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Eerder onderzoek laat zien dat jongeren schoolvoorlichting over kindermishandeling als een belangrijk preventiemiddel zien. In dit kwalitatieve onderzoek namen we semigestructureerde interviews af bij 13 jongvolwassenen met een verleden van mishandeling of verwaarlozing om te achterhalen wat zij vinden van schoolvoorlichting over kindermishandeling en welke onderdelen hierin belangrijk zijn. In de interviews werd ook gevraagd naar het belang van 12 veelvoorkomende componenten van voorlichtingsprogramma’s, afkomstig uit eerder literatuuronderzoek. Alle jongeren vonden het belangrijk dat kinderen op school voorlichting krijgen over kindermishandeling. Voorlichting kan het bewustzijn van kinderen vergroten, zodat zij mishandeling sneller herkennen, en ervoor zorgen dat kinderen eerder gaan praten en dat zij weten bij wie ze terecht kunnen voor hulp. De jongeren vonden het belangrijk dat kinderen door voorlichtingsprogramma’s leren dat mishandeling nooit de schuld is van het kind zelf. Daarnaast vonden zij het leren om weg te gaan uit een onveilige situatie en naar hulp te zoeken, het versterken van sociaal-emotionele vaardigheden, het vergroten van kennis over mishandeling, het leren herkennen van risicovolle situaties, en het versterken van het zelfvertrouwen van kinderen essentiële componenten van schoolvoorlichting. Volgens de jongeren is een belangrijke voorwaarde voor schoolvoorlichting dat voldoende nazorg beschikbaar is. Op basis van de resultaten worden aanbevelingen gedaan, zowel voor de verdere ontwikkeling en implementatie van voorlichtingsprogramma’s als voor toekomstig onderzoek. Bijsluiter voor de praktijk Om kindermishandeling te voorkomen zijn schoolprogramma’s ontwikkeld die zich richten op het voorlichten van kinderen over mishandeling. Kinderen, ouders en leraren zien dergelijke programma’s als een belangrijk preventiemiddel. Wij onderzochten middels interviews wat jongeren die slachtoffer waren van kindermishandeling vinden van dergelijke programma’s, en welke programmacomponenten zij als essentieel beschouwen. Uit de interviews bleek dat jongeren de schoolprogramma’s essentieel vinden, omdat deze vorm van voorlichting bijdraagt aan het vergroten van het bewustzijn van kinderen over kindermishandeling en daarmee het sneller herkennen van mishandeling. Jongeren vinden het vooral belangrijk dat kinderen die deelnemen aan voorlichtingsprogramma’s leren dat mishandeling nooit de schuld is van het kind zelf. Abstract Research showed that school-based child abuse prevention programs are considered as one of the most important strategies for preventing child abuse by adolescents and parents. In this qualitative study we conducted semi-structured interviews with 13 young adults that were a victim of child abuse, to examine how they think about school-based child abuse prevention programs and which program elements they perceive as essential. During the interviews the young adults were also asked about the importance of 12 common program components of school-based prevention programs, derived from a previous literature review. The young adults agreed that it is important to educate children about child abuse at school, as school-based prevention programs may increase children’s awareness, their ability to recognize abuse, knowledge on where to find help and child abuse disclosure. Teaching children that they are never to blame for child abuse was considered one of the most important components of school-based programs, next to learning children to escape from unsafe situations and to find help, increasing children’s social-emotional skills, promoting child abuse related knowledge, recognizing risky situations, and increasing children’s self-esteem. The young adults considered providing sufficient aftercare an important condition for implementing school-based programs. We discuss the implications of the current results for the development and implementation of school-based child abuse programs, as well as for future research. Keywords: school-based programs, child abuse, prevention, child abuse survivors, young adults ---redactioneel--- Redactioneel door Hans Koot Educatieve schoolprogramma’s over kindermishandeling hebben duidelijke en stevige effecten op de kennis van kinderen en hun beschermende vaardigheden, zo blijkt uit internationaal onderzoek. Dat geldt zowel voor programma’s gericht op algemene kindermishandeling als voor die gericht op seksueel misbruik. Programma’s werken vooral goed als ze lang worden volgehouden en gericht zijn op vaardigheden en werken langer als er boostersessies worden gebruikt. Leerkrachten, ouders en kinderen zijn over het algemeen positief over dergelijke programma’s, al vinden sommige schoolleiders dat hiermee wel erg veel op het bordje van de leerkracht komt. Ook in Nederland worden dergelijke programma’s aangeboden en laten ze positieve effecten zien, al zijn ze nog niet allemaal op effectiviteit onderzocht. En, het is onbekend of dergelijke programma’s ook effectief kindermishandeling voorkómen. Maar bovendien is er nog weinig bekend over hoe dit soort programma’s aansluit bij de beleving van kinderen die zelf mishandeld of verwaarloosd worden en over de optimale vormgeving van dit soort programma’s. Het doel van het hier gepubliceerde onderzoek was er dan ook om na te gaan wat ervaringsdeskundigen vinden van schoolvoorlichting over kindermishandeling en welke onderdelen van voorlichtingsprogramma’s zij essentieel vinden. Daartoe werden semigestructureerde interviews afgenomen bij 13 (jong)volwassenen in de leeftijd van 19 tot 36 jaar. De deelnemers hadden allemaal een verleden van kindermishandeling of verwaarlozing. Alle geïnterviewden vonden het belangrijk dat kinderen op school voorlichting krijgen over kindermishandeling. In hun ogen kan deze het bewustzijn van kinderen vergroten, zodat zij mishandeling sneller herkennen, ervoor zorgen dat kinderen eerder gaan praten en dat zij weten bij wie ze terecht kunnen voor hulp. Essentiële componenten van schoolvoorlichting vonden ze dat kinderen leren om weg te gaan uit een onveilige situatie en hulp te zoeken, hun sociaal-emotionele vaardigheden versterken, kennis over mishandeling vergroten, risicovolle situaties leren herkennen, en hun zelfvertrouwen leren versterken. De jongeren vonden het vooral ook belangrijk dat kinderen van voorlichtingsprogramma’s leren dat mishandeling nooit de schuld is van het kind zelf. Opvallend genoeg is dat nu juist een element wat ook uit de effectevaluatie van de programma’s zelf als belangrijk naar voren komt. Een belangrijk advies van ervaringsdeskundigen dus, op te volgen door zoveel mogelijk scholen, met als toevoeging dat het belangrijk is met erkende programma’s te werken en de nazorg voor de kinderen goed te organiseren.

