melissa faulkner senior research officer child advocacy service royal children’s hospital...
TRANSCRIPT
Melissa FaulknerSenior Research Officer
Child Advocacy Service
Royal Children’s Hospital
Reflecting on trends in 25 years of child abuse and neglect reports to the Royal Children’s Hospital
Suspected Child Abuse and Neglect Team
SCAN Teams
• Established by CCOCA in 1980
• Children experiencing or at risk of abuse and neglect
• State-wide system
• Core members:– Queensland Health– Queensland Police Service– Department of Child Safety
SCAN Function
• Provides an inter-agency forum for case discussion and planning
• Makes recommendations for actions by the core departments
• Reviews the effectiveness of the implemented recommendations
RCH SCAN
• Royal Children’s Hospital, Brisbane
• 1980 – 2005
• 6669 cases of children experiencing or at risk of experiencing harm
• Study examining – demographic information – abuse and neglect trends– re-referral
Study Method
• All cases from 1980 – 2005 entered by trained CAS data entry staff
• Randomly selected sample of 5% of charts reviewed for validation
• Ethics approval obtained from RCH & HSD HREC
Study Results- Demographics
Over the 25 years:
• Significantly more female children (54.6%), Pearsons χ2(1, N = 6637) = 56.98, p = .00
• Mean child age 6 years, 2 months
• Slightly more single parent families than two-biological parent families (ns), followed by blended families
• Perpetrator significantly more likely to be intra-familial (84.7%), Pearsons χ2(1, N = 6206) = 4200.97, p = .00.
Results- Presenting Concerns
• Single abuse or neglect type as concern in majority of cases
Neglect 32.3%
Physical 36.7%
Emotional 13.6%
Domestic Violence 6.8%
Sexual 31.7%
% Intrafamilial Alleged Perpetrator
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PhysicalAbuse
Neglect Sexual Abuse EmotionalAbuse
DomesticViolence
Abuse Type and Average Age
0
1
2
3
4
5
6
7
8
9
PhysicalAbuse
Neglect SexualAbuse
EmotionalAbuse
DomesticViolence
Physical Abuse Concerns
• Significantly more male children with concerns of physical abuse, Pearsons χ2 (1, N = 6637) = 89.81, p = 00.
• Most frequently alleged perpetrators of physical abuse– Biological mother (34%)– Biological father (23%)– Both parents (18%)– Step father (12%)– Unknown (6%)
BiologicalMother
BiologicalFather
Both parents
Step father
Unknown
Neglect Concerns
• Significantly more male children with concerns of neglect, Pearsons χ2 (1, N = 6637) = 59.526, p = 00.
• Most frequently alleged perpetrators of neglect
– Biological mother (61%)– Both parents (29%)– Biological father (4%)
BiologicalMother
Both parents
BiologicalFather
Sexual Abuse Concerns
• Significantly more female children with concerns of sexual abuse, Pearsons χ2 (1, N = 6637) = 442.34, p = 00.
• Most frequently alleged perpetrators of sexual abuse:– Biological father (26%)
– Unknown perpetrator (18%)
– Step father (14%)
– Family friend (8%)
– Neighbour (7.5%)
BiologicalFather
Unknown
Stepfather
Family friend
Neighbour
Emotional Abuse Concerns
• Slightly but significantly more male children with concerns of emotional abuse, Pearsons χ2 (1, N =
6637) = 6.41, p = 01.
• Most frequently alleged perpetrators of emotional abuse:– Biological mother (43%)– Both parents (31%)– Biological father (15%)– Step father (5%)
BiologicalMother
Both parents
BiologicalFather
Stepfather
Domestic Violence Concerns
• Slightly but significantly more male children with concerns of domestic violence exposure, Pearsons χ2 (1, N = 6637) = 6.43, p = 01.
• Most frequently alleged perpetrators of domestic violence:– Biological father (43%)– Both parents (26%)– Biological mother (15%)– Step father (14%)
BiologicalFather
Both parents
BiologicalMother
Step father
Summary- Concern Types
• Child mean age youngest in neglect concerns, followed by DV and physical abuse
• Child mean age eldest in sexual abuse
concerns
• Male children significantly more likely to be listed for all concern types aside from sexual abuse
Summary- Alleged Perpetrators
• Intra-familial perpetrators more likely in all concern types
• In all concern types aside from sexual, the child’s biological mother, father or both parents were the most frequently listed alleged perpetrators.
