Child Maltreatment

The decision to substantiate is a key factor in determining eligibility for services and decisions to press criminal charges or to remove a child, and it is frequently the basis for selecting samples of maltreated children or to measure recidivism or intervention effectiveness. Although there is a growing body of research on case substantiation in the United States, few studies have examined this decision in other jurisdictions. Using data from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect, this study examines the profiles of a national sample of 10,010 investigations. Multivariate analyses reveal that substantiation decisions are generally made in a fashion that is relatively consistent with the clinical characteristics of cases. Along with severity of harm, parent risk factors, and housing risk factors, police referrals are among the most important predictors of case substantiation. Cases involving multiple forms of maltreatment are also more likely to be substantiated.

Data from the National Survey of Child and Adolescent Well-being, a national probability study of children and families investigated for child maltreatment, were analyzed to answer the question: Do substantiated and unsubstantiated cases differ in rates of recidivism over 36 months? Recidivism was classified as (a) any re-reports, (b) substantiated re-reports and (c) subsequent foster care placements. Bivariate (survivor functions estimated by the Kaplan-Meier method) and multivariate (Cox regression modeling) analyses were conducted. The results revealed that risk of recidivism was similar regardless of substantiation status of the index investigation. We suggest that the substantiation label be removed from field use. Instead, we suggest that agencies record service needs in the families they serve, and also record whether or not the family meets criteria for referral to the family court. These would be far more practical and meaningful ways to measure child welfare services.

Although it is a widely used indicator, the use of substantiation in child welfare practice and research is not without critics. Much of this criticism concerns the ability of the substantiation disposition to distinguish between child protective services (CPS) investigations in which maltreatment occurs or does not occur. This study examined the relationship between substantiation and maltreatment rereporting using an analytic technique known as propensity score matching (PSM). Children with initially substantiated maltreatment reports were at significantly higher risk for rereporting than those with initially unsubstantiated reports, even after matching the two groups on propensity scores based on several demographic and case characteristics. Although additional study using PSM on other samples is warranted, this evidence supports the predictive validity of the substantiation disposition and its continued use as one factor to consider when allocating limited post-investigation services.

Substantiation can have an important effect on what interventions are pursued for children investigated for maltreatment, but researchers lack knowledge about how the decision to substantiate is made. Using information from 4,515 children from a national probability study of children investigated for maltreatment, this study examined how caseworker judgments of harm, risk, and evidence predicted substantiation. The substantiation rate was 29.9%, but the majority of cases were substantiated when caseworkers reported at least moderate harm, at least moderate risk, and/or probably to clearly sufficient evidence. Each judgment variable significantly predicted substantiation in a multivariable model, with evidence the strongest predictor. Child gender and age were significant predictors beyond harm, risk, and evidence, suggesting that other judgments also influence substantiation. In 9 of 100 cases, reports were not substantiated despite moderate to severe harm. Thus, substantiation is generally based on judgments of harm, risk, and evidence but not exclusively. The findings underline previous researchers' conclusions that substantiation is a flawed measure of child maltreatment and suggest that policy and practice related to substantiation are due for a fresh appraisal by state child welfare service agencies.

Little is known about the influence of evidentiary and case characteristics on adverse appeal outcomes for substantiated cases of maltreatment. This article, therefore, reports on a sample of adverse appeal outcomes during a 2-year period. Using Drake's Harm/Evidence model to examine the adverse outcomes, the study describes differences between substantiated cases that were “modified” versus “overturned” during appeal, as well as differences in their evidentiary characteristics across different types of maltreatment. Content analysis and logistic regression analysis of administrative data were used to predict overturned versus modified outcome. Overall, child neglect, substantiated cases that did not meet basic evidentiary standards, and cases that were deemed as not credible were more likely to be overturned in comparison to being modified. A substantiation assessment framework (SAF) is developed and implications of Drake's Harm/Evidence model for investigating maltreatment as well as for understanding judicial decision making in appealed cases of maltreatment is highlighted.

This study investigates associations between individual, family, and extrafamilial factors and the likelihood of subsequent childhood and adolescent maltreatment. The authors analyzed 1,411 participants in the Chicago Longitudinal Study whose maltreatment records were verified from administrative data. Findings suggest that maternal age at the child's birth was a robust predictor of maltreatment outcomes. Receipt of public assistance and single-parent family status were significantly associated with select outcomes. Among school-age indicators examined, parent participation in school was negatively associated with most maltreatment outcomes. Participation in the Chicago Child-Parent Center program was negatively associated with maltreatment, although effects varied by type and timing of maltreatment. In separate analyses, several factors were associated with neglect, but only maternal age at the child's birth was associated with physical abuse. Findings suggest that prevention programs may need to target select populations and specific mechanisms associated with different types of maltreatment to maximize effectiveness.

Decades of research has identified several psychosocial risk factors for child maltreatment, only some of which are modifiable. The relative importance of the most modifiable psychosocial variables, as compared to more static variables such as demographic characteristics, is not well understood, particularly among children maltreated at a very young age. This study examined predictors of re-referral among 149 urban children originally referred for maltreatment as infants. Of these children, 42.3% were re-referred over a period of 11 to 15 years. Cox regression analyses with time-varying covariates revealed that modifiable psychosocial risk factors failed to predict risk for re-referral in a multivariate model. Demographic characteristics and characteristics of the index incident of maltreatment were the strongest predictors of re-referral. Existing services may not be addressing the underlying reasons for maltreatment, particularly in families with young children. A clearer understanding of the underlying causes of maltreatment is needed.

This study aims to identify characteristics that predict full disclosure by victims of sexual abuse during a forensic interview. Data came from agency files for 987 cases of sexual abuse between December 2001 and December 2003 from Children's Advocacy Centers (CACs) and comparison communities within four U.S. states. Cases of children fully disclosing abuse when interviewed were compared to cases of children believed to be victims who gave no or partial disclosures. The likelihood of disclosure increased when victims were girls, a primary caregiver was supportive, and a child's disclosure instigated the investigation. The likelihood of disclosure was higher for children who were older at abuse onset and at forensic interview (each age variable having an independent effect). Communities differed on disclosure rate, with no difference associated with having a CAC. Findings suggest factors deserving consideration prior to a forensic interview, including organizational and community factors affecting disclosure rates.

Proposals for the application of Bayes' Theorem as an aid to child abuse decision making are discussed critically. Subsequently, two examples of the application of research findings concerning signs of child abuse to decision making are demonstrated, using data from research studies of signs of physical abuse and sexual abuse. The calculation of the probability of the presence of abuse using Bayes' Theorem is described, given prevalence information and specific indicators of abuse. In addition, a method for describing the degree of imprecision in estimates of the probability of abuse is discussed. Specific issues that affect the valid application of research findings within Bayes' Theorem are discussed, including estimates of the prevalence or base rate of child abuse, sensitivity and specificity of diagnostic signs, and the independence of information that is combined in Bayes' Theorem. Recommendations for addressing these issues when Bayes' Theorem is applied to child abuse decision making are discussed, including assessment of the independence of indicators that are combined in Bayes' Theorem, suitable bases for estimating the prevalence of abuse, and the calculation of imprecision in probability estimates of abuse.

Mathews and Kenny recently reviewed the current state of mandatory reporting laws in Australia, Canada, and the United States. The purpose of this article is to draw attention to existing differences between these countries regarding exposure to domestic violence (EDV) and to discuss EDV as a specific and detrimental form of child abuse.