, Compared with 35 nonabused siblings childhood illness in the first year of life, c D-01747) Parent interviews.reviewofmedical illnessin mother ifi child's first year of / '" records life

. . 35 Lynch, M A , 50 children referred to hospital because Abused childrenevidence of emotional Roberts, J of actual or threatened abuse disturbance, admission to special baby (CD-01749) Comparison group of 50 nonabused chil- careunit,andsuggestedinabilityof dren born at same hospital mother to care for the child Hospital records

36 Melruck, B., 10 abusive mothers Abusive mothersscored higher on TAT Hurley, .1 R 10 controls matched for age, social class. pathogenicityand dependencyfrustra- (CD-00675) and education tion, lower on TAT need to give nQrtur- Psychological tests (TAT, California Test, ance. self-esteem,manifestrejection of Personality. Family ( oncepteiven Characterized by inability to empathize tory ) with children, severely frustrated dependency needs, probable history of emotional depravation

37 M)rers, S A 83preadolescentvictimsof felonious Fdicidal mothers overtlypsychotic. - * (CD- 007Q2) homicide, 35 killect.by mothers Immaturity.masculinity,and Oedipal r conflicts observed

38 Newberger, L Ji. 303 'children admitted to inpatient ser- Data support hypothesis that differential Reed. R /1. sices T.itegones of hypothesized stresses and Daniel, J H 257 children whcs visited emergency clinic personal and, social strengths determine 'Hyde..J.NJr ., of urban academic pediatric hospital theoccurrence ofpediatricsocialill- Kotelchut.kr M Hospital interview with mothers of chti- nessesC had abuse associated with more \-.....,, (CD-01,262) .dren extreme disparities of stress and strength

39 011earn, T PJr 23 abusive fathers Abusive fathers were significantly' less (CD-00741 I ( ontrol group of 23 nonabosive fathers. powerful, less assertive, and had signifi- ,snatched for age,-income, age. of chil- cantly lower ego strength dren. and number of children under 5 years, old

40 Paulson. M J. 15 males and 18 females, known abusers, Scales for male and female successful in Abdelmonem. A A . 'M's1P1 identifying abusive parents Chaleff, A., Thomason. M L , Liu, V Y (CD-00779)

41 Paulson, M J . 33 mothers and 27 fathers referred to Findings indicate thattest scores from Afifi, A A . ( hild Trauma Intervention Program this instrument are useful in discovery of Thomasun, M L because of abuse or neglect in family high-nsk families and distinguishing dif- Chaleff. A ( ompanson group pf 63 mothers and 37 ferent types of maltreating parents. (CD-00780) fathers selected /t random from child psychiatric outpatient clinic NMI

I /

4). ... 16 ' 0 t) 4 41 TABLE 4 (Continued) ANNOTATED LIST OF STUDIES' INDIVIDUAL CAPACITIES

Reference Methodology Review of Studies

42, Paulson, M.J., 53 abusive parents Studyfocus'todifferentiateablisive Schwemer, G.T., 113 controls parents from controls using a variety of Bendel, R.B. Psychological tests (MMPI,Magargee test instruments (CD-01874) Over-controlled Hostility Scale)

43. Phillips, P:S, 25 intentionally burned children adm' Parents may have been abused themselves Pickrell, E., ted to hospital as children and are often 'lonely, imma- Morse, T.S. ture, or bored. (CD-01882)

44 Polansky, N A.. 65 mother-child pairs Inadedate mothers caught up in apathy- Borgman, R D , Rural, Appalachia futilitycycle, displaying powerlessness, DeSaix, C Measures of IQ, ego strength, and maturity helplessness,alienation, and depression (CD-012851 generation after generation. Inadequate mental organization (measured by IQ, ego strength, and maturity ) transmitted to .. children

45. Polansky, N A . 67 mother-child pairs , . Findings suggest inadequate maternal care Borgman, R D , Rural, southern, Appalachia .the, result of pervasive characterological DeSalx, C, Enrolled in Head-Start day care center disturbance. Smith. B.J program (CD-008 I 4) Interviews and test battery (( LLS. WAIS, TAT, Rorschach}

46 Polansky, N A 63Appalachianfamiliesator below CLLS score correated significantly with Pollane. L poverty level intelligence andwith features of parents' (CD-01891) 93 AFD( families personalities independently measured CL LS Personality tests

47 Seaberg, J R Datafrom nationwide studyofchild Effectsfromperpetratorbeingpast (CD-008961 abuse subjected to expanded analysis victim of abuse and perpetrat8r being psychologically sick not observed

48. Simons. B 313 case reports involving medical care 50% had psychologicaldifficulties, ,of Downs. E J, Review of cases reported to child abuse that 504,, 20% were alcoholics or drug Hursker.t4 M , registry addicts. Surky found high proportion of Archer, M caseswherefamilyexhibitedmental (CD-00931) problemsorwhere victim was a low birthweight infant.

49 Smith, S M , 214 abusive parents Mothers. abnormal personality, neurotic, Hanson, R . subnormal intelligenceFathers abnot: Noble, S rnal personality., (CD-00949)

50 Smith. S.M , 35 abusive parents All parents found psychopathic and of Honigsbergery L . EEG:psychological tests low intelligence Smith, C.A (CD-00950)

17 23 TABLE 4 (Continued) ANNOTATED LIST OF STUDIES: INDIVIDUAL CAPACITIES Al

Reference Methodology# Review of Studies

11. Sokol, R. Random sample of 360 females, 18 years Potentially abusive motherslove.r self- (CD-01964). andolder seen athospitals"and concept, more, deeply affected by dis- 4, planned parenthood agencies appointment, mlife,generally more Qu1stionnaire anomic.

52. Stern, L. 51 abused children. Much higheriincidence of serious neonatal (CD-00971) Hospital records illness,congenitaldefects,low birth- . 'weight reported.

53. ten Berisel, R W , 10 severely physically abused children Abusing mothers. higher incidenceof Paxson, C L., Jr 10 controls Matched for birthweight gestational illness $ssociated 'with post- (CD-01993). Treated in special care nursery at birth' ponement of first visitation with infant 3-year follow-up .

54. Ten. L C 10 abusive families with children from 3 Exaggerated dominant - submissive or ag- (CD-01002) monthsto9 yearsold' gressivepassive relationships between Interviews. obteryations spouses. Childrendisplayed physical abnormalities or ego defects frustrating to the abuser.

55. Williams.J.E.11 68 cases being considered ,for parole on Nearly 25% had loW or subnormal intelli. (CD-01340) incestconvictions, generally 30-50- gence. year-oid men

56 Wilson, Fl C 52 neglectful families Frequently found a personality character- (CD-01341) Sociological study istic , resembling emotionalretardation which may have been regressive response to economic and piychological Immaturity not always related to neifect.

57. Wright, L 13 convicted abusive parents Abusing parents scored differentlyon (CD-00491, 13 nonabusiyeorneglectfulparents many of tests. appeared snore psycho- . CD-01071) matched for age, sex, race, number of. pathic, scored lower on intelligence. children,maritalandeducational status, income Psychological tests (PeabgdyPicture VocabularyTest,. Rorschach,,MMPI. Rosenzweig Picttsre.Frustration Study)

;

.18 A

\ ...

t , TABLE 5 ) ANNOTATED LIST OF ONGOING RESEARCH STUDIES: INDIVIDUAL CAPACITIES

Reference Research Purpose Methodology b

..- , p 1 Altemeier, W.A., III, Determineifthereis' a charactenstle Screening pregnant women by question-, Qt Condor, S. A pathological pattern in mother that cor- naire to classify as high, moderate, or los( (CR-00003) relate'swith disturbances in child 'care nsk pre-, pen-, and post-natal evaluations. behavior and with abuse or neglect

2 Chapa, D, Investigaterelationships between child Data gathered from interviews and ques- Luebbert, G abuse and neglect and drug abuse tionnaires. 5,000 adults diviled into 1) (CR-00027) child abuse and neglect parents, 2) sub- stanceabuse parents,and3) general population (normal control) -- -- 3 Frodi, A.. Identifycharacteristics of infants and Heart rate, skin conductance, and blood pressure i Lamb, M children, such as excessive crying, facial measuredinparentcouples (CR-000561 features, and child temperament, that watching videotapes of normal br prema- maytriggerimpulsive, aggressive out- ture ,infants. Broussard's Perception of bursts onpartof parents or parent Averageverage Baby Scale, Bother Inven- substitutes tory, Cary Infant Temperament Scale. 32 couples 20-35 years old.

'4' Kadushin. A Develop un derstandingof behavior Experienced social work interviewers to Berkowitz, I leading to abuse by focusing on parent's conduct 60-minute interviews with 100 (CR-00090) perception of chilcis behavior associated abusive parents. .,, with an abuse event `

5 Kennel, I ll To 1) determine if infant's contribution Comparativeanalysisof - infantsand (CR-00092) to perceived reciprocal interaction neces- mothers who receive 'experiences to 1st sary tomother-infantattachment,2) week after birth and matched group who determine if mother-infant contact after 'do not. Second study companng mothers birth increases maternal attachment thus separated fr,orn infants for 1st 24 hours insuring better health for the child, 3) an'd group who were not. Third study investigate situation in which newborn looks at infants with congenital anomalies infant is malformed and compares group receiving intervene lion with one that is 1riot.

6 Kent, J Investigatedevelopmental outcome of Study Population of 1) infants hospital- (CR:000941 high-nsk infants who undergo prolonged ized because of prematunty, and 2? in- hospitalization at birth, develop profile of fants hospitalized due to congenital ano., nsk factors mattes whose parentsvolunteer. Data collected by observation, questionnaire, and psychological evaluation r

7 Mayer, J, to 11 examine distribution frequency and Structured interview of 100 alcoholics Black, R types of child abuse and neglect within and100 opiate addictswith children (CR-00109) sample of alcohol and drug abusers, 2) under age 18. MMP1, Surveyon Bringing investigate child abusers and substance up the Children, the Schedule of Recent abusers for common factors, 3) examine Lxpenence relationship between stages in cycles of / drug and alcohol abuse, adequacy of child care, presence or absence of abuse and neglect, 4) determine extent to which social and situational factors associated with abuse and neglect operative among alcohol and drug addicts

19 TABLE 5 (Continued) ANNOTATEDLIST OP ONGOING RES (ARCH STUDIES. INDIVIDUAL CAPACITIES . Reference Research Purpose Methodo)ogy

8. Tufts. E. Assess role -of failure to thnve as indicator Infants leg than 6 Months' who are 2 (cRiptsco, of potential sus..eptibility to later abuse standard deviations below normal height And neglect. .and weightundur study. Comparison with matched contizol group. All sublets from clinic population.

2tV. 2G Situational Factors regardless of study focus, a substantial proportion of finding% dealt with situational factors. These studies are listed alphabetically by author, and full Situitional factors are defined as the complex citationsaregiveninthe bibliography which of factors unique to an individdal and to families begins on page64.The methodology of each at a given time that arise from the immediate studyi,s described in as much detail as possible, familial7 living space, and social and economic include pg sample size and characteristics., control enviratiment.They canbepositivefactors orcomparisongrpup if spintioned, and means of strengthening the family and improving the quality data collection, where known. In a dition, all of family life, or negative ones, making life more relevaijt informatiOn provided by e abstract on difficult.Situations affecting families may be situational factors can be found uer the heading chronic or acute. A sudden crisis, although of "Review of Studies." Study findings are noted.,, temporary duration, may have as profound an where available, if no findings are indicated in the ' effect on, family functioning as a long- standing abstract, the situational factors dealt, with in the problem. study' are reported.

Methodology.In renewing the methodologies In this review, the situational factors related to used in the completed stuclies,.thel'iroblem of the child muse and neglect are 'divided into three noncomparabilityofresearchisimmediately majorgroups thefamilysituation,living evident.Samplesize,characteristicsof study conditions, and economic status. populations, and data collection methods vary enormously.While themajorityof sample populatiops ranged from 20 to 100 subjects, one The family situation includes the status of the studyhadonly12 subjects,whiteanother marriage,its structure, and the qualityof. the examined questionnaires on 1,44z1 welfare clients. marital relationship, the number, age, and spacing Study populationsalsovariedwidely,e.g., of children, family interaction, the presence or middle-classfamilies,Vavajochildren,and absence of "significant others", and the degree of alcoholic incest offenders were all study subjects. Social isolationLiving conditions are defined by The most commonly used technique of data factors such as housing, clothing, sufficient and collection was review of case records,.eight studies nutntiousJOod, access to health care, geographic used questionnaires or interviews. location, and available transportation. Economic status includes such things as employment status Review of studies. While it is important to keep of one or both parents,incorrie level, and job m mina that the abstract formaillimits the amount sansfaCtion. of informtion available for review, it is interesting to note that three situational fictors did tend to recur in the review of the completed studies: low income, social isolation; and marital discord. The The following pages presentanannotated review which follows shows the broad range listing of 42 completed and six ongoing research situational factors that has been investigated by studies of situational factors related to child abuse .researchers. andneglect.Thesestudies wereselected for Ongoing research studies. Family interaction, inclusion in this section for one of the following poverty, and socioeconomic status are specific reasons(1) tip purpose of the study was to factors under consideration in six studies. Several investigatetherelationshipofaparticular studies describe their' purpose u) general terms but situational factor to child abuse and neglect, or (2) do notadentify specificSactors under study.

21 a i TABLE 6 ANNOTATED LIST OF STUDIES: SITUATIONAL FACTORS

... 4 Reference Methodology Review of Studies

1. taldwin, LA., 60 severely abused children under 5 years Identifyingcharactenaticswere large Oliver, J.E. of age family size, low social class, instability. (CD01376) s Retrospective and prospective study . . 3 2. Ball, M. 109 eases Analysis of violent behavior, 33% of vie. (CD-01377) tuns were children, income of violence viclinis was low.

3. Bethscheider, J.L , 30 ineest.families, 70 neglect &mulles Incest and neglect'families high religious Young, LP , Retrospective study of case reports nonaffihation rate, overcrowded condi- ti, Moms, P,, tions.Neglectfamilies.lackof clean- 9 Hayes, D.D. hness,' inadequdte clothing, inadequate (CD-00083) feeding. .

ia' 4. Brett, DA 23 cases of child abuse, preschool.age Material evaluated to determine family (CD -001 19) childred social charactenstics and behavior prob- Control group of 56 children representing lems, socioeconomic and racial cross section --N, Interviews with mothers Medical and social services records e 5. British Medical , 28 psychiatric patients who had had some Most of the cases reported occurred 'in Journal . experience with incest , largeworking.classfamilies,livingin (CD-01429) . Unselectedfemale 'psychiatric patients cramped quarters in industnal 'towns or who were victims of paternal incest under conditions of extreme isolation in rtiral areas. . -.,..... 6. Brosseau, B.E.. Parents of 600 abused children 90% of abused children's parents stated k (CD-01113) they wanted the pregnancy. . % )

1 7. Bullerdick Corey, LI ,48 ...hildren, to age 6 years, hospitalized No differencesfoundinnumber of Miller, C.L for child battering mothers married presence of siblings, the Widlak, F.W. priparisonigroup of 50 children hospi- extent of prematunty or extended post- (CD-01438) talized for other reasons natal hospitalization Collected demographic and medical data

8, Chavez, G.T. 50 university undergraduates Attemptto identify students who were (CD-01463) subjectedto maltreatment through an instrument based ondysfunctional s rearing characteristics.

.9. Cohen, MI. 43 middle class families Statistical data analyzed on occupation sr (CD-011351 Nrvey questionnaire to child protective and finances, !Wing arrAlgement, recrea- workers tion, marriage expectations, and present relationships. - -,' , 10. Disbrow, M.A. 17 families in 'which either parents 'ap- Abusive parents 'more socia#1y isolated (C'D-01530) -prehended for child abuse or children and isolated as parents. taken into custody Comparison group of 19 families randomly selected from same neighbor. hoods Questionnaires and subject interviews le 22

c l TABLE 6 (Continued) , ANNOTATED LIST OF STUDIE'SlAITUATIONAk FACTORS

Reference Methodology Review of Studies I.

. H. Durham, M E 60 cases of child abuse Findingsshowedtherewere enough (CD-01535) Factor analysts causal relItionship.s among variables to describe the factors and relate various factorstofamilyCohesion, deviance, preceding behaiioroftthechild,life stresses apd tension, means of abuse. 1

12 FerguSson, D M, All' cases, of alleged or suspected child Child abuse concentrated in tower socio- Fleming, J, abuse that came to attention of Child economicstrata, abused childrenfre O'Neill, D P. Wefare Division in New Zealand in quently experienced unstable home back.

WU-01165) ... grounds x7 year Natinal survey, dga collected on start. dardized recording forms

13 Holman, R R..4 28 abused children Finding was that environmental pressures Kanwar, S Retrospective study of phstetnc histories lead to child abuse by susceptible indivi- (CD- 00485. and early lives duals. CD-01208)

14 Hotter, J C . 7 of 69 cases seen in emergency ward for Families displayed a high incidence of Friedman, S B accidents suspected of injury due to' stressfulsituationsattime dfchild's (CD-00488) maltreatment acciden t of 87 cases of suspected abuse in similar survey 6 months later (urveyand evaluation by home visit

15 Holier, J ( .. 19 cases of child abuse from 18 families Families often social isolates, with' few church ties or contacts with social organs . Friedman, S B ((D00489) 0 nations, often new community. Mantal discorq present In majority, unwanted pregnancy played important part in de pression of mothers in 4 families

16 11) man. ( i3 l.dses ot suspected nonai.i.idental in- Abusing parents more doubt concerning fi-D01660) jury, children under 2 years old paternity, more sought termination of Comparison group of 15 cases of known pregnancy, more marital and financial IV accidentalinjury,children under2 problems Abuse occurred more often years old when motherpregnantorwithin7 Questionnairecompleted by health visi- months of last delivery or miscarriage. tors C 17 Kaplurt, D . 112 child homicides under age 15 Severepoverty, illegitimacy of abused Reich, R Postmortem reports, policeinquiry ,re- child, unwanted pregnancy, marital con- (CD.01697) ports. public assistance and child wel- flict,lack of medical care, hostile or fare agency ease records nonexsteni' relationship with. neighbors or relatives associated with abuse. ..." \ V500 children and their families, referred new to neighborhood, 348. Kent. 31' Abusive parents (CD-00562) 1 for direct abuse withotit phone or transportation, few Comparison group of 185 familiesre- fnendsmore complications during preg (erred for reasons other than abuse nancy or bush, 'loth groups poor in such as alcoholism, mental illness, in financial resources. - t , adequate parenting

23 k. 29 t TABLE 6 (Continued) ANNOT1Z.TBFAISTAF STUDIES: SITUATIONAL FACTORS

fah

Reference Methodology Review of Studies ft

> 19. Kushnick, T., 39 abaniioried children seen in metropoli- Limited information available on family Pietrucha, D.M., tan hospital, 6 neglected, 1 abused background indicated larger proportion Kushmck, of poverty, crime, and other disrupting (CD-00586) factors among Parents.

20. Uoyd-Stdl, J.D., 64 cases of ab se andeglectseen at a, Majority of cases related to a combine- Martin, B. rural MostundY3 years of age non of marital difficulties, inadequate (CD-01738) parenting, and economic crises.

21. Lukianowicz, N 26 cases of4aternal incest and 29 cases of Incest interpreted as a subcultural phe- (CD00630) variouto otherincestuousrelations nomenon precipitated by over-crowding found among psyChiatric and child and social isolation. guidance patients

22 Molnar, C 18 incest ,pses, girls 14-J7 years old In all cases marital and sexual relation- Cameron, P. ships of parents dysfunctional (CD-01790)

23 Moore, J G. 2i3 case f violence bet ween,parenti Found a group of children subjected to (CD-01796) emotional battering as a result of perm- te antal conflicts and ensuing cycles of pare tal separation and reunification:

24. Mulford, R M., 1401 holds of 959 families Neglecting parents charactenzed by low Cohen, M 1. Questionnaire distributed to caseworkers motivation, low social participation, and .(CD-01806) with state Society for Prevention of high residential mobility. Cruelty to Children Client Psychosocial Charactenst ICS Form

25. National Society for 25 fariBies referred for treatment because Findings suggest a multicausal model, Prevention of Cruelty of specific abusive incident including mantel discord, social isolation, to Children Retthspective-case study unwant&prignancy, economic stress (CD.01816) k, 26. Oakland, 33 Navajo children, between21 months Neglectful mothers more unmarried with Kane, R L and 3' years admitted to hospital be- smaller families. (CD-00744) t" cause of neglect Age-matched with 49 controls Review Of records

27. Oliver, I.E., .38 severely abused children under 4 years Most of male parents or guardians were Cox, .1.; of age unskilled laborertiad unstable work Taylor,A. Qinical study records. More than half the families had 4 Baldwin, J.A. or more children. (CD-01273)

28. J.A., Jr., 100 caps of child abuse, 3 weeks to 11 Lowsosioeconomicstatus, broken Meacham, WI., years old homes, illegitimacy were associated fac- Briffin, P.P.; tors. Sawyers, J.L. 10- (CD-00743)

ti 24 30 ,a e .. 4, TABLE 6 (Continued) .ANNOTATED LIST OF STUDIES- SITUATIONAL FACTORS I Reference Y Methodology' Review of Studies

29. Paulson, M I , r 96 cases of child maltreatment seen at More documenteJ evidence of abuse in slake, P.R, metropolitan hospital lower economic levels. * (CD-00781)

4 30. Pemberton, D.A , 8 boys and 4 girls No significant characteristics noted when Benady, D.R . Consciously rejected children parents studied individually, marital dis- (CD-01877) Agematched control group cord reported as family characteristic. i

31 Scott, P 6 29 cases in which father or father sulisti- Significant differences in marital status, (CD-008%4) tute Charged with killing his child biological paternity, number of working Compansongroup ofnonfatallyabused mothers . IN babies

32' Segal, R S 32 couples who neglect their children Family interaction -a major determinant (CD-00899) Companson group' of 31 couples who of differences between groups of parents. abuse their children:'',

4, r 33 `Sills, .1. A , 76 childrenwith nonaccidental injury Among features which emerged in associ- Thomas, L I , . seen in an emergericy department of ation with, child abuse were illegitimacy, Rosenbloom, I. hospital younger age pregnancy for mothers, and (CD-01947) Rem* by multidisciplinary team environmental stress factors.

1 34. Skinner, A E , 78 cases of abused children ' Both natural parents living in majority of Castle, R L families, 30 fathers and 74 mothers un- (CD-00938) i employed, financial problem present in 29 families and problems of accommoda- tion encountered in 35% .

35 Smith. S M % 50children, averageage 14 months, Evidence did not indicate that abuse is (CD-00945) hospitalized for "unexplained" injuries restricted tolower social classes or that who showed signs of abuse abused children were unwanted ..-I 36 Smith, S M 1.34 abused infants and children under 5, Lack of family cohesiveness and premap- (CD-01957) and their parents tal conception were significant precursors Comparisonwithmatchedgroup, of to abuse parents whose children admitted as ''emergency cases : . 37 'Tonnes. Y M 20 cases of father- daughter incest . incestuous familiesless time spent in (CD-01018) Comparison gm of 20 cases of non- city, larger families, more young children, incestuous sexual abuse. fewer relatives, lower levels of employ men t, More illegitimacy. i 38 Virkkunen, M . 22 alcbholicincestoffe.nders(father- Alcoholicfamilies.sexual rejection by (CD-02015) daughter) seen at a psychiatric clinic pouse, large families, poor living condi- Corn panson groupoli ,23 nonalcohohc tions. incest offenders seen at a psychiatric clinic . _ 39. Waterway, J. 42victims of sexual abuseor incest More than 50% of families had multiple (CD-02023) referred to Protective Services Unit problems including financial instability Questionnaire and interviews and histories of family disruptions. I

25 TABLE 6 (Continued)

ANNOTATED LlS"c OF STUDIES: SITUATIONAL FACTORS

Reference Mety46 logy Review of Studies

40. Wiffit, B.W. 77 children under ageI referredfor. Abusedchildren.lowsocioeconomic (e -01337) X-rays status, from broken homes. 1 year longitudinal study

41. Young, L. 120 families selected from case files of 2 St(idy foCus was to identify and detail (CD- 02051) public child welfare agencies and 1 recurring behavior in abusive families. pnvate agency handbag only abuse and neglect in a large eastern metro politan area 180 families from 2 rural areas, 2 medium

sizetaties, and 1 large urban area in midwesi,and 1 medium sized city and I rural county on Pacific coast

42. Young, M Groups of recognized ;abusivefamilies Abusive parents significantly more social- (CD-01345, drawn from public nurse caseloads ly isolated, fewer friends outside family, . CD-01346) Companson group of caseload families fewer persons to turn to in times of with no history of abuse stress,lesscommunicationbetween Questionnaire to public health nurses spouses, greater feelings of powerlessness. Psychological testing of parents (Rotter's IE Scale and FIR013)

26 32 4, TABLE 7 1 , . ANNOTATED LIST OF ONGOING RESEARCH STUDIES: SITUATIONAL FACTORS

. _ Reference" Researeh.Purpose 'Methodology

1 - li Bentley, R J Identify stressful conditions and institu- Data obtained, from court records, police (CR-00008) bons which,' impacting onthe black filet, and Dept. of Human Resources. community, may lead to child abuse. Study population450. families(ISO Isolate dominant familial characteristics known abusers, 150 in agency files for involved with child abuseDescribe po- other reasons, 150 normal families), tential correlations which may illuminate child abuse vanables i , . t. 6I Burgess. R I_ DeternSzLewhether specificuiteraction Observations made in homes of abuse and

(CR-00021) 1 patterns distinguish child abusing families neglect, and matched control families. from nonabusing families. Behavioral Observation Sconng System adapted for data collection.

