Change trajectories during home-based services with chronic child welfare cases

Assessing Mothers' Automatic Affective and Discipline Reactions to Child Behavior in Relation to Child Abuse Risk: A Dual-Processing Investigation

Given the scope and adverse clinical consequences of child abuse, assessment of salient etiological factors can lend critical insights needed for abuse prevention. Increasingly, dual-processing models have been applied to aggression, which postulate that parallel automatic and conscious processes can evoke aggressive behavior, implicating both affective and cognitive elements in both routes. Using two samples of mothers (n = 110 and n = 195), the current investigation considered evidence of the reliability and convergent, concurrent, and construct validity of the new Automatic Parent Emotion Analog Response task relevant to parent-child aggression, contrasted with a self-reported conscious processing measure. Findings provide evidence that affective reactions of both anger and worry relate to child abuse risk and inclination to respond aggressively, and demonstrate how mothers' automatic reactions relate to both perceived child misbehavior and child dangerous behavior. Current results lend psychometric support for automatic processing in parent-child aggression consistent with other dual-processing theories of aggression.

Assessing Mothers' Automatic Affective and Discipline Reactions to Child Behavior in Relation to Child Abuse Risk: A Dual-Processing Investigation

Given the scope and adverse clinical consequences of child abuse, assessment of salient etiological factors can lend critical insights needed for abuse prevention. Increasingly, dual-processing models have been applied to aggression, which postulate that parallel automatic and conscious processes can evoke aggressive behavior, implicating both affective and cognitive elements in both routes. Using two samples of mothers (n = 110 and n = 195), the current investigation considered evidence of the reliability and convergent, concurrent, and construct validity of the new Automatic Parent Emotion Analog Response task relevant to parent-child aggression, contrasted with a self-reported conscious processing measure. Findings provide evidence that affective reactions of both anger and worry relate to child abuse risk and inclination to respond aggressively, and demonstrate how mothers' automatic reactions relate to both perceived child misbehavior and child dangerous behavior. Current results lend psychometric support for automatic processing in parent-child aggression consistent with other dual-processing theories of aggression.

Toward tailored care for families with multiple problems: A quasi-experimental study on effective elements of care

Several effective interventions have been developed for families with multiple problems (FMP), but knowledge is lacking as to which specific practice and program elements of these interventions deliver positive outcomes. The aim of this study is to assess the degree to which practice and program elements (contents of and structure in which care is provided) contribute to the effectiveness of interventions for FMP in general and for subgroups with child and/or parental psychiatric problems, intellectual disabilities, or substance use. We performed a quasi-experimental study on the effectiveness of practice and program elements provided in attested FMP interventions. Using self-report questionnaires, we measured primary (child's internalizing and externalizing problems) and secondary (parental stress and social contacts) outcomes at the beginning, end, and three months thereafter. By means of Latent Profile Analysis, we identified groups of families receiving similar combinations of practice elements ("profiles"), and we calculated propensity scores. Next, we assessed how practice element profiles and program elements affected improvement in outcomes, and whether these effects were moderated by subgroup characteristics. We found three practice element profiles (explorative/supportive, action-oriented, and their combination), which were equally effective. Regarding program elements, effects were enhanced by more frequent telephone contact between visits and more frequent intervision. Effectiveness of practice and program elements varied for specific FMP subgroups. Variations in the content of care for FMP do not affect its effectiveness, but variations in the structure of the care do. This finding can help to further improve effective interventions.

Family outcomes in alternative response: A multilevel analysis of recurrence

Alternative response (AR) is preventative, family-centered, strengths-based approach within child protective services (CPS). When AR is offered it typically creates a two-track system where low- to moderate-risk families are not subjected to a traditional, fact-finding response that concludes with a determination of child abuse/neglect. One area that continues to concern child welfare administrators and researchers is recurrence, or when a family returns to CPS. Yet, it is unclear whether AR families have the same or different predictors of recurrence than TR families. Using a multilevel analytic approach, the present study followed 17,741 families in one mid-Atlantic state for 18-months post-response to determine what child, family, and county-level predicted a reported re-investigation and a substantiated re-investigation. We found few differences in predictors at the child and family level but found distinct differences at the county level for AR families. Recommendations are provided for policy, practice, and research, including a suggestion for further inquiry on what makes an optimal AR track.

