What's so different about differential response? A multilevel and longitudinal analysis of child neglect investigations

Differential response (DR) is a system reform that allows child protective services (CPS) agencies to divert low-to-moderate risk families from an investigative track to an alternate track that does not require a maltreatment disposition or identification of an alleged perpetrator. Knowledge of how DR alters the flow of cases through CPS systems has been restricted by methodological limitations in prior research. This study uses cross-sectional and longitudinal data from the National Child Abuse and Neglect Data System (NCANDS) child file to examine the extent to which DR implementation affects the number and demographic composition of cases investigated for neglect. Results from multivariate, multilevel cross-sectional analysis of 2010 data indicated that investigations were 2.4 times more likely to be substantiated in DR counties than in non-DR counties. Children with a previous substantiated report were also more likely to have a current report substantiated and this difference was significantly greater in DR counties than in non-DR counties. Child race and ethnicity did not predict substantiation decisions. Results from a mixed-effect longitudinal analysis of 997,512 cases from 269 counties between 2001 and 2010 suggest that the rate of investigations fell sharply nationwide within three years of DR implementation. However, substantiation rates did not change as a result of DR implementation. Instead, analysis indicated differences between DR and non-DR counties emerged before the launch of DR. The findings highlight the benefit of using “big data” and longitudinal analysis to assess large-scale policy changes.     

Using sibling data to understand the impact of family group decision-making on child welfare outcomes

Few studies have examined the impact of family group decision-making (FGDM) on child welfare outcomes. Studies in this area have often suffered from small sample sizes and lack of adequate comparison groups. Since FGDM is administered at the family level, sibling data provides an ideal way to compensate for small sample sizes and low enrollment rates in research evaluating FGDM. This study utilized sibling data from California's Title IV-E Waiver Demonstration Project Evaluation in Fresno and Riverside Counties to compare child welfare outcomes for children of families randomly assigned to receive FGDM (Fresno County, n = 110; Riverside County, n = 87) to children of families assigned to receive traditional child welfare services (Fresno County, n = 74; Riverside County, n = 52). After controlling for clustering effects using general estimating equations (GEE), group differences in child maltreatment, placement stability, and permanence were modeled using linear and logistic regression. Outcomes from both counties suggested no group differences. Though neutral outcomes on child welfare indicators may bring into question FGDM's efficacy for changing child welfare outcomes, this study confirms previous findings with smaller sample sizes on the impact of FGDM and demonstrates a methodological improvement over individual or family-case analyses.     

Do children in foster care receive appropriate treatment for asthma?

Asthma is the most common childhood chronic disease, and children in foster care have the highest rates of chronic conditions of any studied child population. The purpose of this study is to determine whether there are disparities in asthma management and health care utilization between children in foster care and other children covered by Medicaid in the state of Illinois. We use performance measures developed by the state child welfare system as well as those developed by the National Committee on Quality Assurance and used throughout the country. The study sample was drawn from linked administrative data on children in foster care and paid Medicaid claims. In order to determine the influence of living arrangement setting within the child welfare system, children in foster care were further grouped according to whether they lived in a stable home setting, a stable congregate care setting, or other living arrangement. We found that children living in home settings performed better on most performance measures than income-eligible Medicaid children. In contrast, children with asthma living in congregate care were particularly vulnerable as reflected in poor asthma care measurements and high utilization of hospitalizations despite positive performance on indicators of medication use. This population presents a significant challenge to the child welfare and health care delivery systems.     

Community Informant Explanations for Unusual Neighborhood Rates of Child Maltreatment Reports

This study explored perceptions of community informants on socioenvironmental factors that explain why rates of child maltreatment reporting are different in neighborhoods with similar population characteristics. This study used data from the SoCal Neighborhoods and Child Welfare study, a multiphase, mixed-methods study of neighborhoods in Los Angeles and San Diego counties. Semistructured qualitative interviews with key informants (N = 28) in 22 census tracts explored factors that account for differences in maltreatment rates among sociodemographically similar neighborhoods. Thematic content analysis revealed three themes regarding neighborhood contributors to maltreatment behaviors and reporting: (a) community norms and values, (b) community resources and providers, and (c) housing dynamics and built environment. Findings indicate complexity in forces that affect maltreatment behavior and reporting. Adding to research on neighborhood social dynamics and child maltreatment, findings suggest that composite indicators of maltreatment within neighborhoods are affected by maltreatment behaviors and the definition, recognition, and reporting of maltreatment.     

