Constructing the 'zero family': Breaking the intergenerational transmission of maltreatment from the perspective of care-experienced parents.

BACKGROUND: Several studies have explored the mechanisms of intergenerational transmission of child maltreatment (ITCM), which also involves care-experienced parents; however, what is less explored is their direct experience, especially regarding resilience processes. OBJECTIVE: Developing the theoretical framework of ITCM through an exploration of the perspectives of those who appear to have interrupted it. PARTICIPANTS AND SETTING: A sample of 27 Italian parents - with experience in foster and/or residential care - who have broken the ITCM, completed an in-depth interview between May 2021 and February 2023. METHODS: A Constructivist Grounded Theory (Charmaz, 2014) approach was adopted in carrying out the interviews, which focused on daily experiences of parenting (Morgan, 2011) and on factors perceived as supporting ITCM interruption. Data were analyzed using open, focused and theoretical coding; the analysis itself was discussed with a consultive board of care-experienced parents. RESULTS: The study highlighted important aspects that, from parents' perspectives, play a role in breaking ITCM: for instance, how their parenting experience is a challenging process of constructing what they term 'zero family'. Furthermore, starting a family from scratch requires coming to terms with the past, re-imagining oneself as a parent, and managing the complexity of everyday life despite such tensions. CONCLUSIONS: The results throw light on how the transition to parenthood itself is perceived as a significant developmental opportunity for the interruption of ITCM. However, many problems persist, foregrounding the relevance of discussing possible supports to strengthen parenting agency and skills. Such a discussion should therefore be increasingly informed by ecological approaches and parents' perspectives (also on everyday practices and life contexts), thus avoiding the risk of pathologizing responses.

What was missed in child protection responses during COVID-19? Perceptions of professionals from various countries.

BACKGROUND: The COVID-19 pandemic increased the likelihood of child maltreatment and made already difficult circumstances for children and their families much worse. This increased the significance of the child protection system's role in responding to child maltreatment and ensuring children's rights, including their right to a safe life without violence. Unfortunately, accumulating evidence has indicated that the rates of child maltreatment increased during the pandemic. OBJECTIVE: The current study sought to identify the gaps within child protection responses in various countries during the COVID-19 pandemic and to discover how we can respond to crises in the future while preserving children's rights, including their right to protection from maltreatment. METHOD: Five focus groups with a total of 47 professionals working with children from various countries were conducted via Zoom and analyzed using a thematic approach. RESULTS: Three main themes were identified: 1) gaps in policies, 2) gaps in practice, and 3) professionals' messages to improve policy and practice. CONCLUSIONS: This study emphasizes what was missed in child protection policy and practice, highlighting the continuous neglect of children's needs and voices within policies, practices and guidelines worldwide during the pandemic. Professionals' recommendations for policy and practice are also discussed.

Out-of-home interventions for adolescents who were treated according to the Open Dialogue model for mental health care.

BACKGROUND: The Open Dialogue approach (OD) emphasizes community-based psychiatric treatment for adolescents, but its success in achieving this is poorly documented. OBJECTIVE: To analyse out-of-home intervention usage in a national sample of adolescent psychiatric patients and determine if OD is linked to increased time until out-of-home intervention. PARTICIPANTS AND SETTING: The register-based cohort study included all adolescents aged 13-20 who received psychiatric treatment in Finland between 2003 and 2008. The research group (n = 780) included adolescents whose treatment was initiated in the Western Lapland catchment area, where OD covered the entire psychiatric service. The comparison group (n = 44,088) included the rest of Finland. National register data encompassed the period from treatment onset until the end of the 10-year follow-up or death. The primary outcomes of interest were the times to the first and second out-of-home intervention, including foster care, supportive housing, and hospitalization. The secondary outcomes included the clinical/demographic characteristics of adolescents treated out-of-home. METHODS: The hypothesis was tested via an inverse probability of treatment-weighted Cox hazard model, plus within- and between-group comparisons to analyse the secondary outcome. RESULTS: OD was associated with increased time to the first (adjusted hazard ratio [aHR]: 0.61, 95%CI: 0.52-0.72) and second (aHR: 0.75, 95%CI: 0.58-0.96) out-of-home interventions. In both service types, there was a subgroup of adolescents with repeated out-of-home interventions, who also demonstrated poorer long-term outcomes. CONCLUSION: OD-based psychiatric services for adolescents are associated with fewer out-of-home interventions. The clinical significance of the findings warrants further research.

