Development and Psychometric Properties of the Child Self-Report Multidimensional Neglectful Behavior Scale (MNBS-CR) Glenda Kaufman Kantor, Ph.D. Funded by N.I.C.H.D. Grant # RO1MD Grant No JW-BX-0002 (OJJDP)

Prior Child Report Measures of Neglect Few child measures Young children rarely source of data in instruments measuring neglect Some measure just one or two components of neglect Varying definitions

Measurement Issues Omission Chronicity Causal factors separate from acts Acts vs. Injury Cultural Boundaries

Challenges in Measurement Children’s terminology Language development, grammar Cultural aspects of language Reliability Age of child Distractibility Cognitive ability Response Sets Recall Bias Desire to please

Central Aims of the Study Develop a standardized instrument to measure neglect based on Child Self- Report Describe the relationship of neglect to child behavior problems & family characteristics

Assessment of Child Neglect in Community and Clinical Samples: Development of the Multidimensional Neglectful Behavior Scale for Child Self- Report Glenda Kaufman Kantor & Murray Straus, Family Research Lab; Carolyn Mebert, UNH, Wendy Brown, FRL, Crystal Macallum & Todd Flannery, Westat

Methods

Clinical Sample Spurwink Child Abuse Program Maine DHS NH DCYF

Eligibility Inclusionary Criteria yrs old Lived in foster care < 6 months (age 6-9) Lived in foster care < 1 year (age 10-15) Exclusionary Criteria- Visually impaired Hearing impaired No spoken language ability Non-English speaking Formal diagnosis of mental retardation Deemed “not interviewable” by clinician

Sample Characteristics Clinical Sample N = % 6-9 years of age 50% yrs. of age 50% female 50% male 8% non-white Community Sample N = 84 71% 6-9 years of age 29% yrs. of age 57% female 43% male 27% non-white

Child & Parent Characteristics Children –1/3 in clinical sample had some emotional or or severe behavioral problem- depression, anxiety, ADHD, conduct disorder Parents –10% Developmental Disability –1/3 Substance Abuse Problem –1/3 Depression –>60% Domestic Violence

Maltreatment Types in Clinical Sample Number & % in Group (Total N = 224) Overall Types Neglect Physical abuse Sexual abuse Emotional/Psychological abuse 138 (61.6%) 60 (26.8%) 138 (61.6%) 67 (29.9%) “Pure” Categories (Participants with only one designated abuse type) Neglect Physical abuse Sexual abuse Emotional/Psychological abuse 118 (52.7%) 42 (18.8%) 3 (1.3%) 73 (32.6%) 0 (0%) Multiple Abuse Types106 (47.3%)

Measures Child Report Clinician Caretaker

Child Self Report Neglect Scale Measures cognitive, emotional, supervision, and physical neglect Includes subscales on: Child Endangerment: exposure to parental conflict & violence, abandonment, and parental alcohol abuse; Includes subscale on child’s general feelings or appraisals of each domain

ACASI Audio enhanced version of the Computer Assisted Self-Administered Interview Uses an audio system and touch screen to interview child Tutorial Scale version adapted by Age and Gender of the Child and Gender of the Primary Caretaker Interactive program Older children can take Independently Computer game break

This girl’s father doesn’t make her feel better when she is sad or scared This girl’s father makes her feel better when she is sad or scared Which girl is most like you? Emotional Neglect Sample Item

Is this… Emotional Neglect Sample Item Cont.

This girl’s mother does not talk to her about what she is learning in school This girl’s mother talks to her about what she is learning in school Which girl is most like you? Cognitive Neglect Sample Item

Which boy is most like you? This boy’s mother doesn’t know where he’s playing outdoors This boy’s mother knows where he’s playing outdoors Supervision Neglect Sample Item (age 6-9)

Which boy is most like you? This boy’s father does not find out where he is going after school This boy’s father finds out where he is going after school Supervision Neglect Sample Item (age 10-15)

Hasn’t left alone for a couple of days without grown-ups

Which boy is most like you? This boy’s mother makes sure he takes a bath This boy’s mother does not make sure he takes a bath Physical Neglect Sample Item

Sees grown-ups in the house hitting each other

Hears grown-ups in the house fighting

Child Witnessing Item: Parent Lets Other People in the House Hurt Child

Which girl is most like you? Some girls are unhappy a lot of the time Other girls are pretty happy a lot of the time Depression Sample Item

Is this… Depression Sample Item Cont.

