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Research demonstrates that relationships are key when working to support young people affected by sexual violence. Within these relationships, young people show a preference for non‐judgemental, flexible, consistent and informal support. Peer support – defined here as support provided by those with similar experiences – is however an uncharted area for assisting young people affected by sexual violence. This paper draws on interviews with 25 respondents with knowledge and experience of setting up, supervising and/or participating in peer support initiatives for young people impacted by different forms of sexual violence in Europe and North America. The article highlights how one form of peer support, peer or 'survivor' mentoring, can provide emotional and social support; create space for 'normality'; and give choices to young people. It outlines three unique dimensions to the support provided by peers more generally: relatability, credibility and translatability. The discussion reflects on what this might mean for traditional support provided by professionals. It also draws attention to the significance of recognising both the variety of experience and identity of young survivors of sexual trauma and the impact this may have on promoting relatability within relationships. [ABSTRACT FROM AUTHOR]

Parental substance misuse is a significant child welfare issue and associated with increased risk of child maltreatment. The aim of the present study was to understand what social care outcomes children who live with parental substance misuse have, and to assess factors associated with those social care outcomes over a two‐year period. The paper reports on a retrospective longitudinal study of 299 children all living with parental substance misuse and referred to one local authority in England. Data were collected from children's social work case files about procedural social care outcomes and factors which may be associated with those outcomes. Using cluster analysis, a new typology of children's longitudinal trajectories through the children's social care system was developed, consisting of five distinct types. Analysis indicated that some children received too little intervention from children's social care despite ongoing concerns, while other children were potentially unnecessarily caught up in the social care system. Factors associated with children having the poorest outcomes were: caregiver instability resulting from substance misuse, parenting capacity and household instability. The study's findings indicate that some children who live with parental substance misuse are at significant risk of harm, but others are not and may be better supported through non‐statutory services such as early help. [ABSTRACT FROM AUTHOR]

Child abuse and neglect is a complex problem that needs to be addressed through a multidisciplinary approach. Nurses internationally have frequent contact with children and are ideally placed to respond to children experiencing abuse and neglect. Nurses' roles can include reporting abuse to child protection services (CPS). This paper reports on one aspect of the findings of a qualitative study exploring Australian nurses' perceptions and experiences of keeping children safe from abuse. Specifically, this paper reports on the theme relating to nurses' experiences of communicating their concerns to CPS and the family when reporting abuse and neglect. This qualitative study was underpinned by social constructionism, with data collected through semi‐structured interviews with 21 nurses working with children in Australia. Key findings reported are: (1) being heard; (2) [feeling] disappointed, discouraged and disenfranchised; and (3) managing tensions between engagement and reporting. Nurses at times perceived that they were not taken seriously by CPS and felt powerless to enact change for children. Nurses subsequently had to decide how, and if, to discuss their report with families to mitigate negative reactions and maintain engagement. This study highlights the need for more effective multidisciplinary collaboration between nurses and CPS to promote change for children affected by abuse in Australia. 'This paper reports on... nurses' experiences of communicating their concerns to CPS and the family' Key Practitioner Messages: Nurses often perceived that they were not taken seriously by CPS and felt powerless to make a difference for children.Nurses experienced a tension between openly discussing their intention to report with families and minimising negative reactions such as disengagement and mistrust.This study highlights the need for greater collaboration between CPS and nurses to promote shared understanding and effective action to promote the wellbeing of children experiencing abuse and neglect. [ABSTRACT FROM AUTHOR]

Family and extended kinship systems which nurture healthy, happy children are central to Aboriginal and Torres Strait Islander cultures. Since colonisation, Aboriginal and Torres Strait Islander communities have been impacted by intergenerational cycles of trauma, stemming from colonial violence, genocidal policies and discrimination, including the forced removal of children from their families. Becoming a parent offers a unique life‐course opportunity for trauma recovery and preventing intergenerational trauma. However, identifying or 'recognising' complex trauma carries significant risk of harm for Aboriginal and Torres Strait Islander parents due to reactive prenatal child protection involvement potentially compounding experiences of trauma, and limited benefits due to lack of culturally appropriate support. The Aboriginal‐led participatory Healing the Past by Nurturing the Future project aims to co‐design safe, accessible and feasible perinatal awareness, recognition, assessment and support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. This paper presents views of 38 workshop participants to determine prerequisites for ensuring benefits outweigh risks of assessment to safely recognise parents experiencing complex trauma, consistent with screening criteria. Six essential elements were identified from thematic analysis: high‐quality holistic care; cultural, social and emotional safety; empowerment, choice and control; flexible person‐centred approaches; trusting relationships; and sensitive, skilled communication. Key Practitioner Messages: The impacts of colonisation and rates of Aboriginal and Torres Strait children in out‐of‐home care mean that there can be a myriad of issues facing Aboriginal and Torres Strait Islander parents with regard to perinatal child protection involvement.The benefits must outweigh the risks of identifying parents experiencing complex trauma.Assessment must be offered within foundations of supportive relationships and holistic care in culturally‐safe, empowering settings, where choices are respected and skilled communication approaches are used. [ABSTRACT FROM AUTHOR]

In this paper, we report findings from a qualitative, multidisciplinary analysis of 20 Child Practice Reviews (CPRs) (previously Serious Case Review) in Wales. The reviews were analysed from three different disciplinary perspectives: law, criminology and practice (social work). The following cross‐cutting themes were identified from our coding of the reviews: (i) hierarchy of knowledge, where certain sources of knowledge were privileged over others; (ii) information sharing/recording, where deficiencies of sharing or recording of information were evident; (iii) partial assessment, where certain assessments were not always holistic; and lastly, (iv) voice of the child, where the experience or perspective of the child was not always considered. In addition, our analysis revealed a range of challenges to the CPR process as implemented. This paper is the first to explore themes emerging from (Welsh) CPRs and is also the first to do so from a multidisciplinary perspective. We conclude by highlighting the recommendations for practice, such as the need for greater learning pan‐Wales, regular publication of the major themes emerging from CPRs and the need for deposit of CPRs in a central repository to facilitate learning from reviews. 'Report[s] findings from a qualitative, multidisciplinary analysis of 20 Child Practice Reviews... in Wales' Key Practitioner Messages: There is an urgent need for multidisciplinary training on contemporary data protection requirements as per the General Data Protection Regulation for all safeguarding boards.Creative methods are required to disseminate the messages from Child Practice Reviews more widely.Child Practice Reviews should be deposited and indexed in a central repository to facilitate learning across Wales.Guidance and training for Child Practice Reviews should be revisited, so that the child is repositioned at the centre of the process and the voice of the child is heard. [ABSTRACT FROM AUTHOR]

This paper presents selected findings from a research-based evaluation of a men's domestic violence intervention programme, which aims to assist men to develop alternative ways of relating to their partners, children and others. The qualitative component of this evaluation involved conducting interviews with 21 group participants after their completion of the course. These interviews investigated several issues, including participants' perceptions of their relationships with their children. The main theme underpinning all discussions of children was an expression of love, in that love for their children served as a motivation to stop using violence and to develop alternative ways of relating to all family members. The paper concludes by discussing the potential of men's relationships with their children as powerful contexts, or points of leverage, through which the impact of their violent behaviour can be realised and confronted. By realising the impact that violent behaviour can have on children's wellbeing and fathers' interpersonal relationships with them, it is argued that intervention programmes can support men to develop more appropriate ways of relating to their children, and thus safeguard children from potential long-term consequences of domestic abuse. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Men attending domestic violence intervention programmes demonstrate a wide range of attitudes towards their partners and former partners, but unanimously report a desire to maintain meaningful relationships with their children., Men who have used violence in their family relationships can be challenged and motivated to change through realising the impact of their behaviour on their children's wellbeing and their father-child relationships. [ABSTRACT FROM AUTHOR]