Cumulative incidence of child protection system contacts among a cohort of Western Australian Aboriginal children born 2000 to 2013.

BACKGROUND: Reducing the over-representation of Aboriginal children in the child protection system is a key target for the Australian government. OBJECTIVE: We aimed to provide more recent evidence on the population-level cumulative incidence of contacts for Aboriginal children with child protective services (CPS) in Western Australia (WA). PARTICIPANTS AND SETTING: Linked administrative data was provided for WA CPS between 2000 and 2015 for 33,709 Aboriginal children born in WA between 2000 and 2013. METHODS: Descriptive summaries and cumulative incidence estimates were used to examine changes in CPS contact trends over time and within sibling groups. RESULTS: There was an increase in early-childhood contacts for children born more recently, with 7.6 % and 2.3 % of children born in 2000-2001 having a notification and placement in out-of-home care by age one, respectively, compared to 15.1 % and 4.3 % of children born in 2012-2013. Among sibling groups where at least one sibling had a CPS contact, approximately half of children had their first contacts on the same date as another sibling. For children born after one of their siblings had been placed in out-of-home care, 31.9 % had themselves been placed in out-of-home care by age one. CONCLUSIONS: Multiple children tend to be placed into out-of-home care when at least one sibling is, which is likely to have a significant impact on families affected. The additional risk of placement also carries over to children born after the first removal in a sibling group, highlighting the need for further support to prevent future removals.

Three-Year Custody Outcomes Among Infants Investigated by Child Protection Systems for Prenatal Substance Exposure in California.

OBJECTIVE: Infants affected by prenatal alcohol and drug use are more likely to be removed from parental custody than those in the general population, although it is unclear whether their custody outcomes differ from infants investigated by child protection systems (CPS) for other reasons. This analysis seeks to compare trajectories of involvement and custody outcomes among infants investigated by CPS with and without documentation of prenatal substance exposure (PSE). METHOD: We used vital birth records linked to administrative CPS records to examine the timing of system involvement and 3-year custodial outcomes among investigated infants with and without identified PSE. We defined PSE according to documentation on the state's standardized hotline screening form, which CPS completes upon referral for alleged maltreatment. We estimated the likelihood a child was in nonparental custody at age 3 by specifying multivariable generalized linear models, adjusted for covariates available in the birth record. RESULTS: In our sample of 22,855 infants investigated by CPS in 2017 in California, more than 26% had documentation of PSE. These infants experienced an accelerated timeline of system penetration and were 2.2 times as likely to be in nonparental placement at age 3. DISCUSSION: PSE confers an independent risk of custody interruption among infants investigated by CPS. The younger age of these infants, complexity of parental substance use, and potential misalignment of administrative permanency timelines with parental recovery all suggest the need for increased research, policy, and programmatic interventions to serve this vulnerable population.

Children with PSE face environmental risks in the early developmental period. Often in the United States, CPS is relied on to assess and mitigate these risks. Amid calls for a public health response to PSE, it is essential to understand how children with PSE interact with CPS. We describe the incidence and timing of custody interruptions in a large U.S. state, comparing infants with PSE to those investigated by CPS for other reasons. This study extends current understanding by demonstrating the independent risk of custody interruption conferred by PSE status.

Explorando el sistema de protección de la niñez en El Salvador

(analítico) Se exploran las prácticas institucionales que facilitan u obstaculizan la protección de los derechos de niños, niñas y adolescentes en el sistema de protección de la niñez en El Salvador. Partiendo de un diseño de etnografía institucional, se realizaron 61 entrevistas a trabajadores pertenecientes al sistema de protección. Como resultado, se identificó la ausencia de manuales que establezcan prácticas concretas en la aplicación de la Ley de Protección Integral de la Niñez y Adolescencia, obstruyendo su óptimo funcionamiento. A través del uso de la teoría del interaccionismo simbólico, se explora cómo la interpretación discrecional o no entendimiento de la ley forma instituciones aisladas del sistema; también se analiza el grado en que las dinámicas socioeconómicas del país ponen en desventaja a los sectores rurales para acceder a estos servicios.

