Identifying and Maximizing Opportunities for Intervention in Infancy and Early Childhood
Methods: The first paper uses a large longitudinal administrative database to examine recidivism for a birth cohort of infants referred for a child protective services (CPS) investigation. The second paper uses a longitudinal, nationally-representative sample of children involved with CPS to examine the relationship between exposure to intimate partner violence during early childhood and later development of child behavior problems. The third paper explores predictors of engagement in a community-based home visitation program aimed at preventing maltreatment for high-risk families with newborns. The final paper presents results from a study that translates a missed opportunity identified using longitudinal multi-sector secondary data into a randomized-controlled intervention trial with the goal of preventing emotional and cognitive disorders for young children involved with CPS.
Results: The first paper found that over half of infants referred to CPS were re-referred by age five. Infants who had reports that were evaluated out by CPS were equally likely to be re-referred as those who were investigated. The second paper found that among children referred to CPS, exposure to intimate partner violence in the home had a delayed effect. Using growth curve modeling, this study found that frequently-exposed young children had a measureable, but delayed increase in aggressive behavior later in childhood. The third paper found that among high-risk families with newborns referred for home-visitation, those experiencing greater adversity were more likely to engage with services. The final paper identified an important opportunity for intervention in a large group of young children with frequent CPS contact, major gaps in services, and poor mental health outcomes. These findings informed a translational intervention study linking new families with home-visitation. Process results show some problematic referral but positive uptake by families who consent.
Conclusion and Implications: The results of all four papers, using a diverse set of methods and populations, strongly indicate a major opportunity for intervention during early childhood among families involved with CPS or at-risk for maltreatment. Making the most of identified opportunities to promote the future safety and well-being of infants will hinge on the right families being identified and engaged with the right services.