From maltreatment report to juvenile incarceration: the role of child welfare services

OBJECTIVE: This study examined whether children who received child welfare services (e.g., in-home or out-of-home placement) were more or less likely to become incarcerated as serious and violent youthful offenders than those children who were investigated as victims of abuse and neglect but received no further child welfare intervention. METHOD: Administrative data on child abuse reporting, foster care, birth records, and juvenile corrections (CYA) were linked to prospectively examine the risk of incarceration as an adolescent following an investigation of abuse or neglect after age 6. The 10 county California sample included 159,549 school-aged children reported for abuse and neglect after 1990. RESULTS: About 8 per 1,000 children in the sample were later incarcerated in CYA. African American and Hispanic children who received in-home or foster care services after the index investigation event had a lower risk of incarceration than those whose cases were closed after the investigation. Among females, the rate of incarceration was highest for those who experienced foster or group care placements. Children initially reported for neglect were more likely to be incarcerated than those reported for physical or sexual abuse. CONCLUSIONS: Public child welfare services have rarely been assessed in terms of future negative child outcomes. This study finds that one serious negative outcome, CYA involvement, can only be understood when a number of factors are considered. The importance of understanding the differences between how different subpopulations respond to services is highlighted. Specifically, our findings suggest that more attention should be focused on children who are now receiving no services after an investigated child abuse and neglect report, on females, and on victims of child neglect.     

Exploring children’s perspectives of engagement with their carers using factor analysis

Positive engagement between a child and carer in out-of-home care is understood to have long-term benefits for children who have experienced abuse or neglect. This study analysed data from the ‘Views of Children and Young People in Foster Care 2009′ survey of 937 children in out-of-home care in Queensland, Australia, to identify factors that supported or hindered engagement between a child and carer. Exploratory and confirmatory factor analysis and structural regression were used. Findings suggest that children’s engagement with their carer is influenced by a range of internal and external factors including child characteristics, the care experience, contact with biological parents, and placement trajectory. Child engagement is important because it is central to positive outcomes such as placement stability in out-of-home care. Implications for policy and practice include the need for a structural response that supports building and maintaining positive child-carer relationships.     

Improving child welfare through a children's ombudsman.

OBJECTIVE: This report examines the changes in a child welfare system created by establishing an ombudsman's office to investigate complaints regarding children in the foster care, adoption, and child protection systems. METHOD: Serving as a complaint office, the Michigan Office of Children's Ombudsman investigated 443 cases involving 820 children during its first 18 months of operation. Information was collected regarding the nature of abuse and system concerns identified in child protective services, foster care, or adoption agencies from across our state. Information was also collected regarding changes in agency practices or procedures or legislation resulting from case investigation. RESULTS: The Children's Ombudsman in Michigan identified 209 cases in which "administrative acts" of child protective services, foster care, or adoption agencies led to real or potential harm to children. Through investigation of these complaints, a number of areas of concern in the child welfare system were identified, resulting in changes in case management, investigation, or service provision. CONCLUSIONS: A children's ombudsman can improve the child welfare system through complaint investigation and identification of system-wide deficiencies on a state-wide level.     

The handicapped child and child abuse

For a group of children with handicaps, growth and development are also affected by abuse or neglect. Our understanding of the problems of the abused, handicapped child emerges from experience with 37 children with cerebral palsy who have been maltreated, coupled with a review of the literature in related areas. We identify the following four problems as crucial to the study of abuse and neglect to the child with handicaps: (1) abuse that causes handicaps, (2) abuse that occurs to the handicapped child, (3) compromises in care that can occur when the handicapped child becomes involved with the medical and legal systems, and (4) arrangements for foster care or other out-of-home placement for the child with handicaps. We conclude that the very systems designed to protect and care for the child often fail, leaving the handicapped child without opportunity to reach developmental potential. In light of our observations, we recommend that the pediatrician not only be aware of the existence of abuse and neglect in the population of handicapped children, but also serve in the dual role of coordinator of services and advocate for these children.     

