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Child protection continues to be a pressing social problem. Robust and relevant research is essential in order to ensure that the scale and nature of child maltreatment are understood and that preventative and protective measures are effective. This paper reports selected results from a mapping review of research conducted in the UK and published between January 2010 and December 2014. The purpose of the review was twofold: to develop a typology of child protection research; and to use this typology to describe the features and patterns of empirical research undertaken recently in the UK in order to inform a future research agenda. The paper reports the maltreatment types, substantive topics and research designs used within empirical research published in academic journals. It identifies a number of challenges for the field including the need for conceptual clarity regarding types of abuse, greater methodological diversity and a shift of focus from response to prevention of child maltreatment. The importance of a national strategic agenda is also emphasised. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Messages A substantial proportion of empirical research focuses on child maltreatment generally and less is known about some specific types of maltreatment such as exposure to domestic abuse and child trafficking., More robust evidence is particularly needed concerning the effectiveness of interventions and choice of preventative approaches., Research-minded practitioners have an important contribution to make to the development of a practice-relevant research agenda. [ABSTRACT FROM AUTHOR]

The importance of safeguarding children from violence is internationally recognised. However, detecting, intervening and protecting children from abuse both within the family and in institutions is complex. This paper specifically focuses on safeguarding in England and how workforce reform in the early years offers the opportunity to forge new partnerships with families and professionals. These relationships have the potential to support more positive outcomes for babies, young children and families who are ‘in need’ or where the children are at risk of significant harm or abuse has occurred. The paper draws on the findings from research exploring the impact of workforce reform in the early years and how the changes impact upon the wider safeguarding agenda. It will argue that the introduction of an inter-disciplinary graduate professional in the early years has afforded an opportunity to forge new partnerships that have the potential to significantly impact on child maltreatment. [ABSTRACT FROM PUBLISHER]

This study examined how child abuse and neglect were reported in a sample of 459 newspaper articles between 2003 and 2013 in England and Wales. The results were compared with data on child abuse and neglect over the same decade. Sexual abuse was by far the most commonly reported, in both tabloid and broadsheet newspapers. Although neglect and emotional abuse are the most common causes of child protection plans in England and Wales, neglect and emotional abuse are relatively invisible in newspaper articles, as is physical abuse. Possible explanations for this disproportionate focus on sexual abuse, which has also been found in Australia and the United States, include the fact that sexual abuse cases reach the criminal courts more often than other forms of child victimisation. Although broadsheet papers were more likely than tabloid newspapers to comment on causes and solutions beyond the individual perpetrator committing a crime, the majority of articles in broadsheet papers still did not frame either the causes or the solutions in broader terms. It seems possible that the notion of the decontextualised ‘evil’ perpetrator serves to distance journalist and reader alike from the pervasiveness and pain of child abuse. The article concludes with ideas to improve the accuracy and utility of the coverage of child abuse and neglect in newspapers. [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]

There is appetite in the UK to better measure the impact of domestic violence and abuse (DVA) interventions on children. The spread of outcomes-based commissioning means outcome measurement is no longer just the territory of academic researchers but is now firmly within the purview of practitioners and policy makers. However, outcomes measured in trials only partially represent the views of those delivering and using services with respect to how success should be defined and captured. Even within trials there is huge inconsistency in the definition and measurement of important endpoints. This yields a body of evidence that is difficult to make sense of, defeating the ends for which it was produced - to improve the response to children and families who have experienced abuse. Development of Core Outcome Sets (COS) is seen as a solution to this problem, by establishing consensus across key stakeholder groups regarding a minimum standard for outcome measurement in trials, and increasingly in service delivery contexts. To date COS development has addressed outcomes relating to health conditions or interventions, with limited application to public health challenges. We reflect on our efforts to develop a COS to evaluate psychosocial interventions for children and families experiencing DVA. We highlight the value of COS development as a mechanism for improving evidence quality and the response to families experiencing abuse. Finally, we make recommendations to researchers and COS guideline developers to support this broader application of COS methodology. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and associated public health 'stay at home' restrictions have intensified familial risk factors. Children would appear to be at increased risk of harm and abuse, yet administrative data from the early months of the pandemic showed falling cases of child maltreatment. Using weekly administrative data from Scotland, UK that span the first 17 months of the pandemic, this article found that child maltreatment activity levels fluctuated as 'stay at home' restrictions changed. During lockdown periods, the number of children subject to Inter-agency Referral Discussion fell but a higher number of children were placed on the Child Protection Register. When restrictions were eased, the number of Inter-agency Referral Discussions increased but the number of children placed on the Child Protection Register fell. To explain the fluctuations, the article asserts that the pandemic's impact on services' ability to engage directly with children and families has been critical, but the limitations of administrative data in providing an accurate measure of child maltreatment levels also need to be recognised. The article advocates that analysis of administrative data is best done in tandem with wider quantitative and qualitative sources in order to understand the impact of crisis events on children and families. [ABSTRACT FROM AUTHOR]

