Substantiated Maltreatment Reports Research Articles

Child Welfare Outcomes After Attachment and Biobehavioral Catch-Up Intervention Participation: A Quasi-Experimental Study.

Limited research is available examining distal child welfare outcomes after participation in evidence-based parenting interventions. To address this gap, this study employed a multi-tiered analytic approach to examine child welfare outcomes after participation in Attachment and Biobehavioral Catch-up (ABC). Using propensity score analytic techniques to establish a matched comparison group, logistic regressions examined subsequent maltreatment reports and substantiation, and survival analyses observed time to and likelihood of reunification for children who received one of three ABC curriculums compared to comparison group children (child welfare services as usual). In total, 205 children were included in the impact analysis (n = 66 treatment; n = 139 comparison); the majority of the children were White (53.7%), non-Hispanic (84.4%), males (59.5%) with an average age of 6 months (M [SD] = .50 [1.0]). Over half (56.1%) of the study sample was in out-of-home placement; 23.5% of the removed children experienced reunification. No statistically significant group differences were observed on the likelihood of subsequent or substantiated maltreatment reports. All three ABC curriculums were associated with a statistically significant increased likelihood of reunification, when compared to their matched counterpart. Additional research is warranted, though results indicate ABC may be a promising intervention to help enhance the likelihood of reunification.

Trends from 2005 to 2018 in child maltreatment outcomes with caregivers' substance use

BackgroundCaregivers' substance use is associated with child maltreatment. ObjectiveExamine trends from 2005 to 2018 in percentages of three outcomes with caregivers' drug or alcohol use: child protective services (CPS) referrals, substantiated maltreatment reports, and foster care placements. Participants and setting22 U.S. states that contributed child-level maltreatment outcomes and caregivers' substance use data to the National Child Abuse and Neglect Data System from 2005 to 2018. MethodsJoinpoint regression was used to examine the average annual percent change (AAPC) in outcomes with caregivers' drug or alcohol use and to identify temporal changes. ResultsFrom 2005 to 2018, CPS referrals with caregivers' drug use increased (AAPC 2.33, p < .001), while referrals with alcohol use remained unchanged (AAPC -0.11, p = .92) (trend difference p = .04). Substantiated reports with caregivers' drug and alcohol use increased (AAPC drug use 3.63, p < .001, AAPC alcohol use 1.28, p = .03), with a greater increase observed with drug use (difference p = .03). Foster care placements with caregivers' drug use increased (AAPC 2.54, p < .001), while placements with alcohol use did not change (AAPC -1.22, p = .29), (difference p = .005).Within the study period, changes in trends with caregivers' drug use included increased substantiated reports from 2010 to 2018 (p < .001) and increased foster care placements from 2009 to 2018 (p < .001). With caregivers' alcohol use, CPS referrals and foster care placements decreased from 2007 to 2018 (all p < .001). ConclusionsTrends differed for outcomes with caregivers' drug versus alcohol use. Findings can inform policies to improve care for families affected by substance use.

Recurrence of Substantiated Maltreatment Reports between Low-Income Parents With Disabilities and Their Propensity-Score Matched Sample Without Disabilities.

Using the Longitudinal Studies of Child Abuse and Neglect dataset, 127 low-income parents with disabilities and a propensity score matched sample of 254 parents without disabilities were compared for the rates of repeated substantiated child maltreatment allegations and potentially distinct risks for substantiated child maltreatment recurrence. The number of substantiated child maltreatment allegations was not significantly higher for low-income parents with disabilities (M = 1.17, SD = 1.83) than their matched sample (M = .93, SD = 1.44) (t = -1.29, p = .197). Findings from the negative binomial regression indicated that parental disability was also not a significant predictor for repeated substantiated child maltreatment allegations among low-income parents after controlling other risk factors (Exp(B) = 1.16, p < .353). In both groups, black parents were more likely to have repeated substantiated maltreatments than white parents. For parents with disabilities, being an older parent, receiving SNAP benefits, having a daughter, and having a child in continued out-of-home care significantly increased the risk for repeated substantiations while having a GED or higher education degree and living with a larger number of family decreased the risk. For parents without disabilities, family instability was the only additional risk factor for repeated maltreatment substantiations.

