Child Protective Services Case Research Articles

Disparities in child protective services involvement in pediatric traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of pediatric death and disability. Abusive head trauma confers greater morbidity and mortality compared with accidental TBI. National trends reveal disproportionate involvement of minority children in the child welfare system. The study investigates socioeconomic disparities in child protective services (CPS) involvement in pediatric TBI. Retrospective chart review was conducted for TBI patients (n = 596) admitted to an academic pediatric level I trauma center from 2015 to 2022, where institutional policy dictates automatic CPS referral for TBI patients ≤ 2years. Analysis of variance, chi-squared, and logistic regressions compared racial and ethnic groups and calculated adjusted odds of CPS case acceptance. Rates of non-accidental trauma, CPS involvement, insurance, and marital status differed across racial and ethnic backgrounds (p < 0.05). Of patients ≤ 2years, Hispanic patients (OR: 0.38, 95%CI [0.16,0.91]) had decreased odds of CPS involvement compared to non-Hispanic White patients when adjusting for confounders including injury severity, injury type, and socioeconomic status. We highlight racial and ethnic differences in incidence of pediatric TBI and CPS involvement, even in the setting of an automatic CPS referral policy for pediatric TBI patients ≤ 2years.

“My heart is in the right place, but I don’t feel the court’s heart is beating”: perspectives on feeling valued from multiple nonprofessional stakeholders in child welfare court

ABSTRACT Though the experiences of individual non-professional stakeholders involved with dependency courts overseeing child protective services cases have been documented, this article provides a unique comparison across four non-professional stakeholder groups. Through analysis of focus groups and individual interviews, we compare the perspectives of birth parents (n=6), kinship caregivers (n=14), young adults removed from their homes as children (n=15), and foster parents (n=57) involved with the dependency courts in Maryland. Despite their different roles, the experiences of all groups are characterized by common themes including time, consistency, role, voice, and what is best under the broader context of feeling valued.

Jenna's Project: Preventing Overdose and Improving Recovery Outcomes for Women Leaving Incarcerated Settings During Pregnancy and Postpartum Periods.

For people with opioid use disorder (OUD), transitioning from pregnancy to postpartum and from incarceration to the community is a time of increased risk for opioid overdose. This prospective project evaluated the extent of Jenna's Project's success in preventing overdoses and improving recovery outcomes by coordinating postrelease care in incarcerated OUD perinatal patients. Participants (N = 132) were pregnant or postpartum (1 year postdelivery) with OUD during incarceration and self-referred for postrelease services. From March 2020 to October 2021, participants could receive up to 6 months of postincarceration care coordination services (eg, regular communication, transportation, emergency housing, SUD treatment), medication to treat OUD (MOUD) and other treatment services. Outcomes included verified overdose (fatal), self-reported nonfatal overdose, reincarceration, active Medicaid, receipt of MOUD, presence of children living with participants, open Child Protective Services cases, and number of referrals for services. There were 0 nonfatal and 0 fatal overdoses at both 1 and 6 months postrelease, and 3 of 132 (2%) returned to incarceration. Significantly fewer participants had Medicaid at release (36%) and at 6 months postrelease (60%) than before incarceration (87%) ( P < 0.001 for all 3 pairwise comparisons). At 6 months postrelease, significantly more participants reported MOUD receipt (51%) compared with before incarceration (39%) ( P < 0.001). There was no significant change in the number of open Child Protective Services cases. Referrals for childcare or parenting services were the most common referrals provided. Immediate postrelease care coordination for pregnant and postpartum women with OUD was feasible and effective in preventing overdose, reincarceration, and promoting recovery outcomes.

Identifying newborn discharge to child protective services: Comparing discharge codes from birth hospitalization records and child protection case files

PurposeNewborn removal by North America’s child protective services (CPS) disproportionately impacts Indigenous and Black families, yet its implications for population health inequities are not well understood. To guide this as a domain for future research, we measured validity of birth hospitalization discharge codes categorizing newborns discharged to CPS. MethodsUsing data from 309,260 births in Manitoba, Canada, we compared data on newborns discharged to CPS from hospital discharge codes with the presumed gold standard of custody status from CPS case reports in overall population and separately by First Nations status (categorization used in Canada for Indigenous peoples who are members of a First Nation). ResultsOf 309,260 newborns, 4562 (1.48%) were in CPS custody at hospital discharge according to CPS case reports and 2678 (0.87%) were coded by hospitals as discharged to CPS. Sensitivity of discharge codes was low (47.8%), however codes were highly specific (99.8%) with a positive predictive value (PPV) of 81.4%, and a negative predictive value (NPV) of 99.2%. Sensitivity, PPV and specificity were equal for all newborns but NPV was lower for First Nations newborns. ConclusionsCanadian hospital discharge records underestimate newborn discharge to CPS, with no difference in misclassication based on First Nations status.

