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Research Watch

Research Watch, a periodical review of research articles published in the leading child welfare journals, is a joint initiative of the CECW and the CRCF. Faculty and graduate students from the Universities of McGill and Toronto meet on a monthly basis to review recently published child welfare studies. The most relevant and well designed studies are summarized and disseminated through the CECW's list of over 2500 subscribers across Canada.

For any PhD student potentially interested in joining the Research Watch team or to receive more information, please contact jules [dot] lajoie [at] gmail [dot] com (Jules Lajoie). You can also send him a notice if you want your e-mail to be added to the distribution list.

Latest Release

The articles listed below can be accessed through the corresponding journal website or accessed at a local library or university.

2 April 2013

Child welfare: Organizational culture can affect worker retention

Source: Lee, J., Forster, M., & Rehner, T. (2011). The retention of public child welfare workers: The roles of professional organizational culture and coping strategies. Children and Youth Services Review 33, 102-109.

Reviewed by: Sydney Duder

This was a study of the effect of organizational culture on workers’ intentions to remain employed in child welfare, with worker coping strategies included as mediating variables. The sample comprised 234 front-line workers in Family and Children’s Services offices in a state in the southeastern US. The following measures were used:

• The Professional Organizational Culture (POC) scale (Ellett et al., 2003).

• Latack’s (1986) coping scale, used to measure worker responses to stressful situations at work. Two factors were used: control coping and avoidance coping.

• The Intent to Remain Employed in Child Welfare (IRE) scale (Ellett et al., 2003)

The most significant finding was the strong positive relationship between professional organizational culture and workers’ intentions to remain employed. This showed up in two ways: 1) Directly; and 2) Indirectly, through control coping as a mediating variable. Other variables in the model, avoidance coping, worker experience, and salary, were not found to be significantly related to intention to remain employed.

Methodological notes:

Both the original model and the eventual results of the analysis were illustrated in useful path diagrams. Structural equation modeling was used to test the proposed model; though the sample was not large, fit indices reflected a good fit between the model and the sample data. Overall, the model explained 36% of the variance in workers’ intentions to remain employed.

The authors point out several limitations that could limit the generalizability of the findings. For example, data were limited to only one state, and the proportion of workers with social work degrees (77%) was higher than reported in comparable studies. Also, in a cross-sectional study like this, the causal sequence in the model is theoretical; alternatively, workers more committed to a career in child welfare might be more likely to engage in pro-active control coping. A longitudinal study could clarify this relationship, and also potentially make it possible to examine the relationship between organizational climate and actual recorded worker turnover.

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26 February 2013

Can buy me love: the effect of child welfare expenditures on maltreatment outcomes

Source: Malcolm, M. (2012). Can buy me love: the effect of child welfare expenditures on maltreatment outcomes. Applied Economics, 44(28), 3725-3736.

Reviewed by: Andreas Jud

While the association between adverse economic circumstances and child maltreatment outcomes is well documented in the literature, few have bothered to control this association for child welfare expenditures. Malcolm (2012) presents evidence that increases in state child welfare expenditures are strongly associated with reduced child maltreatment victimization and even fatality rates over time.

As child welfare expenditures are positively correlated with good economic circumstances, much of the measured effect of economic circumstances on child maltreatment appears to be a statistical artifact rather than a causal link. This assumption is tested by measuring the impact of the 2000 recession on the rate of maltreatment victimization in the United States while controlling for state child welfare expenditures. The multivariate regression analysis covers administrative data from the annually collected National Child Abuse & Neglect Data System (NCANDS) between 1996 and 2002. The total number of substantiated child maltreatment victims in a given state and the count of child deaths due to maltreatment were analyzed as dependent variables. Data on child welfare expenditures were available through the Urban Institute’s biennial analysis and cover the whole range of expenditures on child welfare systems (including services contracted out to private agencies, salaries and other overhead). To further control for the economic environment separately from child welfare spending at the state level, the author introduces excess revenues, education spending per child, and generosity of income transfer programs. Poverty and economic insecurity as potential contributors to increased child maltreatment were covered as covariates by including the states’ poverty and unemployment rate.

The study findings indicate that higher expenditures on child welfare were convincingly associated with less child abuse. A $100 increase in child welfare expenditures is associated with a decline in the victimization rate by 15.5% of its mean value. The effect on fatalities was less pronounced with a decline in the arrival rate of 10.1% of its mean value. Second, and more surprisingly, the well-documented effect of poverty and economic insecurity on child maltreatment incidence seems to be overstated if one fails to control for policy differences. Finally, the effect of adverse negative circumstances diminishes further upon controlling for social attitudes correlated with income, as measured by aggregates of the General Social Survey (included attitudes towards harshness of courts, religious attendance, spanking and importance of obedience as a parenting outcome).

