Examining the role of child welfare worker characteristics and the substantiation decision

BACKGROUND

The role of child welfare workers is twofold, to promote the safety of children and youth and to address their wellbeing. This provincially legislated mandate requires child welfare workers to make decisions across the child welfare service continuum. After a report of child maltreatment is investigated, workers are required to assess the veracity of the allegation through the substantiation decision and to determine whether the child has been victimized, which may impact on families' future involvement with services. Little is known whether or how individual worker characteristics impact the substantiation decision.

OBJECTIVE AND METHODS

This study estimated the degree of variation across caseworker characteristics in the substantiation decision through secondary data analysis of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS, 2018). We explored how the substantiation decision varied across clinical and caseworker characteristics, using both simple and multilevel logistic regression models.

RESULTS

Findings suggest that primarily clinical characteristics predicted the substantiation decision, however, worker years of child welfare experience also predicted substantiation, such that more experienced workers were significantly more likely to substantiate than less experienced workers (est = 0.02, SE = 0.01, p < .10). The Intraclass Correlation Coefficient (35 %) suggests differences among child welfare workers' substantiation decision, they are however, characteristics not measured in this study.

CONCLUSIONS

Further research to assess the differential nature of child welfare worker characteristics and their role in decision-making is required.

Who makes the call? Examining the relationship between child maltreatment referral sources and case outcomes in the United States, 2008-2018

BACKGROUND

Research shows general increases in child maltreatment reports in the U.S. However, less is understood about how reporting varies across states and changes over time, from a perspective of referral sources. While recent studies during COVID-19 reported a reduction in maltreatment referrals, predominantly school referrals, little research has examined changes in maltreatment referrals by referral sources before the pandemic and how different referral sources are associated with case outcomes, particularly out-of-home placement.

OBJECTIVES

This study examined 1) variations across states and changes over time in maltreatment reporting by referral source and 2) the relationship between referral sources type and two case outcomes: substantiated maltreatment and out-of-home placement.

PARTICIPANTS AND SETTING

We used 2008-2018 data (N = 24,349,293) from the National Child Abuse and Neglect Data System.

METHODS

We used descriptive trend analysis and pooled, fixed effects binary logistic regression.

RESULTS

We found gradual increases in reporting during 2008-2018, with substantial variations across states and referral sources. States rely differently on certain reporter types, while we see the largest increase in education referrals and a small decrease in social services referrals. Regression results showed that education referrals were less likely to result in out-of-home placement; law enforcement referrals were most likely to be substantiated, while social service referrals were most likely to result in out-of-home placement.

CONCLUSION

This study makes unique contributions to literature by expanding our knowledge of referral sources and examining the likelihood of substantiation and out-of-home placement by referral source type. We provide child welfare policy and practice implications.

An analysis of temporal dimensions in maltreatment reporting and child protection responses

BACKGROUND

The health services literature indicates that the day and time of a medical encounter is often significant factor in patient outcomes, yet little is known about the role of temporal dimensions in child maltreatment reporting or substantiation.

OBJECTIVE

We examined time-specific dynamics of screened-in reports of alleged maltreatment from different reporter sources, including their relationship to the likelihood of substantiation.

PARTICIPANTS AND SETTING

We used a population-based dataset of administrative records for 119,758 child protection investigations involving 193,300 unique children in Los Angeles County, California, between 2016 and 2017.

METHODS

For each report, we coded three categorical temporal dimensions of the maltreatment report: season, day of the week, and time of day. We descriptively examined how temporal characteristics varied by reporting source. Finally, we ran generalized linear models to estimate the likelihood of substantiation.

RESULTS

We observed variability overall and by reporter type for all three measures of time. Reports were less likely during summer months (22.2 %), during the weekend (13.6 %), and after midnight (10.4 %). Counts of reports from law enforcement were more common after midnight and contributed to a greater proportion of substantiations over the weekend than other reporter types. Weekend and morning reports were nearly 10 % more likely than weekday and afternoon to be substantiated, respectively. Reporter type was the most prominent factor for substantiation regardless of temporal dimensions.

CONCLUSIONS

Screened-in reports varied by season and other classifications of time, but temporal dimensions exhibited only a modest influence on the likelihood of substantiation.

The characteristics of children referred to a child protection team in Japan and factors associated with decision-making: A retrospective study using a medical database

BACKGROUND

Despite the potential efficacy of hospital-based multidisciplinary child protection team (CPTs), research analyzing Japanese CPT databases is scarce.

OBJECTIVE

We aimed to describe the characteristics of children and families reported to a CPT in Japan and investigate factors associated with the substantiation of maltreatment.

PARTICIPANTS AND SETTING

This retrospective, cross-sectional study took place in a national children's hospital in Japan and included 350 children who were reported to CPTs between April 2014 and March 2018.

