Prevalence and types of childhood abuse among special education students attending Jordanian Universities

Abstract

This survey study was conducted to determine childhood abuse experiences among pre-service special education teachers at five Jordanian universities. The sample consisted of (384) students. A survey was constructed, validated and administrated on the students. Results revealed that 6.1% of all participants were exposed to a high level of abuse during childhood. Participants rated verbal abuse domain as the highest domain of CA, followed by neglect, emotional abuse and physical abuse. Meanwhile, students rated sexual abuse domain as the lowest domain. Results also revealed statistically significant mean differences in the level of abuse due to gender, maternal employment, marital status, cumulative average, monthly income, parent’s education level and residence location. The implications for planning programmes are described.

Keywords:

• Child abuse
• child maltreatment
• pre-service special education teacher
• university students

Introduction

Child abuse (CA) is an infringement of a child’s basic human rights (Kellogg, Parra, & Menard, 2007), which occurs across cultural and societal boundaries, despite variations in its incidence, form and definition. It is common in both developing and developed countries (Finkelhor, 2000; Futa, Hsu, & Hansen, 2001). In Arab countries, the World health organization (WHO, 2006) indicated that many recent reports document CA in those countries.

CA is defined as all types of physical and/or emotional maltreatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, leading to actual or potential hurt to the child’s health, well-being, development or dignity in the context of a relationship of responsibility, trust or power (WHO, 2002). Related to the factors that are behind CA, Kellogg et al. (2007) mentioned that CA is the result of a set of interrelated familial, social, psychological and economic variables. However, other researchers indicated that factors that can influence an individual’s vulnerability to CA are biological factors, such as age and gender (Dube et al., 2005; Hopper, 1998); parent- and caregiver-related factors, like misuse of alcohol, low self-worth and lack of self-control when upset or angry; and child-related factors such as hyperactivity and impulsivity (WHO, 2002). In addition, Belsky (1980, 1993) mentioned community-related variables, like neighbourhoods, workplaces and schools; country-related variables, like high rates of vacancy and poverty; and societal-related variables, like traditional norms that support the physical punishment of children. The literature cites four main types of CA, physical abuse, sexual abuse, emotional and psychological abuse and neglect (Sakelliadis, Spiliopoulou, & Papadodima, 2009; WHO, 2006, 2002).

The experiences of childhood abuse may have long-term impacts on various features of a child’s character and behaviour (Çelik & Odac, 2012). These impacts involve anxiety, eating disorders, behaviour problems (e.g. destructive behaviour and criminality in adulthood) and suicide (Steel, Sanna, Hammond, Whipple, & Cross, 2004). In addition, these experiences cause health problems, like unintended pregnancies, male involvement in teen pregnancy, sexually transmitted diseases, liver disease (Dong, Anda, Dube, Giles, & Felitti, 2003), heart disease and cancer (Dong et al., 2005; Hillis, Anda, Felitti, Nordenberg, & Marchbanks, 2000). Walrath et al., (2003) mentioned psychological effects of childhood abuse (e.g. negative self-image and depression) and resulting behavioural manifestations (e.g. substance abuse). Browne and Finkelhor (1986) indicated that CA victims experience post-traumatic stress disorder, sadness and severe school problems.

Furthermore, CA has enormous economical effects, because of the cost of services to treat CA victims, like medical care, special education, psychological and welfare programmes, protective foster care and preventive services (WHO, 2013).

There is evidence of the existence of CA in different societies, including among university students (Aboul-Hagag & Hamed, 2012). Research studies that investigate CA experiences among university students have been growing in recent years. For instance, Çelik and Odac (2012) investigated CA experiences among university students. Results indicated that students’ emotional abuse and neglect scores varied significantly according to gender, with males having higher emotional abuse and neglect scores than females. Moreover, males had higher physical abuse scores than females.

Lehrer, Lehrer, Lehrer, and Oyarzun (2007) administrated a sexual violence survey to students registered in General Education courses at a major public university in Santiago. Of those surveyed, 15.6% reported sexual abuse and 17. 2% reported some form of sexual victimisation in the last year alone. Goldman and Padayachi (1997) investigated the prevalence of CA among university students. Results indicated that 45% of female students and 19% of male students had an unwanted sexual experience prior to the age of 17.

