Transcript Document

CHILD NEGLECT
* What is Neglect?
Types of Neglect
What constitutes neglect: Behavior of Parent or Harm to child?
* How Many Children Are Neglected?
Vast Differences between estimates
Difficulty in defining and measuring
Cultural criterion
Where to draw the line
Is failure to protect from observing violence neglect?
* Is there any way to measure neglect aside from the number of injured
children discovered?
* Most prevalent and least researched form of child maltreatment
* Ways of measuring neglect: CPS, CTS scale, MNS-A and MNS-C
* Consequences of Neglect: IDV study, Maine-NH study
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TYPES OF NEGLECT
U.S. Department of Health and Human Services as cited in Barnett:
1.
Health care neglect (the refusal to provide physical and mental health care)
2.
Personal hygiene neglect (personal care and cleanliness standards are failed to be
met)
3.
Nutritional neglect (failure to provide a nutritious and quality diet)
4.
Neglect of household safety (safety hazards either within the house or surrounding
area pose danger to the child)
5.
Neglect of household sanitation (housekeeping and cleanliness standards are not
met)
6.
Inadequate shelter (lack of stable home)
7.
Abandonment (physical abandonment)
8.
Supervisory neglect (parental supervision lacks to the extent that injury is possible)
9.
Educational neglect (parents don’t provide the necessary care and supervision to
promote education)
10. Emotional neglect (security, support, and encouragement aren’t provided)
11. Fostering delinquency (the encouragement of illegal behaviors)
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DEFINITION OF NEGLECT
Neglect is behavior by a caregiver that constitutes a
failure to act in ways that are presumed by the culture of
a society to be necessary to meet the developmental
needs of a child and which are the responsibility of a
caregiver to provide.
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CONTROVERSIAL ELEMENTS IN THE DEFINITION
“Behavior by a caregiver”
* Essential to avoid confounding the definition and measurement of neglect
with either the causes of neglect (such as poverty or motive) or with
the effects of neglect such as physical or psychological damage to the
child.
* Crucial to measure causes or effects. For example, service providers may
often also need data on injury, as this is often prescribed by statute
* Causes and effects must be measured separately from the caregiver behavior
that constitutes neglect.
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HARM TO THE CHILD IS NOT IGNORED
BY A DEFINITION THAT EXCLUDES HARM
•Actualy facilitates research to investigate the degree of harm associated
with deviation from culturally established standards of care.
• Studies of this type
• First identifytype and frequency of neglectful behavior, defined as
deviation from cultural standards.
• Next investigate the probability and degree of harm associated with
those deviations from cultural standards
Example: standards for appropriate levels of supervision, such as leaving a
seven year-old under the daily supervision of a 10 year-old sibling after
school until a parent returns from work.
* What percent of such children are harmed?
* If harm is included in the definition, there is no way of measuring
that.
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“PRESUMED BY THE CULTURE”
* Except possibly at the extremes when a child is seriously injured or
dies, neglect is a culturally constructed phenomenon
* Cultural norms concerning neglect vary from society to society.
Within a given society they change over time.
* Laotia, Cambodian, and many other societies: leaving an infant in the
daylong care of 7 or 8 year old siblings expected rather
than be considered neglect (Korbin & Spilsbury, 1999).
* Contemporary USA: both the infant and the 7 or 8 year-old caregiver
child would be judged as neglected.
* For example, learning to read and write was at one time a privilege of a
small minority of children rather than a developmental need that,
if not met, constitutes neglect.
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“RESPONSIBILITY OF A CAREGIVER”
• Allows for a division of labor between caregivers.
• If there are two caregivers and only one is expected to provide food, and
only one does, the other caregiver has not been neglectful.
• If both are expected to provide food and one does not, that is neglect by
the caregiver who fails to provide food.
• This is the case even if the child gets enough to eat from the other
caregiver because a primary caregiver has failed to meet the
standards of the culture.
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PREVALENCE OF NEGLECT
DIFFERENCES IN RATES FROM THREE SOURCES
Cases reported to Child Protective Services, 1998
53% of all cases reported to CPS
RATE
PER 1,000
7.2
NUMBER
OF CHILDREN
504,000
National Incidence Study of cases known to human
service professionals (random sample of 28 counties)
15.9
1,004,00
National Survey of 1,000 parents, 1995
270.0
18,865,000
Cases known to professionals is double
Cases uncovered by 1995 survey of parents is 37 times greater
WHAT COULD EXPLAIN THESE DIFFERENCES?
