Wednesday, February 1, 2017

Additional information will be added as it becomes available. Please check back.

E1. "You're Getting Warmer": Moving Closer to Diagnosing Abusive Burns

Barbara Knox, Debra Esernio-Jenssen

Description

This workshop will review the evidence-based studies that detail the characteristics of unintentional and abusive burns. Through case presentations, the participant will use this acquired knowledge to "get warmer" in their ability to differentiate unintentional and abusive burns.

Learning Objectives

  1. Review physical examination findings and burn patterns which are highly suggestive of abusive burn injuries.
  2. Understand the strength of the medical evidence supporting a conclusion that a burn is abusive.
  3. Summarize key components of a burn scene investigation.

Abstract

Burns in childhood are significant as they cause both physical and psychological morbidity as well as increased mortality. It is estimated that between 1990 and 2006 more than 2 million children and adolescents were treated for burn related injuries in U.S. emergency departments. Children < 6 years of age sustained the majority of burns and >50 % were due to thermal burns including dry contact burns from hot surfaces and scalds from hot liquids.

Differentiating unintentional burns from abusive burns requires obtaining a very detailed history of the burn injury as well as the developmental ability of the child. Children evaluated in emergency departments for unintentional burns revealed that the most common scald agent for children < 5 was caused by hot beverage pull-downs that affected the front of their body. In older children, scalds were mostly from spilled hot water. For both age groups, the majority of contact injury burns involved the hands and affected the palmar surfaces. In contrast, children determined to suffer abusive burns compared to controls were younger, sustained greater total body surface area burns that were likely caused by hot tap water and had distinct immersions lines. Maltreated children also had younger parents, were less likely to have a parent present when injured and more likely to experience delays in medical care.

This workshop will review the evidence-based studies that detail the characteristics of unintentional and abusive burns. Through case presentations, the participant will use this acquired knowledge to "get warmer" in their ability to differentiate unintentional and abusive burns.

E2. Pre-Pubertal Gender Diversity: Understanding the Clinical Approach, Controversies, and Risk Factors When Fostering Emotionally Healthy Children

Scott Liebowitz

Description

This workshop will discuss the theories of gender identity development in pre-pubertal children and how that relates to clinical practice. Participants will be provided an overview of terminology, diagnostic nosology, gender development, and the current thinking on how to best foster emotionally healthy children when weighing multiple factors.

To download workshop PDF: click here

E3. Sibling Abuse: Trauma Informed Assessment, Prevention, and Intervention

Amy Meyers

Description

Physical and emotional sibling abuse will be presented in the context of the family environment. Through an understanding of risk and protective factors, assessment and intervention strategies will be evident.

Learning Objectives

  1. Participants will learn about forms of physical and emotional sibling abuse and identify it as distinct from normative sibling rivalry.
  2. Participants will understand risk and protective factors of sibling abuse including family dynamics that contribute to the development, existence, and perpetuation of sibling abuse.
  3. Participants will link research findings with best practices and develop assessment skills and strategies for intervention.

Abstract

This presentation will present an overview of the phenomenon of sibling abuse and provide the community with awareness of the short-term and long-term effects of victimization including physical and psychological trauma. This will contextualize risk factors – and in turn promote knowledge of protective factors. Family dynamics and parent-child relationships which may promote the abusive sibling relationship will emphasize the need to involve various family members in prevention and intervention. The presenter’s research and the extant literature will also shed light on environmental, behavioral, and emotional indicators of sibling abuse, arming the participants with the ability to assess for sibling abuse.

Most mental health and social services agencies focus primarily on parent-child relationships: risk assessment around the nature and quality of sibling relationships is virtually ignored, leaving children who are victims of sibling abuse untended. Informed practitioners, advocates, staff, and families can use psycho-education to develop parenting skills and promote safe home environments.

This presentation will allow participants to learn about physical and emotional sibling abuse and identify it as distinct from normative sibling rivalry.

Additional learning objectives include:

  • Understanding risk and protective factors of sibling abuse including family dynamics that contributes to the development, existence, and perpetuation of sibling abuse.
  • Linking research findings with best practices for assessment and intervention strategies.

Published Articles on Evidence-based Topics

  • 2015 (Nov.) Meyers, A. Trauma and Recovery: Factors Contributing to Resiliency of Survivors of Sibling Abuse. Journal of Family Issues. In publication.
  • 2015 (Jul.). Meyers, A. Lifting the Veil: The Lived Experience of Sibling Abuse. Qualitative Social Work. In publication.
  • 2015 Meyers, A. Notes from the Field: Understanding Why Sibling Abuse Remains Under the Radar and Pathways to Outing. Professional Development: The International Journal of Continuing Social Work Education. 18(2), 24-33.
  • 2014 Meyers, A. (Sept.). A Call to Child Welfare: Protect Children from Sibling Abuse. Qualitative Social Work, 13(5), 654-670.

E4. A Picture is Worth a Thousand Words: Presenting Images in the Forensic Interview

Catherine Connell

Description

Victims reluctant to disclose may need more cues. This workshop will discuss the use of evidence and how to present evidence, with emphasis on images, in the investigative interview.

Learning Objectives

  1. Participants understand the dynamics of child pornography victims and how it impacts disclosure.
  2. Participamts will learn how to present evidence in the forensic interview.

Abstract

The use of technology has impacted how children/adolescents are victimized. Research supports that the use of technology during victimization can increase the likelihood that a victim will not disclose. Most interview models are designed for children who have previously disclosed and who transition easily from the beginning of the interview to a substantive interview. Reluctant children may need more cues which may mean utilizing evidence in the forensic interview. This module will discuss the use of evidence and how to present evidence, with emphasis on images, in the investigative interview.

E5. Child Sex Trafficking, Sex Tourism and Exploitation on the U.S. Southern Border

Jim Walters

Description

Exploring the dynamics of child sex trafficking, sex tourism and exploitation in the border region between the United States and Mexico.

Learning Objectives

  1. Participants will understand the extent of trafficking and exploitation in the US Southern border region.
  2. Participatns will understand the dynamics which contribute to the victimization of at risk populations on the US Southern Border.
  3. Participants will understand promising approaches to combating trafficking and exploitation on the Southern border.

Abstract

The U.S. – Mexican border region is a focal point for issues affecting the safety of children; Human Trafficking, Child Exploitation, Sex tourism, parental kidnappings, Cross border abductions, Narco crime involving minors, and Ransom kidnappings all threaten children in the U.S. and Mexico. In addition to fostering sex tourism and trafficking in the border region, many U.S. children also find themselves lured by the promise of money and acceptance from drug trafficking organizations are murdered, abused, or go missing as a result of their association with the criminal organizations. This session will discuss the extent of the problem and efforts to combat trafficking and exploitation on both sides of the border.

To download workshop PDF: click here

E6. Prosecuting Child Abuse Cases with Limited Evidence

Mary Sawicki

Description

This workshop will discuss strategies and suggestions for prosecuting child abuse cases with limited evidence. Maximizing the effectiveness of expert witnesses and search warrants will be detailed.

Learning Objectives

  1. To understand how to effectively utilize expert witnesses in child abuse cases with limited evidence.
  2. To understand how effective search warrants can be in child abuse cases with limited evidence. 
  3. To understand strategies to bolster a child abuse case with limited evidence at the child trial preparation stage and at trial.

Abstract

This workshop will discuss strategies and suggestions for prosecuting cases with limited evidence. Tips for bolstering the strength of the case in the investigative, child trial preparation stage and at trial will be stressed.. Maximizing the effectiveness of search warrants and witness interviews will be discussed. Use of expert witnesses in cases with limited evidence will be highlighted.

To download workshop PDF: click here

E7-a. All Together Now: Variations in the Characteristics of Children's Advocacy Centers and Their Importance to Effective Inter-Agency Collaboration

Wendy Walsh, James Herbert

Description

Developing effective multidisciplinary teams is difficult. This workshop will describe what we learned from a national survey of Children's Advocacy Center directors in the United States.

Learning Objectives

  1. Understand the factors important to the successful development of collaborative relationships with other agencies.
  2. Explore successful avenues for the sustained operation of CACs.
  3. Examine whether different CAC structures impact factors important to a multiagency response to child abuse.

Abstract

A multi-disciplinary team (MDT) approach to investigating allegations of child abuse is the foundation of a Children's Advocacy Center (CAC). While there is a considerable body of research on multi-disciplinary teams responding to child abuse, researchers have noted that there is limited knowledge about structural variations in teams, and how to successfully implement teams. Although accreditation as a CAC requires progress towards a set of national standards, there is a recognition that centers will differ based on their particular context and circumstances.

This workshop will present the findings from an online survey conducted by the Crimes against Children Research Center and the Australian Centre for Child Protection with Directors of Child Advocacy Centers (N = 362) about (a) variations in characteristics of CACs across the United States; (b) variations in the implementation context of CACs; and (c) the factors that directors of CACs in the United States attribute to the development of effective collaborative relationships. We will explore what processes facilitate collaboration and whether different structures and funding arrangements impact collaboration. We will provide time to brainstorm and share ideas about developing, maintaining, and evaluating cross-agency relationships in CACs.