In a recent study, Frías and Erviti (2014) examined the prevalence of sexual abuse during childhood and adolescence in a sample of Mexican teenagers and children. Results showed that 1.76% of participants were forced into their first experience of intercourse and 6.43% had their genitalia touched or their first sexual interaction imposed against their approval. In addition, 6.82% had experienced sexual abuse before the age of 18. In another study, Aboul-Hagag and Hamed (2012) administrated a cross-sectional survey to verify the prevalence and types of child sexual abuse (CSA) among students at Sohag University, Egypt. Results indicated that 29.8% of total respondents, 37.8% of female respondents and 21.2% of male respondents reported CS. The prevalence was higher in rural areas. Hugging and kissing were the most reported types of CS; only 1.1% of the students experienced complete sexual intercourse.

The WHO (2013) conducted a study of childhood abuse experiences among 1277 students of high schools and universities in the Former Yugoslav Republic of Macedonia. Results indicated a high reported prevalence of physical abuse (21%), emotional abuse (10.8%), sexual abuse (12.7%), physical neglect (20%) and emotional neglect (30.6%). Both males and females were affected though sexual abuse. Physical neglect was higher in males and emotional neglect was higher in females.

In their study, Fineran and Gruber (2009) examined the frequency and effect of workplace sexual harassment on work, health and school outcomes of high school girls. Results indicated that the percentage of harassed girls was significantly higher than the figures reported in most studies of working women. Girls who were sexually harassed reported a lower level of quality of work life, had higher levels of academic withdrawal and were more apt to miss school than their non-harassed peers.

The need of conducting a current study emerges due to many reasons. First, according to our knowledge, this study is perhaps one of few studies exploring CA among pre-service special education teachers in specific. The current study will bring attention to this subgroup. Second, available research emphasised the long-term negative effects of CA, which are considered risk indicators if the victims of CA become teachers themselves, and particularly if they become teachers of disabled children (Al-Zboon, 2013). Negative effects of CA, like depression, have been found to negatively affect sufferers’ working status (Dooley, Prause, & Ham-Rowbottom, 2000). Also, victims suffer from low self-esteem, low confidence and the inability to trust (Barrett & Kamiya, 2012).

Curie and Widom (2011) found that those who had been maltreated as children were less likely to be in skilled or professional occupations. This status will negatively influence the quality of life of special education teachers, who are already experiencing burnout and chronic stress (Onder & Sari, 2009). The stress leads to diseases and declines in mental and physical health (e.g. headaches, high blood pressure, depression and anxiety). Sufferers become exhausted and may leave the workforce (Brown, Howcroft, & Jacobs, 2009). This is troublesome because the special education field necessitates highly skilled teachers to work with children with disabilities in diverse educational settings (Wilcox, Putnam, & Wigle, 2003). So, we must be sure that teachers in this field have a high quality of life and are not negatively influenced by CA experiences through providing support services.

Third, conducting a survey of CA experiences among pre-service special education teachers is vital for public policy-makers in health, legal, education and social services sectors, which are the most affected by the consequences of CA and involved in efforts to deal with it. Fourth, the gaps in knowledge of the prevalence of CA of this group necessitate conducting a survey study, which will provide robust quantitative data to assist in bridging those gaps. With the knowledge of these research results, policy-makers can plan programmes to address and mitigate the negative influences CA can have.

For this study, a survey was used to answer the following questions:

•	What is the prevalence of different types of CA among pre-service special education teachers?
•	Does the level of CA among pre-service special education teachers differ due to student’s gender, cumulative average in university and secondary school, maternal employment, fathers’ job, family income, parents’ education level, order in family, family size and residency location?

Child rights in Jordan

Jordan is the first country in the Arab region to address the previously taboo issue of CA. It created an independent child protection system in 1997. This system was the first to permit intervention in the case of CA (The Jordan River Foundation [JRF], 2007). The United Nations Convention on the Rights of the Child was signed by Jordan in August 1990 and entered into force the following year (Save the Children Sweden, 2008). The system has different child protection strategies in Jordan, such as a national plan for early childhood, national strategies for childhood development and a national plan for family protection (United Nations, 2005).