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WHAT COULD EXPLAIN THESE DIFFERENCES?
MOST CASES NOT REPORTED
Even human service professionals do not report all (perhaps half
of cases they know about)
DIFFERENT CRITERIA FOR JUDGING A CASE TO BE NEGLECT
National Survey of parents used parents behavior
CPS and human service professionals tend to use injury to the
child
Most neglect does not result in a visible injury. The most frequent
injury is psychological and it is rarely observable
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HOW CAN NEGLECT BE MEASURED
ASIDE FROM REPORTS TO CPS?
Surveys Of Service Providers – the least useful approach
Epidemiological Surveys = studies of a general population
The CTS Neglect Scale
The Multimensional Neglect Scale
Form A – Adolescent Report and Adult Recall
Form AS – Short form as part of the PRP
Form CR – Computer Administered For children 6-12
Form PR – Parent Self Report
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WHY HAVING OTHER MEASURES IS MPORTANT
Cases known to CPS are the tip of the iceberg
Provides more complete estimate of prevalence
But the criteria are not necessarily the same
A means of testing the effectiveness of prevention and treatment
programs
More adequate data on CPS cases, especially cases with other
presenting problems
Research that will provide the better understanding of the causes
neglect needed to develop "primary prevention" programs
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NATIONAL SURVEY OF 1,000 PARENTS
(Straus et al, 1995)
THE CTS NEGLECT
Prevalence Past Yr
SCALE
Scale and Items
Year Ever Chron
NA. Had to leave your child home alone, even 195 213
6.0
when you thought some adult should be with him/her
NC. Were not able to make sure your child got 110 137
5.5
the food he/she needed
NE. Were so drunk or high that you had a
33 5.9
2.3
Problem taking care of your child
ND. Were not able to make sure your child got to 4 12
2.0
a doctor or hospital when he/she needed it.
NB. Were so caught up with problems that you
2 11
4.6
were not able to show or tell your child that you loved him/her
Neglect Scale (= sum of the 5 items)
270 306
6.9__________
Chronicity is the mean number of times each act was reported among
the subset of parents who reported at least one occurrence.
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MULTIDIMENSIONAL NEGLECT SCALE
SHORT FORM (Form MNS-AS)
Cognitive needs
My parents helped me with homework if I needed help (R)
My parents did not help me to do my best in school
Educational Needs
My parents made sure I went to school (R)
My parents did not care if I got into trouble in school
Emotional needs
My parents helped me when I had problems (R)
My parents did not comfort me when I was upset
Physical needs
My parents gave me enough clothes to keep me warm (R)
My parents did not keep me clean
(R) = REVERSED ITEMS
RELIABILITY COEFFICIENT (ALPHA = .71)
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Table 3: Percent Reporting One or More
Forms of Each Type of Neglect, by Gender
7,500 Students in 14 Countries
Neglect Scale
Total
Cognitive
Emotional
Educational
Physical
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Total
Males