(analytical) This study explores the institutional practices that support or hinder the rights of children and young people in the child protection system in El Salvador. Using an institutional ethnography approach, 61 individuals who worked directly or indirectly in the child protection system were interviewed. The findings highlight a lack of manuals that establish concrete practices in accordance with the application of the Law of Comprehensive Protection for Children and Youth, which reduces the effectiveness of the country's child protection system. Through an analytical approach based on symbolic interactionism, this study explored how the individual interpretations of the law, or lack thereof, combine with socioeconomic disadvantages to create difficulties for rural child protection institutions in terms of accessing operational resources.

(analítico) O presente estudo explora as práticas institucionais que apoiam ou dificultam os direitos de crianças e jovens no sistema de proteção infantil em El Salvador. Utilizando um desenho de etnografia institucional, foram entrevistados 61 indivíduos que trabalhavam ou trabalham no sistema de proteção à criança. Os achados indicam que faltam manuais que estabeleçam práticas concretas em consonância com a aplicação da Lei de Proteção Integral da Infância e Juventude o que dificulta a efetividade do sistema de proteção. Por meio de um entendimento baseado no interacionismo simbólico, este estudo explorou como as interpretações individuais da lei, ou a falta dela, e a desvantagem socio-econômica das instituições colocam os setores rurais em desvantagem no acesso aos recursos.

Child protection system involvement in children of incarcerated mothers: A linked data study.

BACKGROUND: Women prisoners are a growing portion of the prison population. Health and social outcomes of their children have been studied and found to be poor, but little is known about child protection outcomes. OBJECTIVES: Ascertain child protection system contact of children exposed to maternal incarceration. PARTICIPANTS AND SETTING: All children born between 1985 and 2011 exposed to the incarceration of their mothers in a Western Australian correctional facility and a matched comparison group. METHODS: A matched cohort study using linked administrative data on 2637 mothers entering prison between 1985 and 2015 and their 6680 children. We estimated hazard ratios (HRs) and incidence rate ratios (IRRs) of child protection service (CPS) contact post maternal incarceration (four concern levels), comparing rates for children exposed to maternal incarceration with a matched non-exposed group, adjusting for maternal and child factors. FINDINGS: Exposure to maternal incarceration increased risk of CPS contact. Unadjusted HRs exposed vs unexposed children were 7.06 (95%CI = 6.49-7.69) for substantiated child maltreatment and 12.89 (95%CI = 11.42-14.55) for out-of-home care (OOHC). Unadjusted IRRs were 6.04 (95%CI = 5.57-6.55) for number of substantiations and 12.47 (95%CI = 10.65-14.59) for number of removals to OOHC. HRs and IRRs were only slightly attenuated in adjusted models. CONCLUSIONS: Maternal incarceration is a warning flag for a child at high risk of serious child protection concerns. Family-friendly rehabilitative women's prisons, incorporating support for more nurturing mother-child relationships could provide a placed-based public health opportunity for disrupting distressing life trajectories and intergenerational pathways of disadvantage of these vulnerable children and their mothers. This population should be a priority for trauma-informed family support services.

An analysis of temporal dimensions in maltreatment reporting and child protection responses.

BACKGROUND: The health services literature indicates that the day and time of a medical encounter is often significant factor in patient outcomes, yet little is known about the role of temporal dimensions in child maltreatment reporting or substantiation. OBJECTIVE: We examined time-specific dynamics of screened-in reports of alleged maltreatment from different reporter sources, including their relationship to the likelihood of substantiation. PARTICIPANTS AND SETTING: We used a population-based dataset of administrative records for 119,758 child protection investigations involving 193,300 unique children in Los Angeles County, California, between 2016 and 2017. METHODS: For each report, we coded three categorical temporal dimensions of the maltreatment report: season, day of the week, and time of day. We descriptively examined how temporal characteristics varied by reporting source. Finally, we ran generalized linear models to estimate the likelihood of substantiation. RESULTS: We observed variability overall and by reporter type for all three measures of time. Reports were less likely during summer months (22.2 %), during the weekend (13.6 %), and after midnight (10.4 %). Counts of reports from law enforcement were more common after midnight and contributed to a greater proportion of substantiations over the weekend than other reporter types. Weekend and morning reports were nearly 10 % more likely than weekday and afternoon to be substantiated, respectively. Reporter type was the most prominent factor for substantiation regardless of temporal dimensions. CONCLUSIONS: Screened-in reports varied by season and other classifications of time, but temporal dimensions exhibited only a modest influence on the likelihood of substantiation.

