Socioeconomic risk and the longitudinal child lifetime prevalence of child protection involvement.

BACKGROUND: North American studies find that geographic indicators of disadvantage, such as concentrated poverty, significantly increase the risk of child protection involvement. Despite having one of the most extensive family support systems and progressive income redistribution policies in North America, the Canadian province of Québec still faces geographic variations in socioeconomic conditions that remain a major risk factor for child protection involvement. OBJECTIVE: This study asks how child protection involvement is distributed across socioeconomically distinct geographic areas of the province. Drawing from prior literature, we hypothesize that the highest level of child protection involvement across childhood (age 0-17) is found in the lowest socioeconomic areas. PARTICIPANTS & SETTING: This is a population-based prevalence study using administrative child protection data spanning the years 2000 to 2017 across Québec. METHODS: We constructed cumulative risk life tables of first instances of child protection events (report confirmation, compromised security or development, and out-of-home placement). Prevalence rates were mapped onto 10,650 Census dissemination areas divided into three tiers according to a validated socioeconomic status (SES) index. RESULTS: The highest childhood prevalence of confirmed child protection reports, finding of compromised security or development, and out-of-home placement was found in the lowest SES areas. Rates in low SES areas can be over twice the rates in high SES areas. CONCLUSIONS: Area-level socioeconomic vulnerability remains a robust predictor of child protection involvement even in a socially progressive context. Our findings underscore that without targeted pediatric and family services, as well as poverty-alleviation programs for high-need families in high-need areas, even well-intentioned systems may fall short of reaching the families most in need.

Rates of out-of-home care among children in Canada: an analysis of national administrative child welfare data. / Taux de placement des enfants hors de leur foyer familial : analyse des données administratives nationales du système de protection de l'enfance au Canada.

INTRODUCTION: As a part of the public health approach to child welfare, data about children placed in out-of-home care are needed to assess population trends, understand drivers of social and health inequities, and examine outcomes for children and families. We analyzed administrative data from Canada to describe the population of children in out-of-home care, and estimate and compare rates of out-of-home care by province/territory, year, sex/gender, age group and placement type. METHODS: We conducted a cross-sectional analysis of point-in-time data from all provinces and territories for the period 2013/2014 to 2021/2022. We used frequencies and percentages to describe the population of children (and youth up to age 21 years) in out-of-home care and estimated overall and stratified rates and rate ratios. RESULTS: An estimated 61 104 children in Canada were in out-of-home care on 31 March 2022. The national rate of out-of-home care was 8.24 children per 1000 population. Rate variations by province/territory were substantial and changed over time. Rates were highest among males and children aged 1 to 3 and 16 to 17 years. Foster homes were the most common type of placement, although kinship homes accounted for an increasing share. CONCLUSION: This analysis demonstrated that administrative data can be used to generate national indicators about children involved in the child welfare system. These data can be used for tracking progress towards health and social equity for children and youth in Canada.

Differentiating between child protection and family support in the Canadian child welfare system's response to intimate partner violence, corporal punishment, and child neglect.

Rates of reported child maltreatment nearly doubled in Canada over the period 1998-2003, an increase that reflects growing awareness of the harmful effects of an expanding array of parental behaviors, including corporal punishment, lack of supervision, and exposure to intimate partner violence (IPV). Some of these situations may benefit from voluntary family support programs outside of the child welfare system. Analyzing a sample of 11,807 investigations, this paper compares cases where the sole concern is exposure to IPV, or hitting a child, or neglect, or other forms of investigated maltreatment. Situations where exposure to IPV or potentially abusive hitting were the sole reason for investigation presented with fewer risk factors and were less likely to lead to ongoing child welfare interventions compared to other maltreatment investigations. While situations involving alleged neglect presented a higher risk profile and elicited a more intensive child welfare response than did exposure to IPV or hitting, opportunities for alternative services were nevertheless identified. The study also found that visible minority families were overrepresented in cases involving hitting and that Aboriginal families were overrepresented in cases involving neglect. Overall the findings support the development of alternative response programs in Canada.