Females
1+ forms
50.50%
56.20%
47.80%
2+ forms
24.50%
28.70%
22.60%
1+ forms
29.80%
34.40%
27.70%
2+ forms
5.30%
5.60%
5.10%
1+ forms
22.30%
25.50%
20.90%
2+ forms
5.60%
5.20%
5.70%
1+ forms
19.80%
23.20%
18.30%
2+ forms
1.20%
1.40%
1.10%
1+ forms
11.80%
14.40%
10.70%
2+ forms
0.70%
1.30%
0.50%
Chi Square
55.27***
34.66***
29.90***
23.42***
27.93***
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Table 3. Number of Neglectful Behaviors
Experienced by Students
Who Were Neglected, By Gender*
Number of
Behaviors
1
2
3
4
5
6
7
8
Mean
SD
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Total
51.4%
24.3%
12.8%
6.8%
2.9%
1.2%
0.5%
0.0%
1.91
1.22
Males
49.0%
24.1%
14.2%
7.8%
3.3%
1.4%
0.2%
0.0%
1.97
1.23
Females
52.7%
24.4%
12.0%
6.3%
2.8%
1.1%
0.6%
0.0%
1.88
1.22
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Table 5a: Neglect Total Scores in Rank Order by Site, by Gender
NHT1 (% 1 or more)
Rank
Male
NHT1 (% 3 or more)
Female
Male
Female
1
KOR-PUSAN
93.9
KOR-PUSAN
95.0
KOR-PUSAN
28.1
KOR-PUSAN
41.2
2
HKG-HONGKONG
86.2
HKG-HONGKONG
78.9
HKG-HONGKONG
25.3
HKG-HONGKONG
30.8
3
BEL-LEUVEN
73.3
BEL-LEUVEN
64.0
USA-TX NCDCHS
24.3
CAN-LONDON
20.3
4
MEX-JUAREZ
70.2
MEX-JUAREZ
61.8
CAN-WINNIPEG
23.5
USA-MISSISSP
16.3
5
NDL-AMSTRDAM
69.4
ISR-EMEKZYRL
59.3
CAN-LONDON
22.7
USA-TX-MEX
15.5
6
PRT-BRAGA
69.1
CHE-GERMAN
56.9
MEX-JUAREZ
21.3
USA-LOUISIAN
13.9
7
IND-PUNE
65.6
PRT-BRAGA
54.5
USA-TX-N MEX
20.2
MEX-JUAREZ
13.5
8
BRA-SAOPAULO
65.1
NDL-AMSTRDAM
53.6
BRA-SAOPAULO
19.1
ISR-EMEKZYRL
12.9
9
ISR-EMEKZYRL
64.0
BRA-SAOPAULO
53.2
USA-MISSISSP
17.9
CAN-HAMILTON
12.0
10
CAN-HAMILTON
61.9
USA-MISSISSP
52.9
USA-LOUISIAN
17.6
CAN-WINNIPEG
11.2
11
USA-TX-N MEX
58.1
USA-TX-MEX
52.2
USA-CINCINN
17.5
USA-TX-N MEX
10.5
12
USA-UTAH
56.9
CAN-HAMILTON
49.6
ISR-EMEKZYRL
17.4
BRA-SAOPAULO
10.4
13
USA-LOUISIAN
56.8
USA-TX NCDCHS
48.4
USA-UTAH
16.7
IND-PUNE
9.8
14
USA-TX-MEX
56.3
USA-LOUISIAN
48.1
BEL-LEUVEN
16.4
NDL-AMSTRDAM
9.6
15
CAN-MONTREAL
54.8
IND-PUNE
48.1
AUS-MAGILL
14.6
CHE-GERMAN
9.5
16
USA-TX NCDCHS
54.1
CHE-FRENCH
46.6
CHE-FRENCH
13.7
USA-TX NCDCHS
9.5
17
USA-MISSISSP
53.6
CAN-MONTREAL
45.7
USA-NH 2
12.8
AUS-MAGILL
9.4
18
CAN-WINNIPEG
52.9
CAN-LONDON
45.6
CAN-MONTREAL
12.3
CAN-MONTREAL
9.4
19
USA-CINCINN
52.6
CAN-WINNIPEG
42.2
NDL-AMSTRDAM
12.2
PRT-BRAGA
9.1
20
CAN-LONDON
51.5
USA-UTAH
42.0
PRT-BRAGA
12.2
BEL-LEUVEN
8.8
21
CHE-FRENCH
50.5
USA-TX-N MEX
42.0
CAN-HAMILTON
11.9
NZL-CHRISTCH
8.7
22
CHE-GERMAN
48.4
AUS-MAGILL
41.4
IND-PUNE
11.5
USA-CINCINN
7.7
23
AUS-MAGILL
42.7
USA-CINCINN
40.5
USA-TX-MEX
10.1
USA-UTAH
7.6
24
USA-NH 2
40.4
NZL-CHRISTCH
33.7
NZL-CHRISTCH
10.0
CHE-FRENCH
6.2
25
NZL-CHRISTCH
40.0
USA-NH 2
27.8
CHE-GERMAN
6.3
USA-NH 2
4.7
26
USA-NH 1
24.7
USA-NH 1
17.8
USA-NH 1
5.2
USA-NH 1
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2.4
16
Figure 1: Interaction Effect of Gender and Site for Total Neglect
2.30
2.10
1.90
1.70
1.50
1.30
1.10
0.90
0.70
Male
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Female
17
Multidimensional Neglect Scale-Child Report
(MNS-CR)
Glenda Kaufman Kantor, Ph.D., Murray A. Straus, Ph.D., & Melissa Holt, Ph.D,
Family Research Laboratory, University of New Hampshire
Lawrence Ricci, M.D. & Kerry Drach, Psy.D.