Adverse childhood experiences, associated stressors and comorbidities in children and youth with fetal alcohol spectrum disorder across the justice and child protection settings in Western Australia.

BACKGROUND: Individuals with Fetal Alcohol Spectrum Disorder (FASD) are at risk of having adverse childhood experiences (ACEs), especially those with child protection and/or justice system involvement. The complex relationship between FASD and psychosocial vulnerabilities in the affected individual is an important clinical risk factor for comorbidity. This study (1) explored the ACEs and associated stressors in individuals with FASD; (2) investigated the association between ACEs and negative outcomes, i.e., justice/child protection system involvement; and (3) examined the relationship between ACEs and comorbid conditions such as mood and neurodevelopmental disorders. METHODS: Data were collected retrospectively via file review from diagnostic clinics in Western Australia. Life adversity was coded using a standardised ACEs questionnaire. A total of 211 participants (72% males) with FASD with a mean age of 11 years (range = 2-21) were included in the final sample. 70% of the total sample had been involved with the child protection system and 40% had trouble with the law. RESULTS: Exposure to drinking/substance misuse at home (70%) and domestic violence (52%) were the two most common ACEs across the total sample. In the entire cohort, 39% had four or more ACEs, indicating higher risks of poor health outcomes. Additional stressors recorded were disengagement from school (43%), transiency (19%), victims of bullying (12%), traumatic brain injury (9%) and homelessness (5%). ACEs such as drinking/substance misuse at home, emotional neglect and physical neglect were positively associated with child protection system involvement. Additionally, exposure to domestic violence was positively correlated with justice system involvement. Higher rates of life adversity in this clinical population were associated with an increased number of comorbidities. Specifically, those with FASD who had comorbidities such as attachment disorder, substance use disorder, and PTSD also reported higher ACEs scores. CONCLUSION: ACEs were common in this clinical population. Increased ACEs in this sample were associated with increased comorbidities and involvement with the child protection and/or justice system. This highlights that prevention, intervention and early diagnosis of FASD are important for at risk children to reduce the negative effects of ACEs.

Promoviendo la sensibilidad parental con una intervención tempranabasada en la evidencia / Promoting parental sensitivity with an evidence-based early intervention

Las experiencias tempranas son clave como cimientos de las trayectorias de desarrollo. Sufrir adversidad temprana está relacionado con dificultades en regular el comportamiento, las emociones y la fisiología. Las intervenciones que promueven la sensibilidad parental pueden proteger a los niños de las consecuencias negativas de la adversidad temprana y promover trayectorias de desarrollo positivas. Una de estas intervenciones es Attachment & BiobehavioralCatch-up (ABC), un programa de visitas domiciliarias basado en la evidencia que promueve un cuidado sensible y contingente. En este artículo, revisamos los objetivos de la intervención ABC y su eficacia. Describimos también la supervisión de la fidelidad al programa y su diseminación, incluida la implementación de ABC en diversos contextos y con familias de habla hispana en Estados Unidos. Por último, discutimos el potencial de implementar ABC en España y Latinoamérica como una innovación en el campo de la intervención familiar y la protección a la infancia.(AU)

Early caregiving experiences set the stage for children’s developmental trajectories. Children who experience earlyadversity are more likely to show difficulties regulating their behaviors, emotions, and physiology than children whodo not experience adversity. Parenting interventions designed to enhance parental sensitivity and responsivenesscan buffer children from the detrimental effects of early adverse experiences and ultimately enhance child outcomes.One such intervention is Attachment and Biobehavioral Catch-up (ABC), an evidence-based home visiting programdeveloped to enhance parental sensitivity and responsive care. In this paper, we review the intervention objectivesand effectiveness of ABC. We then describe efforts made to supervise the fidelity and dissemination of ABC,including its implementation in diverse cultural contexts and with Spanish-speaking families in the United States.Lastly, we discuss the potential of ABC as a novel intervention to be implemented within the child welfare systemin Spain and Latin America.(AU)

Racial sensitivity training: An inadequate solution to systemic racial disparities in child protection systems.

