John D. Fluke

Longitudinal analysis of repeated child abuse reporting and victimization: multistate analysis of associated factors

Most child subjects of maltreatment reports to child protective services (CPS) are involved just once, whereas other children experience repeated investigations and victimizations. This study examines individual, maltreatment, and service-related factors associated with maltreatment rereporting and substantiated rereporting in a multistate context. Case-level National Child Abuse and Neglect Data System data (505,621 children) were analyzed. Within 24 months, 22% of children were rereported, and 7% were rereported with substantiation. Younger and White and mixed race children, those with disabilities, and those whose caregivers abused alcohol were more likely to be rereported and rereported and substantiated. Service provision, including foster care placement, was associated with increased likelihood of subsequent events. When CPS agency performance is assessed using measures of reentry, separate measures may be necessary for children who receive services, so that improvements in safety can be appropriately recognized. Reentry into CPS is a complex interaction of risks to children and systemic factors tied to the intervention they receive.

The decision making ecology of placing a child into foster care: a structural equation model

The Decision Making Ecology provided a framework for empirically testing the impact of Case, Caseworker and Organizational factors on the decision to place children in out-of-home care. The structural equation model we developed fit the data extremely well, indicating a complex relationship between the variables. The main findings indicate that Case factors, even as aggregated to the worker level, were of most importance: Percent Removed was increased in part by greater average Risk being assessed and more families on a workers caseload being Low Income. Furthermore, removal rates were increased by lower proportions of Hispanic families on the caseload, as well as lower organizational support, and a perception of manageable workload and sufficient resources. Individual factors, i.e., variables characterizing the caseworkers themselves, were not found to directly influence the placement decision, including workers own race/ethnicity, though various orders of mediated effects were indicated, and these are detailed. Interrelationships between variables that affect case, caseworker and organizational factors are discussed along with implications for practice.

Systems, strategies, and interventions for sustainable long-term care and protection of children with a history of living outside of family care☆

OBJECTIVESnThis article reviews the available evidence regarding the efficacy, effectiveness, ethics, and sustainability of approaches to strengthen systems to care for and protect children living outside family care in low- and middle-income countries.nnnMETHODnFor trafficked children, children of and on the street, children of conflict/disaster, and institutionalized children, a systems framework approach was used to organize the topic of sustainable approaches in low- and middle-income countries and addresses the following: legislation, policies, and regulations; system structures and functions (formal and informal); and continuum of care and services. The article draws on the findings of a focal group convened by the U.S. Government Evidence Summit: Protecting Children Outside of Family Care (December 12-13, 2011, Washington, DC), tasked with reviewing the literature on systems, strategies, and interventions for sustainable long-term care and protection of children with a history of living outside of family care in low- and middle-income country contexts. The specific methodology for the review is described in the commentary paper (Higgs, Zlidar, & Balster, 2012) that accompanies these papers.nnnRESULTSnFor the most part, the evidence base in support of sustainable long-term care for the populations of interest is relatively weak, with some stronger but unreplicated studies. Some populations have been studied more thoroughly than others, and there are many gaps. Most of the existing studies identify population characteristics, needs, and consequences of a lack of systemic services to promote family-like care. There is some evidence of the effectiveness of laws and policies, as well as some evidence of service effectiveness, in improving outcomes for children outside of family care.nnnCONCLUSIONSnDespite the weaknesses and gaps of the existing research, there is a foundation of research for going forward, which should focus on developing and implementing systems for these most vulnerable children. The evidence reviewed indicates that child protection systems should aim for appropriate, permanent family care (including reunification, adoption, kinship care, or kafalah) for children in order to secure the best environment for a childs developmental prospects. Evidence also suggests that the quality and duration of care, including both permanent family care and alternative care, are important regardless of setting. The diversity of political, socioeconomic, historical, regional, community, and cultural contexts in which child protection systems operate need to be taken into account during programming and research design.

