The Maltreatment of Children

456 Pages·1978·14.55 MB·English

by  Myre Sim (auth.)

The Maltreatment of Children
TO
May, Benjamin and Michelle
The Maltreatment of Children
EDITED BY
Selwyn M. Smith
Psychiatrist-in-Chief
Royal Ottawa Hospital
and
Director, Department of Forensic Psychiatry,
Faculty of Medicine, University of Ottawa, Canada
~~
MTPPRESS LIMITED International Medical Publishers
Published by
MTP Press Limited
Falcon House
Lancaster, England
Copyright © 1978 Selwyn M. Smith
Softcover reprint of the hardcover I 5t edition 1978
All rights reserved. No part of this publication
may be reproduced, stored in a retrieval
system, or transmitted in any form or by any
means, electronic, mechanical, photocopying,
recording or otherwise, without prior
permission from the publishers
ISBN-13: 978-94-011-6164-0 e-lSBN 13: 978-94-011-6162-6
DOl: 10.1007/978-94-011-6162-6
Text set in 11/12 pt Photon Imprint, printed by Redwood Burn Ltd., Trowbridge
and bound in Great Britain at The Pitman Press, Bath
Contents
List of Contributors vu
Foreword lX
Gerald J. Sarwer-Foner
Preface xu
Selwyn M. Smith
1. Introduction - a child speaks
Myre Sim
2. Child abuse and neglect - medical aspects 9
Christine E. Cooper
3. Radiological and pathological aspects of the battered child syndrome 69
J. M. Cameron
4. Management of the problem 83
A. White Franklin
5. The epidemiology of child abuse 96
J. E. Oliver
6. 'I'he extent of child abuse 121
J. E. Oliver, Jane Cox and Ann Buchanan
7. The psychiatrist's viewpoint 175
P. D. Scott
8. The psychological aspects of child abuse 205
D. R. Henry
9. The needs of children 221
Mia Kellmer Pringle
10. Child abuse, neglect and deprivation and the family 245
J. Jacobs
11. Medical-legal and societal problems involving children - child
prostitution, child pornography and drug-related abuse; recommended
legislation 317
Judianne Densen-Gerber and S. F. Hutchinson
12. The contributions of the social agencies and the social worker 351
Sheila M. Noble
vi CONTENTS
13. The emergence of the child as a legal entity 393
D. Ford
Appendix 415
J. E. Oliver
Index 449
List of Contributors
Buchanan, Ann
Research Social Worker
Burderop Hospital
Wroughton, Swindon, England
Cameron, Professor James M., M.D., Ph.D., M.R.C.Path., D.M.J.Path.
Professor of Forensic Medicine
The London Hospital Medical College
London, England
Cooper, Christine, E., M.D., F.R.C.R.
Consultant Paediatrician
Newcastle, England
Cox, Jane, B. Sc.
Sociologist and Teacher
Burderop Hospital
Wroughton, Swindon, England
Densen-Gerber, Judianne, J.D., M.D., F.L.C.M.,
Director, The Odyssey Institute
New York City, New York, USA
Ford, Donald, M.A., J.P.
Chief Magistrate, Bow St. Court
London, England
Henry, Donald R., Ph.D.
Clinical Psychologist
Department of Forensic Psychiatry
Royal Ottawa Hospital
Ottawa, Canada
Hutchinson, Stephen, F., J.D.
The Odyssey Institute
New York City, New York, USA
Vll
Jacobs, Joseph, M.D., F.R.C.P., F.R.C.P.(C), D.C.M.
Professor of Paediatrics
McMaster University
Hamilton, Canada
Kellmer Pringle, Mia, C.B.E., B.A., Ph.D., D.Sc.
National Children's Bureau
London, England
Noble, Sheila, J.P., M.A.
Department of Economics and Social Science
City of Birmingham Polytechnic
Birmingham, England
Oliver, Jack E., M.B., B.S., M.R.C.S., M.R.C.Psych.
Consultant Psychiatrist in Mental Handicap and Child Psychiatry
Burderop Hospital
Wroughton, Swindon, England
Sarwer-Foner, Gerald J., M.D., F.R.C.P.(C), D.A.B.P.N., F.R.C.Psych.,
F.A.P.A., F.A.C.P., F.A.C.O.N., F.A.C.Pn., F.A.A.Sc., F.I.C.P.M.
Chairman, Department of Psychiatry
Faculty of Medicine and Psychiatrist-in-Chief, Ottawa General
Hospital
University of Ottawa
Ottawa, Canada
Scott, Peter D (Deceased), C.B.E., M.A., M.D., F.R.C.P., F.R.C.Psych.
Formerly Consultant Psychiatrist
The Maudsley Hospital
London, England
Sim, Myre, M.D., F.R.C.P., F.R.C.Psych., F.R.C.P.(C), D.P.M.
Professor of Psychiatry
