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This pUblication was prepared by Mary Porter Martin and Susan L. Klaus, Social Research Group, George Washington University for Herner and Company under Contract Number HEW-lOS-76-1l36, for the National Center on Child 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 infoIm~lioil exchange. No office of the U.S. Government assumes any liability for its content or the use thereof.

l SEPTEMBER 1978

1978 ANNUAL REVIEW OF CHILD. ABUSE AND NEGLECT RESEARCH

NCJRS

JUl '\ '1 '~19

ACQUISITIONS

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Office of Human Development Services Administration for Children, Youth and Families Children's Bureau DHEW Publication No. (OHDS) 79·30168 PREFACE

Since the early 1960s the concerted efforts of researchers, clinicians, and practitioners from a variety of professional disciplines have served to bring to the consciousness and the conscience of our society a problem of tragic proportions-the abuse and neglect of our nation's children. With the passage of the Child Abuse Prevention and Treatment Act 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 Center is directed to compile and pubUsh a summary of recently conducted research in the field of child abuse and neglect. This 1978 Annual Review of Child Abuse and N-:giect Research prilsents a broad overview of the status of research using as its data base the abstracts of completed and ongoing research studies contained in the computerized data base of the NCCAN information Clearinghouse. This Clearinghollse was established by the National Center to collect, process, and disseminate information 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 clearly distingl1;shed. It also helps identify gaps or overlaps in r.:lsearch. We hope it will be a useful resource document for anyone wishing to select a particular area of research for further examination. Unfortunately, information demanded by the abstract format does not permit an in-depth analysis of the material.

This report was written by Mary Porter Martin and Susan L. Klaus with assistance from Ruthann Bates. Dr. Maure Hurt, Jr., directed the work for the Social Research Group, The George Washington University; Dr. Douglas E. Berninger directed the work on behalf of Herner and Company. The assistance of Joseph Wechsler, Government Project Officer and Chief of the NCCAN Clearinghouse, is gratefully acknowledged.

Douglas J. Besharov Director, National Center on Child Abuse and Neglect U.S. Children's Bureau TABLE OF CONTENTS

I. INTRODUCTION

Information Clearinghouse Procedures for Selection of Abstracts for Inclusion in the Review

II. DEFINITION 2

Summary of Research Studies Related to the Definition of Child Abuse and Neglect ...... 2 Summary of Legal Issues and Opinions Related to the Definition of Child Abuse and Neglect 2

Ill. INCIDENCE 4

Estimates of the National Incidence of Abuse 4 Estimates of the National Incidence of Neglect 4 Estimates of Abuse and Neglect in Selected Geographical Areas 4 Ongoing Research Studies Examining Incidence ...... 7 Sources of Discrepancies in Estimates of A buse and Neglect 8

IV. PSYCHOSOCIAL ECOLOGY 10

Individual Capacities 10 Situational Factors . · 21 Attitudes and Values · 28 Social Institutional Factors · 30

V. PREVENTIO!'J AND TREATMENT .38

Primary Prevention . .38 Secondary Prevention .38 Treatmen t ...... 39

VI. EFFECTS/SEQUELAE · S3

APPENDIX

Abbreviations of Standardized Tests .63

BIBLIOGRAPHY ...... 64

ii LIST OF TABLES

Table 1. Comparison of National Estimates of the Extent of Ab:.:se, 1962·1975 5

Table 2. Comparison of National ESl;:w:tes of the Extent of Neglect, 1962·1975 6

Table 3. Annotated List of Ongoing Research Studies: Incidence 7

Table 4. Annotated List of Studies: Individual Capacities 12

Table 5. Annotated List of Ongoing Research Studie~. Individual Capacities 19

Table 6. Annotated List of Studies: Situational Factors .22

Table 7. Annotated List of Ongoing Research Studies: Situational Factors .27

Tabie 8. Annotated List of Studies: Attitudes and Values ...... 29

Table 9. Annot.lted List of Ongoing Research Studies: Attitudes and Values · 30 Table 10. Annota ted List of Studies: Sociallnstitutio!lal Factors .32

Table 11. Annotated List of Ongoing Research Stud;,~s: Social Institutional Factors ...... 36

Table 12. Annotated List of Studies: Secondary Prevention .40

Table 13. Annotated List of Ongoing Research Studies: Secondary Prevention .42

Table 14. Arinotated List of Studies: Treatment .43

Table 15. Annotated List of Ongoing Research Studies: Treatment · 51

Table 16. Annotated List of Studies: Effects/Sequelae of Abuse . · 55

Table 17. Annotated List of Studies: Effects/Sp.quelae of Neglect · 60

Table 18. Annotated List of Ongoing Research Studies: Effects/Sequelae .62 I. INTRODUCTION

Information Clearinghouse Research.2 With the exception of the section on psychosocial ecology, any modifications reflect The NCCAN Information Clearinghouse the availability of material in the abstracts. The systematically scans the world's literature in order section on psychosocial ecology has been refined to identify results of research on child abuse and and enlarged as the result of a symposium on this neglect. These research findings appear in journal subject. 3 articles, books, technical reports, dissertations, etc., which the Clearint;,', .Ise collects and After the initial review and sorting was done, it processes for ·!ntry into the Center's computerized became clear that the definition of research used data base. The Clearinghouse also conducts here excluded legal research, since legal research semiannual surveys to iden tify ongoing research does not follow the procedures of social science projects in the field and to collect information research but has its own methods, ma.inly case about these for its data base. The present report is description. A review of legal abstracts was done; one of several methods used by the Clearinghouse those abstracts that dealt with one or more of the to disseminate information. The abstracts and five substantive areas and that were not descriptions of projects that are used in this report state-specific, but applicable to child abuse and were also published by the National Center in neglect proceedings nationally, were selected and three editions of Child Abuse and Neglect included in the review. Research: Projects and Publications. 1 The same procedure was used in reviewing ongoing research studies in the NCCAN Procedures for Selection of Research Studies Clearinglir)use data base and selecting studies for for Inclusion in the Review inclusion in this review. Those research studies which were underway as of January 1978 are All abstracts included in the NCCAN included. While some of these studies may now be Clearinghouse data base as of November 1977 complete, no formally published documentation were reviewed to select for further examination of research results had been included in the those which met the criteria for a research study. , Clearinghouse data base as of 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 methodology inquiry which proceeds under a well-defined rather than findings, since many of the studies procedure or methodology, uses a known were in the data collection phase when the system of measurement, and documents questionnaire was completed. findings based on empirical data. The sole source of data for review of completed A second review of those abstracts which were and. ongoing research studies is the abstracts of the designated research studies was then carried out to NCCAN Clearinghouse. All studies are cited categorize the material into five substantive areas: according to the "CD" or "CR" identification definition, incidenct', psychosocial ecology, number assigned each study when it is entered into prevention and treatment, and sequelae. This the NCCAN computerized data base. Full citations organizational framework is based on the 1977 are given in the bibliography beginning on page Annual Analysis of Child Abuse and Neglect 64.

1 National Center on Child Abuse and Neglect. Child Abuse and Neglect Research: Projects and Publications. Springfield, Va.: Natiomtl Technical lnfortllation Service, March 1978 (PB-277 825), November 1976 (PB-260 800), May 1976 (PB-2S1 010).

2Martin, M.P. 1977 Analysis of Child A buse and Neglect Research. Wa~hington, D.C.: National Center for Child Abuse and Neglect, January 19'18.

3 Klaus, S.L. The Psyl'ilOsocial Ecology of Child A bllse alld Neglect. (In press, September 1978). II. D EFINI"l'ION

One of the cel,.tral issues in the field of child protective agency than did the members of other abuse and neglec\~ is that of defining the problem. occupations. The ambiguities that surround the definition of this particular social problem touch every aspect In an ongoing study, Gelles (CD-00060) is of the field. For example, the way in which one examining the labeling and classification processes defines abuse and neglect affects what is reported employed by individuals deaiing with suspected and how many reports are made, which in turn cases of child abuse in an attempt to determine a affects the effort to assess an incidence rate. Using common definition of abuse. The opinions of a broad definition, abuse and neglect include all physicians, social workers, and elementary school acts that interfere with the optimal development counselors were asC'ertained througll 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 with this development. At the other extreme, abuse and neglect include only Summary of Legal Issues and Opinions Related those acts that result in observable injuries, a to the Definition of Child Abuse and Neglect definition that excludes an un.;omfortably large number of children who do not exhibit observable Twenty-five studies report on legal issues that injuries, yet are abused and neglected. Prevention are involved in the development of a legal and treatment programs are also influenced by the definition of child abuse and neglect. An inclusion or exclusion of certain behaviors within appropriate legal definition of child abuse and the definition of abuse and neglect. Finally, in neglect is necessary to avoid confusion in reporting many cases comparability across research findings and to allow for effective but appropriately is not possible because of the use of different limited intervention. definitions in studies. The majority of these studies deal with the The following discussion will review the problem of competing interests of the child, available research on the definition of child abuse family, and state in those instances in which legal and neglect. In 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 of defining abuse and neglect. Full third analyzes the effect of a broad versus a citations for all references can be found in the narrow statutory definition of child abuse and bibliography beginning on page 64. neglect.

Competing interests of child, family, and state. Summary of Research Stlldies Related to Legal opinions continue to reflect differences on the Definition 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 neglect. Courts have traditionally held that the the issue of defining child abuse and neglect. natural or biological parents have an inherent and Boehm (CD-00I03, CD-01415) surveyed 1400 superior right to the custody and control of their members of representative community leadership child (CD-00075); at the same time they have groups by questionnaire in order to assess the recognized that parens patriae may be exercised extent of consensus for protective intervention in with the understanding that the state is the various types of abusive and neglectful situations. ultimate keeper of the child's welfare (CD-01698). There was strong consensus for protective action Current law emphasizes family privacy and in situations involving physical hazard to the child, presumed parental fitness although the rights of but a large majority opposed protective action in parents are not absolute (CD-01473). Traditionally cases of emotional neglect. No significant children have the right to be cared for by their relationship was found between occupation and parents, or, in the absence of such care, the state the perceived need for protective intervention, would benevolently provide for them (CD-01006). thus indicating that social work respondents were substantially in agreement with the attitudes At present, the prima facie assumption that expressed by other community groups and did not either the parents or the state necessarily assign greater latitude or responsibility to the represents the interests of the child is questioned

2 (CD-OI006). A Bill of Rights for Children has been CD-00218, CD-00548, CD-00808, CD-00826, proposed which declares that children are people CD-OI030, CD-01162, CD-01231). and that they are entitled to assert individual interests in their own right, to have a fair Statutory definition of abuse and neglect. Many consideration given to their claims, and to have states have enacted legislation whl,ch defines abuse their best interests judged in terms of pragmatic and neglect broadly and permits extensive judicial consequences (CD-O 1172). On balance, the inkrvelltion. Experience ha.~ shown that many of protection of individual rights has not been these statutes have fallen short of a good applied as evenly to children as to parents operational definition. The major flaw in most (CD-01698). statutes is a vagueness that permits intervention in the parent-child relationship on the basis of An importan t legal decision pertaining to the subjective norms rather than on specified, issue of children'~ rights versus parents' rights was objective standards delineated by the legislature made in the case of Wyman v. James, when the (CD-O 1831). Supreme Court ruled on the legality of the state's right to visit welfare mothers, as a security 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 rights protective services aad other nonjudicial and the mother's rights was presented (CD-OO IS 5, approaches to the problem (CD-OI473). There has CD-00266, CD-00267). been support from various involved professional groups for the proposition that parents charged with neglect and abuse are entitled to remedial and Court procedures. Discussions of court supportive services designed to ameliorate the procedures focus on the need for procedural conditions constituting neglect and abuse rather safeguards for parents and children in the legal than the quasi-punitive response of removing the process. The issues include need for due process child (CD-O I 006). The challenge remains to protection, the child's right to counsel, the develop a definition that allows for interventior in parent's right to counsel if indigent, confrontation those instances where children need protection, and cross-examination of witnesses, criminal particularly when parents refuse assistance, but liability of parents of delinquent children, and that protects individuals from arbitrary or various evidentiary problems (CD-00112, inappropriate intervention by the state.

3 Ill. INCIDENCE

Attempts to measure the ratc at which new Estimates of tile National Incidence of Neglect cases of abuse and neglect occur in the United States during 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), more frequency than abuse. Although a variety of have been unsuccessful for a number of reasons. ratios is presented in the literature, a 4: I or 5: I The sources of information have been biased in ratio of neglect to abuse seems likely. ways only partially understood and the resultant figures are not yet statistically con trollable; The actual numbers of neglected children are definitional differen ces across sta tes an d even even more difficult to derive than those of abused within studies have made sta tis ti cal projections to children, b('cause so few reporting systems larger populations inaccurate; incre~',ed public and separate abllse from neglect. The category of professional awareness of the problem, along with abuse; which includes neglect, is generally incrllased enforcement of reporting mandates, have recorded. made trend analysil:: unreliable; and the very private nature of the actions under study and their Table 2, which follows, presen ts a comparison similarity to acciden tal injury or to conditions of national estimates of the extent of ncglect, found in an impoverished environment have made 1962-/975. detection very difficult. There are two other potential sources of 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: juvenile court statistics «('D-01309, neglect, or that report the reslllts of efforts to CD-01848, CD-01849) and statistics on neglected ascertain the sources of discrepandes in estimates children Jiving in institutions that receive federal of abuse and neglect. To date, most studies have funds (CD-O 1946). Data in these studies are not measured incidence rates, though prevalence may national estimates, since the.y refer only to those well be the better measure of neglert (Polansky et neglected children who come into the court al., 1975).4 For this reason, only incidence rates system or who arc institutionalized. Further, the are under consideration here. Full citations for all juvenile court figures include dependency as well references can be found in the bibliography as neglect cases; however, they do provide some beginning on page 64. informa tion on the relative increase in reported neglect cases.

Estimates of the National Incidence of Abuse Estimates of Abuse and'Neglect ill Various methods have be.en used to assess the Selected Geographical Areas national incidence rate of abuse. For example, DeFrancis (CD-O 1511) studied cases reported in There have been numerous studies of the extcnt newspapers in 1962; Gil (CD-O 1187) conducted a of abuse, or abuse or neglect in specific national survey as well as a survey of every geographical areas. These cover compilations of incident reported through legal channels; 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 national estimates of the extent of abuse, The literature includes many studies on the 1962-1975, shown in Table 1, reveals that these extent of abuse and neglect in states, including estimates vary as widely in actual numbers as they Alaska (CD-OI089, CD·01114, CD-01433), do in methodology. Arizona (CD-O 1452), California (CD-O 1447),

4 Polansky, N.A., Hally, C., tInd Polansky, N.!'. Profile of Neglect. A Survey of tile State of Know/edge of Child Neg/ecl. Washington, D.C.: Community Services Administru tion, Social and Rehabilitation Services, DHEW, .1975.

4 TABLE 1

COMPARISON OF NATIONAL ESTIMATES OF THE EXTENT OF ABUSE, 1962-1975

..

Measurement Estimate of Origin of Data Reference Criteria Incidence

Abuse, not further 662 Newspaper accoun ts, DeFrancis (1963) specified 1962 data (CD-0151!)

Abuse, not ~I.lfther 302 71 hospitals, 1962 data Kempe et a1. (1962) specified (Reported in CD-00560)

Abuse, not further 447 77 district attorneys, Kempe et a1. (1962) specified 1962 data (Reported in CD-00560)

Abuse that resulted in 2,500,000-4,070,000 National survey, 1965 Gil (1970) some degree of injury data (Reported in CD-O 1187)

Abuse that resulted in 200,000-500,000 Reanalysis of Gil's 1965 Light (1973) some degree of injury data (CD-00613)

Serious injury by 10,000-15,000 1966 data, no source Helfer and Pollack (1968) nonaccidental means given (CD-00463)

Abuse that resulted in 6,617 Central registries, nation- Gil (1970) some degree of injury wide, 1968 data (Reported in CD-O 1187)

Reported abuse 60,000 Additive estimate, based Kempe and Helfer (1972) on cases reported in (CD-00559) J)i!nver and New York City, 1972 data

Reported abuse 41,104 Official reporting Cohen and Sussman (1975) systems from 10 largest (CD-01136) states, 1973 data ~

Reported abuse 167,000 Agency survey, 1972- Nagi (1975) 1973 data (CD-00704)

Abuse, not reported 91,000 Difference between pro- Nagi (1975) jections from rate of re- (CD-00704) 258,000 (total) ports in Florida and rate from agency survey, 1972-1973 data

Paren t-to-child 1,400,000-1,900,000 Household survey, lY7S Gellcs (1977)* violence data

*Not available tram the NCCAN Clearinghouse when this table was prepared,

5 TABLE 2

COMPARISON OF NATIONAL ESTIMATES OF THE EXTENT OF NEGLECT, 1962-1975

- Measurement Estimate of Origin of Data Reference Criteria Incidence

Reported neglect 432,000 Agency survey, 1972- Nagi (1975) 1973 data (CD-00704 )

Neglect, not reported 234,000 Difference between pro- Nagi (1975) jections from rate of re- (CD-00704) 666,000 (to tal) ports in Florida and rate from agency survey, 1972-1973 data

Neglect and other maltreat- 465,000 Reanalysis of Gil's 1965 Ligh t (1973) ment incidents excluding data (CD-00613) abuse

Hawaii (CD-00446, CD-00447, CD-00448), Illinois study of suspected child abuse cases reported in (CD-00506, CD-0l274), Iowa (CD-01670), Kansas the southeastern states over a five-year period (CD-01608), Kentucky (CD-00563), Massachusetts (CD-00526) was conducted to (1) determine major (CD-00726), New York (CD-01261, CD-01612), demographic characteristics of abused children, North Carolina (CD-01263), Pennsylvania families, and perpetrators; (2) analyze these (CD-01281), Texas (CD-01583 ),. an.d Wisconsin characteristics in terms of case dispositions; (3) (CD-01293). These reports usually include determine the extent of reporting and utility of information on the rate of increase or decrease in state legislation and programs; and (4) find tho: reported cases, some descriptive information relevant associations between selected variables. OJI the child abusing population, or some Another studied state legislation and programs in information on how cases we:'e managed. These the Southeast (CD-O 1219). A third study focused studies are, however, dissimilar in anum ber of on the effectiveness of reporting laws, rate of ways. For example, their scope varies: the statistics reports, and persons involved in reporting sysl>ms for Iowa include only child abuse cases while those for child abuse cases in New York, Califo~;lia, for Kansas include both abuse and neglect cases. Colorado, and West Virginia (CD-01480). The methods of measuring incidence also are not uniform; Alaska estimated its statistics in units of A few documents have published results of physically abused children per 100,000 children Mudies of the extent of abuse and neglect in under the age of 16, while Pennsylvania merely particular cities and cQuntic:=. In Denver counted all the cases reported to the state. Sources (CD-01153), the Department of Welfare analyzed of information are different; a New York study 1972 data on 143 battered children served by the (CD-01612) relied on 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 thai 2,400 agency reports, a survey of physicians and to 2,600 children come to the attention of the hospitals, and projections based on nonreplying program each year. An epidemiologic study of physicians. The years covered by these studies also sexual abuse in children was performed by varied, ranging from a one-year estimate for 1970 reviewing Minneapolis Police Department case in Massachusetts and for 1975 in Iowa, to a records from 1964 to 1971 (CD-01674); about multi-year study, 1972 to 1975, in Kansas. 300 cases were seen each year, and 85% of these involved indecent exposure or indecent liberties. A Three studies examined child abuse reporting five-year review of data on Hennepill and Ramsey practices in more than one state. A comprehensive Counties, Minnesota, stated that 1,285 cases of

6 physical and sexual abuse were reported since found that three times as many cases were referred 1971, 396 of which were reported in 1975 alone in 1970 than in 1968 (CD-01123). The third study (CD-O 1926). A study in Douglas County, estimated that there may be about 11,000 cases of Nebraska, found that 2,570 cases of child abuse nonaccidental injuries to children in England every and neglect had been reported to the county's year by extrapolating from 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 Royal Infirmary (CD-00167); this study also reported in 1973 (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 cOlirii:;.

TABLE 3

ANNOTATED LIST OF ONGOING RESEARCH STUDIES: INCIDENCE

Reference Research Purpose Methodology

Ford, R.I.; Esta blish a general policy as guideline for Survey of biophotographers in 64 chil­ Smistek, B.S. photographing victims of child abuse. dren's hospitals. Legal interpretations (CR-00053) Educate hospital personnel in following being studied. Recontact of biophoto­ guideline. gra phers 2 years la ter.

Lourie, I S. Investigate incidence, typology, and com­ Various techniques from care supervision (CR-00I04) munity management of adolescent abuse to collection of aggregate data and pro­ and neglect. vision for innovative service components. Sample: 250 children.

Tufts, E. Review femur fractures in infants and 40 children who suffered femur fractures (CR-00149) their relationship to mechanisms of in­ to be reviewed. Explanations given by jury. parents compared with type of fracture.

Weston, J.T. Descriptive analysis of data from child Re.trospective survey. Data collected from (CR-00155) abuse deaths in one state and on Indian on-site investigations, postmortem exams reservations. and autopsies, and ancillary exams.

7 Sources of Discrepancies in Estimates of Several research studies examine the Abuse and Neglect relationships of professional awareness to the reported rate of abuse and neglect. One examined The wide discrepancy in estimates of abuse and immunity for reporters as an effective stimulus for neglect may be attributed to a number of reasons, reporting and for gaining full cooperation by child most of which stem from the types of data sources abuse reporters (CD-00337). used for estimating incidence rates: (1) mandated reports, either to a central register or child Other studies focus on the physicians' protective agency, and (2) household surveys. knowledge of and attitudes toward child abuse and Each has certain inherent characteristics 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. private physicians had reported only II, and attributed this to inadequate education in medical One of the most obvious reasons for the wide school and insufficient in-service training discrepancy in estimates is that incidence data (CD-00537). Similar deficiencies in education or collected through mandatory reporting are training were reported in other studies (CD-00458, inaccurate. In general, it is 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-00922). the same time failing to distinguish abuse from neglect and substantiated from unsubstantiated Six studies focus on the school's role in cases. Furthermore, it is known that such a system reporting child abuse and neglect. Four note the of data collection is affected by (1) accuracy of failure of the system to fulfill its responsibility by detection, (2) public and professional awareness, organizing standard procedures and ensuring that (3) degree of enforcement, (4) certain reporting personnel are aware of the problem and the biases, (5) lack of comparability in statutes, and procedures available to them (CD-00277, (6) availability of resources. CD-00635, CD-01544, CD-OI945). One study simply surveyed 33 schools in a metropolitan area Accuracy of detection. Certain children simply and noted that school personnel d~d in fact report are not brought to the attention of authorities, numerous cases of abuse and neglect (CD-O 1294). either because they do not receive any medical This was borne out by an analysis of complainants attention, because their parents use a different and complaints in a public protective services hospital each tilne, or because they are not setting which reported that the greatest number of diagnosed as abused when they are seen by a acceptable complaints came from schools doctor or hospital personnel. Four research studies (CD-01855). examine some aspect 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, neglected had this diagnosis been seriously calls to a hotline. One surv-u sought information considered (CD-OI851). A follow-up study of 33 from a sample of residents c ,\lewark, New Jersey, children hospitalized with bone fractures reported an area reporting the hight:st incidence of child that, at the time of the injury, 10 families (five abuse in the state (CD-01232) 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 t.lJ.e problem of child abuse. Another studied the possibility of child abuse, and two nonabusive nonwhites in Tacoma-Pierce County, Washington families had tlrroneously been accused of abuse and found that a majonty were aware of child (CD-00291). Indicators of suspicion !hat the abuse agencies (CD-OI471). A third discovered injury was intentional include unreliable or that residents of Pueblo County, Colorado were inconsistent history (CD-OI453), delay in re­ aware of 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 was confused (CD-OI37!). The impact of a (CD-00515). coordinated information campaign in Florida (CD-01842) and of the Care-Line, a 24-hour-per-day, 7-day-per-week statewide child abuse prevention and information service in Public and professional awareness. The number Connecticut (CD-01489, CD-01490) has been of child abuse cases reported each year is clearly 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 awareness and how well this awareness is is increasingly aware of the problem and where to translated into actual reporting. report it.

8 Comparability of statutes. State reporting laws CD-00275, CD-00343, CD-00666, CD-00777, also vary as to thz definitions of abuse and neglect, reported in CD-00778, CD-O 1479, CD-O 1540). penal sanctions, who must report, and reporting However, these surveys reveal that standardization procedures. Such variations result in limited of provisions is occurring as jurisdictions broaden comparability among states' data on child abuse their definitions of abuse and neglect, expand the and neglect reports. Several studies from the field classes of persons required to report, expand the of legal research have compared the provisions of provisions for confidentiality of records, and mandatory reporting statutes and state central authorize the operation of central registries. registries (CD-00149, also reported in CD-00141,

9 IV. PSYCHOSOCIAL ECOLOGY

The following section reviews the research on In this review, individual capacities related to the psychosocial ecology of child abuse and child abuse and neglect are divided into three neglect. A companion reportS describes the major groups: personality characteristics, personal psychosocial ecological approach, and presents a attributes, and life experiences. framework for identifying and analyzing all aspects related to individuals and their environment which seem relevant to the problem Personality characterinics include of child abuse and neglect. This psychosocial temperament, motivation, ego strength, capacity oritmtation of the framework shows a concern for for self-discipline, and capacity to give and receive factors related to individuals and families, as well affection. They are shaped by the potential as for the cultural and social environment in which established by heredity, by the developmental they exist, while its ecological approach process of growth and motivation, and by the emphasizes the importance of the residue of memories and experiences 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 which persist throughout a person's life, but personality The major sets of factors that are thought to 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) attitudes and Personal attributes include both physical values, and (4) social institutional factors. These capacities-such as general health, handicaps caused factors affect family dynamics both negatively, by by genetic errors or by disease, and motor creating stresses for the family, and positively, by coordination and dexterity-and cognitive. providing supports that can enhance family capacities, including innate intellectual ability, functioning. It is some particular combination of ability to use language, perceptual skills, and these factors at particular times that is thought to abstract thinking and problem-solving abilities. be associated with child abuse and neglect. Some of these attributes are permanent 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 factors is included areas of an individual's growth and development. once in the review. In many instances, a study Normal capacities develop and change over time, reported findings on both individual capacities and some through the natural maturation process and situational factors. In some cases, attitudes and others through learning and life experiences. values were also reported. The decision to review a study in a particular section was based on the Life experiences importantly affect personality majority of findings it presented. formation and the expression of personality through behavior, while at !:he same time personality characteristics and personal attributes Individual Capacities playa significant part in determining some of the experience which one meets in life. Life experiences involving parent-child interaction in Individual capacities are perhaps the most particular have a profound influence on an adult's critical determinants of behavior. These own parenting ability. If abuse and neglect were characteristics define one's individuality. They experienced as a child, it is possible that under determine the ways in which an individual adjusts stress, these familiar and accessible responses to his environment and affect the ways in which which have become integiated into one's he deals with himself and others. personality structure may emerge.

