586054
research-article2015
CPJXXX10.1177/0009922815586054Clinical PediatricsMcMillin et al
Brief Report
The Role of Maternal Knowledge of Child Development in Predicting Risk for Child Maltreatment
Clinical Pediatrics 1–3 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0009922815586054 cpj.sagepub.com
Stephen Edward McMillin, PhD1, Margaret W. Bultas, PhD, RN, CNE, CPNP-PC1, Tracy Zander, MPH1, Jennifer Wilmott, MSW, MPH1, Sarah Underwood, MSW1, Matthew A. Broom, MD1, and Debra H. Zand, PhD1 Introduction
Methods
Child maltreatment is a serious pediatric concern that results in immediate physical and emotional injuries and also creates increased risk for other adverse outcomes across the life course, such as substance abuse, risky sexual behavior, obesity, mental illness, and criminal behavior.1,2 Child maltreatment is difficult to quantify as many cases are not reported, but nationally representative data suggest that at some point during childhood, 25.6% of children have experienced some degree of maltreatment.2 Pediatricians are mandated reporters of child abuse and neglect and will likely encounter patients at risk for maltreatment in their practice. Incomplete and often poor parental knowledge of child development is linked to unrealistic expectations of young children, leading to maltreatment.3,4 Increasingly child protection systems recognize parental knowledge of child development as a key protective factor against maltreatment.3 Parents with enough child development knowledge to understand the needs and limitations of their developing children are better prepared to provide a safe home environment. Poor parental knowledge of child development is especially problematic in specific subgroups. The overall risk of child maltreatment increases 3 to 4 times for children with developmental disabilities and is related to both child and parent factors.5 As a result, medically and/or developmentally complex children are at even greater risk of child maltreatment. Because 70% of reported child abuse deaths occur prior to age 3,6 understanding parents’ knowledge and perspective about the child development of very young children is important to prevent maltreatment early. This study seeks to contribute to the ability of pediatricians to offer anticipatory guidance to parents about developing appropriate expectations for and anticipating the needs of very young, developmentally disabled children.
Participants This research explored the knowledge of child development among mothers of children aged 2 to 34 months at risk for developmental delays. Participants were enrolled in a parenting intervention conducted within a large Midwestern state’s early intervention program for children at risk for developmental delay or disability. The original study population of 150 mother-infant dyads were recruited directly through the program’s providers or indirectly through brochures and presentations held at early intervention events.4 However, because of issues such as missing data, parental medical issues, schedule constraints, low interest in the study, lack of follow-up, and missing data, only 66 (44.00%) of the original number of mothers recruited were able to fully participate and complete all the tools needed for this study.4 The final sample contained 66 mother-infant dyads (maternal age range = 19-41 years, M = 29.95 years, SD = 5.69 years; infant age range = 2.79-34.60 months, M = 23.04 months, SD = 8.19 months). Forty-one children in the sample (62.12%) were male, with 15 children (22.73%) born prematurely and 30 children (45.31%) coded as at-risk developmentally based on stable but chronic conditions such as language disorders, neurological disease, autism, or global developmental conditions. Twenty-five mothers (37.88%) were African American, 34 (51.52%) were Caucasian, and 5 (7.58%) were Hispanic, while 31 mothers (46.97%) were married, 58 mothers (87.87%) had a high school diploma, and 44 mothers (66.69%) also had a least some college. 1
Saint Louis University, Saint Louis, MO, USA
Corresponding Author: Stephen Edward McMillin, Saint Louis University, 3550 Lindell Boulevard, Saint Louis, MO 63103, USA. Email: [email protected]
Downloaded from cpj.sagepub.com at CAMBRIDGE UNIV LIBRARY on August 15, 2015
2
Clinical Pediatrics
Table 1. AAPI-2 Subscales: Means and Standard Deviationsa.
research-article2015
CPJXXX10.1177/0009922815586054Clinical PediatricsMcMillin et al
Brief Report
The Role of Maternal Knowledge of Child Development in Predicting Risk for Child Maltreatment
Clinical Pediatrics 1–3 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0009922815586054 cpj.sagepub.com
Stephen Edward McMillin, PhD1, Margaret W. Bultas, PhD, RN, CNE, CPNP-PC1, Tracy Zander, MPH1, Jennifer Wilmott, MSW, MPH1, Sarah Underwood, MSW1, Matthew A. Broom, MD1, and Debra H. Zand, PhD1 Introduction
Methods
Child maltreatment is a serious pediatric concern that results in immediate physical and emotional injuries and also creates increased risk for other adverse outcomes across the life course, such as substance abuse, risky sexual behavior, obesity, mental illness, and criminal behavior.1,2 Child maltreatment is difficult to quantify as many cases are not reported, but nationally representative data suggest that at some point during childhood, 25.6% of children have experienced some degree of maltreatment.2 Pediatricians are mandated reporters of child abuse and neglect and will likely encounter patients at risk for maltreatment in their practice. Incomplete and often poor parental knowledge of child development is linked to unrealistic expectations of young children, leading to maltreatment.3,4 Increasingly child protection systems recognize parental knowledge of child development as a key protective factor against maltreatment.3 Parents with enough child development knowledge to understand the needs and limitations of their developing children are better prepared to provide a safe home environment. Poor parental knowledge of child development is especially problematic in specific subgroups. The overall risk of child maltreatment increases 3 to 4 times for children with developmental disabilities and is related to both child and parent factors.5 As a result, medically and/or developmentally complex children are at even greater risk of child maltreatment. Because 70% of reported child abuse deaths occur prior to age 3,6 understanding parents’ knowledge and perspective about the child development of very young children is important to prevent maltreatment early. This study seeks to contribute to the ability of pediatricians to offer anticipatory guidance to parents about developing appropriate expectations for and anticipating the needs of very young, developmentally disabled children.
Participants This research explored the knowledge of child development among mothers of children aged 2 to 34 months at risk for developmental delays. Participants were enrolled in a parenting intervention conducted within a large Midwestern state’s early intervention program for children at risk for developmental delay or disability. The original study population of 150 mother-infant dyads were recruited directly through the program’s providers or indirectly through brochures and presentations held at early intervention events.4 However, because of issues such as missing data, parental medical issues, schedule constraints, low interest in the study, lack of follow-up, and missing data, only 66 (44.00%) of the original number of mothers recruited were able to fully participate and complete all the tools needed for this study.4 The final sample contained 66 mother-infant dyads (maternal age range = 19-41 years, M = 29.95 years, SD = 5.69 years; infant age range = 2.79-34.60 months, M = 23.04 months, SD = 8.19 months). Forty-one children in the sample (62.12%) were male, with 15 children (22.73%) born prematurely and 30 children (45.31%) coded as at-risk developmentally based on stable but chronic conditions such as language disorders, neurological disease, autism, or global developmental conditions. Twenty-five mothers (37.88%) were African American, 34 (51.52%) were Caucasian, and 5 (7.58%) were Hispanic, while 31 mothers (46.97%) were married, 58 mothers (87.87%) had a high school diploma, and 44 mothers (66.69%) also had a least some college. 1
Saint Louis University, Saint Louis, MO, USA
Corresponding Author: Stephen Edward McMillin, Saint Louis University, 3550 Lindell Boulevard, Saint Louis, MO 63103, USA. Email: [email protected]
Downloaded from cpj.sagepub.com at CAMBRIDGE UNIV LIBRARY on August 15, 2015
2
Clinical Pediatrics
Table 1. AAPI-2 Subscales: Means and Standard Deviationsa.