Data Trends
0
20
40
60
80
100
120
140
160
180
200
Year
Num
ber
of c
once
rns
PhysicalSexualEmotionalNeglectDV
Child Protection Act 1999 CMC Inquiry
Physical Abuse Trends
0
20
40
60
80
100
120
140
160
180
200
Year
Num
ber
of c
once
rns
Physical
Neglect Trends
0
20
40
60
80
100
120
140
160
180
200
Year
Num
ber
of c
once
rns
Neglect
Sexual Abuse Trends
0
20
40
60
80
100
120
140
160
180
200
Year
Num
ber o
f con
cern
s
Sexual
Emotional Abuse Trends
0
20
40
60
80
100
120
140
160
180
200
Year
Num
ber o
f con
cern
s
Emotional
Linear(Emotional)
Domestic Violence Trends
0
20
40
60
80
100
120
140
160
180
200
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
Year
Num
ber
of c
once
rns
DV
Abuse Trends
Number concerns
Physical Abuse
Neglect Sexual Abuse
Emotional Abuse
DV
1984 108 64 73 43 6
2004 191 146 79 149 58
Percent Increase
76.8% 128.1% 8.2% 246.5% 866.7%
• 70.3% increase in Brisbane population
76.8% 128.1% 8.2%
Child Sexual Abuse Trends
• Internationally and within Australia, various studies have documented a decline in sexual abuse– Dunne et al (2003), telephone survey 1784
Australian residents• Younger males reported experiencing significantly
less child sexual abuse than older males • Younger women who had intercourse before the
age of 16 were more likely to report that they were a willing participant on first occasion
Child Sexual Abuse Trends• DChS substantiation data
– 2002 – 2006 decreases in sexual abuse (DChS 2006 – 07 Performance report)
Number of children subject to substantiations by
most serious harm type, 2002 – 03 to 2006 - 07
Child Sexual Abuse Trends
• Possible reduction in incidence per population due to:– Parental awareness– Education – Self-protection– Perpetrator awareness– Economic conditions
• Alternatively, emphasis on parental willingness and ability to protect made within the Child Protection Act 1999 – decrease in the number of extra-familial sexual abuse
cases being referred
Abuse Trends
Number concerns
Physical Abuse
Neglect Sexual Abuse
Emotional Abuse
DV
1984 108 64 73 43 6
2004 191 146 79 149 58
Percent Increase
76.8% 128.1% 8.2% 246.5% 866.7%
• 70.3% increase in Brisbane population
246.5% 866.7%8.2%
Trends Summary
• Concern numbers peaked in all abuse types aside from sexual in final two years of study
• Emotional abuse and DV reporting very low for majority of study
• Child Protection Act 1999 legislation impact– Increased reporting of abuse– Large increases in emotional abuse and domestic
violence
Other Possible Trend Influences
• Policy and Awareness
• High Profile Cases
• Daniel Valerio
• Death 1990• Vic. Legislation 1993
High Profile Cases/Media Impact
0
20
40
60
80
100
120
140
160
180
200
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
Year
Num
ber
of c
once
rns
PhysicalSexualEmotionalNeglectDV
Data Limitations
• ‘Suspected’ child abuse and neglect only– Trends in abuse reporting rather than
incidence
• Child abuse and neglect under-reported– Actual incidence likely to be higher than
represented
Study Conclusions
• Understanding of abuse and neglect within the context of the Brisbane Royal Children’s Hospital and Health Service District SCAN team
• Highlights the impact that legislation changes and public awareness can have upon concern reporting levels
• Raises questions regarding incidence trends in the community
Current Focus: Re-referral
• Referrals made after the previous presentation case closure – 5943 unique children in 25 year period– 90.5% children referred once only
• 2 referrals for 7.4% of children • 3 referrals for 1.7% of children • 4 referrals for 0.3% of children • 5 referrals for four children• 6 referrals for one child
Re-referral
• Children with multiple referrals significantly younger than those with only one referral (F (1, 5748) = 3.84; p = 0.05)
– One referral only mean age 6.19 years – Multiple referrals mean age 5.76 years
• Examined demographic variables associations– Regression results currently unfinalised
Re-referral
• Number of referrals and associated demographic variables (bivariate correlations only)
Variable Re-referral r2
Number of Abuse Types at Initial Referral -.07**
Parental Substance Abuse .04**
Parental Abuse as Child .09**
Parent Mental Illness .02
Financial Stress in Family .04**
Disabled Children in Family .03*
Parental Physical Disability .04**
Parental Intellectual Disability .07**
Parental History of Violent Relationships .07**
Acknowledgments
• Royal Children’s Hospital Foundation Brisbane
• Jennifer Crimmins, Director Child Advocacy Service
• QPS, DChS & QHealth SCAN Members