As a parent of their own children, balancing home and work for child protection workers (CPWs) can be difficult. This may contribute to the sustainability of the CPW role for those workers who are also parents, and to the complexity of establishing viable child protection services (CPSs). This paper explores CPWs experiences of being both a parent and a CPW. Findings, drawn from a larger case study which aimed to investigate CPW work practices and the challenges caused by them for workers, will be used to explicate this issue for workers and the organisation. Fifteen CPWs employed by a busy, moderate- to high-risk CPS participated in the larger case study with 14 participants undertaking qualitative semi-structured, open-ended interviews. Data pertaining to the dual roles of being a parent and a CPW were categorised into categories, minor categories and sub-categories. The two sub categories represented in this paper are: 'CPWs: Life as a Parent' and 'CPWs: Parent as a Worker'. Being a parent and a CPW impacted on both professional practices and personal parenting experiences. Strategies by the organisation that supported parent workers in maintaining family-work balance assisted CPWs to be able to maintain stability in their role. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Messages Balancing child protection roles with parenting roles is difficult., CPW roles impact on parenting and parenting roles impact on child protection work., Family-friendly workplace policy for CPWs is required to benefit CPW health and promote sustainability in this role. [ABSTRACT FROM AUTHOR]

This paper reports on the evaluation of an integrated violence and abuse prevention programme for children aged 5–11, focusing on children with special educational needs and disabilities (SEND). The Speak Out Stay Safe (SOSS) programme was delivered in mainstream primary schools across the UK. A small‐scale study of children with SEND nested within the larger evaluation captured their understandings of abuse and harm and readiness to seek help. A specially adapted survey was completed by 76 children with SEND (aged 6–7 and 9–10) at baseline (31 intervention; 45 comparison schools), 12 in intervention schools post‐programme and 37 (four intervention; 33 comparison schools) six months post‐baseline. Qualitative data was captured through 16 teacher interviews. Whilst this nested study was compromised by the COVID‐19 pandemic, it provides important evidence that with appropriate adaptations, a survey approach to investigating the learning of children with SEND can be effective. Findings indicate that awareness of abuse and help seeking strategies may improve over time, whilst interview data suggests that adapting the programme to be inclusive of those children may have a better effect. However, a much larger sample of children with SEND is required to confidently measure the effects of such programmes for this population. [ABSTRACT FROM AUTHOR]

One important cause of retinal haemorrhages (RHs) in children is abusive head trauma (AHT). Our programme of research was conducted on children admitted to hospital over a seven‐year period who had RHs as part of their clinical presentation. This paper summarises important findings from previous publications. As a prerequisite, two basic studies were necessary: (i) a method of reporting the precise location of the RH in the retina; and (ii) defining a simple clinical classification of RHs based on the appearance of the retinal layer involved. Because raised intracranial pressure (RICP) is a frequent secondary brain insult following serious adult head injury, causing hypoxic‐ischaemic injury with a resultant poor outcome, it was considered whether such RICP might also cause RHs in children. Detailed, state‐of‐the‐art monitoring methods were used to investigate this relationship along with retinal imaging. Methodical documentation of the type, area and lifespan of RHs meant that it was possible to address the question of predicting AHT from RH numbers and characteristics, and to describe not only the duration of different layer haemorrhages, but also a previously unreported observation that some RHs transiently enlarge over two to three days before resolving normally. 'One important cause of retinal haemorrhages (RHs) in children is abusive head trauma' Key Practitioner Messages: A new retinal zone classification for research and legal purposes has been developed, as well as a simplified five‐point working classification of RHs, based on existing fundoscopic descriptions.In this cohort study, a young age and a high 'dot‐blot' count (>25 intraretinal haemorrhages) are strong predictors of AHT.There is a complex association between the burden of intracranial pressure insult and RHs.Time to resolution of different RHs has been calculated using two‐dimensional RH area pixel counts from sequential retinal imaging. Two patterns of resolution are reported. [ABSTRACT FROM AUTHOR]

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Child homicides are rare occurrences, but when they occur, they often cause significant outrage. This paper examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases. Focusing on 533 cases of child homicide between 1985 and 2012 in Ontario, Canada, characteristics of intrafamilial and extrafamilial cases, biological and step/foster parents, and maternal and paternal perpetrators are compared. Results show that characteristics of the child homicide vary depending on the degree of intimacy between victims and perpetrators, including: perpetrator and victim age, weapon use, suicide following the offence, sexual violence and use of excessive force. These findings provide support for developmental victimology and a routine activities theoretical perspective. Suggestions for future research and policy implications are also discussed. 'Examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases' Key Practitioner Messages: Younger children are at a greater risk of homicide from family members, while older children are at a greater risk of homicide from individuals outside the family.Developmental victimology and routine activities theory can contribute to a better understanding of the dynamics between victims and perpetrators in child homicide.Collaboration should take place between researchers, child death review committees, mental health services, social services and policymakers to improve child homicide prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

This paper draws on three studies conducted in Australia, Canada and Ireland which explore the factors influencing research utilisation in the child protection sector in each country. The paper recognises that research uptake is complicated by a number of factors. It also acknowledges critiques which cite the equally significant influence of ideologies, context, unpredictability, time constraints and political expediency. However, all three studies recognised the increasing importance of evidence-based practice. The methods used in the three studies were not identical but the frameworks used were sufficiently similar to enable the classification of both common and dissimilar barriers and facilitators to research use. Those which they identified were categorised into four types: individual, organisational, environmental and characteristics relating to the nature of research material. Implications were identified for policy makers, service providers and research producers. The point was made that we now live in a period where unprecedented means of knowledge transfer and exchange provide unique opportunities to improve the lives of children and families. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Avail of opportunities to attend learning events., Draw on research findings when conducting assessments, writing reports, devising intervention plans, evaluating programmes and tendering for funding., Establish links with research centres., Become involved in the conduct of research., Support colleagues (champions) who display particular interest and motivation in the use of research evidence by recognising and/or rewarding effort., Avail of opportunities to undertake further study that includes a research component. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a research study aimed at assessing the reliability and validity of an Arabic version of the Child Abuse Potential Inventory (CAPI) in Muscat, the capital of Oman. The research was carried out among a population of women attending antenatal care clinics (N = 309) and reports on the prevalence of high scores and assessment of reliability and validity of the Arabic CAPI. A sub‐sample of mothers were interviewed to explore their views about the acceptability of the tool locally. The mean score of the Abuse Scale was 159.6 (range 26–390), which was higher than the US version (mean = 91). Internal consistency (Cronbach's α = 0.911) and test–retest reliability (Pearson's r = 0.89; two‐tailed p 0.00) were both high. With regard to the construct validity, the six‐factor structure of the original version was not replicated; only three factors were obtained. The interview data showed that the CAPI was easy to complete and appropriate for use in Oman. The Arabic version of the CAPI showed a highly satisfactory internal consistency and test–retest reliability. This suggests that the Arabic version of the CAPI is a valid and reliable tool to use to assess potential for child physical abuse within Oman. These results are in concordance with other cross‐cultural versions of the CAPI. 'Reports on the prevalence of high scores and assessment of reliability and validity of the Arabic CAPI' Key Practitioner Messages: This research reports a first attempt to assess the psychometric properties of an Arabic version of the CAPI and use it among an Arab Muslim population.The results indicated that the tool is culturally acceptable and appropriate within this context, that mothers are able to complete it, and that it was stable over time.The distribution of CAPI scores showed a higher mean score and a greater proportion of mothers scoring above the original cut‐off score. [ABSTRACT FROM AUTHOR]

