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Physical abuse in children under two: a study of therapeutic outcomes
Insights
Child physical abuse outcomes are poor, with low treatment compliance and high rates of re-abuse. Many children experience out-of-home placement, and family functioning remains compromised long-term.
Area of Science:
- Pediatrics
- Child Psychology
- Social Work
Background:
- Physical abuse in children under two years old presents significant challenges.
- Assessing family prognosis, treatment adherence, and long-term child outcomes is crucial.
Purpose of the Study:
- To evaluate the long-term outcomes for children experiencing physical abuse before age two.
- To examine family prognosis and compliance with recommended treatments.
Main Methods:
- Data collected from a multidisciplinary team and Department of Human Services records.
- Study included 71 children with physical abuse.
- Follow-up assessments of child and family status.
Main Results:
- Low compliance (33%) with mental health counseling and parent training.
- High rates of recurrent abuse (50% of children, 30% post-referral).
- Significant out-of-home placements (mean 11 months foster care, 24.4 months relative care).
- In 69% of families, multiple children were abused.
- At follow-up, 41% of children and 47% of siblings lived outside the parental home.
- Half of families functioned poorly; only nine showed good progress.
Conclusions:
- Child physical abuse under age two has severe, lasting consequences.
- Treatment compliance is low, and re-abuse rates are high, independent of compliance.
- Family dysfunction and child separation from parents are common long-term outcomes.
Abstract:
This study of physical abuse to children under the age of 2 addresses the prognosis of the family, compliance with treatment recommendations and the long term outcome of the child. Data were collected from a multidisciplinary evaluation team and from the Department of Human Services' records on 71 children. Nearly all families were referred for mental health counseling and parent training, but only 33% complied. Half of the children were abused more than once; 30% were abused after referral for counseling. The incidence of reabuse was unrelated to compliance with counseling. The majority of children had some out-of-home placement with a mean time in foster care of 11 months and in care of relatives for 24.4 months. In 69% of families, more than one child was abused. At the time of follow-up, 41% of children and 47% of siblings were not living with either parent. Half of the families were judged to be functioning poorly and only nine had made good progress in counseling.