'There's a will, but not a way': Norwegian GPs' experiences of collaboration with child welfare services - a grounded theory study.

BACKGROUND: Adverse childhood experiences can have immediate effects on a child's wellbeing and health and may also result in disorders and illness in adult life. General practitioners are in a good position to identify and support vulnerable children and parents and to collaborate with other agencies such as child welfare services. There is a need for better integration of relevant services. The aim of this study is to explore GPs' experiences of the collaboration process with child welfare services. METHOD: This is a qualitative grounded theory study, with data consisting of ten semi-structured interviews with general practitioners across Norway. RESULTS: The doctors' main concern was: 'There's a will, but not a way'. Three subordinate stages of the collaboration process were identified: (I) Familiar territory, with a whole-person approach to care by the doctor. (II) Unfamiliar territory, when child welfare becomes involved. Here, a one-way window of information and a closed door to dialogue perpetuate the doctors' lack of knowledge about child welfare services and uncertainty about what is happening to their patients. (III) Fragmented territory, where doctors experience lost opportunities to help and missing pieces in the patient's history. CONCLUSION: General practitioners are willing to contribute to a collaborative process with child welfare, but this is hampered by factors such as poor information flow and opportunities for dialogue, and limited knowledge of the partner. This implies lost opportunities for doctors to help families and contribute their knowledge and potential actions to a child welfare case. It can also impede whole-person care and lead to fragmentation of patient pathways. To counteract this, electronic two-way communication could enable a collaborative process and relationships that enhance coordination between the parties. Making space for all parties and their individual roles was considered important to create a positive collaborative environment.

Information sharing between the dental healthcare and child welfare services regarding child maltreatment-A repeated cross-sectional study in Norway.

BACKGROUND: Little is known about dental healthcare workers reported suspected child maltreatment to and received inquiry from the child welfare services (CWS). AIM: Assess time lag differences in public dental healthcare workers' information sharing with CWS and identify sociodemographic and attitudinal covariates of information sharing with CWS in 2014 and 2019. DESIGN: In 2014 and 2019, a national census of 1542 and 1791 Norwegian dental health care workers, respectively, were invited to participate in an electronic survey. Of them, 1200 (77.8%) and 1270 (70.9%) replied to the questionnaires. Time trends of reported child maltreatment and received inquiries were estimated and adjusted for sociodemographics, attitudes, trust, and collaborative routines in logistic regression analyses. RESULTS: The likelihood of reported child maltreatment to and received inquiry from CWS was higher in 2019 than in 2014 (OR 1.4 [95% CI 1.2-1.7] and OR 1.1 [95% CI 0.9-1.4]). Significant associations occurred with sociodemographic characteristics, attitudes, and collaborative routines. The likelihood of receiving inquiry about whether being employed long versus short term was higher in 2019 than in 2014. CONCLUSION: Information sharing between dental healthcare workers and CWS improved across time and might promote beneficial outcomes.

Treatment for problematic substance use in Nordic youth: a narrative review from the viewpoint of social services.

BACKGROUND: Youth mortality from drugs is worryingly increasing in Europe. Little is so far known about what substance use services are available to young people. An out-of-home care placement is often used but does not suffice alone as an intervention in problematic substance use among youth. Additional interventions are needed. OBJECTIVE: This narrative review investigated what has been done, what works, and what is needed in treating youth substance use in the Nordic countries from the viewpoint of social services. This study brought together previous Nordic studies on this topic and presented responses to youth substance use in Nordic social welfare system to the wider international audience. METHODS: A search of the ProQuest and EBSCOhost databases revealed seven interventions reported in 17 papers. Narrative synthesis was used. RESULTS: Interventions included the Cannabis Cessation Program (CCP), the Icelandic version of the Motivation to Change Inventory for Adolescents, the Norwegian multisystemic therapy program (MST), the Structured Interview Manual UngDOK implemented in the Swedish Maria clinics, the Finnish ADSUME-based intervention in school health care, and the Swedish Comet 12-18 and ParentStep 13-17 programs. Many interventions had originated in the US rather than in the Nordic countries and most of them were adapted from adult interventions when youth specificity was lacking. Parental involvement was deemed important, but ineffective without involving the adolescent themself. Interventions and ways for dealing with young offenders required reconsideration from the perspective of the best interests of the child. The current research focuses on universal prevention while more knowledge about selective and indicative prevention was called for. CONCLUSIONS: Not enough is known about the cessation of problematic youth substance use and subsequent rehabilitation in social services. We would encourage further research on the multi-producer system, subscriber-provider-cooperation in youth substance use services, non-medical youth-specific substance use interventions in social services, and rehabilitative juvenile drug offense practices.