A document entitled ‘Study on Violence against Children Response to the questionnaire received from the Government of Jordan’ (2005), issued by the United Nations, indicated that there are nearly 3024 CA cases from 1999 to 2004 in Jordan. Moreover, the American Foreign Ministry report about human rights in Jordan (2008) indicated that Family Save Unit handled nearly 320 CSA cases from January to August 2008. Jordan’s child protection objectives include improving positive child-rearing practices to protect children, and identifying, dealing with and eliminating different kinds of abuse (Ministry of Education [MOE], 2011). However, there is a lack of counselling services for pre-service or in-service teacher in university or in the field (Al-Zboon, 2013).

Methods

Design

This research employed a descriptive method design. A survey was used to gather data about the prevalence of CA among pre-service special education teachers. Independent variables of the study were student’s gender, cumulative average in university and secondary school, maternal employment, fathers’ job, family income, parents’ education level, birth order, family size and residency location. The dependent variable was CA among pre-service special education teachers.

Participants

The sample was randomly selected. The sample consisted of 384 pre-service special education teachers (112 males, 29.2% and 272 females, 42.9%) attending five Jordanian universities during the academic year of 2014/2015. Table 1 reflects distribution of participants.

Table 1. Distribution of participants.

Variable	N (%)
Gender
Males	112 (29.2)
Females	272 (70.8)
Cumulative average in secondary school
60–69	34 (8.9)
70–79	176 (45.8)
80–89	174 (45.3)
Cumulative average in university
2–2.49	172 (44.8)
2.5–2.99	144 (37.5)
3–3.59	66 (17.2)
2.6–4	2 (0.5)
Father’s job
Without job	12 (3.1)
Teacher	26 (6.8)
Military sector	52 (13.5)
Business	54 (14.1)
Government employee	142 (37)
Handcraft	72 (18.8)
Engineer	18 (4.7)
Medical sector	8 (2.1)
Maternal employment
Working	72 (18.8)
Non-working	312 (81.3)
Marital status
Never Married	328 (85.4)
Divorced	6 (1.6)
Married	50 (13.0)
Family income
Less than 300 JD	42 (10.9)
300–699 JD	244 (63.5)
700–1000 JD	62 (15.5)
More than 1000 JD	36 (9.4)
Birth order
The first	94 (24.5)
Middle	268 (69.8)
Last one	22 (5.7)
Family size
1	6 (1.6)
2–5	64 (16.7)
6–10	266 (69.3)
More than 10	48 (12.5)
Residency place
Urban	288 (75)
Rural	78 (20.3)
Badia	18 (4.7)
Father’s education level
Illiterate	12 (3.1)
School certificate	242 (63)
Diploma	76 (19.8)
Bachelor	52 (13.5)
Postgraduate studies	2 (0.5)
Mother’s education level
Illiterate	30 (7.8)
Secondary school or less	236 (61.5)
Diploma	82 (21.4)
Bachelor	34 (8.9)
Postgraduate studies	2 (0.5)

Instrumentation and Implementation

A survey instrument was developed to address the research questions to identify the level of childhood abuse experiences among undergraduate students in Jordanian universities. The scale consisted of three sections: Part I was related to demographics and socio-economic data (gender, age, residency location, marital status, cumulative average, family income and education level of parents). Part II corresponded to the assessment students’ perception about the level of CA. This section consisted of five dimensions covering (60) items. These dimensions were physical abuse (1–14), verbal abuse (15–22), emotional abuse (23–39), neglect (40–52) and sexual abuse (53–60). A 5-point Likert-type scale was used as the response mode for section II, ranging from (1) indicating ‘never’ to (5) indicating ‘always.’

Part III of the survey included an open-ended question asking students to list other types of CA that were not mentioned in Part II. The purpose of this question was to allow students to voice their experiences even if they did not believe the provided categories reflected the type of CA they experienced.