S Klaus, S.L. The Psychosocial Ecology of Child Abuse and Neglect. (In press, September 1978).

10 The following pages present an annotated general population as a whole. Psychological listing of 57 completed and eight ongoing research testing predomin"lr"i as a method of data studies of individual capacities related to child collection; review of case records was also abuse and neglect. These studies were selected for frequently used. Eight studies interviewed inclusion in this section for one of the following subjects; three studies induded home or hospital reasons: (1) the purpose of the study was to observations of parent-child interaction; and one investigate the relationshir, of a particular used videotape. individual capacity to chiid abuse and neglect; or (2) regardless of study focus, a substantial proportion of findings dealt with individual capacities. These studies are listed alphabetically Review of studies. Most of the completed by author and full citations are given in the studies focus on the personality disorders of bibliography which begins on page 64. The parents rather than children. Intelligence, mental methodology of each study is described in as much illness or psychosis, alcoholism, anomie, and low detail as possible, including sample size and self-concept frequently characterized abusive and characteristics, control or comparison group if neglectful parents. mentioned, and means of data collection, where known. * In addition, all relevant information Study findings related to children described provided by the abstract on individual capacities personal attributes which made the abusing or can be found under the heading "Review of neglectful parent perceive the child as different. Studies." Study findings are noted where available; Congenital defects and other handicapping if no findings are indicated in the abstract, the conditions, prematurity, and in fan t and other individual capacities dealt with in the study are early childhood illnesses were most frequently reported. mentioned.

Findings related to life experiences fell into two major categories: (1) the conditions surrounding Methodology. The sample size in 32 of the the birth experience and mother-infant bonding; completed studies was between 20 and 80 and (2) parental life experiences and background. subjects; six studies had subject populations over 200; study populations were abused or neglected Ongoing research studies. Two of the eight children or their parents in almost every study. studies consider the relationships of child abuse The exceptions were five studies which focused on and substance abuse. The majority of studies are mother-infant pairs and six studies which used as attempting to identify characteristics {)f parents or their subjects white welfare mothers, children that may lead to poor interaction patterns disadvantaged children with low Vitamin-A levels and abuse or neglect. One study considers the role primaparous mothers, poor rural families, wome~ that failure to thrive may play in the susceptibility seen at a planned parenthood program, and the to later abuse or neglect.

*Abbreviations for standardized psychological tests were used wherever possible; a key to these abbreviations can be found on page 63.

11 TABLE 4

ANNOTATED LIST OF STUDIES: INDIVIDUAL CAPACITIES

Reference Methodology Review of Studies

1. Birrell, R.O.; 42 Maltreated children Mental illness or subnormality of parents, Birrell, J.H. W. Admitted to hospital; 31-month case alcoholism, disturbed parental back­ (CD-00093) follow-up ground, and congenital abnormalities in child reported.

2. Bishop, F.I. 70 cases of child mistreatment At risk factors in child abuse cases in­ (CD-00094) Hospital popUlation cluded premature babies, congenital mal­ formations, conception during depressive illness in mother.

3. Boisvert, M.J. 20 cases of child abuse Developed typology of abusive parents (CD-00I04) including: psychotic parents, parents with irresponsible, immature, impulsive, pas­ sive aggre~sive, sadistic, and cold compul­ sive personalities.

4. Borgman, R.D. 34 rural low income mothers referred to Neglectful mothers: large number moder­ (CD-00I09) welfare agency for chronic child ately retarded; lack of intellectual capaci­ neglect ty at root of mothering inadequacy. Contrast group of 16 mothers referred for eval.lation of fitness for employment Standardized test (W AIS)

5. Brant, R.S.T.; 52 cases of possible sexual misuse from Sexual abuse usually a manifestation of Tisza, V.B. cases in pediatric emergency room family pathology. (CD-01425)

6. Brazelton, T.B.; 12 mother-infant pairs during first 5 By 3 weeks of age, newborns demon­ Tronick, E.; months of infant life strated expectancy for interaction with Adamson, L.; Videotape caregiver. Attentional cycling may be Als, H.; diagnostic of optimal mother-infant inter­ Wise, S. actions and seems not to be present in (CD-01426) more disturbed interactions.

7. Browning, D.H.; 14 cases of incest Chronic depression in mother, alcoholism Boatman, B. Referred to psychiatric clinic in father, handicapped or retarded chil­ (CD-01435) dren.

8. Children's Hospital Cases of abnormal ingestion, failure to Problem areas that distinguished cases Medical Center thrive, and child abuse and neglect from controls included problems in (CD-01467) lape recorded interviews mother-child relationship, problems in mother's life history, and child health problems.

9. Cohen, M.I.; 1401 neglecting parents Assessed interpersonal relations, prob­ Mulford, R.M.; lem-solving skills, coping skills, self Philbrick, E. evaluation regarding success-failure, emo­ (CD-00210) tional patterns, perception of reality.

12 TABLE 4 (Continued) ANNOTATED LIST OF STUDIES: INDIVIDUAL CAPACITIES

Reference Methodology Review of Studies

10. Dc Chateau, P.; Primiparous mothers and their infants at Significan t differences in study group Wiberg, B. 36 hours post partum and at 3 months wh 0 were allowed 15-20 min utes of (CD-OIs09) post partum suckling and skin-to-skin contact during 1st hour after delivery. Differences greater for boys than girls. Study mothers spent more time looking en face at infants and infants cried less and smiled more.

II. Delsordo, J.D. 80 cases of physical abuse Patients classified by causes of abuse (CD-00264) including: parental mental illness, alco­ holism, parental frustration, irresponsi­ bility and anomie, and brain damage in the child.

12. Dorman, S. 69 child abuse cases randomly seleGted Several personality traits accoun t for (CD-OIlS 8) from 135 reported to Children's parental behavior: narcissism, immaturi­ Hospital National Medical Center ty, poor ego development, poor self concept. Physically or psychologically deviant children singled out for abuse.

13. Elmer, E. Comparison of abusive and non abusive Abusive mothers: rated medical stress (CD-00294) mothers more severely. Abused babies: less Hospital population he(llthy with higher rate of prematurity.

14. Fanaroff, A.A.; 146 infants confined to intensive care 2 of 111 mothers in Group 1 exhibited Kennell,LH.; nursery for longer than 14 neonatal disorders in mothering; 9 of 38 in Group Klaus, M.H.; days 2 exhibited such disorders. (CD-00304) Divided into two groups: Mothers who visited more than 3 times in 2 weeks (Group 1); mothers who visited fewer than 3 times in 2 weeks (Group 2) Follow-up for 6-23 months after dis­ charge

15. Fl0yd, L.M. 12 abusing and 12 neglecting mothers No difference in abusing and neglecting (CD-Ols66) 32 control mothers mothers on measures of dependency frus­ Compared on 8 personality measures tra tion, nurturance, interpersonal self­ (TAT) esteem. Abusing and neglecting scored higher on TAT need aggression, lower on family adjustment and interpersonal self­ esteem.

16. Fomufod, A.K.; Cases of child abuse seen at metropolitan Hypothesis supported that early and Sinkford, S.M.; hospital over 1 year prolonged neonatal hospitalization inter­ Long, V.E. feres with the development of natural (CD-01170) maternal-infant bonding and sets the scene for greater distortions at later date.

17. Friedrich, W.N.; 357 children Parental stress derived from handicapped Boriskin, J .A. Reported to county welfare as physically children a factor in child abuse. (CD-Ols84) abused Analysis of case reports

13 TABLE 4 (Continued) ANNOTATED LIST OF STUDIES: INDIVIDUAL CAPACITIES

Reference Methodology Review of Studies

IS. Galdston, R. 60 abused children (mostly 6-1S mon tl1s Role reversal in parents, history of un­ (CD-003S0) old) pleasant childhood experiences observed. Hospital population

19. Giovannoni, J.M .; IS6 neglectful mothers Past social and familial situation of Billingsley, A Low income; black, white, or Spanish­ mother did not differentiate neglectful (CD-0037S) speaking from adequate mothers. Neglectful Interviews mothers showed lower degrees of nllftur­ ance toward children and lower prefer­ ence for younger, more dependent children. 20. Goldson, E.; 114 children from neighborhood health 2S% had low birth weights as compared Cadol, R.V.; program with diagnoses of nonacci­ with only 1.4% of children born in the Fitch, M.J.; dental trauma, failure to thrive, or hospital during that period. Umlauf, 1-IJ., Jf. both; 6 weeks to S years of age (CD-01606) 21. Gordon, R.R. Mothers in perinatal period Factors isolated in study to determine (CD-01609) potential child abuse factors included mental dullness, too many pregnancies too close together, late attendance for antenatal care or default.

22. Green, A.H. 60 abusing mothers Child abuse a dysfunction of parenting in (CD-00396, Control group of 30 neglectful mothers, which paren t misperceives child due to CD-OII92, 30 mothers of pediatric outpatients his own frustrating childhood experi­ CD-01614) Structured interviews and review of ences. Parents relied on child for agency records gratification of dependency needs; had impaired impulse control, poor self­ concept, disturbances in identity forma­ tion.

23. Gregg, G.S.; 113 acciden tally injured or abused chil­ Abusec: children: developmental retarda­ Elmer, E. dren (30 abused) tion, irritability as infants. (CD-00406) Observations of children and families

24. Griswold, B.B.; 40 white, welfare mothers Test scores indicated psychotic ten­ Billingsley, A. Psychological testing (MMPI, CPI, WAIS, dencies among abusive mothers and sig­ (CD-00407) Barron's Ego Strength Scale) nificantly lower self-control. Neglectful Interviews mothers: neurotic tendencies, deficiencies in all areas of socialization, lower self­ esteem.

2S. Hepner, R.; 3S urban disadvantaged cnildren with low Strong correlations found between mal­ Maiden, N.C. serum Vitamin .. A nutrition indicators and quality of (CD-00471 ) Pair-matched for age, race, neighborhood, mothering. sex, school, with children with normal Vitamin-A CLLS

26. Hyman, C.A. Abusive families Abused child scored lower on intelligence (CD-OOSOO, Matched control group of normal parents and developmental tests; abusing parents CD-01661) Psychological, intelligence, and develop- scored higher on practical intelligence men tal testing than verbal in telligelice; abusing mothers

14 TABLE 4 (Continued) ANNOTATED LIST OF STUDIES: INDIVIDUAL CAPACITIES

Reference Methodology Review of Studies

26. (Continued) (Stanford-Binet, Bayley Scales, Bene­ scored lower on capacity for character An thony Family Relations Test, integration and maturity of personality; WAIS, Cattell's 16 PF) abusing fathers showed defective person­ ality integration and were more intro­ verted.

27. Justice, B.; 35 abusing parents Abusers report moderate life crisis in the Duncan,D.F. 35 matched nonabusing parents having year prior to abusive event; competed (CD-O 1688) difficulties with their chiidren with other paren tand children for the Social Readjustmen t Rating Scale role of being cared for.

28. Kennell, J.; Primiparous mothers given prolonged Measurable differences lasting for as long Jerauld, R.; contact with baby as I 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, N.C. tine (CD-O 171 0) Structured interviews, physical examina­ tion of babies, time-lapse films of feedings

29. Klaus, M.H.; Mothers and newborn infants Mothers denied physical contact with Kennell, J.S. Observations madc up to one month after their infan ts until 20 days after delivery (CD-00569) discharge showed less coddling and less eye contact with the infants than a group of mothers allowed contact after 5 days.

30. Klein, M.; 51 cases of abused children seen at a 12% were low birth weight infants com­ Stern, L. hospital pared with expected rate of 7-8% in (CD-00570) general population. Associated Witll abuse was a high degree of isolation and separa­ tion of infants from parents during neonatal period and high incidence of m aj or neonatal problems, including psychomotor retardation.

31. Komisaruk, R. 65 cases of child abuse referred to county High number of parents with IQ under (CD-00579) court 75, undiagnosed mental illness, psychic Parent intervicws traumata in their own childhood; depen­ dent, immature, and narcissistic person­ alities.

32. Langshaw, W.C. 29 children identified as abused In 14 cases, history of men tal illness or (CD-00589) psychiatric treatment in atlult. Immaturi­ ty, low frustration threshold, ambivalence or rejection of child, depression, rigid, compUlsive, and passive dependent personalities, absence of remorse common findings. 5 children had physical or intellectual handicaps.

33. Lukianowicz, N. 20 women who had attempted infanticide Mothers: product of an unhappy trau­ (CD-00632) Case study matic childhood; personality disorders and psychiatric disorders observed.

IS - -~------

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

Reference Methodology Review of Studies

34. Lynch, M.A. 25 abused children Factors identified with abused group: (CD-01234, Compared with 35 nonabused siblings childhood illness in the first year of life, CD-01747) Parent interviews; review of medicaJ illness in mother in child's first year of records life.

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

36. Melnick, B.; 10 abusive mothers Abusive motllcrs: scorcd higher on TAT Hurley, J .R. 10 controls matched for age, social class, pathogenicity and dependency frustra­ (CD-00675) and education tion, lower on TAT need to give nurtur­ Psychological tests (TAT, California Test ance, self-esteem, manifest rejection. of Personality, Family Concept Inven­ Characterized by inability to empathize tory) with children, severely frustrated depen­ dency needs, probable history of emo­ tional deprivation.

37. Myers, S.A. 83 pread'Jlescent victims of felonious Filicidal mothers: overtly psychotic. (CD-00702) homici(~e, 35 killed by mothers Immaturity, masculinity, and Oedipal conflicts observed.

38. Newberger, E.H.; 303 children admitted to inpatient ser­ Data support hypothesis that differential Reed, R.B.; vices categories of hypothesized stresses and Daniel, J.H.; 257 children who visited emergency clinic personaJ and social strengths determine Hyde, J.N., Jr.; of urban academic pediatric hospital the occurrence of pediatric social ill­ Kotelchuck, M. Hospital interview with mothers of chil­ nesseS. Child abuse associated with more (CD-01262) dren extreme disparities of stress and strength.

39. O'Hearn, T.P., Jr. 23 abusive fa thers Abusivc fathers were significantly less (CD-00741) Control group of 23 nonabusive fathers, powerful, Icss assertive, and had signifi­ matched for age, income, age of chil­ can tly lower ego strength. dren, and number of children under 5 years old

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

41. Paulsnn, M.J.; 33 mothers and 27 fathers referred to Findings indicate that test scores from Afifi, A.A.; Child Trauma Interven Hon Program this instrumen tare llseful in discovery of Thomason, M.L.; because of abuse or neglect in family high-risk families and distinguishing dif­ Chaleff, A. Comparison group of 63 mothers and 37 feren t types of maltrea ting paren ts. (CD-00780) fathers selected at random from child psychiatric ou tpatien t Cliilic MMPI

16 TABLE 4 (Continued) ANNOTATED LIST OF STUDIES: INDIVIDUAL CAPACITIES

Reference Methodology Review of Studies

42. Paulson, MJ.; 53 abusive parents Study focus: to differentiate abusive Schwcmer, 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 in ten tionally burned children admit­ l>aren ts mrry 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 Inadequate mothers caught up in apathy­ Borgman, R.D.; Rural, Appalachia futility cycle, displaying powerlessness, DeSaix, C. Measures of lQ, ego strength, and maturity helplessness, alienation, and depression (CD-01285) generation after generation. Inadequate mental organization (measured by lQ, 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 DeSaix, C.; Enrolled in Head-Start day care cen ter disturbance. Smith, B.J. program (CD-00814) Interviews and test battery (CLLS, WAIS, TAT, Rorschach)

46. Polansky, N.A.; 63 Appalachian families at or below CLLS score correlated significan tty with Pollane, L. poverty level intelligence and with features of parents'. CD-01891 ) 93 AFDC families personalities independen tty measured. CLLS Personality tests

47. Seaberg, J.R. Data from nationwide study of child Effects from perpetrator being past (CD-00896) abuse subjected to expanded analysis victim of abuse and perpetrator being psychologically sick not observed.

48. Simons, B.; 313 case reports involving medical care 50% had psychological difficulties; of Downs, EJ.; Review of cases reported to child abuse that 50%, 20% were alcoholics or drug Hursker, M.M.; registry addicts. Survey found high proportion of Archer, M. cases where family exhibited mental (CD-0093J) problems or where victim was a low birth weight infant.

49. Smith, S.M.; 214 abusive parents Mothers: abnormal personality, neurotic, Hanson, R.; subnormal intelligence. Fathers: abnor­ Noble, S. mal personality. (CD-00949)

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

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

Referel'~e Methodology Review of Studies

51. Sokol, R. Random sample of 360 females, 18 years Potentially abusive mothers: lower self­ (CD-Q1964) and older seen at hospitals and concept, more deeply affected by dis­ planned parenthood agencies appointment'; in life, generally more Questionnaire anomie.

52. Stern, L. 51 a bused children Much higher incidence of serious neonatal (CD-0097I) Hospital records illness, congenital defects, low birth­ weight reported.

53. ten Bensel, R.W.; 10 severely physically abused children Abusing mothers: higher incidence of Paxson, C.L., Jr. 10 controls matched for birthweight gestational iIIiless associated with post­ (CD-01993) Treated in special care nursery at birth ponement of first visitation with infant. 3-year follow-up

54. Terr, .LC. 10 abusive families with children from 3 Exaggerated dominant-submissive or ag­ (CD-OI002) months to 9 years old gressive-passive relationships between Interviews; observations spouses. Children displayed physical abnormalities or ego defects frustrating to the ahuser.

55. Williams, J.E.H. 68 cases being considered for parole on Nearly 25% had low or subnormal intelli­ (CD-Q1340) incest convictions, generally 30-50- gence. year-old men

56. Wilson, H.C. 52 neglectful families Frequently found a personality character­ (CD-01341) Sociological study istic resembling .emotional retardation which may have been regressive response to economic and psychological strain. , Immaturity not always related to neglect.

57. Wright, L. 13 convicted abusive parents Abusing parents scored differently on (CD-00491, 13 nonabusive or neglectful parents many of tests, appeared more psycho­ CD-Q1071) matched for age, sex, race, number of pathic, scored lower on intelligence. children, marital and educational status, income Psychological tests (Peabody Picture Vocabulary Test, Rorschach, MMPI, Rosenzweig Picture Frustration Study)

18 TABLE 5 ANNOTATED LIST OF ONGOING RESEARCH STUDIES: INDIVIDUAL CAPACITIES

Reference Research Purpose Methodology

1. Altcmcier, W.A., Ill; Dctermine if there is a characteristic Screening pregnant women by question­ O'Connor, S. pathological pattcrn in mothcr that cor­ naire to classify as higll, moderate, or low (CR-00003) reldtes with disturbances in child care risk pre-, peri-, and post-natal evaluations. behavior and with abuse or neglect.

2. Chapa, D.; Investigate relationships between child Data gathered from interviews and ques­ Lucbbert, G. abuse and neglect and drug abuse. tionnaires. 5,000 adults divided into I) (CR-00027) child abuse and neglect parents, 2) sub­ stance abuse parents, and 3) een .. :al population (normal control).

3. Frocli, A.; Identify characteristics of infants and Heart rate, skin conductance, and blood Lamb, M. children, such as excessive crying, facial pressure measured in parent couples (CR-00056) features, and child temperamen t, that watching videotapes of normal or prema­ may trigger impulsive, aggressive ou t­ ture infants. Broussard's Perception of bursts on part of parents or parent the Average Baby Scale, Bother Inven­ su bsti tu tes. tory, Cary Infant Temperament Scale. 32 couples 20-35 years old.

4. Kadushin, A.; Develop understanding of behavior Experienced social work interviewers to Berkowitz, L. leading to abuse by focusing on parent's conduct 60-minute interviews with 100 (C'R-00090) perception of child's behavior associated abusive parents. with an abuse event.

5. Kennell, 1 JI. To I) determine if infant's contribution Comparative analysis of infants and (CR-00092) to perceived reciprocal in teraction neces­ mothers who receive experiences in 1st sary to mother-infant attachment; 2) week after birth and matched group who determine if mother-infant contact after do not. Second study comparing mothers birth increases maternal attachment thus separated from infants for 1st 24 hours insuring bctter health for the child; 3) and group who were not. Third study investigate situation in which newborn looks at infants with congenital anomalies in fan t is malformed. and compares group receiving interven­ tion with one that is not.

6. Kent, 1. Investigate developmental outcome of ;. tudy population of 1) infants hospital­ (C' R -00094) high-risk infants who undergo prolonged ized because of prematurity, and 2) in­ hospitalization at birth; dcvelop profile of fan ts hospitalized due to congenital ano­ risk factors. malies whose paren ts volun teer. Data collected by observation: questionnaire, and psychological evaluation.

7. Maycr, J.; To I) examine distribution frequency and Structured in terview of 100 alcoholics Black, R. types of child ahuse and neglect within and 100 opiate addicts with children (C'R-00I09) sampl!;! of alcohol and drug abuscrs; 2) under age 18. MMPI; Survey on Bringing investigate child abusers and substance up the Children, tile Schedule of Recent abusers for common factors; 3) examine Experience. relationship between stages in cycles of drug and alcohol abuse, adcquacy of child care, presence or absence of abuse and neglect; 4) determine ex ten t to which social and situational factors associa ted with abuse and neglect operative among alcohol and drug addicts.

19 TABLE 5 (Continued) ANNOTATED LIST OF ONGOING RESEARCH STUDIES: INDIVlDLIAL CAPACITIES

Reference Research Purpose Methodology

8. Tufts, E. Assess role of failure to thrive as indicator Infants less than 6 months who are 2 (CR-OOI50) of potential susceptibility to later abuse standard deviations below normal height and neglect. and weight under study. Comparison with matched control group. All subjects from clinic population.

20 Situational Factors regardless of study focus, a substantial proportion of findings dealt with situational factors. These studies are listed alphabetically by author, and full Situational factors are defined as the complex citations are given in the bibliography which of factors unique to an individual and to families begins on page 64. The methodology of each at a given time that arise from the immediate study is described in as much detail as possible, familial, living space, and social and economic including sample size and characteristics, control environment. They can be positive factors or comparison group if mentioned, and means of strengthening the family and improving the quality data collection, where known. In addition, all of family life, or negative ones, making life more relevant information provided by the abstract on difficult. Situations affecting families may be situational factors can be found under 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. scudy are reported. Methodologv. In reviewing the methodologies In this review, the situational factors related to used in the completed studies, the problem of the child abuse and neglect are divided into three noncomparability of res:;)arch is immediately major groups: the family situation, living eviden t. Sample size, characteristics of study conditions, and economic status. populations, and data collection methods vary enormously. While the majority of sample populations ranged from 20 to 100 subjects, one The family situation includes the status of the study had only 12 subjects, while another marriage, its structure, and the " quality of the examined questionnaires on 1,401 welfare clients. marital relationship; the number, age, and spacing Study populations also varied widely, e.g., of children; family interaction; the presence or middle-class families, Navajo children, and absence of "significant others"; and the degree of alcoholic incest offenders were all study subjects. social isolation. Living 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 nutritious food, access to health care, geographic used questionnaires or interviews. ioc;itiofi, and available transport::tion. Economic status includes such things as employment status Review of studies. While it is importan t to keep of one or both parents, income level, and job in mind that the abstract format limits the amount satisfaction. of information available for review, it is interesting to note that three situational factors did tend to recur in the review of the completed studies: low income, social isolation, and marital discord. The The following pages present an annotated review which follows shows the broad range of listing of 42 completed and six ongoing research situational factors that has been investigated by studies of situational factors related to child abuse researchers. and neglect. These studies were selected for Ongoing research studies. Family interaction, inclusion in this section for one of the following poverty, and socioeconomic status are specific reasons: (I) the purpose of the study was to factors under consideration in six studies. Several investigate the relationship of a particular studies describe their purpose in general terms but situational factor to child abuse and neglect; or (2) do not identify specific factors under study.

21 TABLE 6 ANNOTATED LIST OF STUDIES: SITUATIONAL FACTORS

Reference Methodology Review of Studies

I. Baldwin, J.A.; 60 st!verely abused children under 5 years Identifying characteristics were large U\iYf.r, J .E. of age family size, low social class, instability. (CD·(lJ 376) Retrospective and prospective study

2. Ball, M. 109 cases Analysis of violent behavior; 33% of vic­ (CD-013T'1 tims were children; income of violence victims was low.

3. Bethscheider, J.L.; 30 incest families, 70 neglect families Incest and neglect families: high religious Young, J.P.; Retrospective study of case reports non affiliation rate, overcrowded condi­ Morris, P.; tions. Neglect families: lack of clean­ Hayes, D.D. liness, inadequate clothing, inadequate (CD-00083) feeding.