Permanent Placements for Young Children Placed in Foster Care: A Proposal for a Child Welfare Services Performance Standard

Performance indicators for child welfare services for young children entering foster care should be established to help agencies determine the sufficiency of their efforts to provide permanency. Child welfare services need a technically feasible, conceptually sound, and achievable performance standard. Use of a 100% permanency standard, not including long-term foster care or non-kinship guardianship, within four calendar years of placement is forwarded. Data on the permanency planning performance of a state and four counties within it are presented to sharpen the discussion.     

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.     

Farm Structure and the Economic Well-Being of Nonmetropolitan Counties

Abstract The Goldschmidt thesis (1947, 1978) maintains that increasing farm size in the United States has undermined the well-being of rural communities. Recent studies have cast doubt on this, however. We analyze data for nonmetropolitan counties in the United States, and also incorporate indicators of the nonfarm economic sector into our analysis so that we can explore the net effect of farm structure on well-being. In addition, we distinguish nonmetropolitan counties by their level of farm dependency. Our study fails to support the Goldschmidt thesis.     

Shaping child welfare policy via performance measurement

Performance measurement is generally depicted as a neutral, technical exercise providing objective data for decision-making. But it also has a normative role in framing policy problems and solutions. This article explores the role of indicators in shaping child welfare, comparing stated policy with performance indicator regimes in England. It shows how indicators construct child welfare narrowly as investigation and placement, contradicting the more comprehensive family support approaches of policy and legislation.     

Indicators of social well-being and elements of child welfare in Minnesota rural counties

Organizational and structural conditions of rural communities and counties are significant factors in determining child welfare levels and general quality of life in rural areas. This article analyzes the relationship between elements of child welfare and an index of social well-being estimated for the state of Minnesota. The study suggests that social workers may enhance their services by considering county data that depict the viability of rural communities.     

The impact of foster care privatization on multiple placements

The purpose of this study was to assess the impact of foster care privatization policy on multiple placements in Florida's foster care system. A variant of the interrupted time series design allowed for an assessment of privatization policy within 282 data points (six years of data nested in 47 counties). Results from hierarchical linear analysis models identified a significant effect for privatization while controlling for a major alternative explanation. Specifically, the percent of children in fewer than three placements was significantly lower in the post-privatization years than in the pre-privatization years. This effect varied across counties. Line graphs revealed a variety of trends among providers, which may explain the variation of privatization's effect across counties. These results have implications for policymakers seeking to address the goal of permanence and for child welfare administrators involved in the implementation of privatization policy.     

Early indicators of child abuse and neglect: a multi‐professional Delphi study

Through the application of the Delphi technique, this study draws on the expertise of British child protection academics and practitioners from a wide range of disciplines in seeking to develop a consensus opinion on possible early indicators of child abuse and neglect. The search for early indicators is described in the context of a secondary preventative approach to the problem of child maltreatment. A very tentative conclusion arising from the study is that the early indicators of child abuse and neglect that achieved consensus of agreement may help in diagnosing child abuse and neglect at an earlier stage, although they are not necessarily diagnostic. Alternative explanations, differential diagnoses and information‐gathering are paramount, as is a willingness and ability to act on concerns. Although great caution is urged, it is suggested that the findings from the study are credible and of interest to those who are working towards more timely recognition and referral of abused and neglected children. Copyright © 2003 John Wiley & Sons, Ltd.     

Suicide prevention and community-level indictors

This study sought to develop a set of easily obtainable, relevant measures of a community's condition that could be used to guide its suicide prevention efforts. Existing data were gathered across 159 Georgia counties for nine potential social indicators (rates of net migration, divorce, unemployment, violent crimes reported, driving under the influence of alcohol or drugs [DUI] crashes, high school dropouts, Temporary Assistance for Needy Families [TANF], percentage of population aged 65 or older, and percentage of population who are white males) that had been chosen by the communities. Data on the social indicators from 1995 through 1999 were averaged and analyzed to determine their correlation with aggregated 5-year county suicide rates. Results of multivariate modeling procedures showed number of DUI crashes and percentage of the population aged 65 or older to be significant correlates of the suicide rate, controlling for other potential indicators. These preliminary data may provide a useful model of a county's 5-year suicide rate among counties reporting 20 or more suicides. Research with additional indicators and in other states will help determine the generalizability of these findings to other communities.     