Published Articles on Evidence-based Topics

  • Elmquist, J., Shorey, R. C., Febres, J., Zapor, H., Klostermann, K. S., A., & Stuart, G. L. (2015). A review of Children's Advocacy Centers' (CACs) response to cases of child maltreatment in the United States. Aggression and Violent Behavior, 25, 26-34.
  • Herbert, J. & Bromfield, L. (2015). Evidence for the Efficacy of the Child Advocacy Model. Trauma, Violence & Abuse doi: 10.1177/1524838015585319.
  • Jackson, S. L. (2012). Results from the Virginia multidisciplinary team knowledge and functioning survey: The importance of differentiating by groups affiliated with a child advocacy center. Children and Youth Services Review, 34 (7), 1243-1250.

To download workshop PDF: click here


E7-b. When Do Traumatized Children Become Despised Welfare Recipients? Exploring the Links and Breaking the Cycle!

Mary Beth Vogel Ferguson

Description

Exploring the links and breaking the cycle! Links between Adverse Childhood Experiences (ACEs) and attachment to public benefit and child welfare systems.

Learning Objectives

  1. Appreciate the link between ACEs and accessing public benefits.
  2. Explore opportunities for better serving families attached to both public benefit and child welfare agencies.
  3. Discover opportunities for reducing and eliminating the intergenerational transmission of ACEs.

Abstract

Garnishing support for child victims of abuse is relatively easy. Yet, when serving those same individuals struggling with normal tasks of adulthood (employment, maintaining healthy relationships, and appropriate parenting skills) support quickly evaporates. This is especially true when these individuals are seeking state financial support. Few recognize that many of these parents were once children exposed to significant levels of personal and community trauma.

In 2014, a study of 762 cash assistance (TANF) recipients revealed traumatic childhood events, as measured using the Adverse Childhood Experiences (ACEs) study (Felitti et al., 1998), occurring at more than quadruple the rate found in the general population (as measured by the state's Behavioral Risk Factor Surveillance Survey, UDOH, 2011). As discovered in the original ACEs study, high ACE scores were significantly correlated with multiple barriers to employment including physical and mental health issues, learning disabilities, intimate partner violence, etc.

The mixture of rich qualitative narrative and quantitative data (self-report and administrative) provides a substantial foundation for drawing out the "missing pieces" critical for addressing the needs of both parents and children. Such steps are being undertaken using a "family first case management model" designed from a two-generation approach with the goal of helping children of those receiving public benefits from not needing such resources as adults.

The aim of this workshop is to help participants

  1. Appreciate the link between ACEs and accessing public benefits,
  2. Explore opportunities for better serving families attached to both public benefit and child welfare agencies, and
  3. Discover opportunities for reducing and eliminating the intergenerational transmission of ACEs.

Published Articles on Evidence-based Topics

  • Felitti,VJ, Anda,RF, Nordenberg,D, et al. The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine. 1998; 14:245-258.
  • Utah Department of Health (UDOH). (2011). Utah health status update: adverse childhood experiences and health.

To download workshop PDF: click here

E8. Keeping Mothers and Babies Safe: Building Relationships with Child Protection Service

Gabrielle Kaufman

Description

Maternal Mental Health concerns can lead to worries about child safety. We will review how to form partnerships with CPS and educate social workers to advocate not only for children, but for mothers.

Learning Objectives

  1. Participants will identify 3 ways in which Child Protective Services may be involved with maternal mental health concerns.
  2. Participants will be able to identify one potential county partner in their area.
  3. Participants will learn how risk & safety assessment requirements of Child Welfare may be used to help identify maternal mental health issues.

Abstract

"I'm afraid you'll take my baby away!" This phrase heard by women scared to share their feelings of anxiety, depression or tell us about their frightening thoughts. This fear often keeps a woman from opening up and asking for help. This is because Maternal Mental Health concerns often lead to worries about child safety.

Maternal depression and anxiety are treatable and we know the baby will benefit when mom gets the help she needs.
Clinicians may express concerns that asking a mother about her depression may lead to a need for a child abuse or neglect report. By engaging in partnerships with CPS, we can reduce this fear and educate clinicians about the need to provide support for families.

This workshop will review how to form partnerships with local Child Protection Services and educate social workers to advocate not only for children, but for mothers too. We will discuss advocacy with use of evidenced based perinatal mental health screening tools, ways to establish partnerships with child welfare agencies, how to align child safety goals with maternal mental health, and present cases.

Published Articles on Evidence-based Topics

  • Beardslee, W., Out of the Darkened Room: When a Parent is Depressed: Protecting The Children and Strengthening the Family. Little Brown, 2002.
  • Los Angeles County Blue Ribbon Commission On Child Protection Final Report, April 18, 2014; The Road to Safety for Our Children, pp. 32-33.
  • Ludermir, Ana Bernarda, et al. "Violence against women by their intimate partner during pregnancy and postnatal depression: a prospective cohort study." The Lancet 376.9744 (2010): 903-910.
  • National Council on Crime & Delinquency. The Structured Decision Making Model in Foster Care and Placement Support; www.nccdglobal.org/assessment/sdm-structured-decision-makingsystems/foster-care-placement-support.
  • Vericker, T., Macomber, J., Golden, O., Infants of Depressed Mothers Living in Poverty: Opportunities to Identify and Serve, The Urban Institute, Brief 1, Aug. 2010.
To download workshop Handout: click here

To download workshop PDF: click here

E9. Building Resiliency for Traumatized Children in Child Welfare and Creating Positive Outcomes for Children

Jim Drendel, Christine J. Kemp

Description

Highlighting the practice of trauma screening, assessment, trauma services, and strategies for developing a trauma informed community with quantitative positive outcomes.

Learning Objectives

  1. Strategies to Building a Trauma Informed Community.
  2. Understand importance of trauma screening for children/youth in the child welfare system.
  3. Learn key elements to building a model for assessing children/youth identified by the trauma screen.

Abstract

What does it take for Child Welfare Agency to build a resiliency-focused, trauma informed system to achieve positive well-being outcomes for children and families? Child Welfare agencies are granted the responsibility to achieve successful outcomes for children. Historically, this focus has been on achieving safety and permanency outcomes. Understanding well-being beyond compliance with a yearly physical requires an entirely different way of understanding the impact trauma has had on a child's life.

During this session, Larimer County CYF and Dr. James Henry, will showcase the work currently being done in Larimer County to provide quality trauma screening, assessment, trauma focused services, and strategies for developing a trauma informed community. The presenters will demonstrate how a child welfare agency can replicate a resiliency based trauma informed system and create sustainability for children. Attendees will be given engagement strategies for conducting trauma screening for children/youth in the child welfare system using the Trauma Screening Checklist (Henry, Black-Pond & Richardson, 2010) which is a validated screen (Orsi & Holmquist-Johnson, 2014) that correlates with PTSD in children.

The model in Larimer County, through a collaboration with Colorado State University, utilizes the Children's Trauma Assessment Center (CTAC) Comprehensive Neurodevelopmental Trauma Assessment (Henry, Sloane & Black-Pond, 2007; Henry, Richardson, Black-Pond, Sloane, Atchison & Hyter, 2010; Richardson, Black-Pond, Sloane, Atchison, Hyter, Y, & Henry, 2015). The model focuses on identifying the impact of trauma leading to the development of Trauma-Informed Resiliency-Based Case Plan. In Larimer County, resiliency-based strategies built upon developing relatedness, mastery, and affect regulation skills for children/caregivers are then implemented through intensive in-home coaching programs to stabilize placements and increase placements in a family setting or at home.

Presenters will provide attendees with the model overview from trauma screen through trauma service implementation. The quantitative positive findings from this project will be detailed.

To download workshop PDF: click here

E11. Scaling a Program from Innovation to Evidence

Valerie Holmes, Patricia Nellius

Description

Join the founders of a child welfare diversion program to learn how Wraparound is implemented in mandated systems to divert entry and; 2) the process used to scale it from innovation to evidence.

Learning Objectives

  1. Learn strategies that will equip participants of an understanding of the framework and tools necessary to transform a traditional service delivery system into a family centered, flexible and responsive system of care and learn to establish the efficacy of wraparound systems of care by exploring empirical evidence, data and successful outcomes.
  2. Learn the core principles of practice, values and collaborative strategies to engage community based supports with an emphasis on prevention and diversion efforts and review innovative strength based engagement techniques for youth through the use of reframing and community collaboration from the voice of a youth and in developing peer to peer networks.
  3. Review the trend analysis, evaluation process and findings that resulted in Brevard C.A.R.E.S. contributing to advancing collective impact, system change and the advancement of public and private partnerships, data sharing, increased collaboration and cost sharing across multiple systems.

Abstract

This session will focus on current efforts of data analysis and the outcomes of the Brevard C.A.R.E.S. wraparound intervention that resulted in journal article publication in preparation for credentialing as an Evidence Based Practice.
Presenters and attendees will discuss the lessons learned from previous Brevard C.A.R.E.S. evaluation efforts, focusing on studies such as the use of a reduction of risk model to assess child abuse reoccurrence, a data validation study, a trend analysis, and the customer (family) satisfaction survey reporting. This information will:

  • Provide historical information about the agency’s inception using the Florida Title IE Waiver to fund child abuse prevention and community based services;
  • Review of the agency mission and purpose as this relates to preventing the future incidence of child maltreatment;
  • Clarify early efforts to monitor outcomes highlighting important steps and time-lines;
  • Share lessons learned as a result of evaluation process and findings;
  • Discuss challenges in implementing randomized methodologies amongst high risk populations in “real life, from the field”;
  • Engage in candid discussion from staff tasked with engaging families in study participation;
  • Reveal methodology of current model design;
  • Review statistical information and aggregated data about current and historical studies:
  • Highlight key findings that demonstrate progress towards positive outcomes for youth and their families and
  • Explore benefits and expected outcomes as a result of study.
  • The evaluation framework and research design of the current study that is testing the wraparound intervention.