Characteristics of child abuse in immigrant Korean families and correlates of placement decisions

OBJECTIVE: This study examined the characteristics and patterns of child abuse among immigrant Korean families in Los Angeles and critical variables that contribute to the type of placement made by the child protective services (CPS) system. METHOD: Data were obtained from reviewing and analyzing 170 active Korean case files maintained by the Asian Pacific Unit (APU) of the Los Angeles County Department of Children and Family Services (LAC-DCFS) during July through September, 2001. Logistic regression analysis was employed to examine the odds of children being kept in or removed from the home. RESULTS: Some of the major findings from this study include: (1) immigrant Korean families are more likely to be charged with physical abuse (49.4%) and less likely to be charged with neglect (20.6%) in comparison with all other groups in Los Angeles (13.2% and 27.1%, respectively); (2) the circumstance under which physical abuse occurred most frequently was corporal punishment used by Korean parents with an intention to discipline their children; and (3) the context under which emotional abuse occurred among the Korean families was likely to be children's witnessing domestic violence. In addition, the logistic regression showed that response status, referral source, living arrangement, victim's relationship to perpetrator, and chronicity of abuse were significant in predicting out-of-home placement. CONCLUSIONS: An analysis of Korean child abuse cases reported to child protective service revealed that culture and child rearing practices shaped the patterns of child maltreatment. A culturally sensitive approach is strongly suggested for effective child abuse prevention and intervention services with this group by CPS agencies.     

Disentangling the effect of out-of-home care on child mental health

BackgroundChildren in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the care system on children’s mental health outcomes from the effects of the adverse circumstances that led to their admission to care.ObjectiveThis research investigated the association between care placement and the presence of child mental health problems after controlling for children’s pre-care experiences. It also identified factors associated with mental health problems among children in care.Participants and SettingThe sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159).MethodsThe mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers.ResultsThe odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032).ConclusionsThese findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care.     

The relative safety of paternal,maternal, and traditional foster care placements

When children are placed into foster care the caseworker must give preference to an adult relative, many of whom are grandparents, over an unrelated caregiver. This kinship preference is based in evolutionary biology, which suggests that the imperative to care for a child should be greater for kin versus non-kin. However, not all kin are related to a child in the same way, and level of paternity uncertainty may influence level of care provided. For instance, maternal grandparents can be assured that they share genetic material with their grandchild, while paternal grandparents may not have the same level of certainty. Owing to the possibility of paternity uncertainty, we hypothesize that out-of-home placements with paternal grandparents will be at a greater risk of subsequent investigations than placements with maternal grandparents or with foster parents. We secured data on placements n = 560 of children ages 1.5 to 17 following a maltreatment investigation from a merger of the National Survey of Child and Adolescent Well-Being NSCAW II and the National Child Abuse and Neglect Data System NCANDS. Kaplan-Meier and multivariate Cox regression were used to examine the difference in time to the first new investigation by type of out-of-home placement while controlling for covariates. Consistent with our hypothesis, placements with paternal grandparents were at a higher risk of a subsequent investigations than placements with maternal grandparents or non-kin foster parents. Results suggest a need for further considerations of child safety in foster care based on genetic relatedness of caregivers.     

The adoption of children from out-of-home care: The understandings of key decision makers in Victoria,Australia

Adoption is one of a range of options that can provide children in out-of-home care with permanency when they are unable to be reunified with their birth parents. This paper reports on how the adoption of children from out-of-home care is understood by professionals involved in making decisions about the permanent placement of children in out-of-home care in Victoria, Australia, where adoption is rarely used. Data were collected through a single, face-to-face semi-structured interview with 21 professionals; eight child welfare specialists, eight adoption and permanent care specialists and five judicial officers. The adoption of children from out-of-home care was primarily understood as a child-centered practice that can afford children stability and a sense of belonging. Adoption was largely viewed as a voluntary process dependent upon the consent of a child’s birth parents. Adoption and permanent care specialists were the only group to refer to the dispensation of parental consent as a means of obtaining an adoption order. Most decision makers understood that contact between children and their birth parents is possible following adoption, but this was not understood by all judicial officers or all child welfare specialists. Children’s connection to their cultural heritage was viewed as important to the consideration of adoption for children in out-of-home care. This research provides insight into the foundations upon which decision makers may appraise adoption, within a hierarchy of options, as a potential outcome for children in need of permanency.     

