Publication year
2017
Citation Title
Under-ascertainment from healthcare settings of child abuse events among children of Soldiers by the US Army Family Advocacy Program
Journal Name
Child Abuse and Neglect
Journal Volume
63
Page Numbers
202-210
DOI
10.1016/j.chiabu.2016.11.007
Summary
Retrospective data was used to examine the percentage of child maltreatment cases with a substantiated Family Advocacy Program (FAP) report among dependent children of U.S. Army parents. The association between this linkage and child, maltreatment episode, and Soldier characteristics was also examined. The findings indicate that less than a quarter of diagnosed maltreatment episodes had a substantiated FAP report and treatment facility type, maltreatment type, Soldier education levels, and Soldier race/ethnicity influenced this link.
Key Findings
Substantiated FAP reports only accounted for 20% of child maltreatment cases, with most reports being linked to children observed at a military (24%) versus civilian medical facility (10%).
Twenty six percent of physical maltreatment cases were linked to a substantiated FAP report compared to only 15% of sexual maltreatment cases.
Having a parent Soldier who identified as Black or a parent with a high school education or less increased the likelihood of having a linked maltreatment diagnosis and FAP report.
Implications for Program Leaders
Provide education to Service members and their families to enhance resilience and the use of healthy coping mechanisms to prevent child maltreatment
Disseminate information to civilian medical facilities regarding how to report child maltreatment for dependent children of a Service member
Facilitate referrals between military and civilian agencies working with Service members and their families to streamline the maltreatment reporting process
Implications for Policy Makers
Address gaps in reporting requirements for military and civilian medical facilities when a child receives a maltreatment diagnosis
Encourage collaboration between FAP and civilian child protective service agencies to foster open dialog and coordination among the agencies
Continue to support programs that are responsible for the identification and prevention of child maltreatment in military families
Methods
Data were obtained from the Army Central Registry, the TRICARE Management Activity’s Patient Administration System and Biostatistics Activity System, and the Defense Manpower Data Center.
Multiple medical encounters that occurred within a 180-day window were collapsed into one maltreatment episode.
Substantiated FAP reports were linked to a maltreatment episode if they occurred one month prior to and after the start and end date of the maltreatment episode.
Participants
A total of 5,109 Active Duty U.S. Army dependent children between 0-17 years old were identified as having at least one diagnosis of child maltreatment between the years of 2004-2007.
The majority of the sample were children six years of age and older (59%), followed by children between the ages of 3-5 years (23%), and 0-2 years (18%).
Only children of Active Duty Soldiers who served at least three consecutive years from 2001-2007 were included in the study sample.
Limitations
This study only included dependent children of U.S. Army service members, limiting the generalizability to other service branches.
The use of record data from 2004-2007, when the U.S. Army was experiencing high operational tempo, influences the applicability of the results to the current time.
Collapsing multiple medical encounters over a 180-day span may have resulted in an overestimation of the link between maltreatment cases and substantiated FAP reports.
Avenues for Future Research
Review FAP reports that were unsubstantiated to better understand the gap between medically diagnosed child maltreatment cases and substantiated FAP reports
Evaluate the current reporting requirements regarding a child maltreatment diagnosis across the U.S. Army and other military branches
Investigate the potential barriers associated with reporting child maltreatment across civilian and military agencies
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract Document
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