A study of performance indicators and Ofsted ratings in English child protection services

This paper presents new findings from a study of performance measures for children in need and child protection services in England. National datasets and census returns from 152 local authorities over a 13-year period were combined in order to analyse trends and correlations in quality indicators. The study also explored the relationship between these measures and inspection ratings from the Office for Standards in Education, Children's Services and Skills (Ofsted), with a particular focus on services rated as inadequate. The available quality measures mainly focused on the timeliness of work processes, but these did not seem to affect outcomes in the form of re-referral rates. However, re-referrals were higher in local authorities with a tendency to close cases quickly and in those with high rates of agency workers. A small number of indicators were able to predict an inadequate Ofsted rating in 2012 and 2013. Changes in performance measures in the year following an inadequate Ofsted rating may suggest greater use of protective interventions compared with similarly performing local authorities. Implications are considered for performance measurement, management and inspection in the field of child protection.     

Neighborhood racial & ethnic diversity as a predictor of child welfare system involvement

Using U.S. Census and child maltreatment report data for 2052 Census tracts in Los Angeles County, California, this study uses spatial regression techniques to explore the relationship between neighborhood social disorganization and maltreatment referral rates for Black, Hispanic and White children. Particular attention is paid to the racial–ethnic diversity (or ‘heterogeneity’) of neighborhood residents as a risk factor for child welfare system involvement, as social disorganization theory suggests that cultural differences and racism may decrease neighbors' social cohesion and capacity to enforce norms regarding acceptable parenting and this may, in turn, increase neighborhood rates of child maltreatment. Results from this study indicate that racial–ethnic diversity is a risk factor for child welfare involvement for all three groups of children studied, even after controlling for other indicators of social disorganization. Black, Hispanic and White children living in diverse neighborhoods are significantly more likely to be reported to Child Protective Services than children of the same race/ethnicity living in more homogeneous neighborhoods. However, the relationships between child welfare system involvement and the other indicators of social disorganization measured, specifically impoverishment, immigrant concentration child care burden, residential instability, and housing stress, varied considerably between Black, Hispanic and White children. For Black children, only housing stress predicted child maltreatment referral rates; whereas, neighborhood impoverishment, residential instability, and child care burden also predicted higher child maltreatment referral rates for Hispanic and White children. Immigrant concentration was unrelated to maltreatment referral rates for Black and Hispanic children, and predicted lower maltreatment referral rates for White children. Taken together, these findings suggest that racial–ethnic diversity may be one of the more reliable neighborhood-level demographic indicators of child welfare risk across different racial/ethnic groups of children. However, many of the other neighborhood characteristics that influence child maltreatment referrals differ for Black, Hispanic and White children. Consequently, neighborhood-based family support initiatives should avoid a one-size-fits-all approach to child abuse prevention and strategically consider the racial/ethnic make-up of targeted communities.     

Reunification outcomes among Mexican immigrant families in the child welfare system

This study examined reunification outcomes among Mexican immigrant families involved in the child welfare system, and compared characteristics of Mexican-origin and non-immigrant children involved in the child welfare system. An exploratory retrospective longitudinal design using administrative data from two counties in Northern California was utilized. The quantitative sample (N = 2152) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 in the two participating counties. Child welfare administrative data (CWS/CMS) were merged with eligibility data (CalWIN) in order to obtain parent and child place of birth and citizenship status. Quantitative measures drawn from the merged CWS/CMS and CalWIN dataset included the following: demographic characteristics, immigrant characteristics, case characteristics and reunification outcomes. Results indicated that a significantly higher proportion of Mexican immigrant families (70.7%) were reunified than non-immigrant families (43.1%). Significant correlates of reunification among Mexican immigrant families included the following: mothers with authorized citizenship status (vs. unauthorized citizenship status), mothers whose primary language was Spanish (vs. English), and children with two or fewer placements (vs. three or more placements). Differences between Mexican-origin and non-immigrant children were that Mexican-origin children were older on average than non-immigrant children, and they were more likely to experience physical abuse, sexual abuse or emotional abuse; they were also more likely to be placed in foster care or a group home (vs. relative care). Implications for social work practice and policy are discussed.     

