Does changing mandated reporting laws improve child maltreatment reporting in large U.S. counties?

The effects of changes in mandated child maltreatment reporting laws have not been systematically evaluated. To better understand the effects of these changes, the objectives of the present study are: (1) to assess the relationships between report rates and state universal and clergy reporting laws in 2010; (2) to compare the changes in total, confirmed, and maltreatment type report rates and with changes in reporting laws from 2000 to 2010, and (3) to examine whether there is any relationship with report rates and the nature of the mandated reporting law change. We used county-level data from the U.S. National Child Abuse and Neglect Data System for the years 2000 and 2010 to evaluate changes in reporting rates for total reports, confirmed reports, and confirmed maltreatment types while controlling for concurrent changes in child and community variables. We found that trends in 2010 for increased total and confirmed reports were similar to 2000 for counties with universal and/or clergy reporting requirements, which significantly contributed to report rates even after controlling for child and community factors. Universal reporting was associated with higher report rates for physical and sexual abuse, and clergy reporting requirements were associated with more sexual abuse, medical neglect and psychological maltreatment confirmed reports. However, while counties in states that changed their clergy reporting laws had higher increases in total reports, they had fewer confirmed physical and sexual abuse, neglect, and psychological maltreatment reports. More pronounced changes were noted in a state that made more pronounced changes in its clergy reporting laws. Policymakers should consider whether changing requirements for mandated reporting meaningfully improves child maltreatment identification.     

Child maltreatment in families experiencing domestic violence

This study examined the association between physical domestic violence (PDV) and reported child maltreatment in a cohort of children at risk for maltreatment. Participants were 219 6- to 7-year-old children and their caregivers. PDV was measured by combining caregivers' self-reports and children's reports, while child maltreatment was based on state Division of Social Services Central Registry records. Among 219 child-caregiver pairs studied, 42 (19.2%) had at least one maltreatment report in the 2 years following the interviews. PDV consistently predicted child maltreatment, with adjusted odds ratios ranging from 2.96 to 3.46. In addition, we investigated interactions between PDV and other predictors of child maltreatment. Among Aid to Families with Dependent Children (AFDC) participants, PDV was highly associated with child maltreatment. However, this pattern was not observed among subjects who did not have AFDC. There is an increased incidence of child maltreatment reports in families experiencing PDV. AFDC participation intensified the probability of child maltreatment in the presence of PDV. Findings also suggest that in households experiencing PDV, social supports may protect children from maltreatment.     

Moral Challenges When Suspecting Abuse and Neglect in School Children: A Mixed Method Study

The World Health Organization (WHO), concludes that child maltreatment is a global concern calling for a multi sectoral interdisciplinary approach. School professionals, such as social workers, teachers, and health care professionals are in positions to discover and report maltreatment enabling social workers to intervene. However, a variety of reports reveal an evident gap between incidences and frequency of number of cases reported. A review of relevant research indicates that the problem of “not reporting” suggests that moral conflicts are activated in the process of decision-making. The aim was to gain a deeper understanding of school professionals’ experiences of reporting suspected neglect and abuse to the Social Welfare Board. In a mixed method approach 32 school professionals, such as teachers, social workers, nurses and psychologists participated in interviews and responded to questionnaires. Findings from the qualitative content analysis were compared to the quantitative analysis in a meta-analysis. Moral conflicts occur when faced with making decisions about how to best deal with a child’s situation. Thoughts about the child’s best interest and relationship with his/her parents as well as the informants´ own safety, were central. The comparative meta- analysis of both data sets revealed these conflicts commence with a moral sensitivity of possible negative consequences for the child. Moral sensitivity can be viewed as a “good” personal attribute, it paradoxically might lead to moral stress despite an open ethical climate. Based on the results of this study, further research on the interpersonal aspects of dealing with moral conflicts involved in reporting suspected child abuse is indicated.

     

Who suspects and reports child maltreatment to Social Services in Sweden? Is there a reliable mandatory reporting process?

This article deals with the mandatory report process in Sweden. The components that are analysed are who makes the reports, what is reported and the outcome for the reports. Data were collected in a Swedish county in the year 2000 by means of locating every report made to the Social Services during one year (1998). The net sample consisted of 1,570 reports regarding 1,051 children. A follow-up study was carried out in 2003 of all the children for whom a report in 1998 did not lead to an investigation being initiated. We found in these study indicators that the process might not be secure. The professionals reported 1% of the children in the municipality; 22% of the reports from professionals were not investigated. The five-year follow-up study shows that 53% of the children that these reports concerned had been the subject of an investigation. This could be an indicator that children continue to be maltreated after being reported since the assessments are not accurate. In this study, 67% of ‘crime reports’ were ‘not indicating’ child maltreatment. There should be a questioning of ‘crime reports’ automatically entering the mandated report process as, if registered nationally, this could lead to a deflation of mandatory reports. Administration needs to change introducing a national form for filing reports.     

Suicidality in College Women Who Report Multiple versus Single Types of Maltreatment by Parents

To see if child sexual, physical, and psychological maltreatment are linked to adult suicidality, 114 college women completed measures of suicidality, reasons for living, incidence and impact of maltreatment. Women who reported sexual mallreatrnent in combination with other types of maltreafment were significandy more suicidal than those not maltreated or those who reported other types of maltreatment. Apparently, child sexual and multiple maltreatment are more damaging, at least in terns of suicidality, than none or only one type of maltreatment. An implication is that college counseling centers need to assess suicide potential in any women who report child sexual plus other mallreatment.     

