UBC Theses and Dissertations

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UBC Theses and Dissertations

Developmental set and child abuse Lindsay, Gail Margaret 1978

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DEVELOPMENTAL SET AND CHILD ABUSE by GAIL MARGARET LINDSAY BScN U n i v e r s i t y of Toronto 1975 THESIS SUBMITTED IN PARTIAL FULFILLMENT THE REQUIREMENTS FOR THE DEGREE OF MASTER -0F„ SCIENCE IN NURSING i n THE FACULTY OF GRADUATE STUDIES School of Nursing We accept t h i s t h e s i s as conforming to the re q u i r e d standard THE UNIVERSITY OF BRITISH COLUMBIA May 1978 (c) G a i l Margaret Lindsay, 1978 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of Brit ish Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the Head of my Department or by his representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of NURSING The University of Brit ish Columbia 2075 Wesbrook P l a c e Vancouver, Canada V6T 1W5 Date MAY 1, 1978 ABSTRACT C h i l d a b u s e h a s b e e n s t u d i e d f o r t h e p a s t t w e n t y y e a r s i n an a t t e m p t t o d e f i n e i t , d e l i n e a t e e t i o l o g y a n d s u g g e s t t r e a t m e n t m o d a l i t i e s . I n a d e q u a t e m e t h o d o l o g i c a l c o n t r o l s a nd t h e r a p e u t i c a s s u m p t i o n s i n c e s t u o u s l y s h a r e d h a v e r e s u l t e d i n a t h e o r y t h a t d e f i n e s p a r e n t s as b a d , s i c k o r i g n o r a n t b u t d e f i n i t e l y a s t h e c u l p r i t s . More r e c e n t l y , s o c i o l o g i c a l e x p l a n a t i o n s h a v e b e e n w r i t t e n t o p r e s e n t a p s y c h o s o c i a l m o d e l f o r a b u s e . The p u r p o s e o f t h i s s t u d y was t o e x p l o r e w h e t h e r a r e l a t i o n s h i p e x i s t s b e t w e e n c h i l d a b u s e a n d a m o t h e r ' s k n o w l e d g o f g r o w t h a n d d e v e l o p m e n t . Two g r o u p s o f s i n g l e p a r e n t , f e m a l e h e a d e d f a m i l i e s w e r e c h o s e n i n t h e c o m m u n i t y . T w e n t y - t h r e e m o t h e r s p a r t i c i p a t e d i n a t h i r t y c a r d g r o w t h and d e v e l o p m e n t s o r t , d e r i v e d by t h e a u t h o r f r o m a d e v e l o p m e n t a l p r o f i l e b y A l p e r n and B o l l ( 1 9 7 2 ) , i n d i c a t i n g t h e i r u n d e r s t a n d i n g o f when a c h i l d c o u l d f i r s t p e r f o r m t h e b e h a v i o r . The m o t h e r s w e r e a l s a s s i g n e d a number on an a b u s e c o n t i n u u m . The r e s u l t i n g d a t a a nd d e m o g r a p h i c i n f o r m a t i o n w e r e c o r r e l a t e d u s i n g a Spearman Rank O r d e r C o r r e l a t i o n C o e f f i c i e n t a n d C h i - S q u a r e d C o n t i n g e n c y a n a l y s i s a t t h e 0.05 l e v e l o f s i g n i f i c a n c e . No s i g n i f i c a n t r e l a t i o n s h i p was f o u n d b e t w e e n l e v e l o f a b u s e o r k n o w l e d g e o f g r o w t h and d e v e l o p m e n t . Some s i g n i f i c a n t a s s o c i a t i o n s w e r e f o u n d w i t h i n t h e d e m o g r a p h i c c h a r a c t e r i s t i c s , w i t h i m p l i c a t i o n s f o r s t u d y o f v a r i a b l e c l u s t e r s . ( T h e s i s C h a i r m a n ) i i TABLE OF CONTENTS PAGE ABSTRACT i TABLE OF CONTENTS i i CHAPTER I : INTRODUCTION . 1 PURPOSE 3 STATEMENT OF THE PROBLEM 3 HYPOTHESES 3 SIGNIFICANCE OF THE STUDY 4 VARIABLES 4 DEFINITIONS 5 LIMITATIONS 5 ASSUMPTIONS 6 DESIGN AND METHODOLOGY 6 DATA ANALYSIS 7 DEVELOPMENT OF REMAINING CHAPTERS . . . 7 CHAPTER I I : REVIEW AND CRITIQUE OF THE LITERATURE . 9 O v e r v i e w D e f i n i t i o n S o c i e t y The C h i l d P a r e n t - C h i l d I n t e r a c t i o n P a r e n t : S i c k / B a d P a r e n t : I g n o r a n t i i i PAGE CHAPTER I I I : RESEARCH DESIGN 25 S e t t i n g a n d S a m p l e S e l e c t i o n D a t a G a t h e r i n g I n s t r u m e n t I m p l e m e n t a t i o n P ILOT TESTING 32 CHAPTER I V : DATA ANALYSIS AND FINDINGS' 33 CHALLENGE TO THE HYPOTHESIS 34 ANALYSIS OF BEHAVIORAL STATEMENTS . . . . 40 CHAPTER V: DISCUSSION OF RESULTS 4 4 SUMMARY 45 CONCLUSIONS 4 6 IMPLICATIONS 4 6 N u r s i n g R e s e a r c h N u r s i n g E d u c a t i o n N u r s i n g P r a c t i c e RECOMMENDATIONS 4 9 APPENDICES: 52 I C a l c u l a t i o n o f t h e C - S t a t i s t i c I I G r o w t h a n d D e v e l o p m e n t I t e m s - T o o l I I I L e t t e r t o D r s . A l p e r n a n d B o l l I V R e s p o n s e f r o m D r . A l p e r n V D e m o g r a p h i c D a t a V I S t a n d a r d i z e d I n t r o d u c t i o n a n d I n s t r u c t i o n s i v V I I L e t t e r o f C o n s e n t V I I I Raw D a t a I X D e m o g r a p h i c D a t a o f P a r t i c i p a n t s i n t h e S t u d y X Raw D a t a o f F r e q u e n c y T a b u l a t i o n o f A b u s e L e v e l w i t h Age G r o u p f o r B e h a v i o r a l I t e m s LITERATURE CITED B o o k s J o u r n a l s M o n o g r a p h s :v L I S T OF TABLES PAGE TABLES 3.1 TEST-RETEST R E L I A B I L I T Y 27 4.1 PLUS OR MINUS DISTINCTION 34 4.2 SUMMARY OF DEMOGRAPHIC DATA 37 4.3 SUMMARY OF CHI-SQUARED ANALYSIS BETWEEN HIGH OR LOW LEVELS OF ABUSE AND DEMOGRAPHIC DATA 39 4.4 SUMMARY OF CHI-SQUARED ANALYSIS BETWEEN HIGH OR LOW DEGREE OF DISARRAY AND DEMOGRAPHIC DATA 3 9 4.5 FREQUENCY TABULATION OF ABUSE LEVEL VERSUS AGE GROUP FOR ITEM 2 6 4 0 4.6 FREQUENCY TABULATION OF ABUSE LEVEL VERSUS AGE GROUP FOR ITEM 2 7 41 4.7 FREQUENCY TABULATION OF ABUSE LEVEL VERSUS AGE GROUP FOR ITEM 2 8 41 4.8 FREQUENCY TABULATION OF ABUSE LEVEL VERSUS AGE GROUP FOR ITEM 2 9 42 4.9 FREQUENCY TABULATION OF ABUSE LEVEL VERSUS AGE GROUP FOR ITEM 3 0 42 v i L I S T OF FIGURES Page A SOCIAL-PSYCHOLOGICAL MODEL OF THE CAUSES OF CHILD ABUSE 1 2 GRAPH SHOWING RELATIONSHIP BETWEEN LEVEL OF ABUSE AND DEGREE OF DISARRAY 35 v i i THIS I S TO ACKNOWLEDGE AND THANK: JACK YENSEN a n d BETSY LASOR f o r t h e i r e n c o u r a g e m e n t a n d t e a c h i n g , MICHAEL CHANDLER a n d HARRY L E I B E R f o r s h a r i n g t h e i r i d e a s a n d r e s e a r c h , MOTHERS and STAFF a t t h e P r o j e c t a n d D a y c a r e f o r p a r t i c i p a t i n g i n t h e s t u d y , BOHDAN and ELA I N E who e n d u r e d , a n d JOY a n d KAY f o r t h e h o u r s o f t y p i n g . v i i i CHAPTER I INTRODUCTION C h i l d a b u s e b e g a n t o be r e c o g n i z e d and r e s e a r c h e d i n t h e e a r l y 1 960's a f t e r r a d i o l o g i s t s i n t h e 1 9 5 0 " s c a l l e d a t t e n t i o n t o r a d i o l o g i c a l e v i d e n c e o f t r a u m a t o c h i l d r e n ' s b o n e s o f u n d i a g n o s e d o r i g i n . I n t h e t w e n t y y e a r s s i n c e ' c h i l d b a t t e r i n g ' was c o i n e d , a g r e a t d e a l o f l i t e r a t u r e h a s b e e n w r i t t e n t o d e t a i l c h a r a c t e r i s t i c s o f p a r e n t s who a b u s e , t h e c h i l d - v i c t i m and s o c i e t a l norms f o r v i o l e n c e . R e s e a r c h h a s f o c u s e d on a v a r i e t y o f ways one c o u l d a p p r o a c h t h e p r o b l e m o f d e f i n i t i o n and e x p l a n a t i o n o f a b u s e , u s i n g a v a r i e t y o f c o n c e p t u a l f r a m e w o r k s b a s e d on t h e r e s e a r c h e r ' s p r o f e s s i o n a l o r i e n t a t i o n . The u s u a l a p p r o a c h h a s b e e n t o l a b e l one o r more f a c t o r s a s t h e g u i l t y p a r t y o r c a u s e o f a b u s e ; t h e n t o s u g g e s t p r e v e n t i v e and t r e a t m e n t p r i n c i p l e s b a s e d on t h e e t i o l o g i c a s s u m p t i o n s . The m o s t o b v i o u s and h e a v i l y r e s e a r c h e d c u l p r i t i s t h e p a r e n t o f t h e a b u s e d c h i l d , u s u a l l y t h e m o t h e r . R e a s o n s f o r a b u s e i n c l u d e : t h e p a r e n t h a s a p a t h o l o g i c a l p e r s o n a l i t y ( s i c k ) ; i s m a l e v o l e n t , ( b a d ) ; o r i g n o r a n t . The b a d / s i c k i n t e r p r e t a t i o n h a s d i r e c t e d p r o f e s s i o n a l s w i t h more o r l e s s s u c c e s s i n t r e a t m e n t p l a n n i n g f o r t h e l a s t t w e n t y y e a r s . T h i s a u t h o r h a s r e a d many s o u r c e s t h a t s t a t e d a s 1 2 t h e o r e t i c a l a n d c l i n i c a l t r u t h t h a t a b u s i v e p a r e n t s e x p e c t a c h i l d t o p e r f o r m a t a b e h a v i o r a l l e v e l t o o m a t u r e f o r t h e c h i l d ' s r e a l a b i l i t i e s . T h e s e u n r e a l i s t i c e x p e c t a t i o n s , i t f o l l o w s , c a n n o t be met by t h e c h i l d a nd b a t t e r i n g i s t h e r e s u l t . H o wever, i t h a s n o t b e e n i n v e s t i g a t e d w h e t h e r g r o w t h and d e v e l o p m e n t k n o w l e d g e i s known o r known d i f f e r e n t l y t o a b u s i v e and n o n - a b u s i v e p a r e n t s - i n d e e d , d o e s a n y o n e h a v e i n n a t e k n o w l e d g e o f c h i l d r e a r i n g e x p e c t a t i o n s ? The i s s u e o f p a r e n t a l i g n o r a n c e was a d d r e s s e d i n t h i s s t u d y . W h i l e n o t d i s c o u n t i n g l a r g e r s o c i a l p r o b l e m s and t h e i n f l u e n c e a c h i l d h a s i n h i s * own a b u s e , one c o u l d q u e s t i o n how a b u s i v e p a r e n t s l e a r n e d t o p a r e n t ; a r e t h e y l e s s i n t e l l i g e n t ( o r some o t h e r f a c t o r ) t h a n n o n - a b u s i v e p a r e n t s , o r do a b u s i v e p a r e n t s "know" g r o w t h a n d d e v e l o p m e n t c o g n i t i v e l y b u t b l o c k e m o t i o n a l l y f o r p s y c h o d y n a m i c r e a s o n s ? A r e a b u s i v e p a r e n t s , i n e f f e c t , more i g n o r a n t t h a n n o n - a b u s i v e p a r e n t s o f norms i n a c h i l d ' s g r o w t h a n d d e v e l o p m e n t ? The i s s u e o f w h i c h p a r e n t i s t h e a b u s e r was c o n s t r a i n e d by r e a l i t y i n t h i s s t u d y a s a c c e s s i b l e s u b j e c t s w e r e m o t h e r s . I t i s r e c o g n i z e d t h a t s i g n i f i c a n t m a l e f i g u r e s c a n e n a c t a r o l e o f a b u s e r , c o n d o n e r o r e n c o u r a g e r o f a b u s e , o r b y t h e i r a b s e n c e p o t e n t i a t e e n v i r o n m e n t a l s t r e s s e s . As m a l e i n v o l v e m e n t i s u s u a l , e v e n w i t h s i n g l e p a r e n t f e m a l e - h e a d e d h o u s e h o l d s , d a t a were c o l l e c t e d a s t o p r e s e n c e o f a m a l e f i g u r e . The s i g n i f i c a n c e o f s u c h m a l e i n f l u e n c e c a n o n l y be s p e c u l a t e d upon i n t h i s s t u d y . * I t i s a c k n o w l e d g e d by t h e a u t h o r t h a t h i s r e f e r s t o m a l e and f e m a l e c h i l d r e n . 3 T h e r e i s d i f f i c u l t y i n d e f i n i n g c h i l d a b u s e as no c o n s e n s u s h a s b e e n r e a c h e d i n t h e l i t e r a t u r e . The manner i n w h i c h t h e t e r m i s d e f i n e d l i m i t s who i s r e c o g n i z e d , t r e a t e d a n d s t u d i e d . A d e f i n i t i o n w o u l d seem t o i n c l u d e p h y s i c a l a n d e m o t i o n a l h u r t o f a c h i l d w h e t h e r b y a c t s o f o m i s s i o n o r c o m m i s s i o n . I n t h i s s t u d y on a b u s e , n e g l e c t , as a h u r t f u l a c t o f o m i s s i o n , i s c o n s i d e r e d p a r t o f t h e a b u s e c o n t i n u u m . PURPOSE I t i s t h e p u r p o s e o f t h i s r e s e a r c h p a p e r t o t e s t t h e t h e o r e t i c a l a s s u m p t i o n t h a t m o t h e r s who a b u s e , e x p e c t u n r e a l i s t i c a l l y m a t u r e b e h a v i o r f r o m t h e i r c h i l d ( r e n ) . I f , i n e x p l o r a t i o n , one f i n d s p a r e n t a l i g n o r a n c e c a n be c o r r e l a t e d w i t h a b u s e i n c h i l d r e a r i n g , r e m e d i a t i o n i s c l e a r , i n e x p e n s i v e , a n d removes t h e o n u s f r o m p a t h o l o g y . STATEMENT OF THE PROBLEM The p r o b l e m t o be s t u d i e d i s a s f o l l o w s : I s t h e r e a r e l a t i o n s h i p b e t w e e n a m o t h e r ' s d e v e l o p m e n t a l s e t a n d c h i l d a b u s e ? I n t h e c o n c e p t u a l f r a m e w o r k f o r t h i s s t u d y , k n o w l e d g e o f g r o w t h a nd d e v e l o p m e n t i s t h e m o t h e r s ' d e v e l o p m e n t a l s e t . HYPOTHESIS The n u l l h y p o t h e s i s f o r t h i s s t u d y i s ' T h e r e i s no s i g n i f i c a n t r e l a t i o n s h i p b e t w e e n a m o t h e r ' s d e v e l o p m e n t a l s e t and a b u s e o f h e r c h i l d ( r e n ) ' . 4 SIGNIFICANCE OF THE STUDY I t i s assumed a b u s i v e p a r e n t s e x p e c t u n r e a l i s t i c a l l y m a t u r e b e h a v i o r f r o m t h e i r c h i l d r e n . I f t h i s b a s i c a s s u m p t i o n c a n be c h a l l e n g e d , one c o u l d s p e c u l a t e t h a t more o f t h e e t i o l o g i c e x p l a n a t i o n s a r e i n n e e d o f e x a m i n a t i o n a n d , p o s s i b l y , r e f u t a t i o n . The q u e s t i o n o f why a b u s i v e p a r e n t s e x p e c t b e h a v i o r e a r l i e r n e e d s c l a r i f i c a t i o n t o s u p p o r t o r r e f u t e p r e s e n t t r e a t m e n t r a t i o n a l e a n d m o d a l i t i e s . I f one assumes a p a r e n t a b u s e s a s a l e a r n e d b e h a v i o r , one c o u l d u s e c o g n i t i v e i n f o r m a t i o n a n d b e h a v i o r t h e r a p y t o r e d u c e c h i l d a b u s e . ( G i l b e r t , 1976) I f one c o n c e p t u a l i z e s a b u s e a s e v i d e n c e o f s o c i e t a l d e c a y , t h e i n t e r v e n t i o n f o c u s w o u l d be v e r y d i f f e r e n t . The i m p o r t a n t f a c t o r t o n o t e i s t h a t r e s e a r c h e r s a n d h e a l t h c a r e w o r k e r s do n o t know why, o r e v e n i f , a b u s i v e p a r e n t s e x p e c t m a t u r e b e h a v i o r p r e m a t u r e l y . H owever, t r e a t m e n t i s b a s e d on s u c h an a s s u m p t i o n . T h i s i s one e x a m p l e o f how t h e o r y g u i d e s p r a c t i c e , h a s w i d e - t e a c h i n g e f f e c t s o n f a m i l i e s , a n d h a s n e v e r b e e n e m p i r i -c a l l y v a l i d a t e d . VARIABLES The v a r i a b l e s t o be c o r r e l a t e d a r e c h i l d a b u s e a nd d e v e l o p m e n t a l s e t . C o n f o u n d i n g v a r i a b l e s , r e c o g n i z e d a s s i g n i f i c a n t , w e r e e l i c i t e d on a d a t a s h e e t . M o t h e r ' s a g e , c h i l d r e n ' s age and s e x , 5 m o t h e r ' s l e v e l o f e d u c a t i o n , w h e t h e r o r n o t a s i g n i f i c a n t m a l e i s i n v o l v e d w i t h t h e m o t h e r a nd c h i l d r e n , a n d w h e t h e r o r n o t t h e m o t h e r i s e m p l o y e d w e r e i n c l u d e d . T h e r e a r e many o t h e r v a r i a b l e s t h a t may be i n f l u e n t i a l s u c h a s q u a l i t y o f p a r e n t i n g , t h e a b u s e d c h i l d ' s d e v e l o p m e n t a l h i s t o r y i n c o m p a r i s o n w i t h s i b l i n g s , o r s u p p o r t s f o r t h e f a m i l y o u t s i d e t h e home. T h i s d a t a i s d i f f i c u l t t o c a p t u r e , b u t a l s o b e y o n d t h e s c o p e o f t h i s s t u d y . DEFINITIONS D e f i n i t i o n s o f t h e k e y t e r m s a r e a s f o l l o w s : D e v e l o p m e n t a l S e t : a s m e a s u r e d b y t h e d e g r e e o f d i s a r r a y o f s c o r e s f o r d e v e l o p m e n t a l s e t b a s e d on m o t h e r s s e q u e n c i n g g r o w t h and d e v e l o p m e n t i t e m s i n s t a g e s p e r c e i v e d a s a p p r o p r i a t e f o r m a s t e r y by t h e c h i l d . C h i l d A b u s e : a s m e a s u r e d o n an a b u s e c o n t i n u u m i n t h e f o l l o w i n g o r d e r : 1. - N o n - a b u s i v e m o t h e r 2. - A t - r i s k o f a b u s e m o t h e r 3. - N e g l e c t f u l m o t h e r 4. - S u s p e c t e d o f a b u s e m o t h e r 5. - Known t o a b u s e m o t h e r LIMITATIONS 1) The s a m p l e was d e r i v e d f r o m two c o n v e n i e n t p o p u l a t i o n c l u s t e r s . 