What Does Child Protective Services Investigate as Neglect? A Population-Based Study

Maternal Reports to the Child Protection System: A Longitudinal Analysis of Multiple Children

Child maltreatment can affect multiple children in a family, yet its occurrence and chronicity has been often assessed by focusing on a single child. Although this approach provides valuable insights, considering the experiences of all children in a family may provide a more complete understanding of maltreatment dynamics. Using linked birth and child protection system (CPS) records from California, we analyzed 20 years of data on 194,514 first-time mothers to document the prevalence, timing, and chronicity of maternal CPS reporting across multiple children. Mothers were categorized by the number of live childbirths: one (25.7%), two (36.2%), three (20.9%), and four or more (17.2%). Overall, 33.0% of mothers were reported to CPS, increasing from 18.5% for mothers with one child to 63.1% for those with four or more children. For mothers with two or more children, more than 70% experienced an initial CPS report only after the second child's birth. Our findings have implications for understanding the dynamics of maternal reports to CPS, emphasizing the need for lasting and family-focused interventions.

"I got to say two or three lines"-A systematic review of children's participation in child protective services

BACKGROUND

Although children's right to participate in decisions that influence their lives is widely recognized, it is rarely present in the assessment and decision-making processes in child protective services (CPS).

OBJECTIVE

The aim of this systematic review was to examine children's views and experiences of participating in CPS cases of child abuse and neglect and to identify the gap in scientific knowledge.

METHODS

The systematic review follows the PRISMA statement and includes 13 peer-reviewed articles published in several academic journals from 2016 to 2023 reporting primary research with abused and neglected children registered in CPS.

RESULTS

Thematic analysis identified five main themes: participation: assessment and decision-making, information and understanding, interaction and relationships, children vs parents, and experience of younger children. The findings show that although a few children reported instances of meaningful participation, overall, children's participation was often reduced to a tokenistic engagement, with limited influence on the decision-making processes. Children, especially younger children, receive insufficient information and struggle to understand the proceedings. Examples of prioritizing parents' views, needs, and rights rather than centering the children's perspectives are reported.

CONCLUSIONS

The findings highlight a need for significant changes in how child participation is conceptualized and operationalized within CPS. Implications for practice, policy, and research are discussed to foster children's participation in CPS to contribute to the effective care and protection of children experiencing child abuse and neglect.

Three-Year Custody Outcomes Among Infants Investigated by Child Protection Systems for Prenatal Substance Exposure in California

OBJECTIVE

Infants affected by prenatal alcohol and drug use are more likely to be removed from parental custody than those in the general population, although it is unclear whether their custody outcomes differ from infants investigated by child protection systems (CPS) for other reasons. This analysis seeks to compare trajectories of involvement and custody outcomes among infants investigated by CPS with and without documentation of prenatal substance exposure (PSE).

METHOD

We used vital birth records linked to administrative CPS records to examine the timing of system involvement and 3-year custodial outcomes among investigated infants with and without identified PSE. We defined PSE according to documentation on the state's standardized hotline screening form, which CPS completes upon referral for alleged maltreatment. We estimated the likelihood a child was in nonparental custody at age 3 by specifying multivariable generalized linear models, adjusted for covariates available in the birth record.

RESULTS

In our sample of 22,855 infants investigated by CPS in 2017 in California, more than 26% had documentation of PSE. These infants experienced an accelerated timeline of system penetration and were 2.2 times as likely to be in nonparental placement at age 3.

DISCUSSION

PSE confers an independent risk of custody interruption among infants investigated by CPS. The younger age of these infants, complexity of parental substance use, and potential misalignment of administrative permanency timelines with parental recovery all suggest the need for increased research, policy, and programmatic interventions to serve this vulnerable population.

The Impact of COVID-19 on Infant Maltreatment Emergency Department and Inpatient Medical Encounters

OBJECTIVE

To assess the counts of infant maltreatment-related medical encounters at a large medical system during a 21-month span of the COVID-19 pandemic.

METHODS

Retrospective data for this study came from all inpatient and emergency department medical encounters for infants from January 1, 2016, through November 30, 2021, at a single children's hospital system in California. Distributions of medical encounters were tabulated and plotted over time. Interrupted time series models were used to evaluate changes in child maltreatment medical encounters.

RESULTS

Medical encounters for infants with child maltreatment diagnoses increased following the onset of COVID-19. Monthly counts of encounters with indicated maltreatment trended upward following the start of the pandemic. Interrupted time series models showed that the count of maltreatment encounters increased 64% with the onset of COVID-19.

CONCLUSIONS

We found an increase in infant maltreatment medical encounters during a 21-month period following the onset of COVID-19. These findings suggest that the pandemic may have adversely affected the safety of infants and ongoing work is needed to understand better the pandemic impacts on child maltreatment.

