Child Sexual Abuse Evaluations: Adherence to Recommendations

ABSTRACT

Sixty-eight parents of children with alleged child sexual abuse (CSA) were surveyed 4 months after visiting an interdisciplinary CSA evaluation clinic in order to examine the extent to which recommendations were recalled and implemented. Of those parents for whom specific recommendations were provided, 9% recalled recommendations for medical follow-up, 79% recalled recommendations for child therapy, and 43% recalled recommendations for parental therapy. Families were more likely to receive and adhere to recommendations when there were behavioral problems and a strong indication of CSA. To improve communication with families, the reasons for recommendations must be clearly conveyed, and possible barriers to implementation should be anticipated and addressed. In addition, recommendations need to be realistic, and professionals need to facilitate the implementation of their treatment plan.     

Predictors of child protective service contact between birth and age five: An examination of California's 2002 birth cohort

This study utilizes population-level birth data to describe those children who may be at greatest risk of maltreatment during the first five years of life. Based on a unique dataset constructed by linking California's administrative child welfare data to statewide vital birth records, a cohort study design was employed to track reports of maltreatment involving children born in 2002. Twelve variables captured in the birth record were selected for analysis. Generalized Linear Models were used to estimate adjusted risk ratios (RR) for each independent variable. Predicted probabilities of CPS contact were computed based on the count of risk factors present at birth. Results suggest that many of the associations previously observed between birth variables and subsequent maltreatment have sustained value in foretelling which children will be reported to CPS beyond infancy. Of the 531,035 children born in California in 2002, 14% (74,182) were reported for possible maltreatment before the age of five. Eleven of the twelve birth variables examined presented as significant predictors of contact with child protective services.     

Predictors of child protective service contact between birth and age five: An examination of California's 2002 birth cohort

This study utilizes population-level birth data to describe those children who may be at greatest risk of maltreatment during the first five years of life. Based on a unique dataset constructed by linking California's administrative child welfare data to statewide vital birth records, a cohort study design was employed to track reports of maltreatment involving children born in 2002. Twelve variables captured in the birth record were selected for analysis. Generalized Linear Models were used to estimate adjusted risk ratios (RR) for each independent variable. Predicted probabilities of CPS contact were computed based on the count of risk factors present at birth. Results suggest that many of the associations previously observed between birth variables and subsequent maltreatment have sustained value in foretelling which children will be reported to CPS beyond infancy. Of the 531,035 children born in California in 2002, 14% (74,182) were reported for possible maltreatment before the age of five. Eleven of the twelve birth variables examined presented as significant predictors of contact with child protective services.     

Child protection and out-of-home placement experiences of preschool children born to mothers enrolled in methadone maintenance treatment during pregnancy

Children born to opiate-dependent women engaged in methadone maintenance treatment are at high risk of child welfare concern. However, few studies have examined the early child protection service (CPS) contacts of this group or the risk factors that place some but not other mother–infant dyads at increased risk of serious concern resulting in the removal of the child from the family home. As part of a prospective longitudinal study based in New Zealand, 73 women enrolled in methadone maintenance treatment during pregnancy and 54 non-methadone maintained comparison mothers were recruited during pregnancy and interviewed close to delivery, 18-months and 4.5-years. At each follow-up evaluation, detailed life history methods were used to describe children's family circumstances and all CPS contacts. By 4.5-years postdelivery, methadone maintained mothers were ten-times more likely to have been investigated by child protection services than comparison mothers (59% v. 6%, p < .001). Of these contacts, almost half (44%) resulted in the removal of the child from the family home compared to no comparison children (p < .001). These children were most frequently placed before age 1, with an average of 1–2 caregiver changes (range: 0–7). In addition to maternal methadone maintenance treatment during pregnancy (p < .001), significant independent predictors of child out-of-home placement included maternal depression (p = .01), maternal history of child custody loss (p = .02), and to some extent, high levels of family socioeconomic adversity (p = .06). Findings highlight the complex psychosocial needs of this high-risk group, as well as the need for careful monitoring and parenting support following hospital discharge.     

Risk factors in child abuse and neglect

Our knowledge of those factors which place children at risk for physical or sexual abuse is both limited and imprecise. The reasons for these limitations derive from both practical methodological constraints and a lack of definitional consensus among researchers in this field. This paper discusses the difficulties, both methodological and practical, involved in the development of a scientifically- based knowledge of risk factors in child abuse. Those factors known or commonly believed to be related to risk for child abuse and neglect are then described, with emphasis on those which appear to be popularly and clinically over- valued as predictors of abuse: demographic variables, psychopathology, and history of abuse. Likely foci for future research in this area are then described, with special attention to the problems inherent in each.     

