Understanding Child Abuse and Neglect -- Copyright -- Preface -- Contents -- Tribute to Ray E. Helfer, M.D. -- Summary -- CHARGE TO THE PANEL -- A DEVELOPMENTAL AND ECOLOGICAL PERSPECTIVE -- IDENTIFICATION AND DEFINITIONS -- SCOPE OF THE PROBLEM -- OVERVIEW OF ETIOLOGICAL MODELS -- Individual Ontogenic Factors -- Family Factors -- Environmental and Community Factors -- Social and Cultural Factors -- Conclusions -- PREVENTION -- Risk Factors and Pathways to Prevention -- Parental Enhancement Programs -- Community-Based Prevention Programs -- The Role of Cultural and Social Values in Prevention -- Conclusions -- CONSEQUENCES -- Issues of Stigma, Bias, and Discrimination -- Protective Factors -- Conclusions -- INTERVENTIONS AND TREATMENT -- Treatment of Child Victims -- Treatment of Adult Survivors -- Treatment for Adult and Adolescent Sex Offenders -- Family-Oriented Interventions -- Family Income and Supplemental Benefits -- Community-Based Interventions -- Medical Treatment of Child Abuse -- Child Protective Services -- Child Welfare Services -- Legal Intervention in Child Maltreatment -- Social and Cultural Interventions -- Conclusions -- HUMAN RESOURCES, INSTRUMENTATION, AND RESEARCH INFRASTRUCTURE -- The Research Community -- Methodological Issues -- Federal Funding for Research -- State Roles in Research on Child Maltreatment -- Private Foundations -- Conclusions -- ETHICAL AND LEGAL ISSUES -- Human Subjects Research Issues -- Issues Derived from Research on Children and Families -- Research on Socially Sensitive Topics -- Conclusions -- RESEARCH PRIORITIES -- The Nature and Scope of Child Maltreatment -- Understanding the Origins and Consequences of Child Maltreatment -- Improving Treatment and Preventive Interventions -- A Science Policy for Research on Child Maltreatment -- REFERENCES -- 1 Introduction.

THE IMPORTANCE OF CHILD MALTREATMENT RESEARCH -- RESEARCH ON CHILD MALTREATMENT IS CURRENTLY UNDERVALUED AND UNDEVELOPED -- DIMENSIONS OF CHILD ABUSE AND NEGLECT -- THE COMPLEXITY OF CHILD MALTREATMENT -- Selection of Research Studies -- A Comparison With Other Fields of Family and Child Research -- CHARGE TO THE PANEL -- THE IMPORTANCE OF A CHILD-ORIENTED FRAMEWORK -- AN ECOLOGICAL DEVELOPMENTAL PERSPECTIVE -- PREVIOUS REPORTS -- REPORT OVERVIEW -- NOTE -- REFERENCES -- 2 Identification and Definitions -- REVIEW OF DEFINITIONS -- PRINCIPLES UNDERLYING RESEARCH DEFINITIONS -- SPECIFIC DEFINITIONAL ISSUES -- Endangerment Versus Demonstrable Harm -- Severity of Acts -- Frequency of Acts -- Class of Potential Perpetrators -- Intent to Harm and Culpability of the Perpetrator -- Developmental Level -- Culturally Informed Definitions -- IDENTIFICATION OF CHILD MALTREATMENT -- Detection in Medical Settings -- Reports to Child Protection Agencies -- RESEARCH RECOMMENDATIONS -- NOTES -- REFERENCES -- 3 Scope of the Problem -- CURRENT ESTIMATES -- Governmental Case Report Surveys -- National Studies -- National Incidence Studies -- National Child Abuse and Neglect Data System -- Private Sector Studies Using Case Reports -- Population Surveys -- Physical Abuse -- Sexual Abuse -- Prevalence of Abuse and Neglect in Disabled Children -- International Comparisons -- METHODOLOGICAL ISSUES -- Definitional Issues -- Unreported Abuse -- Confusion of Prevalence and Incidence -- Use of Administrative Data -- Rate of Occurrence Versus Rate of Reporting -- Sampling and Design Issues -- Measurement -- Effect of Mandatory Reporting -- CONCLUSIONS -- RESEARCH RECOMMENDATIONS -- NOTES -- REFERENCES -- 4 Etiology of Child Maltreatment -- OVERVIEW OF ETIOLOGICAL MODELS -- INDIVIDUAL ONTOGENIC FACTORS -- Adult Personality Characteristics -- Physical Abuse -- Neglect.