A Multilevel Examination of Whether Child Welfare Worker Characteristics Predict the Substantiation Decision in Canada.

The decision to substantiate a report of child maltreatment represents a key decision point in the child welfare service decision-making continuum. This decision has various potential implications for children and their families, which may include more intensive child welfare involvement or the cessation of services. The substantiation decision is determined by whether there is enough evidence to suggest that maltreatment or the risk of maltreatment has occurred. To date, there has been minimal exploration of whether child welfare worker characteristics might influence this critical decision point. The Decision-Making Ecology would suggest that indeed, worker characteristics play a role in how they carry out their role. Given the importance of this decision point, this study uses secondary data to examine whether worker characteristics, such as education level and type, ethnoracial identity, caseload, and experience, predict substantiation in the Canadian child welfare context. Furthermore, this study utilizes multilevel modeling, a theoretically important and unique method of analyzing organizational data that considers differences in decisions among child welfare workers. The final model included 4,327 children and 567 workers from across Canada. Several case level factors (e.g., child age and functioning, caregiver risk factors) predicted the substantiation decision. Furthermore, and most importantly for this study, worker characteristics significantly predicted their substantiation decision. Workers with fewer years of experience, those in an Ongoing Services role, and with a lower caseload substantiated significantly more often than those with more work experience, in another role, and with higher caseloads. Lastly, caseload and years of experience, and training and caseload both interacted to predict the substantiation decision. Implications for policy and practice and future research areas are discussed.

The more we change the more we stay the same: Canadian child welfare systems' response to child well-being.

BACKGROUND: Child welfare services in Canada are guided by a dual mandate: to protect children from imminent harm and to promote their optimal development and well-being. To understand how child welfare systems respond to this dual mandate, Trocmé et al. (2014) developed a taxonomy to classify child welfare investigations as either being related to urgent protection or chronic needs. OBJECTIVE: To extend Trocmé et al.'s (2014) analysis using data from the Canadian Incidence Study of Reported Child Abuse and Neglect 2019 (CIS-2019). PARTICIPANTS AND SETTING: The CIS-2019 employs a file review methodology to collect information on child maltreatment-related investigations conducted in Canada in 2019. The study's unweighted sample included 41,948 investigations involving children aged 0-15 years. METHODS: Secondary analyses of the CIS-2019 were conducted including frequency counts and bivariate analyses. RESULTS: Ninety percent of investigations conducted in Canada in 2019 were focused on concerns related to chronic needs. Most investigations (90.9 % of urgent protection investigations and 98.3 % of chronic needs investigations) did not involve physical harm to the child. Urgent protection investigations were less likely to have been previously investigated and more likely to be substantiated, involve a child welfare court application, or involve a placement in out-of-home care. CONCLUSIONS: Most child welfare investigations in Canada continue to be focused on chronic needs. Yet, the investigation response seems designed to respond to urgent protection concerns. A truly differential model is needed to appropriately respond to the dual mandate of Canadian child welfare services and better serve children and families.

Impacts of race on family reunification: A longitudinal study comparing exits from Quebec's child welfare system.

BACKGROUND: In the United States, Black children spend more time in out-of-home placement than other children and are less likely to experience family reunification following involvement with child welfare services. Within Canada, very few studies have examined Black children's exits from the child welfare system and factors influencing their service trajectory. OBJECTIVE: This study, the first of its kind in Canada, uses longitudinal clinical administrative data to examine reunification outcomes for Black children following placement in out-of-home care. PARTICIPANTS AND SETTING: The study population includes 1395 children receiving ongoing child welfare services in Quebec between April 1, 2002 and March 31, 2011. METHODS: A longitudinal research design from anonymized clinical administrative data extracted from a single child welfare agency in Montreal. Survival analysis using a Kaplan Meier and Cox proportional hazard regression examined the trajectory and chances of family reunification from the point of each child's initial placement. RESULTS: Black children spend longer lengths of time in out-of-home placement and are less likely to experience family reunification when compared to other children. Poorer reunification outcomes for Black children were associated with placement instability, the age of the child and reasons for child welfare involvement. CONCLUSIONS: While we tend to prioritize prevention services for vulnerable communities, this study indicates that attention must be given to services all throughout Black children's service trajectory to ensure that these children are able to exit the child welfare system in a timely manner.