Risk Factors in Child Abuse and Neglect

Our knowledge of those factors which place children at risk for physical or sexual abuse is both limited and imprecise. The reasons for these limitations derive from both practical methodological constraints and a lack ofdefinitional consensus among researchers in this field. This paper discusses the difficulties, both methodological and practical, involved in the development of a scientifically-based knowledge of risk factors in child abuse. Those factors known or commonly believed to be related to risk for child abuse and neglect are then ,described, with emphasis on those which appear to be popularly and clinically over-valued as predictors of abuse: demographic variables, psychopathology, and history of abuse. Likely foci for future research in this area are then described, with special attention to the problems inherent in each.     

Risk and protective factors for child neglect during early childhood: A cross-study comparison

The present analysis relies upon data from three separate longitudinal studies to identify risk and protective factors associated with subsequent neglect during early childhood. All three studies (Fragile Families and Child Wellbeing [FFCW]; Healthy Families New York [HFNY]; Illinois Families Study-Child Wellbeing [IFS]) involve probabilistic samples or subsamples of low-income families with young children. Multivariate logistic regressions predicting official reports of investigated neglect allegations and a dichotomous indicator of neglect from the Parent-child Conflict Tactics Scale (CTS-PC) were conducted separately for each study, using common sets of predictors derived from baseline or initial survey waves. Across the three studies, consistencies emerged with respect to the predictors of both neglect outcomes. Specifically, consistencies emerged related to indicators of economic resources and hardships, parent well-being, and parenting. Understanding the predictors of child neglect is of critical importance to the development of child maltreatment prevention strategies since a clearer understanding of the risk and protective factors associated with neglect would enable more effectively targeted and tailored interventions.     

Historical, Developmental, and Behavioral Factors Associated with Foster Care Challenges

Three agency-based studies explored the associations of traumatic child histories, as well as their developmental, health and behavioral problems with foster care challenges such as placement instability. The findings represent the convergent perspectives of child welfare workers and foster parents in small cities in Ontario. Alone and in aggregate, child and familial traumas and problems were very strong predictors of various foster care challenges. Foster parent training and other support needs are discussed.     

Parental substance misuse and compliance as factors determining child removal: A sample from the Victorian Children's Court in Australia

Purpose

The current study explores the role of parental substance misuse in child protection cases and examines its impact as a factor in decisions on child removal in court orders.

Methods

A cohort of 273 child protection cases from the Victorian Children's Court was reviewed. This sample consisted of cases where children have been removed (Custody to Secretary Order, n = 142 cases) or remained with parents (Supervision Order, n = 131 cases). Data was extracted on parental substance misuse in single and two parent households as well as compliance with court-based and child protection directives.

Principle results

Parental substance misuse (PSM) was present in 51% of child protection cases sampled and among those, poly-substance abuse was common (67%). PSM was associated with Indigenous status; younger age of child at court appearance; having a court-proven case of emotional abuse, less compliance with child protection services and a longer time between notification to authorities and final court decision. In one parent households, only parental compliance is the primary factor underlying decisions of child removal. In two parent households, the decision to remove a child from the family home was ultimately driven by parental compliance, and to a lesser extent by PSM of illicit drugs and the number of parents misusing drugs.

Conclusion

PSM and non-compliance appear to be significant factors in delaying stability for the child through the granting of court orders which may involve child removal. There is a need, by child protection professionals, for prompt recognition of PSM and associated compliance/engagement issues in order to refer appropriate cases for further assessment and treatment in specialist drug treatment services. Early involvement with specialist drug treatment services provides the Court with an indication of compliance which is an important factor for making decisions that assist with achieving stability for the child.     

Predictors of treatment attrition and treatment length in Parent‐Child Interaction Therapy in Taiwanese families

Parent–Child Interaction Therapy (PCIT) has been used successfully in the United States and in other countries around the world, but its use in Asian countries has been more limited. The present study is the first of its kind to examine the predictors of treatment attrition and length in a sample of Taiwanese caregivers and their children. It is also the first to examine PCIT outcomes in Taiwanese families. Maladaptive personality characteristics of the caregiver were the best predictor of attrition, followed by single-parent, removal of the child from the home, and lower levels of caregiver education. Treatment length was predicted by child minority status and parent–child interactions (i.e., parent commands and negative parent talk). In terms of outcomes, statistically significant treatment changes were noted for all treatment outcome variables at post-treatment and at 3-month follow-up. These findings suggest that PCIT is a promising intervention for this population. The predictors of treatment attrition and length can be used when Taiwanese caregiver–child dyads present for services so that additional assistance can be provided prior to or during treatment to increase adherence to the recommended number of treatment sessions for maximal impact. Future studies may replicate the present study with a larger clinical sample to examine the long-term effects of PCIT and to include a no-treatment control condition to afford a more robust empirical evaluation.     

