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Talmon A, Ditzer J, Talmon A, Tsur N. Maltreatment in Daycare Settings: A Review of Empirical Studies in the Field. TRAUMA, VIOLENCE & ABUSE 2024; 25:512-525. [PMID: 36869785 PMCID: PMC10666466 DOI: 10.1177/15248380231155528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Daycare maltreatment refers to abusive and/or neglectful acts perpetrated by teachers, directors, non-professionals or volunteers, family members of staff, and peers in a daycare setting. Despite growing evidence of its occurrence, the prevalence and consequences of daycare maltreatment for the child, the parent(s), and their dyad are largely unknown. This qualitative systematic literature review was conducted to synthesize the existing literature referring to daycare maltreatment, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In order to be included in the analysis, the manuscripts needed to report empirical findings regarding maltreatment in daycare settings, be written in English, be published in a peer-reviewed journal or a dissertation, and be accessible by our research team. In all, 25 manuscripts met the above criteria and were included in the review. Our results indicate that reports of daycare maltreatment are characterized by early age of abused children, inferring mainly to sexual, physical, and emotional abuse. The majority of these manuscripts reported caregivers' and teachers' abuse, while peer victimization was reported much less. In addition, the findings demonstrated a higher representation of female perpetrators compared to abuse in other scenarios. Although some indications of long-term implications are reported in the manuscripts, a well-validated measure for assessment of daycare maltreatment seems to be lacking. These findings contribute to a more nuanced understanding of the complex experience and ramifications of daycare maltreatment, providing insight into its multi-faceted implications.
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Affiliation(s)
- Anat Talmon
- The Hebrew University of Jerusalem, Israel
- Stanford University, Palo Alto, CA, USA
| | - Julia Ditzer
- Stanford University, Palo Alto, CA, USA
- Leipzig University, Germany
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Vriesman MH, Vrolijk-Bosschaart TF, Lindauer RJL, van der Lee JH, Brilleslijper-Kater S, Teeuw AH, Benninga MA. Prevalence of suspected child abuse in children with constipation: a case-control study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001338. [PMID: 35648803 PMCID: PMC8852724 DOI: 10.1136/bmjpo-2021-001338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/28/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND A possible association between child abuse and neglect (CAN) and functional constipation (FC) has been described in adults, however, limited data are available in children. Our objective was to determine the prevalence of suspected CAN in children with FC as compared with their healthy peers. METHODS A case-control study was carried out in children aged 3-10 years. Children with FC were recruited at a tertiary outpatient clinic, and healthy controls were recruited at schools. Parents were asked to fill out questionnaires about the history and behaviour of their child, children were inquired using a semistructured interview about experienced traumatic events and sexual knowledge. The interview was scored by two independent observers. The prevalence of suspected CAN was determined according to the questionnaires and interview. RESULTS In total, 228 children with FC and 153 healthy controls were included. Both groups were age and gender comparable (50% females, median age 6 years (not significant)). No significant difference in the prevalence of suspected CAN was found between children with FC and healthy controls (23.3% vs 30.1%, 95% CI 0.44 to 1.12, p=0.14), including a suspicion of sexual, emotional and physical abuse. CONCLUSION Suspected CAN was detected in both children with FC as in healthy controls. The possible association between CAN and FC in children could not be confirmed.
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Affiliation(s)
- Mana H Vriesman
- Department of Pediatric Gastroenterology and Nutrition, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | | | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Johanna H van der Lee
- Pediatric Clinical Research Office, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands.,Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, Netherlands
| | | | - Arianne H Teeuw
- Department of Social Pediatrics, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
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Affiliation(s)
- Geoff Debelle
- Child Protection, Birmingham Women and Children's Hospital, Birmingham, UK
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Tsang VMW, Verlinden E, van Duin EM, Twisk JWR, Brilleslijper-Kater SN, Gigengack MR, Verhoeff AP, Lindauer RJL. The Amsterdam Sexual Abuse Case: What Scars did it Leave? Long-Term Course of Psychological Problems for Children Who have been Sexually Abused at a Very Young Age, and their Parents. Child Psychiatry Hum Dev 2021; 52:891-902. [PMID: 33011833 PMCID: PMC8405499 DOI: 10.1007/s10578-020-01067-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2020] [Indexed: 11/30/2022]
Abstract
Longitudinal research of CSA in infancy and early childhood is scarce. The current study examined the long-term course of psychological outcomes (PTSD, dissociation and internalizing and externalizing behavioral problems) in children who were sexually abused in the early childhood. Additionally, we looked into the outcomes for their parents by assessing PTSD symptoms and negative emotional reactions towards the sexual abuse of their child. We examined the outcomes for five consecutive years in a sample of children (n = 45) who were sexually abused at a very young age (0-3) and their parents (n = 42), included in the Amsterdam Sexual Abuse Case-study. We found that outcomes following CSA in early childhood go beyond PTSD symptoms and can manifest in atypical symptoms such as behavioral problems. Parents experienced persistent PTSD in the years following CSA disclosure. CSA in very young children warrants long-term monitoring, as negative outcomes still present 8 years later.