This portion of the presentation will

  • Highlight the current research design and research questions;
  • Explore the major steps used to conduct the current study including the time lines;
  • Discuss the major successes and challenges of the study; and
  • Seek explanations and ideas on how a testing of the wraparound intervention can be placed into context of the existing wraparound research and similar studies and
  • Provide an overview of how to scale a program from innovation to evidence.

Published Articles on Evidence-based Topics

To download workshop Handout: click here

To download workshop PDF: click here

E12. Practical Considerations in Electronic Health Records for Patients Afffected by Violence and Abuse

Cynthia Kuelbs Moderator: Jon Conte

Description

This workshop will use a case based format to address patient confidentiality and information security for patient affected by violence and abuse with proposed solutions.

Learning Objectives

  1. Know protections afforded patients under HIPAA and other regulations and laws relative to reporting and release of information.
  2. Discuss design and build considerations to protect sensitive information.
  3. Understand where information may go within an electronic health record including health information exchanges and patient portals.
  4. List some ways in which decision support may be used to improve care for patients affected by violence and abuse.

Abstract

Electronic medical records offer the opportunity to improve patient care through better information sharing, improved coordination of care, easier decision support, analytics and reporting and enhanced patient engagement. These potential benefits however must be balanced with potential risks due to inadvertent disclosure of sensitive information. This workshop will use a case based format to address patient confidentiality and information security for patient affected by violence and abuse with proposed solutions.

Published Articles on Evidence-based Topics

  • Anoshiravani, A., et al. "Special Requirements for Electronic Medical Records in Adolescent Medicine." Journal of Adolescent Health 51(5): 409-414.

 

 

Mike Olson, Wednesday Plenary Session

To download workshop PDF: click here

 

F15-a. Cancelled

F15-b. Child-Focused Joint Investigation of Child Abuse Cases: 20 Years' Experience in Hong Kong, Part 2

Kindy Yuk Ip Lam, Frances King Hei Lee, Nancy Ching Yee Chow, Sook Yee Chang-Lam

Description

This workshop will illustrate our good practice using an intra-familial sexual abuse case. Strategies in joint departmental training for investigators and interviewers as well as for developing local trainers.

Learning Objectives

  1. To understand the background and practice of joint investigation of child abuse cases in Hong Kong.
  2. To learn the important ingredients of the good practice of joint investigation and video-recorded interviews with child witnesses in criminal proceedings.
  3. To understand the joint departmental training strategies on joint investigation and video-recorded interview.

Abstract

Hong Kong has been adopting a child-centred, multi-disciplinary and case manager approach to combat child abuse. In 1995, ordinances were amended to allow special measures to better protect children in criminal and court proceedings. For example, video-recorded interview with child witness are admissible to court for trial to replace the evidence-in-chief. Live TV link can be arranged for child witnesses to give evidence in court with the companion of a support person.

To enhance the protection of the child's interests during the investigation process, designated units in the Hong Kong Police Force have been set up while the manpower of specialized units in the Social Welfare Department have been strengthened. The police, government social workers, and, if applicable, clinical psychologists join hands in the investigation of serious cases such as intra-familial and organized sexual abuse cases and serious physical abuse cases for the whole process from receiving reports of child abuse to court proceedings. Video-recorded investigative interviews are also jointly conducted by trained police and government social worker / clinical psychologist according to the need of child witnesses, e.g. age, mental capability, etc.

With 20 years' effort, the Hong Kong model of joint investigation, interviewing protocol and witness support with an aim to balancing the legal justice and child's interests has been developed successfully. We would like to illustrate in this workshop our good practice using an intra-familial sexual abuse case. Strategies in joint departmental training for investigators and interviewers as well as for developing local trainers will also be highlighted. With the ever changing societal circumstances, new challenges in child protection, e.g. those being sexually exploited in compensated dating and production of indecent images, those with special needs and from different cultures, etc. will also be discussed.

Published Articles on Evidence-based Topics

  • Tsui, E., Lam, K. & Cheung, S.L. (2002, June). Investigative interviewing of child witness in Hong Kong: an Asian adaptation of British and American practice. Paper presented at the Investigative Psychology 7th International Conference, University of Liverpool, UK.
  • Chang Lam, S. Y. (2010, June). Understanding and handling child sexual abuse reports (in Chinese language). Presented and published in Ten-years Anniversary cum Academic Conference held by the Anti-Domestic Violence Network of the China Law Society, Beijing.
  • Cheung, K. M. (1997). Developing the interview protocol for video recorded child sexual abuse investigations: A training experience with police officers, social workers and clinical psychologists in Hong Kong. Child Abuse & Neglect, 21(3), 273–284.
To download workshop PDF: click here

F15-c. Restoring Safety and Harm

Maria Andrews, Paul Baeten

Description

Changing the way of thinking and acting on behalf of the attack of child abuse in the region of Haaglanden in the Netherlands.

Learning Objectives

  1. View on latest dutch research results on the approach of domestic violence and child abuse and neglect.
  2. First results of practical pilots.
  3. View on the follow up of a three year program.

Abstract

In the Netherlands, we are in the middle of a huge transformation in youth care. There are a lot of practical and political choices made and changes initiated. Some of us intent to use this period full of innovation to improve our interventions. And to do this in such a way that the quality of life of the children involved and the outcome of the efforts made by the professionals will show a rising curve.

To do so we will use the experience of the last years and enforce the lessons learnt over the years national and international. Another important guideline will be the conclusions and recommendations of recent research on the current daily practice.

We have already started several projects that should lead to the desired main goal; letting our interventions truly lead to the improvement of the well-being of the children concerned. To be successful in the next three years we want to combine these initiatives into one program, where practice and research will be bridged.

The frame work of this starting program is the following;

Safe Home Haaglanden is committed to safety and recovery of damage as a result of her intervention in families and households. Important research has been done and the outcome is not what we hoped that it would be. In cases of domestic violence we saw that the violence reduces but one and a half year after the first report, the violence appears not to have been stopped in too many cases. In cases of child abuse, research showed that the quality of life of the children involved had decreased one year after the first report was made. These findings force us to look for improvement of our system.

Besides the significant changes in findings there are also changes in vision and approach. In spite of a fresh
new law, there are ongoing discussions on mandatory reporting. For many years the Netherlands were known because of its medical model: the confidential doctors were responsible for the initial reception of reports of child abuse. They investigated the reports and headed families to the professionals who could offer them support, assistance en treatment. In 2000 the medical model was exchanged for the approach from the youth care.

In terms of partner violence the approach in recent years has changed dramatically. In cooperation with chain partners and municipalities the Safe Forward Teams were developed. Safe home Haaglanden provides an important contribution to this development. The GGD Den Haag initiates a lot of projects and monitors the results of each of them.
Concerning the approach to child abuse the results seems worse than those for partner violence. That leads to the awareness that we have to make dramatic improvements. Several impulses have been made. In 2015, we started with the following projects:

  • Pilot in which the possibilities are examined to arrive at so called routine outcome measurement: determination of the results of the approach on a child level. The behavioral experts of Safe Home are in consultation with the Trimbos Institute (research) and with the Augeo foundation started this pilot. The results and follow-up will be expected tob e clear in the first half of 2016.
  • Project Support in Education. In cooperation with schools, the Augeo Foundation and GGD Haaglanden Safe Home performs this project the aim of which is: every child going through drastic events at home, feels safe at school and knows that there is someone with whom he can turn to; -Encompass: a Project to start in 2016, also in collaboration with Augeo, educational partners and the police, focused on direct support to children who have witnessed domestic violence.
  • The Children Safe and Restored Program: a three-year program that will be the umbrella for all projects and research. In this program in cooperation with chain partners, municipalities and nationwide operating organizations a process will be developed that results in demonstrable security and recovery of children at the end of the interference of of Safe Home.

In this workshop we will discuss the research results that led to the understanding that change is needed and the first results of our practical efforts in 2016. And finally we will clarify the follow up of the program.

F15-d. Attachment, Trauma, Emotion Regulation in Child and Adolescent Psychiatry

Marie-José van Hoof

Description

Workshop on attachment- and trauma-informed diagnostics and treatment in youth care and child psychiatric settings.

Learning Objectives

  1. To increase awareness of the significance of the concepts of attachment, trauma and emotion regulation for child and parent well-being in the field of mental health and youth care.
  2. To update knowledge to the current state-of-the-art standard.
  3. To discuss different perspectives from diverse contexts on use of diagnostics and treatment.

Abstract

Context: The concepts of attachment, trauma and emotion regulation are partially overlapping, partially distinct. They are significant to the work of professionals in health and youth care, in particular child and adolescent psychiatrist. However, an integrated diagnostic and treatment approach and use of attachment and trauma-informed care in child psychiatry and the broader field of youth care is rare due to lack of knowledge about these concepts, diagnostics and treatment options.

