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.     

An examination of relationships between children's protective services social worker assessment of risk and independent LONGSCAN measures of risk constructs

Risk assessment as a Child Protective Services (CPS) decision-making model has been implemented in the field since the late 1980s. Research activities on risk assessment have included comparative analyses, prioritization, classification studies, implementation, and cultural sensitivity analyses. In the last decade, the major research focus has been on studies related to predictive validity. Little research on risk assessment has focused on other types of construct validity, including convergent validity. Using data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) and CPS investigation records, this study examined the correlations between CPS workers' ratings of risk on nine risk factors and independent measures of the same risk constructs collected by research interviewers. The data indicate significant correlations with caregiver risk factors such as physical/mental/emotional impairment, however there is little correlation with child risk factors associated with developmental or behavioral issues, or socio-economic factors such as stress and social support. Implications of the findings for policy and practice are discussed.     

The empirical basis of risk assessment in child welfare: the accuracy of risk assessment and clinical judgment

The importance of risk assessment is juxtaposed with the lack of empirical support regarding the validity of risk inventories. This study compared risk ratings of one risk assessment tool to decisions made by case managers. The researchers sampled 450 children and compared predictive utility of risk assessment to child protection decisions. Risk assessment was consistent with clinical judgment in 74% to 81% of cases, more than previously reported in studies of risk assessment validity. Further analyses identified discriminate functions at the instrument's category and individual-item levels. The results have implications for the validity of the instrument and its utility in child welfare.     

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.     

Actuarial risk assessment in child protective services: Construction methodology and performance criteria

Purpose

To prevent the recurrence of child maltreatment, actuarial risk assessment can help child protective services (CPS) workers make more accurate and consistent decisions. However, there are few published articles describing construction methodologies and performance criteria to evaluate how well actuarial risk assessments perform in CPS. This article describes methodology to construct and revise an actuarial risk assessment, reviews criteria to evaluate the performance of actuarial tools, and applies a methodology and performance criteria in one state.

Methods

The sample included 6832 families who were followed for two years to determine whether they were re-reported and re-substantiated for maltreatment.

Results

Both the adopted and the revised tools had adequate separation and good predictive accuracy for all families and for the state's three largest ethnic/racial groups (White, Latino, and African American). The adopted tool classified relatively few families in the low-risk category; the revised tool distributed families across risk categories.

Conclusions

The revised tool classified more families as low-risk, allowing CPS to allocate more resources to higher-risk families, but at the cost of more false negatives.     

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.     

Relationship of risk assessment to placement characteristics in a statewide child welfare population

Risk assessments allow child and youth services to identify children who are at risk for maltreatment (e.g., abuse, neglect) and help determine the restrictiveness of placements or need for services among youth entering a child welfare system. Despite the use of instruments by many agencies within the U.S. to determine the appropriate placements for youth, research has shown that placement decisions are often influenced by factors such as gender, age, and severity of social–emotional and behavior problems. This study examined ratings of risk across multiple domains using a structured assessment tool used by caseworkers in the Rhode Island child welfare system. The relationship between ratings of risk and placement restrictiveness was also examined. Risk levels varied across placement settings. Multivariate analyses revealed that lower caseworker ratings of parent risk and higher ratings of youth risk were associated with more restrictive placements for youth. Implications for the child welfare system are discussed.     

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.     

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.     

Didn't we just see you? Time to recurrence among frequently encountered families in CPS

In child protection services, multiple maltreatment recurrences, or chronic maltreatment, has been a concern drawing increased attention because of its persistent harm to the children and the need to consider more effective intervention strategies to meet its unique needs. Timing has been an important issue in understanding the pattern of chronic maltreatment. No existing research has examined the influence of the interval between previous maltreatment incidents on future recurrences. The current study uses state administrative data to conduct longitudinal analyses to examine how the interval between previous maltreatment incidents is associated with the likelihood of future maltreatment occurrence among children who encountered multiple maltreatment recurrences. The findings suggest that short intervals are associated with increased likelihood of encountering a future recurrence, while controlling various covariates. The findings suggest the possibility of including the interval between previous maltreatment incidents as an indicator for child maltreatment risk assessment, and the need for developing responsive intervention strategies to stop the trend of chronic maltreatment.     