Methodological notes:

Some aspects are highlighted to underscore the author’s methodological rigor. First, as the linear model is inappropriate for fatality data since the counts are small, the Poisson model was applied. Second, endogeneity, correlation between variable and parameter and error term, of child welfare expenditures is a natural concern. However, the author demonstrates that endogenity would work against the main result as increased child maltreatment incidence ‘reverse causes’ higher child welfare expenditures, either through direct channels (increasing caseloads), or indirect channels (heightened attention of policymakers). While the author proves his strengths in analyzing economic circumstances the inclusion of social trends is of limited value as the chosen variables seem somewhat random and new theoretical developments had not been considered.

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29 January 2013

The economic burden of child maltreatment: Preventive measures could yield huge savings

Source: Fang, X., Brown, D.S., Florence, C.S., & Mercy, J.A. (2012). The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse & Neglect, 36, 156-165.

Reviewed by: Sydney Duder

Child maltreatment (CM) is a serious and prevalent public health problem, which can result in both individual trauma and also huge financial costs for society. This article estimates the economic burden in the U.S., and suggests the possible benefits of preventive measures. The best available secondary data were used to estimate costs per case. Whenever possible, studies based on quasi-experimental longitudinal prospective designs were used; no relevant studies could be found that were based on experimental designs. The authors argue that these estimates are significant new contributions that use a consistent robust approach in incidence-based costing methods; this directly facilitates comparison with other health conditions. The following are the estimated social costs of CM (in 2010 dollars): • Average lifetime cost per victim of nonfatal CM = $210,012 (includes the costs of short-term child health care, long-term adult medical care, productivity losses, child welfare services, criminal justice and special education) • Average lifetime cost per victim of fatal CM = $1,272,900 (includes the costs of medical care and productivity losses) As a result, the total lifetime cost of all new cases in 2008 (estimated to be 579,000 nonfatal and 1,740 fatal cases of CM) = $124 billion. The figure of $210,012 for nonfatal CM is comparable to the costs of other high profile public health problems (e.g., stroke, $159,846; type 2 diabetes, $181,000 - $253,000), which certainly suggests that costs are high enough to justify allocating resources to effective prevention and mitigation strategies. Though this study is based on incidence and costs in the U.S., it seems reasonable to expect that the implications for Canada would be similar.

Methodological notes:

The authors list a number of methodological problems; some of the more significant were: (1) the above figure of 579,000 new substantiated cases is very likely to be too low, as not all maltreated cases may have been reported, and state trimming of social service budgets may have artificially reduced the number of cases that could be substantiated; (2) the costs of some additional adverse outcomes (e.g., reduced life expectancy, decreased quality of life, and negative parenting behaviors, which can lead to negative intergenerational outcomes) were not included, as sufficient data were not available on the magnitude of these effects and their costs; (3) In most of the studies used, the estimates of long-term medical costs did not include the impact of psychological abuse; (4) data were not available to allow reliable estimates of burden by type and severity of maltreatment; (5) long-term medical costs for adults 65 or older could not be estimated. As a result, the cost estimates reported above almost certainly underestimate the true costs to society of child maltreatment.

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15 January 2013

Child welfare: Organizational climate can affect youth outcomes

Source: Glisson, C., & Green, P. (2011). Organizational climate, services, and outcomes in child welfare systems. Child Abuse and Neglect, 35(8), 582-591.

Reviewed by: Sydney Duder

The current study analyzes the relationships between organizational climate in child welfare systems, the casework services provided, and the outcomes for maltreated youth. Data were from all 5 waves of the US National Survey of Child and Adolescent Well-being (NSCAW) over a seven-year follow-up period. The study sample comprised youth aged four to16 years (N = 1,678) and caseworkers from 88 child welfare systems (N = 1,696).

The most important finding was the relationship between organizational climate and youth outcome—long-term outcomes for maltreated children were significantly more positive for children served by agencies with more engaged organizational climates. This was true, when the effects of age, gender and ethnicity were held constant. The relationship between climate and outcome was not affected by the reported quantity and quality of casework services actually provided; this was puzzling. The authors argue that further research is needed, both on ways to improve organizational climates, and on the mechanisms linking climate to youth outcomes.

The following measurement procedures were used:

• Organizational climate was measured by the Organizational Social Context (OSC) measurement system, a well-established instrument. Scores for two dimensions, engagement and stress, were calculated for each system by aggregating responses for all caseworkers who provided child welfare services in that system.

