Child Welfare

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					Chapter 7

  Protecting Children
  from Neglect and Abuse
 Child Protective Services received 2.9
  million referrals alleging child
 Approximately two-thirds of referrals were
  accepted for investigation or assessment.
 After investigation, CPS agencies
  determined that 906,000 children were
  victims of child maltreatment.
 The national rate of victimization was 12.4
  per 1,000 children.
 More than one-half of reports of alleged
  child maltreatment were made by
  professionals including educators, law
  enforcement, medical professionals, social
  service personnel and child care staff.
  Educators provided the largest proportion
  of reports at 16.3%. Law enforcement and
  legal personnel made 16% of reports.
  Social services personnel made 11.6%.
 Friends, neighbors, and relatives submitted
  approximately 43.2% of reports.
 Children under the age of 3 had the highest
  rate of victimization, and girls were slightly
  more at risk to be victims than boys.
 More than 60% of child victims were
  neglected; approximately 20% were
  physically abused; 10% were sexually
  abused; 17% suffered from other types of
  maltreatment; and 5% were emotionally
  maltreated. A child could be a victim of
  more than one type of child maltreatment.
 Approximately 80% of perpetrators of child
  maltreatment were parents. Other relatives
  accounted for 6% and unmarried partners
  of parents and "others" each accounted for
  4% of perpetrators.
 Nearly 76% of perpetrators of sexual abuse
  were friends or neighbors and 30% were
  other relatives. Less than 3% of parental
  perpetrators were associated with sexual
 Approximately 15% of child victims were
  placed in foster care.
 Nearly 57% of victims and 25% of
  nonvictims received services as a result of
  a CPS investigation or assessment.
 An estimated 1,500 children died as a
  result of child maltreatment. More than
  three-quarters of the children who died
  were under four-years old.
Aims and Special Attributes of Child
Protective Services
 Authoritative
 Carry significant social agency
  responsibility, because they are
  directed toward families in which
  children are at risk
 Involve agency sanction from the
 Require a crucial balance in the use of
  the agency’s authority
Historical Development of
Protective Services
 Early attitudes toward the treatment
  of children
   History has recorded mistreatment of
    children: Herod, infanticide, absolute
    obedience, laudanum, flogging and
    caning, child labor.
Beginnings of Care for Neglected
 After Revolutionary War, legislation limiting
  the extend of “binding out”, or street
  children committed to almshouses.
 1790: First public orphanage established in
  South Carolina – cared for and educated
  orphans and also children whose parents
  could not afford to care for them.
 1825: The beginning of recognition that
  public authorities have a right and duty to
  intervene in cases of parental cruelty or
  gross neglect of children and to remove and
  place if necessary.
Societies for the Prevention of
Cruelty to Children
 Up to this point no clear means for finding
  neglected or abused children.
 As a result, societies for the prevention of
  cruelty to children (SPCCs) were
 1873: Mary Ellen – first child removed
  through New York Society for the
  Prevention of Cruelty to Animals.
 By 1898 more than 200 SPCCs in the U.S.
The Battered Child Syndrome
 Coined in the 1960s; advances in the
  technology of radiology made it
  possible for physicians to identify
  patterns of injuries through X-rays.
 Public interest was renewed and
  official procedures for reporting child
  abuse were established.
The Child Abuse Prevention and
Treatment Act
 Passed in 1974; established a
  National Center on Child Abuse and
 Provided grants to states if they
  passed reporting laws; also mandated
Shifting Priorities: Child Safety and
Family Preservation
 1980 Adoption Assistance and Child Welfare
  Act: encouraged agencies to serve children
  in their own homes.
 If child was removed, family reunification
  was the goal, even if it took years.
 1993 Family Preservation and Support Act:
  increased funding for family preservation
  and preservation services before
  maltreatment occurred.
 1997 Adoption and Safe Families Act: still
  worked on family preservation, but shifted
  the national priority to child safety.
The Definitional Dilemma
 Table Talk: discuss and describe Child
  Abuse Prevention and Treatment Act
  of 1974 (CAPTA) national definition of
  child maltreatment.
