Slide outline: After the Intervention: The ongoing challenge of ensuring the safety and wellbeing of vulnerable children in the Northern Territory

CFCA webinar - 21 November 2013

  1. After the Intervention: The ongoing challenge of ensuring the safety and wellbeing of vulnerable children in the Northern Territory

    • Howard Bath
    • CFCA information exchange webinar/seminar
    • 21 November 2013
    • The views expressed in this presentation are those of the presenter and may not reflect those of the Australian Institute of Family Studies or the Australian Government
  2. NT Sexual Abuse Notifications and Substantiations 2008-09 to 2012-13
    • Figure. Source: DCF 2013

      • This figure shows that the proportion of sexual abuse substantiations in the NT has fallen each year over the past 5 years – from approximately 15% in 2007-08; to less than 1% in 2013-13.
  3. Substantiations by Type of Abuse/Neglect, 2008-09 to 2012-13 (percentages)
    • Figure. Source: OCF 2013

      • This figure shows that neglect substantiations make up a majority of these cases with sexual abuse making up 3% of the total.
  4. Notifications of Gonorrhea and Chlamydia by 10-14 age group, 2007-08 to 2011-12.
    • Figure. Source: NT Department of Health - Centre for Disease Control

      • This figure shows that between 2007-08 and 2011-12 notifications of both Gonorrhea and Chlamydia by 10-14 age group increased, from 64 to 81, and 55 to 82 respectively.
  5. Developmental hazards disproportionally faced by Aboriginal children in the NT
    • Exposure to family violence
    • Teen parenting (carer instability, poverty)
    • Exposure to alcohol in utero
    • Exposure to nicotine in utero
    • Parental use of other substances
    • Poor nutrition
    • Various diseases such as otitis media, and anaemia
    • Abuse and neglect
  6. The impact of developmental hazards faced by Aboriginal children in the NT
    • Infant mortality rates 3 times those of other Australian infants
    • Highest child death rates due to injury and accident
    • Lowest school attendance/achievement
    • Highest rate of youth justice incarceration
    • Highest child and youth suicide rates
    • Highest rates of developmental vulnerability
  7. School attendance of very remote Aboriginal children in the NT by year
    • Figure. Source: NT Department of Education and Training

      • This figure shows that between 2006 and 2010 school attendance of very remote Aboriginal children in the NT decreased, with 65% of these children attending school less than 60% of the time in 2010.
  8. Children who are developmentally vulnerable on two or more domains of the AEDI 2012 (percentages)
    • Figure. Source: AEDI (2013)

      • This figure shows that NT rates of developmental vulnerability are not only much higher than for Australia as a whole, they are much higher than those for Aboriginal children elsewhere. Specifically, 38.2% of Indigenous children in the NT are developmentally vulnerable on two or more domains of the AEDI, and 49.9% of very remote Indigenous children in the NT are developmentally vulnerable on two or more domains of the AEDI.
  9. Children who are developmentally vulnerable on two or more domains of the AEDI, 2009 and 2012 (percentages)
    • Figure. Source: AEDI (2010 & 2013)

      • This figure shows that while the 2009 AEDI data suggested that 46.8% of Aboriginal children in the NT had multiple Developmental Vulnerabilities, that figure that has now dropped over 8.5% to 38.2% in 2012. However, these improvements are largely centred on urban rather than remote areas.
  10. Hospitalisation rates for Indigenous children by condition 2000-01 to 2010-11 (per 1,000)
    • Figure. Source: CTG NT Monitoring Report (2013)

      • This figure shows there have been marked decreases in hospitalisation of Indigenous children for certain diseases, including infectious and parasitic disease, nutritional anaemia and rates of malnutrition. For other conditions, including respiratory disease, skin diseases, injuries and accidents, there has been little change.
  11. Trauma theory proposes that the origin of a significant proportion of physical, social, and moral disorder lies in the direct and indirect exposure to external traumatogenic agents
    • Bloom & Farragher, 2011 , p. 123
  12. Adverse Childhood Experiences Studies
    • Household Dysfunction

      • Substance abuse
      • Parental separation/divorce
      • Mental illness
      • Domestic violence
      • Criminal Behavior
    • Abuse
      • Psychological
      • Physical
      • Sexual
    • Neglect
      • Emotional
      • Physical
  13. Ace Study Dose-Response Findings
    • Figure. Source: Adapted from Felitti, VJ, Anda, RF et al (1998)