Experiences of counselors participating in an innovative project to develop a training program for specialized foster parents of youth (13-18 years).

Background: Children placed in foster care represent a vulnerable and distressed group that requires a high level of care. However, good training programs designed to address specific problems presented in specialized foster care are not easily accessible due to logistical, economic and structural barriers. The lack of easy access and a strong desire to provide high-quality services inspired counselors from a specialized foster care center on the frontline to initiate an innovative, developmentally relevant and locally grounded training program. Aims: This study focuses on counselors' experiences with the development of the training program and its impact on their work life. Method: A qualitative research design within a participatory approach framework was used to understand the experiences of the counselors. All the counselors employed in the department and the leaders (n = 14) participated in the study. Data were gathered from participants, including the lead and second authors, using a semi-structured interview, and analyzed using thematic analysis. Results: The analyses yielded three main categories: (i) Psychological Factors, (ii) Social Dynamics, and (iii) Leadership Style and Support. Each of the first two categories consisted of three subcategories. At the psychological level, the employees' experiences reflected the psychological states and traits required to fuel the tasks required by the project. The social dynamics of working in a team influenced the work process and, in turn, were impacted by it. Lastly, leadership style and support provided the foundation for innovation to germinate and grow. Conclusion: Engaging in a locally created training program was associated with a strong sense of collaboration and team spirit. Counselors reported high intrinsic motivation and a strong sense of personal pride and drive for their jobs. They were proactive in seeking colleagues with particular expertise and collaborated on project tasks despite differences. The leadership style reflected the presence of transformational leadership behaviors, signaling an organizational culture conducive to innovation. The study provides an example of how aligning employees' personal aspirations with workplace goals and professional development can create a workplace in which employees feel it is enjoyable to go to work.

Applying after-action reviews to child and family teams to improve mental health service linkage within child welfare services: a study protocol.

BACKGROUND: Half of child-welfare-involved children and adolescents meet the criteria for at least one mental health diagnosis. This project proposes to improve successful mental health service linkage in child welfare services (CWS) by adapting and testing the after-action review (AAR) team effectiveness intervention to augment the child and family team (CFT) services' intervention. Despite being both required and a collaborative approach to service planning, CFT meetings are implemented with questionable fidelity and consistency, rarely including the voice of children and families as intended. METHODS: Using a parallel group trial design, with non-equivalent comparison groups, and qualitative and quantitative methodology, this study will tailor and assess the impact of the AAR on enhancing CFT outcomes. The authors will conduct a qualitative needs assessment targeting the ongoing implementation of the CFT services intervention in a large, publicly funded, CWS system. A qualitative inquiry consisting of interviews and focus groups with key stakeholders will result in the preparation of an action plan to address identified gaps between the current and desired CFT services intervention outcomes. The AAR implementation strategy will be adapted and tailored to address the CFT services' intervention needs. To test the effectiveness of the AAR on improving outcomes associated with the CFT services intervention, we will utilize blocked randomization of four CWS caseworkers from two CWS system regions to either the intervention condition (CFT + AAR) or standard implementation (CFT as usual). The authors will collect data from the CWS caseworkers and additional CFT members via web-based surveys. Mechanisms of the AAR team effectiveness intervention for CFT implementation will be assessed. DISCUSSION: By inclusion of child and family voice, the AAR-enhanced CFT should lead to increased fidelity to the CFT intervention and greater levels of parental satisfaction with the service and shared decision-making, thus resulting in enhanced follow-through with service plans and linkage to mental health treatment services for children. The knowledge gained by this randomized clinical trial has the potential to benefit service delivery and integration for CWS leaders, caseworkers, formal and informal CFT member support persons, parents/caregivers, and children with open cases. Improving intervention effectiveness, both at the system and family levels, is crucial for practice efficiencies and improved child and family outcomes. TRIAL REGISTRATION: NCT05629013. Approval date: November 28, 2022 (version 1). TRIAL SPONSOR: University of California, San Diego. RESPONSIBLE PARTY: Danielle Fettes.

Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety-A secondary analysis of the Better Care study.

Background: Unaccompanied young refugees (UYRs) show elevated levels of mental distress such as post-traumatic stress symptoms (PTSS), depression, and anxiety. The individual post-arrival situation in the host country plays an important role in increasing or reducing mental health risks for these vulnerable children and youth. The study aims at examining the impact of pre- and post-migration factors on the mental health of UYRs. Methods: A cross-sectional survey of N = 131 young refugees (81.7% male, M = 16.9 years old) was conducted in 22 children and youth welfare service (CYWS) facilities in Germany. The participants provided information about pre- and post-flight experiences. Standardized measures were used to assess post-traumatic stress symptoms (CATS-2), symptoms of depression (PHQ-9), and anxiety (GAD-7). Daily stressors were assessed with the Daily Stressors Scale for Young Refugees (DSSYR), sociocultural adaptation with the Brief Sociocultural Adaptation Scale (BSAS), satisfaction with social support with the Social Support Questionnaire (SSQ6-G). Results: Our results demonstrated clinical levels of PTSS in 42.0% of the participants, depression in 29.0%, and anxiety in 21.4%. Hierarchical regression analyses revealed that a higher number of traumatic events and social daily stressors predicted higher levels in all three domains of mental health problems. PTSS and anxiety were also predicted by the distress related to the residence status, depressive symptoms were additionally predicted by sociocultural adaptation, less family contact and length of stay. The satisfaction with social support was not a significant predictor in the regression models. Conclusion: Unaccompanied young refugees in CYWS facilities are a highly vulnerable population. As traumatic events, daily stressors and level of contact to family directly impacted UYRs mental health, interventions should be trauma-focused, but also contain modules on how to cope with daily stressors. On the policy and practical level, stakeholders in host countries are called for establishing measures to reduce post-migration stressors and enhance support for UYRs on all levels.

Changes in parents' mental health related to child out-of-home care placements: A Swedish national register study.

BACKGROUND: Literature on outcomes of children in out-of-home care (OHC) is extensive. However, less is known regarding associations of such placements with parental mental health disorders (MHD). OBJECTIVE: This study investigated changes in hospitalization rates due to MHD among parents, four years before and after placement of their child in OHC. PARTICIPANTS AND SETTING: We used data on 4067 members (Generation 1) of the RELINK53 cohort (individuals born and living in Sweden in 1953) and their 5373 children (Generation 2) in OHC. METHODS: Using random effects regression models, associations between OHC and MHD were examined separately for fathers and mothers. Nested models were tested exploring associations with parent and child/placement-related factors. Marginal effects were computed to assess mean rates of hospitalization annually. RESULTS: Overall, mothers had higher mean hospitalization rates than fathers. Compared to the year of placement, hospitalization rates were significantly lower in the four years before placement for mothers (9.9 %, 9.5 %, 10.5 %, 12.1 %, respectively) and fathers (5.9 %, 7.6 %, 8 %, 9.8 %, respectively). Mothers showed highest hospitalization rates at the year of placement (26.6 %), while fathers, one year after placement (13.4 %). Hospitalization rates declined significantly directly after placement among mothers, but an unclear and non-significant pattern of results was found among fathers. CONCLUSIONS: Most parents have higher hospitalization rates at and directly after placement. Potential hypotheses underlying these findings are discussed, including psychosocial gender differences and opportunities to seek care as means of reunification. There is an urgency to develop strategies to better support these parents throughout the process.

