Melissa Faulkner Senior Research Officer Child Advocacy Service Royal Children’s Hospital Reflecting on trends in 25 years of child abuse and neglect reports.

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

Questions?

Email: [email protected]