• Original scales developed for this study measured casework services provided to each child; the tools were completed by the primary caregiver and child’s caseworker.

• The Child Behavior Checklist (CBCL) measured youth outcomes. The Total Problem T-score, completed by the primary caregiver, was used as a measure of a child’s overall psychosocial functioning.

Methodological notes:

Several strong points are worth noting: 1) Casework services and outcomes were measured for individual children, while climate was measured only as agency averages; therefore, hierarchical linear modeling (HLM) was an appropriate analytical procedure; 2) Completely different data sources were used for organizational climate (worker averages) and youth outcomes (caregiver ratings); and 3) There was no possibility of any common method error variance.

While the authors had expected increased casework services to be associated with better outcomes, the only significant effect actually found was in the opposite direction; in hindsight it seems obvious that cases with more serious problems would receive more, rather than fewer casework services. On the other hand, service quality, as described by caseworkers, was the only service variable associated with improved outcomes.

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18 December 2012

Children discharged from kin and non-kin foster homes: Do the risks of foster care re-entry differ?

Source: Koh, E., & Testa, M.F. (2011). Children discharged from kin and non-kin foster homes: Do the risks of foster care re-entry differ? Children and Youth Services Review, 33, 1497-1505.

Reviewed by: Sarah L. Beatty

A primary goal of the child welfare system is to provide permanence and stability for children, through out-of-home care, or through reunification with their primary caregivers or kin. Extant literature illustrates that children are more likely to be reunited with their caregivers from kinship foster homes versus non-kinship foster homes. This study aims to contribute to the literature and measure the net effect of discharges from kinship foster homes versus non-kinship foster homes. The study is unique in that it uses propensity score matching (PSM). PSM is a statistical method that uses observational data to artificially create matched samples for outcomes measurement when random assignment cannot be used. PSM, in this case, takes into account many of the selection biases that can influence child placement into kin or non-kin foster homes, allowing for a more accurate comparison of outcomes. Child-level variables examined in this analysis include age, gender, race, disability, reason for out-of-home care, year of foster care discharge, number of previous placements, length of stay in out-of-home care, location of out-of-home care (i.e., urban versus rural), and Title IV-E eligibility (proxy for parental poverty status). The research questions include whether children residing in kin foster homes versus non-kin foster homes are more likely to: 1) be reunified; 2) be adopted; 3) or remain in child welfare out-of-home care. To examine their hypotheses the authors utilized the Adoption and Foster Care Analysis and Reporting System (AFCARS) data from Illinois. Analyses include 12,088 children who resided in out-of-home care for at least one week between October 1, 2000 to September 30, 2004. The 12,088 children exited out-of-home care (either kinship or non-kinship foster homes) and entered into one of the following arrangements: 1) reunification (n=6,110); 2) adoption (n=4,752); or 3) guardianship (n=1,226). Analyses with the PSM method revealed that the kin and non-kin groups had an equal likelihood of re-entry into out-of-home care. The authors suggest that there may be selection biases that differentiate the type of children who are accepted into kin foster placements versus non-kin foster placements.

Methodological notes:

While the study was well-designed, the authors indicate limitations: (1) external validity is restricted to Illinois; (2) the statistical models could not incorporate all theoretical assumptions due to a limited number of covariates; and (3) PSM relies upon observed data and does not control for any unobserved conditions that may influence outcomes. The authors point out that several potentially important variables were not available, thus limiting the study.

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4 December 2012

Child welfare decisions: Significant differences in agency referral patterns

Source: FJud, A., Fallon, B., & Trocmé, N. (2012). Who gets services and who does not? Multi-level approach to the decision for ongoing child welfare or referral to specialized services. Children and Youth Services Review 34, 983-988.

Reviewed by: Sydney Duder

This was a study of the services provided in child welfare cases after a report is investigated. Possible actions were ongoing agency service or referral to a specialized service, compared to no additional services beyond the investigation. A number of factors thought to be associated with the service decision were studied, including both case characteristics and agency characteristics. The multi-level strategy was based on a secondary analysis of the data from the Canadian Incidence Study of Reported Child Abuse and Neglect (Trocmé et al., 2008). The sample consisted of 15,980 cases from 111 agencies throughout Canada; in almost 60% of these cases some type of service was offered. The following case characteristics were found to be significantly associated with the decision to provide services: • Any type of actual maltreatment either suspected or substantiated. The strongest association was with exposure to intimate partner violence. • Risk investigations involving caregiver and household concerns (e.g., few social supports, teen parenting, low socioeconomic status). These risks seemed to drive service decisions almost more than substantiation status. Ethnic minority status was not found to be associated with the provision of services; this was surprising, since in many earlier studies ethnicity has been associated with increased placement in foster care. An unexpected finding was the marked effect of agency characteristics on referral rates; this was noted at both the provincial and agency levels. The proportion of cases referred ranged from 30% to 70% for provinces; from 15% to 77% for individual large agencies. Factors accounting for these differences remain largely unexplained; possible reasons might be differences in provincial legislation or funding, or in agency organization (e.g., supervisory support, working climate or staff retention). The authors argue this warrants further investigation.