Tailored Nurse Support Program Promoting Positive Parenting and Family Preservation.

Public health nurse home visiting is a promising approach for addressing the complex needs of families at risk of child maltreatment. The Colorado Nurse Support Program advances service provision by using evidence-based practices to provide tailored assessment and intervention to low-income, primiparous, and multiparous families with children under 18 years of age identified as high risk by county human service systems. This study aimed to test the effects of the Nurse Support Program on child protective services case characteristics between Nurse Support Program families and a demographically comparable reference group of families and evaluate changes in parenting outcomes from pre- to postprogram involvement for Nurse Support Program families. We used a matched comparison group quasi-experimental design in which families in the Nurse Support Program ( n = 48) were compared to families ( n = 150) who were identified using administrative data from Colorado's Comprehensive Child Welfare Information System. Outcomes were child protective case characteristics (child protection referrals, open assessments, founded assessments, open cases, and children's placement in out-of-home care) and parenting outcomes. Nurse Support Program families were less likely to have a child protection case opened or have their child placed in out-of-home care. There were no significant between-group differences in child protection referrals, open assessments, or founded assessments. Families in the Nurse Support Program showed improvements in parenting outcomes over time. Findings suggest that the Nurse Support Program is a successful public health nurse home-visiting approach to promote positive parenting and family preservation among families with complex needs. Implementing tailored public health nurse home-visiting programs, such as the Nurse Support Program, should continue to be evaluated and supported to mitigate the public health risk of child maltreatment.

Characteristics of Fatal Poisonings Among Infants and Young Children in the United States.

Fatal poisoning is a preventable cause of death among young children. Understanding factors surrounding these deaths will inform future prevention efforts. Our objective was to describe the characteristics of fatal pediatric poisonings using child death review data. We acquired data from 40 states participating in the National Fatality Review-Case Reporting System on deaths attributed to poisonings among children aged ≤5 years from 2005 to 2018. We analyzed select demographic, supervisor, death investigation, and substance-related variables using descriptive statistics. During the study period, 731 poisoning-related fatalities were reported by child death reviews to the National Fatality Review-Case Reporting System. Over two-fifths (42.1%, 308 of 731) occurred among infants aged <1 year, and most fatalities (65.1%, 444 of 682) occurred in the child's home. One-sixth of children (97 of 581) had an open child protective services case at time of death. Nearly one-third (32.2%, 203 of 631) of children were supervised by an individual other than the biological parent. Opioids (47.3%, 346 of 731) were the most common substance contributing to death, followed by over-the-counter pain, cold, and allergy medications (14.8%, 108 of 731). Opioids accounted for 24.1% (7 of 29) of the substances contributing to deaths in 2005 compared with 52.2% (24 of 46) in 2018. Opioids were the most common substances contributing to fatal poisonings among young children. Over-the-counter medications continue to account for pediatric fatalities even after regulatory changes. These data highlight the importance of tailored prevention measures to further reduce fatal child poisonings.

Resignation without relief: democratic governance and the relinquishing of parental rights

Sociologists have long studied the ways people resist oppression but have devoted far less empirical attention to the ways people resign to it. As a result, researchers have neglected the mechanisms of resignation and how people narrate their lived experiences. Drawing on 81 interviews with parents with past child protective services cases, this article provides an empirical account of resignation in an institutional setting, documenting how parents understand relinquishing their rights as a process of personalization, calculation, or socialization. Phenomenologically, parents typically confronted multiple barriers and setbacks simultaneously, the combined weight of which pressured them to “give up,” interpreting structural and institutional pressures as individual choice. This article accordingly identifies resignation as a crucial feature of democratic governance.