METHODS

Univariable and multivariable logistic regression analyses were conducted using the CPT database and medical records.

RESULTS

Among 350 cases, 33.4 % were substantiated. Children of <6 years of age comprised 73.4 % of the cases. The majority (67.7 %) received an injury-related diagnosis and physical maltreatment was suspected in 68.3 % of cases. In the univariable analysis, older age, a primary diagnosis other than injury, reporting department, psychological maltreatment, witnessing intimate partner violence, maltreatment by relatives other than biological father or mother, developmental disability, emotional/behavioral difficulty or psychological disorder, maternal/paternal psychological difficulty, and maternal history of maltreatment were significantly associated with substantiation. When adjusted for demographic, child and familial factors, a diagnosis other than injury (AOR 2.02, 95 % CI = 1. 11-3.65) and parental psychological difficulties (AOR 2.49, 95 % CI = 1.37-4.55) were independently associated with substantiation.

CONCLUSION

Most cases reported to our CPT were young children with an injury-related diagnosis. Substantiation was associated with a diagnosis other than injury and parental psychological difficulties. Further prospective and comprehensive studies are needed to establish universal guidelines for databases of hospital-based CPTs.

Association of routine school closures with child maltreatment reporting and substantiation in the United States; 2010-2017

BACKGROUND

There exists a presumption that school closures lead to a diminished capacity to detect child maltreatment, but empiric evidence is lacking.

OBJECTIVE

To determine if child maltreatment reporting and substantiation differ between periods when schools are routinely closed compared to in session.

PARTICIPANTS AND SETTING

Child maltreatment reporting and substantiation among all U.S. States and the District of Columbia from January 1, 2010 through December 31, 2017.

METHODS

Two-week intervals during periods of routine school closure (early January, June through mid-August, late November, and late December) were compared to all other 2-week intervals. Negative binomial generalized estimating equations compared rates of reporting and substantiation, resulting in incidence rate ratios (IRR) with 95% confidence intervals (CI).

RESULTS

Compared to when school was in session, reporting was 16.0% (IRR 0.84 [95% CI: 0.83, 0.85]) lower during school closures and substantiations were 12.3% (IRR 0.88 [95% CI: 0.86, 0.89]) lower. The largest reductions in reporting were observed among education personnel (-42.1%; IRR 0.58 [95% CI: 0.54, 0.62]), children aged 5-17 years (-18.6%; IRR 0.81 [95% CI: 0.80, 0.83), and for physical abuse (-19.6%; IRR 0.80 [95% CI: 0.79, 0.82]). Reductions during closure periods were not matched by increases during two-week intervals immediately following closure periods.

CONCLUSIONS

Results suggest that the detection of child maltreatment may be diminished during periods of routine school closure. Findings may inform prevention planning and risk-benefit analyses for future school closures. Further study should disentangle the issue of decreased detection versus decreased prevalence of maltreatment during school closures.

Predictors of substantiated re-reports in a sample of children with initial unsubstantiated reports

Many children with unsubstantiated reports of child abuse and neglect repeatedly return to the child protection system, indicating that unsubstantiated reports may represent actual child maltreatment or risk for future maltreatment. Identifying patterns of re-reporting and predictors that may be associated with later substantiated re-reporting could help to identify children who are very likely to be maltreated. This knowledge may guide the development of policies and interventions to prevent further maltreatment and the risk for re-reports. The aims of this study were to: (1) measure the period between the time of the initial reports that were not substantiated and the time of first substantiated re-reports; and (2) identify factors associated with the risk of later substantiated re-reporting. The study analyzed secondary data from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN) through survival analysis. Of the 378 children with initially unsubstantiated reports, 81% were re-reported, of which almost two-thirds were substantiated. Children who were younger, non-white, and had caregivers with more depressive symptoms were at increased risk of a substantiated re-report. Among those that were later substantiated, 20% were substantiated within one year. Findings suggest that targeted preventative services should be developed and provided for families who are reported for the first time, even if not substantiated.