Repeat reports among cases reported for child neglect: A scoping review

BACKGROUND

In the United States (US), child welfare policy prioritizes prevention of future harm (e.g., repeat reports) after a report of maltreatment. The majority of reports include some form of child neglect, but no prior review of the recurrence literature has focused on neglect.

OBJECTIVE

This review sought to help guide future research, policy and practice by summarizing recurrence findings related to child neglect with attention to the broader ecological context in which maltreatment occurs.

PARTICIPANTS

The final review included 34 US studies of maltreatment recurrence. Twenty-eight studies compared child neglect with at least one other form of maltreatment and six studies examined recurrence among neglect cases.

METHODS

Eleven online databases were searched to locate relevant empirical studies. This review attended specifically to contextualizing findings according to other modifiable factors as well as methodological variation. A scoping review approach was used to summarize findings.

RESULTS

Of the 28 studies comparing neglect to other types of maltreatment, 14 found increased risk for neglect, 12 found no association, and two reported a lower risk. When significant, the effect size ranged from 10% to over three times higher risk for neglect. Poverty or material need was the most commonly included control (15 studies), with two thirds finding that lower resource families had higher risk.

CONCLUSION

Methodological variability across studies confounds current ability to guide practice or policy. More research is needed that can replicate and extend findings with comparable samples and model specifications that take into account the regional and policy context.

Understanding change among multi-problem families: Learnings from a formative program assessment

This paper describes the implementation of a long-term voluntary intervention to prevent chronic maltreatment among multi-problem families with histories of child welfare involvement. A small formative evaluation included a limited number of interviews with program participants during the first year of program implementation (n=10), a retrospective case file review (n=17) of closed cases following the first three years of implementation, and notes from ongoing meetings and discussion with program staff. Findings regarding client engagement, long-term interaction between risk and services, and program refinement are discussed. Despite the program's voluntary nature, positive comments from families, and extensive engagement strategies, only about 22% of families remained engaged for the full two-year program. Material hardship was one of the most persistent risk factors from baseline to termination. In many cases, unforeseen negative events occurred that, at least partly, derailed progress. In all cases, progress made was not reflective of a consistent linear process used in the design of most child welfare programs. Implications for program theory and design are discussed.

Heterogeneity in Trajectories of Child Maltreatment Severity: A Two-Part Growth Mixture Model

This study examined the trajectories of maltreatment severity and substantiation over a 24-month period among children (N = 82,396) with repeated maltreatment reports. Findings revealed 2 different longitudinal patterns. The first pattern, Elevated Severity, showed a higher level of maltreatment during the initial incident and increased maltreatment severity during subsequent incidents, but the substantiation rates for this class decreased over time. The second pattern, Lowered Severity, showed a much lower level of severity, but the likelihood of substantiation increased over time. The Elevated Severity class was composed of children with an elevated risk profile because of both individual and contextual risk factors including older age, female gender, caregivers' substance use problems, and a higher number of previous maltreatment reports. Implications of the findings are discussed.

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system.

Trajectories of maltreatment re-reports from ages 4 to 12:: evidence for persistent risk after early exposure

This study identified trajectories of maltreatment re-reports between ages 4 and 12 for children first referred to Child Protective Services (CPS) for maltreatment prior to age 4 and either removed from the home or assessed by a CPS intake worker as moderately or highly likely to be abused/neglected in the future, absent intervention. Participants (n = 501) were children from the Southwest and Northwest sites of the Consortium for Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). During the 8-year follow-up period, 67% of children were re-reported. Growth mixture modeling identified four trajectory classes: No re-report (33%), Continuous re-reports (10%), Intermittent re-reports (37%), and Early re-reports (20%). Membership in classes with relatively more re-reports was predicted by several factors assessed at age 4, including physical abuse; living with a biological/stepparent; caregiver alcohol abuse, depression, and lack of social support; receipt of Aid to Families with Dependent Children (AFDC); and number of children in the home. For a subpopulation of high-risk children first reported in early childhood, risk for maltreatment re-reporting may persist longer than previously documented, continuing 8 to 12 years after the first report.