Differential Response: Maltreatment Prevention or Family Support?

Background and Purpose. In states across the country, child welfare systems are undergoing historic reform processes intended to promote safety and permanency through early intervention. In California alone, more than half a million reports of alleged child maltreatment are made to public child welfare agencies each year. But under the traditional system, a majority of these referrals are screened out and never officially opened as cases or offered services. Fewer than 10% of referrals receive significant help. Of these, approximately one-third are re-referrals. Some California counties are now providing community-based services to families whose reports are screened out or unsubstantiated. California's “Differential Response” (DR) model differs from other states'.

In one California county DR is offered on a voluntary basis to families who live in designated zip codes with high rates of reported child maltreatment. Clients receive up to nine months of intensive home visiting and case management. The goals of DR are to support family safety, prevent future child maltreatment, and promote child well-being.

This study examined the evidentiary base for DR services. The following research questions were addressed:

1. What are the primary interventions that families are offered?

2. Is the California model of DR successful in preventing future child maltreatment reports for program families against a comparison group?

Methods. A mixed-methods design was used. For question 1, interviews were conducted with all administrators (n=15), focus groups with all direct line staff (n=12), and telephone interviews with a convenience sample of clients (n=50). Transcripts were analyzed for emergent themes. In response to Question 2, a quasi-experimental static group design was used to examine client outcomes. All clients who completed services formed the treatment group (n=161); a comparison group was constructed with all families reported for child maltreatment in the same timeframe and who were eligible for services, but were not served because of program capacity (n=447). Survival analysis was used to compare rates of re-report and substantiated re-report for the treatment and comparison groups.

Results. Cox regression was used to estimate the effects of California's DR in the studied county. The unadjusted hazard ratio and its p-value (HR 1.03, p-value 0.87) suggest that treatment had no effect on subsequent child maltreatment reports. Because families with prior child maltreatment reports were more likely to be assigned to receive services, additional analyses were restricted to children with prior reports in both treatment and comparison groups. Restricting analyses to children with prior reports only, a trend toward a positive effect appears, although findings are not statistically significant (HR 0.69, p-value 0.064). Other analyses show few effects.

Conclusions and Implications. Based on interviews with staff, the program appears robust and maintains fidelity to the model; social science theory also supports the model. Nevertheless, these findings are in line with meta-analyses of child maltreatment prevention studies, and other studies of DR. The intervention may achieve beneficial outcomes with regards to proximal goals including, for example, families' connections to resources, however, the study design did not allow for examination of these effects.