1. Maltreatment and Adolescent Pregnancy and Parenting Kim Webb University of Missouri

2. MAPPP Presentation

3. Introduction to MAPPP MAPPP stands for Maltreatment and Adolescent Pregnancy and Parenting Program Goals of MAPPP: Increase community awareness of maltreatment in the lives of pregnant and parenting adolescents and their children Assist communities in addressing local issues related to maltreatment and adolescent pregnancy and parenting MAPPP p.14

4. Definition Maltreatment is a broad term used to cover all types of child abuse and neglect, relationships or interpersonal violence, battering, sexual abuse, and any other types of emotional or physical violence inflicted on an adolescent female prior to and/or during adolescent pregnancy and parenting. Maltreatment also included victimization of children born to adolescent mothers. MAPPP p.18

5. 1. What is the relationship between child maltreatment and subsequent adolescent pregnancy? 2. What are the factors associated with maltreatment of pregnant adolescents? 3. What is the likelihood that children of adolescent mothers will experience maltreatment? MAPPP Research Questions MAPPP p. 20

6. MAPPP p. 22

7. 3D. Maltreatment Prior to Adolescent Pregnancy

8. Research is just beginning to establish a link between childhood maltreatment and adolescent pregnancy MAPPP p.32

9. Definition of Sexual Victimization Noncontact molestation: someone looked at the child or forced the child to look at them while naked; sexual photographs Contact molestation: fondling Attempted Rape: trying to have unwanted sexual intercourse Rape: forced sexual intercourse MAPPP p.34

10. Prevalence of Sexual Victimization 36% or 190 had experienced noncontact molestation 51% or 275 had experienced contact molestation 42% or 225 had experienced attempted rape 44% or 235 had experienced rape In a study of 535 adolescent mothers who were 19 or younger at the time of their first pregnancy, 66% (or 351) had been sexually victimized MAPPP p.36

11. Sexual Victimization continued 1. Average age of first molestation……....9.7 years 2. First molestation before 5 years old…..24% (71) 3. Average age of first perpetrator………28 4. More than one incident of abuse……...77% (226) 5. Sexually abused by a family member….54% (259) 55% (294) of the 535 adolescent mothers had been sexually molested MAPPP p.38

12. Rape Raped at least once…………………..44% (235) Raped more than once…………..50% (118) Physical force had been used…….94% (221) Average age at first rape……………..13 years Average age of perpetrator…………..23 years According to the 535 adolescent mothers: MAPPP p.40

13. Responses to Sexual Abuse 1. Traumatic sexualization -developmentally inappropriate attitudes towards sex 2. Feeling betrayed by the perpetrator and by those who did not protect them 3. Powerlessness- feeling unable to control negative events in their lives 4. Stigmatization- thinking that others blame them for the maltreatment MAPPP p.42

14. Emotional Experiences Linked to Abuse Trauma Triggers Flashbacks Dissociative responses MAPPP p.44

15. Effects of Childhood Sexual Abuse on School Behavior Inability to focus on teacher Reoccurring disruptive memories Irrational fears Excuses and justifications for incomplete work Anger and lashing out at others, including adults MAPPP p.48

16. Effects on School Behavior continued Adopting an “I don’t care” attitude Significant gaps in learning Giving up easily Compulsive lying Chronic low self-esteem MAPPP p.50

17. Effects of Childhood Sexual Abuse Linked to Adolescent Pregnancy Poor emotional development due to trauma Poor cognitive development due to trauma Poor physical condition due to trauma MAPPP p.52

18. Sexual Abuse and Emotional Development Attachment and Bonding Relationship Difficulties –Promiscuity –Distant or avoids of opposite sex Depression Anxiety Suicidal ideation or suicide attempts

19. Sexual Abuse and Cognitive Development Brain Development –Physical conditions Heart Palpitations Panic Attacks –Behavioral effects Attention Sleep Mood

20. Sexual Abuse and Physical Condition Eating Disorders –Anorexia –Obesity Physical Appearance –Oversized Clothes –Personal Hygiene

22. 3E. Maltreatment During Adolescent Pregnancy

23. Maltreatment During Adolescent Pregnancy One in five adolescents, compared with one in six adult women, report maltreatment during pregnancy Between 17% and 26% of adolescents report maltreatment during pregnancy Maltreatment prior to pregnancy is a primary predictor of maltreatment during pregnancy Research Findings: MAPPP p.68

24. Maltreatment During Adolescent Pregnancy When they report maltreatment, pregnant adolescents are more likely to report physical abuse (i.e. hitting, slapping, etc.) Pregnant adolescents are subject to maltreatment from multiple perpetrators Pregnant adolescents enter prenatal care late in pregnancies Adolescents are at higher risk for poor pregnancy outcomes-this is compounded by maltreatment Research Findings continued: MAPPP p.70

25. Signs of Intimate Partner Violence 50% of injuries are to head, neck or face Multiple injuries at various stages of healing In pregnant women, injuries are generally to breast, abdomen or genitals Injuries may be inconsistent with explanation Time lag between actual injury and being seen Linda Bullock, University of Missouri, 1999 MAPPP p.78

27. 3F. Maltreatment of Children of Adolescent Mothers

28. Child maltreatment is a complex phenomenon with multiple causes Not all adolescents maltreat their children Not all children of adolescents are maltreated MAPPP p.96

29. A dolescents may not be able to deal effectively with the stressors in their lives and this can put their children at risk for maltreatment. MAPPP p.98

30. Risk Factors for Maltreatment of Children of Adolescent Mothers Family disorganization or disruption Lack of emotional support from an adult during childhood Violence in family of origin MAPPP p.100

31. Risk Factors for Maltreatment of Children of Adolescent Mothers continued Less education Unemployment or underemployment Number of children in the household Economic Factors related to: MAPPP p.102

32. Risk Factors for Maltreatment of Children of Adolescent Mothers continued Lack of social support for the adolescent parent Changes in primary care-giver of the child MAPPP p.104

33. Age of Mother and Risk of Maltreatment for Her Child Some researchers have found a relationship between the age of the mother and the risk for maltreatment of her child. MAPPP p.106

34. Study I: Of 2,031 substantiated cases of child maltreatment, 38% were attributed to women who gave birth to children prior to their 20th birthday. Study 2: Children born to women under 18 were twice as likely to suffer maltreatment as those born to older women. MAPPP p.108

35. Study 3: The younger the mother at the time of birth of the maltreated child, the higher the risk of maltreatment. Study 4: In a review of death records during the first year of almost 35 million children born between 1983 and 1991, the strongest risk factor for death during that year was maternal age less than 17. MAPPP p.110

36. Adolescents as Mothers Tend to be more punitive Tend to be more rigid May have more inappropriate expectations for their children May be prone to use physical discipline Compared to women who are older when they become parents, adolescent mothers: MAPPP p. 112

37. Implications for Practice: Early intervention with those who show a negative attitude prenatally Parenting education Increased social support MAPPP p.114