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Parenting support in the context of violence prevention
The document discusses the effects of adverse childhood experiences (ACEs) on long-term health outcomes, highlighting the significant correlation between ACEs and health-risk behaviors in adulthood. It emphasizes the importance of maternal health and nutrition during pregnancy and adolescence for child development, and outlines factors contributing to child maltreatment. Furthermore, it stresses the need for community-based prevention strategies and intervention programs to mitigate child maltreatment and improve overall childhood wellbeing.
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Parenting support in the context of violence prevention
- 1. Family & ParentingSupport in the Context of Violence Prevention Bernadette J. Madrid, MD University of the Philippines Manila and Child Protection Network Foundation
- 2. 5 year-old Jackson admitted for generalized weakness and possible child neglect
- 3. Critical Periods &Brain Plasticity • A critical period is a time during an organism’s life span when it is more sensitive to environmental influences or stimulation than at other times during its life.
- 4. ACEs HAVE MANYIMPACTS THROUGHOUT THE LIFESPAN Critical & Sensitive Dev’tal period ADVERSE CHILDHOOD EXPERIENCE MORE CATEGORIES – GREATER IMPACT Physical Abuse, Sexual Abuse, Neglect Witnessing Domestic Violence, Depression/Mental Illness in Home Incarcerated Family Member Substance Abuse in Home Loss of a Parent GENETICS Including gender – Remember that experience triggers gene expression (Epigentics) CHRONIC DISEASE PSYCHIATRIC ADAPTATION Hard-Wired Into Biology Brain Development Electrical, Chemical, Cellular Mass DISORDER IMPAIRED COGNITION WORK/ SCHOOL Attendance Behavior, Performance OBESITY ALCOHOL, TOBACCO, DRUGS RISKY SEX Carson & Porter, 2011 POVERTY CRIME INTERGENERATIONAL TRANSMISSION, DISPARITY
- 5. Adverse Childhood Experiencesand Health-Risk Behaviors Among Adults in a Developing Country Setting Laurie S. Ramiro, PhD, Bernadette J. Madrid, MD, David R. Brown, PhD Child Abuse & Neglect 2010; 34: 842-855
- 6. Categories of adverse childhood experiences, Number Percentage (n=1068) 0 26.8 1 24.7 2 18.8 3 13.8 4 or more 9.2 75% had at least one ACE Ramiro L, Madrid B, Brown D Child Abuse & Neglect 2010; 34: 842-855
- 7. Results of theMetro Manila ACE Study Those who were sexually abused are: • 12 times more likely to engage in early sex; • 9 times more likely to have early pregnancy; • 5 times more likely to commit suicide. Ramiro L, Madrid B, Brown D Child Abuse & Neglect 2010; 34: 842-855
- 8. Results of theMetro Manila ACE Study Individuals who felt that they were not loved during childhood are: • Twice as likely to smoke, use illicit drugs, have early sex and multiple sex partners • 5 times more likely to commit suicide. Ramiro L, Madrid B, Brown D Child Abuse & Neglect 2010; 34: 842-855
- 9. Strong graded responsebetween number of ACEs & poor health • Bronchitis/ emphysema • Asthma • Ischemic Heart Disease • Hypertension • Tuberculosis • Skin problems • UTI • Liver problems • GI problems- ulcers, constipation, indigestion • Depression Ramiro L, Madrid B, Brown D. Child Abuse & Neglect 2010; 34:842-855
- 10. Diseases Number ofdeaths Percentage 1. Diseases of the heart 100,908 21.0 2. Cerebro-vascular Many disease chronic diseases 56,670 in adults 11.8 3. Malignant neoplasm 47,732 9.9 4. Pneumonia are determined decades 42,642 earlier, 8.9 5. Tuberculosis by experiences in childhood 25,470 5.3 6. COPD 22,755 4.7 7. Diabetes 22,345 4.6 8. Nephritis, Nephrotic Syndrome 13,799 2.9 9. Assault 12,227 2.5 10. Certain conditions arising from perinatal 11,514 2.4 period Philippine National Statistics Office, 2009
- 12. Maternal and ChildHealth are Intertwined • The status of the mother such as stress, anxiety and depression has been shown to be associated with an increased risk of developing a wide variety of disorders in the offspring e.g. LBW, learning & memory • Maternal over-and under-nutrition has been associated with the onset of metabolic syndrome as well as autism and developmental delays.
- 13. Maternal and ChildHealth are Intertwined • Maternal iron and iodine deficiency affects the child’s cognitive development and later behavioral problems. • Iron deficiency affects learning & memory, motor development, language development, behavior problems including anxiety & depression • Best time to correct the iron and iodine deficiencies is during adolescence before the pregnancy.
- 14. Age/sex/ Physiologic StateNumber Prevalence (%) Philippines 22412 6 mos - < 1 yr 205 1-5 y 2279 6-12 y, M 2039 F 1830 13-19 y, M 1778 F 1488 Pregnant 1516 Lactating 891 19.5 55.7 20.9 20.4 19.2 10.4 18.2 42.5 31.4 Anemia prevalence by age, sex, and physiologic state: FNRI, 2008
- 15. Perinatal risk factorsfor infant maltreatment • Mother smoked during pregnancy • Families with 3 or more siblings • Maternal age less than 20 years • Births to unmarried mothers • Medicaid benficiaries (poverty) • Inadequate prenatal care Zhou Y, Hallisey E, Freymann G (2006) International Journal of Health Geographics 5:53
- 16. Adolescent Risk Factorsfor Child Maltreatment • Area characteristics • Family background/structure • Parent stressors • Exposure to family violence • Parent-child relationship • Education • Peer relationships • Adolescent stressors • Antisocial behaviours • Precocious transitions Thornberry, TP et. al., Child Abuse & Neglect 2013
- 17. Cumulative Risk •Long-term damage that occurs through the compounding of environmental, socioeconomic and behavioral exposures across the life-course.