Potential traumatic events and symptoms of post-traumatic stress in unaccompanied refugee minors-a comparison with youth in foster care.

Building knowledge on how child welfare services (CWS) should tailor services for unaccompanied refugee minors (URMs) is important. URMs and youth in foster care are high-risk groups taken care of by the CWS in Norway. Little is known on whether knowledge gained from youth in foster care can inform services for URMs, and if these groups are comparable in terms of experiences of potential traumatic events (PTEs) and post-traumatic stress disorder (PTSD) symptom load. Eighty-one URMs reported PTEs and PTSD-symptoms using an adapted version of the Child and Adolescent Trauma Screen (CATS). Responses were described and compared with a sample of 303 youth in foster care in linear regression models. We present relative risks (RR) and standardized mean differences (SMD) for the PTEs and the PTSD subscale and total score between the groups in forest plots. URMs had experienced a mean (standard deviation) of 6.4 (3.4) PTEs and 43.9% reported to have PTSD-symptoms at or above the clinical cut off. Compared to the foster youth, URMs reported more exposures of interpersonal violence outside of the family (RRs ranging from 66.4 [95%CI 18.1; 243.5) to 1.3 (1.0, 1.5)], and more PTSD-symptoms in the re-experiencing subscale [SMD = 0.3 (95% CI 0.1, 0.6)]. The frequency and types of PTEs and the PTSD-symptom load and profile among URMs and youth in foster care differed. Findings underscore the importance of qualified and targeted care for URMs, and that this care should differ to that of other high-risk groups in the CWS.

Study design: Pathways to Independence - A study of unaccompanied minor refugees settled in a Norwegian city municipality.

AIMS: The aim of the 'Pathways to Independence' study was to gain knowledge of how to facilitate a healthy development for unaccompanied refugee minors (URMs) after settling in Norwegian municipalities. METHODS: The project is located in the URM child welfare services (URM CWS) of the Bergen municipality. We invited 101 URMs older than 15 years connected to the URM CWS to participate in a comprehensive survey. Of the invited, 81 consented to participate. The survey included questions on the user's experiences and satisfaction with the URM CWS, and questions related to schooling, social support and activities after settlement. We also included standardized and validated questionnaires on potential traumatic events, mental and somatic health, protective factors and quality of life. These questionnaires have previously been used in two Norwegian epidemiological studies, the 'Youth@Hordaland' and 'Young in Foster care', facilitating comparison of the results with other youth populations in Norway. CONCLUSION: Results from the project will be valuable in the process of reaching knowledge-based recommendations for successful settlement of URMs.

Gender disparities in child welfare services' assessments of referrals. Findings from Sweden.

BACKGROUND: Many children referred to the child welfare services are not screened in for further investigation. Factors related to intake decisions have been found on several levels. Many studies, however, lack information about the children's own experiences of child maltreatment and/or behavioral problems. OBJECTIVE: To examine case factors relating to decision to investigate referrals to the child welfare services in Sweden. PARTICIPANTS AND SETTING: Data are used from a prospective longitudinal multisource program (LoRDYA) in Sweden studying two cohorts of adolescent children in four municipalities (n = 1884). METHODS: By linking annual self-rating data with registry data from the child welfare services, data are analyzed through latent-class analysis and Poisson regression. RESULTS: Most children who are self-rated severely exposed to maltreatment and/or behavioral problems are never investigated by the child welfare services (74.2 %). Referrals concerning girls are more likely to be investigated than referrals concerning boys (crudeAME = 0.09 p = ***). For girls, prior referrals (adjAME = 0.16, p = ***), household poverty (adjAME = 0.09, p = *) and any form of self-rated severe exposure to maltreatment and/or behavioral problems (adjAME = 0.14, p = ***) increased the chance of a decision to investigate. For boys, prior referrals (adjAME = 0.24, p = ***) increased the chance of a decision to investigate, while achieved age (adjAME = -0.03, p = *), and being referred on suspicions of neglect and behavioral problems (adjAME = -0.15, p = **) decreased the chance of a decision to investigate. CONCLUSIONS: Child welfare services assess referrals on boys and girls differently, which may explain why boys have in crude numbers a decreased chance of decisions to investigate.

