Environmental influences on incidents of alleged child abuse and neglect in New York state psychiatric facilities: Toward an etiology of institutional child maltreatment

doi:10.1016/0145-2134(86)90078-5

Child Abuse & Neglect

Volume 10, Issue 2, 1986, Pages 171-180

https://doi.org/10.1016/0145-2134(86)90078-5 Get rights and content

Abstract

In order to gain a better understanding of the etiology of institutional child maltreatment, 232 allegations of child abuse and neglect in New York State Office of Mental Health operated facilities were investigated with the hypothesis that environmental stresses placed on professional child care workers can precipitate incidents of child maltreatment in institutional settings in the same way that stress and anxiety experienced by a parent can contribute to incidents of abuse in the home. The study focused on administrative policy decisions, patient census and admissions, seasonal influences, staffing levels and identifiable one-time disruptions in daily routines as potential contributors to institutional abuse. A multivariate regression analysis revealed a significant four-variable model for predicting the number of reports of abuse and neglect per month, R² = .585, F(4, 21) = 7.41, p < .01. Potential preventive measures based on this model were suggested.

Résumé

Le but de l'étude était de mieux comprendre si possible l'étiologie de la maltraitance institutionnelle à l'égard d'enfants; les auteurs ont enquêté sur 232 cas de plaintes de sévices-négligence émanant d'institutions psychiatriques pour enfants dépendant du Bureau d'Hygiène Mentale de l'Etat de New York. L'hypothèse de travail était que des contraintes péristatiques subies par le personnel s'occupant des mineurs placés dans ces institutions pouvaient contribuer à de tels incidents, à l'instar de ce qu'on observe dans les foyers familiaux lorsqu'un parent décompensé par les tensions ambiantes et l'inquiétude se laisse aller à la violence. Les auteurs ont essayé de voir si des facteurs tels que des changements dans les règles administratives, des variations dans le nombre d'admissions et dans le nombre des résidents de ces institutions, d'autres influences saisonnières, des variations dans le nombre et la composition du personnel, et enfin si d'autre perturbations ponctuelles indentifiables dans les procédures quotidiennes, ne pouvaient pas contribuer à la genèse d'incidents de violence-négligence. Une analyse de régression multi-variée a permis de construire un modèle statistiquement valable composé de 4 variables permettant de prédire le nombre de cas pouvant se produire en un mois, R² .585, F(4, 21) = 7.41, p .01. Ce modèle apparaît aux auteurs comme étant utile pour prévenir et diminuer la survenue de ces incidents dus à la violence ou à la négligence, dans de telles institutions.

