Violence Against Children: Recognition, Rights, Responses.

All forms of violence against children (VAC) are violations of children's rights. Traditional definitions of child maltreatment do not address the rapidly evolving global spectrum of VAC. In this article, we offer an expanded definition of VAC that integrates the principles of child rights, clinical medicine, and public health. The authors further expand the socioecological model to establish a trans-societal sphere, composed of root-cause determinants of VAC, including climate change, globalization, armed conflict, etc. A child rights-based taxonomy of VAC is also presented. The authors conclude with recommendations to address VAC in the domains of clinical practice, systems development, and policy generation.

Forcible Displacement, Migration, and Violence Against Children and Families in Latin America.

In Latin America, violence is a major public health issue causing many families to flee to the United States to seek safety. Current US immigration policies fail to address why families are forced to depart their home country or the needs of families once arriving in the United States. This article identifies root causes of family displacement, examines the insufficient protections for children in families during US immigration processing, and provides practice and policy recommendations on how to transform the US immigration system so that it is more humane for children and families forcibly displaced by violence.

Depoimento especial, testemunho judicial, diretrizes internacionais: dissonâncias / Special testimony, judicial testimony, international guidelines: dissonances / Declaración especial, testimonio judicial, directrices internacionales: disonancias

Resumo O depoimento especial de crianças e adolescentes e a Lei 13.431/2017 questionam a interface entre a psicologia e a justiça. Essa lei tem em suas fontes a Resolução 20/2005, do Conselho Econômico e Social das Nações Unidas, que traça diretrizes para a justiça em casos de crianças vítimas ou testemunhas de crime. Realizou-se pesquisa qualitativa, baseada em levantamento bibliográfico e documental, tendo por eixo as legislações mencionadas e os procedimentos e papéis profissionais nelas previstos. Avalia-se a dissonância entre os dois documentos e suas consequências, bem como as definições de vitimização secundária, revitimização, pessoa de apoio e intermediário, não adotadas na Lei 13.431/2017. Algumas práticas estrangeiras alinhadas à Resolução 20/2005 são descritas e comentadas, mostrando diferenças significativas em relação ao que é realizado no Brasil. Conclui-se que uma dessas diferenças entre um e outro documento é o aspecto da proteção, que perde sua força e revela o limite do funcionamento do judiciário no acolhimento daquele que demanda cuidado.(AU)

Abstract The special testimony of children and adolescents and the Law 13431/17 question the interface between psychology and justice. This law results from the Resolution 20/2005 of the Economic and Social Council of the United Nations, which outlines guidelines for justice in matters involving child victims or witnesses of crime. Considering the aforementioned legislation and their provisions for procedures and professional roles, a qualitative research based on bibliographic and documentary surveys was conducted to evaluate the dissonances between the two documents and their consequences, as well as the definitions of secondary victimization, revictimization, support person, and mediator - not provided in the Law 13431/17. This paper describes and comments some foreign practices aligned with the Resolution 20/2005, showing significant differences with the practices employed in the Brazilian scenario. The results indicate that the protection aspect loses its strength between one document and the other, revealing the limit of the judiciary functioning in hosting those who demand care.(AU)

Resumen La declaración especial de niños y adolescentes y la Ley 13.431/2017 cuestionan la relación entre psicología y justicia. Esta ley tiene en sus fuentes la Resolución 20/2005, del Consejo Económico y Social de las Naciones Unidas, relativa a directrices sobre la justicia para los niños víctimas o testigos de delitos. Se realizó una investigación cualitativa, basada en levantamiento bibliográfico y documental, cuyos ejes fueron las mencionadas legislaciones y los procedimientos y roles profesionales previstos en ellas. Se evalúa la disonancia entre los dos documentos y sus consecuencias, así como las definiciones de victimización secundaria, re-victimización, persona de apoyo e intermediario, no adoptadas en la Ley 13.431/2017. Algunas prácticas extranjeras acorde a la Resolución 20/2005 se describen y comentan, subrayando diferencias significativas con lo que se realiza en Brasil. Se concluye que una de estas diferencias es la protección que pierde su fuerza y evidencia el límite del funcionamiento del sistema judicial en la protección de quien demanda cuidado.(AU)

Before Saying "I Do": Legal and Policy Considerations for Facilitating Clarity on Human Trafficking and the Protection of Children in Albania.

