Abstract

Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015:

Introduction: Child sexual abuse has a significant and lasting impact on individuals and families [Richmond-Crum, 2003]. Children who experience sexual victimization are more likely to present adverse effects in childhood and adolescence, including Post-Traumatic Stress Disorder, substance abuse, and delinquent behavior [Felitti, 2009, Browne, 1986]. Child sexual abuse is an adverse childhood experience (ACE) associated with a higher incidence of certain adult health issues and behaviors, including depression, attempted suicide, cigarette smoking and illicit drug use [Felitti, 1998]. The negative impact on the long-term health of individuals and families is significant, given that CSA is, for the most part, a preventable phenomenon [Felitti, 2009]. Vigilance around CSA by adult caregivers for children is conceptualized as sustained purposeful attention and behavior to anticipate a child's safety and well-being needs [Guastello, 2014]. Vigilance as behavior does not refer only to recognizing and avoiding placing child in risky situations. Other child protective behaviors include teaching the child about avoidance of risky situations and how to respond if a threat or event occurs. Behaviors also include rules regarding safety and boundaries within a caregiving environment and what aspects of environments caregivers perceive as being protective that may decrease their drive for on-going vigilance. The extant research related to children's caregivers' vigilance focuses primarily on the individual caregiver and often excludes fathers and stepparents [Browne, 1986, Babatsikos, 2010]. Furthermore, there is a limited, somewhat linear understanding of the factors that may potentially influence caregivers' protective and preventive behaviors [Babatsikos, 2010, 1997]. Missing from the literature are examinations of the ways in which caregivers' behaviors relate across and within the various levels of a child's social ecology and how these behaviors relate to CSA risk and protection [Grzywacz, 2000, Swenson, 2006]. Examining caregiver vigilance from a social ecological perspective reflects the view that CSA is a complex, dynamic, and social phenomenon and that caregiver vigilance is not restricted to one caregiver [Richmond-Crum, 2003, Grzywacz, 2000]. Furthermore, a social ecology model promotes exploration of caregiver vigilance in multiple settings and via multiple caregiver roles [Swenson, 2006].

Methods: Situated within a social ecology framework, this instrumental case study will explore vigilance within the context of one child's caregiving cluster. The research questions are: How does vigilance around child sexual abuse exist within the caregiving cluster of a child's social ecology? What are the experiences of caregivers within a child's social ecology pertaining to vigilance around child sexual abuse? Initially, I will identify a child with a caregiving cluster which meets the inclusion criteria of having a minimum of six English-proficient adult caregivers living within a specified geographic area. The child must be able to communicate through drawn, written, and/or verbal communication about the names and places in their life. In collaboration with the child's primary caregiver, I will identify other caregivers in the child's social ecology; interacting directly with the child, we will ask the child to identify (through writing, drawing, and report) "the people who live at your house, the people who take care of you, the people who teach you." From this initial list of members of the child's caregiving cluster I will arrange with the primary caregiver access to the other potential participants. I will conduct individual, semi-structured interviews with at least two of the identified caregivers in the cluster, including at least one of the primary caregivers responsible for child's daily care and supervision. I will conduct a focus group composed of 4 to 8 caregivers from the caregiving cluster. Interview and focus group questions will be open-ended and centered on participant perceptions of CSA risk locations and situations for child, approaches to teaching child about safety, and perception of actions to take if concerned about child's safety or if child reported safety issue. I will conduct a minimum of two field observations of situations involving child-caregiver interactions, ideally in public settings (i.e., park, school ground, public event). A particular focus of the observations will be to identify safety and supervision messages and actions, physical contact/boundaries between the child and adults, and any other relevant behaviors or events.

Results: Data from the interviews, focus groups, and field observations will be analyzed using open and focused-coding, resulting in a descriptive thematic analysis. A social ecology framework will inform the interpretation of the data. Since these data represent the situation of one caregiving cluster, the interpretations and meanings will be presented as an instrumental case study.

