Child Protective Services Involvement Research Articles

49.8 LEGAL PROBLEMS AND NONSUICIDAL SELF-INJURY IN YOUTH WITH CHILD PROTECTIVE SERVICES INVOLVEMENT

Review of the psychiatry literature showed that inpatient adolescents with sexual and physical abuse histories are at increased risk for nonsuicidal self-injury (NSSI). Mood disorders are also shown to be associated with future legal problems and NSSI. The study’s objective is to explore the likelihood of developing legal issues and NSSI in inpatient youth with Child Protective Services Involvement (CPSI), PTSD, or both.

Childhood Adversity and Health After Physical Abuse.

Involvement with Child Protective Services (CPS) provides an opportunity to recognize those children at risk for ongoing adverse childhood experiences (ACEs). The relationship between ACEs and child health among CPS-involved children and the role of primary care providers (PCPs) in moderating this relationship is unknown. We conducted a convergent mixed-methods study of caregivers of children age 2 to 12 years with a CPS finding of physical abuse, modeling the association between cumulative ACEs and child health-related quality of life (HRQoL) using the PedsQL4.0, a validated 23-item survey of multidimensional health, with and without the moderator of a patient-centered medical home. Interviews elicited descriptions of a child's experience with ACEs, the impact of ACEs on child health, and the role of a PCP in this context. One hundred seventy-eight surveyed caregivers reported a mean of 5.5 (±3.3) ACE exposures per child. In a fully adjusted model, each ACE resulted in a 1.3-point (95% confidence interval: 0.7-2.0) reduction in HRQoL, a clinically important difference in HRQoL associated with ACE exposures. This association was explained by reduced psychosocial HRQoL and was not moderated by a patient-centered medical home. Twenty-seven interviewed caregivers described the influence of ACEs on a child's health. Many felt that a trusted PCP could support a child's well-being after such experiences. Children with CPS involvement have ACE exposures that are associated with reduced HRQoL. Although PCPs are often unaware of CPS involvement or other ACEs, many caregivers welcome the support of a child's PCP in improving child well-being after adversity.

Risk Factors Associated With Child Protective Services Involvement Among Parents With a Serious Mental Illness

People with serious mental illnesses are as likely to be parents as people in the general population but are much more likely to have contact with child protective services (CPS) and experience an out-of-home placement of their children. This study sought to identify risk factors for CPS involvement among parents with serious mental illnesses. Parents with a serious mental illness were identified through a national, representative survey. Data from a follow-up interview were used to compare characteristics of parents who had a CPS contact (N=36) with those who did not (N=38). The interview assessed demographic and health characteristics, social support, traumatic life events, and other general risk factors for CPS involvement. Compared with parents without CPS contact, parents with a CPS contact were more likely to be nonwhite and to be less educated. They were also more likely to have less attachment-related social support, more parenting-related needs in numerous areas, and more substance use-related issues and to have experienced adverse childhood and traumatic events. One-quarter of the parents with CPS contact reported not having a mental disorder diagnosis at the time of the first contact, and those in the CPS group were less likely to have taken medications at the time of the first contact than were parents who did not have a CPS contact. Results suggest a need for policies, programs, and practices that attend to common risk factors associated with CPS involvement that are present in the general population rather than concentrating efforts on addressing behavioral health factors specific to parents with serious mental illness.

“She gave me hope and lightened my heart”: The transition to motherhood among vulnerable (young) mothers

The aim of the present study was to gain an understanding of how vulnerable mothers with adverse childhood experiences transition towards motherhood. Semi-structured interviews were conducted with a convenience sample of 15 vulnerable (young) mothers who were residing in a mother-baby home at the time of the study. By means of inductive thematic analyses, a number of themes were identified that characterized the transition to motherhood. The results showed that mothers experienced a number of adversities during childhood which made them aware early on what type of mother they wanted to be for their children. Because of medical complications or involvement of child protective services, the ability to take care and bond with the baby was sometimes delayed. Further, the arrival of the baby was often considered a turning point: to bring change to the life of the mother or a second chance to motherhood. Relationships with their own parents were generally strained and sometimes put on hold to protect oneself. The mothers also mentioned difficulties with accepting and asking for support, their outlook on social support was generally ambiguous. Clinical implications of the results are discussed in the light of traditional care and the theory on ambiguous loss.