Spurwink Clinic, Portland Maine
•FOR CHILDREN 6-9 AND 10-15
•COMPUTER ADMINISTERD -- SOUND AND TOUCH SCREEN
•WARM-UP PICTURES DONE WITH RESEARCER
•COMPUTER GAME HALF WAY THROUGH
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Emotional Neglect Sample Item
Which girl is most like you?
This girl’s father doesn’t
make her feel better when
she is sad or scared
CA NEGLECT
This girl’s father makes her
feel better when she is sad or
scared
19
Emotional Neglect Sample Item Cont.
Is this…
A little Sort of
A lot Really a lot
like you like you like you like you
CA NEGLECT
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Cognitive Neglect Sample Item
Which girl is most like you?
This girl’s mother talks to
her about what she is
learning in school
CA NEGLECT
This girl’s mother does not
talk to her about what she is
learning in school
21
Supervision Neglect Sample Item
(age 6-9)
Which boy is most like you?
This boy’s mother knows
where he’s playing
outdoors
CA NEGLECT
This boy’s mother doesn’t
know where he’s playing
outdoors
22
Supervision Neglect Sample Item
(age 10-15)
Which boy is most like you?
This boy’s father does not find
out where he is going after
school
CA NEGLECT
This boy’s father finds out
where he is going after
school
23
Hasn’t left alone for a couple of days without grown-ups
CA NEGLECT
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Physical Neglect Sample Item
Which boy is most like you?
This boy’s mother makes sure
he takes a bath
CA NEGLECT
This boy’s mother does not
make sure he takes a bath
25
Sees grown-ups in the house hitting each other
CA NEGLECT
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Depression Sample Item
Which girl is most like you?
Some girls are unhappy
a lot of the time
CA NEGLECT
Other girls are pretty
happy a lot of the time
27
Depression Sample Item Cont.
Is this…
A little Sort of
A lot Really a lot
like you like you like you like you
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Sample Characteristics
• Clinical Sample
•
•
•
•
•
•
N = 143
57% 6-9 years of age
43% 10-15 yrs. of age
59% female
41% male
6% non-white
CA NEGLECT
• Community Sample
•
•
•
•
•
•
N = 45
67% 6-9 years of age
33% 10-15 yrs. of age
53% female
47% male
38% non-white
29
% Child Behavioral Problems by
MNS-CR Median Split Scores
40%
37%
35%
30%
30%
25%
20%
25%
19%
15%
Below Median
Above Median
10%
5%
0%
6-9 year olds
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10-15 year olds
30
Relations of Neglect to Depression and PPVT
Standard Scores: Age 6-9
• Child Depression
•
•
•
•
•
•
•
Neglect Total (r = .54**)
Emotional Neglect (r = .40**)
Cognitive Neglect (r = .40**)
Supervision Neglect (r = .41**)
Physical Neglect (r = .45**)
Parental Alcohol Use (r = .50**)
Child’s Appraisal of Neglect (r = .53**)
• PPVT Standard Scores
• MNS-CR Total Score (r = -.26*)
• Physical Neglect (r = -.36**)
• Neglect Maltreatment Group (r = -.38**)
*p=
CA NEGLECT
.05, ** p = .01
31
Relations of Neglect to Depression and PPVT
Standard Scores: Age 10-15
• Child Depression
•
•
•
•
•
•
Neglect Total (r = .35*)
Emotional Neglect (r = .37**)
Cognitive Neglect (r = .33*)
Supervision Neglect (r = .49**)
Failure to Protect (r = .58**)
Parental Alcohol Use (r = .32**)
• PPVT Standard Scores
• Child’s Appraisal of Neglect (r = -.30*)
• Neglect Maltreatment Group (r = -.50**)
* p = .05, ** p = .01
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SUMMARY
ESTIMATES OF NEGLECT VARY WIDELY
Mainly because they measure different phenomena
Parent behavior versus injury
INFORMATION ABOUT NEGLECT THAT DOES NOT COME TO THE