Substantiated Childhood Maltreatment and Intimate Partner Violence Victimization in Young Adulthood: A Birth Cohort Study

Little is known about the associations between various types of childhood maltreatment and multiple forms of intimate partner violence victimization in early adulthood. This study examines the extent to which childhood experiences of maltreatment increase the risk for intimate partner violence victimization in early adulthood. Data for the present study are from 3322 young adults (55 % female) of the Mater Hospital-University of Queensland Study of Pregnancy with the mean age of 20.6 years. The Mater Hospital-University of Queensland Study of Pregnancy is a prospective Australian pre-birth cohort study of mothers consecutively recruited during their first antenatal clinic visit at Brisbane's Mater Hospital from 1981 through to 1983. Participants completed the Composite Abuse Scale at 21-year follow-up and linked this dataset to agency recorded substantiated cases of childhood maltreatment. In adjusted models, the odds of reporting emotional intimate partner violence victimization were 1.84, 2.64 and 3.19 times higher in physically abused, neglected and emotionally abused children, respectively. Similarly, the odds of physical intimate partner violence victimization were 1.76, 2.31, 2.74 and 2.76 times higher in those children who had experienced physical abuse, sexual abuse, neglect and emotional abuse, respectively. Harassment was 1.63 times higher in emotionally abused children. The odds of severe combined abuse were 3.97 and 4.62 times greater for emotionally abused and neglected children, respectively. The strongest associations involved reports of child emotional abuse and neglect and multiple forms of intimate partner violence victimization in young adulthood. Childhood maltreatment is a chronic adversity that is associated with specific and multiple forms of intimate partner violence victimization in adulthood.

Reprint of "Decision-making in child protective services: Influences at multiple levels of the social ecology"

Decision-making in the child protection system is influenced by multiple factors; agency and geographic contexts, caseworker attributes, and families' unique circumstances all likely play a role. In this study, we use the second cohort of the National Survey of Child and Adolescent Well-Being to explore how these factors are associated with two key case decisions-substantiation and removal to out-of-home care. Analyses are conducted using weighted hierarchical linear models. We find that substantiation is strongly influenced by agency factors, particularly constraints on service accessibility. Substantiation is less likely when agencies can provide services to unsubstantiated cases and when collaboration with other social institutions is high. This supports the concept that substantiation may be a gateway to services in some communities. Agency factors contributed less to the probability of removal among substantiated cases, though time resources and constraints on decision-making had some influence. For both substantiation and removal risks, county, caseworker, and child characteristics were less influential than agency characteristics and family risk factors.

Decision-making in child protective services: Influences at multiple levels of the social ecology

Decision-making in the child protection system is influenced by multiple factors; agency and geographic contexts, caseworker attributes, and families' unique circumstances all likely play a role. In this study, we use the second cohort of the National Survey of Child and Adolescent Well-Being to explore how these factors are associated with two key case decisions-substantiation and removal to out-of-home care. Analyses are conducted using weighted hierarchical linear models. We find that substantiation is strongly influenced by agency factors, particularly constraints on service accessibility. Substantiation is less likely when agencies can provide services to unsubstantiated cases and when collaboration with other social institutions is high. This supports the concept that substantiation may be a gateway to services in some communities. Agency factors contributed less to the probability of removal among substantiated cases, though time resources and constraints on decision-making had some influence. For both substantiation and removal risks, county, caseworker, and child characteristics were less influential than agency characteristics and family risk factors.

Child maltreatment and risk patterns among participants in a child abuse prevention program

The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR=6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR=8.47, 95% CI [2.96, 24.39]), paternal DV (OR=11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR=4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR=2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention.

Why are suspected cases of child maltreatment referred by educators so often unsubstantiated?

School professionals have a unique vantage point for identifying child maltreatment and they are a frequent source of referral to child protective services. Disturbingly, past studies have found that maltreatment concerns reported by educators go unsubstantiated by child protective services at much higher rates than suspected maltreatment reported by other professionals. This study explores whether there are systematic differences in the characteristics of cases reported by educators as compared to other professionals and examines whether such variation might account for differences in investigation outcome. Analyses were based on 7,725 cases of suspected maltreatment referred by professionals to child protective services from the Canadian Incidence Study of Reported Child Abuse and Neglect - 2003 a national database on the characteristics of children and families investigated by child protective services. School professionals were responsible for 35.8% of professional referrals. Reports by educators were much more likely to be unsubstantiated (45.3%) than those by other professionals (28.4%) in subsequent child protective investigation. Cases reported by educators were found to contain significantly more child risk factors (e.g., child emotional and behavioural problems) and fewer caregiver and family risk factors (e.g., caregiver mental health problem, single parent family) than cases reported by other professionals. Even controlling for these differences, educator-reported concerns were still 1.84, 95% CI [1.41, 2.40] times as likely to be unsubstantiated as reports from other professionals. Contrary to the notion that educators are mostly reporting non-severe cases, suspected/substantiated cases reported by school professionals were more likely to be judged as chronic and more likely to involve families with a previous child protection history. Results are concerning for the capacity of the education and child protection systems to work together to meet their shared goal of promoting healthy child development. Additional research is needed on the way in which child risks and problems influence child protective service, particularly in the context of chronic abuse and neglect and lack of availability of child and family mental health interventions. Potential problems with credibility of school professionals as reporters of child maltreatment concerns also warrant further investigation.