Progress and issues in the implementation of the 1984 out-of-home care protection amendment.

The purpose of this paper is to assess the status of implementation of out-of-home protection programs since 1984 in the U.S. Data was obtained from a survey of state child protection services (CPS) liaisons in summer, 1989. A framework for viewing protection after placement is presented and the development of policy regarding maltreatment in out-of-home care is traced from its roots in the deinstitutionalization movement. Changes in state statutes and rules, results in out-of-home abuse and neglect reporting, how states operationalize "properly constituted authority" and "independent investigation," the role of licensing in preventing and remediating out-of-home maltreatment, training initiatives and the extent of the use of background checks are reported. A summary evaluation of the status of the implementation of the federal 1984 out-of-home care protection amendments by state agencies is offered.     

Hospital-based multidisciplinary teams can prevent unnecessary child abuse reports and out-of-home placements

OBJECTIVE: To determine how often and for what reasons a hospital-based multidisciplinary child abuse team concluded that a report of alleged or suspected child abuse was unnecessary in young children with fractures. METHODS: A retrospective review was completed of all children less than 12 months of age who, because of fractures, were referred to the hospital multidisciplinary child abuse team for consultation regarding the need to consider child abuse. RESULTS: The team received 99 consultations, reported 92 (93%) children as alleged or possible victims of physical abuse, and did not report 7 (7%). Age at presentation of those who were reported was 4.2 months compared to 3.0 months in the non-reported group. The average number of fractures in the reported group was 2.9 (SD 3.53) compared to 3.4 (SD 4.6) in the non-reported group. Factors that led to cases not being reported included: (a) a trauma history consistent with the fracture (n=4), (b) a diagnosis of bone fragility secondary to genetic, nutritional or medical therapy etiologies (n=2), and (c) iatrogenic fracture (n=1). CONCLUSIONS: Seven percent of the children less than 12 months of age and with at least one fracture referred to the multidisciplinary team for evaluation of possible child abuse were not reported as alleged or suspected physical abuse. The involvement of the hospital multidisciplinary child abuse team may have prevented unnecessary investigation by the county social services agency and/or police, and possible out-of-home temporary placement.     

Children with behavioral, non-behavioral, and multiple disabilities, and the risk of out-of-home placement disruption

Objective

This study examined the relative risk of placement disruption for 3-10 year-old children placed in out-of-home care based on the biological relatedness of the placement caregiver and child disability status: no disability, a non-behavioral disability only, a behavioral disability only, or both a non-behavioral and behavioral disability.

Methods

Data were used from the baseline and 36 month follow-up of the National Survey of Child and Adolescent Well-Being, a national probability study of children investigated for child abuse and neglect in the United States. Disability status was derived using several different nationally-normed measures of language development, daily-living skills, social skills, and behavioral problems.

Results

Around 1 in 4 children placed in out-of-home care experienced a disruption. Placement with kin decreased the likelihood of disruption for a majority of children, and children with different types of disabilities were no more or less likely to disrupt in kinship care compared to children with no disability. Older children with a behavioral disability only or both a non-behavioral and behavioral disability were more likely to disrupt compared to younger regardless of placement.

Conclusion

The study findings suggest that maltreated children placed with kin will be afforded the same stability provided to children without a disability.     

Child welfare outcomes for youth in care as a result of parental death or parental incarceration

Every day, in the United States, children are removed from their homes and placed into state supervised out-of-home care because of concerns around their safety. These children enter care as a result of child abuse, child neglect, abandonment or some other reasons. Lost in most discussions of out-of-home care is the role that parental incarceration and parental death have on the trajectory of children through the child welfare system. In order to address this gap in the literature, the present study aims to compare youth in foster care as a result of parental death or youth in foster care as a result of parental incarceration with youth in care because of child maltreatment in terms of the length of time to achieve permanency. Holding all other variables constant, entering care as a result of parental death more than doubled the average time to exit (HR = 2.32, SE = 0.22), and these youth were significantly less likely to exit to permanency when compared to children entering care for other maltreatment reasons (OR = 0.35, SE = 0.24). Entering care as a result of parental incarceration led to a 24% longer time to exit (HR = 1.24, SE = 0.09) compared to children entering care for other maltreatment reasons. Findings suggest that a one-size-fits-all approach to policy and practice may not be useful to identifying permanent placements for children entering care as a result of parental death or incarceration.     

