International Studies on the Incidence and Prevalence of Child Maltreatment: Selected Bibliography

Prepared by

Lil Tonmyr under contract to:

Child Maltreatment Division
Division of Health Surveillance and Epidemiology
Centre for Healthy Human Development
Health Canada HPB Bldg. #7, Tunney's Pasture
A.L. 0701D
Ottawa, Ontario
K1A 0L2

Editing assistance: Sharon Bartholomew

---

Table of Contents

• Introduction
• Reference list
  • Methods
    • Search Strategies
    • Keywords
    • Languages
    • Databases Consulted
    • Internet Web Sites
    • Consultations
• Incidence Studies
  • Annotations
  • Table 1: Incidence Studies
• Prevalence Studies
  • Annotations
  • Table 2: Prevalence Studies
• Registries

---

Distribution

This bibliography, Cat. H21-143/1998E, ISBN-0-662-26913-6, is available free of charge from:

National Clearinghouse on Family Violence
A.L.0201A1
Family Violence Prevention Division
Health Promotion and Programs Branch
Health Canada
Ottawa, Ontario
K1A 1B4

Fax: (613) 941-8930
Fax Link: (613) 941-7285 or toll-free: 1-888-267-1233
or call toll-free: 1-800-267-1291

© Minister of Public Works and Government Services Canada, 1998
Cat. H21-143/1998E      ISBN 0-662-82330

Acknowledgement

The Child Maltreatment Division is indebted to the following people, who assisted with the review of this bibliography:

David Allen, National Clearinghouse on Family Violence, Health Canada
D^re Lynda Fortin, Direction de l'analyse et de la surveillance de la santé et du bien-être, Québec
Dr. Karl Hanson, Solicitor General, Canada
Dr. Harriet MacMillan, Centre for Studies of Children at Risk, Hamilton, Ontario
Sandi McLeod, National Clearinghouse on Child Abuse and Neglect, USA
Karen Mihorean, Statistics Canada
Gordon Phaneuf, Child Maltreatment Division, Health Canada
Marianne Saetre, National Resource Centre for Information and Studies on Violence, Norway
Marlyn Willis, Human Resources and Development Canada
Dr. David Wolfe, University of Western Ontario, London, Ontario

Most of the abstracts provided in the bibliography are drawn from the identified journal abstracts. They are reprinted with the kind permission of the different publishers. The publishers are not responsible for the translations made by Health Canada.

---

Introduction

The Child Maltreatment Division, Health Canada, funds the Canadian Incidence Study of Reported Child Abuse and Neglect. It is the first such national incidence study in Canada. In preparation for the study the Division collected publications on incidence and prevalence studies from many different countries as well as information on the data collection methods used in studies of child maltreatment. The publications that were located have been compiled into two bibliographies: 1) Child Maltreatment Data Collection and Related Issues* and 2) International Studies on the Incidence and Prevalence of Child Maltreatment.

This bibliography, on international incidence and prevalence studies, contains the following information related to child maltreatment research:

1. Abstracts of incidence studies

   Tables that summarize the incidence studies with respect to

   • country of study
   • the source of information
   • number of reports of abuse
   • number of finalized investigations
   • substantiation rates
   • types of abuse
   • types of abuse by gender
   • time frame
   
   
2. Abstracts of prevalence studies, technical reports and selected information about secondary analysis

   Tables that summarize these studies with respect to

   • name of study
   • country of study
   • age group
   • type of abuse
   • study size
   • sampling method
   • mode of data collection
   • response rate
   • study results
   
   
3. Abstracts of articles giving information on child abuse registries

   Since studies of child abuse vary greatly in the type of study, mode of data collection, definitions, inclusion criteria and other factors, they are hard to compare. In the United States, for example, estimates of child sexual abuse among women range from 5% to 62% and among men from 3% to 27%⁽¹⁾. Vizard⁽²⁾ has observed that "this is not merely a research point, since cynics have suggested that the wide range of (mostly) prevalence statistics now reported in professional journals and in newspapers could mean that sexual abuse is either so unusual that it should be seen as a small specialist subject or, conversely, that sexual abuse is so common in the population that it should be seen as almost a normal phenomenon."

   In addition to methodologic differences, there is sometimes confusion between incidence and prevalence, meaning that the results of studies are, at best, not comparable and, at worst, misleading. For the purpose of this bibliography the following definitions are given:

   Incidence of child maltreatment is the number of new cases in a specific population occurring in a given time period, usually a year^(2-4).

   Prevalence of child maltreatment is defined as the proportion of a population at a specific point in time that was maltreated during childhood^(2-4).

   Incidence studies based on official reports tend to under report child abuse for several reasons. Many victims are not known to official agencies, police or child welfare agencies; they are afraid of being stigmatized and fear that they will not be believed^(5-9). Hall and Flannery⁽⁸⁾ theorize that adolescents do not want their parents to know because they are afraid of having their activities restricted. Moreover, children are in a dependent situation, which makes them vulnerable to intimidation⁽¹⁰⁾. Children often blame themselves for the abuse and the consequences of disclosure, such as family break up or being put in care^(7,11). MacMillan and colleagues⁽⁷⁾ also point out that professionals sometimes have failed to recognize and report child maltreatment.

