Tonino Esposito

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.

Physical and mental health of children with substantiated sexual abuse: Gender comparisons from a matched-control cohort study

When compared to children from the general population, sexually abused children receive more medical services, both for physical and mental health problems. However, possible differences between sexually abused boys and girls remain unknown. The lack of control group in studies that find gender differences also prevents from determining if the differences are specific to sexual abuse or to gender. The objective of the study was to assess differences in physical and mental health between sexually abused boys and girls in comparison to those from the general population. Administrative databases were used to document physical and mental health problems of 222 males and 660 females with a substantiated report of sexual abuse between 2001 and 2010. A comparison group individually matched to those from the sexually abused group on gender, age and geographic area was also used to document gender differences in the general population. Yearly incidence rates of diagnoses resulting from medical consultations and hospitalizations of males and females were compared over five years after a first substantiated sexual abuse report using the mixed general linear model. Sexually abused girls were up to 2.2 times more likely to consult a physician than sexually abused boys for physical health problems. Similar findings are observed in the general population. Conversely, results revealed that sexually abused boys were up to 2.3 times more likely than females to consult a physician for mental health problems. This gender difference was not apparent in the general population group.

Building research capacity in child welfare in Canada.

There is a surprising dearth of information about the services provided to the children and families being reported to Canadian child welfare authorities, little research on the efficacy of child welfare services in Canada, and limited evidence of new policies and programs designed to address these changes. This paper reports on a research capacity building initiative designed to address some of these issues. By fostering mutual co-operation and sharing of intellectual leadership, the Building Research Capacity initiative allows partners to innovate, build institutional capacity and mobilize research knowledge in accessible ways. The model rests on the assumption that by placing the university’s research infrastructure at the service of community agencies, robust research partnerships are developed, access to agency-based research is significantly enhanced and community agencies make better use of research findings which all equate in greater research utilization and research capacity building.

The Effects of Socioeconomic Vulnerability, Psychosocial Services, and Social Service Spending on Family Reunification: A Multilevel Longitudinal Analysis

Socio-environmental factors such as poverty, psychosocial services, and social services spending all could influence the challenges faced by vulnerable families. This paper examines the extent to which socioeconomic vulnerability, psychosocial service consultations, and preventative social services spending impacts the reunification for children placed in out-of-home care. This study uses a multilevel longitudinal research design that draws data from three sources: (1) longitudinal administrative data from Quebec’s child protection agencies; (2) 2006 and 2011 Canadian Census data; and, (3) intra-province health and social services data. The final data set included all children (N = 39,882) placed in out-of-home care for the first time between 1 April 2002 and 31 March 2013, and followed from their initial out-of-home placement. Multilevel hazard results indicate that socioeconomic vulnerability, controlling for psychosocial services and social services spending, contributes to the decreased likelihood of reunification. Specifically, socioeconomic vulnerability, psychosocial services, and social services spending account for 24.0% of the variation in jurisdictional reunification for younger children less than 5 years of age, 12.5% for children age 5 to 11 years and 21.4% for older children age 12 to 17 years. These findings have implications for decision makers, funding agencies, and child protection agencies to improve jurisdictional resources to reduce the socioeconomic vulnerabilities of reunifying families.

Child Welfare Services in Canada

In Canada, the responsibility for protecting and supporting children at risk of abuse and neglect falls under the jurisdiction of Provinces and Territories and Indigenous child welfare organizations. These services have been shaped by their roots in late nineteenth century child saving movements and colonial assimilationism of Indigenous communities. Modernization of child welfare statutes and programs have shifted the language to concepts of child maltreatment and an emphasis on less intrusive family- centered approaches. Despite these changes, child welfare mandates have been expanding: over 230,000 child maltreatment investigations are conducted every year, and on any 1 day, over 62,000 children are in out-of-home care. While there is significant variation in the structure and organization of services and in the statutes defining intervention mandates, these systems nevertheless share many common characteristics, including mandatory reporting; maltreatment investigations as a primary framework for determining service eligibility; use of court orders to enforce services; and the placement of children and youth in a range of out-of-home care settings. Efforts are being made to develop a broader array of more flexible service alternatives to meet the diverse needs of child welfare-engaged families, a shift most notably needed for Indigenous children and families.

Temporary placements: A crisis-management strategy for physically abused children?