This paper explores a retrospective analysis of children's file data as a research method of gathering information on children's experiences of informal disclosure of child sexual abuse. This study extracted data from files where children were seen for a child sexual abuse evaluation in Ireland and the children were deemed to have given a credible account of abuse by the professionals concerned. A content analysis was conducted using themes identified in previously published research, based on direct interviews with children about their experiences of informal disclosure. The paper discusses the relative merits and limitations of this method, through reporting on the findings of the file analysis and comparing these findings with findings obtained from a smaller sub-sample of this sample of children, who were interviewed about their experiences of disclosure. It is suggested that this method is worth exploring with a larger sample size which would enable statistical analysis and thus explore the predictive factors influencing early informal disclosure. Frontline services can contribute to the knowledge base on what helps children tell through service-based research that uses data already collected from evaluation interviews with children, thus eliminating the need to interview children for research purposes. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Frontline professionals gather useful data on a daily basis on informal disclosures of child sexual abuse., Practitioners can contribute to the knowledge base on informal disclosure by systematically gathering information from service users., We need more information on what helps children tell. We therefore need to explore innovative methods of gathering such information directly from children in ways that do not rely on interviewing children repeatedly yet include the child's voice. [ABSTRACT FROM AUTHOR]

This paper presents the implications and findings of a longitudinal evaluation of a UK charity's network of therapeutic projects for their effectiveness in improving child outcomes following child sexual abuse. Eight intervention projects across England and Wales participated in this one group pre- and post-test evaluation leading to a final sample of 42 children. We collected qualitative and quantitative data via the individual projects. These data included responses from the children's parents, the therapists and from the children themselves. The findings of this evaluation indicate improvements in the children's outcomes in some domains but persistence of problems in others. No deterioration was observed. We conclude the article by addressing the strengths and limitations of the evaluation and suggesting recommendations for future practitioner-researcher collaborations. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Messages This paper presents findings from a longitudinal evaluation of a UK charity's network of therapeutic projects for their effectiveness in improving child outcomes following child sexual abuse., Eight intervention projects nationally participated leading to a final sample of 42 children. Children included in this evaluation showed improvement on most measures but the strength of the findings is limited by the lack of comparison group and the number of children and young people recruited. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have been associated with negative mental and physical health consequences. Neighbourhood police officers (NPOs) are thought to be well placed to identify and support children experiencing ACEs. Within this paper, we describe a qualitative exploration of an initiative deployed by a large UK police force which aimed to aid early identification of young people with ACEs using police data and provide subsequent support given by NPOs. A thematic analysis was conducted using transcripts from three focus groups of NPOs, supplemented by questionnaires. Key themes identified in both sets of data offer reflections for policing and other public service provision seeking to target on the basis of ACEs, including: limitations in the usefulness of police data to identify childhood adversity; challenges using the ACEs framework as a means to target such 'early intervention'; and debates regarding the appropriate role of the police in supporting young people in adversity. Prior to replication of this intervention elsewhere, there are several points to consider: whether police data alone are sufficient in identifying ACEs; ensuring clarity regarding the role of the public sector agencies in such intervention; and determining an apt measure of success for the scheme. Key practitioner messages: Modelling using only police data can provide insight into the population of children who may have suffered from ACEs but may not provide significant opportunities for early interventionThere is a clear need for defining the role of UK police forces in the delivery of early interventionIt is evident that multi‐agency working/data sharing is crucial to preventing the duplication of referrals and interventions conducted with young people who have experienced ACEs 'There is a clear need for defining the role of UK police forces in the delivery of early intervention' [ABSTRACT FROM AUTHOR]

This study set out to answer the research question: 'What are the similarities and differences in the nature of abuse, patterns of disclosure and characteristics of the perpetrator between boys and girls attending a sexual assault referral centre (SARC) for a forensic medical examination?' Retrospective data collection was undertaken from paper case files of 986 service users (142 boys, 844 girls) who attended Saint Mary's SARC for a forensic medical examination (April 2012–March 2015). Demographic data as well as information on the context of the abuse were coded into a standardised digital format. Cross‐tabulation and Pearson's chi‐squared tests were performed to compare the abuse experienced and how abuse was disclosed by children of different genders and ages. Older children accounted for 20 per cent of the boys and 56 per cent of the girls. A higher proportion of girls attended the SARC after a single abusive episode; the abuse of boys was more frequently reported by a parental figure; and boys' abuse was reported later. Younger children were more likely to be abused in the family environment. Younger girls were more likely to experience abuse by a single perpetrator, whereas all boys reported multiple perpetrators. These findings suggest that the relationship between child sexual abuse (CSA) and gender is a complicated and nuanced one. 'What are the similarities and differences in the nature of abuse, patterns of disclosure and characteristics of the perpetrator between boys and girls attending a sexual assault referral centre (SARC) for a forensic medical examination?' Key Practitioner Messages: Some gender differences in CSA may be due to professionals' perceptions. It is important to remain mindful that boys may present differently to girls.Care should be taken when interpreting these results. The majority of CSA is not disclosed nor identified. Where it is, few children receive a forensic medical examination. Practitioners need to be alert to this to safeguard children adequately.Future research can pursue how identified differences affect boys and girls, thereby enabling better support or protection for children. [ABSTRACT FROM AUTHOR]

This paper explores the experience of post-separation fathering, in the context of a prior history of domestic abuse from the perspectives of mothers, fathers, children and professionals participating in a three-year doctoral research project. A mixed methodological research design conducted over two phases involved both the completion of survey questionnaires by 219 mothers and the participation in focus groups and individual interviews by children and young people, mothers, fathers and professionals. The findings highlight clear evidence of post-separation contact facilitating the continued abuse of women and children. The findings also highlight a lack of attention to the parenting of abusive men who were identified as struggling to realise their fathering aspirations and take responsibility for the impact of their abusive behaviour on their children and ex-partners. Particular constructions of family life are found to sustain the often unmonitored presence of abusive men in post-separation family life. This paper concludes by asserting the need to prioritise the construction of fathers as 'risk' in the context of post-separation father-child contact. Doing so does not mean excluding fathers from children's lives; rather, what is critical is to find ways to ensure that abusive men can be 'good enough' fathers. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Separation is not a 'vaccine against domestic violence', with women and children at risk of continued abuse in the post-separation period., Abusive men need to be held responsible for their abusive behaviour before the potential for safe contact can be considered., All of the key players - mothers, children and fathers - may need support from the impact that domestic violence has on parenting capacity and family life. [ABSTRACT FROM AUTHOR]

