The "geography" of child maltreatment in Israel: Findings from a national data set of cases reported to the social services

"I'm in a Bloody Battle without Being Able to Stop It": The Dissociative Experiences of Child Sexual Abuse Survivors

Dissociation in child sexual abuse (CSA) survivors remains under-recognized and diagnosed, partly because of the difficulties involved in identifying dissociative symptoms. Qualitative research can contribute to a better understanding of the lived experiences of dissociation. This study focused on the experiences of dissociation in the context of CSA. In all, 22 female incest survivors, all diagnosed with different dissociative disorders, provided narratives about their experiences of dissociation. The narratives were analyzed using interpretative phenomenological analysis. The narrative analysis revealed four central themes. The first theme deals with reliving the experience of the abuse. The second theme refers to the experience of disconnection from the body, the self, and the surroundings. The third theme covers the lack of coherence in the narrative, and the fourth theme describes the bridge between voluntary controlled and nonvoluntary uncontrolled use of dissociation. The data are discussed in light of several traumagenic constructs, including a lack of self-sense, being entrapped in a victim-aggressor relationship, and distorted time perception. It is suggested that the extent to which participants can control their dissociation and the coherency of their narratives reflects the severity of their dissociation. Clinicians can consider helping clients use dissociation as an adaptive defense mechanism.

Child Sexual Abuse Studies in Arab Societies: A Systematic Review and Directions for Future Research

Although child sexual abuse (CSA) is acknowledged as a worldwide social phenomenon, less is known about CSA within Arab societies. The current systematic literature review was designed to highlight the empirical knowledge on CSA in Arab societies. Guided by PRISMA principles, key databases were searched, with no time limit, for studies meeting the inclusion criteria. Fifty-seven studies were identified. The majority focused on the prevalence of CSA in various Arab societies around the world, with a wide range of rates reported. It is important to stress two main barriers addressed by the included studies. The first relates to the issue of taboo and the forbidden discussion of sexual content. The second is ethical, in which the researchers expressed their fear of creating emotional distress for their participants. A small group of studies examined parents' perceptions of CSA and the need for parents' involvement in the protection of their children. Another small group of studies focused on professionals' perceptions and experiences in contending with CSA, as well as their distress, conflict, and urgent need for support and guidance. The conclusions from the systematic literature review emphasized the enormous challenge of conducting studies on CSA in Arab societies and the urgent need to advance this research while also including children and adult survivors, whose perceptions and experiences are currently understudied. Moreover, the discussion stresses the need to adopt an intersectionality paradigm in future studies to advance the improvement of CSA policy and practice.

"Our family sleeps deeply": The Presence of Others During Intrafamilial Child Sexual Abuse as Conveyed By Girls From Diverse Communities in Israel

Child sexual abuse (CSA) is generally perceived as a crime perpetrated out of sight, without witnesses. Nevertheless, several researchers have explored the presence of others during incidents of abuse in regards to two main aspects: bystanders in extrafamilial CSA and bystanders' decisions whether or not to get involved. However, there is a dearth of knowledge regarding how children who experience abuse perceive and experience the presence of others during abusive incidents. The current study was designed to examine the experiences and perceptions of girls who experienced intrafamilial CSA (IFCSA) with respect to the presence of others, as conveyed during their forensic interviews. A thematic analysis of 24 forensic interviews was conducted with secular Jewish, ultra-Orthodox Jewish, and Muslim Arab girls, aged 4-14. The analysis identified four main themes: (a) the girls' perceptions of others' awareness of them being abused, (b) the girl's experiences of loneliness, (c) the girls' experiences of disclosing to the others present during the abuse, and (d) family dynamics. The discussion highlights the unique, multifaceted and elusive dynamics of IFCSA, calling into question the commonly held view that it happens only in secret. The girls' narratives highlighted their distress and pointed to the abusive and unbearable daily routine in which they live. In spotlighting their encounters with IFCSA, the girls focused on the feelings of guilt, shame, and isolation they experienced.

Factors Associated With Referral of Children With a Femur Fracture to a Social Worker by an Orthopedist for Suspected Child Abuse

OBJECTIVES

This article explores factors associated with referral of children with a femur fracture to a social worker by an orthopedist for suspected child abuse.

METHODS

This retrospective chart review study included 131 children younger than 5 years who sustained a femur fracture and were hospitalized in a major 495-bed hospital located in the northern-central Israel from 2009 to 2021. Data on children who were referred to a social worker by the treating orthopedist and those who were not were compared.

