RECAP:
Definitions of types of CAN
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 haemorrhage, or internal injuries.
Emotional abuse: A repeated pattern of caregiver behaviour or extreme incident(s) that convey to
children that they 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:
- Regimented nature
- High child-to-caregiver ratio
- Multiple shifts
- Frequent change of caregivers
These factors deprive children of continuous and reciprocal interactions with stable caregivers,
necessary to respond to their developmental needs.
1
,HOORCOLLEGE 1
Recap: prevalence and types of maltreatment
- 127.00 children every year in the Netherlands
o 4-16% physical abuse
o 10% neglect/emotional abuse
o 5-10% sexual abuse
- Tip of the iceberg, not all numbers are known, group is bigger than we think
- The Netherlands vs. worldwide
- Source:
o Official records
o Parent/teacher/professional/child report
o Retrospective
Some remarks about definitions
- WHO definitions
- But some ‘grey areas’
o For instance case of raw vegan diet
- Cultural differences
Question boxes in the slides are example questions to practice knowledge on the topic.
2
,Consequences of child abuse and neglect
Somatic health in adulthood
- Focus: obesity/weight
- ACE study, Adversed Childhood Experiences
- Consistent results: CAN is related to many aspects of physical and mental health
- Cumulative effect, more ACE’s → more negative consequences
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
behaviour in household.
Toelichting: ACE and disease conditions (Felitti et al., 1998)
4 ACE’s or more → more negative health outcomes. Increase risk diseases such as cancer, diabetes,
stroke etc.
ACEs are related to:
- Physical and mental health
- Social development
- Educational outcomes
- Child’s developing brain structure
- Neuroendocrine system
(Bright et al., 2016; Elmore & Crouch, 2022; Nusslock & Miller, 2016; Shonkoff et al., 2012)
3
, ARTIKEL – Hinojosa & Hinojosa , 2024 - Positive and adverse childhood experiences and mental
health outcomes of children
Positive Chidlhood Experiences (Hinojosa & Hinojosa, 2024)
- Mental health disorders
- Added ACEs: divorce, discrimination and broader violence in the household.
- National Survey of Children’s Health: sample 22.628 children, aged 6-17, parent report.
- PCE’s:
o Supportive relationships:
▪ Family communications/resilience, mentorship
o Safe, stable environment:
▪ Neighbourhood safety and support
o Opportunities for constructive social engagement
▪ Sports, other lessons/activities
Toelichting: Moderation effect of th dpositive
The outcome for the amoutn of ACES were moderated by the amount of PCE’s
If you had positive experiences, you had less negative outcomes, eventhough you had ACE’s
4
Definitions of types of CAN
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 haemorrhage, or internal injuries.
Emotional abuse: A repeated pattern of caregiver behaviour or extreme incident(s) that convey to
children that they 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:
- Regimented nature
- High child-to-caregiver ratio
- Multiple shifts
- Frequent change of caregivers
These factors deprive children of continuous and reciprocal interactions with stable caregivers,
necessary to respond to their developmental needs.
1
,HOORCOLLEGE 1
Recap: prevalence and types of maltreatment
- 127.00 children every year in the Netherlands
o 4-16% physical abuse
o 10% neglect/emotional abuse
o 5-10% sexual abuse
- Tip of the iceberg, not all numbers are known, group is bigger than we think
- The Netherlands vs. worldwide
- Source:
o Official records
o Parent/teacher/professional/child report
o Retrospective
Some remarks about definitions
- WHO definitions
- But some ‘grey areas’
o For instance case of raw vegan diet
- Cultural differences
Question boxes in the slides are example questions to practice knowledge on the topic.
2
,Consequences of child abuse and neglect
Somatic health in adulthood
- Focus: obesity/weight
- ACE study, Adversed Childhood Experiences
- Consistent results: CAN is related to many aspects of physical and mental health
- Cumulative effect, more ACE’s → more negative consequences
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
behaviour in household.
Toelichting: ACE and disease conditions (Felitti et al., 1998)
4 ACE’s or more → more negative health outcomes. Increase risk diseases such as cancer, diabetes,
stroke etc.
ACEs are related to:
- Physical and mental health
- Social development
- Educational outcomes
- Child’s developing brain structure
- Neuroendocrine system
(Bright et al., 2016; Elmore & Crouch, 2022; Nusslock & Miller, 2016; Shonkoff et al., 2012)
3
, ARTIKEL – Hinojosa & Hinojosa , 2024 - Positive and adverse childhood experiences and mental
health outcomes of children
Positive Chidlhood Experiences (Hinojosa & Hinojosa, 2024)
- Mental health disorders
- Added ACEs: divorce, discrimination and broader violence in the household.
- National Survey of Children’s Health: sample 22.628 children, aged 6-17, parent report.
- PCE’s:
o Supportive relationships:
▪ Family communications/resilience, mentorship
o Safe, stable environment:
▪ Neighbourhood safety and support
o Opportunities for constructive social engagement
▪ Sports, other lessons/activities
Toelichting: Moderation effect of th dpositive
The outcome for the amoutn of ACES were moderated by the amount of PCE’s
If you had positive experiences, you had less negative outcomes, eventhough you had ACE’s
4
