Academic literature on the topic 'Abused children Services for Victoria Evaluation'

In this program description, the authors describe outcomes of a 2-year project influencing programmatic changes to screening/assessment practices and increased collaboration with Child Welfare (CW) in an early intervention (EI) program. The EI professionals reviewed how they assessed children who have been abused/neglected. Based on their findings, they revised the eligibility process and assessment tools utilized. Objectives of the programmatic changes were to increase the number of children substantiated as abused/neglected to become eligible for EI services and improve identification of social emotional delays. A summary of overall outcomes is presented aling with implications for policy and practice.

The Families First Pilot Program in the then Outer East metropolitan region of Melbourne began in mid-1991 as an intensive family preservation and reunification service for children on the verge of state care. The service offered was brief (4-6 week), intensive (up to 20 hours per week), home-based and flexible (24 hour a day, 7 day a week availability) and all members of the household or family were the focus of service even though the goals were clearly grounded in the protection of the child. This paper begins with some of the apprehension expressed both in the field and in Children Australia in 1993, and reports upon the now completed evaluation of the pilot, which covered the first 18 months of operation. The evaluation examined implementation and program development issues and considered the client population of the service against comparative data about those children at risk who were not included. The paper concludes that there is room for Families First in the Victorian system of protective and family services and points to several developmental issues.

The study used a form of the International Association for the Evaluation of Educational Achievement (IEA) Preprimary Project which was adapted for the Australian context to investigate the patterns of usage and factors behind parental choices of early childhood services for four-year-old children in the year prior to formal education. Data were obtained from interviews with 175 parents, usually the mother, regarding where, with whom and how their children spent their day and week. The findings revealed that many children in Victoria spent time in a number of services each day. A substantial number also participated in extra-curricular activities and recreational activities. Data collected concerning parental selection of particular services revealed the complex early care and education arrangements that parents were required to make to meet the educational and social needs of their children as well as the work related needs which influenced parental choice.

This is the second of two articles examining the establishment of Family Decision Making in Victoria. The first ‘Family Group Conferences – Part One: Australia's first Project in Child Protection’ was presented in the previous edition of Children Australia. This article builds upon the first by presenting an overview of the evaluation of the Victorian Family Decision Making Project, and pointing to practice and other implications of the development of this Project for child welfare services generally.

Objectives: Child abuse has been a continuous, hidden health and social problem in all over the world. Identifying risk factors are crucial to implement protective services. In Turkey, data of the legal cases are still lacking. This study aims to assess the sociodemographic and psychiatric features of the sexually abused children who have been referred for forensic evaluation together with their identity issues.Materials and Methods: The forensic files of the sexually abused cases (tı 11: 9 boys, 32 girls) who had been referred to the child psychiatry outpatient clinic were evaluated. Psychiatric diagnoses in the files were based on the Schedule for Affective Disorders and Schizophrenia for School-age children- Turkish Version. Data on age, gender, socioeconomic status and diagnoses of the victims and characteristics of the abusers were gathered and analysed by descriptive statistical methods.Results: Mean age of the victims was 11.54±3.31 years. Socioeconomic levels of their families were mostly lower class with rate of 51.2%. All perpetrators were male with a mean age of 23 years (min 14; max 67). When the consanguinity of the abusers and victims were taken into consideration, it was found that they were intrafamilial (fathers and brothers rate:12.2%), close relatives (19.5%), distant relatives (22.0%), other familiar (such as neighbours, friends: 14.6%) and unfamiliar (24.4%) people for the victims. 19.5% of the victims had mental retardation. The most common diagnoses of the victims were posttraumatic stress disorder (46.3%), other anxiety disorders (17.1%), and major depression (24.4%).Conclusion: Identified risk factors for sexual abuse, determined as the result of this study, are being a female child, late childhood period, mental retardation, and low economic status. The abusers were males who were familiar to the child victims. Preventive measures should be implemented for the entire population, particularly involving the high- risk groups to avoid child abuse.