A large majority of children who are placed outside the family home experience temporary placements (between 1 to 60 days) at some point in time. Yet, information on the use of temporary placements remains fragmentary, with only occasional indirect references. This scant information does, however, suggests a particular link between physical abuse and temporary placements. The objective of the present study is to describe the context in which temporary placements are used by childrens services in Quebec (Canada) while analyzing the associative link between temporary placements and physical abuse as the reason for the placement. Our study is based on a population cohort of 10,181 children placed in Quebec who have been followed for four years. Propensity-weighted multinomial regression analysis was used to assess the relative importance of the various individual pre-placement factors that may be associated with physical abuse. Results show that children investigated for physical abuse alone are 6.335 times more likely to have temporary placement trajectories compared to children investigated for other reasons. Cases that involved physical abuse combined with other reasons, were between 33.4% and 41% more likely to involve trajectories with temporary placements, than cases that were investigated for reasons other than physical abuse. Sex, age, and history of services have been used as covariates. In conclusion, the use of temporary placements is discussed with regards to the mandate of child-protection services and of certain etiological profiles of physical abuse.

Placement Stability, Cumulative Time in Care, and Permanency: Using Administrative Data from CPS to Track Placement Trajectories

Objectives: The Quebec Youth Protection Act was amended in 2007. The main goal of this reform was to improve placement stability for children who are removed from their home for their protection. Among several legal provisions introduced was the establishment of maximum age-specific durations of out-of-home care, after which a plan must be established to provide stability for children placed in substitute care by finding permanent homes for them. The purpose of this study is (1) to examine trends in placement use and placement stability since the reform and (2) to document the current frequency of each type of placement setting, the cumulative time in care before the exit to permanency, and the sustainability of the permanency outcome. Methods: The study relies on 3 entry cohorts of all children investigated who received protection measures in the province of Quebec during 3 specific time frames before and after the reform (n = 9620, 8676, 8425). Cohorts were observed for a period varying from 3 to 4 years. Administrative data from all 16 child protection agencies were used to track placement trajectory indicators and to compare cohorts. Results: There has been a decrease in the proportion of children receiving protection measures who were placed in care since the reform, and placement in kinship care has become more frequent among children placed. Placement stability improved slightly after the reform. Overall, for infants, the most frequent type of permanency attained is adoption, while reunification is the option most often indicated for older children. Some children are at a greater risk of experiencing unstable placement trajectories: young children have a high rate of reunification breakdown, some wait a long time to be adopted, and adolescents are frequently removed from the substitute care setting where they were supposed to stay until the age of 18. Conclusions: The results suggest interesting avenues for policy makers and service providers to improve the stability of placement trajectories. Advantages and disadvantages of administrative data are discussed.

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada

Formal university–child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)—the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI’s). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership — helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research.

Children with disabilities in child protection services

Increasingly, studies show that children with disabilities represent a significant proportion of children receiving child protection services. The most recent child maltreatment report published by the US Children’s Bureau suggests that 13.3% of children receiving child protection services were identified as having an intellectual, physical, or behavioural disability, or a combination of these. Similarly, the most recent cycle of the Canadian Incidence Study of Reported Child Maltreatment – currently the only pan-Canadian source of data on child protection services – suggest that in 10.3% of maltreatment-related investigations, children have a noted intellectual, developmental, or physical disability or a combination of these. While these national data have helped delineate the scope of the representation of children with disabilities in child protection services in Canada and in the US, looking into ways in which the child protection system can respond to the needs of this particularly vulnerable population remains a nascent area of research. As Berg et al. argue, encouraging the participation of children with disabilities in developmentally salient activities is, indeed, a critical issue in child protection. The impact of a disability, in and of itself, often leads to participation restrictions which are then compounded by the effects of maltreatment. This nationally representative study demonstrates the point well, reporting that young people in child protection services (11–17y old) with disabilities were two times less likely to participate in developmentally salient activities and close to seven times less likely to participate if they were polyvictimized. The authors provide a significant contribution to the examination of the participatory needs of maltreated children with disabilities. However, the extent to which restricted participation is explained by maltreatment, disability, or a combination of the two, is an area that would benefit from further examination. Differences have been revealed in risk of maltreatment between children with disabilities and non-disabled children, with the former reported to be at increased risk. Future work can benefit from examining the mediating effects of disability on restricted participation using propensity models, which rigorously adjust for differences between children with disabilities and non-disabled children, and risk of maltreatment. For example, conditional probability of maltreatment can be estimated in order to match children with disabilities and non-disabled children using parent and child risk factors, socio-economic vulnerabilities, etc. This method can help solve the problem of endogeneity bias between children with disabilities and non-disabled children in investigating their risk of maltreatment, and will provide robust estimates of the mediating effects of disability on participation in developmentally salient activities. In my opinion, the study by Berg et al. will stimulate thought around the conceptual and methodological directions of future research in this area. These new lines of inquiry will provide additional insight concerning the difficulties faced by maltreated children with disabilities and their families, while monitoring the impact of innovations in child protection services aimed at addressing these difficulties.