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Affiliation(s)
- Vionna M. W. Tsang
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Verlinden
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ,Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands
| | - Esther M. van Duin
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jos W. R. Twisk
- Department of Clinical Epidemiology and Biostatistics, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Sonja N. Brilleslijper-Kater
- Department of Social Pediatrics, Child Abuse and Neglect Team, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maj R. Gigengack
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnoud P. Verhoeff
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands ,Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Ramón J. L. Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ,De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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Vrolijk-Bosschaart TF, Brilleslijper-Kater SN, Verlinden E, Widdershoven GAM, Teeuw AH, Voskes Y, van Duin EM, Verhoeff AP, de Leeuw M, Roskam MJ, Benninga MA, Lindauer RJL. A Descriptive Mixed-Methods Analysis of Sexual Behavior and Knowledge in Very Young Children Assessed for Sexual Abuse: The ASAC Study. Front Psychol 2019; 9:2716. [PMID: 30687174 PMCID: PMC6333700 DOI: 10.3389/fpsyg.2018.02716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/17/2018] [Indexed: 12/30/2022] Open
Abstract
Child sexual abuse (CSA) is a worldwide problem with serious consequences. We hypothesized that worrisome sexual behavior and knowledge would frequently be reported in children assessed after CSA. We therefore investigated (A) what types of sexual behaviors and knowledge were reported by parents of young children assessed for CSA; (B) in what cases such behaviors and knowledge were worrisome; and (C) how such children responded verbally and non-verbally during child interviews. We conducted a mixed-methods study, including qualitative inductive content analysis and quantitative analysis. It included 125 children (76 boys, 60.8%; median age 3.3 years, age range 0–11), all involved in the Amsterdam sexual abuse case (ASAC) and examined for highly suspected (n = 71) or confirmed CSA (n = 54). We identified themes from (1) the parent reports: sexual behavior (e.g., self-stimulation, touching others, imitation of sexual acts), fears and anxiety with regard to sexuality, and sexual utterances (sexual slang, references to sexual acts); and (2) the child interviews: behavioral reactions (avoidance, distractive behaviors), emotional reactions (anger, aggression), and verbal reactions (conspicuous utterances, refusal to talk about specific subjects). In 37% of the children the sexual behavior was deemed worrisome or very worrisome. Clinicians who assess children for CSA are advised to focus in particular on sexual behavior problems and inappropriate sexual knowledge.
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Affiliation(s)
- T F Vrolijk-Bosschaart
- Department of Social Pediatrics, Child Abuse and Neglect Team, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | - S N Brilleslijper-Kater
- Department of Social Pediatrics, Child Abuse and Neglect Team, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | - E Verlinden
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service, Amsterdam, Netherlands
| | - G A M Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam, Netherlands
| | - A H Teeuw
- Department of Social Pediatrics, Child Abuse and Neglect Team, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | - Y Voskes
- Department of Medical Humanities, VU University Medical Center, Amsterdam, Netherlands
| | - E M van Duin
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | - A P Verhoeff
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service, Amsterdam, Netherlands
| | - M de Leeuw
- Former Medical Student, University of Amsterdam, Amsterdam, Netherlands
| | - M J Roskam
- Former Medical Student, University of Amsterdam, Amsterdam, Netherlands
| | - M A Benninga
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | - R J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, Netherlands.,De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
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van Duin EM, Verlinden E, Vrolijk-Bosschaart TF, Diehle J, Verhoeff AP, Brilleslijper-Kater SN, Lindauer RJL. Sexual abuse in very young children: a psychological assessment in the Amsterdam Sexual Abuse Case study. Eur J Psychotraumatol 2018; 9:1503524. [PMID: 30206471 PMCID: PMC6129781 DOI: 10.1080/20008198.2018.1503524] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 12/13/2022] Open
Abstract
Background: Child sexual abuse (CSA) is a worldwide problem affecting children of all ages and socioeconomic backgrounds. A knowledge gap exists regarding the psychological outcomes for children, boys in particular, who are abused during their early lives. Objective: To provide a descriptive psychological profile of children who experienced sexual abuse as infants or toddlers from a male daycare worker and babysitter, and to assess the psychopathological impact on their parents. Method: Parents of children involved in the Amsterdam Sexual Abuse Case (41 parents; 44 children, age range 3-11 years, 30 boys, 14 girls) completed measures on post-traumatic stress disorder (PTSD), dissociation, sexual and non-sexual behaviour problems, and attachment insecurity in their children, as well as on parental psychological well-being, 3 years after disclosure. Sexual abuse characteristics were obtained from police records. Results: We found that 3% of confirmed child victims had PTSD, 30% sexual behaviour problems, 24% internalizing problems, 27% attachment insecurity, and 18% any psychiatric disorder (including PTSD); 39% were asymptomatic. In parents, we found feelings of guilt, shame, and anger about the abuse of their child; 19% showed PTSD symptoms and 3% showed avoidant and 8% anxious attachment problems in their intimate relationship. Parental symptomatology was related to child symptomatology, except for child sexual behaviour problems. One-quarter of confirmed child victims and 45% of parents had received psychological treatment. Conclusions: Three years after disclosure, extrafamilial CSA in very young children was associated with sexual and non-sexual behaviour problems and attachment insecurity, but rarely with PTSD or dissociation. For parents it was associated with PTSD symptoms and emotional reactions. Assessments and interventions should focus on the wide spectrum of problems that follow CSA, as well as on parental psychopathology and the parent-child relationship. Future follow-up assessments in our longitudinal study should provide insights into longer-term outcomes.