4. Brett, D.1. 23 cases of child abuse, preschool-age Material evaluated to determine family (CD-00119) children social characteristics and behavior prob­ Control group of 56 children represP"'ting lems. socioeconomic and racial cross st)t:tion Interviews with mothers Medical and social services records

5. British Medical 28 psychiatric patients who had had some Most of the cases reported occurred in Journal experience with incest. large working-class families, living in (CD-01429) Unselected female psychiatric patients cramped quarters in industrial towns or who were victims of paternal incest under conditions of extreme isolation in rural areas.

6. Brosseau, B.E. Parents of 600 abused children 90% of abused children's parents stated ,CD-OIl 13) they wan ted the pregnancy.

7. Bullerdick Corey, E.J.; 48 children, to age 6 years, hospitalized No differences found in number of Miller, C.L.; for child battering mothers married, presence of siblings, the Widlak, F.W. Comparison group of 50 children hospi­ extent of prematurity or extended post­ (CD-01438) talized for other reasons natal hospitalization. Collected demographic and medical data

8. Chavez, G.T. 50 university undergraduates Attempt to identify students who were (CD-01463) subjected to maltreatment through an in s tru m ent based on dysfunctional rearing chru:lr teristics.

9. Cohen, M.1. 43 middle class families Statistical data analyzed on: occupation (CD-01135) Survey questionnaire to child protective and finances, living arrangement, recrea­ workers tion, marriage expectations, and pres0nt rela tionships.

10. Disbrow, M.A. 17 families in which either parents ap­ Abusive parents more socially isola ted (CD-01530) prehended for child abuse or children and isolated as parents. taken into custody Comparison group of 19 families ran­ domly selected from same neighbor­ hoods Questionnaires and subject interviews

22 TABLE 6 (Continued) ANNOTATED LIST OF STUDIES: SITUATIONAL FACTORS

Reference Methodology Review of Studies

11. Durham, M.E. 60 cases of child abuse Findings showed there were enough (CD-01535) Factor analysis causal relationships among variables to describe the factors and relate various factors to family cohesion, deviance, preceding behavior of the child, life stresses and tension, means of abuse.

12. Fergusson,D.M.; AJI cases of alleged or sUspected child Child abuse concentrated in lower socio­ Fleming, J.; abuse that came to attention of Child economic strata; abused children fre­ O'Neill, D.P. Welfare Division in New Zealand in quen tly experienced unstable home back­ (CD-01165) one year grounds. National survey, data collected on stan­ dardized recording forms

13. Holman, R.R.; 28 abused children Finding was that environmental pressures Kanwar, S. Retrospective study of obstetric histories lead to child abuse by susceptible indivi­ (CD-00485, and early lives. duals. CD-OI208)

14. Holter, I.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 stressful situations at time of child', (CD-00488) maltreatment accident. 7 of 87 cases of suspected abuse in similar survey 6 months later Survey and evaluation by home visit

15. Holter, LC.; 19 cases of child abuse from 18 families Families often social isolates, with few Friedman, S.B. church ties or contacts with social organi­ (CD-00489) zations; often new community. Marital discord present in majority; unwanted pregnancy played important part in de­ pression of mothers in 4 families.

16. Hyman, C.A. 15 cases of suspected nonacciden tal in­ Abusing parents: more doubt concerning (CD-O 1660) jury, children under 2 years old paternity, more sought termination of Comparison group of 15 cases of known pregnancy, more marital and financial acciden tal injury, children under 2 problems. Abuse occurred more often years old when mother pregnant or within 7 Questionnaire completed by health visi­ months of last delivery or miscarriage. tors

l7. KapluJ1, D.; 112 child homicides under age 15 Severe poverty, illegitimacy of a bused Reich, R. Postmortem reports, police inquiry re­ child, unwanted pregnancy; marital con­ (CD-01697) ports, public assistance and child wel­ flict, lack of medical care, hostile or fare agency case records nonexistent relationship with neighbors or relatives associated with abuse.

18. Kent,J.T. 500 children and their families, referred Abusi\'e parents: new to neighborhood, (CD-00562) for direct abuse without phone or transportation, few Comparison gruup of 185 families re­ friends, more complications during preg­ ferred for reasons other than abuse nancy or birth. Both groups poor in such as alcoholism, mental illness, in­ financial resources. adequate parenting

23 TABLE 6 (Continued) ANNOTATED LIST OF STUDIES: SITUATIONAL FACTORS

Reference Methodology Review of Studies

19. Kushnick, T.; 39 abandoned children seen in metropoli­ Limi ted informa tion available on family Pietrucha, D.M.; tan hospital, 6 neglected, I abused background indicated larger proportion Kushnick, J.B. of poverty, crime, and other disrupting (CD-00586) factors among parents.

20. Lloyd-Still, J.D.; 64 cases of abuse and neglect seen at a Majority of cases related to a combina­ Martin, B. rural clinic, most under 3 years of age tion of marital difficulties, inadequate (CD-01738) parenting, and economic crises.

21. Lukianowicz, N. 26 cases of paternal incest and 29 cases of Incest interpreted as a subcultural phe­ (CD-00630) various other incestuous relations nomenon precipitated by over-crowding found among psychiatric and child and social isolation. guidance patients

22. Molnar, G.; 18 incest cases, girls 14-17 years old In all cases marital and sexual relation­ Cameron, P. ships of parents dysfunctional. (CD-01790)

23. Moore, LG. 23 cases of violence between parents Found a group of children subjected to (CD-01796) emotional battering as a result of persis­ tent marital conflicts and ensuing cycles of parental separation and reunification.

24. Mulford, R.M.; 1401 heads of 959 families Neglecting parents characterized by low Cohen, M.l. 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 Characteristics Form

25. National Society for 25 families referred for treatment because Findings suggest a multicausal model, Prevention of Cruelty of specific abusive incident including marital discord, social isolation, to Children Retrospective case study unwanted pregnancy, economic stress. (CD-01816)

26. Oakland, L.; 33 Navajo children between 2 months Neglectful mothers: more unmarried with Kane, R.L. and 3 years admitted to hospital be­ smaller families. (CD-00744) cause of ne'glect Age-matched with 49 controls Review of records

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

28. O'Neill, J.A., Jr.; 100 cases of child abuse 3 weeks to II Low socioeconomic status, broken Meacham, W.F.; years old homes, illegitimacy were associated fac­ Briffin, P.P.; tors. Sawyers, J.L. (CD-00743)

24 TABLE 6 (Continued) ANNOTATED LIST OF STUDIES: SITUATIONAL FACTORS

Reference Methodology Review of Studies

29. Paulson, M.J.; % cascs of child maltreatment seen at More documen ted evidence of abuse in Blake, 1'. R. metropolitan hospital lower economic levels. (CD-007BI)

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) Age-matched control group cord reported as family characteristic.

31. Scott, P.D. 29 cases in which father or father substi­ Significam diffe;'nces in marital status, (CD-00894) tu te charged wit11 killing his child biological paternity, num ber of working Comparison group of nonfatally abused mothers. ba bies

32. Segal, R.S. 32 cOl.1ples who neglect their children Family interaction a major determinant (CD-00899) Comparison group of 31 couples who of differences between groups of parents. abuse their children

33. Sills, J.A.; 76 children with non accidental injury Among features which emerged in associ­ Thomas, L.J.; seen in an emergency department of ation with child abuse were illegitimacy, Rosenbloom, J. hospital younger age pregnancy for mothers, and (CD-01947) Review by multidisciplinary team environmental stress factors.

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) employed; financial problem present in 29 families and problems of accommoda­ tion encountered in 35%

35. Smith, S.M. 50 children, average age 14 months, Evidence did not indicate that abuse is (CD-00945) hospitalized for "unexplained" injuries restricted to lower social classes or that who showed signs of abuse abused children were unwanted.

36. Smith, S.M. 134 abused infants and children under 5, Lack of family cohesiveness and premari­ (CD-01957) and their parents tal conception were significant precursors Comparison with matched group of to abuse. parents whose children admitted as emergency cases

37. Tormes, Y.M. 20 cases of father-daughter incest Incestuous families: less time spent in (CD-O 10 18) Comparison group of 20 cases of non­ city, larger families, more young children, incestuous sexual abuse fewer relatives, lower levels of employ­ ment, more illegitimacy.

38. Virkkunen, M. 22 alcoholic incest offenders (father­ Alcoholic families: sexual rejection by (CD-02015) daughter) seen at a psychiatric clinic spouse, large families, poor living condi­ Comparison group of 23 nonalcoholic tions. incest offenders seen at a psychiatric clinic

39. Waterway, J. 42 victims of sexual abuse or 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.

25 TABLE 6 (Continued)

ANNOTATED LIST OF STUDIES: SITUATIONAL FACTORS

Reference Methodology Review of Studies

40. Wight, B.W. 77 children under age 1 referred for Abused children: low socioeconomic (CD-OI337) X-rays status, from broken homes. 1 year longitudinal study

41. Young, L. 120 familit:s selected from case files of 2 Study foc'.ls was to identify and detail (CD-020SI) public child welfare agencies and I recurring behavior in abusive families. private agency handling only abuse and neglect in a large eastern metro­ politan area 180 families from 2 rural areas, 2 medium sized cities, and I large urban area in midwest; and 1 medium sized city and 1 rural coun ty on Pacific coast

42. Young, M. Groups of recognized abusive families Abusive parents: significantly more social­ (CD-0134S, drawn from public nurse caseloads ly isolated, fewer friends outside family, CD-01346) Comparison group of caseload families fewer persons to turn to in times of with no history of abuse stress, less communication between Questionnaire to public health nurses spouses, greater feelings of powerlessness. Psychological testing of parents (Rotter's I-E Scale and FIRO-B)

26 TABLE 7

ANNOTATED LIST OF ONGOING RESEARCH STUDIES: SITUATIONAL FACTORS

Reference Research Purpose Methodology

1. Bentley, R.J. Identify stn:ssful conditions and institu­ Data obtained from court records, police (CR-00008) tions which, impacting on the black files, and Dept. of Human Resources. community, may lead to child abuse. Study population: 450 families (150 Isolate dominant familial characteristics known abusers, 150 in agency files for invc,'ved with child abuse. Describe po­ other reasons, ISO normal families). tentiai correlations which may illuminate child abuse valiables.

2. Burgess, R.L. Determine whether specific interaction Observations made in homes of abuse and (CR-00021) patterns distinguish child abusing families neglect, and matched control families. from nonabusing families. . ~ehavioral Observation Scoring System adapted for data collection.

3. Geismar, 1.; Clarify factors which, interacting with 380 abusing families compared with J44 Horowitz, B.; poverty, may make families more likely nonabusing families. Wolock, I. to abuse or neglect their children. (CR-00059)

4. Lewis, M. Investigate effects of birth order, sex, and Observation at home for 2 hours when (CR-00l02) socioeconomic status upon mother-infant infant is 3 months old. At 1 and 2 years, interaction, and upon psychologh;al de­ infants and mothers videotaped in labo­ velopment of infant up to 2 years. ratory. 200 infants and families from 2 economic groups.

5. Money, J.; Develop a phenomenological account of Case history analysis, patient and family Werlwas, J. behavior in families with children suf­ observation, interviews with persons con­ (CR-00115) fering from psychosocial dwarfism to nected with the patients. determine etiological factors related to child abuse.

6. Starr, R.H., Jr. Determine causal and correlative factors 210 families (90 abusing or neglectful, 30 (CR-00142) in child abuse and neglect. mothers entering methadone treatment program, 90 matched controls). Children less than 5 years old.

27 A ttitudes and Values attitu les include beliefs about the parent-child relaticnship; 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 members role in shaping the behavior of parents, ;::hildren, and by society; attitudes a bou t others who may be and families. Each individual is constantly shaping involved in child care; and finally, attitUdes about and reshaping his own personal view of life, how family members relate to one another, such as selecting, developing, and interpreting those the way in which feelings may be expressed or the attitudes and values that are salient for him. Of appropriateness of corporal punishment in course the sophistication and consciousness of this changing a child's behavior. process varies widely from person to person.

This internal process is largely a response to the The following pages oresent 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 members studies which consider the relationship of attitudes of h,~ family and his immediate peer or referenGe and values to child abuse and neglect. These group. In 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: (1) the purpose large primarily 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/alue to child abuse and touch everyone. Anyone individual, therefore, is neglect; or (2) regardless of study focus, the affected by attitudes, values, and beliefs emanating majority of findings dealt 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. Each level influences and is and full citations are given in the bibliography influenced by every other level. For example, a beginning on page 64. The methodology of each family develops a set of attitudes reflecting a stu dy is described in as much detail as possible, blending of values of individual family members. including sample size and characteristics, coptrol In turn the family's values mayor 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 societal values. 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 and families. the abstract, those attitudes and values dealt with in the study are reported. In this review, the attitudes, values, and beliefs that are relevant to child abuse ami neglect are divided into two major groups: attitudes toward children and attitudes toward the family. Methodology. The samples in four of the completed studies reported here were drawn from A ttitudes toward childrell include the value nonabusive populations including representatives placed on children in genera!, based on a view of of various professional groups, middle-class the child's position, role, and status within his families, mothers of five-year-olds, and couples group; attitudes toward unique categories of who married young. Home observation was used children; beliefs about determinants of child to collect data in two studies while three studies behavior and personality characteristics; attitudes used a questionnaire with a professional group about the age at which a child is considered involved in child abuse and neglect. competent to learn and reason, before which attempts to modify his behavior would not be Review of studies. Most of the completed fruitful; and attitudes about age-appropriate research deals with children's behavior and behavior. appropriate 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, and the role and status of each the parental expectations of children's behavior. family member constitute the set of beliefs and There was little rehearch on expectations of family attitudes toward the family that are relevant to life, family relationships, and roles of family child abuse and neglect. Specifically, these members.

28 Ongoing research studies. Unrealistic or rigid information on child 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 still in high Unrealistic expectations of development (CD-01520) school associated with physical punitive mea­ 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. Questionnaire rating punishment inci­ dents

3. Sears, R.R.; 379 mothers of 5-year-olds Study focus: relationship of child's level Maccoby, E.E.; of aggressive behavior, degree to which Levin, H. mothers ptlrmitted such behavior, and (CD-00897) severity with which they punished it.

4. Smith, S.M.; 134 abused children under 5 years old Abusive parents: excessive 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 punishmerlt. accidental emergencies and their parents Hospital and home observation Psychiatric, psychological, and sociologi­ cal interviews Questionnaires

5. Straus, M.A.; Study focus: violence in the family, what Gelles, R.J.; constitutes legitimate and illegitimate Steinmetz, S.K. violence. (CD-01317)

29 ------~-- ---

TABLE 9

ANNOTATED LIST OF ONGOING RESEARCH STUDIES: ATTITUDES AND VALUES

Reference Research Purpose Methodology

1. Egeland, B.; Identify high-risk situations for abuse and Prospective longitudinal study. Child­ Deinard, A. neglect by studying characteristics of rearing attitudes and expectations of 225 (CR-00046) newborns, interaction of mothers and mothers obtained prenatally and 3 infant in 1st year. Investigate hypothesis months after birth. Interactions observed that in situations where mother's expecta­ at 3, 6, and 9 mon ths, and infant tions are unrealistic and rigid, interaction attachment to mother studied at 12 patterns will place child in high-risk situa­ months. tion.

2. Straus, M.A.; To study child abuse within context National sample of 2,143 families inter­ Gelles, R.J.; of all uses of physical violence in family. viewed for data on frequency and modali­ Steinmetz, S.K. Test subjective meaning of acts of vio­ ty of violence. (CR-00145) lence to those involved. Test theories about etiology of intrafamily violence.

Social Institutional Factors provide cultural and recreational opportunities for its members. Basic social institutions include political structures; economic structures; and Social mstitutions exist for different purposes integrative structures, such as community ,md on diflferent levels. At the most universal and organizations, schools, and media. g.~nerallevel are basic institutions that express the purposes and embody the values of a society and shope the lives of all its members. These Social service and social control institutions are institutions are significant for all families and form assigned to provide those general human services the underpinnings without which no society would 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. Induded 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, as well as those dealing with child familie's. Such institutions are numerous and can welfare, drug and alcohol abuse, mental health, render various forms of help, relief, and care to unemployment, and poverty. parents, children, ~d fammes. They range from educational and health institutions that are used at one time or another by all families to those institutions that directly intervene to protect or Individuals and families may and do avail change the behavior of individuals and families themselves of such services voluntarily. But in with specific social problems. some cases society decides to intervene directly to change individual and family behavior which is In this review, social institutional factors are deemed deviant and to protect family members divided into two major groups: basic social who are seen to be at risk, especially children. In institutions and social service/social control these cases social service institutions become institu tions. institutions of social control. In addition, society has established specific instrumen ts of social Basic social institutions are responsible fo: the control--law enforcement and legal general welfare of individuals and communities. institutions-which also have a role to play in They assign and carry out society's tasks, express ameliorating or eliminating inappropriate behavior and help shape its civic and social values, and of individuals and families.

30 The following pages present an annotated Methodology. The intent of completed research listing of 21 completed and II ongoing research related to social institutional factors was to studies focusing on social institutional factors 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 child protective program to an entire state system of the following reasons: (l) the purpose of the or even child protective services in all 50 states. study was to investigate the relationship of a particular social or institutional factor to child Methods of data collection included analysis of abuse and neglect; or (2) 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 institutional factors. Review of studies. Only two studies deal with basic social institutions. Both studies focus on the policies, procedures, and regulations of These studies are listed alphabetically by author educational systems as they relate to child abuse and full citations are given in the bibliography and neglect. beginning on page 64. The methodology of each study is described in as much detail as possible, All other studies focus on child protective including sample size and characteristics, control service systems: needed and available services, and or comparison group if mentioned, and means of the effectiveness and efficiency of system data collection, where known. In addition, all operations. relevant information provided by the abstract on social and institutional factors can be found under Ongoing research studies. General social service the heading "Review of Studies." Study findings and social support systems are under study in 10 are noted where available; if no findings are projects as well as case dispositions in a police indica ted in the abstract, those social or 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.

31 TABLE 10

ANNOTATED LIST OF STUDIES: SOCIAL INSTITUTIONAL FACTORS

Reference Methodology Review of Studies

1. Barrett, L.; II demonstration projects of joint OCD­ In general, average expenditure increased Froland, C.; SRS National Demonstration in Child 20% between Oct. 1975 and April 1976 Cohn, A.H.; Abuse and Neglect while program hours expended remained Collignon, F.C. stable. Comparative tables illustrating (CD·01387) Descriptive 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 that did not warrant legal action Giovannoni,I.M.; participant observation study of a and lack of coordination between legal Purvine, M. protective service system and welfare authorities were problems (CD-00979, questionnaire to protective service in protective services system. CD-01407) social workers in 9 public agencies 2. Organization and functioning of a comparison of abusive and neglectful department is more important than families with normal families size of case loads and education of individual workers; forces within a community can lead to trends in inter­ vention rather than to intervention based on the individual client's prob­ lem. 3. Protective services should be concep­ tualized as comprehensive community services to children in their own homes, since these families ure apt to be in need of a multiplicity of services. 3. Burns, A.; Child abuse and neglect reporting meth­ Criteria for identifying an abuse or sus­ Feldman, M.; ods and procedures 1n 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-OI440) hospitals and personnel in County cases. Little cooperation between various Departments of Public Health and 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 familie~; routine filing of neglect and dependency petitions; failure to prevent neglect, abuse, or dependency; duplica­ tion of effort by several agencies; lack of 24-hour emergency services.

5. Dawe, K.E. 59 cases of child abuse Problem areas uncovered in the retro­ (CD-01507) Retrospective study of medical, social, or spective study included inadequate intake court records records, lack of awareness of the prob­ Survey of 1,000 physicians, lawyers, social lem, insufficient diagnoses and follow workers, nurses, teachers, police, jour­ through, lack of coordination in record nalists, clergy keeping. Recommmdaticns from the study included: a central registry, stan­ dardized reporting procedures, augmenta· tion of child welfare agencies, establish­ ment of child advocacy office.

32 TABLE 10 (Continued)

ANNOTATED LIST OF STUDIES: SOCIAL INSTITUTIONAL FACTORS

Reference M~thodology Review of Studies

6. DeCourcy, P.; 13 cases of child abuse No effective remedial action taken in any DeCourcy, J. Case study of 13 cases because of inadequacies of (CD-01521) courts and social agencies.

7. 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-0l516) 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 SO 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.J. 275 cases in 11 demonstration projects Findings reported on case management in (CD-01522) child abuse and negleet cases from intake and diagnosis through termination and follow-up.

10. Education Commis- 390 educational groups and institutions Most state boards of education, state sion of the States Phone and mail surv~y departments of education, institutions (CD·OI545) did not have policies, procedures, or regu­ lations relating to child abuse and neglect.

11. Harriman, R.L. State school system Few school districts had written child (CD-01633) Written inquiries abuse policies, administrative procedures, or in-servicc training.

12. Johnson, C.L. 2 county protective service units Both systems impeded as a result of state (CD-01681, Collection of data on various agency of their relationship with collater.al sys­ CD-01683) fUnctions tems, especially hospitals which fell short in channeling child abuse and neglect cases. In both systems, the record keep.ing system was an impediment.

13. Maden, M.F. Reported child abuse victims Findings show that cases investigated by (CD-01752) social service agencies compared with law enforcement agencies are less likely to result in removal of victims from home, more likely to receive social services, more likely to invoke community action for perpetrator. Joint investigation more likely to result in removal of child and referral of family for services.

33 TABLE 10 (Continued)

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% of population of 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.

15. Pacheco, C. Analysis of ) 5 child abuse and neglect Severe problems of a high professional (CD-01862) programs in a metropolitan area turnover rate, significant deficiency in num ber of properly trained social workers, overworked city and state ap­ pointed attorneys, insufficient training for juvenile court judges and law enforce­ ment personnel. Insufficient professional exchange of information, too few pre­ vention 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 county prevention, protec­ Analysis: duplication of services, omission for Prevention of tion, and treatment services of some services, in general an unplanned, Cruelty to Children, In-depth study of 3 randomly selected uncoordinated system of care. Study of Inc. cases leaders, directors, and workers: duplica­ (CD-01899) Structured interview:; of 21 leaders in tion of services not a problem but cocr­ field and 166 directors and front-line dination needed in prevention and re­ workers habilitation.

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 Lourie, R.S. Retrospective analysis removal of child by court. (CD-Ol949)

18. Tennessee State Analysis of needed and available services Protective service clients recelVmg more Dept. of Public Wel­ for neglected, dependent, and abused sufficient services than nonprotective ser­ fare children and families. vice clients. Areas covered most insuffi­ (CD-01319) County-by-county survey ciently were the hotline, self-help organi­ Case records and interviews of profession­ zation, 24-hour emergency service, day als care, homemaker, and parent education. Urban areas most deficient in services, while reverse is true in non urban areas. Statewide, non urban areas demonstrate the greatest need for services.

19. Terr, L.C.; Analysis of medical and legal records in Numerous procedural defects in both Watson, A.S. 10 cases of suspected child abuse medical and legal institutions designated (CD-OI003) to deal with suspected child abuse.

34 TABLE 10 (Continued)

ANNOTATED LIST OF STUDIES: SOCIAL INSTITUTIONAL FACTORS

Reference Methodology Review of Studies

20. Varon, E. 13 former clients of private agency Former clients and non clients knew little (CD-02012) 50 nonclients from same neighborhoods or nothing of inner functioning of social Relevant agency and nonagency profes- agencies or their place in social structure. sionals 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 move­ ment, public assistance status, numbers and types of social services provided, and reasons for closing cases.

35 TABLE II

ANNOTATED LIST OF ONGOING RESEARCH STUDIES: SOCIAL INSTITUTIONAL FACTORS

Reference Research Purpose Methodology

1. Bohnstedt, M. Correlate characteristics of child abuse 1500 cases reported to police department (CR-OOOIO) victims and parents with case oflarge wes tern U. S. city. dispositions.

2. Curry, D. Ascertain levels of awareness of abuse Home interviews of adult male and (CR-00032) and neglect and child rearing practices female members of black community in among black community. Identify 14 cities. Interviews with representatives services provided and areas of need in of social service agencies, schools, various agencies dealing with abuse and hospitals, and criminal justice neglect. departments in 2 cities to identify services.

3. Dinges, J. B. Evaluate and improve components of Survey research utilizing interviews, (CR-00039) state case identification. Desigli and test questionnaires, and case readings. methodologies for protective service Experimental research design used. needs and resources assessment. Design models for services identified as needed for prevention and treatment.

4. Garbarino, J. Investigate function of formal and Analysis of data from 93 census tracts to (CR-000s8) informal support systems in mediating determine high- or low-risk stresses which instigate abuse and neighborhoods. These provide contexts neglect. Determine whether isolation for assessment of family stresses and from social support systems is a supports by an interview technique, the necessary condition for abuse and Family Support System Interview, and neglect. Holmes-Rahe Social Readjustment Scale. s. Jones, C. D.; Develop and recommend alternatives Trend analysis on data collected from Fox, P. regarding rol~ of educational system in state and local Boards of Education, (CR-00088) iden tification, treatment, and prevention PT A's, and other educational organi­ of child abuse and neglect. Increase zations. Research on teacher education awareness in these systems and among and preparation in area of abuse. state decision makers. Encourage participation among service delivery systems.

6. Maney, A. C. Develop and report understanding of Models contrasting components of Gaughan, M. those professional bureaucratic and professionally ideal system with those of (CR-00107) political processes which affect metropolitan community's custodially deinstitutionalization of child care oriented system developed. Principal systems. method: participant observation.