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Sexual abuse of children and youth in residential care: An international review
2014, Aggression and Violent Behavior
Citation Excerpt :
Research into sexual abuse began about ten years earlier in the United States. These studies often looked at a broad spectrum of abuse or neglect, rather than sexual abuse specifically (Blatt, 1992; Blatt & Brown, 1986; Groze, 1990; New York State Commission on Quality of Care, 1992; Nunno, 1997). The first study, which dates from 1984, catalogued the number of reported cases of abuse in round-the-clock care in ten federal regions, in both governmental and private child and youth care institutions (Rindfleisch & Rabb, 1984).
This paper reports the results of an international review of academic literature on sexual abuse in residential child and youth care, 1945–2011. The review focusses on questions related to the nature and scope of sexual abuse, on personal and institutional factors providing either protection or risk, and on how residential institutions have responded to signals of sexual abuse. Empirical research did not appear until the 1990s, and is still scarce. A variety of research designs and of definitions of sexual abuse obscure the prevalence of sexual abuse in residential care. Sexual abuse by peers is often overlooked, while this accounts for almost half of the known cases. Histories of sexual abuse prior to placement, group dynamics, institutional culture and insufficient knowledge of professionals on how to address issues of sexuality, appear to be crucial factors in peer abuse. Gender also plays a significant role: most, though not all, victims are females, most, though not all, perpetrators are males. Instead of understanding sexual abuse as a phenomenon related to individual characteristics, it is important to address both institutional factors (culture) and group dynamics in order to provide children in residential homes with the care they need.
Maltreatment of children in out-of-home care: A review of associated factors and outcomes
2012, Children and Youth Services Review
Citation Excerpt :
Furthermore, a study by Stubenbort, Greeno, Mannarino, and Cohen (2002) suggested that secure attachment relationships may serve to buffer the impact of trauma and the subsequent presentation of trauma-related symptoms. Research related to attachment theory has suggested that children who are able to find stability in an out-of-home setting are better able to overcome early attachment failures that are associated with child maltreatment (Bowlby, 1988; Dozier, Stovall, Albus, & Bates, 2001). Unfortunately, children who experience maltreatment in out-of-home care have compounded experiences of insecure attachment relationships.
This paper provides an overview of the nature and consequences of the maltreatment of children in out-of-home care. It discusses maltreatment by individual perpetrators such as carers or other children, and maltreatment inflicted through policies, processes and decisions made within the child protection system. The impacts of maltreatment in out-of-home care on children are reviewed, and the child, worker and system factors that contribute to maltreatment of children in care are discussed. The need for changes in child protection services is highlighted.
Confirmed, unconfirmed, and false allegations of abuse made by adults with mental retardation who are members of a class action lawsuit
2001, Child Abuse and Neglect
Objective: The purpose is to explore differences in confirmed, unconfirmed, and false allegations of abuse made by consumers with mental retardation in regards to type of abuse and perpetrator.
Method: Interviews were conducted with 1,220 people with mental retardation who were part of a class action lawsuit in North Carolina. A content analysis of abuse allegations was performed. Frequencies of responses and subgroup differences are reported for type of abuse allegation and perpetrator.
Results: Unconfirmed claims are the most frequent. Females made more allegations of abuse than males in general, and more allegations of rape. There are no significant differences among the subgroups (confirmed, unconfirmed, and false allegations) by type of abuse allegation. There are significant differences among the subgroups in regard to the alleged perpetrator. Other consumers with mental retardation are most frequently accused of confirmed assaults. Staff members are most frequently accused in false allegations.
Conclusion: Ability of the alleged victim to report information and timing of the investigation are important factors in substantiating abuse. Awareness of consumer-to-consumer violence and prevalence of false accusations against staff necessitates increased safeguards for both consumers and staff.
Objectif: Il s’agit d’explorer les différences entre les allégations confirmées, non-confirmées et fausses faites par des clients retardés mentalement en ce qui concerne le type de sévices et l’auteur.
Méthode: On a interviewé 1,220 déficients mentaux qui participaient à un recours collectif en Justice en Caroline du Nord. Une analyse du contenu des allégations a été faite. Les fréquences des réponses ainsi que les différences entre sous-groupes ont été rapportées au type d’abus allégué et à l’auteur.
Résultat: Les plaintes non-confirmées sont les plus fréquentes. Les femmes ont rapporté plus d’allégations de sévices que les hommes en général et plus d’allégations de viol. Il n’y a pas de différences significatives entre les sous-groupes (allégations confirmées, non-confirmées et fausses) selon le type de sévice. Il y a des différences significatives entre les sous-groupes en ce qui concerne l’auteur allégué. D’autres plaignants retardés mentaux sont le plus souvent accusés d’agressions confirmées. Les membres du personnel sont le plus souvent objets d’allégations fausses.