Data available on victims of human trafficking in Albania does not appear to point to a significant problem of human trafficking in the country. For example, from the years 2016 to 2018, 61 persons were officially determined to be victims of human trafficking, in a context where the average population for that period was 2,871,978 persons. However, beneath this representation of an ostensible average level of trafficking in Albania are signs which seem to be suggestive of a more serious problem in the country. Reports, for example, indicate that authorities have sometimes associated trafficking with a transnational element, while challenges have continued to be posed to the identification of those involved in forced begging, particularly unaccompanied children, street children, and children crossing borders. In addition to highlighting and assessing evident challenges that exist in the identification of real and potential victims of trafficking and the gaps that exist in the protection of children and vulnerable groups in law and in practice, this report provides clarity on the meaning of human trafficking and what could be done to provide a clearer picture of victims of trafficking in Albania. As Albania is being considered for accession negotiations in respect of entry into the European Union, the time is opportune to address challenges and gaps to the prevention and response to trafficking particularly given the European Commission's concerns on human trafficking and child trafficking in Albania.

Worker Perceptions of the Multi-Agency Investigation & Support Team (MIST): A Process Evaluation of a Cross-Agency Response to Severe Child Abuse.

The Multi-agency Investigation & Support Team (MIST) was a new approach to abuse investigations that aimed to minimize the distress and uncertainty experienced by children and non-abusive caregivers in dealing with the many agencies typically involved in a case post-disclosure, while also attempting to improve the accessibility of supportive and therapeutic services. As part of a broader evaluation, this study examined worker perceptions early in the implementation of this new approach. Thirty-three (33) interviews were conducted with workers affected by this new pilot. The interviews identified almost exclusively positive perceptions of the changes relative to practice as usual, particularly in terms of improvements to collaboration and communication across agencies, and the benefits of providing support alongside the investigation process. Some areas of difficulty and areas for improvement were identified, particularly the need for stronger governance of the cross-agency protocol and improved connection to some of the groups involved in the response that were not co-located. The study suggests professionals working in the MIST model consider the model beneficial to the quality of the response to severe child abuse while highlighting that the process of change into this new way of working was challenging at times.

Protective and Supportive Injunctions for Children Exposed to Sexual Abuse: The First Data from Turkey.

Child sexual abuse (CSA) requires multidisciplinary approach by forensic, social, and medical services, thus Child Advocacy Centers (CACs) have been established to evaluate CSA cases in Turkey. At CACs the social needs of children are assessed by social workers. Protective and supportive injunctions (PSIs) are considered at each step of evaluation and are proposed to child courts. This study aimed to evaluate PSIs at a local CAC, which is one of the leading CACs in Turkey. The study group consisted of children and adolescents exposed to CSA admitted to Izmir CAC between April 2014 and April 2015. Socio-demographic characteristics, social investigation reports, psychiatric reports, and proposed PSIs were evaluated. The rate of social investigation necessity was 28.3% (n = 113), and the rate of being proposed for at least one PSI was 24.3% (n = 97). The most common proposed injunctions were maintenance care injunctions (n = 47; 48%) and counseling injunctions (n = 46; 47%). The rate of proposed PSIs was significantly higher in adolescents, incest cases and abuse types including penetration than in the other groups. This is the first study to evaluate PSIs in the child protection system. Our results provide data about the risk groups that need PSIs among the victims of CSA cases.

Ensuring the rights of children with neurodevelopmental disabilities within child justice systems.

A recent UN general comment on criminal justice systems includes guidance to state parties regarding the implementation of the Convention on the Rights of the Child for children with developmental delays or neurodevelopmental disorders or disabilities. This guidance asserts that these children "should not be in the child justice system at all", but when present "should be individually assessed" to enable appropriate safeguards and accommodations to ensure the protection of their rights without discrimination. In this Viewpoint, we examine the significant barriers faced by children who are affected by neurodevelopmental disabilities to the realisation of their rights under international law and standards. These barriers include systemic and cultural barriers created by a lack of awareness among justice professionals about how to identify and work with children who have neurodevelopmental disabilities, as well as procedural barriers, which arise from the complexity and rigidity of many criminal justice processes. The effect of these barriers is that the child is denied their rights on an equal basis with other children without such disabilities.

Fourteen-Year Trends in the Criminal Justice Response to Child Sexual Abuse Reports in New South Wales.

This study of attrition compares the prosecution of child sexual offenses reported while the complainant was still a child with those in which the report was delayed into adulthood; it also compares matters involving adult and young (under 18 years) suspects/defendants. It is based on an analysis of police and court administrative data in New South Wales, Australia over a 14-year period (2003-2016). Only one in five (21.6%) proceeded beyond the investigation stage. Criminal proceedings were more likely to commence when the alleged victim was 7-12 years old at the time of the incident, when the suspect was an adult and at least 10 years older than the victim, and also when the report to police was made when the victim was an adult. Just over half (55.5%) of the matters finalized in court resulted in a conviction. Cases in the higher courts were less likely to be dismissed and more likely to feature guilty pleas and convictions at trial than cases in the lower courts. The overall estimate is that only 12% of offenses reported to police resulted in a conviction, at a relatively stable rate over 14 years. These findings are consistent with those of comparable studies.

Child Advocacy Center intervention with sibling sexual abuse cases: Cross-cultural comparison of professionals' perspectives and experiences.

BACKGROUND: Despite being a complex phenomenon with potentially significant short- and long-term consequences for all involved including siblings, parents and the family as a whole, sibling sexual abuse (SSA) has not received sufficient empirical and clinical attention. Practitioners are often left to cope without appropriate guidance. OBJECTIVE: This study aimed to compare staff perspectives and experiences of working with sibling sexual abuse cases across two Child Advocacy Centers (CACs) within different countries and different cultural and legal contexts. PARTICIPANTS AND SETTING: Participants were staff members from two Child Advocacy Centers: one in Jerusalem, Israel, and the other in Montgomery County, Pennsylvania, United States of America. METHODS: This qualitative cross-cultural comparative study analyzes staff experiences of sibling sexual abuse cases based upon 14 focus groups, in Jerusalem (N = 7) and Montgomery County (N = 7). RESULTS: Findings reveal that both CACs focused on parents, the parents' negative emotional responses to SSA, and the impossible nature of their predicament. The Montgomery County CAC tended to emphasize the needs of the victim while being attuned to the legal proceedings, whereas the Jerusalem CAC emphasized supportive therapeutic responses for the whole family. CONCLUSIONS: The differences across the two Child Advocacy Centers are related to the different legal and cultural contexts of the two CACs and underscore the need to review what may be the most appropriate policy and practice response to SSA that does not itself cause further harm.

Violation of children's and adolescents' rights ­ the profile of a southern state in Brazil

The rights of children and adolescents are provided by law and it is the duty of the State, family and society to care for them. Health and education professionals are responsible for reporting suspected or confirmed cases of rights violation. This study aimed to investigate the prevalence and qualification of violation of children's and adolescents' rights in the State of Paraná between 2009 and 2014. A descriptive and observational quantitative study was carried out based on the records of the Child Protective Services in Paraná, accessed through the Information System for Childhood and Adolescence (SIPIA). A total of 129.123 violations of rights were found. Among those cases, the right to familiar and communitarian companionship stands out with the greatest number of violations, followed by the right to education, culture, sports and leisure. Mothers were found to be the main aggressors, followed by fathers, and sexual violence/abuse was the most prevalent type of violence. In conclusion, there was a significant amount of violation of children's and adolescents' rights in the State of Paraná during the period covered by this research, and it has increased over the years. Besides, we found out that there is a predisposition of gender and age group for each variable analyzed.

The Rights of Children for Optimal Development and Nurturing Care.