7. McCathren, R. R. Investigate decision-making for and Data collected via observation of juvenile (CR-OOIII) disposition of child abuse and neglect court hearings and interviews with by social service and juvenile court attorneys, judges, and social workers. systems. Design and draft administrative Attitude surveys administered to direct and legislative reforms to improve line social workers and attorneys. Survey system. of children under state detention care.

36 TABLE 11 (Continued)

ANNOTATED LIST OF ONGOING RESEARCH STUDIES: SOCIAL INSTITUTIONAL FACTORS

Reference Research Purpose Methodology

8. Nagi, S. Z. Gain nationally representative analytical Intensive interviews with professionals in (CR-00117) picture of reorganization of services and agencies and programs serving a probabil­ control mechanisms concerned with ity sample of U.S. population. child abuse and neglect. Identify limitations and strengths in structure and performance of 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) parents involved in child abuse and Interviewees screened from random neglect cases, and their views of child sample of Non-Work Incentive cases. welfare agency, caseworkers, and services.

10. Steen, J.; Policy study of a military community's Structured survey of military and civilian Marlsy, M. response to problem of abuse and child advocacy personnel. Description (CR-00144) neglect. and statute analysis.

37 V. PREVENTION AND TREATMENT

In the preceding section of this review, those Later programs recognized abuse and neglect as research studies which identified factors that may patterns of interaction involving both parent and contribute to or mitigate against abusive or child. These programs focused on the family unit. neglectful behavior were considered. This section At the same time, it was generally accepted that will review research on the prevention 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 immedia te crisis and to methods of prevention and treatment. provide long-range help. Theoretically, for every cause there exists an effective means of alleviating the situation that At present, numerous treatment models and caused the deviance; thus, the proposed theories of strategies are being used throughout the country, prevention and treatment are the logical outcome including therapeutic intervention, the extended of the identification of these causative factors. family center, foster care, behavior modification, family advocacy, and other support services. Prevention and treatment programs can be categorized as primary prevention, secondary prevention or intervention, and treatment. Since these categories represent a continuum of prevention and treatment efforts,

38 Europew countries; the other three reported on comprehensive, multidisciplinal'- approach to the screening methods used to detect parents with use of drug therapy. These studies are listed potential problems in child rearing or to analyze alphabetically by author and full citations are known abusers to develop sqeening methods. given in the bibliography beginning on page 64. The mode of intervention used in each study is These studies are listed alphabetically by author described in as much detail as possible under the and full citations are given in the bibliography heading "Type of Treatment." The methodology beginning on page 64. The methodology of each of eaeh 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 characteristics, control control or comparison group if mentioned, and or comparison group if mentioned, and means of means of data collection, where known. data collection, where known. In addition, all Abbreviations for standardized psychological tests relevant information provided by the abstract on were used wherever possible; a key to these prevention can be found under the heading abbreviations can be found on page 64. 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." Methodology. Sample size of the completed studies ranged from 33 abusive parents to 500 Type of treatment. A wide range of treatment mothers to the clientele of prevention programs approaches is represented in the completed throughout Europe. Two studies developed a studies, most of which directed their efforts to predictive questionnaire while a third used a changing parental behavior and/or attitudes. Three standardized test instrument. stu dies 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 later abuse; other predictive items included the use of drug therapy. problems of self-esteem, conflict with authority, and concern with isolation. Methodology. The completed studies used a variety of methods to try and assess effectiveness of treatment intervention, including Ongoing research studies. Five of the six studies questionnaires, intelligence and psychological focus on secondary prevention and are developing testing, and comparison of program records. predictive variables or screening profiles of high-risk families. The remammg study is Review of studies. Three studies reported on evaluating the feasibility of using the extended systematic evaluations of total program operation, family in solving the problem of child including cost-effectiveness, realization of program mal trea tmen t. goals, and administrative effectiveness, as well as treatment impact. The others concentrated on assessing effectiveness of treatment. In general, results are reported in terms of improvement in family functioning, self-image of parents and children, and children's IQ level. Only two studies reported recidivism rates as a measure of program impact. Treatment Ongoing research studies. The effectiveness of various treatment modalities, such as psychiatric Tables 14 and 15 present an annotated treatment for infants, volunteer lay therapists, and listing of 31 completed and 12 ongoing research therapeutic playschool, is under study in 11 studies which focus on a wide variety of projects. Larger research efforts assess the impact treatment interventions ranging from a of a number of demonstration projects.

39 TABLE 12

ANNOTATED LIST OF STUDIES: SECONDARY PREVENTION

Reference Methodology Review of Studies

1. Council of Europe Examination of secondary prevention Individual preventive action methods (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'~ homes and youth camps; group efforts include social work in asylums for the homeless and youth clubs.

2. Helfer, R. E.; 500 mothers from various socio­ 100 thought to fall in high-risk category Schneider, C. economic levels with low parenting skills. These mothers (CD-00464, Questionnaire screening for unusual had higher than reasonable expectations CD-00887, rearing practices for the 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 indicating violent punishment of the mother by her parents. Single best predictive cluster had to do with problems of self-esteem. At present questionnaire must be considered as a research tool or screening instrument; the number of false negatives or false positives to be expected 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.

3. Paulson, M. J.; 15 males and 18 females as primary Male abusers were more hedonistic, Afif, A. A.; abusive parent self-centered, suspicious, and in conflict Chaleff, A.; Discriminant 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 also suspicious, distrustful, concerned over motives of their peer group, and fearful of hurting themselves and others.

40 TABLE 12 (Continued)

ANNOTATED LIST OF STUDIES: SECONDARY PREVENTION

Reference Methodology Review of Studies

4. Schneider, C.; 30 known abusers Abusing paren ts reported significantly Helfer, R. E.; Companion group of 30 nonabusers more seve~e physical punishment in their Pollack, C. matched on parent age, education, childhood, more anxiety about dealing (CD-00818) socioeconomic status, number of with their children's problems, more children, with a child of same age as concern about being alone and isolated, the child who had been abused more concern with criticism, 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 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 by first screen. Pre- and post-testing of mother-infant interaction will be conducted. Sample: 30 children and :30 family 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 follOW-Up at home and at work. (CR-00009) child abuse. Determine extent of abuse and neglect in migrant community.

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

4. Gundy, J. H.; Develop and validate risk identification Members of support group will complete Krell, H. for use in newborn and prenatal nursing questionnaires before and after 6-month (CR-00068) clinics. Evaluate support group. period. Scales for risk identification will be validated.

s. Helfer, R.E. Assess reliability and validity of Concurrent validation measured by (CR-00072) Michigan Screening Profile of Parenting. comparing other measures. 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 of effects of various 24 children and families. Randomly and (CR-00143) preventive mental health techniques on secretly assigned to experimental or high-r·.sk children and their families. control groups. Initially evaluated medically, developmentally, and psychologically. Parental Attitude Research Inventory, Cattel Infant Test, Piaget Object Scale, Peabody Picture Vocabulary. Reassessment made 2-2Yz years later.

42 TABLEi4

ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

1. Armstrong, K. L.; Extended family center Evaluation components: Evaluation findings included Cohn, A. 1-1.; (EFC) assessment of service im­ improvement in certain as­ Collignon, F. C. pact pects of family functioning, (CD-01369) assessment of program such as self-image, awareness goal realization of child development, and assessment of program ability to express anger; little costs difference in terms of reinci­ description of program dence between EFC and other operation treatment programs; difficul­ ty on the part of families adjusting to termination of services because of depen­ dence on center support; avoidance of stigmatizing clien ts. Gradual termination of treatment recommended.

2. Bates, T.; Health-based, multidisciplin­ Analysis of 9 multidisciplin­ Found few regul.arly func­ Elmer, E.; ary program ary health-based programs tioning, health-based, multi­ Delaney, J. selected for geographic, disciplinary treatment pro­ (CD-01388) demographic, and method­ grams. No program knew how ologic diversity many other programs existed On-site visits, questionnaires or where they were located. Most programs modeled after Helfer/Kempe description of multidisciplinary teams.

3. Beezley, P.; Psychotherapy, play therapy 12 physically abused children Children who remained in Martin, H. P.; once or twice a week for 50 aged 3.8-8 years therapy for a year displayed Kempe, RJ. minutes Cognitive, speech-language, increased ability to trust (CD-01395) neurologic testing adults, delay gratification, and verbalize feelings, as well as increased self-esteem and increased capacity for plea­ sure.

4. Behavior Associates Self-help Evaluation components: Findings for first 2 years of (CD-01396) documentation of program Parents Anonymous project goals are reported. collection of descriptive information about person­ nel analysis of processes in chapter functioning measurement of program impact

43 TABLE 14 (Continued)

ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies s. Berkeley Planning Joint OCD-SRS National Evaluation components: Projects whose goals were Associates Demonstration in Child project goals most successfully realized had (CD-01400) Abuse and Neglect costs ongoing agency as sponsor Multidisciplinary case management which was already a primary adult client characteristics service provider and was well child client characteristics coordinated and admini­ - community system char­ stered. acteristics Factors contributing to com­ parative cost efficiency: larger total expenditures larger total staff increased hours per staff smaller proportion of ex­ penditures for project ac­ tivities wider variety of services provided Key problems related to case management: poor records inconsistent supervision lack of training inadequate client partici­ pation Less than half of all adult clients had reduced potential for abuse or neglect at termi­ nation of therapy. Findings regarding children were also observed.

6. Burt, M. R. Comprehensive emergency Comparison of program re- I Program objectives were met (CD-01442) services: cords for 1969-70 with those at a substantial reduction in emergency intake for 1973-74 cost. emergency caretaker - emergency homemaker emergency foster homes

7. Daniel,1. H.; Two intervention models: Descriptive, case-<:ontrol Both programs showed pro­ Hyde, J. N., Jr. Parent Education Programs study of families whose chil­ mise after 2 years of expe.ri­ (CD-01147) therapeutic teaching dren exhibit the effects of ence. sessions for 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

44 TABLE 14 (Continued)

t.NNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

8. Ephross, P. H.; Hospital-based multidisciplin­ Evaluation by: While a large proportion of Weissman, L. A. ary approach with administrative assessment the parents had treatment­ (CD-00189, pediatrician, social worker, including staff interviews resistant sociopathic person­ CD-01550, nurse, psychiatrist, an.d and review of case files alities, the project still en­ CD-01551, community aide interviews with 3 families joyed a high successful treat­ CD-01552) questionnaires ment rate. The project team approach demonstrated effec­ tiveness in dealing with all types of parents, including the emotionally disturbed.

9. Fanshel, D. Foster care 624 children in foster care Children who entered care (CD-015S6) S-year longitudinal study of due to own behavioral or parental visiting patterns emotional disorders received higher level of parental visits. lout of 3 children in the neglect or abuse category were visited by a parent. High parental visiting correlated well with discharge rates, particularly during earlier time periods of the study.

10. Galdston, R. Day care for abused children Results obtained with 23 (CD-003S1, Directed group sessions for families and 42 children over CD-003S2) parents 2 years are described in detail.

11. Hoffman, D. L.; Crisis psychotherapy A system of planned short­ Remmel, M. L. term therapy is described and (CD-OI206) evaluated.

12. Jones, B. M. Homemaker services in times 144 children in 29 families Findings: (CD-OOS32) of crisis received services over a I-year separation averted in 142 period cases 2 children placed in foster homes had time to prepare for placement generally improved pattern of family living program Vastly more ec­ onomical than placement

4S TABLE 14 (Continued) ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

13. Jones, M. A.; Intensive family casework I-year evaluation of 9 demon­ Intensive family services were Neuman, R.; services, emphasizing stration programs serving 549 effective in averting or Shyne, A. W. increased casework cases involving 992 children shortening placement, and (CD-01684) counseling 42% of cases included this was accomplished with emotional neglect benefit to the children and at 23% of cases included lower cost. physical neglect Average child in experimental 6% of cases included abuse . programs spent 24 fewer days Compared with children in in faster care. regular public program Fewer of the experimental group children spent allY time in foster care-52% vs. 60% of children in regular programs. 6 months after end of pro­ ject, 92% of experimental chiluren still in own homes compared with 77% of re­ gular program children.

14. Justice, R.; Transactional Analysis 10 child-abusing couples 8 couples had children re­ Justice, B. therapy turned with no further re­ (CD-01691) ports of abuse. 1 couple dropped 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 AssocLtion educational, and health nomically impoverished maker programs, foster care, (CD-00541) services to families of day care, preschool nursery neglected and abused children care, and other traditional approaches are enumerated with cost estimates for each. Specific results obtained with each family are summarized, and some general conclusions regarding parents and chil­ dren are drawn.

16. Lynch, M.A.; Inpatient unit for families of 50 families, with 87 children 80% of families returned Ounsted, C. abused children; group, indi­ 23 children actually home with children. (CD-01748, vidual, and marital psycho­ abused 12 children in 10 families CD-01750) therapy for parents 3 probable abuse need separation from family 24 at risk at admission or after short Variety of socioeconomic trial at home. backgrounds and urban No cases of proven reabuse. and rural areas 2 children subsequently spent short periods in foster care. Many families requested assis­ tance in times of crisis.

46 TABLE 14 (Continued)

ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

17. Money,J.; Removal from home 16 patients with syndrome of 4 patients showed complete Annecillo, C. dwarfism characterized by remission of symptoms of (CD·01793) reversible hyposomatotro­ impaired growth and behavior pUllsm occurring with and had IQ increases of 29 to abuse and neglect 55. Measurement of IQ before 8 had increases of 2 to 14; I and after relocation of showed no change. domicile 3 who showed persistent symptoms, such as bed wet­ ting, temper tantrums, hyper­ kinesis, and atypical food and fluid intake had decreases from I to 12. The longer the pe'dod of removal from home, the larger the increase in IQ.

18. Money,J.; Removal from home 12 children with retarded All improved after leaving the Wolff, G. statural growth associated environment of growth retar­ (CD·01795) with reversible somatotro­ dation, and elevations of IQ phic deficiency (history of by as much as 30-50 points abnormal psychosocial be­ observed. havior and motor retar­ The more advanced the age of dation) child before leaving the Measurement of IQ before or home, or while remaining in on admission to hospital it, the later the onset of and after some period of puberty. removal from home I case reported in detail.

19. Newberger, E. 11.; Hospital-based, 62 cases of abuse, 39 hospi­ Average hospital stay was Hagenbuch, J. J.; multidisciplinary group for talized reduced from 29 to 19 days; Ebeling, N. B.; total management of child average costs reduced from Colligan, E. P.; abuse cases $3,000 to $2,500. Reinjury Sheehan,1. S.; rate reduced from 10% to 2%. McVeigh, S. H. (CD-00727)

20. Newberger, E. H.; Coordination and provision Review of 75 cases 43% of cases referred by McAnulty, E. H. of hospital- and - 23 cases of abuse community-based agencies. (CD-00730) community-based treatment - 2S cases parent-child be- 47% of cases referred for for physical and social havior problems social or psychological thera­ problems of vulnerable - 9 cases multiple accidents py; impl'Ovement seen in 51% children ill multi-problem - 8 cases failure to thrive of these cases. families Recent practical and theoreti­ cal advances in the manage­ ment of such children are discussed.

47 TABLE 14 (Continued)

ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

21. Paget, N. W. 24-hour emergency babysit- 32 cases Review of 32 cases occurring (CD-On7S9) ting service Case review over 11 months indicated overall success of the pro­ gram. Parent reactions were sometimes hostile but never 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'" in­ service, it was difficult to fluence on community differentiate successful treat­ assessment of efficacy of a ment modes. Common Lan­ behavioral approach in guage Assessment System treating emotional neglect proved effecti"f' \n facilitating evaluation of adequacy of choice of therapeutic tech­ the Common Language nique. Assessment System as a model for diagnosing and treating emotional neglect

23. Sherman, E. A.; Services to children in their 553 abused and neglected In own-home cases, both Phillips, M. H.; own homes children parents more frequently pre­ Haring, B. L.; Cases drawn from I voluntary sent and financial situation Shyne, A. W. and 3 public agencies better. (CD-01284, Analysis of monthly service Of 98 clients interviewed, CD-01307) and outcome schedules 66% had positive perception kept by caseworkers; inter­ of helpfulness or effectiveness views of service. Congruence be­ Compared with placement tween parent's and worker's families perceptions of need for ser­ vice and kind of service needed. Areas of greatest positive change were those ill which child care and training were center of concern and service effort.

24. Reich, J. W. Lay therapist as parent aide 8 abusing parents Data were reasonably consis­ (CD-01906) Control groups of: tent in showing an increasing 7 abusing parents having movement toward a more regular social worker positive approach in the inter­ contacts only actions of parents with the 144 nona busing parents aides. Questionnaires pre- and post­ Effect that this might have on trcatmen t parent-child interactions could not be ascertained.

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

Reference Type of Treatment Methodology Review of Studies

25. Rosenblatt, S.; Drug therapy 11 women and 2 men sus­ Short-term mollification of Schaeffer, D.; pected of physical abuse anxiety, depression, and so­ Rosenthal. J. S. or complaining of difficul­ matic symptoms effected in (CD-01919) ty in controlling extreme drug-treated group. Experi­ punitive impulses against mental and control groups their children showed improvements at end Treated with 200 mg of of 6 weeks; however no diphenylhydantoin twice a significant differences were day or an inert placebo for discernible between the 2 8 weeks on a random, groups due to uncontrollable double-blind basis confounding factors. Weekly tests to assess changes No measurable changes attrib­ of attitude toward chil­ utable to drug action were dren, level of depression, found on behavioral para­ hostility, anxiety, and meters hypothetically rele­ other variables (Q sorts vant to child abusing parents. developed from scales from NIMH Depression Study, MMPI. Taylor Manifest Anxiety Scales, and Parental Attitude Re­ search Instrument) 26. Shames, M. Homemaker services 12 families which had been All 12 showed marked im­ (CD-00906) particularly resistant to case provement in most areas and workers' efforts to improve gains made held up after household management and homemaker left. Resulted in child care realignment of family rela­ tionships. Homemaker's own skills less important than her intuitive ability to give mothers accep­ tance, respect, and under­ standing. Professional supervi­ sion of homemaker was im­ portant.

27. Silver, L. B.; Own home services vs. foster Retrospective study of 34 Children are better cared for Dublin, C. C.; care cases of abuse in their own homes if agency Lourie, R. S. in terven tion is effective in (CD-00926) preventing further abuse or improving the quality of home atmosphere.

28. Steele, B. F.; Therapeutic treatment 60 families of abused children Useful contact was estc.\b­ Pollock, C. B. from all socioeconomic levels lished wiih all but a few (CD-00966) and with a variety of emo­ families and significant im­ tional disorders provement s~en in over 75% of those treated. Found decrease in demands on and criticism of child, increased awareness of age­ appropri.ate needs and be­ havior, and development of wide social rela tionships.

49 TABLE 14 (Continued)

ANNOTATED LIST OF STUDIES: TREATMENT

Reference Type of Treatment Methodology Review of Studies

29. Stephenson, P. S. Yl-day enrichment program Multiproblem families with Preliminary findings indicate (CO-01316) for very young high-risk children 18-30 months of that very disadvantaged, de­ children focusing on: age prived, and alienated families I) cognitive and effective Control group who are abusing or neglecting stimulation their children can be success­ 2) working to reduce any fully worke!d with on a observable psychopa- voluntary basis, using pre­ thology school teachers as primary Weekly horne visits engaging therapists for both children both parents and siblings and their families. in therapeutic process

30. Tracy, J.; Behavior modification, inter­ 41 families 84% of families showed im­ Ballard, C.; vention of lay family health - 11 with abused children provement in areas of "do­ Clark, E. worker drawn from the com­ - 30 at high risk mestic concern," 9% rated (CO-OI022) munity the same or worse, 7% rated unknown.

31. Young, L. R. Integration of case work, 125 neglectful, disorganized Preliminary findings showed (CO-01706) education, and group wC)rk families deterioration checked in 90% - 77% receiving public assis­ of families in the first year of tance program. Children showed - 98.5% with annual income considerable progress. In $4,000 or less second year, 55-60% of fami­ lies showed progress in at least one area of family functioning. Importance of family plan­ ning as requirement for fu­ ture family stability stressed.

50 TABLEtS ANNOTATED LIST OF ONGOING RESEARCH STUDIES: TREATMENT

Reference Research Purpose Methodology

I. Doty, E. F.; Formative evaluation of 12 Evaluation compone~ts include Houston, T. R. demonstration centers established by organiZational bases and service modes, (CR-00041) the National Center on Child Abuse and service volume, unit costs, identification Neglect. of measures of impact upon coordination of services, abuse and neglect incidence, and recidivism.

2. Fraiberg, S. Develop psychiatric treatment methods Naturalistic observations from home visits (CR-OOOs4) for infants with moderate to severe recorded in narrative form, playroom developmental problems. Develop visits, developmental (Bayley) testing measures for assessing change in in fan ts supply study data. and parents before and after treatment.

3. Galdston, R.; Develop new techniques to improve Descriptive analysis. Data collected from Bean, S. L. services to young abused children and worker's initial assessment, weekly (eR-OOOs7) parents. Train personnel to pursue progress charts, conferences, observations, further studies into problems related to and follow-up studies on terminated care. abuse. Study origins and fate of violence Sample population: 31 males, 21-34; 51 as force within the family. females, 19-37; 80 children, 3 months to 4.5 years.

4. Hammar, S. L. Assess increased participation, Monitoring agency records, interviewing (CR-00069) utilization, coordination, and agency personnel, analyzing joint 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 effective Data collected and analyzed concerning (CR-00070) guidelines concerning judicial experiences in making 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.; demonstration program. evaluation using case records of Eyman, N. caseworkers. (CR-00097)

7. MacMurray, V. D.; Evaluate intervention process, outcome 50 abusing families to receive treatment Brummitt, 1. R.; effectiveness, and feasibility and practi­ by team and family aide. 50 abusing Cunningham, P. H. cality of services provided by vol un teer families in control group to receive (CR-OOlOs) lay therapists 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 in probability of risk of abuse.

8. Miller, P. J. Formative evaluation of 8 innovative Site visits on quarterly basis to determine (CR-OOI13) demonstration projects in treatment, qualitative data. Quantitative data prevention, and identification of child collected about clientele, costs, and abuse and neglect. services.

9. Pascoe, D. J.; Determine nature of sexual abuse in Demographic and psychological data Glasser, M. children and evaluate effectiveness of collected on victims. Documentation (CR-00120) medical treatment program for sexual from case records an,~ staff conferences. abuse.

51 TABLE IS (Continued) ANNOTATED LIST OF ONGOING RESEARCH STUDIES: TREATMENT

Reference Research Purpose Methodology

10. Paulson, M. J. Assess rehabilitative effectiveness of Study group to receive traditional group (CR-0012l) group therapy intervention for abusive psychotherapy. Matched sample to parents. receive group psychotherapy plus child management training. Matched control group to receive traditional casework supervision. Incidence of abuse or recidivism within family, change in pre-post-therapy psychological test data assessed at end of 12 months of treatment.

11. Rodeheffer, M. A.; Study development, personalities, and Developmental level of 20 children Mirandy, J. A.; behavior of physically abused chiluren. abused at age 2.5-4 years assessed. Cone, S. Assess 0ffects of therapeutic playschool Subsequent development of sample in (CR-0013l) environmen t. therapeu tic playschool compared with matched sample in regular day care or in their own homes. Standardized measures of cognitive speech and language, and motor functioning. Further documentation through behavioral observations of teachers and children in classroom.

52 VI. EFFECTS/SEQUELAE

"Nothing stirs so great a sense of urgency that Tables 16 and 17 present an annotated we move to do something about neglect and listing of 42 GQmpleted and two ongoing research abuse as when we review what is known about its studies focusing on the effects/sequelae of child consequences.,,6 The obvious and primary abuse and neglect. These studies are organized consequences to the victims of abuse or neglect are under four major headings-abuse, neglect, abuse many. Children suffer temporary or permanent and neglect, and failure to thrive-depending on bodily injury; children starve or go without the type of maltreatment. Reports of the effects education and clothing; infan ts 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 incestuous unions; and approximately 2,000 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 su bUe long-range effects of failure to thrive. The studies are listed include emotional, behavioral, and cognitive alphabetically by author within each category and problems. There is some evidence that siblings of full citations are given in the bibliography the abused or neglected individual suffer beginning on page 64. emotional and behavioral problems as well, even if they are not the targets of the abuse or neglect. There are some indications that abused children The methodology of each study is described in later become violent, behaving aggressively toward as much detail as possible, including sample size other members of society as juvenile delinquents, and characteristics; control or comparison group if as murderers, or as abusive parents. Society feels mentioned; means of data collection, where the effect of abusive or neglectful behavior known; and length of time between abuse and through the strain on the school system, the follow-up. A summary of study findings reported protective service system, the courts, and all such in the abstract is also presented in the table under systems whose task it is to identify and treat those the heading "Review of StUdies." families. Finally, there are consequences for the parents themselves. Some may be prosecuted and go to jail. Others will find help through a good treatment program; but certainly few will be Methodology. Most study samples were unaffected by the realization that they have relatively small, the great majority being under harmed their child. 100. A few exceptions were notably large: one study looked at 774 abused children and Any study that focused on the effect of abuse, compared them with 900 juvenile offenders; neglect, or failure to thrive is included in this another evaluated 347 depressed hospitalized 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; another reviewed 1,500 child guidance on the child. The effect of abusive and neglecting clinic cases. behavior on the perpetrator is not reviewed here because of the lack of any systematic examination of this issue. It is not known how often families The study samples can be generally move or how many parents suffer psychological characterized as abused children seen in a hospital problems requiring hospitalization or what the or psychiatric clinic setting. A few studies did impact of the label "abuser" or "neglectful examine other popUlations such as violent patient parent" has on an individual. inmates or juvenile offenders.

6 Polansky,. N.A., Hally, C., and Polansky, N.r. Profile of Neglect: A Sun'ey of the State of Knowledge of Child Neglect. Washmgton, D.C.: Community Services Administration, Social and Rehabilitation Services, DHEW, 1975, p. 27.