Conclusions: La capacité des victimes alléguées à donner des informations et des précisions sur la chronologie lors de l’investigation sont des facteurs importants pour fournir une preuve à l’appui des sévices. La sensibilisation à la violence entre les clients et la fréquence des accusations contre le personnel nécessite un accroissement des garanties à la fois pour les clients et pour le personnel.
Objetivo: El propósito es explorar las diferencias con respecto al tipo de maltrato y a las caracterı́sticas del perpetrador en alegaciones de maltrato confirmadas, no confirmadas y falsas hechas por usuarios del sistema de protección infantil con retraso mental.
Método: Se llevaron a cabo entrevistas con 1.220 personas con retraso mental que formaban parte de un grupo de sujetos de Carolina del Norte con un expediente judicial abierto por abuso sexual. Se analizó el contenido de las alegaciones de maltrato. Las frecuencias de respuesta y las diferencias sub-grupo fueron clasificadas en base al tipo de alegación de maltrato y al perpetrador.
Resultados: Las demandas no confirmadas son las más frecuentes. Las mujeres, en general, hicieron más alegaciones de maltrato que los hombres, y más alegaciones de violación. No hay diferencias significativas entre los sub-grupos (alegaciones confirmadas, sin confirmar, y falsas) por el tipo de alegación de maltrato. Hay diferencias significativas entre los sub-grupos con respecto al presunto perpetrador. Otros sujetos con retraso mental son más frecuentemente acusados de agresiones confirmados. Los profesionales de los centros son más frecuentemente acusados de falsas alegaciones.
Conclusión: La habilidad de la presunta vı́ctima para notificar información y el tiempo empleado en la investigación son factores importantes para confirmar el maltrato. El conocimiento de las agresiones entre usuarios de los centros y la prevalencia de falsas acusaciones en contra del personal necesita una mejora de las garantı́as tanto para los usuarios como para el personal.
Factors associated with child abuse and neglect in residential care settings
1992, Children and Youth Services Review
A random sample of 510 reports of child abuse and neglect incidents in residential care settings was studied in order to begin to develop a systematic understanding of the causes of such incidents. The study was focused on the time and day of the incidents, the time and day of oral reports to the New York State Child Abuse and Maltreatment register, the characteristics of the children involved in the incidents, and the characteristics of the workers involved. It was found that the children allegedly maltreated in residential care settings were older than children abused and neglected in familial settings, that younger staff were more likely to be involved in incidents than older staff, and that male staff were more likely to be involved than female staff. It was also found that incidents were more likely to occur between 5:00 p.m. and 9:00 a.m. In contrast, reporting to the register occurred more frequently between 9:00 a.m. and 5:00 p.m. Incidents of suspected abuse and neglect were reported to the register more quickly if they occurred between 9:00 a. m. and 5:00 p. m. on weekdays.
A descriptive study of abuse and neglect in out-of-home-placement
1991, Child Abuse and Neglect
Selected characteristics of 290 reports of physical abuse, sexual abuse and neglect in foster homes, group homes, residential treatment centers, and institutions are described. At each type of setting physical abuse reports were most common, and neglect reports were least common. Quantitative and qualitative methods demonstrate that a significant percentage of confirmed reports are of a serious nature. Injuries occurred most frequently because of physical abuse while sexual abuse reports were most likely to be confirmed. Prior allegations of abuse or neglect regarding the perpetrator were indicated in 27% of reports. Factors contributing to abuse and neglect and the role of a state institutional review team in developing a systematic approach to this problem are discussed.
Le travail décrit les caractéristiques sélectionnées de 290 signalements d'abus physiques, sexuels ou de négligence dans des familles d'acceuil, des homes, des centres de traitement résidentiel et des institutions. Pour chacun de ces types d'hébergement les signalements d'abus physique étaient le plus fréquent, ceux de négligence les moins fréquents. L'utilisation de méthodes quantitatives et qualitatives démontrent qu'un pourcentage significatif des signalement confirmés sont des signalements graves. Des lésions étaient le plus fréquemment provoquées par des abus physiques alors que les signalements d'abus sexuels avaient le plus de chance de se trouver vérifiés. Des plaintes antérieures d'abus ou de négligences à l'égard des auteurs de mauvais traitements étaient mentionnées dans 27% des rapports. Les facteurs contribuant à l'abus ou à la négligence ainsi que le rôle d'une équipe de supervision des institutions de l'Etat dans le développement systématique du problème sont discutées.
