Regional Partnership: A Quasi-Experimental Study on Intervention Participation and Distal Child Welfare Outcomes

Background/Purpose: Child maltreatment (CM) is a worldwide concern – in America, nearly 600,000 children are confirmed as victims annually. These children have many elevated risk factors, including increased risk for repeat maltreatment and poor developmental outcomes. CM interventions often include evidence-based (EB) parenting interventions, yet limited research examines long-term CM outcomes post-intervention. To address this gap, a longitudinal quasi-experimental design was employed to assess distal child welfare (CW) outcomes --specifically maltreatment re-reports, substantiation status, and reunification -of young CW-involved children after receiving an EB intervention: Attachment and Biobehavioral Catch-up (ABC). As a component of a collaborative, Regional Partnership Grant (Children’s Bureau, ACF) this study sought to enhance the safety and permanency of CW-involved children.

Methods: Using administrative data, this study employed a multi-tiered analytic approach and propensity score matching (PSM) to examine the impact of ABC participation, by age-variant curriculum, on repeat maltreatment reports, repeat substantiated maltreatment reports, and time to reunification. The full sample included 205 substance-affected children (treatment=66; control=139) involved in CW, aged 0-47 months. Control group children received CW services as usual; treatment group children received modified-ABC (m-ABC), ABC-infant (ABC-I), or ABC-toddler (ABC-T). Main impact analyses employed multivariate regressions to examine repeat maltreatment and substantiation; supplemental Cox proportional hazards models (i.e., survival analysis) were conducted to examine time to (in days) and likelihood of reunification (dichotomous). A granular, categorical treatment variable (control=0; mABC=1; ABC-I=2; ABC-T=3) was used. Five covariates including demographic variables and prior CW referrals were included in all analyses.

Results: Children were primarily White(54%), non-Hispanic(84%), males(60%) and had a mean age of .5 years (SD=1.0) at CW referral. Twelve-percent(n=24) had a re-report of maltreatment after study referral; less than 7% (n=13) had a substantiated re-report of maltreatment. Over half (n=115) of the study sample was in out-of-home (OOH) placement and were included in the survival analyses; 24% of the children in OOH placement experienced reunification during the study timeframe. Though descriptive statistics indicated higher prevalence rates of repeat maltreatment and substantiation among ABC children, impact regression analyses revealed these differences were non-significant between treatment and control group children, regardless of ABC curriculum. Survival analyses showed ABC children, across curriculums, were statistically more likely to experience reunification; ABC children were between 360% (mABC, hazard ratio[HR]=3.6, p=.033) and 840% (ABC-I, HR=8.4, p=.000) more likely to experience reunification when compared to control group children. Additionally, ABC children reunified at faster rates, averaging 330 days (SD=170) compared to control group children who averaged 494 days (SD=275) in OOH placement.

Conclusion/Implications: This study implemented a rigorous, multi-tiered design to examine distal CW outcomes after receipt of an EB parenting intervention. Results suggest that each ABC curricula has positive effects on distal CW outcomes among a vulnerable, substance-affected, and CW-involved population emphasizing the potential intervention impact on a child’s safety and permanency and further solidifying its efficacy within the existing literature on parenting interventions. Further research corroborating these findings is needed along with exploration of how ABC booster sessions may impact lasting reunification and decreased likelihood of repeat, substantiated maltreatment reports.