Domestic violence assessments in the child advocacy center

Nationwide Children's Hospital, Center for Child and Family Advocacy, The Ohio State University College of Medicine, Department of Pediatrics, 655 East Livingston Avenue, Columbus, OH 43205, USA.
Child abuse & neglect (Impact Factor: 2.34). 03/2010; 34(3):172-82. DOI: 10.1016/j.chiabu.2009.10.002
Source: PubMed


This study was designed to identify the frequency, methods, and practices of universal assessments for domestic violence (DV) within child advocacy centers (CACs) and determine which factors are associated with CACs that conduct universal DV assessments.
The study design was a cross-sectional, web-based survey distributed to executive directors of National Children's Alliance accredited or accreditation-eligible CACs.
Responses were received from 323 of 376 eligible CACs (86%). Twenty-nine percent of CAC directors report familiarity with current DV recommendations and 29% require annual education for staff regarding DV. Twenty-nine percent of CACs conduct "universal assessments" (defined as a CAC that assesses female caregivers for DV more than 75% of the time). The majority of CACs use face-to-face interviews to conduct assessments, often with children, family or friends present. The presence of on-site DV resources (OR=2.85, CI 1.25-6.50) and an annual DV educational requirement (OR=2.88, CI 1.31-6.32) are associated with assessment of female caregivers. The presence of on-site DV resources (OR=3.97, CI 2.21-7.14) is associated with universal assessments.
Many CAC directors are not aware of current DV recommendations and do not require annual DV training for staff. Less than one-third of CACs practice universal assessments and those that do often conduct DV assessments with methods and environments shown to be less comforting for the patient and less effective in victim identification. CACs are more likely to assess female caregivers if they have co-located DV resources and they require DV training of their staff. CACs are more likely to universally screen for DV if they have co-located DV resources.
The presence of DV in the home has significant potential to negatively impact a child's physical and mental health as well as the ability of the caregiver to adequately protect the child. Current practice in CACs suggests a knowledge gap in this area and this study identifies an opportunity to improve the services offered to these high-risk families.

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    ABSTRACT: Child maltreatment and domestic violence are very prevalent. According to self-reported studies, about half of our children have been maltreated either physically, sexually, psychologically, or have been neglected; yet only a small percentage of cases are being reported and are amenable to child protection services. 2. Impact of child maltreatment on physical, mental, social, sexual and scholastic functioning is profound, long-term and often lifelong with huge economic cost to society. 3. Effective intervention programmes are now available, but their effect can be marginal depending on service availability and quality, staff competence and cross-sectoral collaboration: i. Screening and early detection-no conclusive evidence of their efficacy. ii. Remedial services-available but expensive, labour-intensive and with inconsistent results. iii. Prevention is hence the key, yet investment is grossly inadequate. iv. Having an explicit policy on child safety and child welfare is important, but there is lack of a child policy in Hong Kong, and services are fragmented and poorly organized. 4. The child protection approach in past decades has produced improvement in outcomes, but child maltreatment still persists and is increasing in Hong Kong. A public health approach is very much needed.
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