Samenvatting:Huisartsen spelen een sleutelrol bij het signaleren en melden van kindermishandeling. Toch doen huisartsen slechts incidenteel een melding bij Veilig Thuis. Dit kwalitatieve onderzoek beoogde te achterhalen hoe huisartsen kindermishandeling signaleren, hoe zij handelen bij mishandelingsvermoedens, welke knelpunten zij hierbij ervaren en wat aanknopingspunten zijn voor verbetering. Semigestructureerde interviews werden gehouden met vijftien huisartsen, waarna deze werden uitgeschreven, gecodeerd en thematisch geanalyseerd. Bij signalering van kindermishandeling blijken huisartsen op verschillende signalen te letten en is het niet-pluisgevoel belangrijk. Veel huisartsen denken signalen te missen en hebben behoefte aan bijscholing over wat belangrijke signalen zijn, hoe deze signalen goed met ouders kunnen worden besproken en hoe de stappen in de meldcode het beste kunnen worden toegepast. In huisartsenpraktijken blijken geen signalerings- of risicotaxatie-instrumenten te worden gebruikt, terwijl een deel van de huisartsen dit wel als helpend beschouwd in het besluitvormingsproces rondom kindermishandeling. Ten slotte ervaren huisartsen knelpunten in de samenwerking met instanties, waaronder scholen, jeugdzorg en Veilig Thuis (VT). Concrete aanbevelingen voor verbetering van signaleren en handelen zijn het ontwikkelen van passende signaleringsinstrumenten, het verlagen van de drempel voor het volgen van bijscholing en het verbeteren van samenwerking met hulpverleningsorganisaties, in het bijzonder met VT.AbstractGeneral practitioners (GPs) are crucial in detecting and reporting child abuse and neglect. However, GPs tend to underreport their suspicions of child abuse. This qualitative study aimed to examine how GPs detect potential child abuse, how they act upon their suspicions, which barriers they encounter and how the detection and reporting of child abuse can be improved. Semi-structured interviews were conducted with 15 GPs, which were transcribed, coded and thematically analyzed. GPs are aware of various signs and a gut feeling plays an important role in detecting child abuse. GPs believe they miss child abuse signs and need education about the most important signs of child abuse, how to talk to parents about potential child abuse and the steps of the Dutch reporting code. As for risk assessment, GPs barely use structured instruments even though these are regarded as helpful in the decision-making process. Finally, GPs experience deficits in the cooperation with organizations, including schools, youth care organizations and the Child Protective Services (CPS). Directions for improvement to overcome barriers in child abuse detection and reporting are to develop appropriate instruments, lowering the threshold for GPs to follow child abuse courses, and improving cooperation between GPs and other organizations, especially CPS.

