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The National Survey of Child and Adolescent Well-Being (NSCAW) is the first nationally representative study of children who have been reported to authorities as suspected victims of abuse or neglect and the public programs that protect them. Child Protection is the first book that reports the results of NSCAW, interprets the findings, and puts them into a broader policy context.
The authors, all experts in child welfare issues, address a range of issues made apparent by the survey results, including which types of personal and familial problems the programs are meant to address, the range of services and interventions that the child protection system can make available, and an assessment of these programs. Each chapter discusses the survey's implications and suggests new alternatives for designing and implementing future programs that not only protect at-risk children from further harm but also provide them with security and support. The practical lessons included in this volume make it an essential reference for all professionals working in the child protection field as well as anyone studying in the field of child welfare.
RON HASKINS, FRED WULCZYN, AND MARY BRUCE WEBB
Each year in the United States, nearly 900,000 children are physically harmed or neglected by their caretakers, and approximately 1,300 of them die. In addition, a little more than a half million children live in foster care-a living arrangement that includes families previously unknown to the child, relatives, and various forms of group and residential care. Given the well-known problems associated with foster care, in combination with the abuse or neglect itself, it is little wonder that these children have an elevated incidence of poor school achievement, school dropout, mental health problems, arrests, teen pregnancies, and other afflictions. The number of child victims may vary from year to year, but it is a brute fact of the human condition that some adults caring for children harm them. The United States, responding to this grim reality, has evolved what on paper looks to be a reasonable federalist system for protecting children. The purpose of this volume is to use information from a landmark new study to describe how this system works andto suggest specific ways that those working in the system can use it to improve their practice and thereby improve the odds that these most unfortunate children will grow up to lead happy and productive lives.
The nation's child protection system has several major components and features. The first is mandatory reporting laws-written by and enforced in every state-that require various professionals who have contact with children, such as doctors, nurses, and teachers, to report incidents of suspected abuse or neglect. Professionals who do not report their suspicions are generally subject to penalties. The second component is programs, which are operated by every state or are under the authorization of state government, that investigate these reports, determine whether children have actually been subjected to abuse or neglect, and make several determinations about what to do if abuse or neglect is confirmed. A third component of the system is a somewhat haphazard set of services that aims to help abusive families and their children. As established in federal and state statutes, the goals of the child protection system are to maximize child safety, keep children in permanent living arrangements, and promote the development of children in its care. In pursuing these goals, the public child welfare agency first must decide in confirmed cases of abuse or neglect whether it would be safe to leave the child with the child's family or whether the child should be removed and placed in a foster care home, often with a relative. If children stay at home, the agency has to determine whether to provide services. If children are placed outside their homes, the agency must make reasonable efforts to reunify them with their families, unless the situation is so dire that reunification would not be reasonable. If these efforts fail, the agency must make permanent arrangements in as timely a fashion as possible. In most cases of this type, adoption is the preferred option. These various and complex decisions about the child, which sometimes turn out to be life-and-death matters, are made by social workers, who often have caseloads of twenty or more children. The courts then review the decisions. The entire child protection system-from reporting, to investigating reports, making placement decisions, obtaining services, and maintaining the court system-is paid for by a combination of federal, state, and local resources. Federal funds flow from Title IV of the Social Security Act, which establishes the outline of the federalist system and provides approximately $7 billion per year to states that agree to abide by the federal rules specified in Title IV and in the Child Abuse Prevention and Treatment Act, as well as in various regulations, administrative guidelines, and review systems.
If this system looks somewhat reasonable on paper, in practice it has flaws that are widely recognized. These include inadequate training of the professionals running the system, a shortage of high-quality foster homes, a shortage of effective intervention programs to provide needed services, a dearth of prevention services, an abundance of paperwork, and a somewhat ineffective, though improving, system of accountability. Both the federal government and the states have attempted on many occasions to address these and similar issues, sometimes with modest success, sometimes with less.
