Search Results (57)

Background: Childhood neglect is a pervasive yet often overlooked form of maltreatment that exerts profound and lasting effects on neurodevelopment. Unlike other types of abuse, neglect is characterized by the absence of essential stimuli and caregiving, which are critical for normal brain maturation, particularly in regions involved in executive function. Objective: This narrative review aims to critically explore the neurobiological mechanisms through which early-life neglect impairs the development of executive functions. Special emphasis is placed on alterations in brain structure and function, dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, and emerging epigenetic evidence. Methods: A comprehensive literature search (170 articles) was conducted across PubMed, Scopus, Web of Science, and PsycINFO, including studies published between 1 January 2000 to 31 March 2025. Relevant empirical and review articles were selected based on methodological rigor, relevance to executive functioning, and focus on child neglect. Results: Evidence reveals that neglect disrupts key neural circuits, particularly those involving the prefrontal cortex and amygdala, leading to deficits in attention, working memory, impulse control, and cognitive flexibility. Chronic stress associated with neglect also induces HPA axis dysregulation and elevated cortisol levels, which further compromise neural plasticity. Additionally, epigenetic modifications appear to mediate long-term cognitive and emotional consequences. Conclusions: Childhood neglect represents a distinct and critical risk factor for executive dysfunction. Understanding the neurodevelopmental consequences of neglect is essential for developing targeted prevention strategies and therapeutic interventions aimed at supporting cognitive resilience in affected populations. Full article

Background/objectives: Adolescent dating violence (ADV) is a serious public health concern affecting youth worldwide. Potential risk factors of ADV include child maltreatment (CM) and intimate partner violence exposure (eIPV), though existing research on ADV perpetration specifically is inconsistent. There is limited research on co-occurring eIPV and CM, despite co-occurrence in 30–60% of homes where there is one. This study aims to address these gaps by testing the impact of childhood violence exposure on ADV perpetration and assessing two potential, theory-informed mitigating factors—mental health and parent–youth relationship. Methods: This study utilizes moderated-mediation structural equation modeling with longitudinal data from a sample of 2354 U.S. adolescents (10–18) and one of their caregivers. Three models were tested: (1) childhood violence exposure (eIPV only, CM only, or co-occurring CM & EIPV) and ADV perpetration; (2) mediation by mental health quality on model 1; and (3) overall moderation by parent–youth relationship quality on model 2. Results: The final sample consisted of 961 youth with a history of dating. A significant direct effect between eIPV and ADV perpetration was found. There was a significant direct effect between co-occurrence (eIPV & CM) and ADV perpetration, which was mediated by mental health quality. Conclusions: This study further emphasizes the relation between eIPV and ADV and provides novel evidence of the impact co-occurrence has on ADV. Evidence of a trauma-informed mitigating factor, mental health quality, offers a potential point of intervention to be considered by mental health providers and ADV prevention/intervention programs. Full article

Background: Children with disabilities face an increased risk of neglect and maltreatment due to their dependence on caregivers, social isolation, and challenges in seeking help. While extensive research has examined child abuse, neglect remains an underexplored yet pervasive issue affecting this vulnerable population. Objective: This scoping review synthesizes literature from the past decade to assess the prevalence, characteristics, and risk factors of neglect among children with disabilities, aiming to identify gaps in research and inform policy and intervention efforts. Methods: Following the PRISMA-ScR guidelines, a systematic search was conducted across multiple electronic databases, including PsycNET, Social Services Abstracts, ERIC, PubMed, and EBSCO. Studies were included if they focused on neglect among children with disabilities and were published in English within the last ten years. Thematic analysis was employed to extract and categorize findings. Results: Sixteen studies met the inclusion criteria, revealing a significantly higher prevalence of neglect among children with disabilities compared to their typically developing peers. The type and severity of disability influenced the likelihood and nature of neglect, with children with intellectual disabilities (ID), autism spectrum disorder (ASD), and sensory impairments facing particularly high risks. Key risk factors included parental stress, economic hardship, limited access to resources, and systemic failures in early identification and intervention. Despite the severity of neglect, evidence-based preventive strategies remain scarce, and existing child protection frameworks often fail to account for the unique needs of children with disabilities. Conclusions: The findings underscore the urgent need for targeted interventions, specialized training for professionals, and policy reforms to address the neglect of children with disabilities. Future research should focus on developing and evaluating culturally sensitive and disability-specific support systems to mitigate the long-term consequences of neglect. Full article