Reducing Recurrence in Child Protective Services: Impact of a Targeted Safety Protocol

Statewide implementation of a child safety assessment protocol by the Illinois Department of Children and Family Services (DCFS) in 1995 is assessed to determine its impact on near-term recurrence of child maltreatment. Literature on the use of risk and safety assessment as a decision-making tool supports the DCFSs approach. The literature on the use of recurrence as a summative measure for evaluation is described. Survival analysis is used with an administrative data set of 400,000 children reported to DCFS between October 1994 and November 1997. An ex-post facto design tests the hypothesis that the use of the protocol cannot be ruled out as an explanation for the observed decline in recurrence following implementation. Several alternative hypotheses are tested: change in use of protective custody, other concurrent changes in state policy, and the concurrent experience of other states. The impact of the protocol to reduce recurrence was not ruled out.

Development of an instrument to understand the child protective services decision-making process, with a focus on placement decisions.

When children come to the attention of the child welfare system, they become involved in a decision-making process in which decisions are made that have a significant effect on their future and well-being. The decision to remove children from their families is particularly complex; yet surprisingly little is understood about this decision-making process. This paper presents the results of a study to develop an instrument to explore, at the caseworker level, the context of the removal decision, with the objective of understanding the influence of the individual and organizational factors on this decision, drawing from the Decision Making Ecology as the underlying rationale for obtaining the measures. The instrument was based on the development of decision-making scales used in prior decision-making studies and administered to child protection caseworkers in several states. Analyses included reliability analyses, principal components analyses, and inter-correlations among the resulting scales. For one scale regarding removal decisions, a principal components analysis resulted in the extraction of two components, jointly identified as caseworkers decision-making orientation, described as (1) an internal reference to decision-making and (2) an external reference to decision-making. Reliability analyses demonstrated acceptable to high internal consistency for 9 of the 11 scales. Full details of the reliability analyses, principal components analyses, and inter-correlations among the seven scales are discussed, along with implications for practice and the utility of this instrument to support the understanding of decision-making in child welfare.

The influence of differential response and other factors on parent perceptions of child protection involvement

As Child Protective Services (CPS) agencies examine how to produce better outcomes with the families they serve, child welfare literature has increasingly focused on the perspectives, emotional responses, and engagement of CPS-involved parents or other primary caregivers. Despite this encouraging trend, the construct of engagement is ill-defined and our understanding of precursors to and factors affecting parent engagement is limited. This article extends the literature by presenting a conceptual framework for examining engagement and associating the identified constructs with parent outcomes. Using data from a survey of parents who were randomly assigned to receive either an assessment response (AR) or investigation response (IR) in two states Differential Response CPS systems, a factor analysis on 12 commonly assessed emotional responses reported by parents indicated that parents responded with three primary emotions: positive affect, worry, or anger and that these responses varied by their receipt of AR or IR. Further, the results of multivariate analyses indicate that pathway assignment (AR or IR), parents assessments of the quality of the casework they received, and other parent or household factors contribute to differences observed on the three emotional response factors identified.

Decisions to Protect Children: A Decision Making Ecology

Decisions in child protection and child welfare, for example removal decisions, are made under uncertainty. This chapter provides an overview of decision making theory and research focused on improving decision making in child welfare, and the limitations of our current approaches. The framework developed in the chapter, The Decision Making Ecology (DME) and General Assessment and Decision Making (GADM) model considers child welfare decisions to be a function of case (e.g., type and severity of maltreatment, risk, poverty), decision maker (e.g., experience, values), organizational (e.g., policy, workload, resources), and external characteristics (e.g., critical events, funding). Research has shown that although workers attend to case information similarly to arrive at an assessment, the factors determining their willingness to take action vary; the General Assessment and Decision Making (GADM). Workers, supervisors, administrators, and judges reach individual decision thresholds where assessment information resulting in action in combination with competing views of consequences, including disparities. The chapter concludes with applications of the framework and prospects for improving decision making.

Protecting children outside of family care in low and middle income countries: What does the evidence say?

Some of the most vulnerable children in the world are those living outside of family care – children without families to look after them; left in dysfunctional institutions or alone on the streets; victims of sex trafficking or pornography; trafficked for forced labour, or recruited for armed conflict.