Impacts of intergenerational substance use and trauma among black women involved in the criminal justice system: A longitudinal analysis

IntroductionIntergenerational substance use and trauma disproportionately impact racialized women. Yet, how these factors impact outcomes in women involved in the criminal justice system is understudied. MethodsUsing data from 443 participants in the Black Women in a Study of Epidemics, we assessed the impact of intergenerational substance use and trauma on participant drug use and open Child Protective Services (CPS) cases over 18 months. In repeated-measures logistic regression, intergenerational substance and trauma were independent variables, while participants' drug use at each follow-up and any open CPS case (s) served as separate dependent variables. Models were adjusted for criminal justice involvement, age, marital status, education, childhood guardian, number of children, and prior year homelessness. ResultsOn average, participants were aged 35 years, 64 % had never married, and 44 % were raised by both parents. Two-thirds of women (67 %) reported intergenerational substance use (≥1 parent and/or grandparent with alcohol/drug problems), while only 13 % reported intergenerational trauma. Each increase in the number of parents/grandparents with drug/alcohol problems was associated with 30 % increased odds of participants' drug use (aOR 1.30, 95 % CI: 1.07,1.57) and 40 % increased odds of having an open CPS case (aOR 1.40, 95 % CI: 1.11, 1.78). The association of intergenerational trauma and CPS cases was attenuated with sociodemographic/contextualizing factors. ConclusionsIntergenerational substance use and trauma are associated with negative outcomes. Our findings highlight the need for substance use treatment to address the pervasive generational effects of substance use and trauma faced by racialized women in the criminal justice system.

Factors Associated with Child Maltreatment Fatality among Young Children with an Open Child Protective Services Case at Death

One of the goals of Child Protective Services (CPS) is to prevent maltreatment deaths. We analysed deaths of children younger than five years of age with an already open CPS case at the time of death for characteristics that might be associated with increased risk of fatality with child maltreatment. We used 2513 cases in the National Center for Fatality Review and Prevention – Case Review System during the years 2004–2016 for children ages 0–4 years who died with an already open CPS case. Among these, we compared 1370 children who died from causes determined to be ‘caused or contributed to’ by abuse or neglect to 1143 children who died from other causes. Those who died from maltreatment were older, experienced prior maltreatment, lived in an overcrowded residence, and had a caregiver with history of substance abuse, interpersonal violence, criminal delinquency and their own maltreatment. These risk factors and others may be associated with a higher likelihood of dying with abuse or neglect for children who already have an open CPS case.Key Practitioner Messages Compared with children dying from other causes, children with an already open CPS case at the time they died as a result of maltreatment were more likely to be older, male and living in a parental home with overcrowding. Caregivers were more likely to be male, or had a history of substance abuse, delinquency or prior maltreatment, both as a victim or perpetrator. When cases are opened with CPS, caseworkers should consider these potential risk factors and whether additional services can be put in place to reduce future maltreatment fatality. While additional research is needed, we speculate that other services, such as coordinated paediatric care, universal reporting, child fatality review teams, citizen review panels and public education campaigns, can offer additional ways to decrease future maltreatment deaths.

Associations Between Case, Staff, and Agency Characteristics and the Decision to Place a Child in Out-of-Home Care

Typically, when children are placed into out-of-home care due to child maltreatment concerns, people assume that this decision is based on action or inaction on behalf of the child’s caregivers. While such elements are likely the main drivers of the decision, a growing body of research suggests that other factors contribute to caseworkers’ decisions on the child welfare cases they serve. Drawing from the decision-making ecology (DME), this study examines the extent to which caseworker and organizational factors, in addition to case characteristics, play a role in decisions to remove a child from their home. Survey data from 118 investigation or assessment workers in a southeastern state were paired with administrative data from 10,568 child protective services (CPS) responses assigned to the surveyed workers for analysis. Multi-level modeling (cases, and cases within workers) results identified that, controlling for case characteristics and using 95% confidence intervals, workers who were male (aOR: 0.71 [0.50–0.998]), perceived the agency as more supportive (aOR: 0.87 [0.80–0.94]), and those indicating a strong orientation towards family preservation compared to child safety (aOR: 0.58 [0.42–0.81]) were associated with lower odds of placing children into out-of-home care. Staff who felt more cohesion with their co-workers (aOR: 1.37 [1.19–1.57]) were more likely to place children on their caseloads. These results indicate that the current system of decision-making and case trajectories are prone to influences from caseworkers’ personal biases and perceptions of support. Implications for CPS workforce selection, development, support, and case assignment are discussed.