Discussion/Conclusions: This exploratory instrumental case study of one child's caregiving cluster will provide an in-depth understanding of how caregiver vigilance against CSA exists across and within levels of a child's social ecology. This in-depth exploration of vigilance in one child's caregiving cluster will also serve as measure of feasibility of a larger, more in-depth research project involving the exploration of multiple caregiving clusters. Further explicating caregiver vigilance perspectives and practices may provide direction for the development of situation-specific interventions aimed and CSA prevention.

References:

1. Richmond-Crum, M., et al., Applying a public health approach: The role of state health departments in preventing maltreatment and fatalities of children. Child Welfare, 2003. 92(2): p. 99-109.

2. Felitti, V.J. and R.F. Anda, The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behavior: Implications for healthcare, in "The hidden epidemic: The impact of early life trauma on health and disease", R. Lumins and E. Vermetten, Editors. 2009, Cambridge University Press: Cambridge, England.

3. Browne, A. and D. Finkelhor, "Impact of child sexual abuse: A review of the research." Psychological Bulletin, 1986. 99(1): p. 66-77.

4. Felitti, V.J., et al., The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine, 1998. 14: p. 245-258.

5. Guastello, S.J., Vigilance phenomena, cognitive workload, and fatigue. American Psychologist, 2014. 69(1): p. 85-95.

6.Goodwillie, G., Protective vigilance: a parental strategy in caring for a child diagnosed with ADHD. Journal of Family Therapy, 2014. 36(3): p. 255-267.

7. Sallfors, C. and L.R. Hallberg, A parental perspective on living with a chronically ill child: a qualitative study. Families, Systems & Health: The Journal of Collaborative Family HealthCare, 2003. 21(2): p. 193-204.

8. Babatsikos, G., Parents' knowledge, attitudes and practices about preventing child sexual abuse: a literature review. Child Abuse Review, 2010. 19(2): p. 107-129.

9. Elrod, J.M. and R.H. Rubin, Parental involvement in sexual abuse prevention education. Child Abuse & Neglect, 1993. 17(4): p. 527-538.

10. Hanson, R.F., J.A. Lipovsky, and B.E. Saunders, Characteristics of fathers in incest families. Journal of Interpersonal Violence, 1994. 9: p. 155-169.

11. Price-Robertson, R., Child sexual abuse, masculinity and fatherhood. Journal of Family Studies, 2012. 18(2/3): p. 130-142.

12. Vandeven, A.M. and A.W. Newton, Update on child physical abuse, sexual abuse, and prevention. Curr Opin Pediatr, 2006. 18(2): p. 201-5.

13. Walsh, K. and L. Brandon, Their children's first educators: Parents' views about child sexual abuse prevention education. Journal of Child & Family Studies, 2012. 21(5): p. 734-746.

14. Practice parameters for the forensic evaluation of children and adolescents who may have been physically or sexually abused. AACAP Official Action. American Academy of Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry, 1997. 36(3): p. 423-42.

15. Berrick, J.D., Parental involvement in child abuse prevention training: what do they learn? Child Abuse and Neglect, 1988. 12(4): p. 543-53.

16. Campis, L.K., S. Prentice-Dunn, and R.D. Lyman, Coping appraisal and parents' intentions to inform their children about sexual abuse: A protection motivation theory analysis. Journal of Social and Clinical Psychology, 1989. 8(3): p. 304-316.

17. Grzywacz, J.G. and J. Fuqua, The social ecology of health: leverage points and linkages. Behavioral Medicine, 2000. 26(3): p. 101-115.

18. Swenson, C.C. and M. Chaffin, Beyond psychotherapy: Treating abused children by changing their social ecology. Aggression and Violent Behavior, 2006. 11(2): p. 120-137.

19. Belsky, J., Expanding the ecology of human development: An evolutionary perspective, in Examining lives in context: Perspectives on the ecology of human development , P. Moen, G.H. Elder, and K. Luscher, Editors. 1995, American Psychological Association: Washington, D.C. p. 545-561.

20. Bronfenbrenner, U., A constant frame of reference for sociometric research. Sociometry, 1943. 6: p. 363-397.

Description

43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.