School-based programs seem promising for child abuse prevention. However, research mainly focused on sexual child abuse and knowledge is lacking on how individual program components contribute to the effectiveness of school-based prevention programs for any form of child abuse. This study aimed to examine the overall effect of these school-based programs on (a) children’s child abuse-related knowledge and (b) self-protection skills by conducting two three-level meta-analyses. Furthermore, moderator analyses were performed to identify how program components and delivery techniques were associated with effectiveness. A literature search yielded 34 studies (158 effect sizes; N = 11,798) examining knowledge of child abuse and 22 studies (99 effect sizes; N = 7804) examining self-protection skills. A significant overall effect was found of school-based programs on both knowledge (d = 0.572, 95% CI [0.408, 0.737], p d = 0.528, 95% CI [0.262, 0.794], p d = 0.909 for programs with this component versus d = 0.489 for programs without this component) and self-blame (d = 0.776 versus d = 0.412), and when puppets (d = 1.096 versus d = 0.500) and games or quizzes (d = 0.966 versus d = 0.494) were used. The second meta-analysis on children’s self-protections skills revealed that no individual components or techniques were associated with increased effectiveness. Several other study and program characteristics did moderate the overall effects and are discussed. In general, school-based prevention programs show positive effects on both knowledge and self-protection skills, and the results imply that program effectiveness can be improved by implementing specific components and techniques.

Whether risk factors for recidivism are equally predictive in different offender groups and across recidivism types is a question of high clinical importance. Therefore, this study aimed to examine (a) differences in impact of general delinquency risk factors for three different recidivism types, and (b) differences in the presence of general delinquency risk factors between five different offender groups. The studied sample comprised 8,665 Dutch adult offenders, in which risk factors for recidivism were assessed with the Recidivism RiskAssessment Scales (RISc). Results showed that risk factors were generally stronger related to nonviolent than to violent recidivism, and only weakly or not at all related to sexual recidivism. The total prevalence of risk factors was highest in generalists (non-specialized offenders), followed by nonviolent, violent, sexual, and one-time offenders. In violent offenders, risk factors in the domains relationship with the partner/family, emotional well-being, antisocial personality patterns, and antisocial attitudes/cognitions were more prevalent than in nonviolent offenders, whereas in nonviolent offenders, risk factors in the domains education/work, financial management/income, antisocial friends/acquaintances, and drug abuse were more prevalent. In conclusion, risk factors differ in prevalence and impact across offender groups and recidivism types. Therefore, different treatment approaches are needed for successfully reducing different recidivism types across offender groups.