Calls continue for staff training as an instrumental response to racially based differences in rates of child protection system interactions and outcomes. These recommendations echo a reliance on implicit bias and diversity training (referred to broadly as "anti-bias and racial sensitivity training") across disciplines of social and human services in the United States as a feasible and politically expedient solution to racial disparities. But focusing on anti-bias training to address racial disparities in child protection systems will almost certainly fail to achieve desired objectives for at least three reasons: (a) there is no evidence that implicit bias or racial sensitivity trainings change behavior; (b) personnel training initiatives misapply an individual behavioral solution to an institutional and structural problem; and (c) an emphasis on internal training initiatives distracts and reduces the accountability of other systems of care better positioned to produce change. We conclude that if the goal is to reduce racial disparities, systemic innovations and broader policy reforms both internal and external to the child protection system are needed. Training will not meaningfully shift the downstream effects of structural racism.

Child protection plans in the COVID-19 pandemic in Germany: Maintained, adjusted, or suspended?

BACKGROUND: COVID-19 infection prevention measures have enhanced risks of abuse and neglect for children and youth. Simultaneously, they have affected the practice of child protection, especially impacting the social infrastructure on which child protection work tends to rely, as well as the ability of practitioners to meet with family members face-to-face and in their homes. OBJECTIVES: This article focuses on the ways in which infection prevention measures have shaped child protection plans in Germany, i.e. family support and counselling, which is accompanied by monitoring and scrutiny. METHODS: The article is based on a qualitative study, in which 40 semi-structured interviews were held with first-line management representatives of German Youth Welfare Agencies between July and October 2020. RESULTS: The study's results show that protection plans have either been maintained, modified or (temporarily) suspended. Several influencing factors were identified. First, the extent to which the social infrastructure relevant for child protection could be maintained, or emerging gaps be filled in a timely fashion by child and youth welfare organisations. Second, the degree of effectiveness of the working relationship between practitioners and parents under the new conditions, including practitioners' ability to resort to flexible, digital or hybrid communication methods with families proved important. Moreover, everyday practical help from Youth Welfare Agencies and family service providers could often change the parental perception of these professionals for the better, thereby strengthening the relationship between practitioners and parents. LIMITATIONS: A key limitation of the study comprises the fact that the study findings are limited to the earlier phase of the pandemic.

The EU Strategy on the Rights of the Child and the European Child Guarantee-Evidence-Based Recommendations for Alternative Care.

Protection and promotion of child rights are referred to as a central purpose of the European Union (EU). Therefore in 2021, the EU Strategy on the Rights of the Child and the European Child Guarantee were published to enable children to have the best possible life in the EU and worldwide. Member states were invited to implement the directions of both documents into practice. The present study analyses and showcases the evidence on how to progress implementation of the Strategy and the Guarantee regarding alternative care in Portugal. A literature review was conducted based on international literature. Evidence-based recommendations for the Portuguese transition process towards quality, family and community-based care are stated. De-institutionalisation and strengthening specific services-kinship care, special guardianship, and foster care-are advocated, namely specialising the workforce, and promoting training for kinship carers and prospective special guardians. To conclude, the revision and monitoring of the measures for children in need of alternative care are suggested as well as integrating and publishing data from the diverse services of the alternative care system.

Educational strengths and functional resilience at the start of primary school following child maltreatment.

BACKGROUND AND OBJECTIVE: This study explored the associations between child maltreatment and functional resilience at school commencement, and investigated factors related to resilience separately for boys and girls. PARTICIPANTS AND SETTING: Children were part of a birth cohort of all children born in South Australia between 1986 and 2017 who had completed the Early Australian Development Census (AEDC) at about age 5-6 years when starting primary school (N = 65,083). METHODS: Multivariable logistic regression analysis was conducted with a subsample of 3414 high-risk children who had a maltreatment substantiation or investigation, with resilience defined as having well or highly developed strengths on the Multiple Strength Indicator of the AEDC. RESULTS: CPS involvement was strongly associated with poorer functioning at school commencement. Among high-risk children, 51.2% demonstrated resilience. Predictors of resilience in the multivariable model were being older, not having an emotional condition, and being read to at home. Risk factors were being male, living in rural or remote areas, having a physical or sensory disability, or having a learning disability. Boys who had been maltreated demonstrated few strengths and had less resilience than girls. Boys and girls who were read to regularly at home had more than three times the odds of showing resilience than children who were not read to at home. CONCLUSIONS: The early learning environment provides an ideal opportunity to identify and intervene to help those children who are struggling with school adjustment following familial maltreatment. Boys are likely to need additional help.