A comprehensive Child Death Review programme commenced in England in 2008; police, healthcare and social care professionals now work together, using a joint agency approach (JAA) to investigate unexpected child deaths. The aim of this paper is to explore professionals' experiences of the JAA investigation of sudden unexpected death in infancy (SUDI). This was part of a mixed‐methods study evaluating the JAA investigation of SUDI. Professionals participated in qualitative interviews and case notes were scrutinised. Data were analysed using a framework approach. A total of 23 of a possible 113 eligible SUDI cases were recruited. Twenty‐six professionals involved in investigating 12 of the 23 SUDI cases were interviewed giving theoretical saturation of data. The overarching theme was the conflict between the need to investigate deaths while remaining sensitive to families. Other themes were working together, supporting parents, and the benefits and difficulties of joint working practices. All professionals were positive about the JAA, especially joint police and paediatric interviews and home visits. The difficulties included non‐engagement by social care and poor liaison with coroners. The JAA seems to be a thorough investigative process but could be improved by closer joint agency working and information sharing, and more support and training for professionals. © 2018 John Wiley & Sons, Ltd. Key Practitioner Messages: Joint agency investigation of unexpected infant deaths enables a detailed understanding of the causes of death and the provision of support to families.Joint home visits by police and paediatricians following unexpected infant deaths provide more detailed information and can be more sensitive to families than police death scene examination alone.Prompt information sharing across all agencies is a key part of effective investigation of unexpected infant deaths. 'Explore[s] professionals' experiences of the joint agency approach investigation of sudden unexpected death in infancy' [ABSTRACT FROM AUTHOR]

Parental substance misuse has a pervasive impact on family functioning, parenting, and, ultimately, child wellbeing and development. Subsequently, linkages with informal and formal support networks are crucial for ameliorating risk. To facilitate engagement with these families prior to identification in child protection systems, it is vital to understand the factors inhibiting and promoting engagement with informal and formal support. This paper examines how different factors influence informal and formal help‐seeking by alcohol‐misusing parents with regard to parenting and family concerns. Parents reporting alcohol problems in a clinical range (n = 322) were drawn from a representative parent sample (n = 1991). Alcohol‐misusing parents reported low help‐seeking for parenting‐focused support services. The findings particularly highlight the role of age, education, socioeconomic status, ethnicity, parenting stress, empowerment and trust in support services for predicting parents' help‐seeking. 'Examines how different factors influence informal and formal help‐seeking by alcohol‐misusing parents with regard to parenting and family concerns' Key Practitioner Messages: The role of practitioners working in family welfare and child protection services in identifying and facilitating support for alcohol-misusing families is described.Parenting‐focused support services need to be promoted, especially for vulnerable parent populations.Education of service providers along with the wider community is required to foster and increase trust and support uptake before alcohol-misusing families become involved with statutory systems. [ABSTRACT FROM AUTHOR]

Internationally, there are few studies that have trialled structured intervention programmes designed to prevent excessive weight gain or combat existing overweight/obesity for young people living in out-of-home care. The Healthy Eating, Active Living (HEAL) programme was designed to address this limitation and is, to our knowledge, the first programme that simultaneously encourages young people and their carers to engage in a healthy lifestyle. This is the second of two papers presenting the HEAL evaluation. The aim of this study was twofold: first, to explore the experiences and opinions of key stakeholders regarding the intervention programme; and second, to understand the key enablers and barriers to successful implementation of the HEAL programme in residential care. Seventeen carers and ten programme coordinators participated in semi-structured interviews. Findings demonstrated that HEAL was considered a valuable adjunct to the residential care programme, and was successful in raising awareness about the importance of leading a healthy lifestyle. Positive behaviour change among the young people and carers' dietary, physical activity and sleeping habits, and the development of independent living skills were described. Barriers to implementation included leadership support and professional development of carers. Recommendations are made to improve implementation, particularly around the importance of increasing stakeholder 'buy-in'. [ABSTRACT FROM AUTHOR]

Assessment where there are concerns that an unborn child is likely to suffer significant harm is one of the most difficult tasks that social workers undertake; the legal and ethical context makes the process of assessment and intervention during this period complex. This paper explores pre-birth assessment guidance and practice in England. Local safeguarding guidance in 147 English localities was accessed and analysed, and interviews were conducted with 22 practitioners involved in pre-birth assessments. The findings showed that while most local safeguarding guidance was more detailed and explicit than the national guidance, legal and ethical issues were rarely addressed. Interview data showed that, in general, guidance to support social work assessments during the pre-birth period was insufficient, and that few practitioners used standardised tools to aid assessment. Some practitioners regarded pre-birth assessments as less urgent than cases involving infants/older children, thereby increasing delays in decision-making. It is concluded that existing guidance and practice with regard to pre-birth assessment are inadequate. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: There is a well‐established link between animal‐ and human‐directed violence.Reports of animal abuse in child protection referrals may indicate more severe cases of child abuse.Cross‐reporting of abuse is important, both in the context of child protection and animal welfare. 'There is a well‐established link between animal‐ and human‐directed violence' [ABSTRACT FROM AUTHOR]

Do all newly qualified primary-level teachers report the same experience of child protection practices in their schools? Drawing on findings from a recent Irish study, this paper will consider the operation of official child protection guidelines in schools based on the reported awareness and knowledge of a sample of newly qualified teachers. Their knowledge of child protection guidelines pertains to experience of induction into child protection practices upon taking up employment in the school and their awareness of a designated liaison person, school child protection policy and the procedures for reporting a suspected child protection issue within the school. The findings of this research indicate that schools' compliance with national guidelines on child protection is certainly inconsistent and such an ad hoc approach can be seen to impact on the perceived confidence levels of newly qualified teachers in dealing with child protection issues in the school. Given the crucial role teachers play in the safeguarding of children and the potential for strengthening this role, this paper argues for the standardisation of the operation of child protection procedures across all schools and the provision of training for all school staff. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message There is a clear need for enhanced, standardised pre-service and in-school child protection training., New entrants to the teaching profession should automatically be inducted into the school child protection policy., Schools should have clearly articulated child protection policies and action plans which are consistently communicated to staff on a regular basis., The potential for teachers to promote child welfare and protection should be acknowledged and realised. [ABSTRACT FROM AUTHOR]

This paper compares how frontline staff in four national child welfare systems and policy contexts - Finland, Norway, England and the USA (specifically, California) - respond to questions about a scenario of possible harm to children. The countries have different child welfare systems that we anticipated would be reflected in the workers' responses ( n = 1027). The analysis shows differences and similarities between the systems, although often not in line with system expectations. There is also variation within the country samples. The study shows the complex interactions of individual and agency characteristics in addition to the role of proceduralised decision-making systems and professional discretion. Key Practitioner Messages Professional discretion differs., Proceduralised and high threshold systems result in less variation between workers' responses., System categories do not seem to capture the nuances of frontline decision-making. [ABSTRACT FROM AUTHOR]

Many children are exposed to intimate partner violence against their mothers. Countering assumptions that abused women 'fail to protect' their children, this paper presents the results of a Canadian qualitative study that examined the protective strategies of 18 abused mothers, most of whom are Aboriginal. Half of these women were living in a large city and half were living in remote, northern communities. Despite geographic location, abused mothers engage in acts and behaviours to not only protect their children from immediate physical violence but also to mitigate the potential emotional harms of exposure to violence and to prevent their children from continuing the violence in their own future relationships. Relying on informal supports, such as family, was especially important for mothers living in northern, remote communities, and is not surprising given the few services available. Professionals must be aware of the range of strategies and approaches that mothers use, including those that do not involve formal systems (i.e. the police or shelter). Focusing on their strengths and protective capacities will help to empower abused mothers and limit unnecessary, inappropriate, or intrusive interventions. Recognising mothers' capacities will also lead to better outcomes for children, who fare best when their mothers are appropriately supported. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Abused mothers engage in acts and behaviours to protect their children from the harms of exposure to violence, and these may differ for mothers living in remote, isolated communities., Mothers' protective acts extend beyond calling the police or going to shelter, and include informal supports., Professionals must inquire about mothers' protective strategies and incorporate into case plans., Professionals must support abused mothers so that they can help strengthen the mother-child relationship and help children recover from violence. [ABSTRACT FROM AUTHOR]