Inleiding: Het doel van deze overzichtsstudie was om meer kennis te verkrijgen over effecten van verschillende risicofactoren voor spijbelen en schooluitval door resultaten van eerder onderzoek statistisch samen te vatten. Methode: Na inclusie van 69 studies, waarin gerapporteerd werd over 1,384 effecten van (mogelijke) risicofactoren, werd elke factor geclassificeerd in één van in totaal 44 verschillende risicodomeinen. Vervolgens werd een reeks drie-level meta-analyses uitgevoerd om voor elk risicodomein een effect te schatten Resultaten: Een significant effect werd gevonden voor 40 risicodomeinen, variërend van r = .047 tot r = .336. Relatief grote effecten werden gevonden voor een verleden van doubleren, drugsmisbruik, slechte schoolresultaten, mentale (gezondheids-)problemen, antisociaal gedrag/antisociale cognities, weinig academisch zelfvertrouwen, en negatieve schoolhouding. Discussie: Veel verschillende kind-, gezins-, school- en peer-factoren hangen samen met spijbelen en schooluitval. De resultaten zijn belangrijk voor het succesvol terugdringen en voorkomen van schoolverzuim. Implicaties voor zowel risico- en behoeftetaxatie-instrumenten als interventiestrategieën worden besproken.

Het verkrijgen van inzicht in risicofactoren voor zowel spijbelen als schooluitval is essentieel voor de preventie en vermindering van schoolverzuim. Dit onderzoek geeft een overzicht van de belangrijkste risicofactoren voor spijbelen en schooluitval aan de hand van een omvattende meta-analyse. Een uitgebreid literatuuronderzoek in wetenschappelijke databases leverde 75 bruikbare onderzoeken op, waaruit 1.416 potentiële risicofactoren werden gehaald. Factoren die min of meer gelijk van aard zijn, werden voor spijbelen in 44 en voor schooluitval in 42 wederzijds uitsluitende categorieën van risicofactoren geclassificeerd. Vervolgens werd een reeks drie-level-meta-analyses uitgevoerd om voor elk van deze categorieën een schatting te maken van een gemiddeld effect. Er was een significant effect voor 29 risicofactoren voor spijbelen, variërend van r= 0,099 tot r= 0,509, en voor 23 risicofactoren voor schooluitval, variërend van r = 0,062 tot r = 0,348. Veel verschillende kind-, gezins-, school- en peerfactoren hangen positief samen met spijbelen en schooluitval, en kunnen als risicofactoren aangemerkt worden. De resultaten van dit onderzoek zijn belangrijk voor het succesvol terugdringen en voorkomen van schoolverzuim. Implicaties voor zowel risico- en behoefte-taxatie, als interventiestrategieën om (herhaling van) schoolverzuim te voorkomen worden besproken.

BackgroundHome visiting programs are widely endorsed for preventing child maltreatment. Yet, knowledge is lacking on what and how individual program components are related to the effectiveness of these programs.ObjectiveThe aim of this meta-analysis was to increase this knowledge by summarizing findings on effects of home visiting programs on child maltreatment and by examining potential moderators of this effect, including a range of program components and delivery techniques.MethodsA literature search yielded 77 studies (N=48,761) examining the effectiveness of home visiting programs, producing 174 effect sizes. In total, 35 different program components and delivery techniques were coded.ResultsA small but significant overall effect was found (d=0.135, 95 % CI (0.084, 0.187), pConclusionsIn general, home visiting programs can prevent child maltreatment only to a small extent. However, implementing specific components and techniques can improve program effectiveness.

