Multidisciplinary Team Legislative Language Associated With Elder Abuse Investigations

Professionals from different disciplines providing care and services to persons at risk for or victims of elder abuse have formed various multidisciplinary teams (MDTs). The purpose of the study was to identify the adult protective services–related statutory trends in presence of MDT content and to determine the association of MDT legislation on the rates of reported, investigated, and substantiated domestic elder abuse. Aggregate reports of elder abuse and state statutes for 1999 and 2007 were retrieved from 50 states and the District of Columbia. Statutes of eight states in 2000 and nine in 2008 included text about MDTs. In 2007, investigation rates for those states having MDT text in the statutes were significantly higher than those states without. The incidence of MDTs in the country is unknown. Legislative text is but one factor associated with differences in elder abuse report, investigation, or substantiation rates.     

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.     

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.     

Effect of child protective services system factors on child maltreatment rereporting

This study examined how child protective services (CPS) systems respond to initial and subsequent reports in the context of child maltreatment rereporting and to what extent CPS system factors are associated with the risk of rereporting after controlling for abuse type and child and family factors. This study followed 67,243 families who were reported to the CPS agencies in seven counties in Florida for child abuse and neglect over a period of 5.4 years and found that 14,218 families had one or more child maltreatment rereports. Key findings include that CPS system factors were significantly different from initial report to subsequent reports. Five CPS system factors, reporting source, contact by CPS workers, investigative level at intake, postinvestigation services, and duration ofCPS involvement were significantly associated with the risk of child maltreatment rereporting. Multivariate analyses found that CPS system factors were substantially different for three categories ofrereporting, unsubstantiated rereports, substantiated rereports, and recurrence reports. Interpretations and implications for practice are discussed.     

Allegations of child sexual abuse in parenting disputes: An examination of judicial determinations in the Family Court of Australia

This study examined Family Court of Australia (FCA) judicial determinations in parenting disputes when allegations of child sexual abuse (CSA) are made by an interested party, usually the mother. For the study, 156 published judgments from 2013–2015 were examined to measure how often allegations of CSA are substantiated, suspected to be true, and disbelieved. The characteristics most common in substantiated versus unsubstantiated cases, evidence of abuse presented, and resulting parenting orders were assessed. Findings indicate that, against international comparisons, FCA judges substantiate cases very conservatively, with rates of substantiation much lower than in other studies. Allegations made by mothers against fathers were disproportionately unsubstantiated, as were those which did not fall under the Magellan case management system. Cases where the only evidence of CSA was a child’s disclosure and parent’s allegation were common in both substantiated and unsubstantiated cases, meaning that a lack of other evidence does not preclude a positive finding of risk of CSA by the FCA. Those cases also involving a protection order against the accused were more likely to be substantiated. Confirmation biases and a judicial tendency to err on the side of false negatives are discussed.     

Maybe ignorance is not always bliss: The disparate treatment of Hispanics within the child welfare system

Previous studies indicate that the proportion of culturally diverse children to White children is increasing in public social service agencies. In addition, culturally diverse children are more likely to receive more intensive and punitive services, are more likely to stay within the system for longer periods of time and are reported more often to Child Protective Services. The purpose of the study was to explore how child welfare practices with Hispanic children are different from those applied with White non-Hispanic children. This study was a retrospective, two year, longitudinal, survival analysis of differential child welfare placement outcomes of White non-Hispanic and Hispanic children/families which had substantiated cases of abuse/neglect (n=1001).Findings demonstrate that although cases reported for abuse/neglect are relatively proportionate between Hispanic and White non-Hispanic children, substantiated cases are more likely to occur with Hispanic children. These children are more likely to be placed out of the home more quickly and for longer periods of time than their White non-Hispanic counterparts. The current study demonstrates the need for increased cultural awareness among Child Welfare professionals, especially in terms of assessment and case decision making, and the need for the development of culturally sensitive training modules for CPS and case management personnel.     

Evaluation of the Children’s Advocacy Center Model: Efficiency,Legal and Revictimization Outcomes

This study compares the Children’s Advocacy Center (CAC) model with more traditional child protection services on several important outcomes such as substantiation of abuse, arrest and prosecution of the perpetrator, the efficiency of the multidisciplinary process and child revictimization rates. One hundred and eighty-four child abuse and neglect cases from a large metropolitan area in Florida comprised the sample. Cases were selected over a five year-period from three different modes of child protection services including a CAC. Similar outcomes were found between the CAC model and the Child Protection Team (CPT), a multidisciplinary model, which was first developed in Florida in 1978. In comparison with traditional child protective investigation, these models were associated with improved substantiation rates and investigation efficiency. Results are discussed in terms of the utility of CACs above and beyond the aspect of multidisciplinary coordination and whether the goals of the CAC model need to be redefined. Recommendations for further research in the areas of multidisciplinary team decision–making, the long-term impact of the CACs and the role of supportive professionals on the multidisciplinary team were made.     