RESULTS

More than half the children studied (58.8%, n = 77) were referred to a social worker by an orthopedist for suspected child abuse. However, only a fifth of these cases were eventually reported to the authorities. Male sex (odds ratio [OR], 2.44), younger age of the child (OR, 0.95), and spiral femur fracture type (OR, 5.30) increased the likelihood of referral. In addition, treatment of the child by an orthopedic specialist (as compared with an orthopedic resident; OR, 3.12) and lengthier professional experience of the treating orthopedist (OR, 1.08) increased the likelihood of referral.

CONCLUSIONS

Younger male children presenting with a spiral femur fracture have a higher likelihood to be referred to a social worker because of suspected child abuse by treating orthopedic specialists with lengthier professional experience. The findings point to the need to improve the capacity of orthopedic residents to report child abuse.

The Gender Perspective on Parent-to-child Aggression: Gender and Gender-constellations

Parent-to-child aggressive behavior is a common risk factor for children's health. Gender is correlated also to the odds of using aggression and the odds of being a victim of aggression. Yet, only few studies have considered the constellation of perpetrator's and victim's gender as a factor of parental aggression. The current study addresses parent-to-child aggressive behavior while focusing on the constellation of perpetrator's and victim's gender (i.e., mother-daughter, mother-son, father-daughter, father-son). It utilizes a community sample of Israeli university students (N = 508), 78% of which are female, on average 25.67 years of age (SD = 8.29). The participants reported the incidence and frequency of verbal and physical aggressive behavior of their parents against them during the years of middle school. The results show gender and gender-constellation to be significantly correlated with parental aggression. Overall, sons were more likely to suffer both verbal and physical aggression from their parents than daughters were. Only paternal verbal and physical aggression was more common against daughters, and only maternal verbal and physical aggression was more common against sons. Parental verbal and physical aggression from both parents were more common against sons. For all types and forms of parental aggression, daughters reported higher frequencies. These results suggest that while parent's gender might predict their overall aggressive behavior, and child's gender might predict their overall odds to be victimized by parental aggression, gender-constellation might create gender-specific selective patterns of parental aggressive behavior. Thus, the theoretical contribution of this study is in emphasizing that gender-constellations have an explanatory value beyond gender alone. These findings might be valuable to assess the risk of daughters and sons to suffer parental aggression, and for practitioners to provide apt professional response.

"Yes, My Uncle, I'll Do Whatever You Say": Experiences of Israeli Muslim Arab Children During Forensic Interviews Following Child Sexual Abuse

Children from Arab society in Israel have been overlooked in previous studies and efforts in the area of forensic interviews. The current study provides an in-depth thematic analysis of 30 forensic interviews with Israeli Muslim Arab children following child sexual abuse (CSA), all conducted by Arab forensic interviewers. In multicultural Israeli society, Muslim Arabs make up 18% of the population. In addition to the religious and cultural difference, this minority is involved in an ongoing conflict with the majority Jewish society in Israel and tends to have low trust of government authorities. This background necessarily affects the area of forensic interviews with children. The research explores the unique encounter between maltreated children from Israeli Muslim Arab society and forensic interviewers, highlighting its particular characteristics and challenges. Data analysis revealed a central theme of a clash of worlds. The forensic interviewers, although hailing from a similar background as the children, followed best practices developed in western societies. The children, on the other hand, faced enormous conflict in addressing CSA terminology and complying with the requirements of the forensic world in ways that are forbidden to the them in their own. Moreover, having been educated to accept the authority of adults unquestioningly, the children were torn between the difficulty of disclosing the abuse to someone outside the family, and the obligation to communicate candidly with the adult interviewer as required in the forensic context. The findings highlight the urgent need to reform the services these children receive and to dedicate future efforts to further assessment of cultural context and its impact on maltreated children, particularly in the forensic context.

Increased risk for child maltreatment in those with developmental disability: A primary health care perspective from Israel

BACKGROUND

Child Maltreatment (CM) is a worldwide phenomenon. Literature suggests that children with disabilities are at increased risk for CM. However, limited information exists regarding if such increased risk is noted in community primary care clinics.

AIM

To report on the incidence of CM in children with and without disabilities attending community primary care clinics.

METHOD

This was a cohort study of children belonging to a Health Maintenance Organization (HMO) in Israel. The study group consisted of children with disabilities and the control group consisted of children without disabilities. Formal reports to child protection services, medical and sociodemographic data were extracted from designated documentation and medical records.