Congressional Approval of a National Study of Child Protection
During the highly partisan debate on welfare reform in 1995-96 that led to sweeping reforms of many welfare programs, a bipartisan agreement, primarily between Republicans on the House Ways and Means Committee and then senator Daniel Patrick Moynihan of the Senate Finance Committee, resulted in the appropriation of $6 million per year for seven years to mount a representative national survey of children in the child protection system. The text of the legislation, which passed as part of the 1996 welfare reform law, instructed the Department of Health and Human Services to conduct a study that followed children in the child protection system for several years to discover how their cases were handled by the system, whether they were removed from their homes, what types of services they and their parents received, what were their developmental outcomes, and whether measures of the way cases were handled and services obtained were related to developmental outcomes. Congress in general, and the House Ways and Means Committee in particular (where the original provision authorizing the study was written), was especially interested in two types of results from the survey. First, based in part on testimony received by the Human Resources Subcommittee of Ways and Means over several years, the view of Congress was that there were too few high-quality, large-scale studies of the nation's child protection system. Thus one goal of the study was to provide an overall picture of how the nation's child protection system works by studying a large representative sample of children and families exposed to the system. Such a study could provide reliable answers to fundamental questions about the nation's child protection programs:
-When a case of abuse or neglect is confirmed, what percentage of children remains at home?
-What percentage enters foster care?
-How often is foster care provided by kin?
-How long do children stay in foster care?
-How many different placements do children experience over time?
-Do children or families receive services, and, if so, what types of services?
-Do the services produce good outcomes?
These and other basic questions could be answered, at least in part, by a national survey that would supply abundant national information about child protection that had not been previously available.
A second goal of the study was to learn something about child outcomes. At the time of the 1996 legislation, federal statutes specified that the goals of the child protection system were to preserve child safety and to achieve permanent placements-whether with the family or through adoption-as quickly as possible. But members of Congress and the Clinton administration were concerned about promoting child well-being as well as achieving safety and permanency. Reforms of the child protection system enacted in 1997, combined with the subsequent regulations and especially the new federal review system implemented after the 1997 reforms, established the promotion of child well-being as an important goal of the child protection system. Thus Congress approved funds for the national study for two major reasons: members wanted to know whether the placements of children and the services they received influenced their growth and development, and they wanted reliable data on this and related questions for the nation as a whole and for as many states as possible. Under the strict rules of social science, a survey cannot establish whether the placements or services received by children are causally related to child outcomes, but the correlations between placements and outcomes might be suggestive and might raise issues for further research that could establish causality. In Congress, research methodology and determinations of causality are not a major concern-in reality, for members of Congress and their staffs, correlation is often considered as causation, regardless of the obscure rules of social science.
As it often does, Congress gave the Department of Health and Human Services wide latitude in conducting the study. More specifically, the secretary was directed to conduct "a national study based on random samples of children who are at risk of child abuse or neglect." The secretary was also required to ensure that the study was longitudinal (meaning that the same children and caretakers had to be followed over time) and that it yielded data that were reliable for as many states as possible. The secretary was also required to consider collecting data on the type of abuse or neglect involved; the frequency of contact of the child and family with state or local agencies; whether the child was separated from his or her family; the number, type, and characteristics of out-of-home placements; and the average duration of placements.
The Department of Health and Human Services after extensive consultation with experts in child protection research, policy, and practice convened an internal work group to plan for the study. Decisions by this work group led to two of the more innovative features of the study. First, the group decided that rather than focusing only on children who were served in the child protection system the study should provide a broad overview of children's experiences both before entering the system and then once inside the system, so that pathways from an initial report of maltreatment to long-term outcomes could be explored. This decision meant that the study would include not only children who were placed in foster care or who received other child welfare services but also those who had been reported to child protective services (CPS) without the report of their maltreatment being substantiated, as well as children who remained at home even if their reports were substantiated. Second, the work group decided that the study should emphasize a broad range of developmental outcomes and measures of how children were functioning in day-to-day living. In this respect, the study reflects what seems to be a growing emphasis among policymakers on the development of children in the child protection system.
