Cultural evidence, child maltreatment, and the law

Parenting and child mental health: a cross-cultural perspective

In its most general instrumental sense, parenting consists of care of the young in preparing them to manage the tasks of life. Parents provide childhood experiences and populate the environments that guide children's development and so contribute to child mental health. Parenting is expressed in cognitions and practices. However, parents do not parent, and children do not grow up, in isolation, but in multiple contexts, and one notable context of parenting and child mental health is culture. Every culture is characterized, and distinguished from other cultures, by deep-rooted and widely acknowledged ideas about how one needs to feel, think, and act as an adequately functioning member of the culture. Insofar as parents subscribe to particular conventions of a culture, they likely follow prevailing "cultural scripts" in childrearing. Broadening our definition, it is therefore the continuing task of parents also to enculturate children by preparing them for the physical, psychosocial, and educational situations that are characteristic of their specific culture. Cross-cultural comparisons show that virtually all aspects of parenting children are informed by culture: culture influences when and how parents care for children, what parents expect of children, and which behaviors parents appreciate, emphasize and reward or discourage and punish. Thus, cultural norms become manifest in the mental health of children through parenting. Furthermore, variations in what is normative in different cultures challenge our assumptions about what is universal and inform our understanding of how parent-child relationships unfold in ways both culturally universal and specific. This essay concerns the contributions of culture to parenting and child mental health. No study of a single society can address this broad issue. It is possible, however, to learn lessons about parenting and child mental health from the study of different societies.

Maternal punishment practices in a rural area of Turkey

OBJECTIVE

We examined a number of maternal characteristics that influence punishment practices in a rural area of Turkey.

METHODS

Questionnaires were filled out in face-to-face interviews with 539 mothers who agreed to participate in this study.

RESULTS

The majority findings of this study were as follows: all of the mothers had used various forms of punishment on their children; hitting other children was the primary reason for punishment, and hitting was the most common form of punishment used by mothers. Another interesting finding of this study was that mothers did not demonstrate the same responses to their children when they were alone as when others were present. Mothers commonly felt regret in the post-punishment period.

CONCLUSION

These findings can be useful in establishing parental educational programming that is directed at decreasing the rates of punishment practices.

Physical discipline and children's adjustment: cultural normativeness as a moderator

Interviews were conducted with 336 mother-child dyads (children's ages ranged from 6 to 17 years; mothers' ages ranged from 20 to 59 years) in China, India, Italy, Kenya, the Philippines, and Thailand to examine whether normativeness of physical discipline moderates the link between mothers' use of physical discipline and children's adjustment. Multilevel regression analyses revealed that physical discipline was less strongly associated with adverse child outcomes in conditions of greater perceived normativeness, but physical discipline was also associated with more adverse outcomes regardless of its perceived normativeness. Countries with the lowest use of physical discipline showed the strongest association between mothers' use and children's behavior problems, but in all countries higher use of physical discipline was associated with more aggression and anxiety.

[Foreign minors in the protection system of the Autonomous Community of Aragón (Spain)]

OBJECTIVES

To determine the prevalence of foreign minors in protection centers, their demographic characteristics, and reasons for entry, as well as the relation with geographic area, family, social and health risk factors, and high-priority health needs.

PATIENTS AND METHODS

We performed a retrospective cross-sectional study over an 11-year period (1992-2002). The health and socio-familial reports of 1,619 minors who were admitted to protection centers were reviewed and those from a foreign country were included. Compilation of information, definition of concepts, and health assessments were performed according to standard protocols.