Infantile occult exposure to cocaine in domestic environments represents a complex clinical and medico-legal problem, which can be associated with abuse and neglect and with potential short- and long-term health risks for children. The authors present a retrospective study on 764 children under 14 years old who accessed the Emergency Department of IRCCS Meyer from 2016 to 2023 and were included in the GAIA (Child and Adolescent Abuse Group) protocol for suspected maltreatment and abuse, and for which a urine toxicology analysis was performed. The aim is to discuss the medico-legal implications and highlight the need for a thorough evaluation and management of such situations. Urine screening tests for substances of abuse (e.g., cocaine, opiates, etc.) were performed with an EMIT^® Siemens VIVA-E drug testing system (Siemens, Newark DE) in 124 cases for which the child’s clinical condition raised suspicion of intoxication, or the family context indicated distress or substance abuse dependency. The screening results revealed the presence of cocaine and its main metabolite, benzoylecgonine, in the urine of 11 children. In one case, a single girl was brought to the Emergency Department by staff from the facility where she and her mother were staying. In most of the cases, children were brought to the Emergency Department by their parents who accessed the Emergency Department due to various clinical manifestations (drowsiness, agitation, seizures, hypotonia, diarrhea, vomiting, etc.), except for one case of eye trauma suspected to be caused by abuse or neglect by one of the parents. Three of the children did not have signs or symptoms attributable to substance exposure, whilst eight of the cases presented some of the symptoms associated with occult infant exposure to cocaine, such as neurological manifestations, seizures, gastrointestinal symptoms, and respiratory depression. The probable mode of intake was mostly through breastfeeding and continuous environmental exposure due to domestic contamination or inhalation of “crack”. In the case of a 12-hour-old infant, there was probable prenatal in utero exposure. All the children were hospitalized, some for medical reasons and others solely as a precautionary measure for proper care. In all cases, a report was made to the Prosecutors as required by the Italian Penal Code, as well as to the Court of Minor. The study highlighted the importance of a multidisciplinary approach involving pediatricians, social workers, and forensics, as well as close collaboration with the relevant authorities, as the Gaia service at IRCCS Meyer offers. The occasional detection of cocaine in cases that showed no suspicion of intoxication led to a modification of the procedure and the development of a standardized protocol at IRCCS Meyer both in terms of prevention and in the detection and interception of hidden cases, in order to intervene early and initiate the necessary care pathways (secondary prevention). This protocol includes routine toxicological urine testing in all suspected or confirmed cases of child abuse, not just in those where symptoms might suggest a suspicion of intoxication. Full article

The NYC Administration for Children’s Services and MDRC have partnered since 2021 to develop a rigorous research agenda leading to an impact evaluation of the Family Treatment and Rehabilitation (FT/R) model, a “home-grown” New York City intervention for families experiencing substance misuse and/or mental health challenges that put children at risk of maltreatment. This paper will describe the first phase of that research, which had two goals: (1) to refine a logic model that would result in a shared understanding of core components of the FT/R model, and (2) to create a plan for a subsequent implementation study that would enable MDRC and ACS to understand how 18 FT/R programs are implementing the model across New York City. The paper will describe the team’s orientation to this research, including centering equity in the work by prioritizing the inclusion of staff and family perspectives. Next steps in the research roadmap will be discussed, including convening a council of lived experience advisors, as well as implications for evidence-building for sustainability. This research has the long-term potential to support FT/R’s inclusion in the Family First Prevention Services Clearinghouse and ultimately, the leveraging of Title IV-E funds to support scaling of a locally developed, culturally responsive, and adaptable child welfare prevention model beyond New York City. Full article

This study reflects the evidence-building journey for the Colorado Kinnected kinship navigator program. Colorado Kinnected expands the scope of services, resources, and supports offered to kinship families through an innovative approach that enhances an earlier Kinship Supports Demonstration Project. The Colorado Kinnected target population includes kinship caregivers caring for children and youth of any age with an open child welfare case. The primary purpose of the program is to reduce child welfare involvement by limiting traditional foster care and congregate care use when out-of-home placements are required. A randomized controlled trial was conducted from June to November 2020 to examine the impact of the Colorado Kinnected kinship navigator program on the kinship placement outcomes of 402 children and youth with an open child welfare case in seven Colorado counties. The initial study found that children and youth placed with kinship caregivers who received Colorado Kinnected services were significantly more likely to reunify with their parents after their kinship placements ended than were children and youth who received kinship supports as usual. The sustained effects study featured additional analyses of traditional foster and congregate care entry rates within six months of kinship placement for the same sample of children and youth. Children and youth in the intervention group were significantly less likely than children and youth in the control group to enter foster care or congregate care within six months after the end of their kinship placements. Overall, both analyses indicate that the Colorado Kinnected program promotes sustained permanency among children and youth in formal kinship placements. Data equity analyses to explore the contextual sensitivity of the intervention are detailed, and implications for practice, policy, and research are discussed. Full article