Description of the National Survey of Child and Adolescent Well-Being
After the internal group studied the legislation and wrote a request for proposal (RFP) based on the statute, the Department of Health and Human Services sought bids to conduct a national survey that met the requirements set out by the RFP. The Research Triangle Institute won the competition for the contract and has been the primary agent responsible for collecting the complex and comprehensive data called for by the RFP (see the appendix for an overview of all the measures collected). The study was named the National Survey of Child and Adolescent Well-Being (NSCAW).
NSCAW includes two samples of children: the CPS sample of 5,501 children and the One Year in Foster Care sample of 727 children. The CPS sample is representative of all children in the United States who were the subjects of investigations or assessments of child abuse or neglect conducted by CPS agencies during the fifteen-month period that began in October 1999. Some of the children and families selected for the samples may have had prior experience with CPS or child welfare services.
Both samples were selected using a two-stage stratified sample design. At the first stage, primary sampling units were selected, which were defined as geographic areas encompassing a population served by a single CPS agency. In most cases, these sampling units represented single counties, although there were instances in which some large counties contained multiple sampling units and small, contiguous counties made up a single unit. The sample units were randomly selected using a procedure that gave a higher chance of selection to units having larger caseloads. A few counties that were anticipated to have caseloads too small to provide an adequate workload for a single field interviewer were excluded from the sample (these counties are estimated to contain less than 3 percent of the child welfare population).
The first-stage sample resulted in the selection of 100 sampling units. Seven of these were determined to be very small and were combined with adjacent counties for the study. Of the original 100 sampled units, only six refused to participate in the study and were replaced by randomly selected units of approximately the same size. Eight counties were dropped after the onset of data collection because their laws did not permit contact with study staff without explicit consent-a restriction that would result in an unacceptably low response rate. These counties were not replaced. Thus the final sample comprised 92 sampling units, representing 97 counties.
The second-stage sample was composed of children selected from the 92 sampling units. The frame for selecting children for the CPS sample within sampling units was constructed from lists of children who were investigated for child abuse or neglect during the months October 1999 through December 2000. Sampling domains were constructed that allowed for the inclusion of children in out-of-home care, children receiving child welfare services at home, and children not receiving child welfare services following the investigation. The sample was selected to provide an oversample of infants, sexually abused children, and children receiving child welfare services.
The sampling frame for the One Year in Foster Care sample was also constructed from lists obtained from the participating agencies located in the 92 primary sampling units. Children were eligible for this sample if they met the following criteria:
-they had been placed into out-of-home care approximately one year before the sample selection period,
-their placement into out-of-home care had been preceded by an investigation of child abuse or neglect or by a period of in-home services, and
-they were still in out-of-home care when the sample was selected.
The foster care sample selection period was December 1999 through February 2000. In many sampling units, the number of children available during the original time period was found to be too small to support the sample sizes required. As a result, the window of inclusion was extended in those sampling units to include children who were placed in out-of-home care between July 1998 and February 1999. As a result of this procedure, children in the foster care sample had spent between eight and twenty months in out-of-home care at the time of sampling.
Data were collected from four sources: the children themselves, their primary caregivers, their caseworkers, and, for school-aged children, their teachers. Extensive information was obtained from standardized assessments and interviews that covered children's health; children's social, emotional, behavioral, and cognitive functioning; caregiver characteristics and caregiving environment; and services needed and received (see the appendix). Data were collected at baseline (wave 1) and at twelve months (wave 2), eighteen months (wave 3), and thirty-six months (wave 4) after the baseline data collection. All children with a completed interview at wave 1 were contacted for participation in subsequent waves. Agency-level contextual data were collected from state and county child welfare administrators at baseline. The complex design of NSCAW allows for more sophisticated statistical procedures than those that have traditionally been used in child welfare analyses. These statistical procedures include multilevel modeling, growth curve modeling, and various multivariate analyses. Some of these procedures are featured in this volume.
Excerpted from Child Protection Copyright © 2007 by Brookings Institution Press. Excerpted by permission.
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