ATTENTION OF CPS IS NEEDED BECAUSE CPS CASES ARE A
SMALL FRACTION OF THE ACTUAL NUMBER OF CASES
THE ABOVE STATEMENT IS TRUE ONLY IF ONE MEASURES
NEGLECT BY PARENT BEHAVIOR
IT IS POSSIBLE TO MEASURE NEGLECT IN THE GENERAL
POPULATION
USE OF ONE OF THESE MEASURES IN THE INTERNATIONAL
DATING VIOLENCE STUDY SHOWS THAT NEGLECT OCCURS
WORLD-WIDE
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End for Soc 697
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CA NEGLECT
35
30%
25%
20%
15%
10%
5%
0%
0
5
10
15
20
25
30
35
40
45
50
Neglect History Total INDA%>2TOTAL
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50%
40%
30%
20%
10%
0
5
10
15
20
25
30
35
40
45
Neglect History Total INDA%>2TOTAL
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Central Aims of the Study
• Develop a standardized instrument to
measure neglect
• Estimate the prevalence of different types
of neglect in a community sample
• Describe characteristics of neglectful
families in community and clinical
samples
• Describe the relationship of neglect to
child behavior problems & family
characteristics
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ACASI
• Audio enhanced version of the Computer
Assisted Self-Administered Interview
• Uses an audio system and touch screen to
interview child
• Scale version adapted by age and gender
of the child and gender of the primary
caretaker
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Child Self Report Neglect Scale
• Measures cognitive, emotional,
supervision, and physical neglect
• Includes subscales on: Child
Endangerment: exposure to parental
conflict & violence, abandonment, and
parental alcohol abuse;
• Includes subscale on child’s general
feelings or appraisals of each domain
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Eligibility
• Inclusionary Criteria- 6-15 yrs old
• Lived in foster care < 6 months (age 6-9)
• Lived in foster care < 1 year (age 10-15)
• Exclusionary Criteria• Visually impaired
• Hearing impaired
• No spoken language ability
• Non-English speaking
• Formal diagnosis of mental retardation
• Deemed “not interviewable” by clinician
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Maltreatment Types in Clinical Sample
Number & % in
Group
(Total N = 143)
Overall Types
Neglect
Physical abuse
Sexual abuse
Emotional/Psychological abuse
“Pure” Categories (Participants with
only one designated abuse type)
Neglect
Physical abuse
Sexual abuse
Emotional/Psychological abuse
Multiple
CA NEGLECTAbuse Types
41 (29%)
39 (27%)
104 (73%)
44 (31%)
86 (60%)
8 (5.6%)
2 (1.4 %)
74 (51.7%)
2 (1.4%)
57 (40%)
42
Total MNS-CR Scores by Sample:
Age 6-9
Neglect Total
10
*
8.35
8
6
4.56
4
2
0
Community Sample
Clinical Sample
Significance, * p = <.01
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MNS-CR Scores by Sample: Age 6-9
Neglect Domain
Clinical Sample
(N = 81)
Cmty. Sample
(N = 30)
Emotional
1.83
1.07
Cognitive
1.65
1.17
Supervision
1.88
0.69**
Physical
2.83
1.63
Abandonment
0.16
0*
Failure to Protect
0.88
0.73
Alcohol
0.23
0*
Child’s Appraisal
2.74
3.15
Depression
2.86
2.31
CA NEGLECT
** p < .01, * p < .05
44
Total MNS-CR Scores by Sample:
Age 10-15
Neglect Total
8
6
7.62
5.26
4
2
0
Community Sample
CA NEGLECT
Clinical Sample
45
MNS-CR Scores by Sample: Age 10-15
Neglect Domain
Clinical Sample
(N = 81)
Cmty. Sample
(N = 30)
Emotional
2.26
1.94
Cognitive
1.58
0.80
Supervision
2.04
1.18
Physical
1.58
1.20
Abandonment
0.16
0.13
Failure to Protect
0.66
0.69
Alcohol
0.09
0.0
Child’s Appraisal
1.94
1.91
Depression
2.61
2.43
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46