53 Review of case records and standardized tests likelihood of reabuse or of death. One study were the major means of measurement though one reported that abused children committed fewer study used home visits, another classroom aggressive crimes than their siblings and more observation, and a third a behavior questionnaire escapist crimes, while another noted that abused completed by teachers. children exhibited less overt and fantasy aggressive behavior and were more somber and docile. Length of time of follow-up was seldom reported in the abstract. Of the nine studies that It was 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 lower class membership and by the lack of later, one six years later, and one six months later. knowledge of whether the "effect" in fact was present prior to the abusive incident. Summary of effects. The effects of abuse and/or neglect and failure to thrive reported here Ongoing research studies. One study is were generally delayed language development, evaluating the effects of separation of children mental retardation, and psychological and from parents, and the other is evaluating the behavioral problems. Studies also reported on the effects of an abusive environment on children.

54 TABLE 16

ANNOTATED LIST OF STUDIES: EFFECTS/SEQUELAE OF ABUSE

Reference Methodology Review of Studies

J. Bach-y-Rita, G.; 62 violent patient-inmates. Some of the habitually violent patients Veno, A. Analysis of life histories and clinical who were identified as self-destructive (CD-01372) variables. were subjected to violence or deprivation during childhood. Suggestion of strong co rrel a ti on between neurological impairment and early injury or deprivation.

2. Blager, F. B.; 23 abused children Preschool group showed delayed speech Martin, H. P. - 10 preschoolers subjected to abuse and language developmen t 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. (Illinois Test of Psycholinguistic Ability)

3. Bloom, L. A. 17 children abused in early childhood Abused children demonstrated significant (CD-01413) Control groups: expressive communication 17 children suffering accidents and problems-high incidence of poor similar hospitalization at comparable expressive language, poor conversational age articulation, and stuttering. 25 children with no history of accidents or abuse Assessment of communication skills

4. Bolton, F. G., Jr.; 774 abused children Abused children had low frequency of Reich, J. W.; Comparison group of 900 teported aggressive crimes by comparison with Gutierres, S. E. juvenile offenders siblings-repurted for escapist crimes far (CD-O 1418) Comparison of reported crimes more often than siblings.

5. British Medical 78 cases of abuse Where the first child in a family was J oumal abused, 13: I chance that a subsequent (CD-00124) child would be abused.

6. Christiansen, J. L. 138 abused school-age children referred Abused children found more frequently (CD-01469, to juvenile court in special educa tion classes, an d classes CD-01714) Analysis of welfare case records and for emotionally disturbed and educable school records men tally re tarded. N um ber of a bused children in state mental institutions significant. Academic achievement of majority of abused children below grade level. Many had behaviors indicative of psychological problems.

7. Ebbin, A. J,; 50 parentally abused children Many of the children showed growth Gollub, M. H.; representing 1% 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. G. County-University Medical Center. siblings had also been injured. (CD-00282) Most children less than 2 years old.

55 TABLE 16 (Continued)

ANNOTATED LIST OF STUDIES: EFFECTS/SEQUELAE OF ABUSE

Reference Methodology Review of Studies

8. Elmer, E. 50 children hospitalized for multiple of the 50 children under study, 7 died, 3 (CD-00293, injuries sustained new injuries, 2 were rehospital­ CD-00296) 17 under 3 months ized for treatment, 7 had serious physical 9 between 3 and 6 months defects, 4 were seriously mentally re­ tarded.

9. Elmer, E.; 20 abused children with multiple bone Of II 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 physical defects; more than half had Interviews and psychological testing speech problems. Of 9 children with 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-0116l) 3 study groups: abused, nonabused, most severe problems, mentally and unclassified. physically.

11. Elmer, E. 17 lower class children abused as infants Few group differences in health history (CD-01548, Comparison group of 17 children and development, intellectual CD-0l549) 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 in all groups. untraumatized group of nonabused Effects of lower class membetshii} on children child development may be as powerful as Clinical assessmen t 8 years after abuse. Neglect revealed as significant children were studied in infancy factor related to intellectual retardation.

12. Fitch, M. 1.; 45 physically abused hospitalized Significantly smaller proportion of Cadol, R. V.; children abused children's mothers demonstrated a Goldson, E.; Comparison group of 18 nonabused desire to breast feed. Developmental Wendell, T.; failure to thrive children testing revealed a wide disparity between Swartz, D. Control group of 19 children abused subjects and control group: (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 developmen t. Abilities Evaluation at time of admission and 6 months later

13. Fitti, R. M.; 28 ab~sed children, aged 2-6, who had Characteristic disturbed behavior pat­ Gitt, A. undergone psychotherapy terns, such as distrust and fear of adults, (CD-01167) Review of records variability of behavior, disturbed inter­ personal relationships, poor self-image, communication difficulties, and hyper­ kinetic activity, present in abused chil­ dren.

56 TABLE 16 (Continued)

ANNOTATED LIST OF STUDIES: EFFECTS/SEQUELAE OF ABUSE

Reference Methodology Review of Studies

14. Green, A. H. 70 school age schizophrenic children of Significant association between physical (CD-0039S) whom 32.8% were abused abuse and self-mutilation among boys Screening of case histories though not among girls.

I S. Green, A. H. 59 abused children from low-income Significantly higher incidence of (CD-016IS) ghetto areas self-destructive behavior among abused Control groups of 29 nonabused children. Self-destructive activity often neglected children and 30 normal enhanced by ego deficits and impaired children impulse control, and seemed to represent Interviews with mother or maternal a learned pattern of behavior originating guardian in early traumatic experiences with hostil(! primary objects.

16. Harris,M.L Accidents under 2 years of age of whom Likelihood of rebattering after first (CD-00438) 25% were abused incident is 30%. Death rate among repeatedly abused children is 20% for an overall death rate of 10%.

17. Iowa Child Abuse 74 abused children treated at hospitals 6 children (8%) had died,S (7%) were in Study for injuries institutions, 6 (8%) were living 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 experiences such as Fasman, J.; Comparison groups of 198 normal abuse and punishment associated with DiMascio, A. women not receiving psychiatric later depression. Relationship between (CD-00SI7) care, 114 primarily neurotic degree of depriving child-rearing outpatient females experience and severity of adult illness suggested.

19. Johnson, B.; 101 abused children During period of service, 79 children Morse, H. A. Study undertaken 2-3 years after the n~moved from homes; two thirds (CD-00S2S) abusive incident seriously injured; 3 died of injuries; 1 died of gross neglect.

20. Kempe, C. H.; ClQ2 cases of abused children reported 33 children (II %) died and 85 (28%) Silverman, F. N.; from hospitals suffered permanent brain injury. Steele, B. F.; Survey Droegemueller, W.; Silver, H. K. (CD-OOS60)

21. Kent, J. T. Abused children placed out of natural Both abuse groups had higher incidence (CD-01712) home divided into 3 groups: of problem behavior on intake. Both nonaccidental trauma, gross neglect, nonaccidental trauma and neglect nonabuse group receiving protective children manifested greater services because of high risk for developmental delays in language on abuse follow-up than motor development and Evaluation at intake and after activities of daily living. Abusive placement environment tends to produce highly troubled children independent of low socioeconomic status.

57 TABLE 16 (Continued)

ANNOTATED LIST OF STUDIES: EFFECTS/SEQUELAE OF ABUSE

Reference Methodology Review of Studies

22. Koski, M. A.; 46 children, aged 2-30 months, with l'hysical abuse detrimen tal to neural Ingram, E. M. nonaccidental trauma functioning but not to motor (CD-01718) 38 children with failure to thrive functioning. Neglect detrimental to both Group of normal controls neural and motor functioning. Effects on Bayley Scales, Mental Development boys different from those on girls. Index, Psychomotor Development Index

23. Laver, B.; 130 abused chHdren under 10 admitted Many suffered from emotional, physical Ten Broeck, E.; to a hospital and medi~al neglect as well; 44% had Grossman, M. Control group of concurrent admissions been abused previously. 6 children (5%) (CD-00593) Review of medical and social records died.

24. MacKeith, R. Children with cerebral palsy and SpeCUlation on incomplete data suggests (CD-00639) mentally deficient children (United that nonaccidental injury and associated Kingdom) deprivation account for 90 new cases of cerebral palsy annually (6%), 150 (25%) new cases of severe mental handicap annually, and perhaps 3,000 new cases of children with disturbed personality. An alternative method yields 400 new children each year with chronic neurologic deficits.

25. Martin, H. P.; 58 abused children 53% had some neurologic abnormality of Beezley, P.; 5 year follow-up study which 31 % handicapped everyday Conway, E. F.; Findings reported at a mean 4.5 years function of child; 5% were microcephalic; Kempe, C. H. after abuse 31 % had height or weigh t bolow third (CD-01762, percentile. Hypothesis that mental CD-01767) retardation or brain damage stemming from immaturity elicits abuse from parents not supported. IQs of children with head trauma or residual neurologic defici t significan tly lower. Environmen tal factors significantly related to 1Q scores.

26. Martin, H. P. 42 physically abused children 33% demonstrated failure to thrive at (CD-01760) Follow-up study time of 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% suffered permanent (CD-00742) disability, 80% showed signs of repeated illJUry, 66% had more than one fresh injury when first seen. Psychological scars, neglect, and malnutrition all associated with abuse.

28. Peters, J. J. 64 child victims of sexual assault, 2-12 Improper handling or repressed sexual (CD-OI878) years of age attack may cause serious psychological Home visits and psychiatric interviews problems for victim as an adult.

58 TABLE 16 (Continued) ANNOTATED LIST OF STUDIES: EFFECTS/SEQUELAE OF ABUSE

Reference Methodology Review of Studies

29. Rolston, R. H. 20 foster children who had suffered Abused children characterized by (CD-01298) severe physical abuse or punishment, significan tty overt and fan tasy 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. Abused child significantly higher in scaling of somberness, docility, desire to placate, appetite, masturbation, and thumb-sucking.

30. Sendi, I. B.; 10 adolescents who had committed Environmental factors such as paren tal Blomgren, P. G. homicide brutality, seduction by parent or parental (CD-00900) 10 adoiescents who had threatened or perversion, brutal rejection by father attempted homicide appeared important in :·t!illforcing 10 hospitalized controls homicidal behavior.~--- Evaluation of clinical, developmental, and environmental factors

31. Silver, L. n.; 34 cases of child abuse reported at a In 4 cases (12%) abusive parent was Dublin, C. C.; hospital shown to have been abused as a child; in Lourie, R. S. Review of hospital records 7 cases (20%), abused children 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 histories sometimes dating back 20 years

32. Smith, S. M.; 134 abused children mean age 18.5 Half had serious injuries, 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 hospitalized for conditions not neurological sequelae, 10 (8%) had involving trauma seriotls congenital defects. Twenty-three (! 5%) had been previously admitted to hospital with failure to thrive and overlap with physical negleci considerable. Mortality and morbidity high among siblings.

33. Zuckerman, K.; 60 child abuse cases 2 children (3%) died; one-third placed in Ambuel, P.; Review of cases other homes; reabuse occurred in 17% of Bandman, R. those returned home. (CD-Ol084)

59 TABLEt7

ANNOTATED LIST OF STUDIES: EFFECTS/SEQUELAE OF NEGLECT

Reference Methodology Review of Studies

1. Chase, H. P.; 19 children diagnosed with Undernourished group lower in height, Martin, H. P. undernutrition during first year of weight, head circumference, and (CD-OI461) life developmental quotient. Impairment of Control group matched for physical and mental development socioeconomic status, birth date, correlated with duration of weight, sex, and race undernutrition during first year. Yule Revised Developmental Hxamination, Boston-Iowa Growth G rids, Denver Developmental Screening Test, WAfS Vocabulary Test, Home Stimulation Inventory Scale

Jenkins, R. L.; 1500 child guidance clinic cases Mothers with cha~acteristics of Boyer, A. inadequate mothering most likely to have (CD-00521) children with behavior problp,ms. Correlations not as strong for inadequate fathering.

3. Richardson, S. A. Schoolboys in Jamaica 6-10 years old, Severe malnutrition 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 growth and a favorable social first 2 years of life. background had negligible effect on IQ testing intellectual functioning. In a context of poor overall history of physical growth and unfavorable social background, later impairment of intellectual functionin~ can occur.

4. Schermerhorn, W. 19 neglected boys Deprivation of nurturing care in young (CD-00883) Comparison group of 17 boys from ..:hildren makes them less capable of caring families developing positive human relationships. 1 hour of ciassroom observation by a Significant differences found in areas of social worker and psychologist affiliation, positive self-concept, negative Interviews using projective measures and adult perception, positive teacher and direct questioning peer relationships and negative teacher and peer relationships.

5. Friedman, S. B.; 15 suspected abuse children Accident children had lower incidence of Morse, C. W. 7 gross neglect children aged 5-10 years subsequent injuries; siblings had fewer (CD-01582) seen in university emergency room injuries; relationship with mother judged Compari~on group of 19 children better; and fewer emotional and social representing accident cases problems in the families. Follow-up study 5 years later

6. Morn, C. W.; 25 children from 23 families One-third of children had again been Sabler,O.J.Z.; hospitalized for illnesses judged to be suspected of being victims of physical Friedman, S. B. sequelae of abuse or gross neglect abuse or neglect. 70% of children judged (CD-00695) 3 years after hospitalization outside normal range in intellectllal, emotional, social, and motor development.

60 TABLE 17 (Continued)

ANNOTATED LIST OF STUDIES: EffECTS/SEQUELAE OF NEGLECT

Reference Methodology Review of Studies

7. Sandgrund, 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-0087S, All from families receiving public 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.; 41 children admitted to hospital for More than half showed evidence either of Heagarty, M. c'; failure to thrive, average age 12.5 continued gT0wth failure, emotional Bullard, D. M.; months disorder, mental retardation, or some Pivchik, E. C. Revie w of hospital case records combination of these. A number showed (CD-OO 150, also Follow-up on an average 3.5 years later variety of detrimental social and reported in psychological conditions, one of the most CD-00379) common being parental neglect. Approximately normul distribution of IQ scores; however 6 children were retarded.

9. Hufton, I. W.; 21 children diagnosed as having One-half ha.d abnormal personalities; Oates, R. K. non organic failure to thrive two-thirds had delayed reading age; (CD-01656) Behavior questionnaire completed by one-third had verbal· scores significantly teachers lower than performance scores. 3 had WISC suffered abuse and 2 of these had died. Review at an average of 6 years 4 months after initial presentation at hospital

61 TABLEt8

ANNOTATED LIST OF ONGOING RESEARCH STUDIES: EFFECTS/SEQUELAE

Reference Research Purpose Methodology

I. Leiderman, P. H.; Evaluate effects of separation of Compilation of cases followed by Hastorf, A. children from parents. Primary psychological assessment of children and (CR·OOIOl) attention given to age factors. families using experimental questionnaire-derived and naturalistic techniques. 120 males and 120 females from 1 to 10 years old included. Comparison groups used.

2. Martin, H. P. Determine effects of abusive environ­ Neurological exams and IQ tests in (CR-00108) ment on children. conjunction with persC'nality assessment.

62 APPENDIX

Abbreviations of Standardized Tests

Cattell's 16 PF - 16 Personality Factor Questionnaire CLLS - Polansky Childhood Level of Living Scale CPI - California Psychological Inventory FIRO-B - Fundamental Interpersonal Relations Orientation MMPI - Minnesota Multiphasic Personality Inventory .~oiter's I-E Scale - Rotter's Scale of Internality-Externality TAT - Thematic Apperception Test WAIS - Wechsler Adult Intelligence Scale WISC - Wechsler Intelligence Scale for Children

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CD·00378 California, Univ., Los Angeles. School of Social Welfare. CD·00446 Child Neglect Among the Poor: A Study of Parental Hawaii State Dept. of Social Services and Housing, Honolu· Adequacy in Families of Three Ethnk Groups. lu. Div. Public Welfare. Giovannoni, J. M.; Billingsley, A. A Statistical Report on Child Abuse and Neglect ill Hawaii. Child Welfare 49(4):196·204, April 1970. Hawaii State Dept. of Social Services and Housing, Honolu· lu. Div. Public Welfare., 17 pp., 1970·1971.

CD-00379 Stanford Children's Convalescent Hospital, Palo Alto, Calif. CD·00447 Physical and Psychological Development of Chidren With Hawaii State Dept, of Social Services and Housing, Honolu­ Early FaBwe to Thrive. lu. Div. Public Welfare. Glaser, H. H.; Heagarty, M. C.; Bullard, D. M., Jr.; Pivchik, A Statistical Report on Child Abuse IUld Neillect in Hawaii. E.C. Hawaii State Dept. of Social Services and Housing, Honolu­ Journal of Pedilltricl 73(5):690-698, November 1968. lu. Div. Public Welfare, 23 pp., 1969.

CD-00395 CO-00448 Henry Ittleson Center for Child Research, Riverdale, N.Y. Hawaii State Dept. of Social Services and Housing, Honolu­ Self·Destructive Behavior in Physically Abused Schizo· lu. Div. Public Welfare. phrenic Children. A Statistical R~port on Child Abuse in Hawaii. Green, A. H. Hawaii State Dept. of Social Services and Housing, Honolu­ Archives of General Psychiarry 19: 171-179, July·December iu-. Div. Public Welfare., 17 pp., 1967·1968. 1968.

CD·00458 CD-00396 Michigan State Univ., East Lansing. Dept. of Human State Univ. 01 r~ew J arK, Brookiyn. Div. of Child and Deveiopment. Adolescent Psychiatry. Why Most Physicians Don't Get Involved in Child Abuse Child Abuse: Pathological Syndrome of Family Interaction. Cases and What to Do About It. Green, A. H.; Gaines, R. W.; Sandgrund, A. Helfer, R. E. American Journal of Psychio.rry 131(8):882·886, August Children Today 4(3): 28·32, May·June 1975. 1974.

CD·00463 CO·00406 Colorado Uni"., Denver. Dept. of Pediatrics. Children's Hospital of Pittsburgh, Pa. The Battered Child Syndrome. Infant Injuries: Accident or Abuse? Helfer, R. E.: Pollock, C. B. Gregg, G. S.; Elmer, E. Advances ill Pediatrics 15 :9-:27, 1968. Pediatrics 44(3):434-439, September 1969.

CD·00464 CD-00407 Michigan State Univ., East Lansmg. Dept. of Human West Virginia State Univ., Morgantown. Development. Personality and Social Characterittics of Low·lncome Summary of Current Status of Screkl1ing Questionnaire for Mothers Who Nealect or Abuse Their Children. Unusual Rearing Practices. Griswold, B. B.; Billingsley, A. Helfer, R. E.; Schneider, C. Calif. Univ., Berkeley. School of Social Welfare, 16 pp., Michigan State Univ., East Lansing. Dept. of Human (undated). ,Development, 7 pp., 1974.

67 CD-00471 Cardiology. Maryland Univ., Baltimore. Dept. of Pediatrics. Child Abuse Syndrome: The Cases We Miss. Growth Rate, Nutrient Intake and "Mothering" as Detenni· Jackson, G. nants of Malnutrition in Disadvantaged Children. British Medical Journal 2:756-757, June 24, 1972. Hepner, R.; Maiden, N. C. Nutrition Reviews 29(10):219-223, October 1971.

CD-00517 Boston State Hospital, Mass. Collaborative Depression CD·00485 Study. Early Life of the "Battered Child." (letter). Deprivation in the Childhood of Depressed Women. Holman, R. R.; Kanwar, S. Jacobson, S.; Fasman, J.; DiMascio, A. Archives of Disease in Childhood 5ao ):78·80, January loumal of Nervous and Mental Disease 160(1):5-14, Janu­ 1975. ary 1975.

CD-00488 CO·00521 Rochester Univ., N.Y. Dept. of Pediatrics. Iowa Univ., Iowa City. Dept. of Psychia try. Child Abuse: Early Case Finding in the Emergency Depart· Effects or"Inadequate Mothering and Inadequate Fathering ment. on Children. Holter, J. C.; Friedman, S. B. J enkin~, R. L.; Boyer, A. Pedhltrics 42(1): 128-138, July 1968. International Journal of Social Psychiatry 16(1):72·78, Winter 1969-1970.

CD-00489 Principles of Management in Child Abuse Cases. CD-OOS15 Holter, J. C.; Friedman, S. B. Denver State Dept. of Welfare, Colo. Div. of Services for American Journal of Orthopsychiatry 38(1): 127-136, Children and Youth. January 1968. Injured Children and Their Parents. Johnson, B.; Morse, H. A. Children 15(4):147-152, July-August 1968.

CD-00491 The Child·Battering Parent: Sick but Slick. (Editorial). Hom,P. Psychn/Q!J' Today 8(7):32,35, December 1974. CD·00526 Child Abuse in the Southeast: Analysis of 1172 Reported Cases. Johnson, C. L. CD·OOSOO Georgia Univ., Athens. Welfare Research, 153 pp., 1974. Surrey Univ., Guildford (England). Dept. of Biological Sciences. LQ. of Parents of Battered Babies. (Letter). Hyman, C. A. British Medical Journal 4:739, December 22,1973. CD-00532 A Demonstration Homemaker Project. Jones, B. M. In: Kadushin, A. (Editor). Child Welfare Services. A CD·00S06 Sourcebook. New York, MacMillan Company, pp. 89-93, Illinois State Dept. of Children and Family Services, 1970. Springfield. Office of Research and Development. Child Abuse Reporting. Fiscal Year 1974. Illinois State Dept. of Children and Family Services, Springfield. Office of Research and Development, 5 pp., 1974. CO·00537 Roosevelt Hospital, New York, N.Y. Dept. of Pediatrics. Child Abuse: The Role of the Physician and the Hospital. CD-40S15 Joyner, f. N., III Brook General Hospital. London (England). Dept. of Peditltrics 51(4, part 2):799-803, April 1973.

68 CD·0054i Kentucky State Dept. of Human Resources, Frankfort. Juvenile Protective Association, Chicago, Ill. Family and Children's Services Branch, 10 pp., September The Bowen Center Project. A Report of a Demonstration in 1974. Child Protective Services. 1965·1971. Juvenile Protective Association, Chicago, Ill., 168 pp., 1975. CD-00569 Case Western Reserve Univ., Cleveland, Ohio. Dept. of Pediatrics. CD·00544 Mothers Separated From Their Newborn Infants. What Are Hospitals Doing About Child Abuse? Report of a Klaus, M. H.; Kennell, 1. H. Nationwide Survey. PediDtric Clinics of North America 17( 4): 1015, 1037, Kalisch, B. J. November 1970. Hospital Topics 52(6):21·24, June 1974.

CD-00570 CD·00548 McGill Univ., Montreal (Quebec). Dept. of Pediatrics. Appointment of Counsel for the Abused Child··Statutory Low Birth Weight and the Battered Child Syndrome. Schemes ilJ1d the New York Approach. New York State Klein, M.; Stern, L. Assembly Seiect Committee on Child Abuse, Report American Journal of Diseases of Children 122:15-18, July (1972). 1971. Kaplan, E. N. Cornell Law Review 58:177·190,1972·1973.

CD-00574 Humphreys, Berger, Pit to and Pearl, San Jose, Calif. CD-00559 The Education of the Amish. Child. Colorado Univ., Denver. Dept. of Pediatrics. Knudsen, S. T. Helping the Battered Child and His Family. CaJi;orniD Law Review 62(5):1506-1531, December 1974. Kempe, C. H.: Helfer, R. E. Philadelphia, J. B. Lippincott Co., 313 PL'., 1972.

CD-00579 Wayne County Juvenile Court, Detroit, Mich. Clinic for CD·00560 Child Study. Colorado Univ., Denver. Dept. of Pediatrics. Clinical Evaluation of Child Abuse-Scarred Families: A Tnt: BaUered-Child Syndrome. Preliminary Report Kempe, C. H.; Silverman, F. N.; Steele, B. F.; Droege­ Komisaruk, R. mueller, W.; Silver, H. K. Juvenile Court Judges Jountlll 17(2):66-70, Summer 1966. In: Leavitt, J. E. (Editor). The Battered Child. Selected Readings. Morristown, N.J., General Learning Corp., pp. 4-11,1974. CD-00586 New Jersey College of Medicine, Newark. Dept. of Pedia­ trics. CD·00562 Syndrome of the Abandoned Small Child. University of Southern California, Los Angeles. Dept. of Kushnick, T.; Pietrucha, D. M.; Kushnick, J. B. Pediatrics. Clinical PediDtrics 9(6):356-361, June 1970. What Is Known About Child Abusers. Kent, J. T. In: Harris, S. B. (Editor). Child A buse: Present and Future. Chicago, National ('ommittee for Prevention ot Child CD·00589 Abuse, pp. 47-51, 1975. The Battered Child. Langshaw, W. C. Australia/! Journal of Forensic Sciences 3(2):60-70, Decem­ ber 1970. CO·00563 Kentucky State Dept. of Human Resources, Frankfort. Family and Children's Services Branch. CD-00593 Child Abuse Repol·t Fiscal Year 1973-74. California Univ., San Francisco. Dept. of Pediatrics.

69 Battered Child Syndrome: Review of 130 Patients With CO-00675 Controls. Lauer, B.; Ten Broeck, E.; Grossman, M. Michigan State Univ., East Lansing. Dept. of Psychology. PediDtrics 54(1 ):67-70, July 1974. Distinctive Personality Attributes of Child-abusing Mothers. Melnick, B.; Hurley, J. R. Jourrral of Consulting and Clinical Psychology 33(6):746-749, December 1969.

