Child neglect is the most frequently reported and substantiated form of child maltreatment in the U.S. It is often overlooked in the child maltreatment literature, though it characterizes over 50% of victims, and young children are more likely to die of neglect than of any other maltreatment type (USDHHS, 2003). Service integration (SI) approaches seek to address as many facets of a targeted problem as possible in an integrated manner. Although the rationale for SI is clearly established in the literature (Ragan, 2003), approaches to measurement and evidence of effectiveness are sparse. For child neglect, SI approaches involving child welfare and TANF services are of particular interest, given the importance of poverty as a risk factor. The purpose of this presentation is to report results of a mixed method study examining child welfare, TANF and SI for child neglect cases. A qualitative case study using agency documents, interviews with 45 stakeholders and an expert panel focus group, examined the SI model. A case record review of 200 closed, neglect cases was conducted to examine the relationships between family need clusters, service clusters, SI characteristics, intensity, and case outcomes (out of home placement, new child neglect reports, time to case closure, changes in parental income and changes in safety, risk and family functioning ratings.) Cluster analysis determined groupings of needs and services, and a new measure of SI was developed based on the key informant interviews. Multiple linear, logistic and Cox regressions were used to determine relationships between family needs, services, service integration and case outcomes. Case study results highlight 3 major themes: the process for changing agency culture, acceptance of the SI model, and variations in implementation. Implications include the importance of a structured, non-hierarchical approach to concept development and culture change, and the need for a strong implementation model. Four distinct clusters of need are present among neglecting families. In addition, five clusters of services are found, though the match between need clusters and service clusters is not strong. SI level of intensity and the nature of SI collaboration varies greatly, and are related to service clusters. These three sets of variables (needs, services and integration) are significantly related to child outcomes. For example families in the meth-substance abuse cluster are more likely to experience more child placement, longer service episode and lower changes in risk, safety and family functioning than is any other cluster. The service cluster characterized by concrete services is related to positive outcomes as well. Several interaction terms are significant for specific outcomes. For example, while the cluster characterized by meth-substance abuse is related to child placement, this relationship is moderated by the high service integration approach associated with the drug-court service cluster.

References

Ragan, M. (2003). Building comprehensive human service services. Focus, 22, 58-62. Wisconsin: Institute for Research on Poverty.

U.S. Department of Health and Human Services, Administration on Children Youth and Families. (2003). Child maltreatment, 2001: Reports to the national child abuse and neglect data system. Washington DC: US Government Printing Office.