   Research definitions vary among studies. Haugard and Emmery⁽¹²⁾ found in their study on undergraduates that a broad definition of sexual abuse, such as  experience of exhibitionism, resulted in a higher occurence of self-reported abuse (9.3%) than a more narrow definition (7.0%). With an even more restricted definition, such as oral, anal or vaginal intercourse, 1.7% of respondents reported abuse. In a Canadian context, Badgley⁽¹³⁾ found quite different results when comparing contact and non-contact sexual abuse.

   Since child welfare authorities in different jurisdictions have developed data systems to meet their own administrative and case management needs, there are major variations in the data collected and in published reports. Units of analysis may be either families or children⁽¹⁴⁾.

   Definitions of abuse that consider age differences between victim and perpetrator also create different estimates. Peer assaults are often seen as unworthy of attention by researchers, but there is no reason to think that children are less sensitive to peer violence than adults would be⁽¹⁵⁾. When an age gap of 5 years is used, many sibling and peer assaults would be excluded^(10,16,17). On the other hand, when the same age is permitted as a criterion, consensual sex between teenagers might be included, even though few would see it as an abusive act^(9,15,18,19). Some studies limit their definition of abuse to maltreatment by parents; abuse by relatives other than parents, teachers or babysitters may not always be captured⁽²⁰⁾.

   The number and nature of questions being asked have varied among studies. Broad questions involving wide-ranging definitions have the advantage of a higher rate of spontaneous recall, as found by Finkelhor and colleagues⁽²¹⁾. Questions that include examples of types of abuse that might have been experienced have achieved higher response rates. Such questions may be a cue for memory, but there is also a danger of report bias⁽²²⁾.

   Comparability of study populations is another difficulty. The tables in this document present information from studies using samples of different individuals: community members, physicians, patients, comprehensive school students, college students and others. Furthermore, among the studies of college students some include only males, others include only females, and still others include students of both sexes. In international comparisons, samples that appear similar may actually be quite different. For example, colleges in the United States offer only academic programs whereas United Kingdom colleges combine academic, vocational and training courses, and students may be part time or full time⁽⁹⁾.

   The mode of data collection ranges from self-administered questionnaires to face-to-face interviews. Direct interviewing techniques have provided higher response rates among women, as shown in Russell's study⁽¹⁶⁾. Nash and West⁽²³⁾ found that almost a fifth of the respondents who had not mentioned abuse in the self-administered questionnaire did so in the interview situation. The more anonymous data collection methods, such as telephone interviews and self-administered questionnaires, are more effective for male respondents⁽²⁴⁾. Some research suggests that the sex of the interviewer has an effect on response. This seems to be most important for women, who prefer interviewers of the same sex^(5,16,25). Russell⁽¹⁶⁾ matched respondents and interviewers on the basis of race and ethnic background to establish rapport. Incentives are at times built in to the studies to yield a higher participation rate, e.g., money, participation for class credit, or allowing time to fill in the questionnaire during class.

   Despite the limitations of comparability of the presented studies, the Division hopes that the bibliography will provide useful information to readers. The Division would appreciate information on other incidence and prevalence studies of child abuse and neglect.
   

---

* Copies of this publication are available from the

National Clearinghouse on Family Violence
Health Promotion and Programs Branch, Health Canada
Address Locator 0201A1, Ottawa, Canada K1A 1B4
(613) 957-2938 - Fax: (613) 941-8930
Fax Link: (613) 941-7285 or toll-free: 1-888-267-1233 or call toll-free: 1-800-267-1291