Disentangling Poverty From Neglect: Using a Person-Centered Approach to Examine Risk Factors for Neglect Among Families in Poverty

Approximately 18% of U.S. children under 5 years old live in poverty, which is one of the strongest predictors of child neglect. However, most families in poverty do not engage in neglect and this may be due to heterogeneity in risk factors. This study examined how risk factors co-occurred among families in poverty across early childhood and whether risk profiles were differentially related to physical and supervisory neglect across time. Results suggested there were four risk profiles across early childhood (i.e., years 1 and 3). At year 1, the four profiles in order of prevalence were: Low Risk, High Risk, Depressed and Uninsured, and Stressed with Health Problems. At year 3, the profiles were: Low Risk, High Risk, Depressed with Residential Instability, and Stressed with Health Problems. Overall, the High Risk profile was associated with more physical and supervisory neglect across time compared to the Low Risk profile; however, the Stress with Health Problems profile was also associated with greater physical neglect. These findings illustrate heterogeneity in the risk factors among families in poverty and demonstrate the differential impact of risk exposure on later neglect. Results also provide evidence to practitioners and policymakers about target risk experiences to prevent neglect.

Effects of the Nurturing Parenting Program Nurturing Skills for Families on child safety and permanency

BACKGROUND

Many child welfare agencies use the Nurturing Parenting Program Nurturing Skills for Families (NPP) program to strengthen parenting skills. NPP includes a flexible sequence of lessons that are tailored to meet each family's needs.

OBJECTIVE

This study estimated the effects of NPP on child safety and permanency outcomes using a quasi-experimental design.

PARTICIPANTS AND SETTING

This study included 1102 children in Arizona whose families were referred to NPP between 2018 and 2020 (treatment group) and 6845 children in Arizona whose families were referred to other in-home family preservation services during the same period (comparison group).

METHODS

Outcomes were based on child welfare administrative data. The study estimated (1) the effects of being referred to NPP (regardless of a family's level of participation) and (2) the effects of completing NPP. Baseline equivalence was established for each analysis. Impacts were calculated by comparing regression-adjusted differences between the study groups.

RESULTS

The study found no evidence of impacts of being referred to NPP. However, children whose families completed NPP were less likely to experience an investigation (ES = -0.28; p = 0.03) or substantiated investigation (ES = -0.66; p = 0.03) 4 months after the service referral, and less likely to experience a removal 16 months later (ES = -0.70; p = 0.00).

CONCLUSIONS

NPP had favorable effects on child welfare outcomes when families completed the program. Additional research is necessary to understand the supports that enable families to complete NPP and the specific components that are particularly effective.

State support policies and children's living arrangements

BACKGROUND

Many children in the United States live apart from their parents, in either formal or informal foster care, due to concerns about child abuse and neglect. Prior research has established a connection between poverty and child maltreatment, but many aspects of state support to families remain unexamined in relation to child living arrangements.

OBJECTIVE

We test welfare access, welfare generosity, work supports, and family supports indicators as predictors of foster care removal rates and nonparental care rates.

PARTICIPANTS AND SETTING

We use a population of 51 states, including the District of Columbia, for years 2008 to 2018, totaling 561 state-years.

METHODS

We utilize negative binomial regression models with state and year fixed effects.

RESULTS

We find that one-dollar higher minimum wages are negatively associated with both foster care removal rates (IRR = 0.947, p < 0.001) and nonparental care rates (IRR = 0.975, p < 0.01), but that other state policies are not consistently beneficial.

CONCLUSIONS

Our results have implications for policies to assist families and reduce child maltreatment.

Associations Between State TANF Policies, Child Protective Services Involvement, And Foster Care Placement

The Temporary Assistance for Needy Families (TANF) program, which was established in 1996 and renewed in 2005, constituted a major reform of the US welfare system. Since its renewal, few studies have examined its effects on children. We used instrumental variables, two-way fixed effects, and event studies to examine the associations between state-level TANF policies, Child Protective Services involvement, and foster care placement during the period 2004-16. We found that each additional TANF policy that restricted access to benefits was associated with a 13 percent reduction in TANF caseloads. Using TANF policies as an instrument, we found that increases in TANF caseloads were associated with significant reductions in numbers of neglect victims and foster care placements. In two-way fixed effects models, restrictions on TANF access were associated with more than forty-four additional neglect victims per 100,000 child population and between nineteen and twenty-two additional children per 100,000 placed in foster care. Our findings suggest that additional research using data that capture the nuances of maltreatment should be used to investigate the relationships among TANF policies, child maltreatment, and foster care placement.