RESULTS

The odds to be identified as suspected CM, after adjusting for sociodemographic variables, was 6.2 times higher among children with disabilities compared to children without disabilities and 5.0 times higher among children with severe vs. mild disability.

CONCLUSIONS

Developmental disability is a risk factor for CM, and is noted even more seriously in community primary care clinics. CM positively correlated with the severity of disability. The presented data marks higher figures than previously reported, enhancing understanding of the scope of the problem and its relation to the type of organization being examined.

Students' willingness to seek help from school staff when coping with parental maltreatment

BACKGROUND

Many children who suffer parental maltreatment are unknown to welfare authorities and do not receive any treatment or support. Schools, which serve as a key social resource for child protection and welfare enforcement, also fail to identify these students.

OBJECTIVE

The aim of the study was to examine children's willingness to seek help at school for dealing with parental maltreatment and to reveal those factors that enhance students' willingness to seek help at school.

PARTICIPANTS AND SETTING

A national random sample of 859 Israeli students (56 % girls) in 6th-12th grades participated in the study.

METHODS

Using a sequential mixed-methods research design including both surveys and interviews, the study investigated students' willingness to seek help from their homeroom teacher, school counselor, school teachers, and friends when dealing with neglect, abuse, corporal punishment, and psychological aggression.

RESULTS

About half of the students who suffer parental maltreatment never sought help in school. Of those who sought help, about 19 % sought from their friends, and 15 % sought help from the school staff in which school counselors (8.2 %) comprised the most common help resource. Three fundamental factors that explained students' willingness to seek help were revealed: An active helper, positive relationship with the helper, and the importance of confidentiality and trust.

CONCLUSIONS

The findings highlight the role of active efforts by school for enhancing students' willingness to seek help and the need to devote more attention to friends who serve as a strong help resource and as a possible bridge between peers and the educational team.

Development of screening tool for child abuse in the korean emergency department: Using modified Delphi study

Mandatory reporting rate of suspected child abuse by health care provider is relatively low in South Korea. The purpose of the study was to develop a screening tool for child abuse and evaluate the feasibility of using this screening tool in emergency department (ED) of South Korea. Injured children younger than 14 years old in the ED were enrolled as subjects to use this screening tool. Candidate items for screening tool were decided after reviewing relevant previous studies by researchers. Using the modified Delphi method, it was judged that the consensus for items of screening tool was achieved in 2 rounds, and the final item of the screening tool was decided through the discussion in the final round. The registry including the developed screening tool was applied to 6 EDs over 10 weeks. Variables of the registry were retrospectively analyzed. A child abuse screening tool called Finding Instrument for Non-accidental Deeds (FIND) was developed. It included 8 questions. One item (suspected signs in physical examination) had 100% agreement; 3 items (inconsistency with development, inconsistent history by caregivers, and incompatible injury mechanism) had 86.7% agreement; and 4 items (delayed visit, inappropriate relationship, poor hygiene, and head or long bone injury in young infants) had 80% agreement. During the period of registry enrollment, the rate of screening with FIND was 72.9% (n = 2815). 36 (1.3%) cases had 1 or more "positive" responses among 8 items. Two (0.07%) cases were reported to the Child Protection Agency. An ED based screening tool for child abuse consisting of 8 questions for injured children younger than 14 years old was developed. The use of screening tools in Korean ED is expected to increase the reporting rate of child abuse. However, further study is necessary to investigate the accuracy of this screening tool using a national child abuse registry.

Child maltreatment identification rates in a child development center: suggestions for improved detection

Under-identification of child maltreatment (CM) remains a significant problem. The study aim was to examine rates of CM identification in a child development center (CDC) vs. a community clinic (CC). This was a cross-sectional study, involving study (CDC) and comparison groups (CC) and using administrative data for the period 2011-2015. The study group consisted of children 0-18 years belonging to the Meuhedet Health Maintenance Organization (HMO)-Northern Region, who attended the CDC, including satellite clinics, for assessment/treatment. The CDC employed a multi-disciplinary approach to improve CM identification. The comparison group consisted of children with a disability belonging to the HMO, who attended a CC, but were not known to the CDC. Rates of CM identification, socio-demographic characteristics, and disability severity were compared. CM identification during the study period was 2.1% for the CDC vs. 0.8% for the CC. Children visiting the CDC had five times higher odds to be identified with suspected CM than children in the CC, after adjusting for age, gender, socioeconomic status, ethnicity, and disability severity.

