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Background: Childhood abuse is a serious public health issue, which puts the child population at risk of developing poor mental health in later life. Low socio-economic status is understood to be a common contributory factor associated with child abuse. However, it can be defined child abuse can be referred to as any act, regardless of background and class, that brings harm to a child through the potential caregiver (Spring, 2011).
The World Health Organization has defined child maltreatment as being: Write in your own words please
“All forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.” (Butchart, et al, 2006, p.59)
Furthermore, child abuse has been a serious issue for several years with many people finding the very notion of children being maltreated very difficult. Furthermore, child abuse is a substantial social problem, with over 8,395 cases reported in 2015 by the Statistics Portal (2015). This abuse has implications for the child, the family, and society itself. While personal and familial costs are more obvious, social expenses are potentially also detrimental, with a huge financial burden placed on the child welfare system. It requires vast amounts of time and money to identify, substantiate, and prosecute cases of abuse. Additional funding is required to remove and provide placements for abused children. However, as was made known by Caroline et al, (2012), most cases of child abuse are not reported – which makes it difficult to get an accurate estimate of those children that are going through one type of abuse or the other. Nevertheless, a report by the National Society for the Prevention of Cruelty to Children (NSPCC) indicates that about 16% of children in the United Kingdom suffer some form of abuse in their lifetime. Hibbert and Bradshaw (2001) also highlight the high prevalence of both physical and emotional abuse.
In addition, the World Health Organization (2002) has confirmed that the highest rates of fatal child abuse are found among children aged 0-4 years; and the most common cause of death is head injury, followed by abdominal injuries and intentional suffocation. Infants and young children who are small and in need of constant care are at risk of experiencing certain forms of maltreatment, such as being shaken by parents or caregivers, who may be frustrated or overwhelmed by persistent crying (American Psychology Association, 2016). Teenagers, on the other hand, are at greater risk of being sexually abused and undoubtedly, children with physical, cognitive and emotional disabilities or chronic illnesses may be at risk of abuse at some point in their life, in that they may experience maltreatment from a parent or caregiver. As a result of their child’s health predicament, a parent or caregiver of such a child are more likely to be stressed, depressed and angry (American Psychology Association, 2016).
Millions of children are victims of non-fatal abuse and neglect. Some studies, according to WHO (2002), indicate that between one-quarter and one-half of children report severe and frequent physical abuse, including being beaten, kicked, or tied up by parents. Available data also suggests that about 20 % of women and 5-10 % of men suffered sexual abuse as children.
Out of 15 European countries, Home Office figures show that Finland has the highest child homicide rate, Scotland has the second-highest rate, and Northern Ireland the fourth-highest, while England and Wales rank eighth in this list. Austria has the lowest rate – at 0.64 child homicides per 100,000 of the population (Home Office, 2010). Babies under the age of 12 months have the highest homicide rates of any age group in England and Wales, with a rate of 27 per million compared to 12 per million in the general population, as reported in 2008-9 (Home Office, 2010).
Policy analysts confirm that the UK ranks at the bottom of the league for measures aimed at ensuring child wellbeing, compared with other countries in Western Europe (UNICEF, 2007), and that children in Britain today have more challenging lives than previously (Layard and Dunn, 2009). However, while overall child wellbeing indicators for the UK compare unfavourably with other countries in Western Europe, indicators of child maltreatment used in international comparisons have been limited to homicidal rates, for which the UK is by no means performing the worst (Smith et al, 2010; UNICEF, 2003; UNICEF, 2007).
According to the National Society for the Prevention of Cruelty to Children (NSPCC, 2016), there are various different types of child abuse, including emotional abuse, physical abuse, bullying and cyberbullying, domestic abuse, child trafficking, female genital mutilation (FGM), child sexual exploitation and others.
There is a substantial amount of harsh punishment in the form of hitting, punching, kicking or beating, which occurs in homes and other institutions; but children are also subjected to psychological or emotional abuse as well as neglect – though the true extent of these problems are not known, and deaths might just be the tip of the iceberg in terms of this problem.