Addressing the overrepresentation of Black children in Ontario's child welfare system: insights from child welfare workers and community service providers.

BACKGROUND: The overrepresentation Black children experience in the child welfare system is well documented in the United States, but such studies are now emerging in Canada. In Ontario, there are few studies that address this issue concerning Black families. OBJECTIVE: This study is to explore the insights of child welfare workers and community service providers on how to potentially address Black children's overrepresentation in Ontario's child welfare system. PARTICIPANTS AND SETTING: Twenty-one child welfare workers from two child welfare organizations in Ontario that serves many Black families and thirteen community service providers in Toronto participated in the study. METHODS: Six focus groups were conducted with thirty-four participants. Audio recording from each of the focus groups was manually transcribed verbatim. We utilized constant comparison analysis to analyse the transcribed data. RESULTS: Potential solutions to overrepresentation that emerged from the focus group discussions included viewing Black families as experts of their own lives; increasing workforce diversity; educating referral sources and Black families on child welfare practices; subjecting referral sources to detailed questioning; stopping harmful record keeping on families; providing cultural sensitivity training and education; partnering with community organizations; and providing mentorship opportunities. CONCLUSIONS: The findings from this study emphasize the need for changes related to child welfare assessment tools, workforce development, and shifts in system orientation to address systemic racism and Black children's overrepresentation in the child welfare system.

Risk of Future Maltreatment: Examining Whether Worker Characteristics Predict Their Perception.

Child welfare workers aim to promote the well-being and safety of children and are the link between the child welfare system and families. Families served by the child welfare system should expect similar service based on clinical factors, not based on their caseworker's characteristics. Using secondary data analyses of the most recent Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2008) and multilevel modeling, this study examines whether child welfare worker characteristics, such as education level and field, age, and experience predict their perception of the risk of future maltreatment. A total of 1729 case-level investigations and 419 child welfare workers were included in this study. Several one-level logistic regression and two-level logistic regression analyses were run. The best-fit model suggests that caseworkers with a Master's degree, more than 2 years of experience, and more than 18 cases were significantly more likely to perceive risk of future maltreatment. Further, the interaction between degree level and age also significantly predicted the perception of risk of future maltreatment. Results suggest that the perception of risk of future maltreatment may be influenced by caseworker factors, thus service to families may differ based on caseworker characteristics.

Understanding the overrepresentation of Black children in Ontario's child welfare system: Perspectives from child welfare workers and community service providers.

BACKGROUND: The overrepresentation of Black children in the child welfare system is a social problem that has received longstanding attention in the United States, but has recently received increasing attention in Canada. OBJECTIVE: This qualitative study explores the findings of two quantitative studies (Antwi-Boasiako et al., 2020, 2021) in order to interpret them through the perspectives of child welfare workers and community service providers. The aim is to gain a deeper understanding on the potential factors that contribute to the overrepresentation of Black children in Ontario's child welfare system. PARTICIPANTS AND SETTING: The study involved twenty-one child welfare workers from two child welfare organizations in Ontario serving lots of Black families and thirteen community service providers in Toronto. METHODS: Six focus groups were completed with thirty-four participants. Each of the focus groups was audio recorded and manually transcribed verbatim. Constant comparison analysis was used to analyze the transcribed data. RESULTS: Themes that emerged from the study include the following concerns: racism and bias from referral sources; racism and bias from child welfare workers; lack of cultural sensitivity; lack of workforce diversity/training; lack of culturally appropriate resources; assessment tools; duty to report; fear of liability; lack of collaboration; and poverty. CONCLUSIONS: The results from this study reinforce the need to shift practice that acknowledges Black families as valuable stakeholders and experts of their own lives and involves them in the development and implementation of policies and practices that affect them.

