An exploratory study of drug-exposed infants: case substantiation and subsequent child maltreatment

This study explores factors related to drug-exposed infants' case substantiation and subsequent child maltreatment. Child protective services computerized administrative data (from January 1998 to October 2001) were obtained from an urban Nevada county. The data included 457 drug-exposed infant cases. Chi-square, t-test, one-way ANOVA, and logistic regression were used to analyze the data. Results indicate that: (1) drug-exposed infant case substantiation was related to the type of drug exposure and the unit to which the case was assigned, but not to the mother's ethnicity; and (2) subsequent maltreatment among drug-exposed infants was related to the mother's age and prior parental alcohol abuse, but not to the type of drug exposure, nor to the initial drug-exposed infant status of case substantiation. Implications for child welfare practice and research are discussed.     

Child maltreatment dynamics among immigrant and U.S. born Latino children: Findings from the National Survey of Child and Adolescent Well-being (NSCAW)

Latino children are the largest and fastest growing ethnic minority group in the United States, and the proportion of child maltreatment victims who are of Latino ethnicity has been growing since 2000. However, our knowledge of the characteristics, maltreatment patterns, and risk factors associated with maltreatment among immigrant and U.S. born Latino children and their families has been incomplete. The goals of this study are to establish the national prevalence of immigrant and U.S. born Latino children who come to the attention of child welfare systems in the United States; to expand our knowledge regarding the role of nativity in child maltreatment patterns among Latinos; and to determine if disparities in child maltreatment patterns and risks exist among Latino families using data from the National Survey of Child and Adolescent Well-being. Despite considerable risks, data indicate that immigrant Latino children are slightly underrepresented among children who present to child welfare systems when compared to the general population. Moreover, no significant differences were observed between immigrant children and U.S. born children with regard to substantiation patterns. However, significant differences emerged between the two groups in risk factors and maltreatment type, warranting further investigation.     

Child welfare supervised children's participation in center-based early care and education

Research suggests that early care and education (ECE) services, particularly center-based ECE, may help prevent child maltreatment and also mitigate some of the negative developmental outcomes associated with child maltreatment. There is also preliminary evidence to suggest that ECE could reduce the likelihood that maltreatment allegations will be substantiated by child welfare authorities and/or result in children being placed in out-of-home care. However, little is known about rates of ECE participation among children receiving child welfare services, nor the factors that determine ECE participation for this population. Data from the first wave of the National Survey of Child and Adolescent Wellbeing II, a nationally representative sample of children referred to the United States (U.S.) child welfare system (CWS) for suspected maltreatment, were used to measure the frequency with which 0–5 year olds participate in center-based ECE. Additionally, logistic regression analyses explored the effects of maltreatment type, substantiation, and children's living arrangements (i.e., with parents, relatives, or foster parents) on this outcome, controlling for a range of child and family covariates associated with ECE participation in the general population. Results indicate that less than a third of 0–5 year olds receiving child welfare services in the U.S. are participating in center-based ECE. Among the various categories of maltreatment type measured, being reported to the CWS for suspected physical abuse was associated with decreased odds of center-based ECE participation; however, other types of maltreatment, substantiation, and living arrangement were unrelated to center-based ECE participation. These findings suggest that, despite recent efforts by the U.S. federal government to promote ECE participation for CWS-supervised children, the vast majority of young children in the U.S. CWS are not receiving center-based ECE, and physically abused children are particularly disadvantaged when it comes to accessing these services.     

Substantiating neglect of first nations and non-aboriginal children

First Nations (Native American) children are greatly overrepresented in the Canadian child welfare system, and disproportionality in the substantiation of maltreatment contributes to this overrepresentation. This study explores the factors driving disproportionality in the substantiation of maltreatment and, more specifically, neglect. Data from the Canadian Incidence Study of Reported Child Abuse and Neglect (2008) are used in multivariate analyses which examine the relationship between the substantiation of maltreatment/neglect and worker assessments of case, child, household, and caregiver characteristics. These case factors fully explain disproportionality in maltreatment substantiation for First Nations and non-Aboriginal children; the disproportionality reflects underlying differences in the case, child, household and caregiver characteristics identified in First Nations and non-Aboriginal investigations. However, case factors do not fully explain disproportionality in substantiation of neglect-only investigations. Further analysis indicates that the weight that workers assigned to caregiver substance abuse, housing problems, and presence of a lone caregiver when substantiating neglect also differed for First Nations and non-Aboriginal children. Discussion of these findings explores possible explanations for these differences, and links to broader discussions around definitions of neglect and the role of substantiation in child welfare decision making processes.     