It has been established that there is a strong correlation between child abuse and family income. Researchers and policy makers have long recognized that children from low income families are 10 times more likely to be at risk of maltreatment, compared to children of higher social economic status (Cancia et al., 2010). Just as importantly, aggression, attention deficit issues, difficult temperaments, and behaviour problems in children may be directly linked with an increased risk of mal-treatment, especially when parents have low coping skills or are unable to empathize with the child or to control their own emotions (American Psychology Association, 2016). Maltreatment often ex-acerbates the problem, and a physically abused child may develop aggressive behaviours that lead to recurring maltreatment.
Research has also found that children living in the most deprived neighbourhoods have a greater chance of being on a child protection plan or being taken into care than children in the least deprived areas (Jutte et al., 2014). Sometimes the services they need just aren’t available, or they aren’t able to access them. This can put children at a higher risk of harm, and research has found that there are clear links between social isolation and child abuse or neglect (Jutte et al., 2014). Socio-economic status (SES), however, has been identified as a factor, and this is measured as a combination of education, income, and occupation. It is commonly conceptualized as the social standing or class of an individual or group. When viewed through such a class lens, privilege, power, and issues of control are emphasized. Furthermore, an examination of SES as a gradient or continuous variable reveals inequities in both the access to, and distribution of, resources. SES is relevant to all realms of behavioural and social science, including research, practice, education, and advocacy (American Psychological Association, 2016).
According to Schowengerdt (1996), research studies on child abuse report on such aspects as socio-economic levels; the characteristics of abuse; demographic factors; and assessment for detection of potential abusers. Characteristics of potential or actual abusers are frequently cited in relation to low socio-economic status. Yet at the same time, data indicates that child abuse has no socioeconomic boundaries. There is minimal data reported that would help nurses to identify potential child abusers from higher socioeconomic levels, and further study is needed to identify if there are any noticeable differences in the potential for child abuse as measured between parents of low socioeconomic status and parents of high socioeconomic status.
Spring (2011) indicated that single parent households are perceived to be particularly vulnerable to abuse, as a result of the high stress of raising a child alone as well as the lack of good income, com-pared to more affluent families. Also, children raised in a home with a step-parent are at a higher risk of abuse, according to spring (2011). Statistics show that children in this category are 40 times more likely to be abused than those who live with both biological parents.
The detrimental effect of child abuse can be both short-term and long term, and may result in psychological, emotional, mental, behavioural and physical effects. The latter may include head injury, neck and facial injury, damage to the torso, or death. The United States of America (USA, 2015) has also indicated that severe and repeated trauma may have an enduring effect on both neurobiological and psychological development, altering the stress response and adult patterns of behaviour considerably; this can include mood changes, anxiety and personality issues throughout adulthood.
Avanci, (2012), argued that childhood depression affects the morbidity, mortality and life functions of children. Individual, family and environmental factors have been documented as psychosocial risk factors in childhood depression, and family violence is a strong factor, leading as it does to in-adequate support, low family cohesion and poor communication. Avanci’s study investigates the association between psychosocial depression factors in low-income schoolchildren, and reveals the potential trouble spots, highlighting several different forms of violence that can take place within the family context.
A number of studies have explored the relationship between childhood trauma and later health concerns. Research has found that childhood abuse contributes to the likelihood of depression, anxiety disorders, addictions, personality disorders (Spila, Makara, Kozak, & Urbanska, 2008), eating dis-orders, sexual disorders, and suicidal behaviour (Draper et al., 2007). A study by Palmer, Brown, Rae-Grant, & Loughin (2001) with 384 survivors of childhood abuse, found that such survivors tended to be depressed, have low-self-esteem, and to have problems with family functioning as adults. A recent study found that almost 76% of adults reporting child physical abuse and neglect suffer from at least one psychiatric disorder in their lifetime; and nearly 50% have three or more psychiatric disorders (Harper et al., 2007). Adults with abuse histories also present with physical problems more frequently than those who have not experienced abuse (Draper et al., 2007). Furthermore, child sexual abuse has been found to be a key factor in youth homelessness, with 50-70% of young people within Supported Accommodation Assistance Programs having experienced child-hood sexual assault (van Loon & Kralik, 2005b). Research shows that children and adults with histories of child abuse often respond excessively to minor triggers. Traumatised children (and adult survivors) become increasingly responsive to relatively minor stimuli as a result of decreased frontal lobe functioning (learning and problem-solving) and increased limbic system (amygdala) sensitivity (impulsiveness) (Streeck-Fischer & van der Kolk, 2000).