Examining the Role of Child Protection Services in Domestic Violence Cases: Lessons Learned from Tragedies

Exposure to domestic violence (DV) reports account for a significant portion of child welfare cases. However, there is a lack of resources for specifically working with cases that present a high-risk for lethality. The present study examined the involvement of child protection services (CPS) prior to domestic homicide cases. A retrospective case analysis was conducted utilizing cases reviewed by a domestic violence death review committee in Ontario, Canada. The study also examined the recommendations made by the committee to the child welfare sector. Overall, less than one-quarter of the homicide cases with children in the family system had CPS involvement. There were no differences in the presence of CPS involvement in cases where children were killed compared to cases where children were not killed. CPS-involved cases had significantly more risk factors and the family was involved with significantly more agencies overall. Recommendations directed to the child welfare sector highlighted the need for enhanced ongoing service provision to promote safety and hold perpetrators accountable, specialized DV training, and increased cross-sector collaboration. The child protection sector plays a critical role in assessing and managing risk in DV cases and preventing tragedies. The findings stress the importance of multi-disciplinary collaborations, and specialized ongoing training in engaging perpetrators and managing risk.

Parental sensitivity mediates the sustained effect of Attachment and Biobehavioral Catch-up on cortisol in middle childhood: A randomized clinical trial

ImportanceParenting interventions have been found to normalize cortisol regulation among high-risk children early in development; it is important to investigate the sustainability of these effects and their mechanisms, given the maladaptive outcomes associated with cortisol dysregulation. ObjectiveTo determine whether the Attachment and Biobehavioral Catch-up (ABC) intervention, implemented in infancy, predicts cortisol regulation in middle childhood via changes in early parental sensitivity. DesignDouble blind randomized clinical trial design; started January 2006, the follow-up for this project concluded March 2016. SettingParents of children under age 2 referred from child protective services agencies in a large, mid-Atlantic city. Participants103 parent-child dyads (45.6% female children) with histories of child protective services involvement, randomly assigned to receive ABC (n = 45) or a control intervention (n = 58); in infancy, the children’s ages ranged from 1.60 to 25.30 months (M = 9.87 months); at the middle childhood follow-up, they ranged from 8.0 to 11.0 years old (M = 8.52 years). InterventionsBoth conditions included 10-week, in-home, manualized interventions. The experimental condition, ABC, has 3 primary targets for parents: increasing nurturance to child distress, increasing following the child’s lead, and decreasing frightening behavior. The control intervention, Developmental Education for Families (DEF), is an adaptation of a program focused on enhancing cognitive and language development. Main outcomes and measuresParental sensitivity was coded from a semi-structured interaction task between the parent and child in early childhood. Middle childhood diurnal cortisol slopes were modeled by collecting salivary cortisol samples from children at wake-up and bedtime over the course of 3 consecutive days. ResultsABC participation in infancy was associated with increased parental sensitivity post-intervention, β = 0.28, p = .004, and this increased sensitivity predicted steeper decline across the day in children’s cortisol concentration in middle childhood, β = −.53, p = .002. The indirect effect of ABC on cortisol regulation via sensitivity was significant, β = −0.15, p = .038. Conclusions and relevanceABC has an indirect effect on middle childhood diurnal cortisol regulation via parental sensitivity; future research should seek to determine how this enhanced neurobiological regulation relates to children’s behavioral, socioemotional, and psychological outcomes. Trial registrationclinicaltrials.gov Identifier: NCT02093052.

Overlap between child protection services and the youth justice system: protocol for a retrospective population-based cohort study using linked administrative data in Manitoba, Canada

IntroductionChildren who have a history of involvement in child protection services (CPS) are over-represented in the youth and adult criminal justice systems. There are significant health and socioeconomic implications for...

Cumulative Incidence of Child Protection Services Involvement Before Age 5 Years in 153 670 Australian Children

This study examines the incidence of notifications to and investigations, substantiations, and out-of-home care placements by child protection services for children aged 0 to 5 years in New South Wales, Australia.