RESULTS

Two hundred forty-one foreign minors (males 66.4 %) with a mean age (SD) of 11 (3.2) years (adolescents 64.7 %, infants-preschoolers 26.1 %) were admitted during the study period. The prevalence was 4.6 times higher than that expected. Origin: Africa 68.9 % (Maghreb 56.4 %, sub-Saharan 12.5 %), Europe 23.6 % (west 14.5 %, east 9.1 %), Latin-America 5.4 %, and Asia 2.1 %. Reasons for entry, demography and relation with geographic area were as follows: 1. Being an abandoned illegal immigrant 41.1 % (all male adolescents, 98 % from the Maghreb); 2. Maltreatment 33.2 % (passive maltreatment-to-active ratio 2.3:1, no difference by sex, age mode 2 years; Asia 80 %; Europe 61.5 %, west-to-east ratio 4.8:1, gypsy ethnicity from Portugal and Rumania 90.3 %; Latin-America 38.4 %; Africa 21.7 %, no difference by geographic area); 3. Temporary incapacity for their care 18.7 % (female-to-male ratio 1.8:1, age mode 1 year; Latin-America 38.4 %, Africa 18.1 %, Europe 17.5 %); 4. Other causes 7 %.

RISK FACTORS

at least one (78.4 %) and more than one (33.6 %); housing problems and especially living in a single parent family. Health disorders: at least one (65.1 %); disabling disease (2.1 %); main problems: dental (36.3 %), immunization (27.6 %), dermatologic (19.1 %), growth and nutrition (13.7 %), and infectious and parasitic diseases (13.3 %).

CONCLUSIONS

Being a minor immigrant in a foreign country with problems of documentation, housing or family regrouping and especially if there are language, cultural or racial (ethnic minorities) barriers is a major risk factor for living in a situation of vulnerability, risk or neglect/abandonment that requires social protection measures. Continuous follow-up by the social services of the adoptive community is required for the prevention and early detection of children in need of protection.

Comparación entre los niños de etnia gitana e inmigrantes extranjeros ingresados en centros de protección por maltrato

OBJECTIVES

To determine whether there are differences between Spanish gypsy and foreign immigrant children admitted to protection centers in the characteristics of the maltreatment, social and familial factors linked to maltreatment, and health status.

METHODS

The social and health reports of 83 Spanish gypsy and 105 foreign immigrant children admitted to protection centers of the Aragonese Institute for Social Services (Instituto Aragones de Servicios Sociales [IASS]) because of maltreatment from January 1994 to December 2003 were reviewed. Maltreatment, its types, and warning signs were defined and assessed according to the guidelines drawn up by the IASS. The social and familial risk factors associated with maltreatment were determined according to national studies. Health status was assessed following protocols used by the IASS. A descriptive and comparative statistical study was performed.

RESULTS

The Spanish gypsy children were mostly in the age group of 0-5 years, while foreign immigrants were mostly in the age group of 12-17 years. Spanish gypsy children showed a greater frequency of physical and emotional neglect and/or abandonment (p < 0.001) and were more likely to have families with problems of crime (odds ratio [OR] = 16.5; 95% confidence interval [95%CI], 6.7-40.7), drug/alcohol abuse (OR = 8.8; 95%CI, 3.7-21) and families with more than one social and health risk factor (OR = 9.3; 95%CI, 3.8-22.8). Spanish gypsy children showed a greater frequency of neurological disorders, disabling diseases, absent or incomplete immunizations, and dermatologic diseases. Foreign immigrant children showed a greater frequency of physical and psychological and/or sexual abuse (p < 0.001) and were more likely to live in a single parent family (OR = 7.9; 95%CI, 2.2-27.7).

CONCLUSIONS

Identifying the differences between these two groups of maltreated children could be useful for professionals working in the community social services in charge of developing intervention strategies for the prevention and early detection of maltreatment, as well as for professionals in charge of the health of these children during their stay in a protection center.

A reporting and response model for culture and child maltreatment

As our society becomes increasingly culturally diverse, there is a growing concern in the mental health field as to whether clinicians are able to accurately distinguish different cultural parenting discipline practices from child maltreatment. Clinicians in various fields continue to differ on what is reportable. Although there is literature describing characteristics of various ethnic minority groups, there are limited data to support why clinicians do what they do and no decision-making model to guide a clinician's reporting behavior when working with clients from different cultures. This article focuses on cultural discipline practices rather than healing practices (e.g., coining) that may be challenging to assess. The authors propose a model to guide clinicians through the decision-making process and discuss interventions and clinical responses that may be most appropriate when presented with different scenarios involving cultural parenting discipline practices and child maltreatment. Finally, limitations of the presented model along with future clinical and research directions are discussed.