3 Geismar. J . Clanfyfactorswhich, interacting with 380 abusing families compared with 144 Hornwitz, B , poverty. may make families more likelY nonabusing (miles. Wolock, I to abuse or neglect their children. (C1O0059)

4 Lewis, M Investigate effects of birth order, sex, and Observation at home for 2 hours when (CR-00102) sooe..onomic status upon motherinfant infant is 3 months old. At 1 and 2 years, . interaction, and upon psychological de- infants and mothers videotaped in labo- velopment of infant up to 2 years . ratory. 200 infants and families frpm 2 economic groups

5 Money, 1 . Develop a phenomenological account of Case history analysis, patient and family Werlwas, J behavior infamilies with children suf- observation, interviews with persons cone (CR-00115) feringfrompsychbsocial dwarfism to nected with the _patients. determine etiological factors related to child abuse

6--)Stars,R H , Jr Determine ...ausal and correlative factors 210 families (90 abusingbr neglectful, 30 (CR-00142) in child abuse and neglect mothers entering methadone treatment progra9i, 90 matched controls). Children less than S years old.

) I 4

27 33 .0."/ Attitudes and Values attitudes include beliefs about the parent-child relationship, attitudes about the different roles that family members should assume, the value of Attitudes, values, and beliefs play an important these roles as perceived by other family rriembers role in shaping the behavior of parents, children, and by society . attitudes about others who may be and families. Each individual is constantly, shaping involved in child-tare, and finally, attitudes about and reshaping his own personal view of life. how family members relate to one another, such as selecting, deve ping,andmterpre ngthose the way in which feelings may be expressed or the attitudes and v s that are salient r him. Of appropriateness of corporal punishment in course the sophisticon and consciousness of this changing a child's behavior process vanes widely froperson to person

This internal process is largely a response to the The following pages present an annotated individual's exposure to the attitudes and values of listing of five completed and two ongoing research significant others in his life, such as the mepibers studies which consider the relationship of attitudes of his family and his immediate peer or reference and values to child abuse and neglect. 'These groupIn addition, each person is affected by his studies were selected for inclusion in this section perception of the attitudes and values of society at for one of the following reasons( I ) the purpose large pnmanly as expressed through the media and of the study was to investigate the relationship of through the social and political institutions that a particular attitude or value to child abuse and tofu .everyone. Any one individual, therefore, is neglect, or (2) regardless of study focus, the Elected by attitudes, values, and beliefs emanating of findingsdealt with attitudes and from a variety of sources values

Thus the context of attitudes and values within which individuals and families exist is These studies are listed alphabetically by author multidimensional Eachlevelinfluences andis and fullcitations are given, in the bibliography influenced by every other levelFor example, a beginning on page 64 The methodology of each familydevelops a set of attitudes reflecting a study is described in as much detail as possible. blending of values of individual family members including sample size and characteristics, control In turn the family's values may or may not be or comparison group if mentioned, and means of congruent- with those of its immediate reference data collection, where known In addition. all group Further, if this group represents a particular relevant information provided by the abstract on minority or special subculture,. its values may not attitudes and values can be found. under the be reflective of broader societarvalues Dissonance heading "Review of Studies." Study findings are or conflict between attitudes and values at any noted where available, if no findings are noted in level may create stress for individuals mid families. the abstract, those attitudes and values dealt with in the study are reported In this review, the attitudes, valuds, and beliefs that are relevant to child abuse and neglect are divided into two major groupsattitudes toward children and attitudes toward the family Methodology. The samples infour of the completed studies reported here were drawn from Attitudes toward thildtrn include thevalue nonabusive populatiohs including representatives placed on children in general, based on a view of of variousprofessional groups, middle-Class the child's position, role, and status within his families, mothers of five-year-olds, and couples group, attitudes toward uniquecategoriesof who married young. Home observation was used children,beliefsabout determinantsofchild to collect data in two studies while three studies behavior and personality characteristics, attitudes used a questionnaire with a professional group about the ageat which a 'childis considered involved in child abuse and neglect. competent tolearn and reason, before which attempts to modify his behavior would not be Review of studies. Most of the completed fruitful.and.attitudesaboutage-appropnate research dealswithchildren'sbehaviorand behavior appropnate means of modifying it. Four of the studies sought information' on attitudes toward Expectations about family life, family punishment. Three studies reported findings on relationships, andthe role and status of each the parental expectations of children's behavior family member constitute the set of beliefs and There was tittle research on expectations of family attitudes tufted the tamilithat are relevant to life,family relationships. and roles of family child abuseand neglect Specifically,these mem ben'.

.3 Ongoing research srudies. Unrealistic or ngid information onchild abuse in the context of expectations on the part of the mother are the physical violence in general. subject of one study, while the other sought

TABLE 8 ,- ANNOTATED LIST OF STUDIES: ATTITUDES AND VALUES

Reference Methodology Review of Studies

1 De Lissovoy, V 48 couples married while stillin high Unrealistic expectations of devejopment (CD-0 I 520) school associated with physical punitive mea- (1. Home visits over 3 years sures.

2. Dolder, S.J L 120 pediatricians, social workers, police- Study focus. differences among groups (CD-01532) men, teachers, middle-class working regarding attitudes ,toward punishment adults, and high school teachers and behavior of parents. Questionnairerating punishmentincl. dents

3. Sears, R R , 9 mothers of 5-year-olds Study focus. relationship of child's level Maccoby, E.E , of aggressive behavior, degree to which Levin, H mothers permitted such behavior, and (CD-00897) seventy with which they punished it.

4. Smith, S.M , 134 abused children under' 5 years old Abusive parentsexcessive in maternal Hanson, R. and their parents over-involvement, demands for obedience, (CD-01959) Control group of 53 children admitted as and use of physical punishment. accidental emergenciesand their parents Hospital and home observation Psychiatric, psychological, and sociologi cal interviews Questionnaires

5. Straus, M.A., Study focus: violence in the family, what Gales, R.J.: constituteslegitimateandillegitimate Steinmetz, S.K. violence. (CD-01317)

29 3t t..1 ; $ TABLE 9 r 'ANNOTATED LIST OF ONGOING RESEARCH STUDIES. ATTITUDES AND VALUES

h Reference Research Purpose Methodology

t. Egeland. B., Identify high-nsk situations for abuse and Prospective longitudinalstudy.Child- Deward, A. neglect by studying characteristics of rearing attitudes and expectations of 225 (CR-00046) newborns, interaction of mothers and mothersobtainedprenatally and 3 infant in 1st year investigate hypothesis months after birth. interactions observed that in situations where mother's expects- at3,6,and 9 months, andinfant ions are unrealistic and ngid. interaction attachment to mother studiedat 12 patterns will place child in high-risk situa- months tion \ . 2. Straus, M A,, To studychild abuse within context National sample o( 2,143 families inter- Genes, R J , of all uses of physics violence in family. viewed for data on frequency and modali- Steinmetz, S.1( Test subjective meaning of acts of vio- ty of violence (CR-00 I 45 ) lencetothoseinvolvedTest theories .) about etiology of intrafamily violence

I.%

$ ' Social Insittunonal Factors provide cultural and recreational opportunities for itsniembers.Basicsocialinstitutionsinclude politicalstructures,economicstructures, and Social institutions exist for different purposes integrative structures, such as community and on different levels At the most universal and organizations, schools, and media. general level are basic institutions that express the purposes and embody the values of a society .and $ c shapethelivesofallitsmembers These Social service and social control institutions are institutions are significant for all families arill form assigned to provide those general human services the underpinnings without which no societ) would 1 that may be needed at one time or another by all function. members of the community, and to deal with specific problems in our society. Included here At another leVel are social service and social would be institutions such as health and day care control institutions that exist to serve the needs of facilities,aswell as those dealing with child rfamilies. Such institutions are numerous and can welfare, "drug and alcohol abuse, mental health, rendei venous' forms of help. relief, and care to unemployment, and poverty. parents. children, andjamilies. They range fiom educational and health Institutions that are used.at . one .time pr another .byallfamilies to those ,instinitions that directly' intervene to protect or Individuals and families may and do avail chant the behavior of individuals and families themselves of such services voluntarily. But in some cases society decides to intervene directly to With specific social pioSlems., .

1 change. individual and family behavior which is In thii review, social institutional factors are deemed deviant and to protect family members dividedintotwo major, groupsbasicsocial who are seen to be at risk, especially children. In iristiNtmes lindsocialservice/socialcontrol thesecasessocial -serviceinstitutions become institulthns,' /. institutions of social control. In addition, society hasestablishedspecificinstruments of social Basic social institutions are responsible for the controllaw enforcement . -and legal general welfare 6f 'individuals and communities, institutionswhich also have a role to play in . They assign andcarry out society's tasks, express ameliorating or ehminating,inapproPriate behavior and help shape itscivic and social values. and 'of individuals and families. 30 I, 30 e ,...... :0' , i A . 1 k ), The following pages presentanannotated MethodokigyThicatent of completed research LA wars; i listing of 21 completed and 11 ongoing research relatedtosocialinstitutionalfactors to studies focusing on social institutionalfactors analyze the effectiveness of a particular system. related to child abuse and neglect. These studies. Thus. the samples studied ranged from a single were selected for inclusion in this section for one % h i I ki protective program to an.sentiro state system of the foUcitving reasons(l) the purpose of the or even child 'protective services in all 50 states. study was to investigate therelationship of a particular social or institutional factor to4. hall . Methods ofdata collection incitided analysis of abuse and neglect, or (2j regardless of study focus. program records, interviews with staff, and in one a substantial proportion of findings dealt with study, interviews with clients. . social or institutiol factors Review ofstudies Only two studies deal with basic 4ocial institutions. Both studies focus on the policiel, n.rocedures, and reguiitions of These studies are listed alphabetically by author educational systems as they relate to child abuse and fullcitations are given in the bibliography and neglect. beginning on page 64 The methodology of each :-.) study is described in as much detail as possible. Allothersstudies focusonchild 'protectik including sample size and characteristics. control service systems needed and available services, and or comparison group if menttened, and means of theeffectiveness and efficiency ofsystem datacollection, where knownIn addition,all operations c relevant information provided by the abstract on social and institutional factors can be found under Ongoing research studies.General social skrvice the heading "Reiuew of StudiesStudy findings and social support systems are under study in JO arenoted where available,ifno findingsarc projects as well as case dispositions in a police indicated in the abstract. those socialor department, role of the educational system, the institutional factors dealt with in the study are juvenile court system, and a military community reported system's management of abuse and neglect

)

411

31 it 3", i \.,--: t TABLE 10 ANNOTATED LIST OF STUDIES: SOCIAL INSTITUTIONAL FACTORS 4o-

Reference Methodology Review of Studies

I. Barrett, L., II demonstration projects of joint OCD- in general, average expendituhrincreased Fro Lind, C., SRS National Derdonstration in Child 20% between Oct. 1975 and April 1976 Cohn, A.R.; Abuse and Neglect while program hours expended remained Colligrion, F.C. i stable.Comparativetablesillustrating (CD-01387) Descnptive analyses.of project's resource unit cost trends appended, index of rela- allocation tive cost efficiency of projects and factors associated briefly described.

2. Billingsley, A., 3 studies' 1. Cases dint did not warrant legal action Giovannoni, J.M., participantobservationstudyofa and lack of coordination between legal Purvine, M. protective service systen1 add welfare authorities were problems (CD-00979, questionnairetoprotectiveservice in protective services systerii. CD-01407) social workers in 9 public agencies 2. Organization and functioningofa comparison of abusive and negltful department is more important than families with normal family size of case, loads ,and education of individualworkerS, forces within a community aln lead to trends ininter- vention rather than to intervention based on the individual client's problem. 3. Protective services should be concep- tualized as comprehensive community servicestochildiinintheir own homes, since theseimifies are apt to be in need of a mu)iplicity of services., 3. Burns. A., Chid abuse and neglect reporting meth-Cntena for identifying an abuse or sus- Feldman, M., ods and procedures in one county pected abuse case varied for each indivi- Kaufman, A., dual. Most hospitals did not have a policy Stransky, P. Questionnaire directed to personnel'in 6 for delineating guidelines in suspected (CD-01440) hospitals and personnelin County cases. Little cooperation between various Departmentsof. PublicHealth an agencies. Knowledge of abuse and neglect Social Service .... as health and social problem inadequate and inaccurate. 4. Burt. M.R., 1,200 cases of county child welfare agen- Program shortcomings included unneces- Blair. L.H. cy sary abrupt removal- of children from (CD-00154) Case records families; routine filing of neglect and dependency petitions, failure to prevent neglect, abuse, or dependency, duplication of effort by several agencies, lack of 24-hour emergency services.

5. Dawe, K.E. 59 cases of child abuse i Problem areas uncovered in the retrospective study included inadequate intake 1CD-01507).,., Retrospective study of medical, Suwai, or court records records, lack of awareness of the prob- Survey of I ,000 physicians, lawyers, social lem, insufficient diagnoses and follow workers. nurses, teachers. police, jour- through. lack of coordination in record nalists, clergy keeping.Recommendationsfromthe study includeda central registry, standardized reporting procedures, augmenta-

1 tion of child welfare agencies, establish- 1ment of child advocacy of9ce.

32 3d . TABLE 10 (Continued) ' a

ANNOTATED LIST OF STUDIES; SOCIAL INSTITUTIONAL FACTORS

Reference Methodology Review of Studies . 6. DeCdurcy, P.; 13 cases of child abuse No effective remedial action taken in any v). . DeCourcy, J. . Case study of 13 cases because of intaequacies of (CD-01521) courts. and social agencies.. A .1. 1. De Francis, V. 9000 cases of sex crimes against children Findings of project designed to study ,(CD-00252, also Review of case records effectiveness of a child protective service- reported in program extended to child victims of CD-01 516) sexual crimes reveal little intervention on behalf of children vulnerable to sexual abuse: 50% of affected households had prior contact with welfare authorities.

8. De Francis, V Child protective services in 50 states Program was grossly underdeveloped, no (CD-00251) Survey state or community had a program ade- , quate in size to meet needs of all reported cases of abuse and neglect.

9. DeGraaf, B.1 275 cases in 11 demonstration projects Findings reported on case management in (CD-01522) child abuse and neglect cases from intake and diagnosis through termination and follow-up.

10. Education Commis- 390 edu..ational groups and institutions Moststateboards of education, state ., sion of the States Phone and mail survey departments of education, institutions (CD-01545) did not have policies. procedures, or regu- lations relating to child abuse and neglect

' 11. Hammen, R.L. State school system Few school districts had written ct,ild (CD-01633 Written inquines abuse policies, administrative procedures, or in-service training. A 12.Johnson C.L 2 county protective service units Both systems impeded as a result of state . (CD-01681, Collectionofdataon various agency of their relationship with collateral sys,:- CD-016 83) functions terns, especially hospitals`wkich fell short,'ti in channeling child abuse and Neglect cases. In both systems, the record Jteepuig system was an impediment.1 .. , . 13. Maden, M.F. Reported child abuse victims Findings show that cases utrestigated by (CR-01752) . .c.,7 social service agencies comPared with law enforcement agencies are/less likely to result in removal of victiMs from home, more likelyto receive "socialservices, more likely to invoke community action ) for perpetrator. Joint investigation more likely to result in removal pf child and referral of family for services a i N.. a / ., ), 1 A 33 39 I 4,

TABLE 10(CoAnued) . ANNOTATED LIST OF STUDIES: SOCIAL INSTITUTIONAL FACTORS

Reference Methodology Review of Studies

14. New Jersey State Analysis of state child abuse and neglect An estimated 80% ofpopulationof Div., of Youth and treatment services abused and neglected children received no Family Services assistance from state Division of Youth (CD-01256) and Family Services. The most serious deficiency in treatment system is the lack of programs to help develop and improve parenting behavior and skills.

1$. Pacheco, C. Analysts of 15 child abuse and neglect Severe problems of a high professional (CD-01862) programs in a metropolitan area turnover rate, tignificant deficiency in numberofproperly trainedsocial workers, overworked city and state ap- pointed attorneys, insufficient training for Juvenile court Judges and law enforcement personnel. Insufficient professional exchange of information, too few prevention programs, no printed material for Spanish-speakers, reporting system does not encourage reporting, duplication -of effort in identification and treatment.

16. Queensboro Society Analysis of ounty, prevention, protec- Analysis duplication of services, omission forPreventionof tion, and treatment services of some services, in general an unplanned, Cruelty to Children, 1n-depth study of 3 randomly selected uncoordinated system of care. Study of Inc. cases leaders, directors, and workers, duplica- (C'D-01899) Structuredinterviews of 21 leaders in tion of services not a problem but coor- field and 166 directors and front-line dination heeded in prevention and re- workers habditation.

17. Silver, L.B., Hospital and agency records of 34 cases Only intervention effective in preventing Dublin,C.C., of abuse further episodes of ..abuse or neglect was Loune, R.S. Retrotpectivi analysis removal of child by court. (CD-01949)

18. TennesseeState Analysis of needed

19. Teri, L.C., Analysis of medical and legal records in Numerous proceduraldefects in both Watson, A.S. 10 cases of suspected child abuse medical and legal institutions designated (C D.01003) to deal with suspected child abuse.

34 4'

TABLE 10 (Continued) . I ow, ANNOTATED LIST OF STUDIES: SOCIAL INSTITUTIONAL FACTORS

Reference Methodology- -Revkwyf 'Studies

20. Varon, E. 13 former clients of private agency Former clients and non clients knew little (CD-02012) 50 tionchenrs from same neighborhoods or nothing of inner functioning if social tRelevant agency and nonagency professagencies or their place in social structure. . sionals ti Interviews

21. Webber, D.N. Analysis of state specialized child protec- Study focus. referral movement, referral (CD-02030) tive service program sources, reasons for referral and reasons for rejection of referral, caseload movement, public assistance status, numbers and types of social services provided, and masons for clfosing cases. J.

r ti

AID 1.4y 4o.

354 C.

TABLE It

ANNOTATED LIST OF ONGOING RESEARCH STUDIES SOCIAL INSTITUTIONALFACTORS

Reference Research Purpose Methodology

I. -Bohnstedt, M. Corielate charactensucr of child abuse 1500 cases reported to police department (CR-00010) victims and parents with case of large western U.S. city. dispositions.

2. Curry, D. Ascertain levels of awareness of abuse Home interviewsofadult male and (CR-00032) and neglect and child rearing practices female members of black community in amongblackcommunity.Identify 14 cities. Interviews with representatives services provided and areas of need in ofsocialservice agencies,schools, venous agencies dealing with abuse and hospitals,.,a criminal justice neglect. departmentsin2c' identify services. FS?. 3. Dines, J.13. Evaluate and improve components of Survey research utilizinginterviews, ICR.430039) state case identification. Design and test questionnaires,and case readings. methodologiesforprotectiveservice Experimental research design used ;, needs and resources assessment. Design models for services identified needed for prevention and treatment

4. Garbanno, f Invegtigatefunctionofformaland Analysis of data from 93 census tracts to, (CR-00058) informal support systems in mediating determine ,high- or low-risk stresses -which instigateabuse ,and neighborhoods. These provide contexts neglect.Determine whether isolation forassessment of familystresses and fromsocialsupportsystemsis a supports by an iritervie0 technique, the necessaryconditionforabuseand Family Support' System Interview, and neglect Holmes-Rahe Social Readjustment Scale.

Jones, C. D., Develop and recommend alternatives Trend analysis on data -collected from Fox, P. regarding role of educational system in state and localBoards of Education, (CR-00088) identification. treatment, and prevention PTA's, and other educationalorgani- . , of childabuse and neglect. Increase zations. Research on teacher education 'awareness in these systems and among and preparation in area of abuse. state.decision makers. -Ent ourage participationamong service 4delivery systems.-'

6. Mani)+, k C. Develop and report understanding of M dels contrasting componentsof Gaughan, M. thoseprofessional ,bureaucraticand p fessionally ideal system with those of (CR.00107) political processes which affect etropolitancommunity'scustodially deinstitutionalizationofchildcare oriented,syslem NflevelopectPrincipal systems. method participant observation. ' 4 7. aceathrenR Investigatedecision makingfor and Data collected via observationof juvaide (CR-00111 disposition of child abuse anneglect courthearingsandinterviewswith 'IP by socialservice and juvenilecourt attorneys, 'judges, and social workers. systems. Design and draft administrative Attitude surveyf administered to direct andlegislativereforms.to- improve line social workers 1rd attorneys. Survey system of children under hate detention care.

36 4".4 . ... TABLE 11 (Continued) ..

ANNOTATED LIST OF ONGOING RESEARCH STUDIES. SOCIAL INSTITUTIONAL FACTORS

. Reference Research Purpose Methodology .. 1

8. Nagi, S. Z. Gain nationally representative analytical Intensive interviews with professionals in (CR-0011 7) picture of reorganization of services and agencies and programs serving, a iirobabd- b- ir control- Mechanismsconcernedwith ity sample of U.S. population. childabuse andneglect. Identify limitations and strengths in structure and performanceof these programs. ) Prepare recommendations for improving' identification and control.

9. Pelton, L. H. Ascertain subjective realities of natural Unstructured interviews. 50-100 parents. (CR-00122) parentsinvolvedinchildabuse and Interviewees screened from random neglect cases, and their views of child sample of Non-Work Incentive cases. welfare agency, caseworkers, and 4 Services.

10. Steen, I., Policy study of a military community's Structured survey of military and civilian, blarisy, M. responsetoproblemof abuse and childadvocacypersonnel.Description (CR-00144) neglect. and statute analysis.

I 1. .. /14. N

1 1 i,,,..-..

...I

;

I .. C

e . . 37 43 OP . .