It has been suggested that a framework of prevention strategies and services before abuse and neglect can occur need to be developed (Draper et al., 2007. alongside remedial strategies. Child abuse survivors, Draper suggests, demonstrate poor mental health outcomes and they are more likely to be depressed in later life, as well as being at risk of developing poor physical health. Draper stressed further that a child experiencing abuse, is at increased risk of medical diseases on reaching adult-hood including cardiovascular events in women. Survivors tend to face a higher risk of broken relationships and experience a lower chance of marriage in life. It is also recognized that abuse is associated with behavioural health effects, including increased likelihood of smoking, substance abuse, physical inactivity, and suicidal behaviour. The impact of child abuse does not end when the abuse stops, and the long-term effects can interfere with day-to-day functioning. However, it is still possible for a child abuse survivor to live a full and constructive life, and even thrive – to enjoy a feeling of wholeness, satisfaction and fulfilment in work, and genuine love and trust in relationships. Understanding the relationship between prior abuse and current behaviour is known to be the first step towards ‘recovery’.
Over two decades of research have demonstrated the potential negative impacts of child abuse and neglect on mental health, including: depression, anxiety disorders, poor self-esteem, aggressive behaviour, eating disorders, use of illicit drugs and alcohol abuse, post-traumatic stress disorder, sexual difficulties, self-harming behaviours, and personality disorders. Survivors are also more likely to commit crimes as juveniles and adults.
The Child Welfare Information Gateway (2013), argued that there is a significant body of ongoing research on the consequences of child abuse and neglect. The effects vary depending on the circumstances of the abuse or neglect, personal characteristics of the child, and the child’s environment. Consequences may be mild or severe; disappear after a short period or last a lifetime; and affect the child physically, psychologically, behaviourally, or in some combination of all these ways.
Understanding what drives child abuse is of key importance to academics interested in the process of lifecycle skill formation, and to policymakers concerned with intergenerational social mobility. A large body of research has documented the cognitive ability and socio-emotional deficits of low-income children
Ultimately, due to related costs to public entities such as those of health-care, human services, and educational systems, abuse and neglect of children impacts not only the child and family concerned, but society as a whole. Therefore, it is imperative for communities to provide a framework of prevention strategies and services, before abuse and neglect can occur, and to be prepared to offer re-mediation and treatment when necessary. Brown et al (2014) advised that prevention is central to the public health approach and takes place at three levels: primary, secondary and tertiary prevention. Primary prevention in this case includes initiatives targeted at the general population, which aim to stop child sexual or physical abuse from occurring in the first place. Secondary prevention initiatives also aim to stop abuse from occurring, but are targeted at specific groups who are known to be at greater risk. Tertiary level initiatives are used when sexual or physical abuse has already happened, and are targeted at groups including perpetrators, victims/survivors, families and communities (Smallbone at al, 2008; NSPCC, 2011). These initiatives aim to reduce the consequences of child abuse and to prevent it from reoccurring. They include services for victims / survivors of abuse, but can also include work aimed at helping abusers to manage their own behaviour and not offend again.