6 2) R e l i a b i l i t y may be l i m i t e d b y i t e m a m b i g u i t y i n t h e d a t a c o l l e c t i o n i n s t r u m e n t . 3) M e a s u r e m e n t o f t h e v a r i a b l e o f a b u s e was l i m i t e d due t o m o t h e r s b e i n g a s s i g n e d t o an a b u s e c o n t i n u u m two months b e f o r e d a t a c o l l e c t i o n w h i c h d o e s n o t t a k e i n t o a c c o u n t t h e d y n a m i c n a t u r e o f a b u s e . 4) The r e a l i t y o f t i m e , e n e r g y a n d p a t i e n t a c c e s s ( b o t h numbers a v a i l a b l e a n d w i l l i n g t o p a r t i c i p a t e ) c o n s t r a i n e d t h e s a m p l e s i z e o f t h i s s t u d y . ASSUMPTIONS 1) C h i l d a b u s e i s a phenomenon w i t h b r o a d a n d numerous e t i o l o g i c o r i g i n s . 2) C h i l d a b u s e i n c l u d e s e m o t i o n a l a s w e l l a s p h y s i c a l h u r t and d e p r i v a t i o n . 3) C h i l d r e n a n d s i g n i f i c a n t m a l e f i g u r e s h a v e a d e g r e e o f i n f l u e n c e i n a c h i l d a b u s e s i t u a t i o n . 4) M o t h e r s w i l l r e p o r t g r o w t h a n d d e v e l o p m e n t k n o w l e d g e a c c u r a t e l y a s t h e r e i s no g a i n o r l o s s t o s e l f o r c h i l d by m a n i p u l a t i n g t h e d a t a c o l l e c t i o n i n s t r u m e n t . DESIGN AND METHODOLOGY T h i s i s a. c o r r e l a t i o n a l s t u d y i n v o l v i n g n i n e m o t h e r s f r o m a D a y c a r e a n d f o u r t e e n m o t h e r s f r o m a P r o j e c t w i t h m e a s u r e s made on t h e two v a r i a b l e s o f d e v e l o p m e n t a l s e t and l e v e l o f 7 c h i l d a b u s e . E a c h m o t h e r t h a t p a r t i c i p a t e d s o r t e d t h i r t y c a r d s b a s e d on d e v e l o p m e n t a l i t e m s i n t o age g r o u p s t h a t t h e y p e r c e i v e d a p p r o p r i a t e f o r mastery by a c h i l d . DATA ANALYSIS E a c h o f t h e s o r t e d c a r d d e c k s was c o m p a r e d w i t h an i d e a l l i t e r a t u r e s o r t . The r e s u l t i n g g r i d was s u r v e y e d f o r s i g n i f i c a n t d i f f e r e n c e s b e t w e e n e a c h m o t h e r ' s s o r t a n d t h a t e x p e c t e d f o r i d e a l k n o w l e d g e . A c o m p o s i t e number r e p r e s e n t i n g t h e d e g r e e o f d i s a r r a y was c a l c u l a t e d . T h i s d i s t r i b u t i o n o f d i s a r r a y s c o r e s was c o r r e l a t e d w i t h t h e d i s t r i b u t i o n o f c o r r e s p o n d i n g m o t h e r ' s p o s i t i o n s o n a n a b u s e c o n t i n u u m . The r e s u l t s a r e p r e s e n t e d g r a p h i c a l l y a n d t h e o r i g i n a l h y p o t h e s i s c h a l l e n g e d u s i n g Spearman's Rank O r d e r C o r r e l a t i o n t e s t a t <=^-l e v e l 0.05 and a t w o - t a i l e d t e s t . R e l a t i o n s h i p s b e t w e e n d e v e l o p m e n t a l s e t a n d o t h e r d e m o g r a p h i c v a r i a b l e s w e r e t e s t e d by c h i s q u a r e d c o n t i n g e n c y a n a l y s i s a t l e v e l 0.05. DEVELOPMENT OF REMAINING CHAPTERS The f i r s t c h a p t e r p r e s e n t e d t h e p u r p o s e , t h e p r o b l e m and i t s , s i g n i f i c a n c e a n d a c o r r e l a t i o n a l h y p o t h e s i s f o r t h i s s t u d y . I t f u r t h e r o u t l i n e d t h e d e s i g n and m e t h o d o f a n a l y s i s c o n c e p t u a l i z e d f o r t h i s r e s e a r c h . T h e r e a r e f o u r r e m a i n i n g c h a p t e r s i n t h i s t h e s i s . C h a p t e r I I c o n t a i n s a s e l e c t e d c r i t i c a l r e v i e w o f t h e r e l e v a n t l i t e r a t u r e o r g a n i z e d t o s u b s t a n t i a t e t h e s i g n i f i c a n c e o f t h i s s t u d y . C h a p t e r I I I o u t l i n e s t h e r e s e a r c h d e s i g n i n c l u d i n g 8 m e t h o d o l o g y and p i l o t t e s t i n g . C h a p t e r I V p r e s e n t s t h e f i n d i n g s a n d d a t a a n a l y s i s i n c l u d i n g t a b l e s a nd g r a p h s . F i n a l l y , t h e f i f t h c h a p t e r p r e s e n t s t h e c o n c l u s i o n s a n d ^ d i s -c u s s e s t h e i m p l i c a t i o n s o f t h e f i n d i n g s f o r n u r s i n g p r a c t i c e , r e s e a r c h a nd e d u c a t i o n a n d o u t l i n e s r e c o m m e n d a t i o n s . CHAPTER I I REVIEW AND CRITIQUE OF THE LITERATURE O v e r v i e w R e c e n t e f f o r t s o n t h e p a r t o f s o c i a l s c i e n t i s t s , h e a l t h c a r e w o r k e r s a n d e d u c a t o r s a t t e m p t e d t o d e f i n e t h e phenomenon o f c h i l d a b u s e , e t i o l o g y , p r e v e n t i o n and t r e a t m e n t . Contempo-r a r y a u t h o r s w e r e c r i t i c a l o f t h e r e s e a r c h m e t h o d o l o g y a n d t h e i n c e s t u o u s s h a r i n g o f t h e r a p e u t i c a s s u m p t i o n s i n e a r l i e r a r t i c l e s . The r e s u l t i n g s c o p e o f l i t e r a r y m a t e r i a l i n c l u d e d d o c u m e n t a t i o n a n d s p e c u l a t i o n r e l a t e d t o how s o c i e t y , t h e c h i l d , and p a r e n t i n t e r a c t t o p r o d u c e a phenomenon c a l l e d ' c h i l d a b u s e ' . W i t h o u t d i s c o u n t i n g t h e i s s u e s o f s o c i e t y and t h e c h i l d ' s i n p u t , a p a r e n t - c e n t e r e d c r i t i q u e o f t h e l i t e r a t u r e on why p a r e n t s a b u s e was p r e s e n t e d . The a n s w e r t o t h e q u e s t i o n o f why p a r e n t s a b u s e c o u l d be one o r a l l o f t h r e e p o s s i b i l i t i e s : b e c a u s e t h e p a r e n t i s s i c k , b a d o r i g n o r a n t . I t was t h i s a u t h o r ' s i n t e n t t o a d d r e s s t h e i s s u e o f p o s s i b l e i g n o r a n c e on t h e p a r t o f a b u s e p a r e n t s o f r e a s o n a b l e c h i l d - r e a r i n g s t r a t e g i e s i n g e n e r a l and d e v e l o p m e n t a l norms i n p a r t i c u l a r . D e f i n i t i o n The i s s u e o f d e f i n i n g a b u s e h a s not b e e n r e s o l v e d . M o s t 9 10 a u t h o r s c h o o s e a n a r r o w d e f i n i t i o n u s i n g p h y s i c a l harm a s a c r i t e r i o n a n d do n o t i n c l u d e t h e a m o r p h o r o u s c r i t e r i o n o f e m o t i o n a l a b u s e , (as i n E l m e r , 1 9 6 7 : 1 ; S t e i n h a u e r e t a l . , 1 9 7 7 : 3 6 1 ) . As d e f i n i t i o n l i m i t s who i s l a b e l e d , t r e a t e d a n d r e s e a r c h e d , t h e d i l e m m a c o n t i n u e s . As G e l l e s ( u n d a t e d p u b l i -c a t i o n ) o u t l i n e s , t h e r e i s a r o u n d i n g e r r o r w h e r e i n " a g e n c i e s a r e g o i n g t o n o t o n l y d i s c o v e r c a s e s o f c h i l d a b u s e , t h e y a r e a l s o g o i n g t o h a v e a number o f f a l s e p o s i t i v e s ( c a s e s l a b e l e d a b u s e w h i c h a r e n o t ) and f a l s e n e g a t i v e s ( c a s e s n o t l a b e l e d a b u s e w h i c h a r e ) . " (17) The i m p l i c a t i o n s o f t h e s e e r r o r s i n c l u d e w a s t e d r e s o u r c e s on f a m i l i e s n o t i n n e e d o f c h i l d a b u s e s e r v i c e s a n d e m b a r r a s s m e n t f o r some o t h e r f a m i l i e s a t b e i n g f a l s e l y i d e n t i f i e d . S o c i e t y L i t e r a t u r e o n s o c i e t y a s a f a c t o r i n c h i l d a b u s e w i l l be d i s c u s s e d a t t h i s p o i n t . A r t i c l e s v a r y i n c o n t e n t f r o m e x h o r t i n g p e o p l e t o l o o k a t t h e i r own p o t e n t i a l f o r v i o l e n c e (Wasserman, 1974) t o d o c u m e n t i n g v i o l e n c e a s p a r t o f e v e r y d a y l i f e . ( " I n d e ed, m o s t A m e r i c a n s s e e a m o r a l o b l i g a t i o n f o r p a r e n t s t o u s e p h y s i c a l p u n i s h m e n t as a means o f c o n t r o l l i n g c h i l d r e n . " S t e i n m e t z e t a l . , 1974:3.) T h i s l a t t e r p o i n t was f u l l y d e v e l o p e d i n t o s o c i o c u l t u r a l m o d e l s t o e x p l a i n t h e f o r c e s i n v o l v e d i n a b u s e . An i m p o r t a n t f e a t u r e o f t h e s e m o d e l s i s t h a t p r e d i c t i o n s f o r a b u s e c a n be e x t r a p o l a t e d w i t h i m p l i c a t i o n s f o r c u l t u r e , f a m i l y , t r e a t m e n t a g e n c i e s a n d g o v e r n m e n t . G e l l e s (1973) 11 h a s p r e p a r e d a s o c i a l p s y c h o l o g i c a l m o d e l i n t e g r a t i n g b o t h t h e i n t r a p e r s o n a l a n d t h e s o c i e t a l c a u s e s o f a b u s e . He i s c r i t i c a l o f i n t e r v e n t i o n b a s e d on b a n d - a i d s a n d b l a m i n g p a r e n t s . The f r a m e w o r k p r o p o s e d c a n be d e m o n s t r a t e d g r a p h i -c a l l y . FIGURE 2.1 A SOCIAL-PSYCHOLOGICAL MODEL OF THE CAUSES OF CHILD ABUSE (Gelles, 1973:619) Socialization experience Abuse Role Model of Violence Aggression Psychopathic States Personality Traits Character Traits Poor Control Neurological Disorders Social Position of Parent Age Sex Socioeconomic Status Situational Stress A. Relations Between Parents 1. Intermarriage 2. Marital disputes Structural Stress 1. Excess children 2. Unemployment 3. Social isolation 4. Threats to parental authority, values, self-esteem Child Produced Stress 1. Unwanted child 2. Problem child a) colicky b) incontinent c) discipline problem d) i l l e) physically deformed f) retarded Class & Community —^ Values & norms regarding violence "Subculture of violence." Immediate precipitating situations Child misbehaves, Argument, etc. Child Abuse 1. Single physical assault Repeated assaults Psychological violence, ie. verbal attack. 13 D a v i d G i l , (1971) u s e d a s i m i l a r s o c i o c u l t u r a l p e r s -p e c t i v e t o l i s t n e c e s s a r y c h a n g e s i n s o c i e t y a s i n c l u d i n g e d u c a t i o n t o remove p h y s i c a l f o r c e a s a d i s c i p l i n e m e a s u r e , e l i m i n a t i o n o f p o v e r t y , f a m i l y p l a n n i n g p r o g r a m s i n c l u d i n g l e g a l a b o r t i o n s , f a m i l y l i f e e d u c a t i o n f o r a d o l e s c e n t s , a n d n e i g h b o u r h o o d - b a s e d s o c i a l s e r v i c e s . ( G i l , 1 9 7 4 : 1 6 7 - 1 6 9 ) . G i l (1971) u s e d n a t i o n - w i d e s u r v e y s on c h i l d a b u s e , c a s e s t u d i e s and m e d i a s u r v e y s a s d a t a s o u r c e s . H o w e v e r , t h e s e s o u r c e s do n o t a c c u r a t e l y r e p r e s e n t t h e a b u s i v e v e r s u s n o n -a b u s i v e p o p u l a t i o n . The N a t i o n a l I n s t i t u t e o f M e n t a l H e a l t h (1977) s p e a k s t o t h i s b a s i c m e t h o d o l o g i c a l e r r o r . R e s e a r c h h a s t e n d e d t o o v e r r e p r e s e n t l o w s o c i o e c o n o m i c g r o u p s w i t h l o w i n c o m e , unemployment o r l o w - s k i l l j o b s , f e m a l e - h e a d e d s i n g l e - p a r e n t h o u s e h o l d s , y o u n g a t t i m e o f m a r r i a g e and b i r t h o f f i r s t c h i l d . T h e s e c o h o r t c h a r a c t e r i s t i c s t e n d t o be s e e n a s c a u s a l f a c t o r s i n a b u s e . The e r r o r o c c u r s i n t h a t t h e r e s e a r c h c o m p a r i s o n g r o u p s a r e n a t i o n a l a v e r a g e s i n s t e a d o f b e i n g f r o m t h e g e n e r a l p o p u l a t i o n o f t h e l o w s o c i o e c o n o m i c g r o u p . (131-136) T h i s e r r o r was w e l l d o c u m e n t e d i n a s t u d y by P a u l s o n , e t a l . , ( 1 9 7 4 ) . F o u r p s y c h o l o g i s t s s t u d i e d g r o u p s o f p a r e n t s u s i n g t h e M.M.P.I. ( M i n n e s o t a M u l t i p h a s i c P e r s o n a l i t y I n v e n t o r y ) as a t o o l a nd c o n c l u d e d t h e r e a r e d i f f e r e n c e s i n r e f e r e n c e t o i n t e r p e r s o n a l i s o l a t i o n a nd i n c r e a s e d i m p u l s e p o t e n t i a l b e t w e e n a b u s i v e a n d n o n - a b u s i v e p a r e n t s . The p r o b l e m was t h a t t h e a b u s i v e p a r e n t s w e r e drawn f r o m a Trauma I n t e r v e n t i o n C e n t e r 14 w h i l e t h e n o n - a b u s i v e w e r e s e l e c t e d f r o m a c h i l d p s y c h i a t r y o u t - p a t i e n t d e p a r t m e n t . The g r o u p s w e r e n o t m a t c h e d s o c i o -e c o n o m i c a l l y a n d a r e i n v a l i d f o r c o m p a r i s o n . E l a n g e r ( 1 9 7 4 ) , r e s e a r c h e d t h e d i f f e r e n t s o c i a l c l a s s e s i n t h e i r u s e o f p h y s i c a l p u n i s h m e n t a n d f o u n d t h a t " v a r i a t i o n w i t h i n s o c i a l c l a s s e s ( t a k i n g i n t o a c c o u n t r a c e , s e x o f t h e c h i l d a n d p a r e n t e t c . ) i s a t l e a s t a s i m p o r t a n t a s d i f f e r e n c e b e t w e e n c l a s s e s " . (8) T h i s f i n d i n g d i r e c t e d t h i s i n v e s t i g a t o r t o n o t o n l y h a v e a s i m i l a r s o c i o e c o n o m i c l e v e l i n a c o m p a r i s o n g r o u p b u t a l s o t o e l i c i t v a r i a b l e s s u c h a s a g e , s e x , e d u c a t i o n and e m p l o y m e n t o f p a r e n t s . G e l l e s ( u n d a t e d p u b l i c a t i o n ) c i t e d t h e f a c t t h a t com-m u n i t y a g e n c i e s l a b e l i n j u r e d c h i l d r e n o f m i d d l e t o h i g h s o c i o e c o n