Methodological notes:

This analysis was based on very sophisticated multi-level statistical procedures, including univariate and multivariate logistic regressions, using specialized statistical software (Mplus 5). Given the large sample size, the findings reported above were at a very high level of statistical significance. However, the authors pointed out a number of limitations. Longer-term service outcomes could not be measured and analysis was only of the referrals stage of the process. Very few agency-level variables were available in the analysis. In future studies it would be useful if more variables at both provincial and individual-agency levels could be included. In the latter case, this could potentially provide information to support improvements in practice.

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20 November 2012

Fully delegated community child welfare model appears to be more effective than a hybrid state managed service contract model in Florida

Source: Lamothe, M. (2011). Redesigning the Hollow State: A Study of Florida Child Welfare Service Reform through the Lens of Principal-Agent Theory, International Journal of Public Administration, 34, 497–515.

Reviewed by: Nico Trocmé

Contracting child welfare service delivery to third party service providers is being used increasingly in across Canada. While third party service providers, often relatively small not-for profit community-based agencies, may, in some instances, be in a better position to build on community resources and tailor programs to the specific needs of children and their families, careful consideration needs to be given to developing contracting mechanisms that allow government administrators to ensure service quality and control costs. In her study of child welfare service reform in Florida, Meeyoung Lamothe examines the challenge of aligning the priorities of government administrators with contract service providers through the lens of Principal (government) Agent (contract agencies) Theory. Through a series of key informant interviews and analysis of government documents, the author describes Florida’s transition from a service delivery model where the government run child welfare authority administered caseloads but contracted most direct services to hundreds of service providers, to a model where case management responsibilities were transferred to 22 “lead agencies”, who provide some services directly and sub-contract other services. State and agency administrators interviewed for the study generally viewed the transition as a success. The previous contracting process was perceived to be a fragmented compromise between a state run and agency run model, where responsibility for outcomes remained with the state and service contracts were compliance and process driven. By delegating most of the state’s authority and functions to a small number of not-for profit community agencies, state and agency administrators noted that the reporting relationship was refocused on service outcomes, allowing the lead agencies more flexibility in developing their own program models. The study revealed some unintended consequences; for example, in addition to delegating more authority to the lead agencies, the reform also stressed increased community involvement, which led to an unexpected shift to “parochial” concerns, hindering statewide policymaking ability. Interestingly, from a Canadian perspective, the Florida model looks very much like the delegated agency model that has been in place for over a century in several jurisdictions across the country.

Methodological notes:

Semi-structured interviews with senior state administrators and administrators in six of the 22 lead agencies were conducted by the author or her co-investigator. State reports, contracts and agency planning documents were also reviewed. The study did not attempt to assess the impact of reforms through analysis of caseload statistics, nor were clients or community service providers interviewed.

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6 November 2012

A person-centered approach to understanding the parenting behaviours of biological fathers

Source: Lee, S.J., Kim, J., Yaylor, C., & Perron, B. (2011). Profiles of disciplinary behaviors among biological fathers. Child Maltreatment, 16(1), 51-62.