Reunification trajectories in Quebec: Acknowledging chronic family challenges to support stability.

BACKGROUND: While family reunification following out-of-home placement is a goal of child protection policy, complex family needs may not be met at the point that child protection systems reunify families. Permanency legislation creating maximum placement timeframes prompts questions regarding what families need to be supported in stably reunifying following a child's removal from the home. OBJECTIVE: We aim to identify clinical risk factors salient for initial placements and placements following a child reunifying with their family to inform successful reunification and improve children's stability. PARTICIPANTS AND SETTING: The study includes a representative sample of children in Quebec with a child protection investigation in 2008 (N = 3051) followed for nine years. METHODS: Cross-sectional clinical data from the Quebec Incidence Study (QIS) on Evaluated Child Protection Reports (2008) were linked with longitudinal administrative data from 16 provincial child protection agencies. Canadian Census data (2006) were used to create a factorial index measure for poverty. Chi-square automatic interaction detector (CHAID) decision tree analysis was used to compare risk factors salient for initial placements (n = 1120) with post-reunification placements (n = 455). RESULTS: For the placement sample (n = 1120), significant factors were: attachment issues, caregiver drug use, child's suicidal thoughts, child's self-harming behavior, and academic difficulties. Of the children who reunified with their families (n = 847), over half (n = 455; 54%) returned to out-of-home placements. Certain factors remained significant for placement after reunification: academic difficulties, attachment issues, and caregiver drug use. The CHAID model fit estimates suggest 70.9% (SE = 0.008) accuracy predicting out-of-home placement following child protection investigation and 58.2% (SE = 0.017) accuracy predicting re-placement following family reunification. CONCLUSIONS: Complex needs among families most likely to experience reunification breakdown indicate potential service gaps. When legislated placement timeframes prompt quick resolution of family challenges, these analyses can contribute to policy discussions regarding clinical family challenges that impact stability.

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.

Childhood Prevalence of Involvement with the Child Protection System in Quebec: A Longitudinal Study.

The goal of this study, the first of its kind in Canada, was to estimate the child lifetime prevalence of child protection involvement in Quebec. Using administrative and population data spanning 17 years, we performed a survival analysis of initial incidents of child protection reports, confirmed reports, confirmation of a child's security or development being compromised, and placement outside the home for one day or more. We found that before reaching the age of 18 years, over 18% of children were reported to child protection at least once, one in every ten children (10.1%) in the province had a report that led to the finding of their security or development being compromised, and over 5% were placed outside the home. We found that neglect was a primary concern in close to half (47.6%) of cases. By using a full population dataset, we obtained a more accurate prevalence estimate than studies using synthetic cohort life tables. These findings only captured initial incidents of involvement with child protection, meaning this study does not show the extent of recurrent involvement for some children. The findings reflect prior results showing that neglect is common in initial child protection involvement but less pervasive than has been shown in incidence studies, suggesting that recurrent child protection involvement is more driven by neglect than initial incidents are.

Young Children and Ongoing Child Welfare Services: A Multilevel Examination of Clinical and Worker Characteristics.

There is a growing body of research that underscores that young child welfare-involved children are a unique vulnerable subgroup of children. The decision to provide postinvestigation child welfare services is consequential to children's safety and well-being and has fiscal implications for organizations. Despite the potential ramifications of the decision, there is little known about the factors associated with the ongoing services provision for young children. This study uses secondary data analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect 2008 to explore what case and worker factors predict the provision of ongoing child welfare services. Multilevel modeling was used to assess the relationship between independent variables and the decision to provide ongoing services; analyses included 2,296 children and 555 workers. Case and worker characteristics, including worker training and worker position, predicted ongoing child welfare services suggesting that further research examining the role of what worker characteristics impact child welfare decisions is warranted and essential.