Broad and Narrow Definitions
 One definitional problem is whether
  the motivation of the parent to harm
  the child is necessary for abuse to be
  said to have occurred (intentional and
  accidental behavior).
 Cumulative harm – repeated
  moderate abuse or prolonged neglect.
Cultural Attitudes
 Differences among cultures in child rearing
  practices and perceptions of acceptable
  parental behavior complicate the problem
  of providing clear definitions of child abuse
  and neglect.
   Coin rubbing – SE Asians
   Navaho Indians
   Culturally acceptable forms of physical discipline
    cannot always be considered abuse.
     Physical discipline if it does not harm the child
     African American child-rearing practices
Reporting Child Maltreatment
 Since CAPTA in 1974, mandated reporters.
 Problems with the Reporting Law
   Two major problems: large number of cases that
    go unreported and the large number of
    unfounded reports
   Unreported: lack of clarity on which situations
    require reporting, concerns about confidentiality,
    effect of reporting on the therapeutic
    relationship, concerns about lawsuits or
    reprisals, reluctance to become involved, belief
    that reporting will not help the situation.
   Unfounded: 60% Many reports by nonmandated
    reporters (neighbors, relatives who do not know
    definitions). Also child custody disputes.
An Ecological View of
Child Maltreatment
 Community Deficits
   Lack of early case-finding techniques
   Case Accountability:
     Giving inadequate or incomplete services.
     Failing to follow through on referrals for another
     Setting up barriers of communication or
       bureaucratic procedures that cut off some
       people from asking for or receiving help.
     Showing concern only about fragments of family
       life that present symptoms troublesome to the
     Failing to develop an agency function that is an
       active part of a community-wide program of
Serious Social Problems
 Large-scale incidence of mental illness and subtance
 Escalating health costs and unequal medical services
 Poverty in the midst of affluence
 Lack of jobs for youth and heads of families
 Deplorable housing for large numbers of the
 High rates of delinquency
 Inadequate and irrelevant education for much of the
  nation’s youth
 Lack of preparation for jobs, higher education,
  parenthood and other aspects of adult responsibility
Societal Attitudes
 Images of Violence
   Child abuse must be viewed within the
    context of a society that accepts and
    often condones violence.
 Poorest children three times more
  likely to suffer maltreatment
 Poor families frequently live in poor
  neighborhoods with few services
 Welfare reform may increase burdens
  on poor families
 Inadequate child care
 Convicted felons for drug use
  ineligible to receive welfare
Race and Ethnicity
 Some racial and ethnic groups are more
  likely to be reported for child maltreatment
  than others (Figure 7.3)
 Misunderstandings about cultural beliefs
  and practices
 Poor African American children are more
  likely to be reported
 Ethnicity by itself does not increase risk of
  maltreatment for children
Family Structure
 Abuse and neglect are more likely to
  occur in single-parent households;
  single parents more susceptible to
 Number of children at home; those
  with more children are at higher risk
Substance Abuse
 Parents who abuse are often unable to provide
  consistent, nurturing care. Feeding the addiction
  takes needed resources from the family.
 Use of psychoactive drugs increase risk
 Many women who are addicted experienced sexual or
  physical abuse as children
 Only recently have efforts been made to link the child
  protective and substance abuse service systems.
 Family treatment courts: bring together legal
  services, social welfare services and substance abuse
  services in the same courtroom with a permanently
  assigned judge to the case.
Domestic Violence
 Physical assault on children is much more
  common in households in which women are
   Even if the children are not themselves abused,
    they may suffer neglect or psychological
    maltreatment associated with the abuse of a
    parent by another adult.
   Effects on very young children
   PTSD
   Domestic violence workers generally are not
    named as mandated reporters
   Violence Against Women Act 0f 1994 require a
    connection between domestic violence services
    and CPS.
Animal Abuse
 Link may exist between animal abuse
  and child abuse and other domestic
  violence. Needs further research.
Parental Characteristics
 Abusive and neglectful caretakers often
  have inappropriate expectations of their
  children. May lack parenting skills and
  knowledge of child development, may have
  unreasonable high expectations of their
  children to care for themselves, to care for
  younger siblings, and to comply with
  parental demands.