      • This figure shows the strong relationship between the number of adverse childhood experiences and later alcoholism. For those with zero ACEs, the lifetime risk of reporting alcoholism use was 2%; the risk for those with four or more ACEs was 16%.
    • We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors �in adults
  14. Ace Study Dose-Response Findings
    • Figure. Source: Adapted from Felitti, VJ, Anda, RF et al (1998)

      • These figures show the strong relationship between the number of adverse childhood experiences and later IV drug use and suicide attempts. For those with zero ACEs, the lifetime risk of reporting IV drug use use was 2%; the risk for those with four or more ACEs was 34%. For those with zero ACEs, the lifetime risk of reporting a suicide attempt was 1%; the risk for those with four or more ACEs was 19%.
  15. Ace Study Dose-Response Findings
    • Figure. Source: Adapted from Felitti, VJ, Anda, RF et al (2010)

      • This figure shows that women are more adversely affected in later life by ACEs than men, with the population attributable (to ACEs) risk being 54% for depression and 58% for female suicide attempts.
    • The population attributable (to ACEs) risk is 54% for depression and 58% for female suicide attempts
  16. ‘These findings provide a credible basis for a new paradigm of medical, public health and social services practice… ‘Many of our most intractable public health problems are the result of compensatory behaviours such as smoking, overeating, and alcohol and drug use, which provide partial relief from the emotional problems caused by traumatic childhood experiences.’
    • Felitti & Anda, 2010, p. 86.
  17. Trauma Affects...
    • social skills and attachment
    • biological systems and medical issues
    • regulation of emotions/impulses
    • dissociation
    • behavioural control
    • cognitive functioning
    • self-concept, shame and guilt
    • future orientation
  18. The most significant consequence of early relational trauma is the loss of the ability to regulate the intensity and duration of affects (Allan Schore) At the core of traumatic stress is a breakdown in the capacity to regulate internal states like fear, anger, and sexual impulses (Bessel van der Kolk)
  19. Children exposed to repeated episodes of overwhelming arousal …may never develop their capacity to self-regulate…they may be chronically irritable, angry, unable to manage aggression, impulsive, anxious or depressed.
    • Bloom & Farragher 2011
  20. Violence in the Northern Territory
    • Aboriginal people in the NT are twice as likely to be hospitalised for assault as are Aboriginal people in the rest of Australia (AIHW).
    • The latest Closing the Gap report revealed that the night patrols which were set up as a first response to violence or potential violence, dealt with over 84,700 incidents in the last 6 month reporting period, or 160,000 incidents p.a. – that is in a target area of around 30,000 adults.
  21. Violence in the Northern Territory
    • Aboriginal women in the NT make up only 0.3% of all Australian women, but they account for 14% of the hospitalisations for assault.
    • In 2009/10, 27 non-Indigenous women had assault related admissions to hospital in the NT. In the same period 842 Aboriginal women were admitted.
    • Aboriginal women in the NT are 80 times more likely to be hospitalised as a result of assault.
      • AIHW, National Hospital Morbidity Database, 2011/12
  22. National Comparison Aboriginal Children Substantiation rates during 2011–12 (number per 1,000 children)
    • Figure. Source: AIHW 2013 (adapted from table 2.4) Note: AIHW Caveats apply.

      • This figure shows that the NT rate is well above the National average.
  23. National Comparison Aboriginal Children in care rates at June 2012 (number per 1,000 children)
    • Figure. Source: AIHW 2013 (adapted from table 4.4) Note: AIHW Caveats apply.

      • This figure shows that the NT Aboriginal out of home care rates are almost 3 times lower than the National average.
  24. Number of Repeat Substantiations within a 12 Month Period
    • Number of children with a substantiation in 2010-11: 1425 (100%)
    • Number of children re-substantiated within 12 months: 337 (23.6%)
      • Source: OCF 2012
    • A child substantiated as being harmed has almost a one in four chance of being re-substantiated within 12 months. These children are not being protected by the system.
  25. After the Intervention: The ongoing challenge of ensuring the safety and wellbeing of vulnerable children in the Northern Territory
    • Howard Bath
    • CFCA information exchange webinar/seminar
    • 21 November 2013

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