The researchers prepared the study scale based on a literature review; then, a focus group of undergraduate students was surveyed to add items for the specific situation in Jordan. In addition, the researchers administrated the scale of study on an exploratory sample to be sure of clarity of items and their fitness. The exploratory sample was ten of special education student–teachers, and the scale of study was amended due to the experiment.

To investigate the validity of the survey, experts and reviewers were asked to review items and provide feedback to authors. All reviewers’ comments and suggestions were taken into consideration and were incorporated in the final survey. Reliability indicators were determined by using Cronbach’s alpha; the coefficient alpha statistic was 0.95, reflecting good levels of internal consistency.

The implementation process included contacting the deanships of students’ affairs in five universities. Then the sample was randomly selected from a national pool. Survey instruments were completed and data were entered and analysed.

Ethical considerations

Taking ethical considerations into account, approval for the study was obtained from official authority. All participants were initially contacted, asked to participate in the study and informed about the core and the aims of the research. Participant consent was gained. They were assured of the anonymity of their responses by using pseudonyms to report the results and were guaranteed confidentiality of collected data. Students were asked not to write any information that may enable them to be identified. The study was conducted in a very familiar and safe environment for students. This study was approved by Institutional Review Board at the Hashemite University.

Data Analysis

Data were entered and analysed using the Statistical Package for the Social Sciences (SPSS-16.0). Descriptive statistics (e.g. frequencies, & percentages) were presented in the results section. In addition, one-way ANOVA and independent samples t-test were used to check for any significant mean difference according to independent variables of the study.

Results

To answer the first question, percentages were obtained. Table 2 shows students’ perceptions regarding the level of CA.

Table 2. Percentages of students’ perceptions of abuse.

Domain	Percentages (%)
Physical abuse	2.1
Verbal abuse	17.7
Emotional abuse	4.7
Neglect	5.2
Sexual abuse	0.5
Total	6.1

Table 2 shows that 6.1% of all participants were exposed to high level of abuse during childhood. Participants rated verbal abuse domain as the highest domain of CA (17.7%), followed by neglect domain (5.2%). The percentage was 4.7% for emotional abuse and 2.1% for physical abuse. As well, students rated sexual abuse domain as the lowest domain (0.5%).

To answer the second question, two independent sample t-tests were obtained. Results revealed statistically significant mean differences in level of abuse seen by students due to gender in favour of male (t = 3.7, p < 0.02) and due to maternal employment in favour of non-working mother (t = −1.3, p < 0.03).

In addition, the omnibus ANOVA statistic for this analysis revealed no statistically significant differences due to father’s job (F = 1.03, p = 0.40), family size (F = 0.121, p = 0.94), birth order (F = 0.21, p = 0.88) and average in secondary school (F = 1.18, p = 0.30) on the total abuse variable for students.

Furthermore, using a One-Way ANOVA and Tuckey (HSD) post-hock analyses revealed significant differences due to cumulative average (F = 9.74, p = 0.00), in favour of students with lowest average. Analyses revealed significant differences due to monthly income (F = 3.93, p = 0.004), in favour of lowest income. In addition, analyses revealed significant differences due to mother’s education level (F = 5.5, p = 0.001), in favour of illiterate mother. Analyses revealed significant differences due to father’s education level (F = 6.35, p = 0.00), in favour of lowest illiterate father. Finally, analyses revealed significant differences due to residence location (F = 3.8, p = 0.02). These differences are between Badia and rural locations, in favour of Badia, and between rural and urban location in favour to rural location.

Discussion

Abuse is an adversity in childhood and is a pattern of behaviour that is usually transmitted from one generation to the next (WHO, 2013). Studies establish a link between prior victimisation and youth violence (e.g. Durant, Pendergrast, & Cadenhead, 1994; Singer, Anglin, Song, & Lunghofer, 1995). Furthermore, CA experiences negatively affect the working status of CA victims (Curie & Widom, 2011; Dooley et al., 2000). This study was conducted to estimate CA among pre-service special education teachers at Jordanian universities. The findings demonstrate that 6.1% students experienced a high level of CA. This result isn’t surprising and it is in line with Futa et al. (2001) and Finkelhor (2000) who confirmed existence of this problem among different countries.