The association between poverty and maltreatment is well established, and numerous studies show the detrimental effects of economic and material hardship on maltreatment, child welfare involvement, and family well-being. In turn, an increasing body of literature suggests the value of programs and services that provide economic and concrete support in stabilizing and supporting families and, ultimately, reducing occurrences of maltreatment. In this article, we examine the effectiveness of economic and concrete support in reducing primary outcomes of child maltreatment and child welfare involvement and in improving secondary outcomes of child and adult well-being through a systematic review of the literature. We review studies published between 1990 and 2023 through searches of scholarly databases, child welfare websites, and evidence-based clearinghouses. We used a two-stage review process to identify a final sample of articles for data extraction. Twenty-four studies with low risk of bias were included in the synthesis. Regardless of delivery mechanism, we found consistent, favorable evidence of the impact of economic and concrete support as a prevention strategy to reduce child maltreatment and child welfare entry and to a lesser extent, improvements in child and adult well-being across these studies. Implications for policy, practice, and racial equity are discussed. Full article

Since all policies address problems, they necessarily include implicit or explicit constructions of these problems. This paper explores how child maltreatment has been constructed in New Zealand’s child protection policies. It questions the underlying assumptions of this problem construction and seeks to shed light on what has been omitted. Utilizing a qualitative content analysis of eight key policy documents, this study reveals the construction of child maltreatment has been dominated primarily by a child-centric, risk-focused approach. This approach assigns blame and shifts responsibilities onto parents and families. In addition, the vulnerability discourse and social investment approach underpinning this perspective have allowed important structural factors, such as poverty and inequality, to remain unaddressed. This paper also highlights the one-dimensional focus on the lower social class to control future liabilities. We suggest that the harm inflicted by corporations on children’s well-being is another form of child exploitation currently omitted from the problem construction. We suggest that child abuse should be defined and understood in policy as harm to children’s well-being and argue that the state should prevent and mitigate harm by addressing structural forces of the problem as well as protecting children against corporate harms. Full article

Although home visiting programs have generally shown small overall effects on the prevention of child maltreatment, at-risk families with severe strain do not seem to benefit sufficiently from this support. A crucial factor for success seems to be the quality of the service system. The aim of the current study is to evaluate the effects of mentalization-based team supervision on the already existing welfare service of a German early prevention program (EPP). This will be a non-randomized, open-label, single-arm feasibility study. The EPP staff will be trained according to the mentalization-based team approach (MB-TA) and regularly receive MFT supervision by a trained and experienced child and adolescent psychiatrist. A minimum of eighty-four families with defined risk factors with children below 24 months of age and pregnant women in the third trimester will be included. Assessments will take place at T0 (after inclusion in the study), at T1 (after family care ends, as an intermediate assessment,) and at T2 (as a follow-up). We hypothesize that the risk of maltreatment can be reduced by strengthening the skills and capacities of the primary care system. This will be evaluated at the end of the follow-up period by comparing the Parental Stress Index (PSI) scores of all participants pre- and postintervention. Stress levels and mentalization abilities will be assessed as feasibility endpoints for the participating EPP teams. Full article

Child maltreatment is a global public health issue known to affect an average of 600,000 U.S. children of all ages (0–18 years old) annually. However, a preponderance of preventive programs target children on the younger end of the spectrum, specifically those aged 0–5. Annual reports of the prevalence of maltreatment provide opportunities to analyze trends, but in 2009, these reports stopped reporting the ages of victims for each type of maltreatment (i.e., neglect, physical abuse, emotional abuse, and sexual abuse). This omission limits the ability to match (or design) prevention programs responsive to the ages of those at greatest risk. Using data from the National Child Abuse and Neglect Data System (NCANDS) from 2011–2020, this secondary data analysis describes trends for four types of maltreatment by age from an epidemiological perspective. Implications for practice (i.e., prevention) and policy are presented. The findings of this study offer the first step in what is hoped to be a line of research that seeks to identify, match, and/or develop evidence-based programs to prevent child maltreatment among the populations at highest risk. Full article

