Citation

Holbrook HM, Hudziak JJ. Child Abuse Negl. 2019; 99: e104279.

Affiliation

Vermont Center for Children, Youth and Families, University of Vermont Medical Center, 1 South Prospect Street, Burlington, VT, United States. Electronic address: james.hudziak@med.uvm.edu.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.chiabu.2019.104279

PMID

31791009

Abstract

BACKGROUND: Substantiated and unsubstantiated reports of maltreatment are associated with similar risk of emotional and behavioral problems. However, substantiation status often determines service provision.

OBJECTIVE: We examined substantiated and unsubstantiated reports to identify patterns of recurrence over a five-year period and identified family risk factors that predicted recurrence patterns. PARTICIPANTS AND SETTING: We studied a subsample (N = 246,021) of the National Child Abuse and Neglect Data System from 2011-2015.

METHODS: Measures included child, caregiver, and child protective services case characteristics obtained in 2011. We used latent class analysis to identify heterogeneous classes, then entered class membership as the outcome variable in a multinomial logistic regression to identify risk factors.

RESULTS: Four latent classes emerged: (1) initial unsubstantiation and moderate recurrence, (2) initial unsubstantiation and low recurrence, (3) initial substantiation and moderate recurrence, and (4) initial substantiation and low recurrence. Domestic violence (relative risk ratio (RRR) = 2.56, β = 0.94, SE = .02, p < .001), caregiver substance abuse (RRR=2.23, β=0.80, SE=.02, p < .001), and Native Hawaiian/Pacific Islander race (RRR=1.67, β=0.52, SE=.11, p < .001), predicted initial substantiation status but were not meaningful predictors of long-term recurrence. Prior substantiated report and poverty predicted initial substantiation status (report RRR=1.50, β=0.41, SE=.02, p < .001; poverty RRR=1.50, β=0.41, SE=.02, p < .001) and long-term recurrence (report RRR=2.60, β=0.96, SE=.02, p < .001; poverty RRR = 1.35, β=0.30, SE=.02, p < .001). Asian American race predicted low recurrence rates (RRR=2.09, β=0.74, SE=.12, p < .001).

CONCLUSIONS: Similar recurrence patterns between substantiated and unsubstantiated reports emphasize the importance of providing services regardless of substantiation status. Integrating administrative databases may reveal more variables that predict long-term recurrence.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Child abuse; Child maltreatment; Child protective services; Latent class analysis; Risk assessment