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Howard Dubowitz

Publications and source records attributed to Howard Dubowitz.

14 recordsLinked to original sources
PubMed2005

Suicidal ideation among 8-year-olds who are maltreated and at risk: findings from the LONGSCAN studies.

Suicidal ideation was examined among 1,051 8-year-old children identified as maltreated or at risk for maltreatment. Of these children, 9.9% reported suicidal ideation. Many variables, including maltreatment, had bivariate associations with suicidal ideation. Severity of physical abuse, chronicity of maltreatment, and the presence of multiple types of maltreatment strongly predicted suicidal ideation. In multivariate analyses of the domains of proximity, only ethnic background remained significant among demographic variables, only witnessed violence and maltreatment remained significant among family or contextual variables, and only child psychological distress, substance use, and poor social problem solving remained significant among child variables. The effects of ethnicity, maltreatment, and witnessed violence on suicidal ideation were mediated by child functioning. There were few interactions between maltreatment and other factors to predict suicidal ideation. Children who are maltreated and those exposed to community and domestic violence are at increased risk of suicidal ideation, even by age 8.

Child↗
PubMed2005

Examination of a conceptual model of child neglect.

This study attempted to provide empirical support for conceptual definitions of child neglect. We identified 12 types of needs, conceptualizing neglect as occurring when children's basic needs are not adequately met. We examined measures administered to 377 children and caregivers at ages 4 and 6 years participating in longitudinal studies on child mal-treatment to identify potential indicators of these needs. Indicators were found for latent constructs, operationalizing three of the basic needs (emotional support and/or affection, protection from family conflict and/or violence, and from community violence). These latent constructs were used in a measurement model; this supported the conceptual definitions of neglect. A structural equation model then assessed whether the latent constructs were associated with child adjustment at age 8 years. Low level of perceived support from mother was associated with internalizing and externalizing behavior problems. Exposure to family conflict was also linked to these problems, and to social difficulties. Finally, children's sense of experiencing little early affection was associated with subsequent externalizing behavior and social problems. The approach of conceptualizing neglect in terms of unmet child needs, developing a measurement model to define latent neglect constructs, and relating these constructs to subsequent adjustment can build our understanding of neglect.

Affect↗
PubMed2005

Family connections: a program for preventing child neglect.

Family Connections was a demonstration program specifically designed to prevent child neglect. This article describes the development of prevention strategies and the assessment of outcomes for families who received two versions of the intervention. The sample included 154 families (473 children) in a poor, urban neighborhood who met risk criteria for child neglect and who were randomly assigned to receive either a 3- or 9-month intervention. Self-report and observational data were analyzed using analyses of variance (ANOVA) with repeated measures. Results for the entire sample indicated positive changes in protective factors (parenting attitudes, parenting competence, social support); diminished risk factors (parental depressive symptoms, parenting stress, life stress); and improved child safety (physical and psychological care of children) and behavior (decreased externalizing and internalizing behavior). Results further reflected no advantage of the 9-month intervention for improving parenting adequacy. Further testing of the intervention with other target populations is being conducted.

Child↗
PubMed2004

Measurement of three major subtypes of child neglect.

This study examines the relationships among three major subtypes of neglect (physical, psychological, and environmental), a summary measure of neglect, and neglect as defined by Child Protective Services (CPS). The predictive validity of the subtypes of neglect assessed when children were 5 years of age was examined using children's behavior at age 6. Study findings include modest to moderate correlations among the neglect subtypes, CPS neglect, and children's behavior. After controlling for CPS neglect, the subtypes remained predictive of children's behavior. The set of three subtypes was more strongly related to children's behavior, particularly maternal report of internalizing problems, than was the summary neglect measure. These findings suggest that considering the subtypes of neglect may enhance our understanding of neglect and lead to interventions tailored to families' specific needs.

Adult↗
PubMed2003

Failure to thrive.

