Barbara Fallon

Methodological Challenges in Measuring Child Maltreatment.

OBJECTIVE This article reviewed the different surveillance systems used to monitor the extent of reported child maltreatment in North America. METHODS Key measurement and definitional differences between the surveillance systems are detailed and their potential impact on the measurement of the rate of victimization. The infrastructure requirements, quality of information, timely access to data and the usefulness for child welfare policy are compared and contrasted and a summary table of the type of information by each system is presented. RESULTS Two studies collect data regarding the extent and nature of child maltreatment using survey methodology reported to professionals: the United States National Incidence Study of Child Abuse and Neglect (NIS) and the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS), and the United States National Child Abuse and Neglect Data System (NCANDS) uses administrative data methods to collect annual case-level and state data. PRACTICE IMPLICATIONS The purpose of this comparison is to assist researchers and policy analysts with interpreting data from these studies as well as to help officials from other countries in developing surveillance systems that are appropriately adapted to their needs.

Placement decisions and disparities among aboriginal groups: An application of the decision making ecology through multi-level analysis

OBJECTIVE This paper examined the relative influence of clinical and organizational characteristics on the decision to place a child in out-of-home care at the conclusion of a child maltreatment investigation. It tested the hypothesis that extraneous factors, specifically, organizational characteristics, impact the decision to place a child in out-of-home care. A secondary aim was to identify possible decision making influences related to disparities in placement decisions tied to Aboriginal children. Research suggests that the Aboriginal status of the child and structural risk factors affecting the family, such as poverty and poor housing, substantially account for this overrepresentation. METHODS The decision to place a child in out-of-home care was examined using data from the Canadian Incidence Study of Reported Child Abuse and Neglect. This child welfare dataset collected information about the results of nearly 5,000 child maltreatment investigations as well as a description of the characteristics of the workers and organization responsible for conducting those investigations. Multi-level statistical models were developed using MPlus software, which can accommodate dichotomous outcome variables, which are more reflective of decision making in child welfare. MPlus allows the specific case of the logistic link function for binary outcome variables under maximum likelihood estimation. RESULTS Final models revealed the importance of the number of Aboriginal reports to an organization as a key second level predictor of the placement decision. It is the only second level factor that remains in the final model. This finding was very stable when tested over several different levels of proportionate caseload representation ranging from greater than 50% to 20% of the caseload. CONCLUSIONS Disparities among Aboriginal children in child welfare decision making were identified at the agency level. PRACTICE IMPLICATIONS The study provides additional evidence supporting the possibility that one source of overrepresentation of Aboriginal children in the Canadian foster care system is a lack of appropriate resources at the agency or community level.

The Canadian child welfare system response to exposure to domestic violence investigations

OBJECTIVE While child welfare policy and legislation reflects that children who are exposed to domestic violence are in need of protection because they are at risk of emotional and physical harm, little is known about the profile of families and children identified to the child welfare system and the systems response. The objective of this study was to examine the child welfare systems response to child maltreatment investigations substantiated for exposure to domestic violence (EDV). METHODS This study is based on a secondary analysis of data collected in the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003). Bivariate analyses were conducted on substantiated investigations. A binary logistic regression was also conducted to attempt to predict child welfare placements for investigations involving EDV. RESULTS What emerges from this study is that the child welfare systems response to EDV largely depends on whether it occurs in isolation or with another substantiated form of child maltreatment. For example, children involved in substantiated investigations that involve EDV with another form of substantiated maltreatment are almost four times more likely than investigations involving only EDV to be placed in a child welfare setting (Adjusted Odds Ratio=3.87, p<.001). CONCLUSIONS These findings suggest that the involvement of child welfare has not resulted in the widespread placement of children exposed to domestic violence. The Canadian child welfare system is substantiating EDV at a high rate but is concluding that these families do not require child protection services. PRACTICE IMPLICATIONS There is debate in the literature about how the child welfare sector should respond to cases involving exposure to domestic violence. Contrary to conventional wisdom, this study finds that children who are the subject of investigations involving substantiated exposure to domestic violence are less likely to be removed from their home than children experiencing other forms of maltreatment. Strategies need to be developed to counter misperceptions about the intrusiveness of child welfare, and discussions need to take place about when it is appropriate for child welfare to become involved when children are exposed to domestic violence.

