Rates of Emotional Disturbance Among Children in Foster Care: Comparing Federal Child Welfare Data and Medicaid Records in Two States.

The purpose of this study is to estimate the rate of emotional disturbance (ED) among children in foster care and assess the validity of the national foster care census data (AFCARS) measure of ED. This study used linked child protection and Medicaid records from 2014 and 2015, for the states of California and Wisconsin, as well as data from AFCARS, a federal population census of children in foster care which states are mandated to contribute to. ED is defined by AFCARS and includes an array of mental and behavioral health diagnoses. According to AFCARS, 13% of CA children in foster care and 15% of WI children in foster care had an ED, whereas Medicaid claims produce rates of 45% and 48%, respectively. Rates of ED among children in congregate care were underestimated by 43-46 percentage points, with substantial proportions having diagnoses of disruptive behavioral disorders. Despite the AFCARS ED measure being cited in congressional testimonies and its wide use in research, results from this study suggest that the AFCARS ED estimates are an unreliable metric for use in research, policy, or practice.

Child protective services involvement and exclusionary school discipline.

The study examined the impact of child protective services (CPS) contact on out-of-school suspensions for 49,918 Wisconsin students (followed from ages 5-6 to 14-15; [school years 2010-2019; 74% White; 7% Black; 11% Hispanic; 8% other; 49% female]). A quasi-experimental design comparing recent CPS contact to upcoming (future) CPS contact shows that both recent CPS contact without foster care and future CPS contact predict higher odds of suspension compared with no contact. Higher odds of suspension emerged prior to CPS contact and did not substantially increase during or after CPS contact, suggesting that system-induced stress is not a primary driver of behavioral problems leading to suspension. Foster care reduced the odds of suspension among White children and children in special education.

A Meta-Regression of Racial Disparities in Wellbeing Outcomes During and After Foster Care.

Children in foster care face heightened risk of adverse psychosocial and economic outcomes compared with children in the general population. Yet, the effects of foster care as an intervention are heterogeneous. Heterogeneity outcomes by race and ethnicity are of particular interest, given that Black and Indigenous youth experience foster care at higher rates than other racial/ethnic groups and experience group differences in setting, duration, and exits to permanency. This meta-regression explores racial disparities in education, employment, mental health, and behavioral outcomes during and following foster care. A systematic search of PsycINFO, ERIC, and Academic Search Complete using a series of search terms for studies published between January 2000 and June 2021 found 70 articles and 392 effect sizes that provided outcomes of US-based foster care by race/ethnicity. Findings reveal that Black foster care impacted persons (FCIPs) have 20% lower odds (95% CI: .68-.93) of achieving employment or substantial financial earnings and have 18% lower odds (95% CI: .68-1.00) of mental health concerns compared to White FCIPs. Hispanic FCIPs have 10% lower odds (95% CI: .84-.97) of achieving stable housing compared to non-Hispanic FCIPs. Moderator analyses revealed certain study features (i.e. publication type, timing of the study, location of the study, and placement status of the participants) have a significant impact on the gap between Black and non-Black and Hispanic and non-Hispanic FCIPs. The findings provide important implications for racial disparities in foster care outcomes, as well as highlight important gaps and missing information from published studies.

It's not "Just poverty": Educational, social, and economic functioning among young adults exposed to childhood neglect, abuse, and poverty.

BACKGROUND: Neglect is the most common allegation in Child Protective Services (CPS) investigations. Researchers and media have questioned whether and how CPS-investigated neglect differs from poverty. Prior studies are limited by self-reported or cross-sectional measures, small samples, and short observation periods. OBJECTIVE: (1) To estimate the "added harm" of CPS-investigated neglect, net of poverty exposure (depth and duration), on high school completion, employment and earnings, incarceration, and teen parenthood; (2) To assess whether abuse is a stronger risk factor for adverse outcomes than neglect. PARTICIPANTS AND SETTING: 29,154 individuals born in 1993-1996 from Milwaukee County, WI, who either received food assistance or were reported to CPS before age 16. METHOD: Using logistic regression with a rich set of social and demographic controls, we compared individuals with CPS-investigated neglect, abuse, or both abuse and neglect in early childhood or adolescence to those who experienced poverty but not CPS involvement. We calculated cumulative measures of poverty duration and poverty depth between ages 0 and 16 for the full sample using public benefit records. RESULTS: Outcomes among children with alleged or confirmed neglect were statistically significantly worse in all domains than impoverished children without maltreatment allegations, and similar to children with alleged or confirmed abuse. Effect sizes varied by outcome. CONCLUSIONS: Overall, this study suggests that CPS allegations of neglect are distinct from poverty and an important risk factor for adverse outcomes in adulthood.

Patterns of intergenerational child protective services involvement.