Failure to thrive is a condition commonly seen by primary care physicians. Prompt diagnosis and intervention are important for preventing malnutrition and developmental sequelae. Medical and social factors often contribute to failure to thrive. Either extreme of parental attention (neglect or hypervigilance) can lead to failure to thrive. About 25 percent of normal infants will shift to a lower growth percentile in the first two years of life and then follow that percentile; this should not be diagnosed as failure to thrive. Infants with Down syndrome, intrauterine growth retardation, or premature birth follow different growth patterns than normal infants. Many infants with failure to thrive are not identified unless careful attention is paid to plotting growth parameters at routine checkups. A thorough history is the best guide to establishing the etiology of the failure to thrive and directing further evaluation and management. All children with failure to thrive need additional calories for catch-up growth (typically 150 percent of the caloric requirement for their expected, not actual, weight). Few need laboratory evaluation. Hospitalization is rarely required and is indicated only for severe failure to thrive and for those whose safety is a concern. A multidisciplinary approach is recommended when failure to thrive persists despite intervention or when it is severe.

Child↗
PubMed2002

The neglect scale: confirmatory factor analyses in a low-income sample.

The Neglect Scale is an easy-to-administer, retrospective, self-report measure of neglect. Research conducted by Straus and colleagues with college students indicates that this scale has a high level of internal consistency reliability and moderate construct validity. The purpose of this article is to examine the reliability and validity of the Neglect Scale when used with a low-income, inner-city sample. The sample included 151 women who were participating in a neglect prevention demonstration project. The Neglect Scale was completed as part of a computer-administered baseline interview before services were provided. To assess whether the 20-item, four-factor structure reported by Straus et al. fit the data from this sample, a confirmatory factor analysis was performed; the model did not fit the data well. Additional analyses identified a model that did fit the data well and suggest that the Neglect Scale is a promising self-report measure.

Child↗
PubMed2002

Behavior problems among preschool children born to adolescent mothers: effects of maternal depression and perceptions of partner relationships.

Investigated how maternal depression influenced the relation between mothers' perceptions of the quality of their partner interactions and behavior problems among their preschool children. Participants included 194 low-income families from 4 sites. Approximately three fourths of the mothers (72%, n = 139) identified a male partner and comprised the analysis sample. Mothers were adolescents (< or = age 19) at delivery, and data were gathered when children were 4 to 5 years of age. In this high-risk sample, 42.4% of the children had been maltreated, 36% had externalizing scores in the clinical range, and 10.8% had internalizing scores in the clinical range. Multiple regression analyses revealed (a) maternal perceptions of negative partner interactions were associated with more internalizing behavior problems among the children, adjusting for the effects of maltreatment; (b) maternal depression mediated the relation between the maternal perceptions of the quality of partner interactions and children's internalizing and externalizing behavior problems; and (c) maternal perceptions of positive partner interactions did not protect children from internalizing or externalizing behavior problems associated with maltreatment. Programs for adolescent mothers should provide screening and treatment for depressive symptoms and help partners negotiate caregiving roles and mutually satisfying relationships.

Adolescent↗
PubMed2002

Behavior and development of preschool children born to adolescent mothers: risk and 3-generation households.

OBJECTIVE: To investigate whether living in a 3-generation household (grandmother-mother-child) is associated with fewer behavior problems and better cognitive development among preschool children of mothers who gave birth during adolescence and whether it protects children from the behavior and developmental problems associated with maltreatment and maternal depression. DESIGN: Cohort study. SETTING: Participants included low-income families recruited from 4 sites: East, Northwest, Midwest, and South, who are part of LONGSCAN, a longitudinal study of children's health, development, and maltreatment. PARTICIPANTS: One hundred ninety-four mothers who were adolescents (less than age 19) at delivery. Data were gathered when children were 4 to 5 years of age. Twenty-six percent of the children lived in 3-generation households, 39% had a history of maltreatment, and 32% of the mothers had depression scores in the clinical range. MAIN OUTCOME MEASURES: Child behavioral problems were measured with the Child Behavior Checklist, completed by the mother, and child developmental status was assessed with the Battelle Developmental Inventory Screening Test, administered by research assistants. RESULTS: Multiple regression analyses revealed that children who had been reported for maltreatment and had mothers with depressive symptoms had more externalizing behavior problems, compared with children who experienced neither risk or only 1 risk. However, when residential status was considered, children with the greatest number of externalizing behavior problems were those who experienced both maltreatment and maternal depressive symptoms and lived in 3-generation households. Children who had been reported for maltreatment or had mothers with depressive symptoms were more likely to have internalizing problems, compared with children with neither risk. Residential status was not related to children's internalizing behavior problems or cognitive development. CONCLUSIONS: Living in a 3-generation household did not protect preschool children from the behavior problems associated with maltreatment and depression. In contrast, living in a 3-generation household was associated with more behavior problems among the highest risk group of children--those who had been maltreated and had mothers with symptoms of depression. Although 3-generation families may provide an important source of support and stability for adolescent mothers and their infants early in the parenting process, it may not be advisable to rely on 3-generation households as young mothers enter adulthood, particularly among those with a history of maltreatment or depression. Children with the fewest number of behavior problems were living with their mothers in their own household (often with the father), had not been maltreated, and had mothers with few symptoms of depression.

