Pediatric Grand Rounds (RECORDING) Neglected Children: A Role for Child Health Professionals

This presentation is a recording of a Stanford Pediatric Grand Rounds Session.  World-renowned experts will present the latest research, practice guidelines, and treatment protocols to advance best practices in the care of pediatric patients. These online recordings will provide pediatricians and family physicians with up-to-date clinical information on a wide range of clinical issues encountered in daily pediatric practice. 

This session covers the epidemiology of neglect, definitional dilemmas, the etiology and assessment of neglect, and suggestions for addressing the problem.

  Release Date: June 15, 2022
  Expiration Date: June 14, 2023
  Estimated Time to Complete: 1.0 hours 
  Registration Fee: FREE
 *Originally recorded 04/08/2022.

1. Identify why child neglect is an important problem.
2. Recognize risk and protective factors influencing neglect.
3. Recognize key issues for assessing and addressing neglect.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography

Barth, R. P., et al. (2021). Research to Consider While Effectively Re-Designing Child Welfare Services. Sage Journals. https://doi.org/10.1177/10497315211050000

Beckett, C., Maughan, B., Rutter, M., Castle, J., Colvert, E., Groothues, C., Kreppner, J., Stevens, S., O'connor, T. G., & Sonuga-Barke, E. J. (2006). Do the effects of early severe deprivation on cognition persist into early adolescence? Findings from the English and Romanian adoptees study. Child development, 77(3), 696–711. https://doi.org/10.1111/j.1467-8624.2006.00898.x

Center on Children, Families, and the Law. (2019). Nebraska IV-E Waiver Final Report. University of Nebraska-Lincoln. https://dhhs.ne.gov/Documents/Nebraska%20IV-E%20Waiver%20Final%20Report.pdf

Child Welfare Information Gateway. (2021). Child Maltreatment 2019: Summary of Key Findings. Children's Bureau. https://www.childwelfare.gov/pubpdfs/canstats.pdf

Department of Health and Human Services. (2021). Prevention Resource Guide. Administration for Children and Families. https://www.childwelfare.gov/pubPDFs/guide_2021.pdf

Dong, M., Giles, W. H., Felitti, V. J., Dube, S. R., Williams, J. E., Chapman, D. P., & Anda, R. F. (2004). Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation, 110(13), 1761–1766. https://doi.org/10.1161/01.CIR.0000143074.54995.7F

Dubowitz, H. et al. (1993). A Conceptual Definition of Child Neglect. Sage Journals; Criminal Justice & Behavior. https://doi.org/10.1177/0093854893020001003

Dubowitz, H. et al. (1998). Community and Professional Definitions of Child Neglect. Sage Journals; Child Maltreatment. https://doi.org/10.1177/1077559598003003003

Hines, D. A., Kantor, G. K., & Holt, M. K. (2006). Similarities in siblings' experiences of neglectful parenting behaviors. Child abuse & neglect, 30(6), 619–637. https://doi.org/10.1016/j.chiabu.2005.11.008

Hornby Zeller Associates. (2019). Arkansas IV-E Waiver Demonstration Project: Final Evaluation Report. Arkansas Department of Human Services; Division of Children and Family Services. https://humanservices.arkansas.gov/wp-content/uploads/AR_Waiver_Final_Evaluation_R eport.pdf

Kohl, P. L., Jonson-Reid, M., & Drake, B. (2009). Time to leave substantiation behind: findings from a national probability study. Child maltreatment, 14(1), 17–26. https://doi.org/10.1177/1077559508326030

Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: a causal review. Social science & medicine (1982), 128, 316–326. https://doi.org/10.1016/j.socscimed.2014.12.031

Rostad, W. L., Rogers, T. M., & Chaffin, M. J. (2017). The influence of concrete support on child welfare program engagement, progress, and recurrence. Children and youth services review, 72, 26–33. https://doi.org/10.1016/j.childyouth.2016.10.014