CO-00613 Abused and Neglected Children ill America: A Study of Alternative Policies. CO-00695 Light:R. J. Rochester Univ., N.Y. Dept. of Psychiatry. Harl'ard Educational R!'l'iew 43(4):556-598,1973. A Three-Year Follow-up Study of Abused and Neglected Children. Morse, C. W.; Sahler, O.J.Z.; Friedman, S. B. American Journal of Diseases of Children 120:439-446. November 1970. CD·00630 Whiteabbey Hospital, Belfast (N. Ireland). Child Guidance and Family Psychiatry Clinic. Incest. I: Paternal Incest. CD-00702 Lukianowicz, N. Lafayette Clinic, Detroit, Mich. Dept. of Psychiatry. British Journal of P,ychiatry 120(554):301-313, January Maternal Filicide. 1972. Myers, S. A. American Journal of Diseases of Children 120:534-536, December 1970. CO-00632 Whiteabbey Hospital, Belfast (N. Ireland). Child Guidance and Family Psychiatry Clinic. Attempted Infanticide. CO-00704 Lukianowicz, N. Ohio ~tate Univ., Columbus. Dept. of Sociology and Public Psychial7ia C/inica 5( 1): 1-16, 1972. Policy. The Structure and Performance of Programs on Child Abuse and Neglect. Interim Report. Child Abuse and Neglect Programs--A National Overview. CD-00635 Nagi, S. Z. Pennsylvania State Dept. of Health, Harrisburg. School Prepared for: Office of Child Development (DHEW), Health Program. Washington, D.C. 16 pp., March 1975. Child Abuse in the School-age PopUlation. Lynch, A. Journal of School Health 45(3): 141-148, March 1975.

CD·00726 Governor's Advisory Committee on Child Abuse, Boston. CO-00639 Mass. Child Abuse in Massachusetts. Speculations on Some Possible Long-Term Effects. Mac Keith, R. Newberger, E. H.; Haas, G.; MUlford, R. M. MasSDchusemPhysician 32(1):31-38, January 1973. In: Franklin, A. W. (Editor). Concerning Child Abuse. Edinburgh, Scotland, Churchill Livingstone, pp. 63-68, 1975.

CO·00727 CO-00660 Children's Hospital Medical Centel, Boston, Mass. Reducing the Literal and Human Cost of Child Abuse: Minnesota·Univ., Minneapolis. School of Law. . Impact of a New Hospital Management System. The Battered Child and Other Assaults Upon the Family: Part One. Newberger, E. H.; Hagenbuch, J. J.; Ebeling N. B.; Colligan, E. r., Sheehan, J. S.; McVeigh, S. H. McCoid, A. H. Pediatrics Minnesota Law Review 50: I-58, 1965-1966. 51(5):840-848, May 1973.

70 CD·00730 CO·00778 Children's Hospital Medical Center, Boston, Mass. Family Columbia Univ., New York, N.Y. School of Law. Development Study. Child Abuse Reporting Laws··Some Legislative History. Family Intervention in the Pediatric Clinic: A Necessary Paulsen, ~1. G.; Parker, G.; Adelman, L. Approach to the Vulnerable Child. George Washington Law Re~'iew 34(3):482·508, 1966. Newberger, E. H.; McAnulty, E. H. Annual Meeting of the Ambulatory Pediatric Association, 22 pp., May 1974. CD·00779 Calilornia Univ., Los Angeles. Child Trauma Intervention and Research Project. CD·00741 An MMPI Scale for Identifying "At Risk" Abusive Parents. Denver Univ., Colo. Graduate School of Arts and Sciences. Paulson, M . .1.; Abdeimonem, A. A.; Chalelf, A.; Thomaso1\, . A Comparison of Fathers in Abusive Situations With M. L.; Liu, V. Y . Fathers in Non·abusive Situations. Journal of Clinical Child Psychology 4( 1):22-24, Spring O'Hearn, T. P., Jr. 1975. Doctoral Dissertation. Ann Arbor, Mich., Ur.lversity Micro· films, 137 pp., 1974.75·1872.

CO·00780 California Univ., Los Angeles. Center for the Health CO·00742 Sciences. Vanderbilt Univ., Nashville, Tenn. Dept of Surgery. The MMPI: A Descriptive 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, April 1973. Journal of Clinical Psychology 30(3):387-390, July 1974.

CO'()0743 CO-00781 Vanderbilt Univ., Nashville, Tenn. Dept. of Surgery. California Univ., Los Angeles. Dept. of Psychiatry. Patterns of Injury in the Battered Child Syndrome. The Physically Abused Child: A Focus on Prevention. O'Neill, J. A., Jr.; Meacham, W. F.; Griffin, P. P.; Sawyers, Paulson, M. J.; Blake, P. R. J. L. Child Welfare 48(2):86-95, February 1969. Joumalo/Trauma 13(4):332-339,1973.

CO·00808 CO·00744 Evidenti:.ry Problems in Criminal Child Abuse Prosecutions. Yale Univ. New Haven, Conn., School of Medicine. Plaine, L. L. The Working Mother and Child Neglect on the Navajo Georgetown Law Journal 63(1 ):256·273, October 1974. Reservation. Oakland, L.; Kane, R. L. Pediatrics 51(5):849-853, May 1973. CO-00814 Georgia Univ., Athens. School of Social Work. CO·00759 Mental Organization and Maternal Adequacy in Rural Children's Aid and Society for thl: Prevention of Cruelty to Appalachia. Children, Buffalo, N.Y. Polansky, N. A.; Borgman, R. D.: DeSaix, C.; Smith, B. J. Emergenc}" Parent·-A Protective Service to Children in Georgia Univ., Athens. School of Social Work, 15 pp., Crisis. 1969. Paget, N. W. Child Welfare 45(7):403-407, July 1967.

CD·00818 Children's Defense Fund, New York, N.Y. CO·00777 Professional Abuse of Children: Responsibility for the Columbia Univ" New York, N.Y. School of Law. Delivery of Services. Child Abuse Reporting Laws: The Shape of the Legislation. Polier, J. W. Paulsen, M. G. American Journal of Orthopsychiatry 45(3):357-362, April Columbia Law Review 67(1): 1-49, January 1967. 1975.

71 CD·00826 CD-00896 Evidence. Child Abuse. Expert Medical Testimony Con· Wisconsin Univ., Madison. Dept. of Sociology. cerning "Battered Child Syndrome" Held Admissible. Physical Child Abuse: An Expanded Analysis. Prince, R. C. S«:aberg, J. R. Fordh«m Law Review 42 :935~943, 1973·1974. Doctoral Dissertation, Ann Arbor, Mich., University Micro­ films, 185 pp., ! 974.74·26,512.

CD·00831 Hull Royal Infirmary (Englan.d). Pediatnc Unit. CD-00897 Battered Babies. The Sources of Aggression in the Home. Pugh, R. J. Sears, R. R.; Maccoby, E. E.; Levin, H. Lancet 2(7662):466-467, July 4, 1970. In: Steinmetz, S. K.; Straus, M. A. (Editors). Violence in the Family. New York, Dodd, Mead and Company, pp. 240-246, 1974.

CD·00853 Queen's Univ., Kingston (Ontario). Dept. of Psychiatry. Child Murder by Depressed Parents. CD-00899 Rodenburg, M. Columbia Univ., New York, N.Y. School of Social Work. COllodion Psychiatric Associatioll Journal 16(1):41-47, A Comparison of Some Characteristics of Abusing and February 1971. Neglectinl, Non'abusing Parents. Segal, R. S. Doctoral Dissertation, Ann Arbor, Mich., University Micro· films, 277 pp., 1971. 72·1386. 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. CUnton Valley Center, Pontiac, Mich. Div. of Child Psychi­ Sandgrund, A.; Gaines, R. W.; Green, A. H. atry. American Journal o[ Mental Deficiency 79(3):327·330, A Comparative Study of Predictive Criteria in the Predis· November 1974. position of Homicidal Adolescents. Send; I. B.; Blomgren, P. G. AmericDn Journal of Psychiotry 132(4):423-427, April 1975. CD-00883 California Univ., Berkeley. Dept. of Education. The -Neglec-ied Child'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. 7 I -9746. In: Kadushin, A. (Editor). Child Welfare Services. A SOllrcebook. 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 Child Abuse. Children's Hospital, Washington, D.C. Dept. of Psychiatry. Schneider, C. J. Child Abuse Laws-Are They Enough? American Psychological Association Annual Meeting, New Silver, L. B.; Barton, W.; Dublin, C. C. Orleans, La., II pp., September 1974. JOllrnal of the A merican Medical Association 199(2):101·104, January 9, 1967.

CD·00894 Maudsley Hospital, London (England). Dept. of Forensic Psy chia try. CD-0092S Fatal Battered Baby Cases. Rutgers Univ., New Brunswick, N.J. 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 Silver, L. B.; Dublin, C. C.; Lourie, R. S, E.E.G. and Personality FactolS in Baby Batterers. Pediatrics 44(4):594-600, October 1969. Smith, S. M.; Honigsberger, L.; Smith, C. A. British Medical Joumal 3(5870):20-22; July 7, 1973.

CD-00926 Rutgers Univ., New Brunswick, N.J. Dept. of Psychiatry. CD-00!166 Does Violence Breed Violence? Contributions From a Colora:lo Univ., Denver. Dept. of Psychiatry. Study of the Child Abuse Syndrome. A Psychiatric Study of Parents Who Abuse Infants and Silver, L. B.; Dublin, C. C.; Lourie, R. S. Small Children. American loumal of PsychiDtry 126(3):404-407, Septem­ Steele; B. F.; Pollock, C. B. ber 1969. In: Helfer, R. E.; Kempe, C. H. (Editors). The Battered Chi/d. Chicago, University of Chicago Press, pp. 89-133, 1974 .

•CO-00931 Child Abuse. Epidemiologic Study of Medically Reported CD-00971 Cases. Montreal Children's Hospital (Quebec). Dept. of Newborn Simons, B.; Downs, E. F.; HUrster, M. M.; Archer, M. Medicine. New York State Joumal of Medicine 66(19): 2783-2788, Prematurity as a Factor in Child Abuse. October 1, 1966. Stern, L. Hospital Practice 8(5): 117-123, May 1973.

CD·00938 National Society for the Prevention of Cruelty to Children, CD·0097S London (England). Dept. of Battered Child Research. National Committee for Prevention of Child Abuse. Chi· Seventy·eight Battered Children: A Retrospective Study. cago, Ill. Skinner, A. E.; Castle, R. L. Opening Session. National Society for the PreventIOn of Cruelty to Children, Stone,D.J. London (England). Dept. of Battered Child Rese:uch, 21 In: Harris, S. B. (Editor). Child Abuse: Present and Futllre. pp., September 1969. Chicago, National Committee for Prevention of Child Abuse, pp. 15-16, 1975.

CD·00945 Birmingham Univ. (England). Dept. of Psychiatry. CD-00979 Child Abuse Syndrome. (Letter). California Univ., Berkeley. School of Social Welfare. Smith, S. M. A Study of Social Work Practice in Protective Services: It's British Medical Joumal 3: Ii 3·114, July 8, 1972. Not What You Know, It's Where You r/ork. Streshinsky, M.; Billingsley, A.; Gurgin, V. Child Welfare 45:444-450,471, October 1966.

CD·00946 Birmingham Univ. (England). Dept. of Psychiatry. 134 Battered Children: A Medical and Psychological Study. CO-01002 Smith, S. M.; Hanson, R. Case Western Reserve, Cleveland, Ohio. Dept. of Psychiatry. British Medical Joumal 3(5932):666-670, Sel>tember 14, A Family Study of Child Abuse. 1974. Terr, L. C. American Joumal of PsychiDtry 127(1):125-131, July 1970. CD·00949 Birmingham Uniy. (England). Dept. of Psychiatry. Parents of Battered Babies: A ControUed Study. CD·01003 Smith, S. M.; Hanson, R.; Noble, S. Case Western Reserve Univ., Cleveland, Ohio. Dept. of British Medical JoumaI4(5889):388-39I, November 1973. Psychiatry. The Battered Child Rebrutaliled: Ten Cases of Medical­ Legal Confusion. Terr, L. C.; Watson, A. S. CO·00950 American Joumal of PsychiDtry 124(7):1432-1439, Janu­ Birmingham Univ. (England). Dept. of Psychiatry. ary 1968.

73 CD-OI006 Statistical Description of Cases FoUowed by the Anchorage Child Neglect Proceedings--A New Focus. Child Abuse Board,lnc., October 1972·March 1975. Thomas, E. K. Andreini, M.;Green, S. Indiana Law Joumal 50(1 ):60-81, Fall 1974. Anchorage Child Abuse Board, Inc., Alaska, 10 pp., 1975.

CO-01018 CD·OI090 Child Victims of Incest. Georgetown Univ., Washington, D.C. Juvenile Justice TOWles, Y. M. Clinic. American Humane Association, Denver, Colo. Children'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 Law JournDI63(4):887·937, March 1975. CD-OI022 Washington Univ., Seattle. Dept. of Psychiatry and Be­ havioral Sciences. CD-01113 Child Abuse Project: A Follow.up. Battered Child and Unwanted Pregnancy. (Letter). Tracy. J. J.; Ballard, C. M.; Clark, E. H. Brosseau, B. E. Social Work 20(5):398-399, Sept,mber 1975. Canadian Medical Association Joumal 112:1039, May 3, 1975.

CD-OI029 University of Chicago Law Review. CJ)'01114 The CUstody Question and Child Neglect Rehearings. Anchorage Child Abuse Board, Alaska. University of Chicago Law Review 35(3):478-492, Spring Child Abuse and Neglect in Alaska. 1968. Brown, G.; Wolf, J.; VIe, B.; Zartman, H.; Davis, B. Alaska Medicine 16(5): 108-111, September 1974.

CO-OI030 Valparaiso University Law Review. Criminal Liability of Parents for Failure to Control Their CD-Oil 23 Children. National Society for the Prevention of Cruelty to ChUdren, Valparaiso U/liversity Law Review 6(4):33:!-35:!, Slimmer London (England). Battered Child Research Dept. 1971. A Study of Suspected Child Abuse. Castle, R. L.; Kerr, A. M. National Society for thj~ Prevention of Cruelty to Children, London (England), 19 pp., September 1972. CD-01071 Oklahoma Univ., Oklahoma City. Dept. of Pediatrics. The "Sick but Slick" Syndrome as a Personality Com­ ponent for Parents of Battered Children. CD-0113. Wright; L. Children Today. American Psychological Association Annual Meeting, New Iowa Child Abuse Study. Orleans, La., 9 pp., September 1974. Childrtn TodDY 5(1):30-31, January-February 1976.

CD-41084 CD-01135 Ohio State Univ., Columbus. Coli. of Medicine. Simmons Coli., Boston, Mass. Child Neglect and Abuse. A Study of Cues Evaluated at Neglect and Abuse of Children in the Middle Class. Cohambua ChUmn', Ho,pital in 1968-1969. Cohen, M.1. Zuckerman, K.; Ambue~ P.; Bandman, R. Master's Project. Simmons College., Boston, Mass., 120 pp., Ohio State Medical Joumal68(7):629-032, July 197~. May 1971.

CD·OI089 CD-01136 Anchorage Child Abuse Board, Inc., Alaska. Institute of judicial Administration, New York, N.Y. Model

74 Child Abuse Reporting Law Project. Fergusson, D. M.; Fleming, J.; O'Neill, D. P. The Incidence of Child Abuse in the United States. Department of Social Welfare, Wellington (New Zealand), Cohen, S. J.; Sussman, A. 342 pp., 1972. Child Welfare 54(6):432-443, June 1975.

CD-Oil 67 CD·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. Behlvior Profde of Abused Children. Dalhousie Univ., Halifax (Nova Scotia), 295 pp., 1973. Fitti, R. M.; Gitt, A. Child 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. CO-01170 Working With High·Risk Families: Family Advocacy and Howard Univ., Washington, D.C. Dept. of Pediatrics. the Parent Education Pro81'am. Mother-Child Separation at Birth: A Contributing Factor in Daniel, J. H.i Hyde, J. N., Jr. CbUd Abuse. (Letter). Children Today 4(6):23·25,36, November·December 1975. Fomwod, A. K.; Sinkford, S. M.; Louy, V. E. Lanc~t 2(7934):549·550, September 20,1975.

CJ>.OI rs3 Denver Dept. of Welfare, Colo. Div. of Services for CO-01171 Families, Children, and Youth. New York Univ., N.Y. School of Law. Child Abuse. 1972. A BUI of Righta for Children. Denver Dept. of Welfare, Colo. Div. of Services fo.t Foster, H. H., Jr.; Freed, D. J. Families, Children, and Youth, 36 pp., 1973. Fam., Law QlllU'terly 6(4):343·375, Winter 1972.

CO-Oil S8 CD·Oll84 George Washington Univ., Washington, D.C. School of Rhode Island Univ., Kingston. Dept. of Sociology. Medicir.e. The Violent Home. A Study of Physical Aggression Child Abuse: A Review of 69 Cases. Between Husbandi and Wives. Dorman, S. Gelles, R. J. ai"ical Proceedings 31(11):256·262, December 1975. Sag.e Library of Social Research, Volume 13, Beverly Hills, Calif., Sage Publications, Inc., 230 pp., 1972.

CI).01161 Pittsburgh Univ., Pa. Dept. of Pediatrics. Children in Jeopardy. A Study of Abuaed Minors and Their 'amltes. CD·01l87 Elmer, E. Brandeis Univ., Waltham, Mass. Florence Heller Graduate Pittsburah, University of Pittsburzh Press, 125 pp., 1967. School for Advanced Studies in Social Welfare. Violence Against Children. Gil, D. G. C~mbridge, Mass., Harvard University Press, 216 pp., 1973. CO-01162 Dependclnt-Nejleet Proceedlnp: A Case for ProceduraJ l:)ue Proc:aI. Faber, D. M. CD·01192 Dllqll.",e Law Review 9:65 1-664,1971. Downstate Medical Center, Brooklyn, N.Y. Div. of Child and Adolescent ~sychiatry. A Psychodynamic Approach to the Study and Treatment of Child Abusin8 Parents. CO-0116S Green, A. H. Department of Social Welfare, Wellington (New Zealand). American Medical Association Annual Meeting, New York, ClUld Abuae in New Zealand. 22 pp., June 26, 1973.

7S CD-01194 Co.Ol232 Downstate Medical Center, Brooklyn, N.Y. Div. of Child Rutgers Un~v., Newark, N.J. Newark CoD. of Arts and and Adolescent Psychiatry. Sciences. Psycholotical Sequelae of Child Abuse and Nestect. Public Knowledlle of Child Abuse. Green, A. H.; Gaines, R. W.; Sandgrund, A. Lindenthal, 1. J.; Bennett, A.; Johnson, S. American Psychiatric Association 127th Annual Meeting, Child Welfare 44(7):521·523, July 1975. Detroit, Mich., 17 pp., May 6'10, 1974.

CD·01234 CI).01206 Park Hospital for Children, Headington (England). Family Service of Milwaukee, Wis. Ill·health and Child Abuse. Uncovering the Precipitant in Crisis Intervention. Lynch, M. A. Hoffman, D. L.; Remmel, M. L. Lancet 2(7929):317·319, August 16, 1975. SociDl Casework 259-267, May 1975.

CD-01256 CD·01208 New JersllY State Div. of Youth and Family Services, Bristol Royal Infirmary (England). Trenton. Bureau of Research, Planning, and Program Early Life of the 'Battered Child.' Development. Holman, R. R.; Kanwar, S. Abuse and Neglect in New Jersey . .\ Guide for Communi­ Archives of Disease in Childhood 50( 1):78-80, January ties and Provider Allencies. 1975. New Jersey State Div. of Youth and Family Services, Trenton. Bureau of Research, Planning, and Program Development, 21 pp., August 1974. CD·01219 Georgia Univ., Athens. Regional Inst. of Social Welfare Research. CD-01251 Child Abuse: State Legislation and Programs in the South· New York State Dept. of Social Services, Albany. _ east. Cases of Suspected Child Abuse and Maltreatlneni: Re­ Johnson, C. L. ported to the NYS Central Child Abuee and Maltrutment Georgia Univ., Athen.s, Regional Inst. of Social Welfare Resister - 1973. Research, 108 pp., August 1973. New York State Dept. of Social Services, Albany, Program Brief Nc. 2, 4 pp • April 1974.

CD-01223 Boston ColI., Chestnut Hill, Mass. School of Law. CD-01262 Emancipating Ow Children - Coming of Lea" Age in Children's Hospital Medical Center, Boston, Mass. Family America. Development Study. Katz, 8. N.; Schroeder, W. A.; Sidman, L. R. Toward an Etioloaic a_fication of Pediatric Social Family Law Quarterly 7(3):111·241, Fall 1973. Dlnesa: A Descriptive EpidemiolOl)' of Child Abuse and Nealect, Failure to Thrive, Accidents and Poisoninp in Children Under Fow Years of Aile. Newberger, E. H.; Reed, R. B.; Daniel, J. H.; Hyde, J. N., Co.Ol226 Jr.; Kotelchuck, M. Alaska State Supreme Court, Fl'irbanks. Society for Research in Child Development Biennial Mee,· TIM: ~lalance of Power Amonll Infanta, Their Parents and ing, Denver, Colo. 20 pp., April II, 1975. ,IIC State, rart 2. Parental Power. kleinfeld. A. J. Family lJlw Quarterly 4(4):410-443, December 1970. CD-OI263 North Carolina State Dept. of Human Resources, Raleigh. CD·01231 Oiv. of Social Services. Caveat Pa,-'",""::: A Demystification of the Child Protection Neslect aDd Abuse of Chidren in North Carolina. System. North Carolina State Dept. of Human Resources, Raleigh. Levine, R. S. Oiv. of Social Services, Speci.d Report No. 30, 32 pp., Univmity of Pittlburgh Law Review 35(1): 1·52, Fall 1973. January 1975.

76 I CD-01273 Roberts, D.; Adler, M. Burderop Hospital, Wroughton (England). Dept. of Psy­ Wisconsin State Dept. of Health and Social Services, chiatry. Madison. Diy. of Family Services, 13 pp., 1974. Severely ID-treated Young Children in North-East Wiltshire. Oliver, J. E.; Cox, J.; Taylor, A.; Baldwin, J. A. Oxford Uniy. (England). Dept. of Clinical Epidemiology, Research Report 4, 88 pp., August 1974. CD-01294 Southern minois Univ., Edwardsville. Dept. of Educational Research. What Can the Schools Do About Cbild Abuse? CD-01274 Rochester, D. E.; Ellis, M. A.; Sciortino, S. C. Illinois UniY., Chicago. Rush Medica! Coil. In: Leavitt, J. E. (Editor). The Banered Child. Selected The Illinois Child Abuse and Neglect Reporting Acts Past Readings. Morristown, N. J., General Learning Corp., pp. and Present. 213-214,1974. Pachman, D. 1. Illinois Medical Journal 149(2): 175-184, February 1976.

CD-01298 Louisiana State Univ. and Agricultural and Mechanical CD-01278 Coli., Baton Rouge. Dept. of Psychology. California Univ., Lo;; Angeles. The Effect of Prior Physical Abuse on the Expression of A Discriminant Function Procedure for Identifying Abusing Overt and Fantasy Agpessive Behavior in Children. Parents. Rolston, R. H. Paulson, M. 1.; Afifi, A. A.; Cbaleff, A.; Liu, V. Y.; Doctoral Dissertation. Ann Arbor, Mich., UnNersity Micro­ Thomason, M. L. films, 123 pp.(UM 71-29,389),1971. Suicide 5(2): 104-114, Summer 1975.

CD-01307 CD-01281 Child Weh:i::~ League of America, New York, N.Y. Pennsylvania State Dept. of Public Welfare, Harrisburg. Research Cc.ll:er. Bureau of Child Welfare. Service to Children in Their Own Homes: Its Nature and 1973 Child Abuse Report. Outcomf.', Pennsylvania State Dept. of Public Welfare, Harrisburg. Sherman, E. A.; Phillips, M. H.; Haring, B. L.; Shyne, A. W. Bureau of Child Welfare, 31 pp., 1974. New York, Child Welfare League of America, Inc., 156 pp., 1973.

CO-01284 Child Welfare League of America, New York, N.Y. Re­ CD-01309 search Center. Social and Rehabilitation SeIVice (DHEW), Waslrington, Factors Associated With Placement Decisions in Child D.C. National Center for Social Statistics. Welfare. Juvenile Court Statistics. 1971. Phillips, M. H.; Shyne, A. W.; Shennan, E A.; Haring, B. L. Social and Rehabilitation Service (DHEW), Washington, New York, Child Welfare League of America, Inc., 113 pp., D.C. National Center for Social Statistics, (SRS) 73-03452, 1971. 20 pp., December 1972.

CD-01285 CD-01316 Georgia Univ., Athens. School of Social Work. British Columbia Univ., Vancouver. Div. of Child Psychia­ Roots of Futility. try. Polansky, N. A.; BOTEman, R. D.; De Saix, C. Project Toddler: Interim Report. San Francisco, Jossey-Bass, Inc., 272 pp., 1972. Stephenson, P. S. British Columbia Univ., Vancouver. Diy. of Child Psychia­ try, 112 pp., September 1975.

C»-01293 Wisconsin State Dept. of Health and SOCial Services, Madison. Diy. of Family Sero."ices. CD-01317 Child Abuse in Wisconain. New Hampshire Univ., Durham. Dept. of Sociology ..

77 Theories, Methods, and Controversies in the Study of CD·01345 Violence Between Family Members. Child Study Center, Oklahoma City, Okla. Strauss, M. A.; GeUes, R. J.;Steinmeu, S. K. Parental Alienation: Ominous Precursor of Child Abuse. American Sociological Association Meeting, 73 pp., June Young, M. 1973. Child Study Center, Oklahoma City, Okla., 15 pp., November 1975.

