Risk and protective factors for child abuse and neglect

Risk and protective factors for child abuse and neglect

CFCA Resource Sheet— May 2017
Risk and protective factors for child abuse and neglect

This paper provides an overview of the risk and protective factors for child abuse and neglect in families. It is designed for practitioners and policy-makers who work in the areas of child maltreatment. This paper was developed using a scan of relevant literature on risk and protective factors for child abuse and neglect (1998-2016). It is for information purposes only and should not be used as a risk assessment tool in child protection practice. For more information on risk assessment in child protection see Risk Assessment Instruments in Child Protection.

Why discuss risk and protective factors?

Understanding the risk and protective factors for child abuse and neglect[1] is useful when developing effective prevention and early intervention strategies, and identifying families who are most likely to benefit from additional support.

Child protection authorities use specific risk assessment instruments to determine if a child is at risk of maltreatment but all professionals who work with families can benefit from a broad understanding of the factors that may place children at risk of harm, the factors that can protect them from harm, and the ways in which these risk and protective factors interact. Having an understanding of the risk and protective factors that contribute to child abuse and neglect enables practitioners to have a more holistic view of family experience and to engage with other services in a multi-service system response (Bromfield, Sutherland, & Parker, 2012).

It is essential to keep in mind that while certain risk factors may exist among families where child abuse and neglect occur, this does not mean that the presence of these factors necessarily leads to child abuse and neglect (Goldman, Salus, Wolcott, & Kennedy, 2003). Risk factors are not causes of child abuse or neglect, and the presence of one or more risk factors will not necessarily result in child abuse and neglect, just as the presence of protective factors does not guarantee that children will be kept safe. For instance, one risk factor identified in Table 1 is a large family size. This should never be interpreted as meaning that all children in large families are at high risk of maltreatment. It simply means that at the population level there is a statistical association between family size and child maltreatment. Child maltreatment occurs in a minority of families, and most people, even those experiencing many risk factors, do not abuse or neglect their children. Indeed, child maltreatment can also occur in families that experience none of the commonly associated risk factors (Ronan, Canoy, & Burke, 2009).

Definitions

  • Risk factors for child maltreatment are the measurable circumstances, conditions or events that increase the probability that a family will have poor outcomes in the future (Child Welfare Information Gateway, 2014; Masten & Wright, 1998). When combined with limited protective factors, they increase the probability of children experiencing child abuse or neglect.
  • Protective factors are attributes or conditions that can occur at individual, family, community or wider societal level. Protective factors moderate risk or adversity and promote healthy development and child and family wellbeing (Child Welfare Information Gateway, 2014). They serve as safeguards that can help parents find resources or supports and encourage coping strategies that allow them to parent effectively, even under difficult circumstances.
  • Child abuse and neglect (or child maltreatment) consist of any acts of commission or omission by a parent, caregiver or other adult that results in harm, potential for harm or the threat of harm to a child (0-18 years of age) even if the harm is unintentional (Gilbert et al., 2009). Child abuse and neglect can be in the form of physical abuse, sexual abuse, emotional abuse, neglect or exposure to family violence. For more information on child maltreatment see: What is Child Abuse and Neglect?

The interaction of risk and protective factors

There are differences in risk and protective factors for physical abuse, emotional abuse, neglect and sexual abuse (Stith et al., 2009). For example, parental mental health problems are more likely to be associated with neglect (Cowling, 2004). Risk and protective factors also operate differently as children grow (Li, Godinet, & Arnsberger, 2011). For example, one study found that low birth weight and birth abnormality ceased to be a risk factor for maltreatment after age 1 (Putnam-Hornstein & Needell, 2011).

The evidence furthermore suggests that exposure to risk factors is cumulative. That is, the more risk factors in a child's life, the greater the chance that they will experience maltreatment (Begle, Dumas, & Hanson, 2010; MacKenzie, Kotch, & Lee, 2011). Risk factors are often interconnected. For example, unemployment can be connected to mental health problems, and both unemployment and mental health problems are connected with low self-esteem, which are all risk factors for child maltreatment.

Risk and protective factors also vary according to the context in which maltreatment is occurring. This resource sheet focuses on the risk and protective factors that contribute to child maltreatment within a family context, but it is important to note that there are differences between these and the risk and protective factors that contribute to child abuse in other settings, such as institutional child sexual abuse (Kaufman & Erooga, 2016). For a discussion of risk and protective factors for institutional child sexual abuse, see this literature review prepared for the Royal Commission into Institutional Responses to Child Sexual Abuse.