Education and healthcare professionals are crucial in detecting and reporting child abuse and neglect. However, signs of child abuse are often undetected, and professionals tend to underreport their suspicions of abuse and neglect. This qualitative study aimed to examine experiences, attitudes, perspectives, and decision-making skills of healthcare and education professionals with regard to identifying and reporting child abuse and to gain insight into how detection and reporting can be improved. Semi-structured interviews were conducted with 49 Dutch professionals working in child health care, mental health care, primary schools, and secondary schools. The I-Change model was used as a theoretical framework to organize the results. Many professionals believe they miss child abuse signs in their daily work, partially due to a lack of focus on child abuse. Further, professionals indicated having insufficient knowledge of child abuse, and lack communication skills to detect or discuss signs indicative of child abuse in conversations with parents or children. As for risk assessment, professionals barely use structured instruments even though these are regarded as very helpful in the decision-making process. Finally, professionals experience deficits in the cooperation with child welfare organizations, and in particular with Child Protective Services (CPS). Various directions for improvement were discussed to overcome barriers in child abuse detection and reporting, including developing tools for detecting and assessing the risk of child abuse and improving communication and information transfer between organizations.

Interventies die kindermishandeling moeten voorkomen, hebben te weinig effect, blijkt uit onderzoek. Mogelijk komt dit doordat in de jeugdbescherming de ‘what works-principes’ onvoldoende worden toegepast. Om ook daar volgens deze principes te kunnen werken, zijn de ARIJ-Risk en ARIJ-Needs ontwikkeld.

There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining potential moderators of this effect, such as intervention components and study characteristics. Identifying effective components is essential for developing or improving child maltreatment interventions. A literature search yielded 121 independent studies (N = 39,044) examining the effects of interventions for preventing or reducing child maltreatment. From these studies, 352 effect sizes were extracted. The overall effect size was significant and small in magnitude for both preventive interventions (d = 0.26, p < .001) and curative interventions (d = 0.36, p < .001). Cognitive behavioral therapy, home visitation, parent training, family-based/multisystemic, substance abuse, and combined interventions were effective in preventing and/or reducing child maltreatment. For preventive interventions, larger effect sizes were found for short-term interventions (0–6 months), interventions focusing on increasing self-confidence of parents, and interventions delivered by professionals only. Further, effect sizes of preventive interventions increased as follow-up duration increased, which may indicate a sleeper effect of preventive interventions. For curative interventions, larger effect sizes were found for interventions focusing on improving parenting skills and interventions providing social and/or emotional support. Interventions can be effective in preventing or reducing child maltreatment. Theoretical and practical implications are discussed.

Research in adolescent populations has shown that the severity, impact, and relative importance of dynamic risk factors for recidivism changes over the course of adolescence. This study examined whether there were age differences in the severity, impact, and relative importance of dynamic risk factors for recidivism in an adult offender population. The sample consisted of 8665 Dutch offenders and was divided into four age groups: 18–25 years old, 26–30 years old, 31–40 years old, and 41 + years old. The results showed that the severity and impact of dynamic risk factors varied across the age groups. An increase of the impact of dynamic risk factors was found over the course of adulthood, indicating that dynamic risk factors had a larger predictive power for recidivism in the older age groups. The relative importance of the risk factors also varied across age. In late adolescence, recidivism was most strongly predicted by problems in the education, alcohol use, and peer domains, whereas in adulthood, problems with drugs and alcohol were the most important predictors of recidivism. Results emphasize the importance of directing offender treatment at high risk offenders, and the focus on age specific criminogenic needs to maximize the effect of treatment.

This is the first meta-analytic review investigating what components and techniques of parent training programs for preventing or reducing child maltreatment are associated with program effectiveness. A literature search yielded 51 studies (N = 6670) examining the effectiveness of parent training programs for preventing or reducing child maltreatment. From these studies, 185 effect sizes were extracted and more than 40 program components and techniques were coded. A significant and small overall effect size was found (d = 0.416, 95% CI (0.334, 0.498), p < 0.001). No significant moderating effects were found for contextual factors and structural elements (i.e., program duration, delivery location, and delivery setting). Further, no significant moderating effects were found for most of the coded program components and techniques, indicating that these components are about equally effective. Only a few program components and techniques moderated program effectiveness, however these effects were negative. These results indicated that improving parental personal skills, improving problem solving skills, and stimulating children’s prosocial behavior should not be the main focus of parental training programs for preventing and reducing child maltreatment. This also holds for practicing new skills by rehearsal and giving direct feedback in program sessions. Further clinical implications and directions for future research are discussed.