Risk factors for nonaccidental burns in children

BackgroundThe relative influences of baseline risk factors for pediatric nonaccidental burns have not been well described. We evaluated baseline characteristics of pediatric nonaccidental burn patients and their primary caretakers. MethodsA single-center retrospective cohort study was conducted of pediatric (age < 17) burn patients from July 1, 2013, to June 30, 2018. The primary outcome was nonaccidental burn, defined as burn secondary to abuse or neglect as determined by the inpatient child protection team or Child Protective Services. Univariate and multivariate analyses were performed. ResultsOf 489 burn patients, 47 (9.6%) suffered nonaccidental burns. Nonaccidental burn patients more frequently had a history of Child Protective Services involvement (48.9% vs 9.7%, P < .001), as did their primary caretakers (59.6% vs 10.9%, P < .001). Non-Hispanic black children had higher rates of Child Protective Services referral (50.7% vs 26.7%, P < .001) and nonaccidental burn diagnosis (18.9% vs 5.6%, P < .001) than children of other races/ethnicities. On multivariate analysis, caretaker involvement with CPS (odds ratio 7.53, 95% confidence interval 3.38–16.77) and non-Hispanic black race/ethnicity (odds ratio 3.28, 95% confidence interval 1.29–8.36) were associated with nonaccidental burn. ConclusionCaretaker history of Child Protective Services involvement and non-Hispanic black race/ethnicity were associated with increased odds of pediatric nonaccidental burn. Prospective research is necessary to determine whether these represent true risk factors for nonaccidental burn or are the result of other confounders, such as socioeconomic status.

Mothers abused by intimate partners: Comparisons of those with children placed by child protective services and those without

In Western Canada, 504 mothers with children 18 years and younger participated in a study of the impacts of intimate partner violence (IPV). Of these, 68 (13.5%) had children currently taken into either temporary or permanent care by child protective service (CPS). This exploratory secondary data analysis compares demographics, mental health/well-being, and protective mothering strategies of the mothers whose children were taken into care compared to those whose children were not to identify key characteristics associated with children being removed by CPS. The demographic characteristics that differentiated the groups most significantly were that mothers with children in care had more CPS involvement as children, themselves, and were less educated. No differences were found on the Severe Combined Abuse, Emotional, Harassment, or Total abuse as measured by the Composite Abuse Scale (CAS). However, mothers with children in care reported significantly more Physical Abuse (CAS). On the mental health measures, mothers with children in care reported significantly more psychological distress (SCL-10; with scores in the clinical range) and lower quality of life but no differences on depression (CES-D-10) or PTSD symptoms (PCL), neither in the clinical range. With regard to protective strategies, the women with children in care were more likely to remain with partners and to physically fight back. Implications of these findings are discussed.

MON-070 Cross-Reactivity of Human Insulin and Insulin Analogues in Human Insulin Immunoassay Complicates Case of Medical Child Abuse

Background: Measurement of insulin levels with human insulin immunoassays is important in the investigation of hypoglycemia; however, cross-reactivity with insulin analogues complicates clinical assessment. Clinical Case: A 2-month-old male presented with hypoglycemia. Initial tests were consistent with hyperinsulinemic hypoglycemia: low serum glucose (29 mg/dL, n 70 to 99), elevated insulin (90.1 mU/L, n 3.0 to 19.0), suppressed beta-hydroxybutyrate (0.16 mmol/L, n 0.02 to 0.27), and suppressed free fatty acids (0.27 mmol/L, n 0.50 to 1.60). C-peptide level resulted undetectable (<0.1 ng/mL, n 0.8 to 3.5) raising suspicion for exogenous insulin administration. History revealed an older brother with type 1 diabetes mellitus treated with insulins glargine and lispro. Only one caregiver was present in the hospital, who denied knowledge of exogenous insulin administration. Hypoglycemia persisted despite placement of a continuous 1:1 sitter, high-dose intravenous glucose (glucose infusion rate up to 21.6 mg/kg/min), and treatment with diazoxide. A repeat insulin measurement with the Roche Diagnostics assay specific for human insulin was performed on a critical sample and resulted elevated (13.9 uIU/L, n 2.6 to 24.9), suggestive of endogenous insulin. However, an extensive study of commercial human insulin immunoassays by Heurtault et al., including the Roche Diagnostics assay, has demonstrated cross-reactivity with insulin analogues and their metabolites [1]. Given persistent concern for exogenous insulin administration, the patient’s caregiver was asked to leave the bedside for an extended period of time which resulted in normoglycemia. Diazoxide and dextrose-containing IV fluids were discontinued. Patient maintained normoglycemia for the remainder of the admission and was discharged in the care of child protective services. Conclusions: Cross-reactivity exists in human insulin immunoassays with insulin analogues and their metabolites complicating the determination of endogenous versus exogenous insulin as the cause of hyperinsulinemic hypoglycemia. It is important to know the cross-reactivity of the assay used if a diagnosis of surreptitious insulin administration is suspected. Separation of patient and possible perpetrators and involvement of child protective services is essential in suspected cases of exogenous insulin administration. Evaluation in cases where self-injection of insulin is suspected may be more difficult to decipher, and inclusion of c-peptide measurement at the time of hypoglycemia is critical. Reference: [1] Heurtault B, Reix N, Meyer N, et al. Extensive study of human insulin immunoassays: promises and pitfalls for insulin analogue detection and quantification. Clin Chem Lab Med. 2014; 52:355-362.