 Having been mistreated as a child puts a
  parent at greater risk for abusing and
  neglecting a child.
 Ability to form attachments is transmitted
Child Characteristics
 Younger children, premature infants,
  children with developmental delays or
  physical or mental disabilities and
  disordered behavior, and children
  with irritable temperaments are at
  higher risk for abuse and neglect.
 Girls at higher rise for sexual abuse.
 Infants are more likely to die of
Consequences of Child
 Results of Maltreatment:
   Impairments
       Physical
       Psychological
       Cognitive
       Social
Child Fatalities
 All 50 states plus Washington DC
  have established Child Fatality Review
   Made up of representatives from health
    services, law enforcement, child
    protective services, the medical
    examiner’s office and the prosecutor.
   Review circumstances leading to death;
    purpose is to prevent future child death
    or serious injury.
The Resilient Child
 How do some children become successful adults
  despite abuse?
   Environment and personal factors:
         Good intellectual ability
         Positive attitude toward others
         Physical attractiveness
         Enthusiasm
         Internal locus of control
         Caring adults outside of abusive vamily
         Parents are able to offer some family stability
         Expectations of academic performance
         Abuse is sporadic rather than constant
         Good health
Child Neglect
 Physical Neglect
   Predominant form of maltreatment
     Much damage from neglect accrues over
      time; cumulative effect of malnutrition, lack
      of medical care, inattention to education,
      emotional deprivation.
     Neglect is generally defined as “deprivation
      of adequate food, clothing, shelter or
      medical care”.
Signs of Neglect
   Chronic hunger
   Inappropriate dress
   Poor hygiene
   Abandonment or lack of supervision
   Unattended medical needs
   Behaviors may include stealing, fall
    asleep at odd times, unexplained
    absences from school, self-
    destructive activity
Family Traits
 Likely to be poor
 Headed by a single parent
 Many children
 Socially isolated
 Parents may lack empathy, have difficulty
  relating to others, impulsive, or have
  ineffective communication skills. May not
  demonstrate nurturing behaviors to their
  children, interactions lack warmth.
 Lives often seem chaotic, with many
  conflictual relationships.
Lack of Supervision
 Situations in which children are without a
  caretaker or the caretaker is inattentive or
  unsuitable, and therefore the children are
  in danger of harming themselves or
  possibly others.
 Children are allowed to remain away from
  home overnight without the parents’
  knowing or attempting to find out the
  child’s whereabouts, expulsion from home
  or refusal to allow the child to return home,
  and abandonment.
Expelled or Runaway Youth
 Told to leave home by a parent who
  has made no adequate arrangement
  for their care by others –
Nonorganic Failure to Thrive
 Diagnosed in infants when their
  height and weight are below the fifteh
  percentile, if these measurements
  were once within normal ranges and
  if no apparent medical or organic
Medically Fragile Children
 Disregard for Fetal Development
   Neglect to get prenatal care and not
    acting on sound medical advice
   Reasons may include mental illness,
    mental retardation, addiction to
 Children with AIDS
Child Abuse
 Physical Abuse
     Hitting with a hand, stick or other object
     Punching
     Kicking
     Shaking
     Throwing
     Burning
     Stabbing
     Choking
Suspicious injuries
 Location
   Accidents are usually injuries to chins,
    foreheads, hands, shins and knees
   Injuries more likely by assault: thighs,
    genitals, buttocks, torso, corner or joint
    fractures, presence of old as well as new
Physical Abuse and Reasonable
 Differentiating between reasonable
  discipline and child abuse
   Discipline would be considered
    unreasonable if its “reasonably
    foreseeable consequence was or could
    have been the child’s serious injury”
Parent and Family Characteristics
   Families larger than average
   Caretakers tend to be young
   Family structure
   Mother’s boyfriends
   Abusive parents that have learned
    negative behavioral models of
    parenting that they duplicate
Shaken Baby Syndrome
 Injuries include brain swelling and
  damage, subdural hemorrhage,
  mental retardation or developmental
  delays, blindness, hearing loss,
  paralysis and speech and learning
  difficulties and death
Munchausen’s Syndrome by Proxy
 Situation in which a parent induces
  symptoms in his or her child
   Illness fabricated
   When child presented to doctors, perpetrator
    denies causing the child’s illness
   Illness goes when the child is separated from
   Perpetrator is considered to be acting out a need
    to assume to sick role by proxy or as another
    form of attention seeking behavior
Psychological Maltreatment
   Spurning
   Terrorizing
   Isolating
   Exploiting/corrupting
   Denying emotional responsiveness
   Mental health, medical and
    educational neglect
Sexual Abuse of Children
 Parent and Family Characteristics
   Sometimes presence of stepfathers
   Single-parent families
   Reliance on punitive discipline
   Extreme marital conflict
   Social isolation
   Disorganized family life
   Substance abuse
   Depression
 Usually by a family member, neighbor or friend
 Majority of perpetrators are male
 Mothers have frequently been victims themselves.