Purpose: Therefore we present state of the art knowledge and experience regarding attachment, trauma and emotion regulation: its concepts, diagnostics and treatment options.

Desired outcomes: increased attention for an integrated attachment- and trauma-informed approach to care conceptualization and delivery and services.

Published Articles on Evidence-based Topics

  • Mejdoubi J., van den Heijkant SC, van Leerdam FJ, Heymans MW, Hirasing RA and Crijnen AA. Effect of Nurse Home Visits vs. Usual Care on reducing intimate partner violence in young high-risk women: a randomized controlled trial. Plos One 2013: 8.10: e78185 10.1371; e0120182.
  • Mejdoubi J. et al. The effect of VoorZorg, the Dutch Nurse Family Partnership, on child maltreatment and development: a randomized controlled trial. Plos One, 2015: DOI 10.1371; e0120182.
  • Riem, M.M.E., Alink, L.R.A., Out, D., Van Ijzendoorn, M.H., & Bakermans-Kranenburg, M.J. (2015). Beating the brain about abuse: Empirical and meta-analytic studies of the association between maltreatment and hippocampal volume across childhood and adolescence. Development and Psychopathology, 27, 507–520. Doi:10.1017/S0954579415000127.
  • Van Hoof MJ, van Lang NJA, Speekenbrink S, van Ijzendoorn MH and Vermeiren RRJM. Adult Attachment Interview differentiates adolescents with Childhood Sexual Abuse from those with clinical depression and non-clinical controls. Attachment & Human Development, 2015, 17(4), 354-375.

F15-e. Bullying and Cyberbullying in the Arab Region

Bernard Gerbaka

Description

Discussion of  emerging issues.

F15-f. Dental Health and Child Welfare Services, for the Child's Best Interest

Ingfrid Vaksdal Brattabø

Description

This presentation will give an insight of what and how the dental service can contribute in child protection issues.
Findings from a study conducted among dental personnel in Norway will be presented.

Learning Objectives

  1. Give an understanding of what and how dental health service can contribute in child protection.
  2. Reveal what makes dental personnel concerned for their patients and what triggers a report of concern.
  3. Highlight how cooperation between the services can strengthen child protection.

Abstract

Background:
One of the many challenges in regard to combat child-maltreatment is to identify the children at risk and those already being a victim. Dental personnel are in a unique position to detect child-maltreatment, as they treat most children on a regular basis. In Norway, do all children under the age of 19 have a statutory right to free and regular treatment at the public dental service. Further has Norwegian health personnel a mandatory obligation to report to child welfare services if they suspect child-maltreatment.

Purpose:
To present findings from a national study conducted among public dental health personnel in Norway, and give an insight of how the dental service can contribute in child protection issues.

The study aimed to assess dental personnel's experience with suspicion of child-maltreatment, reporting to and cooperation with the child welfare services.

Material and methods:
Cross-sectional study. An electronic questionnaire was sent to 1542 public dental hygienists and dentists in Norway.

Results:
77.8% (1200) of the dental personnel responded upon the survey. A total of 60.0 % reported to have filed a report of concern during their career, while 32.6% had suspected child-maltreatment but failed to report it to child welfare service.

Conclusions:
Dental service is an important contributor in child protection. Mandatory reporting is challenging, therefore a mutual cooperation between the services is recommended.

Desired outcomes:
Inspire to enhance multidisciplinary cooperation, by raising the knowledge on:
- What and how the dental service can contribute in child protection issues.
- How the child welfare service can contribute to increase dental personnel's reporting frequency.
- How both services actively can take use of each other.

Published Articles on Evidence-based Topics

 

 

G1. Birth Related Injuries

Arne Graff

Description

Injuries may occur with normal deliveries (including birth by cesarean) and not be identified immediately. The presentation will look at an approach to evaluation of possible birth related injuires.

Learning Objectives

  1. Develop understanding of potential birth related injuries.
  2. Develop approach to evalution for injuries.

Abstract

Evaluation for maltreatment must always include sorting out medical causes for the injury. This presentation will help provide an approach to evaluation of injuries noted around the birth/newborn period for decision making on maltreatment vs birth-related.

To download workshop PDF: click here

G2. Puberty, Pronouns, and Parent Acceptance: Helping Today's "Genderation" of Adolescents Navigate a Binary World

Scott Liebowitz

Description

In this workshop, attendees will learn about gender diverse adolescents and best practices across both mental health and medical domains. Gender diverse adolescents are presenting in clinical practice with increased frequency and are more vulnerable to developing significant mental health challenges than their non-transgender peer counterparts. Stigma and family rejection has been demonstrated to play a large role in these negative mental health outcomes. Mental health providers play an important role in the assessment and treatment of these youth, and the complexity of decision making can pose challenges within the treatment frame.

Participants will be provided an overview of the diagnostic nosology, clinical assessment aims, practical therapeutic tools to assist in gender exploration, and develop familiarity with the appropriate medical interventions used across development for these youth.

G3. Trauma-Focused Cognitive Behavioral Therapy for Commercially Sexually Exploited Children, Part 1

Judith Cohen, Anthony Mannarino

Description

This workshop will describe clinical applications of an evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for children who have experienced commercial sexual exploitation.

Learning Objectives

  1. Learn strategies for engaging CSEC and caregivers in TF-CBT n in TF-CBT.
  2. Learn strategies for addressing risky behaviors commonly exhibited by CSEC.
  3. Learn strategies for TF-CBT trauma narration with CSEC.

Abstract

Therapists often struggle to apply evidence-based treatments for commercially sexually exploited children (CSEC) for several reasons including 1) difficulty to engage CSEC in treatment (e.g., child may view the exploiter as a boyfriend and/or deny that the CSE was traumatic); 2) caregivers may be difficult to engage in treatment due to children's severe behavioral problems; 3) challenges in addressing running away or other serious behavior problems; and 4) uncertainty in how to address child's complex, multiple trauma history. This presentation will describe how to apply TF-CBT for CSEC, specifically addressing how to address the above clinical challenges.

Published Articles on Evidence-based Topics

  • Cohen, JA, Mannarino, AP & Kinnish, K (in press) Trauma focused CBT for commercially sexually exploited youth. J Child Adolescent Trauma
  • Cole, J, Sprang, G, Lee, R & Cohen, JA (2016) The trauma of commercial sexual exploitation of youth: A comparison of CSE victims to sexual abuse victims in a clinical sample. J Interpersonal Violence, 31, 122-146.
  • Cohen, JA, Mannarino, AP, Kliethermes, M & Murray, LA (2012). Trauma-focused CBT for youth with complex trauma. Child Abuse and Neglect, 36, 528-541. PMID 22749612.

G4. She Says It Didn't Happen…Now What?: When a Child Recants Sexual Abuse Allegations

Carrie Paschall

Description

Recantation and its place in the process of disclosure, how to investigate a recan,t and when and how to interview a child who has recanted.

Learning Objectives

  1. Participants will have a better understanding of the disclosure process and how recantation fits can sometimes be a normal part of this process.
  2. Participants will learn about blocks to disclosure that can exist as a result of the victim dynamics and offender grooming and manipulation tactics.
  3. Participants will leave with very specific examples of techniques that can be used when interviewing these victims.

Abstract

This presentation will discuss the risk factors that might be present in a case which could be indicative of a possible recant as well as potential ways to ensure both the physical and emotional protection of the child as well as immediate intervention services for both the child and the in an effort to prevent a recant in the first place. Presenter will also discuss ways for the MDT to evaluate the report of recantation to determine what to do next. Next, presenter will discuss when a second interview should occur, by whom and the adjustments that need to be made to traditional interview protocols in order to gather pertinent information.

Published Articles on Evidence-based Topics

  • "Victim Recantation in Child Sexual Abuse Cases: A Team Approach to Prevention, Investigation and Trial" by Susan Marx.
  • "How Children tell: the Process of Disclosure in Child Sexual Abuse" by Teena Sorenson and Barbara Snow.
  • "I Take It Back: When a Child Recants" by Mary-Ann R. Burkhart.
To download workshop PDF: click here

G5. Pediatric Aquatic Child Abuse and Death Investigation, part 1

Andrea Zaferes

Description

Pediatric homicides staged as drowning accidents may be more often missed than recognized. Learn how to recognize and investigate aquatic punishment, sexual abuse, and homicides.

Learning Objectives

  1. List the key red flags of possible fould play on aquatic scenes.
  2. List at least three examples of key evidence to look for on each of the following scenes: bathtubs, pools, lakes, and explain how to document them.
  3. State three key questions to ask on aquatic scenes and explain how they can be used as an investigation framework.

Abstract

Pediatric homicides staged as drowning accidents may be more often missed than recognized. Toddlers found unresponsive in bathtubs after being left alone for 2-3 minutes, missing autistic children found in lakes, children falling into pools. Tragic accidents? Punishments gone too far? Pedophilia? Homicides?

Investigators are typically provided little or no training on homicidal drowning, sexual assaults in aquatic environments, aquatic punishment and torture, and land-based homicides staged as drowning accidents. Nor are they assisted by specialized investigators as they are in motor vehicle, fire, and aviation fatality investigations. Additionally, these cases can be compromised with tunnel vision as police respond in rescue mode, assume "accident" manner of death, do not understand that drowning is a diagnosis of exclusion, and do not effectively recognize or process critical, aquatic-specific evidence.

