Child Maltreatment and Abuse – A Predictor Agencies are Using Prediction to Prevent

According to 2011 data,  12.5 percent of children under the age of 18 are abused or neglected in the United States each year.  A Facts on Youth brief from the Center for Health and Justice at TASC cites a study published in JAMA Pediatrics that found confirmed maltreatment for 1 in 8 youth, with nearly 6 percent of cases  (just less than half of confirmed reports) involving children ages 5 and under.  The brief also notes that studies of child abuse and maltreatment that rely on self-reports rather than substantiated reports indicate a rate of up to 40 percent.

The Child Trends brief Preventing Violence: Understanding and addressing determinants of youth violence in the United States reviewed relevant research on interventions and policy approaches to reducing youth violence, with an emphasis on individual, family and school/community factors.  This review identified several predictors of violence, including domestic violence, dysfunctional parenting, gun availability, low self-control, and lack of connectedness to school.  Child maltreatment, however, was a strong predictor of nearly every type of violence.  The prevention of child abuse and provision of interventions to address the impact of such trauma appear to be critical actions in reducing the potential of future violence.  That said, although child maltreatment is a risk factor for criminal behavior, the longer term negative effects of that experience may be offset or amplified by other life events. Completing high school/getting a GED and getting married were two factors identified by a research team at the Social Development Research Group at the University of Washington as having a positive impact on a person’s life, thus reducing the power of the relationship between the maltreatment and future high risk behaviors.  A history of maltreatment combined with additional risk factors, such as poverty, increases the likelihood of criminal behavior.

As safety and health are essential factors in optimal child development, and may affect a multitude of life outcomes, new strategies have emerged to better identify and “triage” high-risk situations.  States are turning to the big data playbook to assist in investigations of abuse and maltreatment, using predictive analysis to help prioritize reports and better provide preventive services. Information such as family history, school reports and other administrative data, plus case officer knowledge, gives child welfare decision-makers more (if not necessarily better) data to guide the use of resources for the protection of children. Along with Connecticut, Florida, and Los Angeles County, Allegheny County here in western Pennsylvania is utilizing predictive analytics in an effort to reduce child maltreatment, abuse, and fatalities.  For more information on how predictive analysis is being used in child welfare, see Who will Seize the Child Abuse Prediction Market by Darian Woods and Checklists, Big Data and the Virtues of Human Judgement by Holden Slattery, both in The Chronicle of Social Change.

 

Infants and Toddlers in the Child Welfare System

The report from, Zero to Three and ChildTrends, Changing the Course for Infants and Toddlers: A Survey of State Child Welfare Policies and Initiatives by Elizabeth Jordan, Jaclyn Szrom, Jamie Colvard, Hope Cooper and Kerry DeVooght, examines child welfare policies for the very young and differences in practices used with this population and children of other ages. In 2011, children under 1 year old were most often the victim of substantiated reports of maltreatment, followed by those ages 1 to 3 years.   Forty-seven states responded to the 2012-13 survey with information on how they treat cases involving abused and neglected infants and toddlers. Some of the findings from the report:

  • A lack of services or case schedule (expedited hearing, review or meeting schedules) crafted with the special needs and developmental changes of 0-to-3 year olds in mind. Some states (9) did allow more frequent visitation between parents and their very young children in foster care. The majority of states (42) have policies that involve the birth parent(s) in discussion of their children’s health and healthcare decisions while in state care.
  • Although their is interest in improving practices, overall, policies and training around child maltreatment are not driven by research on the impact of trauma on the still-developing brain of a child less than 3 years old. Neurological formation is critical from birth to age 3, but only 6 percent (3) of states reported mandatory training for all child welfare staff grounded in research on “promising practices” for infants and toddlers.  Of those responding to the survey, 25 states require such training for front-line caseworkers and 15 states offer it as voluntary.
  • The most commonly provided service was parenting education (offered by 39 states) or therapy provided to the young child (28 states). Seventeen states do not collect data on the services received by infants or toddlers who have been abused.

In the wake of the Sandusky case, Pennsylvania created the Task Force on Child Protection to review child abuse legislation and procedure. The final report released in 2012, available at their website as a PDF, contains several recommendations including,

  • The use and fiscal support of evidence-based child abuse prevention programs
  • Increasing the training requirements for caseworkers
  • Expediting communication and information sharing through use of electronic communication
  • An overhaul of the Child Protective Services Law, revision of definitions of key terms and expanding the list of mandatory reporters (with penalties for non-reporting)
  • Creating a statewide database containing information from every report concerning possible neglect or abuse of a child, including those determined as unfounded, while eliminating the expungement process

Recent updates on the Pennsylvania Legislature’s actions around the recommendations are summarized in the Pittsburgh Post Gazette article Seven bills pass through Senate panel to strengthen Pa. child abuse laws by Kate Giammarise and at the Pennsylvania School Boards Association website.

 

 

Lessons on Systems Change from The Center on Substance Abuse and Child Welfare

The impact of parental substance abuse on children’s stability and well-being is a concern that crosses systems.  Data suggests that parental drug and alcohol use is related to abuse and neglect and increases the likelihood of a parent’s involvement in the justice system – including the possibility of incarceration. The National Center on Substance Abuse and Child Welfare (NCSACW) provides In-Depth Technical Assistance (IDTA) to a handful of sites across the country in the areas of substance abuse, child welfare and the courts to result in better outcomes for families involved in these systems.  For approximately 18 months, the IDTA team works with local, state or tribal entities to coordinate strategy and services across systems through the use of evidence-based programs and on-site technical assistance in order to grow capacity for improved child and family outcomes.

The report, In-Depth Technical Assistance (IDTA) Final Report 2007-2012 provides an overview of the IDTA program model, related site accomplishments, and the lessons of system change at various levels. Some findings include,

  • 50 percent of the sites implemented (or enhanced) a recovery specialist model in their programs;
  • 68 percent developed and/or implemented cross-system training plans;
  • 60 percent developed and/or implemented screening protocols that resulted in lowers costs, reduced redundancy and a more efficient referral process;
  • 27 percent used cross-system data collection and tracking processes, such as case reviews and drop-off analysis, to inform policy and program decisions. (Note: according to the SAMHSA website, a Drop-Off Analysis is “a method used to assess linkages among child welfare, treatment agencies and courts. The method helps to identify connections that families need to make between systems to obtain services and achieve their child welfare case goals.”)

In addition to program findings, the brief discusses numerous lessons learned around systems change, particularly: issues in achieving long-term policy and practice changes and avoiding the fracture of collaborative relationships post-project,  leadership focused on engaging and sustaining partners,  use of data to identify areas of and opportunities for change, and realistic timelines for implementing system change and shared accountability.

Child Welfare Court-Ordered Reforms – A Best Practice?

The role of courts in demanding change from the child welfare system is not a new one.  However,  in the paper Court-Based Child Welfare Reforms: Improved Child/Family Outcomes and Potential Cost Savings, Liz Thornton, a Staff Attorney for the American Bar Association’s Center on Children and the Law, finds evidence that such reforms have resulted in both lower fiscal costs and improved child welfare outcomes.

Several case studies are presented to discuss court-ordered changes including those around service accessibility, family treatment and improvements to child welfare system processes or practices. Of interest to Pennsylvanians may be the American Bar Association’s Permanency Barriers Project which, according to the brief, resulted in 20 PA counties reducing the average time by youth spent in foster care by 9 months, resulting in a significant cost savings.

The complete brief is available for download at the First Focus website.