Millions of children are subjected to abuse, neglect, and displacement, and millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children's rights, progress is slow and impeded by political considerations. The United Nations Convention on the Rights of the Child, a global comprehensive commitment to children's rights ratified by all countries in the world except the United States (because of concerns about impingement on sovereignty and parental authority), has a special General Comment on "Implementing Child Rights in Early Childhood." More recently, the World Health Organization and United Nations Children's Fund have launched the Nurturing Care Framework for Early Childhood Development (ECD), which calls for public policies that promote nurturing care interventions and addresses 5 interrelated components that are necessary for optimal ECD. This move is also complemented by the Human Capital Project of the World Bank, providing a focus on the need for investments in child health and nutrition and their long-term benefits. In this article, we outline children's rights under international law, the underlying scientific evidence supporting attention to ECD, and the philosophy of nurturing care that ensures that children's rights are respected, protected, and fulfilled. We also provide pediatricians anywhere with the policy and rights-based frameworks that are essential for them to care for and advocate for children and families to ensure optimal developmental, health, and socioemotional outcomes. These recommendations do not necessarily reflect American Academy of Pediatrics policy.

What I Learned From the Antivaccine Movement.

The following is the runner-up submission from the third annual Section on Pediatric Trainees essay competition. This year's competition was informed by the 2018-2019 Section on Pediatric Trainees Advocacy Campaign: Advocacy Adventure, which empowered trainees to find their areas of passion, acquire and polish new skills, and organize advocacy efforts collaboratively. We asked writers to share experiences as physician advocates and were impressed with the broad variety of important topics submitted by trainees from around the country. This essay by Dr Ju describes advocating at the California state level for childhood immunization protections, which transformed her perspective of those who hold a different view. Along with the winning submission by Drs Panda and Garg that also appears in this issue, this piece is a wonderfully inspiring reminder that we are all well positioned to advocate for children in our roles as trainees and pediatricians.

Fathers detained, contact restrained: Experiences of Palestinian children visiting their fathers in Israeli detention.

BACKGROUND: Very little is known about the experiences of children of political prisoners internationally, because of the challenges of researching within politically oppressive contexts. OBJECTIVE: The aim of this secondary analysis was to explore and understand Palestinian children's experiences visiting their fathers in Israeli detention. PARTICIPANTS, SETTING AND METHODS: Qualitative data from sixteen in-depth interviews with thirty-one children were analyzed. Structural and longitudinal coding cycles were employed and focused upon the timeline of the visitation process. RESULTS: Three overarching themes emerged, which included: Children's experiences 'before the visit', 'during the visit', and 'after the visit'. Subthemes related to the distressing and at times traumatic experiences the children suffered throughout the process of preparation for, going through, and the aftermath of the visit. This included reports of experiencing punitive measures at checkpoints and waiting areas and humiliation and maltreatment by the Israeli authorities during the visitation process. These findings are discussed with reference to the United Nations Convention on the Rights of the Child. It was clear that the children's best interests were denied and contact and interaction with their fathers was restrained under the Israeli visitation scheme. Despite the arduous visitation process that children often hated, they loved to see their fathers. CONCLUSIONS: Even though the children's rights were infringed upon, they still endured hardships to maintain whatever contact was possible. International advocacy for the realization of the 'rights of the child' for Palestinian children, as well as other children of political detainees is warranted.

Canada, cannabis and the relationship between UN child rights and drug control treaties.

Article 33 of the UN Convention on the Rights of the Child requires States to take appropriate measures to protect children from illicit drugs 'as defined in the relevant international treaties'. Those treaties are the UN drugs conventions. Following cannabis legalisation, then, can Canada remain in compliance with the CRC while breaching treaties to which Article 33 expressly refers? This article investigates this question with reference to the drafting of the CRC and the drugs conventions, how the relationship between the two systems has been approached, and the practice of the UN Committee on the Rights of the Child from 1993-2015. While the CRC could offer an alternative framework through which to critically assess drug laws and policies, by and large it has operated so as to reinforce the drug control system. An interpretation of Article 33 in the light of Canada's cannabis reforms is proposed. Based on the text of the provision, the pacta tertiis rule, and the object and purpose of the provision, it decouples the CRC from the normative requirements of the drugs conventions.