Development and Psychometric Properties of the Child Self-Report Multidimensional

Neglectful Behavior Scale (MNBS-CR)

Glenda Kaufman Kantor, Ph.D.

Funded by N.I.C.H.D. Grant # RO1MD39144-01

Grant No. 2002-JW-BX-0002 (OJJDP)Grant No. 2002-JW-BX-0002 (OJJDP)

Prior Child Report Measures of Neglect

• Few child measures

• Young children rarely source of data in instruments measuring neglect

• Some measure just one or two components of neglect

• Varying definitions

Measurement Issues

• Omission

• Chronicity

• Causal factors separate from acts

• Acts vs. Injury

• Cultural Boundaries

Challenges in Measurement

• Children’s terminology• Language development, grammar• Cultural aspects of language• Reliability• Age of child• Distractibility• Cognitive ability• Response Sets• Recall Bias• Desire to please

Central Aims of the Study

• Develop a standardized instrument to measure neglect based on Child Self-Report

• Describe the relationship of neglect to child behavior problems & family characteristics

Assessment of Child Neglect in Community and Clinical Samples:

Development of the Multidimensional Neglectful Behavior Scale for Child Self-

Report

Glenda Kaufman Kantor &

Murray Straus, Family Research Lab; Carolyn Mebert, UNH, Wendy Brown, FRL, Crystal Macallum & Todd Flannery,

Westat

MethodsMethods

Clinical Sample

• Spurwink Child Abuse Program

• Maine DHS

• NH DCYF

Eligibility

• Inclusionary Criteria- 6-15 yrs old• Lived in foster care < 6 months (age 6-9)• Lived in foster care < 1 year (age 10-15)

• Exclusionary Criteria- • Visually impaired • Hearing impaired• No spoken language ability• Non-English speaking • Formal diagnosis of mental retardation• Deemed “not interviewable” by clinician

Sample Characteristics

• Clinical Sample• N = 224• 49% 6-9 years of age• 50% 10-15 yrs. of age• 50% female• 50% male• 8% non-white

• Community Sample• N = 84• 71% 6-9 years of age• 29% 10-15 yrs. of age• 57% female• 43% male• 27% non-white

Child & Parent Characteristics

• Children– 1/3 in clinical sample had some emotional or or

severe behavioral problem- depression, anxiety, ADHD, conduct disorder

• Parents– 10% Developmental Disability– 1/3 Substance Abuse Problem– 1/3 Depression– >60% Domestic Violence

Maltreatment Types in Clinical SampleNumber & % in

Group

(Total N = 224)

Overall Types

Neglect

Physical abuse

Sexual abuse

Emotional/Psychological abuse

138 (61.6%)

60 (26.8%)

138 (61.6%)

67 (29.9%)

“Pure” Categories (Participants with only one designated abuse type)

Neglect

Physical abuse

Sexual abuse

Emotional/Psychological abuse

118 (52.7%)

42 (18.8%)

3 (1.3%)

73 (32.6%)

0 (0%)

Multiple Abuse Types 106 (47.3%)

Measures

Child ReportClinicianCaretaker

Child Self Report Neglect Scale

• Measures cognitive, emotional, supervision, and physical neglect

• Includes subscales on: Child Endangerment: exposure to parental conflict & violence, abandonment, and parental alcohol abuse;

• Includes subscale on child’s general feelings or appraisals of each domain

ACASI

• Audio enhanced version of the Computer Assisted Self-Administered Interview

• Uses an audio system and touch screen to interview child

• Tutorial• Scale version adapted by Age and Gender of

the Child and Gender of the Primary Caretaker

• Interactive program• Older children can take Independently• Computer game break

This girl’s father doesn’t make her feel better when

she is sad or scared

This girl’s father makes her feel better when she is sad

or scared

Which girl is most like you?

Emotional Neglect Sample Item

Is this…

Emotional Neglect Sample Item Cont.

A little Sort of A lot Really a lot like you like you like you like you

This girl’s mother does not talk to her about what she is

learning in school

This girl’s mother talks to her about what she is

learning in school

Which girl is most like you?

Cognitive Neglect Sample Item

Which boy is most like you?

This boy’s mother doesn’t know where he’s playing

outdoors

This boy’s mother knows where he’s playing

outdoors

Supervision Neglect Sample Item(age 6-9)

Which boy is most like you?

This boy’s father does not find out where he is going after

school

This boy’s father finds out where he is going after

school

Supervision Neglect Sample Item(age 10-15)

Hasn’t left alone for a couple of days without grown-ups

Which boy is most like you?

This boy’s mother makes sure he takes a bath

This boy’s mother does not make sure he takes a bath

Physical Neglect Sample Item

Sees grown-ups in the house hitting each other

Hears grown-ups in the house fighting

Child Witnessing Item:Parent Lets Other People

in the House Hurt Child

Which girl is most like you?

Some girls are unhappy a lot of the time

Other girls are pretty happy a lot of the time

Depression Sample Item

Is this…

Depression Sample Item Cont.