V. PREVENTION AND TREATMENT

In the preceding section of As review, those Later programs recognized abuse and neglect as research studies which identified factors that may patterns of interaction involving both parent and contributetoormitigatea?ainstabusiveor child. These programs focused on the family unit. neglectful behavior were considered. This section At the same time, it was generally accepted that witreviewresearchOnthepreventiOn and no one treatment method was sufficient and that treatment of child abuse and neglect. As the causes most abusive situations demanded a range of of abuse and neglect are many and complex, so are services, both to relieve the immediate cnsikand to Methods of prevention}, and treatment. provide long-range help. Theoretically,for .eier cause there exists ah effective means of alleviating the situation that At present, numerous treatment models and caused the deviance, thus, theiaroposed theories of strategies are being used throughout the country, prevention and treatment Ste the logical outcome including therapeutic intervention, the extended of the identification of these causaiive.factors. family center, foster care, behavior modification, family advocacy, and other support services. Prevention and treatmen tprograms can be categorizedasprimaryprevention, econdary prevention or intervention;.and treatment. Since - thesecategoriesrepreserfta. continuumof prevention and treatment efforts, and since some programs may well incorporate elements of each Primal); Prevention of these categories, it is often difficult to'assign programs to ode or the otber of thesevategones. For purposes of tireview, pnmarx prevention none ofthecompletedresearchstudies' will be defined as preventing abuse before it occurs currently contained in the NCCAN Clearinghouse and will include those efforts that are available to databalehasaddressedissuesofprimary . the population in general, such as education for prevention as a primary research focus. parenthood programs, community hotlines, and familysupportservices.Secondary prevention One ongoing study (CR00132) is testing the includesthoseeffortsduettedathighnsk hypothesis that health personnel might contribute populations which might abuse or neglect them toprimarypreventionby providing increased children unless given help, Treatment includes support for maternal attachment and maternal care. In thisstudypregnantwomenare those services targeted toward the known abuser S. or neglecter in an effort to.ameliorate whatever interviewed in their ninth month and after delivery was the cause of this behavior and to prevent its are assigned to one of two groups. One group recurrence. receives routine hospital care, while the other recei.....244early or tended contact with the infant Of the substantive areas being considered in this in the hosPM andfrequentvisits by review, nonehas, produceda -largerbody of paraprofessionals trained to facilitate attachment information than treatment. Public attention has and bonding. been focused on the problem of child abute and negler4bydramaticnewt account, andany increase in federal meanies, particularfrom the National Center on Child Abuse end Neglect, has givep rise to numerous strategies for treating both abusers and the abused. f Secondary Prevention Initial efforts which sought punishriA or the perpetrator gave way to treatmen'( r ans of traditional clinical treatment rot,* social Tables ,12_Juid13presentan annotated work practices. The child was conagaied a victim listing of four completed and six ongoing studies andreceivedprotective seEvias:ipdssiblywas. which focus on secondary prevention efforts. Of removed), medical care, aqd little elst. Treatment the cgrgpletedresearch, one study examined success wits measured in firms of re"vism rates preventionstructures in various

. a

38 44 It European countries, the other three reported on comprehensive, multidisciplinary approach to the screening methods used to detect parents with useof drug therapy. These studies arelisted potential problems in child rearing or to analyze alphabeticallyby author and full citations are known abusers to develop Screening methods. given m the bibliography beginning on page64. The mode of intervention used in each study is These studies are listed alphabetically by'author descnbed in as much detail as possible under the and fullciltations are given in the bibliography heaxling "Tye of Treatment." The methodology beginning on page 64. The methodology of each of each study is described in as much detail as study is described in as much detail as possible, possible including sample size and characteristics, including sample size and charactetstics, control control or comparison group if mentioned, and or .companson group if mentioned, and means of means of data collection,whereknown. data collection, where known. In addition, all Abbreviations for standardized psychological tests relevant information provided by the abstract on wereused wherever possible, a key19 these preventioncan be found undertheheading abbreviationscanbe found on page64.In "Review of Studies." addition, all information provided by the abstracts on the outcome of treatment interventions can be found under the heading "Review of Studies." MethodologySample size of the completed studies ranged from 33 abusive parentsto 500 Type oftreatment. A wide range of treatment mothersto the clientele of prevention pfograms approachesisrepresented m thecompleted throughout Europe. Two studies developeda studies, most of which directed their efforts to predictivequestionnairewhileathird useda changing parental behavior and/or attitudes. Three standardized test instrument Studies mentioned specific therapeutic activities targeted toward the child. Several studies dealt -Review of studies.Two studies reported that with the family unit offering both therapeutic severe punishment in childhood was predictive of and /or supportive services One study evaluated laterabuse,other, predictiveitemsincluded the use of drug therapy. problems of self-esteem, conflict with authority, and concern with isolation MethodologyThe completed studies used a vanety of methods to try and assess effectiveness of treatment intervention, including Ongoing research studiesFive of the six studies questionnaires,intelligenceandpsychological focus on secondary prevention and are developing testing, and comparison of program records. predictivevariablesor . screeningprofilesof Review of studies tughrisk families Theremainingstudy is Three studies reported on evaluating the feasibility of using the extendedow systematic evaluations of total program operation, family in solving the problemofchild ' including cost-effectiveness, realization of program maltreatment goals, and administrative effectiveneswas well as treatment irripact.The others concentrated on assessing effectiveness of treatment. In general, results are reported in terms of improvement in familyfunctioning, self.imageofparents and children. and children's IQ level. Only two studies reported recidivism rates as a measure of program impact. Treatment Ongoing research studiesThe effectiveness of vanous treatment modalities, such as psychiatric Tables 14and 15 presentanannotated treatment for infants, volunteer lay therapists, and hsting of 31 completed and 12 ongoing research therapeuticplayschool,isunder studyin11 studieswhichfocuson awidevarietyof projects. Larger research efforts assess the impact treatment tntervenuons ranging from a of a number of demonstration projects.

39 5- , ll TABLE 12 $ ANNOTATED LIST OF STUDIES: SECONDARY PREVENTION

Reference Methodology Review of Studies

1. Council of Europe Examination of secondary prevention Individualpreventiveactionmethods (CD-01496) structures in, Austria, Belgium, described include family guidance and Denmark, Germany, France, assistance agencies, child guidance Netherlands,Norway, Sweden, Great centers, economic and housing assistance, Britain and children's homes and youth camps; group efforts includesocialwork in asylums forthe homeless and youth clubs.

2. Helfer, R. E., 500 mothersfromvarioussocio- 100 thought to fall in high-risk category Schneider, C. economic levels with low parenting skills.- These mothers (CD-00464, Questionnaire screeningforunusual had higher than reasonable expectations CD-00887, rearing practices forthe child and more self-righteous CD-01938) attitude toward punishment; felt more unloved, criticized, and isolated; and had prevailing feeling of hopelessness, despair, and depression. Most heavily weighted item in prediction of abuse was response indicatingviolentpunishment of the motherbyherparents.Singlebest predictiveclusterhadtodowith problemspf self-esteem. At present questionnaire must be considered as a research tool or screening instrument, the number of false negatives or false positives to bg pxpected has not yet been determined. Future uses of questionnaire may include gathering diagnostic data, identification of families at risk, and perhaps determining degree of success of treatment. "Li

3. Paulson, M. J., IS males and 18 females as pri,riary Male abusers far/eremore hedonistic, Afif, A. A.; abusive parent self-centered, sispicious, and in conflict Chaleff, A., Discnminant function analyses of MMPI with both parental and societal demands Liu, V. Y.; Clinical interviews, medical history more often than normal males. , Thomason, M. L. ,Female abusers Manifested (CD-01278) counterculture behaviors bringing them into conflict with authority. They were alsosuspicious,distrustful,concerned ever motives of their peer group, and iv:Wu'. of hurting themselves and others.

4°4 TABLE 12 (Continued)

ANNOTATED LIST OF STUDIES: SECONDARY PREVENTION

Reference Methodology Review of Studies

Schneider, C.; --.30 known abusers Abusing parents reportedsignificantly Helfer, R. E., Companion groupof 30 nonabusers MOM severe physical punishment in their Pollack, C. matched on parent age, education, childhood, more anxiety about dealing (CD-00818) socioeconomi t.status,number of r'withthenchildren'sproblems, more children, with a child of same age as concern about being alone and 'isolated, the child who had beyn abused more concern with cnticum, and higher expectations for performance of their 'children. 5 different personality types were found, 2 . nonabusing and 3 abusing.Scores misidentified 2 false negatives and 6 false positives.

41 fi s TABLE 13

ANNOTATED LIST OF ONGOING RESEARCH STUDIES: SECONDARY PREVENTION

Reference Research Purpose Methodology

1. Alger, M., , Identify newborns and parents at high Screening mothers for psychosocial stress Uohara, B. . risk of abuse. Demonstrate feasibility of factors. Interviews conducted for mothers (CR-00002) early intervention technique. identified byfirstscreen.Pre-and posttesting of mother-infant mteitetion will be conductdd. Sample: 30 children and 30 (am* units.

2. Bermea, M., Test and evaluate feasibility of using Data compiled from general care profiles, Moreno, H. extended family in solving problem of extensive followup at home and at work. (C R -00009) child abuse. Determine extent of-abuse and neglect in migrant community. -

'3. Brotman, R., Develop predictive vanables for use in Comprehensive screening,case reviews, Zarin-Ackerman, J. preventive counseling of young families. 2year developmental assessment of (CR-00016) infants born into program, parental rating scales. 71 adults with natural comparison groups from intake representation.

4. Gundy, Develop and vaLdate risk identification Members of support group will complete ' Krell, ' for use in newbom and prenatal nursing questionnaires before and ,after 6-month (C R -000681 Evaluate support group. period. Scales for nsk identification will

be validated. A.

S. Helfer, R.E. Assess rehabihty and validityof Concilrrent validation.measured by (CR-00072) Michigan Screening Profile of Parenting. comparingothermeasures.Reliability Develop. and refine new scoring studies performed utilizing a test/retest techniques and instrumentation. method. Data gathered by participating field study groups.

6. Stephenson, S. P. Evaluation ofeffects ofvanous 24 children and families. Randomly and (C R-00143) preventive mental health techniques on secretly assignedtoexpenmentalor high-risk children and their families. control groups. Initially evaluated= medically, developmentally, and psychologically. Parental' Attitude Research Inventory, Cattel Infant Test, PiagetObjectScale,PeabodyPicture,,' 1 Vocabulary.Reassessment made 2-21/2 " years later.

42 43 TABLE 14

ANNOTATED LIST OF STUDIES: TREATMENT S wi

Reference Type ol Treatment Methodology Review of Studies

1. Armstrong, K. L, Extended family center Evaluation components Evaluation findings included Cohn, A. H.; (EFC) - assessment of service im- improvementincertain as- Collignon, F. C. pact pects of family functioning, (t D-01369) - assessment ofprogram such as self-image, awkreness goal realization of childdevelopment, and - assessmentofprogram ability to express anger; little costs difference in terms of reinci- descnption ofprogram donee between EFC and other operation treatment programs; difficult ty on thepart of families adjusting totermination of servicesbecauseof depen- denceoncentersupport; avoidance ofstigmatizing clients.Gradual termination of treatment recommended.

Bates, T , Heal thibase d.multi disciplin- Analysis of 9 multidisciplin- Found fewregularlyfunc- Elmer, E., ary pro nth ary health-based programs tioning, health-based, multi- Delaney, I selectedforgeographic, disciplinarytreatmentpro- (CD01388 demographic, and meth od- grams. No program knew how °logic diversity many other programs existed On-sste visits, 5gestionnaues or where they were located. Most programs modeled after HelferiKempe descnption of multidisciplinary teams.

3. Beezley, P. Psyctotherapy, play therapy 12 physically abused children Children who remainedin Martin, H. 4)., once or twice a week for SO aged 3.8.8 years therapy for a year displayed Kern pe. R.1 minutes Cognitive, speech-language, increased abilitytotrust (CD-01395) neurologic testing adults, delaygratification, and verbalize feelings, as well as increased self-esteem and increased capacity for plea- sure.

4, Behavior A6sociates Self-help Evaluation components. Findings for first 2 years of (CD-0139) - documentation of program Parents Anonymous project goals are reported. - collectionofdescriptive information about personnel - analysisof processesin chapter functioning - measurement of program impact

43 49 IA

6.0

4 TABLE 14 (Continued)

S ' ANNOTATED LIST OF STUDIES: TREATMENT

' - Reference: Type of Treatment Methodology Review of Studies

5. Berkeley Palming Joint OCD-SRS National Evaluation components Projectswhosegoalswere Associates . , 'DemonstrationinChild - project goals most successfullY realized hid (ep-0140a) Abuse and Neglect - costs ongoing agencyas sponsor Multidisciplinary - case management which was already a primary - adult client charactensticsservice provider and was well - child client charactenstics coordinated and admini- - communjty system char- stered. actensncs Factors contributing' to comparative cost efficiency: - largertotalexpenditures - larger totalstaff increased hours per staff - smaller proportion of ex- penditures for project activities - wider variety of services provided Key problems related to case management. - poor records - inconsistent supervision, - lack of training - inadequate clientpartici- pation 41P Less than half of all adult clients had reduced potential for abuse or neglect at termination of therapy. Findings regarding children were also observed.

6. Burt, M. R. Comprehensive emergency Comparison of program re-Program objectives were met (CD-01442) services cords for 1069-70 with those at a substantial reduCtion in - emergency intake for 1973-74 cost. - emergency caretaker - emergency homemaker mergency foster homes 4-4 7. Daniel, I Two, interventionmodels Descriptive, case-conic.g1 Both programs showed pro- Hyde, J N Parent Education Programs study of families whose chil-mise after ,1 years of expen- (CD-01147) - therapedpc teachingdren exhibitthe effects of ence.. sessions fdr mothers for pediatric social illness such as 12-14 weeks child abuse, accidents, inges- Family Advocacy Program tions, failure to thrive - provide services-to families while developing new modes of intervention for working with families ( 6

44 '50 TABLE 14 (Continued)

ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review or Studies

O. Ephross, P. H.; Hospital-based multidsciplui- Evaluation by. While a large proportion of We an, L. A. a ry approach with administrativeassessment theparents had treatment- (CD-00189, pediatrician,socialworker, dudin g staff interviews resistant sociopathic person- CD-01550, nurse, psychiatrist, and and review of case files alities, jibe projectstill en- CD-01151, community aide - interview;_with 3 families joyed a'high successful treat- CD-01552) - questionnaires ment rate. The project team approach demonttrated effec- dieness indealing with all types of parents, including the emotionally disturbed.

9. fanshel, D. Foster care 624 children infositrcare Children who entered care (CD-01556) 5-year longitudinal study of due to own behavioral or parent*visiting patterns emotional disorders received higher level of parental visits. 1 out of 3. children in the neglectorabusecategory were visited by a parentriligh parentalvisitingcorrelated wellwithdischargerates, particularly duringearlier time periods of the study.

10. Galdston, R. Day care for abused children Resultsobtainedwith23 (CD-00351, Directed group sessions for families and 42 children over CD-00352) parents 2yearsaredescribedin detail. 4a. 11. Hoffman, D. L., Crisis psychotherapy A system of planned short- Remmel, M. L. term therapy is described and (CD-01206) evaluated.

12. Jones, B. M. Homemaker services in times 144 children in 29 families Findings. (CD-00532) of cnsis received services over a 1-year - separation avertedin 142 period cases - 2 children paced in foster homes ha"me to prepare for place nt - generally improved pattern of family living - program vastly more ec- onomical than placement

ger TABLE 14 (Continued) ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

13. Jones, M. A., Intensive familycasework year evaluation of 9 demon- Intensive family services were Neuman, R., services, emphasizing stration programs serving 549 effective in avertingor Shyne, A. W. increased casework cases involving 992 children shorteningplacentent,and (CD-01684) counseling - 42% ofcasesincluded this \vas accomplished with emotional neglect benefit to the children and at -. 23% ofcasesincluded lower cost. physical neglect Average child in ex pe rime ntal- e - 6% of cases included abuse programs spent 24 fewer days - COMpared with children in in foster care. regular public program Fewer of the experimental group thildren spent any time in foster care-52% VS. 60% of children in regular programs. 6 months after end of project,92% of experimental children stillin own homes compared with' 77% of regular program children.

14. Justice, R., Transactional Analysis 10 child-abusingcoihes 8 couples had childrenre- Justice, B. therapy turned with no further re- (CD-01691) ports of abuse. 1 coupledropped out of group and child not returned .to them. I couple, still in group, given child on weekend basis.

15.Juvenile Protective Coordinated social, 35 families socially and eco- Details of services of home- Association educational, and health nomically impovenshed maker programs, foster care, (CD030541) services to families of day care, preschool nursery

of Alr neglected and abused children care, and othertraditional approachesare enumerated with cost estimates for each. Specific results obtained with each family are summarized, and some general conclusions regarding parents and dren are drawn.

16. Lynch, M.A., Inpatient unit for families of 50 families, with 87 children 80%offamiliesreturned Ounsted, C. abused children, group, indi- 23 children actually homeith children._ (CD-01748, vidual, and marital psycho- abused 12childrenin10 families CD-01750) therapy for parents 3 probable abuse need separation from family - 24 at risk atadmission or after short Vane tyofsocioeconomic trial at home. backgroundsandurban No cases of proven reabuse. and rural areas 2 children subsequently spent short periods in foster care, Many families requested assistance in times of crisis.

a 46 . TABLE 14 (Continued)

I ANNOTATED LIST OF STUDIES: TREATMENT

t-- Reference Type of Treatment Review of Studies iethodology...

17.Money, J.; Removal from home 16 patients with syndrome of 4 patients showed complete Annecillo, C. dwarfism characterized by remissionof symptoms of (CD-01793) s reversible hyposomatotro- impaired growth and pinism occurring with and had IQ increases of 29 abuse and neglect 55. .. . Measurement of IQ before 8 had increases of 2 to 141 andafter. relocationof showed no change. . domicile 3 who showedpersistent ..v symptoms, such as bedwet- ting, temper 'tantrums, hyper - kinesis, and atypical food and fluidintake had decreases from 1 to 12, i The longertheperiod of removalfromhome,the larger the increase in IQ ; . ' t I8. Money, J., Removal from home 12childrenwithretarded All improved after le ving the Wolff, G. statural growth associated environment gro di retar- (CD-01795) with reversible somatorro-dation, and elevations of IQ phic deficiency (history ofby as much as 30-50 points abnormal psychosocial be-observed.. ' havtor and motoi retar- The more advanced the age of dation) child beforeleavingthe Measurement of IQ before orhome, or while remaining in on admission to hospitalit,thelatertheonset of a and after some period of'puberty. removal from home I case reported in detail.

19. Newberger, E H.. Hospital-based, 62 cases of abuse, 39 hospi- Averagehospitalstaywas Hagen birch, J. J.; multidisciplinarygroupfor talized reduced from 29 to 19 days; Ebeling, N. B., totalmanagement of child average costs reduced frdin Colligan, E. P , abuse cases $3,000 to $2,500. Reinjury Sheehan, I. S.: rate reduced from 10% to 2%. *McVeigh, S. H. I - . (CD-00727)

20.Newberger, E. H., Coordination andprovision Review of 75 cases 43% ofcasesreferred by McAnulty, E. H. of hospital- and - 23 cases of abuse community-based agencies. (CD-00730) community -basedtreatment 25 cases parent-child be-47% of casesreferredfor for physical and social havior problems .A social or psychological thera- problems of vulnerable 9 cases multiple accidents py, improvement seen an 51% childrenin multi-problem -- 8 cases failure to thrive of these cases. families am. Recent practical and theoreti- cal advances in the management of such children are discussed. . 1

47 53

5 :

1 TABLE 14 (Continued)

ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

% 2i.'Paget, N. W. 24-hour emergency babysit 32 cases Review of 32 cases occurring (CD-00759) tang service Case review over 11 monthsindicated overall success of the program. Parent reactions were sometimes hostile but pever violent. . . Overall cost of program was $2,000 a year.

22. Panel for Family Multidisciplinary approach Evaluation components Since Panel intake procedures" Living - Parent education treatment outcomes stressed concurrent multiple (CD-01866) assessment of Panel's in service,itwas- difficultto fluence on community differentiate successful treat- assessment of efficacy-of a ment modes. Common Lan- behavioralapproach in guage Assessment System f treating emotional neglect proved effective in facilitating evaluation of adequacy of choice of therapeutic tech- the Common Language ruque. /' r Assessment System as a model for diagnosing and \-, treating emotional neglect a' '7 - / 23. Sherm E. A., Services to ddren in* their 553abused and neglected Inown-homecases,both . Phillip , M. H., own homes children parents more frequently pre- Hanng, B. L.. s drawn (rom 1 voluntary sent and financial situation Shyne, A. W. Clrietnd 3 public agencies better. (CD-01284, Analysis of monthly service Of 98clientsinterviewed, CD-01307) and outcome schedules 46% had Positive perception kept by caseworkers, inter- of helpfulness or effectiveness 1i views of 'service.Congruencebe- Compared withplacement tween parent's and worker's families perceptions of need for same andkindofservice needed. Areas' ofgreatest 44 positive change were those in which child care and training i were center of concern and c service effort. 2 v. .24. Reich, J. W. Lay therapist as patent aide 8 abusing parents Data were. reasonably consis- (CD-01906) Control groups of tent in showing an increasing 7 abusing parents having movement towarda more regularsocialworker positive approach in the inter- contacts only actions of parents with the I 44snonabusing parents aides. . Questionnaires pre- and post- Effect that this might have on treatment parent-child interactions could not be ascertained. / i .1=1..1.... 48

5q Til .. S 9

...a TABLE 14 (Continued) ANNOTATED LISTOF STUDIES: TREATMENT' I Nit I Referenc Type of Treatment Methodology Review Studies-

. 25. Rosenblatt, S., iv Drug therapy IIwonilnand 2 men ,stis- Short-termrnollificati* of Schaeffer, D.; ',Acted ofphysicalabuse anxiety, depression, -and so- - Rosen tlial, J. S. .4 or complaining of difficul- made symptoms effected in (CD.0191 9) ty in controlling extreme drug-treatedgroup. Expert- c punitive impulses against mental andcontrol groups their children showed improvements at end Treatedwith200 of of6weeks; however no . diphenyJhydantoinleea significant" differences were day 'or an inert placebo for discerniblebetweenthe2 8 weeks ona random, groups due to uncontrollable double-blind basis confounding factors' Weekly 'tests to assess changes No measurable changes attrib- ofattitude toward chil- utableto drug letioti were dren,Vvel -of depression, found onbehavioralpara- hostility, anxiety, and metershypotheticallyrele- othervariables (Q sorts ivant to child abusing parents. developed from scales fromNIMH Depression a41 Study, MMPI, Tiylor ManifestAnxietyScales, and Parental Attitude' Re- search Instrument) fia. 26. Shames, M. Homemaker services 12 families which had been All12 showed marked 'im- (CD-00906) particularly resistant to case provement in most areas and workers', efforts to improve gainsmade . held upafter- household management and homemaker left.' R4,sulted in child care realignmentof familyrela- donships. r Homemaker's own skills lesser important than her ,mtuitive ability to give mothers accip- tante,respect, andunder- 41. standing. Professional supervision of homemaker was im- a *. portant.

01. 127. Silver, L. B., Own home services vs foster RVrossiectivestudyof 34 Children are better cared for Dufilin, C. C. r care cases of abuse -in their own homes if agency Laurie, R. S. interventionis,effectivein (CD-00926) preventing further abuse or improvingthequalityof home atmosphere. . -. 28. Steele, B, F , Therapeutic treatment 60 fa'milies of abused children Usefulcontactwasestab- Pollock, C. B A from all socioeconomic levels lishedwithallbut a few (CD-00966) d' with, variety of emo- families and significant im- . 14, Io41,disqrders provement seen in over 75%, of thost treated. Fouhd decrease in demands on andcriticismof child, increased awareness of age- appropriatfneeds and behavior, and development of 41 wide social relationships. 'I T4BLE414 (Continued) lt .ANNOTATED LIST OF STUDIES: TREATMENT

. .- .. . . 1 Reference 0 Type of Treatment Methodology Review of Studies , .

29. Stephenson, P. S. 93-dayennchmentprogram Multiproblemfamilieswith Preliminary findings_indiclite (CD-01316) for very young high-risk children 18-30 months of that 'very disadvantaged, de- children focusing on- age piivbcf, and alienated families i -1) cognitive and effective Control group who are abusing or neglecting stimulation their children can be success- 2) working to reduce any . , . fullyworkedwithon a observable psychopa- voluntarybasis,usingpre- ,.. thology .' schoolteachersas primary

1 Weekly home visits engaging theraphts for both children

CI 1 both parents and siblings . and their la milks. , in therapeutic process . . 30. Tracy, J Behavior modification, inter--41 families 84% of families showed im- Bg Bard, C., vention of lay family health 11 with abused children provement in areas of "do- . CbrE",.E. worker drawn from the com- 30 at high risk 'mesticconcern," 9% rated (CD-01022) mutiny the same or worse, 7% rated !-- . . unknown. _ 31. Voting, L. R. Integrationof casework, 125 neglectful, disOrganized Preliminary findings showed (CD-01706) education, and group work families deterioration checked in 90% 77% receiving public assts- of families in the first year of . - . tance program.Childrenshowed 98.5% with annual income considerable progress. In $4,000 or less second year, 55.60% of fad- liesshowed progress inat . leastonearea family e of ' functioning. Importance of family plan- - . ning as requirement for fu= . ture family stability stressed.

41.

f lat

50 .5V. ft

o' R TABLE 15 , * 4ls ANNOTATED LIST 0 ONGOING RESEARCH STUDIES: TREATMENT

Reference Research Purpose Methodologytl-..\ .. . . DCiy,c`E. F.; 7Formative evaluation of 12 Evaluation components include Houston, T. R. demonstration centers establishedby organizational bases and service modes, (CR-00041) the National Center on Child Abuse and service volume, unit cbsts, identification Neglect. of measures of impact upon coordination of services, abuse. and neglect incidence, i and recidivism. 2. Freiberg, S. Develop psychiatric treatment methods Naturalistic observations from home visits 44 (CR-00054) forinfants with moderateto severe recordedinnarrative form, playroom developmental, problems. Develop visits,developmental(Bayley)testing measures for assessing change in infants supply study data. and parents before and after treatment. I .3. Galdston, R., Developnece techniques to improve Descriptive analysis. Data collected from Bean, S. L. seplces to young abused children and worker's Initial assessment, weekly (CR-00057) parents.Trainpersonneltopursue progress charts, conferences, observations, further studies into problems related to and follow-up studies on terminated care. abuse Study origins and fate of violenceilkSample population: 31 males, 21.34; 51 as forcrwithin the family . females, 19-37, 80 children, 3 months to 4 5 years

4. Minima, S. L Assess increased participation. Monitonng agency records, interviewing (CR00069) utilization, coordination. and agency personnel, analyzing mint agency effectiveness of service delivery conferences. Control groups of serviced Demonstrate a model of prevention and and nonserviced families. treatment of abuse and neglect .

