Child Abuse and Neglect Lectures
Information about this course
- Student presentation 10%
- Written assignment 30%
- Exam 60%
- MC 20 vragen + 2 open vragen met abcd
Lecture 1 – Introduction and consequences
Recap
‘How many families are we talking about? Based on…?
- We don’t really know how many families we are talking about exactly, because we
can’t look behind the frontdoor. Prevalence studies are a guess…
Prevalence of maltreatment (and neglect)
- 127.000 children every year in the Netherlands
o 4-16% physical abuse
o 10% neglect/emotional abuse
o 5-10% sexual abuse
→ these are estimations.
Remarks about prevalence rates…
- ‘tip of the iceberg’:
o A lot of services are using case files
- The Netherlands vs. worldwide
- Source?
o Official records
o Parent/teacher/professional/child report: if it is self-report parents aren’t
always honest because of social desirability.
, o Retrospective? Thinking back about what happened to someone a while ago is
not always accurate.
Remarks about definitions…
- WHO definitions (on BS)
- Bus some ‘gray areas’…
o Most definitions are clear, but sometimes there is a gray area or cases which
are difficult. These situations made it so that definitions become vaguer.
- Cultural differences?
Casus gray area: mother who was a raw vegan. She gave her baby only cold raw coal foods.
The baby was not growing properly so mother went to the pediatrician. They said the baby is
smaller than she is supposed to be.
Documentary about Tom! About 8 years ago.
Definitions of types of CAN (WHO)
Sexual abuse = involvement of children in sexual activities that they do not fully understand,
are unable to give informed consent to, for which they are not developmentally prepared, or
that violate the standards of the society in which these children live.
Physical abuse = any non-accidental injury to a child under the age of 18 by a parent or
caretaker. These injuries may include beatings, shaking, burns, human bites, strangulation, or
immersion in scalding water, with resulting bruises and welts, broken bones, scars, burns,
retinal hemorrhage, or internal injuries.
Emotional abuse = a repeated pattern of caregiver behavior or extreme incident(s) that
convey to children that are worthless, flawed, unloved, unwanted, endangered, or only of
value in meeting another’s needs.
Physical neglect = the chronic failure of a parent or caretaker to provide a child under 18 with
basic needs such as food, clothing, shelter, medical care, educational opportunity, protection,
and supervision.
Emotional neglect = the consistent failure of a parent or caretaker to provide a child with
appropriate support, attention, and affection.
Structural neglect =
- Institutional rearing characterized by:
o Regimented nature
o High child-to-caregiver ratio
o Multiple shifts
o Frequent change of caregivers
- These factors deprive children of continuous and reciprocal interactions with stable
caregivers, necessary to respond to their developmental needs.
Statements
, 1) Non-accidental burning a child is an example of physical abuse.
2) Not taking a child to the doctor when he/she needs to, is an example of emotional
abuse.
3) Drunk driving by the parent (with the child in the same car) is an example of physical
neglect.
4) Locking a child in a room is an example of emotional neglect.
‘Can child maltreatment make you sick? Which illness can be the consequence of
maltreatment?’
- The relationships are not THAT direct, but there are mechanisms which can affect and
explain the relationship when they are found.
‘Does it affect your mental health?’
‘What are possible methodological limitations that we have to be aware of?’
Consequences of child abuse and neglect
Somatic health in adulthood
- Focus: obesity/overweight
o Finding: most people with obesity or overweight had negative childhood
experiences
- ACE study
o It is a bit older study
- Consistent results: CAN is related to many aspects of physical and mental health
- Cumulative effect = if you experience more negative things, you have more negative
outcomes
ACE study
- 13.494 Kaiser Health Plan members who completed standardized medical evaluations
at the Health Appraisal clinic (August-November 1995 and January-March 1996)
- Questionnaires mailed in week after visit
- 9.508 (70.5%) returned questionnaire
Adverse Childhood Experiences
- Psychological abuse
- Physical abuse
- Sexual abuse
- Substance abuse in household
- Mental illness in household
- Mother treated violently
- Criminal behavior in household
, ACE =
Explain the following sentence: “ACE’s have a cumulative effect on the development of
psychological and physical problems.”
Most important finding: cumulative effect → people with 4 or more ACE’s had a higher
chance at negative consequences for mental and physical health.
ACE’s are related to…
If you experienced ACE’s you have a higher chance to:
- Physical and mental health
- Social development
- Educational outcomes
- Child’s developing brain structure
- Neuroendocrine system
PCE’s? (positive childhood experiences)
Hinojosa & Hinojosa (2024) – Positive and adverse childhood experiences and mental health
outcomes of children.
- National Survey of Children’s Health
- Sample:
o 22.628 children
o Aged 6-17
- Parent report
- Mental health disorders
- Added ACE’s: divorce, discrimination, broader violence in the household (father
could also be the victim)
- Supportive relationships:
o Family communication/resilience, mentorship (an adult who was a mentor for
the child)
- Safe, stable environment
o Neighborhood safety and support
- Opportunities for constructive social engagement
Information about this course
- Student presentation 10%
- Written assignment 30%
- Exam 60%
- MC 20 vragen + 2 open vragen met abcd
Lecture 1 – Introduction and consequences
Recap
‘How many families are we talking about? Based on…?