Challenges to achieving and maintaining viral suppression among children living with HIV.

The objective of this study was to determine the time to, and durability of, viral suppression, among Canadian children living with HIV after initiation of combination antiretroviral therapy (cART). Prospective, multicenter Canadian cohort study (Early Pediatric Initiation Canada Child Cure Cohort), using both prospective and retrospectively collected data. Kaplan-Meir survival estimates with Cox regression were used to determine the time to and risk factors for viral suppression, defined as two consecutive undetectable viral loads (<50 copies/ml) at least 30 days apart after initiation of cART. A total of 228 children were enrolled between December 2014 and December 2018. The time to viral suppression was significantly shorter among children initiating cART after 5 ≤ 5 vs. years or less of age [adjusted hazard ratio (aHR) 1.57, 95% confidence interval (CI) 1.13-2.20], among those born after 2010 vs. prior (aHR 1.71, 95% CI 1.04-2.79), and among those without child protection services involvement (aHR 1.44, 95% CI 1.03-2.01). Overall, 27% of children had a viral rebound within 3 years of achieving viral suppression; the risk of viral rebound was significantly lower among children initiating cART after 5 vs. 5 years or less of age [adjusted odds ratio (aOR): 0.32, 95% CI 0.13-0.81], those whose families had not received social assistance (aOR 0.16, 95% CI 0.06-0.46), and females vs. males (aOR 0.51, 95% CI 0.26-0.99). Only 73% of the children in the Early Pediatric Initiation Canada Child Cure Cohort had maintained viral suppression 3 years after it was first achieved. Age at cART initiation, and socioeconomic factors were predictors of both time to viral suppression and risk of viral rebound in this cohort.

Psychotherapy for child welfare cases: Clinicians' and parents' perspectives

AbstractParents involved with child protective services (CPS) often face various challenges, including sociostructural marginalization, mental illness and difficulties in family relationships. Although their need for mental health services is generally acknowledged, the extant child welfare literature lacks studies on how CPS‐involved parents may benefit from such services. In an attempt to address this gap, the current study seeks to explore clinicians' and parents' perspectives regarding the role of psychotherapy services (e.g. individual or conjoint counselling/therapy) for child welfare cases. Semi‐structured interviews were conducted with clinicians working with CPS‐involved families and parents accused of child maltreatment. Thematic analysis of the interview data generated three themes: (1) psychotherapy as a place for safety and empathy, (2) psychotherapy as a place for challenge and (3) psychotherapy as a place for problem resolution. The findings suggest that psychotherapy services may benefit CPS‐involved parents not only by offering much‐needed emotional support and resources within sessions but also by facilitating parents' collaboration with CPS through their partnership with caseworkers outside of sessions. For child welfare practice, it is recommended that psychotherapy services be included from the outset of parents' CPS involvement to promote their psychological and relational well‐being as well as their successful completion of CPS requirements.

Mothers and fathers in the criminal justice system and children’s child protective services involvement

BackgroundParental criminal justice system (CJS) involvement is a marker for child protective services (CPS) involvement. ObjectiveTo document how parental criminal case processing affects children’s CPS involvement. Participants and settingParticipants included mothers and fathers with a serious criminal charge (mothers = 78,882; fathers = 165,070) and without any criminal charge (mothers = 962,963; fathers = 743,604) between 2008-2012. Statewide North Carolina records on court proceedings, births, CPS assessments/investigations, and foster care placements were used. MethodsThe observational unit was an individual’s first charge date of a year. Outcomes were CPS assessment/investigation and foster care entry within six months and alternatively three years following the charge. Key explanatory variables were whether the charges resulted in prosecution, conviction following prosecution, and an active sentence conditional on conviction. An instrumental variables approach was used. ResultsParents charged with a criminal offense had higher rates of having a CPS assessment/investigation during the three years preceding the charge than parents who were not charged. Among mothers who were convicted, CPS assessment/investigation increased 8.1 percent (95 % CI: 2.2, 13.9) and 9.5 percent (95 % CI: 1.3, 17.6) 6 months and 3 years following the charge. An active sentence increased CPS assessment/investigations by 21.6 percent (95 % CI: 6.4, 36.7) within 6 months. For fathers, active sentence increased foster care placement by 1.6 percent (95 % CI: 0.24, 2.9) within 6 months of the criminal charge. ConclusionsChanging parental incarceration rates would change CPS caseloads substantially. The criminal justice and CPS systems work with overlapping populations, data and services sharing should be considered a high priority.