However, the prevalence revealed in the current study is lower than the figures reported in most studies of CA (e.g. Aboul-Hagag & Hamed, 2012; Frías & Erviti, 2014; WHO, 2013). This finding could be due to a religious community we live in. There are a lot of principles and guidelines for how to treat children. Koenig, McCullough, and Larson (2001) and Donahue and Benson (1995) concluded that a person raised with some participation in religious activities tends to be exposed to fewer risk situations. Makepeace (1987) and Gover (2004) and Lehrer et al. (2007) and Nazar and Kouzekanani (2007) reported that some attendance to religious activities had a protective effect for children. In addition, the result could be due to contextual factors because many of the participants live with their families. This factor, as mentioned by Lehrer et al. (2007), provides higher levels of parental supervision and less opportunity for exposure to abuse.

Participants rated the verbal abuse domain as the highest domain of CA (17.7%) and the sexual abuse domain as the lowest domain (0.5%). This result is in line with Nazar and Kouzekanani (2007) who indicated that participants reported verbal abuse as the main domain and sexual abuse as the lowest domain. This may be explained by the difficulty for CA victims, especially sexual abuse victims, to reveal secrets (Kelly & McKillop, 1996), and this type of secret sets formidable barriers towards disclosure (Crisma, Bascelli, Paci, & Romito, 2004; Paine & Hansen, 2002). Furthermore, the literature suggests that there are serious obstacles hindering victims from disclosing sexual assault, which keeps it as a hidden subject (Goodman-Brown, Edelstein, Goodman, Jones, & Gordon, 2003; Kelly & McKillop, 1996). These obstacles include embarrassment, lack of knowledge regarding victim rights and the need to keep the event hidden from other people (Emmert & Köhler, 1998). In addition, the estimates of sexual abuse prevalence are likely to be conservative (Lewis & Fremouw, 2001), as participants tend to underreport sexual abuse, even in an anonymous questionnaire. The shame, secrecy and denial associated with sexual abuse promote pervasive cultures of silence, where victims (especially girls) cannot speak about sexual abuse they have suffered (WHO, 2013).

Interestingly, the findings of this study suggested that there are statistically significant differences in the total score due to gender, in favour of males. However, previous studies present contradictory results. Some research reported that the rate was higher for males than females (e.g. Pearce, 2006; WHO, 2013), while other previous studies indicated that the rate was higher for females than males (e.g. Aboul-Hagag & Hamed, 2012; AlMadani, Bamousa, Alsaif, Kharoshah, & Alsowayigh, 2012; Dube et al., 2005; Dunne, Purdie, Cook, Boyle, & Najman, 2003; Finkelhor, 1994; Hopper, 1998).

WHO (2013) explains the higher rate of CA among males than females as due to cultural background. Inflicting more severe forms of violence on males is considered more appropriate because males are viewed as having endurance and strength. Thabet (2008) indicated that males are often playing outdoors, not under the supervision of their families, while females tend to stay at home close to their mothers.

Moreover, a lower level of CA reported by females can be attributed to denial of exposure to abuse by females as a result of social related factors. One of these factors is females’ tendency to maintain her social appearance, which is necessary to gain and maintain social acceptance and eligibility for marriage. Our community gives freedom to males for expressing themselves. This is particularly due their responsibility to be in charge and provide financially for their family. In addition, we live in eastern community, which is described as a reserved religious community, whose traditions and observances put limitations on females’ opportunity to report abuse experiences. It is regarded as a family secret. These traditions have been deeply rooted in the cultural and social contexts where they were raised. These conditions could be the reasons behind higher probability of males to report CA experiences than females. The males are freer to speak their minds because there is less negative consequence than if a female were to do the same.