Access to Public Support Systems Related to Severity of Adversities and Resilience among Adolescents.

Access to support systems is crucial for providing immediate assistance and treatment to children to counteract the long-term detrimental effects of various forms of violence. This study examines how adversity such as victimization of violence and self-injury behaviors among young people with their individual resilience is related to their access to support systems. The data used in our analysis are from two national youth surveys carried out in Norway in 2007 and 2015. We ask: To what degree do young people with experiences of violence gain access to support systems such as child welfare services, mental health services for children and youth, and pedagogical psychology services? Our results show that although not all young people who need help have gained access to support systems, victimization of violence and self-injury behavior significantly increase the likelihood of accessing these support systems. Our results also reveal a persistent effect of young people's home socio-economic background on their unequal access to system support. More future research is needed on the subtle mechanisms and social-emotional implications of individual accessing system support from the macro-societal level and meso-system/family level.

Huellas afectivas del trabajo en política de protección a la infancia / Affectivity in the implementation of child welfare policies / Traços afetivos do trabalho de política de proteção à infância

Resumen (analítico) Chile es un caso emblemático en la instalación de una política de protección a la infancia con orientación neoliberal. Actualmente, esta política es ejecutada casi completamente por organizaciones privadas, financiadas conforme al logro de indicadores de desempeño estandarizados. Algunas investigaciones plantean que estos indica-dores gobiernan la racionalidad de los trabajadores y trabajadoras; empero, estudios internacionales señalan que este tipo de gobernanza no solo es racional, sino también afectiva. A partir de un análisis textuala-fectivo de 14 entrevistas individuales y dos talleres grupales realizados a cinco trabajadoras y un trabajador de distintos organismos colaboradores del Servicio Nacional de Menores, se reporta que este modelo de gestión consume y maquiniza los cuerpos de estas y estos profesionales. No obstante, el afecto es el que hace posible la resistencia.

Abstract (analytical) Chile is an emblematic case in the implementation of a neoliberal child welfare policy. This policy is now almost entirely undertaken by private organizations, financed based on their achievement of standardized performance indicators. Scientific literature suggests that these indicators govern workers' rationality. However, international studies indicate that the effect of indicators is not just rational but also affective. From a textual-affective analysis of 14 interviews and 2 workshops conducted with 5 female workers and 1 male worker from different partner organizations within the Chilean National Service for Minors, participants reported that this management model consumes and mechanizes the work carried out by these professionals. However, it is affectivity that makes resistance possible.

Resumo (analítico) O Chile é um caso emblemático na instalação de uma política neoliberal de proteção à criança. Esta, é hoje quase inteiramente executado por organizações privadas, financiadas de acordo com a obtenção de indicadores de desempenho padronizados. Pesquisas sugerem que estes indicadores governam a racionalidade dos trabalhadores; enquanto estudos internacionais indicam que este governo não é apenas racional, mas também afetivo. A partir de uma análise textual-afetiva de 14 entrevistas e duas oficinas realizadas a cinco trabalhadoras e um trabalhador de diferentes Organizações Colaboradoras do Serviço Nacional de Menores, é relatado que este modelo de gestão consome e mecaniza os órgãos destes profissionais. No entanto, é o afeto que torna possível a resistência.

Sleep patterns and insomnia among adolescents receiving child welfare services: A population-based study.