Presentation attendees will be able to recognize key red flags of foul play on aquatic scenes, will have a basic ability todocument and process aquatic scenes, and will be able to use a proven aquatic death and abuse investigation process. The presentation is designed to meet the needs of law enforcement, death investigators, social workers, prosecutors and other child protection workers.

Published Articles on Evidence-based Topics

  • Kemp A, Mott A, Sibert J, Accidents and child abuse in bathtub submersions, Archives of Disease in Childhood 1994; 70: 435-438
  • Quan L, Gore E, Wentz K, Allen J, Novack A. Ten-year study of pediatric drownings and near drowning in King County, Washington: lessons in injury prevention. Pediatrics 1989; 83: 1035-40.
  • Nixon J, Pearn J. Non-accidental immersion in the bath; another aspect of child abuse. BMJ7 1977; i: 271.

G6. Working with Victims and Witnesses with Intellectual Disabilities and Developmental Delays in the Legal System

Edward Chase

Description

In this challenging world of child abuse investigation and prosecution, we need to take extra care with our victims and witnesses who suffer with intellectual disabilities and developmental delays.

Learning Objectives

  1. Explore the dynamics of this category of victim.
  2. Discuss the various ways to prove vulnerability under various statutes.
  3. Exchange ideas regarding trial strategy and bringing your case before a jury .

Abstract

This class of society is the most vulnerable and arguably the most victimized class that we, as child abuse professionals, encounter in our careers. This workshop will focus on working with that special population of society —adults and children alike—who suffer with intellectual disabilities and other forms of developmental delays. As child abuse professionals, we need to take that extra care needed to protect, understand and seek justice for those who need it the most.

Additionally, we need to educate our fact finders about the special characteristics of this population of victims during the prosecution of these types of cases to make sure that justice is served. Case studies will be part of this presentation and used as examples of the various ways that a victim is labeled as "vulnerable".

To download workshop PDF: click here

G7. What Victims of Sextortion Say About Non-Consensual Distribution of Sexual Images: New Research & Practical Implications

Janis Wolak, Wendy Walsh, David Finkelhor

Description

We advertised on Facebook for people who had received threats to expose sexual images to take an online survey. We describe what the 1,631 respondents told us about sextortion and its impact.

Learning Objectives

  1. Understand the range of contexts in which non-consensual sharing of sexual images occurs and the characteristics of victims and perpetrators
  2. Understand the barriers to disclosure and reporting.
  3. Understand current limitations in terms of response by technology companies and law enforcement.

Abstract

Sextortion, defined as threats to expose sexual images in order to make a person do something or for reasons such as revenge or humiliation, has been widely described in the media. However, few research studies have examined the characteristics of or response to such incidents.

Between July and December 2015, we conducted an online survey of persons ages 18 to 25 who had been targets of sextortion (N=1,631) and telephone interviews with a subset of the sample (n=48). Respondents were mostly women (83%) and 45% were minors when the threats began. The episodes they reported were diverse, but incidents broadly fell into two groups: 1) In the wake of face-to-face romantic or sexual relationships during which images were taken or shared, an aggrieved partner threatened to disseminate images either to force reconciliation or to embarrass or humiliate the respondent, or 2) A perpetrator who met a respondent online used a sexual image obtained from the respondent or some other source to demand more images or in-person sexual favors.

There was considerable diversity in the specific dynamics, the duration of the threats, and the actions that victims took. The most serious cases involved stalking and physical and sexual assault in addition to sextortion and threats that lasted for 6 months or more.  About 1 in 5 respondents reported their situation to a website and 16% reported incidents to the police. Many expressed frustration with the responses they received.

The presentation will describe the characteristics of these incidents, victims and perpetrators; the results of in-depth telephone interviews with a sub-set of victims; and disclosure and reporting by victims. Implications for improving prevention and intervention efforts will be discussed.

Published Articles on Evidence-based Topics

  • Gordon-Messer, D., et al., Sexting Among Young Adults. Journal of Adolescent Health, 2013. 52: p. 301-306.
  • Mitchell, K., et al., Prevalence and Characteristics of Youth Sexting: A National Study. Pediatrics, 2012. 129(13-20).
  • Wolak, J. and D. Finkelhor, Sexting: A typology, 2011, Crimes Against Children Research Center: Durham, NH. p. 1-11.
  • Wolak, J., D. Finkelhor, and K.J. Mitchell, How Often Are Teens Arrested for Sexting? Data from a National Sample of Police Cases. Pediatrics, 2012. 129(1): p. 4-12.

To download workshop PDF: click here

G8. Protective Environmental Factors for Intergenerational Continuities in Early Adversity

Kimberly Henry, Todd I. Herrenkohl, Melissa Merrick, Marilyn Metzler, Tom Schofield

Description

The prevention of child abuse and neglect via identification of safe, stable, nurturing relationships and environments for young children and (2) findings from the CDC-convened scientific panel investigating the role of environmental-level protective factors in disrupting the intergenerational continuity of child abuse and neglect and other early adversity.

Learning Objectives

  1. Increase attendee understanding of CDC efforts to prevent child abuse, neglect, and other early adversities and their associated health and life consequences.
  2. Increase attendee understanding of the intergenerational continuities in child abuse, neglect, and other early adversity.
  3. Increase attendee understanding of potential environmental-level protective factors that can disrupt intergenerational continuities in childhood adversity and the unique role longitudinal data can play in filling gaps in the scientific knowledge base.

Abstract

This panel consists of researchers and public health leaders from CDC's Division of Violence Prevention as well as partners from four research studies – the U.K. E-Risk Study, the Family Transitions Project, the Rochester Youth Development/ Intergenerational Study, and the Lehigh Family Study. CDC scientists will provide an overview of the project and how it relates to CDC's vision for all children, Essentials for Childhood: Assuring Safe, Stable, Nurturing Relationships and Environments for All Children. Researchers from the partner sites will share findings of recent analyses on the potential protective role of safe, stable, nurturing environments in interrupting the intergenerational continuity of childhood adversity like child abuse and neglect. The findings will be discussed within a health equity frame such that we all have a role to play in preventing early adversity.

G9. Better Together? Findings of a Three Year Program of Research on Multi-Agency Teams Responding to Child Abuse

James Herbert

Description

This presentation reports on the findings of a three year program of research on multi-disciplinary centre/team approaches to responding to allegations of severe abuse in Australia.

Learning Objectives

  1. Develop an improved understanding of the current evidence for multi-agency approaches.
  2. Consider the implications of formative evaluation approaches such as theory of change and implementation science for multi-agency service delivery.
  3. Consider the implications of Australian research evidence for US jurisdictions.

Abstract

This presentation will summarise the findings of a three year project on multi-disciplinary responses to severe child abuse in Perth, Western Australia. This project involves three parts: (a) examination and development of the evidence base of child advocacy centers and similar multi-disciplinary approaches; (b) the evaluation of a developing multi-agency approach in Perth, Western Australia; (c) examination of the characteristics of Child Advocacy Centers in the United States. The purpose of this presentation is to share up to date findings about the state of research on CACs/MDTs, discuss their implications across jurisdictions, and to encourage research with multi-disciplinary teams.

This presentation will primarily report on the findings of an evaluation of the Multi-Agency Investigation & Support Team in Perth, Australia. Adopting a model closely related to the Child Advocacy Centre approach in the United States, a team of interviewers, Child Abuse Squad detectives, child and family advocates, and on-site therapeutic and paediatrician services were co-located in a community owned centre in a district of Perth with high rates of abuse. Drawing on cross-agency administrative data, interviews with staff, and a caregiver satisfaction survey, the evaluation set out to examine (a) the implementation of the model; (b) the fidelity of practice with the model outlined; (c) areas for improvement with the model; and (d) a comparison of the cases that received a MIST team response compared to the standard joint-agency (Police and Child Protection) response on criminal justice, child protection, and therapeutic service delivery outcomes.

Published Articles on Evidence-based Topics

  • Herbert, J. & Bromfield, L. (2015). Evidence for the Efficacy of the Child Advocacy Model. Trauma, Violence & Abuse. doi: 10.1177/1524838015585319.
  • Lalayants, M. & Epstein, I. (2005). Evaluating multidisciplinary child abuse and neglect teams: A research agenda. Child Welfare, 84(4), 433-458.
  • Walsh, W. A., Lippert, T., Cross, T. P., Maurice, D. M., & Davison, K. S. (2008). How long to prosecute child sexual abuse for a community using a children's advocacy center and two comparison communities? Child Maltreatment, 13(1), 3-13.

G11. Fulfilling the Calls for Collaboration Among Evidence-based Models: Putting Our Efforts Where Our Mouths Are

John Lutzker

Description

Addressed here will be the actualization of calls for evidence-based home visiting programs to collaborate for the benefit of families and to try to solve common cross-model problems such as family engagement with services.

Learning Objectives

  1. Partciapnts will understand why collaboration among EBP is so essential.
  2. Learners will be able to describe a research trial that braids 2 EBP.
  3. Particiapnts will be able to describe three proejcts aimed at improving family engagement in home visiting programs.

Abstract

There have been many calls for collaboration among evidence-based models (EBP) to prevent child maltreatment. HRSA and others have described the importance of evidence-based models working together to find best-fits for families and to try to solve cross-model problems such as attrition and engagement, and to create technological enhancements that improve provider and parent training.