Purpose – The wider research literature indicates that health professionals’ ability to identify possible child maltreatment varies, and that this can lead to under-reporting of possible maltreatment to local authority (LA) statutory child protection agencies. The purpose of this paper is to understand how acute trust paediatric and LA services work together in suspected cases of child maltreatment, and what is viewed locally as good practice. Design/methodology/approach – A mixed-method approach, consisting of an online survey, qualitative case studies and good practice examples, was used to describe key features of current practice in joint working between acute trusts and LA services, and to generate insights that could help improve practice. Findings – Holistic assessment and information gathering, supported by training and expert input, were identified as being critical to a comprehensive approach to identifying maltreatment. Both in-hospital and community-based social work arrangements can be effective bases for joint working in respect of child maltreatment. Effective joint working relies on shared vision and values, and investment in, and commitment to, collaborative working. Research limitations/implications – This study covered arrangements in emergency departments (EDs) and maternity departments only, so future research could usefully look more broadly within acute care settings. Study respondents were also limited to safeguarding leads so, in future, there would be real value in exploring the experiences, practices and views of frontline practitioners. Practical implications – The study includes practical implications for hospital and social work teams working to safeguard children. Originality/value – The study highlights the characteristics of effective liaison between acute trust maternity and EDS and social work teams. [ABSTRACT FROM AUTHOR]

The threshold at which state social work services respond to children who may have been maltreated has been the subject of debate in the UK and elsewhere over a number of years. This paper presents a conceptual model that helps to explain how threshold decisions are made, based on a review of research in the UK and elsewhere. A range of factors were found to affect thresholds, including the nature of the welfare concerns for the child, the policy and organisational circumstances, the role of collaborative practice amongst a range of professionals, and the decision making of front line social workers, teams and managers. A central argument is that the technical–rational model of thresholds, which is commonplace in the UK, is insufficient and the concept of ‘thresholds’ too limiting. In their place, we adopt a naturalistic decision-making approach, arguing that ‘threshold decisions’ are mediated through various sense-making strategies at local level. These strategies may appear as shortcuts to thinking, arising from a pressurised working environment. We argue, however, that they are consequential features of the context within which children's social work services operate and that taking them into account allows for a more nuanced understanding of how thresholds are managed. [ABSTRACT FROM AUTHOR]

• Risk of maltreatment from combined toxic trio factors a dominant concept in UK child protection. • Systematic review found 20 papers. • Evidence base lacks definition of key measures, intersectionality analysis or theoretical basis. • Other key risk factors, especially family socio-economic circumstances, excluded. • Need to rebuild the evidence base and rethink the focus of policy and practice. The term 'toxic trio' was coined to describe the risk of child abuse and neglect stemming from a combination of domestic violence, parental mental health issues and/or learning disability, and parental alcohol and/or drug misuse (Brandon, 2009). Although concerns about the language have been raised in some quarters, it has become a dominant reference point in children's social care in England and, to an extent, internationally over the past two decades. It has become embedded in the family justice system, child protection assessment processes and national data collection. There is evidence that each factor in isolation can lead to worse child outcomes, although this is of mixed quality and far from comprehensive. This article reports the results of a systematic review of evidence relevant to the relationship between the 'toxic trio' factors in combination and child maltreatment, identifying 20 papers. Despite the term's currency, we found little quality evidence of the incidence of the 'trio' factors in child maltreatment, little consideration of intersectionality and almost no theoretical examination of the supposed relationships. Such studies as have been conducted have too rarely taken into account, or controlled for, contextual factors, such as the socioeconomic circumstances or the ethnicity of the families, or children's ages. The discrepancy between the priority given to the 'toxic trio' and the paucity of the evidence-base makes a case for a shift away from over-simplified attributions of parental risk in policy and practice, and towards greater attention being given to other significant factors for child protection. [ABSTRACT FROM AUTHOR]

Although we know there are high rates of mental health difficulties amongst young people in out-of-home care (i.e. social welfare-involved children), there is limited evidence on the longitudinal development of these problems, particularly from when they enter the care system. Using the routinely collected carer-reported strengths and difficulties questionnaire, we explored internalising (emotional and peer) and externalising (conduct and hyperactivity) difficulties for 672 young people across their first 3 years in the UK care system (2–16 yrs, 51% boys, 76% Caucasian). In all cases stable profiles (resilient or chronic) were most common, while changing profiles (recovery or delayed) were less common. Findings showed that entry into the care system is not enough of an intervention to expect natural recovery from mental health difficulties. Number of placements and being separated from siblings were associated with greater difficulties. Implications for child welfare and mental health systems are discussed. [ABSTRACT FROM AUTHOR]