Se describen características seleccionadas de 290 informes de abuso físico, abuso sexual y negligencia en hogares sustitutos, grupos de hogares y centros e instituciones de tratamiento residencial. Los informes de abuso físico fueron los más comunes y los de negligencia los menos comunes. Los métodos cualitativos y cuantitativos demostraron que un porcentaje significative de los informes confirmados son serios. Las lesiones fueron causadas más frecuentemente por el abuso físico mientras que los informes de abuso sexual fueron los más frecuentemente confirmados. Acusaciones anteriores de abuso o negligencia relacionadas con el perpetrador estuvieron presente en 27% de los informes. Se discuten los factores que contribuyen a que se cometan actos de abuso y negligencia, así como el papel de un equipo estatal de inspección de las instituciones en el desarrollo de un enfoque sistemático de este problema.
Sexual abuse in the developmentally disabled: Dilemmas of diagnosis
1990, Child Abuse and Neglect
Evaluation of developmentally disabled persons for physical signs of sexual abuse presents many challenges to the practitioner. This group is especially vulnerable to all types of abuse. A group of 35 mentally retarded females from a residential treatment facility was examined by the child abuse medical team at Harbor/UCLA Medical Center after one inpatient was found to be pregnant. Patients ranged in age from 13 to 55 years (median, 26 years; mean, 31.3 ± 13.6 years). All of the women had some degree of disability, with 24 (69%) being categorized as profoundly retarded. No patient was able to provide a history. There were 13 (37%) patients who had genital findings we believe are consistent with prior vaginal penetration. Dilemmas which arose during evaluation included the significance of healed genital lesions in this population and the implications of the findings for the residential facility. While developmentally disabled persons need an advocate in the medical and legal systems, these patients can overwhelm the practitioner. Whenever possible, a team approach is recommended to decrease the work load and frustration and provide collegial support and affirmation of findings.
Les personnes déficientes au niveau du développement sont particuliérement vulnérables au mauvais traitements de toutes sortes. Le praticien qui fait subir un examen á ces personnes pour établir s'il y a eu abus sexuels affronte de véritables défis. Dans un centre de traitement résidentiel pour femmes attardées, ayant découvert qu'une d'elle était enceinte, on invita l'équipe médicale du Centre médical Harbor de l'Université de la Californie á Los Angeles á examiner les 35 femmes qui y résidaient. Elles étaient âgées de 13 á 55 ans (la médiane étant de 26 ans, la moyenne de 31.3 ± 13.6 ans). Toutes étaient déficientes mentales, dont 24 (69%) l'étaient profondément. Aucune ne pouvait fournir de renseignements. A l'examen gynécologique, 13 (37%) femmes manifestaient des signes qu'on associe normalement á la pénétration vaginale. Cette étude souléve certaines questions: Que peut signifier des lésions guéries chez cette population? Quelles sont les responsibilités des centres d'accueil par rapport aux agressions sexuelles? Il faut á ces patientes quelqu'un pour défendre leurs droits par rapport aux systémes légal et médical. Ces cas sont délicats et le praticien voudra s'entourer d'une équipe, tant pour partager le travail que pour s'assurer un support collégial et vérifier ses observations.
La evaluación de síntomas corporales del abuso sexual en las personas con trastornos evolutivos presenta grandes problemas. Este grupo es expecialmente vulnerable a todo tipo de abuso. Un grupo de 35 retardadas mentales. en una institución de tratamiento residencial fue examinado por el equipo de abuso al menor en el Harbor/ UCLA Medical Center después que una paciente resultó estar encinta. Las pacientes tenían de 33 a 55 años (mediana, 26 años, media 31.3 ± 13.6 años). Todas las mujeres padecían de un cierto grado de retardo y 24 (69%) eran profundamente retardadas. Ninguna paciente fue capaz de ofrecer una historia. Trece (37%) de las pacientes mostraban síntomas vaginales que consideramos consistentes con la penetración vaginal previa. Entre los dilemas encontrados se hallaba el significado de las lesiones genitales curadas en este grupo, y las implicaciones de los hallazgos para la institución residencial. Aunque los retardados mentales necesitan un defensor en los sistemas médico y legal, estos pacientes pueden abrumar al profesional. Siempre que sea posible, se recomienda un enfoque de equipo para disminuir el trabajo y la frustración, y para proveer apoyo y confirmación de los hallazgos.

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^☆: Portions of this paper were presented at the Fifth International Congress on Child Abuse and Neglect, Montreal, Canada. September 1984.

^☆☆: The senior author was employed at the New York State Office of Mental Health while this research was being conducted.

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Environmental influences on incidents of alleged child abuse and neglect in New York state psychiatric facilities: Toward an etiology of institutional child maltreatment☆,☆☆

Abstract

Résumé

Child Abuse & Neglect

Journal of Pediatrics

Beyond the Best Interest of the Child

Christmas in Purgatory

One Hundred Years in Psychiatry

State Mental Hospitals: Problems and Potentials

Institutional abuse of children in out-of-home care

Child maltreatment: An ecological integration

American Psychologist

Child abuse: An interdisciplinary analysis

Review of Child Research and Development

Reproductive risk and the continuum of caretaking casualty

Prospective study of child maltreatment from a transactional perspective

Helping the Battered Child and His Family

The battered child syndrome

Advances in Pediatrics

The Maltreated Child