The labor and birth experience of women with opioid use disorder: A qualitative study

ObjectiveThis study describes the experience of pregnancy and childbirth from the perspective of women with opioid use disorder. MethodsThis qualitative study analyzed semi-structured interviews about the prenatal care and birth experience of nine women with opioid use disorder as a sub-analysis of a qualitative study of women with a history of sexual trauma. Transcripts were analyzed using inductive content analysis. ResultsAnalysis revealed unique interactions with the healthcare system specific to pregnant women with opioid use disorder. Participants identified pregnancy as a reason to enter and maintain recovery and an increased availability of resources when pregnant. Yet during labor and birth, concerns regarding pain control, child protective services involvement and provider stigma led to negative interactions with the healthcare system. ConclusionPregnant woman with opioid use disorder face unique challenges when seeking care. The perspectives of women with a history of opioid use disorder can inform creation of a harm reduction, non-stigmatizing model of prenatal, labor and birth, and postpartum care.

The Cumulative Effect of Prior Maltreatment on Emotional and Physical Health of Children in Informal Kinship Care.

Millions of children cared for by their grandparents or other kin without a biological parent present are not part of the foster care system. Maltreatment may have precipitated out-of-home care arrangements, but most children in informal kinship care are not being tracked or receiving services. Importantly, the extent of previous child welfare involvement and its association with well-being among this population are not well known. Kinship caregivers known to social service and community agencies were recruited for this study. Caregivers who agreed to participate rated the physical and emotional health of children under their care. Maternal mental health and demographic data were collected, and matched records of children were retrieved from the state child welfare database. The nested structure of children within families was addressed using a generalized estimating equation model. The sample included 365 children from 274 families. Only 25% of the children were in private kinship care with no known Child Protective Services (CPS) involvement. An average of 2.37 open CPS cases were observed for those in voluntary kinship care. One out of 4 children scored below the clinical level of emotional health. The number of CPS cases and kin caregiver's parenting stress were inversely associated with child's physical and emotional health. The presence of maternal mental health problem was significantly associated with poor child emotional well-being. Many children in informal kinship care experienced multiple episodes of maltreatment. This study's results add further evidence of the cumulative negative effects of child maltreatment on child well-being. Children in informal kinship care are in need of services to mitigate their traumatic experiences.

It’s not “Just poverty”: Educational, social, and economic functioning among young adults exposed to childhood neglect, abuse, and poverty

BackgroundNeglect is the most common allegation in Child Protective Services (CPS) investigations. Researchers and media have questioned whether and how CPS-investigated neglect differs from poverty. Prior studies are limited by self-reported or cross-sectional measures, small samples, and short observation periods. Objective(1) To estimate the “added harm” of CPS-investigated neglect, net of poverty exposure (depth and duration), on high school completion, employment and earnings, incarceration, and teen parenthood; (2) To assess whether abuse is a stronger risk factor for adverse outcomes than neglect. Participants and Setting29,154 individuals born in 1993–1996 from Milwaukee County, WI, who either received food assistance or were reported to CPS before age 16. MethodUsing logistic regression with a rich set of social and demographic controls, we compared individuals with CPS-investigated neglect, abuse, or both abuse and neglect in early childhood or adolescence to those who experienced poverty but not CPS involvement. We calculated cumulative measures of poverty duration and poverty depth between ages 0 and 16 for the full sample using public benefit records. ResultsOutcomes among children with alleged or confirmed neglect were statistically significantly worse in all domains than impoverished children without maltreatment allegations, and similar to children with alleged or confirmed abuse. Effect sizes varied by outcome. ConclusionsOverall, this study suggests that CPS allegations of neglect are distinct from poverty and an important risk factor for adverse outcomes in adulthood.

Provider Consensus on Candidate Protective and Risk Factors for Adverse Psychosocial Outcomes Following Discharge From a PICU: A Modified Delphi Study.