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Affiliation(s)
- Esther M van Duin
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Verlinden
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Thekla F Vrolijk-Bosschaart
- Department of Social Pediatrics, Child Abuse and Neglect Team, Academic Medical Center, Amsterdam, The Netherlands
| | - Julia Diehle
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnoud P Verhoeff
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Sonja N Brilleslijper-Kater
- Department of Social Pediatrics, Child Abuse and Neglect Team, Academic Medical Center, Amsterdam, The Netherlands
| | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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Vrolijk-Bosschaart TF, Brilleslijper-Kater SN, Widdershoven GAM, Teeuw AH, Verlinden E, Voskes Y, van Duin EM, Verhoeff AP, de Leeuw M, Roskam MJ, Benninga MA, Lindauer RJL. Psychosocial symptoms in very young children assessed for sexual abuse: A qualitative analysis from the ASAC study. CHILD ABUSE & NEGLECT 2017; 73:8-23. [PMID: 28942057 DOI: 10.1016/j.chiabu.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 07/25/2017] [Accepted: 09/03/2017] [Indexed: 06/07/2023]
Abstract
Child sexual abuse (CSA) is a worldwide problem with serious consequences. No recognizable symptom pattern for suspected CSA has yet been identified in very young children. We aim to investigate psychosocial symptoms in a sample of children with confirmed or strongly suspected CSA and the interpretations given to such symptoms by independent clinical experts. Secondly we examined whether experts were able to identify confirmed victims of severe CSA. A qualitative study including inductive content analysis of medical files and focus group discussions with independent experts on the interpretation of psychosocial symptoms was conducted. We included 125 children (76 boys, 60.8%, and 49 girls, 39.2%; median age 3.3 years; age range 0-11) who were involved in the Amsterdam sexual abuse case (ASAC) and had been examined for strongly suspected CSA. We identified four themes among the psychosocial symptoms: problems concerning emotions, behavior, toilet training, and development, whether or not associated with the daycare center or the perpetrator. Clinical experts identified signs of posttraumatic stress disorder (PTSD), regression in continence skills (not otherwise explained), and problems triggered by exposure to the perpetrator or the abuse location as concerning symptoms for CSA. Less concerning symptoms were designated as worrisome if they were numerous and there was no clear explanation for these symptoms. A clear symptom pattern was lacking and about half of the confirmed severe victims of CSA did not display any psychosocial problems. Therefore, it is difficult for experts to identify confirmed CSA victims. Thus, the assessment of suspected CSA should be over time and multidisciplinary.
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Affiliation(s)
- T F Vrolijk-Bosschaart
- Department of Social Pediatrics, Child Abuse and Neglect Team, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands.
| | - S N Brilleslijper-Kater
- Department of Social Pediatrics, Child Abuse and Neglect Team, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | - G A M Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam, Netherlands
| | - A H Teeuw
- Department of Social Pediatrics, Child Abuse and Neglect Team, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | - E Verlinden
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Amsterdam, Netherlands
| | - Y Voskes
- Department of Medical Humanities, VU University Medical Center, Amsterdam, Netherlands
| | - E M van Duin
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | - A P Verhoeff
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Amsterdam, Netherlands
| | - M de Leeuw
- Former Medical Student, University of Amsterdam, Netherlands
| | - M J Roskam
- Former Medical Student, University of Amsterdam, Netherlands
| | - M A Benninga
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | - R J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, Netherlands; De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
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