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.     

Characteristics and factors impacting reunification outcomes among Vietnamese immigrant families in the child welfare system

Using a mixed methods approach, this study examined reunification processes and outcomes among Vietnamese immigrant families involved in the child welfare system. A quantitative design was used to describe characteristics and reunification outcomes of Vietnamese immigrant children and families who are involved in family reunification services. Qualitative methods were used to explore factors that may influence reunification outcomes among Vietnamese families.The quantitative portion of the study included an exploratory design using administrative data from one county in the Northern California. The quantitative sample (N = 32) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 from child welfare administrative data (CWS/CMS) which was merged with eligibility data (CalWIN) in order to obtain parent and child place of birth to determine country of origin. The qualitative study included an exploratory design using interview data from child welfare workers (N = 8) and Vietnamese immigrant parents who had successfully reunified (N = 7).Quantitative results indicated that the most common type of maltreatment leading to entry into care was caretaker absence or incapacity, an abuse category that is often used in cases of parental substance abuse. 53.8% of Vietnamese immigrant children in the quantitative sample reunified with their parents, which is close to the national rate of reunification. Qualitative findings pointed to the importance of the following factors within reunification: acculturation-related issues, parental substance abuse, child welfare worker cultural competency and issues related to service availability and effectiveness. Implications for social work practice and policy are discussed.     

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.     

The journey of dually-involved youth: The description and prediction of rereporting and recidivism

Dually-involved youth refers to youth that are simultaneously receiving services from both the child welfare and juvenile justice systems. The current study focused on a sample of dually-involved youth (N = 1148). The study examined the characteristics of dually-involved youth and reported and predicted the incidence of subsequent maltreatment and re-offending. We found that 8% of dually-involved youth had at least one arrest before entering child welfare system, 32% experienced new reports of maltreatment referrals subsequent to arrest, and 56% were charged with a second offense (i.e., recidivated). The court outcomes received in delinquency court were associated with both rereporting and recidivism. These findings support the development of a shared services model for child welfare and juvenile justice systems.     

An innovative child welfare pilot initiative: Results and outcomes

Successful family reunification is achieved only about 50% of the time when children are in foster care. Parents' ability to access and complete court ordered services are paramount in determining whether the family can achieve reunification. However, the research on how to best facilitate service access and utilization are sparse. A matched sample of 100 families with no prior child welfare involvement and at least one child in out of home care were selected from Department of Children and Family closed administrative case files. This study compared 48 families who received traditional child welfare services to 48 families who received a Family First model intervention (PFFP) from a large urban public child welfare agency. The independent variables were the elements that distinguished the Family First model from traditional child welfare services and included the number of caseworkers for the life of the case, caseload size, and service needs met through community partnerships. The dependent variables were the stability of the children's out of home placement, the time to reunification, the length of agency involvement, the stability of reunification at one year follow up, subsequent substantiated child maltreatment reports one year after the cases were closed, the distance a placement location was from the home of the family at intake, the match between identified needs and the timely access of services. Hierarchal regression and survival models were constructed to examine elements of the intervention for their impact on family outcomes. The results suggested that a community partnership model that incorporated family engagement, enhanced service provider accessibility, reduced caseloads, one caseworker for each family, are associated with successful reunification outcomes. Moreover, the intervention families were more likely to have their needs met with clinical or economic services, experienced fewer days in out-of-home placement, shorter involvement with the agency, reduced placement moves and were more likely to be reunified sooner compared to the group who received standard child welfare services. At one year follow up, the intervention families also had fewer substantiated child maltreatment reports and children were more likely to be living in the parental home. Implications for policy, research and practice are presented.     

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.     

Protective factors among families with children at risk of maltreatment: Follow up to early school years

The purpose of this study is to explore both risk and protective factors of child maltreatment among at risk elementary school children. This study used data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), following a cohort of 405 children from age 4 to age 8. Multivariate logistic regression revealed that children attending preschool irregularly (OR = 2.98; 95% CI: 1.08-8.26), families with a high level of life events (OR = 2.68; 95% CI: 1.12-6.41), and mothers with a history of childhood maltreatment (OR = 2.26; 95% CI: 1.07-4.76) were more likely to have a child maltreatment report. In contrast, mothers who were married (OR = 0.19; 95% CI: 0.06-0.64), mothers who attained 12 or more years of education (OR = 0.09; 95% CI: 0.02-0.34), and family with high level of social support (OR = 0.29; 95% CI: 0.11-0.80) were less likely to have a child maltreatment report. For mothers who had not graduated from high school, adequate social support reduced the risk of child maltreatment by a factor of two. The provision of adequate social support should be incorporated into child maltreatment prevention programs, particularly those targeting at risk families.     

The relationship between parent immigration status and concrete support service use among Latinos in child welfare: Findings using the National Survey of Child and Adolescent Well-being (NSCAWII)

The underutilization of concrete services by immigrants is widely documented across several service sectors, yet evidence is lacking on the use of such services among immigrants reported to child welfare for the purposes of reducing maltreatment. It has been suggested that Latino immigrants involved with the child welfare system may face steep challenges to receiving needed services due to issues surrounding legal status, language and cultural barriers. The purpose of this study was to determine whether referral to and receipt of concrete services by Latino families reported to child welfare agencies, was associated with legal immigration status. The sample included children of Latino parents who participated in the second National Survey of Child and Adolescent Well-being (NSCAWII), who remained in the home following a child welfare investigation (n = 561). Over a third (37%) of Latino families were referred for at least one concrete service, yet only 17% received any. Weighted logistic regression models showed that families in which the primary caregiver was undocumented had significantly lower odds (OR = .24) of receiving services once referred. Families who had trouble paying for basic necessities (OR = 7.52), those with active domestic violence in the home (OR = 4.98), and those receiving ongoing child welfare services (OR = 4.52) had increased odds of referral for services by the caseworker. The odds of receiving services increased when the primary caregiver was unemployed (OR = 5.24), when there was domestic violence in the home (OR = 4.59), and with the receipt of child welfare agency services (OR = 8.83). There appears to be an unmet need for concrete services among Latinos investigated by child welfare, as demonstrated in the gap between overall service referral and receipt. A parent's legal status may be one reason for that unmet need, implying that children of undocumented parents are less likely to have basic needs met to mitigate economic stress and reduce maltreatment risk upon contact with child welfare. Policy recommendations and implications for child welfare practice are discussed.     

Moving toward cultural competence in the child welfare system

This paper uses a culturally competent (Cross, Bazron, Dennis & Isaacs, 1989) perspective to examine the child welfare system's, namely protective services, response to children of color. The purpose of the paper is to indicate how the absence of cross-cultural considerations in both child welfare policy and practice, limits the effectiveness of service delivery to children of color and their families. Specifically, three key aspects of the child welfare system are addressed: past responses to children of color, worker-client interactions, and child protective service agencies. The paper ends with several recommendations.     

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.     

Trauma-informed forensic child maltreatment investigations

Trauma-informed child welfare systems (CWSs) are the focus of several recent national and state initiatives. Since 2005 social work publications have focused on systemic and practice changes within CW which seek to identify and reduce trauma to children and families experiencing child maltreatment or other distressing events, as well as to the agency personnel working with these clients. Within the body of trauma-informed literature, little attention has been devoted specifically to the initial investigative response and its role in controlling for system induced trauma to the child, family, and caseworker. Training child protection services (CPS) workers on the impact of trauma in child maltreatment forensic investigations and the worker's role in anticipating and mitigating the effects of trauma during the investigative process is rarely addressed in the trauma-informed literature. This article reports on a training strategy to infuse trauma information into an existing forensic child maltreatment investigation curriculum with the goal of enhancing CPS caseworker's knowledge, skills, and values concerning the importance of viewing investigations and their associated tasks through a trauma lens.     