Focus on the first years: Correlates of substantiation of child maltreatment for families with children 0 to 4

The overall purpose of this study was to examine the correlates of substantiation of child neglect or child abuse in children 0–48 months of age in five areas: (1) child characteristics, (2) parent characteristics, (3) home characteristics, (4) social characteristics, and (5) maltreatment characteristics. A second purpose was to compare the results of this study to the current body of child maltreatment research.This study uses an ex-post facto design. A random sample of cases from a large metropolitan area in the southwest was obtained. Families whose cases were substantiated for maltreatment were compared to families whose cases were not substantiated. The exposure of children to a dangerous environment and poor parental skill were predictive of the substantiation in the multivariate analysis. Parents with fewer parenting skills, such as the inability to effectively communicate, lack of impulse control and use of harsh discipline, were predictive of child maltreatment in the multivariate analysis. The bivariate analysis revealed additional 22 variables as correlates of the substantiation within the 5 factors.     

Patterns of child maltreatment referrals among Asian and Pacific Islander families

Much of the available data on Asian American families who become involved with the child welfare system relies on global ethnic categories, such as the category Asian/Pacific Islander. To explore the diversity of experience that is hidden by such categories, this article analyzes two years of child maltreatment referrals for Asian and Pacific Island families in Washington state. The study findings show that considerable variation exists within the Asian and Pacific Islander population with regard to child protection referrals. Although Asian Americans as a whole were less likely to be referred to child protective services than other groups, the within group picture that these data capture is considerably more complex. Some Asian/Pacific Islander ethnic groups, particularly those which have experienced higher levels of social and economic stress, were more at risk of child welfare involvement than other groups. Such findings underscore the need for child welfare policies and practice that are sensitive to the considerable variability within the Asian/Pacific Islander community.     

What criteria do child protective services investigators use to substantiate exposure to domestic violence?

The primary purpose of this study is to determine whether child protective services investigators apply a recognizable set of criteria to substantiate batterers and victims of battering for exposing their children to domestic violence. Although domestic violence occurred in 35% of the 1,248 substantiated incidents of child maltreatment, only 31 (7.1%) couples were investigated for exposing a child to domestic violence or failing to protect a child from domestic violence. All of the batterers investigated and in the caregiver role when their children were exposed to domestic violence were substantiated. The unsubstantiated victims of battering tended to use more protective behaviors (M=3.82) than the substantiated victims (M=2.00); yet, at the case level, using more than one protective behavior did not seem to be a criterion used to substantiate the victims. Instead, it appears that investigators were discriminating between those protective behaviors by the victims that ended contact between the batterers and the children--for a substantial amount of time--and those that did not in both the substantiation and removal decision. Key issues related to applying criteria in incidents involving domestic violence are discussed along with recommendations to further refine and document them.     

Risk factors and services for child maltreatment among infants and young children

Objectives

Child maltreatment (CM) causes injury in large numbers of U.S. children. This study uses a large, multi-state dataset of child protective services reports for infants and young children under five years of age to examine risk factors and the effects of services in confirmed maltreatment investigations and recurrence over five years.

Methods

The Child Files of the National Child Abuse and Neglect Data System (NCANDS) for 2003-2007 were used to study confirmed CM reports to child protective services (CPS) using regression models and survival analysis among a cohort of children first reported during 2003.

Results

There were 1.2 million confirmed maltreatment reports to state child protective services agencies in 22 states during 2003-2007 in NCANDS, including 177,568 infants and young children under five years. 19.3% had a second confirmed CM report within 5 years. White race, inadequate housing and receiving public assistance were associated with significantly increased risk of CM recurrence. Infants and young children received more services and had less recurrence than did older children.

Conclusions

Infants and young children have different risk factors and receive different services than do older children in the CPS system. We need additional research to further assess and better target services for the special needs of infants, young children and their families if we are to protect them and reduce future child maltreatment.     

Risk assessment in child sexual abuse cases

Despite continuing improvements in risk assessment for child protective services (CPS) and movement toward actuarial prediction of child maltreatment, current models have not adequately addressed child sexual abuse. Sexual abuse cases present unique and ambiguous indicators to the investigating professional, and risk factors differ from those related to physical abuse and neglect. Incorporation of research on risk factors specifically related to sexual offender recidivism into existing CPS risk assessment models may improve the ability to assess the risk of future sexual maltreatment to children. This article reviews the literature on risk factors for sexual offense recidivism and discusses their relevance and application to CPS assessment models. An evidence-based model for assessing risk in child sexual abuse cases is proposed.     

