Child Abuse and Neglect: Screening for Risks During the Perinatal Period

Abstract

!Purpose: Currently, there is a claim for earlier interventions for families in order to prevent child maltreatment. Here, a screening instrument to assess risk indicators for child abuse and neglect already in the context of maternity clinics is introduced. The present study is the first report on the psychometric properties of this instrument, the "short questionnaire for risk indices around birth" (RIAB). Material and Methods: Data were collected in the context of three different studies conducted at Ulm University Hospital. To examine interrater reliability eight case vignettes were rated by n = 90 study participants (50 students and 40 experts working at a maternity clinic). Criterion validity was examined in two studies applying the German version of the child abuse potential inventory CAPI (n = 96 families at risk and n = 160 additional families). Results: Both laymen and experts were able to understand and use the screening instrument correctly, leading to a high agreement with the sample solutions given. A high concordance was found between parentsʼ and expertsʼ ratings: In case of no reported risk factors applying the screening instrument RIAB, parents themselves reported significantly less stressors and burdens, compared to those parents with an indication for a thorough examination as pointed out in the RIAB. Conclusion: In the context of maternity clinics the RIAB is a useful, broadly applicable instrument, screening for existing risk factors at the earliest and thus allowing for the initiation of specific interventions when needed.

Meconium Indicators of Maternal Alcohol Abuse during Pregnancy and Association with Patient Characteristics

“…After validation, alcohol screening could be implemented systematically in prenatal care [42, 43] as well as the postnatal identification of women being at high risk for child neglect [44, 45]. …”

“…There is an ongoing immense need for further investigations in the field of alcohol consumption during pregnancy, because in Germany alone, every year, about 4000 newborn children suffer from the FAS, and even more are those born with symptoms of the fetal alcohol spectrum disease. After validation, alcohol screening could be implemented systematically in prenatal care [ 42 , 43 ] as well as the postnatal identification of women being at high risk for child neglect [ 44 , 45 ].…”

Genetic Variants in the Genes of the Stress Hormone Signalling Pathway and Depressive Symptoms during and after Pregnancy

“…There is a correlation of pregnancy-associated depression with poorer obstetric outcome measures, with fetal and neonatal complications [ 7 , 8 ], with the length of the mother's hospital stay at the time of delivery [ 9 ], and with a negative impact on the child's development [ 10 – 13 ]. Information about the pathogenesis for pregnancy-associated depression may therefore be helpful for planning early interventions and understanding the pathogenesis of this disease, as it is not a part of the early intervention program in Germany yet [ 14 ].…”

Das Ausmaß von Kindesmissbrauch, -misshandlung und -vernachlässigung in Deutschland

“…Dazu gehört die Einführung von einheitlichen Risikochecklisten beispielsweise in der Geburtsklinik. Hier wurde von Kindler (18,39) der "Anhaltsbogen für ein vertiefendes Gespräch" entwickelt, der befriedigende Testgütekriterien aufweist (40). Ein genaues Erkennen von Risiken kann als ergänzende Maßnahme zu der jetzt festgelegten Kodierung tatsächlicher Gefährdung gesehen werden, um so- wohl gemäß der Epidemiologie von Risiken als auch von tatsächlichen Gefährdungen genauere Prävalenzzahlen zu erhalten.…”