The analysis of child abuse and neglect cases assessed by a multidisciplinary study group between 2005-2008.

This study aimed to evaluate the diagnosis, treatment and follow-up of child abuse and neglect (CAN) cases. Subjects were 102 cases that were clinically assessed by the multidisciplinary hospital team. Early and late childhood cases (according to the age at first abuse) were compared by means of characteristics of abuse. Among the 102 subjects, 64 were female and 38 were male (mean age: 8.68 years). Being abused by someone within the family was found to be significantly higher in preschool children compared to children in late childhood. 27.5% (n: 28) of the cases concomitantly had low socioeconomic and educational level and high parental psychological problems and 64.8% had psychiatric problems. A limited number of studies have compared characteristics of early and late childhood abuse considering the age of onset of maltreatment. Consistent with the literature, our study showed that early age of onset of maltreatment is a poor prognostic factor in many ways.

An examination of the characteristics of mothers neglecting their children.

BACKGROUND: This study is aimed to recognize families who have neglected their children in the early period, to raise awareness among experts especially pediatricians-working in this field about the reasons contributing to the neglect. METHODS: For this purpose, data were collected by quantitative and qualitative methods. The mothers of 32 neglected children and 30 children who were not neglected were included in to the study. Sociodemographic Information Form, Neglect Assessment Tool, Close Relationships Inventory, Perceived Social Support Scale, Marital Adjustment Scale, Childhood Trauma Survey Scale, Semi Structured Interview Form, SCID I and SCID II were used as data collection tools. T-test, ANOVA, Chi-square test, Kruskal Wallis, Pearson Correlation test were used for quantitative analysis and descriptive analysis method was used in the analysis of qualitative data. RESULTS: In the quantitative findings obtained; mothers of neglected children and control group mothers differed in terms of their age, income perceptions, multidimensional perceived social support, marital adjustment, physical and emotional abuse subscales on the scale of childhood abuse, adult attachment patterns, however; it was found that there was no difference in terms of mental illness and personality disorder, and scores on sexual abuse subscale of child abuse. Qualitative results demonstrated that most of the mothers did not consider themselves adequate for parenting, were not satisfied with their parenting role, had insufficient emotional investment in their children and could not balance their roles. CONCLUSIONS: It was concluded that the mothers of neglected children had problems in the areas of social support, marital adjustment, adult attachment patterns and they were also exposed to physical and emotional abuse during their own childhood and these problems negatively affected the quality of their childcare. For this reason, it is important to provide support to neglectful families and family interventions should be established.

Relationship disorders and cognitive functioning in young children.

The aim of this study was to investigate the cognitive functioning of young children with or without relationship disorders with their mother. Mother-infant dyads were recruited during the first three postpartum days. Parent Infant Relationship Global Assessment Scale (PIRGAS) scores and mother-child relationship disorders were decided when children were 41-49 months of age by integrating the data obtained from psychiatric interview with mothers, Clinical Problem Solving Procedure (CPSP) and home observation. Cognitive functioning of young children was evaluated with Stanford-Binet Intelligence Scale. The young children without relationship problems/disorders had higher intelligence quotient (IQ) scores even after controlling for the effect of independent variables on cognitive functioning. These findings suggest that there is a link between the quality of the mother-child relationship and cognitive functioning in young children. Therefore, physicians should assess the interactions of children with their mothers even if they are brought for reasons other than relationship problems.

Medicolegal evaluation of a maternal filicide attempt: a case report.

Foto-Özdemir D, Balseven-Odabasi A, Teksam Ö, Karadag F, Akçan F, Yilmaz E. Medicolegal evaluation of a maternal filicide attempt: a case report. Turk J Pediatr 2019; 61: 622-628. Filicide mainly refers to the murder of a child by his/her parents. Even though filicide is a rare event, outcome of filicide is more severe compared to other types of murders. In this report, we aim to discuss the factors in which the case of a woman who attempted to kill her 2.5-year-old daughter along with the demographical characteristics. Twenty-nine-year-old mother attempted to kill her daughter by hanging. Even though the victim did not die as the mother, regretted her action the triggers and the plot of the case discussed within the filicide framework. Therefore, the presented case report would contribute to the understanding of the nature of the filicide, and it might bring a different perspective, because of the different development process of filicide, sharing the disorder and interwoven motivations between the child and mother. In this respect, we aim to draw attention of pediatricians, child psychiatrists and forensic pathologists about the importance of filicide.

Child maltreatment and associated factors among children with ADHD: a comparative study.

This study aimed to compare the mothers of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and the mothers of children with no psychiatric diagnosis with respect to abusive discipline attitudes. One hundred children with ADHD, 25 children with no psychiatric diagnosis, and their mothers answered the questionnaires and open-ended standard questions about the type and frequency of parental abusive discipline. Conners scores of the children were associated with characteristics of the children, maternal characteristics, and maternal use of verbal discipline. Maternal approval scores on verbally abusive disciplinary acts were predicted by maternal past experiences, maternal characteristics and Conners scores of children. Similarly, characteristics of the children and the mothers predicted maternal approval scores on physical disciplinary acts. ADHD symptoms increase the risk of parental verbally and physically abusive discipline. Vice versa, verbal discipline also predicts increased ADHD symptoms. Understanding the risk factors may help in developing more effective intervention and prevention programs.

Munchausen syndrome by proxy presented as recurrent respiratory arrest and thigh abscess: a case study and overview.

While many physicians are familiar with the sexual or physical abuse of children, there is little awareness about Munchausen syndrome by proxy (MSBP). As case reports of MSBP increase, awareness among physicians is thought to increase as well. We thus present herein a 16-month-old girl who admitted to Hacettepe University Ihsan Dogramaci Children's Hospital with the complaint of seizure, recurrent apnea and thigh abscess, who was later diagnosed as MSBP. The case was being followed by the Child Protection Team of the hospital (Haceteppe University Child Protection Unit [HU-CPU]). HU-CPU contributed to the early detection of this case and protected the child from a possible fatal outcome. The mother was confronted for MSBP and refused to take responsibility for her child's symptoms. As seen in this case, when MSBP is suspected, psychiatric evaluation of the mother, evaluation of the mother-child interaction and collection of a detailed family and social history can have a positive impact on the prognosis in these cases. This case report underlines the importance of multidisciplinary team work to share the responsibility and reduce the burden during the treatment process of these difficult and complicated cases.

Establishment of interdisciplinary child protection teams in Turkey 2002-2006: identifying the strongest link can make a difference!

OBJECTIVES: The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. METHODS: A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. RESULTS: Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. CONCLUSIONS: A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. PRACTICE IMPLICATIONS: Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.