C1).01319 Tennessee State Dept. of Public Welfare, Memphis. CD-01346 Study on Child Abuse Dnd Child Neglect in Tennessee. Oklahoma Univ., Norman. Graduate Coll. Tennessee State Dept. of Public Welfare, Memphis, 72 pp., Some Selected Dimensions of Alienation in Abusive and March 1975. Non·Abusive Families: A Compaiative St'.1dy. Young, M. Master's Thesis. University of Oklahoma, Nonnan, 99 pp., 1975. CI).01327 Stanford Univ., Palo Alto. School of Law. State Intervention on Behllf of 66Nealected" Children: A Search for Realistic Standards. CD-01369 Wald, M. Berkeley Planning Associates. Calif. Stunford Law Review 27(4):985'1040, April 1975. Evaluation Summary: Extended Family Center 1973·1975. Armstrong, K. L.; Cohn, A. H.: Collignon. F. C. Berkeley Planning Associate~. Cillif. 29 pp., undated.

CI>-01335 Army General Hospital, Frankfurt (West Gennany). Dent. of Psychiatry. CD·01371 The Characteristics and Management of Child Abuse in the Child Abuse Reporting Project. U.S. Army - Europe. Baade, R. A. Wichlacz, C. R.; Randall, D. H.; Nelson, J. H.; Kempe, C. H. Prepared for: Colorado State Department of Social Serv­ Clinical PediDtricsl4(6):545·548, June 1975. ices, Denver. Office of Public Information, 20 pp., June 1976.

CI).01337 CD-01372 Pittsburgh Univ., Pa. Dept. of Maternal and Child Health. California State Dept. of Corrections, Sacramento. The Control of Child·Environment Interaction: A Con­ HabituaJ Violence: A Profile of 62 ~·Ien. ceptual Approach to Accident Occurence. Bach-y-Rita, G.: Veno. A. Wight, B. W. Ameri<:an Journal of Psychiatry 131 (9): 1015-1017, Pediatrics 44:799·805, 1969. September 1974.

CI).01340 l.ondon School of Economics and Political Science (Eng· CD·01376 l:ll:\d). Oxford Univ. (England). Unit of Clinical Epidemiology. :l1n Neglect of Incat: A Criminologist's View. Epidemiology and Family Characteristics of Severely·Abused Wii.:iams, J.E.H. Children. M.dkine, Sci.nce, and thl!. 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.

C1).01341 Problem Families and the Concept of Immaturity. CD·01377 Wilson, H. C. Family Service of Detroit and Wayne County, Mich. In: Kadushin, A. (Editor). Child Welfa~ Services. A Issues of Violence in Family Casework. Sourcebook. New York, Macmillan and Co., pp. 17-23, Ball, M. 1970. Social C:l~e'Work 58( 1):3-12. January 1977.

78 CD-Ol387 Speech and Language of Abused Children. Berkeley Planning Associates, Calif. Blager, F. B.; Martin. H. P. Full Cost Analysis: Findings to Date. Evaluation, National In: Martin, H. P. (Editor). The Abused Child: A Multidis­ Demonstration in Child AblL'Ie and Neglect. ciplinary Approach to Developmental Issues and Treat· Barrett, L.; Froland, c.; Cohn. A. H.: Collignon. F. C. ment. Cambridge, Mass .• Ballinger Publishing Co., pp. 83- Prtpared for: Health Resources Administration (DHEW), 92. 1976. Rockville, Md. National Center for Health Services Re­ search, 49 pp., November 1976.

CD-01413 Pittsburgh U niv., Pa. CD-Ol388 Communication Skills of Abused Children. Health Based Programs in Child Abuse and :'IIegl~t. Bloom. L. A. Bates, T.; Elmer, E.: Delaney, J. Doctoral Dissertation. Ann Arbor, Mich .. University Mi­ In: Fifth National SymposiurJ on Child Abuse. Denver, crofilms. UM 76-14108, 98 PJ.!., 1975. Colo., American Humane Association, pp. 32-37, 1976.

CD·01415 CD-0t395 Child Welfare League of America. New York, N.Y. Colorado Univ., Denver. Dept. of Pediatrics. The Communit~' and the Social Agency Define Neg~t. Psychotherapy. Boehm. B. Beezley. P.; Martin. H. P.; Kempe, R. S. Child Welfare 53(9):453-464. November 1964. In: Martin H. P. (Editor). The Abused Child: A Multidisci­ plinary Approach to Developmental Is,ues and Treatment. Cambridge, Mass., Ballinger Publishing Co., pp. 201-214, 1976. CD-01418 Arizona Community Development for Abuse and Neglect. Phoenix. CD-01396 Delinqeency Patterns in Maltreated ChHdren and Siblings. Behavior Associates, Tucson, Ariz. Bolton, F. G., Jr.; Reich, J. W.; Gutierres, S. E. Parent., Anonymous Self.Help for Child Abusing Parents Arizona Community Development for Abuse and Neglect. Proj~t. Evaluation Report for Period May 1, 1974.April 30, Phoenix, 14 pp., 1977. 1976. Prepared for: Parents Anonymous National Office, Redon­ d("\ Beach, Calif., 152 pp., 1976.

CD-01425 Beth Israel Hospital. Boston. Mass. CD·Ol-WO The Sexuallv Misused Child. Berkeley Planning Associates, Calif. Brant, R.S.l'.; Tisza. V. B. Summary of Findings to Date, Evaluation of the Joint ()CD· American Journal of Orthopsychiatry 47( 1):80-90, January SRS Demonstration Program in Child Abuse and NegI~t. 1977. Prepared for: Health Resources Administration (DHEW), Rockville, Md. National Center for Health Services Re­ search. 43 pp., November 1976. CD-01426 Harvard Univ., Boston. Mass. School of Medicine. Early Mother·Infant R~iprocity. CD·01407 Brazelton. T. B.; Tronick. E.; Adamson. L.; Als, H.; California Univ., Berkeley. School of Social Welfare. Wise, S. Studies in Child Prot~tive Services. Ciba Foundation Symposium (33): 137-154. 1975. Billingsley. A.; Giovannoni, J. M.; Purvine. M. California Univ .. Berkeley. School of Social Welfare, 212 pp., September 1%9.

CD·01429 CD·Ol~12 British Medical Journal. Colorado Un;v .• Denver. Dept. of Speech Pathology and Incest and Family Disorder. Audiology. British ,Uedical Journal 2(58\0):364-365, May 13. 1972.

'79 CD·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. University of Toronto Carter, J. E.: Gayou. R. Press, pp. 461-468, 1976. British Columhia Medical Journal 18(2):50-52, February 1976.

CD·01435 Oregon Univ., Portland. Child Psychiatry Clinic. CD-01459 Incest: Children at Risk. California U niv., Berkeley. Maternal and Child Health Browning, D. H.; Boatman. B. Program and Family Health Program. American Journal of Psychiatry 134{1):69-7~, January 1977. Child Abuse and N~'gIect: Physicians' Knowledge, Altitudes, and Experience. Chang, A.; Oglesby, A. C.; Wallace, H. M.; Goldstein, H.; Hexter, A. C. CD·01438 American Public Health Association Annual Meeting, Chi­ Indiana Univ., Indianapolis. School of Nursing. cago,25 pp., November 17, 1975. Factors Contributing to Child Abuse. Bullerdick Corey, E. J.; Miller. C. L.; Widlak, F. W. Nursing Research :!4(4):293-295. July-August 1975. CD-Ol461 Colorado Univ .. Denver. B. F. Solinsky Lab. Undernutrition and Child Developm~nt. CD-01440 Chase. H. P.: Martin. H. P. State Univ. of New York, Stony Brook. School of Nurs­ NeK' England Journal of Medicine 28~(17):933-939, April ing. 23, 1970. An Area for Concern ., A Study on Identifkation and Re· porting by Mandated Sources in Cases of Child Abl!.se and Neglect in Suffolk County. Burns. A.; Feldman. M.: Kaufman. A.; Stransky. P. CD·01463 Setauket, N.Y., Edmond Publishing Co., 39 pp .. 1973. Arizona State Univ., Tempe. School of Education. A Descriptive Study. Undergraduate University Students Identifying Themselves With Dysfunctional Rearing Patterns as Measured by the Family Relations Survey. CD·OI442 Chavez. G. T. Burt Associates. Inc., Bethesda. Md. Arizona State Univ .. Tempe. School of Education, 48 pp .• Fin::.! Results of the Nashville Comprehensive Emergency May 1976. Services Project. Burt, M. R. Child Wellare55(9):66I-664, November 1976. CD·01467 Children's Hospital Medical Center. Boston, Ma~;s. Family Development Study. First Annual Report. CD-Ol447 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, 1973-3. 180 pp., December 1973. CD-OI469 Utah State Univ .• Logan. Dept. of Education. Educational and Psychological Problems of AblL'ied Chil· dren. Christiansen. J. L. CD-01452 Doctoral Dissertation. Ann Arbor. Mich., University Mi­ Northern Arizona Univ., Flagstaff. Dept. of Psychology. crofilms. 163 pp., 1975. Comparison of Child Abuse Paramt!ters for the State of Ari­ zona From 1971 to 1975. Caplan, L. D. CD-01471 Master's Thesis. Northern Arizona Univ., Flagstaff, 54 Pacific Lutheran Univ .• Tacoma, Wash. Office of Ethnic pp., April 1976. Studies.

80 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 No\'a Scotia. 1976. Dawe, K. E. Australian Paediatric .JournaJ9(6):294-296, December 19i3.

CD·01473 Creighton Univ., Omaha, Nebr. School of Law. CD·OI509 Child Abuse: The Problem of Definition. Umea Univ. (Sweden). Dept. of Paediatrics. Clements, T. J. Long·term Effect on Mother·lnfant Behaviour of Extra Con· Creighton Law Re.'iew 8(4):729-742, June 1975. t.lICt During the First Hour Post Partum. II. A FoIlow·up at Three Months. De Chateau. P.; Wiberg, B. Acta Paediatrica Scandinavica 66(2): 145-151, March 1977. CD·01479 Institute of Judicial Administration, Inc., New York, N.Y. Juvenile Justice Standard:; Project. A National Survey of Attitudes of Selected Professionals (:D·01511 Involved in the Reporting of Child Abuse and Neglect. American Humane Association. Denver, Colo. Children's Cohen. S. J. Div. Institute of Judicial Administration. Inc., New York, Child Abuse •• Preview of 8 Nationwide Survey. N.Y., Juvenile Standards Project. 36 pp., 1974. De Francis, V. Denver, Colo .. American Humane Association, 18 pp., 1963.

CD·01480 Institute of Judicial Administration, Inc., New York, N.Y. Juvenile Justice Standards Project. CD·01516 A Study of Child Abuse Reporting Practices and Services in American Humane Association, Denver, 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·OI489 1969. Connecticut Child Welfare Association, Inc., Hartford. Second Annual Report of the Care· Line. Connecticut Child Welfare Association, Inc., Hartford. 39 pp., September 30, 1975. CD·01520 Pennsylvania State Univ., University Park. Coil. of Hu­ man Development. Child Care by Adolescent Parents. CD·01490 De Lissovoy, V. Connecticut Child W-elfare Association, Inc., Hartford. Children Today 2'1-25, July-August 1973. Third Annual Report of the Care·Line, January 1, 1976 • December 31, 1976 .. Connecticut Child Welfare Association, Inc., Hartford, 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 Coul\cil of Europe, Strasbourg (France). Group of Coordi­ nated Research Fellowship-Holders for 1968. Social Cooperation in Europe. Social Action to Prevent the CD.01522 Breakdown of the Family, the Neglect of Children, and Ju· Berkeley Planlling Associates, Calif. venile Delinquency. Evaluating Case Management. New York, Manhattan Publishing Co., 59 pp., 1972. DeGraaf, B. J.

81 ~nd National Conference on Child Abuse and Neglect, CD·OI548 Houston, Tex., 9 pp., April 17-20, 1977. Pittsburgh Univ .• Pat School of Medicine. A Follow.up Study of Traumatized Children. Elmer, E. Pediatrics59(2):273-279, February 1977. CD·01530 Peviant Behavior and Putative Reference Persons: Child Abuse as a Special Case. Disbrow, M. A. CD·OI549 Nursing Research Conference 5:322-346, 1969. Pittsburgh Child Guidance Center. Pat Follow.Up Study of Traumatized Children. Final Report. Elmer, E.; Reinhart, J. B.; Evans, J. B. Pittsburgh Child Guidance Center, Pat 117 pp., 1975. CD-01532 California School of Professional Psychology, San Fran­ cisco. Differential Attitudes Towards Punishment and Child CD-01550 Abuse. Maryland Univ .. Baltimore. School of Social Work and Dolder, SJ.L. Community Planning. Doctoral Dissertation. Ann Arbor, Mich., University Mi­ Treatment of Child-Abusing Families, III. An Evaluative crofilms, 201 pp., 1975. Assessment. Ephross, P. H. Prepared for: Sinai Hospital of Baltimore, Inc., Md., 41 pp., September 1974. CD-01535 Louisiana State Univ. and Agricultural and Mechanical CoiL, Baton Rouge, School of Social Welfare. Multivariate Implications in Child Abuse. CD-01551 Durham, M. E. Maryland Univ., Baltimore. School of Social Work and Master's Thesis. Louisiana State Univ. and AR.ricultural Community Planning. and Mechanical Coil., Baton Rouge, 81 pp., 1976~ Treatmt'~~ d Child· Abusing Families. An Evaluative Assess· mt'nt. Ephross, P. H. Prepared for: Sinai Hospital of Baltimore, Inc., Md., 48 CD·01540 pp., September 1972. Education Commission of the States, Denver, Colo. Child Abuse and Neglect Project. Child Abuse and Neglect in the States: A Digest of Critical CD-01552 Elements of Reporting and Central Registries. Maryland Univ., Baltimore. School of Social Work and Education Commission of the States, Denver, Colo. Child Community Planning. Abuse and Neglect Project, Report No. 83, 21 pp., March Treatment of Child· Abusing Families, II. An Evaluative 1976. Assessment. Ephross, P. H.; Weissman, L. A. Prepared for: Sinai Hospital of Baltimore, Inc., Md., 58 CD-Ol544 pp., September 1973. Education Commission of the States, Denver, Colo. Child Abuse Project. Teacher Education··An Active Participant in Soh'ing the Problem of Child Abuse and Neglect. Education Commission of the States. Denver, Colo., Re­ CD·01556 port No. 99., 14 pp., April 1977. Columbia Univ., New York, N.Y. School of Social WO/k. Parental Visiting of Children in Foster Care: Key to Di'i' charge? Fanshel, D. CD-01545 Social Service Rcyiew493-514. December 1975. Education Commission of the States, Denver, Colo., Child Abuse and Neglect Project. Education Policies and Practices Regarding Child Abuse and Neglect and Recommendations for Policy Development. CD-01563 Education Commission of the States, Denver, Colo., Denver Dept. of Health and Hospitals, Colo. Child Study Report No. 85,64 pp., April 1976. Program.

82 Cognitive Development 01 AbtL~ and Failure-to-Thrive Goldson. E.; Cadol, R. Y.; Fitch, M. J.; Umlauf. H. J., Children. Jr. Fitch, M. J.: Cadol, R. Y.; Goldson, E.; Wendell, T.: Denver City and County Dept. of Health and Hospitals, Swartz, D. Colo., 15 pp., 1974. Jour:Jalof J)t'tliatric PsYI:h%gy 11:2):3:2-37. Spring 1976.

CD.ol608 CD·01579 Kansas Univ., Kansas City, Medical Center. Minors' Rights to Medical Care. Child Abuse and Neglect: Epidemiology in Kansas. Frentz, T. W. Gonzalez-Pardo, L.; Thomas, M. Journal of Family Law 14(4):581-596. 1975-1976. J:mrnaJ of the Kansas Medical Society 78(2):65-69, February 1977.

CD·01582 Rochester Univ .. N.Y. Dept. of Pediatrics. CD·Ol609 Child Abuse: A Five-Year Follow-up of Early Case Finding Northern General Hospital, Sheffield (England). in the Emergency Depa,,·tment. Predicting Child Abuse. (Letter). Friedman, S. B.: Mors..:, C. W. Gordon, R. R. - Pediatrics 54(4):4()..1-410, October 1974. British Medical Journa./1(6064):841, March '26, 1977.

CD·01583 CD·Gl612 Texas Univ., Houston. School of Public Health. New York State Dept. of Social Services, Alba:-1Y. Office Epidemiological Survey of Physical Child AbtL'ie. of Researc h. Friedrich, W. N. Trer.rl:i in ChUd Abuse Reporting in New York State. 1966- Texas Medicine 7:2:31-84. October 1976. 197'2. Gray, J. J. New York Stale Dept. of Social Service~, Albany. Office of Research, 31 pp., April 1973. CD·0l584 North Dakota Univ .. Grand Forks. Dept. of Psychology. III·Health and Child Abuse. (Letter). Friedrich. W. N.; Boriskin, J. A. CD·01614 Lancet 1(7%0):649-650, March :20, 1976. Downstate Medical Center. Brooklyn, N.Y. Div. of Child and Adolescent Psychiatry. A Psychodynamic Approach to the Study and Treatment of Child· Abusing Parents. CD.ol603 Green, A. H. Violence Against Children: Physical Child Abuse in the Un­ Journal of Child Psychiatry 15(3):414-429. Summer 1976. ited States. Gil.D. G. In: Bronfenbrenner. U.; Mahoney, M. A. (Editors). Influ­ ences ot: Human Development. Hinsdale, Ill., Dryden Press. rp. 190·201, 1975. CD·01615 State Univ. of New York, D.coklyn. Div. of Child and Adolescent Psychiatry. SeIf·Destructive Behavior in Battered Children. CD-Ol604 Green. A. H. Brandeis Univ., Waltham. Mass. State Univ. of New York, Brooklyn. Div. of Child and Legally Reported Child Abuse: A Natio:-n'ide Survey. Adolescent Psychiatry, 26 pp., 1976. Gil, D. G. Social Work Practice, 1968134-158, 1968.

CD-01627 CD-Ol606 Royal Infirmary. Preston (England). Developmental Evaluation Center. Denver, Colo. The Battered Baby Syndrome. Non·Accidental Injuries in Non·accidental Tr.uirna and Failure to Thrive: A Socio­ Children. Medical Profile In Denver. Hall, M. H.

83 In: Papers for Discussion at Sessions. 79th Health Con­ CD-OI681 gress of the Royal Society of Health, Eastbourne, April Regional Insl. of Social Welfare Research. Inc., Athens, 24-28, 1972. London. Royal Society of Health, pp. 97-102, Ga. 1972. Two Community Protec.ive Service Systems: Nature and Effectiveness of Service Intervention. Johnson, C. L. CD·Ol633 Regional Inst. of Social Welfare Research. Inc., Athens. University of (he Pacific, Stockton, Calif. Dept. of Educa­ Ga., 386 pp., 1977. tion. Child Abu.w and the School. Harriman. R. L. CD·Ol683 Doctoral Dissertation. Ann Arbor, Mich .• University Mi­ Georgia Univ .. Athens. Regional Inst. of Social Welfare crofilms, 128 pp., 1975. Research. Two Community Protective Sen-ice Systems: Comparative Evaluation of Systems Operations. Johnson. C. L. CD·01656 Geor3ia Univ., Athens. Regional Inst. of Social Welfare Royal Alexandra Hospital for Children, Camperdown Research, 52 pp .. ~Iarch 1976. (Australia). Community Pediatric Unit. Nonorganic Failure to Thrive: A Long. Term Follow-up. Hufton. I. W.; Oates, R. K. Pediatrics59(1):73-78, January I. 1977. CD-Ol684 Child Welfare League of America. Inc., New York, N.Y. Research Center. A Second Chanl'e for Families. Evaluation 01 a Program to CD·01660 Reduce Foster Care. National Society for the Prevention of Cruelty to Chil­ Jones, M. A.; Neuman. R.; Shyne. A. W. dren. London (England). National Advisory Center for the New York, Child Welfare League of America. Inc., 133 Battered Child. pp., January 1976. Accidents in the Home to Children Under Two Years. A Report on a Questionnaire. Hyman. C. A. Health Visitor 47(5): 139-141 , May 1974. CD-O I 688 Texas Univ., Houston. School of Public Health. Life Crisis as a Precursor to Child Abuse. Justice. B.: Duncan, D. F. CD-OI661 Public Health Reports 91(2): 110-115. March-April 1976. National Society for the Prevention of Cruelty to Chil­ dren. London (England). National Advisory Center on the Battered Child. A Psychological Study of Child Battering. CD·01691 Hyman, C. A.; Mitchell, R. TA Work With Child Abuse. Health ~'isitor 48(8):294-296, August 1975, Justice. R.; Justice, B. Transactional Analysis Journal 5( 1):38-41. January 1975.

CD·01670 Iowa State Dept. of Social Services, Des Moines. Bureau CD-Ol697 of Management Information. New York City Human Resources Administration. N.Y. Statistical Data on Child Abuse Cases Reported to the State Office of Psychiatry. Department of Social Sen-ices. 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., February 24, 1976. Amerkan Journal of J'sychi8try 133(7):80~-813, July 1976.

CD·01674 Minnesota Univ .. Minneapolis. Dept. of Pediatrics. CD-01698 Sexual Abuse of Children. An Epidemiologic Study. Boston CoiL, Chestnut Hill, Mass. School of Law. Jaffe, A. C.: Dynneson. L.: ten Bensel. R. W. Children. Individuals Without Rights. Amerit'an Journal of Diseases of Children 129(6):689-692. Katz, S. N. June 1975. Student Lawyer 1(3):48, 50, 52, February 1973.

84 CD·01699 CO·01738 Bo~ton Coil" Chestnut Hill. Mass. School of Law. Pennsylvania State Univ., Hershey. Dept. of Pediatrics. Legal Research on Child Abuse and Neglect: Pa~t and Fu· Child Abuse in arural Setting. ture. L1cyd-Still, J. D.: Martin, B. Katz, S. N.: Ambrosino, L.: McGrath, M.: Sawitsky, K. Pennsylvania JUcdicine 79(3):56-60, March 1976. Family LO!w Quarterly 11(2): 151-1 S4. Summer 1977.

CO·01748 CO·01706 Oxford Univ. (England). Park Hospital for Children. National Center for the Prevention and Treatment of Child Residential Therapy -. A Place of Safety. Abuse and Neglect. Denver. Colo, Lynch, M. A.: Ounsted, C. Predicting and Preventing Child Abuse: E.~tablishing Chil· In: Helfer, R. E. and Kempe, C. H. (Editors). Child dren's Rights by Assuring Access to He.aUh Care Through Abuse and Neglect. The Family and the Community. the Health Visitors Concept. Cambridge, Mass., Ballinger Publishing Co., pp. 195-107, Kempe, C. H. 1976. In: Proceedings of the First National Conference l)O Child Abuse and Neglect, January -1-7, 1976. Washington. D.C .. National Center on Child Abuse and Negll'<'\ !OH EW). (OHD) 77-30094. pp. 67-75, 1977. CO·017-'9 Park Hospital for Children. Headington (England). Human Development Research Unit. Predicting Child Abuse: Signs of Bonding Failure in the Maternity Hospital. CO·0171O Lynch, M. A.: Roberts. J. Case Western Reserve Univ., Cleveland, Ohio. Dept. of British Medical JournaIl(6061):6::!4-6::!6, March 5, 1977. Pediatrics. Maternal Behavior One Year After Early and Extenrled Post'partum Contact. Kennell, J.: Jerauld, R.: Wolfe, H.: Chesler. D.; Kreger, CO-01750 N. C. Park Hospital for Children. Oxford (England). DeVf,lopmentaJ Medicine and Child Nellrology 16(2): 172-179, Family Unit in .1 Children's Psychiatric Hospital. April19R Lynch, M. A.; Steinberg, D.: Ounsted, C. British IHedkal JOllrnal ::!(5963): In-I::!9, April 19, 1975.

CO·01712 Children's Hospital, Los Angeles, Calif. Family Develop­ CO·01752 ment Project. Portland State Univ., Oreg. A Follow.up Study uf Abused Children. The Disposition of Reported Child Abuse. Kent, J. T. Maden, M. F . .Journalof Pcdi:ltric Psyehology I(::!):25-3I , Spring 1976. Doctoral Di~isertation, Portland State Univ., Oreg., 160 pp., 1977.

CO·01714 Utah State Univ" Logan. Dept. of Special Education. CO·01760 Final Report. Educational and Psychological Problems of Colorado Univ., Denver. John F. Kennedy Child Develop· Abused Children. ment Center. Kline, D.; Christiansen, J. L. Nutrition: It.. Helationship to Children's Physical, Mental, Prepared for: Office of Education (DHEW). Washington. and Emotional Development. D. C. Bureau of Education for the Handicapped. 162 pp .. Martin. H. P. September 1975. American Journal of Clinical Nutrition 26:766-775, July 1973.

CO·01718 Colorado Univ., Denver. CO·01762 Child Abuse and Neglect! Effect>, on Bayley Scale Scores. Colorado Univ., Denver. Dept. of Pediatrics. Koski, M. A.; Ingram, E. M. Neurologic Statw; of Abused Children. Journal of Abnormal Chiid Psychology 5( 1):79-91. 1977. Martin, H. P.

85 In: Martin, H. P. (Editor). The Abused Child: A Multidis­ Psychosocial Characterb1ics of Neglecting Parenl~. Implica­ ciplinary Approach to Developmental Issues and Treat­ tions for Treatment. ment. Cambridge, Mass., Ballinger Publishing Co., pp. 67- Mulford. R. M.; Cohen, M. I. 82, 1976. In: Neglecting Parents. A Study of Psychosocial Charac­ teristics. Denver, Colo .. American Humane Association, pp. 5-20, May 25, 1967.