.5 Harrell, M. Evaluation to develop more effectiye Data collected and analyzed concerning (CR-00070) guidelines concerning judicial experiencesinmaking Judgments and disposition of abused infants disposition and outcome of treatment for child and parents.

6., Knox: J. C., Formative evaluation .of regional Descriptive data collection for formative Phillips, Y., flitemonstration program. evaluation using case records of Fyman, N. case workers. (CR00097)

7. MacMurray, V, D., Evaluate intervention process, outcome 50 abusing families to receive .treatment Brummitt, JR.. effectiveness, and feasibility and practi- by team and family aide, 50 abusing Cunningham, P H.- cality of services provided by volunteer familiesincontrolgroup toreceive (CR00105) laytherapists or family aides working treatment by team alone. Data will be 'with abusing parents examined to identify which independent and control variables account for decrease r> ( in probability of risk of abuse.

8 Miller, P r. e . Formative evaluation 9f .li dinnovative Site visits on quarterly basis to determine (cR:90113) demonstrationprojectsintreatment, qualitative data. Quantitative data prevention, and identification of child collectedaboutclientele,costs,and abuse and neglect *4 services. ly, 9 Pascoe. I) J, Determine nature of sexual abuse in Demographicand psychologicaldata Glasser, M children and evaluate effectiveness of collectedonvictims Documentation (CR-00f 20) medical treatment program for sexual from case records and staff conferences. abuse , . . . -., 51 5 A EIS (Continued) ANNOTATED LIST OP6 gBINGESEA RCH STUDIES. TREATMENT a

. lference Research Purpose Methodology

10. Paulson, M. J. Assessrehabilitativeeffectivenessof Study group to receive traditional group (C R- 00121) group therapy intervention for abusive psychotherapy Matched sample to parents. receive group psychotherapy plus child management training. Matched control grouptoreceivetraditional casework supervision. Incidence of abuse or recidivism withinfamily, change Qi pre-posttherapy psychological test data assessed at end of 12 months of treatment.

_ I1. Rodeheffsr, M. A , Studydevelopment.personalities, and Developmental . levelof20children Mirandy,W. A.. behavior of ph) sially abused children. abusedat age2.5-4yearsassessed. Cone, S. Assess ,effeets of therapeutic playschool Subsequent development of samptein (CR-00130 environment therapeuticplayschool compared with matched sample, in regular day care or in their Own homes Standardized measures of cognitive speech and language, and mo.tor functionin Further documentation, through behavioral observations of teachers inchildren in classroom.

to .52 1 VI. EFFECTS/SEWELAE

"Nothing stirs so great a sense of urgency that Tables 16and17presentanannotated we move to do something about neglectand listing of 42 completed and two ongoing research abuseas when we review what is known about its studiesfocusingon the effects/sequelae of child ainsequences."6 The obviousand primary abuse and neglect. These studies are organized consequences to the victims of abuse or neglect are under four ,major headingsabuse, neglect, abuse many. Children suffer temporary or permanent and neglect, and failure to thrivedepending on bodilyinjury,childrenstarveor gowithout the type of maltreatment. Reports of the effects education and clothing, infants are born addicted of abuse constitute the largest category, to heroin, adolescent girls become pregnant from accounting for 33 of the 42 studies. Four studies incestuousunions,andapproximately2,000 report effects of neglect; three report on the children die each year, victims of child abuse or effects of abuse and neglect, and 2 on the effects neglect.' Other more subtletong -rangeeffects offailuretothrive.The studies 'arelisted includeemotional,behavioral, an cognitive alphabetically by author within each category and problems. There is some eviden that siblings of fullcitationsaregiveninthebibliography the abusedorneglected individualsuffer beginning on page 64. emotional and behavioral problems as well, even if they are not the targets of the abuse or negrect. There are ion* indications that abused children The methodologyipf each tudy is described in later become violent, behaving aggrossively toward as much detail as possible, in luding sample size other members of society as juvenile delinquents, and characteristics; control or mparbon group if as murderers, or as abusive parents. Society feels mentioned, meansofdatacollection, where theeffect or abusiveorneglectfulbehavior known, and length of time between abuse and , 1 through the strain on the school system. the follow-up. A summary of study findings reported proticttve service system, the courts, and all such in the abstract is also presented in the table under ,systems whote task it is to identify and treat those the heading "Review of Studies." ----families. 'Finally, there are consequerices for the parents themselves. Some may be prosecuted and t6 jail. Others will find help through a good treatment program, butcertainlyfewwillbe Methodology. Most study samples were 'unaffectedby the ireahration that they have relatively small, the great majority being under harmed their child.'.. 100. A few exceptions were notably large one studylookedat774abusedchildrenand Any study that focused on the effect of abuse, compared them with 900 juvenileoffenders, neglect, or failure to thrive is included in this anotherevaluated 34=7 depressedh,ftliitalized review. To date research efforts have focused women with a comparison group of 198 normal almost entirely on the effects of abuse and neglect women, anther reviewed 1,500 child guidance on the child. The effect of abusive and neglecting dlinic cases. behavior on the perpetrat s not reviewed here because of the lack of any tematic examination of this issue. It is not icvm how often families The study samples can be generally move or how many parents suffer psychological charicterized as abused children seen in a hospital problems requiring hospitalization or what the or psychiatric clinic setting. A few studies did impactof .the. label"abuser" or"neglectful examine other,populationssuch as violent patient parent" has oh an in.dividuil. inmates or juvenile offenders.

.'Polansky. N.A., Nally. C., and PlAralcy.N4. Profile of Neglect A Survey of the Stateof-ifAzwkdge of ?Irk! ,Negleet. Washington. D.C" tvmmunn) SerKes Admunutatp,n. Svual and Rchatalitatiolv Screws. DiirW. 1975. p 27 ,

.9 Review of case records, and standardized tests hkelihood of reabuse orof death. One sturdy were the major means of measurement though one reported that abused children committed fewer study used homevisits,anotherclassroom aggressive cnmes thantheir siblings and more observation, and a thud a behavior questioziwure escapist cnmes, while another noted that abused completed by teachers. children exhibited less overt and fantasy aggressive behavior and were more somber and docile.' Lengthoftameoffollowup was seldom o reported in the abstract. Of the nine studies that Itwas noted that the effects of abuse. and did report this, six studied effects 'three to five neglect are often confounded by the effects of years after the abusive incident, one eight years lowerclassmembership andbythelackof later, one six years later, and one six months later knowledge of whether the "effect" in fact was present pnor to the abusive incident. Summary of effects.The effectsof abuse and/or neglect and failure to thnve reported here Ongoingresearchstudies One study is weregenerallydelayedlanguage development, evaluating the effects of separation of children mental retardation,and psychological and from parents, and the otheris evaluating the behavioral problems. Studies also reported on the effects of an abusive environment on chtldron

fit

Cu TABLE16

., ANNOTATEDLISTOF STUDIES.. EFFECTS/SEQUELAE OFABUSE

A Reference' Methodology Review of Studies

'1. Bach-y-Rita, G., 62 violent patient-inmates. Some of the habitually violent patients Veno, A. Analysis of lift hisiones and clinical' who were identified as self-destructive (CD-01372) variables. were subjected to violence or deprivation dunng childhood. Suggestion of strong correlation between neurological impairment and early injury or deprivation.

2. Mager, P.B., 23 abused children Preschool pomp showed delayed speech Martin, H. P. 10 preschoolers subjected to abuse and language development on all (CD-01412) within preceding 6 months measured parameters. Older group more 13 older children in psychotherapy within normal limits but showed more Seen several years after incident scatter of abilities and disabilities than Speech and language assessments expected. (IllinoisTestofPsycholinguistic Ability)

3 Blooni, L A 17 children abused in earl) childhood Abused children demonstrated significant (CD-01413) Control groups expressive communication -1,7 children suffering accidents and problemshigh incidence of poor suntlar hospitalization at comparable expressive language, poor cotversational ale 1, articulation, and stuttering . .25childrenwithnohistory of accidents or abuse Assessment of 'communication skills

4 Bolton, F. G , Jr , 774 abused children Abused children had low frequency of W,, Comparison, groupof 900 reported aggressive cnmes by comparison with Gutierres, S. juvenile offenders siblings-reported for escapist crimes fai (CD.01418) Comparison of re pqrted cnmes more often than siblings

5 Bntish Medical 78 cases of abuse Where the first childin a family was Journal abused:13 1chance that a subsequent (CD-00124) child would be abused

6. Chnstiansen, J1. 138 abused schoCii-age children referred Abused children found more frequently (CD-01469, to juvenile covrt in special education classes, and classes CD-01714) Analysis of welfare case records and for emotionally distiirbed and educable school records mentallyretarded. Number of abused childreninstatementalinstitutions Significant.Academicachievementof majority of abused children below grade level. Many had behaviors indicative of psychological ptSblems,

7 bbin, A 1 450 parentally abused ,children- Many ofthechildren showed growth Gollub, M. 11, representing1' of admissions to retardation or anemia Three died 25 had Stein. A. M Children's Division of been injured previously, and in 8 cases Wilson, M (; County-UniversityMedicalCenter siblings had also been injured. 1( D 00282) Most children less than 2 years old

55 L. TABLE 16 (Continued)

ANNOTATED LIST OF STUDIES: EFFECTS/SEQUELAE OF ABUSE

Reference Methodology Review of Studies

8. Elmer, E. 50childrenhospitalized formultiple Of the 50 children under study, 7 died, 3 (CD-00293, injuries sustained new injuries, 2 were rehospital- ciz-cr0296) 17 under 3 months 'zed for treatment, 7 had senous physical 9 between 3 and 6 months defects, 4 were senously mentally retarded.

9. Elmer, E., 20 abused children with multiple bone Of 11 children without medical Gregg, G. S. injuries abnormalities prior to abuse, 2 failed to (CD'00295) 13 white thrive, 4 had IQ's below 80, 4 were 7 black emotionally disturbed, 3 displayed Los SES physicaldefects;more than' half Brad Interviews and psychological testing speechproblems. Of 9 childrenwith previous abnormalities, 3 failed to thrive, 2 were obese, 6 were mentally retarded, S were emotionally. disturbed, 4 displayed physical defects.

10. Elmer, E. Children hospitalized for injury Abused children had highest number of (CD-01161i "3studygroups abused, nonabused, mostsevere problems,mentallyand unclassified. physically

11. Elmer, E. 17 lower class children abused as infants Few group difference's in health history (CD-01548, Corn pan son groupof17children and development, intellectual CD-01549) injured in accidents matched for age. functioning, language, self- concept, race, sex, and socioeconomic status impulsivity, and aggression. High Comparison group of matched incidence of problems inall groups. untraumatized group of nonabused Effects of lower class membership on children child development may be as powerful as Clinical assessment 8 years after abuse. Neglectrevealed assignificant children were studied in infancy factor related to intellectual retardation.

12. Fitch, M. J , 45 physically abused hospitalized Significantly smaller proportion of Cadol, R. V., children abused children's mothers demonstrated a Goldson, E., Companson groupof18 nonabused desire tobreastfeed.Developmental ,)tendell, T., failure to thrive children testing revealed a wide disparity between Swartz, D. Control group of 19 children abused subjectsandcontrolgroup (CD-01563) Review of hospital charts abused children scored generally lower Bayley Scales of Infant Development, than control subjects in areas of cognitive McCarthy Scales of Childrens develop men t. Abilities Evaluation at time of admission and 6 months later

13. Fitti, R. M., 28 abused children, aged 2-6, who had Characteristicdisturbedbehavior pat Gut, A. undergde psychotherapy terns, such as distrust and fear of adults, (CD-01167) Review of records variability of behavior, disturbed interpersonal relationships, poor self-image, 'communication difficulties, and hyper- kinetic activity, present in abused chil - dren

56 6 o

TABLE 16 (Continued)

ANNOTATED LIST OF STUDIES: EFFECTSISEQUEL4E OF ABUSE

Reference Methodology Review of Studies

14. Green, A. H. 70 school age schizophrenic children of Significant association between physical (CD-00395) whom 32.8% were abused abuse and self - mutilation among boys Screening of case histories though not among girls.

15. Green, A. H. 59 abused children from low-income Significantly higher incidence of (CD-01615) ghetto areas self-destructive ,behavior . among abused

. . Controlgroups of 29nonabused children.Self-destructiveactivity often , neglected children jnd 30 normal enhanced by ego 'delieits anunpaired children impulse control, and seemed to represent Interviewswith motherormaternal a learned pattern of behavior originathig guardian inearly'traumaticexperienceswith hostile primary objects.

16. Hams. M. J. Accidents under 2 years of age of whom Likelihoodofrebattenngafterfirst (CD-00438) 25% were abused incidentis30%.Deathrateamong repeatedly abused children is 20% for an overall death Tate of 10%. ,

17. Iowa Child Abuse 74 abused children treated at hospitals 6 children (8%) had died, 5 (7%) were in Study for injunes . . institutions.6 (8%) wereliving' with (CD 01131) Review of present social situations relatives, 9 (12%) had been adopted, and 12 (16%) were in foster care.

18 Jacobson. S 347 depressed hospitalized women Negative child-rearing expenences such as Fasman, J., Compansongroupsof 198normal abuse and punishment associated with DiMascio, A. womennotreceiving psychiatnc laterdepression. Relationship between (CD-00517) care, 114 _prunanly neurotic degree of depriving'child-rearing outpatient females experience and seventy of adult -illness suggested.

19 Johnson, B., 101 abused children During penod ofservice, 79 children Morse. H. A. Study undertaken 2-3 year% after the removed from homes, twothirds (CD-00525) abusive incident senously injured, 3 died of injunes,I died of gross neglect.

20. Kempe, C. H,. 302 cases of abused children reported 33 children (11%) died and 85 (28%) 0 Silverman, F.N., from hospitals suffered permanent brain injury Steele, B. F Survey Droegemueller, W., Silver, H. K. (CD-00560) .. 21. Kent, J. T Abused children -placed out of natural Both abuse oups had higher urcidence (CD-01/12) home divided into 3 groups of probl behavior on intake, Both nonaccidental trauma, gross neglect, nonaccidental trauma and neglect nonabuse group receiving protective children manifeste'd greater services becauseof high nsk for developmental ,rlelaysinlanguage on abuse . . follow-up than motor cleyelopment and Evaluation atintake,and after activities of dailyliving. Abusive placement .. . environment tendstoproduce highly troubledchildrenindependent of low socioeconomic status

.. .57 .4 i

TABLE 16 (Continued)

ANNOTATED LoyOF EFFECTS/SEQUELAB OF ABUSE

teferenee Methodology Review of Studies

22. Koski, M. A., 46children, aged 2.30 months, with Physicalabusedetrimentaltoneural Ingram, E. M. nonaccidental trauma functioning but not .to motor (C041718) 38 children with failure to thrive functioning. Neglect detrimental to both / Group of normal contiols neural and motor functioning. Effects on BayleyScales,Mental Development boys different from those on girls. . Index,Psychomotor Development Index

23. Laver, B.. 130 abusedchildren under 10 admitted Many suffered from emotional, physical Ten Broeck. E., to a hospital and medical neglect as well, 44% had Grossman, M. Controlgroup of concurrent admissions been abused previously. 6 children (5%) (CD-00593) Review of medical and social records died. 1 24 MacKeith. R. Childrenwith cerebral palsy and Speculation on incomplete data suggests r (CD-00639) mentally deficient children 113.1uted that nonaccidental injury and associated Kingdom ) deprivation account for 90 new cases of cerebralpaisYannually° (6%), 150(25%) new casesof severe mental handicap annually, and perhaps 7,000 new cases of children with disturbed personality. An alternative methodyields 400new .." children each year with chronic --neurologic deficits. . . '.25.Martin, H, P., 58 abused children Sn had some neurologic abnormality of Beezley, P 5 year follow-up study 4vhich 31% handicapped everyday Conway, E. F., i Findings reported at a mean 4 5 years function of child, 5% were microcephabc, a Kem pe, C, H. after abuse t 31% had height or weight below third (CD-01 762, percentile. Hypothesis thatmental CD01767) retardation or brain damage stemming from immaturityehcitsabusefrom \.. parents not supported. !Qs of children withhead trauma or residual neurologic deficit significantly lower. Environmental factors significantly related to IQ scores.

26. Martin, H, P 42 physically abused children 33% demonstrated failure to thriveat (CD-01760) Follow-up study timeof admission. Mental retardation twice as frequent when failure to thrive accompanied physical abuse.

27. O'Neill, J. A., Jr. 110 abused children 7% died. 10% sufferedpermanent (CD-00742) disability. 80% showed signs of repeated injury, 66%. had more than one fresh injurywhenfirstseen.Psychological scars,neglect,andmalnutrition all associated with abuse.

28. Peters, J. J. 64 child victims of sexual assault, 2-1 2 Improper handling or repressed sexual (CD-01878) years of age attack may cause serious psychological Home visits and-Thiatric interviews problems for victim as an adult i,

6 4 TABLE 16 (Continued) ANNOTATED LIST OF STUDIES: EFFECTSISEQUELAE OF ABUSE

Reference Methodology Review of Studies me. 29.Rolston, R. H. 20 foster children who 'had suffered Abusedchildrencharacterized by (CD-01298) severe physical abuse or punishment, sigruficantly overt and fantasy aggressive mean age 10.6 years behavior, lower ratings on 20 foster children without history of competitiveness, truancy, physical abuse quarrelsomeness, destructiveness,and TAT, behavioral rating scales verbosity.Abusedchildsignificantly higher in scaling of somberness, docility, desire to placate, appetite, masturbation, and thumb-sucking.

30.Serich, I. Er, 10adolescents who hadcommitted Environmental factors such as parental Blomgren, P. G. homicide brutality, seduction by parent or parental (CD 00900) 10 adolescents who had threatened or perversion, brutal resection byfather attempted homicide appeared important in reinforcing 10 hospitalized controls homicidal behavior. Evaluationof clinical, developmental, rl and environmental factors

. 31.Silver, L B.. 34 cases of child abuse reported at a In 4 cases (12%) abusive parent was Dube* C. C.. hospital shown to have been abused as a child; in Loute, R. S. Review of hospital records 7cases(20%),abusedchildren had (CD-00926) supplemented by police and social already come to the attention of juvenile service agency records court within 4 years of abuse. . Family histones sometimes dating back 20 years

32. Smith, S. M., 134 abused children mean age18.5 Half had senous uisuneit 21 (15%) died, Hanson, R months 65 (48%) had been abused more than (CD-00946) Control group of 53 children once, 20 (15%) had permanent hospitalizedforconditionsnot neurological,sequelae,10(8%) had involving trauma serious congenital defects. Twenty-three (15%) had been previously admitted to hospital with failure to thrive and overlap with physical neglectconsiderable. Mortalityand morbidityhigh among

33. Zuckerman, K , 60 child abuse cases 2 children (39idied, one-thud placed in Ambuel, P,, Review of cases other homes, r use occurred in 17% of Sandman, R those retumedlhome. (CD-01084)

6 C-c., 59 TABLE 17

ANNOTATED LIST0(.4iSTUDIES; EFFeCTS/SEQUELAE OF NEGLECT

Reference Methodology Review of Studies

1. Chase, H. P.; 19 children d iagnosed with . Undernourished group lower in height, Martin, H. P. undernutntion during first year of weight, head circumference, and (CD-01461) life developmental quotient. Impairment of Control group matched for physical and mental development socioeconomicstatus,birthdate, correlated with duration of weight, sex, and race undernutrition during rust year. Yale Revised Developmental Examination, Boston -Iowa Growth Grids, Denver. Developmental Screening Test, WA1S Vocabulary Test, Home Stimulation Inventory Scale 2. Jenkins, R. L., 1500 child guidance clinic cases Mothers with characteristics of Boyer, A. inadequate mothering most likely to have (CD-00521) children with behavior problems. Correlations not as strong for inadequate fathering.

3. Richardson, S A. Sthoolbo}s in Jamaica 6-10 years old, Severe malnutritiod in infancy occurring (CD-01909) some of whom had experienced an in a context of an overall history of good' episode of severe malnutrition during' physical gYowth and a favorable social first 2 years of life. background hadnegligibleeffect on IQ testing intellectual functioning. In a context of poor overall history of physical growth and unfavorable social background, later impairment ofintellectual functioning cam occur,

4. Schermerhort, W. 19 neglected boys Deprivation of nurturing care in young (CD-00883) Comparison group of 17 boys from childrenmakes them lesscapable of families developing positive human relationships.' 1 hour of 'classroom observation by a Significant differences found in areas of social worker and psycholOgist affiliation, positive self-concept, negative 'Interviews using projeolive measures and adult perception, positive teacher and direct questioning peer relationships and negative teacher and peer relationships. . 5. Fnedman, S. B., 15 suspected abuse children Accident children had lower incidence of Morse, C. W. 7 gross neglect children aged, 5.l0 years subsequent uquries, siblings had fewer (CD-0158,21 seen in university emergency room injuries, relationship with mother judged Comparisongroupof 19children better; and fewer emotional and social represcnting accident cases problems in the families. M Follow-up study 5 years later

6. Morse, C. W., 25 ' children from 23 families One-third of children had againact Sailer, 0.1.Z., hospistalized for illnesses judged to be suspected of being victims of physical Friedman, S..11. sequelae of abuse or Von neglect abuse or neglect. 70% of Children judged (CD-00695) 3years after hospitalization outsidenormalrange. inintellectual.

4 Fnotional, social, and motor deVelopmetit.

60 66 TABLE 17 (Continued)

ANNOTATED LIST OF STUDIES: EF FECTS/SEQUELAE OF GLECT

Reference . Methodology Review of Studies

7. Sandgmnd, A.; -60 abused children Abused and neglected found considerably Gaines, R. W.; 30 neglected children impaired in ego pathology-normality and Green, A. H. Control group of 30 normal children cognitive intactness. Abused and (CD-00875, Allfromfamiliesreceivingpublic, neglected had significantly lower IQs, no CD-01194) assistance, all from Inner-city significant difference between abused and All between the ages of 3 and 5 neglected children. WISC for children, Wechsler Preschool and Primary Scale of Intelligence, 13 scales

8. Glaser, H. H., 41children admitted to hospital for More than half showed evidence either of Heagarty, M. C., failure to thrive, average age 12.5 continuedgrosythfailure,emotional Bullard, D. M.; months disorder,mental retardation, vx some Plvchik, E. C. Review -of hospital case records combination of these. A number showed (CD-00150, also Follow-up on an average 3.5 years later variety ofdetrimental social and ' psychological conditions, one of the most yr& reported in CD-00379) common being parental neidect... Approximsc.ty normal distribution of 10t scores; however 6 children Were retarded.

9. Hufton, I. W., 21 children diagnosedashaving One-halfhadabnormalperionalities, Oates, R. K. nonorganic failure to thrive two-thirdshaddelayedreadingage; (CD-01656) Behavior questionnaire completed .by one-third had verbal scores significantly teachers lower than performance scores. 3 had WISC suffered ablise and 2 of these had died. Review at an average of 6 years 4 months after initial presentation at hospital

. af

. 4 s TABLE 18

ANNOTATED LIST OF ONG0hVG RESEARCH STUDIES: EFFECTS/SEQUELAE 4,

Refetence Research Purpose Methodology

I. Leiderman, P. H.; Evaluateeffectsofseparationof Compilationofcases followed by Haitorf, A. children from parents. Primary psychological assessment of children and (CR-00101) attention given to age factors. families using experimental questionisairederived andnaturalistic techniques. 120 males and 120 females 'from 1 to10 yearsoldincluded. Comparison groups used.

. .2- Mirbn, H. P. Determine effects of abusive environ Neurological exams and1Qtestsin (CR-00108) meat on children. , conjunction with personality assessment. -

...... r.

so 6 2 6 L ,. 0. 1 . A.

APPENDIX Vs

Abkreviationt of Standardized rests A.

4:0

Cattell's`l 6 PF16 Personality; Frictor Questionnaire CLLS rolansky Childhood Level of Living §cale . Cl'!Californiaychological Inventory f FIROe Fun mental Interpersonal Relati4bs Ocientatt4on MMPI Minn a Mdltiphasic Pirsonality Inventory ftotter's 1-E Scale ROtter's Scale.of InternilityExternality TATThematic Apperception Test, *4, VAISWechsler Adult lntelligerae Scale WISC Wechsler Intelligence Scale for Chil4ren 44,,-tk. . ...

44.