Pediatric palliative care promotes interdisciplinary, family-centered care when children are faced with diagnoses threatening length and/or quality of life. A significant knowledge gap remains in how to best match pediatric palliative care resources to palliate the psychosocial impact of a PICU admission. This study was designed to identify drivers of adverse post-PICU psychosocial outcomes related to social determinants of health to inform pediatric palliative care services and improve post-PICU psychosocial outcomes. Modified Delphi technique to develop consensus regarding social determinants of health and clinical factors affecting post-ICU psychosocial outcomes. All Delphi rounds were via an electronically mailed survey link. First-round participants were PICU and pediatric palliative care clinicians at the study institution. Subsequent rounds invited participants from national PICU and pediatric palliative care professional online listserves. None. Consensus was defined a priori as items assigned a score greater than or equal to 4 (5-point scale) by greater than75% of respondents. One-hundred twenty-six surveys were returned and scored. Social determinants of health risk factors included child protective services involvement (91%), caregiver with intellectual disability (87%), lack of friend or family support (82%), caregiver with behavioral health diagnosis (81%), teenage caregiver (79%), transportation challenges (79%), and language/cultural barrier (76%). Clinical risk factors included new home ventilator (94%), new tracheostomy (90%), greater than or equal to 3 hospitalizations in the prior 6 months (88%), and greater than or equal to 3 hospitalizations in the prior 12 months (82%). Social determinants of health protective factors included extended family support (91%), caregivers in a committed relationship (79%), and caregiver optimism (78%). Respondents reported that pediatric palliative care services had the greatest impact on caregiver satisfaction with the healthcare system (90%) and increased family involvement with state social services programs (80%). Consensus on candidate risk and protective factors for post-ICU psychosocial challenges and candidate pediatric palliative care-sensitive variables were identified. Further research is needed to operationalize and optimize a screening tool based on these consensus items and test it prospectively.

Patterns of intergenerational child protective services involvement

BackgroundPrior research on Child Protective Services (CPS) involvement among at-risk youth focuses on their roles as parents perpetrating maltreatment against biological offspring. Given family complexity and assortative partnering, measuring all CPS involvement – as perpetrators and non-offending parents of victims – provides new insight into intergenerational maltreatment patterns. ObjectivesOur objective was to investigate the risk of multiple forms of parent or perpetrator CPS involvement (PP-CPS) by age 25, among those exposed to three forms of adversity in their late teens (at ages 14–17): alleged victim on a CPS investigation, out-of-home care (OHC), and poverty. Participants and settingWe used a sample of 36,475 individuals born in 1990–1991 from the Wisconsin Data Core longitudinal administrative database, and tracked their involvement in CPS, OHC, and the food assistance program (SNAP) over time. Our sample consisted of individuals who, at ages 14–17, met one of the following criteria: were in OHC; had CPS involvement as a victim but no OHC (CPSV group), or received food assistance without CPSV or OHC (SNAP group). MethodsUsing logistic regression, we modeled four forms of PP-CPS involvement: parent-perpetrator, resident parent non-perpetrator, nonresident parent non-perpetrator, and non-biological parent-perpetrator. ResultsPredicted risks of any PP-CPS involvement by age 25 were 10 % (SNAP group), 17–22 % (CPSV group), and 26–33 % (OHC group); among OHC youth known to have a biological child, rates exceeded 40 %. The proportion of CPS involvement that involved parent-perpetration varied substantially by sex and adversity type. ConclusionsFocusing only on intergenerational maltreatment in which the parents are the perpetrators may substantially understate the risk of maltreatment recurring across generations.

Discordance in Reporting of Maternal Aggression: Exploring Differences by Characteristics of Children, Mothers, and Their Environments.

This study investigated discordant reports of maternal aggression using the Fragile Families and Child Wellbeing Study (N = 1,606). Multinomial logistic regression models predicted discordant reports of hitting and shouting from child, mother, and environmental characteristics. Compared to dyads in which both mothers and children reported aggression, mothers with a college degree had higher child-only and mother-only reports of both hitting and shouting versus mothers with less than a high school diploma. High-income mothers had higher child-only reports of hitting, while families with past Child Protective Services involvement had higher child-only and mother-only reports of hitting. Additionally, children with lower reading test scores and whose fathers had history of incarceration had higher child-only reports of hitting. Families residing in neighborhoods for which mothers were scared to let children play outside also had higher child-only and mother-only reports of hitting and shouting.