Reviewed by: Jennifer Nutton

Research suggests that when fathers are positively involved in the care of their children (e.g., by providing emotional support, appropriate discipline, supervision), the risk of negative youth behaviours such as delinquency are reduced. Conversely, when fathers are negatively involved with family members (i.e., substance abuse, mental health problems, intimate partner violence), there is increased risk of harm to the children in the home. This exploratory study focuses on the parenting behaviours among involved, biological fathers to better understand the effects of both positive and negative disciplinary techniques. Unlike much of the research on parenting, this study focuses on paternal not maternal disciplinary behaviours. This study is also unique in its use of a person-centered approach, such as latent class analysis (LCA), to better understand the disciplinary behaviours of fathers by assigning them to mutually exclusive subgroups based on their responses to 14 variables. This study used data from the Fragile Families and Child Wellbeing Study (which collects data through interviews with mothers and fathers at birth and again when the child is one and three years of age) and the follow-up In-Home Longitudinal Study of Pre-School Aged Children (interviews conducted with mothers only who completed the FFCWS core interview). To assess fathers’ discipline of their three year old child, data were collected from a subsample of (n=1,238) mother and father participants. Information was collected only on the parenting behaviours of biological fathers residing in the home. The Parent-Child Conflict Tactics Scales was used in the LCA model to assess both nonaggressive and aggressive disciplinary behaviours. Participants were assigned to subgroups based on four paternal parenting profiles (low discipline, low aggression, moderate physical aggression and high physical and psychological aggression). Results of the study indicated the most serious form of discipline, psychological aggression (e.g., calling the child dumb/lazy, shaking the child and pinching) were uncommon among all groups. The most prevalent forms of discipline were nonaggressive, which included explaining what was wrong and giving the child something else to do and taking away privileges. Fathers in the high physical and psychological aggression group were more likely to have children with higher levels of aggression. Parental arguing and father’s perceived support from the child’s mother were virtually equal among all four parenting profiles. The authors suggest that normative parental arguing may not differentiate fathers in relation to their parenting style. However, results demonstrated that more serious forms of marital conflict increased the risk of psychological or physical aggression towards the child.

Methodological notes:

As an exploratory study, it is important to note the potential benefits of using a person-centered approach. For example, the LCA revealed qualitative differences among the subgroups of parenting profiles that total scores from the Parent-Child Conflict Tactics Scales (PCCTS) would not. However, the LCA model also revealed limitations as the ability to detect differences between groups is determinant on having a large enough sample within each of the subgroups; and, in this study, the size of the high physical and psychological aggression parenting profile group was small (n=42). The Parent-Child Conflict Tactics Scales used in this study has been widely used in parenting research and in many countries, which speaks to the reliability and validity of this measurement. However, there are methodological limitations around scales of self-reports particularly when participants are asked about their own socially undesirable behaviours leading to underreporting. Finally, the sample only included biological fathers residing in the home so the findings are not generalizable to non-biological fathers residing in the home or biological fathers not residing in the home.

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16 October 2012

Why do African American children have more out of home placements than white children, even when controlling for identified risk factors?

Source: Foster, E. M., M. M. Hillemeier, et al. (2011). Explaining the disparity in placement instability among African-American and white children in child welfare: A Blinder-Oaxaca decomposition. Children and Youth Services Review, 33(1), 118-125.

Reviewed by: Pamela Weightman

There is an overrepresentation of African Americans residing in out-of-home care in the U.S. child welfare system, the reasons for which are unclear. In addition, African Americans in foster care experience more frequent placement changes. This is especially concerning as frequent placement changes can have a negative impact on a child’s development. This quantitative study compares out-of-home placement instability among African American and Caucasian children in the National Survey of Child and Adolescent Well Being (NSCAW) and attempts to identify mechanisms that may be at the root of racial disparities. Many of the identified risk factors associated with placement instability (e.g., emotional and behavioural problems, chronic medical conditions, lower socioeconomic status) are disproportionally found in African American children in the child welfare system. However, the findings show that when controlling for these factors, African American children still have more out-of-home placements than Caucasian children. Additional factors not accounted for in the study may explain African American’s increased risk of out-of-home placement instability. Authors posit a potential explanation could be a difference in the way the child welfare system treats children of different races. Predictors of placement instability among African American children include older age, initial placement in a setting other than kinship care, and behavioural problems. Among Caucasian children only the initial placement in foster care predicted placement instability.

Methodological notes:

The authors analyzed data from the Child Protective Services cohort of NSCAW which is a national study of child welfare in the United States that collects data directly from children and families involved with child welfare as well as child welfare workers. Interviews were conducted at four time points after the conclusion of the investigation or assessment: between two and six months; 12 months; 18 months; and 36 months. Children were selected for inclusion in the study if they were aged two years or older at the initial interview (this limit was imposed as the Child Behaviour Checklist is not available for children under two years), were African American or Caucasian, and were placed in an out-of-home setting at the initial interview. The authors point out that several potentially important variables were not available, thus limiting the study.

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2 October 2012

Despite moderate decline in corporal punishment in the US, spanking and slapping young children remains normative; Canadian review raises concerns about effects on child development

Source: Zolotor, A. J., Theodore, A. D., Runyan, D. K., Chang, J. J., & Laskey, A. L. (2011). Corporal punishment and physical abuse: population-based trends for three-to-11-year-old children in the United States. Child Abuse Review, 20(1), 57-66; Durrant, J. & Ensom, R. (2012). Physical punishment of children: lessons from 20 years of research. Canadian Medical Association Journal Early release, published at www.cmaj.ca on February 6, 2012.

