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The cost of child abuse and neglect in France: the case of children in placement before their fourth birthday
- Authors:
- PRIGENT Amelie, et al
- Journal article citation:
- Child Abuse and Neglect, 118, 2021, p.105129.
- Publisher:
- Elsevier
Background: Despite the high prevalence of child abuse and neglect and its consequences on health, very few studies have evaluated the trajectories of children in placement in France, and there are no cost studies available. Objective: To estimate the cost of abuse and neglect in children in placement before their 4th birthday in France. Participants and setting: A cohort of children in placement before their 4th birthday in a single nursery between February 1994 and June 2001 was followed from birth until they left care. Methods: Child protective services (CPS), health, health and social, and judiciary services utilization was derived from a qualitative analysis of the children's files and valued with their unit costs in 2013 euros from the societal perspective. Total costs and mean annual cost per child followed by CPS were calculated overall, by cost category, and by status at admission to the nursery. Results: 129 children were included. Mean age at first admission was 1.9 years (SD = 1.3). The mean length of follow-up by CPS was 14.3 years (SD = 5.0). Mean annual cost per child was estimated at €53,265 (SD = 42,077), with CPS costs representing 78% of costs. 80% of health care costs were due to psychiatric care. Children with no identified psychosocial risk factors had significantly higher psychiatric care costs and health and social care costs than pre-term children and children with identified psychosocial risk factors. Conclusion: More research should be carried out to address early and comprehensively the multiple needs of children followed by CPS in the short- and long-term. (Edited publisher abstract)
Do abused young children feel less pain?
- Authors:
- DROUINEAU Marie-Helene, et al
- Journal article citation:
- Child Abuse and Neglect, 65, 2017, p.248–254.
- Publisher:
- Elsevier
The objective of this study was to investigate whether acute pain in abused children was under recognised by doctors and nurses compared to children evaluated for accidental injuries. The authors hypothesise that an abused child's reaction to physical pain could be an additional symptom of this challenging diagnosis. For the observational prospective case control study in an emergency department, children were eligible when: younger than six years old, the reported trauma occurred within the previous seven days, the trauma comprised a bone injury or burn, and the child was able to express his or her pain. The case group comprised children for whom the medical team reported their abuse suspicions and supporting information to a court, and whose cases of abuse were subsequently confirmed. The control group consisted of children with a plausible cause for their injury and no obvious signs of abuse. The children were matched according to their age and type of trauma. The pain was assessed by doctors and nurses before analgesic administration using a certified pain scale. Among the 78 included children, pain was significantly less recognised in the abused children vs. the controls (relative risk = 0.63; 95% CI: 0.402–0.986; p = 0.04). A discrepancy between the nurses' and doctors' scores for the pain assessments was observed (Kappa coefficient = 0.59, 95% CI: 0.40–0.77). The results demonstrate that pain expression in abused children is under recognised by medical staff. They also suggest that abused children may have reduced pain expression after a traumatic event. Paying particular attention to the pain of abused children may also optimise the analgesic treatment. (Edited publisher abstract)
Making better sense of children's trajectories in child protection in France
- Authors:
- SERAPHIN Gilles, BOLTER Flora
- Journal article citation:
- Children and Youth Services Review, 73, 2017, pp.145-148.
- Publisher:
- Elsevier
In France, the child protection system – as well as family-related policies in general – links specific interventions and schemes to the recognition of a particular situation: this is usually called the status-based approach. But in child protection, the status-based approach has severe limitations that may affect the quality of care. Piling up a number of statuses does not promote an overall vision of the child, and the evolving, dynamic nature of a child's development and history tends to disappear in a framework that relies heavily on ascertained, stable situations. Practitioners have started to develop tools to work with the children and families over time and in a more holistic manner, but these developments need to be mainstreamed and to be mirrored in administrative practices and at policy level to really take into account life trajectories. (Publisher abstract)
Parent-provider relationship in home visiting interventions
- Authors:
- SAIAS Thomas, et al
- Journal article citation:
- Children and Youth Services Review, 69, 2016, pp.106-115.
- Publisher:
- Elsevier
Home visiting, while a very popular method of early childhood intervention, is not effective for all eligible at-risk families. The relationship between the home visitor and the family is central to the success of this type of intervention. This study aims to investigate, through 1024 home visit case notes from a French home visiting program, the ways in which the home visitor-family relationship develops, and identify the obstacles to and facilitators of a good quality relationship from the provider's point of vue. Results from a qualitative analysis suggest that the factors associated to the quality of relationship are present within the very first moments of the intervention. Poor relationship quality was found to be significantly associated with the family's mistrust towards the home visitor and with poor social conditions that make the supporting relationship difficult to develop. Good relationship quality was found to be facilitated by the parents' high involvement in the intervention and associated with a feeling of isolation and an ability to form social bonds. The necessitation for home visitor training is discussed, together with a reflection on the risk of home visiting programs to increase social inequalities, when they are not flexible enough to meet families' needs. (Publisher abstract)
Recent reforms in childcare and family policies in France and Germany: what was at stake?
- Author:
- FAGNANI Jeanne
- Journal article citation:
- Children and Youth Services Review, 34(3), March 2012, pp.509-516.