Rutter, M. (1998). Developmental catch-up, and deficit, following adoption after severe global early privation. English and Romanian Adoptees (ERA) Study Team. Journal of child psychology and psychiatry, and allied disciplines, 39(4), 465–476. https://pubmed.ncbi.nlm.nih.gov/9599775/

Sedlak, A. J. et al. (2010). Fourth National Incidence Study of Child Abuse and Neglect (NIS-4). U.S. Department of Health and Human Services. https://cap.law.harvard.edu/wp-content/uploads/2015/07/sedlaknis.pdf

Sege, R. D., & Harper Browne, C. (2017). Responding to ACEs With HOPE: Health Outcomes From Positive Experiences. Academic pediatrics, 17(7S), S79–S85. https://doi.org/10.1016/j.acap.2017.03.007

Sheridan, M. A., Fox, N. A., Zeanah, C. H., McLaughlin, K. A., & Nelson, C. A., 3rd (2012). Variation in neural development as a result of exposure to institutionalization early in childhood. Proceedings of the National Academy of Sciences of the United States of America, 109(32), 12927–12932. https://doi.org/10.1073/pnas.1200041109

Sonuga-Barke, E., Kennedy, M., Kumsta, R., Knights, N., Golm, D., Rutter, M., Maughan, B., Schlotz, W., & Kreppner, J. (2017). Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study. Lancet (London, England), 389(10078), 1539–1548. https://doi.org/10.1016/S0140-6736(17)30045-4

Strathearn, L., Giannotti, M., Mills, R., Kisely, S., Najman, J., & Abajobir, A. (2020). Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect. Pediatrics, 146(4), e20200438. https://doi.org/10.1542/peds.2020-0438

TriWest Group. (2019). Washington State IV-E Waiver Demonstration Project: Family Assessment Response Final Evaluation Report. Boulder, CO. https://www.dcyf.wa.gov/sites/default/files/pdf/reports/FAR_Final_Report_8.2019.pdf

UN General Assembly. (1989). Convention on the Rights of the Child. United Nations, Treaty Series, vol. 1577, p. 3. https://www.refworld.org/docid/3ae6b38f0.html

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Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Member Information

Role in activity

Nature of Relationship(s) / Name of Ineligible Company(s)

Alan R. Schroeder, MD
Clinical Professor
Stanford University

Co-Course Director and Reviewer

Nothing to disclose

Howard Dubowitz, MD, MS
Prof of Pediatrics
University of Maryland School of Medicine

Faculty

Nothing to disclose

Debra Babcock, MD
Stanford Childrens (PCHA)

Planner

Nothing to disclose

Caitlin Billingham, MD, MPH
Chief Resident
Stanford Pediatrics

Planner

Nothing to disclose

Lisa Jo Chamberlain, MD
Professor of Pediatrics – General Pediatrics
Stanford Children's Health

Planner

Nothing to disclose

Olivera Marsenic Couloures, MD
LPCH

Planner

Nothing to disclose

Lane Donnelly, MD
University of North Carolina

Planner

Nothing to disclose

Baraka Dechelle Floyd, MD
Clinical Assistant Professor and Associate Chair for Diversity, Equity, and Inclusion
Stanford University School of Medicine

Planner

Nothing to disclose

Ingrid Garnica, Other
Stanford Pediatrics

Planner

Nothing to disclose

Charles Gawad, MD, PhD
Associate Professor
Stanford

Planner

Ownership-BioSkryb Genomics

Allison Guerin, EdD
Stanford

Planner

Nothing to disclose

Mary Beth Leonard, MSCE, MD, MSCE
Arline and Pete Harman Professor and Chair, Department of Pediatrics
Stanford University

Planner

Nothing to disclose

Stephen J Roth, MPH, MD
Attending, Cardiovascular ICU
Lucile Packard Children's Hospital Stanford

Planner

Nothing to disclose

Sarina Tom, BA
Education Operations Manager
Stanford Pediatrics

Planner

Nothing to disclose

Ke-You Zhang, MD
Stanford University

Planner

Nothing to disclose