Sexual Abuse -- Emotional Maltreatment -- Summary -- Adult Attitudes, Attributions, and Cognition -- Intergenerational Transmission of Abusive Parenting -- Alcohol and Drugs -- Biology and Child Maltreatment -- Demographic Factors -- Child Characteristics -- THE FAMILY MICROSYSTEM -- Family Functioning in Maltreating Families -- Parenting Styles -- Physical Discipline -- Stressful Life Events and Child Maltreatment -- Summary -- THE EXOSYSTEM -- Family Income/Poverty -- Unemployment -- Neighborhood Impact -- Summary -- THE MACROSYSTEM -- Cultural and Social Values -- Pornographic Materials -- SUMMARY OF ETIOLOGICAL FACTORS -- RESEARCH RECOMMENDATIONS -- NOTES -- REFERENCES -- 5 Prevention -- OVERVIEW -- Risk Factors and Preventive Interventions -- Summary -- THE FAMILY MICROSYSTEM -- Pathways to Parental Practices -- Prevention Programs for Families with Young Children -- Comprehensive Home Visitation Programs -- Center-based Programs -- Community-based Programs -- Hospital-based Interventions -- Summary -- THE EXOSYSTEM -- The Role of the States and Child Abuse Prevention Challenge Grants -- School-Based Sexual Abuse Prevention Programs -- Other Community-based Prevention Programs -- Antipoverty and Vocational Training Programs -- Educator and Child Care Staff Training -- Violence Prevention in the Schools -- Clergy and Religious Institutions -- Media Roles -- Bystander's Responses -- Summary -- THE MACROSYSTEM -- Corporal Punishment -- Use of Criminal Sanctions -- CONCLUSIONS -- RESEARCH RECOMMENDATIONS -- NOTES -- REFERENCES -- 6 Consequences of Child Abuse and Neglect -- CHILDHOOD -- Medical and Physiological Consequences -- Cognitive and Intellectual Consequences -- Psychosocial Consequences -- Behavioral Consequences -- Effects of Witnessing Domestic Violence -- ADOLESCENCE -- Delinquency -- Violence -- Becoming a Runaway.

Intimacy, Sexual Problems, and Teenage Pregnancy -- Alcohol Problems -- Illicit Drug Use or Abuse -- Self-Destructive Behavior, Depression, and Suicide Attempts -- Summary -- ADULTHOOD -- Intergenerational Cycles of Abuse -- Long-term Consequences of Child Maltreatment -- ISSUES OF STIGMA, BIAS, AND DISCRIMINATION -- INTERACTION OF RISK AND PROTECTIVE FACTORS -- Intelligence -- Temperament -- Cognitive Appraisal of Events -- Relationship with a Significant Person -- Placement Experiences and Foster Care -- Summary -- RESEARCH RECOMMENDATIONS -- NOTES -- REFERENCES -- 7 Interventions and Treatment -- TREATMENT EFFORTS AT THE INDIVIDUAL LEVEL -- Treatment of Child Victims -- Treatment of Adult Survivors -- Treatment for Adult Sex Offenders -- Adolescent Sex Offenders -- Self-Help Services for Abusive Adults -- MICROSYSTEM APPROACHES: FAMILY-ORIENTED INTERVENTIONS -- Parental Enhancement -- Family Systems Treatment -- Home-Based Services and Family Preservation Services -- Family Income and Supplemental Benefits -- COMMUNITY EXOSYSTEM INTERVENTIONS -- Medical Treatment of Child Abuse -- Child Protective Services -- Intake and Assessment -- Investigation and Substantiation -- Case Management and Referrals -- Child Welfare Services -- Foster Care -- Criteria Regarding Out-of-Home Placement Decisions -- Treatment for Children in Foster Care -- Legal Intervention in Child Maltreatment -- SOCIAL/MACROSYSTEM INTERVENTIONS -- CONCLUSIONS -- RESEARCH RECOMMENDATIONS -- NOTES -- REFERENCES -- 8 Human Resources, Instrumentation, and Research Infrastructure -- THE RESEARCH COMMUNITY -- TRAINING ISSUES -- INSTRUMENTATION ISSUES -- INFORMATION SERVICES -- FEDERAL FUNDING FOR RESEARCH ON CHILD MALTREATMENT -- U.S. Department of Health and Human Services -- Administration on Children, Youth, and Families -- Public Health Service -- Department of Justice.

Office of Juvenile Justice and Delinquency Prevention (OJJDP) -- National Institute of Justice -- Other Federal Departments -- STATE ROLES IN RESEARCH ON CHILD MALTREATMENT -- PRIVATE FOUNDATIONS -- CONCLUSIONS -- RESEARCH RECOMMENDATIONS -- Human Resources -- Training Programs -- Research Infrastructure -- NOTES -- REFERENCES -- 9 Ethical and Legal Issues in Child Maltreatment Research -- FRAMEWORK OF ANALYSIS -- ISSUES IN RESEARCH ON HUMAN SUBJECTS -- ETHICAL ISSUES IN CHILD MALTREATMENT RESEARCH -- Recruitment of Subjects -- Informed Consent and Deception -- Assignment of Research Subjects -- Privacy, Confidentiality, and Autonomy -- Debriefing -- RESEARCH ON CHILDREN AND FAMILIES -- The Importance of Validity -- Dissemination of Research Results -- RESEARCH ON SOCIALLY SENSITIVE TOPICS -- CONCLUSIONS -- RESEARCH RECOMMENDATIONS -- NOTES -- REFERENCES -- 10 Priorities for Child Maltreatment Research -- THE NATURE AND SCOPE OF CHILD MALTREATMENT -- UNDERSTANDING THE ORIGINS AND CONSEQUENCES OF CHILD MALTREATMENT -- IMPROVING TREATMENT AND PREVENTIVE INTERVENTIONS -- A SCIENCE POLICY FOR RESEARCH ON CHILD MALTREATMENT -- Appendixes -- A Panel Activities -- Survey Respondents -- B Supplementary Views -- C Biographical Sketches -- Index.