As the COVID‐19 lockdown regulations continue to be implemented differently across the four UK administrations, professionals working with children and families have continued to adapt their service delivery mechanisms and ways of working. In the child protection arena, the priority to keep children safe and prevent child harm has meant that frontline professionals have had to be creative in their engagement and communication with children and families, with limited home visiting. This is highlighted in the COVID‐19 reflective practice piece in this issue written by Wendy Roberts (2020), a practice mentor to social workers across Children and Families Services in Gwynedd. Roberts (2020) reflects on some important practice issues and considers carefully how social workers (although her piece can be applied to all those working with children and families) ensure effective communication during the pandemic. She highlights how during the pandemic we have all ‘been told by those in power how to live our lives. We are told it is to keep us safe, mirroring the work that goes on in child protection every day’ (Roberts, 2020, p. 586) and reflects how the pandemic has provided her with a deeper level of understanding in her work with children and families. Roberts (2020) asks the important question ‘How can we make it a better experience?’ (p. 586) and stresses the need to continue to review and improve new ways of working, procedures and arrangements put in place because of the pandemic.

‘Frontline professionals have had to be creative in their engagement and communication with children and families, with limited home visiting’

Our first paper in this issue by Emily Douglas and Kerry Lee (2020) from the USA addresses the challenges associated with determining fatal child maltreatment and revisits a topic that we have previously covered in Child Abuse Review (Brandon et al., 2014; Brown and Tyson, 2014; Sidebotham, 2013). Douglas and Lee (2020) begin their paper by making the case that child maltreatment fatalities in the literature are generally treated as a single construct, when actually the research shows ‘that abuse and neglect emerge from different child and family risk factors’ (p. 507). They also highlight the literature and anecdotal evidence from frontline staff showing discrepancies in the reporting of how children die and what happens in practice.

‘Highlight the literature and anecdotal evidence from frontline staff showing discrepancies in the reporting of how children die and what happens in practice’

This important study involved three ED units and compared the extent to which data were recorded for three child maltreatment risk factors (developmental impairment, domestic violence, any social care involvement) in both ED and HV records. Data were examined from HV records for 232 children across three UK cities: Cardiff, Manchester and Bristol. Unsurprisingly, HVs who work closely with vulnerable children and families identified between 0.9 and 23.7 per cent of risk factors for child abuse and neglect, with the most common being ‘prior injuries (n = 55, 23.7%), carer/parental mental health problems (n = 48, 20.7%) and domestic violence (n = 47, 20.3%)’ (Nuttall et al., 2020, p. 518). Of the 232 cases, 158 had a record of the presence or absence of all risk factors, with knowledge about safety measures in the home being the least well recorded. What is interesting about the study is that when the HV records proforma was compared with children under five years old who presented to ED with a burn and assessed by the standardised Burns and Scalds Assessment Tool, many risk factors which were known to and recorded by HVs were not identified by the ED staff. For example, domestic violence was recorded as a risk factor by five (10.6%) ED staff compared with 47 HVs, development impairment was recorded by four (17.4%) ED staff compared with 23 HVs and social care involvement for prior or ongoing child protection concerns was recorded by only ten (22.2%) ED staff compared with 45 HVs. This highlights the important role of HVs in identifying children who may be at risk of abuse and neglect, owing to their unique home visiting role (Appleton, 2015; Peckover and Appleton, 2019). Nuttall et al. (2020) conclude their paper by recommending that consideration should be given to electronic records being shared between ED staff and HVs, highlighting the presence or absence of family risk factors. Nuttall et al. (2020) argue that this could improve risk assessment by ED staff, by enabling them to make a more thorough and comprehensive assessment and ultimately improve care for children.

‘This highlights the important role of HVs in identifying children who may be at risk of abuse and neglect, owing to their unique home visiting role’

The next two papers in this issue are both literature reviews. The first by Aislinn Conrad and colleagues (2020) from the University of Iowa School of Social Work was conducted to examine the extent to which the US child welfare system acts as an informal income maintenance programme. This paper highlights the burden of child poverty in the US, as discussed previously by Pritchard et al. (2019) in Child Abuse Review, and particularly for those families involved with the child welfare system. The literature review included nine studies which met the inclusion criteria, although no information is provided about the appraisal or data extraction processes. The review reports that US child welfare programmes offer financial and in‐kind transfers that may be as simple as giving donated clothes, nappies and food to families, which are ‘similar to centralised income maintenance programmes’ (Conrad et al., 2020, p. 529). The literature review findings suggested that these cash and in‐kind transfers could increase families' involvement in and completion of child welfare programmes, and improve relationships between parents and workers.