Multidisciplinary Team Involvement and Prosecutorial Decisions in Child Sexual Abuse Cases

This study examines the impact of multidisciplinary teams (MDTs) coordinated by Children’s Advocacy Centers (CACs) on the prosecutorial decision to accept or reject cases of child sexual abuse (CSA). This analysis is part of an examination of the utility of CACs as it relates to prosecutorial decisions. Case specific information was obtained on all cases with both child protective services (CPS) law enforcement involvement processed through one Texas CAC, serving multiple counties, from 2010 to 2013. For the purposes of this study one county is listed as rural and one is listed as urban. The study site also unofficially serves several more rural counties. The urban county accounts for approximately 75% of all cases processed through the CAC. The final analyses included 553 cases of alleged CSA. Logistic regression was used to evaluate the utility of MDTs and case coordination among law enforcement and CPS as they relate to prosecutorial decisions. The number of participants at MDT meetings was correlated with an increase in prosecutorial acceptance rates by approximately 30%. Prosecutor presence at MDT meetings was correlated with an increase in acceptance rates by approximately 80%. Official case coordination between law enforcement and CPS was not statistically significant. Results of this study suggest that the MDT model provides a useful tool for prosecutors when determining whether to accept or reject cases of CSA, while official coordination may be less impactful.     

Sexual and reproductive health policies for foster youth in California: A qualitative study of child welfare professionals' experiences and perceptions of policies

Child welfare professionals and foster parents increasingly suggest the importance of establishing clear and consistent policies and procedures to address the sexual and reproductive health of youth in foster care. The present study examines the content and context of such policies across 18 California counties through a search of publically available county policy documents, and surveys and expert interviews with child welfare professionals (N = 22). A policy framework for agenda setting and policymaking was used to guide the data collection and analysis process. Child welfare professionals were aware of multiple sources of information, support and services for foster youths' sexual and reproductive health, though few practiced in counties with formal policies that outline the resources and support that youth should receive. Participants demonstrated widespread recognition that issues of youth sexual and reproductive health were significant; posing challenges to youth, foster parents and child welfare staff. Identified policy solutions included: 1) training for social workers and foster parents; 2) collaborative partnerships with public health nurses and community providers; 3) data tracking and monitoring of outcomes to assess youth needs and evaluate the impact of programs and policies; and 4) involvement by advocacy organizations in defining problems and advocating for improved services and support for youth in care. Social workers largely perceived that support from child welfare administrators and policy leaders is necessary to prioritize this issue and initiate policy formation. Additional research is needed to further examine the impact of policy mandates on social workers, foster parents and youth in foster care.     

Explaining Black‐White Disparity in Maltreatment: Poverty,Female‐Headed Families,and Urbanization

The purpose of the current study was to assess a structural level explanation of racial disparity in child maltreatment. Using data from Florida counties (1998–2001) and the 2000 census, the effects of poverty, concentrated poverty, and female‐headed families in poverty on Black, White, and the difference between Black‐White rates of child maltreatment were assessed (N= 67). Results suggested that the structural covariates of maltreatment vary by race and that differences in female‐headed families in poverty can explain some, but not all, of the Black‐White racial disparity in child maltreatment. Increasing programs that focus on reducing poverty among female‐headed Black families and the exposure of Black families to concentrated poverty should decrease some of the overrepresentation of Black children in the child welfare system.     

Multiple Response System: Evaluation of Policy Change in North Carolina's Child Welfare System

Systemic challenges within child welfare have prompted many states to explore new strategies aimed at protecting children while meeting the needs of families, but doing so within the confines of shrinking budgets. Differential Response has emerged as a promising practice for low or moderate risk cases of child maltreatment. This mixed methods evaluation explored various aspects of North Carolina's differential response system, known as the Multiple Response System (MRS), including: child safety, timeliness of response and case decision, frontloading of services, case distribution, implementation of Child and Family Teams, collaboration with community-based service providers and Shared Parenting. Utilizing Child Protective Services (CPS) administrative data, researchers found that compared to matched control counties, MRS: had a positive impact on child safety evidenced by a decline in the rates of substantiations and re-assessments; temporarily disrupted timeliness of response in pilot counties but had no effect on time to case decision; and increased the number of upfront services provided to families during assessment. Qualitative data collected through focus groups with providers and phone interviews with families provided important information on key MRS strategies, highlighting aspects that families and social workers like as well as identifying areas for improvement. This information is useful for continuous quality improvement efforts, particularly related to the development of training and technical assistance programs at the state and local level.