Major findings from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018.

BACKGROUND: The Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) is the only source of province-wide statistics on families investigated by child welfare. OBJECTIVE: This paper presents key findings from the 2018 cycle of the OIS (OIS-2018) and highlights select policy and practice implications of these findings. PARTICIPANTS AND SETTINGS: The OIS-2018 captured information directly from investigating child protection workers about children and families who were the subject of a child protection investigation sampled for inclusion in the study. METHODS: The OIS-2018 sample was drawn in three stages: first, a representative sample of child welfare agencies in Ontario was selected, then cases were sampled over a three-month period within selected agencies, and, finally, investigations that met the study criteria were identified from the sampled cases. The data collected for the OIS-2018 were weighted in order to derive provincial, annual incidence estimates. RESULTS: An estimated 158,476 child maltreatment-related investigations were conducted in Ontario in 2018. In the majority of investigations, there was no documented physical or emotional harm to the child. The overall incidence of investigations remains unchanged between 2008 and 2018. The only statistically significant difference during this time period is an increase in risk investigations between 2013 and 2018. CONCLUSIONS: Data from the OIS gives Ontario child welfare policymakers and practitioners an empirical basis for making evidence-informed decisions. Findings are compared to the United States and Australia.

Recurrent involvement with the Quebec child protection system for reasons of neglect: A longitudinal clinical population study.

Studies in several jurisdictions have found that families become recurrently involved with child protection systems most frequently for reasons of neglect. Child protection involvement for reasons of neglect is shown to correlate with various socioeconomic vulnerabilities. OBJECTIVE: This study, the largest of its kind in Canada, examines when and for whom recurring conditions of neglect were most likely to occur for all children involved with child protection in the province of Quebec over a span of fifteen years. PARTICIPANTS AND SETTING: Specifically, the study population includes all children whose ongoing child protection intervention in Quebec closed between 2002 and 2017 (N = 76,176). METHODS: This clinical population study uses a longitudinal research design drawing anonymized clinical administrative data from all of Quebec's child protection jurisdictions spanning 15 years, and Quebec data extracted from the 2011 Canadian National Household Survey to estimate socioeconomic vulnerability. RESULTS: Of the total population studied, 32.5 % (N = 24,816) experienced a recurrence of maltreatment during the study period, of which more than one third (N = 8707) experienced a recurrence for reasons of neglect. CONCLUSIONS: Because the association between socioeconomic vulnerability and recurrence of neglect indicates a gap in material and social supports-which child protection systems have neither the mandate nor the resources to fill-we propose additional avenues that we urge policymakers and practitioners to consider in supporting the demonstrated needs of these families.

Differences and disparities over time: Black and White families investigated by Ontario's child welfare system.

BACKGROUND: Black-White disparities in child welfare involvement have been well-documented in the United States, but there is a significant knowledge gap in Ontario about how and when these disparities emerge. OBJECTIVE: This paper compares incidence data on Black and White families investigated by Ontario's child welfare system over a 20-year period. METHODS: Data from the first five cycles of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) (1993-2013) were used to examine trends in child maltreatment investigations involving Black and White families. Incidence rates were calculated. T-tests were conducted to assess statistically significant differences between and within cycles. Population and decision-based enumeration approaches were also used to examine child welfare disparities. RESULTS: The incidence of investigations involving White families almost doubled between 1998 and 2003, but for Black families the incidence increased almost fourfold during the same period. These increases and the difference between Black and White families in 2003 were statistically significant. The results further indicate that Black families experience disparate representation in Ontario's child welfare system over time for most service dispositions. CONCLUSIONS: Several possible explanations are offered for the study's outcome, including changes in risk related to social safety net, the threshold for risk of harm, and bias and racist institutional policies and practices. This study invites policy-makers and child welfare authorities to rethink service delivery in addressing the disparate representation of Black families in the child welfare system.