Differential Child Maltreatment Risk Across Deployment Periods of US Army Soldiers.

We described the risk for maltreatment among toddlers of US Army soldiers over different deployment cycles to develop a systematic response within the US Army to provide families appropriate supports. We conducted a person-time analysis of substantiated maltreatment reports and medical diagnoses among children of 112,325 deployed US Army soldiers between 2001 and 2007. Risk of maltreatment was elevated after deployment for children of soldiers deployed once but not for children of soldiers deployed twice. During the 6 months after deployment, children of soldiers deployed once had 4.43 substantiated maltreatment reports and 4.96 medical diagnoses per 10,000 child-months. The highest maltreatment rate among children of soldiers deployed twice occurred during the second deployment for substantiated maltreatment (4.83 episodes per 10,000 child-months) and before the first deployment for medical diagnoses of maltreatment (3.78 episodes per 10,000 child-months). We confirmed an elevated risk for child maltreatment during deployment but also found a previously unidentified high-risk period during the 6 months following deployment, indicating elevated stress within families of deployed and returning soldiers. These findings can inform efforts by the military to initiate and standardize support and preparation to families during periods of elevated risk.

CHILD MALTREATMENT IDENTIFICATION AND REPORTING BEHAVIOR OF SCHOOL PSYCHOLOGISTS

A majority of substantiated maltreatment reports are made by educators and thus, teacher knowledge of child maltreatment reporting mandates and reporting behavior has been a focus of research. The knowledge and behavior of school psychologists, however, has not received similar attention. This study investigated the child maltreatment reporting behavior and knowledge of school psychologists. Practicing school psychologists (N = 274) responded to scenarios from the Crenshaw Abuse Reporting Survey—Form S (CARS‐S) that required respondents to recognize reportable child maltreatment and answer factual questions regarding the reporting mandate. A significant correlation was found between school psychologists’ accuracy in deciding whether to report and their overall knowledge of the reporting mandate. Results highlight the knowledge and behavior of school psychologists working in varied settings when presented with cases focused on differing types of maltreatment issues. Practical implications for school psychology practice and training are discussed.

Results from a family finding experiment

Abstract The purpose of this study was to test the effectiveness of family-finding, a child welfare practice approach that provides intensive search and engagement efforts for children in foster care and their families with the objectives of strengthening family connections and permanency. We used an experimental design with randomization to family finding or a control group. The family finding approach was more effective than standard child welfare services in engaging a larger network of family and kin, in facilitating a greater number of family team meetings, and in ensuring that every child in care has at least one supportive emotional connection with an adult. Children receiving family finding were more likely to be adopted by relatives and less likely to age out of care without permanency resolution, but other forms of permanency, number of placement disruptions, and subsequent substantiated maltreatment reports did not differ between groups. As a method for strengthening family connections, the evidence in support of family finding is clear; as a mechanism for physical permanency resolution, mixed results from this experiment indicate a need for further research on family finding for specific permanency outcomes.

Relationship Between Birth Spacing, Child Maltreatment, and Child Behavior and Development Outcomes Among At-Risk Families

Prior research indicates that closely spaced births are associated with poor outcomes for the mother and subsequent child. Limited research has focused on outcomes for the index child (the child born immediately prior to a subsequent child in a birth interval). The objectives are to assess the association of short birth intervals in at-risk families with: (1) indicators of harsh and neglectful parenting behaviors towards the index child, including substantiated maltreatment reports across 6 years; and (2) the index child's behavior and development in first grade. This is a longitudinal study of 658 women screened to be at-risk for child maltreatment. Twenty percent of women had a rapid repeat birth (RRB), defined as the birth of a subsequent child within 24 months of the index child. Generalized estimating equations, survival analyses, and linear and logistic regression models were used to assess the associations between RRB and index child outcomes. Women with an RRB were more likely than those without an RRB to report neglectful parenting of the index child. Children of mothers with an RRB were more likely than children of mothers without an RRB to have more behavioral problems and lower cognitive functioning in first grade. This study is among the first to focus on the associations of birth spacing with maltreatment, behavior and development outcomes in the index child. Future work regarding the effects of birth spacing should include a focus on the index child.