---

Reference list

1. Ghate D, Spencer L. The prevalence of child sexual abuse in Britain. Studies in child protection. London: HMSO, 1985.
2. Vizard E. Incidence and prevalence of child sexual abuse. In: Ousten J, ed., The consequences of child sexual abuse. Papers presented at the Association for Child Psychology and Psychiatry. London: Guy's Hospital, Occasional Papers No. 3, 1989:10-20.
3. Wyatt G, Peters S. Methodological considerations in research on the prevalence of child sexual abuse. Child Abuse and Neglect 1986;10:241-51.
4. Wyatt G, Peters S. Issues in the definition of child abuse in prevalence research. Child Abuse and Neglect 1988;10:241-51.
5. Sorenson SB, Stein JA, Siegel JM et al. The prevalence of adult sexual assault - the Los Angeles Epidemiologic Catchment Area Project. American Journal Epidemiology 1987;126(6): 1154-64.
6. Priest R. Child sexual abuse histories among African American college students: a preliminary study. American Journal of Orthopsychiatry 1992;62(3):475-76.
7. MacMillan HL, Fleming JE, Trocme N et al. Prevalence of child physical and sexual abuse in the community: results from the Ontario Health Supplement. Journal of the American Medical Association 1997;278(2):131-35.
8. Hall ER, Flannery PJ. Prevalence and correlates of sexual assault experiences in adolescents. Victimology: An International Journal 1984;9(3-4):398-406.
9. Kelly L, Regan L, Burton S. An exploratory study of the prevalence of sexual abuse in a sample of 16-21 year olds. London: Child Abuse Studies Unit, Polytechnic of North London, 1991.
10. Flemming JM. Prevalence of childhood sexual abuse in a community sample of Australian women. Medical Journal of Australia Aust 1997;166 (20):65-8.
11. Khan N. Patterns of child sexual abuse in Zimbabwe: an overview. Zimbabwe Journal of Education Research 1995;7(2):181-208.
12. Haugard J, Emery R. Methodological issues in child sexual abuse research. Child Abuse and Neglect 1989;13:89-100.
13. Badgley RF, Allard HA, McCormick N et al. Sexual offences against children. Ottawa: Dept. of Supply & Services, cat. no. J2-50/1984E, 1984.
14. Federal-Provincial Working Group on Child and Family Services Information. Child and family services annual statistical report. Ottawa: National Clearinghouse on Family Violence, 1996.
15. Finkelhor D, Dziuba-Leatherman J. Children as victims of violence: a national survey. Pediatrics 1994;94(4):413-20.
16. Russell DEH. The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children. Child Abuse and Neglect 1983;7:133-46.
17. Schötensack K, Ellinger T, Gross A et al. Preva-lence of sexual abuse of children in Germany. Acta Paedopsychiatrica 1992;55:211-16.
18. Krugman S, Mata L, Krugman R. Sexual abuse and corporal punishment during childhood: a pilot retrospective survey of university students in Cost Rica. Pediatrics 1992;90(1):157-61.
19. MacKenzie G, Blaney R, Chivers A et al. The incidence of child sexual abuse in Northern Ireland. International Journal Epidemiology 1993;22(2): 299-305.
20. Widom C. Sampling biases and implications for child abuse research. American Journal of Orthopsychiatry 1988;58(2):260-70.
21. Finkelhor D, Hoalting G, Lewis IA et al. Sexual abuse in a national sample of adult men and women: prevalence, characteristics and risk factors. Child Abuse and Neglect 1990;14:19-28.
22. Peter SD, Wyatt GE, Finkelhor D. Prevalence. In: Finkelhor et coll., ed. A source book on child sexual abuse. Beverly Hills, CA: Sage, 1986.
23. Nash CL, West DJ. Sexual molestation of young girls: a retrospective survey. In: West D, ed. Sexual victimisation. Aldershot: Gaver Publishing, 1985.
24. Collings SJ. Childhood sexual abuse in a sample of South African university males: prevalence and risk factors. South African Journal of Psychology 1991;21(3):153-58.
25. Schei B. Prevalence of sexual abuse history in a random sample of Norwegian women. Scandinavian Journal of Medicine 1990;18:63-8.

---

Methods

Search Strategies
The articles selected for this bibliography were identified by consulting databases and Web sites. Those dealing specifically with prevalence and incidence studies of child maltreatment were chosen.

Keywords
Incidence, prevalence, international, comparative studies, reliability, validity, questionnaire, survey, data collection, frequency.

The key words were combined with:

Child abuse, child maltreatment, physical child abuse, sexual abuse, neglect, emotional abuse, child neglect, battered child syndrome

Languages
English, French, Swedish, Dutch, Norwegian, Spanish, Icelandic and Danish.

Databases Consulted
Medline (January 1966 - August 1997)
Social Work Abstracts (January 1977- May 1997)
Sociofile (January 1974 - June 1997)
Social Science Index (February 1983 - December 1996)
Psychinfo (March 1997 - August 1997)
Sociological Abstracts (March 1997 - August 1997)
Social Science Abstracts (March 1997 - August 1997)
Books in Print (accumulative database until August 1997)
Eric (January 1966 - July 1997)

Internet Web Sites
UNICEF
World Health Organization
National Data Archive on Child Abuse and Neglect
CANDIS (The Child Abuse and Neglect Database Instrument System)
National Crime Victims Research and Treatment Center

Consultations
Vrije University, Faculty of Law, Amsterdam, the Netherlands
National Resource Centre for Information and Studies on Violence, Oslo College, Norway
American Humane Association, USA
National Data Archive on Child Abuse and Neglect, USA
National Criminal Justice Reference Service, Department of Justice, USA
Family Violence and Sexual Assault Institute, USA
National Resource Center on Child Abuse and Neglect, USA
National Clearinghouse on Child Abuse and Neglect Information, USA
International Society for the Prevention of Child Abuse and Neglect, USA
National Resource Center on Child Maltreatment, USA
National Council on Child Abuse & Family Violence, USA
Justice Canada
Statistics Canada
Human Resources and Development Canada
Centre for Youth and Media Studies, Denmark
Youth Research Centre, Sweden
Gothenburg Centre for Youth Research, Sweden
Institute of Tema Research, Sweden
Department of Youth Research, Norway
Youth Culture at Stockholm University, Sweden
Umeå Youth Research Association, Sweden
Centre for Child and Youth Research, Sweden
Institute of Educational Research, Iceland
National Centre for the Protection of Cruelty to Children, UK
Australian Institute of Health & Welfare, Australia
Statistics, Sweden