Primary prevention requires simultaneous effort on multiple levels to promote, and sustain, lasting social and behavioural change. Approaches are needed that recognize that child abuse is a wide-spread and harmful social practice that is reinforced every day by long-standing and problematic cultural beliefs and values. In response, the Safeguarding Children Research Initiative is an important element in the government response to the problem of child abuse, and its purpose is to provide a stronger evidence-base for the development of policy and practice to improve the protection of children in England. Three specific areas have been identified as requiring particular attention:
• Identification and initial response to abuse
• Elective interventions after abuse or its likelihood have been identified
• Elective inter-agency and inter-disciplinary working to safeguard children.
Aim: the main aim of this research is to explore the relationship between childhood abuse and low socio-economic status in the United Kingdom;
o The factors influencing child abuse
The effects of abuse on the victim’s health and well-being
The interventions which could be implemented to reduce child abuse
The objective study will include qualitative and quantitative.
Method: A search strategy will be developed to obtain literature related to studies in the English Language and performed in the United Kingdom, as far as is possible. There will be no restriction on study design. All studies included or excluded will be screened according to set criteria; only studies that meet the inclusion criteria will be reviewed.
This literature review will evaluate the findings of primary research articles. It would be difficult to gather articles directly relating to the relationship between child abuse and low income families in the UK alone, as these are few in number. However, the search will look at articles from across the United Kingdom, including Scotland, Wales, England and Northern Ireland. A literature review is a written evaluation of what is already known, and the existing knowledge on a topic, without a given methodology (Jesson et al, 2011). Literature reviews include a broad study and interpretation of literature relating to a particular topic (Aveyard, 2007). Jankowitz (2005) described this as a process of building on existing work with a focus on description, and bringing the work together in a critical way. This implies that literature reviews should be a description of literature relevant to a particular topic, with a logical structure and discussion of the key writers, and their theories and hypotheses, methods and methodologies.
The search for articles relating to the topic will entail working alongside the librarian, and was carried out by looking at journals, online databases, Google books, and the National Health Service website, used appropriately to collect useful information directly related to the chosen topic. The key words used would be child abuse, child maltreatment in UK, domestic abuse, health policy,. These key words are referred to as natural language words, and they enable the database to search for relevant record
The search approach will involve obtaining relevant information from: EBSCOhost, Medline, Swetwise, Social Care Online, psychology and behavioural science websites, Science Direct, PsycINFO, CHAHL, Oxford Journals, Cochran Library, key national government websites such as those for social workers, the Metropolitan Police website, the Home Office website, and Google.
The literature inclusion search will be limited to the years 2005 to 2015, in order to obtain the most recent studies, and to avoid outdated information. In addition, relevant literature review articles will be included that were published in English and which related to child abuse in order to meet the aims of the study. However, there was no study excluded based purely on its method, design, aim or recommended intervention.
The very serious issue of child abuse has been discussed in this proposal in terms of it’s the relation-ship with socioeconomic parameters as well as other environmental and familial circumstances. The various types of childhood abuse and their health and wellbeing impacts on adult survivors have also been discussed. It is worthy of note that although child abuse does occur across all social levels, it has been found to be more prevalent in low income areas. This fact, as part of the cause and effect nature of child abuse, has been highlighted, and the relevant interventions by the government and various organisations mentioned. It is clear that further study is needed in this area to more fully understand the relationship between child abuse and socio-economic factors, to shed more light on this major social problem.
Spring (2011) Family Violence
Schowengerdt RK (2009)
Greg et al,(2007), Understanding the relationship between parental income and multiple child outcomes: a decomposition analysis
Avanci J, Assis S, Oliveira R, Pires T (2012) Childhood Depression :Exploring the relationship between violence and psychological factor in low income children
World Health Organization (2002), Child Abuse and Neglect
Cancan M,Slack K and Yang M (2010),The Effect of Family Income on Risk of Child Maltreatment
National Society for the Prevention of Cruelty to Children (2016) Child Abuse
United Nations International Children’s Emergency Fund (UNICEF) (2007) Child poverty in perspective: an overview of child wellbeing in rich countries. Florence: Innocenti Research Centre www.unicef-icdc.org.