The impacts of institutional child sexual abuse: A rapid review of the evidence

While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.     

Child welfare services involvement among the children of young parents in foster care

Despite the high rate of early parenthood among youth in foster care as well as the increased risk of child maltreatment among children whose adolescent parents have been neglected or abused, very little is known about child welfare services involvement among children whose parents were in foster care when they were born. This study uses administrative data from the Illinois Department of Children and Family Services (DCFS) to examine the occurrence of child abuse and neglect investigations, indicated reports and out of home care placements among the children of youth in foster. Thirty-nine percent of the children were the subject of at least one CPS investigation, 17 percent had at least one indicated report and 11 percent were placed in out of home care at least once before their 5th birthday. Cox proportional hazard models are also estimated to identify characteristics of parenting foster youth and their placement histories associated with the risk of child welfare services involvement. Implications of the findings for policy and practice are discussed.     

Predicting re-involvement for children adopted out of a public child welfare system

Some of the approximately 400,000 children currently placed out-of-home in a public child welfare system will not reunify with their family of origin. They may instead be adopted into a new family. Adoption placements can be characterized by poor adjustment for children; some such placements even result in disruption or dissolution. We conducted a stratified Cox regression of 4,016 children from the Colorado public child welfare system. All of the children had a finalized adoption during the years 2002 through 2006. The two outcomes analyzed were new child protection and youth-in-conflict referrals and assessments for these previously adopted children. New child welfare referrals and assessments may be early indicators of poor adjustment for adopted children within the adoptive family. Study results indicate that older children and Hispanic children had higher rates of referral and assessment. Children with a pre-adoption history including longer time out-of-home or a larger number of out-of-home placements also experienced higher referral and assessment rates. Additional factors which predicted subsequent system re-involvement included presence of paid adoption assistance, adoption by a non-relative foster parent and younger adoptive parent age. Several study results were moderated by the presence or absence of an ethnic match between the child and the adoptive parents. We provide an overview of the statistical model used for analysis and we discuss implications of the study results for child welfare practice.     

The impact of childhood foster care and other out-of-home placement on homeless women and their children

OBJECTIVE: This study compares homeless women who had childhood histories of foster care or other out-of-home placement to those who have not. METHOD: A countywide probability sample of homeless women (n = 179) received structured interviews. RESULTS: One-third of homeless women reported being raised apart from their parents. Among women with children under age 18, most (61.5%) had children who had lived in foster care or other out-of-home placements. Variables associated with homeless mothers' children living in foster care or other out-of-home placements were: Child was school-age, mother was age 35 or older, mother had a current alcohol or drug use disorder, mother experienced childhood sexual abuse, and mother ran away from home (when under age 18). CONCLUSIONS: Parenting is difficult for homeless mothers who may need to place their children with others to facilitate school attendance. Parent-child interaction may be problematic in family shelters where privacy is rare. Thus, programs promoting family preservation for homeless mothers should provide parenting support as well as permanent housing.     

Contextual and individual-level predictors of abused children's reentry into out-of-home care: a multilevel mixture survival analysis

Objectives

This study examined the effects of individual and contextual factors on reentry into out-of-home care among children who were discharged from child protective services in fiscal year 2004-2005. The objectives were to: (1) examine individual and contextual factors associated with reentry, (2) explore whether there are meaningful groups of youth who differ in terms of risk for reentry, and (3) determine whether relatively homogeneous clusters of child welfare agencies, based on contextual characteristics, differ significantly in terms of the reentry rates of the children whom they serve.

Method

The study design involved a multilevel longitudinal analysis of administrative data based on an exit cohort. Two Cox proportional hazards multilevel mixture models were tested. The first model included multiple individual level predictors and no agency level predictors. The second model included both levels of predictors.

Results

The results of multilevel Cox regression mixture modeling indicated that at the individual level, younger age, being placed in out-of-home care because of neglect and having physical, health problems corresponded to a decreased likelihood for reentry. At the agency level, lower average expenditures per child and contracting out case management services were associated with faster reentry into out-of-home care.