The Impact of Housing Instability on Child Maltreatment: A Causal Investigation

More than a half million children are confirmed as victims of maltreatment by the child welfare system each year. Children from unstably housed families are over-represented in child maltreatment reports, and a growing body of evidence links housing problems to maltreatment and Child Protective Services (CPS) investigation. The present study applies two propensity score analysis approaches—greedy matching and propensity score weighting—to data from the Fragile Families and Child Well-being Study to move toward a causal explanation of child maltreatment behaviors among mothers in low-income households. Utilizing two separate methods to correct for overt selection bias, the present study finds that housing instability leads to a small increase in maltreatment behaviors, yet this small positive net impact on child maltreatment does not fully explain the over-representation of unstably housed families in the child welfare system. Families experiencing housing problems likely have a range of needs that require earlier, targeted intervention to mitigate consequences of poverty, domestic violence, and maternal depression. Child welfare services should invest resources in housing assistance programs in-house as well as through partnerships with local public housing authorities to stabilize families, reduce housing-related strain on caregivers, and promote family preservation.     

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.     

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.     

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.     

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.     

Paediatric intervention in child protection

Since BASPCAN was founded 12 years ago an enormous amount has been achieved in both understanding and responding to the problems of child maltreatment. Paediatricians have played their part along with others, although the traditional view of medicine was that this was a social problem outside medical responsibility. Attitudes are changing and there is an increasing appreciation of the importance of maltreatment in many child health problems. It is also now accepted that doctors can only be effective if they work together in teams with other professionals. The consequences of child maltreatment present to paediatricians in many ways and symptoms and signs linked to abuse are common in clinical practice. Today the role of the paediatrician is much clearer and there is more guidance and information available about the diagnosis of sexual abuse. 1991 was the beginning of a new era in child protection where it will be seen whether the new insights acquired over the past decade can be applied for the welfare of children and families.     

Economic predictors of child maltreatment in an Australian population-based birth cohort

A correlation between socioeconomic disadvantage and child maltreatment has long been observed, but the drivers of this association are poorly understood. We sought to estimate the effects of economic factors on risk of child maltreatment after adjusting for other known influences using the Australian Temperament Project, a population-based birth cohort of 2443 individuals and their parents. We used logistic regression to estimate associations of childhood economic factors (parental education, occupation, and unemployment; type of housing; and retrospective perception of poverty) with retrospective reports of perceived child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and witnessing of domestic violence), controlling for demographic factors, parental mental health and substance use, and child health. We then used these estimates to approximate the proportions of child maltreatment—population attributable fractions—that are theoretically preventable by addressing childhood economic disadvantage. Economic factors were associated with all types of child maltreatment. For the most part, these associations diminished only partially when controlling for noneconomic confounders, supporting hypotheses of causal relationships. Jointly, economic factors were significant predictors of physical abuse, sexual abuse, and witnessing of domestic violence but not of emotional abuse or neglect. Retrospective perceptions of childhood poverty were, in particular, strongly associated with most forms of child maltreatment but not with sexual abuse after accounting for other economic factors. We estimated that 27% of all child maltreatment was jointly attributable to economic factors. These findings suggest that strategies that reduce economic disadvantage are likely to hold significant potential to reduce the prevalence of child maltreatment.     

Training the workforce following a serious case review: lessons learnt from a death by fabricated and induced illness

In England, when a child dies as a result of suspected maltreatment, the Local Safeguarding Children Board is required to establish whether lessons can be learnt about collaborative working to safeguard children. These reviews usually include recommendations for both inter and intra‐agency training. In this paper, the authors argue that it is crucial, when planning and delivering training in this situation, to recognise the emotional impact on the workforce of the death of a child from maltreatment. This is particularly important when the child has died as a result of fabricated and induced illness (FII) by a carer and professionals may have inadvertently contributed to the child's suffering. Drawing on a case example of training following the death of a child from FII, this paper considers the challenges encountered by those responsible for commissioning and providing training. Attention is given to managing logistics, such as time delays between the death of the child and the eventual publication of the serious case review. The particular knowledge and skills required by trainers, not only in relation to the subject matter but also in managing complex group processes, are discussed. The support required by course participants and the trainers themselves is explored. The paper concludes with a checklist for those commissioning and providing training. Copyright © 2009 John Wiley & Sons, Ltd.     

The Representation of the Family’s Voice in Serious Case Review Reports of Child Maltreatment

Australia and the United Kingdom have mandatory systems of case reviews, which are conducted whenever a child known to welfare or health services has died or been seriously harmed due to maltreatment. In the United Kingdom those conducting case reviews are required to involve family members in their deliberations. This study employed discourse analysis to examine the representation of family voices in 41 Overview Reports of Serious Case Reviews undertaken in England and published during 2014. The findings revealed that the contributions of family members were generally relegated or their legitimacy undercut by the positivist framing of most overview reports. However, the research also identified how the framing of family contributions within an interpretivist paradigm could engender highly complex understanding of deficiencies in child protection systems and lead to crucial new learning for professionals.     

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.     

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.     

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.     

Characteristics of evidence-based child maltreatment interventions

This project summarizes, using a treatment protocol review technique, characteristics of effective interventions from nine studies of child maltreatment that examined recovery from abuse or the effects of maltreatment on child and parent outcomes. Results suggest that stronger effects are yielded by targeting parents and the parent-child interaction context in home-based settings during early childhood, designing multicomponent interventions delivered by professionals for teaching parenting competency skills, and targeting families of higher risk children.