o m i c s t a t u s a s " a c c i d e n t v i c t i m s " w h i l e t h o s e o f l o w e r c l a s s e s a r e s e e n a s " a b u s e d " . (12) E l i z a b e t h E l m e r (1977) c o m p a r e d s e v e n t e e n a b u s e d c h i l d r e n w i t h s e v e n t e e n c h i l d r e n who h a d b e e n i n a c c i d e n t s i n a f o l l o w - u p s t u d y a n d f o u n d t h a t b e i n g i n a l o w s o c i o e c o n o m i c g r o u p was a s d a m a g i n g as a b u s e . (273) One c o u l d q u e s t i o n t h e d i s t i n c t i o n b e t w e e n i n j u r y a n d a b u s e i n t h e s t u d y a s t h e c h i l d r e n who w e r e " i n j u r e d " i n u n s u p e r v i s e d p l a y may be v i c t i m s o f a f o r m o f n e g l e c t . A n o t h e r p o i n t t o c o n s i d e r i s t h a t w h a t E l m e r a l s o m e a s u r e d was t h e d i f f e r e n c e b e t w e e n b e i n g h u r t by a p a r e n t i n g f i g u r e a s a p p o s e d t o an i n a n i m a t e o b j e c t . The c o n s e q u e n c e o f t h a t d i f f e r e n c e was n o t m e n t i o n e d o r e x p l o r e d . I n e x a m i n i n g t h e c y c l e o f a s s e s s m e n t , d i a g n o s i s , t r e a t -ment and e v a l u a t i o n , one c a n s e e f r o m t h e l i t e r a t u r e on s o c i e t a l f a c t o r s how m y t h s o f l o w c l a s s , f e m a l e c a u s e d a b u s e c o n t i n u e . The v a s t number o f v a r i a b l e s b u i l t i n t o s o c i o c u l t u r a l m o d e l s f i n a l l y make an a t t e m p t t o d e c l a s s i f y a b u s e and e n h a n c e u n d e r -s t a n d i n g o f w h a t l a r g e s c a l e c h a n g e s a r e n e c e s s a r y . The C h i l d C h i l d a b u s e c a n be e x a m i n e d f r o m t h e p e r s p e c t i v e o f how t h e c h i l d i n v i t e s t h e a b u s e . B a k a n ( 1 9 7 1 ) , B e l l ( 1 9 7 1 ) , E l m e r ( 1 9 6 7 ) , F r e i d r i c h a n d B o r i s k i n ( 1 9 7 6 ) , H a r p e r ( 1 9 7 1 ) , S a m e r o f f a n d C h a n d l e r ( 1 9 7 5 ) , S t e i n h a u e r a n d R a e - G r a n t (1977) e a c h d i s c u s s t h e r o l e o f t h e c h i l d i n a b u s e a s p o t e n t i a t e d i f t h e c h i l d was p r e m a t u r e , h a n d i c a p p e d , o r t h e "wrong" s e x o r p e r s o n a l i t y t y p e . M a r t i n ( e t a l , 1974) d i s c u s s e d t h e v u l n e r a b l e c h i l d a s n o t r e i n f o r c i n g n o r m a l p a r e n t i n g o r e l i c i t i n g n o r m a l p a r e n t i n g b e h a v i o u r w i t h s m i l e s , " a b s e n c e o f d e f e c t s a n d m a t c h i n g o f p a r e n t s ' e x p e c t a t i o n s " . (63-64) M i l o w e a n d L o u r i e (1964) e x p l o r e d t h e r e l a t i o n s h i p s o f c h i l d r e n who h a v e l e a r n e d t o e q u a t e l o v i n g w i t h b e i n g h u r t and a r e r e - b a t t e r e d by f o s t e r p a r e n t s when r e m o v e d t o f o s t e r homes. To m a i n t a i n p e r s p e c t i v e on t h e c h i l d r e n b e i n g d i s c u s s e d , one s h o u l d n o t e t h a t G a l d s t o n (1965) d e s c r i b e d t h e c h i l d r e n i n h i s s t u d y a s " r a n g i n g i n age f r o m t h r e e m onths t o t h r e e a n d one-h a l f y e a r s w i t h t h e l a r g e s t g r o u p b e t w e e n s i x and e i g h t e e n m onths o f a g e " . (440) . S t e e l e and P o l l a c k (1974) d e s c r i b e m o s t a b u s e a s o c c u r r i n g b e t w e e n b i r t h a n d f o u r y e a r s o f a g e ; o l d e r c h i l d r e n a r e u s u a l l y i n v o l v e d i n s e x u a l a b u s e . (90) 16 T h i s m a t e r i a l p r e s e n t s f a c t o r s i n a b u s e t o be a ware o f b u t w i l l n o t be f u r t h e r e x p l o r e d i n t h i s p a p e r . P a r e n t - C h i l d I n t e r a c t i o n P a r e n t - c h i l d i n t e r a c t i o n i s a f a c t o r t o n o t e when d i s c u s s i n g c h i l d a b u s e . E x a m p l e s o f i n t e r a c t i o n t h a t r e s u l t i n a b u s e i n c l u d e p a r e n t s o b s e s s i v e l y d e m a n d i n g n e a t n e s s f r o m an e x p l o r i n g two y e a r o l d ( S m i t h a n d H a n s o n , 1 9 7 5 ) ; s i b l i n g r i v a l r y t h a t l a b e l s one c h i l d a s f a m i l y s c a p e g o a t ( R o l l i n s e t a l . , 1 9 7 3 ) ; o r s p o u s e s d e a l i n g w i t h c o n f l i c t by a c t i n g o u t t h e i r f e e l i n g s upon t h e c h i l d ( S t e e l e a n d P o l l a c k , 1 9 7 4 ) . E l i z a b e t h E l m e r (1967) c o n c e p t u a l i z e d a b u s e as a p r o c e s s i n c l u d i n g t h e a b u s e r , a b u s e e and c o m p l i a n t a d u l t . (27) T h i s w o u l d s u g g e s t t h a t t h e c h i l d i s a n i n t e g r a l p a r t o f t h e f a m i l y t r i a n g l e (Bowen, 1976) t h r o u g h w h i c h f e e l i n g s a n d l e v e l o f d i f f e r e n t i a t i o n a r e e x p r e s s e d . (84) S t e i n m e t z and S t r a u s (1974) document v a r i a b l e s i n c l u d i n g f a m i l y o r g a n i z a t i o n a n d p o s i t i o n , i n d i v i d u a l f a m i l y member c h a r a c t e r i s t i c s , p r e c i p i t a t i n g f a c t o r s , v i o l e n c e a n d s o c i e t a l f a c t o r s a s i n t e r r e l a t i n g t o p r o d u c e c o n s e q u e n c e s f o r t h e c h i l d , f a m i l y a n d s o c i e t y . , (18-19) S y n t h e s i s o f t h e s e f a c t o r s i s one m o d e l f o r t h e e t i o l o g y o f c h i l d a b u s e . P a r e n t : S i c k / B a d The m a j o r f a c t o r t o be c o n s i d e r e d i n t h i s r e s e a r c h i s t h e p a r e n t s ' r o l e i n a b u s e . R e s e a r c h on t h e p a r e n t who a b u s e s 17 g e n e r a l l y c o n c l u d e s o r u s e s a s an a s s u m p t i o n t h a t s u c h p a r e n t s a r e e i t h e r b a d o r s i c k . S m i t h , e t a l . , (1973) f o u n d s i g n i f i c a n t n umbers o f b a t t e r i n g p a r e n t s h a d p e r s o n a l i t y a b n o r m a l i t i e s . T h e s e a b n o r m a l i t i e s w e r e " e m o t i o n a l i m m a t u r i t y and d e p e n d e n c e , n e u r o s i s a n d l i t t l e c o n c e p t o f a p p r o p r i a t e c h i l d r e a r i n g p r a c t i c e s " . (391) S m i t h ' s and r e l a t e d s t u d i e s assume a c a u s a l c o n n e c t i o n b e t w e e n a b u s e a n d any c h a r a c t e r i s t i c w h i c h d i f f e r e n -t i a t e s a b u s i v e a n d n o n - a b u s i v e g r o u p s . W h i l e s u c h p r e c o n d i t i o n s may be n e c e s s a r y , t h e y a r e f a r f r o m s u f f i c i e n t . C l e a r l y , a l l t h o s e who c a n be l a b e l e d a s n e u r o t i c o r i g n o r a n t o f g r o w t h a n d d e v e l o p m e n t norms a r e n o t a b u s i v e . M e r r i l l , a s c i t e d by S p i n e t t a and R i g l e r ( 1 9 7 2 ) , a r t i c u l a t e d f o u r c l u s t e r s o f c h a r a c t e r i s t i c s o f a b u s i n g p a r e n t s . T h e s e w e r e p s y c h o d y n a m i c f e a t u r e s o f h o s t i l e , d e p e n d e n t , r i g i d , u n happy p e o p l e a r r a n g e d i n a t y p o l o g y t o h e l p p r o f e s s i o n a l s d i s t i n g u i s h " t y p e s " o f a b u s i v e p a r e n t s . (300) The p r o b l e m w i t h u s i n g M e r r i l l ' s t y p o l o g y i s t h a t i t d o e s n o t d i s t i n g u i s h a b u s e r f r o m n o n - a b u s e r . I t h a s no p r e d i c t i v e v a l i d i t y , r a t h e r one c a n s l o t a known a b u s e r i n t o one o f t h e c a t e g o r i e s . The v a l u e o f t h i s b e y o n d t h e s a t i s f a c t i o n i n l a b e l i n g i s u n a p p a r e n t . S u c h a t y p o l o g y i s u n i d i m e n s i o n a l i n t h a t i t d o e s n o t d e s c r i b e a t o t a l p e r s o n w i t h s t r e n g t h s o r p o s i t i v e f e a t u r e s and d e f i n i t e l y p l a c e s r e s p o n s i b i l i t y f o r a b u s e on i n t r a p s y c h i c f a c t o r s . W a l t e r s (1975) h a s an i m p r o v e d m o d e l i n l i g h t o f t h e p r e c e d i n g c r i t i c i s m s . (35) I t i s a l i s t o f t e n c a t e g o r i e s o f a b u s e a n d i n c l u d e s s i t u a t i o n a l o r s o c i a l f a c t o r s . I t i n c l u d e s : 1. S o c i a l l y a n d p a r e n t a l l y i n c o m p e t e n t a b u s e r s 18 2. F r u s t r a t e d and d i s p l a c e d abusers 3. S i t u a t i o n a l abusers 4. N e g l e c t f u l abusers 5. A c c i d e n t a l or unknowing abusers 6. V i c t i m p r e c i p i t a t e d abuse 7. S u b c u l t u r a l abuser 8. Mentally i l l abuser 9. I n s t i t u t i o n a l l y p r e s c r i b e d abusers 10. S e l f - i d e n t i f i e d abuses. The f i r s t and f i f t h p o i n t s a l l o w f o r p a r e n t a l ignorance as a f a c t o r i n accounting f o r abuse. This p o s s i b i l i t y w i l l be explored i n the f o l l o w i n g s e c t i o n s . Many a r t i c l e s have been w r i t t e n to explore c h a r a c t e r i s t i c s of abusers as opposed to non-abusers using psychopathology or malevolence as an unde r l y i n g assumption. Melnick and Hurley (19 69) "explored hypotheses d e r i v e d from contemporary c h i l d abuse w r i t i n g s " using two groups of ten mothers matched f o r age, s o c i a l class, and education. (746) This was one of the few s t u d i e s t h a t used appropriate c o n t r o l groups f o r comparison w i t h abusive groups. The r e s u l t s showed that nurturance, empathy and bonding were low i n the abusive groups while defenses and r i g i d i t y were high. (749) This causal account, rooted i n the assumption that abusive mothers l a c k an a b i l i t y t o r e l a t e to t h e i r c h i l d , encourages the question of why such mothers do not know how t o provide adequate care? This issue w i l l be f u r t h e r explored i n a d i s c u s s i o n of p a r e n t a l ignorance i n the next s e c t i o n . 19 P s y c h o a n a l y t i c t h e o r y h a s b e e n u s e d b y many a u t h o r s t o d e l i n e a t e e t i o l o g y o f t h e " s i c k " p a r e n t . A s y n t h e s i s o f t h e t h e o r y f o l l o w s : T h e r e a r e two l e v e l s t o p a r e n t i n g . One i s r e m e m b e r i n g how one was p a r e n t e d . The o t h e r i s t h e memory o f o n e s e l f a s a c h i l d ( H e i f e r a n d Kempe, 1 9 7 6 : 1 4 ) . The p a r e n t who was a b u s e d as a c h i l d h a s a g r e a t d e a l o f c o n f u s i o n a n d n e g a t i v e f e e l i n g s a t t a c h e d t o s u c h m e m o r i e s . N o t b e i n g g o o d e n o u g h , n o t b e i n g u n c o n d i t i o n a l l y c a r e d f o r , a n d n o t b e i n g a b l e t o l o o k t o o n e ' s p a r e n t s f o r t h e m e e t i n g o f b a s i c n e e d s ( t r u s t , s a f e t y ) l e a v e t h e a d u l t c r i p p l e d e m o t i o n a l l y . T h u s , a s i t u a t i o n i s p r e p a r e d w h e r e t h i s a d u l t ' s c h i l d ( r e n ) w i l l be a b u s e d ( E b e l i n g a n d H u l l , 1975; S t e e l e a n d P o l l a c k , 1 9 7 4 ) . A b u s e r e s u l t s f r o m t h e p a r e n t p r o j e c t i n g h i s "bad" s e l f o n t o t h e c h i l d a n d t h e n p u n i s h i n g t h e c h i l d ( i n e f f e c t , t h e p a r e n t s e l f - a b u s i n g ) o r t h e p a r e n t c o n c e p t u a l i z e s t h e c h i l d a s a n e e d - g r a t i f y i n g o b j e c t who f r u s t r a t e s a n d , t h e r e f o r e , d e s e r v e s t h e p u n i s h m e n t t h e a d u l t c o u l d n e v e r g i v e h i s own p a r e n t s . ( B o s z o r m e n y i - N a g y a n d S p a r k , 1 973; G a l d s t o n , 1 9 6 5 ; H e i f e r a n d Kempe, 1976; S p i n e t t a a n d R i g l e r , 1 9 7 2 ; S t e e l e a n d P o l l a c k , 1 9 7 4 ) . The c h i l d , a c c o r d i n g t o Anna F r e u d , i d e n t i f i e s w i t h t h e a g g r e s s i o n i n p r e - v e r b a l s t a g e s and t h e a g g r e s s o r b y age two y e a r s . The i d e n t i f i c a t i o n m e e t s t h e n e e d t o make s e n s e o u t o f an i n c o n s i s t e n t e n v i r o n m e n t b u t l e a v e s t h e c h i l d a n g r y a nd g u i l t y . T h u s , t h e c h i l d ' s i n t r a p s y c h i c d e v e l o p m e n t i s d i s t o r t e d l o n g b e f o r e t h e n e x t g e n e r a t i o n a p p e a r s t o f e e l t h e e f f e c t s . (A. F r e u d , 1966; S p i t z , 1 9 5 8 ) . 20 T h i s t h e o r y " e x p l a i n s " i n t e r m s o f i n t r a a n d i n t e r p e r s o n a l p a t h o l o g y why a b u s e o c c u r s i n a v i c i o u s c y c l e t h e o r y . I t d o e s n o t i n c l u d e o r a c c o u n t f o r t h e i m p o r t a n t f a c t o r s l i s t e d e a r l i e r i n t h i s p a p e r u n d e r t h e h e a d i n g s o f s o c i e t y a n d t h e c h i l d . E l m e r (19 71) c o m p a r e d two g r o u p s o f m o t h e r s , m a t c h e d f o r s o c i o e c o n o m i c f a c t o r s , a n d f o u n d s i g n i f i c a n t l y more " p e r s o n a l i t y p r o b l e m s i n t h e ( a b u s i v e ) m o t h e r " . (53) S i m i l a r l y , G r e e n , e t a l . , (1974) o b s e r v e d a nd t e s t e d s i x t y f a m i l i e s i d e n t i f i e d a s a b u s i v e . (882) They w e r e i n n e r -c i t y ( g h e t t o ) r e s i d e n t s , i n t h e l o w e s t s o c i o e c o n o m i c g r o u p , r e c e i v i n g p u b l i c a s s i s t a n c e a n d g e n e r a l l y f e m a l e - h e a d e d , s i n g l e -p a r e n t f a m i l i e s . On t h e b a s i s o f t h e i n t e r v i e w s , w i t h no c o n t r o l g r o u p , no c o n s i d e r a t i o n o f a b u s e i n o t h e r s o c i o e c o n o m i c l e v e l s , t h e a u t h o r s d e s c r i b e d p e r s o n a l i t y f a c t o r s o f t h e m o t h e r s , e x p l o r e d t h e r o l e t h e c h i l d p l a y e d i n h i s a b u s e , e x p l o r e d p a r e n t - c h i l d i n t e r a c t i o n , c o n s t r u c t e d a p s y c h o d y n a m i c f r a m e w o r k f o r a b u s e and a s s e s s e d e n v i r o n m e n t a l f a c t o r s a s s o c i a t e d w i t h a b u s e . N o t s u r p r i s i n g l y , t h e a u t h o r s r e v e r t e d t o t h e t h e o r y o f t h e i r p r o f e s s i o n - a p s y c h o d y n a m i c i n t e r p r e t a t i o n o f e t i o l o g y w i t h i n t e r v e n t i o n b a s e d on p s y c h o t h e r a p y . I n summary, t h e a c c o u n t o f t h e e m o t i o n a l l y " s i c k " p a r e n t a p p e a r s t o be b a s e d on t h e o r i e s u n s u p p o r t e d by r e s e a r c h e v i d e n c e . The . a l a r m i n g , a s p e c t o f t h e a c c e p t a n c e o f t h i s t h e o r y d e s -c r i b i n g a b u s i v e p a r e n t s a s b a d / s i c k i s t h a t o t h e r p r o f e s s i o n s , l i k e n u r s