Child Welfare Decision-Making: A Longitudinal Examination of out of Home Placements in Ontario, Canada

Background: Cross-sectional analyses using provincial and national incidence study data in Canada have identified several factors associated with the decision to place a child in out-of-home care during an investigation including children’s age, and functioning concerns; caregiver’s age and risk factors. This study extends this foundational work by using longitudinal administrative data, for the first time in Ontario, Canada, to assess the decision to place a child in out of home care within 12 months of an initial investigation.

Methods: We developed an entry cohort from agency-level administrative data that were extracted, harmonized, and stored by the Ontario Child Abuse and Neglect Data System (OCANDS). The dataset included all families investigated during 2012 (January to December) across 13 child welfare agencies, and these cases were followed for 12 months to determine which children had an out of home placement. Variables included characteristics of the child, family, and investigation, and information generated from actuarial safety and risk assessments. We conducted descriptive comparative analyses, comparing children that experienced a placement within twelve months of an investigation to those that did not, and used these results to generate a generalized linear model that assessed predictors of the decision to place a child. We conducted a cox-proportional survival analysis exploring the decision to place a child.

Results: Of the 34,397 families investigated in a sample of Ontario agencies in 2012, approximately 2% of children were placed in out of home care within 12 months. Rates of placement were highest among investigations in which immediate safety was a concern; future risk of maltreatment was identified; and investigation concerns were verified by the investigating worker. In the multivariable model, families considered high risk or very high risk according to Ontario’s risk assessment tool were more likely to have a child placed. Survival analyses demonstrate that the likelihood of a placement becomes less likely with increased time.

Conclusions and Implications: This is the first longitudinal study in Ontario, Canada exploring the decision to place a child in out of home care after the initial investigation. Decisions about a child placement were largely based on safety and risk assessments items. The decision to place a child in Ontario, Canada is a rare event; therefore, the tools used to assess this decision are better suited for high and very high risk cases with placements, and not the majority of cases investigated that have more chronic, long-term, moderate risk issues without placements. Considerations for practice and policy will be discussed.