Reasonable suspicion in reporting child maltreatment: a survey among German healthcare professionals.

BACKGROUND: With regular contacts to the general child population, healthcare professionals could play an important role in the detection of child maltreatment. However, a majority of child maltreatment cases go unnoticed by the healthcare system. Child protection legislations usually offer terms like "reasonable suspicion" to corner a threshold that warrants reporting to child protection services (CPS) is defined as. The indistinct legal terminology leads to marked differences in the interpretation of this threshold. Therefore, we aimed to systematically assess the understanding of reasonable suspicion and subsequent handling of cases in the German context. METHODS: A cross-sectional online survey was conducted among 2485 physicians and psychotherapists working with children and adolescents. Field access was gained by German professional associations. Via case vignettes, predictors of thresholds for reporting were assessed. RESULTS: The probability of a report to CPS increased positively with the degree of suspicion for maltreatment. However, even if participants were certain that child maltreatment occurred, 20% did not chose to report to CPS. Training in child protection lowered the professionals' threshold for reasonable suspicion; experience with child protection cases and good knowledge of the legal framework increased the likelihood to report an alleged situation of child maltreatment to CPS. CONCLUSION: Our data show that a significant proportion of health care professionals are uncertain about estimating reasonable suspicion and on how to proceed when there are strong indications for child maltreatment Therefore, data point towards the relevance of training in child protection among healthcare professionals in order to improve detection and adequate handling of cases of child maltreatment.

A Population-Based Examination of Suicide and Child Protection System Involvement.

PURPOSE: The purpose of this study was to provide a population-based analysis of child protection system (CPS) involvement among children and adolescents who died by suicide. METHODS: We performed a case-control study of child and adolescent suicide and CPS involvement. Using linked birth, death, and CPS records, we longitudinally followed all children born in California in 1999 and 2000 (N = 1,052,333) in CPS and death records through 2017. Cases were defined as children who died in California and had a manner of death coded as suicide using the International Classification of Diseases, 10th revision (n = 170). Each suicide case was matched to four living controls, and children were classified based on CPS exposure: no history, reported for alleged child maltreatment, substantiated for child maltreatment, and placed in foster care. Crude suicide rates were documented, and conditional logistic regression models were used to estimate the adjusted odds of suicide. RESULTS: Among children and adolescents who died by suicide, 56.5% had a history of past allegations of abuse or neglect. Children with any CPS history had three times the odds of suicide compared to children with no history. No additional risk was found for children substantiated or placed in foster care compared to children with only an allegation. CONCLUSIONS: Suicide risk is not isolated to the relatively small group of children and youth placed in foster care. Findings reinforce the importance of increased attention to the experiences of the larger universe of children who remain at home after alleged or substantiated maltreatment.

Jóvenes con problemas de comportamiento graves atendidos en centros terapéuticos residenciales: ¿al final del sistema de protección infantil? / Young people with severe behavior problems taken care of in residential therapeutic centers: ¿at the end of the child’s protection system?

El objetivo del trabajo es describir las características de los menores en atención residencial terapéutica (ART) con graves problemas de conducta y analizar posibles mejoras en las intervenciones terapéuticas tanto para los profesionales de salud mental como para los profesionales del sistema de protección y los decisores políticos. (AU)

The objective of the work is to describe the characteristics of minors cared for in therapeutic residential centers (TRC) with serious behavior problems analysing possible improvements in therapeutic interventions for mental health professionals as well as for professionals in the protection system and political decision-makers. (AU)

Explorando el sistema de protección de la niñez en Honduras / Exploring the child protection system in Honduras / Explorando o sistema de proteção infantil em Honduras