‘Interviewing child victims more than once can be helpful in police investigations, but… also carries the potential for generating contradictory information’

Our fifth paper in this issue is by John Ratcliffe from the University of Sheffield and colleagues (2020). This paper reports on a study which sought to gather the views of representatives from the 147 former English Local Safeguarding Children Boards (LSCBs) on the challenges to safeguarding children when fabricated or induced illness (FII) is suspected or proven. The study involved an electronic survey carried out by the Association of Independent LSCB Chairs. Despite a low response rate, 18 respondents from the 147 LSCBs including four telephone interviews, several challenges (n = 17) were identified. The most commonly reported challenges included inadequate resources and training, poor multiagency collaboration, anxiety and uncertainties among professionals who have to identify FII, the relative rarity of FII and the variety of ways in which FII can present. Over 40 per cent of respondents were not familiar with the Incredibly Caring training materials (Department for Children, Schools and Families, 2009) on how to respond to concerns about FII, which include several video case studies. Ratcliffe et al. (2020) conclude by stating that there is a need to find ‘ways to ensure that all relevant professionals are familiar with existing guidance’ which ‘would support the development of greater knowledge about how best to respond to FII cases’ (p. 559).

A short report in this issue by Brittany Lange and colleagues (2020) from the University of Oxford and Yale School of Nursing reports on part of a larger research study which aimed to examine how mothers who have experienced child sexual abuse (CSA) look after their children. As part of this study, mothers who have experienced CSA were asked about how they defined CSA, and whether definitions varied based on the features of their CSA experience or their personal characteristics. Thirty‐five mothers took part in the survey and were recruited via specialist abuse, mental health and parenting organisations in the UK and Republic of Ireland. This interesting and well‐conducted study found that the vast majority of mothers participating in the survey ‘included both contact and non‐contact forms of abuse in their definition’, while Lange et al. (2020) note that many researchers ‘limit the definition of CSA to contact forms of abuse’ (p. 580). They also found that mothers perceived the context to be important to defining CSA, and while most ‘felt that a child needed to be younger than a certain age for CSA to have occurred, few mothers believed that the perpetrator should be a certain number of years older than the child for an act to be considered CSA’ (Lange et al., 2020, p. 578). Lange et al. (2020) concluded by drawing attention to the implication that the study has for practitioners assessing abuse and the need to enquire about different aspects of CSA and the context. There are similarities with Douglas and Lee's (2020) study as Lange et al. (2020) highlight the variation in how CSA is defined in policy and research as ‘problematic’, finding that ‘many mothers disagreed with the current legal definition of CSA in England and Wales’ (Lange et al., 2020, p. 581). They recommend that policymakers in future could benefit from involving CSA survivors in their work to find out why these differences exist.

‘Mothers perceived the context to be important to defining CSA’

There are two training update reviews in this issue. The first review is by Jo Gifford (2020) of an online learning resource Medical Evaluation of Child and Adolescent Sexual Abuse produced by Evidentia Publishing. Gifford (2020, p. 589) describes this as an ‘ambitious’ and high‐quality resource ‘developed by highly respected doctors in the USA’. The review is very favourable and suggests that the training may be useful for a broad audience of safeguarding paediatricians, forensic examiners and those non‐forensic examiners who see children and young people in their role. She particularly highlights the excellent clinical images and high‐quality sections on clinical presentations and history, including the handling of disclosures. Gifford (2020, p. 590) very usefully in her review draws attention to key transatlantic differences in the materials, as well as ‘omissions and incompatibilities’ for UK‐based professionals, who she says ‘will need to be clear on their role and it limits in their own country before undertaking the modules’. She recommends a UK‐specific version of the training resource which would be extremely useful and well received.

The second training review by Maddie Burton (2020) focuses on the MindEd training resource Suicide and Self‐Harm Prevention, Skills for Schools created by the Royal College of Paediatrics and Child Health and a number of other organisations including e‐learning for Healthcare. Burton (2020) provides a useful and complimentary overview of the content of this MindEd training, describing the materials as ‘accurate, timely and appropriately supported by up‐to‐date research and understanding’ (p. 593). The training will be helpful for those staff working in schools who are well placed to identify children and young people who may be suffering from mental health problems, but who may not have received formal training in child and adolescent mental health.

This issue concludes with a review by Helen Howells (2020) of Eileen A. Dombo and Christine Anlauf Sabatino's 2019 book Creating Trauma‐Informed Schools: A Guide for School Social Workers and Educators, which focuses on school communities in the USA. This book discusses the impact of trauma on children and young people's education and emotional development. Howells describes the book as an extremely useful evidence‐based resource for those professionals wanting to introduce trauma‐informed practice within schools as it offers a framework to do so and to create safe environments in schools.