- Publisher:
- Elsevier
German family policy has seen many changes in recent years, with legislators increasingly distancing themselves between from the traditional male-breadwinner model through the introduction of new laws in the domain of parental leave and child care provision. On the other hand, France has continued to consolidate and enhance its promotion of policies to support the work and family life balance along with steady increases in spending related to childcare provision. Despite a rise in its overall supply of formal childcare Germany, however, still lags far behind France in this domain. This article considers why the German and the French governments introduced reforms in family and childcare policy, what the rationales underpinning these reforms were, and what the key drivers of change were. It also highlights a number of recurrent issues that help explain the differences that persist between France and Germany in spite of recent reform efforts.
The contribution of the United Nations Convention on the Rights of the Child to understanding and promoting the interests of young people making the transition from care to adulthood
- Authors:
- MUNRO Emily R., et al
- Journal article citation:
- Children and Youth Services Review, 33(12), December 2011, pp.2417-2423.
- Publisher:
- Elsevier
The United Nations Convention on the Rights of the Child (UNCRC) recognises that young people without parental care are entitled to special support from the State. This article examines how the UNCRC guidelines outlining how States should promote the rights of young people making the transition from care to adulthood can be used as an instrument to track global patterns of change in policy and practice. Observations from 15 countries shows that there has been limited engagement with understanding and promoting the needs of this group in the reporting process; although where a government is committed to developing legislation and practice then this does find its way into their national reports. Documents reveal that national concerns, political ideology, public awareness, attitudes and knowledge of the vulnerability of care leavers influence service responses to protect the rights of this group. The authors conclude that future work is needed on both promoting and monitoring of the impact of the UNCRC.
The mental health of young people aging out of care and entering adulthood: Exploring the evidence from England and France
- Authors:
- STEIN Mike, DUMARET Annick-Camille
- Journal article citation:
- Children and Youth Services Review, 33(12), December 2011, pp.2504-2511.
- Publisher:
- Elsevier
This article reviews the evidence from England and France on the mental health of young people ageing out of care and into adulthood. It is the first comparative review of the two countries and concentrates on the evidence on the mental health of young people in the general population, young people living in care, young people aging out of care, and young adults. The article shows the high levels of psychological adversity of young people entering car, and the high rates of mental health problems of young people in care compared with the general population of young people. It highlights the increased risk of mental and physical problems at the time of ageing out of care, and the general improvement in longer-term outcomes for young adults, although some continue to have serious mental health problems. In conclusion, the article argues that interventions across the life course of young people are needed in both countries.
Prevalence rate of DSM mental disorders among adolescents living in residential group homes of the French child welfare system
- Authors:
- BRONSARD Guillaume, et al
- Journal article citation:
- Children and Youth Services Review, 33(10), October 2011, pp.1886-1890.
- Publisher:
- Elsevier
The rate of mental disorders in children and young people in the child welfare system worldwide is known to be very high. The aim of this study was to determine the prevalence of some major mental disorders among adolescents living in a residential group home in France, and the distribution of these disorders by gender. The participants included 183 adolescents living in residential group homes in the county of Bouches-du-Rhône. A structured psychiatric Diagnostic Interview Schedule for Children was used to assess diagnoses of the following over the previous 6 months: anxiety disorder; major depression; conduct disorder; eating disorder; enuresia; psychosis screen; and Attention Deficit Hyperactivity Disorder. The existence of suicide attempts during the lifetime of each child was also assessed. The results indicated that 48.6% of the participants had at least one psychiatric disorder during the last 6 months, and 23% reported lifetime suicide attempts. Females were more affected than boys with 64.9% having at least one disorder compared to 36.8% of boys. The article concludes that the prevalence of mental disorders in adolescents living in French residential group homes is 2.5 to 3.5 times higher than in the overall population.
History of abuse and neglect in patients with schizophrenia who have a history of violence
- Authors:
- BENNOUNA-GREENE Mehdi, et al
- Journal article citation:
- Child Abuse and Neglect, 35(5), May 2011, pp.329-332.
- Publisher:
- Elsevier
This study investigated the prevalence of five forms of abuse or neglect during childhood and adolescence in a group of schizophrenic patients with a history of violence. Participants included 28 patients in a highly secured psychiatric unit in France. Abuse or neglect during patients’ upbringing was evaluated, as was history of substance abuse, incarceration, and death of a close relative. Findings indicated that 46% of patients experienced at least 1 form of abuse/neglect during childhood and 21% of them had experienced more than 2 forms. The 2 most frequent forms were 39% physical and 18% emotional. Significant history of substance abuse was found, and 43% of patients had a close relative die, of which 42% were violent. The authors highlight the importance of systematically assessing a history of abuse and neglect during upbringing in schizophrenic patients in order to provide specific treatments.
Tourniquet syndrome: interest of a systematic analysis of families' social conditions to detect neglect situations
- Authors:
- CLAUDET Isabelle, et al
- Journal article citation:
- Child Abuse and Neglect, 33(9), September 2009, pp.569-572.
- Publisher:
- Elsevier
Tourniquet syndrome denotes an injury to a young child caused by the constriction of one or more appendages (fingers, toes, genitals) by a hair or textile thread. There is a lack of consensus on whether these injuries are caused by abuse or by accident. This brief communication describes a prospective study which aimed to identify the characteristics of a cohort of tourniquet syndrome admissions to a paediatric emergency department and to analyse the benefits of follow up by social workers. During the five year period, out of 179,500 admissions, 41 cases of tourniquet syndrome were diagnosed. Although most cases seem accidental, the study concludes that all cases should be followed up by child protection services to investigate the possibility of abuse or neglect.