Barn som riskerar att fara illa i sin hemmiljö: Utmaningar i ett förebyggande perspektiv

The aim with this thesis was to increase the knowledge about children at risk of maltreatment and to identify challenges in a preventive perspective. Two areas have been studied; Physical abuse of children with chronic conditions/disabilities and Detection and support within the pre-school environment.

Four data sets were used: a national survey of school children (I), an in-depth interview study with parents (II) and two pre-school studies (III, IV).

I-II: Chronic conditions in children increase the risk for physical abuse, but vary with socio-economic circumstances. The highest risk for physical abuse was found among children with chronic conditions born outside Sweden. The subsequent study revealed direct risk factors related to parent and child (emotional demands in precarious situations), and indirect risk factors related to parent and professional (gradual shift in responsibility and emotionally closed environment) and social norms (taboo on talking about abuse).

III-IV: Preschool staff suspected child maltreatment for two percent of the preschool children. In less than half of the cases, the parents were informed and a report to social services was made in a third of the cases. The most common reason for not making a report was that the staff believed that the pre-school had sufficient resources to help the child. In the subsequent study, preschool teachers’ concerns about the child’s home environment were explored in a broader perspective over a one year period. The study showed that concern for the children’s home situation related to increased concern for several aspects of children’s health and development, increased need of special support in preschool, insufficient contact with parents, and lower parental socioeconomic status.

The results are discussed according to identified challenges in a preventive perspective. These include emotional obstacles for prevention and a need for a more nuanced and proactive professional approach to enable early support to children at risk of maltreatment and their parents.