School absenteeism and dropout are associated with many different life-course problems. To reduce the risk for these problems it is important to gain insight into risk factors for both school absenteeism and permanent school dropout. Until now, no quantitative overview of these risk factors and their effects was available. Therefore, this study was aimed at synthesizing the available evidence on risk factors for school absenteeism and dropout. In total, 75 studies were included that reported on 781 potential risk factors for school absenteeism and 635 potential risk factors for dropout. The risk factors were classified into 44 risk domains for school absenteeism and 42 risk domains for dropout. The results of a series of three-level meta-analyses yielded a significant mean effect for 28 school absenteeism risk domains and 23 dropout risk domains. For school absenteeism, 12 risk domains were found with large effects, including having a negative attitude towards school, substance abuse, externalizing and internalizing problems of the juvenile, and a low parent-school involvement. For dropout, the risk domains having a history of grade retention, having a low IQ or experiencing learning difficulties, and a low academic achievement showed large effects. The findings of the current study contribute to the fundamental knowledge of the etiology of school absenteeism and dropout which in turn contributes to a better understanding of the problematic development of adolescents. Further, more insight into the strength of effects of risk factors on school absenteeism and dropout is important for the development and improvement of both assessment, prevention and intervention strategies.

Risk assessment tools are increasingly being used to guide decisions about supervision and treatment of domestic violence perpetrators. However, earlier review studies showed that the predictive validity of most of these tools is limited, and is reflected in small average effect sizes. The present study aimed to meta-analytically examine the predictive validity of domestic violence risk assessment tools, and to identify tool characteristics that positively moderate the predictive validity. A literature search yielded 50 independent studies (N = 68,855) examining the predictive validity of 39 different tools, of which 205 effect sizes could be extracted. Overall, a significant discriminative accuracy was found (AUC = 0.647), indicating a moderate predictive accuracy. Tools specifically developed for assessing the risk of domestic violence performed as well as risk predictions based on victim ratings and tools designed for predicting general/violent criminal recidivism. Actuarial instruments (AUC = 0.657) outperformed Structured Clinical Judgment (SCJ) tools (AUC = 0.580) in predicting domestic violence. The onset of domestic violence (AUC = 0.744) could be better predicted than recurrence of domestic violence (AUC = 0.643), which is a promising finding for early detection and prevention of domestic violence. Suggestions for the improvement of risk assessment strategies are presented.

Martial arts are very popular among juveniles all over the world, but the relation between martial arts and externalizing behavior in juveniles remains unclear. The current multilevel meta-analysis of 12 studies, including 94 effect sizes and N = 5949 juveniles, was conducted to examine the relation between martial arts participation and externalizing behavior in juveniles, and to examine factors with a possible moderating effect. Results showed that there was no overall relation between martial arts participation and externalizing behavior in juveniles. However, a trim-and-fill procedure implicated publication bias of studies reporting that juvenile martial artist showed more externalizing behavior than non-martial artists, suggesting that the current overall outcomes might underestimate externalizing behavior in martial artists. Moderator analyses showed that studies published in higher impact factor journals, and studies with a higher training intensity in martial arts found more externalizing behavior in martial artists. Furthermore, karate was found to be less related to externalizing behavior than judo. Finally, in comparison with non-athletes and team sport athletes, martial artists showed similar levels of externalizing behavior, but they showed more externalizing behavior when compared to individual sport athletes. Implications for future policy and research are discussed.