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Children with medical complexity may be at elevated risk of experiencing child maltreatment and child welfare system involvement, though empirical data are limited. This study examined the extent of child welfare system involvement among children with medical complexity and investigated associated health and social factors. A retrospective chart review of children with medical complexity (N = 208) followed at a pediatric hospital-based complex care program in Canada was conducted. Descriptive statistics and odds ratios using logistic regression were computed. Results showed that nearly one-quarter (23.6%) had documented contact with the child welfare system, most commonly for neglect; of those, more than one-third (38.8%) were placed in care. Caregiver reported history of mental health problems (aOR = 3.19, 95%CI = 1.55–6.56), chronic medical conditions (aOR = 2.86, 95%CI = 1.09–7.47), and interpersonal violence or trauma (aOR = 17.58, 95%CI = 5.43–56.98) were associated with increased likelihood of child welfare system involvement, while caregiver married/common-law relationship status (aOR = 0.35, 95%CI = 0.16–0.74) and higher number of medical technology supports (aOR = 0.75, 95%CI = 0.57–0.99) were associated with decreased likelihood. Implications for intervention and prevention of maltreatment in children with high healthcare needs are discussed. [ABSTRACT FROM AUTHOR]

Gender-based relations of power and attributions of blame for child sexual abuse have been longstanding in child welfare policy and practice. Nonoffending mothers continue to be ascribed responsibility through the ideologically and institutionally entrenched doctrine of failure to protect. Feminist critical discourse analysis was used to (a) expose and disrupt dominant discourses of gender, motherhood, and risk that operate to construct and reinforce notions of blame and failure to protect, as enacted by way of child welfare text in context; and (b) build a credible case for social and organizational change grounded in an alternative discourse with greater explanatory power. Progressive avenues for resistance, negotiation, and transformation are proposed. [ABSTRACT FROM AUTHOR]

Most theories of child sexual abuse are, to some degree, gendered, with nonoffending mothers bearing the burden of blame, ideologically and legally, for the transgressions of predominantly male offenders. This article explores the social construction of blame for child sexual abuse via critical analyses of evolving theoretical perspectives on maternal culpability for the inception and maintenance of abuse dynamics. Drawing on selected conceptual and research knowledge that supports and refutes anecdotal claims, this synthesis of the literature culminates in the proposal of an evidence-informed, feminist-grounded, multitheoretical child sexual abuse framework that disrupts dominant mother-blaming discourse and guides socially just and ethically responsive policy, practice, and research. [ABSTRACT FROM AUTHOR]