Prior Placements of Youth Admitted to Therapeutic Foster Care and Residential Treatment Centers: The Odyssey Project Population

Two samples of youth in the child welfare system were compared—youth entering residential treatment centers (RTCs) and youth entering therapeutic foster care (TFC). Three questions were addressed: (1) Where were youth living prior to the current placement? (2) Had youth been treated in other systems of care? (3) How many prior placements did youth have? Time 1 data of the national “Odyssey Project” developed by the Child Welfare League of America were used. The^.measure utilized was the child and family characteristics form (CFC). Results revealed that youth admitted to RTCs were more likely to be entering from other systems of care and stepping down to the RTC while youth entering TFCs were more likely to be entering from within the child welfare system and stepping up to a higher level of care. The results have implications for improving clinical practice and for the development of a cross-system perspective on serving troubled youth.     

Are economic trends associated with child maltreatment? Preliminary results from the recent recession using state level data

The objective of this study is to investigate the effects of the recent economic recession on child maltreatment rates. Specifically, we examine whether unemployment rates, labor force participation, and food stamp usage are associated with aggregate rates of child abuse and neglect (CAN) rates using state-level data. Theory and prior empirical evidence supports the relationship between family and neighborhood poverty and incidence of child maltreatment; however, the relationship between general economic environment and CAN remains unclear.The study uses a multiple case study design at the state level, analyzing administrative child maltreatment and economic data for seven U.S. states. Aggregate numbers for child maltreatment reports and food stamp usage were obtained from state respective agencies and economic data for unemployment and labor force from the Current Population Survey from the Bureau of Labor Statistics. Empirical growth plots and OLS regression were used to examine changes in maltreatment and utilization of economic variables as predictors over time. Bivariate correlations and OLS regression results show a weak and inconsistent relationship between the economic indicators in this study and maltreatment rates. Several possible reasons accounting for these results are explored.     

Outcomes of Parent–Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts

This study examined outcomes of Parent–Child Interaction Therapy (PCIT) for 52 clinically referred children with oppositional behavior and their parents treated in an urban, community mental health clinic serving demographically (i.e., income level, ethnicity) diverse families. Standardized observations of parent–child interactions and parent reported measures of child behavior were collected at pre- and post-treatment. We addressed two primary research questions: (1) What are pre-treatment predictors of treatment completion? (2) What are treatment outcomes both for families who successfully completed PCIT and for treatment dropouts? Multiple logistic regression results showed a significantly greater likelihood of treatment completion related to higher parent education, male child gender, and two parent households. Among families who completed treatment, pre–post data demonstrated significant parent change in observed skill use and improvement in parent reported disruptive behaviors with medium to large effect sizes. Findings also documented early treatment benefits for families who completed the first phase of PCIT but dropped out in the final phase prior to meeting full graduation criteria. We discuss the findings and implications for community-based applications of PCIT in the context of community mental health's mission to provide effective treatment and maximize community access to services.     

Factors impacting intention to leave in social workers and child care workers employed at voluntary agencies

Introduction

To ameliorate high turnover in child welfare, researchers have attempted to identify factors that lead to undesirable turnover. While this has been studied extensively, little attention has been paid to turnover based upon job roles. Like social workers in child welfare, the field of child care also experiences high turnover. Child care workers employed in child welfare settings are no exception. The current study seeks to understand differential factors that impact intent to leave for preventive and child care workers employed in child welfare agencies.

Materials and methods

Data for prevention workers (n = 538) were obtained from all preventive service programs under contract with the City. Data for child care workers (n = 222) were obtained from three voluntary agencies located elsewhere in the State. The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included job satisfaction, intention to leave, career commitment, and agency investment. Data were analyzed using bivariate analysis and Structural Equation Modeling (SEM).

Results

Child care workers had more positive perceptions of child welfare and planned to stay in child welfare longer. Despite this, prevention workers felt more invested in their work. Child care and prevention workers had different levels of satisfaction with their jobs although overall job satisfaction did not differ nor did their intention to leave. Tenure at the agency was predictive of career investment. Investment, perceptions of child welfare, satisfaction with nature of work, and contingent rewards were associated with career commitment. Commitment and satisfaction with supervision were the greatest predictors of intention to leave.