Differentiating Between Substantiated, Suspected, and Unsubstantiated Maltreatment in Canada

The decision to substantiate is a key factor in determining eligibility for services and decisions to press criminal charges or to remove a child, and it is frequently the basis for selecting samples of maltreated children or to measure recidivism or intervention effectiveness. Although there is a growing body of research on case substantiation in the United States, few studies have examined this decision in other jurisdictions. Using data from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect, this study examines the profiles of a national sample of 10,010 investigations. Multivariate analyses reveal that substantiation decisions are generally made in a fashion that is relatively consistent with the clinical characteristics of cases. Along with severity of harm, parent risk factors, and housing risk factors, police referrals are among the most important predictors of case substantiation. Cases involving multiple forms of maltreatment are also more likely to be substantiated.

Placement Decisions and Disparities among Aboriginal Children: Further Analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect Part A: Comparisons of the 1998 and 2003 Surveys.

OBJECTIVE Fluke et al. (2010) analyzed Canadian Incidence Study on Reported Child Abuse and Neglect (CIS) data collected in 1998 to explore the influence of clinical and organizational characteristics on the decision to place Aboriginal children in an out-of-home placement at the conclusion of a child maltreatment investigation. This study explores this same question using CIS data collected in 2003 which included a larger sample of Aboriginal children and First Nations child and family service agencies. METHODS The decision to place a child in an out-of-home placement was examined using data from the Canadian Incidence Study of Reported Child Abuse and Neglect-2003 and a reanalysis of CIS-1998 data (Fluke et al., 2010). The CIS-2003 dataset includes information on nearly 12,000 child maltreatment investigations from the time of report to case disposition. The CIS-2003 also captures information on the characteristics of investigating workers and the child welfare organizations for which they work. Multi-level statistical models were developed to analyze the influence of clinical and organizational variables using MPlus software. MPlus allows the use of dichotomous outcome variables, which are more reflective of decision-making in child welfare and facilitates the specific case of the logistic link function for binary outcome variables under maximum likelihood estimation. RESULTS Final models revealed the proportion of investigations conducted by the child welfare agency involving Aboriginal children was a key single agency level predictor of the placement decision. Specifically, the higher the proportion of investigations of Aboriginal children, the more likely placement was to occur. Contrary to the findings in the first paper (Fluke et al., 2010), individual Aboriginal status also remained significant in the final model at the first level. CONCLUSIONS Further analysis needs to be conducted to further understand individual and organizational level variables that may influence decisions regarding placement of Aboriginal children. There is also a need for research that is sensitive to differences among, and between, Métis, First Nations and Inuit communities. Results are not generalizable to Québec because data from this province were excluded.

Emotional maltreatment in Canada: Prevalence, reporting and child welfare responses (CIS2)

OBJECTIVES To determine the prevalence and characteristics of reports of emotional maltreatment (EMT) in Canada, as well as changes in these reports between 1998 and 2003. METHODS This study is based on a secondary analysis of data collected in the first and second Canadian Incidence Study. Emotional maltreatment (excluding exposure to intimate partner violence) investigations were categorized into six groups: emotional abuse, emotional neglect, and other maltreatment as the only investigated form of maltreatment, and these same three groups were examined when they co-occurred with another form of maltreatment. RESULTS Both the rate of emotional-abuse-only investigations and emotional-neglect-only investigations increased almost threefold from 1998 to 2003. Substantiated emotional neglect investigations had the highest rate of transfer to ongoing services. Half of the investigations involving single forms of emotional maltreatment occurred for six months or more. Finally, emotional neglect cases (in single form and when it co-occurs with another form of maltreatment) were more likely to be associated with emotional harm and longer duration of maltreatment. CONCLUSIONS In 2003, EMT represented a significant increasing form of maltreatment and is detected nearly twice as often in situations in which abuse or neglect are also reported. Reports of emotional abuse are two and a half times more frequent than reports of emotional neglect. Nevertheless, lack of emotional engagement may also be difficult to identify, since an omission is more difficult to detect. Reports of EMT often reveal situations of chronic victimization that have been the subject of previous reports and are associated with greater emotional impact.

Should child protection services respond differently to maltreatment, risk of maltreatment, and risk of harm?

