Research That Matters (January 17 - 20, 2008)

Purpose: While the vast majority of cases of child maltreatment are categorized as neglect, the concept has been poorly defined and therefore its consequences have been poorly understood. In order to ameliorate these deficiencies, the National Institutes of Health developed an RFA addressing this gap. This study, part of a longitudinal study of the effects of maltreatment on adolescent development, was part of that effort. Our goal was to clarify the experiences of neglected children's encounters with the child welfare system, to determine the accuracy of the classification system used by one child welfare authority, and to begin to understand how this classification influenced children's experience in the system.

Method: The case records of a racially mixed sample of 189 children who had an open case with the Los Angeles County Department of Children and Family services were reviewed to obtain information about episodes of maltreatment including perpetrators, characteristics of the maltreatment, number and kinds of referrals, and disposition of cases. The data was summarized to determine the number and kinds of reports officially substantiated by Child Protective Services (CPS) and the number and kind supported by record review. These were compared (Kappa) for agreement for the sample and for each ethnic group. Analysis of variance was used to see if the number of referrals predicted placement for the sample and each ethnic group.

Results: Children had an average of 4.95 referrals. There was little agreement between the CPS official maltreatment classification, the CPS substantiated maltreatment types, and the maltreatment reviewers found for the sample and for the different ethnic groups. For example, CPS officially classified only 4% (n=8) of the cases as having multiple types of maltreatment; the records found CPS had substantiated multiple maltreatment in 23% (n=44) of the cases, whereas our reviewers found that 64% (121) of the cases had multiple types of maltreatment. In neglect, CPS officially classified 93% as neglect only, records indicated that 44% were neglect only, and our review of the record indicated that only 27% of children had experienced neglect only. The racial ethnic breakdown was similar with little agreement among official classifications, actual substantiated types of maltreatment, and the experiences of maltreatment gleaned from the records. There was a statistically significant underreporting of multiple maltreatment in white youngsters. The number of maltreatment referrals did predict placement type (F=6.750, p<.001) with a higher number of referrals relating to placement in foster care and no difference between home and relative placement.

Implications for Practice and Research: Neglect is clearly not an isolated experience with the majority experiencing multiple types of maltreatment and numerous referrals before action is taken. This disparity calls into question our knowledge of neglect since much previous research has utilized official designations of maltreatment type. Research needs to attend to this through the expensive and laborious task of record review. Practitioners must recognize that neglected children are likely to have experienced other types of maltreatment that must be addressed.