Limitations of the research

The evidence on risk and protective factors for maltreatment is far from definitive. Although a few factors (e.g., low socio-economic status) are consistently associated with child abuse and neglect, the empirical research has produced inconsistencies and conflicting findings.

The evidence on risk and protective factors is limited in several ways. The majority of the research has looked at mothers (Stith et al., 2009) and therefore the risk and protective factors that have been identified may be less applicable to fathers or other parents and carers. Much of the research examines individual-level causes of child maltreatment, examining the characteristics of the child or parent (Stith et al., 2009), and much less research has looked at the social and environmental factors.

The types of research methods used make it difficult to determine the direction of causality. This means that it is possible that some of the factors that have been identified could be the result of abuse or neglect. It is also possible that many of the risk factors identified by the research may be indicators of low socio-economic status (Wu et al., 2004).

Finally, the majority of the research has been undertaken in North America and there may be differences in risk and protective factors in the Australian context.

For a more detailed discussion of some of the issues and criticisms of the risk-based approach to child abuse and neglect, see Risk Assessment Instruments in Child Protection.

Common risk factors for child abuse and neglect

Any effort to identify definitive causes of child abuse and neglect is complicated by the interrelatedness of factors. One model that has been used to demonstrate how factors at multiple levels intersect to increase the likelihood of child abuse and neglect is Bronfenbrenner's (1979) "developmental-ecological" model (Horton, 2003; Irenyi, Bromfield, Beyer, & Higgins, 2006).

The developmental-ecological model has four levels:

  1. cultural beliefs and values (macrosystem);
  2. neighbourhood and community settings (exosystem);
  3. family environment (microsystem); and
  4. the individual's own characteristics and developmental stage.

International research has identified many risk factors for child abuse and neglect. It is beyond the scope of this paper to provide detailed evidence of all of these risk factors or to discuss the extent to which specific risk factors relate to different forms of maltreatment. However, Table 1 presents some of the commonly cited risk factors for chid maltreatment, divided according to the ecological levels of the developmental-ecological model described above (factors relating to the macrosystem are not included as they are likely to vary significantly between societies and cultures).[2]

This table was developed using a scan of recent literature (1998-2016) that identified risk factors for child maltreatment. Studies were included that had a large sample size (n > 330) or were a meta-analysis or literature review. Risk factors were included in the table if they were common across two or more studies.

It is important to note that although there are risk factors at the individual child level, children are never to blame for child abuse or neglect. Additionally, as stated above, although there is a statistical association between these factors and child abuse and neglect, this does not mean that these factors cause child abuse and neglect.

Table 1: Commonly cited risk factors for child abuse and neglect

Ecological level

Risk factors

Sources: Black, Smith Slep & Heyman, 2001; Brown, Cohen, Johnson, & Salzinger, 1998; Clément, Bérubé & Chamberland, 2016; Dubowitz et al., 2011; Forston, Klevens, Merrick, Gilbert & Alexander, 2016; Freisthler, Merrit & LaScala 2006; Li et al., 2011; Palusci, 2011; Putnam-Hornstein & Needell, 2011; Shook Slack et al., 2011; Stith et al., 2009 Wu et al., 2004)

▪ Individual child factors

  • low birth weight
  • pregnancy or birth complications
  • child temperament or behaviour
  • child disability

Family/parental factors

  • parental substance abuse
  • involvement in criminal behaviour
  • family conflict or violence
  • mental health problems
  • child perceived as problem by parents
  • history of child abuse and neglect
  • large family size
  • exposure to stress
  • parental temperament
  • teenage/young parent/s
  • single or unmarried parents
  • low level of parental education
  • use of corporal punishment
  • unplanned pregnancy
  • physical health problems
  • low self-esteem
  • social isolation

Social/environment factors

  • socio-economic disadvantage
  • parental unemployment
  • housing stress
  • lack of access to social support
  • lack of pre-natal care
  • neighbourhood disadvantage
  • neighbourhood violence

Common protective factors for child abuse and neglect

Research has identified a number of protective factors that are associated with reduced incidences of child abuse and neglect. Overall, less is known about protective factors, as much less research has been undertaken to identify and examine protective factors when compared to risk factors (Li et al., 2011).

The factors found in the research that may reduce the likelihood of child abuse and neglect are outlined in Table 2, using the developmental-ecological model. Table 2 lists every protective factor identified in the literature scan (1998-2016).

