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.

Child protection services and parents with intellectual and developmental disabilities.

BACKGROUND: Information about parents with intellectual and developmental disabilities (IDD) in the child protection system (CPS) continues to evolve. This study examined characteristics, experiences and representation of parents with IDD across three CPS decision points, as compared to parents with other disabilities and parents without disabilities in the United States. METHODS: The sample consisted of 303,039 individuals: 2,081 were individuals identified as parents in a CPS investigation; 1,101 had children in out-of-home care (OHC); and 308 experienced termination of parental rights (TPR). Descriptive statistics, chi-square analysis, disparity indices and logistic regression were employed. RESULTS: Parents with IDD were significantly more likely than parents without disabilities (but not significantly more likely than parents with other types of disabilities) to experience disproportionately representation. CONCLUSIONS: Parents with IDD are generally over-represented within CPS; however, this representation is dependent upon the comparison group utilized and other risk factors. CPS system-level changes are necessary.

The inclusion of disability as a condition for termination of parental rights.

OBJECTIVES: All 50 states and the District of Columbia have statutes outlining the grounds for terminating parental rights (TPR) in relation to child abuse and neglect. Although recent research has found that parents with disabilities are not more likely to maltreat their children than parents without disabilities (Glaun & Brown, 1999; Oyserman, Mowbray, Meares, & Firminger, 2000), studies have found very high rates of TPR of parents with disabilities (Accardo & Whitman, 1989). The objective of this study is to examine how states are including disability in their TPR statutes. METHODS: This study used legal document analysis, consisting of a comprehensive Boolean search of the state codes of the 50 states and District of Columbia (DC) relating to TPR, using the most recent state code available on Lexis-Nexis in August 2005. TPR and related statutes were searched for contemporary and historical disability related terms and their common cognates, such as: "mental," "disability," "handicap," and "incapacity." Two researchers independently conducted the searches, and the searches were reconciled. A code list was then developed to measure for inclusion of disability, preciseness, scope, use of language, and references to accessibility or fairness. Statutes were then reanalyzed, and groupings developed. RESULTS: Thirty-seven states included disability-related grounds for termination of parental rights, while 14 states did not include disability language as grounds for termination. Many of these state codes used outdated terminology, imprecise definitions, and emphasized disability status rather than behavior. All of the 14 states that do not include disability in TPR grounds allowed for termination based on neglectful parental behavior that may be influenced by a disability. CONCLUSIONS: The use of disability language in TPR statutes can put an undue focus on the condition of having a disability, rather than parenting behavior. IMPLICATIONS: This paper recommends that states consider removing disability language from their statutes, as such language risks taking the emphasis away from the assessment based on parenting behavior.

Status and trends in the direct support workforce in self-directed supports.

Self-directed programs that allow individuals with intellectual and developmental disabilities to exercise greater control over their finances have become increasingly common in recent years. At the same time, challenges in the recruitment, retention, and training of direct support workers in the field have grown more acute. In this article, the authors investigate the status of the direct support workforce for people using self-directed supports in 1 Midwestern state, based on the results of a statewide survey of service users. Although additional research is needed, the results of this study suggest that people who use self-directed funding options are satisfied with their ability to direct staffing, though challenges remain. Among these challenges, the presence of higher than expected wages but lower than expected benefits provision compared with traditional services may have serious policy and staff retention ramifications that affect the long-term viability of self-directed funding options. In addition, staff training remains a challenge, with service users in this sample reporting low rates of training beyond a general skill set. Implications of these findings are discussed.

Approaches to child protection case management for cases involving people with disabilities.

OBJECTIVES: This exploratory study examines the delivery of child protection services by county child protection agencies involving cases with a family member with a disability. METHOD: Telephone surveys were conducted with the directors or their designees of 89% of the child protection agencies in a Midwestern state. Respondents were asked about the policies and/or procedures for approaching cases involving a person with a disability and the barriers and strengths agencies have in serving people with disabilities. RESULTS: Only 6.7% of respondents reported their agency had a written policy related to serving persons with a disability. There were 18 different approaches to serving clients with a disability within child protection, with the most common being informally teaming for information, dual case assignment, and teaming with an outside consultant. Five counties had specialty workers who were experts in both child protection and disability. Barriers reported varied between rural and non-rural counties, with the most important barriers being lack of resources, lack of knowledge regarding disabilities, systems conflicts, and rural issues, such as lack of providers and lack of transportation. Strengths included accessing and coordinating services, individualizing services, good collaboration and creativity. CONCLUSION: While few county agencies had any written policies, both formal and informal collaboration is happening at the individual level. The lack of standardization in providing services indicates a need for more attention to issues regarding disability within child protection, including more training for workers, the development of models of collaborative case management and the removal of systemic barriers.