Furthermore, results revealed significant differences due to maternal employment. Students of non-working mothers reported a higher level of abuse than students of working mothers. This result contradicts the results of the WHO’s study (2013) which revealed that in 10% of students of working mothers, the mothers were subjected to violence. This can be explained in the light of the contextual factor which provides extended family support for working woman in care of her child. The support decreases the pressure of working mothers (Lussier, 2002). In addition, non-working mothers face pressure and restriction on their freedom to go outside the home, as all of her responsibility is limited to housekeeping and child-rearing. This situation develops her feeling of annoyance and boredom. Furthermore, the result of higher rates of CA in households of non-working mothers can be attributed to the fact that most non-working mothers have a low level of education, and low levels of education are also correlated to higher instances of CA. On the other hand, even if a female is well educated, her husband may be forbid her from working. This may cause pressure and resentment, the feeling that all the effort for studying was wasted, and she could come to resent motherhood. The resentment may lead to psychological problems and cause CA.

Furthermore, results revealed significant differences due to cumulative average. This finding is similar to that of Fineran and Gruber (2009), who reported that abuse victims had higher levels of academic withdrawal, and were more apt to miss school than their non-abused peers. CA can have extensive consequences, as these experiences limit victims’ ability to achieve their educational potential (Mirsky, 2007).

Not surprisingly, results revealed significant differences due to monthly income in favour to low income. This finding is considered rational and congruent with other studies previously reported (e.g. Finkelhor, 1994; Gonzalez & Gavilano, 1999; Goodman, Joyce, & Smith, 2011; Kantor & Jasinski, 1998; Krug, Dahlberg, Mercey, Zwi, & Lozano, 2002; Nazar & Kouzekanani, 2007; WHO, 2013).

Similarly, results revealed significant differences due to parents’ education level, as students whose parents are illiterate reported higher levels of CA than students whose parents are educated. This result replicates the result of Lehrer et al. (2007) which reported that witnessing CA was significantly more common when parental education was low. Nazar and Kouzekanani (2007) indicated that domestic violence increases in less educated families. This can be explained by the relation between education level and a person’s quality of life. Less education can mean a lower paying job, less income and decreased social stature. These factors increase the likelihood of experiencing CA.

Results revealed significant differences due to residency location; the prevalence was higher in rural areas than urban ones. These results are supported by previous studies (e.g. Bergman, 1992; Hallberg, Hallberg, & Kramer, 2007; Nazar & Kouzekanani, 2007; Nosek, Hughes, Swedlund, Taylor, & Swank, 2003; Spencer & Bryant, 2000). Conversely, this result disagrees with results of other studies (e.g. Hagras, Moustafa, Barakat, Azza, & El-Elemi, 2011; Niu, Lou, Gao, Zuo, & Feng, 2010) which showed that the prevalence was higher in urban areas over rural ones. Also, it contradicts the results of Lehrer et al. (2007) who reported that residence in a large city was not significant in the abuse rate. The current study revealed that the Bedouin areas have a high level of abuse in comparison to rural areas. This is considered logical, as these areas are marginal and faraway areas that are poor and have low levels of education, and have been found to foster exposure to CA.

Conclusions

The results of this study provide valuable insights into the prevalence of CA among pre-service special education teachers in five Jordanian universities. Students who participated in the study reported experiencing abuse, mainly verbal, emotional abuse or neglect. This study revealed significant differences due to monthly income, parent’s education level (illiterate mother) and residential area (Badia and rural location).

Identification of the prevalence of CA is considered an initial step that will guide programmes to deal with the negative effects of abuse, and the results of this study may suggest the level of abuse among students at Jordanian universities. The findings of this preliminary study underscore the need for providing counselling programmes at universities for survivors of abuse, including those who wish to follow a career path that is known to be challenging and stressful. Furthermore, there is clearly a need to continue this line of investigation. It is also essential to continue to examine CA, which may be of particular importance to countries newly interested in providing a safe environment for children. We recommend that surveys should be conducted to examine the available counselling programmes for students at universities and teachers in the field.

Limitations

There are some limitations to this research, the main one being the research methodology. This is a self-reported study, in which only students’ perceptions have been presented. In future studies, different methods, such as interview and focus group, could be used to achieve in-depth knowledge regarding CA. A second important limitation was connected to the sample, which was drawn from five Jordanian universities and did not include student teachers in college, who graduate with a diploma in special education. We recommend conducting additional studies of larger samples from a wider range of participants.

Disclosure statement

No potential conflict of interest was reported by the authors.