Results

Reliability and Validity Full Scale Alpha Older Children =.94 Full Scale Alpha Young Children.76 Emotional Subscale- highest alphas for both young and older children

Total MNBS-CR Scores by Child Neglect Sample: Age 6-9 p <.01 N = 60N = 110

Total MNBS-CR Scores by Child Neglect Sample: Age N = 24N = 114

% Neglect Reported by Child and Community & Clinical Samples 6-9 years10-15 years SubscaleClinical n = 66 Cmty. n = 63 Clinical n = 78 Cmty. n = 24 % Emotional % Cognitive % Supervision % Physical % Abandonment6254 % Violence Exp % Alcohol Exp.9090

Neglect Profile 6-9 yr. old children Severe Neglect : Abandonment Alcohol-related Parental Neglect Physical Neglect--Not enough food in the house Inadequate Supervision Minor Neglect yr. old children Severe Neglect Failure to Protect--lets other people in the house hurt him Abandonment Alcohol-related parental neglect Physical Neglect Minor Neglect--separate factor

Effects of Parental Characteristics on Child Reports of Neglect Series of Analyses –Severity weighted score MNBS-CR = dependent variable –Clinical Record Data on: Parent Mental Illness (No effects found) Domestic Violence Parent Substance Abuse*

% Child Behavioral Problems by MNBS-CR Median Split Scores N = 98N = 102

DV, Victimization and Child Depression Among young children, self-reported depression is not associated with their reports of exposure to conflict/violence. –But Exposure to conflict/violence is significantly correlated with their self-reports of emotional neglect Among older children, self-reports of exposure to conflict/violence are associated with significantly more self-reported depression.

DV, Victimization and Child Behavior Problems: Summary of Analysis Results 6-9 Year Olds No significant effects of DV, Sex of Caretaker, or self reports of severe Neglect on CBCL scores Year Olds No significant effects of DV or sex of caretaker on CBCL scores Severe Neglect is a significant predictor of CBCL scores: Beta=.336, t=2.101, p=.04

PPVT Standard Scores by Presenting Maltreatment Type PPVT Standard Score Age 6-9 (n=109)Age (n=107) Neglect Concerns Yes94.24**96.81 No Physical Abuse Concerns Yes No Sexual Abuse Concerns Yes98.75*97.78 No Psych. Abuse Concerns Yes No * p <.05, ** p <.01

Relation between MNBS-CR Scores & Parent/Child Characteristics: 6-9 Higher neglect total & appraisal scores were related to more child self-reported depression Child Reports of supervisory neglect significantly correlated with Clinical Reports of Parental drug abuse Child reports of emotional neglect significantly correlated with their reports of conflict/violence exposure Higher appraisal scores were associated with lower Parent IQ scores

Sibling Concordance Tested 83 pairs of siblings –61 pairs in clinical sample –22 pairs in community Results of Analysis –If one sibling reported neglect, other sibs had 78% chance of also reporting neglect –Children in Clinical sample reported greater similarity in neglect than those in community –Gender significant predictor of concordance (girls more concordant than boys)

Relation between MNBS-CR Scores & Parent/Child Characteristics: (1) Higher neglect total & appraisal scores were related to more child self-reported depression & more severe child behavioral problems Greater perceptions of neglect were associated with more child-reported social, thought, & attention problems and aggressive behavior Higher alcohol exposure scores were related to more child-reported delinquency, thought problems, & aggressive behaviors Greater perceptions of neglect were associated with lower parent IQ and more parental substance abuse

Conclusions Children, particularly older children report patterns of severe neglect that are consistent with typical CPS cases Neglect multidimensional phenomenon Parental Substance major component of Child Neglect No significant effects of Domestic Violence or Parental Mental Illness But parental failure to protect the child from being hurt, or to keep the child safe, are associated with a severe dimension of neglect

Conclusions MNBS-CR is promising measure –Strong Discriminant Validity –Substantial Evidence of Construct Validity –High Reliability for Older Children –Moderate Reliability for Younger Children –Important tool for screening, assessment, target interventions –Multiple measures best

Next Steps Test modified items Social Desirability Scale Follow-up Study Develop cutting points Immediate Score Reports