Faculty Bibliography

This paper reviews abuse and neglect among children with disabilities and highlights the impact of disability on child abuse and neglect in the United States and internationally. Children with various disabilities have variable increases in their risk for maltreatment because of their increased vulnerability, difficulties in communication, and potential for ongoing victimization. Patterns of victimization are defined and discussed in categories of different types of maltreatment, including physical and sexual abuse, psychologic maltreatment, and neglect. The effects of disabilities of various types on this epidemiology are discussed, serving as an introduction to the problem of child abuse and neglect as well as describing potentially intervenable risk factors among the population of disabled children. Recommendations are given to improve our understanding of how to best identify child maltreatment among children with disabilities so they may maximize their developmental and intellectual potentials.

The effects of changes in mandated child maltreatment reporting laws have not been systematically evaluated. To better understand the effects of these changes, the objectives of the present study are: (1) to assess the relationships between report rates and state universal and clergy reporting laws in 2010; (2) to compare the changes in total, confirmed, and maltreatment type report rates and with changes in reporting laws from 2000 to 2010, and (3) to examine whether there is any relationship with report rates and the nature of the mandated reporting law change. We used county-level data from the U.S. National Child Abuse and Neglect Data System for the years 2000 and 2010 to evaluate changes in reporting rates for total reports, confirmed reports, and confirmed maltreatment types while controlling for concurrent changes in child and community variables. We found that trends in 2010 for increased total and confirmed reports were similar to 2000 for counties with universal and/or clergy reporting requirements, which significantly contributed to report rates even after controlling for child and community factors. Universal reporting was associated with higher report rates for physical and sexual abuse, and clergy reporting requirements were associated with more sexual abuse, medical neglect and psychological maltreatment confirmed reports. However, while counties in states that changed their clergy reporting laws had higher increases in total reports, they had fewer confirmed physical and sexual abuse, neglect, and psychological maltreatment reports. More pronounced changes were noted in a state that made more pronounced changes in its clergy reporting laws. Policymakers should consider whether changing requirements for mandated reporting meaningfully improves child maltreatment identification. (C) 2016 Elsevier Ltd. All rights reserved.

This paper addresses significant misconceptions regarding the etiology of fractures in infants and young children in cases of suspected child abuse. This consensus statement, supported by the Child Abuse Committee and endorsed by the Board of Directors of the Society for Pediatric Radiology, synthesizes the relevant scientific data distinguishing clinical, radiologic and laboratory findings of metabolic disease from findings in abusive injury. This paper discusses medically established epidemiology and etiologies of childhood fractures in infants and young children. The authors also review the body of evidence on the role of vitamin D in bone health and the relationship between vitamin D and fractures. Finally, the authors discuss how courts should properly assess, use, and limit medical evidence and medical opinion testimony in criminal and civil child abuse cases to accomplish optimal care and protection of the children in these cases.

The medical evaluation is an important part of the clinical and legal process when child sexual abuse is suspected. Practitioners who examine children need to be up to date on current recommendations regarding when, how, and by whom these evaluations should be conducted, as well as how the medical findings should be interpreted. A previously published article on guidelines for medical care for sexually abused children has been widely used by physicians, nurses, and nurse practitioners to inform practice guidelines in this field. Since 2007, when the article was published, new research has suggested changes in some of the guidelines and in the table that lists medical and laboratory findings in children evaluated for suspected sexual abuse and suggests how these findings should be interpreted with respect to sexual abuse. A group of specialists in child abuse pediatrics met in person and via online communication from 2011 through 2014 to review published research as well as recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics and to reach consensus on if and how the guidelines and approach to interpretation table should be updated. The revisions are based, when possible, on data from well-designed, unbiased studies published in high-ranking, peer-reviewed, scientific journals that were reviewed and vetted by the authors. When such studies were not available, recommendations were based on expert consensus.