Latent class analysis risk profiles: An effective method to predict a first re-report of maltreatment?

Perinatal Health Profiles Associated With Removal From the Home and Subsequent Child Protective Services Report in Maltreated Infants

Infants face the highest risk of abuse and neglect nationally. There is a compelling need to understand the individual risk factors and needs of families of maltreated infants so that prevention efforts can be tailored for optimal effectiveness. Using linked birth certificate and CPS records data, we employed latent class analysis to identify distinct profiles of perinatal health factors associated with infant maltreatment. Classes were then regressed onto two key child welfare outcomes-removal from the home and re-report. Results indicated 10 latent classes primarily associated with supervisory neglect and presumed prenatal substance exposure. Rapid repeat pregnancy, smoking during pregnancy and inadequate prenatal care emerged as key risk factors. Presumed substance exposure was associated with high risk of removal from the home and low risk of re-report. The opposite was found for supervisory neglect. Substantial variation existed across classes and types of maltreatment, suggesting a need for tailored prevention strategies.

Does a child maltreatment report source predict differences in immediate and subsequent report outcomes?

BACKGROUND

Mandated reporting policies, a core response to the identification of child maltreatment, are widely debated. Currently, there are calls to abolish or scale back these policies to include only certain professionals. These calls warrant evaluation of whether there are any differences in child welfare outcomes based on report source.

OBJECTIVE

To determine if the initial report source predicts immediate and long-term risk of re-referral, substantiation, and placement.

PARTICIPANTS AND SETTING

We used yearly National Child Abuse and Neglect Data System (NCANDS) hotline report and placement data. Children (0-14y) with a first ever hotline report in 2012-2014 were followed for three years. The final sample included 2,101,397 children from 32 states.

METHODS

We use descriptive and bivariate statistics to show initial report outcomes by reporter source type and logistic regression models to evaluate the effect of report source on immediate and subsequent report outcomes.

RESULTS

Professional sources varied in levels of substantiation and placement, with law enforcement, medical, and social service sources showing much higher rates. Reports from professional sources have higher odds of initial report substantiation and foster care entry, and slightly lower odds of later re-report than nonprofessional sources. We found no differences between professional and nonprofessional sources in subsequent foster care entry.

CONCLUSIONS

Reports from professional, nonprofessional, and unclassified sources have varying levels of risk in some of their short- and long-term outcomes. To the degree that child protective services embrace a long-term preventative role, reports by nonprofessional report sources may provide opportunities for prevention.

Leveraging integrated data for program evaluation: Recommendations from the field

Use of administrative data to inform decision making is now commonplace throughout the public sector, including program and policy evaluation. While reuse of these data can reduce costs, improve methodologies, and shorten timelines, challenges remain. This article informs evaluators about the growing field of Integrated Data Systems (IDS), and how to leverage cross-sector administrative data in evaluation work. This article is informed by three sources: a survey of current data integration efforts in the United States (U.S.) (N=63), informational interviews with experts, and internal knowledge cultivated through Actionable Intelligence for Social Policy's (AISP) 12+ years of work in the field. A brief discussion of the U.S. data integration context and history is provided, followed by discussion of tangible recommendations for evaluators, examples of evaluations relying on integrated data, and a list of U.S. IDS sites with publicly available processes for external data requests. Despite the challenges associated with reusing administrative data for program evaluation, IDS offer evaluators a new set of tools for leveraging data across institutional silos.

Parent and Caregiver Relationships and Mental Health Symptom Profiles of Youth in Foster Care

Adolescents in foster care can be quite resilient, yet they also are at risk for developing internalizing and externalizing mental health concerns. Positive family relationships are central to adolescent mental health, and these relationships can be complex for youth in foster care placements. Accordingly, there can be significant heterogeneity in the mental health symptoms of youth in foster care. The aims of this study were to identify distinct subgroups of youth patterns of internalizing and externalizing symptoms and determine the extent to which positive biological and foster parent relationships predicted profiles of low youth mental health symptoms. Using data from the National Survey of Child and Adolescent Well-being II (N = 343) and a person-centered analytic approach, results revealed four distinct profiles of youths' mental health symptoms, those with: high internalizing and high externalizing symptoms, high internalizing and moderate externalizing symptoms, moderate internalizing and moderate externalizing symptoms, and low internalizing and low externalizing symptoms. Additionally, youth with better relationships with biological parents were less likely to be in the high symptoms group compared to the low symptoms group. These findings can be used to inform targeted intervention efforts aimed to lessen the mental health symptoms of youth in foster care.