Child protective services rereporting and recurrence--context and considerations regarding research

Measures of repeated involvement of children and families in the child protection system have been consistently recognized as indicators used to evaluate the performance of Child Protective Services (CPS) agencies in the US. Foremost among these uses, the US Children’s Bureau continues to include child maltreatment recurrence as one of the indicators it employs for the Child and Family Service Review (CSFR) process under the Adoption and Safe Families Act of 1997 (ASFA) (Federal Register, 2006). Recognition of repeat involvement as an important topic for those concerned with intervention in CPS has been prominent since shortly after the passage of the first reporting laws as evidenced by the work of Herrenkohl, Herrenkohl, Egolf, and Seech (1979). Most CPS agencies at state and local levels also recognize the importance of repeat involvement as both an indicator of performance as well as an indicator of the existence of patterns of repeat involvement possibly leading to the intensification of services. Ultimately, the value of addressing repeated involvement is to help improve interventions and services to children and their families. Key to achieving this, however, is the development of an understanding of repeat involvement through ongoing research. The study by Connell, Bergeron, Katz, Saunders, and Tebes (2007) that appears in the May, 2007, (31[5]) issue of the Journal contributes in useful ways to the developing research base on repeat involvement. The authors use National Child Abuse and Neglect Data System (NCANDS) data from 2001 to 2004 to examine children re-referred to CPS in the State of Rhode Island. Through the use of survival analysis procedures, they examined children who were re-referred, meaning that a child had a subsequent investigation regardless of the results of the investigation. Of the 22,584 children in their data set, roughly 40% were estimated to be re-referred 3.75 years after the initial report. In addition, their analysis reveals that relative risks for re-referred children were greater for younger children and physically disabled children, and African American and Hispanic children were at lower relative risk compared to children of other races. Children whose caregivers abused substances and children from families with indications of financial difficulties were also found to be at greater risk. Children who had been sexually maltreated were at lower risk compared to other forms of maltreatment as were children who had been substantiated for maltreatment initially. The provision of post-investigation services at the time of the initial report did not impact on the overall risk of re-referral, but it did increase the risk for children who were also substantiated based on the findings of the subsequent investigation. There are two aspects of this study that are the subject of this commentary: (1) the use of NCANDS data and associated methods; and (2) the findings of the study in relation to repeat involvement research in a broader context of related studies. NCANDS as an official data system of the Children’s Bureau of the US Department of Health and Human Services has been in operation since 1989 (US Department of Health and Human Services, 1992). For federal fiscal year 2005 (FFY 2005) case and aggregate level data were submitted to the federal government by 49 states and US territories, while the remaining three states provided aggregate data only (US Department of Health and Human Services, 2007). Unique encrypted identifiers for children provided with the case level data make it possible to analyze re-referrals (or rereporting in NCANDS terminology) and recurrence. Recurrence, used as a performance measure by the US federal government, means a subsequent substantiated finding based on a CPS investigation for a child whose initial or index investigation was also found to be substantiated. While each state supplies unique identifiers in its annual submission, most states like Rhode Island continue to retain the same identifier for each child with every annual submission. Thus, in addition to a range of other immediate uses, over time the

On the nature and scope of reported child maltreatment in high-income countries: opportunities for improving the evidence base

Abstract Although high-income countries share and value the goal of protecting children from harm, national data on child maltreatment and the involvement of social services, the judiciary and health services remain relatively scarce. To explore potential reasons for this, a number of high-income countries across the world (Belgium, Canada, Germany, the Netherlands, New Zealand, South Korea, Switzerland and the United States) were compared. Amongst other aspects, the impact of service orientation (child protection-vs-family-services-orientated), the complexity of systems, and the role of social work as a lead profession in child welfare are discussed. Special consideration is given to indigenous and minority populations. The call for high-income countries to collect national data on child maltreatment is to promote research to better understand the risks to children. Its remit ranges well beyond these issues and reflects a major gap in a critical resource to increase prevention and intervention in these complex social situations. Fortunately, initiatives to close this gap are increasing.