Conclusions

This study demonstrates that children who reenter out-of-home care appear to be a homogeneous population and that reentry is associated with both contextual factors and individual characteristics.

Practice implications

The most important implication that can be drawn from the study findings is that reentry may be most effectively prevented by focusing on such factors at the organizational level as contracting out case management services and funding allocation. Child welfare agencies that are responsible for an array of services and decide to contract out case management should consider the use of performance-based contracts and emphasize and strengthen quality assurance approaches for contracted services. In addition, to compensate for lower funding allocated for children served in out-of-home care, child welfare workers should become more familiar with community resources and help connect families to these supports.     

Infant removals: The need to address the over-representation of Aboriginal infants and community concerns of another ‘stolen generation’

ObjectivesThe removal of a child from their parents is traumatising, particularly in Aboriginal communities where a history of child removals has led to intergenerational trauma. This study will determine where disparities in child protection involvement exist among Aboriginal and non-Aboriginal children and characteristics associated with infant removals. Challenges faced by child protection and other agencies, and opportunities for overcoming these, are discussed.MethodsData from both the Australian Institute of Health and Welfare and linked Western Australian government data was used to examine disparities between Aboriginal and non-Aboriginal children in the child protection and out-of-home care system.ResultsNationally, Aboriginal children are ten times more likely to be placed in out-of-home care than non-Aboriginal children and this disparity starts in infancy. Infants were removed from parents with high levels of risk. Aboriginal infants were at increased risk of being removed from women with substance-use problems and had greater proportions removed from remote, disadvantaged communities than were non-Aboriginal infants.ConclusionsAboriginal infants have a high rate of removal. Although there are many complexities to be understood and challenges to overcome, there are also potential strategies. The disparity between Aboriginal and non-Aboriginal infant removals needs to be seen as a priority requiring urgent action to prevent further intergenerational trauma.     

Parental cognitive impairment and child maltreatment in Canada

Objectives

The aim of this study was to determine the prevalence of parental cognitive impairment in cases opened for child maltreatment investigation in Canada, and to examine the relationship between parental cognitive impairment and maltreatment investigation outcomes including substantiation, case disposition and court application.

Methods

The method was secondary analysis of the Canadian Incidence Study of Child Abuse and Neglect (CIS-2003) core-data, which is derived from a multi-stage stratified cluster sample of 11,562 child maltreatment investigations.

Results

Parental cognitive impairment was noted in 10.1% of sampled cases that were opened for child maltreatment investigation in 2003, and in 27.3% of sampled cases that resulted in child welfare court application. Neglect was the most common cause of concern. With child and case characteristics held constant, parental cognitive impairment predicted investigation outcomes. The data further suggest that the relationship between parental cognitive impairment and investigation outcomes was partially mediated by perceived parent non-cooperation, mental health issues and low social support.

Conclusions

The number of children who are living with a parent with cognitive impairment and who are referred for protective services is thought to be increasing. Building systems capacity to support parents with cognitive impairment and promote child wellbeing is therefore essential to containing the human and economic costs of maltreatment and out-of-home care.

Practice implications

A broad-spectrum approach is needed to support parents with cognitive impairment and their children. Equipping services with the knowledge, skills, and mandate they need to deliver evidence-based parent training is vital. However, strategies are also needed to tackle discrimination, alleviate family poverty, strengthen the social ties of parents with cognitive impairment and in turn, improve the life chances of their children.     

Physical abuse in children under two: a study of therapeutic outcomes

This study of physical abuse to children under the age of 2 addresses the prognosis of the family, compliance with treatment recommendations and the long term outcome of the child. Data were collected from a multidisciplinary evaluation team and from the Department of Human Services' records on 71 children. Nearly all families were referred for mental health counseling and parent training, but only 33% complied. Half of the children were abused more than once; 30% were abused after referral for counseling. The incidence of reabuse was unrelated to compliance with counseling. The majority of children had some out-of-home placement with a mean time in foster care of 11 months and in care of relatives for 24.4 months. In 69% of families, more than one child was abused. At the time of follow-up, 41% of children and 47% of siblings were not living with either parent. Half of the families were judged to be functioning poorly and only nine had made good progress in counseling.