Bruises in suspected abuse are routinely measured for clinical and forensic purposes. We aimed to determine the consistency of electronic and manual bruise measurements. Over two sessions, 45 observers recorded the greatest lengths of eight bruises in cross-polarised images. Observers were presented with six images in each session; four were common to both sessions. Manual measurements were achieved using a paper tape-measure on hard-copy images; electronic measurements used ImageJ software for digital on-screen images. Differences in mean measurements between methods were tested using paired t-tests; within- and between-observer variations were computed. On average, manual measurements were smaller than electronic measurements. Observers were prone to rounding bias in manual measurements. Overall standard deviations of measurements (0.39-0.63cm) did not differ greatly between methods. Measuring electronically, observers showed more consistency between sessions than measuring manually. Electronic measurements had greater variation between observers than manual measurements. Overall, 95 per cent of measurements for a given bruise lay within a range of 2 cm. We conclude that measurement of a bruise by either method varied. In clinical practice, we recommend that a right-angled linear scale is included in any photographic image of a bruise, such that clinicians can standardise the estimate of bruise size. [ABSTRACT FROM AUTHOR]

While violence against children is a common occurrence only a minority of incidents come to the attention of the authorities. Low reporting rates notwithstanding, official data such as child protection referrals and recorded crime statistics provide valuable information on the numbers of children experiencing harm which come to the attention of professionals in any given year. In the UK, there has been a strong tendency to focus on child protection statistics while children as victims of crime remain largely invisible in annual crime reports and associated compendia. This is despite the implementation of a raft of policies aimed at improving the system response to victims and witnesses of crime across the UK. This paper demonstrates the utility of a more detailed analysis of crime statistics in providing information on the patterns of crime against children and examining case outcomes. Based on data made available by the Police Service for Northern Ireland, it highlights how violent crime differentially impacts on older children and how detection rates vary depending on case characteristics. It makes an argument for developing recorded crime practice to make child victims of crime more visible and to facilitate assessment of the effectiveness of current initiatives and policy developments. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages UK recorded crime is not routinely disaggregated by age and there is limited consideration of the changing patterns of crime against children., Practitioners working to reduce offending against children and to support victims through the criminal justice system are not being provided with the appropriate data to measure throughput through the system., Lack of information on the reasons why cases remain undetected means that strategies to reduce case attrition are essentially 'flying blind'. [ABSTRACT FROM AUTHOR]

The aim of this paper was to assess the degree and nature of any mismatch between officially recognised child maltreatment and adolescent self-report of adverse child experiences. Participants included 136 adolescents (72 males, 64 females, Mage = 17 years, age range 14-23 years) who had been confirmed as victims of maltreatment prior to age 13 by Child Protective Services. Participants' self-reports were obtained in adolescence, at least four years after identification. Physical neglect was the most prevalent experience found in the records (87%, n = 118). When this experience was assessed through self-report, only 36 per cent ( n = 49) of participants reported physical neglect. Sexual abuse was self-reported by 17 per cent ( n = 23) of the sample, compared with eight per cent ( n = 11) in the records. Only 17 per cent ( n = 23), a small number of self-reports, were consistent with official records. Kappa values show that agreement is low (under 0.40) for seven of the ten categories. Our findings suggest substantial unreliability in the reporting of child abuse and neglect, including household adverse experiences. They also suggest the failure of professionals to discover several adverse experiences during childhood, even after identification by authorities. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Messages Child protection practitioners need to be aware of multiple experiences that can co-occur with the suspicion or situation initially reported to child protection agencies., Little attention is given to protecting children and young people from later re-victimisation., The conclusions from the relationship between childhood maltreatment and later outcomes should be approached with caution when retrospective reports or official data are used alone. [ABSTRACT FROM AUTHOR]

Many domestic violence perpetrator programmes have incorporated the issue of children's safety and the harmful parenting of domestically violent fathers within their programme content. However, little attention has been paid to the services offered to, and possible outcomes for, the children of men on such programmes. This paper draws on a survey of 44 domestic violence services and 73 interviews with men who were on, or had completed, a programme, ex/partners, programme workers and programme funders/commissioners, to explore how a positive outcome for children might be conceptualised. Despite a desire to improve the situation of children, very few organisations provided a direct support service to the children of men on programmes. Work with men and support for their ex/partners operated as some form of proxy service to children. Many men had not told their children they were attending a perpetrator programme, and we suggest that more encouragement to do so would improve perpetrator accountability and respect for children. A positive outcome for children from their father's involvement on the programme is identified as having three dimensions: changes in the father that would benefit children; changes in the father-child relationship; and changes in the child's functioning. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Messages: A positive outcome for children whose father has participated on a domestic violence perpetrator programme has a range of dimensions., Men on domestic violence perpetrator programmes should be actively encouraged and supported to tell their children about their attendance., There is a need for more direct support services for the children of men on domestic violence perpetrator programmes. [ABSTRACT FROM AUTHOR]

Mandatory child abuse and neglect reporting laws apply to teachers in many countries of the world. However, such laws have not yet been introduced for teachers in Malaysia, and there is debate about whether the laws should be extended to teachers at all. This paper aimed to investigate the level of support among teachers to assume mandatory reporting duties and to identify factors determining this support in Malaysia. A total of 668 teachers from 14 randomly selected public primary schools completed an anonymous self-administered questionnaire. Results showed that 44.4 per cent of the respondents supported legislation requiring teachers to report child abuse. Teachers of Indian ethnicity, those with a shorter duration of service in teaching (< 5 years), the availability of knowledgeable and supportive school staff and a higher level of commitment to reporting were significant factors affecting teachers' support for mandatory reporting. This study provides important insights into factors influencing teachers' support for the introduction of mandatory reporting legislation for teachers in Malaysia. Teachers do not unanimously support these laws and there is a lack of clarity about what such laws will mean for teachers. The data highlight the need for specific training programmes to raise teachers' awareness, build their confidence and enhance their willingness to report child abuse. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Malaysia does not currently have mandatory child maltreatment reporting requirements for teachers., Factors influencing teachers' support for the introduction of mandatory reporting include an attitude of commitment to the duty and the availability of other knowledgeable and supportive school staff., There is a need for specific training programmes to raise teachers' awareness, build their confidence, and enhance their willingness to engage with issues relating to child maltreatment. [ABSTRACT FROM AUTHOR]

Men's intersecting identities as fathers and as perpetrators of domestic violence are increasingly acknowledged in research and practice and children's social services are referring such men to perpetrator programmes. This paper draws on the evaluation of a newly established voluntary programme for male perpetrators of domestic violence in north-east England to consider how men's involvement with children's social services and fathering roles shaped motivation to engage with a process of change. The evaluation drew on project throughput data and background information on programme participants as well as interviews undertaken with men and their partners. Men who were currently involved with children's social services were found to be more likely than other programme participants to engage with the programme for more than five sessions. The desire to secure or regain access to their children or to avoid care proceedings was an extrinsic form of motivation that appeared effective in securing men's initial engagement with the programme. However, children could also function as a form of intrinsic motivation with men developing their awareness of the impact of abusive behaviour on children and viewing their participation in the programme as a means of becoming a 'better father'. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Messages Most men who contacted Strength to Change (STC), a voluntary programme for perpetrators of domestic violence in north-east England, were parents., Involvement with children's services and regarding the programme as a means of acquiring access to children or avoiding care proceedings facilitated rather than hindered men's engagement with the programme., Men's identity as fathers functioned as a source of intrinsic motivation with men describing the programme as enabling them to become a 'better father'., Although the STC programme did not have a specific remit to address fathering, it enabled men to use the image of themselves as fathers and awareness of the impact of domestic violence on children as a means of achieving change. [ABSTRACT FROM AUTHOR]