The effects of child maltreatment on violent offending among institutionalized youth

While prior literature generally supports the connection between child maltreatment and violent offending in adolescence and early adulthood for general population samples, less is known about the relationship between child maltreatment and the frequency of violent offending among serious juvenile offenders. As a result, few studies have examined whether the effects of child maltreatment on the frequency of violent offending are mediated by other social processes, as developmental models of aggression and violence would suggest. To examine this issue, self-report data on child maltreatment, general delinquency risk factors, and violent offending were collected from 3,694 juveniles confined to 48 correctional institutions. Results from a series of negative binomial regression models indicated that the relationship between child maltreatment and the frequency of violent offending was mediated by social risk factors. The implications of these findings for theory and practice are discussed.     

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

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

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

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

Decision-Making processes in the child protection system: A comparative study between students and professionals in Portugal

Abstract

This research aims to achieve a better understanding of factors that influence the assessments and decisions of professionals and students about the possibility to remove a child at risk from her birth family. The study also analyzes the influence of the attitudes of the child’s mother on that decision. It was used a questionnaire based on a case vignette of alleged child maltreatment. Compared with students, professionals were more pro-removal, more in favor of reunification and parents’ participation in the decisions, and had a higher assessment of emotional abuse, and emotional and physical neglect. Mother’s wish did not show to have any impact in the two samples regarding maltreatment, risk assessments, and intervention recommendations.     

Maltreatment history as persistent risk: An extension of Li and Godinet (2014)

Using individual growth curves with mixed models, this study examined the influence of maltreatment on the trajectories of both internalizing and externalizing behavioral problems from early childhood (age 4) to late adolescence/emerging adulthood (age 16) in the LONGSCAN samples of children with early maltreatment exposure or early risk for maltreatment. Maltreatment reports for each child were used to create a time-varying predictor, which was assessed on an ongoing basis in the LONGSCAN study. Child/youth emotional and behavioral problems were measured at ages 4, 6, 8, 10, 12, 14, and 16 using the Child Behavior Checklist. Maltreatment allegations significantly predicted subsequent trajectories of both internalizing and externalizing problems. For both types of problems, the effect of repeated maltreatment was on the rate of change (the trajectory), and in the case of externalizing problems, this effect grew more pronounced through age 16. Although behavioral problems may not be seen in younger children who experience maltreatment, these children are at ongoing risk for such problems as they grow older, and this risk is either maintained through adolescence (in the case of internalizing problems) or increases in strength through adolescence (in the case of externalizing problems). Maltreatment history is a persistent risk factor for child outcomes through adolescence. Assessment for recent maltreatment, as well as for earlier history of maltreatment, in adolescent children would improve treatment and service plans for children with behavioral and emotional problems through adolescence.     

Child maltreatment in China: An ecological review of the literature

This article presents findings of a systematic review of empirical studies on child maltreatment in China that were published in either English or Chinese. The review uses Bronfenbrenner's ecological systems theory as a lens to examine risk and protective factors of child maltreatment within micro-, meso-, exo-, macro-, and chrono- system levels. A search of 5 electronic bibliographic databases and websites identified 24 outcome studies on child maltreatment in China, which included studies that examined physical/emotional/sexual abuse, and neglect. The most direct influences of child maltreatment in the micro-level system include the parent-child relationship and intergenerational transmission of abuse. At the macro-system level, maltreatment is explained by cultural values such as filial piety and familism. In essence, different factors are found within the various system levels that indicate the complexities of the factors that influence child maltreatment. Throughout the article, we highlight the need to understand the cultural dynamics, values, and mores of Chinese families. The discussion includes practical suggestions and implications for intervention with children, parents, and grandparents that school teachers, social workers, policy makers, and researchers can utilize.     

Psychometric testing of the Chinese version of ISPCAN Child Abuse Screening Tools Children's Home Version (ICAST-CH-C)

