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Children Exposed to Violence: Current Status, Gaps, and Research Priorities

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Children Exposed to Violence: Current Status, Gaps, and Research Priorities Children Exposed to Violence: Current Status, Gaps, and Research Priorities WASHINGTON, D.C. JULY 24-26, 2002 Workshop Summary WORKSHOP ORGANZING SPONSORS: National Institute of Child Health and Human Development, National Institutes of Health National Institute on Drug Abuse, National Institutes of Health National Institute of Mental Health, National Institutes of Health Fogarty International Center, National Institutes of Health Office of Behavioral and Social Sciences Research, National Institutes of Health Office of the Assistant Secretary for Planning and Evaluation Centers for Disease Control and Prevention Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services National Institute of Justice Department of Justice Office of Special Education Programs U.S. Department of Education The statements, conclusions, and recommendations contained in this document reflect both individual and collective opinions of the symposium participants and are not intended to represent the official position of the U.S. Department of Health and Human Services, the National Institutes of Health, the U.S. Department of Justice, or the U.S. Department of Education. Prepared by Analytical Sciences, Inc. July 2002 NICHD Workshop on Children Exposed to Violence, July 24-26, 2002 TABLE OF CONTENTS I. Introduction..........................................................................................................................1 II. Setting the Context: Definitional and Measurement Issues.................................................2 III. Domestic Violence...............................................................................................................6 IV. Community and School Violence ......................................................................................11 V. Terrorism and War.............................................................................................................16 VI. Services and Interventions for Children Exposed to Violence ..........................................21 VII. Legal and Policy Issues......................................................................................................27 VIII. Summary and Next Steps...................................................................................................30 IX. References..........................................................................................................................30 APPENDICES Appendix A. Domestic Violence ..................................................................................................32 Appendix B. Community and School Violence.............................................................................37 Appendix C. Terrorism/War ..........................................................................................................39 Appendix D. Services and Interventions/Legal and Policy Issues ................................................44 Appendix E. Final Agenda.............................................................................................................46 Appendix F. Biographical Sketches of Presenters.........................................................................53 Appendix G. Workshop Participants .............................................................................................63 Page i NICHD Workshop on Children Exposed to Violence, July 24-26, 2002 CHILDREN EXPOSED TO VIOLENCE: CURRENT STATUS, GAPS, AND RESEARCH PRIORITIES WASHINGTON, D.C. JULY 24–26, 2002 I. INTRODUCTION This workshop brought together researchers, practitioners, and policymakers to provide perspectives on the current state of knowledge regarding children exposed to violence, and to identify research gaps and promising avenues for future research. Three main areas of violence were addressed: 1. Children exposed to domestic violence; 2. Children exposed to community violence, including school violence; and 3. Children exposed to war and terrorism. There were also additional, overarching presentations addressing definitional and measurement issues, services and interventions, as well as legal and policy issues. The workshop was jointly sponsored by the National Institute of Child Health and Human Development (NICHD), the National Institute on Drug Abuse (NIDA), the National Institute of Mental Health (NIMH), the Fogarty International Center (FIC), and the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH); the Office of the Assistant Secretary for Planning and Evaluation (ASPE); the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services (DHHS); the National Institute of Justice (NIJ) in the Department of Justice; and the Office of Special Education Programs (OSEP) in the Department of Education. The involvement and commitment of such a multitude and diversity of Federal agencies attests to the rising public interest in children exposed to violence. In her opening remarks, Dr. Margaret Feerick described the pivotal influence of September 11 on the workshop agenda, transforming the initial focus on children exposed to domestic and community violence to a broader focus encompassing the effects on children of exposure to war and terrorism. While the many components of NIH have supported some research in this area, there is a need for more targeted attention on the topic, particularly with regard to measurement, sampling, and intervention/services. The workshop planners were most interested in obtaining focused recommendations to guide the development of a national research agenda. The first part of the workshop consisted of formal sessions that attempted to document what is known for each of the three main topic areas in terms of prevalence, consequences, protective factors, mediators/moderators, and social and cultural factors, and the current state of definitions and measurement, services, and interventions. Each session was followed by a discussion period that allowed participants to ask questions and exchange ideas. The second part of the workshop consisted of four breakout groups that sought to identify critical research gaps and future research directions in their respective topic areas: Domestic violence; community and school violence; terrorism/war; and services and interventions/policy issues. The closing session was devoted to key research needs and next steps in building a research agenda. Page 1 NICHD Workshop on Children Exposed to Violence, July 24-26, 2002 II. SETTING THE CONTEXT: DEFINITIONAL AND MEASUREMENT ISSUES Moderator: Ileana Arias, Centers for Disease Control and Prevention A. Defining and Conceptualizing Children’s Exposure to Violence Penelope K. Trickett, Ph.D., University of Southern California Drawing upon 20 years of experience examining definitional issues in the field of child abuse and neglect research, Dr. Trickett summarized the critical issues for studying children exposed to violence. First, better definitions are needed to facilitate communication in this complex research area. At the same time, better definitions will enable scientific progress through better understanding of the independent variables, as well as the components of treatment that “make the difference.” It is also important to sort out the contextual factors that may affect children such as poverty, the family environment, neighborhood violence, and whether these children experience other forms of victimization. Children in child abuse and neglect studies frequently experience more than one form of abuse, with 90 percent of the subjects in one study experiencing more than one form of abuse and neglect (McGee, et al. 1995). In addition, community violence may affect rates of child abuse since violent neighborhoods tend to have higher rates of physical child abuse. These factors should be considered when conducting a study. Dr. Trickett presented data on the characteristics of sexual abuse trauma and their impact on girls’ development to demonstrate the use of a conceptual model for understanding the possible independent variables. For the sample of victims studied, a number of factors must be considered as independent variables, including severity of abuse, age of onset, duration, relationship to perpetrator, and whether there were multiple perpetrators. These factors are interrelated and can make a “difference” in how one child reacts to abuse compared to another. Data on the onset and duration of abuse for different perpetrator categories also illustrate the variability of experiences of abuse that must be considered. There is also a need to better assess the reliability and validity of reporters. In comparing the reliability of parents and children as reporters of abuse, children are more consistent. Studies on domestic violence have shown a lack of concurrence between parents and children about the child’s exposure to violence, often because the parent is involved in the violence and may underreport it. Therefore, it is important to consider other sources of information such as police records or neighbors. Finally, researchers need to look at children’s exposure to violence from a multidimensional perspective that considers variables such as the severity of violence (e.g., watching a drug deal versus watching a neighbor get shot and killed), its dangerousness and proximity, the frequency, duration, and timing of the violence, the relationship
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