Adolescent↗
PubMed2002

Child neglect: outcomes in high-risk urban preschoolers.

BACKGROUND: Limited longitudinal research has been conducted on the impact of neglect on children's health and well-being. There is a need to consider the impact of specific subtypes of neglect on children's functioning. In addition, there is interest in examining the cumulative effect of experiencing >1 subtype of neglect. OBJECTIVE: To examine the individual and cumulative relationships among physical, psychological, and environmental neglect and children's behavior and development at age 3, and the impact on changes in children's behavior and development between ages 3 and 5. METHODS: One hundred thirty-six children and their primary caregivers participating in a prospective longitudinal study of children's development and maltreatment were assessed when the children were aged 3 and 5 years. The children were recruited from primary care clinics because of failure to thrive, risk for human immunodeficiency virus, or as a comparison group. Evaluations were conducted in laboratory and home settings using observations, maternal self-report, and standardized testing of the children. Scores on physical, psychological, and environmental neglect were combined into a Cumulative Neglect Index. Regression analyses were run to examine the association of specific subtypes of neglect and of cumulative neglect with children's functioning at age 3, controlling for group, sociodemographic risk, and maternal depression. The analyses were repeated examining the impact on child outcomes at age 5, controlling for the above 3 variables as well as the children's cognitive development and behavior at age 3. RESULTS: Of the subtypes of neglect at age 3, only psychological neglect was significantly associated with increased internalizing and externalizing behavior problems at age 3; the Cumulative Neglect Index was associated with internalizing problems. None of the neglect subtypes or cumulative neglect were predictive of changes in children's behavior and development between ages 3 and 5. Cognitive development of the entire sample was impaired at age 5, averaging 0.85 standard deviations below the norm, and their average externalizing behavior score was significantly problematic with an average of 0.60 standard deviations above the norm. CONCLUSIONS: In the context of poverty where many preschool children have poor cognitive development and increased behavior problems, psychological neglect is significantly related to reported behavior problems. Children who experienced multiple types of neglect had increased internalizing problems. Neglect did not explain changes in children's behavior or development between ages 3 and 5. There is a need for pediatricians to identify and address child neglect, particularly psychological neglect, as early as possible. Pediatricians should also screen for maternal depression.

Adult↗
PubMed1987

Inflicted and noninflicted injuries: differences in child and familial characteristics.

Clinicians involved in child protection work are frequently confronted with decisions as to whether a child's injury is inflicted or accidental. This study examines child, parental, familial, and environmental characteristics in a group of 25 abused children compared to a group of 90 children with accidents. Significant differences and commonalities are discussed.

Accidents↗
PubMedDate not supplied

The involvement of low-income African American fathers in their children's lives, and the barriers they face.

OBJECTIVE: To examine the involvement of fathers in the lives of low-income African American 8-year-old children, and the barriers they face. METHODS: The sample was comprised of 117 fathers or father figures of 8-year-olds in families participating in a longitudinal study of child development and maltreatment. The men were asked a series of open-ended questions pertaining to their involvement in the children's lives. Their responses were audiotaped and transcribed. Major themes and subthemes were identified and coded on NVIVO software. RESULTS: The men conveyed a strong sense of commitment to the children, identifying many issues reported by white and middle class men, such as providing support and affection and teaching values and skills. They raised the need to protect the children and help take care of them when sick, some adding that they did not feel confident doing so. They saw discipline as one of their roles, but described this as difficult for them. The men faced challenges of not having financial resources, not living with the child, and lacking knowledge or skills. CONCLUSIONS: This group of fathers appears to be clearly committed to their children, despite significant challenges. There are a variety of ways that pediatricians can help facilitate their positive involvement in children's lives, and they may well contribute to the health and development of such high-risk children.

Adult↗