CONCLUSION

CM identification rates in children with disability were higher in a CDC vs. CC. The approach used in the CDC may significantly improve CM identification in children with disability. What is Known: • There is significant under-identification of CM. What is New: • By examining child maltreatment identification rates in a child development center vs. the community, the study found that a multi-disciplinary staff approach can significantly improve CM Identification.

Situational Factors Related to Childhood Sexual Abuse in the Orthodox Jewish Community Among Adult and Juvenile Offenders

In recent years, increasing attention has been paid to situational factors associated with childhood sexual abuse (CSA) to explain incidence of CSA, as well as to provide potential targets for prevention efforts. However, very few studies have examined situational factors associated with juvenile perpetration, despite juveniles composing a substantial proportion of offenders. In addition, no studies to our knowledge have applied a situational framework to CSA research in the Orthodox Jewish community (OJC). In the present study, we obtained data from therapists regarding 80 victims of CSA in the OJC from both the United States and Israel. We hypothesized that (a) more abusers' first perpetration would be between ages 12 and 17 than between any other age range, which corresponds to increased sexual urges, as well as increased unsupervised access to minors; (b) among juvenile offenders, the time of day of the abuse would depend on the relationship of the offender to the victim; and (c) age of the victim and grooming strategies would be associated with the frequency of abuse. Our first two hypotheses were confirmed, and our third hypothesis was partially confirmed, as younger victims tended to have higher frequency of abuse. Additionally, we discuss possible implications of significant correlations found during exploratory analyses. Our results generally support the importance of considering culturally specific situational factors when studying or developing prevention efforts for CSA.

Prevalence of Child Maltreatment in Israel: A National Epidemiological Study

The current study is based on data collected from Jewish and Arab 6th, 8th and 10th grade students (age range 12-17) within the Israeli national school system (N = 12,035). Data collection for the study utilized two complementary instruments: the Childhood Trauma Questionnaire (CTQ) and the Juvenile Victimization Questionnaire (JVQ). Study results revealed that the lifetime prevalence of child maltreatment in contemporary Israeli society is within the range of estimates from other countries. However, contrary to others, Israeli boys reported higher rates of abuse, including sexual abuse, compared to girls. Additionally, Arab compared to Jewish children and youth reported higher rates of all types of abuse. The need for widely accepted, uniform definitions of the various child maltreatment types, a standardized methodology of data collection, and regularly updated national and international data bases is discussed.

"Body self" in the shadow of childhood sexual abuse: The long-term implications of sexual abuse for male and female adult survivors

Childhood sexual abuse (CSA) may have long-term negative outcomes for victims' body representations. In this study we examined a model in which the relation between CSA and an individual's discomfort when in close proximity to others is mediated by disrupted body boundaries, and the relation between CSA and body shame is mediated by body self-objectification. Since most of these variables were conceptualized and assessed primarily among women, gender differences regarding the proposed model were examined. Study participants were 843 college/university students (536 women and 307 men). Results from structural equation modeling analyses indicated that in both genders, disrupted body boundaries mediated the relations between CSA and an individual's discomfort when in close proximity to others, as well as between CSA and body shame. Body self-objectification was not associated with history of CSA. Finally, we discuss the role these findings may play in the detrimental long-term effects of CSA on both male and female survivors, and refer to their common underlying mechanism.

From My Own Brother in My Own Home: Children's Experiences and Perceptions Following Alleged Sibling Incest

Sibling incest is an understudied field despite its high prevalence rates. The current study was designed to characterize the way children describe their experiences and perceptions following alleged sibling incest. The sample consisted of 20 forensic investigations with children who were referred to forensic investigation following suspected sibling incest. The age range of the children was between 6 and 12 years old, including 17 girls and three boys. Thematic analysis was conducted on all the interviews and the children's perceptions greatly echoed the ecological framework while they elaborated on three levels: family level, in which children discussed the context of the abuse and the disclosure; sibling level, in which children discussed their siblings' behaviors and the grooming process; and the child level, in which the children discussed their own behavior during the abuse. The discussion highlights the relevance of the ecological framework to the study's results and stresses the complexity of this phenomenon and the challenges it raises for practitioners in various contexts-child protective, forensic, and clinical.

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OBJECTIVES

The objectives of this study were to 1) map the geographic distribution of rates of children reported to Montreal child protective services by ethnocultural group (Black, other visible minorities, not from visible minorities) and 2) estimate the relative contribution of different territorial characteristics to the rates for those groups.