MNS-CR Scores by Neglect: Age 6-9
Yes
(N = 20)
No
(N = 54)
Neglect Total
8.14
8.24
Emotional
1.66
2.00
Cognitive
1.40
1.56
Supervision
1.76
1.99
Physical
3.22
2.56*
Abandonment
0.10
0.13
Alcohol
0.25
0.23
Failure to Protect
0.45
1.05
General Appraisal
2.77
2.77
Depression
3.44
2.63*
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MNS-CR Scores by Psych. Abuse: Age 6-9
Yes
(N = 20)
No
(N = 54)
Neglect Total
6.07
9.00
Emotional
1.05
2.22
Cognitive
1.16
1.65
Supervision
1.60
2.05
Physical
2.21
2.94
Abandonment
0.05
0.15
Alcohol
0.30
0.21
Failure to Protect
0.61
0.99
General Appraisal
2.61
2.82
Depression
2.07
3.10
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48
MNS-CR Scores by Neglect: Age 10-15
Yes
(N = 17)
No
(N = 47)
Neglect Total
8.20
6.15
Emotional
2.52
1.80
Cognitive
1.73
1.28
Supervision
1.94
1.98
Physical
1.89
1.09
Abandonment
0.12
0.0
Alcohol
0.06
0.10
Failure to Protect
0.49
0.55
General Appraisal
2.26
1.72
Depression
2.40
2.69
CA NEGLECT
49
MNS-CR Scores by Psych. Abuse: Age 10-15
Yes
(N = 21)
No
(N = 37)
10.12
4.84
Emotional
3.11
1.39
Cognitive
2.13
1.00
Supervision
3.16
1.16
Physical
1.63
1.16
Abandonment
0.10
0.0
Alcohol
0.24
0.0
Failure to Protect
0.97
0.28
General Appraisal
1.81
1.92
Depression
3.35
2.13
Neglect Total
CA NEGLECT
50
MNS-CR Scores by Past
CPS Involvement
9
8.8
8
7
6
5
6.74
5.76
Never Involved
Ever Involved
4
3
2.54
2
1
0
6-9 year olds
CA NEGLECT
10-15 year olds
51
MNS-CR Scores by Current CPS
Involvement (Open Case)
12
10
10.51
8
6.82
6
6.49
5.16
4
Currently No Open
Case
Current Open Case
2
0
6-9 year olds
CA NEGLECT
10-15 year olds
52
PPVT Standard Scores by Presenting
Maltreatment Type
PPVT Standard Score
Age 6-9
Age 10-15
Yes
88.37**
87.87**
No
100.31
100.74
Yes
92.17
95.33
No
98.79
98.00
Yes
99.64**
99.58*
No
89.67
90.80
Yes
94.80
95.43
No
98.02
98.19
Neglect Concerns
Physical Abuse Concerns
Sexual Abuse Concerns
Psych. Abuse Concerns
CA NEGLECT
* p < .05, ** p < .01
53
Table 1: Comparison of Neglect Estimated
Authors
Sample
Randomly
Gallup
selected US
Organization, 1995 households
Randomly
selected 18-24
Cawson, P., et al., year old UK
2000
residents
Christensen, E.,
1996
Health Nurses
in Denmark
Department of
Families in
Department of
Queensland,
Families, 2002
Australia
U.S. Department of Child Protective
Health and Human Services and
Services, 1999
DHHS in US
National
Clearinghouse on
Child Abuse and
Child Protective
Neglect, 1999
Services in US
Sedlak, A. J., et al.,
1996
CA NEGLECT
Case Source
Neglect Type
Perpetrators
interviewed
Total Neglect
Victims
interviewed
Total known
cases of
victimization
Human Service Total known
Professionals in cases of
US
victimization
27.00%
Physical Neglect
6.00%
Passive Neglect
4.00%
Officially reported
cases of
victimization
Total Neglect
Officially reported
cases of
victimization
Passive Neglect
Total known
cases of
victimization
Prevalence Rate
Total Neglect
Total Neglect
Educational
Physical
Emotional
3.00%
0.60%
0.60%
1.30%
0.60%
0.50%
0.30%
54
Table 2: Reliability of Neglect
File
Version
Individual level file
Original
0.71
0.71
Individual level file
DA
0.58
0.58
Aggregate file
DA
0.63
0.76
Aggregate file
D
0.90
0.91
Aggregate file
Pooled
0.59
0.70
CA NEGLECT
Alpha
Standardized
55
Reliability Summary for MNS-CR Scores
Scale
Number
of Items
Alpha
Age 6-9
Age 10-15
Neglect Total
36
.78
.91
Emotional
7
.55
.79
Cognitive
5
.30
.59
Supervision
8
.29
.73
Physical
13
.45
.72
Abandonment
2
-.02
N/A
Alcohol Use
2
-.07
N/A
Failure to Protect
3
-.04
.35
General Appraisal
6
.50
.45
Depression
6
.68
.78
CA NEGLECT
56