Described here will be the work of a national coalition of six EBP as well as two grants funded by the Annie E. Casey Foundation (AECF) for collaboration among evidence-based models. The national collaboration is funded by the Heising-Simonds Foundation. One Annie E. Casey research grant has just recently been completed. That randomized control trial involved the braiding of two EBP, Parents as Teachers and SafeCare®. Data and lessons learned will be presented, as well as sustainability plans. The other AECF grant involves the Mark Chaffin Center for Healthy Development being a funder of three high risk-highreward pilot research projects, each aimed at improving family engagement in EBP. Many well-known EBPare represented by the projects. Many EBP participated in the development of the request for funding, as well as the scoring and awarding of the projects. The projects and processes to date will be described.

Each project tackles a different aspect of engagement and each is making important contributions to addresses this issue in home visiting. Finally, addressed here will be suggestions for what continued innovative collaboration need to occur.

G14. Applying Predictive Analytics to Child Maltreatment Response and Prevention

Emily Putnam-Hornstein, Rhema Vaithianathan

Description

An emerging new paradigm, where big data can be crunched in a way that helps determine which children are at greater risk of being abused.

 

 

H1. Nothing But the Truth: Presenting Medical Evidence of Child Abuse in Court

Tom Fallon, John Stirling

Description

Medical testimony is often difficult for jurors; consequently the attorney and the physician must learn to work together to effectively communicate with the jurors.

Learning Objectives

  1. Learn to identify issues and assess the need for expert opinion.
  2. Doctors and Lawyers must learn the Rules of Engagement.
  3. Learn how to present the ir ideas and opinions in an understandable way.

Abstract

The presentation of expert medical testimony is often critical to the successful prosecution or defense of child abuse cases. Effective presentation of medical testimony depends upon careful case assessment, selection of the right physician offer the key expert opinions(s) and or to compliment the work of the responding medical professionals in your community. The attorney and physician must work together to ensure a smooth, effective, team presentation. This workshop will examine the process and offer suggestions to improve the pre-trial preparation and trial presentation of expert medical testimony.

To download workshop PDF: click here

H2. The Virtual World of Medical Child Abuse: Using the Internet to Create and Dispel Cases

Reena Isaac, Lisa Creamer

Description

The inclusion of the internet in cases of medical child abuse has added another dimension to these investigations.  This presentation will break down the various areas in which the internet has contributed to this particular form of child maltreatment, as well as provide insight into the diagnosis and prosecution of such cases.

Learning Objectives

  1. To illustrate the methods and manners in which the internet has enhanced cases.
  2. To describe the process in which these complicated, controversial cases are investigated.
  3. To describe the power of the multidisciplinary team (MDT) approach and its requirement.

Abstract

The inclusion of the internet in cases of medical child abuse has added another dimension to these investigations. For example, a previously held belief was that most perpetrators of medical child abuse have a background or work experience in the medical or nursing field.

With the advent of the internet, this has shown to be an obsolete concept. With queries into medical scenarios and symptoms, literally at the tips of curious fingers, a deceptive clinical picture can be constructed that mirrors true medical situations and thereby stumping clinicians when diagnostic tests and examinations don't correlate with provided medical complaints.

As attention-seeking remains a significant motivation, the internet can allow worldwide exposure for the perpetrators to report their experiences while garnering desired emotional secondary gains. Review of virtual journals can provide insight into such motivations, while comparing the true clinical picture of a patient with a fantastical retelling online. Secondary gains in the form of monetary donations and other services are also observed.

This presentation will break down the various areas in which the internet has contributed to this particular form of child maltreatment, as well as provided insight into the diagnosis and prosecution of such cases.

Published Articles on Evidence-based Topics

  • Brown AN, Gonzalez GR, Weister RT, et al. Care taker blogs in caregiver fabricated illness in a child: a window on the caretaker's thinking? Child Abuse Negl. 2014; 38(3):488-97.
  • McCulloch V, Feldman MD. Munchausen by proxy by internet. Child Abuse Negl. 2011; 35(11): 965-6.
  • Feldman MD, Cunningham JM. Munchausen by Internet: current perspectives and three new cases. Psychosomatics. 2011; 52(2): 185-9.
To download workshop PDF: click here

H3. Trauma-Focused Cognitive Behavioral Therapy for Commercially Sexually Exploited Children, Part 2

Judith Cohen, Anthony Mannarino

Description

This workshop will describe clinical applications of an evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for children who have experienced commercial sexual exploitation.

Learning Objectives

  1. Learn strategies for engaging CSEC and caregivers in TF-CBT.
  2. Learn strategies for addressing risky behaviors commonly exhibited by CSEC.
  3. Learn strategies for TF-CBT trauma narration with CSEC.

Abstract

Therapists often struggle to apply evidence-based treatments for commercially sexually exploited children (CSEC) for several reasons including 1) difficulty engaging CSEC or caregivers in treatment (e.g., child may view the exploiter as a boyfriend and/or deny that the CSE was traumatic); caregivers difficult to engage in treatment; 2) challenges in addressing running away or other serious behavior problems; and/or 3)difficulty incorporating child's complex, multiple traumas into trauma narration and processing. This presentation will describe how to address the above clinical challenges when implementing TF-CBT for CSEC.

Published Articles on Evidence-based Topics

  • Cohen, JA, Mannarino, AP & Kinnish, K (in press) Trauma focused CBT for commercially sexually exploited youth. J Child Adolescent Trauma.
  • Cole, J, Sprang, G, Lee, R & Cohen, JA (2016) The trauma of commercial sexual exploitation of youth: A comparison of CSE victims to sexual abuse victims in a clinical sample. J Interpersonal Violence, 31, 122-146.
  • Cohen, JA, Mannarino, AP, Kliethermes, M & Murray, LA (2012). Trauma-focused CBT for youth with complex trauma. Child Abuse and Neglect, 36, 528-541. PMID 22749612.

H4. But I Love Him: When Children Love Their Offenders (Or Think They Do)

Carrie Paschall, Kelly Slaven

Description

How to  help investigators and therapists in working cases where the child doesn't feel they are a victim, but rather feels that they are in a loving relationship with the offender.

Learning Objectives

  1. Participants will have a better understanding of the demographics and characteristics of both the victims that might find themselves in this type of abusive relationship, but also the offenders and ways that they groom their victims to solidify a strong emotional bond.
  2. Participants will learn about blocks to disclosure that can exist as a result of the victim dynamics and offender grooming and manipulation tactics.
  3. Participants will leave with very specific examples of techniques that can be used when interviewing these victims to overcome blocks including what evidence can be helpful to use and how, out of the box rapport building techniques, comfort statements and specific question typology.

Abstract

This presentation will discuss the demographics of possible victims that might fall prey to those seeking to lure children into abusive relationships by forming emotional attachments to the victim. These bonds can be so strong, that victims themselves fail to see the manipulation that has occurred, but instead see themselves as in a loving relationship which can complicate both the investigative and interview process in an attempt to protect the offender and their “relationship”. The desired outcome of this presentation is that attendees will leave having a better understanding of these victims, perpetrators and potential interview blocks and will leave having learned techniques to help them deal with this sort of case in the field.

Published Articles on Evidence-based Topics

  • How Children Tell: The Process of Disclosure on Child Sexual Abuse by Sorensen and Snow.
  • Exploring Sex Offender Grooming by Tanner and Brake.
  • Compliant Child Victims: Confronting an Uncomfortable Reality by Kenneth Lanning.
To download workshop PDF: click here

H5. Pediatric Aquatic Child Abuse and Death Investigation, Part 2

Andrea Zaferes

Description

Pediatric homicides staged as drowning accidents may be more often missed than recognized. Learn how to recognize and investigate aquatic punishment, sexual abuse, and homicides.

Learning Objectives

  1. List the key red flags of possible fould play on aquatic scenes.
  2. List at least three examples of key evidence to look for on each of the following scenes: bathtubs, pools, lakes, and explain how to document them.
  3. State three key questions to ask on aquatic scenes and explain how they can be used as an investigation framework.

Abstract

Pediatric homicides staged as drowning accidents may be more often missed than recognized. Toddlers found unresponsive in bathtubs after being left alone for 2-3 minutes, missing autistic children found in lakes, children falling into pools. Tragic accidents? Punishments gone too far? Pedophilia? Homicides?

Investigators are typically provided little or no training on homicidal drowning, sexual assaults in aquatic environments, aquatic punishment and torture, and land-based homicides staged as drowning accidents. Nor are they assisted by specialized investigators as they are in motor vehicle, fire, and aviation fatality investigations. Additionally, these cases can be compromised with tunnel vision as police respond in rescue mode, assume "accident" manner of death, do not understand that drowning is a diagnosis of exclusion, and do not effectively recognize or process critical, aquatic-specific evidence.

Presentation attendees will be able to recognize key red flags of foul play on aquatic scenes, will have a basic ability todocument and process aquatic scenes, and will be able to use a proven aquatic death and abuse investigation process.

The presentation is designed to meet the needs of law enforcement, death investigators, social workers, prosecutors and other child protection workers.