Table 2: Protective factors for reducing the incidence of child abuse and neglect

Ecological level

Protective factors

Sources: Black et al., 2001; Brown et al., 1998; Clément et al., 2016; Dubowitz et al., 2011; Forston, Klevens, Merrick, Gilbert & Alexander, 2016; Freisthler et al., 2006; Li et al., 2011; Palusci, 2011; Shook Slack et al., 2011; Stith et al., 2009

Individual/child factors

  • social and emotional competence
  • attachment to parent/s

Family/parental factors

  • strong parent/child relationship
  • parental self-esteem
  • family cohesion
  • two-parent household
  • high level of parental education
  • self-efficacy
  • family functioning
  • knowledge of parenting and child development
  • parental resilience
  • concrete support for parents

Social/environmental factors

  • positive social connection and support
  • employment
  • neighbourhood social capital
  • adequate housing
  • socio-economically advantaged neighbourhood
  • access to health and social services

Practice applications of skills and protective factors

Risk and protective factors can be used to develop both universal and targeted approaches to reducing child maltreatment. Universal approaches seek to reduce risk factors and promote protective factors in all families. This could include ensuring that all parents are provided with accessible information about parenting and child development. Identifying social and environmental risk factors such as low socio-economic status or neighbourhood disadvantage can inform systemic responses that seek to address the causes of disadvantage (Bromfield, Lamont, Parker, & Horsfall, 2010).

Identification of risk and protective factors can also be used to develop targeted approaches to reducing child abuse and neglect. Families that display multiple risk factors and minimal protective factors can be identified and provided with additional services and support (Putnam-Hornstein & Needell, 2011; Wu et al., 2004). Strengths-based practice, emphasising the assets and strengths within families, is a common strategy used to build and enhance protective factors and promote quality communication and engagement with families (Bromfield et al., 2012).

Conclusion

All families exhibit both risk and protective factors to some extent. The interaction of multiple risk factors in combination with limited protective factors may increase the likelihood of child abuse and neglect. Strong protective factors in families such as supportive social networks and a good parent-child attachment can build resilience in children and parents.

Understanding risk and protective factors enables the development of both universal and targeted approaches to reducing the incidence of child abuse and neglect.

Additional CFCA readings

Risk assessment instruments in child protection

What is child abuse and neglect?

Issues for the safety and wellbeing of children in families with multiple and complex problems: The co-occurrence of domestic violence, parental substance misuse, and mental health problems

References

Begle, A. M., Dumas, J. E., & Hanson, R. F. (2010). Predicting child abuse potential: An empirical investigation of two theoretical frameworks. Journal of Clinical Child & Adolescent Psychology, 39(2), 208-219.

Black, D. A., Smith Slep, A. M., & Heyman, R. E. (2001). Risk factors for child psychological abuse. Aggression and Violent Behavior, 6, 189-201

Bromfield, L., Lamont, A., Parker, R., & Horsfall, B. (2010). Issues for the safety and wellbeing of children in families with multiple and complex problems (NCPC Issues 33). Retrieved from <www.aifs.gov.au/nch/pubs/issues/ issues33/index.html>.

Bromfield, L., Sutherland, K., & Parker, R. (2012). Families with multiple and complex needs: Best interest case practice model. Specialist practice resource. Melbourne: Victorian Department of Human Services. Retrieved from <www.dhs.vic.gov.au/__data/assets/pdf_file/0008/721880/Families-with-multiple-and-complex-needs-specialist-resource.pdf>.

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, Mass.: Harvard University Press.

Brown, J., Cohen, P., Johnson, J., & Salzinger, S. (1998). A longitudinal analysis of risk factors for child maltreatment: Findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect. Child abuse & Neglect, 22, 1065-1078.

Child Welfare Information Gateway. (2014). Protective factors approaches in child welfare. Washington, DC: US Department of Health and Human Services.

Clément, M.-È., Bérubé, A., & Chamberland, C. (2016). Prevalence and risk factors of child neglect in the general population. Public Health, 138, 86-92

Cowling, V. (2004). Children of parents with mental illness 2: Personal and clinical perspectives. Melbourne: ACER Press.

Crouch, J., & Behl, L. (2001). Relationships among parental beliefs in corporal punishment, reported stress and physical child abuse potential. Child Abuse & Neglect, 25(3), 413-419.

Douglas, E. (2006). Familial violence socialization in childhood and later life approval of corporal punishment: A cross-cultural perspective. American Journal of Orthopsychiatry, 76, 23-30.

Dubowitz, H., Kim, J., Black, M. M., Weisbart, C., Semiatin, J., & Magder, L., S. (2011). Identifying children at high risk for a child maltreatment report. Child Abuse and Neglect, 35, 2, 96-104.

