Child maltreatment, i.e. physical and emotional abuse and neglect, sexual abuse and witnessing domestic violence, remains a major social problem across the world. Unfortunately, parents and children are often reluctant to seek help themselves. Therefore governments across the world nowadays strongly appeal to professionals who work with children and families to address suspected child abuse and neglect. To support professionals’ handling of suspected abuse or neglect, guidelines have been developed.
On the 7th of June, Annemieke Konijnendijk will defend her PhD thesis with the title "Fragile, please handle with care. Understanding and supporting professionals’ response to suspicions of child abuse and neglect" at the University of Twente. Prior to this promotion, the Academic Workshop for Youth Twente is organizing a mini symposium: "Child abuse; professional action", starting at 10 a.m..
The central question in the thesis was to what extent Dutch child-serving professionals, in particular preventive child healthcare professionals, follow guideline recommendations on the prevention of child abuse and neglect, and how can preventive child healthcare professionals be supported in following these recommendations.
Understanding guideline adherence
The results showed that variation exists in professionals’ performances of guideline activities: not all preventive child healthcare professionals perform all guideline activities in all of their suspected cases, and child-serving professionals vary in their preferences and experiences regarding seeking consultation from professionals outside their organisation.
Furthermore, poor recollection of the guideline, in other words, not thinking about using the guideline, was found to be a critical factor associated with lower overall guideline adherence. When taking a closer look at one guideline activity, i.e. in-house expert consultation, five factors were identified that facilitated professionals’ adherence: better recollection of consulting the in-house expert (i.e. not forgetting to consult the in-house expert), familiarity with consultation, having positive attitudes and beliefs about consultation, and being more susceptible to the behaviour and expectations/opinions of colleagues regarding in-house expert consultation. The study on inter-organisational consultation revealed that a majority of the participating professionals would seek inter-organisational consultation based on the situation of child maltreatment described in a vignette. Mainly facilitators to inter-organisational consultation were identified based on professionals’ experiences, including degree of support from a consultee, expected action from a consultee and the way respondents were regarded by consultees.
Supporting guideline adherence
Next to a better understanding of why professionals do or do not follow guidelines on preventing (on-going) child abuse and neglect, the findings of three studies performed in the preventive child healthcare setting provided concrete guidance for the development of an intervention to support child healthcare professionals’ guideline adherence. In particular, this intervention aimed to support preventive child healthcare professionals’ awareness and familiarity with the contents of the guideline, and to prevent them from forgetting to perform guideline activities. As use of the tool during the study period was low and guideline adherence rates were high in both study groups, no conclusions could be drawn about the effects of the tool on guideline adherence.