i n g a nd s o c i a l w o r k , a d o p t t h e c o n c e p t u a l f r a m e w o r k a t f a c e v a l u e . ( B e s h a r o v , 1975; D a n i e l , 1 9 7 5 ; F r e i d m a n e t a l . , 1976) I n t e r v e n t i o n i s p l a n n e d b y i n d i v i d u a l s a n d a g e n c i e s t h e n 21 i m p l e m e n t e d w i t h f e w e v a l u a t i v e t e c h n i q u e s . B a s i c a l l y , a s i t u a t i o n h a s a r i s e n w h e r e huge amounts o f e n e r g y , t i m e a n d money a r e b e i n g s p e n t i n d o i n g s o m e t h i n g t h a t h a s n e i t h e r b e e n f u l l y r e s e a r c h e d n o r e v a l u a t e d . P a r e n t : I g n o r a n t R e s e a r c h e r s and t h e o r i s t s i n t h e a r e a o f c h i l d a b u s e h a v e e x p l o r e d t h e f a m i l y t r i a n g l e i n p a r t s , a s a w h o l e , a n d a s a s egment o f s o c i e t y . The e t i o l o g y o f c h i l d a b u s e f o l l o w s s o c i o l o g i c a l o r p s y c h o l o g i c a l i d e o l o g y i n a l a r g e l y s e l f -f u l f i l l i n g m anner, a s r e s e a r c h e r s t e n d t o e x p l o r e and v a l i d a t e o n l y t h e i r own t h e o r e t i c a l a s s u m p t i o n s i n t h e i r s t u d i e s . The i d e a s p r e s e n t e d t h u s f a r h a v e n o t c o n c l u s i v e l y d e f i n e d a b u s e , n o r e x p l a i n e d o r p r e d i c t e d i n d i c a t o r s t o s e p a r a t e a b u s e r s f r o n n o n - a b u s e r s . A p o t e n t i a l e t i o l o g i c a l a c c o u n t o f c h i l d a b u s e m e n t i o n e d b u t n o t y e t d e l i n e a t e d i s t h a t o f p a r e n t a l i g n o r a n c e . A c c o r d i n g t o t h i s v i e w , i t i s p o s s i b l e t h a t a b u s i v e p a r e n t s a r e n e i t h e r s i c k o r b a d , b u t a r e i g n o r a n t o f g r o w t h a n d d e v e l o p m e n t norms -a s e c o n d and s i g n i f i c a n t p o i n t q u e s t i o n s t h e s o u r c e o f i g n o r a n c e and a s k s w h e t h e r i t i s due t o e m o t i o n a l o r e d u c a t i o n a l f a c t o r s ? A b u s i v e p a r e n t s "have t y p i c a l l y b e e n f o u n d t o l a c k a p p r o p r i a t e k n o w l e d g e o f c h i l d r e a r i n g . . . p a r e n t s who w e r e a b u s e d as c h i l d r e n may h a v e u n r e a l i s t i c e x p e c t a t i o n s w h i c h t h e y e n f o r c e w i t h i n c o n s i s t e n t and p o o r l y c h o s e n p a r e n t i n g t e c h n i q u e s . Of p a r t i c u l a r r e l e v a n c e i s t h e f i n d i n g o f G r e g g a n d E l m e r (1969) t h a t a b u s i v e m o t h e r s w e r e p a r t i c u l a r l y i n e f f e c t i v e i n t h e i r 22 e f f o r t s t o p r o v i d e a d e q u a t e c a r e when t h e i r c h i l d r e n w e r e i l l . " ( S a m e r o f f and C h a n d l e r , 1975:222) H e i f e r and Kempe (1976) s t a t e " t h e s e p a r e n t s h a v e n ' t l e a r n e d t h e b a s i c s k i l l s , s o how i n t h e w o r l d c a n t h e y t r a n s m i t them t o t h e i r c h i l d r e n " . (54) A c c o r d i n g l y , t h e s e a u t h o r s h a v e o u t l i n e d a b u s e a s a l e a r n e d b e h a v i o r . M a r t i n a n d B e e z l e y (1974) s t a t e d t h a t an i n d i c a t o r o f i m p r o v e m e n t i n p a r e n t - c h i l d i n t e r a c t i o n i s t h a t " t h e p a r e n t s ' e x p e c t a t i o n s o f t h e c h i l d a r e a g e - a p p r o p r i a t e . T h i s m a r k s a s h i f t f r o m t h e h i g h l y u n r e a l i s t i c e x p e c t a t i o n s o f m o s t a b u s i v e p a r e n t s " . (261) Van S t o l k (1972) p r e s e n t e d t h a t " b a t t e r i n g p a r e n t s r e g a r d c h i l d r e n - e v e n s m a l l i n f a n t s - a s c a p a b l e o f a d u l t r e s p o n s e s and c o m p r e h e n s i o n . I t i s t h i s b e l i e f t h a t t h e i r c h i l d r e n a r e c a p a b l e o f p e r c e i v i n g as a d u l t s w h i c h a l l o w s t h e p e c u l i a r e m o t i o n a l j u s t i f i c a t i o n o f t h e i r demands". (21) G r e e n (1976) s t a t e d a b u s i v e p a r e n t s h a v e " i n a p p r o p r i a t e p a r e n t a l e x p e c t a t i o n s f o r p r e c o c i o u s o r u n r e a l i s t i c p e r f o r m a n c e " . (425) M a r g r a i n (1977) saw one o f t h e c a u s e s o f b a t t e r i n g b e i n g "a r e s u l t o f p a r e n t a l i g n o r a n c e a b o u t a g e - r e l a t e d b e h a v i o r o r how t o r e a r c h i l d r e n " . (53) S t e e l e (1975) c h a r a c t e r i z e d a b u s i v e p a r e n t s a s s i g n i f i c a n t l y l a c k i n g " b a s i c " k n o w l e d g e . (4) S i l v e r , e t a l . , (1969) c o n c l u d e d t h a t v i o l e n c e b r e e d s v i o l e n c e i n t h e i r l o n g i t u d i n a l s t u d y o v e r t h r e e g e n e r a t i o n s . T h e i r m ethod was t o r e v i e w c a s e h i s t o r i e s o f f a m i l i e s r e p o r t e d a s a b u s i v e t o h o s p i t a l s i n t h e D i s t r i c t o f C o l u m b i a . G e n e r a l a b u s i v e b e h a v i o r was n o t e d i n p a r e n t i n g d e s p i t e i n t e r v e n t i o n b y 23 t h e h e a l t h c a r e s y s t e m . A t t h e C o n f e r e n c e on F a m i l y V i o l e n c e ( M a r c h 1977) a w o r k s h o p on c h i l d a b u s e p r e s e n t e d p a r e n t i n g a s a l e a r n e d s k i l l b a s e d on t h e p a r e n t s ' c h i l d h o o d e x p e r i e n c e s . The theme t o t h e s t u d i e s o r a r t i c l e s c i t e d was t h a t p a r e n t i n g i s l e a r n e d , one d o e s n o t "know" how t o p a r e n t i n n a t e l y . I n some way, a b u s i v e p a r e n t s may n o t know how t o r a i s e c h i l d r e n . I s t h e i s s u e one o f a p a r e n t n e e d i n g c o g n i t i v e k n o w l e d g e a b o u t g r o w t h and d e v e l o p m e n t ? W o u l d an a s s e s s m e n t o f g r o w t h and d e v e l o p m e n t k n o w l e d g e p r e d i c t a p o t e n t i a l a b u s e r ? T h i s i s s u e o f i g n o r a n c e , w h e t h e r c o g n i t i v e o r m o t i v a t i o n a l , n e e d s e x p l o r a t i o n b e f o r e i t c a n be a c c e p t e d a s t h e f a c t s t a t e d i n m ost s t u d i e s a s p a r t o f t h e t h e o r y o n c h i l d a b u s e . M o s t i m p o r t a n t l y , c a n one r e l a t e t h i s i g n o r a n c e c a u s a l l y t o a b u s e as i s assumed i n t h e l i t e r a t u r e ? I n summary, t h e r e w e r e no s t u d i e s f o u n d t h a t t e s t e d t h i s p e r v a s i v e a s s u m p t i o n o f p a r e n t a l i g n o r a n c e . W a l t e r s (1975) o u t l i n e d t h r e e p o i n t s o f c o n c e r n w i t h t h e l i t e r a t u r e o n c h i l d a b u s e : . . . r e s e a r c h e r s i n t h e a r e a o f c h i l d a b u s e o f t e n f a l l i n t o t h e s o p h o m o n i c m i s t a k e o f b e l i e v i n g t h a t c o r r e l a t i o n i m p l i e s c a u s a t i o n . . . . We l a c k t h e o r y i n t h e a r e a o f c h i l d a b u s e . . . . One b a s i c t h e o r e t i c a l i s s u e t h a t must be r e s o l v e d i s t h e l a c k o f d i s c r i m i n a t i o n among a b u s e r s . (30-33) The c r i t i c i s m s o f e a r l i e r s t u d i e s a n d t h e c o n c e r n s l i s t e d by W a l t e r s d i r e c t e d t h i s a u t h o r t o t e s t a b a s i c a s s u m p t i o n c i t e d i n t h e l i t e r a t u r e o n c h i l d a b u s e t h a t a b u s i v e p a r e n t s e x p e c t u n r e a l i s t i c a l l y m a t u r e b e h a v i o r f r o m t h e i r c h i l d ( r e n ) . 24 O n l y by "means o f e v a l u a t i n g s u c h v a r i a b l e s ( i d e n t i t y a n d h i s t o r y o f c h i l d - c a r e t a k e r , p a t t e r n s a n d k n o w l e d g e o f c h i l d c a r e ) w i l l i t become p o s s i b l e i n p r a c t i c e t o s e p a r a t e t h e a b u s i v e f r o m t h e n o n - a b u s i v e f a m i l i e s . . . p r e d i c t o r s c a n be f o u n d o n l y t h r o u g h p a t i e n t a n d s y s t e m a t i c s t u d y " . ( E l m e r , 1 9 7 4 : 3 4 ) . T h i s c h a p t e r p r e s e n t e d a c o m p r e h e n s i v e summary o f t h e l i t e r a t u r e on c h i l d a b u s e and r e v i e w e d c r i t i c a l l y s a l i e n t r e s e a r c h s u p p o r t i n g t h e c o n c e p t u a l i z a t i o n o f t h i s s t u d y . S o c i e t y , t h e c h i l d a n d p a r e n t - c h i l d i n t e r a c t i o n w e r e b r i e f l y e x p l o r e d a s t o t h e i r p a r t i n a b u s e . The p a r e n t a l r o l e , w h e t h e r due t o p s y c h o p a t h o l o g y , m a l e v o l e n c e o r i g n o r a n c e , was c o m p r e h e n s i v e l y d e s c r i b e d . P a r e n t a l i g n o r a n c e was p r e s e n t e d t o s u p p o r t t h e s i g n i f i c a n c e , a n d t o i n t r o d u c e t h e m e t h o d o l o g y o f t h i s s t u d y . CHAPTER I I I RESEARCH DESIGN S e t t i n g a n d Sample S e l e c t i o n The s a m p l e f o r t h e s t u d y was d r a w n f r o m a D a y c a r e c e n t e r and P r o j e c t f o r p a r e n t s and c h i l d r e n . The P r o j e c t , u n d e r t h e D e p a r t m e n t o f Human R e s o u r c e s , was s t a f f e d by s o c i a l w o r k e r s , c h i l d c a r e w o r k e r s a n d p e o p l e w i t h s o c i a l s c i e n c e s d e g r e e s . The p r o g r a m i n v o l v e d t h i r t y m o t h e r s and t h e i r c h i l d r e n i n two m i l i e u c e n t e r e d g r o u p s . The M o n d a y - T u e s d a y s e c t i o n was t h e " c o u r t " g r o u p who may h a v e had c h i l d r e n r e m o v e d f r o m t h e i r c a r e due t o a b u s e o r n e g l e c t , w h i l e t h e W e d n e s d a y - T h u r s d a y g r o u p i n c l u d e d m o t h e r s a t r i s k f o r a b u s e o r n e g l e c t due t o e n v i r o n m e n t a l s t r e s s e s . The a u t h o r s p e n t t i m e w i t h s t a f f a nd m o t h e r s a t t h e P r o j e c t t o f a m i l i a r i z e them w i t h h e r p r e s e n c e and r e s e a r c h i n t e r e s t s . On t h e two d a y s i d e n t i f i e d f o r d a t a c o l l e c t i o n , any m o t h e r who a g r e e d t o p a r t i c i p a t e became p a r t o f t h e s a m p l e , r e s u l t i n g i n a s a m p l e s i z e o f f o u r t e e n . The D a y c a r e s e r v e d t h i r t y - t w o f a m i l i e s a nd was s t a f f e d b y d a y c a r e s u p e r v i s o r s , S c h o o l o f M o t h e r c r a f t and s o c i a l s c i e n c e g r a d u a t e s . The c h i l d r e n w e r e d i v i d e d i n t o 1 u n d e r - t h r e e ' s ' a n d 1 o v e r - t h r e e ' s ' - t h e age r a n g e b e i n g e i g h t e e n m onths t o s i x y e a r s . 25 26 The p r o p o s e d s t u d y was p r e s e n t e d t o t h e B o a r d o f D i r e c t o r s who a g r e e d t o t h e c o n t a c t i n g o f m o t h e r s i n t h e g r o u p . A r e q u e s t f o r s i n g l e - p a r e n t , h i g h - s c h o o l g r a d u a t e m o t h e r s r e s u l t e d i n s e v e r a l p e o p l e v o l u n t e e r i n g . T h e s e m o t h e r s w e r e l a t e r c o n t a c t e d b y phone t o c o n f i r m t h e i r i n t e r e s t a nd s e t a d a t e f o r d a t a c o l l e c t i o n . N i n e m o t h e r s p a r t i c i p a t e d . D a t a G a t h e r i n g I n s t r u m e n t The D e v e l o p m e n t a l P r o f i l e d e v e l o p e d by A l p e r n and B o l l (1972) was t h e b a s i s o f t h e r e s e a r c h t o o l . The p r o f i l e i s d i v i d e d i n t o p h y s i c a l , s e l f - h e l p , s o c i a l , a c a d e m i c , a n d c o m m u n i c a t i o n s e c t i o n s , e a c h w i t h a g e - a p p r o p r i a t e d e v e l o p m e n t a l i t e m s . The r e l i a b i l i t y and v a l i d i t y o f t h e p r o f i l e i s d e f e n d e d by t h e a u t h o r s : . . . t h e f i v e s c a l e s o f t h e D e v e l o p m e n t a l P r o f i l e a r e c o n s i d e r e d t o p r o v i d e a h i g h l y v a l i d a s s e s s m e n t o f t h e d e v e l o p m e n t o f c h i l d r e n a d e q u a t e l y r e p r e s e n t e d by t h e s t a n d a r d i z a t i o n s t u d y p o p u l a t i o n . S p e c i f i c a l l y , t h e i n s t r u m e n t i s c o n s i d e r e d t o be a b l e t o c o r r e c t l y d e t e r m i n e t h e d e v e l o p m e n t a l a g e s o f b l a c k a n d w h i t e u r b a n m i d - A m e r i c a n s o f a l l s o c i a l c l a s s e s . (60) The m a j o r c o n c l u s i o n s f r o m t h e two r e l i a b i l i t y s t u d i e s i s t h a t t h e D e v e l o p m e n t a l P r o f i l e g e n e r a t e s s c o r e s w i t h e x t r e m e l y h i g h s c o r e r , r e p o r t e r and t e s t - r e t e s t r e l i a b i l i t y . ( r i = l l ; t t e s t showed no s t a t i s t i c a l s i g n i f i c a n c e ) . (68) T h r e e m o t h e r s i n t h i s s t u d y p a r t i c i p a t e d i n t h e p i l o t t e s t a n d a c t u a l d a t a c o l l e c t i o n . T h e i r t e s t - r e t e s t r e l i a b i l i t y i s i l l u s t r a t e d i n t a b l e 3.1. ( A l s o s e e A p p e n d i x I ) 27 TABLE 3.1 THE C - S T A T I S T I C ( C i c c h e t t i e t a l . , 1971:101-109) ADAPTED FOR TEST-RETEST R E L I A B I L I T Y M o t h e r ' s Code Number and number on t h e a b u s e c o n t i n u u m 134-4 120-4 110-5 C - S t a t i s t i c r e f l e c t i n g o v e r a l l a g r e e m e n t ( h i g h r e l i a b i l i t y ) 0. 968 0.936 0. 936 C o n t e n t v a l i d i t y o f t h e t o o l was d e t e r m i n e d by A l p e r n and B o l l (1972) i n t h e i r u s e o f e x i s t i n g d e v e l o p m e n t a l s c a l e i t e m s , t h e l i t e r a t u r e , a n d i t e m s b a s e d on c o n c e p t s u n d e r l y i n g t h e p r e t e s t . (30) The p i l o t t o o l was u s e d and e v a l u a t e d f o r t h r e e y e a r s t h e n s t a n d a r d i z e d by t e s t i n g t h e m o t h e r s on c h i l d r e p o r t w h i l e t e s t i n g t h e c h i l d ' s r e a l a b i l i t y t o p e r f o r m t h e i t e m s . E a c h c a t e g o r y d e r i v e d became a d i s t i n c t g r o u p o f i t e m s , d r awn f r o m a u n i v e r s e o f g r o w t h a n d d e v e l o p m e n t i t e m s , s p e c i f i c t o a n age r a n g e . C o n t e n t v a l i d i t y was h i g h f o r t h e a u t h o r ' s d a t a c o l l e c t i o n i n s t r u m e n t and w i l l be d e m o n s t r a t e d f u r t h e r i n t h i s c h a p t e r . F a c t o r s a c c o u n t i n g f o r v a r i a n c e i n t e s t p e r f o r m a n c e i n t h i s s t u d y w e r e c o n t r o l l e d by s t a n d a r d i z i n g t h e t e s t i n g p r o c e d u r e a n d t h r o u g h u s e o f t h e c o n f o u n d i n g v a r i a b l e d a t a s h e e t . C r i t e r i o n - r e l a t e d v a l i d i t y was d i f f i c u l t t o e s t a b l i s h 28 as i t i s n o t known w h e t h e r a p a r e n t who c o g n i t i v e l y "knows" g r o w t h and d e v e l o p m e n t k n o w l e d g e , c a n a p p l y i t t o t h e e m o t i o n a l l y l o a d e d s i t u a t i o n o f r a i s i n g t h e i r own c h i l d . I t w o u l d be i n t e r e s t i n g t o h a v e t h e m o t h e r s w i t h y o u n g c h i l d r e n do t h e c a r d s o r t when t h e i r c h i l d r e n h a v e m a t u r e d t o d e t e r m i n e how e x p e r i e n c e w i t h a d e v e l o p m e n t a l s t a g e a l t e r s d e v e l o p m e n t a l s e t . T h i s a u t h o r c h o s e an i t e m f r o m e a c h s e c t i o n f o r f i v e age g r o u p s : I n f a n t , 0-12 m o n t h s ; T o d d l e r , 13-24 m o n t h s ; P r e - s c h o o l , 2-4 y e a r s ; S c h o o l - a g e , 5-10 y e a r s ; a n d , A d o l e s c e n c e , 11-16 y e a r s . T h e s e i t e m s w e r e c h o s e n u s i n g t h e f o l l o w i n g c r i t e r i a t o p r e s e r v e c o n t e n t v a l i d i t y : 1. B e h a v i o r d e m o n s t r a t e d w i t h i n t h e age r a n g e d e l i m i t e d (as o p p o s e d t o a c r o s s age r a n g e s ) . 