Generational and Intergenerational Adversity Among Low-Income Families in Home Visiting Programs: Exploring Connections between ACEs, Domestic Violence, and CPS Involvement

Background/Purpose: The study of adverse childhood experiences (ACEs) continues to proliferate, adding to our understanding of how major adversities and their consequences accumulate within a lifetime and across generations. To date, however, the study of ACEs and their consequences have been largely sequestered from the study of family involvement in public child welfare systems. One common factor of interest to both areas of inquiry is household domestic violence (DV), which has been shown to be both a consequence of childhood adversity and predictor of child protective services (CPS) involvement.

This study aims to (1) describe the timing and prevalence of CPS involvement in a sample of families receiving perinatal home visiting services; (2) test the association between maternal ACEs and child CPS involvement and (3) assess whether recent DV history mediates the association between ACEs and CPS involvement.

Methods: The study is a secondary analysis of data gathered by home visitors from 3,065 maternal caregivers and their children enrolled in a network of evidence-based home visiting programs in a Midwest U.S. state between 2014 and 2019. We used state administrative data to identify children who also experienced a screened-in CPS report. Maternal covariates included age at childbirth, race and ethnicity, education, and marital status. Ten conventional ACEs were measured, including five types of child maltreatment and five types of household dysfunction. Five novel ACEs were also assessed: food insecurity, prolonged parental absence, homelessness, bullying, and violent crime victimization. The measure of recent DV included acts and threats of violence within the last year perpetrated by spouses, partners, and other adult household members. Child CPS involvement was defined as having at least one screened-in CPS report. Cohort subsamples were used to assess the prevalence of CPS involvement among children at age one, three, and five years. We used multivariate path models to test the association of ACEs and DV on CPS involvement while accounting for covariates. Models used weighted least-squared mean and variance adjusted estimators and bootstrapping (10,000 samples).

Results: By 12 months, 13.3% of children were involved in CPS. By age five, the prevalence increased to 35.2%. Women who endured ACEs and recent DV were more likely to have a CPS-involved child. The mediation model indicated that, once DV was added as a mediator, the direct effect of the 10-item ACE measure on CPS involvement was not significant (.02, standard error, SE, = .01, p = .07). However, there was a significant indirect effect of ACEs (.03, SE = .01, p < .001) and total effect of DV (.19 SE= .04, , p < .001) on CPS involvement.

Conclusion and Implications: Maternal ACEs were associated with recent DV and child CPS involvement, and DV mediated the effect of ACEs on CPS involvement. Findings from this study support the need to explicitly acknowledge the complex trauma histories of families coming into contact with CPS. Investment in trauma-responsive assessments and service referrals at the “front end” of child welfare systems may help to disrupt the accumulation of generational and intergenerational adversity.