METHOD

The study covered the 505 Montreal-area census tracts for which complete data were available. The reporting rates by group (dependent variables) and various territorial characteristics such as poverty (independent variables) were mapped and subjected to multiple linear regression and geographically weighted regression. The results of the geographically weighted regression were then mapped.

RESULTS

The geographic distribution and reporting rates varied greatly by group, with the Black children having the highest rates. Although territorial characteristics explained 51% of variance for the children who were not members of visible minorities, they were clearly less effective in predicting rates in the case of Black children (18%) and other minorities (18%).

CONCLUSION

Already well-known territorial risk factors are at work in Montreal, but their influence is not equally strong in all census tracts nor, especially, in all ethnocultural groups. Therefore, when only the distribution and prediction of reports for all children as a whole are examined, important differences are underestimated. Access to and appropriateness of services offered to vulnerable families, including those of visible minorities, could, however, be improved with a better understanding of local dynamics.

Effect of Ethnicity on Parenting Styles and Attitudes Toward Violence Among Jewish and Arab Muslim Israeli Mothers

The cultural heterogeneity of Israeli society creates a unique opportunity to study the effects of ethnicity and intergenerational differences on parenting styles, attitudes, and practices. Three groups of mother–daughter dyads took part in the study: Native-born Jewish (NBJ) Israelis (155 dyads), Jewish Mizrahi (JM) immigrants (immigrants from Muslim countries (133 dyads), and native-born Arab Muslim (NBA) Israelis (86 dyads). Participants were located through a “snowball” process in which participants referred their friends to the researchers or gave the researchers names of potential participants. Interethnic differences were found in the mothers’ generation, with JM mothers falling in between NBJ and NBA mothers. This trend changed when we examined differences between the daughters. Although intergenerational differences were found in all groups, the differences were more prominent among Jewish mother–daughter dyads than among mother–daughter dyads in the Muslim population. Contrary to the research hypothesis, the parenting style of JM women was closer to that of NBJ mothers than to NBA mothers. The findings are discussed with reference to the complexity of Israeli society and to the encounter between the culture of the immigrant women who came from Muslim countries and the Western culture of the host society.

Community characteristics, social service allocation, and child maltreatment reporting

This study expands research on the relationship between community (defined here as a locality) characteristics and child maltreatment. Research in this field is not new, but it is scarce. Our study is unique by examining changes between two periods rather than focusing on one point in time. Furthermore, our study examines structural conditions in small and medium size localities in Israel, a non-Western and non-Christian society. We compare our results with those from studies on inner-city and suburban neighborhoods in Western countries and earlier studies in Israel. We collected data on 169 Israeli localities, ranging from small ones (with as few as 1,500 residents) to medium size localities (i.e., towns) (with as many as 50,000 residents) in which approximately 34% of the Israeli child population resides. Our study tested four hypotheses: (1) Socioeconomic characteristics of the locality will be negatively correlated with the availability of social services; (2) Reported child maltreatment rates will be negatively correlated with the socioeconomic characteristics of the locality; (3) The availability of social services will be positively correlated with reported child maltreatment rates; and (4) Overall reported child maltreatment rates will be negatively correlated with the overall status of the localities. We have supported our second and third hypothesis in full, and partially supported our first and fourth hypothesis. In particular we have demonstrated that while demographics play a different role in Israel than in other countries in regard to child maltreatment, social, economic and cultural context are crucial for understating reported rates of child maltreatment.

An ecological approach to children's rights and participation: interrelationships and correlates of rights in different ecological systems

Current knowledge emphasizes either a developmental or a cultural/contextual theoretical framework for understanding children's approaches to the concepts of rights and participation. This study, carried out among 1,753 Israeli adolescents (ages 15-17), uses a socioecological perspective instead to understand children's rights and participation. It examines adolescents' approaches to their rights and participation at 4 ecological levels-family, school, community, and the larger sociopolitical system-as well as a number of possible child, family, and societal correlates. It also looks at the interactions between some of these correlates. The findings show that different correlates have different links with various ecological circles. For example, girls reported higher levels of participation in the family and at school, but no significant differences were found between boys and girls in their participation in the community and at civic-political levels. Israeli Palestinians reported higher levels of participation in their schools and at the civic-political level but lower levels of participation in the family and the community compared with their Jewish counterparts. The significant interaction effect between nation and gender showed that, among Arab students, there were larger gaps between boys and girls in the different participation domains than there were among Jewish students. Furthermore, higher rates of participation in the family and lower rates of civic participation were found among students from single-parent families. This study shows that employing an ecological framework to the efforts to understand children's approaches to rights and participation is a first step in the right direction for fostering children's rights and participation.