OBJECTIVE To examine evidence available in large-scale North American datasets on child abuse and neglect that can assist in understanding the complexities of child protection case classifications. METHODS A review of child abuse and neglect data from large North American epidemiological studies including the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS), the National Child Abuse and Neglect Data System (NCANDS), and the National Incidence Studies of Reported Child Abuse and Neglect (NIS). RESULTS The authors of this paper argue that recent evidence from large North American epidemiological studies examining the incidence of child abuse and neglect demonstrate that children and families identified as being at risk of maltreatment present with as many household and caregiver concerns as investigations that are substantiated. CONCLUSIONS In order to continue to develop appropriate services and policies for vulnerable children the authors urge continue definitional clarity for research in child maltreatment that considers the exemplars or indicators of categories, in tandem with parental and child characteristics which can provide one source of evidence-basis to meaningful child protection case classifications. Continued monitoring, refined by the dilemmas faced in practice, are critical for a continued public health investment in childrens well-being, predicated upon upholding childrens rights.

Shifting definitions of emotional maltreatment: an analysis child welfare investigation laws and practices in Canada.

OBJECTIVE Although there is growing evidence that the emotional dimensions of child maltreatment are particularly damaging, the feasibility and appropriateness of including emotional maltreatment (EM) in child welfare statutes continues to be questioned. Unlike physical and sexual abuse where investigations focus on discreet incidents of maltreatment, EM is not as easily defined and delimited. Through a review of legislation and child welfare investigation practices in Canada, this paper examines (1) whether Canadian child welfare services respond to EM with the same level of perseverance as with other forms of maltreatment and (2) the extent to which the introduction in 2008 of a more specific EM taxonomy distinguishes between EM and family problems that could lead to EM. METHOD Following an analysis of the legislative framework for EM across Canada, investigations practices in Canada are examined using data from the 1998, 2003 and 2008 cycles of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS). Using data from the 2008 cycle, EM investigations are compared to other maltreatment investigations for all of Canada (N=15,980). Changes in EM investigations over time are then compared using data from the three cycles of the study, excluding Québec because of limited data availability in 2003 (N=5,360 in 1998, 11,562 in 2003 and 14,050 in 2008). RESULTS EM is included as a form of reportable maltreatment in all provincial and territorial statutes in Canada. Over 11,000 cases of EM were substantiated in Canada in 2008, at a rate of 1.86 cases per 1,000 children. While EM investigations were substantiated at a lower rate as other forms of maltreatment, a higher proportion of EM cases were referred for specialized services, kept open for on-going child welfare services, lead to an out of home placement, and lead to an application to child welfare court. Using a broad definition of EM the number of investigations classified as EM in Canada, excluding Québec, nearly tripled from 1998 to 2003. In 2008, using more specific definitions focusing on caregiver definitions, the number of investigations classified as EM nearly returned to their 1998 level, with nearly twice as many cases being classified as risk of future maltreatment. CONCLUSION EM is a well established category for child welfare intervention in Canada, however, more emphasis should be given to distinguishing between EM and family problems that place children at risk of EM.

Characteristics of Young Parents Investigated and Opened for Ongoing Services in Child Welfare

This study uses a national child welfare dataset to examine the profile of young parents who are the subject of maltreatment-related investigation and to identify which factors determine service provision from the child welfare system at the conclusion of the investigation. Specifically, it examines how workers in the child welfare system decide which young parents require ongoing services the conclusion of a maltreatment related investigation where other risk factors are also being assessed. It found that young parents are struggling with a number of issues including poverty, housing, mental health, violence and children who are exhibiting functioning concerns. Workers in the child welfare system provide ongoing services to young parents particularly in investigations where they have noted concerns around drug/solvent use, cognitive impairment, mental health issues, physical health issues and few social supports. The opportunity to target interventions for the specific concerns for this very vulnerable population is evident.

Differentiating between child protection and family support in the Canadian child welfare system's response to intimate partner violence, corporal punishment, and child neglect

Rates of reported child maltreatment nearly doubled in Canada over the period 1998-2003, an increase that reflects growing awareness of the harmful effects of an expanding array of parental behaviors, including corporal punishment, lack of supervision, and exposure to intimate partner violence (IPV). Some of these situations may benefit from voluntary family support programs outside of the child welfare system. Analyzing a sample of 11,807 investigations, this paper compares cases where the sole concern is exposure to IPV, or hitting a child, or neglect, or other forms of investigated maltreatment. Situations where exposure to IPV or potentially abusive hitting were the sole reason for investigation presented with fewer risk factors and were less likely to lead to ongoing child welfare interventions compared to other maltreatment investigations. While situations involving alleged neglect presented a higher risk profile and elicited a more intensive child welfare response than did exposure to IPV or hitting, opportunities for alternative services were nevertheless identified. The study also found that visible minority families were overrepresented in cases involving hitting and that Aboriginal families were overrepresented in cases involving neglect. Overall the findings support the development of alternative response programs in Canada.