Comments on how child protective services investigators decide to substantiate mothers for failure-to-protect in sexual abuse cases

This commentary discusses the decisions of child protective service (CPS) investigators to substantiate mothers for failure to- protect (FTP) in child sexual abuse cases. Four areas are identified in which the scientific literature remains inadequate to fully inform child maltreatment researchers, CPS practitioners and child welfare policymakers on models and outcomes for FTP substantiation decisions. Attention is called to the need for more information about how differences in statutory definitions, common guidelines, and professional education and training influence FTP substantiation decisions. Current gaps in the knowledge base on FTP and nonoffending caregivers are highlighted. doi:10.1300/J070v15n04_05.     

Disentangling substantiation: The influence of race, income, and risk on the substantiation decision in child welfare

Understanding the source of disparities found at decision-making points along the child welfare pathway is essential to understanding and addressing the overrepresentation of African American children. Although research has documented the existence of disparities, it has been less successful in identifying the explanatory factors behind them. Critiques of research examining these disparities have suggested that poverty is likely a stronger explanatory factor than race, yet analyses that include measures of poverty using data from child welfare systems have largely not been conducted. This study uses data from the Texas child welfare system to identify the factors contributing to disparities at the substantiation decision. Given the relationship between poverty and child maltreatment, the analyses control for the effect of family income, as well as other factors related to maltreatment, to better understand the effect of race on this decision-making point. Findings indicate that when family income is controlled, race is not a significant factor in the substantiation decision. However, when also controlling for caseworker perceptions of risk, race emerges as the stronger explanatory factor. This suggests not only an important relationship between race, income, and risk assessment, but also that disproportionality in the child welfare system is a complex phenomenon that cannot be explained by a single factor. These results further demonstrate that the effect of racial bias on decision-making remains an important consideration in understanding the overrepresentation of African American children.     

Directions for developmental screening in child welfare based on the ages and stages questionnaires

Many young children investigated for maltreatment have developmental problems qualifying them for early intervention services, yet only a portion of these children receive such services. To address this gap, all children ages 0-3 with child welfare (CW) substantiated maltreatment in Pennsylvania are screened for developmental and socioemotional problems using the Ages and Stages Questionnaires (ASQ). This study views screening results for over 500 children to address whether children's substantiation status, living situation, and administering worker as CW or early intervention (EI) predicts screening rates. Bivariate and logistic regression analyses were used. Results showed that 22% of children scored in the problem-range of at least one developmental area and 18% scored in the problem-range of social-emotional concerns warranting EI referral. Results of bivariate analyses showed that children who spent time in the NICU were more likely to have developmental concerns. Socioemotional concerns were related to child race, foster care living situation, child as the subject of the referral, and physical neglect. Older children and children whose referral involved lacking basic needs showed both developmental and socioemotional concerns. There were no significant differences in screening results of children with substantiated versus unsubstantiated maltreatment. Children whose screening was conducted by EI were more than three times as likely to show developmental concerns compared with those screened by CW. Child welfare workers need more support when conducting developmental screening, and policies that limit screening to children with substantiated maltreatment or to children in out-of-home care should be reconsidered.     

Describing the context and nature of emotional maltreatment reports in children

The circumstances leading to reports of emotional maltreatment are potentially unique from those of other abuse types. This study utilized data from the National Child Abuse and Neglect Data System (NCANDS), which is a federally sponsored effort requiring the submission of case-level data on all children who were subject to maltreatment investigations by state child welfare agencies. The central aims of this study were to examine case-level characteristics of sole occurrences of emotional maltreatment Child Protective Service (CPS) reports in an effort to address how caregiver and child risk correlates affect the substantiation of these allegations. A cluster analysis was performed to explore how the risk assessment factors grouped together; secondarily, the cluster groupings were examined in a logistic regression model to measure factors associated with substantiation of these abuse reports. Four unique clusters emerged, with one cluster absent any risk assessment factors entirely and another cluster solely composed of domestic violence. Caregiver risk factors with the highest odds of predicting report substantiation included caregiver substance abuse, domestic violence, and caregiver learning disabilities.     

Services for maltreated children: variations by maltreatment characteristics

Mental health services were the most frequently recommended service for maltreated children known to a child protective service agency, but more than one-fourth of the children with serious behavioral problems did not receive referrals for such services. Children with long histories of maltreatment were more likely to be referred for some services, especially out-of-home care. Gaps in services remain, underscoring a need for research focused on the need for interventions targeted to maltreated children involved with child protective service agencies.     