Resumen (analítico): Se exploran las prácticas institucionales que facilitan u obstaculizan la protección de derechos de niños, niñas y adolescentes en el sistema de protección de la niñez en Honduras a través de sus diferentes etapas. Desde un diseño de Etnografía Institucional, se realizaron entrevistas a catorce trabajadores de instituciones que trabajan con niñez, y a tres residentes en un domicilio de protección. Como resultado, se identificaron múltiples instancias de denuncia, y una estrecha comunicación entre las mismas. Sin embargo, existe carencia de recursos en el sistema, y prejuicios contra adolescentes de la comunidad LGTBIQ; así como prácticas alimentadas por una concepción tradicional de la niñez. El sistema no solamente parece incumplir con algunos principios de la Convención, sino que se encuentra desbordado por precarias condiciones del contexto nacional.

Abstract (analytical) This study explores institutional practices that either facilitate or hinder the protection of the rights of children and adolescents in the child protection system in Honduras. The research focuses on the different stages that users go through when they request services. Using an institutional ethnography design, semistructured interviews were held with 14 workers from institutions that work with users in the system, as well as with three adolescents living in a protection home were conducted. The main results found that there are multiple mechanisms for reporting cases of child abuse, as well as close communication between the different mechanisms. However, there is a lack of resources in the system as well as prejudice against adolescents from the LGTBIQ community; also, practices are fed by a traditional conception of childhood. The system doesn't just violate some of the principles of the Convention on the Rights of the Child, but that its work is overwhelmed by the precarious conditions in the national context.

Resumo (analítico) Este estudo teve como objetivo explorar práticas institucionais que facilitam ou dificultam a proteção dos direitos das crianças e adolescentes no sistema de proteção à criança em Honduras, através das diferentes etapas. Para isso, com base no desenho de Etnografia Institucional, foram realizadas entrevistas semiestruturadas com quatorze trabalhadores de instituições governamentais e não governamentais e com três adolescentes residentes em um lar de proteção. Entre os principais resultados, constatou-se que existem várias instâncias para relatar casos de abuso infantil, bem como uma estreita comunicação entre elas. No entanto, havia também falta de recursos nas instituições que compõem o sistema, bem preconceitos contra adolescentes da comunidade LGTBIQ. Na análise, muitas práticas são alimentadas por uma concepção tradicional da infância. Por outro lado, o sistema de proteção à criança parece não apenas violar alguns dos princípios da Convenção, mas que seu trabalho é sobrecarregado por precárias condições do contexto nacional.

Lifetime risk of child protection system involvement in South Australia for Aboriginal and non-Aboriginal children, 1986-2017 using linked administrative data.

BACKGROUND: Child protection services exist to reduce potential harms from child maltreatment. Many jurisdictions produce annual data on child protection system (CPS) involvement, leaving a gap in knowledge of lifetime involvement. OBJECTIVE: To describe lifetime involvement in CPS, by type of contact. PARTICIPANTS: All 608,547 children born in South Australia (SA), Australia between 1986 and 2017. METHODS: A retrospective cohort design using linked administrative data to report cumulative incidence of CPS involvement from birth to age <18 (or June30 2017) by Aboriginal status. CPS involvement was categorised into notifications (3 levels), investigations, substantiations and out-of-home care (OOHC). Cumulative incidence curves were derived for 5 birth cohorts. RESULTS: Across childhood (to age <18 years), substantiated maltreatment was experienced by 3.2-3.6% of non-Aboriginal and 19-25% of Aboriginal children, 7 times reported annual substantiation rates. For most CPS categories CPS involvement increased until 2010, and was occurring earlier in life. By age 3, 0.5% of non-Aboriginal and 4.5% of Aboriginal children born 1986-1991 were the subject of a substantiation compared with 1.9% and 15% of non-Aboriginal and Aboriginal children, respectively, born 2010-2017. Incidence rates beyond age 3 were similar. OOHC contact was similar across cohorts, with ˜1.5% of non-Aboriginal and 12.7% of Aboriginal children ever-placed in care. CONCLUSIONS: Data linkage is an essential tool for understanding life course involvement with the CPS and describing trends not observable from annual snapshots. Such information is critical for burden of disease estimates, informing policy and monitoring CPS performance.