Abstract Maternal and Child Health Services (MCHS) provide ideal settings for oral disease prevention. In Victoria (Australia), child mouth-checks (Lift-the-Lip) and oral health promotion (OHP) occur during MCHS child visits. This study trialled Tooth-Packs (OHP resources, toothbrushes, toothpastes) distribution within MCHS to (i) assess the impacts of Tooth-Packs distribution on child and family oral health (OH) behaviours and knowledge, including Maternal and Child Health Nurses (MCHN) child referral practices to dental services, and (ii) determine the feasibility and acceptability of incorporating Tooth-Packs distribution into MCHN OHP practices. A mixed-methods evaluation design was employed. MCHN from four high-needs Victorian Local Government Areas distributed Tooth-Packs to families of children attending 18-month and/or 24-month MCHS visits (baseline). Families completed a questionnaire on OH and dietary practices at baseline and 30-month follow-up. Tooth-Packs distribution, Lift-the-lip mouth-checks and child OH referrals were conducted. Guided discussions with MCHN examined intervention feasibility. Overall, 1585 families received Tooth-Packs. Lift-the-lip was conducted on 1493 children (94.1%). Early childhood caries were identified in 142 children (9.5%) and these children were referred to dental services. Baseline to follow-up behavioural improvements (n = 230) included: increased odds of children having ever seen an OH professional (OR 28.0; 95% CI 7.40–236.88; p < 0.001), parent assisted toothbrushing twice/day (OR 1.76; 95% CI 1.05–3.00; p = 0.030) and toothpaste use >once/day (OR 2.82; 95% CI 1.59–5.24; p < 0.001). MCHN recommendations included distribution of Tooth-Packs to at-risk children <12-months of age. MCHS provide an ideal setting to enable timely family-centred OHP intervention and adoption of good OH behaviours at an early age.

The objectives of this study were to perform an economic evaluation of a targeted school-based dental checkup program in northern metropolitan Melbourne, Victoria. A 12-mo retrospective case-control cohort analysis using the decision tree method evaluated the incremental cost-utility and cost-effectiveness ratio (ICUR/ICER) for passive standard care dental services and an outreach pilot intervention completed in 2013. A societal perspective was adopted. A total of 273 children ( n = 273) aged between 3 and 12 y met the inclusion/exclusion criteria: 128 in the standard care group and 145 in the intervention group. The total society costs included health sector costs, patient/family costs, and productivity losses in 2014 Australian dollars. Outcome measures were evaluated using quality-adjusted tooth years (QATY) and the combined deciduous and permanent decayed, missing, and filled teeth prevented (DMFT-prevented). A generic outcome variable was created to determine the impact of the intervention to reach underserved populations based on government concession eligibility (cardholder status). Uncertainties were incorporated using 95% confidence intervals. The mean total society cost per child is $463 and $291 ( P = 0.002), QATY utility difference is 0.283 and 0.293 ( P = 0.937), effectiveness difference is 0.16 and 0.10 ( P = 0.756), and cardholder status is 50.0% and 66.2% ( P = 0.007), respectively, for the standard care and intervention groups. On average per child, there was a cost saving of $172 and improvement of 0.01 QATY, with an additional proportion of 16.2% of cardholder children reached. The calculated ICER was $3,252 per DMFT-prevented. The intervention dominates standard care for QATY and per 1% cardholder reached outcome measures. Our study found the pilot checkup program was largely less costly and more effective compared with the current standard care. Further research is needed to quantify the value of outreach interventions to prevent dental caries development and progression in populations from low socioeconomic status. Knowledge Transfer Statement: The findings of this research demonstrated that an outreach dental program can be less costly and more effective than standard models of dental care. It showed that a school-based dental checkup program is beneficial despite other opinions that dental screening is ineffective as a method to improve public dental health. There is fiscal economic evidence to support broader expansion of similar programs locally and internationally to reduce dental caries for children from low-income families.