Post-natal home visits have been shown to be one of the most effective ways to prevent child maltreatment and reduce risks among children. Unfortunately, these programs tend to be expensive and thus not accessible or practical in many contexts. To address this problem, this paper reviews the literature on home visits conducted shortly after giving birth, considering different types of programs and their outcomes, while focusing on short-term and volunteer-based programs, two approaches that can answer the gap in accessibility. It then introduces a new, innovative, short-term, home visiting program that was developed in Israel. This post-natal program is uniquely structured as volunteer-based to allow it to be culturally informed and inexpensive and therefore accessible to municipalities. The paper describes how experts in the field developed the program and how the volunteers were trained. It elaborates on the protocol for the three defined home visits, each with a specific focus: (1) preventing risks at home, (2) providing parents with emotional support and tools to deal with stress, and (3) connecting them to community resources. We detail the pilot implementation process and some of the challenges that arise. Finally, we describe the design of the evaluation study that is currently collecting data in an Arab town in the north of Israel, with a final discussion on insights gained thus far from the overall process in light of the literature. Full article

Adverse childhood experiences (ACEs) encompass various adversities, e.g., physical and/or emotional abuse. Understanding the effects of different ACE types on various health outcomes can guide targeted prevention and intervention. We estimated the association between three categories of ACEs in isolation and when they co-occurred. Specifically, the relationship between child maltreatment, witnessing violence, and household dysfunction and the risk of being involved in violence, engaging in health-harming behaviors, and experiencing mental ill-health. Data were from eight cross-sectional surveys conducted in England and Wales between 2012 and 2022. The sample included 21,716 adults aged 18–69 years; 56.6% were female. Exposure to child maltreatment and household dysfunction in isolation were strong predictors of variant outcomes, whereas witnessing violence was not. However, additive models showed that witnessing violence amplified the measured risk beyond expected levels for being a victim or perpetrator of violence. The multiplicative effect of all three ACE categories demonstrated the highest level of risk (RRs from 1.7 to 7.4). Given the increased risk associated with co-occurring ACEs, it is crucial to target individuals exposed to any ACE category to prevent their exposure to additional harm. Implementing universal interventions that safeguard children from physical, emotional, and sexual violence is likely to mitigate a range of subsequent issues, including future involvement in violence. Full article

The aim of this study was to assess the 12-week group version of the mentalization-based Lighthouse Parenting Program for child maltreatment prevention. Parents who might be facing mentalizing difficulties due to challenges in the parent–child relationship were invited to participate in the program. The aim of the program was to promote mentalizing—to encourage parents’ curiosity about their children’s minds and their willingness to reflect on their own feelings, thoughts, and behaviors. Study participants were 101 parents (82 mothers, 19 fathers). Parenting practices and parental and family adjustment were assessed using the Parent and Family Adjustment Scale and mentalization was measured using Mentalization Scale at pre- and post-intervention assessments. Parents’ feedback on the program was gathered after the program. Results revealed that mentalization, parental adjustment, and family functioning improved while coercive parenting practices decreased after the intervention. Study results provide preliminary indications of the benefits of the 12-week Lighthouse Parenting Program for parents referred or self-referred for mental health services due to their own or their child’s difficulties. Full article

Purpose: This study aimed to explore links between child maltreatment (CM) and experiences of interpersonal violence (IV) in sport among adolescent sport participants. To our knowledge, no studies have yet considered this association. This is surprising given that the literature outside of sport clearly shows that CM is related to revictimization in adolescence and adulthood. Methods: The sample consists of 983 adolescents aged 14 to 18 years old participating in an organized sport. They completed a self-report survey in class at six Canadian schools assessing CM and IV in sport. Logistic regressions were performed to examine the associations between CM and IV in sport. Results: Child physical abuse, emotional abuse, and exposure to domestic violence were significantly associated with psychological violence and neglect in sport. Exposure to domestic violence was the only form of CM significantly associated with physical violence in sport. Child sexual abuse and neglect were significantly associated with sexual violence in sport, while child emotional abuse and exposure to domestic violence were significantly associated with peer violence in sport. Physical abuse was the only form of CM significantly associated with coach violence. Child physical abuse, emotional abuse, neglect, and exposure to domestic violence were positively associated with violence from parents in sport. Conclusions: Considering the associations between CM and IV in sport, further investigations are necessary on how to prevent revictimization. It also highlights the importance of athlete-centered and trauma-informed practices in sport. Implications and Contribution: This study was the first, to our knowledge, to show the relationship between CM and the experience of IV in organized sport, as reported by 983 Canadian adolescents. Our findings reveal different associations depending on the type of IV (physical, sexual, psychological, or neglect) and the perpetrators (peers, coaches, or parents). Full article