随着COVID-19锁定法规在英国四个政府部门中的实施方式有所不同，与儿童和家庭一起工作的专业人员继续调整其服务提供机制和工作方式。在儿童保护领域，确保儿童安全和防止儿童伤害的优先考虑意味着一线专业人员必须创造性地与有限的家庭探访儿童和家庭进行接触和交流。温迪·罗伯茨（Wendy Roberts，2020年）写的本期COVID-19反思性实践文章对此进行了重点介绍，该文章是格温内德市儿童与家庭服务部门社会工作者的实践指导。罗伯茨（2020）思考一些重要的实践问题，并仔细考虑社工（尽管她的作品可以适用于所有与儿童和家庭打交道的人）如何确保在大流行期间进行有效的沟通。她着重指出，在大流行期间，当权者告诉我们如何生活。有人告诉我们要保证我们的安全，反映每天在儿童保护方面开展的工作”（Roberts，  2020年，第586页），并反映出这种流行病如何使她在与儿童的工作中加深了理解。和家人。罗伯茨（2020）问了一个重要问题：“我们怎样才能使它成为更好的体验？” （p。586），并强调有必要继续审查和改进由于大流行而制定的新的工作方式，程序和安排。

“前线专业人员在与儿童和家庭的互动和交流中必须具有创造力，而家访次数有限”

美国的Emily Douglas和Kerry Lee（2020）在本期杂志上发表的第一篇论文探讨了与确定致命儿童虐待相关的挑战，并重新审视了《虐待儿童评论》（Brandon et al。，  2014 ; Brown and泰森（Tyson），  2014年；锡德伯特（Sidebotham），  2013年）。道格拉斯和李（2020）在开始他们的论文时，先假设文献中的儿童虐待致死率通常被视为一个整体，但实际上研究表明``虐待和忽视是来自不同的儿童和家庭风险因素''（第507页）。他们还着重介绍了前线工作人员的文献资料和轶事证据，这些证据表明在报告儿童如何死亡以及实际发生的情况方面存在差异。

“突出显示来自一线工作人员的文献和轶事证据，这些证据表明在报告儿童死亡的方式和实际发生的情况方面存在差异”

这项重要的研究涉及三个急诊科，并比较了在急诊和高血压记录中记录的三个儿童虐待风险因素（发育障碍，家庭暴力，任何社会护理参与）的数据范围。从HV记录中检查了英国三个城市（加的夫，曼彻斯特和布里斯托尔）的232名儿童的数据。毫不奇怪，与弱势儿童和家庭密切合作的HV确定了0.9％至23.7％的儿童遭受虐待和忽视的风险因素，最常见的是“在先伤害（n = 55，23.7％），照顾者/父母的精神健康问题（n = 48，20.7％）和家庭暴力（n = 47，20.3％）'（Nuttall et al。，  2020，第 518）。在232例病例中，有158例记录了所有危险因素的存在或不存在，其中关于家庭安全措施的知识最少。这项研究的有趣之处在于，当将HV记录的形式与五岁以下接受ED烧伤并通过标准化烧伤和烫伤评估工具进行评估的儿童进行比较时，HV知道并记录了许多危险因素急诊人员没有发现。例如，五名（10.6％）急诊人员将家庭暴力记录为危险因素，而47辆HV，四名（17.4％）急诊人员记录了发展障碍，而23辆HV和先前或正在进行的儿童保护涉及社会护理仅十名（22.2％）急诊人员记录了疑虑，而45辆HV。 2015 ; Peckover和Appleton，  2019年）。Nuttall等。（2020）在论文的结尾提出建议，应考虑到急诊室工作人员和HV之间共享的电子记录，强调存在或不存在家庭危险因素。Nuttall等。（2020）认为这可以改善ED工作人员的风险评估，使他们能够进行更加全面的评估，最终改善对儿童的照料。

“这凸显了HV由于其独特的家访角色，在识别可能有遭受虐待和忽视风险的儿童方面的重要作用”

本期的下两篇论文都是文献综述。爱荷华大学社会工作学院的艾琳·康拉德（Aislinn Conrad）及其同事（2020年）进行了第一次研究，以考察美国儿童福利体系在多大程度上充当了非正式的收入维持计划。正如Pritchard等人先前所讨论的，本文重点介绍了美国儿童贫困的负担。（2019）在虐待儿童评论中，尤其适用于那些参与儿童福利系统的家庭。文献综述包括九项符合入选标准的研究，尽管没有提供有关评估或数据提取过程的信息。审查报告指出，美国的儿童福利计划提供的财政和实物转移，可能就像向家庭捐赠捐赠的衣服，尿布和食物一样简单，“类似于集中式收入维持计划”（Conrad等，  2020年，第529）。文献综述的结果表明，这些现金和实物转移可以增加家庭对儿童福利计划的参与和完成，并改善父母与工人之间的关系。