IntroductionAustralia’s current healthcare system for children is neither sustainable nor equitable. As children (0–4 years) comprise the largest proportion of all primary care-type emergency department presentations, general practitioners (GPs) report feeling undervalued as an integral member of a child’s care, and lacking in opportunities for support and training in paediatric conditions. This Strengthening Care for Children (SC4C) randomised trial aims to evaluate a novel, integrated GP-paediatrician model of care, that, if effective, will improve GP quality of care, reduce burden to hospital services and ensure children receive the right care, at the right time, closer to home.Methods and analysisSC4C is a stepped wedge cluster randomised controlled trial (RCT) of 22 general practice clinics in Victoria and New South Wales, Australia. General practice clinics will provide control period data before being exposed to the 12-month intervention which will be rolled out sequentially each month (one clinic per state) until all 22 clinics receive the intervention. The intervention comprises weekly GP-paediatrician co-consultation sessions; monthly case discussions; and phone and email paediatrician support, focusing on common paediatric conditions. The primary outcome of the trial is to assess the impact of the intervention as measured by the proportion of children’s (0–<18 years) GP appointments that result in a hospital referral, compared with the control period. Secondary outcomes include GP quality of care; GP experience and confidence in providing paediatric care; family trust in and preference for GP care; and the sustainability of the intervention. An implementation evaluation will assess the model to inform acceptability, adaptability, scalability and sustainability, while a health economic evaluation will measure the cost-effectiveness of the intervention.Ethics and disseminationHuman research ethics committee (HREC) approval was granted by The Royal Children’s Hospital Ethics Committee in August 2020 (Project ID: 65955) and site-specific HRECs. The investigators (including Primary Health Network partners) will communicate trial results to stakeholders and participating GPs and general practice clinics via presentations and publications.Trial registration numberAustralia New Zealand Clinical Trials Registry 12620001299998.

This thesis describes an evaluation of Sexual Assault in Families Inc., Perth, Western Australia (the SAIF programme) which offers therapy and counselling to families where one or more of the children have been sexually abused by one of the family members. The purpose of the study was to demonstrate the use of a triangulated qualitative research methodology in order to determine whether the programme is achieving its objectives in terms of service delivery. It adopted a phenomenological approach in which participants were acknowledged as expert informants who were capable of identifying valued aspects of the programme. The participants were twelve families who had completed the 12 month SAIF therapy programme and who had reunited or were in the process of reunification. The paper describes the families' perceptions and experiences of having Participated in the programme, what changes had occurred as a result of the process, and whether there was evidence that the abuse bad stopped. Levels of family cohesion and adaptability were also measured using the FACES III (Family Adaptability & Cohesion Evaluation Scale). A content analysis procedure identified emergent themes of safety, communication, trust, victim empathy, group Support and self-awareness for each of the three groups of participants, which were then compared to the findings of the FACES III questionnaire.

This study assessed the extent to which victim families are or are not helped by the support services in Davis County, Utah. A sample of 29 mothers of sexually abused children indicated that existing intervention services were greatly underutilized and hard to locate. Seventeen of these mothers reported that they were either ignored by their caseworkers or, conversely, told not to get counseling until their case was adjudicated because of the investigator's belief that any exposure to therapy might erode the child's credibility as a witness. Only 48% of the families were informed of their Victim Rights as required by Utah state law. When asked to state how the incident impacted the family, 41% of the mothers reported that they felt they were still functioning in an elevated state of stress and tension six months or more after the disclosure of the incident. Fully 72% of the mothers reported that the child abuse disclosure had created major changes in the family system. Results of the Moos & Moos Family Environmental Subscale testing indicated that the d i stressed sample families scored significantly higher on the conflict and control subscales as hypothesized. An unexpected finding was the sample's high score on the moral religious emphasis (MRE) subscale. The MRE finding may have some influence on the process by which victim families seek help in child abuse incidents. The results of this study suggest the need for a uniform county-wide victim support and information program and improved training for professional investigators and public agencies charged with the implementation of the Victim's Bill of Rights as outlined in the Utah Code of Criminal Procedures, 77-37-1-5.

An estimated 800,000 Canadian children are exposed to domestic violence in their homes every year. Families experiencing domestic violence use various community and government agencies along with the criminal and civil court systems. Unfortunately, collaboration between these agencies and the courts is described by professionals in Montreal as being problematic and strained. Elsewhere in Canada and the United States, some cities and communities have made progress in working through the complex obstacles inherent in the coordination of services in the area of domestic violence. This thesis will examine 14 inter-agency programs and coordinated models of intervention that have been initiated outside the province of Quebec to respond to the needs of children exposed to domestic violence. The history of these programs, their objectives and along with coordination mechanisms will be examined. A discussion regarding the implications of these findings for practice in regards to coordination of services in Montreal will also be presented.