%et

1 I .%

4 S 4

Is A

, 63 4

ra BIBLIOGRAPHY

41;64

s CD-00049 - coo0104 Cretghton Univ., Omaha, Neb. Dept. of Pediatrics f Youth Opportunities Upheld, Worchester, Mass - Child Abu*. and Neglect. A Study of Cases Reported to The Battered-Child Syndrome, Douglas County Child Protective Service From 1967-1973. I:lomat, M. J. Banaple , R. C.. Mointire,1M. S. Social Casework 53(8).475-480, October 1972. Creighton Univ., 'Omaha, Neb. Dept. .of Pediatrics 19 pp.. 1973,

CD-00109 Georgia Univ. Asheville, N.C. Child Research Field Station. CD -00095 Intelligence and Maternal Inadequacy. Fan* Law -- Termination of Parentsi Rights-A New Stan-, Borgman, R. D. dud for Balancing the Rights of Parents, ChOdren, and Chad Welfare 48(1) 301-304, January 1969. 0 . Society. Berginan..N W. ','Emory LaW Journal 21(i) 1831194, 1975 CD-00112 1 Does Due Process ,Require Clear and Convincing Proof

4 Before Life's Liberties May ise Lost? CD-00083. Bowers, W. C. Texas Rehabilitation Commission, Austin Emory Law Journal 24(1):105-150, 1975. ,o A Study of Father-Daughter Incest in the Hartis County child Welfare Unit. Bethscheider J. L., Young, J. P , Moms, P., Hayes, D D. Camino! Justice Monograph 4(4) 1.131, 1973. CD-00119 The Battered and Abused Child Syndrome. Brett, D.1, Doctoral Dissertation, Ann Arbor, Mich., University Micro- films, Inc., 150 PP.. 1966. 674510. CD-00094 .itoyal Children's Hospital, Melbourne (Australia) Medical Out-Patient Dept. The .--Maltrestment Syndromein ChildrenA Hospital CD-00124 Survey. Bntish Medical Journal. Bidell, R. G., BirreO, J.H.W. Battered Babies. (Editorial). Medical .iournaeof Australia 2(23) 1023-1029, December British Medial Jounita 3(5672) 667-668, September 20, 7, 1968. 1969. S

CD-00094 CD-00340 Children at Risk. Cook County Hospital, Chicago,111. Bishop, F.1. Child Abuse: Attempts to Solve the Problem by Reporting Medkal Journal of Australia 1 623-628, March 201971. ,Laws. Drown, R. H. Werner' Lawyers Journal 60(2).73-78, Spring 1974.

4 CD-00403 4 Protective services for Neglected Children: C1:00141 Boehm, B. Cook County Hospital, Chicago, Ill In. Davies, J. R., Smith, JD., Jorgensen, J D. (Edit Controlling Child Abuse. Reporting Laws. Child Welfare Services. A Sourcebook, New York, M own, R. H. Ian Company, pp. 4.17, 1970. Case and Comment 80(1) 1046, January-February 1975

4 154 Boa i CD-00154 CD-00264 I Options for Improving4ieCKe of Neglected and Depart. Pennsylvania Society to Protect' addren From Cruelty, dent Children. Program Analysis Applied to Local Govern. Philadelphia. Chddteh's Protective Service, meat. Protective Casework for Abused Children. Burt, M. R.; Blau, L. H. t Delsordo, 1. D. ... Urban Institute, Washington, D.C., 136 pp., March 1971 In Leavitt, .1.(Editor). TheBanered Child. Selected Readings, Morristown, NJ., General Learning Corporation,. pp. 46.51, 1974.

CD-00155 Forcing Protection on Children and Their Parents: T)1e Impact of Wyman vs. James. CD-00266 Burt, R. A. New York State Dept of Probation, New York Fun Michigan Law Retifew 69(7).1259-1310, June 1971 Court. tiwt"/ The Good of tad Versus the Rights of the Parent Thi r Supieme Court Upholds the Welfare HomeViut.,, Dembitz , N. t Vk CD-00189 Patinae! ScienceQuarterly86(3).389 .405, Sa pie ne. ( Sinai Hospital of Baltimore lac., Md. Dept of Pediatncs 1971 The Ptoblem of .Chad Abuse: A Community Hospital Approach. Chabon, R. S.; Barnes, G. B.; Hertzberg, L. J. Maryland State Medical Journal pp. 50.55, October 1973 CD-00267 . . New York State Dept of Probation, New York Family Court. Welfare Home Visits: Child Versus Parent,: CD-00210 Dembitz, N. Associonon Journal 57 871474, Septembq ...--.---Mafrachusetts Society. forthe Prevention of Cruelty to American Bar. , Children, Boston. 197). . Neilecting Parents. A Studyof Psych asocial Characteristics Cohen, WI., Mulford, R. M.,Phalbnck, E Denvet, Colo., AmericanHumane Association, 28 pp , CD-00275 1967. The Legal Resilbnse to Child Abuse. .. Donovan. T. 1, . '. William and Mary Law Review 11 960-987, 1969-1970 CD-00218 ( Columbia Law Review. Child Neglect' Due Ptocess for die Parent. CD-00277 Columbia Law Review 70(34.465-485, March 1970. The Chad and His School. Drews, K. InHelping the Battered Child and Hisimily, ?Wade!.. phia,J B Lippincott Company, pp 115.123, )9-72 , fs" . CD-00251 9 $ American Humane Association, Denver, ColoChildren's Div. The Status or ChildProtectiveServices. A National D-00282 , Dilemma. Urersityof Southern California, Los Angeles' Medical De Pianos, V. Cente ? la: Kempe. C. H., Heifer. R. E (Editors) Helping the Battered ild, Syndrome atthe Los Angeles (fount); tnered Child and His Family. Philadelphia, 1B Lappin- General H hill tt Company, pp. 172-145, 1972. Ebbin, A. J ,Goo juts, M. H,titin,,A, M ,Wilson, 144 American Journal of Diseases brekldren 118 66

October 1969. ; 4 ...",,.. *--..__ e$ . CD-00252 American Humane Association, Denver, Colo Children's Div. CD-00291 Protecting the Child Victim of Sex Crimes Committed by Children's Hospital of Pittsburgh. Pa Adults. .. Hazards in Determining Child Abuse. De Francis, V. . Elmer. E. , 1 Federal Probation 35(3) 15-20, September 1971 Child Welfare 45 43, January 1966. ... . t . I ) 65 ,.Z a

A- `Iv #

CD-00293* Fraser, B. G. Children's Hospital of Pittsbuigh, AmericanCriminal Law Review12103;124, Summer Identification of Abused Children. 1974. Elmer, E. In: Leavitt, I. 'E. (Eartor).The Battered Child.. Selected Readings.Morristown, N.J., General Learning Corporation, pp. 24-28, 1974. CD00350 Children's Hospital Medical Center, Boston, Mass Dept of Psy.chia try. Observations on Children Who Have BeenPhysically CD-00294 i Abused and Their Paren.ts. au Pittsburgh Child Guidance Center, Pa. . Galdston, R. A Social Worker's Assessment of Medico.Social Sties in Amencan Journal of Psychiarr;122(4) 440-443, October Child Abuse Case', . 1965 Elmer, E. In4th National Symposuim on Child Abuse Amencan Hum)? Association, Charleston, S.C October 23, 1973. Deny, Colo., AmericanHumane Association, pp. 86-91, CD00351 1975, Children's Hospital Medical Center. Boston, Mass Dept of Psychiatry. Preventing the Abuse of Little Children The Parents' 'CD-00295 Center Project for the Study and Previntion of Child Pittsburgh Unit'., Pa. Dept. of Pediatrics Abuse. Developmental Characteriities of Abused Children. Galciston, R. Elmer, E Gregg, G. S AmericanJournal of Orrhopsycluarry45(3) 372-381, April .Pediarriesk40(4):596-602, October 1967 19751^

CD00352 CD-00296 Children's Hospitalqleclical Center, Boston, Mass Dept of Pittsburgh Univ., Pa Dept of Se.aal Case Work Psychiatry. Studiesof Child Abuse and Infant Accidents. Violence Begins at Home. The Parents' Center Project for Elmer, E., Gregg, G., Wright, B., Reinhart, J. B., McHenry, the Study and Prevention of Chad Abuse B., Geisel, P., Wittenberg, C. Galdston, R. Mensal Health Program Reportr5).58-89, December 1971 Journal of the American Acadenti of Child 10 336.350, Apnl 1971. 3

CD-00304 ' Case. Western Reserve Univ ,Cleveland, Ohio. Dept. of CD-00367 . Pediatrics. Brandeis Univ., Waltham, Mass, Florence.lieller Graduate FollowUp of Low Built Weight Infants The Predictive School for Advanced Studies in Social Welfare ,Value oMalemal Visiting Patterns. Violence Against Children. Fanaroff, A. A*.gennell, J H., Klaus, M H Gil,D, G. Pediatrics49(1) 287.290, January 1972 Journal of Marriage and ;hi Famiy33(4).637-648, Novem- ber 1971.

CD-00337- . . 'Bettered Child Legislation and ProfessionalImmunity, CD-00370 Foster, H H.) Jr., Freed, Di Brandeis Univ , Waltharii; MassFlortnce Seller Graduate AmericanRai A trocianon 'Journal5: 1071-1073, School for Advanced Studies in Socsal Welfare November 1966. Physical Abuse of Children. Findings and Implications of 4 Nationwide Survey. ..f0 Gil, D. G Pediatrics 44 (Supplement) 857.864, November 1969 4 CD:00343 . National Center for the Preven and Treatment of Child Abuse and Neglect, Denver, Colo A Pragmatic Alternative toCurient Legislative Approaches CD00374 to Child Abuse. Brandeis UnivWaltham, MassFlorence Hellfr Graduate

..- 44 is . " .4. . 4 % 4 3. 66 ft. ., i . School for Advance Studies in Social Weifate CD-00438 Pubficowledge, Actinides, and Opinions A.boiFfhysical Discussion on --khe Battered Child Syndrome. Child Aliiles in the U.S. Harris. M I t Gil, D.G Nobk,J.H. Australian Journaloftorenne Sciences3(2) 77.78. Decem- Child Welfare 47(7).396-401, 426 ,/uly J969 bet 1970

CD-00378 California, Um., Los 11°1 es. School of Social Welfare, CD-00446 to Child Neglect Among the Poor., A ,Study of Puente] Hay. au State Dept of Social Services and Housing, Honolu- Adequacy in Families of Three Ethnic Groups. lu, Div. Public Welfare. - Giovannoni, 3. MBillingsley,A. A Statistical Report on Chad Abuse and Neglect in Hawaii. Child Welfare 49(4).196.2041 A pnl 1970. Hay. au State Dept of Social Services and Housing, Honolu- lu Div Public Welfare., 17 pp., 1970.1971.

1 CD-00379 Stanford Children's Canvalescent Hospital, Palo Alto, Calif CD-00447 Physical and Psychological Development of Children With Hawaii State Dept. of Social Servu-es and Housing, Honolu- Early Failure to Thrive. lu. Div Public Welfare Glaser, H. Hesprty, M. C Bullard, D. NC, Ji , Pivchak, A Statistical Report on Child Abuse and Neglect m E. C. Hawaii State Dept. of Social Services and Housing, Honolu- Journal of Pediatrics 73(6).690-698, November 1968. lu Div. Public Welfare. 23 pp., 1969.

CD-00395 CD-0044840. Henry [Meson Center fonthild Researh, Riverdale. N Y Hawaii State Dept 4.,1 Social Service rand Housing. Honolu- SelfDestructive BehaviorinPhysically Abused Schizo- lu, Div Public Welfare phrenic Childien, A Statistical Repoo on Child Abuse in Hawaii's. Green, A H. Hawaii State Dept of Social Services and Housing. Honolu- Archives of General Psychiatry 19 171-179. JulyDecember lu Div Public Welfare17 pp . 1967.1968 1968

CD-00458 CD-00396 MichiganStateUniv ,EastLansing. Dept. of Human State Univ of New York. Brooklyn Div of Child and .Development. Adolescent Psychiatry Why Most Physicians Don't Get Involved in Child Abuse Child Abuse Pathological Syndrome of f=amily Interaction Cues and What to Do About lt. Green, A H Gaines, R W Sandgrund, A Helfer. R E American Journal of Psychiatry 13148) 882-886. August Children Today 4(3) 28-32, May.ft 1975 1974

CD0463 CD00406 Colorado Liu% . Denver Dept of Pediatrics Children's Hospital ofPittspurgh. Pa The Battered Child Syndrome Infant Injuries Accident ktAbusel licher R EPollock C B Gregg, G S Eimer. E Advances iii /Worms 1$ 9-27. 1968 Pediatrics 44(1) 434-439, September 1969

CD-00464 CD-00407 MichiganStateUniv.,EastLansing, -Dept. of Human ) West Virginia State Limy Morgantown Development. Personalityand Social ChatacteristisofLow In.ume Summary of Current Status of Screening Questionnaite for Mothers Who Neglect or Abuse Their Children Unusual Rearing Practices. Griswold, B. B.; Billingsley, A. . Helfer, R, E ,Schneider, C CalifUniv , Berkeley School of Social Welfare. 16 pp MichiganStateUniv.,East LansingDeptof Huinan. (undated) Developmknt, 7 pp.. 1974.

k 4'

.. CD-00471 Cardiology, Maryland Univ., Baltimore. Dept. of Pediatrics. . Child Abuse Syndrome. The Cases We Miss. Growth Rate, Nutrient Intake and "Mothering" as Determi Jackson, G. nants of Malnutrition in Disadvantaged Chadren, Brinsh Medical Journal 2.756-757, June 24, 1972, Hepner, R.; Maiden, N. C. Nutrition Reviewr 29(10).219-223, October 1971 .. CD-00517 . 4 BostonStateHospital,Mass.Collaboratme Depression CD-00485 Study, Early Life of the "Battered Child." (Letter). Deprivation in the Childhood of Depressed Women. Holmln, R. R., Kanwar, S. Jacobson, S., Fortran, J., DiMascro, 4 Archives of Disease in Childhood !,0(1) 78-80. Januar). Journal of Nervous and Mental Disease 160(1).5-14, Janu- 1975 ary 1975, . %.. el/40488 . CD-00521 Rochester ling , N Y Dept of Pediatrics Iowa Urns, Iowa City Dept. of Psychiatry, Child Abuse Early Case Finding in the Emergency Depart Effects of Inadequate Mothering and Inadequate Fathering men t. on Children Holier, J. C., Friedman, S B Jenkins, R L , Boyer, A Pediatrics 42(1) 128138.1111Y 1968 Internanonal Journal of Social Psychiatry 16(1) 72.7, Winter 1969.1970

CD-00489 4 Principles of Management in Chad Abuse Cases CD-00525 Holier, I C.. Fnedman, S B Denves State Dept of Welfare. Colo Div of Services for American Journal of Orthopsychiatry38,111 127.136, Children and Youth, January 1968 Iniured Children and Their Parents. JohnsiA, B, Morse,H A Children 15(4) 147.152. July-August 1968. .9' CD.0049 I The Chad-Battering Parent Sick but Slick (Editorial) Horn, P. Psychology Today 8(7) 32, 35. December 1974 CD00526 ' Child Abuse in the Southeast Atalysis of t172 Reported Cases. Johnson, C., L CD-00500 Georgia limy , Athens Welfare Research, 153 pp, 1974 Surrey Urn Guildford (England,Deptoflitiologtca, toe noes, LQ, of Parents of Battered Babies (Letter) Hyman, C A .., British Medical Journal 4 739. December 22. 1973 CD-00532 A Demonstration It omemilker.Project. ' , Jones, B M a In Kadushin, A . (Editor), Child Welfare Services. A 'CD.00506 Sourcebooi.. New York, MacMillan Company, pp 89.93, Illinois StaleDeptof Childre n and Family Services, 1970 4. Springfield Office of Research and Development . . Child Abuse Repealing. Fiscal Year 1974. IllinoisStateDeptof Children and Family Services SpringfieldOffice of Research and Development, 5 pp, 197g. C D.00,537 Roosevelt Hospital: New York, N Y De pr of Pediatrics Child Abuse The Role of the Physician -and the Hospital. CD-00515' . Joyner, E. N , HI Brook GeneralHospital, London (England). Depta .Pedjirries 51(4, part 2) 7494303, Apnl 1973 ' 4 P I r ...... 4 , 68. of

1. CD-00541 Kentucky State Deptof Human Resources. Frankfort. Juvenile Protective Association. Chicago, Ill Family and Children's Services Branch, 10 pp September The Bowen Center ProAct. A Report of a Demonstration in 1974, Child Protective Services. 19654971. Juvenile Protective Association, Chicago,' Ill 168 pp , 1975. CD-00569 Case Western Reserve Univ., Cleveland, OhioDept. of Pediatncs CD-00544 Mothers Separated From, Their Newborn Infants. What Are Hospitals DoingAbout Child Abuse?. Report of a Klaus, M H., Kennell, J H Nationwide Survey Pedsatnc Clinicsof North Amenca 11(4) 1015. 1037, Kahsch, B ) November 1970 &spud Topics 52(6)21-24. June 1974

CD-00570 CD-00548 McGill Univ , Montreal (Quebec). Dept. of Pediatrics Appointment of Counsel for the Abused ChildStatutory Low Birth Weight and the Battered Child Syndrome. Schemes and the New York Approach New York State Klein, M., Stem, L. AssemblySelect Committee on Child .1 Abuse, Report American Journal of Diseases of Chiclre 122 15.18, July (1972). 1971 Kaplan, E N Cornell Law Review 58 177.190. 1972.1973-

CD-00574 HumpNtys, Berger. Pitto and Pearl. San Jose, Calif 0559 'The Education of the Amish. Child C orado Lni Denser Dept of Pediatncs Knudsen, S. T Helping the Battered Child and His Family California Law Review 62(5) 1506-1531, December 1974 Kernpe, C HHelfer. R E Philadelphia. I B Lippincott Co. 313 pp , 1972

CD-00579 Wayne County Juvenile Court, Detroit, Mich Chnic for CD-00560 Child Study. Colorado UrnsDenver Dept of Pediatrics Clinical Evaluation of Child Abuse-Scarred Families A The Battered-Chad Syndrome Preliminary Repast. 'Kempe, C. H .Silverman, F N Steele, B F Droege Kornisaruk, R Inueller, W., Silver, H K Juvenile Court Judges Journal 17(2) 66.70, Summer 1966 InLeavitt. JE (Editors The Bartered Child Selected ReadingsMorristown. N IGeneral Learning Corppp, 441, 1974 CD00586 Neu Jersey College of Medicine. Newark Dept of Pedia- trics CD-00562 Syndrome of the Abandoned Small dild. University of SouthernCal/forma.Los /6"geles. Dept. of Kushruck, TPictr ucha. D M., Kushitick, J. B Pediatrics. Clinical Pediatrics 9(6) 356.361, Tune 1970 What Is Known About Child Abusers Kent. J. T. In Hams, S. B. (Editor). Child A bust Present and Future. Chicago,National Committee for Prevention of Child CD-00589 Abuse. pp. 47-5 I. 1975 The Battered Chad, Langshaw, W. C. Australian Journal of Forensic..$ctences 3(2) 60-70, Decem- ber 1970 CD-00563 Kentucky State Deptof Human Resources. Frankfort Family and Children's Services Branch CD-00593 Child Abine Report. Fiscal Year 1973-74, California Univ., San Francisco Dept of Pediatrics

69 I-J Uttered Child Syndrome: Review of 130 Patients With CD00675 Conti° Es. Michigan State en,East Lansing Dept of Psychology Lauer; B., Ten Broeck, E.,Ghvssman, M. Distinctive Personality A ttributis of Childabusing Mothers Peril:tries 54(1).61-10, July 1914 Me Irock, BHurley. J R JournalofConsulting, andClinicalPlychology ti 3346) 746.749, December 1969

CD00613 Abused and Neglected Children in America A Study of Al trmative Policies Light.-R J RCoDcleps6t9erS1..n'h, N `1'Dept of Psychiatry Harvard Educational ROW% 4314 i 56.508 1NI A Three-Year Follow-up Study of Abused and Neglected Children - Morse, C W Sahier 0 J ZFriedman. S B American Journal of Diseases of Children 120 4.39-446 November 1970 CD-00630 Whiteabbey Hospital. Belfast tN Ireland) Child Guidance and Family Psychiatry Clinic Incest, I. Patem*1 Incest CD00707. Luinanowicz, N Lafayette Clint: Detroit Mich Dept of Psy Britirli Journal of Psychiatry 1200541'301-313, January Maternal Filicide. 1972 Myers S A American Journal of Disease; of Children 120 534436: Dr.ernber 1970

CD00632 Whiteabbey Hospital, Belfast (N Ireland) Child Guidance and Family Psychiatry Clinic Attempted Infanticide CD-00704 Lukianowicz, N Ohio State Um%. ColumbusDept of Sociology and Public Pryehiama Chnica 5(l) 116, 1972 Policy' The Structure and Performance of Programs on Chad Abuse and NeglectInterim ReportChild Abuse and Neglect ProgramsA National Overview Nagi, S Z CD-00635 PreparedforOfficeofChild Development 1DHEWi Penns) Nania State Etc of MedlinflarrisouTg Washiggton D C 16 pp MarciP197$ Health Program Child Abuse in the choorsge Population Lynch A Journal of School Health 45(3) 14,146, Mara 1075 CD00126 . Governor's Advisory Committee on Child Abuse, Boston Mass CD-00639 Child Abuse in Massachusetts Speculations on Some aPosstble Long-Term Effects Newberger, E H.. Haas, G . Mulford, R M Mac Keith, R Manachulett; Phystesan 32(1) 31.38, January 1973 1,9 Franklin, A W (Editor,Concerning Child Abuse -.Edinburgh, Scotland. Churchill Livingstone. pp63-63, 1975

CD.007 27 Children's Hospital Medical Center, Boston, Mass C D -00660 Reducing the Literal and Human Coat of Child Abuse Minnesota Limy . Minneapolis School Jr Law Impact of a New Hospital Management System. The Battered Chad and Othet Assaults Upon the Family Ne*betger, E K ,Kagenbuch, JJ N B .Cci1;an,.44a- Part One E P . Sheehan, S McVeigh, S H MeCoid, A H Pediatnca Murrierom Law Rene w .50 1-58.1965.1966 3,113) 840848, May 1973.

'7G 70 CD-00730 CD00778 Children's Hospital Mtdical 'Center, Boston. Mass Family Columbia Um , New York, S Y School 'of Law Development Study. ' Chad Abuse Reporting Laws-Some Legislative History. - Famay Intervention in the Pediatric Clinic A Necessary Paulsen, M GParker, G . Adelman, L Approach so the Vulnerable Mid George Washington Law Review 34(3) 482.508. 1966 Newberger, E 'H., McAnuhy. . E. H Annual Meeting of the Ambulatory Pediatric - Association, k 22 pp., May 1974 CD-00779 California Univ, Los Angeles Chad Trauma intervention and Research Project CD-00741 An MMPI Scale for Identifying "At Risk" Abusive Parents. Denver Uniy . ColoGraduate School of Arts and Sciences Paulson, M. IAbdelmonern. A A., Chaleu, A , Thomason, A Comparison of FathersinAbusive Situations With M L , Liu, V Y , Fath ers in Non - abusive Situations Journal of Clinical" Child Psychology 4(l) 22-24. Spnng °Hearn. T P , Jr 1975 Doctoral Dissertation Ann Arbor. Mich, UniversityMicro. films 137 pp ; 1974 7$1872

, CD-007g0 . California 'Univ, LosAngelesCenter for the Health CIT-00742 ' Sciences Vanderbilt cmv Nashville, Tenn Dept of Surgery The MMPI A Descnptive Measure of Psychopathology in Deliberate Childhood Trauma Surgical Perspectives Abusive Parents. O'Neill, J A. Jr Paulson, M J. Afifi. A A .Thomason. M L, Chaleff,,A Journal of Trauma 13(4) 399-400, A pnl 1973 Journal of Clinical Psychology 30(3) 387.390, July 1974

CD-0074 3 CD-00781 Vanderbilt Univ , Nashville, Tenn Dept of Surgery California Univ , Los Angeles Dept of Psychiatry Patients of Injury in the Battered Child Syndrome the Physically Abused Child A Focus on Prevention O'Neill, J. A , Jr., Meacham, W F , Gnffin, P P . Sawyers. Paulson, M .1. Blake P R 31 Child Welfare 48(2) 86.95, February 19 69 Journal of Trauma 13(4) 332-339,1973

CD00808 CD-00744 Evidentiary Problems in Criminal Child Abuse Prosecutions A Yale Univ New Haven, Cpnn School of Medicine Plaine, L L The Working- Mother and Child Neglect on the Navajo Georgetown Law Journal o3o 1 1 2 56.273. October 1974 Reservation Oakland. L , Kane, It L Pediatrics 5 I(S) 849 -853, May 1973 CD-00814 a Georgia Urn . Athens School of Social Work . CD007.S9 Mental Organization and Maternal AdequacyinRural Children's Aid and Sowery for the Prevention )f Cruelty to Appalachia. Children, Buffalo, N Y Polansky, N ,ABorgman, R DDeSaix. C. Smith. B J Emergency Parent --AProtective Service to Children in Georgia Univ , Athens School of Social Work, 15 pp., Crisis. 1969 Paget, N W Child Welfare 451') 403-407. July 1967

CD-00818

Children's Defense Fund, New York. N Y i CD-0077 7 Profeuional Abuse ofChildren. Responsibility for the Columbia Lniv , New York. N Y School of Law Delivery of Services. Child Abuse Reporting Laws The Shape of the Legislation Polar, J W Paulsen, M G A ',tertian Journal of Orthoprychiatry 45(3) 357.362, Apnl Columbia Law Review 671 I1 1-19, January 1967 1975 . 'CD-00826 CD. 00896 Evidence. Child Abuse. Expert Medical Testimony Con. Wisconsin Univ., Madison. Dept. of Sociology ceming "Battered Child Syndrome" Held Admissible. Physical Child Abuse. An Expanded Analysis. Pnnce, R. C. v Seaberg, J R. Fordhain Law Review 42 935.943. 1973.1974 Doctoral Dissertation, Ann Arbor, Mich., University Micro. , films. 185 pp , 1974.74- 26,512

CD-00831 Hull Royal Infirmary (England). Pediatric Urn. CD.00897., Battered Babies. The Sources of Aggression in the Home Pugh, R. I. Sears. R. R., Maccoby, E. E., Levin, H Lancet 2(7662) 66.467, July 4, 1970 InSteinmetz, S. K., Straus, M. A. (Editors) Violence in the Family. New York, Dodd,. Mead and Company, pp. 240.246,1974.