BackgroundChild maltreatment is a global problem and the true extent remains unknown. The International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool — Children's Home version (ICAST-CH) has provided accurate assessment of the scope and prevalence of child maltreatment. Yet measures of children's experiences of child maltreatment are limited in the Chinese population.ObjectivesThe study aimed to translate and validate a Chinese version of the ISPCAN Child Abuse Screening Tool — Children's Home version (ICAST-CH) and to evaluate its reliability and validity among Taiwan adolescents.MethodsA three phase study was conducted. In phase 1, the ICAST was translated into Chinese using forward–backward translation procedures with the translation equivalence and content validity assessed. In phase 2, the data provided by a convenience sample of 98 adolescents was used to assess the internal consistency of the ICAST-CH Chinese version (ICAST-CH-C). In phase 3, the psychometric properties of the ICAST-CH-C were tested with a nationwide random sample of 5236 adolescents from 35 schools.ResultsThe translation equivalence and content validity index of the ICAST-CH-C was satisfactory. The inter-rater agreements were .90–.91 for comparability of language and .89–.94 for similarity of interpretability. Results indicated that the ICAST-CH-C had a high level of equivalence with the original English version and demonstrated a high internal consistency (.71–.89). Confirmatory factor analysis revealed the presence of five factors supporting the conceptual dimension of the original instrument.ConclusionThis study provided initial psychometric properties of the ICAST-CH-C and supports it as a reliable, valid, and highly usable instrument to identify childhood victimization in adolescents. It provided health care professionals with a useful tool to assess the severity and prevalence of child maltreatment within Chinese communities.     

Participant responses to retrospective surveys of child maltreatment: does mode of assessment matter?

This study examines the impact that different methods of assessing child maltreatment history may have on adult participants. A total of 334 female undergraduate students were randomly assigned to complete a retrospective measure of child sexual and physical abuse in one of three conditions: paper-and-pencil questionnaire, face-to-face interview, or computer-administered survey. Disclosure rates of abuse, psychological distress and mood change, preferences for assessment format, and perceptions of confidentiality were examined across the three assessment formats. Although disclosure did not vary by condition, participants with a history of abuse reported more distress and mood change than did nonvictims, particularly in the computer condition. Nevertheless, the computer condition was rated as the most preferred format and was viewed by participants as the most confidential means of assessing maltreatment history. Participants reporting abuse through interviews were more likely than those in other conditions to state a preference for another type of assessment format. The implications of these findings for abuse history research are discussed.     

Predicting relapse of problematic child-rearing situations

BackgroundThe development and evaluation of risk assessment instruments for child maltreatment is still in its infancy, both in the Netherlands and internationally. The aim of this study was to examine the predictive validity of a structured clinical judgement instrument – the Check List of Child Safety (CLCS) – that is widely used in the Netherlands. The second aim was to examine the predictive validity of a newly developed actuarial risk classification that is based on variables measured with the CLCS.MethodThe sample consisted of 3963 Dutch families who were under the supervision of the Dutch Child Welfare Agency (CWA) between 2011 and 2013 because of problematic child-rearing situations. Relapse was defined as restarting treatment by the CWA because of newly substantiated problematic child-rearing situations. The actuarial risk classification was developed by means of a CHAID analysis. The predictive validity of the CLCS and the actuarial risk classification were examined by calculating several performance indicators (sensitivity, specificity, false positives, false negatives and AUC values).ResultsThe predictive validity of the CLCS was poor, with a non-significant AUC of .530, meaning that the CLCS performed no better than chance. The predictive validity of the actuarial risk classification was moderate, with a significant AUC of .630.ConclusionThe actuarial risk classification not only outperformed the CLCS, but is also time-saving in practice since it comprises only variables that are significantly related to relapse.     

The impact of repeated maltreatment on behavioral trajectories from early childhood to early adolescence

Using multilevel model for change, this study examined the trajectories of both internalizing and externalizing behavioral problems from early childhood to early adolescence among a cohort of 685 children with early alleged maltreatment from age 4 through age 12. These children were recruited from five study sites using the LONGSCAN archive data. Repeated allegation of maltreatment for each child was treated as a time-varying variable and was tracked continuously and assessed at each measurement of the child behavioral problems. Child behavioral problems were measured at ages 4, 6, 8, 10, and 12 using the Child Behavior Checklist. Findings indicated that repeated maltreatment significantly predicted subsequent trajectories of both internalizing and externalizing problems. In both cases, the effect of repeated maltreatment was on the slope, rather than on the intercept which was reflected in the trajectories. Repeated maltreatment was associated with significantly steeper increases in both internalizing and externalizing problems over time. Although there were no differences in early behavioral assessments (e.g., age 4 and age 6), both internalizing and externalizing behaviors emerged later and became more pronounced over time among those with repeated maltreatment (e.g., since age 8) compared to those without. Although behavioral problems may not be seen in younger children who experience multiple maltreatment, it is prudent to be aware that the impact may likely emerge in later ages of the child. Thus, ongoing monitoring and assessment of treatment needs for children who have had multiple occurrence of maltreatment becomes imperative.