This study outlines the results of an evaluation of programmes through a developmental quality assurance process within shelters for abused women and their children in Gauteng Province. The survey obtained the attitudes and opinions of the social workers/social auxiliary workers and shelter managers towards their services. The study reflects empirical findings as well as strengths and developmental areas within these shelters. The results from the study indicate that shelters for abused women and their children are functioning well. However, the Minimum Standards for Shelters are not fully adhered to. Therefore, internal and external evaluations should be used by shelter managers to evaluate their own performance and to improve service delivery.
Social Work
MA(SS) (Social Work)

The researcher identified in her work as a social worker that sexually abused adolescents experience difficulties with testifying in court. The goal of this research was directed at developing guidelines to assist adolescents who have to testify in court. The researcher utilised the qualitative research approach with an exploratory and descriptive nature. Semi-structured interviews were done with a sample of adolescents who have testified in court, a sample of parents or caregivers of adolescents who have testified in court and social workers working with adolescents who testify in court. These interviews were conducted to gain insight into how the research participants experienced the court process in order to formulate guidelines for adolescents who have to testify in court. The researcher concluded that adolescents experience testifying in court as negative. Guidelines were developed from the information obtained from the research participants to support adolescents who has to testify in court.
Social work
M.Diac. (Play therapy)

It was recommended by the American Psychological Association and the American Bar Association in October 1999, that the time had come for psychologists to do more than act as expert witnesses, and that their influence should be felt " ... at the first level of intervention" (Foxhall, 2000, p. 1). The first level of intervention is considered, in this study, to be the decision-making process. This research examines the decision-making processes used by four of the disciplines integral to the child abuse multi-disciplinary team. Social workers, child protection officers of the South African Police Services, psychologists and prosecutors currently involved in the child abuse arena in South Africa were given case vignettes to anchor their decision-making on simulated examples. On the basis of these in-depth interviews, using a Grounded Theory methodology, three specific questions are addressed, namely: how decisions are made and substantiated; how they differ across disciplines; and how they compare to recommended protocol. Results indicate interesting differences across these four disciplines. The differences between the decision-making processes in the disciplines seem to be rooted in their philosophical tenets, which give rise to specific aims in addressing child abuse. Differences between the decision-making processes and recommended protocol were also noted in cases where guidelines are available. In addition differences in expected outcomes of the vignettes, use ofassumptions and a level of mistrust between professionals was shown. If this research can help to sensitise professionals to begin to understand their own decision-making processes and those of their fellow decision-makers, then perhaps key role players and policy makers may be one step closer to responding to the challenge of child sexual abuse in South Africa.
Thesis (M.A.)-University of Natal, Pietermaritzburg, 2002.

