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[Investigation and analysis of child neglect in 1163 urban children aged 3 - 6 years].

OBJECTIVE
Child abuse and neglect (CNS) increasingly have become a serious problem in modern society all over the world. Children neglected and abused are at risk for maladaptation in behavioral, emotional, social, cognitive, and physical functioning. The purpose of this investigation was to develop the Child Neglect Scale for children aged 3 - 6 years in Chinese urban areas and to test the reliability and validity of this norm.


METHODS
According to the principle and procedure of developing scales, a child neglect questionnaire was designed. Multistage sampling was used in the study in accordance with sex, age, the levels of economy and kindergartens, a random sample of 1,465 children aged 2 - 6 years was selected from 25 cities. Of the 1,465 subjects who completed the Child Neglect Questionnaires again 2 weeks later, 66 had completed data on each of the two occasions. The Child Neglect Questionnaires were completed by parents and caregivers. The data were analyzed using items analysis, factor analysis, internal consistency analysis and the reliability and validity of the norm were tested. The factor structure of the Child Neglect Scale was determined using an oblique rotation. The internal consistency was reflected in Cronbach's alpha. Since no existing categorization scheme on child neglect could be found in the literature, one was formulated in an attempt to efficiently and meaningfully group similar types of caregiver behaviors. The initial pool of potentially neglecting caregiver behaviors was drawn from literature. The most common patterns of parental behaviors were grouped according to six neglect subscale schemes found in the literature, with modifications made to increase item specificity and reduce overlap. The initial Child Neglect Questionnaire contained a 25-item physical neglect subscale, a 59-item emotional neglect subscale, a 23-item educational neglect subscale, a 20-item safety neglect subscale, a 10-item medical neglect subscale, a 9-item social neglect subscale.


RESULTS
Completed Child Neglect Questionnaires were obtained from 1,457 subjects, 726 males and 731 females. The overall findings of this study came from 1,163 subjects, because children aged 2 years (294 subjects) were removed from subjects by statistical method. The 91-item Child Neglect Scale was presented to the respondent as a child neglect questionnaire with a 9-item social neglect subscale and some items in other subscales were removed from the initial questionnaire by using statistical method. The questionnaire contained 17 physical neglect items, 40 emotional neglect items, 17 educational neglect items, a 10 safety neglect items, and 7 medical neglect items. The internal consistency of the overall Child Neglect Scale as reflected in Cronbach's alpha was 0.94, the split-half reliability was 0.88, the test-retest reliability was 0.92. For physical, emotional, educational, safety, medical neglect subscale, Cronbach's alpha, respectively was 0.80, 0.88, 0.84, 0.68, 0.60, the split-half reliability was 0.54 - 0.88, the test reliability was 0.89, 0.94, 0.87, 0.80, 0.77, respectively. The construct validity, face validity and exterior validity of the norm were good. For physical, emotional, educational, safety, medical neglect subscale and overall child neglect scale, the scores of percentiles 90 were used as cut-point. They were 35, 80, 40, 20, 15, 190, respectively.


CONCLUSIONS
The norm was consistent with China's economic-cultural background and reality. It not only may be used for research purpose but also may be useful in assessing parent's and child-oriented individual's behaviors and attitude as a measuring instrument.