Measuring Child Neglect in Community and Clinical Samples

1. Measuring Child Neglect in Community and Clinical Samples Glenda Kaufman Kantor, Ph.D. Funded by N.I.C.H.D. Grant # RO1MD39144-01 Grant No. 2002-JW-BX-0002 (OJJDP) Glenda.Kantor@unh.edu

2. Why Study Neglect?

3. Child Fatalities By Type Of Maltreatment, 2001 (NCANDS) 1 2 1 Does not include neglect. 2 Does not include physical abuse. Percentage U.S. Dept. of HHS, Admin. On Children, Youth, & Families, Child Maltreatment 2001 (Washington, DC: U.S. Government Printing Office, 2003).

4. Prior Child Report Measures of Neglect • Few child measures • Young children rarely source of data in instruments measuring neglect • Some measure just one or two components of neglect • Varying definitions

5. Definition of Neglect • “Neglectful behavior is behavior by a caregiver that constitutes a failure to act in ways that are presumed by the culture of a society to be necessary to meet the developmental needs of a child and which are the responsibility of a caregiver to provide.” • Straus & Kaufman Kantor, 2004

6. Challenges in Measuring Neglect • Omission • Chronicity • Causal factors separate from acts • Acts vs. Injury • Cultural Boundaries

7. Challenges in Measurement • Children’s terminology • Language development, grammar • Cultural aspects of language • Reliability • Age of child • Distractibility • Cognitive ability • Response sets • Recall bias • Desire to please

8. Central Aims of the Study • Develop a standardized instrument to measure neglect based on Child Self-Report • Describe the relationship of neglect to child behavior problems & family characteristics

9. Assessment of Child Neglect in Community and Clinical Samples:Development of the Multidimensional Neglect Scale for Child Self-Report Glenda Kaufman Kantor & Murray Straus, Family Research Lab; Carolyn Mebert, UNH, Wendy Brown, FRL, Crystal Macallum & Todd Flannery, Westat

10. Methods

11. Clinical Sample • Spurwink Child Abuse Program • Maine DHS • NH DCYF

12. Eligibility • Clinical Sample Inclusionary Criteria- 6-15 yrs old • Lived in foster care < 6 months (age 6-9) • Lived in foster care < 1 year (age 10-15) • Exclusionary Criteria • Visually impaired • Hearing impaired • No spoken language ability • Non-English speaking • Formal diagnosis of mental retardation • Deemed “not interviewable” by clinician

13. Clinical Sample N = 287 46% 6-9 years of age 54% 10-15 yrs. of age 50% female 50% male 8% non-white Community Sample N = 207 63% 6-9 years of age 37% 10-15 yrs. of age 52% female 48% male 18% non-white Sample Characteristics

14. Maltreatment Types in ClinicalSample

15. Child & Parent Characteristics • Children • 42% in clinical sample had some emotional disorder or behavioral disorder (depression, anxiety, ADHD conduct disorder) • Parents • 50% Mental illness • 19% Developmental Disability • 45% Substance Abuse Problem • 70% Domestic Violence

16. Peabody Picture Vocabulary Test (PPVT) Scores by Age and Sample p <.001

17. PPVT Standard Scores by Presenting Maltreatment Type * p < .05

18. Measures Observational Child ReportClinicianCaretaker

19. Parent-Child Interactions Within Neglectful Families • Study by Burgess & Conger (1978) highlighted that: • Neglectful parents’ behaviors were marked by extreme negativity. • Neglectful parents had fewer positive interactions with their children, gave more commands, and complied less with their children’s commands than controls. • Findings were particularly strong for mothers. • Interactions of abusive parents were different from those observed in neglectful families.

20. Parent-Child Interactions

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23. Parent-Child Interaction Scale • Developed by Farran & colleagues (1986) • 11 aspects of parenting are rated for: • Amount (frequency during time sample) • Quality (harsh vs. gentle) • Appropriateness (related to timing, age, & situation)

24. Physical involvement Verbal involvement Responsiveness Play interaction Control over child’s activities Directives Teaching Positive statements Negative statements Relationship among activities Goal setting PCIS Behaviors Rated

25. Caregiver Participants • Majority female (78%) • Ages ranged from 27- 54 (M = 34.7) • Risk factors included: • mental illness (64%) • developmental disabilities (13%) • substance abuse (42%) • domestic violence (81%) • Neglect substantiated in 70% cases

