Lifetime Rates and Types of Subsequent Child Protective Service Involvement Following a First Report of Neglect: An Age Stratified Analysis

Purpose: An estimated 27 to 37% of all U.S. children will experience an investigation by the Child Protection System (CPS) for allegations of child maltreatment during their childhood. The vast majority of these allegations are for neglect. Despite the large number, comparatively few of these children will be found as victims or enter foster care. Studies have found little difference in child outcomes between children with substantiated and unsubstantiated allegations, however, to date no studies have followed children for the entirety of their childhood following an initial allegation of neglect. The purpose of this study is to: (1) estimate the rates of subsequent referral, substantiated maltreatment, placement in foster care, and allegations of physical and sexual abuse by age 18 for all children initially reported due to neglect; and (2) assess how rates of subsequent involvement vary as a function of the outcome of the initial CPS neglect investigation and age.

Methods: This study uses population-based California vital birth records linked to CPS administrative records to prospectively follow children born in 2000 through age 18. Outcome of interest was subsequent CPS involvement by level (re-report, future substantiated report, future placement) and by type (physical abuse, sexual abuse). Children were examined by age of initial investigation and outcome of initial investigation (unsubstantiated, substantiated but remained in home, entered foster care). Subsequent analyses stratified by race and ethnicity.

Results: Overall 64% of children initially reported for neglect were re-referred to CPS. Children initially investigated as infants had the highest rates of subsequent involvement, with 79 to 83% experiencing a subsequent maltreatment allegation following the closure of the initial investigation, and 29 to 43% of infants experiencing a subsequent removal. Over one-third (33%) of all children who were the subject of an initial neglect only investigation were subsequently referred for alleged abuse, including 14% for alleged sexual abuse and 26% for alleged physical abuse.

Conclusion: An alarmingly high number of children initially reported due to allegations of neglect are coming back to the attention of CPS, and not just for allegations of neglect, nearly half are being subsequently referred due to abuse allegations, indicating either an escalation in risk or a missed opportunity following he initial investigation. Who and how many families are offered services varies greatly across states, and uptake of services, especially, voluntary services, remain low. While this study is not able to determine differences dependent on service receipt, as a whole, findings demonstrate that families are returning to CPS at alarmingly high rates, indicating a need to think outside of services as usual in offering families support.