Childhood abuse, whether physical or sexual, is a major public health issue. The most recent United States data from Child Protective Services (CPS) show that in 2013 there were 3.5 million referrals of child maltreatment involving 6.4 million children. Out of these cases, 18% were for physical abuse and 9% were for sexual abuse. However, researchers argue that CPS data grossly underestimate the prevalence of childhood abuse as most childhood abuse goes unreported. Indeed, to date, the true prevalence of childhood abuse remains unknown as research has been hampered by inconsistent definitions of abuse and wide variation in methodologies including measures for its identification and modes of administration of these measures. Although a health care visit presents an opportunity to identify a childhood abuse history, health care providers frequently fail to ask about it. The reasons doctors give for not asking about abuse include lack of training, not knowing how to ask, and lack of familiarity with practical methods for screening that can be used in primary care settings. There is little to no research on effective means for identifying childhood abuse histories, especially in the adolescent and young adult population, or on how different modes of administration of screens to identify childhood abuse compare to each other. The net result is that most childhood physical and sexual abuse is never identified and many victims do not get the needed services to help them heal. When unaddressed, childhood abuse has negative impacts on victims’ health and wellbeing over the life course. Prior studies of adults show that when compared with non-victims of abuse, victims tend to perceive their health as poorer and utilize more health care services including emergency room and urgent outpatient care. These studies also suggest that adult victims use less routine and preventive care than non-victims. Only two studies, conducted among widely different adolescent populations, have examined how adolescent victims perceive their health. Similarly, limited evidence examining perception of health is available for young adults. These studies found that victims perceive their health as poorer than non-victims. There have been no adolescent-specific studies of how victimization impacts adolescents’ utilization of health care. One study includes participants ages 15 to 98 years and only two studies focusing on this issue in samples primarily of young adults attending college have been published. These studies found that victims utilize more health care than non-victims. Therefore, we lack a sufficient body of evidence to come to clear conclusions of how childhood abuse affects self-perceived health in adolescents and young adults. The general lack of evidence about both how childhood abuse impacts perception of health and utilization of health care in adolescents and young adults indicates a need for further study. Given that little is known about how to best identify an abuse history in adolescents and young adults and the impact of abuse on perception of health and utilization of health care, this dissertation pursued three aims: (1) to review the literature comparing modes of administration of screens to identify adolescent and young adult victims of childhood physical and sexual abuse; (2) to investigate how different modes of administration of screens to identify adolescent and young adult victims of childhood physical abuse within a primary care health setting compare to each other, and; (3) to examine the association of a history of childhood abuse (defined as none, physical only, and sexual with or without physical) with perceived health status and the health care utilization patterns among adolescents and young adults. For aim 1, a comprehensive literature review was conducted via PubMed of studies, published between January 1st, 1994 and December 31st, 2014 that compared modes of administration of screens to identify a history of childhood physical and sexual abuse in adolescents and young adults. Only one study was found. This study compared paper and pencil questionnaire, computer assisted survey, and face to face structured interview in the identification of childhood physical and sexual abuse among young adults in a college setting. No significant difference in the proportion of childhood physical abuse or childhood sexual abuse was identified by mode of administration. The identification through this search of only one study – which was conducted among college students, with no studies done among adolescents – shows a significant gap in our knowledge regarding this issue. Given that understanding how to identify childhood abuse is a critical issue, this gap is disturbing and underscores the need for studies of identification of childhood abuse to be a research priority. For aim 2, a sample of participants, ages 12-24 years, receiving health services at the Mount Sinai Adolescent Health Center in New York City were randomized to one of four modes of administration to identify a history of childhood physical abuse. The four modes of administration of screens to identify childhood abuse were paper and pencil screen, Audio Computer Assisted Self Interview screen (ACASI), face to face structured screen and face to face unstructured interview. The full sample also completed measures to assess demographic characteristics and to screen for depression symptoms. Of the sample, 44.5% of the participants disclosed childhood physical abuse. There was a statistically significant difference in the proportion of childhood physical abuse identified according to mode of administration: face to face unstructured interview identified the highest proportion of childhood physical abuse victims, followed by face to face structured screen. After adjusting for age, gender, race/ethnicity, depression, living arrangement and last grade completed, the odds of identifying physical abuse was 1.6 (95%CI: 1.0, 2.7) and 4.5 (95%CI: 2.6, 7.8) greater for face to face structured screen and for face to face unstructured interview, respectively as compared to paper and pencil screen. ACASI and paper and pencil were similar to each other but inferior to the face to face methods. For aim 3, in addition to what was measured for aim 2, the sample completed measures on a history of childhood sexual abuse and perceived health and health care utilization. The sample was then categorized into three groups: no abuse, physical abuse only, and sexual abuse with or without physical abuse. The association of childhood abuse status with perceived health and health care utilization were examined. There was no statistical significant association between a history of childhood abuse status and perceived health. However, the odds of reporting a fair/poor perception of health among those reporting childhood abuse were at least 40% lower regardless of whether the abuse was physical (OR: 0.60; 95%CI: 0.3,1.2) or sexual (OR: 0.50; 95%CI: 0.2,1.1). No significant association was found between childhood abuse status and health care utilization. However, the odds of victims reporting using urgent care only versus routine care only were at least 10% lower regardless of whether the abuse was physical (OR: 0.50; 95%CI: 0.3, 1.1) or sexual (OR: 0.90; 95%CI: 0.4,1.9). The odds of reporting using both urgent and routine care versus routine care only was similar between victims and non-victims for physical abuse (OR: 1.0; 95%CI: 0.6, 1.5) and was 30% higher for victims of sexual abuse (OR: 1.3; 95%CI: 0.8, 2.2). The findings from the three aims examined identified significant gaps in our knowledge on childhood abuse among adolescents and young adults suggesting an urgent need for further research. While much research has focused on the impact of childhood abuse on health and well-being, aim 1 reveals that little is known about which mode of administration of screens to identify childhood abuse is most effective in the identification of childhood abuse in adolescent and young adults. Furthermore, we know even less about what modes of administration of screens might be practical in primary care settings, or what must be done to improve the level of screening for childhood abuse by physicians and other health care providers. Although the findings from aim 2 suggest that face to face modes of administration are most effective in screening for childhood physical abuse in primary care settings, further studies are needed to support these findings. In addition, there is a need for studies that examine what are the best methods to use to identify childhood sexual abuse in primary care settings. The findings from aim 3 suggest that adolescents and young adults with a history of childhood physical and sexual abuse, receiving health care at the Mount Sinai Adolescent Health Center, do not perceive their health as worse than non-victims nor do they appear to utilize health care differently from non-victims. These findings contrast with results from prior studies of perceived health status and health care utilization among adolescents and young adult childhood abuse victims. Understanding how abuse impacts both the perception of health and health care utilization will be crucial in the development of interventions to identify and support adolescent and young adult victims of childhood physical and sexual abuse.