CD008S 3 -ni Queen's UnitKingston (Ontario Dept of Psychiatry Child Murder by Depressed Parents CD-00899 Rodenburg, M Columbia Univ., New YOrk, N Y School of Social Work. CanadianPki, chiatnc Association Journal; ti I , 414", A Comparison of Some Characteristics of Abusing and February 1971 . Neglecting, Nonabusing Parents. Segal. R. S. Doctoral Dissertation, Ann Arbor, Mich , University Micro- films, 277 pp., 1971. 724386. CD-0087S Downstate Medical Center, Brooklyn, N Y Div of Child and Adolescent Psychiatry Child Abuse and Mental Retardation A Problem of Cause CD-00900 and Effect. Clanton Valley Center, Pontiac, Mich. Div. of Child Psychi- Sandy:incl. A., Gaines, R W. Green, A H atry. American Journal of Mental Deficiency79t3) 3:7 330, A Comparative Study of Predictive Criteria in the Predis- November 1974 S' position of Hornicklal AdOleseents. Sendi, 1. B., BlomPen, B. G. Amencan Journal of Psychiatry132(4) 423.427, Apnl '., 1975. CD 00883 California Unit., Berkeley Dept. of Education The Neglected Odd's Perception of the Public School CD.00906 Experience. Use of Homemaker Service in Families That Neglect Their Schermerhorn. W Children. Doctoral Dissertation. Ann Arbor Mich , University Micro -Shames, M films, 202 pp., 1970 71 -9746. InKadushin. A(EditorsChild Welfare Services A Sourcebook, New York, MacMillan Company. pp 101-110. 1970.

CD-00887 National Center for the Prevention and Treatment of Child Abuse and Neglect, Denver, Colo CD.00922 Prediction, Treatment, and Prevention of Chad Abuse. Children's Hospital, Washington, D C Dept ..Sf Psychiatry Schneider, C. I Child Abuse LawsAre They EnOughl Amencan Psychological Association Annual Meeting. New Silver. L B, Batton. W, Dubhn C C i Orleans, La., 11 pp , September 1974 -JournaloftheAmericanMedicalAssociation 199(2) 101404. January 9. 1967

CD00894 Maudrteyfie/vital, London (England) Dept of Fositsic Psychiatry CD.00925 Fatal-Battered Baby Cases. Rutgers Lnsv New Brunswick. N I Dept of Psychiatry Scott. P. D. Child Abuse Syndrome The "Gray Areas" in Establishing a Medicine, Science and the Law 13(3) 197.206, July 1973 Diagnosis

'72 . Sliver, L. B., Dublin. C C.. Lourie,,R. S. %E.G. and Personality Factors In Baby &Wirers. Pediatrics 44(4) 504-600, Octo ber 1969 ' Smith, S M., Honigsbetger, L., Smith, C. A. British Medical Journal 3(5870)20.22; July 7, 1973.

CD-00936 Rutgers Univ.. New Brunswick, NJ. pe_ Psychiatry. . CD00966 Does Violence Breed Violence? Contribu-dons From a Colorado Limit, Denver Dept. of Psychiatry. s Study of the Child Abuse Syndrome. A 'ochistric Study of Parents Who Abuse Infants and Silver, L. B.; Dublin, C. C.: Louise, R. S. Small Children. American Journal of Psychiatry 126).404407, 'Septern. ' Steele., B F , Pollock, C. B. ber 1969: InHelfer, R E., Kempe, C, H. (Editors). The Battered, Child. Chicago, University of Chicago Press, pp. 89.133, 1974,

,CD.00931 'Child'Abuse. Epidengolosic Study of Medically Repotted CD-00971 Cases. t* Montreal Children's Hospital (Quebec) Dept. of Newborn Simons, B.)1Downs, E F , Hurster, M , Arches, M. Medicine Her York State Jounial of Medicine 66(19) 2783 27813. Prematurity as a Factor in Child Abuse. October 1, 1966. Stern, L. Hospital Practice 8(5):117-1,4 May 1973.

. CD-06938 4. National Society for the Prevention of Cruelty to Children, CD-00975 London (England) Dept of Battered Child Research National Committee for f'tevention of Child Abuse Chi- Sevaity:eight Battered Children A Retrospective Study cago,111 Sionnk, A. E., Castle, R. L. Opening Session. National Society for the Prevention of Cruelty to Children, Stone, D I 1,pndon (England) Dept of Battered Child Research, 21 InHarris. 4. B (Editor) Child Abuse Present and Future. pp., September 1969 Chicago. National CommitteeforPrevention of Child Abu', pp 15.16, 1975.

CD00945 Birmtngharn Univ (England). Dept of Psychiatry CD00979 Child Abuse Syndrome. (Letter). California Univ, Berkeley School of Social Welfare Smith; S M A Study of Social Work Practice in Protective Services les. British Medical Journal 3 113.1 t4, July 8, 1972 Not whai You Know, Its Where You Work. Streshinsky, M. Bilhngsley A., Gurgin, V Child Welfare 45.444450. 471, October 1966

CD00946 Birmingham linty (England) Dept of Psychiatry 334 Battered Children: A Medical and Psychological Study CD01002 Smith, 5 M. Hanson, R Case Western Reserve, Cleveland. Ohio. Dept. of 'sychiatry. British Medical Journal 3(5932)666670. September 14, A Family Study of Child Abuse. 1974. Terr, L. C. American Journal of Psychiatry127(1).125.131, July 1970. CD-00949" Birmtnghim Um (England) Dept of Psychiatry Parents of Bettered Babies A Controlled.Study. CD01003 Smith, S. M., Hanson, R Noble, S. Case Western Reserve U111%., Cleveland, Ohio, Dept. of British Medical Journal 4(5889) 388-391, November 1973 Psychiatry. The Bs ftered Child RebrutilizedTen Cues of Medical. Legal Confusion. Terr. L C , Watson, A S. CD00950 American Journalof Psychiatry124(7).1432-1439. Janu Burninghaminiv (Erigland) Dept of Psychiatry ary 1968.

7379 e D 0 I 0 0.6 Stet'ical Description of Cases Foamed by the Anchorage Child Neglect Proceedings-A New Focus. Childbase Board, Inc., October 1972-March 1975. Thpmas, E. K. Andrei!' reen, S. Indiana Law Journal 50(1) 60:81, Fail 1974 Anchorage Child AbuseBoard,Inc., Alaska, 10 pp., 1975.

CD-01018 CD-01090 Child Victims of Incest. Georgetown Univ.,Washington, D.C.JuvenileJustice Tormes, Y. M. Clinic, American Humane Assuc-iation, Denyer, C510Children's Intervention Between Parent and Child. A Reappraisal of Div, 40 pp. the State's Role in Child Neglect and Abuse Cases. Areen, J. Georgetown LawJournal 63(4):887.937, March 1975.

CD-01022 Washington Univ., Seattle. Dept. of Psychiatry and Be- havioral Sciences. CD-01113 Child Abuse Project. A Follow-up. Battered Chilli and Unwanted Pregnancy. (Letter). Tracy, J. I., Ballard, C. M., Clark, E. H. Brossean, B. E, Social Work 20(5).398.399, September 1975. CanadianMedicalAssocibtionJournal 112.1039, May 3, 1975.

CD-01029. University of Chicago Law Review CD-01114 The Custody Question and Child Neglect Rehearings Anchorage Child Abuse Board, Alaska. University of Chicago Law Renew 35(3) 478492. Spnng Child Abuse and Neglect in Alaska. 1968. Brown, G., Wolf, 1 Uri, B.; Zartman, H.; Davis, B. Alaska Medicine 16(5):108.111, September 1974,

CD .01030 . Valparaiso University Law Review. Criminal Liability o( Parents for Failure to Control Their CD.01123 Children. National Society for the Prevention of Cruelty to Children, Valparaiso Ciiiwerstri {,aw Review 654) 332-352 Sununu- London (England). Battered Child Research Dept. 1972 A Study of Suspected Child Abuse. Castle, R. L.; Kerr, A. M. National Society for the Prevention of Cruelty to Children, London (England), 19 pp., September 1972. CD-01071 . Oklahoma Univ , Oklahoma City Dept of Pediaincs The "Sick but Slick" Syndrome as a Personality Com. ponent for Parents dl Battered Children. CD-01131 Wright, L. Children Today. American Psychological Association Annual Meeting. New Iowa Child Abuse Study. Orleans, La., 9 pp., September 1974. Children Today5(1):30-31, January-Ftmari 1976.

CD-01084 CD-01135 Ohio State Univ., Columbus. Coll. of Medicine. Simmons Coll., Boston, Mass. Chi Neglect and Abuse. A Study of Cum Evaluated at Neglect and Abuse of Children in the Middle Class. Columbus children's Hospitalin 19681969. Cohen, M. 1- Zuckerman, K.. Ambuel, P., Bandman, R. Master's Project. Simmons College, Boston, Mass., 120 pp., Ohio State Medical Journal 68(7) 629-632; July 1972 May 1971.

CD-01089 CD-01136 Anchorage Child Abuse Board, Inc., Alaska. Institute of Judicial Administration, New York, N.Y, Model

74 80 Child Abuse Reporting Law Project. Ferguson, D. M.; Fleming, I.; O'Neill, D. P, The Incidence of Child Abuse in the United States. Department of Social Welfare, Wellington (New Zealand), Cohen, S. I.; Sussman, A. 342 PP.. 1972. Child Welfare 54(6):43243, June 1975p

CD-01167 013.01144 Child Guidance and Mental Health Clinics of Delaware Dalhousie Univ., Halifax (Nova ScOtia). School of Law. County, Media, Pa. . Child Abuse in Nova Scotia. Behavior Profile of Abused Children. Dalhousie Univ., Halifax (Nova Scotia), 29$ pp.. 1973. Fitti, R. M.; Gitt, A. Chile Guidance and Mental Health Clinics of Delaware County, Media, Pa., 11 pp., April 1975.

CD-01147 Children's Hospital Medical Center, Boston, Mass. Family Development Study. CD-01170 Working With High-Risk Families. Family Advocacy and Howard Univ., Washington, D.C. Dept. of Pediatrics. the Parent Education Program. MotherChild Separation at Birth. A Contributing Factor in .Daniel,I. H.; Hyde. ). N., Jr. Child Abuse: (Letter). Children Today 4(6).23-25, 36, N ovem be rDecember 1975. Fomufod, A. K.;Sinkford, S. M., Louy, V. E. Lancet 247934):549-$50, Septembei 20, 1975.

CD-011 S3 DenverDept.of Welfare,Colo.Div.of Servicesfor CD-01172 , Families, Children, and Youth. New York Univ., N.Y. School of Law. Chad Abuse. 1972. A Bill of Rights for Children. DenverDept.of Welfare, Colo.Div. of Services for Foster, H. IL, Jr.; Freed, D. I. Families, Children, and Youth, 36 pp., 1973, Family Law Quarterly 6(4): 343-375, Winter 1972.

CD-01150 CD-011114 George Washington Univ.,. WashingtOn, D.C. School of Rhode Island Univ., Kingston. Dept of'Sociology. Medicine. The Violent Home. A Study of Physical Aggression Child Abuse: A Review of 69 Casa. Between Husbands and Wives. Dorman, S. Gelles, R. I. . 'Clinical Proceedings 31(11).256.262, December 1975. Sage Library of Social Research, Volume 13, Beverly Hills, Calif., Sage Publicaticins, Inc.. 230 pp., 1972.

CD-01161 Pittsburgh Univ., Pa. Dept. of Pediatrics. Children In Jeopardy. A Study of Abused Minors and Their Familia. CD-01187 Elmer, E. Brandeis Univ., Waltham, Mass. Florence Heller Graduate Pittsburgh, University of Pittsburgh Press, 125 pp., 1967. School for Advanced Studies in Social Welfare Violence Against Children. Gil, D. G. Cambridge, Mass., Harvard University Press, 216 pp.,1973. CD-01162 Dependent-Neglect -Proceedings: A Case for Procedural Due Proems. Faber, D. M. CD-01192 Child Duquesne Law Review 9:651464, 1971. Downstate Medical Center, Brooklyn, N.Y._ Div. of and Adolescent Psychiatry, A Psychodynemle Approach to the Study and Treatmentof Child Abusing Parent!. CD-0116S Green, A. H. Department of Social Welfare, Wellington (New Zealand). American Medical Association Annual Meeting, NewYork, Child-Abuse In Nino Zealand_ 22 'pp,: June 26, 1973. . .

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CD-01194'4 CD-01232 Downstate Medical Center, Brooklyn, 'N.Y. DIV.74 Child Rutgers Univ., Newark, N.J. Nezark Coll. of Artsand and Adolescent Psychiatry. Sciences. Psychological See:liaise of Child Abuse and Neglect. Puhlid Knowledge of Child Abuse. - Green, A. IL; Gaines, R. W.; Saridgrinid, A. Lindenthal, J. J.; Bennett, A.; Johnson, S. American Psychiatric Aisociation 127th Annual ?leering, Child Welfare,44(7).521-523, July 1975. Detroit, Mich.,17 pp., May 6:1 0, 1974.

Ci91234 CD-01206 ". gait Hospital for Children. He adingtosi (England). Family Service of Milwaukee, Wis. &health and Chid Abuse. Uncovering the Precipitant is Crisis Intervention. . Lynch. M. A. Hoffman, D. L.:Re:mei. M. L. Lancer 2(7929):317.319, August 16,1975. Social Casework 259-267, May 1975.

CD1256 CD-01208 New Jersey State Div. of Youth and Family Service4, Bristol Royal Infirmary (England) Trenton.Bureau of Research. Planning, and Pmgralo Early Life of the *Battered Development. Hojrnan, R. R.; Kanwar, S. Abuse and Neglect in New Jersey. A Guide for Cosurnunk Archives of Disease us Childhood 50(1) 78-80, January ties and Provider Agencies. 1975. New Jersey State .Div. of Youth' and Family Services, Trenton. Bureauof Research, .Planning, and Program Development, 21 pp..., August 1974. s CD.01219 Georgia Pm., Athens. Regional Inst. of So cial Welfare Research. CD01 261 Child Abuse. State Legislation and Programs in the South. New York State Dept. of Social Services,/A/any.- east. Cams of Suspected Child Abuse and Maltreatment Re- Johnson, C. L.- ported to the NYS Central Child Abase and Maltreatment Georgia thuv.. Athens. Regional Inst. of Socia l Welfare Register 1973. Research, 108 pp., August 1973. New York State Dept. of Social rvices, Albany, Program Brief No. 2, 4 pplilikpril 1974.

CD01223 Boston Coll., Chestnut Hill. Mass. School of Law. CD-01262 Emancipating Our Children- Coming of Legal Age di Children's Hospital Medical Center, Boston, Mass. Family America. pevglopment Study. Katz, S. pi., Schroedei:W. A., Sidman. L. R. Toward imEtiologic Claseificadon of Pediatric Social Family Law Quarterly 7(3).211.241, Fall 1973. Maces: A Descriptive Epidemiology of Child Mini and Neglect, failure to Thrive, Accidents and Poisonings in Children Under Pour Years of Age. Newbeyger4. H.; Reed, R. B.; Daniel, J. H.; Hyde, J. N., CD -01226 Jr.; Ktitelchuck, M. Alaska State Supreme Court, Fairbanks. Society for Research m Child Development Biennial Meet- The Balance of Power Among Infants, Their Parents and ing, Denver, Colo. 20 pp., April 11, 1975. the State, Part 2. Parental Power. .1Ckinfeld, A. J. Family Law Quarterly 4(4):410443, December 1970.

CD-01263 0 North Cuiiiins State Dept>of,Hurnari Resources, Raleigh. CD -01231 Div. of Social Services. i Caveat Patens. A Demystification of the Chid Protection Neglect and Abuse of Children in North Carolina. System. North Carolina Sate Dept. of Human Resources. Levine. R. S. Div.. of Social Services, Special Report' No.30, 32 pp., Iie University of Pittsburgh bsiv Review 35(1).1-5 2, Fall 1973. January 1975, '

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CD0121/3 Roberts, D.; Adler, M. Burderop Hospital, Wroughton (England). Dept. of Psy Wisconsin StateDept. of Health and SocialServices, chbtry. Madison. Div. of FamBy Services, 13'pp., 1974. Severely DI-treated Young Children in North-East Wiltshire. . Oliver, J. E.; Cox, J.; Taylor, A.; Baldwin, J. A. Oxfoid Univ, (England). Dept. of Clinical Epidemiology, Research Report 4, 88 pp., August. 1,974 11!1294 h theiriiIllinois Univ., Edwardsville. Dept. of Educitional ir" Research. What Can the Schools Do +bout Child Abuse? CD01274 Rochester, D. E.; Ellis, M. A.; Sciortino, S. C. - Illinois Univ.Mhigago. Rush Medical Coll. In. Leavitt, J. E. (Editor). The Battened Chad. Selected The Minos Child Abuse and Neglect Reporting Acts ert Readings. Morristown, N. J.; General Learning Corp., and Present. " 213-214, 1974. Pachnian, D. La, lltiitolsMediCal7aPf1,1149(1175-184,February 1976.

CD0129B Louisiana 'State Univ. and Agricultural and Mechanical CD01278 Coll., Baton Rouge. Dept. of Psychology. . California Univ., Los Angeles. The Effect of Prior Physical Abuse on the Expression jif A, DiscriniinanT Function Procedure for Idenkying Abusing Overt and Fantasy Aggressive Deily/101 in Children. Parents. Robson, R. H. Paulson, M. J., Afifi, A. A., Chaleff, A , Lw, Y Y.f Docioral Dissertation. Mn Arbor, Mich., University Thomason, .M. L," 4° films, 123 pp. (UM 71-29,389), 1971. Suicide 5(4):104-114, Summer 1975. 1C7

CD-01307 . CD01281 ." ChildWelfireLeagui of America,. New Yogic, Y. 'Pennsylvania State Dept. ofPublic Welfare, Hamsburg. Research Center. Bureap of Child Welfare. Service to Children in Timis ,Own H Nature and 1973 Child Abuse Report. Outcome, Pennsylvania State Dept. ofPublic Welfare, Hamsburg. Sherman, E. A., Phillips, M. H., Haring, B. L.. Shyne, A. W. 'Bureau,of Child Welfare, 31 pp.,1974. blew York, Child Welfare League of .Ameriga, Inc., I% pp.,

I 1973. 1 . 6 . -CD01284 S Child Welfare League of Amen ca, New 'Yank, N Y. Re; CD -01309 . search Center.. Social and jtehabilitation Service' (DREW), Washington; Factors Associated With Placenient D oak in Child D.C. National' Center for Social Statistics. ., Welfare. *. .' . , Juvenile Court Statistics. 1971! - . Phillips, M.H.,'Shyne, A. W., Sherman, E..-., Haring, B. L. Social and Rehabilitation' Service?DH&W),. iaih gt on, York Child Welfare League of America, Innis., 113 pp., D.C. National 'Center for Sodil Statistics, (S RS) 73-03452,_ New . w v. . 20 pp., December 1972: . -,

. w . Ca285 CD-013) 6 ..- , Georgia Umv., Athens. S,.hool of Social Work. Bntish Columbia Univ., VanConver, Div. Of .Child Prychia- .

ingots of Futility. ,* ,, Polarlsky, N. A.; Borgman, R, D.;'De Saix, C. Project:toddle:Ante:1m Rep*. Sari Francisco, Jossey-Bass, Mc., 272'pp.. 1972. Stephenson, P. S. British Gdlu mbia Univ., Vancouver: Div. of Child Psychia- try, 112 pp., September 1975. ., i . 293 nein, State Dept. of Health and Social',Services, Madison. Di/. of Family Serkes. .CD-01317 Child 'Abuse in Wisconsin. New Hampshire Univ., DurAm. Dept. of Sociology. r . .11

t .

Theories, Methods; and Controversies in the Study of CD-01345 . . . Violence Between Family Members. Child,Study Center, Oklahoma City, Okla. Strauss, M. A.;Gellea, R J., Steinmetz, S. K. Parrtal.Alienation Om nobs Precursor of Chl base. American Socking (cal Association Meeting, 73 pp., June Young, M. 1973. ChildStudyCenter, 01Rhoma CityP Okla.,15pp., November 1975. %

CD-01319 . . Tennessee State Dept. of Public Welfare, Memphis. CD-01346 ... f Study on Child Abuse and Child Neglect in Tennessee. Oklahoma Univ., Norman. Graduate Coll. Tennessee State Dept.. of Public Welfare, Memphis, ?2 pp., Some Selected Dynepons of Alienation in Abusive and March 1975r, . Non-Abusive Families: A Comparative Study. , . . J Young, M. , 16* Master's Thesis. University of Oklahoma, Norman, 99 pp., 1975. CD-01337 Stanford Univ., Palo Alto. School of Law. State Intervention on Behalf of "Neglected" Children: A Search for Realiatk Standards. CD-01369 v. ,Berkeley Planning Associates. eabf 4 Santora Law Review 27(4).985-1040, Apnl 105. Evaluation,Nmmary. Extended Family Center 1973-1975. Armstrong. K. L . Cohn. A. H.. Collignun. F C. Berkeley Planning Associates. Calif 29 pp . undated. at . $D41335 4 army General Hospital, Frankfurt (West Germany). Dept. of Psychiatry. CD-01371 . '`alt The CharacteOsiies snd Management of Child Abuse in.the Child Abate Reporting Profile!. 4. ..U.S. ArmyEurope. Baade, R. A Wichlacz, C. R., Randall, D. IL, Nelson, J. H.empe, C. H. Prepared forColorado Stole Department of Social Serv- Clinical Pediatrics 14(6).540-548, June 197 ices. Denver. Office of Public Information.. 20 pp.. June- 4 1976 , . fib 0

6D-01337 : CD-01372 Pittsburgh Univ., Pa. Dept,rMaternaland ChildHealt h, California State Dept of Correction's. Sacramento The Control of Ch0d-Environment Interaction. A Con- Hakim! Violence: A Prole 62 Men. esptual Approlch to Accident Occurepcs. Bach-y.Rita. GA Veno. A. Wight, B. W. American Journal of Psychiatry 1310).1015-1017. Pediatrics 44:799405, 1969. September 1974 '

f CO-01434Q' Lando,hoel of Economies and Politicalcience (Eng- . CD -81376 Oxford Univ. (EnglandA Unit of Clinical Epidimiology. t of Incest. A Criminologist's View. Epidemiology ind Family Characteristics of Severely. stbused Fefi41;1, Children. Medicine Scet, anthe Law 14(1):64.67, January 1974. Baldwin. J A.: Oliver. J. E. British Journal of Preventive and Social Medicine 29(4)-205- 221. 1975. .

CD41341 Problem Families and thhone ept of immaturity. CCM)1377 Wilson, H, Family Service of Dryad and Wayne County. Mich. In:Kadushin, A. (Editor). Child Welfare Services. A issues of Violence in Family Casework. Sourcabook. New York, Macmillan anj Co., pp. 7-23. B411. M. 1970. Social Casework 58(1) 3- q. January 1977. .

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BCD -01387 Speech and Language"( Abused Children; Berkeley Planning Associates, Calif Blager. F. B.: Martin. H. P. Full Cost Atpdysis: Findings to Date. Evaluation, National In. Martin. H P. ltilitor). The Abused Child. A Multiclig- Demonstration in ChiAbuse and Neglect. Approaa to Developmental issues and Treat- Barrett. L.Fro land. C.. Cohn, A. H., Colligrion, F C. ment Cambridge. Mass.. Ballinger Publishing Co., pp. 83- Prepared for: 'Health-Resources AdminIstraticii (DREW. 92. 1976 Rockville. Md. National Center for Health Services Re- search, 49 pp Hpvember 1976.