2. I t e m s t a t e d c o n c i s e l y r e q u i r i n g l i t t l e c h a n g e o f w o r d i n g ( t o m a i n t a i n i t e m v a l i d i t y ) . A s w e l l , f i v e comments a s t o p a r e n t a l e x p e c t a t i o n s w e r e c h o s e n f r o m t h e l i t e r a t u r e . (See A p p e n d i x I I ) . T h e s e t h i r t y i t e m s w e r e r e w o r d e d i n t o s t a t e m e n t s f r o m t h e i r o r i g i n a l f o r m o f b e i n g q u e s t i o n s . D r s . A l p e r n a n d B o l l k i n d l y g a v e p e r m i s s i o n f o r t h e a d a p t a t i o n o f p r o f i l e i t e m s . (See A p p e n d i x I I I a n d I V ) . I t e m l a b e l s w e r e c o m p u t e r g e n e r a t e d a n d g l u e d t o t h e b a c k o f c o m p u t e r c a r d s numbered one t o t h i r t y . E n v e l o p e s l a b e l e d w i t h e a c h age g r o u p d i v i s i o n ( i n f a n c y t o a d o l e s c e n c e ) c o m p l e t e d t h e t o o l . T h e s e e n v e l o p e s w e r e u s e d by t h e m o t h e r s t o h o l d t h e c a r d s s o r t e d f o r e a c h age g r o u p . 29 Implementation Two months before data c o l l e c t i o n , the author met w i t h P r o j e c t s t a f f t o a s s i g n each mother a number on an abuse continuum. Abuse was defined, f o r the continuum, as "an abused c h i l d i s a person, under the age of seventeen years, who has s u f f e r e d or i s s u f f e r i n g from s e r i o u s p h y s i c a l harm caused by the non-accidental use of f o r c e by those r e s p o n s i b l e f o r the c h i l d ' s care or others e x e r c i s i n g temporary or permanent c o n t r o l over the c h i l d " . (Porteous 1977) Neglect was d e f i n e d , as p a r t of the continuum, to be harm s u f f e r e d by a c h i l d due to l a c k of p a r e n t a l concern f o r p h y s i c a l or emotional s a f e t y and s e c u r i t y of the c h i l d i n h i s environment. The abuse continuum contains f i v e e x c l u s i v e l e v e l s : 1. Non-abusive - Mothers never i d e n t i f i e d by s o c i a l agencies as abusive or n e g l e c t f u l . 2. At Risk of Abuse - Mothers i d e n t i f i e d by s o c i a l agencies as having environmental and i n t r a p s y c h i c f a c t o r s predisposing to abuse of c h i l d r e n . 3. Neglect - Mothers i d e n t i f i e d by s o c i a l agencies as not having provided adequate p h y s i c a l , s a f e t y and s e c u r i t y features i n t h e i r c h i l d ' s l i f e . 4. Suspected Abuse - Mothers i d e n t i f i e d by s o c i a l agencies as p o s s i b l e abusers due to reasonable s u s p i c i o n t h a t abuse has occurred or may occur. 5. Known Abuse - Mothers i d e n t i f i e d by s o c i a l agencies and/or themselves as having p h y s i c a l l y i n j u r e d t h e i r c h i l d ( r e n ) . 30 The s t a f f a t t h e P r o j e c t a s s i g n e d e a c h m o t h e r a number f r o m one t o f i v e i n d i c a t i n g h e r a p p r o p r i a t e s t a g e i n t h e c o n t i n u u m . Two weeks l a t e r t h e a u t h o r r e p e a t e d t h i s s t e p t o e n s u r e r e l i a b i l i t y . A l l m o t h e r s t h a t p a r t i c i p a t e d i n t h e s t u d y ( e l e v e n ) h a d t h e same number g i v e n t o t h e m b o t h t i m e s by t h e t e n s t a f f members. A n o t h e r m e t h o d f o r e l i c i t i n g t h e a p p r o p r i a t e numbers w o u l d h a v e b e e n t o h a v e e a c h s t a f f member, s e p a r a t e l y , c o d e e a c h m o t h e r , t h e n t o h a v e c o m p i l e d t h e r e s u l t s . A l i m i t a t i o n o f t h i s a p p r o a c h was t h a t t h e m o t h e r s w e r e n o t a l l known by t h e t o t a l s t a f f . A l s o p r i o r t o d a t a c o l l e c t i o n , t h e a u t h o r r e v i e w e d t h e f a c e s h e e t s i n c l i e n t f i l e s t o r e c o r d t h e m o t h e r ' s a g e , number an d s e x o f c h i l d r e n , w h e t h e r o r n o t a s i g n i f i c a n t m a l e was i n v o l v e d w i t h h e r a n d h e r c h i l d r e n and t h e l e n g t h o f t i m e t h e y h a d b e e n i n v o l v e d w i t h t h e P r o j e c t . A c o d e number was a p p l i e d t o t h e i n f o r m a t i o n t o e n s u r e c o n f i d e n t i a l i t y . On t h e day o f d a t a c o l l e c t i o n , e a c h m o t h e r was a s k e d i f she was e m p l o y e d and t h e l e v e l o f e d u c a t i o n s h e h a d a t t a i n e d . The m o t h e r s a t t h e D a y c a r e w e r e g i v e n a f o r m ( s e e A p p e n d i x V) t o e l i c i t d e m o g r a p h i c d a t a . Two d a y s w e r e s p e n t a t t h e P r o j e c t , one d a y w i t h e a c h g r o u p o f m o t h e r s , and one a f t e r n o o n a t t h e D a y c a r e t o c o l l e c t d a t a . The P r o j e c t m o t h e r s w e r e aware o f t h e c a r d s o r t m e t h o d due t o s e v e r a l o f them b e i n g i n v o l v e d i n t h e p r e - t e s t , w h i c h w i l l be d i s c u s s e d l a t e r . 31 Each mother, p r i o r t o p a r t i c i p a t i n g , was informed of the study purpose and her r i g h t s w i t h regard to consent. (See Appendix V I ) . This procedure was standardized to increase r e l i a b i l i t y of f i n d i n g s . E t h i c a l r e s p o n s i b i l i t y was discharged -in the mother . • being informed of her r i g h t to r e f u s e , to withdraw, t h a t no personal i d e n t i f y i n g data would be used, t h a t feedback and d e b r i e f i n g would occur at the completion of the study. (See Appendix V I I ) . I f the mother then wished to continue, she signed the consent. ' One mother d i d not wish to s i g n but was w i l l i n g t o p a r t i c i p a t e , so a witness signed v e r i f y i n g her v e r b a l consent. The code numbers were a f f i x e d to the card deck at t h i s p o i n t , demonstrating c o n f i d e n t i a l i t y . The mothers, i n d i v i d u a l l y , then sorted the t h i r t y cards i n t o whichever envelope they thought was the appropriate age group f o r a c h i l d to f i r s t be able to perform the item w r i t t e n on the card. The mothers at the Daycare followed a s i m i l a r process except t h a t they had volunteered previous t o the data c o l l e c t i o n time and came by appointment to the Daycare. These appointments were a l l at the time the mother u s u a l l y picked up her c h i l d at the end of the day. Following data c o l l e c t i o n , a computer card numbered: 1 ( i n f a n c y ) , 2 ( t o d d l e r ) , 3 (pre-school), 4 (school-age), and 5 (adolescence) replaced the envelopes. Each deck contained a face card keypunched w i t h code numbers, f i v e cards d e s i g n a t i n g the age groups and the t h i r t y cards as the mothers had sorted them. 32 PILOT TESTING The purpose of the p r e - t e s t was to determine i f the growth and development items were understandable, the method c l e a r and o p e r a t i o n a l , and i f the subjects were approachable. F i v e mothers at the P r o j e c t and one at the Daycare volunteered to do a p r e - t e s t of the study's t o o l . They r e c e i v e d i n s t r u c t i o n s and signed a consent as i n the a c t u a l study. The items were c l e a r l y understood, the method o p e r a t i o n a l and administered i n l e s s time than o r i g i n a l l y planned. Subjects w i l l i n g l y p a r t i c i p a t e d and expressed i n t e r e s t i n the study r e s u l t s . The c o n s i s t e n t question t h a t arose, however, was "Do I s o r t as my c h i l d has done these behaviors or as c h i l d r e n g e n e r a l l y would do them?" The author's response was uniformly to repeat "Place the cards wherever you t h i n k a c h i l d can f i r s t perform the behavior." R e l i a b i l i t y may have been decreased i f the mother's i n t e r p r e t a t i o n of the items r e f l e c t e d item ambiguity. Q u a l i t a t i v e i n s p e c t i o n of the p i l o t data i n d i c a t e d t h a t the non-abusive mother had the highest degree of d i s a r r a y w h i l e the " a t - r i s k to abuse" mother, the " n e g l e c t f u l " mother and the "suspected of abuse" mother i l l u s t r a t e d a p a t t e r n of l e s s abusive behavior w i t h more growth and development knowledge. This chapter reviewed the s e t t i n g and sample s e l e c t i o n f o r t h i s study. The data-gathering instrument was described w i t h v a l i d i t y and r e l i a b i l i t y estimates explained. Implementation and p i l o t t e s t i n g were d e t a i l e d i n c l u d i n g b r i e f d i s c u s s i o n of the p r e - t e s t i n g r e s u l t s . CHAPTER IV DATA ANALYSIS AND FINDINGS This chapter presents the data c o l l e c t e d and the methods of a n a l y s i s . Each of the mother's card s o r t s were charted as i n Appendix V I I I . Items one to twenty-five were surveyed to i d e n t i f y those of the mother's s o r t not i n agreement w i t h the i d e a l l i t e r a t u r e s o r t . These d i f f e r e n t items were i d e n t i f i e d as plus or minus the number of age groups they were away from the c o r r e c t group (the Roman type i l l u s t r a t e s t h i s d i f f e r e n c e ) . As Ferguson (1976) o u t l i n e d i n h i s book, S t a t i s t i c a l  A n a l y s i s , the concept of d i s a r r a y could be a p p l i e d to the data to ob t a i n a composite growth and development score f o r each mother. (364-365) The sum of the item scores represents the degree of d i s a r r a y or "S" f o r each mother. The minimum degree of d i s a r r a y would be zero and would represent a mother having sorted each item i n agreement w i t h the l i t e r a t u r e . The l a r g e r the S, the greater the discrepancy between the mother's s o r t and the l i t e r a t u r e , r e presenting a l a c k of knowledge of growth and development. The plus or minus d i s t i n c t i o n was u t i l i z e d to maintain 33 34 t h e l o g i c a l c o n s i s t e n c y o f t h e c o n c e p t o f d i s a r r a y , S, a s a p p l i e d t o k n o w l e d g e o f g r o w t h a n d d e v e l o p m e n t . TABLE 4.1 PLUS OR MINUS DISTINCTION F o r e x a m p l e : I t e m 12 s h o u l d be i n age g r o u p 3 ( p r e - s c h o o l a g e ) . M o t h e r #1 p u t i t e m 12 i n g r o u p 1 M o t h e r #2 p u t i t e m 12 i n g r o u p 5 - 2 + 2 B o t h m o t h e r s w e r e i n e r r o r by 2 age g r o u p s , ( X 1 " Y l > #1 [3 - (-2)] 2 = ( 3 + 2 ) 2 - 5 2 d e g r e e o f d i s a r r a y = S 25 #2 f 3 - (2) ] 2 = (3-2) 2 = 1 The s i g n i f i c a n c e o f m a i n t a i n i n g t h e p l u s o r m i n u s d i s t i n c t i o n i s t h a t e x p e c t i n g a b e h a v i o r e a r l i e r t h a n n o r m a l r e s u l t s i n a h i g h e r s c o r e . CHALLENGE TO THE HYPOTHESIS The h y p o t h e s i s was: t h e r e i s no s i g n i f i c a n t r e l a t i o n -s h i p b e t w e e n d e v e l o p m e n t a l s e t and c h i l d a b u s e . T h i s was c h a l l e n g e d by t h e Spearman Rank O r d e r C o r r e l a t i o n C o e f f i c i e n t a n d a t w o - t a i l e d t e s t , a t a s i g n i f i c a n c e l e v e l , 0.05. The v a l u e o f " r " c o m p u t e d was f o u n d t o be a p p r o x i m a t e l y z e r o a s g r a p h i c a l l y e v i d e n c e d i n f i g u r e 4.1 35 FIGURE 4.1 GRAPH SHOWING. RELATIONSHIP/ BETWEEN LEVEL OF ABUSE AND DEGREE OF DISARRAY 110 Mother's 5 Number 1 3 4 109, 138 on the 4 " 1 2 0 abuse 136,_ 122 continuum 3 I 2 8 «> * 1 0§> (code i i - > numbers 2 1 0, 3 1 2 6.1 1 1 J-02 H3 label the points) 1 222. 