This paper draws on the results of a commissioned systematic map of UK child protection empirical research published between 2010 and 2014. It analyses current patterns in child protection research in relation to three variables – disciplinary background of authors, types of maltreatment examined, and focus of the research – and considers the relationship between these. It finds first authors' disciplines to be reliable indicators of both the focus and topic of the research, with the dominant fields of psychology, medicine, and social work addressing respectively the long term outcomes of sexual abuse, the short term outcomes of physical abuse, and the care system's response to child maltreatment. The proportion of research dedicated to specific types of maltreatment appears to depend on factors other than their real-world prevalence. Instead, definitional issues and ease of access to research participants appearing to be more influential in determining the topic of the research. UK child protection research appears to show narrow multidisciplinary interaction and little focus on preventative or ameliorative interventions. The development of a coordinated national strategy adopting an interdisciplinary approach in the design and commissioning of child protection research could help maximise research efforts by reducing duplication and potentially facilitating the emergence of more innovative directions. [ABSTRACT FROM AUTHOR]

Background: Although there is strong evidence for a relationship between child abuse and neglect and conduct problems, associations between child abuse experienced at different developmental stages and developmental trajectories of conduct problems have not been examined. We sought to investigate effects of timing of child abuse on conduct problem trajectories in a large UK birth cohort study. Methods: We applied latent class growth analysis to identify conduct problem trajectories in the Avon Longitudinal Study of Parents and Children, using parent-rated conduct problems from ages 4–17 years (N = 10,648). Childhood-only and adolescence-only abuse, in addition to abuse in both developmental periods ('persistent' abuse), were assessed by retrospective self-report at age 22 years (N = 3172). Results: We identified four developmental trajectories: early-onset persistent (4.8%), adolescence-onset (4.5%), childhood-limited (15.4%), and low (75.3%) conduct problems. Childhood-only abuse and 'persistent' abuse were associated with increased odds of being on the early-onset persistent and adolescence-onset conduct problem trajectories compared to the low conduct problems trajectory. Adolescence-only abuse was not predictive of trajectory membership. There were no associations between abuse and childhood-limited trajectory membership. Conclusions: Early-onset persistent and adolescence-onset conduct problems showed similar patterns of association with abuse exposure, challenging developmental theories that propose qualitative, as opposed to quantitative, differences in environmental risk factors between these trajectories. The results also highlight that childhood-only and 'persistent' abuse were more strongly linked to elevated conduct problem trajectories than adolescence-only abuse, and that 'persistent' abuse is particularly detrimental. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: Closed, often tight‐knit army communities can potentially provide protective factors for children; however, this environment can make it difficult to seek help or to speak out when there are concerns about children's safety or wellbeing.The needs and experiences of non‐serving parents (often female partners) can be overlooked unless, or until, child protection concerns are serious.Army‐connected children benefit from accessing army and civilian health, education and welfare services; however, transitions and communication between these services need to be improved. [ABSTRACT FROM AUTHOR]

Aim: To study caregiver reports of children's experience of physical harm and exposure to family violence due to others' drinking in nine societies, assess the relationship of harm with household drinking pattern and evaluate whether gender and education of caregiver affect these relationships. Method: Using data on adult caregivers from the Gender and Alcohol's Harm to Others (GENAHTO) project, child alcohol-related injuries and exposure of children to alcohol-related violence (CAIV) rates are estimated by country and pooled using meta-analysis and stratified by gender of the caregiver. Households with and without heavy or harmful drinker(s) (HHDs) are compared to assess the interaction of caregiver gender on the relationship between reporting HHD and CAIV, adjusting for caregiver education and age. Additionally, the relationship between caregiver education and CAIV is analyzed with meta-regression. Results: The prevalence of CAIV varied across societies, with an overall pooled mean of 4% reported by caregivers. HHD was a consistent correlate of CAIV in all countries. Men and women in the sample reported similar levels of CAIV overall, but the relationship between HHD and CAIV was greater for women than for men, especially if the HHD was the most harmful drinker (MHD). Education was not significantly associated with CAIV. Conclusions: One in 25 caregivers with children report physical or family violence harms to children because of others' drinking. The adjusted odds of harm are significantly greater (more than four-fold) in households with an HHD, with men most likely to be defined as this drinker in the household. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment is associated with cardiovascular disease (CVD), but mediation pathways have not been fully elucidated. The aim of the current study was to determine and quantify the underlying pathways linking child maltreatment and CVD.Methods: We conducted a retrospective cohort study using the UK Biobank. The number and types of child maltreatment, including abuse and neglect, were recalled by the participants. Lifestyle, biological, physical, and mental health factors measured at baseline were explored as potential mediators. Incident CVD was ascertained through record linkage after baseline measurement. Age, sex, ethnicity, area-based deprivation, and education level were adjusted for as confounders. Cox proportional hazard models were conducted to test for associations between child maltreatment and incident CVD.Results: A total of 152,040 participants who completed the child maltreatment assessment were included in the analyses, and one third reported at least one type of child maltreatment. There was a dose-response relationship between the number of maltreatment types and incident CVD. On average, each additional type of child maltreatment was associated with an 11% (95% CI 8-14%, P < 0.0001) increased risk of CVD. The majority (56.2%) of the association was mediated through depressive symptoms, followed by smoking (14.7%), high-density lipoprotein cholesterol (8.7%), and sleep duration (2.4%).Conclusion: Child maltreatment is associated with incident CVD through a combination of mental health, lifestyle, and biological pathways. Therefore, in addition to interventions to reduce the occurrence of child maltreatment, attention should be targeted at promoting healthy lifestyles and preventing, identifying, and treating depression among children and adults who have previously been maltreated. [ABSTRACT FROM AUTHOR]