BACKGROUND: Prior research on Child Protective Services (CPS) involvement among at-risk youth focuses on their roles as parents perpetrating maltreatment against biological offspring. Given family complexity and assortative partnering, measuring all CPS involvement - as perpetrators and non-offending parents of victims - provides new insight into intergenerational maltreatment patterns. OBJECTIVES: Our objective was to investigate the risk of multiple forms of parent or perpetrator CPS involvement (PP-CPS) by age 25, among those exposed to three forms of adversity in their late teens (at ages 14-17): alleged victim on a CPS investigation, out-of-home care (OHC), and poverty. PARTICIPANTS AND SETTING: We used a sample of 36,475 individuals born in 1990-1991 from the Wisconsin Data Core longitudinal administrative database, and tracked their involvement in CPS, OHC, and the food assistance program (SNAP) over time. Our sample consisted of individuals who, at ages 14-17, met one of the following criteria: were in OHC; had CPS involvement as a victim but no OHC (CPSV group), or received food assistance without CPSV or OHC (SNAP group). METHODS: Using logistic regression, we modeled four forms of PP-CPS involvement: parent-perpetrator, resident parent non-perpetrator, nonresident parent non-perpetrator, and non-biological parent-perpetrator. RESULTS: Predicted risks of any PP-CPS involvement by age 25 were 10 % (SNAP group), 17-22 % (CPSV group), and 26-33 % (OHC group); among OHC youth known to have a biological child, rates exceeded 40 %. The proportion of CPS involvement that involved parent-perpetration varied substantially by sex and adversity type. CONCLUSIONS: Focusing only on intergenerational maltreatment in which the parents are the perpetrators may substantially understate the risk of maltreatment recurring across generations.

Socioeconomic Resource Environments in Biological and Alternative Family Care and Children's Cognitive Performance.

OBJECTIVE: We examined social and economic resources in the environments of children involved with child protective services and their associations with children's cognitive performance. METHODS: We used a national dataset of child protection investigations (children ages 6 to 16 at wave 1). Using latent class analysis, we constructed profiles of the financial resources, parental education and employment, and family structure and size. We then examined within- and across-time associations between resource environment profiles and children's math and reading scores, and tested whether associations differed by family care type. RESULTS: Our latent class analysis identified four distinct family resource environments: educated middle class, single earner, large working class, and severely disadvantaged. Family resource environment profiles predicted current cognitive performance and changes in performance over time, but associations were more consistent for children in biological family care. CONCLUSION: Children who remain in home following maltreatment allegations may benefit from services that target social as well as economic resources.

Predicting Child Protective Services (CPS) Involvement among Low-Income U.S. Families with Young Children Receiving Nutritional Assistance.

This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele.

The Complex Interplay of Adverse Childhood Experiences, Race, and Income.

An extensive research base shows evidence of racial disparities in health outcomes, and a growing body of evidence points to associations between adverse childhood experiences (ACEs) and poor health. This study uses data from the 2011 and 2012 Wisconsin Behavioral Risk Factor Surveillance System surveys to identify the relative contributions of ACEs, race, and adult income to predicting three sets of adverse adult health outcomes. The authors found that controlling for demographic factors, ACEs strongly predict health risk behaviors, indicators of poor general health, and chronic health conditions. Adult low-income status is associated with poor general health and chronic health conditions, but not health risk behaviors. African American race is marginally associated only with indicators of poor general health, and this association is attenuated when ACEs and adult income are controlled. These findings suggest a complex interplay among ACEs, race, and income.

Corporal Punishment in U.S. Public Schools: Prevalence, Disparities in Use, and Status in State and Federal Policy.

School corporal punishment is currently legal in 19 states, and over 160,000 children in these states are subject to corporal punishment in schools each year. Given that the use of school corporal punishment is heavily concentrated in Southern states, and that the federal government has not included corporal punishment in its recent initiatives about improving school discipline, public knowledge of this issue is limited. The aim of this policy report is to fill the gap in knowledge about school corporal punishment by describing the prevalence and geographic dispersion of corporal punishment in U.S. public schools and by assessing the extent to which schools disproportionately apply corporal punishment to children who are Black, to boys, and to children with disabilities. This policy report is the first-ever effort to describe the prevalence of and disparities in the use of school corporal punishment at the school and school-district levels. We end the report by summarizing sources of concern about school corporal punishment, reviewing state policies related to school corporal punishment, and discussing the future of school corporal punishment in state and federal policy.

Home Foreclosure and Child Protective Services Involvement.

OBJECTIVE: We estimated associations between experiencing a home foreclosure filing and experiencing a child protective services (CPS) investigation or substantiation. METHODS: We linked a large sample drawn from administrative data on foreclosure filings, CPS involvement, and participation in a host of other public programs for >60,000 Wisconsin households over a 4-year period from 2008 to 2011. Our empirical analyses used piecewise exponential survival models to estimate the risk of CPS involvement (investigation or substantiation) as a function of a home foreclosure filing and a set of individual and household characteristics. We fitted these models with and without the inclusion of propensity score weights. RESULTS: Households that experienced a foreclosure filing had a much higher probability of CPS involvement. This was true in the year before the filing as well as the year after the foreclosure filing. However, these associations were generally largest in the period before or shortly afterward. CONCLUSIONS: Experiencing a foreclosure filing is associated with increased CPS involvement. However, it is not clear that this association is driven by the foreclosure filing action itself. Rather, increased risk of CPS involvement is apparent during the process of moving toward the filing as well as the year or so after the filing, both of which are likely characterized by limited economic resources as well as by financial and other stress.