Does Breastfeeding Protect Against Substantiated Child Abuse and Neglect? A 15-Year Cohort Study

We explored whether breastfeeding was protective against maternally perpetrated child maltreatment. A total of 7223 Australian mother-infant pairs were monitored prospectively over 15 years. In 6621 (91.7%) cases, the duration of breastfeeding was analyzed with respect to child maltreatment (including neglect, physical abuse, and emotional abuse), on the basis of substantiated child protection agency reports. Multinomial logistic regression was used to compare no maltreatment with nonmaternal and maternally perpetrated maltreatment and to adjust for confounding in 5890 cases with complete data (81.5%). Potential confounders included sociodemographic factors, pregnancy wantedness, substance abuse during pregnancy, postpartum employment, attitudes regarding infant caregiving, and symptoms of anxiety or depression. Of 512 children with substantiated maltreatment reports, >60% experienced > or =1 episode of maternally perpetrated abuse or neglect (4.3% of the cohort). The odds ratio for maternal maltreatment increased as breastfeeding duration decreased, with the odds of maternal maltreatment for nonbreastfed children being 4.8 times the odds for children breastfed for > or =4 months. After adjustment for confounding, the odds for nonbreastfed infants remained 2.6 times higher, with no association seen between breastfeeding and nonmaternal maltreatment. Maternal neglect was the only maltreatment subtype associated independently with breastfeeding duration. Among other factors, breastfeeding may help to protect against maternally perpetrated child maltreatment, particularly child neglect.

Substantiation and Maltreatment Rereporting

Although it is a widely used indicator, the use of substantiation in child welfare practice and research is not without critics. Much of this criticism concerns the ability of the substantiation disposition to distinguish between child protective services (CPS) investigations in which maltreatment occurs or does not occur. This study examined the relationship between substantiation and maltreatment rereporting using an analytic technique known as propensity score matching (PSM). Children with initially substantiated maltreatment reports were at significantly higher risk for rereporting than those with initially unsubstantiated reports, even after matching the two groups on propensity scores based on several demographic and case characteristics. Although additional study using PSM on other samples is warranted, this evidence supports the predictive validity of the substantiation disposition and its continued use as one factor to consider when allocating limited post-investigation services.

Child Maltreatment and Domestic Violence Editorial: Current State of Knowledge and Emerging Strategies for Policy and Practice