CD-01413 - Pittsburgh Univ.Pa: CD-01388 Communication Skills of Atsecl Children. Health Based Programs in Child Abuse and Neglect. Blotim. L. A Bates. T.: Elmer. E.. Delaney. J Doctoral Dissertation Ann Arbor. Mich.. University Mi- . In: Fift)f National Symposium on Child Abuse. Denver. crofilms. UM 76-14108.. 98 pp.1975. Colo.. American Humane Association. pp 32.37. 1976

CD-01415 CD-0139S. Child Welfare League of America. New York. N.Y. Colorado Univ . Denver Dept of Pechaincs The Community and the Social Agency Define Neglect. Psycliptherapy. Boehm. B Beezley. PMartin. H P . Kempe. R. S Child Welfare 33(9) 453-464. November 1964. In: Martin H. P (Editor). The Abused Child A itIlti-tilSCI plinary Approach to Developmental Ivsues and Treatment Cambridge. Mass. Ballinger Pubtang Co . pp 201.214. 1976. CD-01418 Anzona Community Development for Abuse and Neglect., f Phoenix , : CD-013961 Delinquency Patterns in Maltreated Childrep and Siblings. Behavior Associates. Tucson. Ariz Bolton. F. G.. Jr : Reich, J. W.: Gutierres. S. E. Parents, ALIOJIMOILS Self.Help for Child 'Abusuig Parents Anzona Community .Development for...Abuse anii.Ntgleia, Project. Evaluation Report for Period May 1. 1974April 30. Phoenix. 14 pp.. 1977 .. 1976. tre'pared for Parents Anonymous rational Office. Redon- do Beach. Calif . 152 pp . 1976

CD41425 . . ,, Beth Israel Hospital. Boston. Mass. .CD-01400 The Sexually Misused Child. .. Berkeley Planning Associates. Calif Brant. R.S.T ; Tisza. V. B A . ' ,'"' - Summary of Findings to Date. E;almition of the Joint OCD- Amerscanclowital of Orthopsychant, 47(5.89;90. January SRS Demonstration Program in Child Abine and Neglect. 197;. Prepared for. Health Resources Administration (DHEWI. Rockville. Md National Center for Health Services Re search. 43 pp : Novernikr 1976 te CD-01426 Harvard UnivBoSton. Mass School of Medicine. Early :Mother - infant Reciprocity. CD-01407 Brazelton. T. BTronick. E.: Adamson. L.. Ms. H.. California Univ.. Berkeley School of Social WeJtpre Wise. S Studies in Child Protective Sentices. Ciba Foundation Symposium (33).137-154. 1975. Billingsley. A.: Giovannone) J M Parvine. M California UnivBerkeleySchool of So"al Welfare. 212 s '. 11969 PP.. Septembe 4..

.CD-01429 CD-01412 Bntish Medical Journal Colorado Univ.. Denser Dept. of Speech Pathology and Ineogt and Family Disorder. Audiology. - British Medical J01117101 2(5810):364-365, May 13. 1972..

dm.

79 ,Q .9 fw A 4

Co:01433 ' CD-01453 Child Abuse in Alaska. British Columbia Univ.. Vancouver. Dept. of Pediatrics. Brown .G" W: Relationships of Head Injury and Child Abuse. 'In; Circumpolar Health.Toronto.Umversity of Toronto Carter. JE Gayou. R. Presspp 161-468. 1976 BritishColumbia Medical Journal18t2):50.52, February 1976.

4* b co-01435 Oregon Univ., Portland. Child Psychiatry Clinic CD-014S9 Incest: Children at Risk. California Univ.. Berk,. Maternal and Child Health Browning, D. H.; lkiratman; B Program and Family Health Program. Amerian Journal o Psschiati7.11-111169 fantiap, 19 Child Abuse and Neglect: Physicians' Knowledge, Attitudes, and Experience. Chang. A.. Oglesby.. A. C.: Wallace. H M. Goldstein. H.; Hexter, A. C. . - CD4/1438 - ., American Public Health Association Annual-Meeting. Chi- Indiana Univ.Indianapolis School of Nursing ' sago, 2 pp, November 17, 1975. . Factors Contributing to Child Abuse. Bullerdick Corey. E. .1; Miller. C L L. Widlak. F W Nursing Research2414) 291-295, July-August .1974 , 1461 oloro Univ.. Deny B F Solinsky Lab. Undernutrition and Child Developitsent. CD-01440 Chase. H P : Martin. H. P. State Cniv of New Yotk. Stony j3rook ,School of Nurs- .'NeilEngland Journal of Medicine28207033-939. April ing. . 23. 1970. An Area forloncern A Study on identifications and Re- porting by !Wdated Sources in Cases of Child Abuse and Neglect in Suffolk County. Burns. A.. Feldman. M : Kaufman. A . Stransky. P CD-01463 - Setauket. N Y ;Edmond Publishing Co . 39 pp .l9'3 Anzona State Univ.. Tempe School of Education. A Descriptive Study. Undergraduate University Students Identifying With Dysfunctional Rearing Patterns . as Measured by Family Relations Survey. CD-0,1442 Chavez, G'T . - Burt Associates. Inc.BethAffa. Md Anzona State Univ.. Tempo. School of Education. 48 pp.. Final Results of the Nashville Comprehensive Emergency May 1976 Services Project. t, Bun. M R. Child.Weffare5549).661-664, November 1976 CD-014.P., Children's Hospital Medical Center. Boston, Mass. Family Devd6pment Study. First Annual Report. CD-01447 Children's Hospital Medical Center. Boston. Mass.. 121 California State Health and Welfare ;Agency', Sacramento pp.. August 1973 Dept. of Social Welfare Statistical Report on Specialized. Child Protective Services. California State Health and Welfare Agency, Sacramento .. , Dept. of Social Welfare, 1973.1, 180 pp., December 1973 CD-01469 . .. -Utah State Univ., 4togan:Dept. of "EducaOn. . Educational 'and Psychological Problems of Abused Chil- dren. Christiansen, .1L. CD-01452' Doctoral. Diss livion. Ann Arbor, Mich.. University Mi- Northern Arizona Univ . Flagstaff Dept of Psychology .crofilms. 163p.. 1975. Comparison ofChild AbuseParanieters for the State of Ari-. *.' zone From 1971'to 1975, . Caplan. L. D. CD-0147,1 . Master's 'ThesisNorthern Arizona L' no 54 Pacific Lutheran Univ.. Tacoma. Wash. Office of Ethnic pp., April 1976 Studies , . Ito 8f' A

Child Abuse in Pierce County's Nonwhite Community: A CD-01507 Study of Perceptions and Attitudes. Royal Children's Hospital. Melbourne (Australia). Dept. of Clarke. A.; Menzel. R. Medical Social Work. Panel for Family Living. 'Tacoma. Wash.. 24 pp ; May Child Abuse in Nova Scotia.,.., 1976. Dawe. K. E. Australian Paediatric Journal 9(6):294.296: December 197? J

CD-01473 Creighton Univ.. Omaha. Nebr. School of Law. CD-01509 Child Abuse: The Problem of Definition. Umea Univ (Sweden). Dept. of Paediatrics. Clements. T. J. Long -term Effect on Mother-Infant Behaviour of Extra Con- Creighton Law Review 8(4729-7, 42. June 1975 tact During the First Hour Post Partum. Il. A Follow-up at . Three Months. De Chateau. P.: Wiberg. Acts Paediatrics Scandinavink.66(2)145-151fMarch 1977. CD-01479 institthe of Judicial Administration. Inc., New York. N Y Juvenile Justice Standards ?roject. A National Survey of AttitudeS of Selected FrofesSionals CD-01511 Involved in the Reporting of Child Abuse and Negleit. American Humane Association. Denver. Colo, Children's Cohen. S. J. Div. . institute of JudicialAdministration.In4. Nev. York. Child Abuse Preview of, a Nationwide Survey. N.Y.. Juvenile Standards Project. 36 pp. 1974 De Francis. V Denver. Coro.. American Humane Association. 18 pp.. 1963

CD-03480 I Institute of Judicial Administration. Inc . New York. N Y Jusoile Justice Standards Project. CD01516 A Study of Child Abuse Reporting Practices and Services in Arrieri...an Humane Assuciatton. Dem, eAr. Colo Children's Four States. Div Cohen. S. J. Protecting the Child Victim of Sex Crimes Committed by Adults. De Francis. V Denver. Colo . American Humane Association. 230 pp. CD-01489 1969 . Connecticut Child Welfare Association. Inc. Hartford .Second Annual Report of the Care-Line. Connecticut Child Welfare Association. Inc. Hartford 39 V "pp.. September 30. 1975. CD-01520 Penpsylvania State Univ..University Park. Coll.; of Hu- -man Development. Child Care by Adolescent Parents. CD-01490 De Lissqvoy. V Connecticut tlfild Welfare Associalion. Inc . Hartford Children Today 22.25, Jul'y4i .d&ust 1973 Third A111111111 Report of the Care- Line. January 1, 1976 - December 31. 19176. Connecticut Child Welfare Association. Inc . Hartfordl 50 pp.. December 1976 CD-01521 A Silent Tragedy. Child Abuse in The Community. DeCourcy. P.DeCourcy, J. Port')Washington. N.Y.,. Alfred Publishing CO.. Inc.. 231 pp . 1973 - CD-01496 - C6uncil of =Europe. Strasbourg (France). Group of Coordi- flitted Resekch Fellowship-Holders for 1%8 r Social Cooperatiroin Europe. Social Arden to Prevent the CD-01522 pebreakdown of the Family, the !(eglect of Children, and Ju Berkeley Planning Associates. Calif Delinquency. - Evaluating Case Managen,ient. ev*-York. Manhattan Publishing Co.. 59 pp-. 1972. DeGraaf. B

.4 ar. . ..111

2nd National Conference on Child Abuse and Neglect. CD 01548 ', -s, Houston. Tex .9 pp. Apnk 17-20, 1977 Pittsburgh liniv:,,Pa School of Medicine. A Follow-up Study of Trativiatized Children. Eimer, E. pediatrics 590E273-279, fegruary 19117 1 CD-1115311 Deviant Behavior 'and Putative Reference 417c10:---Child. Abuse as a Special Case. Disbrow. M. A. CO-0049 Nursing Research Conference 5 322-346. 1969 Pittsburgh Child (iiidance Center. Pa. Follow-Up Study of Traumatized Children. Mal Report. Eimer. E.. Reinhart. .I B ; Evans. I B. Pittsburgh Child Guidance Center. pa 117 pp1975: "CD-01532 California School of Professional Ps -hology. San Fran- cisco DifferentialAttitudesTowardsPUitishnientandChild CD -01550 Abuse. Maryland nis .. BaltimoreSchool ofSocialWorkand Dolder, S i L. Communn Planning. Doctoral DissertationAnn Arbor. Mich . UnherSli) Mi- Treatrnenof ChildAbusing Families, Ill. An praluative crofilms. 202 pp, 1975 Assessment. Ephross. P H Prepared forSinai Hospital of Baltimore. Inc.Md,41 pp September 1974 CD-01535 Louisiana State thus,and Agricultural and Mechanical Coll. Baton Rouge School of SocialV.elfare Multivariate implications in Child Abuse. CD-01551 Durham. I E Maryland Linis.Baltimore School of Social Work and Master's ThesisLouisiana State Ums and Agricultural Community Planning and Mechanical CoilBaton Rouge. 81 ppl9-6 Treatment el Child-Abusing Families. An Evaluative Assess- ment. Ephross. P. H Prepared forSinai Hospital of Baltimore. Inc. Md . 48 CD-01540 pp.. September 1972 Education Commission of the States. Denser. Colo 'Child ra Abuse and Neglect Project Child Abuse and Neglect in the States: A Digest of Critical CD -01$52 Elements of Reporting and Central Registries. Maryland Uri's.. BaltimoreSchobl of Social Work and Education Commission of the States. Denver, Colo Child Community Planning. Abuse and Neglect Project. Report No 83. 21pp. March Treatment of ChildAbusing Families,II. An Evaluative 1976. Assessinent. Ephross. P H.. Weissman. L A Prepared for Sinai Hospital of Baltimore, Inc . Md , 58 L-Clr-01544 PP . September 197) . Education Commission of the States. DenserColo Child Abuse Project, . Teacher EducationAn Active Participant in &Jibing the Problem of d Abuse and Neglect. Educatio Co fission of the States. Denver, ColoRe- ,CD-01556 port No. 99 . 14 pp . April 1977 Columbia Lim New 'York. N Y School of Sticial Work. Parental Visiting of Children in Foster Care: Key,toDis- charge? - Fanshels0 CD-0154.5 Social Serpic new 493414. December 1975 ,Education Commission of tbe_States. Denver. Colo. Child Abuse, and Neglect Prone( Education Policies and Practiecjiegardini Child Abuse and Neglect and Recommendations for Policy Development. CD-01$63 Education Commission oftheStates.Denser. Colo Denser Dept of Hall' and Hospitals. Colo Child Study , .Report No .85. (4 pp . April 1976 . Program \\' 82 r 88 Cognitive Development of Abused andFailureto-Thrive ,Goldyadol.'R. V .Fitch. M J . Umlof. H . Children. Jr , Fitch, M. J.. Cadol. R V . Goldson.E .Wendell. T., Denver City and County Dept.,of Health-and 'Hospitals. Swanz, D - Colo. 15 pp . 1W4 Journal of Pediatric Psycho log) 1421 -12. 3-.Spring 19'6

CD-01608 CD-01.579 Kansas Kansas CityMedical Center. Minors' Rights to Medical Care. Child Abuse and Neglect: gpidemiology in Kansas. Frentz, T W. Gonzalez - Pardo: L.: Thomas, M. Journal of Family Law 1414i 581-596. 19'75-1976 Journalof ' theKansasMedical Soda,713121.0544. February 1977.+

CD-01582 Rochester Univ . N Y Dept of Pediatrics CD01609 Child Abuse: A Five-Year Follow-up of Early Case Finding Northern General Hospital, Sheffield i Englahcli* in the Esnergency Department. \tpredicting Child Abuse. iLerteri. Friedman. S. B . Morse. C W ordon. R R Pediatrics54t 41 441410. 04-tober 19'4 British i4edical Journal 1460641 pt. March 26. 19"

T41583 CD-01612 eas Univ.. Houston School of Public Health New York State Deptof Social Services. AlbanyOffice .Epidemiological Surrey of Physical Child khuse. of Research Friedrich. W N Trends in Child Abuse Reporting in New Work State. 1966- Texas Medicine 72 81.84. October 19'6 1972. Gray, JJ Nev. York State Deptof Social Services. Albany Office of Research. 11 pp . Apnl 1973, CD-01S84- Ad.. - North Dakota env._ Grand Forks Dept(4f Psycho1034, 111-Healthand Child Abuse. iLetteri. Friedrich. W NBortskin. J A CD-01614 Lancet !1"'9601 6i9 -650. klurh 20. 19-6r Downstate Medical Center. Brooklyn, N Y Di.of Child and Adolescent Psychiatry A Psychodynamic Approach to the Study and Treatment of Chad-Abusing Parents. . lomiso4 Green. A H. Against Children. Physical Child Abuse in the l n- Journal of Child Psych:Jur, 15(l 414-429. Sumner 1976 het Slates - In Eiroafenbrenner .11 . Mahoney. M a 'Editors)Influ- ences at Human DevelopmentHinsdale III Dr.den Press. 'pp i902.01. 1975 CD-0161$ State tdrii.of New York. Brooklyn Thy of Child and Adolescent Psychiatry SelfDestructive Behavior in Battered Children. C6-01604: Green, A H Brandeis CO1V . Walt am. Mass State Univof Nev. York, Brooklyn Div of Childand Legally R4ported ChiAbuse: A Nationwide Surrey,. . Adolescent Psychiatry. 26 pp . 1976 ,SGil, D. Gf Social Work ,Piactice, 18 134-158. 1968

CD-4116,2, 'D-01606 Royal Infirmary. Preston (England) Develornenta) E.vitization Ce ter. Denver. The Battered Baby Syndrome. Non- Accidental Injuries in Non-sceiticiind Testi= and Failure to Thrive: A Soria- Children. ' 'Mediae Pro#le la Denver. Hall, M H

183 8,9 in: Papers for Discuksion at Sessions. 79th Health Con- CD-01681 gress of the Royal Society of Health. Eastbourne. April Regturhil InNt_ of Social Welfare Research. Inc.. Athens. 24.28. 1973; London. Royal Society of Health. pp 97-102, Ga 1972. Two Community Protective Service Systems: Nature and Effectivetyess of Service Intervention. Johnson. C L . CD-01633 Regional Instof Social Welfare Research. Inc . Athens. University. of the Pacific. Stockton. Calif. Dept. of Educa- Ga . 386 pp . 1977 tion. Child Abuse and the School. Harriman. R L. CD-01683 , Doctoral Dissertation Ann Arbor. Mich.University MI- ,Georgia Lanus. Athens RegionAl Instof Social Welfare crofiims, 128 pp. 1975. Research Two Community Protective Sallee Systems: Comparative

cc Evaluation Of Systems Operations. Johnson. C L CD 01656 Georgia troyAthens Regional Instof Social Welfare Royal AlexandraHospitalforChildren.' Carnpirdown Research. 52 pp ..klarch 1976 lAustraliai Community Pediatnc Unit Nonorganic Failure to Thrive: A. Long-Term Folloaup. Hufton. I 'W . Oates. R K Pediatrics 59t 1, 738. January I. 1977 CD-01684 Child Welfare League of Amenca. Ins . New York. N Y Research Center A Second Chance for Families. Evaluation of a Program to CD-01660 Reduce Foster Care. National Society for the Prevention of Civet} to Chil- Jones. M A Neuman. R. Shyne: A W dren. London iEnglindi National Advisory Center fur the New York. Child Welfare League of America. Inc .133 Battered Chikl pp.. Jaopary 1976 Accidents In 14 Home to Chitldren Lander Two Years. A Report on a Questionnaire. Hyman. e A .ilealtkVisifor 37151 139-141. May 1974 CD-01688 Texas UnivHouston School of PubliC Health.

Life Crisis as a Precursor to Child Abuse. ' Justice. B . Duncan. D F ,CD-01661 Public Health Reports91(:) 110-1i5. March-April 1976 Notional Society for the Prevention1Cruelty toChil- dren. London tEnglandi. National Ads:ry Center on the Battered Child A Psychological Study of Child Battering. itD-01691 Hyman. C A , Mitchell. R TA Work With Child Abuse. Health Visitor 48(8) 294.296. August 19"5 t Justice. R . Justice. B Transactional Analysis Journal `11) 38-41. January 1975 4

1 CD-01670 Iowa State Dept of Social Services, Des Moines Bureau CD-01697 of Management Information - New York City Human Resource.,Administration. N.Y Statistical Data on Child Abuse Cases Reported to the State Office of Psychiatry Department of Social Services. October-December 1975. The Murdered Child and His Killers. Iowa State Dept of Social Services. Des Moines Bureau Kaplun. D . Reich. R Of Management Information. 5 pp ,Irehruary 24197401 American Journal of Psychiatry 1371 809.813. July 1976

CD-01674 Minnesuta Cray . Minneapolis Dept of Pediatrics CD-01698 . Sexual Abuse of Children. An Epidemiologic Study, Boston Coll . Chestnut Hill. Mass School of Law Jaffe. A. CDynneson. L. ten Sense!:R W Children. Individuals Without Rights. American Journal a ,Diseases of Children 129i6) rot9.6,92, Katz. S. N . 'June 1975 Student Lawyer 1(31.48. 50. 52. February 1973 ft

M CD-01699 CD-01738 Boston Coll . Chestnut Hill. Nlas. School of Law Pennsyl.ania State Crits . Hershey Dept of Pediatncs Legal Research on Child Abase and Neglect: Past and Fu- Child Abuse in arural Setting. ture. Lloyd-Still. J D . Martin. B K4EZ. S N . Ambrosino. L . Nic Grath. s1. K Pennol, ania %ledicine7913 56-60. March 1976 Panel, Law Quarterts l4i2)151-1$4. Summer 19"

CD-01748 CD-01706 Oxford Unr. (England) Park Hospital for Ghikiren National Center for the Pre.ention and Treatment of Chiki Residential Therapy - A Place of Safety. Abuse and Neglect. Denier Colo Lynch. M A . Ounsted. C Predicting and Preventing Child Abase. Establishing Chile InHelfer. R Eand Kempe. C H (EditorsChild ,dress's Rights by Assuring Access to Health Care Through Abuse and NeglectThe Family and the Community the Health Nisitors Concept Cambridge. \la... Ballinger Publishing Co pp195-207. Kempe. C H 1976_ In Proceedings of the First NationalConferesce on Child Abuse and Neglect January 4.-19-6 114.t.hineion National COnier on Child Abuse and Negicvt .r)t-IF4 101-1DC".t(Xt94 pp 6'--419-- CD-01749 Park Hospital for ChildrenHeaderigton (Englund) Human De.elopment Research Unit Predicting Child Abase: Signs of Bonding nature in the Maternity Hospital. CD-01710 Lynch. M A.. Roberts. J Ca.e Wcsiern Re 0.1 e L*10. Cpe.eland Ohio1>rpt <4 British %ledical Journal116061i 6244126, .Nfircl.7!. 197 Pediatrics . Maternal Behzior One Near After Early and Fstended Postpartum Contact. Kennett. J JerauitiR 11 4. hekr 1)hreeer CD-01750 C Park Hospital for Children. Oxfords( Englandi Deseopinental Irdulne and Child Neurvioe .F.2. Family L nit in a Children's Psychiatric Hospital. April 19-4. "Lynch NI ASteinberg. D. Ounsted.C British %ledical Journal:09M)127-1:19. April 1919'5

CD-01712 Children 1-1,,,pttalI f arn11, CD-01752 bnent Project Portland State L nr, . Oreg A Follow-up Study of Abused C hildren , The Disposition of Reportgd Child Abase. Kerit.'J T %laden M F Journalof PediatricPS.$thniuits1.22' lorin4 ' Doctoral DissertationPortland State Uni`, ()leg 160 pro

CD-0I'114 Utah State Lniv(_Dean Dept of Special CD 11760 Final Report. Educational and Psychological Problem. .4 Colorado ant.Denser John F Kennedy Child Develop Abused Children. ment Center Kline D Christiansen .1 I Nutrition: Its Relationship to Children'. Physical. Mental. Prepared for(Mfi.e. of Fducdtion ,1)1-1FA a,hirigtor, and Emotional Development. D C Bureau of Edui.4tion for The Handicapped h2 rr H P sepiernixp Imerican Journal o1ClituralNutrition 26 c 19-1

CD-01718 Colorado 1 nr. Denver CD01762 Child Abase and Neglect. Effect. an Basks Scale 'wore,. Colorado Iriss. Dero.cr I) piof Pediatrics Koski. M AIngramF5 Ni Neurologic Status of Abused Children.

Journal of Abnormal ( hildPs s choingy < I-.4, '; Martin H P InStarlit!, H P (Editor) The Abused Child A !vtultidis- Psychosocial Characteristics of Neglecting Parents. Implica- ciplinary Approach to Developmental Issues and Treat. tions for Treatment. ment Cambridge. Mass . Ballinger Publishing Co. pp67- Mulford. R M. Cohen.M I 82. 1976 InNeglecting Parent> A Study of Psychosocial Charac- Teri-alesDenver. Colo. AmericanHumane Association. pp 5-20, May 25. 1967

CD-01767 ,ayCOloradil Univ. Denver John F Kennedy Child Develop. meet Center CD-01816 The Development of Abused Children. Part 2. Physical; National. Safety for Prevention of Cruelty to Children. !vieurologre. and Intellectual Outcome. London (England) Dept of Battered Child Research Martin. H P. BeelleyP Conway. E F. Kempe. C H At Risk. Adsances in Pediatrics21 44.73, 1974 London. Routledge and Kepi' Paul Ltd246 pp 1976

CD-04.790' CD-0183I McMaster C nivHamilton (Ontario) Dept of Psychiatry iev. York University Law Review Incest Syndromes. Obstrvatiuns in a General Hospital Psy- In the Child's Best Interests. Rights of t!it Natural Parents chiatric L nit. in Child Placement Proceedings. Molnar. G. Cameron.P 'sew York Lniversit)Lass Revies. 51.146477. June 1976 Canadian Ps,schiairkAssociation Journal. 1'0(51 373-177 August 1975

CD-01842 Office of Child Development WHEW"). Washington. D C CD-01793 The Public Idformation Campaign. Johns Hopkins I. ni.Baltimore std Dept of Psychiatry Office of Child Development WHEW). Washington. D C . and Behavioral Svience> 34 pp.July 3. 1974 IQ Change Folloaing Change of Domicile in the Syndrome .1' of Reversible Hy posomatotropinism1Pyy chosocial Du arfism Pilot ln,vestigation. CD-01848 Moiv. JAnnecallo C Office of Youth Development WHEW), Washington, D C. National Institutes of Health Conference on Research on Juvenile Court Statistics -- 1972. .Child Abuse and NeglectBethesda pp June 1-. OfficeofYouthDevelopment WHEW). W'rishington, 1974 I) C :19 pp .1974..

