Double Jeopardy: Multiple Victimization Among Youth With Disabilities in the US Child Welfare System

Abstract: Disability, whether diagnosed at birth or in adolescence, places children at heightened risk of abuse and neglect. Childhood disability not only heightens risk of maltreatment, but also, entry into the Child Welfare System (CWS), which in itself, is a disruptive experience for youth and their families. Some studies suggest that youth with disabilities who enter the CWS are more vulnerable to poor outcomes, including maltreatment re-report and additional health challenges. Missing, in this literature, is the investigation of the multiple victimization experiences of youth with disabilities in the CWS.  Narrowing in on only one victimization may underestimate the full spectrum of violence experienced by youth with disabilities in the CWS while overestimating the impact of single events of violence on the mental health outcomes of these youth. Finally, a single victimization approach hinders the identification of the most vulnerable children in the CWS–those who experience multiple traumas, and consequently, shoulder the burden of mental health difficulties. This study aims to address the current gap in the literature by exploring whether disability status: 1) is associated with heightened risk of multiple victimization among youth in the CWS and 2) moderates the impact of multiple victimization upon reported symptoms of clinical depression..

Methods: The study results are based upon a secondary analysis of data from the second National Survey of Child and Adolescent Well Being (NSCAW II).  NSCAW II included 5,872 children, ages birth to 17.5 years sampled from 83 counties nation-wide of child welfare investigations closed between February 2008 and April 2009. For our sample, we selected youth age 11-17 years old, currently residing with biological families (N=675). Youth with disabilities were identified if they reported at least one physical or neurodevelopmental special health care need, as defined by the Maternal and Child Health Bureau (N=247). Clinical symptoms of depression were identified by t-scores of over 65 on the Children’s Depression Inventory. Weighted multiple logistic regression analyses were utilized with statistical procedures that take into account the complex survey design.

Results: One-third of youth with disabilities in the CWS report two or more victimizations during the previous 12 months compared to 23% of youth without disabilities. Controlling for demographic and family factors, the odds of youth with disabilities in the CWS reporting two or more victimizations are, on average, 120% higher  (p < 0.01) than youth without disabilities. Among youth with disabilities in the CWS who reported multiple victimization, 20% experienced symptoms of clinical depression, compared to  8.5% of multiply victimized youth without disabilities (p<.05).

Conclusion & Implications: Youth with disabilities in the CWS are at high risk of experiencing two or more forms of victimization, in comparison to youth without disabilities.  They are also more likely to report clinical symptoms of depression. Our findings suggest that social work professionals need to screen youth with disabilities in the CWS for multiple forms of victimization, and develop and implement appropriate services which target the behavioral health sequelae that may jeopardize their independence in adolescence and their subsequent adult independent living.