All over the world, poor and illiterate girls living in rural areas are at higher risk of becoming underage marriage than well‐educated girls living in cities. Early marriages exacerbate inequalities between females and males in society and violate children's and women's rights. This study aimed to demonstrate temporal changes in the prevalence of child marriage and underage childbearing in Turkey by exploring the causes of regional variations in the schooling rate. Our retrospective, descriptive and register‐based study obtained input data on childbirth, marriage, population and schooling from official statistics published by the Turkish Statistical Institute (TURKSTAT) and the Republic of Turkey Ministry of National Education. Based on official statistics, underage childbearing rates decreased from 2002 to 2019 in Turkey. This study outlined significant regional variations in the ratio of childbearing female under 18 to the population that were higher in the northeastern, central eastern, and southeastern Anatolia regions of Turkey than in other regions. During the same period, there were downward trends in the number of legal marriages of female aged 16–17 and the number of underage females who gave birth in contrast with an increasing population of girls living in Turkey. In terms of welfare, education and healthcare, developments in Turkey were considered to have contributed to the downward tendency of childbearing and marriages of underage females. However, an increase in the schooling rate of girls was the critical determinant of the observed tendency. Therefore, officially setting the compulsory education age to 18 can help to prevent underage marriage and childbearing. [ABSTRACT FROM AUTHOR]

The article focuses on the underestimation of the risk of family and domestic violence (FDV) in child protection cases. The study compares the data collected through fixed-field methods and narrative data, revealing that the extent of children's exposure to FDV is higher when using narrative data, highlighting the limitations of fixed-field data in capturing the complete picture of FDV.

This article explores the rarely considered role of friends and peers supporting young people after sexual abuse experienced in adolescence, drawing on participatory research with 32 young people in the UK with lived experience. The article considers ways in which relationships with friends and peers interplay with recovery from abuse. This includes friends and peers as recipients of disclosure, conduits to professional support, sources of emotional support and distraction, and being embroiled in often challenging, precarious peer cultures that young people navigate post‐abuse. The article explores young people's rationale for, and experiences of, reaching out to friends and peers. It considers what young people seek and gain from these relationships in the aftermath of abuse, while acknowledging complex risks and precarity of these relationships. It argues that support from friends offers something distinct to family and professionals. It explores benefits of these relationships, but also potential for peer responses to undermine wellbeing if not sufficiently supportive or informed. The article ends by arguing for professionals to better recognise and respond to these relational contexts and consider whether there are safe and appropriate ways to 'support young people to support' without responsibilisation, and recognising welfare needs of those providing such support. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate whether the training offered about child abuse and neglect to families in which there are disagreements and problems between parents will be effective in enhancing awareness. Background: Even if families are the places where children are the safest, they sometimes constitute the risky groups in terms of neglect and abuse. Parents could perpetrate physical and emotional abuses against their children due to conflicts with their spouses. Method: The research was conducted as a pre‐test–post‐test quasi‐experimental study. A total of 142 parents (71 couples) took part in the research. The Socio‐Demographic Information Form, the Abuse Awareness Scale – Parent Form and the Revised Dyadic Adjustment Scale were used as the data collection tools. Awareness training on child neglect and abuse, created by the researcher, was given to parents. Results: Before the training, the mean of pre‐test scores obtained by participant parents from the AAS‐PF was 62.5 ± 7.77 points. The mean of post‐test scores obtained by participant parents from the AAS‐PF was 47.5 ± 4.94 points. There was a statistically significant relationship between participant parents' AAS‐PF and RDAS scores. Implications: In line with the findings obtained from the research, disagreements between spouses pose a risk for children in terms of neglect and abuse. The education program on child neglect and abuse given to parents raises awareness and reduces the risk. [ABSTRACT FROM AUTHOR]

Repeated reporting to child protection is common. One approach to early intervention is for jurisdictions to receive and respond to child protection concerns raised before children are born. Despite this, little research has comprehensively examined subsequent child protection contact for those first reported prenatally. This study aimed to examine the subsequent child protection contact for up to a two‐year period for a cohort of children who were reported about prebirth. Child protection administrative data were extracted for 640 children reported for a concern about an unborn child in a single jurisdiction during 2014. Data about child protection contacts included reports, investigations, substantiations and out‐of‐home placements for children reported prenatally. Of the 640 children, 79% reported about prenatally also had contact with child protection between birth and age two. From birth and up to age two, children reported prenatally had between zero and 21 reports. Twenty‐two per cent of the children reported prenatally were removed from their birth parents and placed in out‐of‐home care prior to age two. These findings highlight the importance of intervening and supporting families prior to and during pregnancy to reduce harm to children and reduce the need for contact with child protection. [ABSTRACT FROM AUTHOR]

Background: Worldwide statistics highlight that many adolescents suffer from various types of maltreatment, which often tend to co‐occur in the form of poly‐victimisation. The experience of maltreatment at a young age causes physical and mental health problems, and can also lead to self‐harm and suicide. The aim: To explore the possible impact of maltreatment and poly‐victimisation on adolescent self‐harm and suicide attempts. Participants and settings: In total, 1898 students (15–18 years old) from Lithuanian vocational schools completed the survey (65.5% male). Method: The impact of maltreatment and poly‐victimisation on self‐harm and suicide attempts was tested using multivariable binary logistic regressions. Results: Different maltreatment types were significantly associated to self‐harm (odds ratio from 2.47 to 3.80, p < 0.001) and suicide attempts (odds ratio from 3.15 to 7.58, p < 0.001). The odds ratios for self‐harm and suicide attempt increased as the number of different types of maltreatment experienced increased. A history of experiencing four types of poly‐victimisation increased adolescent risk for self‐harm (OR = 18.57, p < 0.001, 95% CI: 5.77–59.72) and suicide attempts (OR = 45.54, p < 0.001, 95% CI: 14.37–144.28) the most. Conclusion: Adolescents with experience of maltreatment, particularly if poly‐victimised, are at greater risk of engaging in self‐harming and suicidal behaviours. [ABSTRACT FROM AUTHOR]

