Browsing by Author "Lachman, Peter Irwin"

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    Childhood sexual abuse : the Red Cross War Memorial Children's Hospital experience, 1986-1988
    (1990) McKerrow, Neil Hugh; Lachman, Peter Irwin; Jacobs, Marian
    This retrospective descriptive study reviews sexually abused children who presented to the Child Abuse Team at the Red Cross War Memorial Children's Hospital (RCWMCH) between 1 January 1986 and 31 June 1988. During this period 365 children were referred to the Child Abuse Team, of whom 357 were entered into this study. 297 of these were cases of confirmed sexual abuse. There were 48 male children and 123 children under 6 years of age. Most children were victims of a single episode of sexual abuse with only 13, 7% presenting following repeated abuse. More serious forms of sexual abuse, rape or sodomy, were common, accounting for 60% of the cases. Over 70% of the children had physical signs to substantiate their claims of having been sexually abused. Sexually transmitted disease was a common finding, being present in 15,6 % at presentation. All children were accompanied to hospital by an adult, usually a parent. 60% of the children presented directly to RCWMCH. A delay between abuse and presentation was common, only 42% of the children presenting within 48 hours of having been abused. Physical problems frequently required management. Very few children received more than crisis intervention for their emotional state and only 20% needed any form of intervention to ensure their safety. Only 1% of cases involved a female abuser. In general, the age of the abuser was older than previously reported with 18, 6% being under 20 years of age. The relationship between abused and abuser was similar to that described in the literature, as was the reaction of the family against the abuser. 27,4% were prosecuted and of those that appeared in court 7 4, 5% were convicted. Further comparison of the following sub-groups of abused children are presented: male and female, young and old, intrafamilial and extrafamilial abuse, a single episode of abuse and repeated abuse.
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    An investigation into the relationship between the development of rotation of the hip motor control
    (1991) Versfeld, Pamela Anne; Lachman, Peter Irwin
    Although the relationship between increased anteversion and abnormal motor control in children with cerebral palsy is well documented there are no published studies that look at the possible links between motor control and femoral anteversion in children without neurological deficits. Children with intoeing gait are reported to be clumsy; but this clumsiness is usually ascribed to the gait angle. The aim of this study, therefore, is to explore the possible relationship between detorsion of the femur during growth and the development of hip posture and movement. Hip internal and external rotation are commonly used as a clinical measure of anteversion of the femur. In this study the range of hip internal and external rotation (as a clinical measure of anteversion) was related to performance of motor tasks requiring control of the posture and movement of the hip. If the degree of femoral anteversion is linked to the development of motor control, the next step would be to investigate the effectiveness of exercise programmes on the process of detorsion of the femur in children with excessive medial femoral torsion.
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    Referral patterns to the Red Cross War Memorial Children's Hospital
    (1989) Lachman, Peter Irwin; Jacobs, Marian
    This prospective descriptive study describes the referral patterns to the Red Cross War Memorial Children's Hospital. The study was conducted from 1st July to 31st December 1987 and entailed the collection of all referral letters presented (9288) to the hospital and the analysis of a sample of these letters (4702). The results indicated: * The patients are similar in terms of age and sex to those attending the Outpatients Department except that relatively fewer referred patients are Black. * The private sector, i.e. general practitioners, is the largest referral agency followed by Day Hospitals. * Most patients were ref erred to the Outpatients Department without an appointment. * Of the specialist clinics, the surgical clinics, i.e. Ophthalmology and Ear, Nose and Throat Clinics, were utilised the most. * The majority of patients (84,90%) were not admitted. * The contact made by the hospital with referral agents was poor (only in 30,30%). * The quality of information in referral letters was generally poor and did not contribute to patient care. Recommendations are made to the hospital and relevant health authorities.
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    Reported child abuse and neglect in Cape Town
    (1997) Lachman, Peter Irwin
    The problem: The study of child abuse in South Africa has concentrated on management issues, and the epidemiology of child abuse and neglect has yet to be determined. Child abuse intervention programmes are based on data from studies conducted in the United States and Europe. Over the past few years practitioners in the field have expressed the need for local information to be available in order to plan future child protection programmes. A review of the literature reveals that the medico-legal model developed in the United States and the United Kingdom, based on investigation, is under strain due to the large number of reported cases of child abuse. Aims: The study aims to compare the data collected with that reported in the literature. The specific research questions include: • Can the characteristics of abused children in Cape Town be determined? • Do the characteristics of child abuse and neglect in Cape Town differ from those reported in the literature? • Should and can a child abuse reporting system be developed and implemented? • Can prevention and intervention strategies be developed based on the epidemiological data that has been collected? • Can the study in Cape Town provide an impetus for further research in the field of child abuse and neglect? • Can the results provide the basis for a National Plan of Action on child abuse and neglect? Methodology Following extensive consultation in with professionals and practitioners in the field, a child abuse reporting system was established in Cape Town, South Africa. Clear definitions of child abuse and neglect were agreed upon, and for the period October 1993 to May 1995 practitioners in the field reported all cases of child abuse and neglect to a central reporting centre. The data was entered on to a computer and analysed by the researcher. Results • The overall picture of child protection in Cape Town: • Child abuse and neglect primarily affects females in the Cape Town area; • younger children are more likely to be physically abused or neglected; • older children are more likely to be sexually abused. • Characteristics of the children abused, in particular, the differences between male and female children: • Females are at a high risk of child sexual abuse, • Males are more prone to physical abuse. • There is an absence of reported fatal child abuse. • Profile of the alleged perpetrator: • most of the abuse is either intra-familial, or inflicted by a person known to the child. • The geographical distribution of child abuse: • the distribution of abuse is influenced by the reporting agencies. In this study the incidence of reported child abuse and neglect is predominantly from the Cape Flats areas, though this does not reflect the rate of reported child abuse and neglect. • Action is taken by child protection agencies: • the majority of reported child abuse and neglect is managed by social service agencies; • the police do not investigate child reported child abuse and neglect in the majority of cases. • Comparison with the literature: • The characteristics of reported child abuse differ from that in the literature. • Child physical abuse is under-reported in comparison to other countries. • Rates of reported child sexual abuse are higher than those reported in the literature. Conclusions and recommendations Child abuse is an important problem in Cape Town, and in South Africa as a whole. The required response to this phenomenon is the development of an appropriate Child Protection Service, based on the concept of the prevention of child abuse and neglect, rather than on a reaction to abuse already present. This involves consideration of the data in this study and other studies, as well as examination of the philosophy behind the Child Protection Service to be set up. This approach can be adapted in other countries.