Author Details

Kate K. Chappell, APRN, CPNP

Sigma Membership

Alpha Xi

Lead Author Affiliation

University of South Carolina, Columbia, South Carolina, USA

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Child Sexual Abuse, Caregiving Cluster, Social Ecology

Conference Name

43rd Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Las Vegas, Nevada, USA

Conference Year

2015

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Exploring adults' vigilance behaviors within a child's caregiving cluster

Las Vegas, Nevada, USA

Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015:

Introduction: Child sexual abuse has a significant and lasting impact on individuals and families [Richmond-Crum, 2003]. Children who experience sexual victimization are more likely to present adverse effects in childhood and adolescence, including Post-Traumatic Stress Disorder, substance abuse, and delinquent behavior [Felitti, 2009, Browne, 1986]. Child sexual abuse is an adverse childhood experience (ACE) associated with a higher incidence of certain adult health issues and behaviors, including depression, attempted suicide, cigarette smoking and illicit drug use [Felitti, 1998]. The negative impact on the long-term health of individuals and families is significant, given that CSA is, for the most part, a preventable phenomenon [Felitti, 2009]. Vigilance around CSA by adult caregivers for children is conceptualized as sustained purposeful attention and behavior to anticipate a child's safety and well-being needs [Guastello, 2014]. Vigilance as behavior does not refer only to recognizing and avoiding placing child in risky situations. Other child protective behaviors include teaching the child about avoidance of risky situations and how to respond if a threat or event occurs. Behaviors also include rules regarding safety and boundaries within a caregiving environment and what aspects of environments caregivers perceive as being protective that may decrease their drive for on-going vigilance. The extant research related to children's caregivers' vigilance focuses primarily on the individual caregiver and often excludes fathers and stepparents [Browne, 1986, Babatsikos, 2010]. Furthermore, there is a limited, somewhat linear understanding of the factors that may potentially influence caregivers' protective and preventive behaviors [Babatsikos, 2010, 1997]. Missing from the literature are examinations of the ways in which caregivers' behaviors relate across and within the various levels of a child's social ecology and how these behaviors relate to CSA risk and protection [Grzywacz, 2000, Swenson, 2006]. Examining caregiver vigilance from a social ecological perspective reflects the view that CSA is a complex, dynamic, and social phenomenon and that caregiver vigilance is not restricted to one caregiver [Richmond-Crum, 2003, Grzywacz, 2000]. Furthermore, a social ecology model promotes exploration of caregiver vigilance in multiple settings and via multiple caregiver roles [Swenson, 2006].

Methods: Situated within a social ecology framework, this instrumental case study will explore vigilance within the context of one child's caregiving cluster. The research questions are: How does vigilance around child sexual abuse exist within the caregiving cluster of a child's social ecology? What are the experiences of caregivers within a child's social ecology pertaining to vigilance around child sexual abuse? Initially, I will identify a child with a caregiving cluster which meets the inclusion criteria of having a minimum of six English-proficient adult caregivers living within a specified geographic area. The child must be able to communicate through drawn, written, and/or verbal communication about the names and places in their life. In collaboration with the child's primary caregiver, I will identify other caregivers in the child's social ecology; interacting directly with the child, we will ask the child to identify (through writing, drawing, and report) "the people who live at your house, the people who take care of you, the people who teach you." From this initial list of members of the child's caregiving cluster I will arrange with the primary caregiver access to the other potential participants. I will conduct individual, semi-structured interviews with at least two of the identified caregivers in the cluster, including at least one of the primary caregivers responsible for child's daily care and supervision. I will conduct a focus group composed of 4 to 8 caregivers from the caregiving cluster. Interview and focus group questions will be open-ended and centered on participant perceptions of CSA risk locations and situations for child, approaches to teaching child about safety, and perception of actions to take if concerned about child's safety or if child reported safety issue. I will conduct a minimum of two field observations of situations involving child-caregiver interactions, ideally in public settings (i.e., park, school ground, public event). A particular focus of the observations will be to identify safety and supervision messages and actions, physical contact/boundaries between the child and adults, and any other relevant behaviors or events.

Results: Data from the interviews, focus groups, and field observations will be analyzed using open and focused-coding, resulting in a descriptive thematic analysis. A social ecology framework will inform the interpretation of the data. Since these data represent the situation of one caregiving cluster, the interpretations and meanings will be presented as an instrumental case study.