Differentiating between substantiated, suspected, and unsubstantiated maltreatment in Canada.

The decision to substantiate is a key factor in determining eligibility for services and decisions to press criminal charges or to remove a child, and it is frequently the basis for selecting samples of maltreated children or to measure recidivism or intervention effectiveness. Although there is a growing body of research on case substantiation in the United States, few studies have examined this decision in other jurisdictions. Using data from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect, this study examines the profiles of a national sample of 10,010 investigations. Multivariate analyses reveal that substantiation decisions are generally made in a fashion that is relatively consistent with the clinical characteristics of cases. Along with severity of harm, parent risk factors, and housing risk factors, police referrals are among the most important predictors of case substantiation. Cases involving multiple forms of maltreatment are also more likely to be substantiated.

An examination of trends in child sexual abuse investigations in Ontario over time.

BACKGROUND: Child sexual abuse (CSA) rates have been declining since the 1990s (Dunne et al., 2003; Finkelhor & Jones, 2004, 2012; Jones et al., 2001). Discrepancies in contexts and measures complicate comparing CSA rates across jurisdictions and studies, and there is limited literature about trends in CSA in Canada. OBJECTIVE: Using data from the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS), the only source of provincially aggregated data in Ontario, Canada, that describes child welfare investigations, this paper provides information on reported and investigated CSA over the past 20 years. PARTICIPANTS AND SETTING: The OIS uses a file review methodology; information is collected directly from investigating child welfare workers. METHODS: A sample of child welfare agencies is selected for the study, and data are collected over a three-month period. Weights are applied to produce annual provincial estimates. RESULTS: The rates of investigated CSA in Ontario decreased between 1993 and 2013, from 5.20 (95% CI [3.94, 6.47]) to 1.81 (95% CI [0.97, 2.66]) children per 1000. During this time, the rate of all child maltreatment-related investigations doubled, from 21.41 (95% CI [18.38, 24.42]) to 53.32 ([29.61, 77.03]) children per 1000. CONCLUSIONS: Unlike other forms of child maltreatment, the incidence of investigated CSA in Ontario declined since 1993. Substantiation rates for CSA investigations decreased more dramatically than the rate of all CSA investigations, which could indicate a true decline in rate or an inability to accurately identify cases of CSA.

The Canadian child welfare system response to exposure to domestic violence investigations.

OBJECTIVE: While child welfare policy and legislation reflects that children who are exposed to domestic violence are in need of protection because they are at risk of emotional and physical harm, little is known about the profile of families and children identified to the child welfare system and the system's response. The objective of this study was to examine the child welfare system's response to child maltreatment investigations substantiated for exposure to domestic violence (EDV). METHODS: This study is based on a secondary analysis of data collected in the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003). Bivariate analyses were conducted on substantiated investigations. A binary logistic regression was also conducted to attempt to predict child welfare placements for investigations involving EDV. RESULTS: What emerges from this study is that the child welfare system's response to EDV largely depends on whether it occurs in isolation or with another substantiated form of child maltreatment. For example, children involved in substantiated investigations that involve EDV with another form of substantiated maltreatment are almost four times more likely than investigations involving only EDV to be placed in a child welfare setting (Adjusted Odds Ratio=3.87, p<.001). CONCLUSIONS: These findings suggest that the involvement of child welfare has not resulted in the widespread placement of children exposed to domestic violence. The Canadian child welfare system is substantiating EDV at a high rate but is concluding that these families do not require child protection services. PRACTICE IMPLICATIONS: There is debate in the literature about how the child welfare sector should respond to cases involving exposure to domestic violence. Contrary to conventional wisdom, this study finds that children who are the subject of investigations involving substantiated exposure to domestic violence are less likely to be removed from their home than children experiencing other forms of maltreatment. Strategies need to be developed to counter misperceptions about the intrusiveness of child welfare, and discussions need to take place about when it is appropriate for child welfare to become involved when children are exposed to domestic violence.