Reviewed by: Nico Trocmé

Analysis of results from four surveys using a standardized measure conducted between 1975 and 2002 in the Unites States (three national samples, and one conducted across the Carolina states) shows a moderate decrease in parent-reported use of spanking and slapping. Across all four surveys rates of spanking or slapping dropped most rapidly for six to eight year olds, from 80% in 1975 to 60% in 2002, while remaining high for children in the three to five year old range (over 80%). While the authors note that the decline in self-reported rates of spanking or slapping may reflect the beginning in an encouraging trend, they note, however, that nearly a third of parents reported using an object to hit and discipline their children. A review of 20 years of research on the effects of physical punishment on children published in the Canadian Medical Association’s Journal raises concerns about negative long-term developmental outcomes as well as increased risk of physical abuse. The authors also draw attention to evidence of the efficacy of programs that teach non-violent approaches where parents are taught communicate clearly and apply contingent consequences. In light of these findings, the authors encourage physicians to promote non-violent approaches to discipline and raise concern about Section 43 from the Criminal Code, which provides legal justification for the use of physical punishment, and undermines public education efforts to promote positive parenting.

Methodological notes:

Three of the four studies reviewed by Zolotor et al. were telephone surveys, while the 1975 study was based on a face-to-face household survey. Sample sizes ranged from 1,000 to 3,360 randomly selected parents. In all four surveys, the Conflict Tactics Scales or a modified version, the Parent-Child Conflict Tactics Scales, was used. Changes to the question about hitting with an object limit comparability between the earlier and more recent surveys. Assessing the effect of social desirability on response rates is a challenge in interpreting the results of these self-report studies, however, even the results remain relevant even if they are partially measuring a shift in public attitudes. While the Durrant and Ensom CMAJ analysis was not a systematic review, it presents a concise review of some of the key methodological challenges that physical punishment researchers have attempted to address, and provides a useful analysis of the Canadian practice and policy implications of these studies.

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18 September 2012

Predictors of early childhood neglect: A tri-study comparison

Source: Slack, K., Berger, L., DuMont, K., Yang, M., Kim, B., Ehrhard-Dietzel, S. & Holl, J. (2011). Risk and protective factors for child neglect during early childhood: A cross-study comparison. Children and Youth Services Review, 33(8), 1354-1363.

Reviewed by: Kristen Lwin

There is a dearth in research identifying predictors of child neglect during early childhood. Factors that are associated with neglect, either risk or protective, are important to understand, as this information can inform prevention and intervention efforts.

The authors conducted secondary analysis of three longitudinal studies of families with young children. The three studies are different in their sample size, variables and methodology. However, all three include families with children under the age of five years, involve predominantly low-income families, and measures of neglect. The studies (Fragile Families and Child Wellbeing (FFCW), n=3033; Healthy Families New York (HFNY), n=1173; and Illinois Families Study-Child Wellbeing (IFS-CWB), n=583) distinguish neglect from other types of maltreatment and encompass more than one type of neglect (e.g., financial, emotional).

Within the FFCW, results indicated that several economic variables (e.g., receipt of financial assistance from family members, use of a food bank, inability to see a doctor) were significantly associated with child welfare involvement for concerns of neglect. The results of the FFCW also indicated that caregiver self-efficacy was inversely associated with child welfare contact (i.e., higher self-efficacy was associated with fewer contacts). The HFNY also established numerous economic predictors (e.g., receipt of public benefits, inability to see a doctor, difficulty paying rent) to be significantly associated with increased odds of a child welfare report of neglect. Similarly, the IFS-CWB study found economic variables (e.g., receipt of food stamps, food bank use, difficulty paying rent) were associated with increased odds of contact with child welfare for neglect concerns.

All variables measured amongst the three studies were statistically similar except for the measures of caregivers’ employment, receipt of food stamps, and involvement with children’s activities. Thus, associations between variables and investigated child welfare neglect were not strongly influenced by differences among the three studies.

Economic resource variables such as receiving financial assistance from family members, food bank use, housing subsidy and being unemployed predicted involvement with child welfare for concerns of neglect within all three studies (non-significantly in HFNY, p<.10). Economic hardship factors (e.g., reduced meal size, utility shut off, and difficulty paying rent) predicted child welfare neglect concerns within the FFCW and HFNY studies.

Authors suggest findings are important for prevention efforts. Child welfare organizations may focus too heavily on parental characteristics as the source of maltreatment and focus of interventions, whereas poverty-reduction efforts are likely more important.

Methodological notes:

Variation in several measures was not given full consideration. Child welfare official records were available for two of the three samples. The third sample includes a self-report measure of child welfare involvement, which may have caused an under-estimation of this involvement.