Faculty of Medicine
University of Ottawa
Ottawa, Canada
Smith, Selwyn M., B.S., M.D., M.R.C.Psych., D.P.M., F.R.C.P.(C)
Associate Professor, of Psychiatry Faculty of Medicine
University of Ottawa; Director, Department
of Forensic Psychiatry, Royal Ottawa Hospital
Ottawa, Canada
White-Franklin, Alfred, M.B., F.R.C.P.
Consultant Paediatrician
Harley St., London, England
viii
Foreword
The maltreatment of children is an issue that has always been with us and
civilized societies provide a range of services both social and medical to care for
the children and families afflicted. In recent years, greater attention has been
drawn to the medical aspects by competent authorities in the fields of forensic
medicine, forensic psychiatry, epidemiological psychiatry, child psychiatry and
family psychiatry; as well as the social aspects by those child welfare and child
care agencies who have the difficult and distasteful task of removing children,
with the help of the courts, from parents who can abuse them and are not able
to care for them adequately. A multitude of social agencies, whose range of ac
tivities involve both the care and, where possible, the social betterment of
afflicted families are now involved.
Not least in importance is an increase in our global knowledge to help in the
prevention or better treatment of these problems. This means more informa
tion on familial and genetic factors in human central nervous system develop
ment in its broadest sense. This would include how the central nervous system
originates, mediates and controls the build up, speed of development and im
pulsive release, mastery and direction of aggressive drives and impulses. Very
little is so far known about these factors.
The proper application of existing psychiatric knowledge about stress im
posed on mothers' passive-dependency needs by the demands of mothering a
child, particularly when the mother is a single parent, or inadequately nurtured
with love by a mate, or is unwilling or ambivalent about being a parent mother,
whose security, in terms of a constant object relationship is being threatened, is
an important area that can be improved by the application of existing psy
chiatric expertise. Similarly, application of existing psychiatric data and
knowledge on family dynamics, the psychodynamics of aggression and rage and
the eruption of uncontrolled, impulse ridden anger and aggression can be help-
ix
x FOREWORD
ful in understanding and dealing with the behaviour patterns of mothers and
fathers, or of men living with women who have very young children and who
have very limited tolerance for children.
The importance to all who deal with children in trouble of knowing that men
and women, who have themselves suffered from inadequate 'mothering' and
'fathering' have difficulties in relating to others, including violent outbursts
towards their own children when they themselves mate, is obvious. The
teaching of the dynamics of projective self envy, as it is felt towards their
children, at having parents, etc., is another factor that is often lacking or is
poorly done. The details of which psychopathology determines which type of
reaction and which outcome, the problems of the build up of aggressive impulse
and its expression, the problem of how to control and handle these factors, are
areas that merit much-needed further study.
The virtue of this book is that it brings together recognized authorities in the
field of paediatrics, law, forensic and epidemiological psychiatry, social work,
social work agencies, and psychiatry in its broadest sense and collates the
knowledge on these issues in well-balanced discussions. These excellent con
tributions by themselves would not have the general impact that has been
achieved by the careful selection and editing of Dr Selwyn Smith, Director of
Forensic Psychiatry, University of Ottawa, Faculty of Medicine.
Gerald J. Sarwer-Foner