2 0 6 2° 7„202 2°.3 22l 2 20 2°«4 201  0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 DEGREE OF DISARRAY (S) Therefo r e , t h e n u l l h ypothesis was accepted, namely t h a t t h e r e i s no s i g n i f i c a n t r e l a t i o n s h i p between developmental s e t and l e v e l of abuse, as d e f i n e d f o r t h i s study. As an i n t e r e s t i n g e x p l o r a t i o n , a t t e s t was computed to determine i f there was a r e l a t i o n s h i p between the abusive mothers' knowledge of growth and development (2,3,4,5 on the continuum) and the non-abusive (1 on the continuum). With twenty-one degrees of freedom, a t the<A = 0.05 l e v e l of s i g n i -f i c a n c e l e v e l , t h e r e was no s i g n i f i c a n t d i f f e r e n c e . . However,-i f mothers 201, 2 04, 22 0..and 221 are disc o u n t e d , v i s u a l survey of f i g u r e 4.1 r e v e a l s an apparent regression line of abuse level on disarray. The d i s a r r a y scores have a range of S=55-167. The non-abusive (Daycare) mothers had scores t h a t ranged from 55-167 w h i l e the abusive (Project) mothers' scores spread over 59-154. The d i s a r r a y scores have a mean of 106.9 and a standard d e v i a t i o n o f 31.1. The standard e r r o r of the mean was 6.5, thus 36 n i n e t y p e r c e n t o f t h e t i m e , t h e mean f o r t h e p o p u l a t i o n w o u l d be b e t w e e n t h e l i m i t s o f 93.8 - 120.0. A m o t h e r ' s s c o r e o f 106.9 c a n be m e a n i n g f u l i n c o m p a r i s o n t o t h e maximum d e g r e e o f d i s a r r a y . T h i s maximum o f S=42 0 was c a l c u l a t e d b a s e d o n a m o t h e r r a n d o m l y s o r t i n g a c a r d f r o m e a c h age g r o u p i n t o e a c h age g r o u p . T h i s w o u l d s u g g e s t t h a t a p p r o x i m a t e l y s e v e n t y - f i v e p e r c e n t o f t h e t i m e , t h e m o t h e r s i n t h e s a m p l e make a c o r r e c t g r o w t h a n d d e v e l o p m e n t d e c i s i o n i n c h i l d r e a r i n g . I n t e r m s o f t h e d e m o g r a p h i c v a r i a b l e s , d a t a was s u m m a r i z e d a s shown i n t a b l e 4.2. A p p e n d i x I X i l l u s t r a t e s t h e a c t u a l d a t a . The v a r i a b l e s o f i n t e r e s t i n c l u d e d m o t h e r ' s a g e , number o f c h i l d r e n , m o t h e r ' s e d u c a t i o n , i n v o l v e m e n t o f a s i g n i f i c a n t m a l e a n d m o t h e r ' s employment s t a t u s . TABLE 4.2 SUMMARY OF DEMOGRAPHIC DATA Mother's number on the abuse continuum Number of mothers i n the group (N=2 3) Mother's age range (years) C h i l d r e n ' s age range (years) and sex Mother's education l e s s than high high school school graduation Present f u l l - t i m e involvement of a s i g -n i f i c a n t male Yes No Present f u l l - t i m e employment outside the home Yes No Non-abusive 23-45 2-27 7 female 4 male A t - r i s k to abuse 17-28 1-10 4 female 5 male 0 5 Neglect 21-29 1-8 5 female 3 male 0 4 Suspected of abuse 20-29 2-5 2 female 5 male 1 3 5 1 35 7-12 1 0 0 1 1 0 Known abuse 2 female 1 male 38 This data was analyzed f o r a s s o c i a t i o n s between v a r i a b l e s , p a r t i c u l a r l y the r e l a t i o n s h i p of abuse and developmental set to demographic f a c t o r s . The v a r i a b l e s of mother's age, number of c h i l d r e n , and education were dichotomized using the group median. Thus, mother's age was d i v i d e d i n t o t w e n t y - f i v e years and under or over twenty-five years. Number of c h i l d r e n was represented by one c h i l d or more than one c h i l d . Education was i n two categories of l e s s than high school graduation or high school graduation and other education. The f a c t o r s of mother's employment and involvement of a s i g n i f i c a n t male were dic h o t o -mized i n t o yes or no c a t e g o r i e s . The v a r i a b l e of abuse was represented by d i v i d i n g the continuum i n t o two groups. Non-abusive, at r i s k to abuse and n e g l e c t f u l mothers (1,2,3) were one category w h i l e the sus-pected or known to abuse (4,5) were the other. Degree of d i s a r r y was dichotomized by surveying the range of S and d i v i d i n g i t i n t o two groups. Therefore, mothers w i t h an S of 55-110 formed one group w i t h 111-167 as the second. Fol l o w i n g t h i s , simple 2X2 contingency a n a l y s i s was a p p l i e d to i n v e s t i -gate whether a r e l a t i o n s h i p e x i s t e d between S, abuse, or demographic data. This was done a f t e r the f a c t as no r e l a t i o n -ship could be demonstrated between S and abuse and perhaps there were other i n f l u e n t i a l a s s o c i a t i o n s . This a n a l y s i s was a p p l i e d to v a r i a b l e s using chi-squared t a b l e s at a s i g n i f i c a n c e l e v e l of 0.05. Tables 4.3 and 4.4 summarize the chi-squared values i l l u s t -r a t i n g no s i g n i f i c a n t r e l a t i o n s h i p f o r the v a r i a b l e s shown. 39 TABLE 4.3 SUMMARY OF CHI-SQUARED ANALYSIS BETWEEN HIGH OR LOW LEVELS OF ABUSE AND DEMOGRAPHIC DATA VARIABLES CHI-SQUARED VALUE ABUSE X MOTHERS' AGE 3.7 2 ABUSE X NUMBER OF CHILDREN 2.25 ABUSE X MOTHERS' EDUCATION 4.62* ABUSE X INVOLVEMENT OF A MALE 3.14 ABUSE X MOTHERS' EMPLOYMENT 2.34 *<=<.= 0.05, c r i t i c a l value X 2 = 3.84, s i g n i f i c a n t at P< 0.05 TABLE 4.4 SUMMARY OF CHI-SQUARED ANALYSIS BETWEEN HIGH OR LOW DEGREE OF DISARRAY AND DEMOGRAPHIC DATA VARIABLES CHI-SQUARED VALUE S X MOTHERS' AGE 2.61 S X NUMBER OF CHILDREN *3.94 S X MOTHERS' EDUCATION *4.32 S X INVOLVEMENT OF A MALE *4.21 S X MOTHERS' EMPLOYMENT *5.55 * = 0.05, c r i t i c a l value X 2 = 3.84, s i g n i f i c a n t at P< 0.05 40 There would appear to be a r e l a t i o n s h i p between abuse and mothers' education; S and number of c h i l d r e n , mothers' education, involvement of a male, and employment. Amount of growth and development knowledge seems to be a common s i g n i -f i c a n t f a c t o r i n a n a l y z i n g the demographic f a c t o r s f o r a s s o c i a t i o n s . ANALYSIS OF BEHAVIORAL STATEMENTS The f i v e items completing the growth and development t o o l were derived from the l i t e r a t u r e and do not have an i d e a l age group s o r t . These items (26-30) were summarily described and tabu l a t e d as shown i n frequency t a b l e s 4.5 - 4.9. (Raw data i n Appendix X). TABLE 4.5 FREQUENCY TABULATION OF ABUSE- ;LEVEL. VERSUS AGE GROUP FOR ITEM 2 6^: THE CHILD OBEYS AUTHORITY ABUSE LEVEL 1 Non-abusive 2 At risk 3 Neglect 4 Suspected 5 Known 1 2 3 4 5 Infant Toddler Preschool School Age Adolescent 7 3 2 2 1 2 1 N=2 3 Numbers w i t h i n t a b l e r e f e r to frequency. 41 TABLE 4.6 FREQUENCY TABULATION OF ABUSE-.LEVEL VERSUS AGE GROUP FOR ITEM 27:. --•. THE CHILD CAN HOLD A GRUDGE ABUSE LEVEL 1 Non-abusivel 2 At r i s k 3 Neglect 4 Suspected 5 Known 1 2 3 4 5 Inf a n t Toddler P r e s c h o o l School Age Adoles c e n t 1 2 5 1 1 1 1 2 3 2 1 TABLE 4.7 FREQUENCY TABULATION OF ABUSE LEVEL VERSUS AGE GROUP FOR ITEM"..2 8-: THE CHILD CAN COMFORT HIS PARENTS WHEN THEY ARE UPSET ABUSE LEVEL 1 Non-abusive| 2 At r i s k 3 N e g l e c t 4 Suspected] 5 Known 1 2 3 4 5 In f a n t Toddler P r e s c h o o l School Age Adolescent 7 4 1 2 1 1 3 42 TABLE 4.8 FREQUENCY ^TABULATION OF ABUSE. LEVEL ~. VERSUS AGE GROUP FOR ITEM 29: . THE CHILD UNDERSTANDS HIS PARENTS1 EXPECTATIONS ABUSE LEVEL 1 Non-abusivej 2 At r i s k 3 Neglect 4 Suspected| 5 Known 1 2 3 4 5 Infant Toddler Preschool School Age Adolescent 1 1 4 1 2 1 1 3 3 1 3 1 1 TABLE 4.9 FREQUENCY TABULATION OF ABUSE LEVEL VERSUS AGE GROUP FOR ITEM 3.0: THE CHILD KNOWS WHEN HIS. PARENT IS FRUSTRATED ABUSE LEVEL 1 Non-abusive| 2 At r i s k 3 Neglect 4 Suspected] 5 Known 1 2 3 4 5 Infant Toddler Preschool School Age Adolescent 3 2 1 1 1 3 1 1 43 There appears t o be no c l u s t e r i n g of expectations f o r any of the f i v e item behaviors i n terms of l e v e l of abuse or developmental age. In other words, developmental l e v e l i n which a behavior was perceived to be appropriate and a mother's l e v e l of abuse, seem to be independent. This chapter presented the data a n a l y s i s as conceptualized by the author and adapted from Ferguson (1976). The n u l l hypothesis was t e s t e d and accepted demonstrating no s i g n i f i c a n t c o r r e l a t i o n between developmental set and c h i l d abuse. However, c o n s i d e r a t i o n of the v i s u a l curve i n f i g u r e 4.1 seen a f t e r excluding four of the l e v e l one mothers, may mean t h a t given a d i s a r r a y score one could p r e d i c t l e v e l of abuse of a mother. Demographic data were summarized and analyzed using chi-squared contingency t a b l e s . No s i g n i f i c a n t r e l a t i o n s h i p was demon-s t r a t e d between developmental s e t , abuse, mother's age, number of c h i l d r e n , mother's education, involvement of a male or employment. B e h a v i o r a l items which completed the t o o l were tabul a t e d and e a r l i e r developmental expectations were not demonstrated as c h a r a c t e r i s t i c of high l e v e l s of abuse. CHAPTER V DISCUSSION OF RESULTS The data presented d i d not demonstrate a s i g n i f i c a n t r e l a t i o n s h i p between a mother's developmental s e t and abuse i n c h i l d - r e a r i n g . I t would seem t h a t abusive and non-abusive mothers do not know growth and development norms. Under the circumstances of t h i s study i t was c l e a r t h a t the knowledge v a r i a b l e i s not a p r e d i c t o r or i n d i c a t o r o f abuse. F a c t o r s i n t h i s study t o account f o r the r e s u l t s c o u l d be item ambiguity i n the data c o l l e c t i o n instrument, assignment of mothers t o an abuse continuum p r e v i o u s to the data c o l l e c t i o n time, or t h a t the p a r t i c i p a n t s were obtained from two d i s t i n c t , convenient p o p u l a t i o n c l u s t e r s . One c o u l d s p e c u l a t e t h a t more growth and development items, w i t h i n fewer age groups would i n c r e a s e r e l i a b i l i t y and v a l i d i t y of the t o o l . The mothers co u l d have been assigned t o the abuse continuum concurrent with data c o l l e c t i o n t o account f o r the dynamic nature of abuse and n e g l e c t and i f r e a l i t y allowed, more s t a f f c o u l d have independently r a t e d the mothers. A sample drawn from l e s s d i s t i n c t c l u s t e r s may have demonstrated a d i f f e r e n t f i n d i n g . The r e l a t i o n s h i p between the demographic data and abuse or growth and development knowledge was a l s o not s i g n i f i c a n t . The mother's age, the number, age and sex of c h i l d r e n , 44 45 e m p l o y m e n t , e d u c a t i o n , a nd i n v o l v e m e n t o f a m a l e r e f l e c t e d a homogeneous s a m p l e and d i d n o t r e l a t e t o t h e v a r i a b l e s o f a b u s e and d e v e l o p m e n t a l s e t . The d e m o g r a p h i c d a t a c o u l d n o t be u t i l i z e d a s p r e d i c t o r s o r i n d i c a t o r s o f a b u s e . I g n o r a n c e o f g r o w t h a n d d e v e l o p m e n t norms i n t h i s s t u d y c o u l d be a t t r i b u t e d t o l a c k o f c o g n i t i v e k n o w l e d g e o r t o e m o t i o n a l f a c t o r s . I g n o r a n c e d o e s n o t a p p e a r t o be a c a u s e o f a b u s e , h o w e v e r , t h i s l e a v e s t h e p r o b l e m o f t h e e t i o l o g y o f a b u s e r e l a t i v e l y u n r e s o l v e d . P a r e n t i n g i s l e a r n e d , why t h e n , d o e s one p a r e n t who d o e s n o t know g r o w t h a n d d e v e l o p m e n t a b u s e , w h i l e a n o t h e r w i t h a s i m i l a r l a c k o f k n o w l e d g e d o e s n o t a b u s e ? A s w i t h much r e s e a r c h i n v o l v i n g human b e i n g s , t h e f i n d i n g s o f t h i s s t u d y h a v e g e n e r a t e d more q u e s t i o n s t h a n a n s w e r s . R e c o m m e n d a t i o n s a r i s i n g f r o m t h i s s t u d y w e r e b a s e d on some o f t h e s e q u e s t i o n s . SUMMARY The p u r p o s e o f t h e s t u d y was t o d e t e r m i n e i f t h e r e was a r e l a t i o n s h i p b e t w e e n a m o t h e r ' s d e v e l o p m e n t a l s e t and c h i l d a b u s e . S i n c e t h e l i t e r a t u r e assumes a b u s i v e p a r e n t s e x p e c t m a t u r e b e h a v i o r u n r e a l i s t i c a l l y e a r l y f r o m t h e i r c h i l d r e n , i g n o r a n c e o f g r o w t h a n d d e v e l o p m e n t was p o s t u l a t e d a s an e t i o l o g i c a l f a c t o r i n a b u s e . I n t h e d a t a c o l l e c t e d , w i t h a s a m p l e s i z e o f t w e n t y - t h r e e , no s i g n i f i c a n t r e l a t i o n -s h i p was e s t a b l i s h e d b e t w e e n d e v e l o p m e n t a l s e t a n d a b u s e , a l t h o u g h r e p l i c a t i o n o f t h e s t u d y may show s i g n i f i c a n c e - b a s e d on t h e r e g r e s s i o n l i n e o f a b u s e l e v e l on d i s a r r a y a s i n c h a p t e r . f o u r . V a r i a b l e s f r o m t h e p a r t i c i p a n t s ' l i f e s t y l e s f a i l e d t o r e l a t e t o a b u s e . T h e r e w e r e s i g n i f i c a n t r e l a t i o n s h i p s b e t w e e n a b u s e 46 and m o t h e r ' s e d u c a t i o n ; a nd a l s o b e t w e e n d e g r e e o f d i s a r r a y a n d number o f c h i l d r e n , m o t h e r ' s e d u c a t i o n , i n v o l v e m e n t o f a m a l e and employment. The o r i g i n a l n u l l h y p o t h e s i s was a c c e p t e d a n d t h e f i n d i n g s d i s c u s s e d i n r e l a t i o n t o m e t h o d o l o g i c a l a n d t h e o r e t i c a l c o n t r i b u t i o n s t o t h e r e s u l t s . CONCLUSIONS The h y p o t h e s i s t h a t t h e r e i s no s i g n i f i c a n t r e l a t i o n -s h i p b e t w e e n a m o t h e r ' s d e v e l o p m e n t a l s e t a n d a b u s e was a c c e p t e d . The r e s u l t s c a n be c a u t i o u s l y g e n e r a l i z e d t o f e m a l e -h e a d e d , s i n g l e p a r e n t f a m i l i e s . Due t o c e r t a i n l i m i t a t i o n s o f t h e s t u d y , i t was n o t d e s i r a b l e t o g e n e r a l i z e b e y o n d t h e s a m p l e o f f a m i l i e s e m p l o y e d i n t h e s t u d y . IMPLICATIONS N u r s i n g R e s e a r c h T h i s s t u d y c h a l l e n g e d a n e t i o l o g i c a l a s s u m p t i o n f o u n d i n t h e l i t e r a t u r e on c h i l d a b u s e . F u r t h e r s t u d y i s n e e d e d t o d e t e r m i n e t h e o r y a nd t o d i r e c t p r a c t i c e . Q u e s t i o n s a r i s i n g f r o m t h e s t u d y i n c l u d e : how i s g r o w t h a n d d e v e l o p m e n t know-l e d g e a f a c t o r i n c h i l d r e a r i n g ? ; what a r e t h e i n d i c a t o r s a n d p r e d i c t o r s o f a b u s e ? An a w a r e n e s s o f t h e n e e d f o r c a r e f u l , c r i t i c a l a n a l y s i s o f n o n - e m p i r i c a l l y t e s t e d a s s u m p t i o n s h a s b e e n e n g e n d e r e d i n t h i s a u t h o r . T h i s p e r s p e c t i v e h e l p s one se e how much o f t h e o r y i s u n t e s t e d and assumed t o be t r u e . 47 Many more o f t h e " t r u t h s " n e e d s t u d y t o v a l i d a t e b a s i n g p r a c t i c e on them. T h e r e i s a t r e n d i n c o n t e m p o r a r y r e s e a r c h t o d e v e l o p t o o l s and s k i l l s t h a t w o u l d p r e d i c t p a r e n t s a t r i s k t o a b u s e ( K e n n e l l e t a l . , 1974; M e l n i c k and H u r l e y , 1969; S m i t h e t a l . , 1 9 7 3 ) . T h i s s t u d y e x p l o r e d f a c t o r s t h a t do n o t r e l a t e c a u s a l l y and d i r e c t e d f u r t h e r r e s e a r c h t o c l u s t e r p o t e n t i a l p r e d i c t o r s o r e v e n t o q u e s t i o n i f a c l e a r i n d i c a t o r e x i s t s f o r t h e c o m p l e x phenomenon o f c h i l d a b u s e . W i t h n u r s i n g ' s a s s e s s m e n t s k i l l s a nd i n v o l v e m e n t i n many p h a s e s o f f a m i l y l i f e , t h e r e a r e o p p o r t u n i t i e s f o r t h e s t u d y o f i n d i v i d u a l s a nd g r o u p s i n t e r m s o f t h o s e f a c t o r s i n d i f f e r e n t i a t i n g a b u s i v e f r o m n o n - a b u s i v e p a r e n t s . F o r e x a m p l e , d e v e l o p m e n t o f a h i g h - r i s k t o o l f o r u s e by o b s t e t r i c a l a n d n e o n a t a l n u r s e s c o u l d f a c i l i t a t e p r e -v e n t i v e i n t e r v e n t i o n , and r e f e r r a l t o p u b l i c h e a l t h a g e n c i e s t o s u p p o r t i d e n t i f i e d f a m i l i e s s o t h a t a b u s e d o e s n o t o c c u r . I t w o u l d be i n t e r e s t i n g t o a d m i n i s t e r t h e g r o w t h and d e v e l o p m e n t t o o l t o d i f f e r e n t p r o f e s s i o n a l g r o u p s , s u c h a s , n u r s e s , c h i l d c a r e w o r k e r s a n d s o c i a l w o r k e r s . S i n c e a b u s i v e and n o n - a b u s i v e m o t h e r s c a n n o t be s e p a r a t e d a c c o r d i n g t o l e v e l o f g r o w t h and d e v e l o p m e n t k n o w l e d g e , c o u l d p r o f e s s i o n a l s ? Does e d u c a t i o n a l p r e p a r a t i o n i n c r e a s e s u c h k n o w l e d g e o r i s t h e k n o w l e d g e e v e n n e c e s s a r y t o p r o f e s s i o n a l p r a c t i c e ( o r p a r e n t i n g ) ? Does anyone know o r n e e d t o know g r o w t h and d e v e l o p m e n t n orms? I t w o u l d seem t h a t t h e s e b a s i c q u e s t i o n s n e e d s t u d y t o v a l i d a t e t h e i m p o r t a n c e g i v e n t o k n o w l e d g e o f age a p p r o p r i a t e norms. 