Increasing tourism numbers in third world countries affect their economies and certain aspects of their society positively; however, there are concomitant negative effects that expose the dark side of the tourism industry. One of these is the escalating commercial sexual exploitation of children (CSEC), particularly child prostitution (CP) in the context of tourism, a phenomenon known as child sex tourism (CST). Although tourism plays an important role in creating the perfect storm of poverty-stricken children colliding with wealthy tourists, it is not solely responsible for this phenomenon. Internationally and nationally, the lacuna of knowledge on CST in particular hampers an informed response by way of resource allocation and coordinated service delivery to both victims and perpetrators. Utilising a qualitative research approach, and the collective case study and phenomenological research designs complemented by an explorative, descriptive and contextual strategy of inquiry, the researcher explored the status of the knowledge of and response to the CSEC through the lens of closely associated role players, who were purposively selected for inclusion in the study. These were adult survivors who were as children engaged in sex work and victims of child sex tourism, social workers and non-social workers involved in rendering child welfare and protection services, members of the Family Violence Child Protection and Sexual Offences (FCS) Unit of the South African Police Service (SAPS) and representatives of the hospitality and tourism industry. Data was collected via individual in-depth semi-structured interviews, telephone interviews, and email-communication and thematically analysed. The researcher found that a range of microsystem level factors, such as poverty and family dysfunction, pushed children to the street, and as a means to survive engage in sex work, enabling tourists (i.e. local - out of towners) and foreigners, mainly men from varied sexual orientation) to commercially sexually exploit both boys and girls, from as young as nine years of age, and of different race groups, which leave them with physical and psychological scars. The following main findings surfaced: The social workers, in comparison to the non-social workers, who have a primary responsibility to provide child welfare and protection services were ill-informed in terms of identifying CST as phenomenon, untrained and/or slow to respond appropriately with interventions directed to the victims and perpetrators of CSEC. The service provider groups, as microsystems interfacing on a mesosystem, were fraught with perceptions that the social workers and the SAPS were being inadequate. Furthermore a lack of cooperation, collaboration and communication between the service provider groups to respond to CSEC existed. The hospitality and tourism industry service representatives were also ill-informed about the phenomena of CP and CST with a response that at best can be labelled as fluctuating between an indirect response to that of turning a blind-eye. From the findings, recommendations for social work practice, education and training and recommendations specific for the other closely associated role players in responding to the CSEC were forwarded.
Social Work
D.Phil. (Social Work)