Alternative Responses to Child Maltreatment: Findings from NCANDS
This report is available on the Internet at:http://aspe.hhs.gov/hsp/05/child-maltreat-resp/
- Key Findings
- State Policies on Alternative Response
- Overall Referral Trends
- What are the characteristics of children who received an alternative response?
- How are the circumstances of the reported maltreatment related to the chances that a child receives an alternative response or an investigation response?
- How do outcomes differ between children who receive an alternative response and children who receive an investigation response?
Many child protective services (CPS) agencies face a large volume of CPS reports, increasingly complex cases, and strained resources. Moreover, there is a growing recognition that many CPS cases do not require a traditional investigative response. Thus, many States have developed practices and policies to differentiate how particular types of cases are handled (U.S. Government Accounting Office, 1997). Referred to as alternative response, differential response, dual track, or family assessment, these efforts at system reform promote new practices that affect how certain reports of maltreatment are handled. Generally, investigation responses involve a more forensic approach and include processes for determining if a child is at risk of child maltreatment or if child maltreatment occurred. Alternative responses are characterized by an emphasis on an assessment of the needs of families and children with less emphasis on determining if the maltreatment occurred (U.S. Department of Health and Human Services, 2003a).
The intent of the analyses presented below is to examine case-level data reported in 2002 to the National Child Abuse and Neglect Data System (NCANDS) by six States that offered both alternative response and traditional investigation as part of their child welfare services. After reviewing previous research on alternative response, this report describes the methodology of, and findings from, this analysis. Case characteristics, circumstances of reports, and outcomes for children who received an alternative response are presented. Finally, emerging trends, similarities, and differences across States that are implementing alternative response systems are discussed.
A review of the literature suggests that most studies conducted to date have focused on single States and did not systematically report on all the factors considered in this study regarding the provision of alternative response services.
System Structure and Functions
According to the National Study of Child Protective Services Systems and Reform Efforts (CPS Reform Study) a survey conducted of a nationally representative sample of 300 county child protective services agencies a majority (64%) of local agencies employed alternative response practices in addition to the traditional investigative response (U.S. Department of Health and Human Services, 2003a). Still, a separate review of policies as part of the same study noted that while 20 States had identifiable alternative response policies, only 11 had implemented the approach statewide (U.S. Department of Health and Human Services, 2003b). Further, the implementation of alternative response systems was neither uniform across all States (Virginia Department of Social Services, 2004; Loman & Siegel, 2004a; Loman & Siegel, 2004b) nor necessarily dependent on the existence of State-level policies defining the practice (U.S. Department of Health and Human Services, 2003a; U.S. Department of Health and Human Services, 2003b).
The CPS Reform Study and other State-specific studies suggested that investigation responses were employed when more serious types of maltreatment were alleged, and that alternative response was utilized when children were at risk of maltreatment, or when it was believed that the presenting issues could be addressed without needing an investigation (Siegel & Loman, 2000; Loman & Siegel, 2004a; Virginia Department of Social Services 2004; Center for Child and Family Policy, 2004; Chipley, Sheets, Baumann, Robinson, & Graham, 1999; U.S. Department of Health and Human Services, 2003a; U.S. Department of Health and Human Services, 2003b). Generally, cases were assigned to the alternative response track when factors suggested that the child was at lower risk of harm or that the family would benefit from community-based services. If a case was assigned to the alternative response track but circumstances arose that suggested investigation was warranted, it could then be redirected for an investigation response. Severe physical abuse and sexual abuse cases were typically handled using the investigation approach (see U.S. General Accounting Office, 1997; Loman & Siegel, 2004a; Loman & Siegel, 2004b; Center for Child and Family Policy, 2004).
The CPS Reform Study found many similarities across the States in the activities performed by each track. Most commonly, both approaches involved a review of CPS records and interviews or formal observations of the child and family. The study also found that the same professional resources or service providers were available to investigation or alternative response cases. However, reports handled by the alternative response were less likely to include an assessment of a familys safety needs, a determination of child maltreatment, a recommendation for court action, or the removal of a child from the home. Moreover, most agencies (81%) closed alternative response reports with no further action if the time frame for response elapsed, but 84 percent would not close an investigation if the response timeframe for completion had been exceeded (U.S. Department of Health and Human Services, 2003a). An increased emphasis on use of community-based services to augment CPS agency efforts during investigations but more often with alternative response assessments was consistent with an enhanced recognition that CPS agencies alone do not have the resources or the local support network to mediate the impact or prevent all child abuse or neglect effectively (U.S. General Accounting Office, 1997; Farrow, 1997; Waldfogel, 1998).
Still, purposes for alternative response systems vary. From the 20 States identified as having alternative response systems in the CPS Reform Study, three key purposes for the system were identified. States identified child safety (55%), family preservation or strengthening (45%), or prevention of child abuse and neglect (20%) as the reason for the alternative response approach. Most of these States (70%) explicitly noted that community agencies were responsible for conducting the assessments (U.S. Department of Health and Human Services, 2003b).
Alternative response systems differ not only in approach but also in the possible action outcomes following an assessment. In the CPS Reform Studys review of State policies, the majority of those States with alternative response policies allowed the options of no further action, referral to voluntary services, or returning a case to an investigation unit. Nearly one-half (40%) of the alternative response States allowed petitioning the court for mandatory services. The same percentage of States (40%) also allowed the response to be closed without completion of all activities.
While these findings represent considerable variation in implementation, as the study noted, the formalization of the alternative response approach is still relatively new. As time progresses, State policies may either converge or diverge, in part due to local needs and resources (U.S. Department of Health and Human Services, 2003b).
Outcomes of Alternative Response Evaluations
To date, few studies have examined outcomes of alternative response systems, and those few have focused on an individual States system. Since most systems are relatively new, much of the data reflect evaluations of outcomes early in the implementation phase of the systems (Center for Child and Family Policy, 2004; Loman & Siegel, 2004b; Virginia Department of Social Services, 2004). Nevertheless, some systems have been implemented long enough to produce more comprehensive outcome evaluations (English, Wingard, Marshall, Orme & Orme, 2000; Loman & Siegel, 2004a).
Most States identify which types of cases must be investigated instead of assessed; however, varying degrees of discretion are granted to workers who must decide which cases are assigned to the assessment track across the States (Virginia Department of Social Services, 2004; Loman & Siegel, 2004a; Loman & Siegel, 2004b). Despite this, a review of the findings from studies of pilots and fully implemented alternative response systems suggests that certain trends in characteristics and outcomes of children and families referred to alternative response are emerging.
Impact on the System
Studies suggest that the percentage of reports diverted to alternative response systems ranged from 42 percent to 71 percent (Siegel & Loman, 2000; Loman & Siegel, 2004a; Virginia Department of Social Services, 2004; Center for Child and Family Policy, 2004; