Child Protection Investigation Research Articles

Child homicide: generating victim and suspect risk profiles

Purpose– In England and Wales, on average one child every week is a victim of homicide. The purpose of this paper is to explore whether different victim-risk profiles and suspect variables can be differentiated for specific victim ages.Design/methodology/approach– This paper presents a preliminary analysis of more than 1,000 child homicides committed in England and Wales between 1996 and 2013, from data provided through the Homicide Index. Statistical techniques such as cluster analysis were used to identify specific victim-risk profiles and to analyse suspect variables according to the age of victim.Findings– The findings present a clearer picture of the risk-age relationship in child homicide, whereby several specific risk profiles are identified for specific child ages, comprised of crime variables including; likely victim and suspect demographics, the most likely circumstances of the homicide and methods of killing. Using similar techniques, a number of tentative clusters of suspects implicated in child homicide are also described and analysed, with suggestions of further analysis that might prove of value.Practical implications– The practical implications cannot be understated. For those professionals working in the fields of child protection and criminal investigation the identification of risk profiles promises to provide a back-cloth with which to practice when confronted with complex and distressing child homicide scenarios. This research promises most to those currently training in related professions.Originality/value– Although the statistical level of risk has been linked with the age of a child (with younger children being most vulnerable to killing by a parent or step-parent and older children most vulnerable to killing by acquaintances and strangers), extant research is yet to progress beyond the identification of broad age-risk categories. The paper concludes with a discussion of the likely implications for those charged with reducing and investigating child homicide and outlines the possibility of future research.

Child Protection Investigations in Out-of-Home Care: Perpetrators, Victims, and Contexts.

Keeping children safe in out-of-home care requires an understanding of the contexts under which maltreatment occurs. This study examines how maltreatment investigations differ across four settings (nonrelative foster, informal kinship, formal kinship, and congregate care). I focus on four elements of maltreatment: the perpetrator's role (e.g., out-of-home caregiver and peer), maltreatment type, probability of substantiation, and victim characteristics. I use statewide Wisconsin administrative data in years 2005-2012, which has an analytic sample of over 96,000 placements. Data are analyzed using descriptive statistics and multi-level logistic regression. Alleged maltreatment is not uncommon in out-of-home care-the total investigation rate ranged from 5% (congregate care) to 15% (informal kinship care). Four percent of all placements were investigated for maltreatment by an out-of-home caregiver, of which 9% were substantiated. Maltreatment by peers (siblings or other foster children) was investigated in 1% of all placements, of which 20% were substantiated. Neglect was the most commonly alleged maltreatment type in informal kinship care, whereas physical abuse was most commonly alleged in all other placement types. Children who were female, Black, or between ages 6 and 10 experienced heightened risk of maltreatment in out-of-home care.

P154 – 2946: Faltering weight, feeding difficulties, and rib fractures in a child with hyperekplexia due to GLRB mutation: A medical or a social problem?

Objectives We describe a case of hyperekplexia due to GLRB mutation in whom child protection concerns had been raised due to faltering weight and rib fractures. Methods A male infant with a known diagnosis of hyperekplexia due to GLRB mutation had poorly controlled symptoms on clonazepam. Previously he had a number of spasms which caused him to drop his saturations and compromise his breathing. The Vigevano manoeuvre was required to terminate these spasms. The maneuver produced enough force to cause rib fractures. These concerns and poor feeding with inadequate weight gain together with a perceived parents' lack of engagement with the professionals prompted detailed child protection investigations, leading to the child being taken into foster care. A videofluroscopy performed for assessment of feeding difficulty revealed abnormalities in initiation of swallow, presence of oral residue following swallow and penetration into airway with risk of aspiration. This lead to a recommendation of a combination of nasogastric and oral feeds and the child gained weight adequately on this regimen. Results Hyperekplexia leads to oral hypersensitivity which can lead to abnormal swallowing and risk of aspiration. This in turn can set off a spasm requiring the Vigevano manoeuvre. Ultimately it can cause a child to have failure to thrive. This should not be confused with neglect. Conclusions Management of faltering weight in a child with hyperekplexia due to GLRB mutation presents specific challenges. While it is known that children with chronic health problems are at increased risk of abuse, it is also important to note that GLRB mutation leads to one of the more severe forms of hyperekplexia. We describe a case of hyperekplexia due to GLRB mutation in whom child protection concerns had been raised due to faltering weight and rib fractures. A male infant with a known diagnosis of hyperekplexia due to GLRB mutation had poorly controlled symptoms on clonazepam. Previously he had a number of spasms which caused him to drop his saturations and compromise his breathing. The Vigevano manoeuvre was required to terminate these spasms. The maneuver produced enough force to cause rib fractures. These concerns and poor feeding with inadequate weight gain together with a perceived parents' lack of engagement with the professionals prompted detailed child protection investigations, leading to the child being taken into foster care. A videofluroscopy performed for assessment of feeding difficulty revealed abnormalities in initiation of swallow, presence of oral residue following swallow and penetration into airway with risk of aspiration. This lead to a recommendation of a combination of nasogastric and oral feeds and the child gained weight adequately on this regimen. Hyperekplexia leads to oral hypersensitivity which can lead to abnormal swallowing and risk of aspiration. This in turn can set off a spasm requiring the Vigevano manoeuvre. Ultimately it can cause a child to have failure to thrive. This should not be confused with neglect. Management of faltering weight in a child with hyperekplexia due to GLRB mutation presents specific challenges. While it is known that children with chronic health problems are at increased risk of abuse, it is also important to note that GLRB mutation leads to one of the more severe forms of hyperekplexia.

Understanding Difficult Parental Behaviours During a Child Protection Investigation

When child protection caseworkers make first contact with the parents of a child (or children) who is suspected of being at ‘significant risk of harm’ they may encounter a range of hostile, angry and aggressive verbal responses from parents. If this contact results in a child being removed from parental care, it is not unknown for these responses to escalate into attempts at verbal intimidation and loud threats of personal violence. These behaviours then get recorded in case files and in materials submitted to the Children's Court to support the case for permanent removal of a child from parental care; these behaviours being presented as evidence of the parents’ unsuitability and unwillingness to comply with demands for changes in their child rearing practices. But how should child protection caseworkers view these less-than-helpful parental responses, and how should they, in turn, respond? This article explores this issue and offers a number of ways of understanding these behaviours, and canvasses new ways for caseworkers to respond when these behaviours occur.

From investigation to collaboration: Practitioner perspectives on the transition phase of parental agreements

Internationally there is a growing trend to implement alternative pathways within statutory child protection. This trend has emerged in response to burgeoning pressures on statutory child protection authorities and research highlighting the potentially negative impact of intrusive interventions on families. There is great diversity in the types of alternative pathways that have been implemented across jurisdictions. Differential response and parental agreements are two examples of alternative pathways that can be enacted for cases that warrant ongoing intervention. Whilst sharing commonalities such as providing supportive responses and working collaboratively with parents to avoid children going into out-of-home care, these two approaches have a significant difference in their implementation. Differential response allows families to be linked with supportive interventions without the prerequisite of a full child protection investigation. In contrast, in many jurisdictions, including Queensland (Australia) where this study takes place, the implementation of parental agreements occurs after the investigation has occurred. As such parents are expected to transition from being investigated to being a collaborative partner in addressing child protection concerns. In this paper, we report on a study into the use of parental agreements, known in Queensland as “Intervention with Parental Agreement” (IPA) and focus on this transition phase. Drawing on interviews with 25 practitioners we highlight the factors that impact this critical stage of IPA practice and identify factors that facilitate and inhibit a successful transition from investigation to collaboration.

Transverse fractures of the femoral shaft are a better predictor of nonaccidental trauma in young children than spiral fractures are.

Certain fracture configurations, especially spiral fractures, are often thought to be indicative of nonaccidental trauma in children. The purpose of this study was to determine whether femoral fracture morphology, as determined by an objective measurement (fracture ratio), was indicative of nonaccidental trauma in young children. Consecutive patients who were three years of age or younger and had a closed, isolated femoral shaft fracture treated at an urban pediatric level-I trauma center between 2005 and 2013 were identified. Anteroposterior and lateral fracture ratios (fracture length/bone diameter) were calculated for each patient by a fellowship-trained pediatric orthopaedic surgeon who was blinded to the patient's clinical history. The presence or absence of a Child Protective Services referral as well as institutional Child Assessment Program evaluations were reviewed. Nonaccidental trauma was deemed to be present, absent, or indeterminate by Child Protective Services or an on-site Child Assessment Program team. To further evaluate and quantify the likelihood of nonaccidental trauma, the criteria of the Modified Maltreatment Classification System were used. Of 122 patients identified, ninety-five met the inclusion criteria for this study. Of these ninety-five, fifty-one (54%) had either a Child Protective Services or a Child Assessment Program consultation because of suspected nonaccidental trauma. Thirteen (25%) were found to have nonaccidental trauma as determined by Child Protective Services or the Child Assessment Program team and seven (14%) had indeterminate Child Protective Services or Child Assessment Program investigations. All thirteen patients with nonaccidental trauma, as well as the seven patients with an indeterminate Child Protective Services or Child Assessment Program investigation, had positive Modified Maltreatment Classification System scores for physical abuse. Patients who had nonaccidental trauma had significantly decreased mean anteroposterior fracture ratios compared with those who had confirmed accidental trauma (p < 0.0001). The fracture ratio can be helpful to determine fracture morphology and can be used as part of the assessment of a child with suspected nonaccidental trauma. While not diagnostic, the presence of a transverse diaphyseal femoral fracture in a young child should raise the index of suspicion for nonaccidental trauma. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Kinship Care

Kinship Care

Promoting Children's Rights in Social Work and Social Care: A Guide to Participatory Practice By MargaretBell London: Jessica Kingsley Publishers, 2011 ISBN 9781843106074, 224 pp, £19.99 (pb)

Participatory work in child care draws on two broad currents of theory and practice: an older tradition of individually focused social work and psychological therapies, sensitive to children's needs and wishes and with an emphasis on empathic communication; and a newer tradition of empowerment, based on theories of children's rights and responsiveness to service users, and to some extent on new thinking about the social status and capabilities of children. Both traditions are reflected in this book (number 14 in the ‘Children in Charge’ series edited since the late 1990s by Mary John) which represents the fruit of the author's work over many years as a practitioner, a teacher and a researcher in social work with children. The first half of the book introduces and reviews children's participation in theory, policy and practice. The first chapter offers a broad overview of underpinning principles and how they have been expressed in different arenas. This is followed by a review of methods and means by which children can participate in decision-making — direct presence, representation, advocacy, consultation — and of the different factors that require to be taken into account. A little more could have been said here about the issue of age. Chapter 3 gives a thorough review of policy and guidance in the UK (or rather England). Chapter 4 is devoted to the different theoretical perspectives on which practitioners are encouraged to draw, eclectically but not uncritically. This account is more confident in handling psychological theories (cognitive development, attachment, etc.) than in relation to sociological paradigms. The final chapter in Part I is a very helpful review of the barriers to children's participation, particularly in relation to adult attitudes — at cultural, individual and organisational levels. On the last, a reference back to Shier's ‘pathways’ might have been helpful. Part II is devoted to four pieces of empirical research conducted by the author, singly or with colleagues. The first was a study of family group conferences, whose conclusions were broadly positive in that children did have a real sense of participation and influence. The second was a study of initial child protection investigations in which, perhaps unsurprisingly, there was little evidence of children being effectively engaged or even, in some cases, having much of a clue as to what was going on, and where for the few children who did participate the experience was not necessarily positive. Both studies were conducted more than a decade ago, but are still highly relevant. The third was a more recent study of electronic case recording under the Integrated Children's System, which focused in part on children's perspectives on the process and the scope for children's input. The fourth study looked broadly at children's involvement in service evaluation, on both an individual and a collective level. Each of these studies offers useful learning about the ways in which children can be supported to participate in their care and protection, and the author draws this out very clearly in each chapter. Because the focus is so much on her own research, at times less is made of other research than might have been helpful — in particular the (admittedly small) body of work that directly addresses children's participation in care, most of which is mentioned here but not discussed at much length. A slightly fuller review of some of this work could have added value to what is already a very useful text. There is a very good summing up of the learning from all four studies; although I was struck by the repeated statement that ‘the child must be seen alone’, i.e. presumably without parents or carers — but is it not sometimes helpful to see children together, whether they are siblings or sharing a place of residence? This book is primarily aimed at the thinking practitioner or manager who wants to make their work more responsive to children's claims for inclusion in the decisions that affect their lives. It offers them a sound review of the underpinning theories and principles, and an excellent research-based analysis of the barriers in practice and how they can be overcome. Although the foregrounding of ‘children's rights’ in the title is not really followed through in much of the writing, which tends to be couched more in terms of children's needs and best interests, the author does return to this theme in the conclusion. This book will certainly help those practitioners and organisations who want to adopt a rights-based approach to working with children, especially at the individual level. For children and young people's collective participation, it should probably be read alongside Mike Stein's gritty history of the development of Who Cares?, NAYPIC and A National Voice (Stein, 2011).

Improving Child Protection Services: Australian Parents’ and Grandparents’ Perspectives on What Needs to Change

This exploratory, small-scale research aimed to understand parents’ and grandparents’ experiences and expectations of child protection investigations. Semi-structured, in-depth interviews were conducted with nine participants. The central theme, captured as ‘a domino effect’, crystallises the participants’ views of why it is important to improve child protection services: that there were significant practical and relationship repercussions in families’ lives beyond the immediate investigation. The sub-themes that emerged — support within systemic complexity, policies in practice, intervention processes and practices, and ‘it’s just a job to them’ — suggested how child protection services contributed to ‘the domino effect’ in their lives. A final sub-theme indicated participants’ awareness of the complexity and difficulty of child protection as a job, notwithstanding their expressed frustrations. We have made practical recommendations based on participants’ perspectives about ‘what needs to change?’, and suggestions for improvements to practise that centralise social work as a profession which values the professional relationship with service users. We also suggest that the professional relationship should extend beyond the interpersonal to guiding service users within the legal complexities in contemporary child protection. Being exploratory, this study and its recommendations guide future research to contribute to improving child protection services.

Collaborating with families in differential responses: practitioners' views

AbstractChild protection authorities in many countries are concerned with reducing the rates of investigations and with diverting at‐risk families from the child protection service system. In several countries, differential responses have been introduced into child protection law providing service providers with some choice between investigative or family support pathways, depending upon the level of risk posed in the circumstance. In this paper, we report on a study into a form of differential response known as Intervention with Parents' Agreement introduced in Queensland, Australia, in 2005. A unique feature of this differential response is that it occurs after an initial child protection investigation, although it does provide child protection services with options for providing supportive interventions to at‐risk families to prevent the further escalation of concerns. In this paper, we analyse practitioners' perceptions of factors that inhibit and promote implementation of the Intervention with Parents' Agreement. Drawing upon interviews with 25 practitioners, we identify factors that become important for securing participation after an initial investigation has occurred. We discuss the implications for the development of differential responses in child protection service systems.