Stress and adversity are an inevitable part of family life, and these are mostly dealt with in ways that are both healthy and resourceful. Few situations, though, are as stressful or provoke more crises within families than domestic violence (DV) and child maltreatment (CM). These social problems, at once separate and intertwined, are all too frequent and debilitating. Lifetime worldwide estimates of the prevalence of physical assault by males against females range between 10 and 69% (Heise, 2002), making intimate partner violence (IPV) one of the most common forms of trauma experienced by women. Estimates of the prevalence of child abuse are more difficult to ascertain and vary by age, but data from North America suggest that 6 per thousand to 22 per thousand children had a confirmed allegation of maltreatment in 2004 (U.S. Department of Health and Human Services Administration for Children and Families, 2006; Trocme et al., 2005; Trocme, in press). However, this is generally considered an underestimate of the actual rate of child maltreatment as most child abuse and neglect likely goes unreported (Trocme, in press). The intersection between child maltreatment and DV is substantial, by any measure reaching into a large number of households. The co-occurrence of DV and child maltreatment may reach as high as 60% (Edleson, 1999) and, when measured as a form of maltreatment as it is in some provinces in Canada, accounts for over one quarter of all substantiated maltreatment reports (Trocme et al., 2005). In addition to the obvious trauma and related difficulties faced by women who are abused, childhood exposure to DV has been associated with elevated levels of psychosocial and behavioral difficulties (Edleson, 1999; Wolfe, Crooks, Lee, McIntyre-Smith, & Jaffe, 2003). There is also reason to believe that children are present in a large proportion of homes where DV occurs and are often witnesses to the violence between their caregivers (Catalano, 2007; Johnson, 2006). Despite the large overlap between child protective services and DV services, the two sectors have traditionally been uncoordinated, reflecting differences in mandates and ideological underpinnings (Edleson, 1999; Hartley, 2004). Inconsistencies and lack of coordination of services at pivotal moments in the lives of families, whether due to misunderstandings between systems or inadequate funding, limits effective treatment and may even escalate the crises faced by families. This special issue is part of an effort to understand this disjuncture, further evaluate the epidemiology of the cooccurrence of DV and childmaltreatment, evaluate new interventions, and propose conceptual, From the University of Toronto and California State University, Los Angeles. Contact author: Aron Shlonsky, University of Toronto. E-mail: aron.shlonsky@utoronto.ca.

Adolescent maltreatment and its impact on young adult antisocial behavior

Statement of problem Childhood maltreatment is known to be a risk factor for a range of later problems, but much less is known about adolescent maltreatment. The present study aims to investigate the impact of adolescent maltreatment on antisocial behavior, while controlling for prior levels of problem behavior as well as sociodemographic characteristics. Methods Data are from the Rochester Youth Development Study, a cohort study of the development of problem behaviors in a sample of 1,000 urban youth followed from age 13 into adulthood. Subjects include 68% African American, 17% Hispanic, and 15% White youth. This analysis includes a maximum of 884 subjects, of whom 9.3% had substantiated maltreatment reports in adolescence. Among the maltreated adolescents, 14 experienced sex abuse, 36 experienced physical abuse, and 32 were neglected or emotionally abused. Outcomes explored in late adolescence (ages 16–18) and young adulthood (ages 20–22) include arrest, self-reported general and violent offending, and illicit drug use. Control variables include prior levels of these outcomes as well as sociodemographic characteristics like poverty, parent education, and caregiver changes. Results Logistic regression analysis determined that experiencing any substantiated maltreatment during adolescence increases the odds of arrest, general and violent offending, and illicit drug use in young adulthood, even controlling for sociodemographic characteristics and prior levels of problem behavior. Different types of adolescent maltreatment, including neglect, appear to produce similar adverse behavioral consequences. Conclusions Adolescent maltreatment necessitates increased attention in view of its enduring and potentially wide-ranging impact on the life span.

Defining maltreatment according to substantiation: distinction without a difference?

Objective: To examine whether children with substantiated maltreatment reports between 4 and 8 years of age differ from children with unsubstantiated reports on any of 10 behavioral and developmental outcomes. Method: Longitudinal data from 806 children and their adult caregivers collected in four US study sites were pooled and analyzed using Analysis of Variance (ANOVA) and multivariate linear regression. Results: There were no significant differences between the mean scores of children with unsubstantiated and substantiated maltreatment reports filed between 4 and 8 years of age for any of the 10 behavioral and developmental outcomes. In the multivariate analysis, substantiation status was not significantly associated with any of the 10 outcomes after adjusting for prior functioning, prior maltreatment status, and sociodemographic characteristics. Findings from within-site analyses were generally consistent with the pooled analyses in finding no association between substantiation status and the outcomes examined. Conclusions: In this high-risk sample, the behavioral and developmental outcomes of 8-year-old children with unsubstantiated and substantiated maltreatment reports filed between ages 4 and 8 were indistinguishable. Future research should attempt to replicate these findings on probability samples that represent the full range of childhood maltreatment risk and with models that control for the impact of social services.