An examination of attachment representations among child welfare professionals

Research has documented a relationship between adult attachment representations and client relationships and outcomes for professionals in relationship-based fields (e.g., , , , , ,  and ), but has not examined the child welfare professionals specifically. The current study examined attachment representations of 54 child welfare professionals. The Adult Attachment Interview (AAI) was administered to participants prior to attending a professional workshop. Results indicated significant differences between the AAI distribution of child welfare professionals and a non-clinical norm sample (AAI four-way distribution: Goodness of fit χ² = 23.63, p < .01; Bakermans-Kranenburg & van IJzendoorn, 2009). Dismissing classifications were overrepresented and free-autonomous classifications were underrepresented. Results may indicate challenges in the child welfare system that could alter the effectiveness and decision-making processes of child welfare professionals. Further research is needed to evaluate whether these differences are typical for samples of child welfare professionals and if so, the impact it could have on families who are being served. Effective interventions, focused on shifting attachment from insecure to secure, for child welfare professionals also should be explored through further research.     

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.     

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.     

The impacts of accessible child protection services on services, jobs, and families

This multi-faceted study assessed the differences between accessible and central child protection service delivery sites in Ontario on: (1) family functioning; (2) front-line child protection service providers' satisfaction with services; (3) parents' satisfaction with services; (4) the services and supports available to families; (5) front-line service job satisfaction; and (6) front-line helping relationships in child welfare. A quasi-experimental outcome design gathered data from parents at case-opening and approximately 10 months later. Semi-structured individual or group qualitative interviews were conducted with parents, front-line service providers, and supervisors/managers. Information also was gathered from agency files. Front-line service providers completed an employment questionnaire. Findings indicated that the accessible sites were able to foster a greater proportion of cooperative helping relationships with families and to create more service partnerships. Parents at the accessible sites were more positive about their service involvements and more willing to ask for help again in the future. Front-line child protection service providers at both service delivery models described positive aspects of their jobs as well as frustrations with the expectations of the formal child protection system.     

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.     

Factors impacting intention to leave in social workers and child care workers employed at voluntary agencies

Introduction

To ameliorate high turnover in child welfare, researchers have attempted to identify factors that lead to undesirable turnover. While this has been studied extensively, little attention has been paid to turnover based upon job roles. Like social workers in child welfare, the field of child care also experiences high turnover. Child care workers employed in child welfare settings are no exception. The current study seeks to understand differential factors that impact intent to leave for preventive and child care workers employed in child welfare agencies.

Materials and methods

Data for prevention workers (n = 538) were obtained from all preventive service programs under contract with the City. Data for child care workers (n = 222) were obtained from three voluntary agencies located elsewhere in the State. The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included job satisfaction, intention to leave, career commitment, and agency investment. Data were analyzed using bivariate analysis and Structural Equation Modeling (SEM).

Results

Child care workers had more positive perceptions of child welfare and planned to stay in child welfare longer. Despite this, prevention workers felt more invested in their work. Child care and prevention workers had different levels of satisfaction with their jobs although overall job satisfaction did not differ nor did their intention to leave. Tenure at the agency was predictive of career investment. Investment, perceptions of child welfare, satisfaction with nature of work, and contingent rewards were associated with career commitment. Commitment and satisfaction with supervision were the greatest predictors of intention to leave.

Discussion

There is a gap in literature addressing child care workers in child welfare, and future study of this group is needed. Child care workers are just as likely to intend to leave their jobs as prevention workers. For both groups, it appears that investment in their jobs increases commitment to the field which reduces intention to leave.     

Intergenerational families in child welfare: Assessing needs and estimating permanency

Much of the empirical literature on intergenerational child maltreatment focuses on the mechanisms that explain how maltreatment is transmitted across generations. Few studies have examined child protective service outcomes associated with intergenerational families. The current study addresses this gap in the literature. This study compares 1196 caregivers, most of whom are single African American females, and 2143 children from first and second generation child welfare-involved families. All families have a history of substance abuse. We sought to understand how first and second generation families differ with regard to social and economic status indicators, as well as whether intergenerational child welfare involvement is associated with permanency outcomes. Our findings indicate that second generation families experience significantly more risk factors at the time of case opening, and are two-thirds as likely to be reunified as compared with first generation families. The singular effects of generation status disappeared, however, once the interaction between mental health diagnosis and second generation status was entered into the model, suggesting that it is not just being intergenerationally involved in the child welfare system that reduces the chance of reunification, but rather second generation caregivers have more mental health problems that are associated with a lower likelihood of reunification.