607 Characteristics of Pediatric Burn Patients with Child Protective Services Involvement at an Academic Children’s Hospital

Abstract Introduction Pediatric burns are typically accidental, but burns caused by caregiver abuse/neglect represent a significant proportion of patients. Literature on risk factors most associated with these injuries include younger age, male, African American, and larger burns. This study examined child and burn injury factors that were associated with Child Protective Services (CPS) involvement at an urban, academic children’s hospital. Methods At this institution, decision to report a burn patient to CPS is determined by a multi-disciplinary medical team. Criteria for referral is multifactorial and may include burn patterns consistent with forced immersion, a reported mechanism that does not match the burn pattern or the patient’s developmental capabilities, concern for lack of supervision, or a delay in seeking medical care. Data from inpatient admissions over a 3-year period (July 2016 – June 2019) were extracted from hospital charts, and analyses (chi-square, t-tests) examined age, sex, total body surface area (TBSA), burn severity, length of stay, insurance type, race/ethnicity, and whether a CPS report was made (i.e., yes/no). Records for the outcome and disposition of the CPS case, such as whether the CPS investigation confirmed the abuse/neglect allegations, were not readily available as the law requires confidentiality. Results 389 children were admitted for burn treatment. 80% had partial-thickness burns; 33% White, 43% Black, 62% male; 10% had CPS involvement. 72% had Medicaid/other government insurance, 23% had private/commercial, 4% were uncovered, and 1% insurance status unknown. Medicaid/government insurance was overrepresented among burns compared to other inpatients at the hospital (72% vs 51%). Consistent with previous findings, CPS reports involved children who were younger (2.8 vs 4.8 years), had greater TBSA (8.4% vs 4.9%), and had longer admissions (7.5 vs 3.0 days). Children with Medicaid/governmental or no insurance were more likely to have CPS reports than commercial/private insurance (97% vs 3%). Importantly, contrary to prior findings, child sex, child ethnicity, and burn thickness were not significantly different between children with and without CPS reports. Conclusions Younger children with bigger burns and longer admissions were most associated with CPS involvement. Historical findings on risk factors of male sex, African American ethnicity, and greater burn thickness were not replicated. Prior literature may not be generalizable to many settings; the current study provides an important update. Further research is needed to examine outcomes of CPS involvement and long-term patient health outcomes. Findings are limited to only urban, inpatient pediatric burns.

Social and Demographic Characteristics and the Contribution of Fireplay to Fire-Related Mortality Among Children in the U.S., 2004–2016

This study seeks to describe the circumstances of fire deaths among children, identify deaths related to fireplay, and compare children whose deaths were related to fireplay with non-fireplay-related deaths. Children aged 1-14 years who died in a fire during 2004-2016 were identified from the National Fatality Review Case Reporting System. Social, demographic, and fire characteristics were described and then compared for children who died in fires caused by fireplay versus non-fireplay-related deaths. Unadjusted ORs and 95% CIs were calculated. Data were collected 2004-2018 and analyzed in 2019. A total of 1,479 children who died in fires were identified. They were predominantly male (54%) and White (47%); 34% were Black. Two or more children died in 54% of incidents. Fires occurred most frequently in single-family homes (52%) and rental properties (37%); 23% were started by smoking materials or candles. Smoke alarm information was largely missing (42%) and noted to be present and working for only 82 deaths. Fireplay was responsible for 175 (12%) of the deaths. Compared with non-fireplay-related deaths, children who died in fireplay fires were more likely to be aged 1-4 years (OR=2.6, 95% CI=1.5, 4.3), male (OR=1.6, 95% CI=1.2, 2.2), have supervision documented as no, but needed (OR=8.8, 95% CI=4.1, 18.8), and have an open Child Protective Services case (OR=1.8, 95% CI=1.1, 3.0). This study provides data on supervision and the role of fireplay in fatal fires among young children, offering information for the development of innovative primary prevention strategies and future research.

Who Is and Is Not Served by Child Protective Services Systems? Implications for a Prevention Infrastructure to Reduce Child Maltreatment

The majority of alleged abuse or neglect reports to the U.S. child welfare system are either screened out prior to an investigation (i.e., at the “hotline” stage) or investigated only to be closed with no finding of immediate child safety concerns. Yet while many of these children and families are at risk of subsequent incidents of child maltreatment or child welfare system involvement, they are not systematically offered services or benefits intended to reduce this risk at the point that child protective services (CPS) ends its involvement. This article provides an overview of the “front end” of the child welfare system, commonly referred to as CPS, highlighting which families are served and which are not. We then argue for a systematic and coordinated child maltreatment prevention infrastructure that incorporates elements of “community response” programs that several U.S. states have implemented in recent years. Such programs are focused on families that have been reported to, and sometimes investigated by, CPS, but no ongoing CPS case is opened. We further argue that such programs need to pay particular attention to economic issues that these families face.