Forston, B. L., Klevens, J., Merrick, M. T., Gilbert, L. K., & Alexander, S. P. (2016). Preventing child abuse and neglect: A technical package for policy, norm, and programmatic activities. Atlanta, GA: National Centre for Injury Prevention and Control, Centers for Disease Control and Prevention.

Freisthler, B., Merritt, D. H., & LaScala, E. A. (2006). Understanding the ecology of child maltreatment: A review of the literature and directions for future research. Child Maltreatment, 11, 3, 263-280.

Gilbert, R., Spatz Widom, C., Browne, K., Fergusson, D., Webb, E., & Janson, J. (2009). Burden and consequences of child maltreatment in high-income countries. Lancet, 373, 68-81.

Goldman, J., Salus, M., Wolcott, D., & Kennedy, K. (2003). What factors contribute to child abuse and neglect? A coordinated response to child abuse and neglect: The foundation for practice. Washington D.C.: Office on Child Abuse and Neglect.

Horton, C. (2003). Protective factors literature review: Early care and education programs and the prevention of child abuse and neglect. Washington, DC: Center for the Study of Social Policy.

Irenyi, M., Bromfield, L. M., Beyer, L. R., & Higgins, D. J. (2006). Child maltreatment in organisations: Risk factors and strategies for prevention (Child Abuse Prevention Issues No. 25). Retrieved from <www.aifs.gov.au/nch/pubs/issues/ issues25/issues25.html>.

Kaufman, K., & Erooga, M. (2016). Risk profiles for institutional child sexual abuse: A literature review. Sydney: Royal Commission into Institutional Responses to Child Sexual Abuse.

Li, F., Godinet, M. T., & Arnsberger, P. (2011). Protective factors among families with children at risk of maltreatment: Follow up to early school years. Children and Youth Services Review, 33, 139-148.

MacKenzie, M. J., Kotch, J. B., & Lee, L. (2011). Toward a cumulative ecological risk model for the etiology of child maltreatment. Children and Youth Services Review, 33, 1638-1647.

Masten, A. S., & Wright, M. O. (1998). Cumulative risk and protection models of child maltreatment. Journal of Aggression, Maltreatment & Trauma, 2, 7-30.

Palusci, V. J. (2011). Risk factors and services for child maltreatment among infants and young children. Children and Youth Services Review, 33, 1374-1382.

Putnam-Hornstein, E. & Needell, B., (2011). Predictors of child protective service contact between birth and age five: An examination of California's 2002 birth cohort. Children and Youth Services Review, 33,1337-1344.

Ronan, K., Canoy, D., & Burke, K. (2009). Child maltreatment: Prevalence, risk, solutions, obstacles. Australian Psychologist, 44, 195-213.

Stith, S., Liu, T., Davies, C., Boykin, E., Alder, M., Harris, J. M. et al. (2009). Risk factors in child maltreatment: A meta-analytic review of the literature. Aggression and Violent Behavior, 14(1), 13-29.

Shook Slack, K., Berger, L. M., DuMont, K., Yang, M-Y., Kim, B., Ehrhard-Dietzel, S., & Holl, J. L. (2011). Risk and protective factors for child neglect during early childhood: A cross-study comparison. Children and Youth Services Review, 33, 1354-1363.

Wu, S. S., Chang-Xing, M., Carter, R. L., Ariet, M., Feaver, E. A., Resnick, M. B., & Roth, J. (2004). Risk factors for infant maltreatment: a population-based study. Child Abuse and Neglect, 28, 1253-1264.

Endnotes

1 In this paper, the terms "child abuse and neglect" and "child maltreatment" are used interchangeably.

2 Child abuse and neglect may occur across all socio-economic, religious, cultural, racial and ethnic groups. Determining the extent to which cultural values (macrosystem) influence rates of child abuse and neglect is difficult. However, research suggests that cultural attitudes towards violence is associated with approval rates of physical punishment (Douglas, 2006), which has in turn been associated with higher rates of physical child abuse (Crouch & Behl, 2001).

 

Authors and Acknowledgements

This paper was compiled by Jessica Smart, Senior Research Officer at the Australian Institute of Family Studies. Previous editions have been compiled by Alister Lamont and Rhys Price-Robertson.

The feature image is by Noah Silliman, CC0 1.0 .

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CFCA Resource Sheet
Published by the Australian Institute of Family Studies, May 2017.
Last updated May 2017

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