- We don’t really know how many families we are talking about exactly, because we
can’t look behind the frontdoor. Prevalence studies are a guess…
Prevalence of maltreatment (and neglect)
- 127.000 children every year in the Netherlands
o 4-16% physical abuse
o 10% neglect/emotional abuse
o 5-10% sexual abuse
→ these are estimations.
Remarks about prevalence rates…
- ‘tip of the iceberg’:
o A lot of services are using case files
- The Netherlands vs. worldwide
- Source?
o Official records
o Parent/teacher/professional/child report: if it is self-report parents aren’t
always honest because of social desirability.
, o Retrospective? Thinking back about what happened to someone a while ago is
not always accurate.
Remarks about definitions…
- WHO definitions (on BS)
- Bus some ‘gray areas’…
o Most definitions are clear, but sometimes there is a gray area or cases which
are difficult. These situations made it so that definitions become vaguer.
- Cultural differences?
Casus gray area: mother who was a raw vegan. She gave her baby only cold raw coal foods.
The baby was not growing properly so mother went to the pediatrician. They said the baby is
smaller than she is supposed to be.
Documentary about Tom! About 8 years ago.
Definitions of types of CAN (WHO)
Sexual abuse = involvement of children in sexual activities that they do not fully understand,
are unable to give informed consent to, for which they are not developmentally prepared, or
that violate the standards of the society in which these children live.
Physical abuse = any non-accidental injury to a child under the age of 18 by a parent or
caretaker. These injuries may include beatings, shaking, burns, human bites, strangulation, or
immersion in scalding water, with resulting bruises and welts, broken bones, scars, burns,
retinal hemorrhage, or internal injuries.
Emotional abuse = a repeated pattern of caregiver behavior or extreme incident(s) that
convey to children that are worthless, flawed, unloved, unwanted, endangered, or only of
value in meeting another’s needs.
Physical neglect = the chronic failure of a parent or caretaker to provide a child under 18 with
basic needs such as food, clothing, shelter, medical care, educational opportunity, protection,
and supervision.
Emotional neglect = the consistent failure of a parent or caretaker to provide a child with
appropriate support, attention, and affection.
Structural neglect =
- Institutional rearing characterized by:
o Regimented nature
o High child-to-caregiver ratio
o Multiple shifts
o Frequent change of caregivers
- These factors deprive children of continuous and reciprocal interactions with stable
caregivers, necessary to respond to their developmental needs.
Statements
, 1) Non-accidental burning a child is an example of physical abuse.
2) Not taking a child to the doctor when he/she needs to, is an example of emotional
abuse.
3) Drunk driving by the parent (with the child in the same car) is an example of physical
neglect.
4) Locking a child in a room is an example of emotional neglect.
‘Can child maltreatment make you sick? Which illness can be the consequence of
maltreatment?’
- The relationships are not THAT direct, but there are mechanisms which can affect and
explain the relationship when they are found.
‘Does it affect your mental health?’
‘What are possible methodological limitations that we have to be aware of?’
Consequences of child abuse and neglect
Somatic health in adulthood
- Focus: obesity/overweight
o Finding: most people with obesity or overweight had negative childhood
experiences
- ACE study
o It is a bit older study
- Consistent results: CAN is related to many aspects of physical and mental health
- Cumulative effect = if you experience more negative things, you have more negative
outcomes
ACE study
- 13.494 Kaiser Health Plan members who completed standardized medical evaluations
at the Health Appraisal clinic (August-November 1995 and January-March 1996)
- Questionnaires mailed in week after visit
- 9.508 (70.5%) returned questionnaire
Adverse Childhood Experiences
- Psychological abuse
- Physical abuse
- Sexual abuse
- Substance abuse in household
- Mental illness in household
- Mother treated violently
- Criminal behavior in household
, ACE =
Explain the following sentence: “ACE’s have a cumulative effect on the development of
psychological and physical problems.”
Most important finding: cumulative effect → people with 4 or more ACE’s had a higher
chance at negative consequences for mental and physical health.
ACE’s are related to…
If you experienced ACE’s you have a higher chance to:
- Physical and mental health
- Social development
- Educational outcomes
- Child’s developing brain structure
- Neuroendocrine system
PCE’s? (positive childhood experiences)
Hinojosa & Hinojosa (2024) – Positive and adverse childhood experiences and mental health
outcomes of children.
- National Survey of Children’s Health
- Sample:
o 22.628 children
o Aged 6-17
- Parent report
- Mental health disorders
- Added ACE’s: divorce, discrimination, broader violence in the household (father
could also be the victim)
- Supportive relationships:
o Family communication/resilience, mentorship (an adult who was a mentor for
the child)
- Safe, stable environment
o Neighborhood safety and support
- Opportunities for constructive social engagement