Discussion/Conclusions: This exploratory instrumental case study of one child's caregiving cluster will provide an in-depth understanding of how caregiver vigilance against CSA exists across and within levels of a child's social ecology. This in-depth exploration of vigilance in one child's caregiving cluster will also serve as measure of feasibility of a larger, more in-depth research project involving the exploration of multiple caregiving clusters. Further explicating caregiver vigilance perspectives and practices may provide direction for the development of situation-specific interventions aimed and CSA prevention.

References:

1. Richmond-Crum, M., et al., Applying a public health approach: The role of state health departments in preventing maltreatment and fatalities of children. Child Welfare, 2003. 92(2): p. 99-109.

2. Felitti, V.J. and R.F. Anda, The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behavior: Implications for healthcare, in "The hidden epidemic: The impact of early life trauma on health and disease", R. Lumins and E. Vermetten, Editors. 2009, Cambridge University Press: Cambridge, England.

3. Browne, A. and D. Finkelhor, "Impact of child sexual abuse: A review of the research." Psychological Bulletin, 1986. 99(1): p. 66-77.

4. Felitti, V.J., et al., The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine, 1998. 14: p. 245-258.

5. Guastello, S.J., Vigilance phenomena, cognitive workload, and fatigue. American Psychologist, 2014. 69(1): p. 85-95.

6.Goodwillie, G., Protective vigilance: a parental strategy in caring for a child diagnosed with ADHD. Journal of Family Therapy, 2014. 36(3): p. 255-267.

7. Sallfors, C. and L.R. Hallberg, A parental perspective on living with a chronically ill child: a qualitative study. Families, Systems & Health: The Journal of Collaborative Family HealthCare, 2003. 21(2): p. 193-204.

8. Babatsikos, G., Parents' knowledge, attitudes and practices about preventing child sexual abuse: a literature review. Child Abuse Review, 2010. 19(2): p. 107-129.

9. Elrod, J.M. and R.H. Rubin, Parental involvement in sexual abuse prevention education. Child Abuse & Neglect, 1993. 17(4): p. 527-538.

10. Hanson, R.F., J.A. Lipovsky, and B.E. Saunders, Characteristics of fathers in incest families. Journal of Interpersonal Violence, 1994. 9: p. 155-169.

11. Price-Robertson, R., Child sexual abuse, masculinity and fatherhood. Journal of Family Studies, 2012. 18(2/3): p. 130-142.

12. Vandeven, A.M. and A.W. Newton, Update on child physical abuse, sexual abuse, and prevention. Curr Opin Pediatr, 2006. 18(2): p. 201-5.

13. Walsh, K. and L. Brandon, Their children's first educators: Parents' views about child sexual abuse prevention education. Journal of Child & Family Studies, 2012. 21(5): p. 734-746.

14. Practice parameters for the forensic evaluation of children and adolescents who may have been physically or sexually abused. AACAP Official Action. American Academy of Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry, 1997. 36(3): p. 423-42.

15. Berrick, J.D., Parental involvement in child abuse prevention training: what do they learn? Child Abuse and Neglect, 1988. 12(4): p. 543-53.

16. Campis, L.K., S. Prentice-Dunn, and R.D. Lyman, Coping appraisal and parents' intentions to inform their children about sexual abuse: A protection motivation theory analysis. Journal of Social and Clinical Psychology, 1989. 8(3): p. 304-316.

17. Grzywacz, J.G. and J. Fuqua, The social ecology of health: leverage points and linkages. Behavioral Medicine, 2000. 26(3): p. 101-115.

18. Swenson, C.C. and M. Chaffin, Beyond psychotherapy: Treating abused children by changing their social ecology. Aggression and Violent Behavior, 2006. 11(2): p. 120-137.

19. Belsky, J., Expanding the ecology of human development: An evolutionary perspective, in Examining lives in context: Perspectives on the ecology of human development , P. Moen, G.H. Elder, and K. Luscher, Editors. 1995, American Psychological Association: Washington, D.C. p. 545-561.

20. Bronfenbrenner, U., A constant frame of reference for sociometric research. Sociometry, 1943. 6: p. 363-397.