Identifying Child Sexual Abuse
 Some behaviors:
     Depression
     Excessive seductiveness
     Sudden massive weight loss or gain
     Substance abuse
     Suicide attempts
     Hysteria
     Sudden school difficulties
     Avoidance of physical contact
     Devaluation of self
     Inappropriate sex play or premature
      understanding of sex
 Corroborating witnesses are a good
  source of evidence, but they rarely
  exist because abuse usually takes
  place in secrecy.
 Children do not often make false
  allegations or misunderstand innocent
 Interviewing sexual abuse victims
  requires specialized knowledge and
Legal Intervention
   Child protective services
   Law enforcement
   Juvenile court
   Prosecuting attorneys
   Criminal courts
   These agencies are often not well-
Social Work Intervention
 First goal: stop abuse
 Careful assessment of each parent
 Individual and group treatment,
  maybe family therapy
 Sexual abuse cases are difficult to
  manage because they require
  specialized knowledge of several
  disciplines – multidisciplinary teams
  are an effective way to respond.
Survivors of Sexual Abuse
 Effects can last into adulthood.
 Adults who were abused are more likely to
  have sexual disturbance or dysfunction,
  report homosexual experiences, to have a
  diagnosable anxiety disorder, to show
  evidence of depression, to have difficulty
  expressing anger, and to have suicidal
  ideas and behavior.
 May develop PTSD
 Dissociation
Effects of Child Sexual Abuse on
 Some survivors report very few
  symptoms, while others experience
  overwhelming difficulties.
 Severity of problems are related to
  characteristics of the abuse.
 Families that are supportive and have
  a higher general functioning can help
  the victim’s recovery, especially
  mothers’ ability to support.
Ritualism and Child Sexual Abuse
 Ritualistic abuse: abuse that occurs in
  the context linked to some symbols
  or group activities that have a
  religious, magical, or supernatural
  connotation, and where the
  invocation of these symbols or
  activities, repeated over time, is used
  to frighten and intimidate the
Child Protection
 Core services must provide
  safeguards for the rights of the child,
  the parents and society; the
  development of clear standards and
  rules, proper observation of legal
  provisions that will help to ensure
  that decision making is reasonable
  and based on relevant criteria
 Receives reports of abuse and
 Function is to take the report and
  screen it for suitability for
 Timely gathering of information,
  through contact with the child, the
  parents, and individuals who can
  provide collaborating information.
Disposition Determination
 Timely decisions about the status of the abuse
  or neglect report and the need for further CPS
   Unsubstantiated
   Substantiated
   Critical sources of information not accessible
 Difference between unsubstantiated and not
  confirmed: the agency was unable to find
  credible evidence of maltreatment according to
  its definitions. However, it it possible that the
  family has some deficits in child rearing that
  are not serious enough to be labeled abuse or
  neglect but need attention.
Crisis Intervention
 Should be available from CPS as
  needed during the time that CPS is
  engaged with the family, including
  during intake. These service should
  provide immediate protection of the
  child and help families remain
  together during short-term
Case Planning and Coordination
 Also the responsibility of CPS.