“不止一次与儿童受害者进行面谈可能对警察的调查有所帮助，但是……也可能产生矛盾的信息”

我们本期的第五篇论文是谢菲尔德大学的John Ratcliffe及其同事（2020年）。本文报道了一项研究，该研究试图收集来自147个前英国地方保护儿童委员会（LSCB）的代表的意见，以怀疑或证实人为或假冒疾病（FII）时对儿童保护的挑战。该研究涉及由独立LSCB主席协会进行的电子调查。尽管答复率很低，但来自147个LSCB的18名受访者（包括四次电话采访）发现了一些挑战（n = 17）。报告中最常见的挑战包括资源和培训不足，多机构合作不佳，必须识别FII的专业人员之间的焦虑和不确定性，FII的相对稀有性以及FII可以采用的多种方式。超过40％的受访者不熟悉令人难以置信的关怀培训材料（儿童，学校和家庭部，  2009年），涉及如何应对有关FII的担忧，其中包括一些视频案例研究。Ratcliffe等。（2020年）最后指出，有必要找到“确保所有相关专业人员熟悉现有指南的方式”，“这将有助于发展有关如何最好地应对FII案件的更多知识”（第559页） 。

布列塔尼·兰格（Brittany Lange）和同事在此期的简短报告（2020牛津大学和耶鲁大学护理学院的研究报告）是一项较大研究的一部分，该研究旨在研究遭受儿童性虐待（CSA）的母亲如何照顾孩子。作为这项研究的一部分，询问了经历过CSA的母亲如何定义CSA，以及定义是否根据其CSA经验的特征或个人特征而有所不同。三十五名母亲参加了调查，并通过英国和爱尔兰共和国的专职虐待，心理健康和育儿组织招募。这项有趣且行为良好的研究发现，参与调查的绝大多数母亲“在定义中都包括了接触和非接触形式的虐待”，而Lange等人。（2020年）指出，许多研究人员“将CSA的定义限制为接触滥用形式”（第580页）。他们还发现，母亲认为背景对于定义CSA很重要，尽管大多数人认为孩子要比CSA发生年龄要小，但很少有母亲认为肇事者应在一定年限内被视为CSA'的行为要比孩子大（Lange et al。，  2020，p.578）。兰格等。（2020）通过提请注意该研究对从业人员评估滥用的含义以及询问CSA不同方面和背景的必要性得出结论。与道格拉斯和李（2020）的兰格研究相似等。（2020年）强调了政策和研究中对CSA的定义是“有问题的”的变化，发现“许多母亲不同意英格兰和威尔士对CSA的现行法律定义”（Lange等人，  2020年，第581页）。 。他们建议，未来的决策者可以从CSA幸存者的工作中受益，以找出存在这些差异的原因。

“母亲认为背景对于定义CSA很重要”

本期有两个培训更新评论。第一次评论是由乔·吉福德（Jo Gifford，2020年）撰写的，该在线学习资源由Evidentia Publishing生产，该书是《儿童和青少年性虐待的医学评估》。Gifford（2020，p。589）将其描述为“由美国备受尊敬的医生开发的”雄心勃勃的高质量资源”。这项审查非常有利，并表明该培训可能对广大保护儿科医生，法医和那些以儿童和年轻人为角色的非法医的受众有用。她特别强调了关于临床表现和病史的出色的临床影像和高质量部分，包括披露的处理。吉福德（2020，第 590）在她的评论中非常有用地提醒人们注意材料的主要跨大西洋差异，以及英国专业人员的“遗漏和不兼容性”，她说“将需要明确他们的角色及其在本国的局限性在进行模块之前。她建议使用特定于英国的培训资源版本，这将非常有用并广受欢迎。

Maddie Burton（2020年）进行的第二次培训回顾着重于MindEd培训资源《自杀和自我伤害预防》，由儿科和儿童健康皇家学院以及许多其他组织（包括电子医疗保健）创建的学校技能。Burton（2020）提供了有关MindEd培训内容的有用且免费的概述，将材料描述为“由最新研究和理解所提供的准确，及时且适当的支持”（第593页）。培训将对那些在学校工作的员工很有帮助，他们能够确定可能遭受精神健康问题但未接受过儿童和青少年心理健康正规培训的儿童和年轻人。

该问题以Heile Howells（2020年）对Eileen A.Dombo和Christine Anlauf Sabatino的2019年著作《创建创伤知情的学校：学校社会工作者和教育者指南》的评论作为结尾，该书侧重于美国的学校社区。本书讨论了创伤对儿童和年轻人的教育和情感发展的影响。Howells将这本书描述为那些希望在学校内引入创伤知情实践的专业人员的极为有用的循证资源，因为它提供了这样做的框架并为学校创造了安全的环境。