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.     

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.     

Determinants of maltreatment substantiation in a sample of infants involved with the child welfare system

Children under one year of age are highly vulnerable to child maltreatment, which can lead to serious immediate and long-term physical and mental health consequences. Child welfare workers encounter unique challenges when assessing allegations of maltreatment involving infants. This study identifies correlates of maltreatment substantiation in a sample of 793 infants less than one year of age investigated by child welfare. It is based on data from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003), a national study of reports of child maltreatment. The analysis consisted of two stages. First, bivariate analyses were conducted using unadjusted odds ratios and chi-square tests on variables known to be associated with substantiation. In the second stage, a logistic regression was performed to examine these associations in a multivariate model.Multivariate findings suggest that certain vulnerabilities present in the primary caregiver, such as substance abuse and few social supports, as well as the child's positive toxicology at birth are associated with substantiated infant maltreatment. Exposure to domestic violence, which is reported mostly by the police, and physical harm stemming from maltreatment are strongly associated with substantiation, whereas reports of physical abuse and neglect have an inverse relationship. The authors discuss these results and implications for policy and programs.     

Substance use behaviors by parents and the decision to substantiate child physical abuse and neglect by caseworkers

The changing policy landscape with regards to marijuana and a growing epidemic related to opioid misuse may affect caseworkers' decisions to substantiate maltreatment involving use of those two substances. This study examined whether caseworkers factor marijuana and opioid use, including whether or not the drug was medically prescribed, into substantiation decisions. In this study, each respondent (n = 467) was given two vignettes (one for neglect and one for physical abuse) with one of five drug use conditions. Logistic regression models showed that any drug use was related to higher odds of substantiating neglect. Only illicit opioid or marijuana use was positively related to substantiating physical abuse. Any substance use may impair a parent's functioning and be interpreted as placing a child in greater risk for potential harm from neglect. For physical abuse, caseworkers may view illicit substance use as participating in a deviant behavior making physical abuse seem more likely.     

Risk factors associated with elder abuse: the importance of differentiating by type of elder maltreatment

Elder abuse research rarely differentiates by the type of elder maltreatment involved when identifying risk factors. The purpose of this study was to compare risk factors across four predominant types of elder maltreatment (financial exploitation, physical abuse, neglect by others, and hybrid financial exploitation [HFE]). Data were collected from two sources: interviews with victims of substantiated elder abuse, responding adult protective services (APS) caseworkers (N = 71), and third-party informants; and a statewide database that contained all substantiated cases over a corresponding 2-year period (N = 2,142). Using chi-square (interview data) and logistic regressions (Adult Services/Adult Protective Services [ASAPS] data), significant differences across the four types of elder maltreatment were found. These two datasets provide converging evidence for the importance of differentiating by type of maltreatment when identifying risk factors for elder maltreatment and for the importance of considering both the elderly victim and the abusive individual when predicting type of elder maltreatment.     

Differential response in child protection: How much is too much?

Recurring maltreatment can have devastating, lifelong consequences for children who are victims of abuse and neglect. The primary mission of child protection services (CPS) agencies is to prevent the recurrence of child maltreatment by offering families services designed to prevent future maltreatment. In order for these services to be effective, however, families must actually engage in them. This study focuses on how differential response programs impact families' successful engagement in services as indicated by long-term child safety outcomes.Differential response refers to a dual track system that allows public CPS agencies to respond to accepted reports of child abuse or neglect with either a traditional investigative response (TR) or an alternative response (AR). The AR is designed to be a less authoritative and less adversarial approach to families presenting a low- to moderate-risk of maltreatment. The AR involves collaboration with the family in a comprehensive assessment of the family's needs, risks and strengths and a referral to services on a voluntary basis. States implementing DR systems statewide vary greatly in the percentage of accepted reports that are assigned to the AR track. The goal of this study is to determine what rate of AR utilization is most effective in reducing subsequent reports of abuse and neglect for cases assigned to the AR.This study compares child safety outcomes for children assigned to the AR and those assigned to the TR within each of the fourteen states which implemented DR statewide between 2000–2012. The analysis uses Cox proportional hazards regression. Data for this observational study are drawn from the 2000–2012 data in the National Child Abuse and Neglect Data System (NCANDS) child files. Child safety is measured by re-reporting of the child to CPS.The theoretical model underpinning the study is McCurdy and Daro's (2001) Integrated Theory of Participant Involvement (ITPI) which outlines a conceptual model of parental engagement in services. This study hypothesizes that AR utilization rates affect the risk level of cases assigned to the AR. The ITPI model offers a possible explanation as to why higher risk cases may not be as responsive to the AR approach which depends upon the family's voluntary participation in services.The key finding of this study is that, in states assigning > 33% of reports to the AR, children on the AR track are being re-reported at equal or higher rates than those on the TR track. Only in those states utilizing the AR track for < 33% of the cases are AR cases being consistently re-reported at lower rates than those on the TR track. This article explores ways to improve the accuracy of track assignment decisions to prevent the assignment of higher risk families to the alternative response.     