Discussion

There is a gap in literature addressing child care workers in child welfare, and future study of this group is needed. Child care workers are just as likely to intend to leave their jobs as prevention workers. For both groups, it appears that investment in their jobs increases commitment to the field which reduces intention to leave.     

Managing risk under the children act 1989: Diversion in child care?

The idea of diversion has dominated the theory and practice of juvenile justice for some time. Developments in child care practice in the 1980s mirror those which produced diversion. Diversion provides an alternative conceptual framework within which the changes to child care law introduced by the Children Act 1989 can be analysed, particularly the interrelation of s.1(5), the so-called non-intervention principle, and Part III, which establishes the duty of local authorities to provide services for children in need. These provisions and current child care practices may be seen to promote four distinct forms of diversion: (1) diversion from court; (2) diversion from care or residential provision; (3) diversion from procedures; and (4) diversion from social work. Examining the law and practice in terms of diversion focuses on the potential gains and losses resulting from the Children Act's emphasis on partnership, planning and bureaucracy without presuming that losses will be compensated for by the provision of services. It also suggests the need to consider child care in terms of net widening and tariff raising.     

The moderating effect of substance abuse service accessibility on the relationship between child maltreatment and neighborhood alcohol availability

This study investigates how the relationship between dense concentrations of alcohol retailers and high rates of child maltreatment may be moderated by the presence of substance abuse service facilities. Using a cross-sectional design, the study utilized data from Bergen County, New Jersey on child maltreatment reports, alcohol-selling retailers, substance abuse service facilities, and the United States Census. Findings indicate child maltreatment rates were higher in neighborhoods with lower socioeconomic status and those with greater alcohol outlet density. Neighborhoods with easily accessed substance abuse service facilities had lower rates of child maltreatment. Additionally, the relationship between child maltreatment and alcohol outlet density was moderated by the presence of substance abuse service facilities. The study findings highlight the relevance of making primary prevention approaches readily available and using multi-sector collaboration to reduce child maltreatment.     

Child Protection Workers’ Perceptions of Foster Carers and the Foster Care System: A Study in Queensland

Abstract

Child protection workers are key players in the statutory system for the protection of children and young people. For this reason, their perceptions of the operation of the system are important. This study, conducted in Queensland, Australia, explored the views of child protection workers regarding foster carers and the foster care system. The present study revealed the difficulties the child protection workers encountered in engaging with foster carers. These difficulties were due to the structure of the child protection system and the conflicts experienced by workers in balancing the needs of children and young people, their primary clients and the carers of those children and young people. Several recommendations for policy and practice are made.     

Explaining heterogeneity in the child poverty rate among immigrant families: Differences by parental citizenship

Much of the debate about child poverty among immigrant families has centered on factors that place immigrant children at a high risk for poverty. What is missing in this debate and the literature is that children in immigrant families are economically heterogeneous and that children in naturalized families are doing as well as or better than children in native families in terms of economic status. To examine the heterogeneous economic status of children in immigrant families, this study compared children's poverty rates by parental nativity and citizenship status, decomposing demographic risk factors of child poverty. The results indicate that whereas lower parental education and employment status largely explain the relatively higher poverty rate among children in noncitizen families, higher parental education and employment rates and a lower rate of single parenthood explain why children in naturalized families have a lower rate of poverty than those in noncitizen families. Implications of these findings are discussed in detail.     

Who uses child care subsidies? Comparing recipients to eligible non-recipients on family background characteristics and child care preferences

The federally funded, state-administered child care subsidy program provides subsidies to low-income families. Despite being among the government's most significant investments in early care and education, recent national estimates suggest that fewer than 30% of eligible families receive subsidies and the predictors of subsidy receipt remain poorly understood. This study investigates the predictors of subsidy receipt among eligible families, with data drawn from the nationally representative Early Childhood Longitudinal Study — Birth Cohort (ECLS-B). Using logit regression models, we compare subsidy recipients to the eligible non-recipients of subsidies as a group, and then classified by the type of care the non-recipients do use: Head Start, public pre-kindergarten, or unsubsidized care. Results indicate that subsidy recipients are generally more advantaged than the eligible non-recipients of subsidies. In particular, subsidy recipients have more resources and fewer hassles than eligible non-recipients. These findings can aid state subsidy administrators in more effectively targeting their outreach and enrollment efforts and ultimately in increasing the use of this important program.