Cardiopulmonary resuscitation (CPR)-related posterior rib fractures in neonates and infants following recommended changes in CPR techniques

Posterior rib fractures are highly indicative of non-accidental trauma (NAT) in infants. Since 2000, the “two-thumbs” technique for cardiopulmonary resuscitation (CPR) of newborns and infants has been recommended by the American Heart Association (AHA). This technique is similar to the grip on an infant's thorax while shaking. Is it possible that posterior rib fractures in newborns and infants could be caused by the “two-thumbs” technique? Using computerized databases from three German children's hospitals, we identified all infants less than 12 months old who underwent professional CPR within a 10-year period. We included all infants with anterior–posterior chest radiographs taken after CPR. Exclusion criteria were sternotomy, osteopenia, various other bone diseases and NAT. The radiographs were independently reviewed by the Chief of Pediatric Radiology (MB) and a Senior Pediatrician, Head of the local Child Protection Team (IF). Eighty infants with 546 chest radiographs were identified, and 50 of those infants underwent CPR immediately after birth. Data concerning the length of CPR was available for 41 infants. The mean length of CPR was 11min (range: 1–180min, median: 3min). On average, there were seven radiographs per infant. A total of 39 infants had a follow-up radiograph after at least 10 days. No rib fracture was visible on any chest X-ray. The results of this study suggest rib fracture after the use of the “two-thumbs” CPR technique is uncommon. Thus, there should be careful consideration of abuse when these fractures are identified, regardless of whether CPR was performed and what technique used. The discovery of rib fractures in an infant who has undergone CPR without underlying bone disease or major trauma warrants a full child protection investigation.

Bruising and child protection investigation outcomes

Journal of Paediatrics and Child HealthVolume 50, Issue 2 p. 161-161 Heads UpFree Access Bruising and child protection investigation outcomes First published: 16 February 2014 https://doi.org/10.1111/jpc.12521_2AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Building on previous work by this esteemed group of child protection researchers, this study explores the relationship between bruising characteristics and outcomes of child protection investigations of children referred for suspected physical abuse (PA). This work used complete assessment and multiagency case conferences to determine outcomes of cases referred for witnessed abuse, alleged abuse, unexplained injuries, concerning histories, domestic abuse or sibling abuse. Of those with bruising, there was no effect of developmental stage between cases where PA was confirmed and cases where PA was excluded. Confirmed abuse cases had more bruises and more sites affected than the PA-excluded group. Odds of PA-confirmed bruises on buttocks, genitalia, cheeks, neck, trunk, head, front of thighs or upper arms were significantly greater than in PA-excluded children. Petechiae, linear or patterned bruises and clustered bruising were significantly greater in the PA-confirmed group. The strength of this study is the decision made by multiagency assessment in determining outcome, which minimises circular reasoning where outcome is based on characteristics of the bruises themselves. The authors put this study into context as a population study highlighting distinct patterns of bruising emerging that differ between children with confirmed PA and those where is PA excluded after assessment. Reference 1 Kemp AM, Maguire SA, Nuttall D, Collins P, Dunstan F. Bruising in children who are assessed for suspected physical abuse. Arch. Dis. Child. 2014; 99: 108– 113. Reviewer: Catherine Skellern, Catherine_Skellern@health.qld.gov.au Volume50, Issue2February 2014Pages 161-161 ReferencesRelatedInformation

"Parental Maltreatment, Regulatory Focus, and Recommending the Placement of Children in Foster Care"

A sample of child protection investigators read two detailed and realistic cases of children being victimized by parental maltreatment, after which they indicated how strongly they would recommend the children to be placed in foster care. One was a case of abuse whereas the other was a case of neglect. The investigators were more likely to recommend the children be placed in foster care in the case of abuse rather than neglect. Moreover, and as predicted by regulatory focus theory, the tendency to recommend foster care placement more for abuse than neglect was greater among investigators who were more prevention focused and less among those more promotion focused. Theoretical and practical implications are discussed.

Case 1: A 15-month-old boy with bilateral upper extremity burns

A 15-month-old boy was playing outside at a private home daycare. After returning inside, the daycare provider washed the toddler’s hands in the sink under running water. The child cried, as he always did, during this daily hand-washing ritual. Over the next hour, the child continued to cry and the skin on his hands began to blister. His mother was immediately notified and she brought him to a local emergency department, where the physician noted blistered partial-thickness burns to both hands with sharp demarcation lines of erythema extending around both wrists suggesting an immersion pattern (Figures 1 and ​and2).2). The physician reported the case to local child protection authorities because the appearance of this ‘glove-type’ pattern of burn injury suggested an immersion mechanism. Figure 1) Extensive blistering of palmar surfaces with sharp demarcation at the wrists Figure 2) Less blistering of the dorsal surface of the hand, although the line of demarcation is still apparent A police investigation was conducted based on local protocols for child protection investigations, and included a site visit, measurement of the water temperature at the sink and the water heater, and a detailed re-enactment of events by the daycare provider. This was a previously well child with no other injuries. The daycare is a well-established home daycare with an unblemished safety record. Investigators determined that the water reached a maximum temperature of 55.5°C (131.9° Fahrenheit) at the sink. The provider demonstrated how she had stood behind the child to assist him with hand washing over a period of 15 s to 30 s. The water had been running the entire time while the other two children washed their hands. Neither the caregiver nor the other children’s hands were burned.

Inadequate housing and the child protection system response

Involvement with child protective services (CPS) is common among families experiencing inadequate housing conditions. As with other issues of material deprivation, inadequate housing is an area where the distinction between neglect and poverty is difficult to ascertain, and the response of the child protection system to inadequately-housed families is largely understudied. This study uses a nationally representative sample of child protection investigations to explore the associations between two types of inadequate housing—doubling up and experiences of homelessness—and system outcomes. Specially, we identify that, after accounting for other risk factors, inadequate housing is significantly associated with the receipt of services, but not directly associated with either substantiation or case closure. Moreover, housing concerns may have a different association with case outcomes when interacted with other risk factors, specifically mental health and substance abuse, and domestic violence. Overall, results suggest that, while child protection workers do not view inadequate housing as neglect in and of itself, they do identify housing issues as a service need.

Why are suspected cases of child maltreatment referred by educators so often unsubstantiated?

School professionals have a unique vantage point for identifying child maltreatment and they are a frequent source of referral to child protective services. Disturbingly, past studies have found that maltreatment concerns reported by educators go unsubstantiated by child protective services at much higher rates than suspected maltreatment reported by other professionals. This study explores whether there are systematic differences in the characteristics of cases reported by educators as compared to other professionals and examines whether such variation might account for differences in investigation outcome. Analyses were based on 7,725 cases of suspected maltreatment referred by professionals to child protective services from the Canadian Incidence Study of Reported Child Abuse and Neglect – 2003 a national database on the characteristics of children and families investigated by child protective services. School professionals were responsible for 35.8% of professional referrals. Reports by educators were much more likely to be unsubstantiated (45.3%) than those by other professionals (28.4%) in subsequent child protective investigation. Cases reported by educators were found to contain significantly more child risk factors (e.g., child emotional and behavioural problems) and fewer caregiver and family risk factors (e.g., caregiver mental health problem, single parent family) than cases reported by other professionals. Even controlling for these differences, educator-reported concerns were still 1.84, 95% CI [1.41, 2.40] times as likely to be unsubstantiated as reports from other professionals. Contrary to the notion that educators are mostly reporting non-severe cases, suspected/substantiated cases reported by school professionals were more likely to be judged as chronic and more likely to involve families with a previous child protection history. Results are concerning for the capacity of the education and child protection systems to work together to meet their shared goal of promoting healthy child development. Additional research is needed on the way in which child risks and problems influence child protective service, particularly in the context of chronic abuse and neglect and lack of availability of child and family mental health interventions. Potential problems with credibility of school professionals as reporters of child maltreatment concerns also warrant further investigation.

P3.007* Gonorrhoea, Syphilis, Chlamydia and Trichomonas in Children Under Thirteen Years of Age: National Surveillance in the UK and Republic of Ireland

BackgroundChildren who have been sexually abused (CSA) are potentially at risk of sexually transmitted infections (STI). It is not known how frequently such infections are identified within the population nor...

Social Worker and Teacher Apprehension of Children's Stimulation and Support in the Home Environment and Care-Giver Perception of the HOME Inventory in Sweden

Assessment tools are needed for the operationalisation of child protection guidelines and frameworks. The HOME Inventory taps into three domains that are often highlighted in guidelines: parenting capacity; the child's developmental needs; and family and environmental factors. Social workers are obliged to collaborate in child protection investigations, such as with teachers. This collaboration can be an important source of information, since whether or not social workers always perform home visits is unclear. The primary aim of this study was to compare social workers' and teachers' apprehensions of the support and stimuli provided in children's home environments. Social workers' apprehensions were assessed using the subscales of the Home Observation and Measurement of the Environment (HOME) Inventory. Teachers' apprehensions were assessed using a different, but comparable, questionnaire. The pre-school teachers' apprehension showed a weak association with the social workers' assessments. Hence, it is important for social workers to reflect upon the type of information different professions may provide. This study also describes care-givers' perception of the HOME Inventory. Such information, although rarely published, is central to the successful implementation of assessment tools. Care-givers were highly satisfied with the HOME Inventory: they considered the content relevant and the format acceptable. Language: en

Resolution of Intimate Partner Violence and Child Behavior Problems After Investigation for Suspected Child Maltreatment

OBJECTIVE To describe longitudinal change in child behavior problems associated with resolution of intimate partner violence (IPV) after an investigation for suspected child maltreatment. DESIGN Retrospective cohort study. SETTING The National Survey of Child and Adolescent Well-Being, a nationally representative longitudinal sample of US households investigated for suspected child maltreatment. PARTICIPANTS The study included 320 school-aged subjects with caregiver-reported IPV in the year prior to baseline interview. Caregivers were interviewed an average of 3, 20, 36, and 81 months following investigation. MAIN EXPOSURE Resolution vs persistence of baseline IPV. Persistence was defined by report of IPV during any follow-up interview. MAIN OUTCOME MEASURES Clinically significant internalizing or externalizing child behavior problems. RESULTS In total, 44.6% of caregivers who reported IPV at the baseline interview reported persistent IPV. After adjusting for significant covariates, IPV resolution was associated with an 11.9% reduction in internalizing problems by 81 months (P=.03); IPV persistence was associated with persistence in baseline problems. Resolution of IPV was associated with an 18.5% reduction in externalizing problems by 20 months that was sustained at 36 and 81 months (all P&lt;.05). Intimate partner violence persistence was associated with a steady but nonsignificant increase in externalizing behavior problems during 81 months (10.1%, P=.07). The adjusted relative risks for internalizing and externalizing behavior problems 81 months following a child protective services investigation for children exposed to persistent vs resolved IPV were 1.79 (95% CI, 0.91-3.52) and 1.88 (95% CI, 1.12-3.18), respectively. CONCLUSIONS Resolution of IPV after a child protective services investigation for suspected child maltreatment is associated with meaningful, sustained reductions in clinically significant child behavior problems.

Does differential response make a difference: examining domestic violence cases in child protection services

AbstractLarge numbers of domestic violence (DV) cases on child protection caseloads have necessitated the development of practices that address both DV and child safety. The first step in this process is to gain an understanding of the differences between DV‐involved cases and other forms of maltreatment. The implementation of a differential response service model in Ontario offered an opportunity to compare risk assessment ratings, service outcomes and recurrence and to identify pathways of DV cases through child protection services (CPS). A sample (n = 785) of child protection investigations over a 4‐month period was examined. Of these investigations, 26% cases were DV referred; 87% of the DV victims were mothers; perpetrating partners were mostly absent from investigations; non‐white families were more often investigated for DV than white families; and DV cases were more likely to remain open for ongoing CPS. Only one‐third of DV‐exposed children were assessed as having been harmed and most community referrals were made for the victim parent. Mothers were the primary target of investigation, remaining in CPS for extended service provision although recurrence rates were lower than found in other investigations. Results are discussed to inform investigative procedures, assessment and service response to more adequately respond to children and families when DV is present.