Stress, social support, and substantiated maltreatment in the second and third years of life

Objective: The purpose of this research was to determine whether risk factors for a maltreatment report in the first year of life, especially the interaction of life event stress and social support, persist into the second and third years of life. Method: Predominantly low income mothers who had been interviewed shortly after the birth of infants in a longitudinal cohort were re-interviewed around the infants' first birthdays, and reports to North Carolina's Central Registry of Child Abuse and Neglect were tracked for substantiated maltreatment reports. Results: Variables significantly associated with a substantiated maltreatment report in the second or third year of life ( p < .01) were first year maltreatment reports and participation in Medicaid. Three interactions between a stressful life event indicator variable and a social support indicator variable were significant predictors of substantiated second or third year reports ( p < .05). Conclusions: Even in the presence of significant risk factors from the first year of life, life event stress can increase the risk of a substantiated maltreatment report in the second or third years of life, but social support may moderate the effect of life events.

The reported health and functioning of children maltreated while in family foster care

The ability to assess accurately risk factors for maltreatment while in family foster care is essential for developing prevention and intervention strategies. Yet information about children involved in maltreatment episodes while in foster care is severely limited. This correlational study reports on characteristics, health, and functioning parameters of all 78 children with substantiated maltreatment reports between 1984–1988 in an urban foster care program as compared to a random sample of 229 nonmaltreated children in foster care in the same time period. Almost 50% of the substantiated maltreatment was sexual abuse with the remainder physical abuse and neglect. Problems in health, development, and functioning were reported in the social services record for a large number of all children, but children sexually abused while in care were significantly more likely to have a nonkinship placement, and to have mental health and development problems identified. Physical abuse and neglect while in foster care were not associated with child health and functioning characteristics. The implications of these results are discussed within the context of the data source used.

The Mediating Effect of Good School Performance on the Maltreatment-Delinquency Relationship

This article explores the possibility that good school performance may reduce the elevated risk of delinquency produced by maltreatment. Using a random sample of children with substantiated maltreatment reports (N = 522) and a random comparison sample of the general school population (N = 256), the authors find that neglected and physically abused, but not sexually abused, children are more likely than the general school population to be reported for delinquent acts. Good school performance, specifically good grades, low rates of in-school behavior problems during the elementary years, and good attendance, is associated with substantially reduced delinquent involvement for both at-risk groups. For physically abused children the elevated risk falls to statistically insignificant levels. The findings suggest interventions to raise the grades and attendance and improve the classroom behavior of physically abused and neglected children with the aim of reducing delinquency in these groups.

Current parental stress in maltreating and nonmaltreating families of children with multiple disabilities

Questionnaires were mailed to families of children with multiple disabilities to investigate whether differences in parental perception of stress and burden of care could be identified in those families who had previously been reported and substantiated as abusive or neglectful as compared to those families who had not been so reported. Two hundred and fifty-seven parents completed Friedrich's revised version of Holroyd's Questionnaire on Resources and Stress (QRS-F), an instrument designed to measure stress and burden of care in families of children with disabilities. Twenty-five (9.7%) had previously substantiated maltreatment reports. Results suggest that a history of maltreatment is not related to the family's currently perceived stress levels as measured by the Friedrich scale. Implications of the results are discussed.

Reported maltreatment in children with multiple disabilities

This study examined a population of children with multiple disabilities to investigate whether functional, developmental, or perinatal factors could differentiate children reported and substantiated as maltreated from those not so reported. Data were collected from medical records of a cohort of 500 children evaluated between 1973 and 1984 at the Kennedy Institute in Baltimore, Maryland. Maltreatment reporting was documented through the State of Maryland Abuse Registry and the counties of residence of all study children. Results indicated that the profiles of demographic and family characteristics associated with child maltreatment reporting in this population are consistent with the literature, but child functional and developmental characteristics were not confirmed as risk factors for substantiated maltreatment reports. Indeed, contrary to investigator expectations, the more severely disabled children, in terms of functioning, appeared at less risk of maltreatment than did disabled children functioning at more age-appropriate levels.