Signalering van kindermishandeling: een dossieronderzoek naar relevante aspecten.

Abstract

Aim: To explore relevant and important aspects concerning child maltreatment (CM) as found in treatment files and to verify the relation of these aspects with social workers perceived and nonperceived CM. Relations between documented CM in different parts of the treatment files are studied. Methods: From a database of 843 treatment files 72 were selected by the treatment coordinator and the head of the out-patient unit on the basis of perceived CM. Digital files could not be found for 19 files and another 53 files were randomly added to the sample, which ultimately consisted of 106 files. The files were blindly assessed on containing words and sentences about CM, based on an extensive definition of the phenomenon. Aspects to be explored were frequencies of CM incidents, CM types, offenders, level of gravity, risk factors and verbalization of CM. Relations between different parts of the treatment files were analysed using Spearman’s correlations. Results: CM was found to be overlooked by the social workers in 30% of the files. The most common type of CM was children witnessing domestic violence, followed by emotional maltreatment and sexual abuse. Sexual abuse and children witnessing domestic violence have been found to be significantly more perceived by the treatment coordinator. Severe as well as less severe incidents of CM were found to be overlooked by the coordinator for every type of CM except sexual abuse. Perceived CM files were found to contain more words about unspecified types of CM than did non-perceived files. Found risk factors for different types of CM are gender, children’s skill, parental psychological problems, parental drugs and alcohol abuse, parental history of maltreatment, financial problems and violent interactions within the family. Frequencies of documented CM were found to vary substantially between different parts of the treatment files. Small but significant correlations were found for the verbalization of CM between the different parts of the files and were strongest for sexual abuse. Conclusions: Treatment files contain a great deal of relevant information concerning CM and associated aspects. More attention should be drawn to perceiving and treating child maltreatment adequately.