Risk assessment in a multicultural context: Risk and protective factors in the decision to place children in foster care

Decision-making in the child protection services is a challenging task, in particular for workers who operate in a multicultural context. Studies have found that children from immigrant groups are overrepresented in the rates of cases reported to CPSs because of the higher prevalence of some distal risk factors. However, it remains unclear whether these distal factors may also lead to child removal interventions by CPS workers. This research compared immigrant and Italian families on the factors included in the Protocol of risk and protective factors to deepen the knowledge of CPS professionals' decision-making process (Di Blasio, 2005). Social records of 175 immigrant families and 153 Italian families referred for child maltreatment to CPSs were analyzed. The results confirmed the higher prevalence of specific distal risk factors (chronic poverty, low educational level, lack of network and social integration, approval of violence, and punishments as educational practices) among immigrant families. Furthermore, the analysis identified diverse factors that appear to lead to the CPSs workers' intervention (child out-of-home placement or monitoring and parental abilities support) for immigrant and Italian families.     

Child Maltreatment, Abortion Availability, and Economic Conditions

Child maltreatment is a substantial problem in the U.S. yet has received relatively little attention from economists. This article examines the relationship between abortion availability and economic factors at the time children were conceived and subsequent measures of child maltreatment in the U.S. as well as the influence of contemporaneous economic conditions. Our measures of child maltreatment are state-level rates of child abuse and neglect reports, the fraction of children receiving social services, and child deaths and murders. The results indicate that legalized abortion for each successive cohort led to a decline in total reported incidents of child abuse and neglect of about 10 percent and a negative effect on the fraction of children receiving social services. Child deaths and murders are not related to abortion legalization. Medicaid funding restrictions are associated with an increase in substantiated reports of abuse and an increase in murders by relatives or parents; other post-legalization restrictions are not consistently associated with the various measures of child maltreatment. The effects of welfare benefits, average income, and unemployment rates are mixed.     

Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes

Few studies have specifically examined prevention of child maltreatment among higher-risk populations in rural communities. The overarching goal of this study was to conduct a randomized clinical trial of SafeCare augmented for rural high-risk population (SC+) compared to standard home-based mental health services (SAU) to examine reductions in future child maltreatment reports, as well as risk factors and factors proximal to child maltreatment. Parents (N = 105) of young children (5 years or less) who had identifiable risk of depression, intimate partner violence, or substance abuse were randomized to SC+ or SAU. Participants randomized to SC+ were more likely to enroll (83% vs. 35% for SAU) and remain in services (35 h vs. 8 h for SAU). SC+ (for participants who successfully completed services) may have had limited impact on child welfare reports during service provision. Further, SC+ had fewer child welfare reports related to DV than SAU. Parent self-reports of parenting behaviors, risk factors, and protective factors did not demonstrate significant sustained program impact. Limitations include power constraints related to sample size. Promising next steps entail future trials with larger sample sizes examining service compliance and further augmentation of SafeCare to bolster service impact and address risk and protective factors.     

Financial Abuse of Older People by Family Members: Views and Experiences of Older Australians and their Family Members

Abstract

Risk assessment in child protection services has been promoted as the most reliable way to ensure that maltreatment to children is prevented and has become central to practice with children and families. However, recent research in Australia has suggested that children are being left in unsafe situations, leading to further maltreatment, by the very agencies responsible for their protection. The present article explores the reasons why child protection has become central to child protection practice and presents a wide ranging critical appraisal of risk assessment and its application. It is argued that risk assessment is a flawed process and, as a central tenet of practice, is implicated in any problems that children's protective services face. Consequently, any future reconfiguration of services for children in need of protection needs to include a re-evaluation of the efficacy of risk assessment.     

Socioeconomic Resource Environments in Biological and Alternative Family Care and Children's Cognitive Performance*

We examined social and economic resources in the environments of children involved with child protective services and their associations with children's cognitive performance. We used a national dataset of child protection investigations (children aged 6–16 at Wave 1). Using latent class analysis, we constructed profiles of the financial resources, parental education and employment, and family structure and size. We then examined within‐ and across‐time associations between resource environment profiles and children's math and reading scores and tested whether associations differed by family care type. Our latent class analysis identified four distinct family resource environments: educated middle class, single earner, large working class, and severely disadvantaged. Family resource environment profiles predicted current cognitive performance and changes in performance over time, but associations were more consistent for children in biological family care. Children who remain in home following maltreatment allegations may benefit from services that target social as well as economic resources.