Victims of medical child abuse (MCA) often have gastrointestinal (GI) complaints and nutritional difficulties, leading to non‐oral feeding methods. We documented the frequency of GI complaints, non‐oral feeding methods, medical complaints leading to them and difficulties experienced. They were compared with children evaluated preoperatively by a G‐tube protocol. Children with possible MCA at Children's Hospital, 2011–2015, were retrospectively reviewed. They were compared with a 5 per cent random sample of G‐tube protocol children, 2013–2015. Sixty‐five of 143 (45.5%) children evaluated for MCA were determined to be MCA victims. Twenty‐four out of 65 children with MCA (39.6%) had GI complaints compared to nine out of 60 G‐tube protocol children (15.0%). Gastroesophageal reflux and oral‐motor dysfunction were the most frequent GI problems in both groups. Fewer MCA children had prior non‐oral feeding methods than G‐tube protocol children. However, MCA victims had more prior GI investigations, non‐oral feeding types and complications thereof. MCA children were less likely to have feeding tubes placed, but caretakers took 30 per cent who did not receive a tube elsewhere for tube insertion. Interventions in MCA children restored many to oral feeding and resolved nutritional and developmental complaints. MCA victims had frequent GI complaints, numerous investigations and frequent complications. They had more uncommon GI complaints. MCA interventions improved feeding and nutrition. Key Practitioner Messages: Gastrointestinal (GI) problems and non‐oral feeding methods are common in medical child abuse (MCA).MCA victims undergo many investigations and tend to have multiple GI complaints.Non‐oral feeding methods are common and often fail or are fraught with complications.Consider MCA in children with unusual primary and/or GI diagnoses.Intervention can relieve feeding and developmental problems and failure to thrive. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: Emergency medicine physicians demonstrate practice variation in child abuse screening in infants with skull fractures.Previously unknown barriers may contribute to emergency medicine physicians' practice variation in child abuse screening of infants with skull fractures. [ABSTRACT FROM AUTHOR]

Child sexual abuse is a frequent phenomenon in Chile, but it is not often disclosed by its victims. The lack of disclosure is more common in the male population, presumably owing to cultural factors. The objective of this study was to deepen understanding of child sexual abuse disclosure in the Chilean population, focusing particularly on the role of gender. The study combined data extraction from the internal database of child sexual abuse specialist care centres with a small number of in‐depth interviews. In the initial quantitative phase, data on 210 adolescents between ten and 18 years of age were reviewed, and in the qualitative phase, ten young people between 18 and 20 years participated; all the participants had suffered sexual abuse. The results of the quantitative phase show that boys actively disclose less frequently than girls. The results of the qualitative analysis revealed some obstacles to disclosure both in boys and in girls (guilt and shame, or the lack of family support), but they suggested that the disclosure process would be particularly difficult for boys owing to cultural factors (e.g. questioning the masculinity of male victims and the feminisation of sexual abuse). The discussion addresses the implications of these results for promoting disclosure in adolescents of both genders. 'Child sexual abuse is a frequent phenomenon in Chile, but it is not often disclosed by its victims' Key Practitioner Messages: In Chile, disclosure of sexual abuse is difficult for male and female adolescents owing to guilt and shame, or the lack of family support.In macho cultures, male adolescents would have greater difficulty with disclosure given the associated stigmatisation and gender stereotypes.All practitioners who work with children and adolescents in Chile should be attentive to the gender factors that hinder the disclosure of sexual abuse in male and female adolescents. [ABSTRACT FROM AUTHOR]

Research on commercial sexual exploitation (COMSE) of youth tends to focus on young females as victims, and much less is known about male and transgender commercially sexually exploited youth (COMSEY). Understanding the psychosocial background and past COMSE experiences among COMSEY is important to provide support for gender‐specific or gender‐inclusive interventions for COMSEY. The study included 57 cisgender females, 40 males and 23 transgender females who received services from a multi‐module programme for COMSEY in Israel. Case managers provided data on the youth regarding background characteristics, health variables and COMSE experiences prior to entering the service. The youth had similar rates in most psychosocial background characteristics, including being a victim of abuse. Cisgender females were less likely than cisgender males and transgender females to be from an ethnic minority and more likely to have been in out‐of‐home placement. Past experiences of COMSE were also similar between genders, though cisgender females were less involved in street prostitution and more likely to have been sexually abused during COMSE. The findings provide support for a gender‐inclusive approach to intervention with COMSEY and call for re‐consideration of present gender‐specific interventions in this domain. Further research on intervention with COMSEY is needed, specifically regarding male and transgender COMSEY. 'The study included 57 cisgender females, 40 males and 23 transgender females who received services from a multi‐module programme for COMSEY in Israel' Key Practitioner Messages: Youth who sell or swap sex have troubled pasts, regardless of their gender.There are more similarities than differences in psychosocial backgrounds and past sexual exploitation experiences between cisgender females, cisgender males and transgender females.Empirical evidence to support the need for gender‐specific intervention was not demonstrated among these youth.Gender‐inclusive interventions may be an appropriate approach and will promote access to treatment for all commercially exploited youth. [ABSTRACT FROM AUTHOR]

Burns are common causes of paediatric emergency care attendance; approximately ten per cent result from maltreatment. Following emergency department (ED) attendance with a burn by 232 under five‐year‐olds, 11 risk factors for maltreatment were collected via health visitor (HV) telephone surveys. Three of these risk factors (domestic violence, social care involvement and developmental impairment) were also available in ED records, and information collected was compared between the two. Non‐parametric Fisher's exact tests were applied. Fifty‐nine per cent of children lived in families with risk factors for maltreatment. Prominent risk factors known by HVs included: prior injuries (n = 55, 23.7%), carer/parent mental health problems (n = 48, 20.7%), domestic violence (n = 47, 20.3%) and social care involvement (n = 45, 19.4%). A total of 158 cases had complete data for all 11 risk factors: 49 (31.0%) lived in households with one factor, 22 (13.9%) with two factors and 27 (17.1%) with three or more risk factors. In cases where HVs recorded the following risk factors as present, EDs recorded five of 47 (10.6%) for domestic violence, ten of 45 (22.2%) with social care involvement and four of 23 (17.4%) with developmental impairment. Many risk factors that were known to HVs were not identified by EDs staff despite being part of a standardised proforma. Maltreatment risk assessment could be improved if EDs staff had access to HV information. Key Practitioner Messages: Fifty‐nine per cent of pre‐school children who attended an ED with a burn live in a family with one or more maltreatment risk factors, as identified by HV records.ED staff should be able to access a child's HV record electronically at the time of presentation, to identify known maltreatment risk factors.The lack of integration of community and acute setting health records is a barrier to comprehensive assessment and treatment decisions for children in EDs, especially in relation to safeguarding risks. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: The COVID‐19 pandemic has resulted in negative consequences for children exposed to violence and abuse.Domestic violence refuge staff were greatly concerned about children both living outside and inside refuges.Domestic violence refuges have played a pivotal role during the COVID‐19 pandemic and should receive wider acknowledgement and greater support for their work. [ABSTRACT FROM AUTHOR]

Although confessions related to abusive head trauma (AHT) are reported, no detailed analysis exists. Therefore, we systematically reviewed studies of AHT confessions and examined the details, including country of origin, mechanisms and perpetrators' characteristics. Employing 36 search terms across three search engines, we searched Medline and CINAHL from 1963 to 2018. All relevant studies underwent two independent reviews and data extraction. Descriptive statistics were used to characterise the sample; chi square and Fisher's exact tests were used to assess differences in demographic and clinical characteristics. Of 6759 identified studies, 157 full texts were reviewed and 55 articles from 15 countries spanning four continents were included. Included articles contained 434 confessions. The mechanisms of abuse included shaking alone (64.1%), impact alone (17.1%), shaking plus impact (18.0%) and other (0.9%). There was no statistically significant difference in the percentage of confessions reporting shaking alone when comparing continents: North America (64.0%), Europe (64.2%) and Oceania (60.0%; p = 0.92), or when comparing circumstances in which the confession was obtained: medical evaluation (74.6%) vs police or judicial investigations (63.4%; p = 0.11). Of 119 cases with identified perpetrators, 67.2 per cent were cases with males alone. Confessions reveal striking similarities in the mechanism of AHT (predominantly shaking) that occur across the globe. Key Practitioner Messages: Confessions can provide important information about AHT and have been reported in medical literature for over 40 years.The quality of evidence for the association of shaking with AHT has been questioned, but no systematic review of confessions of AHT has been performed previously.This systematic review of confessions of AHT reveals that shaking is the most common mechanism reported and that shaking and AHT occur together across the world. 'We systematically reviewed studies of AHT confessions and examined the details, including country of origin, mechanisms and perpetrators' characteristics' [ABSTRACT FROM AUTHOR]