Child maltreatment and romantic relationships in adolescence and young adulthood: The mediating role of self-perception

BackgroundChild maltreatment (CM) can disrupt the development of self, influencing the ability to form positive relationships, including romantic attachment. While mental health is a known mediator of maltreatment history and romantic relationships, less is known about the role of self-perception. ObjectiveThe goal of this work is to understand the role self-perception plays in the association between CM history and romantic relationships during adolescence and young adulthood. ParticipantsLongitudinal data from child welfare involved and comparison youth were gathered to examine whether self-perception mediated the association between CM history and the proportion of positive romantic relationships. Mean age at T1 was 11.03 years and 18.24 years at T4. MethodsParticipants in the CM group were recruited from active Child Protective Services cases in a large west coast city. The comparison group was recruited using names from school lists of children residing in the same 10 zip codes. Assessments were conducted at an urban research university. After assent/consent were obtained, the adolescent was administered questionnaires. For the current analyses, only those who indicated they had ever had a romantic relationship were included (n = 306). Hypotheses were tested used path modeling in Mplus 7.0. ResultsCM history was associated with lower self-perceptions in all domains. Only behavioral (β = 0.15, p= 0.02) and scholastic (β= -0.14, p= 0.04) self- perceptions predicted proportion of later positive romantic relationships. A significant mediation effect was found only for behavioral self- perceptions. ConclusionsInterventions aimed at bolstering self- perceptions and engagement in positive behaviors could strengthen positive relationships for youth with CM and child welfare experiences.

Using Child Protective Services Case Record Data to Quantify Family-Level Severity of Adversity Types, Poly-victimization, and Poly-deprivation

BackgroundChild protective services (CPS) case records contain a vast amount of narrative information that is underutilized for estimating risk, conceptualizing family needs, and planning for services. ObjectiveThe current study applied a novel method for quantifying family-level severity of maltreatment and non-maltreatment-related adversity types to narrative information reflecting a family’s full CPS history. Participants and settingCases were randomly sampled (N = 100) from two regions of Connecticut that were referred over a specified 6-month period. MethodsDe-identified data were extracted through comprehensive chart review of electronic and paper case records. The Yale-Vermont Adversity in Childhood Scale (Y-VACS; Holbrook et al., 2015) was used to quantify adversity severity across a range of intrafamilial and extrafamilial experiences. ResultsSeveral family-level adversity severity ratings were associated with administrative data on allegations and investigative outcomes. Poly-victimization (β = .47, p < .001) and poly-deprivation (β = .25, p = .005) significantly predicted total allegation types and total substantiation types (β = .30, p = .002; β = .26, p = .008, respectively) across the case history. Poly-victimization significantly predicted the presence of a new allegation within 12 months of the index report, OR = 1.72, SE = .25, p = .027. ConclusionsFindings support the feasibility of a novel method that uses narrative case record information to quantify severity of maltreatment and non-maltreatment-related adversity types, as well as cumulative measures of threat- and deprivation-based adversities at the family level. Implications for utilizing case record data to inform CPS intervention are discussed.

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.

Examining the Association between Severity of Child Neglect and Quality of Parenting

Child neglect is the most prevalent form of child maltreatment (CM) in the U.S. and is consistently associated with negative outcomes for children. Although some research suggests that differences in parenting exist across the spectrum of maltreatment severity, little is known about whether and how severity of neglect relates to observed parenting quality. The present study tested whether mothers who engage in documented, higher severity neglect of their children would display less warm, affiliative parenting, and more harsh, controlling parenting while interacting with their preschool child, than less severely neglectful mothers, and non-CM mothers. A sample of 121 mother-preschooler dyads [low severity neglect (n = 29), high severity neglect (n = 40), and non-CM (n = 52)] participated, and parenting behaviors were coded during a joint laboratory challenge task. This study explored associations between severity of child neglect perpetration through coding of child protective services case records; and quality of observed parenting, using observational, micro-social coding of parenting behaviors. Regression analyses showed that high severity neglecting mothers displayed significantly less warm, affiliative parenting than lower severity neglecting and non-CM mothers, and more harsh, controlling parenting relative to their non-CM peers. Further, there were no differences between low severity neglect and non-CM mothers in the amount of warm, affiliative parenting observed. These findings advance our understanding of child neglect by revealing important differences in quality of observed parenting across the spectrum of neglect severity. Implications for conceptualizing child neglect and targeted intervention strategies are discussed.