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10 July 2012

Study looks at contextual effects on externalizing behaviors in children in out-of-home care

Source: Cheung, C., Goodman, D., Leckie, G., & Jenkins, J.M. (2011). Understanding contextual effects on externalizing behaviors in children in out-of-home care: Influence of workers and foster families. Children and Youth Services Review, 33(10), 2050-2060.

Reviewed by: Sarah L. Beatty

Some research suggests that children residing in out-of-home care are more likely to exhibit externalizing behaviours (e.g., destruction of property, violation of societal norms, harm towards others) than children living with their biological parents. There is considerable individual variation in levels of externalizing behaviour. The expression of externalizing behaviour is likely impacted by many factors, including cognitive ability, placement disruptions, and maltreatment experiences. In addition to child specific features, some research shows that foster parent characteristics influence the externalizing behaviour of children in their care.

Using the Assessment and Action Record (AAR) data from the Ontario Looking After Children (OnLAC) project (2007-2008), the authors conducted secondary cross-sectional data analysis to explore the relationship between worker and foster families characteristics and externalizing behaviours of children in-care (i.e., foster, n=865, 81%; kinship, n=91, 9%; and group care, n=107; 10%) aged 10-17 years (average age of 13 years, 7 months). Results reveal two important findings: (1) child protection workers with less formal education tend to work more with children that have higher levels of externalizing behaviours (24% of the variance seen at the worker level); and (2) foster parent negativity (such as disfavouring an individual foster child) tends to be associated with higher levels of externalizing behaviour in the disfavoured child. These findings imply that child-level, worker-level, and foster family-level characteristics should be considered when developing policy and practice approaches.

Methodological notes:

The authors examined three sources of data: (a) AAR data from 2007-2008 for 1,063 children in-care who were randomly selected from 12 Children’s Aid Societies (9 urban agencies, 3 rural agencies); (b) Information on 528 workers, who were identified through cross-referencing worker-specific variables (of which 221, 42%, worked with multiple children in-care); and (c) Information on 962 foster parents, who were identified through cross-referencing foster parent specific variables. Five models were created to test the participant specific variables. The authors did acknowledge limitations to the study, including its cross-sectional design, which was unable to address the long-term relationships between the variables. There was also a low participant rate from child welfare agencies, and a lack of information on genetic influences.

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27 April 2012

Home-based intervention for high-risk rural families: A randomized clinical trial

Source: Silovsky, J., Bard, D., Chaffin, M., Hecht, D., Burris, L., Owora, A. et al. (2011). Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes. Children and Youth Services Review, 33(8), 1435-1444.

Reviewed by: Kristen Lwin

There has been little research in the area of child maltreatment prevention within high-risk rural populations. Rural caregivers struggling with substance use, intimate partner violence (IPV), and depression may be at high risk for perpetrating child maltreatment, yet few home-based prevention programs are customized for this population. SafeCare (SC) is a skills-based model designed to alter parenting behaviours related to child maltreatment and delivered by trained home based service providers. For the purposes of this study, the SC method was adapted for high-risk rural communities (SC+) enhanced with Motivational Interviewing and compared to a standard home-based mental health service (SAU). It was hypothesized that families who received SC+ (n=48), as compared to SAU (n=57), would have: 1) enhanced engagement in services; 2) lower rates of out-of-home placements; and 3) greater improvement of risk factors (i.e., depression, substance misuse, IPV) and parenting skills (e.g., dealing with child health and home hazards).

Families randomized to SC+ were significantly more likely than SAU participants to complete the initial intake meeting where home visitors obtain demographic information and a needs assessment of the family. Providers of SC+ were more likely to refer and connect families to additional services, compared to SAU service providers. Further, SC+ participants were much more likely to be satisfied with the service they received. Caregiver self-reports indicated participants randomized to SC+ were better able to address child health and home hazards, as well as prevent child behaviour problems. Ten participants (21%) of SC+ and 18 participants (32%) of SAU had a future referral to child welfare services. Amongst families with additional child welfare referrals the median length until a first report was 103 days for SAU participants and 200.5 days for those receiving SC+. Differences in re-referral rates and time were not statistically significant. Although preliminary results suggest engagement and satisfaction with SC+ service, further examination with a larger sample size is required for more rigorous results.

Methodological notes:

One hundred and five parents of children 5 years or less who had identifiable risk of depression, IPV, or substance abuse were randomized to SC+ or SAU. There were no significant differences between the two groups with respect to demographic characteristics (i.e., age, gender, ethnicity, marital status, education, pregnancy and employment status). The average age of caregivers was 27 years (SD=9), and families had an average of two children. Both African American and First Nation populations were overrepresented compared to their rates in the general population in the United States.

