Reflections on service provision based on results from Swedish national school studies 1995- 2016. Riga February 2018 Staffan Janson Sweden What is the point of making study like this? To give a knowledge base for politicians and stakeholders like preschools, schools, health services, Police forces a.o. about what it looks like concerning upbringing and violence at the present time By making repeated surveys with the same methodology, point at trends in behavior and attitudes. Point at development of new phenomena In case the trends are positive try to explain why the development goes I a positive direction and hopefully be a model and inspiration for other countries when it comes to decent behavior towards children and the support of child rights.

The most vulnerable – who cares for them? Poly-victimized children Severely neglected Children placed in foster-home and out of home care Children with disabilities Children unsure about their sex (gender) Children with severely disagreeing parents Children who have no or little control of their own lives Families with multi-problems (alcohol-drugs, violence. criminality, economy)

Child polyvictimization From the 2011 national study on corporal punishment and humiliation 3202 Swedish pupils 15-16 years of age Abused any time at home 18 % Witness of IPV 7 % Psychological abuse 13 % Severe neglect 3 % Severely neglected children 85 % poly-victimized Witness of IPV 76 % poly-victimized Physicalabuse l Witness Of IPV Neglect Psychological abuse

Neglect and Quality of Life 2011 Swedish National School Study Adjusted for gender and economy

Neglect Physical: basic needs (food, shelter, hygiene) Medical: Not provided for the child´s need of health care, medicines etc. Emotional: Special treatment, witness of violence and severe threats. Lack of security, warmth and attachment. Education: Lack of control of truancy, no push to get child to school, no academic support, no attention to special educational needs Increased risk (x 2-4) in adulthood for: Depression, anxiety, behavior problems, sexual risk behaviour, eating disorders, suicidal ideation and suicides. OBS! After adjusting for other severe exposition in childhood

Children placed in foster care or in institutions Children placed in foster care or institutions have especially been subjected to poly- victimization and more severe forms of maltreatment, most of them ahead of placement.

Children with chronic diseases and disabilities Increased risk for maltreatment (all diseases and disabilities) Highest risk for neuro-psychiatric disorders (ADHD, Autism. Asperger) Almost 80 % maltreatment history in children with eating disorders More than 30 % of children with eating disorders had been subjected to any form of sexual abuse by an adult. Disabled children report witness of IPV twice as often as children with no chronic condition Parents with disabled children: Get into repeated imperative situations with their children, with increased risk for violence Feel abandoned by professionals Have high risk of divorce

Children unsure about their sex (gender)

Children with little control over their own lives

Families with multi-problems Alcohol, drugs, psychiatric and severe somatic diseases, unemployment, weak economy etc. Higher risk for repeated and severe maltreatment of children Severe risk of neglect

How can we help to make life better for our children? Advocacy for Children’s rights and welfare. Realize where the risks are highest Increase discovery of abuse and neglect – give children opportunity to talk! Make interventions focused on the child´s life circumstances. Work for gender equity and ”empower” dispriviliged mothers. Use existing well functioning social networks (neighborhood, schools etc. Work with “evidence based” methods, which are defendable from a child rights perspective. Vi startar i höst fördjupade undersökningar med föräldrar och professionella som har kontakt med funktionshindrade barn och barn med kronisk sjukdom med avsikten att: Ge en fördjupad bild av; - hur föräldrar som har barn med långvarig sjukdom/funktionsnedsättning hanterar sin livssituation och sitt föräldraskap - på vilket sätt det professionella stödet från olika samhällsinstanser påverkar familjen Att bidra med kunskap och ta fram förslag kring; - hur det intersektoriella arbetet kan utvecklas kring familjer med multipla behov och kring barn som far illa eller misstänks fara illa