Maltreatment Type Classifications and Transitions During Childhood for a California Birth Cohort

Childhood maltreatment involves dynamics between the type of maltreatment experienced and the context of maltreatment. Reports of alleged maltreatment to child protective services may overlap and shift over time, complicating understanding of their independent and interacting nature, including how child protection systems respond. Latent class analysis (LCA) and latent transition analysis (LTA) were used to construct data-based models of longitudinal dynamics of alleged maltreatment throughout childhood. We sought to identify patterns leading to system decisions to substantiate allegations of maltreatment and place children in foster care. Using linked birth and child protection records, we defined a cohort of children born in California in 1999, 29.4% of whom had at least one referral for alleged maltreatment before their 18th birthday. Maltreatment and perpetrator indicators were coded, and LCA identified five alleged maltreatment classes and one class of children without referrals. LTA determined consistency of classifications and estimated transitions between classes over age periods. Children with multitype maltreatment patterns or experiences of neglect were most likely to experience future maltreatment allegations. Estimated probabilities of placement indicated children with Multitype Maltreatment allegations were more likely to experience substantiated maltreatment allegations and out-of-home placements. Findings identify a repeatable method for better understanding complex systems.

A latent class analysis of modifiable risk factors associated with child maltreatment re-reporting and recurrence

BACKGROUND

Maltreatment re-reporting and recurrence represent missed opportunities for prevention and early intervention in child welfare settings.

OBJECTIVES

This study identified latent classes of risk among families who experienced a child maltreatment re-report or maltreatment recurrence within 12-months of initial case closure.

PARTICIPANTS AND SETTING

Administrative child welfare data from a large urban county were subject to secondary analysis. Samples included children who experienced a maltreatment re-report (n = 4390), and children who experienced a second maltreatment substantiation (n = 694).

METHODS

Five modifiable risk factors (i.e., mental health, substance abuse, domestic violence, disability, parenting challenges) were extracted from the initial investigation and subject to latent class analysis. Case characteristics (i.e., age, gender, race, ethnicity, maltreatment type) were then compared across the latent classes in a post-hoc analysis.

RESULTS

Re-report classes were characterized by (1) "Few Identified Challenges" (56%, n = 2458), (2) "Mental Health and Domestic Violence Challenges" (26%, n = 1133), and (3) "Substance Abuse, Domestic Violence, Mental Health, and Parenting Challenges" (18%, n = 790). Re-report classes differed according to child age, race, ethnicity, neglect and physical abuse allegations. Recurrence classes were characterized by (1) "Domestic Violence Challenges" (48%, n = 333), (2) "Mental Health Challenges" (15%, n = 104), and (3) "Domestic Violence, Mental Health, and Parenting Challenges" (37%, n = 257). Recurrence classes differed according to child race and age.

CONCLUSIONS

Findings underscore the complex and co-occurring nature of maltreatment risk, and provide insights to strengthen assessment and intervention practices to reduce repeated contacts with child welfare systems.

Engaging Families in Voluntary Prevention Services to Reduce Future Child Abuse and Neglect: a Randomized Controlled Trial

Research on secondary prevention is mixed as to whether referrals to evidence-based practices and other community interventions reduce maltreatment recidivism. This evaluation sought to rigorously assess whether a community service-linkage model to evidence-based programs decreased subsequent reports of abuse and neglect among families reported to the child protection system (CPS). Between 2016 and 2018, administrative CPS records were used to identify families with at least one child under 5 years of age recently reported for maltreatment in Orange County, California, but where no follow-up services were mandated. Families were randomized to one of two community outreach and engagement conditions (i.e., targeted provider outreach vs. treatment-as-usual). Re-reporting outcomes were tracked in administrative records for a period of 12 months. A total of 4873 families met eligibility criteria, with 2231 (45.0%) randomized to the intervention arm and 2642 (54.0%) families to the control group. Among families in the intervention group, 811 (36.4%) were successfully contacted by a community provider. Of those families contacted, 145 (18.0%) agreed to participate in voluntary services. Overall, we did not detect any significant difference in re-reporting between our treatment and control groups (P = .433). Likewise, no significant differences in re-reporting were observed when we stratified the treatment group by levels of outreach and service engagement. Findings indicate low levels of successful engagement of families in voluntary services. Notwithstanding the absence of significant findings, this study demonstrates the potential for using community-based RCTs and administrative records to rigorously evaluate secondary prevention programs in the child protection system.