OBJECTIVES: Sleep problems are common in adolescence. We aimed to investigate sleep patterns and insomnia in Norwegian adolescents who have been in contact with child welfare services (CWS), both adolescents living in foster care (FC) and adolescents receiving in-home-services (IHS). Both groups were compared to youth who reported they were not receiving child welfare interventions. DESIGN: Cross-sectional. SETTING: The population-based study youth@hordaland from 2012 in Hordaland, Norway. PARTICIPANTS: About 9421 adolescents (53.8% girls), age range 16-19 years, were divided into 3 groups; IHS group (n = 123), FC group (n = 132), and control group (n = 9166). MEASUREMENTS: Self-reported information about demographics, detailed sleep patterns, sleep problems, and adverse life events. RESULTS: Adolescents receiving IHS (vs. controls) had significantly shorter sleep duration, lower sleep efficiency, longer sleep onset latency (SOL), wake after sleep onset (WASO), and higher prevalence of insomnia. They had increased odds of insomnia (adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.19-2.62) and SOL ≥ 30 minutes (AOR = 1.95, CI = 1.32-2.87). Adolescents in FC (vs. controls) reported lower sleep efficiency and longer WASO. When adjusting for sex and age, the associations did not substantially change. When additionally adjusting for adverse life events, the associations were considerably attenuated for both groups, and were no longer significant for the FC group. CONCLUSION: Our results indicate a higher rate of sleep problems among adolescents receiving interventions from CWS, particularly those receiving IHS. Adverse life events accounted for a substantial part of the increased risk of sleep problems.

An Examination of Past Trends in School Reports to Child Welfare: Considerations for Reported Child Maltreatment.

This study examines whether increased interaction and observation of young children by school professionals leads to an increase in school-based reports to child welfare authorities and in the identification of child maltreatment victims. Comparing provincial-level data collected before and after full-day kindergarten implementation in Ontario, a doubling in rates of school-referred investigations involving 4- and 5-year-old children was found. There was no significant difference in the rates of maltreatment substantiation, service referrals made or transfers to ongoing services, but the rate of child functioning concerns noted in these investigations tripled. The findings suggest there are differences in how the school and child welfare systems define and respond to suspected child maltreatment. Implications for practice, policy and research are explored.

Reasonable Efforts? Child Maltreatment Investigations and Service Referrals of Parents With Ascribed Cognitive Impairments in Canada.

Parents with ascribed cognitive impairment (CI) are more likely than parents without CI to have their children removed by child protective services (CPS). Inequitable access to parenting and family supports and services is thought to be a contributing factor. Utilizing data on a 3-month sample of 15,980 child maltreatment investigations across Canada, including 1,244 cases featuring parents with CI, this study investigated service referrals and non-referrals. The results of this secondary data analysis suggest that, relative to need, parents with CI are less likely to be referred for matched services, including home based\reunification services post child removal. It is unclear whether disparate rates of referral are driven by a lack of inclusive services, and/or the conflation of parental CI with perceived parenting deficits. When perceived parenting deficits are attributed to parental CI, CPS may wrongly assume that these are irremediable. The findings highlight the need for building inter-sectoral service pathways in order to render appropriate assistance to parents with CI in the performance of their childrearing responsibilities.

A Review of Screened-Out Families and Child Protective Services Involvement: A Missed Opportunity to Prevent Future Maltreatment With Community-Based Services.

The objective of this article is to frame, understand, and draw implications from existing research on families screened out by child protective services (CPS) after a referral alleging child maltreatment. We review descriptive and outcome data together with emerging intervention research amidst a developing consensus that the current reactive role of CPS should be supplemented by supportive and preventative services that primarily address poverty. State-level data indicate that screened-out families are at high risk of re-referral and similar to higher-risk families reported to CPS. Intervention research is scant and mixed, but there is indication that providing community-based services may reduce future CPS involvement. Considering that screened-out referrals present an opportunity to prevent future maltreatment, CPS should identify and collaboratively engage screened-out families in community-based services. More research on the outcomes of these community responses is needed to identify best practices related to engagement and service provision.

Experience of child welfare services and long-term adult mental health outcomes: a scoping review.

