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Most pervious population-based surveys have been directed towards adult survivors of child maltreatment, either through telephone interviews or postal questionnaires. As known from all retrospective studies, responses from adult participants are subject to memory biases and reflect what may have happened decades ago rather than the current situation. Self-reports from adolescents, on the other hand, provide a more current view on the scope of the problem and respondents’ memories are less affected by a long delay [4]. A drawback may be that adolescents are too close to the events to have acquired a more objective perspective.

A recent systematic review of childhood maltreatment assessments in population-representative studies since 1990 [10] discusses several important topics concerning population surveys. In the introduction, it is stated that although causality cannot be inferred from cross-sectional surveys, it has recently been argued that representative community-based surveys have an important role to play in understanding child maltreatment and such surveys allow the study of relevant health outcomes that may be undocumented in administrative medical and social services databases. In addition, such studies allow for the exploration of research questions that are potentially difficult to address with child samples due to ethical and reporting requirements. However, population samples usually have as a drawback the fact that they are limited to persons with fixed household addresses and do not reach persons in prisons or institutions as well as other marginalised groups that may have been heavily exposed to maltreatment in childhood. This exclusion may give rise to underestimation of the true incidence of maltreatment as well as weaker associations between maltreatment and adverse outcomes.

One of the world’s most well-known survey instruments aimed towards parents is the Conflict Tactic Scale (CTS), which since its creation in the 1970s has been revised and developed continuously [11]. It is:

•Currently the world’s most accepted and used scale for interpersonal violence with more than 600 reviewed papers. There is a specific scale for the parent-child-relationship (upbringing).

•Starts from the assumption that conflicts are unavoidable and asks about conflict solution techniques, from verbal consensus to severe violence. Asking in this way, from non-provoking questions and slowly trickling down to questions surrounded by taboo or strong emotions has been proved to work well.

•Quantification from zero to >10 times a year.

•Does not inquire about attitudes and emotions associated with the conflict solution techniques.

•Can be administered as personal interview, telephone interview or questionnaires.

The scale has been criticized for not putting the violence into a greater range of circumstances such as family life conditions, economy and isolation. It has few questions concerning neglect, emotional abuse and no questions about sexual abuse.

Although retrospective self-reports generally include more detailed information of maltreatment than administrative reports, it has been shown empirically that they may miss violent incidents that have been officially reported. This appears to be true not only for events in early childhood but even later on. The reason may be not to awake unpleasant memories.

Prospective studies are important to elucidate causality but miss events that happen after the end of the study period. This may partially be solved by longstanding prospective studies, with the downside that the results may reflect a non-current societal situation.

Reliance on a single method to identify experiences of childhood maltreatment often overlooks many cases. The maximal number of maltreatment cases is normally identified by using a combination of available methods, where the prospective methods seem to be most comprehensive. The most severe cases are, however, likely to be identified by both prospective and retrospective methods [6].

The majority of the world’s countries have no data on the occurrence of child abuse and have no official mechanism for receiving and responding to reports of child abuse or neglect. In 1996, the UN Secretary General called for the creation of a global study on children and violence that would address violence against children in homes and schools, but when the WHO report on violence against children was published in 2006, this work had not yet been started [5]. However, with support from the international child maltreatment report, the WHO required that studies on violence against and maltreatment of children should be carried out in every country, and data on child abuse should be collected and reported from all countries. This is part of each state’s responsibility to fulfill their obligation to the Convention on the Rights of the Child. While this chapter was written, WHO Europe has published a short practical handbook – Measuring and Monitoring National Prevalence of Child Maltreatment [12] – with the basic aim to support the creation of a surveillance system to measure and monitor child maltreatment across the European countries. The handbook suggests community-based surveys on prevalence as the most appropriate method in setting up a child maltreatment surveillance system and proposes the use of 3 established maltreatment questionnaires: the ICAST, the JVQ (see more below) or the ACE-IQ, that is, The Adverse Childhood Experiences International Questionnaire, developed by the Centers for Disease Control and Prevention at the Kaiser Permanente in San Diego 1995. The handbook also introduces a Short Child Maltreatment Questionnaire (one page) for countries lacking funds for bigger surveys.

With UNICEF support, The International Society for the Prevention of Child Abuse and Neglect began the development in 2004 of an international survey through repeated Delphi rounds with experts from 31 countries. The survey was basically modelled after the CTS [11], but also from Juvenile Victimization Questionnaires [13] and the WorldSAFE questionnaire [14]. The parental version was finally tested in 7 countries in Asia, Latin America and in Russia and subscales showed high internal consistency except for neglect and sexual abuse subscales [15]. A child version (ICAST-C) was successively developed using the same type of methodology and has been tested in a number of countries. The ICAST-C is now a multi-national, multi-lingual, consensus-based survey instrument available in a number of languages for international research to estimate child victimization. In this way, international comparisons of prevalence can be done in order to set national and international priorities and garner support for programs and policy development aimed at child protection [16].

Serial surveys repeating the same questions at different points in time are of great value. In Sweden, parental self-report studies according to the CTS model have been performed in 1980, 2000, 2006 and 2011 [17].