- 18. Critical Periods •Note that the peak of plasticity for each sensitive period is staggered throughout development. • More-complex or multifaceted brain functions, especially those in humans, tend to reflect cumulative sensitive periods rather than one critical period -
- 19. Connected by 25:Improving the life chances of the country’s most vulnerable 14-24 year olds Disconnected youth: They have not acquired the skills needed to connect with the labor force and they have not established social support systems: 1. Those who do not complete high school. 2. Youth deeply involved in the juvenile justice system. 3. Young, unmarried mothers 4. Adolescents in foster homes Michael Wald & Tia Martinez 2003 Stanford University
- 20. Disconnected youth •Unless something is done they become either victims of trafficking, commercial sexual exploitation or incarcerated. • “These youth need major, major ongoing support in overcoming the sense of inadequacy, in acquiring job skills and education and in staying connected once change has started to occur.” Michael Wald & Tia Martinez 2003 Stanford University
- 21. Child Maltreatment PreventionReadiness in Low- and Middle-Income Countries Mikton, Mehra, Butchart, et al (2011) • Evidence-based interventions alone are not sufficient to prevent child maltreatment, other conditions must be met to bridge the “science-practice” gap.
- 22. 10 Dimensions ofthe Readiness Assessment for Child Maltreatment Prevention Mikton, Mehra, Butchart, et al (2011) 1. Attitudes toward child maltreatment & its prevention 2. Knowledge about child maltreatment & its prevention 3. Existence of scientific data on child maltreatment & its prevention in the country 4. Existing child maltreatment prevention programs; CMP components could be integrated; outcome evaluations
- 23. 10 Dimensions ofthe Readiness Assessment for Child Maltreatment Prevention Mikton, Mehra, Butchart, et al (2011) 5. Legislation, official mandates of government or NGOs, and policies relevant to CMP. 6. Will to address the problem 7. Institutional links & resources of institutions involved in CMP. 8. Material resources –funding, infrastructure, equipment
- 24. 10 Dimensions ofthe Readiness Assessment for Child Maltreatment Prevention Mikton, Mehra, Butchart, et al (2011) 9. Human and technical resources -mental health, social work 10. Informal social resources
- 25. 9. High Levelof Community Ownership 8. Confirmation / Expansion 7. Stabilization 6. Initiation STAGES OF COMMUNITY 5. Preparation READINESS 4. Preplanning 3. Vague Awareness 2. Denial / Resistance 1. No Awareness
- 26. Way to Go • Formation of a coalition of government agencies and NGO’s that will steer the country’s direction towards prevention of child maltreatment • National Prevalence Study on Child Maltreatment • Invest on a primary prevention program that is population-based; has been shown to work and can generate political support: Parenting Program
- 27. Kenrich, et al2010
- 28. Economies of Scale • Universal Health Care • Conditional Cash Transfers
- 29. Breakdown of sexualabuse cases by age 260 476 375 501 1147 675 83 '0-3 4-6 7-9 10-12 13-15 16-17 >18 Sexual abuse Child Sexual Abuse Cases (2012)
- 30. 70 60 50 40 30 20 10 0 Minor Perpetrator referred to Psychiatry 2 4 30 2003-2011 47 65 10 1 4 '0-3 4-6 7-9 10-12 13-15 16-17 >18 UV Age
- 32. Material situation MLau and J Bradshaw 2010 Child Indicators Research Vol. 3 No. 3, 367-383
- 33. Health M Lauand J Bradshaw 2010 Child Indicators Research Vol. 3 No. 3, 367-383
- 34. Education M Lauand J Bradshaw 2010 Child Indicators Research Vol. 3 No. 3, 367-383
- 35. Living environment MLau and J Bradshaw 2010 Child Indicators Research Vol. 3 No. 3, 367-383
- 36. Risk and safety M Lau and J Bradshaw 2010 Child Indicators Research Vol. 3 No. 3, 367-383
- 37. Subjective well-being MLau and J Bradshaw 2010 Child Indicators Research Vol. 3 No. 3, 367-383
- 38. Can Money buyhappiness?
- 39. High income improvesevaluation of life but not emotional well-being By Daniel Kahneman and Angus Deaton Center for Health & Well-Being Princeton University 2010 • When plotted against log income, life evaluation rises steadily. • Emotional well-being also rises with log income, but there is no further progress beyond an annual income of $75,000. • Low income exacerbates the emotional pain associated with misfortunes as divorce, ill health & being alone.
- 40. Can Money buyhappiness? High income improves evaluation of life but not emotional well-being Daniel Kahneman and Angus Deaton Center for Health & Well-Being Princeton University 2010 • Conclusion: High income buys life satisfaction but not happiness, and low income is associated with both low life evaluation and low emotional well-being.