This study was limited by drop out over time, although all analyses are based on results for the full randomized samples. The sample size was also quite small, which may explain the lack of significance on some outcome measures.

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13 March 2012

Major Findings from the Fourth National Incidence Study of Child Abuse and Neglect (NIS)

Source: Sedlak, A.J., Mettenburg, J., Basena, M., Petta, I., McPherson, K., Greene, A., and Li, S. (2010). Fourth National Incidence Study of Child Abuse and Neglect (NIS–4): Report to Congress. Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families.

Reviewed by: Jennifer Ma

The National Incidence Study (NIS) examines the incidence of child abuse and neglect in the United States. The Fourth National Incidence Study (NIS-4) collected data from a representative sample of 122 counties across 126 Child Protection Service (CPS) agencies. The NIS-4 examines children who are maltreated including those investigated by CPS agencies and others not reported to CPS or screened out by CPS without investigation but recognized as maltreated by community professionals. The findings of the NIS-4 demonstrate a general decrease in the incidence of maltreatment since the Third National Incidence Study (NIS-3), with decreases in particular maltreatment categories and increases in others. Further analyses of the data need to be completed to understand the observed changes in the incidence of maltreatment.

The NIS-4 collected 6,208 forms from community professionals and 10,677 forms on the investigation outcomes from participating CPS agencies over a three-month period. National estimates were derived from the collected data to reflect the numbers of abused and neglected children in the United States. The NIS uses standard definitions of abuse and neglect therefore the incidence rates of maltreated children are standardized across various CPS and community agencies and NIS cycles. Abuse includes physical abuse, sexual abuse, and emotional abuse. Neglect includes physical neglect, emotional neglect, and educational neglect. The NIS-4 further defines maltreatment by employing two definitional standards: the Harm Standard and the Endangerment Standard. The Harm Standard identifies abuse or neglect as situations where an act or omission results in substantiated harm. The strength of the Harm Standard is its objectivity while its limitation is its rigidity in the inclusion of children who are maltreated. Conversely, the Endangerment Standard includes all children who meet the Harm Standard in addition to children who have not yet been harmed by abuse or neglect if a professional deemed that the maltreatment endangered the child or if a CPS investigation substantiated their maltreatment.

Under the Harm Standard category, more than 1.25 million children (an estimated 1,256,000 children or a rate of 17.1 children victimized per 1,000 children) experienced maltreatment during the NIS-4 study year (2005-2006). The NIS categorizes children in every applicable type of abuse or neglect; as such the portions may amount to more than 100%. An estimated total of 553,300 children were abused (44%) while 771,700 children were neglected (61%). Most of the abused children were physically abused (58% or an estimated 323,000 children), approximately a quarter experienced sexual abuse (24% or an estimated 135,500 children) while more than quarter experienced emotional abuse (27% or an estimated 148,500 children). Almost half of the neglected children experienced educational neglect (47% or an estimated 360,500 children), more than a third were physically neglected (38% or an estimated 295,300 children) and a quarter were emotionally neglected (25% or an estimated193,300 children). Overall, the incidence rate of Harm Standard maltreatment in the NIS-4 declined by 19% since the NIS-3. The number of children who experienced Harm Standard abuse decreased significantly by 26% (an estimated 743,200 children in the NIS-3 to an estimated 553,300 children in the NIS-4). There are no statistically significant changes from the incidence of Harm Standard neglect since the NIS-3.

Under the Endangerment Standard category, more than 2.9 million children (an estimated 2,905,800 children or a rate of 39.5 children victimized per 1,000 children) experienced maltreatment during the NIS-4 study year. An estimated total of 835,000 children were abused (29%) while an estimated 2,251,600 children (77%) were neglected. Most of the abused children were physically abused (57% or an estimated 476,600 children) while approximately a third (36% or an estimated 302,600 children) were emotionally abused and less than a quarter (22% or an estimated 180,500 children) were sexually abused. More than half of the neglected children experienced physical neglect (53% or an estimated 1,192,200 children). Almost half were emotionally neglected (52% or an estimated 1,173,800) and 16% (an estimated 360,500 children) were educationally neglected. A statistically significant change was not observed in the overall incidence rate of Endangerment Standard maltreatment in the NIS-4 from the NIS-3. Nevertheless, there was a significant 32% decrease in the number of children who experienced Endangerment Standard abuse (an estimated 217,700 children in the NIS-3 to an estimated 135,300 in the NIS-4). There were no statistically significant changes from the incidence of Endangerment Standard neglect since the NIS-3.

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