48 N u r s i n g E d u c a t i o n An i m p o r t a n t i m p l i c a t i o n f o r n u r s i n g e d u c a t i o n i s t h e n e e d t o t e a c h s t u d e n t s t o r e a d and p r a c t i c e c r i t i c a l l y . The s t u d e n t must be a b l e t o d e f e n d t h e r a p e u t i c i n t e r v e n t i o n b a s e d on u s e o f r e s e a r c h a n d l i t e r a t u r e , b o t h c o n t r i b u t i n g t o a k n o w l e d g e b a s e . S k i l l a n d k n o w l e d g e o f r e s e a r c h m e t h o d s and a n a l y s i s p r o v i d e s t h e f o u n d a t i o n f o r s o p h i s t i c a t e d a w a r e n e s s . I f , i n f u r t h e r s t u d y , i t became o b v i o u s t h a t t e a c h i n g g r o w t h a n d d e v e l o p m e n t norms c o u l d i n f l u e n c e a b u s e , s t u d e n t s w o u l d n e e d t o know and be a b l e t o t e a c h s u c h norms. I n t e a c h i n g t h e c o n c e p t o f a b u s e , s t u d e n t s n e e d t o be t a u g h t t h e r e i s no s i n g l e c a u s e o r e x p l a n a t i o n and t h a t f u r t h e r r e s e a r c h i s n e c e s s a r y . N u r s i n g P r a c t i c e I t i s d i f f i c u l t t o s e p a r a t e p r a c t i c e f r o m e d u c a t i o n and r e s e a r c h . Much o f t h e l i t e r a t u r e r e v i e w e d s t r e s s e d t h e i m p o r t a n c e o f c o m m u n i t y - b a s e d f a c i l i t i e s b u t t h e e f f e c t i v e n e s s o f t h i s s e t t i n g h a s n o t b e e n e m p i r i c a l l y v a l i d a t e d n o r a r e a l l n u r s e s p r e p a r e d a c a d e m i c a l l y t o w o r k i n t h e c o m m u n i t y ( C a r t e r e t a l . , 1976; G r e e n , 1977; Z a l b a , 1 9 7 1 ) . The f o c u s o f t h e f a m i l y a s t h e u n i t o f t r e a t m e n t was t h e m a j o r i m p l i c a t i o n f o r p r a c t i c e i n t h e t r e a t m e n t o f c h i l d a b u s e . T h i s r e s e a r c h i m p l i e s t h e p r a c t i t i o n e r s h o u l d be c r i t i c a l o f e x i s t i n g t h e o r y a n d c o m m i t t e d t o i t s s t u d y . I f t h e e t i o l o g i c b e l i e f i s t h a t a b u s e a r i s e s f r o m a c o m p l e x i t y o f p s y c h o s o c i a l i s s u e s , t h e p r a c t i t i o n e r m ust be a b l e t o 49 c o l l e c t data and analyze s o c i a l and f a m i l y systems to intervene e f f e c t i v e l y . T h e o r e t i c a l assumptions cannot be accepted unless one i s w i l l i n g to r i s k spurious r a t i o n a l e s t h a t support themselves but have l i t t l e to do w i t h r e a l i t y . I t would seem, that teaching c o g n i t i v e growth and development s k i l l s to parents would enhance t h e i r knowledge i f t h e i r ignorance i s e d u c a t i o n a l . For emotionally based ignorance, the p r a c t i t i o n e r needs s k i l l and knowledge of fa m i l y systems and an a b i l i t y t o intervene using nursing process w i t h developmental set as a small piece of a complex whole. RECOMMENDATIONS With regard to t h i s study's d u p l i c a t i o n , the author has four recommendations. The f i r s t i s tha t the number of growth and development items i n the t o o l be increased and the number of age groups decreased. This would increase r e l i a b i l i t y and v a l i d i t y of the t o o l . The second recommendation i s tha t the mothers at the Pr o j e c t would be assigned a number on the abuse continuum c l o s e r to the day of data c o l l e c t i o n . The dynamic nature of human beings and abuse would be accounted f o r i n coding the mothers as they were at the time they were administered the s o r t . A t h i r d recommendation would be to increase the sample s i z e to increase s t a t i s t i c a l s i g n i f i c a n c e of the r e s u l t s . A l a r g e r n would increase g e n e r a l i z a b i l i t y i f the sample were 50 r e p r e s e n t a t i v e o f t h e t a r g e t p o p u l a t i o n . F i n a l l y , c l u s t e r i n g v a r i a b l e s t o s e e k o u t a s s o c i a t i o n s c o u l d be a t t e m p t e d . E x a m i n i n g i n d i v i d u a l v a r i a b l e s w o u l d seem t o be t o o s i m p l i s t i c g i v e n t h e i n t e r p l a y o f p s y c h o s o c i a l f a c t o r s i n an i n d i v i d u a l ' s l i f e . T h i s w o u l d t a k e i n t o a c c o u n t f u r t h e r e x p l o r a t i o n o f t h e r e l a t i o n s h i p t h a t a p p e a r e d t o e x i s t b e t w e e n d e g r e e o f d i s a r r a y a n d d e m o g r a p h i c d a t a i n t h i s s t u d y . F o r f u r t h e r s t u d y t h e a u t h o r w o u l d recommend r e s e a r c h o f t h e n a t u r e o f p a r e n t a l i g n o r a n c e w i t h r e g a r d t o d e v e l o p -m e n t a l norms a n d t h e p a r t i t p l a y s i n a b u s e . The a s s u m p t i o n t h a t a b u s i v e p a r e n t s e x p e c t u n r e a l i s t i c a l l y m a t u r e b e h a v i o r a t a n e a r l y age may be t r u e b u t n o t r e l a t e d t o k n o w l e d g e o f g r o w t h a nd d e v e l o p m e n t . D i f f e r e n t f a c t o r s , s u c h a s p a r e n t i -f i c a t i o n o f a c h i l d may a c c o u n t f o r t h e e x p e c t a t i o n s a n d n e e d s s t u d y . ( B o s z o r m e n y i - N a g y e t a l . , 1 9 7 3 : 1 5 1 ) . N u r s i n g h a s a v e r y s i g n i f i c a n t r o l e t o p l a y i n t h a t g r o w t h a nd d e v e l o p m e n t norms a r e t a u g h t t o n u r s e s who i n t u r n t e a c h o t h e r s . N u r s e s i n t e r a c t w i t h f a m i l i e s i n t h e home and h o s p i t a l , f r e q u e n t l y i n t i m e s o f s t r e s s . T h i s o p p o r t u n i t y t o o b s e r v e a n d r e c o r d p e r t i n e n t d a t a r e l a t e d t o c h i l d r e a r i n g w o u l d e n a b l e n u r s e s t o make s i g n i f i c a n t a d d i t i o n s t o t h e t h e o r y o f a b u s e . The a u t h o r w o u l d recommend n u r s i n g i n c r e a s e i t s s t u d y w i t h i n t h i s a r e a . T h i s c h a p t e r p r e s e n t e d a d i s c u s s i o n o f t h e f i n d i n g s , a summary, c o n c l u s i o n s , i m p l i c a t i o n s a n d r e c o m m e n d a t i o n s f o r n u r s i n g r e s e a r c h , e d u c a t i o n a n d p r a c t i c e . I t w o u l d a p p e a r t h a t t h e r e i s a n e e d f o r c r i t i q u e a n d s t u d y o f c u r r e n t t h e o r y a n d 51 l i t e r a t u r e . M o s t i m p o r t a n t l y , i t a p p e a r s t h a t one c a n n o t r e l a t e s i n g l e f a c t o r s , s u c h a s d e v e l o p m e n t a l s e t t o a b u s e , a n e c e s s a r y r e q u i r e m e n t i n t h e s e a r c h f o r c a u s a l i t y . 52 APPENDICES APPENDIX I C a l c u l a t i o n of the C - S t a t i s t i c ( C i c c h e t t i et a l . , 1971:101-109) To assess t e s t -r e t e s t r e l i a b i l i t y P e r f e c t agreement Agreement w i t h i n one p o i n t Agreement w i t h i n two p o i n t s Agreement w i t h i n three p o i n t s Agreement w i t h i n four point s P e r f e c t disagreement X 1 . 8 . 6 .4 .2 0 f*134-4 22 2 1 0 0 0 120-4 18 6 1 0 0 0 110-5 17 8 0 0 0 0 * Mother 1 s code number and number on the abuse continuum. C i c c h e t t i ' s C a l c u l a t i o n : (X±f ) + ( x 2 f ) + ( x 3 f ) 2 5 25 i s the number of growth and development items. 134-4 - 0.968 120-4 - 0.936 which i n d i c a t e s high r e l i a b i l i t y 110-5 - 0.936 54 APPENDIX I I GROWTH AND DEVELOPMENT ITEMS FROM DEVELOPMENTAL PROFILE INFANT 0 - 1 2 MONTHS 1. The c h i l d , without help, can r o l l from h i s stomach t o hi s back and from h i s back to h i s stomach. 2. The c h i l d t r i e s to get o b j e c t s t h a t are near but beyond h i s reach. 3. The c h i l d shows he wants t o have a t t e n t i o n p a i d t o him. 4. The c h i l d r e a c t s , by being more or l e s s a c t i v e , to such changes as being picked up or having a person come i n t o the room. 5. The c h i l d babies or uses some sounds which show he/she i s i m i t a t i n g words or speech. TODDLER 13 - 24 MONTHS 1. The c h i l d walks w e l l enough, without support, t h a t he i s able to walk about the house unwatched without bumping i n t o o b j e c t s . 2. The c h i l d knows the d i f f e r e n c e between food and things which cannot be eaten. 3. When t o l d , the c h i l d b r ings something from or takes some-t h i n g to some place. 4. The c h i l d can use p e n c i l s or crayons w i t h d e f i n i t e attempts to make marks on a surface. 5. The c h i l d knows the names of at l e a s t f i v e t h i n g s , not i n c l u d i n g the names of people and can say them c l e a r l y . PRE-SCHOOL 2 - 4 YEARS 1. The c h i l d u s u a l l y walks u p s t a i r s and downstairs by p l a c i n g only one foot on each s t a i r . 2. The c h i l d cares f o r h i s own t o i l e t needs without help except f o r f a s t e n i n g back buttons or bows. 3. The c h i l d l i k e s to help the parents around the house. 4. The c h i l d uses s i z e words (l a r g e , l i t t l e , b i g , small) of t e n and c o r r e c t l y . 5. The c h i l d can t e l l people (by speaking or hold i n g up fin g e r s ) how o l d he/she i s now, was l a s t year, and how o l d next year. 55 APPENDIX I I - (Continued) SCHOOL-AGE 5 - 1 0 YEARS 1. The c h i l d can catch a t e n n i s b a l l w i t h one hand when thrown ge n t l y from at l e a s t s i x f e e t away. 2. The c h i l d u s u a l l y decides what to wear. 3. The c h i l d has at l e a s t one chore he/she has to do weekly such as washing dishes or t a k i n g out the garbage. 4. The c h i l d knows by memory at l e a s t three telephone numbers which he/she i s able to use. 5. The c h i l d , without help, has w r i t t e n and mailed a l e t t e r . ADOLESCENCE 1 1 - 1 6 YEARS 1. The c h i l d competes i n sports and shows as much s k i l l as most of the same-sexed eleven and twelve year o l d s . 2. The c h i l d manages money w e l l enough so t h a t he plans ahead. 3. The c h i l d could do a r e s p o n s i b l e job of b a b y s i t t i n g , during the day, w i t h a three year o l d c h i l d f o r at l e a s t three hours. 4. The c h i l d uses the newspaper r e g u l a r l y (at l e a s t weekly) f o r news information. 5. The c h i l d has w r i t t e n and addressed, by h i m s e l f , a t l e a s t f i v e l e t t e r s , each at l e a s t ten sentences long. FROM THE LITERATURE 1. The c h i l d obeys a u t h o r i t y . 2. The c h i l d can hold a grudge. 3. The c h i l d can comfort h i s parents when they are upset. 4. The c h i l d understands h i s parents' expectations. 5. The c h i l d knows when h i s parent i s f r u s t r a t e d . 58 APPENDIX V DEMOGRAPHIC DATA PLEASE FILL IN THE SPACES AS INDICATED. THANK YOU FOR YOUR ASSISTANCE. 1. Your age i n years 2. L i s t your children by age and sex. 3. State the l e v e l of education attained including any course you may be taking now. Is there a s i g n i f i c a n t male figure involved with you and your children on a regular basis? YES NO 5. Are you employed? YES NO 59 APPENDIX V I INTRODUCTION AND INSTRUCTIONS GIVEN MOTHERS PRIOR TO SORTING CARDS. (Show c o n s e n t t o m o t h e r ) H i I My name i s G a i l L i n d s a y a n d I'm a n u r s e . I h a v e b e e n w o r k i n g w i t h g r o u p s o f m o t h e r s t h i s y e a r t o e x p l o r e w h a t t h e y know a b o u t c h i l d r e n ' s g r o w t h a n d d e v e l o p m e n t . T h e r e i s no p e r s o n a l i d e n t i f y i n g i n f o r m a t i o n s u c h a s name o r a d d r e s s u s e d . Y o u c a n s t o p y o u r p a r t i c i p a t i o n a t any p o i n t . The p r o c e s s i n v o l v e s p l a c i n g e a c h o f 30 c a r d s i n t o one o f f i v e e n v e l o p e s i n d i c a t i n g w h e r e y o u b e l i e v e a c h i l d c a n f i r s t p e r f o r m t h e b e h a v i o r . I t u s u a l l y t a k e s f i f t e e n m i n u t e s f o r t h e e n t i r e p r o c e s s . I w i l l make my r e s u l t s a n d c o n c l u s i o n s a v a i l a b l e t o y o u i n A p r i l . ( Get c o n s e n t s i g n e d ) INSTRUCTIONS P l e a s e p l a c e e a c h c a r d i n t h e e n v e l o p e r e p r e s e n t i n g t h e age w h e r e y o u t h i n k a c h i l d c a n f i r s t p e r f o r m t h e b e h a v i o r on t h e c a r d . 60 APPENDIX VII CONSENT LETTER LETTER OF CONSENT I UNDERSTAND the purpose of the study i s to use an information gathering t o o l about a c h i l d ' s growth and development. I UNDERSTAND c o n f i d e n t i a l i t y w i l l be respected as no i d e n t i f y i n g or personal data w i l l be used i n the process. I UNDERSTAND tha t I can withdraw at any time from the study. I KNOW the process i n v o l v e s p l a c i n g t h i r t y cards i n t o one of f i v e envelopes and i n v o l v e s one h a l f hour of my time at Project/Daycare. I UNDERSTAND the r e s u l t s of the process w i l l be a v a i l a b l e i n w r i t t e n form at Project/Daycare. I AGREE to p a r t i c i p a t e Date Researcher APPENDIX V I I I RAW DATA AND DEGREE OF DISARRAY GROWTH AND DEVELOPMENT Mother's code number and number on abuse continuum ITEMS IN AGE ( 3ROUP 201-1 202 -1 203-1 204-1 206-1 207-1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 3 1 Infant 1 1 1 1 1 1 4 1 1 1 1 1 1 5 1 1 1 1 1 1 6 1 2 3 +1 2 2 2 7 3 +1 1 - I 3 +1 1 - I 3 +1 3 +1 8 2 Toddler 1 - I 2 3 +1 2 3 +1 2 9 2 2 3 +1 1 - I 3 +1 2 10 2 2 2 2 2 2 11 2 - I 3 2 - I 2 - I 3 3 12 3 3 3 2 - I 3 2 - I 13 3 Pre- 2 - I 3 2 - I 1 - I I 2 - I 3 14 school 3 3 3 2 - I 3 3 15 3 3 3 3 4 3 16 4 3 3 - I 3 - I 4 3 - I 17 3 - I 2 - I I 3 - I 2 - I I 3 - I 4 18 4 School- 3 - I 3 - I 4 2 - I I 3 - I 4 19 age 4 4 4 4 4 4 20 4 4 4 4 4 4 21 5 5 5 5 5 4 22 3 - I I 4 - I 5 4 - I 5 5 23 5 Adoles- 5 5 5 5 5 5 24 cent 4 - I 5 4 - I 4 - I 5 5 25 4 - I 4 - I 4 - I 4 - I 5 4 - I 26 2 2 3 2 2 2 27 3 4 2 2 3 3 2 8 Behav i o r a l 3 3 3 2 3 3 2 9 items 3 3 4 2 3 3 20 1 3 1 1 4 2 DEGREE OF DISARRAY 133 86 116 167 62 79 LEGEND: Arabic numerals represent the age group i n t o which a mother sorted the item. Roman numerals represent the number of age groups a mother's s o r t d i f f e r e d from the i d e a l l i t e r a t u r e s o r t . 