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Maltreatment in psychiatrically hospitalized children and adolescents with developmental disabilities: prevalence and
R T Ammerman1, M Hersen, V B van Hasselt
1Western Pennsylvania School for Blind Children, Pittsburgh 15213-1499.
Insights
Child maltreatment is prevalent in hospitalized youth with developmental and psychiatric conditions. Risk factors include child
Area of Science:
- Child psychiatry
- Developmental disabilities
- Child maltreatment research
Background:
- Hospitalized children and adolescents with developmental disabilities often have co-occurring psychiatric disorders.
- Child maltreatment is a significant concern within vulnerable populations.
Purpose of the Study:
- To determine the prevalence of child maltreatment in hospitalized children and adolescents with developmental disabilities and psychiatric disorders.
- To identify maternal and child characteristics associated with severe disciplinary practices.
Main Methods:
- 138 psychiatrically hospitalized children/adolescents with developmental disabilities and their mothers were assessed.
- Semistructured interviews and questionnaires evaluated risk factors for child maltreatment.
- Prevalence and severity of maltreatment were rated using the Child Abuse and Neglect Interview Schedule and hospital charts.
Main Results:
- 61% of children experienced severe maltreatment in their lifetime.
- Child factors predicting severe discipline: younger age, high social functioning, disruptive behaviors.
- Maternal factors predicting severe discipline: low social support, increased anger reactivity.
Conclusions:
- Child maltreatment is highly prevalent in this population, necessitating clinical assessment.
- Elevated risk in families with younger, higher-functioning, disruptive children and mothers with low social support and anger reactivity.
Objective:
The goals of this study were (1) to determine the prevalence of child maltreatment in hospitalized children and adolescents with developmental disabilities and concomitant psychiatric disorders, and (2) to identify the contribution of specific mother and child characteristics to the use of more severe disciplinary practices by mothers.
Method:
One hundred thirty-eight psychiatrically hospitalized children and adolescents with developmental disabilities and mothers were assessed using a semistructured interview (Child Abuse and Neglect Interview Schedule) examining factors associated with risk of child maltreatment, and questionnaires measuring maternal and child functioning. The Child Abuse and Neglect Interview Schedule and hospital charts were then used to derive ratings on the prevalence and severity of child maltreatment.
Results:
Findings revealed that 61% of children had experienced some form of severe maltreatment by a care provider in their lifetime. Regression analysis indicated that interactions between high levels of social functioning and disruptive/oppositional behaviors and younger age in children, and low levels of social support and increased anger reactivity in mothers, were most predictive of mothers' use of severe disciplinary practices.
Conclusions:
Maltreatment in psychiatrically hospitalized children and adolescents with disabilities is very prevalent, and it warrants careful clinical assessment. In the psychiatric setting, families in which the child is younger, higher functioning, and behaviorally disruptive, and where mothers have little social support and exhibit increased anger reactivity, are at especially elevated risk.