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This chapter focuses on ways of giving voice to the survivors of institutional abuse and how their contribution can be capitalised in raising community awareness of this phenomenon. The collection of testimonies demonstrates that institutional abuse is a common and widespread phenomenon that in most cases remains unrevealed throughout the life course. The participatory research process we describe is part of an important social and clinical intervention developed in the framework of two projects. The chapter illustrates outputs and outcomes related to disclosure of institutional abuse and its long-term consequences, as well as the meaning and implications of collective trauma. Results confirm the need to promote the voice of survivors to build a new professional and community culture and sensitisation towards children's right to be heard as an essential instrument to prevent and detect institutional ill treatment. Participatory processes can overcome the resistance of individuals, professional communities and politicians to recognising the phenomenon, emphasising institutional responsibilities and the specific effects of a serious form of maltreatment that requires extraordinary and specific interventions in terms of intensity and flexibility. This chapter describes a fieldwork and research experience made possible thanks to a strong alliance with survivors who engaged in a process of reflection and theoretical elaboration that generated both social and clinical impacts.

A parent who continuously physically abuses her/his child doesn't aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12%) were caused by child battering and 13 (7%) by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot) and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse) were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent) and often substance dependence (31%). None of them were psychotic. Authorities and community members should pay attention to the change in child's behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent's life, the child may be in danger.

The paper aims to recommend legal and regulatory reforms to better prevent child abuse in childcare institutions in Hong Kong.

A summary of investigation report and news reports are referred to in describing the abuse incidents which occurred in a children’s residential home. Routine Activity Theory (RAT) is used as the framework for identifying the causes. Local and overseas legislation, regulations, case law, and policies are analysed to provide recommendations for reforms.

There are systematic failures such as workload issues, inadequate supervision, and the absence of continuing professional development (CPD) that contributed to the incidents. The regulations governing the operation of childcare centres and criminal laws against child abuse are long overdue for an update in Hong Kong. On the institutional side, this paper recommends enacting regulations that mandate CPD, lower the staff-to-child ratio, and strengthen the Social Welfare Department’s (SWD) supervisory powers over childcare centres. From the criminal law perspective, it is recommended that “reasonable chastisement” be abolished as a defence of corporal punishment, and that there be new offences for failure to report suspected child abuse incidents and causing or allowing the death/serious harm of a child.

The child abuse incidents, occurring in a childcare institution, have drawn wide public concern. Reform is required to protect vulnerable children and regain public confidence.

This chapter examines the phenomenon of internet users attempting to report and prevent online child sexual exploitation (CSE) and child sexual abuse material (CSAM) in the absence of adequate intervention by internet service providers, social media platforms, and government. The chapter discusses the history of online CSE, focusing on regulatory stances over time in which online risks to children have been cast as natural and inevitable by the hegemony of a “cyberlibertarian” ideology. We illustrate the success of this ideology, as well as its profound contradictions and ethical failures, by presenting key examples in which internet users have taken decisive action to prevent online CSE and promote the removal of CSAM. Rejecting simplistic characterizations of “vigilante justice,” we argue instead that the fact that often young internet users report feeling forced to act against online CSE and CSAM undercuts libertarian claims that internet regulation is impossible, unworkable, and unwanted. Recent shifts toward a more progressive ethos of online harm minimization are promising; however, this ethos risks offering a new legitimizing ideology for online business models that will continue to put children at risk of abuse and exploitation. In conclusion, we suggest ways forward toward an internet built in the interests of children, rather than profit.

Culture significantly influences individuals' lives and shapes their behaviour in an ecological framework. In this chapter, we examine the issue of children's participation in research about child abuse and neglect (CAN) in the context of Turkey – a country that bridges the Asian and European continents. This study was based on a review examining studies on CAN in Turkey. Thus, the main goal was to find cultural explanations for the scarcity of participatory research with children in the field of child maltreatment. A review examining studies on CAN in Turkey found that no study included children victims of CAN or explored why children victims of CAN have not been participating in research. Therefore, we analysed ecological factors influencing the participation of children in CAN studies and interpreted the findings based on our observations as experts in this field. The analysis indicated that causes are not only due the characteristics of the caregivers and children but also result from the interaction of various environmental and systemic factors. Recommendations for politicians and researchers to increase children's participation in research are discussed.

Based on an extensive literature review, this chapter outlines key developments in global health and research during the last century with focus on the emergence of violence and child maltreatment as international public health priorities. Violence has been known to humans for millennia, but only in the late 1990s was it recognised as a global public health issue. Every year, an estimated 1 billion children are exposed to trauma, loss, abuse and neglect. Child maltreatment takes a social and economic toll on countries. Research initiated in 1985 found child maltreatment to be associated with increased disease, disability and premature death in adult survivors. The global availability of data on child maltreatment is, however, sporadic with low validity and reliability. Few global experts have consulted and involved the survivors of child maltreatment, as the experts by experience, in their attempts to provide a more comprehensive picture of reality. Youth and adult survivors of child maltreatment are often traumatised by the experience, and it is important to use trauma-informed approaches to prevent re-traumatisation. Participatory and inclusive research on child maltreatment is only in its infancy. There is a need for more inclusive research, designed by survivors for survivors, hereby strengthening local capacity building and informing policymakers from the bottom up. This chapter reviews lessons learnt and provides recommendations for how to enhance the participation and inclusion of the experts by experience in research on child maltreatment.

The purpose of this paper is to educate forensic interviewers about autism spectrum disorder (ASD) and tools for interviewing youth with ASD when there are concerns of child sexual abuse (CSA).

Research is reviewed to discuss risk factors for CSA in youth with ASD, why CSA is often not recognized and research-based strategies for forensically interviewing youth with ASD.

Youth with ASD are at increased risk of CSA compared to neurotypical peers, but recognition of CSA in youth with ASD can be difficult. Forensic interviewing strategies can help interviewers obtain reports of CSA from youth with ASD.

Given the increase in prevalence of ASD and the increased risk of CSA, forensic interviewers need to have information about ASD, about why CSA may not be recognized, about risk factors for CSA and, especially, about how to accommodate for ASD when conducting forensic interviews.

This paper provides a novel framework for considering evidence-based practices for forensically interviewing youth with ASD when there are concerns of CSA. Specifically, this paper includes multiple, but related areas, in one article including research related to ASD, risk factors for CSA in those with ASD, obstacles to identifying CSA and the implications of this research for specific strategies regarding how to forensically interview youth with ASD when there are concerns of CSA.

The Models of Child Health Appraised (MOCHA) project recognises that child health policy is determined to a great extent by national culture; thus, exploring and understanding the cultural influences on national policies are essential to fully appraise the models of primary care. Cultures are created by the population who adopt national rituals, beliefs and code systems and are unique to each country. To understand the effects of culture on public policy, and the resulting primary care services, we explored the socio-cultural background of four components of policy-making: content, actors, contexts and processes. Responses from the MOCHA Country Agents about recent key national concerns and debates about child health and policy were analysed to identify the key factors as determinants of policy. These included awareness, contextual change, freedom, history, lifestyle, religion, societal activation and tolerance. To understand the influence of these factors on policy, we identified important internal and external structural determinants, which we grouped into those identified within the structure of health care policy (internal), and those which are only indirectly correlated with the policy environment (external). An important child-focused cultural determinant of policy is the national attitude to child abuse. We focused on the role of primary care in preventing and identifying abuse of children and young people, and treating its consequences, which can last a lifetime.