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.     

Dosage matters: The relationship between participation in the Nurturing Parenting Program for infants, toddlers, and preschoolers and subsequent child maltreatment

This article uses statewide data on caregivers of young children referred to the Nurturing Parenting Program (NPP) for allegations of abuse and neglect to examine the relationship between program dosage and subsequent maltreatment. At six months after participating in the program, caregivers who attended more sessions were significantly less likely to be reported for child maltreatment, holding other factors constant. At two years after participating, caregivers attending more sessions were significantly less likely to have a substantiated maltreatment incidence, controlling for other characteristics of families associated with maltreatment. These findings demonstrate the program is associated with preventing short-term allegations and longer-term substantiated incidences of maltreatment for a child welfare population. By demonstrating the importance of participation in the NPP, we increase the evidence about effective parent education programs for this population.     

Substantiation of Sexual Abuse Allegations

Professional practices and decision-making procedures in investigation of child sexual abuse were studied by interviewing child protection professionals in the southeastern U.S. regarding 175 allegations of abuse. Investigation procedures used, factors associated with the decision to substantiate, and the child protection workers' degree of confidence in their decisions were recorded for each allegation. It was found that substantiated cases: (a) involved significantly older children; (b) were more likely to involve intrusive types of abuse and children of minority race; and (c) were less likely to involve a visitation or custody dispute. Characteristics of the child's disclosure served as the primary basis for substantiation decisions, although medical evidence and affective and behavioral indicators also contributed to the decisions. Case workers were less certain of their decisions when allegations involved young children and adolescents and when allegations were made in the context of custody disputes. In terms of investigatory procedures, anatomical dolls and drawings were rarely used, alleged offenders were interviewed in fewer than one quarter of the cases, and medical and law enforcement consultations were obtained at a higher rate than mental health consultations.     

Development of short-form measures to assess four types of elder mistreatment: Findings from an evidence-based study of APS elder abuse substantiation decisions

Improving the standardization and efficiency of adult protective services (APS) investigations is a top priority in APS practice. Using data from the Elder Abuse Decision Support System (EADSS), we developed short-form measures of four types of elder abuse: financial, emotional/psychological, physical, and neglect. The EADSS data set contains 948 elder abuse cases (age 60+) with yes/no abuse substantiation decisions for each abuse type following a 30-day investigation. Item sensitivity/specificity analyses were conducted on long-form items with the substantiation decision for each abuse type as the criterion. Validity was further tested using receiver–operator characteristic (ROC) curve analysis, correlation with long forms and internal consistency. The four resulting short-form measures, containing 36 of the 82 original items, have validity similar to the original long forms. These short forms can be used to standardize and increase efficiency of APS investigations, and may also offer researchers new options for brief elder abuse assessments.     

Types and timing of child maltreatment and early school success: A population-based investigation

The purpose of the present study was to investigate the prevalence of types of child maltreatment and co-occurring risks in an entire county population of children in public education and to examine the unique relations of the child maltreatment types and timing on children's early academic success while accounting for the children's multiple-risk context. A cohort of 11,835 second grade students who were born in the county and attended the public school district served as participants. Information on first reported experiences of substantiated physical abuse, neglect, unsubstantiated child maltreatment reports, health, maternal, and social risks, and academic and behavioral outcomes was obtained and linked through a county-wide integrated data system. Results indicated that after controlling for demographics and the set of other risks, substantiated child neglect and unsubstantiated reports were associated with poorer outcomes than physical abuse. Also, first substantiated child maltreatment and unsubstantiated reports prior to kindergarten were related to a more comprehensive set of poor outcomes than post-kindergarten first reports. The differential patterns that emerged for the association between age of first reported maltreatment by type and educational outcomes were discussed with implications for future research and policy.