This study analyses the psychological, clinical and criminal characteristics of neonaticide focusing on court verdicts with the aim of formulating recommendations for judicial guidelines. This study was register based, comprising all known neonaticides in Austria and Finland between 1995 and 2005. The cases (n = 28) were obtained by screening death certificates from coroner departments and analysing them alongside all further reports available. Five out of 21 convicted offenders were imprisoned with an average sentence of 1.65 years. A mental disorder, at the time of the offence, was diagnosed in half of the offenders (9/18) who underwent forensic examination. Of the total offenders, 14 were deemed responsible for the crime, one was deemed to have had diminished responsibility and three were considered not responsible for the crime. The main motive, determined by court evaluation, was an 'unwanted child', followed by 'no motive', 'fear of abandonment or a negative response from others' and 'mental overload'. The rate of repeated neonaticide was 13 per cent. Considering the rate of mental illness within the neonaticide offenders, we would recommend a treatment detention order instead of imprisonment or non‐prosecution, as well as state‐of‐the‐art guidelines for the court. 'Analyses the psychological, clinical and criminal characteristics of neonaticide focusing on court verdicts' Key Practitioner Messages: Autopsies should be conducted for all suspected neonaticides.Forensic examinations should be performed by experts with knowledge and experience of neonaticide.There should be standardised forensic examinations using structured psychiatric and psychological methods by two independent experts.Neonaticide cases should be tried in specialised courts.A psychiatric treatment order should be made for all neonaticide offenders as a preventive measure to reduce reoffending and address the high psychological burden. [ABSTRACT FROM AUTHOR]

The article examines the influence of children, birth parents and foster carers on the matching decision in the foster care process in Netherlands. Topics discussed include involvement of stakeholders in the matching process, appointment of practitioners by foster care organizations to match children with foster carers and the use of paternalistic view by practitioners.

Survivors of clerical institutional childhood abuse (ICA) experience poor mental health outcomes in adulthood. Resilience research with this group has focused on psychological adjustment and we know less about the factors across the social ecology that support positive adaptation, including the impact of migration. This study explores the influence of resilience‐enhancing factors across the social ecology on the mental wellbeing (MWB) of Irish emigrant survivors of ICA and how this compares with non‐migrant survivors. Fifty‐six survivors based in the UK and 46 based in Ireland completed a quantitative survey that assessed resilience‐potentiating resources and associations with MWB. A further nine participants, resident in the UK, engaged in a structured interview which aimed to further explain these quantitative data. Results indicate more resilience‐enhancing resources across the ecology of emigrant survivors of ICA. Personal skills and competencies, such as problem‐focused coping, altruism and defiance, and social inclusion were associated with MWB regardless of country of residence. For the migrant group, social identity not defined by institutional care facilitated social inclusion. Migration to the UK and informal instrumental support in the aftermath of institutional care were identified as key turning points towards resilience. Key Practitioner Messages: Multiple factors across the ecology influence the resilience of survivors of institutional childhood abuse (ICA).Resilience strategies for survivors of ICA are contextual and may appear maladaptive to practitioners unfamiliar with the cultural context of this abuse.For Irish emigrant survivors of ICA, problem‐focused coping, defiance, altruism, social inclusion, instrumental support and a social identity not defined by childhood abuse enhanced resilience.Resilience is dynamic and emerges over time for adult survivors of chronic childhood abuse. 'Explores the influence of resilience‐enhancing factors across the social ecology on the mental wellbeing... of Irish emigrant survivors of institutional childhood abuse' [ABSTRACT FROM AUTHOR]

In 2015, LVCT Health (a Kenyan non‐governmental organisation) conducted an exploratory study to assess the quality and comprehensiveness of services provided to child survivors of sexual violence at two public health facilities in Kenya. Both quantitative and qualitative data collection methods were used, including a retrospective review of 164 child survivor medical records, a health facility staff inventory, in‐depth interviews with 31 healthcare providers and 19 exit interviews with 14 child survivors and their caregivers. Ethical approval was obtained from two independent ethics committees. Quantitative data were analysed using SPSS version 22, while qualitative data were analysed using NVivo 10 based on a thematic coding framework. The health facility staff inventory indicated that only two out of 581 providers had undergone previous training on the management of child survivors of sexual violence. Both health facilities lacked the appropriate equipment for the collection of forensic evidence from children and private rooms in which to conduct the clinical examination. Providers cited challenges in offering psychosocial support to children. Only 27 per cent of child survivors were documented to have received trauma counselling. There is a need for health facilities to enhance their human resource and infrastructural capacity to facilitate the delivery of comprehensive care to child survivors. 'An exploratory study to assess the quality and comprehensiveness of services provided to child survivors of sexual violence... in Kenya' Key Practitioner Messages: There is a need to develop child‐specific guidelines for healthcare providers in order to ensure that child survivors of sexual violence receive good‐quality services at the facility level.Healthcare providers in public health facilities need competency‐based training to enable them to acquire knowledge and skills to identify and respond to child survivors of sexual violence, collect evidence, communicate with the children and offer counselling support to child survivors effectively.Services for child survivors should be centralised in health facilities to minimise the number of different contact points. [ABSTRACT FROM AUTHOR]

Health professionals fulfil an essential role within the multiagency response to safeguarding concerns. This study explored the experiences, attitudes and perceptions of paediatricians relating to child protection (CP) work. A mixed‐methods approach was adopted, using the explanatory sequential design. The quantitative strand involved a population survey of paediatricians (N = 56). Data were analysed and used to inform a subsequent qualitative strand. Both strands indicated that CP work was perceived as complex, emotive and stressful. Paediatricians perceived themselves to be working within an unstructured system. Despite most reporting to have assessed CP cases, 77.4 per cent (n = 41) had never received training. The majority reported that response pathways and reporting procedures were unclear and that they were not involved in tasks beyond identification. These factors contributed to a lack of confidence and ambivalence towards CP, particularly child sexual abuse. Participants felt reassured by having a designated consultant, however, this role also enabled them to offload responsibility. Overall, CP work was not being fully owned. This study suggests that the lack of mandatory and statutory guidance results in significantly suboptimal practice. Investment in structured training and support systems is recommended to engage professionals. Designated professionals should complement, rather than minimise, the role and responsibility of other professionals. 'This study explored the experiences, attitudes and perceptions of paediatricians relating to child protection work' Key Practitioner Messages: Child protection is the responsibility of every professional working with children.Developing child protection systems requires a strong national commitment reflected in legislation and statutory guidance in order to ensure that they are standardised, robust and sustainable.Engaging professionals in child protection work is essential and calls for structured training programmes, support systems and provisions in law that protect against legal liability.Designated professionals in child protection are essential, however, their role should complement, rather than minimise, the role and responsibility of other professionals.Child sexual abuse requires specialist input. [ABSTRACT FROM AUTHOR]