July 5 juillet 13:45 – 15:45
Room NCDH–200
Chair:
Jean-Paul Braun
, Cour du Québec
Neglect is a serious problem in childhood reportedly accounting for over half of the child maltreatment related deaths in the United States. Many different attempts have been made to develop a definition of neglect that is accepted by the various disciplines involved in child maltreatment. Defining neglect from the child’s perspective seems logical. Neglect can be defined as when a child’s basic needs are not met adequately. Basic needs include food, nurturing, shelter, clothing, safety, education, and medical care. By focusing on the issue from the child’s eyes, we can work together to develop strategies to ensure improvement. Neglect is a shared responsibility with many important contributors.
In the ecological model important factors include the parents, i.e. parental ability, cognitive ability, interpersonal problems; families, i.e. extent of family support; the community, ie, social isolation, extent of support networks; and society, i.e. poverty.
Operationalizing the definition is problematic. Personal values attitudes and judgements play a large role in establishing if the issue is neglect. Case examples will be presented that will challenge the definition.
In recent years, attitudes toward family reunification have dramatically changed, notably in California. When the state “detains” a child based upon abuse/neglect and places the child in foster care, it needs to make one of two decisions. It can either (1) provide reunification services to the family for a specified time; or (2) treat the case as one where the prospects of a safe reunification are so tenuous that an alternative permanent plan should be promptly determined. A trend has developed around the first decision; namely, to provide very little time for the parent(s) to “make substantive progress” and so enable their child’s return. For example, if a child is aged three or under, only six months of services are legally required to enable a parent to change. This abbreviated service period belies the time it takes to effect behavioral change in dealing with addiction or family violence. Are similar trends developing elsewhere?
I have noticed two responses to this trend: (1) California is experimenting with the New Zealand model of the family conference that permits the family to devise a plan that avoids placing the child in foster care with a stranger; and (2) Alternatively, if the family can recognize the problem before the state does, a relative can apply for legal guardianship in probate court with the parent’s consent and so avoid dependency jurisdiction when the parent is incapable of caring for the child. Are abbreviated services evoking similar responses in other jurisdictions?
Child sexual abuse is not a new phenomenon. Although child sexual abuse today is largely recognized as a complex and serious issue, many aspects of the problem still remain poorly understood. This paper argues that the underlying dynamics of child sexual abuse continue to be poorly misunderstood in a criminal justice setting. The specific focus of this paper is the level of understanding among judicial members of the behavior of children who have been sexually abused. An analysis of relevant case law in Australia, Canada and the United States highlights that judicial perceptions of the way children respond to sexual abuse are grounded in misunderstandings and misconceptions about the underlying dynamics and nature of child sexual abuse. Specifically, many judgements demonstrate a poor understanding of the disclosure process. Expert testimony relating to the behavior of children who have been sexually abused represents an important forensic tool. Expert evidence of this kind can assist judges and other courtroom players in a criminal context to better understand the underlying dynamics of child sexual abuse and accordingly better evaluate the testimony of child-victims. Admissibility of this kind of evidence can help ensure that decision-making in the courtroom and the criminal justice system more broadly, is better informed, more objective and is ultimately fair and just.
When considering reporting of sexual abuse by professionals,
we should distinguish intrafamilial versus extrafamilial abuse. In intrafamilial
abuse, one obstacle would be “Am I going to destroy the family”. In
extrafamilial sexual abuse, one question would be: “is it worth the
trouble”. To overcome the obstacles in reporting by professionals, we have to
address these questions and others. Reporting of sexual abuse by professionnals
is in itself desirable. However, it is not without potential problems to the
victims and their families. For example, in the case of an adolescent who would
not prefer not to report with parents who would like to report; the professional
could additionally burden this victim and her family. Reporting by professionals
can only effective if we avoid increasing the suffering of the victim and the
family. This means specific intervention with necessary resources and time are
required. Reporting by professionals also means education and information are
required before imposing it by law.
In Western countries, sexual abuse is probably the most
important trigger in the subsequent development of posttraumatic stress disorder
(PTSD). Structured clinical interviews are frequently regarded as the best
instrument to reliably evaluate the presence of clinical disorders, with the
added benefit of frequently (as in the case of SCID and CAPS) offering
retrospective longitudinal data that are more conclusive than single-point
time-limited measurements. CAPS data from 14 patients treated because of
borderline personality disorder at the behavior therapy unit of the University
Hospital Department of Psychiatry are presented and document the developmental
onset of PTSD symptomatology as remembered by the patient, which was marked by a
usually early onset of PTSD symptoms with a reduction over adult development,
but fulfilling criteria at the time of presentation years after the trauma.
Child victims of sexual and/or physical abuse are often imprisoned in a code of silence as to the various forms of abuse they suffer at the hands of others, whether they are parents, brothers, sisters, friends of the family, or strangers. They endure, being ill equipped to deal with these difficult situations. This code of silence is often imposed by the abusive person or by external circumstances. The child victim does not wish to shatter the family or expose beloved friends of the family. In cases of abuse by strangers, the shame felt is oftentimes so overpowering that the child keeps the secret locked inside. But when the abusive situation does come to light, through disclosure by the victim or outside observers, it is imperative that the various agencies, governmental or other, act swiftly and together to ensure that the child victim is offered the adequate protection and help required by the situation. To do so, information must be shared. Otherwise, the abusive situation may be but halfway remedied or badly remedied.
On March 1ST 2001, the Québec government made public two policies:
§
Orientations
gouvernementales en matière d’agression sexuelle, which addresses
all crimes of a sexual nature;
§
l’Entente
multisectoriellle relative aux enfants victimes d’abus sexuels, de mauvais
traitements physiques ou d’une absence de soins menaçant leur santé physique,
which specifically addresses the problem of sexual assaults, physical assaults,
or lack of care endangering the health of child victims.
These governmental policies call for the collaboration of all interested parties to bring swift, adequate and comprehensive action to all cases of child victims. It is imperative that the information detained by children’s aid societies, police forces, crown attorneys and any other implicated organisation be shared with the other partners involved. Such collaboration is essential to ensure that the actions taken by the respective parties be coherent and ensure, overall, the desired aid and protection to the child victim.
When deciding the actions to be taken, the primary concern must always be that of the interest and well being of the child victim.
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