Insight into the effects of methodological characteristics on reported child maltreatment prevalence rates can facilitate the interpretation of results of previous studies and improve the design of future prevalence studies. We reviewed findings from four previous meta-analyses (Stoltenborgh et al., , , , ) on methodological moderators in self-report prevalence studies on child sexual ( k = 323, N = 410,951), physical ( k = 157, N = 250,167) and emotional abuse ( k = 42, N = 76,586), and physical ( k = 13, N = 59 406) and emotional neglect ( k = 16, N = 59 655). We provide an overview of the moderating effects of participant characteristics (e.g. age), the sampling method and measurement characteristics (e.g. validation). No characteristic was without influence, but specific characteristics were significant moderators for certain types of abuse and not for others. This implies that the wide range of lifetime prevalence rates reported in the literature can partly be explained by methodological differences. Our best-evidence synthesis (sexual abuse: k = 4, N = 52 749; physical abuse: k = 2, N = 40 341; emotional abuse: k = 6, N = 4029; emotional neglect: k = 3, N = 3226) suggests that depending on the methodological characteristic under consideration a certain prevalence rate can be an over- or underestimation of the actual prevalence. Taking methodological characteristics' influence into consideration and choosing a sound methodology can help to get as close as possible to the actual child maltreatment prevalence. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Messages The methodological quality of studies affects the reported lifetime prevalence rates of child maltreatment, but the direction of this effect depends on the indicator of methodological quality., A higher response rate is related to a higher reported lifetime prevalence of child maltreatment for all maltreatment types except physical abuse., A sound study design and methodology can help researchers to get as close as possible to the actual lifetime prevalence of child maltreatment. [ABSTRACT FROM AUTHOR]

Background: Follow-up for public health trials may benefit from greater use of routine data. Our trial of a home-visiting intervention for first-time teenage mothers assessed outcomes to the child's second birthday. To examine its medium-term impact, particularly upon maltreatment outcomes, we designed a study using routine records. Methods: We aimed to establish the feasibility of our study design, which combines trial data with routine health, social care and education data using a dissent-based linkage model. Trial participant identifiers were linked to routine health, social care and education data if women did not dissent. Data were forwarded to a safe haven and further linked to de-identified trial outcome data. The feasibility study aimed first to establish the acceptability of data linkage through a discussion group of young mothers and by levels of dissent received by the research team. Second, we assessed levels of accurate linkage to both health (via NHS Digital) and education and social care (both via National Pupil Database, NPD). Third, we assessed the availability of data and levels of missingness for key outcomes received for a sample of target study years. Results: Of 1545 mother-child dyads contacted, eight women opted out. The engagement exercise with stakeholders found support for the principle of data linkage, including in the context of maltreatment. Some contributors preferred opt-in consent. Most (99.9%) health records were matched on either three or all four identifiers. Fifty participants were not matched to any health data. Primary outcome data from NPD are derived from any one of three fields, all of which were satisfactorily returned and provided an indication of cases for analysis. Missing data for secondary outcomes varied from 0% (Child looked after status) to 70% (Anatomical Area A&E diagnosis) however when combined with other variables the levels of missingness for outcome decrease. Conclusions: Through study set-up and in this pilot, we provide evidence that the main study is feasible, satisfies governance requirements and is likely to generate data of sufficient quality to address our main research questions. Observed levels of missingness or low event rates are likely to affect some secondary analysis (e.g. state transition modelling) although overall were satisfactory. [ABSTRACT FROM AUTHOR]