Child maltreatment reports in Israel: the intersection between community socioeconomic characteristics and ethnicity

The authors examined the relationship between community characteristics and child maltreatment reports in Israel, comparing Jewish and Arab localities both in terms of maltreatment reports and the responses of the social services to these reports. Administrative data were obtained from the protective services and the Central Bureau of Statistics for 231 local authorities in Israel (covering 98% of children in Israel). Jewish communities showed significantly more reports of sexual abuse and physical abuse than Arab communities. Reporting rates also showed different associations with socioeconomic and demographic variables. In Jewish localities, demographic, economic, and educational factors were all correlated with the reporting of child maltreatment, whereas in Arab localities, only median age (young) of the local population was associated with a greater rate of child maltreatment reporting. No differences in the responses of the protective services were found. Implications of the results for future policy are discussed.

Factors affecting medical and nursing staff reporting of child abuse

AIM

The purpose of the current research was to examine whether the theory of planned behaviour (TPB) succeeds in predicting nursing and medical staff reporting of suspected child abuse.

BACKGROUND

Despite the rising incidence of child abuse in Israel, medical and nursing staff reports of suspected child abuse remain low.

METHODS

This descriptive, correlational, cross-sectional study was based on TPB. The Child Abuse Report Intention Scale questionnaire was administered to 143 nurses and 42 doctors who work with children in various departments of a central Israeli hospital and in a large affiliated community-based clinic. Descriptive, correlational and linear regression statistics were calculated.

RESULTS

Objection to child abuse, views of professional responsibility on this issue, degree of self-control and subjective beliefs, affect reporting of suspected child abuse. Differences in reporting are evident between doctors and nurses and also between medical and nursing staff from the Arab and Jewish sectors. Doctors report more than nurses and Jewish staff members report more than their Arab colleagues. Medical and nursing staff's number of own children has a direct effect on their inclination to report child abuse.

CONCLUSIONS

The TPB model succeeds in partly predicting medical and nursing staff reporting of suspected child abuse. This model can serve as a basis for intervention plans aimed at developing medical and nursing simulations of coping with conflict issues involving child abuse in an attempt to eradicate and treat inadequate reporting.

A global perspective on child sexual abuse: meta-analysis of prevalence around the world

Our comprehensive meta-analysis combined prevalence figures of childhood sexual abuse (CSA) reported in 217 publications published between 1980 and 2008, including 331 independent samples with a total of 9,911,748 participants. The overall estimated CSA prevalence was 127/1000 in self-report studies and 4/1000 in informant studies. Self-reported CSA was more common among female (180/1000) than among male participants (76/1000). Lowest rates for both girls (113/1000) and boys (41/1000) were found in Asia, and highest rates were found for girls in Australia (215/1000) and for boys in Africa (193/1000). The results of our meta-analysis confirm that CSA is a global problem of considerable extent, but also show that methodological issues drastically influence the self-reported prevalence of CSA.

Prevalence of child maltreatment in The Netherlands

The first nationwide prevalence study of child maltreatment in The Netherlands (NPM-2005) was designed as a replication of the National Incidence Studies (NISs) conducted in the United States. Child maltreatment cases were reported by 1,121 professionals from various occupational branches, trained in a detailed registration system of six types of abuse and neglect. In addition, cases registered by the Dutch Child Protection Services (CPS) were analyzed. For 2005, the overall prevalence rate was estimated to be 107,200 (95% CI 102,054-112,882) maltreated children aged 0-18 years, or 30 cases per 1,000 children. Neglect was the most prevalent type (56% of all cases) and sexual abuse had the lowest rate (4%). Of the maltreated children, 47% experienced more than one type of maltreatment. Major risk factors were very low parental education and unemployment. It is worrisome that CPS agencies only see the tip of the iceberg as only 12.6% of all maltreatment cases were reported to the CPS. Training of professionals in observing and reporting child maltreatment is badly needed. The absence of a legal obligation to report in The Netherlands needs reconsideration.

Socioeconomic correlates of rates of child maltreatment in small communities

This study expands the research on neighborhood effects and child maltreatment by examining the structural conditions, including religion and nationality, in small towns in Israel. The results are compared with those in inner-city and suburban neighborhoods in Western countries. Five community structural variables were statistically correlated with investigated cases of child maltreatment: adults' unemployment rate, rate of new immigrants, rate of children in single-parent families, population gain or loss, and the community's location in relation to a central city. A multivariate regression analysis of these variables explained 44% of the variance.