Published Articles on Evidence-based Topics

  • Kemp A, Mott A, Sibert J, Accidents and child abuse in bathtub submersions, Archives of Disease in Childhood 1994; 70: 435-438.
  • Quan L, Gore E, Wentz K, Allen J, Novack A. Ten-year study of pediatric drownings and near drowning in King County, Washington: lessons in injury prevention. Pediatrics 1989; 83: 1035-40.
  • Nixon J, Pearn J. Non-accidental immersion in the bath; another aspect of child abuse. BMJ7 1977; i: 271.

H6. Recognizing and Addressing Vicarious Trauma for Child Abuse Prosecutors and Allied Professionals

Mary Sawicki

Description

Definition and characteristics of vicarious trauma and discuss suggestions to effectively address the effects of this syndrome on those that work with abused children.

Learning Objectives

  1. To understand the definition and characteristics of vicarious trauma.
  2. To become aware lof teh risk factors of vicarious trauma for child abuse prosecutors and allied professionals.
  3. To understnd effective tools to address and reduce the effects of vicarious trauma.

Abstract

This workshop will explore the varied effects exposure to trauma may have on child abuse prosecutors and allied professionals. This workshop will define vicarious or secondary trauma and explore the characteristics of this syndrome. In additions, the symptoms and risk factors for those that work with abused children on a daily basis will bedetailed. Suggestions on how to address and reduce these symptoms and risk factors will be highlighted.

To download workshop Handout: click here

To download workshop PDF: click here

H7-a. Voluntary Maltreatment Preventions Programs: Using Propensity Scores and Administrative Date to Evaluate Safecare Outcomes

Julia Blomberg, Rebecca Orsi, Kristy Beachy-Quick

Description

Can propensity scores and administrative data improve child maltreatment prevention research? Join us to look at how these have been used to evaluate a recent, voluntary implementation of SafeCare, a homebased parenting intervention.

Learning Objectives

  1. Participants will experience an accessible introduction to propensity score analysis.
  2. Participants will understand issues specific to using propensity scores for child maltreatment research and evaluation.
  3. Participants will contribute to a discussion about how propensity score analysis can be further improved for use in child maltreatment research.

Abstract

Colorado is implementing the evidence-based SafeCare® program as part of its statewide maltreatment prevention efforts. The in-home parent education program is designed for high risk families with children ages 0-5. The purpose of this session is to discuss an outcomes evaluation designed to measure whether SafeCare Colorado has been effective in reducing future child welfare involvement for voluntary participants with past involvement. Due to the lack of random assignment in the implementation design, our evaluation team has constructed a comparable group which did not receive SafeCare using both propensity scores and state administrative data. The use of propensity scores for a child maltreatment outcomes evaluation will be presented in an accessible format, for researchers and practitioners alike.

Topics will include: How do we select appropriate variables to include in a child welfare propensity score analysis? And, how can state administrative data be combined with SafeCare program data to strengthen an outcomes evaluation? Session participants will be invited to ask questions about the analysis and to make suggestions for future improvements. Participants will leave with an understanding of the challenges and successes inherent in evaluating voluntary child maltreatment prevention efforts.

Published Articles on Evidence-based Topics

  • Brännström, L., Vinnerljung, B. & Hjern, A. (2013). Long-term outcomes of Sweden's Contact Family Program for children. Child Abuse & Neglect, 37(2013), 404-414.
  • Falconer, M. K., Clark, M. H. Clark & Parris, D. (2010). Validity in an evaluation of Healthy Families Florida - A program to prevent child abuse and neglect. Children and Youth Services Review, 33(2011), 66–77.
  • Casanueva, C., Martin, S. L., Runyan, D. K., Barth, R. P. & Bradley, R. H. (2008). Parenting services for mothers involved with child protective services: Do they change maternal parenting and spanking behaviors with young children? Children and Youth Services Review, 30(2008), 861-878.

H7-b. Voluntary Maltreatment Preventions Programs: Using Propensity Scores and Administrative Date to Evaluate Safecare Outcomes

Helen Holmquist-Johnson, Chris Lee

Description

SafeCare® is an evidence-based home visiting curriculum. The process evaluation includes measurement of key implementation indicators and employs both qualitative and quantitative methods.

Learning Objectives

  1. Participants will be able to discuss how knowledge about parent engagement may be applied to improve program efforts in engaging parents.
  2. Participants will be able to describe parent experiences of engaging in a voluntary home visiting program.
  3. Participants will be able to distinguish between factors that may help to promote or hinder parent engagement in a voluntary home visiting program.

Abstract

for the Colorado Department of Human Services (CDHS). SafeCare Colorado was introduced as part of this systems change. SafeCare® is an evidence-based home visiting curriculum thatprovides direct skills training for parenting, child safety, and child health. Currently in year three, SafeCareColorado is being implemented by the Colorado Department of Human Services in partnership with the Kempe Center for the Prevention of Child Abuse and Neglect. The process evaluation includes measurement of key implementation indicators and employs both qualitative and quantitative methods. Key informant interviews, surveys with referring agencies, home visitors, parents who had exited the program, and process outcomes were collected to evaluate and to inform the on-going implementation process. Quantitative data included the analysis of demographic and intake data to determine the reach of the program. Session data were analyzed to assess the program dosage. Home visitor data included  survey data as well as organizational level indicators, such as time to SafeCare® certification and staff turnover.

Engagement with primary intended users was critical and multiple stakeholder groups were consulted throughout the evaluation process. Strengthening relationships with evaluation  stakeholders has contributed to increased buy-in; thereby increasing the likelihood the findings will be used.

Published Articles on Evidence-based Topics

  • Chaffin, M., Hecht, D., Bard, D., Silovsky, J.F., Beasley, W.H. (2012) A statewide trial of the SafeCare homebased services model with parents in child protective services. Pediatrics, 129 (3), 509-515.
  • Beasley, L.O., Silovsky, J.F., Ridings, L.E., Smith, T.J., & Owora, A. (2014). Understanding program engagement and attrition in child abuse prevention. Journal of Family Strengths, 14(1), 1-24.
  • Damashek, A., Doughty, D., Ware, L., & Silovsky, J. (2011). Predictors of client engagement and attrition in home-based child maltreatment prevention services. Child Maltreatment, 16(1), 9-20.

H8. Moving Beyond Behavior: The Interior Worlds of Emotional (DYS) Regulation

Ruth Newton

Description

This workshop explores subcortical arousal organizations found in the histories of traumatized infants, young children and families and focuses on intervention approaches that support emotional regulation.

Learning Objectives

  1. Participants will be able to describe subcortical biological survival mechanisms as it relates to trauma.
  2. Participants will be able to describe autonomic nervous system survival organizations behind emotional dysregulation.
  3. Paticipants will be able to consider two therapeutic approaches to emotional dysregulation.

Abstract

The purpose of this workshop is to introduce to participants to the impact of trauma on the autonomic  nervous system and how entrainment in this system due to chronic stress requires a neurobiological approach to intervention with the child and family. The outwardly expressed behavior of a child is often not sufficient to understand the impact of lived experience on the child's feeling self. Nonverbal, implicit communications and behaviors in the histories of traumatized children and families show chaotic interactions, confusions in self development, chronic fears of abandonment, and extreme fluctuations in the autonomic nervous system in attempts to create survival patterns that help to buffer stress. The desired outcome is that behavior stemming from trauma is recognized as having deeply biological underpinnings.

Published Articles on Evidence-based Topics

  • Lanius, R. A., Vermetten, E., & Pain, C. (Eds.). (2010). The impact of early life trauma on health and disease. The hidden epidemic. Cambridge, UK: Cambridge University Press.
  • Newton, R. P. (2011). Complex developmental trauma. San Diego Psychological Association October/November Newsletter, 26(5).
  • Schore, A. N., & Newton, R. P. (2013). Using modern attachment theory to guide clinical assessments of early attachment relationships. In J. E. Bettmann & D. D. Friedman (Eds.), Attachment-based clinical social work with children and adolescents, pp. 61-98. NY: Springer.
To download workshop Handout: click here

To download workshop PDF: click here

H9. Trauma-Informed Treatment Foster Care: A Promising Alternative to Congregate Care

Heather Simonich, Jodi Duttenhefer

Description

Children in the child welfare system have experienced extremely high rates of early trauma exposure. Treatment Foster Care (TFC) organizations must be leaders in trauma-informed care to mitigate the well-documented potential for negative outcomes.

Learning Objectives

  1. Review the prevalence and impact of trauma exposure on youth in the foster care system.
  2. Describe a comprehensive trauma-informed treatment foster care model.
  3. Share state-wide outcome data from a trauma-focused treatment foster care program.

Abstract

Research suggests that over 90% of youth in foster care report exposure to traumatic life events (Dorsey et al. 2012). It is well documented that early trauma exposure is associated with a wide range of negative physical and mental health outcomes. In particular, behavioral and emotional functioning are often the focus of attention for youth in Treatment Foster Care (TFC).

Given the prevalence of early childhood trauma in foster care youth, it is critical that TFC programs are well poised to mitigate the negative effects of such early trauma exposure. There is a general consensus in the field of child welfare that the placement of children with foster parents, or the least restrictive family-like environment, is ideal for optimal development. In this workshop, we will describe the successes and challenges of a large TFC organization's efforts to fully implement a trauma-informed TFC model. Preliminary outcomes from the following trauma-informed initiatives will be shared:

  • a foster parent training program,
  • a child welfare worker training program,
  • a professional development outreach program for educators, and

A comprehensive trauma screening protocol for TFC youth. Additionally, broad organizational strategies aimed at increasing trauma awareness and responsiveness will be described. Please join us for this lively discussion regarding the enhancement of treatment foster care as a strong alternative to congregate care.

