Child Neglect Subtypes in Relation to Recurrence and Foster Care Entry Outcomes

Background and Purpose:

While there has been increased attention to the implementation of evidence-based services in preventing child maltreatment, the primary goal of the child welfare system is to prevent the recurrence of maltreatment and foster care entry for children involved with child protective services (CPS). To achieve this goal, the first step is to determine which type of child maltreatment has high recurrence or foster care entry rates. There have been mixed findings on whether neglect increases the risk of re-report and foster care entry compared with other maltreatment types. Because previous studies suggested child neglect was a heterogeneous phenomenon, the present study examined whether the re-report and foster care entry outcomes varied by types of initial maltreatment reports, focusing on neglect subtypes.

Methods:

Data were derived from a regional longitudinal study with linked CPS and state-level administrative data provided by multiple agencies in St. Louis, Missouri. The data included children, age 11 or younger, with initial maltreatment reports in the years of 1993 or 1994, and included up to 16-year follow-up CPS reports. Re-report of child maltreatment and foster care entry were operationalized using the official CPS data, and the types of initial maltreatment reports were measured as a nominal variable with six neglect subtypes (physical neglect, lack of supervision, educational neglect, medical neglect, abandonment, and mixed neglect) and two types of abuse (physical abuse and sexual abuse). Multivariate logistic regression models were used to assess the probability of recurrence and foster care entry outcomes while controlling for various risk factors.

Results:

Results showed that certain neglect subtypes were more likely to be re-reported than physical and sexual abuse. For example, physical neglect was more likely to be re-reported than physical abuse (OR=1.55) and sexual abuse (OR=1.79). Educational neglect was more likely to be re-reported than sexual abuse (OR=1.54). For foster care entry, children reported for lack of supervision (OR=0.74) or educational neglect (OR=0.48) were less likely to be placed in foster care compared with children with reports for physical abuse. On the contrary, children with reported mixed neglect (OR=1.51) or abandonment (OR=5.43) were more likely to be placed in foster care than children with reported physical abuse. Among neglect subtypes, children reported for abandonment were more likely to be placed in foster care when compared with any other neglect subtype. In addition, children reported for physical neglect were more likely to be re-reported (OR=1.54) and placed in foster care (OR=0.28) than children reported for lack of supervision.

Conclusions and Implications:

The present study revealed that child welfare outcomes vary by neglect subtype, and this may indicate a need for type-specific interventions. With all subtypes grouped under the umbrella classification of “neglect,” it is a challenge to identify high-risk populations and develop intervention programs. Given the significant individual, system, and societal costs of neglect, this study facilitates rigorous investigation of child neglect and the potentially modifiable targets of intervention that hold the most promise for preventing the re-report of child maltreatment and foster care entry.