CD-01767 Colorado Univ., Denver. John F. Kennedy Child Develop­ ment Center. CD-01816 The Development of Abused Children. Part 2. Physical, National Society for Prevention of Cruelty to Children, Neurologic, and Intellectual Outcome. London (England). Dept. of Battered Child Research. Martin, H. P.; Beezley. P.; Conway. E. F.; Kempe, C. H. At Risk. AdYances in Pediatrics 21: 44-73. 1974. London, Routledge and Kegan Paul Ltd .. 246 pp., 1976.

CO-01790 CD-OI831 McMaster Univ .• Hamilton (Qntario). Dept. of Psychiatry. New York University Law Review. Incest Syndromes: Observations in a General Hospital Psy­ In the Child's Best Interests: Rights of the Natural Parents chiatric Unit. in Child Placement Proceedings. Molnar, G.; Cameron. P. New York UniJ'ersitJ' Law ReJ'iew 51 :+16-477, June 1976. Canadian Psychiatric As.mciation Journal 20(5):373-377. August 1975.

CD-O 18-12 Office of Child Development (DHEW), Washington, D.C. CD-01793 The Public Information Campaign. Johns Hopkins Univ., Baltimore, Md. Dept. of Psychiatry Office of Child Development (DHEW), Washington. D.C.. and Behavioral Sciences. 34 pp. July 3, 1974. IQ Change Following Change of Domicile in the Syndrome of Reversible HyposOI"\latotropinism (Psychosocial Dwarfism): Pilot InVt.'Stigation. CD-Ol848 Money. J.; Annecillo. C. Office of Youth Development (DHEW), Washin~ton, D.C. National Institutes of Health Conference on Research in Juvenile Court Statistics -- 1972. Child Abuse and Neglect. Bethesda. 1'.10., 7 pp. June 17, Office of Youth Development (DHEW), Washington, 1974. D.C., 19 pp., 1974.

CD-01 7 95 Johns Hopkins Univ., Baltimore, Md. Dept. of Psychiatry CD-O 1849 and Behavioral Sciences. Office of Youth Development WHEW), Washington, D.C. Late Puberty, Retarded Growth, and Reversible Hypc.asoma­ totropinism (Psychosocial Dwarfism\. Juvenile Court Statistics -- 1973. Money, J.; Wolff, G. Office of Youth Development (DHEW). Washington. Adolescence 9(33): 121-134, Spring 1974. D.C., OHD-O),D 75-26043, 18 pp .. March 1975.

CD-01796 CD-01851 National Society for the Prevention of Cruelty to Chil­ National Society for Prevention of Cruelty to Children, dren. London (England). London (England). Battered Child Research Dept. Yo-Yo Children. Childhood Accidents and Child A/luse. Moore, J. G. Okell, C. Nursing Times 70(49): 1888-1889 December 5, 1974. Community .'Hedicine 126: 124-127, 1971.

CD-01806 CD-01855 Massachusetts Society for the Prevention of Cruelty to University of Southern California, Los Angeles. School of Children, Boston. Social Work.

86 An Analysis of Complainants and Complaint~ in a Public Jourr.al of the American College of Emergency Physicians Agency Protective Services Setting. 3(6):388-390, November-Decembcr 1974. Olsen, L. O. Master's Thesis. University of Southern California. Los Angeles, 91 pp .. June 1966. CD-01891 Georgia Univ., Athcns. School of Social Work. Measuring Adequacy of Child Caring: Further Develop­ CD.Ol862 ments. Colorado Commission on Children and Youth. Denver. Polansky, N. A.; Pjilane, L. Colo. Child Welfare 5<1(!·):354-359, May 1975. Child Abuse·-Child Neglect in the Metropolitan Denver Art·a. Pacheco, C. Colorado Commission on Children and Youth. Denver. CD·01S99 Colo., 44 pp. October 10. 1974. Qucensboro Society for the Prevention of Cruelty to Chil­ dren, Inc., Jamaica, N, Y. Olild Ahll'i1!: The Feasibility of Establishing a Coordinated System for :'tlaltreatment Sen-iet'S in Queens County. CD-01866 Queensboro Society for the Prevention of Cruelty to Chil­ Panel for Family Living, Tacoma, Wash. dren, Inc., Jamaica, N.Y., :!45 pp .. Octoher 1976. Coordinating COlllmunity Concern for Child Abuse and Neglect. First Annual Rl'Search Report. Panel for Family Living, Tacoma. Wash., 124 pp" 1975. CD-01906 Arizona State Univ., Tempe. Dept. of P.>ychology_ Experimental Assessment of a Treatml:nt Project. CD-01874 Reich. J. W. California Univ., Los Angeles. School of Medicine. Journal of Pediatric Psychology 1(2):94-97, Spring 1976. OinicaJ Application of the PD, MA and (OH) Experimental MMPI Scales to Further Understanding of Abusive Parents. Paulson, M. J.; Schwerner, G. T.; Bendel, R. B. Journa! of CJinic:11 Ps),(.'hologJ· 3:!(3):558-5M. July 1976. CD-01909 Albl!rt Einstein Coil. of Medicine. Bronx. 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 Clinic. Shirehafl ligence of School Children With Differing Life Histories. (England). Richardson, S. A. Consciously Rejected Children. Pediatric Research 10:57-61. 1976. Pemberton, D. A.; Benady, D. R. British Journal of Psychiatry 123(576):575-578, November 1973.

('D·01919 City Univ. of New York. N.Y. Mt. Sinai School of Medi­ CD-01878 cine. Philadelphia General Hospital, Pa. Philadelphia Se~ Of­ Effects 01 Diphenylhydantoin on Child-Abusing Parents: A fender and Rape Victim Center. Preliminary Report. Childi'en Who Are Victims of Sexual Assault and the PS}­ Rosenblalt. S.; Schadfer, D.: Rosenthal. J. S. chology of Offenders. Current Therapeutic Re.<;el,n·h 19(3):33:!-336, March 1976. Peters. J. J. ftmerican Journal of P.t;),chotherapy 300):398·4:! I. July 1976.

CD-01926 Minnesota Univ., Minneapolis. Univ. Hospitals. CD-Ol882 Child Abuse and Neglect. A Minnesota Update -- 1977 Be­ Ohio State Univ., Columbus. Dept. of Nursing. yond the Battered Child Syndrome. Intentional Burning: A Severe Form of Child Abuse. Runyan, D. K.: ten Bensel, R. W. Phi!lips, P. S.; Pickrell. E.; Morse, T. S. Minnesota Medl,dne 60C!): 141-144, February 1977.

87 CO·O 1938 Interpersunal R.e1ationships and Child-R.earing Practicl'S in Colorado Univ., Boulder. Dept. of Psychology. 214 Parents of 8atw.red Children. A Predictive Screening Questionnaire for Potential Problems Smith. S. M.: Hanson. R. in Mother·Child Interaction. British Journal of Psychiatry 1~7:513-525, December 1975. Schneider. c.: Hoffmeister. J. K.: Helfer. R. E. In: Helfer. R. E. and Kempe. C. H. (Editors). Child Abuse and Neglect. The Family and the Community. Cambridge. Mass .• Ballinger Publishing Co" pp. 393--107, CO·OI964 1976. D-drtmoU'th College. Hanover. N.H. Some Factors Associated With Child Abuse Potential. Sokol. R. American Sociological Association 71$1 Annual Meeting, CO·01945 New York, N.Y., 17 pp .. September 2. 1976. New York Daily News. N.Y. Child Abuse: A Killer Teachers Can Help Control. Shanas. B. Phi Delta Kappan 56(7):-1-;9-482. 1975. CD·01993 Minnesota Univ .. Minneapolis. Dept. of Pediatrics. Child Abuse Following Early Postpartum Separation. (Let· ter). CD·01946 ten Bensel. R. W.: Paxson. C. L .. Jr. _ National Center for Education Statistics (DHEW). Wash­ Journal of Pedi8tri~ 90(3):490-491. March 1977. ington. D.C. Education Div. Neglected or Delinquent Children Living in State Operated or Supported Institutions. Fiscal Year 1972. Siegel, L. CO·02012 National Center for EJuc\\tion Statistics (DHEW). Wash­ Brandeis Univ .. Waltham. Mass. ington. D.C. Available from the Government Printing The Client of a Protective Agency in the Context of the Office,40 pp., 1975. Community: A Fietd Study of the Massachusetts Society tor the Prevention of Cruelty to Children. Varon. E. Doctoral Dissert

CO-01949 Rutgers, The State Univ .• New Brunswick. N.J. Dept. of Psychiatry. CO·02023 Agency Action and Interaction in Cases of Child Abuse. Western Michigan Univ .. Kalamazoo. Silver, L. B.; Dublin, C. c.; Lourie. R. S. Sexual Ahuse of Children by Relatives: An Exploratory Social Casework 52(3):164-171. March 1971. Study. Waterwav. J. Western ~,tichigan Univ .. Kalamazoo. 53 pp .. March 1976.

CO·01957 Birmingham Univ .• (England). Dept. of Psychiatry. The Battered Child Syndrome •• Some Research Findings. CD·02030 Smith. S. M. California State Dept. of Social Welfare. Sacramento. Nursing Mirror 140(22):4lS-53. June 12. 1975. Program Information Bureau. Statistical Report on Specialized Child Protective Services for 1972. Webber. D. N. CD-01959 California State Dept. of Social Welfare. Sacramento. Birmingham Univ. (England). Dept. of Psychiatry. 1973-3. 53 pp .. December 1973.

88 , " I, I

I !. !'-

~1- ONGOING RESEARCH STUDIES

CR-OOOO2 CR·OOO16 Family Service Center, Honolulu, Hawaii. New York Medical Coil., N.Y. Center for Comprehensive 2319 Rose St. Health Practice. Honolulu, HI 96819 5 E. 102nd St. Hana Like Home Visitor Project. New York, NY 10029 Alger, M.; Uohara, B. Family Care Program May 75-Jun 78 Brotman, R.; larin-Ackerman, J. Office of Child Development (DHEW), Washington, D.C. Feb 75··Feb 78 ~ew York Medical Coli., N.Y.; National Inst. of Drug Abuse! (DHEW), Rockville, Md.

CR·OOOO3 Vanderbilt Univ., Na,;hville, Tenn. Dept. of Pediatrics. 21st Ave. South anJ Garland St. CR·OOO21 Na~hville, TN 37232 Pennsylvania State Univ., University Park. Inst. for the Causal Factors in Neglect and Ba~tering: A ProsPfdive Study of Human Development. Study. University Park, PA 16801 Altemeier, W. A., III; O'Connor, S. Social Interaction Patterns Relating to Child Abuse and Jun 75-Dec 78 Neglect. Natiual -=:enter on Child Abuse and Neglect (DHEW), Burgess, R. L. Wasl.ington, D.C. Jun 75-Jun 78 National Center on Child Abuse and Neglect (DHEW), Washington, D.C.

CR·OOOO8 National Council for Biac" Child Development, Inc., CR·OOO27 Washi,ngton, D.C. Mexican American Neighborhood Civic Organization 1411 K St. N.W. Suite 500 (MANCO), San Antonio, Tex. Washington, D.C. 20005 118 Broadway Rm 327 An EJ.:.,loratory Investigation of Potential Societal and Intra. San Antonio, TX 78205 familial Factors Contributing to Child Abuse and Negkc:t. 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 (DHEW), National Center on Child Abuse and Neglect (DHEW), Washington, D.C. Washington, D.C.

CR·OOO32 CR·OOOO9 National Urban League, New York. N.Y. Texas Migrant Council, Laredo. 500 East 62 St. P. O. Box 917 New York, NY 10021 Laredo, TX 78040 Project Thrive: Enhancing the Black Family and Protectill Migrant Child Abuse and Neglcct Prevention Project. the Children. Bermea, M.; Moreno, H. Curry, D. Jul 75-Jun 78 Jun 75-Jun 78 National Center on Child Abuse and Neglect (DHEW), National Center on Child Abuse and Neglect (DHEW) Washington, D.C. Washington, ~.C.

CR·OOO39 CR·OOOtO Texas Stille Dept. of Public Welfare, Austin. California State Dept. of Youth Authority, Sacramento. 3000 S. Interregional Hwy. Research Div. Austin, TX 78702 1829 16th St. Child Abuse and Neglect Resources Demonstration Sacramento, CA 95814 (CANRED, Project. Analysis of Child Abuse Reported to a Law Enforcement Dinges. J. B. Agency. Jan 75-Jun 78 Bohnstedt, M. National Center on Child Abuse and Neglect (DHEW). May 77-continuing. Washington, D.C.

89 CR·00041 CR·OOO57 White (E. H.) and Co., San Francisco, Calif. Children's Mission, Inc., Boston, Mass. Parents' and Chil­ 347 Clement St. drens' Services. San Francisco, CA 94118 329 Longwood Ave. Ilevelopment and Conduct of a System of Evaluation for Boston, MA 02115 Demonstration Centers in Child Ab~ and Neglect. Parents' Center Project for the Study and Prevention of Doty, E. F.; Houston, T. R. Child Abuse. Dec 74-Jun 78 Galdston, R.; Bean, S. L. National Center on Child Abuse and Neglect (DHEW), Sep 68-continuing . Washiilgton, D.C. Children's Mission, Inc., Boston, Mass.; Grant Founda­ tion, New York, N.Y.

CR·OOO46 Minnesota Univ., Minneapolis. School of Psychology Training Program. CR-00058 N 548 Elliott Hall Boys Town Center for the Study of Youth Development, Minneapolis, MN 55455 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 The Human Ecology of Child Maltreatment. National Center on Child Abuse and Neglect (DHEW), Garbarino, J. Washington, D.C. Sep 76-Jun 78

CR·OOO53 Children's Hospital of Buffalo, N.Y. Dept. of Medical CR·OOO59 Photography. Rutgers, The State Univ., New Brunswick, N. J. Graduate 219 Bryant St. School of Social Work. Buffalo, NY 14222 New Brunswick, NJ 08901 Photography of Suspected Child Abuse and MaitFatment. Factors Relating to Levels of Child Care Among Families Ford, R. J.; Smistek, B. S. Receiving Public Assistance in New Jersey. Oct 74-continuing Geismar, L.; Horowitz, B.; Wolock, I. Children's Hospital of Buffalo, N.Y. Jun 75-continuing National Center on Child Abuse and Neglect (DHEW), Washington, D.C.

CR·OOO54 Child Development Projec! Ann Arbor, Mich. 201 E. Catherine St. CR·OOO6O Ann Arbor, MI 48104 Rhode Island Univ., Kingston. Dept. of Sociology. An Infant Mental Health Program. Kingston, RI 02881 Fraiberg, S. The Social Construction of Child Abuse. Sep 72-May 78 Gelles, R. J. National Inst. of Mental Health (DHEW), Rockville, Md.; Apr 74-cor.tinuing l\:'chigan State Dept. of Mental Health, Ann Arbor, Natipnal Center on Child Abuse and Neglect (DHEW), Mici:.; The Grant Foundation, New York, N.Y. Washington, D.C.

CR·OOO56 Northern Iowa Univ., Cedar Falls. Dept of Psychology. CR-00068 Wisconsin Univ., Madison. Dept. of Psychology. Dartmouth Coil., Hanover, N.H. Dept. of Maternal and Cedar Falls, IA 50613 Child Health. Possible Contributions of Children to Their Own Abuse. Hanover, NH 03755 Frodi, A.; Lamb, M., Children At Risk Program. Sep 76-continuing. Gundy, J. H.; Krell, H. Wisconsin Univ., Madison. Graduate School Research Jan 76-continuing Committee. National Inst. of Child Health and Human Spaulding Potter Charitable Inst., Concord, N.H.; Richard Development (DHEW), Bethesda, Md. King Mellon Foundation, Pittsburgh, Pa.

90 CR-00069 CR-00092 Kauikeolani Children's Hospital, Honolulu, Hawaii. Rainbow Babies and Children's Hospital, Cleveland, Ohio. 226 Kuakini St. 2040 Adelbert Rd. Honolulu, HI 96817 Cleveland, OH 44106 Hawaii Child Abuse Demonstration Projt.'Ct-Hllwaii. Family Mother to Infant Attachment. Stress Center. Kennell, J. H. Hammar, S. I," Jul74-continuing .Ian 75-Jun 78 Maternal and Child Health Service (DH EW), Rockville, National Center on Child Abuse and Neglect (DHEW), Md. Washington, D.C.

CR-00070 CR-00094 Parental Stress Center, Pittsburgh, Pa. Children's Hospital. Los Angeles, Calif. Div. of Psychia­ 918 S. Negley Ave, try. Pittsburgh, PA 15232 P.O. Box 54700 Terminal Annex Parental Sln'Ss Center. Los Angeles, CA 90054 Harrell, M, Behavior, Parenting, and Outcome of High-Risk Infants. Feb 74-79 Kent. J. Nationai Ccnter on Child Abuse and Neglect (DHEW), Oct 74-continuing Washington. D.C.; Governor's Justice Commission, Pitts­ Bureau of Community Health Services (DHEW), Washing­ burgh, Pa. ton, D.C.

CR-00072 CR-00097 Michigan State Univ., East Lansing. Dept. of Human Child Abuse and Neglect Demonstration Organization Development. (CAN-DO), Belton, Tex. B240 Life Sciences Building P. O. Box 729 East Lansing, MI 48824 Belton. TX 76513 Service Project to Determine the Reliability and Validity of Central Texa'i Council of Governments Child Abuse and the Child· rearing Qut.'Stionnaire. Neglect Demonstration Organization. Helfer, R. Knox, J. c.; Phillips, Y.; Eyman, N. .Iun 75-May 78 Dec. 74-.Iun 78 National Center on Child Abuse and Neglect (DHEW), National Center on Child Abuse and Neglect (DHEW), Washington,D.C. Washington. D,C.

CR-00088 CR·(l{) 10 I Education Commission of the States, Denver, Colo. Dept. Stanford Univ., Calif. Boys Town Center. of Elementary and Secondary Services. Stanford, CA 94305 1860 Lincoln St. Psychological Sequelae of Foster Home and Parental Place­ Denver, CO 80203 ment of Abl1'tCd and Neglected Children. The Educational System's Role in Child Abuse and Neglect. Leiderman. P. H.; Hastorf, A. .lones, C. D.; Fox, P. Sept 75-Aug 79 .Ian 75-.Iun 78 Stanford Univ .. Calif. National Center on Child Abuse and Neglect (DHEW), Washington. D.C.

CR·()()t02 CR-0009O Educational Testing Service, Princeton. N.J. Wisconsin Univ .• Mallison. Dept. of Social Work. Rosedale Rd. 425 Henry Mall Princeton. NJ 08540 Madison, WI 53700 The Effect of Ilirth Order on Mother--Child Relationship. The Child's Contribution to Child Abuse. Lewis. M. Kadushin, A.; Berkowitz, L. Jul 75-continuing Jun 76-Jun 78 National Inst. of Child Health and Human Development National Inst. of Mental Health (DHEW), Rockville, Md. (DHEW). Bethesda. Md,

91 CR·OOI04 CR·OOlll Center for Studies of Child and Family Mental Health, Texas Univ., Austin. School of Law. Rockville, Md. Mental Health Study Center, Rockville, 2S00 Red River Md. Austin. TX 7870S 5600 Fishers Ln. Rl'gional Rl'S9urce Center OIi Child Abuse and Neglect. Rockville, MD 208S3 McCathren, R. R. Studies of the Abused and Neglected Adolescent. Jul 7S-Jul 78 Lourie, I. S. National Center on Child Abuse and Neglect (DHEW), Sep 7S-continuing Washington, D.C. National Inst. of Mental Health (DHEW), Rockville, Md.

CR·OOIl3 CR·OOI05 CPI Associates, Inc., Washington, D.C. Calgary Univ. (Alberta). Div. of Community Health Sci­ 2030 M St. N.W. enc.e. Washington, IX' 20036 1f,1I 29 S1. N.W. A Process Evaluation for innovative Demonstration Projects. Calgary. Alberta, Canada T2N4J8 Miller, P. J. A Family Aide Project for Parents With a High Risk of Aug 75-Mar 78 Child Abuse. National Center on Child Abuse and Neglect (DHEW), MacMurray, Y. D.; Brummitt, J. R.; Cunningham, P. H. Washington, D.C. Aug 76-Aug 79 Department of National Health and Welfare, Ottawa (On­ tario). CR·OOllS Johns Hopkins Medical Institutions, Baltimore. Md. Psy­ chohormonal Research Unit. CR·OOI07 601 N. Broadway National Inst. of Mental Health (DHEW), Adelphi, Md. Baltimore. MD 2120S Mental Health Study Center. Reversible Hyposomatotropinism (Psychosocial I)warfism): 2340 E. University Blvd. Behavioral I)ata in Cases and Their Families. Adelphi, MD 20783 Money, J.; Werlwas, J. Participant Observation of the Reorganization of a System Sep 74-continuing of Care for Abused and Neglected Children: A Study in Public Health Service (DHEW), Washington, D.C. Child Advocacy. Maney, A. C.; Gaughan, M. .,S-continuing.

CR·OO117 Ohio State Univ., Columbus. Mershon Center. CR·OOI08 1250 Chambers Rd. JFK Child Development Centl!r, Denver, Colo. Columbus. OH 43212 4200 E. 9th Structure and Performance of Programs of Child Abuse and Denver, CO 80220 Neglect. FoIlow·up Studies of Abused Children. Nagi. S. Z. Martin, H. P. Jul74-continuing 71-continuing Office of Child Development (DH EW). Washington. D.C. Bureau of Community Health Services (DHEW), Bethes­ da, Md.

CR·OOI09 CR·OOI20 Washington Center for Addiction, Boston, Mass. San Francisco General Hospital, Calif. Dept. of Pediatrics. 41 Morton St. 1001 Potrero Boston, MA 0::!130 San Francisco. CA 94110 An Investigation of the Relationship Between Substance Sexual Abuse of Children. Abuse and Child Abuse and Neglect. Pascoe. D . .I.; Glasser, M. Mayer, J.; Black, R. Mar 77-Mar 78 Jun 75-continuing San Francisco General Hospital, Calif.; San Francisco National Center on Child Abuse and Neglect (DHEW), City Dept. of Health, Calif.; Queen's Bench Foundation, Washir.gton, D.C. San Francisco, Cdlif.

92 CR·()Ol21 CR·OOI43 California Uni\'., Los Angeles. Neuro·psychiatric Ins\. British Columbia Univ., Vancouver. Div. of Child Psy­ 760 Westwood Plaza chiatry. Los Angeles, CA 90024 Vancouver, B.C. V6T IW5, Canada University of California at Los Angeles (UCLA) Child Trau· Projt.'Ct Toddler: F..arly Intervention With High.Risk Chil­ rna Intervention Projt.'Ct. dren and Their Families. Paulson, M. J. Stephenson, S. P. .I an 70-.IL1I1 gO Apr 72-78 Health Resources Administration (DHEW), Bethesda, Md. Department of National Health and Welfare, Ottawa (On­ tario).

CR·OOI22 CR-OOI44 New Jersey State Div. of Youth and Pamily Services, Texas State Dept. of Public Welfare, Austin. Special Pro Trenton. Bureau of Research, Planning, and Program iects Bureau. Development. John H Reagan Bldg. I S. Montgomery St. Austin, TX 78701 Trenton, NJ 08625 Project Care: Child Advocacy Resources Expansion. Parent Interview Study of Child Abuse and Neglect Cases. Stern, J.; Marley, M. Pelton, L. H. Ju175-78 Scp 75·continuing Office of Child Devdopment (DHEW), Washington, D.C. New Jersey State Div. of Youth anfl Pamily Services, Trenton.

CR·OOI45 New Hampshire Uni, Durham. Dept. of Sociology. ca·OOl3l Durham, NH 03!L·: National Center for the Prevention and Treatment of Child Physical Violence in American Families. Abuse and Neglect, Denver, Colo. Straus, M. A.; Gelles, R. J.; Steinmetz, S. K. 1001 Jasmine S\. Jul 75-Sep 78 Denver, CO 80220 National Ins\. of Mental Health (DHEW), Bethesda, Md. Circle HOllse Therapeutic Playochool for Abused Children. Rodeheffer, M. A.; Mirandy, J. A.; Cone, S. Dec 74-Dec 78 CR·OOI49 National Center for the Prevention and Treatment of Child Oregon Univ., Portland. Rosenfeld Center for the Study Abuse and Neglect, Denver, Colo.; Commonwealth Pund, and Treatment of Child Abuse. New York, N.Y. 3181 SW Sam Jackson Park Rd. Portland, OR 97201 Fractured Femur Study. Tufts, E. CR·OO132 Dec 75-continuing North O.folina Univ., Chapel Hill. Dept. of Maternal and Child Hea!th. Chapel Hill, NC 27514 CR·OOI50 Hospital and Home Support for Maternal Attachment. Oregon Univ., Portland. Rosenfeld Center for the Study Saunders, M.; Schaefer, E. S.; Bauman, K. E.; Siegel, E.; and Treatment of Child Abuse. Ingram, D. D. 3181 SW Sam Jackson Park Rd. Jun 75·May 78 Portland, OR 9720 I National [nst. of Child Health and Human Development Failure to Thrive. (DHEW), Bethesda, Md. Tufts, E. Jun 75-Jun 80

CR·OO142 Maryland Univ., Baltimore County. Dep\. of Psychology. CR·OO155 Baltimore, MD 21228 New Mexico Univ., Albuquerque. Office of the Medical Child Abuse: A Controlled Study of Social, Familial, Indivi­ Investigattlr. dual, and Intor.ractional Factors. Albuquerque, NM 87131 Starr, R. H .. Jr. Routine Mortality Case Finding, Statewide. Jun 75-Mar 78 Weston, J. T. National Center on Child Abuse and Neglect (DHEW), Jul 73-continuing Washington, D.C. New Mexico Univ., Albuquerque. School of Medicine.

93

*U.S. GOVERNMENT PRINTING OFFICE: 19790-620-182/5656 REGION 3-i i ' i I