To download workshop PDF: click here

H11. Detecting Child Maltreatment Based on Parental Characteristics

Hester Marieke Diderich–Lolkes de Beer

Description

Since 2013, the Dutch law requires all professionals working with adult patients or clients, to ask if they are responsible for minors and if they have concerns about the situation of their patient or client - a so called Child Check. This screening of child maltreatment is based on parental characteristics for all different professionals (ER, ambulance, GP's and currently all psychiatrists and psychologists). All these professionals cope with different implementation dilemmas, but still good progress is being made!

This session will discuss the effectiveness and success of the Child Check and how to implement the screening for all different professionals.

Learning Objectives

  1. How to detect child maltreatment based on parental characteristics.
  2. How to implement the Child Check.
  3. How to adapt the Dutch Child Check to existing protocols.

Abstract

Since 2013, the Dutch law requires all professionals working with adult patients or clients, to ask if they are responsible for minors, if they have concerns about the situation of their patient or client, a so called Child Check.
Since 2013 we have been working hard to implement this screening of child maltreatment based on

parental characteristics for all different professionals (ER, ambulance, GP's and currently all psychiatrists and psychologists). All these professionals cope with different implementation dillema's. You will learn the outcomes of the scientific research on the basis of which the Child Check was made mandatory by law. We will show you how this implementation was rolled out nationally and what hurdles had to be taken. It will become clear how this approach can also be implemented in other countries (in 2016 Switzerland and Norway will start a pilot).

Published Articles on Evidence-based Topics

  • Diderich, H.M., Fekkes, M., Verkerk, P.H., Pannebakker, F.D., Velderman, M.K., Sorensen, P.J., Baeten, P., & Oudesluys-Murphy, A.M. A new protocol for screening adults presenting with their own medical problems at the Emergency Department to identify children at high risk for maltreatment. (2013). Child Abuse and Neglect, 7(12):1122–31. doi: 10.1016/j.chiabu.2013.04.005.
  • Diderich, H.M., Dechesne, M., Fekkes, M., Sorensen, P., Buitendijk, S.E., & Oudesluys-Murphy, A.M. Facilitators and barriers for successful implementation of a protocol to detect child abuse based on parental characteristics. (2014) Child Abuse and Neglect; 38(11):1822–31. doi: 10.1016/j.chiabu.2014.07.016.
  • Diderich, H.M., Verkerk, P.H., Oudesluys-Murphy, A.M., Dechesne, M., Buitendijk, S.E., & Fekkes, M. Missed cases in the detection of child abuse based on parental characteristics at the Emergency Department (the Hague protocol). (2014) Journal of Emergency Nursing; 41(1):65–8. doi: 10.1016/j.jen.2014.05.016.
  • Diderich, H.M., Dechesne, M., Fekkes, M., Verkerk, P.H., Buitendijk, S.E., & Oudesluys-Murphy, A.M. What parental characteristics can predict child maltreatment at the Emergency Department? Considering expansion of the Hague protocol. (2014) European Journal of Emergency Medicine, 2014 Jun 2. [Epub ahead of print] doi: 10.1097/MEJ.0000000000000174.
  • Diderich, H.M., Dechesne, M., Pannebakker, F.D., Buitendijk, S.E., & Oudesluys-Murphy, A.M. Support and monitoring of families after child abuse detection based on parental characteristics at the Emergency Department. (2014). Child: Care, Health and Development; 41(2):194–202. doi: 10.1111/cch.12201.
  • Diderich, H.M., Dechesne, M., Fekkes, M., Buitendijk, S.E., & Oudesluys-Murphy, A.M. Detecting child abuse based on parental characteristics: Does The Hague protocol cause parents to avoid the Emergency Department? (2014). International Emergency Nursing; 23(2):203–6. doi:10.1016/j.ienj.2014.09.004.
  • Oudesluys-Murphy, A.M, Diderich, H.M., Dechesne, M., Buitendijk, S.E., Violence against women: do not forget their children! (2015) Lancet; 385(9977):1505. doi: 10.1016/S0140-6736(15)60744-9.

H14. A National Platform for Quality Improvement in Child Sexual Abuse Planning, Pitfalls, and Performance

Lori Frasier, Suzanne Starling

Description

This workshop will discuss the development of two national peer review platforms. Data analysis from these projects will be presented in order to demonstrate the importance of such projects in an era of medical quality improvement.

Learning Objectives

  1. Recognize the purpose of peer review in child sexual abuse evaluations.
  2. Understand how data gathered from QI projects can improve clinical practice.
  3. Identify areas of quality improvement in child sexual abuse evaluations for future study.

Abstract

Peer review and quality improvement practices are becoming integral to the practice of medicine. This includes the medical evaluation of children who are sexually abused. Application of QI principles is important in advancing and improving practice. Two national projects "myQIportal" and "myCasereReview" have been developed by the Midwest Regional Advocacy Center in order to provide platforms for both peer review and Quality Improvement. Both platforms utilize principles of quality improvement science in different ways.

These platforms will be discussed by the developers, administrators, and reviewers. The evolution of the projects will be discussed as well as the data outcomes measuring quality and improvement of quality. There will be a discussion by those involved as to their perception of practice issues in child sexual abuse across the US. The data from both projects will be presented. A discussion of what a future research agenda in Quality Improvement for Child Sexual Abuse evaluations will include the audience and moderators.

Published Articles on Evidence-based Topics

  • Adams, Starling, Frasier, et al. Diagnostic accuracy in child sexual abuse medical evaluation: Role of experience, training, and expert case review; Child Abuse & Neglect Volume 36, Issue 5, May 2012, Inter-rater reliability in child sexual abuse diagnosis among expert reviewers
  • SP Starling, LD Frasier, K Jarvis, A McDonald; Child Abuse & Neglect, 2013 Development of standardized clinical training cases for diagnosis of sexual abuse using a secure telehealth application
  • LD Frasier, I Thraen, R Kaplan, P Goede; Child Abuse & Neglect, 2012.
To download workshop Handout: click here

To download workshop PDF: click here

 

 

I1. Attorneys/Judges

Edward Chase

Description

Discussion of emerging issues.

I2. Child Welfare/Advocates

Charles Wilson, Lisa Conradi

Description

Discussion of emerging issues.

I3. Forensic Interviewers (English)

Lisa McCulloch, Sheri Rouse

I3. Forensic Interviewers (Spanish)

Marisol Olguin, Christina Shultz

Description

Discussion of emerging issues.

Learning Objectives

  1. To cultivate a better understanding of major issues within the profession.
  2. To develop knowledge on the major challenges faced by practitioners within the discipline.
  3. To give participants a platform to exchange information, share practice standards or guidelines to standardize and improve research-to-practice applications.
  4. To promote relations and research ideas among the participants.

I4. Infant & Early Childhood Mental Health

Virginia Bial, Andrew Campbell, Kristin Gist

Description

Discussion of emerging issues.

Learning Objectives

  1. To cultivate a better understanding of major issues within the profession.
  2. To develop knowledge on the major challenges faced by practitioners within the discipline.
  3. To give participants a platform to exchange information, share practice standards or guidelines to standardize and improve research-to-practice applications.
  4. To promote relations and research ideas among the participants.

I5. International Guests

Bernard Gerbaka, Pragatha Tummala

Description

Discussion of emerging issues.

Learning Objectives

  1. To cultivate a better understanding of major issues within the profession.
  2. To develop knowledge on the major challenges faced by practitioners within the discipline.
  3. To give participants a platform to exchange information, share practice standards or guidelines to standardize and improve research-to-practice applications.
  4. To promote relations and research ideas among the participants.

I6. Investigators

Richard Bennett, Ronald Laney, Rick O’Hanlon

Description

Discussion of emerging issues.

Learning Objectives

  1. To cultivate a better understanding of major issues within the profession.
  2. To develop knowledge on the major challenges faced by practitioners within the discipline.
  3. To give participants a platform to exchange information, share practice standards or guidelines to standardize and improve research-to-practice applications.
  4. To promote relations and research ideas among the participants.

I7. Nurses

Alicia Ramirez, Patty Secor

Description

Discussion of emerging issues.

Learning Objectives

  1. To cultivate a better understanding of major issues within the profession.
  2. To develop knowledge on the major challenges faced by practitioners within the discipline.
  3. To give participants a platform to exchange information, share practice standards or guidelines to standardize and improve research-to-practice applications.
  4. To promote relations and research ideas among the participants.

I8. Physicians

John Stirling

Description

Discussion of emerging issues.

Learning Objectives

  1. To cultivate a better understanding of major issues within the profession.
  2. To develop knowledge on the major challenges faced by practitioners within the discipline.
  3. To give participants a platform to exchange information, share practice standards or guidelines to standardize and improve research-to-practice applications.
  4. To promote relations and research ideas among the participants.

I9. Mental Health/Therapists

Iby Kantor

Description

Discussion of emerging issues.

Learning Objectives

  1. To cultivate a better understanding of major issues within the profession.
  2. To develop knowledge on the major challenges faced by practitioners within the discipline.
  3. To give participants a platform to exchange information, share practice standards or guidelines to standardize and improve research-to-practice applications.

 

Welcome reception for all attendees.