PURPOSE: This is the first comprehensive review of empirical research that investigated the association between receipt of child welfare services and adult mental health outcomes. The review summarised the results of studies about mental health outcomes of adults with a history of child welfare involvement. METHODS: A scoping review methodology was used to search five electronic databases (MEDLINE, EMBASE, PsychINFO, IBSS, Social Policy and Practice). Studies were included if they examined any child welfare exposure (including receipt of services while remaining at home/being placed in care) and adult mental health status. RESULTS: In total 4591 records were retrieved, of which 55 met the eligibility criteria. Overall, receipt of child welfare services was associated with an increased risk of adult mental ill-health, suicide attempt and completed suicide. Results regarding potential moderating factors, such as gender and care-related experiences, were mixed. Relatively few studies investigated the reasons for requiring child welfare services, the experience of abuse or neglect or the adult outcomes of child welfare service users who remained in their own homes. Mental ill-health was defined and measured heterogeneously and details about the nature and type of welfare service utilisation were lacking. CONCLUSION: There is a need for detailed, longitudinal studies to better understand the relative contribution of pre-existing adversity versus experiences during and after exposure to child welfare services on adult mental health outcomes. More standardised measures of mental ill-health and greater detail from authors on specific care exposure are also needed.

The Relationship Between Maternal Domestic Violence and Infant and Toddlers' Emotional Regulation: Highlighting the Need for Preventive Services.

In an effort to further understand the impact of domestic violence (DV) on infant and toddlers' development, this research utilized data from the second cohort of National Survey of Child and Adolescent Well-Being (NSCAW II) to examine the relationship between maternal DV and infant and toddlers' emotional regulation, and determine whether mothers' receipt of DV services mediated this relationship. The sample was limited to children aged 0 to 3 years and included (a) infants less than 1 year old (n = 603), (b) infants 1 to less than 2 years old (n = 310), and (c) toddlers 2 to 3 years old (n = 268). Infant/toddlers' emotional regulation was measured using mothers' response on the How My Infant/Toddler/Child Usually Acts questionnaire. In addition, data were collected to assess whether (a) active DV was present during the time of the Child Protective Services (CPS) investigation and (b) mothers received DV services during the past year. Study research questions were examined using a series of multiple regression analyses. Mediation was tested based on Baron and Kenny's recommended model for establishing mediation. The mediational model was not found to be significant; however, a positive relationship existed between maternal DV and emotional regulation among infants aged less than 1 year old (ß = 1.61, p = .039). There were no statistically significant relationships between DV and emotional regulation in the other age groups. These findings highlight the need to provide CPS-involved families victimized by DV with services that focus on preventing poor infant emotional regulation.

Child Maltreatment Investigations in Canada: Main and Moderating Effects of Primary Caregiver Cognitive Impairment.

Children of parents with cognitive impairment are overrepresented in the child protection system (CPS). The aim of this study was to examine the relationship between primary caregiver cognitive impairment (CCI) and CPS investigation outcomes using the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2008). The CIS-2008 includes process and outcomes data on a national sample of CPS investigations involving a total of 15,980 children under the age of 16 years. This secondary data analysis found that primary CCI was noted in 6.3% of all investigations. When primary CCI was noted, investigations were 3-4 times more likely to result in child removal and court action. The results further suggest that some case characteristics, including case history variables, are weighted differently in decision making depending on whether or not primary CCI is indicated. A systematic, national strategy is needed to build capacity in government and community sectors for the provision of research-informed child and youth protection and family support services for these parents and their children.

Are Dual-System Offenders Different? An Examination of Prevalence and Specialization in Criminal Offending and Child Maltreatment Perpetration.

Although most theoretical and policy approaches treat criminal behavior and child maltreatment as different issues, we examine the prevalence of those involved in both the criminal justice system and child protective services as perpetrators, assessing how several criminal career characteristics differ between dual-system and single-system offenders. Using longitudinal cohort data from the Queensland Cross-Sector Research Collaboration (QCRC), we found that while dual-system-involved offenders made up only 4% of the population, their proportion was much higher among those with a delinquent history, especially among females (males = 21%, females = 38%). Those involved with both systems were more serious offenders and child maltreatment perpetrators with respect to the number and versatility of system contacts. These findings suggest involvement in both the criminal justice and child welfare systems are part of an underlying vulnerability or predisposition toward antisocial behavior and represent an important overlap of service delivery that must be managed effectively.