Risk factors that predict longitudinal patterns of substantiated and unsubstantiated maltreatment reports

BackgroundSubstantiated and unsubstantiated reports of maltreatment are associated with similar risk of emotional and behavioral problems. However, substantiation status often determines service provision. ObjectiveWe examined substantiated and unsubstantiated reports to identify patterns of recurrence over a five-year period and identified family risk factors that predicted recurrence patterns. Participants and SettingWe studied a subsample (N = 246,021) of the National Child Abuse and Neglect Data System from 2011–2015. MethodsMeasures included child, caregiver, and child protective services case characteristics obtained in 2011. We used latent class analysis to identify heterogeneous classes, then entered class membership as the outcome variable in a multinomial logistic regression to identify risk factors. ResultsFour latent classes emerged: (1) initial unsubstantiation and moderate recurrence, (2) initial unsubstantiation and low recurrence, (3) initial substantiation and moderate recurrence, and (4) initial substantiation and low recurrence. Domestic violence (relative risk ratio (RRR) = 2.56, β = 0.94, SE = .02, p < .001), caregiver substance abuse (RRR=2.23, β=0.80, SE=.02, p < .001), and Native Hawaiian/Pacific Islander race (RRR=1.67, β=0.52, SE=.11, p < .001), predicted initial substantiation status but were not meaningful predictors of long-term recurrence. Prior substantiated report and poverty predicted initial substantiation status (report RRR=1.50, β=0.41, SE=.02, p < .001; poverty RRR=1.50, β=0.41, SE=.02, p < .001) and long-term recurrence (report RRR=2.60, β=0.96, SE=.02, p < .001; poverty RRR = 1.35, β=0.30, SE=.02, p < .001). Asian American race predicted low recurrence rates (RRR=2.09, β=0.74, SE=.12, p < .001). ConclusionsSimilar recurrence patterns between substantiated and unsubstantiated reports emphasize the importance of providing services regardless of substantiation status. Integrating administrative databases may reveal more variables that predict long-term recurrence.

Quantifying Severity of Maltreatment, Adversity, and Trauma From Child Protective Services Case Record Files.

Children referred to child protective services (CPS) for allegations of abuse or neglect often have diverse experiences of maltreatment, adversity, and trauma. Severity of these experiences is associated with greater mental health impairment and increased risk of revictimization and other adversities. Although aspects of these experiences are often captured during CPS investigations and stored in case records as narrative documents, much of this information is underutilized in estimating risk and service planning. The current study extracted case record information from a randomly selected sample of 100 families, with 150 children referred to CPS during a 12-month period. The Yale-Vermont Adversity in Childhood Scale (Y-VACS) was applied to extracted information for quantifying severity of various forms of childhood maltreatment, adversity, and trauma. Study aims were to examine (a) the scope and severity of maltreatment, adversity, and trauma types and their associations; (b) linkages between severity and CPS allegation types and outcomes; and (c) the utility of severity in predicting new allegations of abuse or neglect within 12 months of referral. Results indicated feasibility in quantifying severity of maltreatment and other adversities from case record information and revealed associations between adversity severity and CPS allegation types and outcomes. Severity of psychological intimate partner violence and neglect were predictive of new allegations of abuse or neglect within 12 months of referral. Findings support moving beyond an incident-based CPS strategy to one that better incorporates case record information to assess risk.

The Organizational Context of Substantiation in Child Protective Services Cases.

Substantiation of child maltreatment is among the most important decisions made by Child Protective Services and may have wide-reaching implications for child and family well-being. Yet, relatively little research has been undertaken to understand the organizational context of substantiation. Using national population data from the United States, this study examined the associations between state and county contexts with county substantiation rates using multilevel negative binomial regression. The results show that organizational context (policy and practice characteristics) influences substantiation rates. In particular, standards of evidence, alternative options for investigation and disposition of allegations, and workload burden were all significant predictions of substantiation rates. However, the associations of organizational factors and substantiation varied across types of maltreatment allegations; neglect and physical abuse allegations were more heavily influenced by organizational factors than sexual abuse or multi-type maltreatment allegations. Implications for child protection policy and practice are discussed.