A little Sort of A lot Really a lot like you like you like you like you

ResultsResults

Reliability and Validity

• Full Scale Alpha Older Children =.94

• Full Scale Alpha Young Children .76

• Emotional Subscale- highest alphas for both young and older children

Total MNBS-CR Scores by Child Neglect Sample: Age 6-9

3.96

8.31

0

2

4

6

8

10

Community Sample Clinical Sample

Neglect Total

p < .01

N = 60 N = 110

Total MNBS-CR Scores by Child Neglect Sample: Age 10-15

5.10

11.40

0

2

4

6

8

10

12

Community Sample Clinical Sample

Neglect Total

N = 24 N = 114

% Neglect Reported by Child and Community & Clinical Samples

6-9 years 10-15 years

Subscale Clinical

n = 66

Cmty.

n = 63

Clinical

n = 78

Cmty.

n = 24

% Emotional 38 26 43 29

% Cognitive 47 36 35 29

% Supervision 40 26 46 39

% Physical 50 32 34 25

% Abandonment 6 2 5 4

% Violence Exp. 37 28 25 18

% Alcohol Exp. 9 0 9 0

Neglect Profile

6-9 yr. old childrenSevere Neglect :• Abandonment• Alcohol-related Parental

Neglect• Physical Neglect--Not

enough food in the house

• Inadequate SupervisionMinor Neglect

10-15 yr. old childrenSevere Neglect• Failure to Protect--lets

other people in the house hurt him

• Abandonment• Alcohol-related parental

neglect• Physical NeglectMinor Neglect--separate

factor

Effects of Parental Characteristics on Child Reports of Neglect

• Series of Analyses– Severity weighted score MNBS-CR =

dependent variable– Clinical Record Data on:

• Parent Mental Illness (No effects found)• Domestic Violence• Parent Substance Abuse*

% Child Behavioral Problems by MNBS-CR Median Split Scores

36%37%

31%

62%

0%

10%

20%

30%

40%

50%

60%

70%

6-9 year olds 10-15 year olds

Below Median

Above Median

N = 98N = 102

DV, Victimization and Child Depression

• Among young children, self-reported depression is not associated with their reports of exposure to conflict/violence.– But Exposure to conflict/violence is significantly

correlated with their self-reports of emotional neglect

• Among older children, self-reports of exposure to conflict/violence are associated with significantly more self-reported depression.

DV, Victimization and Child Behavior Problems: Summary of Analysis Results

6-9 Year Olds• No significant effects

of DV, Sex of Caretaker, or self reports of severe Neglect on CBCL scores

10-15 Year Olds• No significant effects

of DV or sex of caretaker on CBCL scores

• Severe Neglect is a significant predictor of CBCL scores:

• Beta=.336, t=2.101, p=.04

PPVT Standard Scores by Presenting Maltreatment Type

PPVT Standard Score

Age 6-9 (n=109) Age 10-15 (n=107)

Neglect Concerns

Yes 94.24** 96.81

No 100.54 99.50

Physical Abuse Concerns

Yes 92.81 96.41

No 98.43 98.20

Sexual Abuse Concerns

Yes 98.75* 97.78

No 93.26 97.53

Psych. Abuse Concerns

Yes 95.46 98.85

No 97.53 96.96* p < .05, ** p < .01

Relation between MNBS-CR Scores & Parent/Child Characteristics: 6-9

• Higher neglect total & appraisal scores were related to more child self-reported depression

• Child Reports of supervisory neglect significantly correlated with Clinical Reports of Parental drug abuse

• Child reports of emotional neglect significantly correlated with their reports of conflict/violence exposure

• Higher appraisal scores were associated with lower Parent IQ scores

Sibling Concordance

• Tested 83 pairs of siblings– 61 pairs in clinical sample– 22 pairs in community

• Results of Analysis– If one sibling reported neglect, other sibs

had 78% chance of also reporting neglect– Children in Clinical sample reported greater

similarity in neglect than those in community– Gender significant predictor of concordance

(girls more concordant than boys)

Relation between MNBS-CR Scores & Parent/Child Characteristics: 10-15 (1)

• Higher neglect total & appraisal scores were related to more child self-reported depression & more severe child behavioral problems

• Greater perceptions of neglect were associated with more child-reported social, thought, & attention problems and aggressive behavior

• Higher alcohol exposure scores were related to more child-reported delinquency, thought problems, & aggressive behaviors

• Greater perceptions of neglect were associated with lower parent IQ and more parental substance abuse

Conclusions• Children, particularly older children report patterns

of severe neglect that are consistent with typical CPS cases

• Neglect multidimensional phenomenon• Parental Substance major component of Child

Neglect• No significant effects of Domestic Violence or

Parental Mental Illness• But parental failure to protect the child from being

hurt, or to keep the child safe, are associated with a severe dimension of neglect

Conclusions

• MNBS-CR is promising measure– Strong Discriminant Validity– Substantial Evidence of Construct Validity– High Reliability for Older Children– Moderate Reliability for Younger Children– Important tool for screening, assessment,

target interventions– Multiple measures best

Next Steps

• Test modified items

• Social Desirability Scale

• Follow-up Study

• Develop cutting points

• Immediate Score Reports