CD-01795 Johns Hopkins iniv Baltimore. did Dept of Psychiatry CD -0I849 and Behavioral Sciences dffice of Youth Deselopment WHEW). Washington. D.0 Late Puberty. Retarded. Growth, and Reversible 11) posoma. totropinisrn (Psychosocial Dwarfism, Juvenile Court Statistics -- 1973. Money. J . Wolff. G Officeof YouthDevelopment (DREW). '.Vashingt9n- Adolescence 9)13) 121.134,Spring ira D C OHDOYD 75-26043, 18 ppMarch 19-5

CD-017% CD-01851 National Society for the Prevention of Criicliyn.Chit National Society for Prevention of Cruelty to Children. dren, London (England, London (England) Battered Child Research Dept lo-Yo Children. Childhood Accidents and Child Abuse. More J Mei! C 'fuming Tins.% 71.144g)1888-1889 Detrriber 41974 Community iledicine126 124-127. 1971

CD-0I806 ' CD-01855 Massachusetts Society for the Prevention of Cruelty to University of SOuthern Calfori:Lia, Los Angeles School of Children Boston Social Work

86 An Analysis of Complainants and Complaints in a Public Journal of the American College of Emergency Physical's Agency Protective Services Setting. 3(6)388-390. November-December 1974. Olsen. L. G. Master's Thesis. University of Southern California. Los Angeles. 91 pp.. June 1966. CD-01891 . Georgia Univ.. Athens. School of Social Work, Measuring Adequacy of Child Caring: Further Develop- CD-01862 ments. Colorado Commission on Children and Youth. Denver Polansky. N. A. Pollane. L Colo. Child Welfare 54(5):354 -359. May 1975. Child Abuse-Child' Neglectinthe Metropolitan Denser

Pacheco. C Colorado Commission on Children and Youth. Denser CD-01899 . 0°10- 44 PP October 10. 1974 .Queensboro Society for the Prevention of Cruelty to Chil- dren. inc.. Jamaica. N Y. Child Abuse: The Feasibility of Establishing a Coordiliated. ;rein forMaltreatment Servicesin QueensCounty. CD-01866 eensboro Society for the Prevention of Cruelty to Chil- Panel for Family Living. Tacoma. Wash &c.o. IncJamaica. N Y. 245 pp . October 1976 Coordinating Community Concern for Child Abuse and . Neglect. First Annual Research Report. Panel for Family Living. Tacoma. Wash124 pp 1975 CD-01906 Arizona State Univ . Tempe Dept of Psychology*. Experimental Assessment of a Treatment Project. CD-01874 Reich.1 W California UnivLos Angeles School of Medicine Journal of Pediatric Psychology 1(2).94-97. Spring 1976 Clinical Application of the PD. MA and t0Hi Experimental MMPI Scales to Further 1.-nderstanding of Jibusise Parents. Paulson. \i J. Schwemer. G T. Bendel. REl Journal of Clinical Psychology Y.:(3 (58- c6-1Jul) 19-6 CD01909 Albert Einstein Collof Medicine. Brons. N Y Dept of Pediatrics and Community Health CD-01877 The Relation of Severe Malnutrition in Infancy to the intel- Salop County Council Child Guidance Clint... Shire hall ligence of School Children V,ith Differing Life Histories. (England). Richardspn. S Consciously Rejected Children. Pediatric', Research 10 57;61. 1976 Pemberton. D A . Bendy. D R. British Journal of Psychiatry 123( c'61 575-57R. Novern 1973

s CD-01919 City Univ of New York. N Y Mt Sinai School of Media ' CD-01878 tine Philadelphia General Hospnal. PaPhiradelphi..' Ses Of- Effects of Diphenylhydantoin on Child-Abusing Parents: A fender andRapeVictimCornier Preliminary Report. Who Are Victims of Sexual Assault and the P. Rosenblatt. S.. Schaeffer. D. Rosenthal. J S chology of Offenders. Curreht Therapeutic Research 19(3) 332- 336. March 1976 Peters-1.) - Aniertan Alum, of Psychotherapy%0C.4) 398-411 July 1976

CD-01926' Minnesota Urns,Minnea(olis.Univ Hospitals CD-01882 Child Abuse and Neglect. A Minnesoth Update -- 1477 Be- .Ohio State Univ.Columbus. Dept of Nursik yond the Battered Child Syndrome. Intentional Burning: A Severe Fnrm of Child Abuse. Runyan. D K . ten Bensel. R W Phillips. P S . Pickrell. E.. Morse. T S Minnesota Medicine WC) 141-1.14. February 1977

87 CD-01938 Interpersonal Relationships and Child-Rearing Practices in Colorado Univ', Boulder. Dept. of Psychology 214 Parents of Battered Children. A Predictive Screening Questionnaire for Potential Problems Smith. S M.. Hanson. R. in Mother-Child Interaction. British Journal of Pechiatr.,127 513.525. December 1975 Schneider. C.: Hoffmeister..1. K.: Helfer. R E. In: Helfer. R. E. and Kernpe. C H (Editors)Child Abuse and Neglect. The Family and the Community Cambridge. Mass.. Ballinger Publishing Co. pp393.407. CD-01964 1976 Dartmouth College. Hanover. N.H " Some Factors Associated With Child Abuse Potential. Sokol. R. American Sociological Association 71st Annual Meeting, CD-01945 New York. N Y.. 17 pp.. September 2. 1976 New York Daily News. N Y. Child Abuse: ik Killer Teachers Can Help 'Control Shanas. B. Phi Delta Kappan56(7) 479.482. 1975 CD-01993 Minnesota Univ . Minneapolis Dept. of Pediatrics Child Abuse Following Early Postpartum Separation. iLet- ter). a CD-01946 ten Sense,. R W . Paxson. C L. Jr National Center for Education Statistics DHEW). Wash- Journal of Pediatric,90(3) 490-491. March 1/77 ington. D.C. Education Div Neglected or Delinquent Children Living in State Operated or Supported Institutions. Fiscal Year 19721 Siegel. L. CD-02012 National Ceter for Education Statistics iDHEWi. Wash. Brandeis Univ . Waltham. Mass ington. D.0Available., from the Government Printing The Client of a Protective Agency in" the Context of the Office. 40 pp.. 1975 Community: A Field Study of the Massachusetts Society for the Prevention of Crucify to Children. Varon. E Doctoral Dissertatioq. Ann Arbor. MichUniversity Mi CD-01947 , crofilms. (UM 62-1215). 302 pp.. 1962 1 RoyaTHospitai fix Sick Children. Edinburgh (Scotland) Non-AcrWistal Injury: A Two-year Study in Central Liter- . pool. Sills..1. A.: Thomas, L., J.. Rosenbloom. L. CD-02015 Developmental Medicine and Child %eurologt1911i 26-33. Helsinki Univt Finland, Dept. of Foreap. Psychiatry February 1977 Incest Offences and Alcoholism. ti Virkkunen. M Medicine. Science, and the Law,14(2).124-128. April 1974.

CD-01949 Rutgers. The Slate Univ.. New Brunswick. N .1Dept of Psychiatry. CD-0,2023 Agency Action and Interaction in Cases of Child Abuse. Western Michigan Univ.. 'Kalamazoo Silver. L. B. Dublin. C C . Lourie. R.S 'Sexual Abuse of Children by Relatives: An Exploratory SocialCasework52(3):164-171. March 1971 Study. Waterway. J Western Michigan Univ.. Kalamazoo. 53 pp . March 1976.

CD-01957 ! Birmingham Univ.. (England). Dept. of Psychiatry The Battered Child Syndrome -- §arne Research Findings. CD-02030 Smith. S M. California, State Dept.of Social Welfare. Satramento. *rang Mirror140(22):48-53. June 12. 1975. Program Information Bureau. ( Statistical Report on Specialized Child Protective Services for 1972. Webber. D. N CD-01959 California State- Deptof Social Welfare. Sacramento. Birmingham Univ. (England). Dept of Psychiatry, (1973 -3.53 pp. December 1973.

. 88 94 ONGOING RESEARCH STUDIES.

.CR-00002- CR-00016 Family Service Center, Honolulu. Hawaii. New York MediCar CollN.Y. Center for ComPrehenstve 2319 Rose St. Health Practice. Honolulu. HI 96819 , S E. IQ2nd St. liana Like Home Visitor Project. New York. NY 10029 Alger'. M.; Uohara. B. Family Care Program ( May 75-Jun 78 Brotman. R.; ZarinAckerman, J. Office of Child Development (PHEW}. Washington. D C Feb 75-Feb 78 New York Medical Coll:. N.Y.; National Inst. of Drug Abuse (DHEW). Rockville, Md.

CR-00003 Vanderbilt Univ.. Nashville. Tenn Dept. of Pediatrics 21st Ave. South and Garland St CR-00021, Nashville, TN 37232 Pennsylvania State Univ.. University Park. -inst. -for the Calmat Factors in Neglect and Battering; A Prospective Study of Human Development. Study. University Park. PA 16801 Altemeier, W A.. 111, O'Connor. S Social interaction Patterns Relating to Child Attie ahtl Jtm 75; Dec 78 Neglect.' National Center on Child Abuse and Neglect (DREW). Burgess. R. L Washington. D C. _Jun 75-Juna National Center on Child Abuse and Neglect (DHEW). -Washington. D.C.

CR-00008 c. National Council for Black Child Development. dine CR-00027 Washington. D.0 MexicanAmericanNeighborhoodCivicOrgabization I4i1 K St. N.W. Suite 500 iMANC011, San Antonio. Tex. Washington. D.C. 20005 118 Broadway Rm 327 An Exploratory Investigation of ,Potendal Societal and Ultra- San Antonio. TX 7820$ familial Factors Contributing to Child Abuse and Neglect. San Antonio Child Abuse and !Neglect Research Project.. Bentley, R. J. Chapa, D.; Luebbert. G Jun 75-continuing Jul 75-Jun 78 National Center on Child Abuse and Neglect 1DHE1111, National Center cu} Child Abuse and Neglect tDHEW). Washington. D C Washington. D C.

CR:00032 CR-00009 National Urban League, New York. N.Y. Texas Migrant Council. Laredo 500 East 62 St. P. 0. Box 917 New York. NY 10021 Laredo. TX 78040 Project Thrive; EahancAng the Black Family an Migrant Child Abuse and Neglect Prevention Project. the Children. Etermea, M.; Moreno. H. Curry, D. Jul 75-Jun 78 Jun 75-Jun 78 National Center on chili Abuse and Neglet tDHEW), islational Center on Child Abuse and Negl (DHEW) Washington. D.C. Washington. D.C.

CR-00039 CR-00010 Texas State Dept. of Public Welfare. Austin. California State Dept. of Youth Authonty1/4Sacramento. 3000 S. Interregional Hwy. Research Div. 'Austin. TX 78702 1829 16th St. Cidtd Abu'se and Neglect ResourcesDemonstration Sacramento, CA 95814 (CANRED) Project. Analysts of Child Abuse Reported to a Law Enforcement Dinges, J. B. AgeneY Jan 75-Jun 78 _ Bohnstedt. M.. National Center on Child Abuse and Neglect (DHEWO' May 77-continuing. Washington. D C.. CR-00041 CR-00057 White (E. H. and Co., San Erancisco, Calif. Children's Mission, Inc., Boston. Mass. Parents' and Chit- 347 Clement St. drens' Services San Francisco,' CA 94118 329 Longwood Ave Development and Conduct of aystem of Evaluation for Boston, MA 02115 Demonstration Centers in Childhuseand .'neglect. Parents' Center Project for the Study and Prevention of Doty. E. F.: Houston, T. R Child Abuse. Dec 74-Jun 78 . Galdsion. R.Bean, 5 I. National Center on *old Abuse and Neglect (DHF.W), Sep 68continuing Washington. D.C: Children's Mission. Inc., Boston. MassGrant Founda- tion, New Yott, N.Y. .

CR-00046 Minnesota Univ.,MinneapolisSchool of Psychology Training Program . CR-00058 N'548 Elliott Hall Boys Towit Center for the Study of Youth Development. Minneapolis, MN 55455 lor' Omaha, Neb A 'Prospective Study of the Antecedents of Child Abuse. 11414 W Center Rd Egeland, B.: Deinard. A. Omaha'. NE 68144 May .75-Jul 78 Ale Human Ecology of Child Maltreatment. Noticing Center on Child Abuse and Neglect (DHFW). / Garbarmo, 4 Washintlion, D.0 Sep 76-Jun 78 .

CR-00053 Children's Hospital ofBuffalo. N Y Deptof Medical CR-00059 Photography Rutgers. The State Univ., New Brunswick, N. J. Graduate ' 219 Bryant St. School of Social Work Etuffalo, NY 14222 New Brunswick, NJ 08901 Photography of Suspected Child Abuse and Maltreatment. Factors Relating to Levels d Child Care Among Families Ford, R. J.. Smistek, B S Receiving Public Assistance in New Jersey. Oct 74continuing Geismar. L.: Horowitz._ B Wolock. 1. Children's Hospital of Buffalo. N Y Jun 75-continuing -* National Center 'on Child Abuse and Neglect (DHEW). Washington, D.C. , , CR-00054 Child Development Project. Ann Arbor.Mieh t 201 E. Catherine St. CR-00060 1 . Ann Arbor, MI 48104 Rhode Island Univ02883./ King'slon, DePt. of Sociology. An Infant Mental Health Program. 1 Fraiberg. S. . . 111Child, Abuse: Sep 72Max 78 . si W.,.Ge les, National Ins!, of Mental Heilih (DHEW). Rocks*. Md Apr 74-conn Michigan State Dept. ofMental Health. Ann Arbor. 0.National Center on Abuse and Neglect` (DREW). Mich.:The Grant Foundation, New York. N Y JVashington, D.C.,_

CR-00056 *I Norther4 Iowa Univ., Cedar FallsDept of Psychology CR-00068 ^ ' Wisconsin Univ., Madison. Dept of Psychology Dartmouth "Co114. Hanoi;er. N.H. Dept. of Maternal old

Cedar Falls. IA 50613 ChildHealth. . Possible Contributions piChilditen to Their Own Abuse. Hanover, NH 03755 -/` Frodi. A.; Limb, M. - Children At Risk Kogram. Sep 76-continuing- Oundy,J. H.: Krell, It't Wisconsin Univ.. -Modilon. Graduate School Rcseareh Jan 76-continuidg Ciimmittee. National 1%1. of C ild -Realth and Heap Spaulding Potter Charitable inst..; Concird. N.H. :.Richard" Development Bethesd Md. King Mellon Foundation. Pittsburgh. Pa.

90' Ad

Iot 4 .CR-00069 CR-00092 Kautkolant Children's Hospital, Himillulu Hawaii Rainbow Babies and Children's H./spud). Cleveland. Ohio 226 'Kuakini St. 2040 Adeibert Rd. $. Honolulu. Hi 96817 Cleveland, OH 44106 Hawaii Child Abuse Demonstration Project-Hawaii Family Mother to Want Attachment. Stress Center.' Kennett, JH. Hammar. S 1. 4 Jul 74continuing Jan 7, .Jon 78 Maternal and Child Health Service(DHEW). Rockville. National Center on Child Abuse and Neglect WHEW) Md Washingtint. 1) C

CR-00070 CR-00094 Parental Stress Center, Pittsburgh. Pa Children's Hospital. l.os Angeles, CalifDiv .of Psychia- 918 S Isftley Abe try :Pittsburgh. PA' 15212 P 0 Bt* 54700 Terminal Annex Parental Stress Center. Angeles. CA 90054 Harrell. M Behavior. Parenting. and Outcome of High.Risk Infants. Feb 74.79 Kent. J National Center on Child Abuse and Negleci (1)1-1F.W) (ki 74-continuing WashingtonI) (4.9sernor'. Justice ( umniv.sionPuts- Bureau of Community Health Servii:cs I DHEVv't. Washing- 'burgh, Pa ton, I) C

CR-00072 CR.00097 Michigan State Urns .FastLansingDeptof Human ( hild Abuse and NeglectDemonstration Organization Development (CAN -DOL Helton, Tex B240 Life Sciences Building P 0 Box 729 Fast Lansing. MI 48824 Belton. TX 76511 Service Project to Determine the Ratability and %alidity of ( tntral Texas Counul of - Government Child Abuse and the Child-rear,ing Questionnaire. Neglect Demonstration Organization. Helfer. R Knox J C Phillips. Y , Eyrnan N Jun 75-May 78 Dec 74-Jun 78 National center on Child Abuse and Neglect(1)1-1FW) Nation,i) Center on Child Abuse and Neglect tl)HEW). Washington, I) C - Washington. D <'

CR00088 CR-00101 EducationCommission'ilitheStates, Denver, ( olo Dept Stanford UglyCalif Boy. Town Center of Elemenury and Setondfry Services Stanford,- ('A 94305 A 186() kineffrn Si Psychological Sequelae of Faster Home and Parental Place- DenVer. CO 80201 ment of Abused and Neglected Children. The Educational System's Role in Child Abuse and 'Neglect. ciderman. P H . Hastorf. A Jones. C . Fox. P Sept 75-Aug 79 Jan 75-Jun 78 Stanford Um.,(Ala National Center (In Child Abuse and Neglect tI)HEW). Washington. I) C

('R 00102 CR-00090 klucational Testing Service. Princeton, N Wisconsin Limy , Madison Dept,'of Social Work Rosedale Rd 425 Henry Mall Princeton. NJ (18540 ,Madison, WI 53700 The Effect of Birth Order on MotherChild Relationship. The Child's Contribution 1. Child Abuse: .cwis. Kadushin. A.. Berkowitz. I. Jul 75-continuing Jun 76-Jun 78 National Instof ( hild Health and Human Development National Inst of Mental Health (DHEW). Rockville, Md 41)D Wi Bethesda, Md .

91 9 CR-00104 . ca-00111 OPP Center for Studies of Child and Family Mental Health, Texas Um, :Austin School of Law Rockville. Md Mental Health Study Center. Rockville. 2500 Red Rixer Md. Austin, TX 71;705 5400 Fishers. Ln Regional Resource Center on Child Abuse and Neglect. Rockyille. MD 20853 McCathren. t1utiles of the Abused and Neglected Adolescent. Jul 75-Jul 7K tie. I. S. National Center on Child Abeie. and Neglect (DHEW). P414-continuing ' 'Washington. D C Nationalhist of Mental Health (DREW). Rockville. Md I

CR-00113 CR00105 CPI Associate., Inc. Washington. D C Calgory Univ, (Alberta)Div. of Communtly 'Health Sco- 2010 M St N W duce Washingtbri. DC 2001(- 116'1 29 St N W A Process Evaluation for Innovative Demonstration Projects: Calgary. Alberta. Canada T2N4JK Miller. P J ' 1 . A Family Aide Project for Patents With a High Risk of Aug 75-Mar 78 Child'Abuse. N.itional Center on Child Abuse and Neglect (DHgW). . - MacMurray. V DBrummitt, J R .('unningham, P H Washington. DC i , Aug 76- Aug 79 Department of National Health and Welfare. Ottawa tOn tariol et CR00115 Johns Hopkins Medical Institutions. Baltimore. MdPey chohorrnonal Research Unit .- CR-00107 601 N Broadway National,Instof Mental Health (DHEW). Adelphi. Md BAtimure. MD 21205 Mental Health Study Center Re*sible Hyposornatotropinisna4Psychosocial Dwarfismi. 2340 E. University Blvd Behavioral Detain Cases and Their Families. Adelphi MD 20783 Money, J, Weriwas Participant Observation of the Reorganization of a System Sep 74-tontinuing of Care for Abused and Neglected Children: A Study in Public Health Ser.). IDHEW)Washengton, O C Child Advocacy. Maney A C Gaughan. M ts,7-5,:sontinuing

CR-00117 Ohio State Unie. Columbus Mershon Center CR-00108 I2i0 Chambers Rd JFK Child Development Center, Denver. Colo Columbus, 01-1 41212 4200 F. 9th Structure and Performance of Programs ti Child Abuse and Denver, CO 80220 Neglect. Follow-up Studies of Abused Children. Nigi S Mani*. I l P Jul 744.0minuong 71-con truing &(1ike id ( hold lk)elopment HIM% )41,i.hingtonI) ( Bureau of Community Health Service. IDHF.Wi. Bethes- da. Md e

CR-00109 CR-00120 Washington Center for Addkiton. Bosiun. Mass San f;ran..r... General Hospital. ( alif. Dept of Pcdiatncc 41 Morton St I(X11 Potrero Boston, MA 02130 San Francisco. CA 44110, An Investigation of the Relationship Bet en Substance Sexual Abuse of Children. / Abuse and Child Abuse *rod' Neglect. . Pasege. I) .1 Glasser, M ; Mayer. J.; Black. R Mar 77-'Mar 78 Jun 75-continuing San Francisco GeneralHospitil.CalifSan Francisco National Center on Child Abuse and Negliit (DHEWi, 411, De_pi t4 Health. Calif . Queen s Bench rouraf,t(lon Washington, psc San Francisco '

92 96

ar . CR-00121 CR-00143 s Cahforma Unts . Los Angeles Neuro-pschiatrts Ins! British ('eiltimbia env. 1; an s ou v er Dtvof Child Pkyi 760 Westwood Plaza chiatry Los Angeles. CA 90024 Vancouver, B C V6T1W5. Canada Unkversity of California at Los Angeles ,[:CI. k) Child Trau- Project Toddler. Early Intervention With High-Risk Chtl ma iptervention Project. dren rind Their Families: Paulson. M Stephenson. S P Jan 70Jun 80 Api 72.78 Health Resort.. -s Admimsttatin il5111W1 Bethesda. MO Department of National Health andWelfare. Ottawa (On- tario)

CR.00122 CR00144 New Jersey State 'Divof Yytith and Family Sers ices. Texas Slate Dept oflublic Welfare, Austin Special Pro TrentonBureau of Research. Planning. and Program Jects Bureau Development John H Reagan Bldg U.S Montgomery St / Austin, TX 78701 Trenton. NJ 0862V Project Care: Child Advocacy Resources Expansion. Parent Interview Staab of Child Abuse and Neglect Cases. Stern. JMarley. M Pelton, I. H Jul 7c.78. t..o Sep 75-continuing Office of Child Development WHEW). Washington. D C New Jersey State Do.of Youth andI amtl) Sets ices Trenton.

CR-00145 New Hampshire UnisDurham Dept of Sot tolon (-R 00131 Durham. NH 011824 National Center for the Presvntion and Treatment of Child Physical'io)ence in American Families. Abuse and Neglect, Denser ( olo Straus, "s1A . Gelles. R .1. Steinmeti. S K 1001 Jasmine St Jul 75-Sep 7$ Denver. CO 80220 !,Bonet Inst of Mental Health WHEW). Bethesda Md Circk House Therapeutic Playschool for Abused Children. Rodebeffer. M A %randy. J A Cone, S . Dec 74-Dec 78 CR00149 A National Center for the Plesention and Treatment of Child Oregon I_ rus, PortlandRosenfeld Center for the Study Abuse and Neglect. Denser Colo( ommonwealtatind, and Treatment of, Child Abuse New York. N Y 1181 SW Sam Jackson Park Rd Portland, OR 97101 Iractured Femur StOdy. Yoh., F. CR-00132 Oec 75-continuing North Carolina Univ , ( hapel Hill Dept ofMaternal and .Child Health Chapel Hill, NC rs CR00150 Hospital and HomeSupport for Maternal Attachment. Oregon Uriiv.Portland.Rosenfeld (enter for the Study Saiinders. M SchaefeuF. S.. Bauman K F and Treatment of ChildAbuse I ngrarn.D. D 3181 SW Sam' JacksonPark Rd Jur 75-May Tic 'Portland. OR 97201 National Instof Child Health and HumanDevelopment Failure to 'Thrive. IDHEW). Bethesda. Md Tufts. F. Jun 75Jun $0

C'R-00142 Maryland !Jew . Baltimore County Dept of Psychology CR-00155 Baltimore, MI) 21228 New Mexico Univ , AlhuquorquoOffice of the Medical Child Alum: A Controlled study of Social, Familial. Indivi- Invesfigator clue!, and interactional Factori. Albuquerque. NM 87131 Starr, R H Jr, : Routine Mortality Case Finding, Statewide. Jun 75:Mar 7$ Weston, J National Center- (n Child Abuse and Neglect tf)Fir Jtil 71conlinuing ; Washington.. , C New Mexico UnivAlbuquerque fichocil of Medicine

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