62 A p p e n d i x V I I I ( C o n t i n u e d ) GROWTH AND DEVELOPMENT M o t h e r ' s c o d e number and number on a b u s e c o n t i n u u m ITEMS I N AGE GROUP 220-1 221-1 222-1 102-2 103-2 111-2 1 1 1 1 1 1 1 2 1 1 1 1 1 1 3 1 I n f a n t 1 1 1 2 +1 1 1 4 1 1 1 2 +1 1 1 5 1 1 2 +1 1 2 + 1 1 6 1 - I 2 2 2 2 2 7 3 +1 2 2 3 +1 3 + 1 3 8 2 T o d d l e r 2 2 3 +1 2 2 2 9 2 3 +1 2 3 +1 2 2 10 2 1 - I 2 2 3 + 1 2 11 2 - I 2 - I 3 3 3 2 12 2 - I 3 3 3 3 2 13 3 P r e - 3 3 3 3 3 3 14 s c h o o l 3 3 3 3 4 +1 3 15 3 3 3 3 3 3 16 4 4 4 4 4 5 17 4 3 - I 4 4 4 4 18 4 S c h o o l - 3 - I 4 4 4 4 4 19 age 4 4 4 3 - I 4 4 20 4 4 4 4 5 + 1 4 21 1 - I V 4 - I 5 4 - I 4 - I 4 22 4 - I 4 - I 4 - I 4 - I 5 4 23 5 A d o l e s - 5 5 5 5 5 5 24 c e n t 4 - I 4 - I 5 5 5 5 25 4 - I 4 - I 4 - I 4 - I 5 5 26 2 2 3 3 3 2 27 3 3 4 4 3 3 2 8 B e h a v i o r a l 3 4 3 4 3 3 29 i t e m s 4 4 5 2 4 3 30 3 4 3 3 2 1 DEGREE OF DISARRAY 142 133 55 101 59 8c 63 Appendix V I I I (Continued) GROWTH AND DEVELOPMENT Mother's code number and number on abuse continuum ITEMS IN AGE GROUP 113 1-2 126-2 106-3 122-3 128-3 136-3 1 1 1 1 1 1 1 2 1 2 +1 1 1 1 1 3 1 Infant 1 1 2 +1 2 +1 1 1 4 2 +1 2 +1 1 1 2 +1 1 5 2 +1 2 +1 1 1 1 1 6 2 3 +1 3 +1 2 2 2 7 2 3 +1 3 +1 3 +1 2 3 +1 8 2 Toddler 3 +1 3 +1 3 +1 2 2 3 +1 9 3 +1 3 +1 4 +11 3 +1 3 +1 2 10 2 3 +1 4 +11 3 +1 3 +1 2 11 2 - I 3 3 2 - I 2 - I 3 12 3 3 2 - I 3 3 3 13 3 Pre- 3 2 - I 2 - I 3 3 3 14 school 3 4 +1 2 - I 4 +1 2 - I 3 15 1 - I I 4 +1 3 3 3 3 16 4 4 2 - I 4 4 3 - I 17 2 - I I 4 3 5 +1 5 +1 3 - I 18 4 School- 4 4 4 +1 4 4 4 19 age 4 5 +1 3 3 - I 4 4 20 4 5 +1 4 +1 3 - I 5 +1 4 21 5 5 4 - I 4 - I 4 - I 5 22 4 - I 5 5 4 - I 5 5 23 5 Adoles- 5 5 5 5 5 5 24 cent 4 - I 5 5 5 5 4 - I 25 4 - I 5 5 4 - I 5 4 - I 26 2 2 4 5 4 3 27 5 4 3 4 4 2 2 8 Behavioral 3 3 3 4 4 4 29 items 4 4 3 4 5 3 30 1 5 3 4 4 1 DEGREE OF DISARRAY 119 82 100 154 84 90 64 Appendix V I I I (Continued) GROWTH AND DEVELOPMENT ITEMS IN AGE GROUP Mother's code number and number on abuse continuum 109-4 120-4 134-4 138-4 110-5 1 2 3 4 5 6 7 8 9 10 1 Infant 2 Toddler 1 1 1 1 1 2 3 +1 2 2 3 +1 1 1 1 2 +1 1 2 3 +1 3 +1 2 2 2 +1 2 +1 1 2 +1 3 +11 2 2 3 +1 3 +1 3 +1 1 1 2 +1 2 +1 2 +1 2 4 4 2 4 + 11 +11 + 11 1 1 1 2 +1 2 +1 2 2 3 +1 2 2 11 12 13 3 Pre-14 school 15 3 3 3 3 3 3 3 2 - I 3 3 2 3 3 3 3 3 4 4 4 3 + 1 +1 +1 2 - I 3 3 4 +1 3 16 17 18 4 School-19 age 20 4 4 4 4 3 - I 4 3 - I 3 - I 4 4 5 +1 3 - I 4 4 4 4 4 5 +1 5 +1 5 +1 4 3 - I 3 - I 4 4 21 22 23 5 Adoles-24 cent 25 4 - I 4 - I 4 - I 5 4 - I 3 - I I 4 - I 4 - I 5 5 5 5 4 - I 4 - I 5 5 4 - I 5 5 4 - I 3 - I I 4 - I 5 5 4 - I 26 3 27 3 28 Behavioral 3 2 9 items 4 30 2 2 2 1 3 2 2 2 3 4 2 3 4 5 5 2 3 3 4 3 3 DEGREE OF DISARRAY 124 125 89 140 131 APPENDIX IX DEMOGRAPHIC DATA OF PARTICIPANTS IN THE STUDY MOTHERS1 CODE NUMBER AND - CHILDRENS' PRESENT FULL-TIME PRESENT FULL-TIME NUMBER ON THE MOTHERS' AGE SEX AND AGE MOTHERS' INVOLVEMENT OF A EMPLOYMENT ABUSE CONTINUUM IN YEARS IN YEARS EDUCATION SIGNIFICANT MALE OUTSIDE THE HOME 201-1 26 1 female 2h years High school graduate Yes Yes 202-1 27 1 female 2h years Less than high school Yes Yes 203-1 26 1 male 2\ years High school plus certificate No Yes 204-1 29 1 male 3h years High school plus accounting course No Yes 206-1 28 1 female 2 years High schoolplus 3 years c o l l e g e No No 207-1 30 1 male 2-3/4, 1 female 5 yrs High school graduate No Yes 220-1 45 1 male 26, 1 female 27 yrs Less than high school Yes Yes 221-1 32 1 female 7 years High school graduate No Yes 222-1 23 1 female 3% years High school plus 2 yrs university Yes No 102-2 28 4 males; 1 female, 2-10yrs Less than high school Yes No 103-2 17 1 male; 1 female, 1-2 yrs Less than high school No No Appendix IX (Continued) MOTHERS' CODE NUMBER AND CHILDRENS1 PRESENT FULL-TIME PRESENT FULL-TIME NUMBER ON THE MOTHERS' AGE SEX AND AGE MOTHERS' INVOLVEMENT OF A EMPLOYMENT ABUSE CONTINUUM IN YEARS IN YEARS EDUCATION SIGNIFICANT MALE OUTSIDE THE HOME 111-2 17 2 male, 1 female, 3-5 yrs High school graduate No No 113-2 21 1 male 4 years Less than high school Yes No 126-2 24 1 female 2 years High school graduate No No 106-3 21 2 females 2, 3 years High school graduate No No 122-3 29 3 males, 1 female, 2-8 yrs Less than high school Yes No 128-3 26 1 female 1 year Less than high school No No 136-3 25 2 males, 1 female, 1-8 yrs Less than high school No No 109-4 29 2 males, 4-5 years Less than high school No Yes 120-4 25 2 males, 2-3 years Less than high school No No 134-4 23 1 male, 1 female, 3-5 yrs Less than high school Yes No 138-4 20 1 female 2 years Less than high school Yes No 110-5 35 1 male, 2 females, 7-12 yrs Less than high school No Yes 67 APPENDIX X RAW DATA OF FREQUENCY TABULATION OF. ABUSE LEVEL VERSUS AGE GROUP FOR BEHAVIORAL ITEMS Item 26: The c h i l d obeys a u t h o r i t y 1 2 3 4 5 Infant Toddler Preschool School age Adolescent 1 Non-abusive 201 220 203 202 221 222 204 206 207 2 At r i s k 111 113 102 126 103 ABUSE LEVEL 3 Neglect 136 106 128 122 4 Suspected 120 134 109 138 5 Known 110 68 I t e m 27: The c h i l d c a n h o l d a g r u d g e . 1 2 3 4 5 I n f a n t T o d d l e r P r e s c h o o l S c h o o l age A d o l e s c e n t 1 Non-abusive 203 201 220 202 204 206 221 222 207 2 A t r i s k 111 102 113 103 126 m u s E 3 N e g l e c t 136 106 122 LEVEL 5 Known 110 128 4 S u s p e c t e d 120 109 138 134 I t e m 28: The c h i l d c a n c o m f o r t h i s p a r e n t s when t h e y a r e u p s e t . 1 2 3 4 5 I n f a n t T o d d l e r P r e s c h o o l S c h o o l age A d o l e s c e n t 1 Non-abusive 204 201 207 221 202 220 203 222 206 103 111 102 113 126 2 A t r i s k ABUSE LEVEL 3 N e g l e c t 106 122 128 136 4 S u s p e c t e d 120 109 138 134 5 Known 110 69 I t e m 29: The c h i l d u n d e r s t a n d h i s p a r e n t s ' e x p e c t a t i o n s , 1 2 3 4 5 I n f a n t T o d d l e r P r e s c h o o l S c h o o l age A d o l e s c e n t 1 Non-abusive 204 201 202 203 222 206 207 220 221 2 A t r i s k 102 111 103 113 126 3 N e g l e c t 106 136 122 128 4 S u s p e c t e d 120 109 138 134 5 Known 110 I t e m 30: The c h i l d knows when h i s p a r e n t i s f r u s t r a t e d , 1 2 3 4 5 I n f a n t T o d d l e r P r e s c h o o l S c h o o l a ge A d o l e s c e n t 1 Non-abusive 201 207 202 206 203 220 221 204 222 2 A t r i s k 111 103 102 126 113 3 N e g l e c t 136 106 122 128 4 S u s p e c t e d 109 138 120 134 5 Known 110 70 LITERATURE CITED BOOKS Abdellah, F. and Levine, E. 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The B a t t e r e d C h i l d i n C a n a d a , T o r o n t o : M c L e l l a n d and S t e w a r t L t d . , 1975. W a l t e r s , D. P h y s i c a l a n d S e x u a l A b u s e o f C h i l d r e n , B l o o m i n g t o n : I n d i a n a U n i v e r s i t y P r e s s , 1975. Wasserman, S. "The A b u s e d P a r e n t o f t h e A b u s e d C h i l d , " i n The B a t t e r e d C h i l d , by J . L e a v i t t (ed.) F r e s n o : G e n e r a l L e a r n i n g C o r p . , 1974. JOURNALS B e l l , R. " S t i m u l u s C o n t r o l o f P a r e n t o r C a r e t a k e r B e h a v i o r by O f f s p r i n g , " D e v e l o p m e n t a l P s y c h o l o g y 4 ( 1 9 7 1 ) : 6 3 - 7 2 . B e s h a r o v , D. " B u i l d i n g a Community R e s p o n s e f o r C h i l d A b u s e and M a l t r e a t m e n t , " C h i l d r e n T oday 4 ( S e p t e m b e r - O c t o b e r 1 9 7 5 ) : 2 - 4 . B l u m b e r g , M. " P s y c h o p a t h o l o g y o f t h e A b u s i n g P a r e n t , " A m e r i c a n J o u r n a l o f P s y c h o t h e r a p y , V o l . 28 ( 1 9 7 4 ) : 2 1 - 2 9 . C a r t e r , J . a n d D r e s c h e r , L. "A Community R e s p o n s e t o C h i l d A b u s e , " B.C. M e d i c a l J o u r n a l 18 ( F e b r u a r y 1 9 7 6 ) : 4 5 - 4 6 . C i c c h e t t i , D. and A l l i s o n , T. "A New P r o c e d u r e f o r A s s e s s i n g R e l i a b i l i t y o f S c o r i n g EEG S l e e p R e c o r d i n g s , " A m e r i c a n  J o u r n a l o f EEG T e c h n o l o g y 11 ( 1 9 7 1 ) : 1 0 1 - 1 0 9 . C o h e n , J . "A C o e f f i c i e n t o f A g r e e m e n t f o r N o m i n a l S c a l e s , " E d u c a t i o n a l a n d P s y c h o l o g i c a l M e a s u r e m e n t 20 ( 1 9 6 0 ) : 37-46. D a n i e l , J . a n d Hyde, J . J r . " W o r k i n g w i t h H i g h - R i s k F a m i l i e s , " C h i l d r e n T o d a y 4 (November-December 1 9 7 5 ) : 2 3 - 2 5 , 36. E l m e r , E. "A F o l l o w - u p S t u d y o f T r a u m a t i z e d C h i l d r e n , " P e d i a t r i c s V o l . 59 ( F e b r u a r y 1 9 7 7 ) : 2 7 3 - 2 7 9 . F r e i d m a n , A., J u n t h , J . and S c o b e i c , M. " N u r s i n g R e s p o n s i b i l i t y i n C h i l d A b u s e , " N u r s i n g Forum 15 ( 1 9 7 6 ) : 9 5 - 1 1 2 . F r e i d r i c h , W. a n d B o r i s k i n , J . "The R o l e o f t h e C h i l d i n A b u s e : A R e v i e w o f t h e L i t e r a t u r e , " A m e r i c a n J o u r n a l o f O r t h o - p s y c h i a t r y 46 ( O c t o b e r 1 9 7 6 ) : 5 8 0 - 5 9 0 . 73 G a l d s t o n , R. " O b s e r v a t i o n s on C h i l d r e n Who Have Been P h y s i c a l l y A b u s e d and T h e i r P a r e n t s , " A m e r i c a n J o u r n a l o f P s y c h i a t r y , 122 ( O c t o b e r 1 9 6 5 ) : 4 4 0 - 4 4 3 . G e l l e s , R. " C h i l d A b u s e a s P s y c h o p a t h o l o g y , " A m e r i c a n J o u r n a l  o f O r t h o p s y c h i a t r y , V o l . 43 ( J u l y 1 9 7 3 ) : 6 1 1 - 6 2 1 . G i l , D. " V i o l e n c e A g a i n s t C h i l d r e n , " J o u r n a l o f M a r r i a g e a n d  t h e F a m i l y , (November 1971) : 637-648. G i l b e r t , M. " B e h a v i o r a l A p p r o a c h t o t h e T r e a t m e n t o f C h i l d A b u s e , " N u r s i n g T i m e s , ( J a n u a r y 1 9 7 6 ) : 1 4 0 - 1 4 3 . G r e e n , A., G a i n e s , R. and S a n g r u n d , A. " C h i l d A b u s e : P a t h o -l o g i c a l Syndrome o f F a m i l y I n t e r a c t i o n , " A m e r i c a n  J o u r n a l o f P s y c h i a t r y 131:8 ( A u g u s t 1 9 7 4 ) : 8 8 2 - 8 8 6 . G r e e n , A. "A P s y c h o d y n a m i c A p p r o a c h t o t h e S t u d y and T r e a t m e n t o f C h i l d - A b u s i n g P a r e n t s , " J o u r n a l o f C h i l d P s y c h i a t r y , 15 (Summer 1 9 7 6 ) : 4 1 4 - 4 2 9 . G r e e n , A. " S o c i e t a l N e g l e c t o f C h i l d A b u s i n g P a r e n t s , " V i c t i m o l o g y V o l . I I , No. 2 (Summer 1 9 7 7 ) : 2 8 5 - 2 9 3 . H a r p e r , L. "The Young a s a S o u r c e o f S t i m u l i C o n t r o l l i n g C a r e t a k e r B e h a v i o r , " D e v e l o p m e n t a l P s y c h o l o g y 4 (1971) :73-88. H e i f e r , R. "The E t i o l o g y o f C h i l d A b u s e , " P e d i a t r i c s , V o l . 5 1 , ( A p r i l 1973) -.777-779. K e n n e l l , J . ; J e r a u l d , R.; W o l f e , H.; C h e s l e r , D.; K r e g e r , N.; M c A l p i n e , W.; S t e f f a , M. and K l a u s , M. " M a t e r n a l B e h a v i o r One Y e a r A f t e r E a r l y a n d E x t e n d e d P o s t - p a r t u m C o n t a c t , " D e v e l o p m e n t a l M e d i c a l C h i l d N e u r o l o g y 16 ( 1 9 7 4 ) : 1 7 2 - 1 7 9 . L y s t a d , M. " V i o l e n c e a t Home: A R e v i e w o f t h e L i t e r a t u r e , " A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y 4 5 , ( A p r i l 1 9 7 5 ) : 3 28-345. M a r g r a i n , S. " R e v i e w : B a t t e r e d C h i l d r e n , T h e i r P a r e n t s : T r e a t m e n t a n d P r e v e n t i o n , " C h i l d C a r e H e a l t h and  D e v e l o p m e n t 3 ( J a n u a r y - F e b r u a r y 1 9 7 7 ) : 4 9 - 6 3 . M a r t i n , H . ; B e i z l e y , P.; Conway, E.; Kempe, C. "The D e v e l o p m e n t o f A b u s e d C h i l d r e n , " A d v a n c e s i n P e d i a t r i c s , V o l . 21 ( 1 9 7 4 ) : 2 5 - 7 3 . M e l n i c k , B. and H u r l e y , J . " D i s t i n c t i v e P e r s o n a l i t y A t t r i b u t e s o f C h i l d - A b u s i n g M o t h e r s , " J o u r n a l o f C o n s u l t i n g a n d  C l i n i c a l P s y c h o l o g y 33 ( 1 9 6 9 ) : 7 4 6 - 7 4 9 . M i l o w e , I . and L o u r i e , R. "The C h i l d ' s R o l e i n t h e B a t t e r e d C h i l d Syndrome," J o u r n a l o f P a e d i a t r i c s 65 ( 1 9 6 4 ) : 1 0 7 9 - 1 0 8 1 . 74 P a u l s o n , M.; A f i f i , A.; Thomason, M. a n d C h a l e f f , A. "The MMPI: A D e s c r i p t i v e M e a s u r e o f P s y c h o p a t h o l o g y i n A b u s i v e P a r e n t s , " J o u r n a l o f C l i n i c a l P s y c h o l o g y 3 0 ( 1 9 7 4 ) : 3 8 7 - 3 9 0 . R o l l i n s , N.; L o r d , J . ; W a l s h , E.; W e i l , G. "Some R o l e s C h i l d r e n P l a y i n T h e i r F a m i l i e s : S c a p e g o a t , B a b y , P e t , a n d P e a c e m a k e r , " J o u r n a l o f C h i l d P s y c h i a t r y 12 ( 1 9 7 3 ) : 5 1 1 - 5 3 1 . S i l v e r , L.; D u b l i n , C. and L o u r i e , R. "Does V i o l e n c e B r e e d V i o l e n c e ? " C o n t r i b u t i o n s f r o m a s t u d y o f t h e C h i l d A b u s e Syndrome." A m e r i c a n J o u r n a l o f P s y c h i a t r y 126:3 ( S e p t e m b e r 1 9 6 9 ) : 4 0 4 - 4 0 7 . S m i t h , S. a n d H a n s o n , R. " I n t e r p e r s o n a l R e l a t i o n s h i p s and C h i l d R e a r i n g P r a c t i c e s i n 214 P a r e n t s o f B a t t e r e d C h i l d r e n , " B r i t i s h J o u r n a l o f P s y c h i a t r y 127 (December 1 9 7 5 ) : 5 1 3 - 5 2 5 . S m i t h , S., H a n s o n , R. a n d N o b l e , S. " P a r e n t s o f B a t t e r e d B a b i e s : A C o n t r o l l e d S t u d y , " B r i t i s h M e d i c a l J o u r n a l 4 ( 1 9 7 3 ) : 3 8 8 - 3 9 1 . S o l o m o n , T. " H i s t o r y a n d Demography o f C h i l d A b u s e , " P e d i a t r i c s V o l . 51 (1973) : 773-776. S p i n e t t a , J . a n d R i g l e r , D. "The C h i l d - A b u s i n g P a r e n t : A P s y c h o l o g i c a l R e v i e w , " P s y c h o l o g i c a l B u l l e t i n 77 ( 1 9 7 2 ) : 2 9 6 - 3 0 4 . S p i t z , R. "On t h e G e n e s i s o f S u p e r - E g o Components," P s y c h o  a n a l y t i c S t u d y o f t h e C h i l d 13 ( 1 9 5 8 ) : 3 7 5 - 4 0 3 . Z a l b a , S. " B a t t e r e d C h i l d r e n , " T r a n s - A c t i o n ( J u l y - A u g u s t 1 9 7 1 ) : 5 8 - 6 1 . MONOGRAPHS G e l l e s , R. Community A g e n c i e s a n d C h i l d A b u s e : L a b e l l i n g a n d G a t e k e e p i n g , U n i v e r s i t y o f Rhode I s l a n d , D e p a r t m e n t o f S o c i o l o g y , G r a n t f r o m t h e O f f i c e o f C h i l d D e v e l o p m e n t , 90-C-425, d a t e o f p u b l i c a t i o n n o t a v a i l a b l e , pp. 1-25. 

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