Home Office (2010). Recent data on homicides, rearm offences and domestic violence 2008–9 London: Home Office. Available at https://rds.homeof ce.gov.uk/rds/pdfS10/hosb0110hopla.xls.
Layard, R. and Dunn, J. (2009) A good childhood: searching for values in a competitive age. London: Children’s Society/Penguin.
Smith, K., Flatley, J., Coleman, K., Osborne, S. Kaiza, P. and Roe, S. (2010) Homicides, rearm offences and intimate violence. London: Home Of ce.
Adult Surviving Child Abuse (2015) Impact of Child Abuse
Cild Welfare Information Gateway (2013) Long-Term Consequences of Child Abuse and Neglect
Streeck-Fischer A1, van der Kolk BA (2000)Down will come baby, cradle and all: diagnostic and therapeutic implications of chronic trauma on child development.
Spilla B, Makara mKozak G and Urbanska A (2008) Abuse in Childhood and Mental Disorder in Adult Life
Van Loom A M&Kralik (2005) Facilitating Transition After Child Sexual Abuse, Royal District Nursing Service Foundation Research Unit. Centacare
Butchart,A., Putney, H., Furniss,T. and Kahane,T. (2006) Preventing child maltreatment: a guide to taking action and generating evidence. Geneva:World Health Organisation.
Brown A, Jago N, Kerr J, Nicholls C, Paskell C, Webster S (2014 )Call to keep children safe from sexual abuse: A study of the use and effects of the Stop it Now! UK and Ireland Helpline
Aveyard H (2010) Doing a Literature Review: in Health and Social Care open University press
Jankowitz A (2005) Business Research Projects 4th Edition Thompson
This should be a short summary of the procedures, your major findings and conclusions drawn from them in approx 150-250 words. It should not contain references; the reader will look for these in the main body of the report. A good abstract should contain four basic pieces of information:
• Why the work was done (found in the introduction)
• What was done exactly (an outline description of the methods used)
• What the results were (a summary of the main results)
• What the authors concluded from these results (a summary of the discussion and conclusions)
1.1 Introduction
This should contain a brief description of the aim(s) of the project, the approach and the background to the dissertation. It should set your work in an appropriate context, presenting the problem the dissertation has been designed to address.
1.2 Aim& Objectives
1.3 Hypothesis 1
1.4 Hypothesis 2
1.5 Hypothesis 3
1.6 Hypothesis 4
1.7 Objectives
Methodology- how you did your literature review, search terms, what you found, how many articles, inclusion and exclusion criteria, any issues of problems encountered
Literature Review
Outline the main resources /research papers you are focusing on & the provide an analysis and critique of these in a systematic, ordered way eg :use themes as headings or sub-headings .
This section should contain a concise description of method(s) used, together with sources of material. This should be written in sufficient detail so that the reader could repeat the process. It should not contain superfluous procedural details and any original methods should be described fully. Statistical methods used to analyse results should also be noted in this section.
Chapter 4 (532 WORDS)
Discussion and conclusions
This section should include processed (summary) data in the form of graphs or tables. These figures/tables should have titles and explanatory legends so that the results they contain may be understood without reference to the text. Legends to tables appear above the table; legends to figures appear below the figure. Ensure the format of all tables and figures are consistent. Resist the temptation to present the same results in more than one form. You must, however, write brief descriptions of your results in the text. You should include some indication of how the raw data has been processed. Unprocessed original results should not be in the main text.
Chapter 5 (661 WORDS)
In this section you should discuss and explain your results. This should be a discussion of how your results fit in with other findings and the significance of your results to your original hypothesis. In this type of project you can speculate more than would be acceptable in a published paper. You can also suggest further research which could be done if more time and resources were available or how this research could be developed.
Hypothesis 1
Hypothesis 2
Hypothesis 3
Hypothesis 4
Conclusion and Recommendations
Writer should make use of this book as part of reference
‘’Social Research Methods 5th Edition’’.

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