Manders Jeanette E, Stoneman Zolinda
Institute on Human Development and Disability, Rivers Crossing Building, The University of Georgia, 850 College Station Road, Athens, GA 30602-4806, USA.
Child Abuse Negl. 2009 Apr;33(4):229-37. doi: 10.1016/j.chiabu.2008.10.001.
The study used a series of vignettes to investigate how the presence of three disabilities (cerebral palsy, intellectual disabilities, emotional/behavioral disabilities) affects the processes and outcomes of child abuse investigations at two levels of child injury severity (moderate, severe).
Seventy-five CPS case workers completed study surveys and answered questions in response to a series of eight vignettes.
This study revealed differences in the responses of CPS case workers when the alleged victim of physical abuse had a disability. Children with disabilities were more likely than children without disabilities to be seen as having characteristics that contributed to their abuse. Most CPS workers felt at least some empathy with abusive parents; empathy was highest when the children had emotional/behavioral disabilities. Services recommended for families of children with disabilities were more likely to be child-focused. Parent-focused services, such as individual counseling and adult anger management, were more likely to be recommended for families of children without disabilities. In general, differences among disability groups and between cases involving children with and without disabilities were more pronounced when the children's injuries were less severe. Even with more severe injuries, such as a concussion or broken bones, the CPS workers still responded differently depending on the disability status of the child victims.
Recommendations are made concerning the utilization of investigation teams that include disability specialists and the need for further disability-related training for CPS case workers.
There is a strong need for training related to disability, with an emphasis on attitudes as well as knowledge and skills. The training should include examples of healthy family functioning and positive aspects of parenting a child with a disability to counteract the prevailing perception of disability as a cause of chronic stress and dysfunction; identification of broader ecological contexts in which these families live, including social response to disability and the disability-related service system and; strategies for disentangling the signs of abuse from characteristics of the disability. Interdisciplinary teams should include members from disability-related fields to share expertise and increase communication between systems.
本研究使用了一系列案例 vignettes，以调查三种残疾情况（脑瘫、智力残疾、情感/行为残疾）在儿童伤害严重程度的两个级别（中度、重度）下，如何影响虐待儿童调查的过程和结果。
75 名儿童保护服务（CPS）工作人员完成了研究调查，并针对一系列八个案例 vignettes 回答问题。
本研究揭示了在身体虐待指控的受害者有残疾时，CPS 工作人员的反应存在差异。残疾儿童比无残疾儿童更有可能被视为具有导致其受虐待的特征。大多数 CPS 工作人员对虐待儿童的父母至少有一定程度的同理心；当儿童有情感/行为残疾时，同理心最强。为残疾儿童家庭推荐的服务更有可能以儿童为中心。以父母为中心的服务，如个体咨询和成人愤怒管理，更有可能被推荐给无残疾儿童的家庭。总体而言，当儿童受伤不太严重时，残疾群体之间以及涉及残疾儿童和无残疾儿童的案例之间的差异更为明显。即使是更严重的伤害，如脑震荡或骨折，CPS 工作人员仍会根据儿童受害者的残疾状况做出不同反应。
针对如何利用包括残疾专家在内的调查团队以及 CPS 工作人员进一步开展与残疾相关培训的必要性提出了建议。
迫切需要开展与残疾相关的培训，重点是态度以及知识和技能。培训应包括健康家庭功能的示例以及养育残疾儿童的积极方面，以抵消将残疾普遍视为慢性压力和功能障碍原因的观念；识别这些家庭所处的更广泛生态环境，包括社会对残疾的反应以及与残疾相关的服务系统；以及将虐待迹象与残疾特征区分开来的策略。跨学科团队应包括来自与残疾相关领域的成员，以分享专业知识并加强系统之间的沟通。