   For substantiated cases: individualized,
    goal-oriented case plan that clearly sets
    out what the agency expects parents to
    do in order to maintain children in the
    home. It is required that parents be
    actively involved in developing the case
    plan and be aware of the time frame
    within which they most work
Nature and Use of Authority
   Discharge
   Central Registries
   Sociolegal and Psychological Authority
   Use of Authority in Practice
Nature and Use of Authority
 Discharge appropriate when one of
  the following:
   Child is no longer at sufficient risk to
    warrant CPS involvement
   The family is voluntarily receiving
    services from another agency to
    strengthen family functioning
   CPS involvement is not needed because
    the child is no longer at risk
Nature and Use of Authority
 Central Registries
   Centralized data system of child abuse and
    neglect reports maintained by states.
 Sociolegal and Psychological Authority
   The power to influence or command thought,
    opinion, or behavior.
     Sociolegal: authority of an office, or designated
       position, and the possession of this formal
       power is a legitimate one.
     Psychological: the power to bring about change
       through influencing behavior, is subject to
       another person’s perception of authority and
       readiness to be influenced, directed, or
Nature and Use of Authority
 Use of Authority in Practice
   Need not be a necessary but negative
    part of protective services; it can be
    utilized as a factor to enable parents to
    fulfill their responsibility to their children
    more satisfactorily.
Decision Making in Child Protective
 Direct Evidence
   Includes physical evidence on the child and in the
     home; parental admission of maltreatment; child’s
     statements of maltreatment; reports of witnesses
 Parental Response
   Workers assess the appropriateness of parent’s
     response to the situation and whether or not they can
     provide consistent and credible explanations of the
     child’s injury.
 Child’s Vulnerability
   Workers are more likely to substantiate if the child is
     very young, has a serious mental or physical illness,
     exhibits unusual behavior problems, or is
     developmentally delayed. Also considered are
     interactions between parent and child and the child’s
     reaction (flinching or avoiding contact).
Assessing Risk and Safety
 Systematic collection of information
  to determine the degree to which a
  child is likely to be abused or
  neglected at some future point in
 Assessment includes collecting
  information on the family.
Risk Factors compiled by the National
Association of Public Child Welfare
 Impact of parental behavior: CPS
  intervenes if behavior is serious and
 Severity of abuse and neglect
 Age and physical mental ability of the child
 Frequency and recency of alleged abuse or
 Credibility of the reporter
 Location and access of child to perpetrator
 Parental willingness to protect child and
 Parental ability to protect
Protecting Children at Home or in
Foster Care
 Crucial phase of child protective work
  is the determination that children can
  be properly protected within their
  own home, or that they should be in
  foster care.
 Adoption Assistance and Child
  Welfare Act of 1980 requires agencies
  to make a “reasonable effort” to
  preserve families.
Interviewing in Child Protective
 Planning the Interview
   Purpose
   Interviewing Separately or Together
   Age of Child
   Location
   Multidisciplinary Interview Centers
 Establishing Rapport
   Respect, Cultural Considerations, Handling Resistance
 Types of Questions
   Open-ended questions and focused questions are
     preferable because the children’s answers are less
     likely to be influenced by the interviewer.
   Younger children may need to draw, use dolls,
     puppets, and other props as a means of
Aspects of Community Support and
 Multidisciplinary Teams
   Might include social workers, psychologists,
    nurses and law enforcement
 Advocacy Organizations
   National Advocacy groups such as the Children’s
    Trust Fund provides state revenue to fund
    programs to prevent child abuse and neglect.
   American Humane Association founded in 1877
   National Committee to Prevent Child Abuse
   Victims of Child Abuse Laws
   National Center on Child Abuse of Neglect
   Child Welfare League of America
Trends and Issues
 Appropriate Scope of State Intervention
   One view: CPS should be involved only for serious
     cases of child maltreatment and that less serious
     situations should be referred to other social service
     agencies. Another view is that CPS should be
 Child Protective Services in a Comprehensive System
   CPS should be more connected to the community
     through partnerships with schools, police and
     neighborhood groups.
 Staffing Child Protective Service
   A major challenge is to improve the quality of the
     staff and the conditions in which they work
   Agencies have too few resources
   Social work education

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