26. Results of Observational Analysis

27. Quantitative Findings: Types of Neglect • Among younger children, parents who had neglected their children in emotional & supervisory capacities interacted less, were less appropriate, & had lower quality interactions • For older children, these same interaction patterns were seen among parents who had emotionally or physically neglected their children

28. Quantitative Findings: Parent Characteristics • Less frequent, less appropriate, & lower quality interactions were observed among families in which domestic violence was present • Less frequent and less appropriate interactions were observed among parents with mental illnesses who had young children

29. Summary of Research • Observing interactions provides a better understanding of specific areas that could be targeted for interventions • Parent-Child Interaction Scale is one option for coding dyadic interactions • Important to note that the presence of risk factors does not always mean that parents are not capable of parenting their children effectively

30. Supports Other Neglect Research • Evidence for pervasive lack of involvement • Neglectful mothers of infants were withdrawn, uninvolved, initiated few activities, provided little stimulation (Crittenden & Bonvillian, 1984). • After controlling for education level, neglectful mothers were less responsive & less developmentally appropriate compared to controls (Fagan & Dore, 1993).

31. Child Self-Reports

32. ACASI • Audio enhanced version of the Computer Assisted Self-Administered Interview • Uses an audio system and touch screen to interview child • Tutorial • Scale version adapted by Age and Gender of the Child and Gender of the Primary Caretaker • Interactive program • Older Children can take Independently • Computer Game Break

33. Child Self Report Measures • Measures cognitive, emotional, supervision, and physical neglect • Includes subscales on potential areas of child endangerment: • Exposure to parental conflict & violence • Abandonment • Parental alcohol abuse • Includes subscale on child’s general feelings or Appraisals of each domain • Includes Child Self-Report Measure of Depression • Includes Social Desirability Scale

34. Emotional Neglect Sample Item Which girl is most like you? This girl’s father makes her feel better when she is sad or scared This girl’s father doesn’t make her feel better when she is sad or scared

35. Emotional Neglect Sample Item Cont. Is this…

36. Cognitive Neglect Sample Item Which girl is most like you? This girl’s mother does not talk to her about what she is learning in school This girl’s mother talks to her about what she is learning in school

37. Supervision Neglect Sample Item(age 6-9) Which boy is most like you? This boy’s mother doesn’t know where he’s playing outdoors This boy’s mother knows where he’s playing outdoors

38. Supervision Neglect Sample Item(age 10-15) Which boy is most like you? This boy’s father does not find out where he is going after school This boy’s father finds out where he is going after school

39. Physical Neglect Sample Item Which boy is most like you? This boy’s mother makes sure he takes a bath This boy’s mother does not make sure he takes a bath

40. Abandonment Sample Item Which girl is most like you? This girl’s father hasn’t left her alone for a couple of days without grown-ups This girl’s father has left her alone for a couple of days without grown-ups

41. Exposure to Violence Item Which boy is most like you? This boy sees the grown-ups in the house hitting each other This boy does not see the grown-ups in the house hitting each other

42. Exposure to Violence Item Which girl is most like you? This girl hears grown-ups in the house fighting This girl does not hear grown-ups in the house fighting

43. Exposure to Violence Item Which boy is most like you? This boy’s mother does not let other people in the house hurt him This boy’s mother lets other people in the house hurt him

44. Exposure to Violence Item Which boy is most like you? This boy sees grownups in the house throwing things This boy does not see grownups in the house throwing things

45. Depression Sample Item Which girl is most like you? Some girls are unhappy a lot of the time Other girls are pretty happy a lot of the time

46. Depression Sample Item Cont. Is this…

47. Item Child Feels Like Someone Takes Care of Him Child Has to Take Care of Parent Child Feels Like Someone Loves Him Child Feels like Someone Helps with schoolwork Child Feels Hungry a lot Picture Child Happy Face with Adult Child Pulls Covers over Parent in bed Happy Child Happy Child with Book Sad Child with Stomach Hurting Appraisal Scale

48. Social Desirability Scale • I always say please and thank you to grown-ups. • Sometimes I don’t feel like doing what my teachers want me to do. • Sometimes I feel like throwing things or breaking them. • I never talk back to my parents. • When I do something wrong, I always say I am sorry. • I sometimes feel like making fun of someone. • I always wash my hands before eating. • I sometimes feel angry when I don’t get my way. • Sometimes I argue with my parent to do something she doesn’t want me to do. • I always do what my parent tells me to do.

49. Results on Psychometric Properties of MNBS-CR

50. Reliability and Validity • Full Scale Alpha Older Children =.94 • Full Scale Alpha Young Children =.76 • Emotional Subscale - highest alphas for both young and older children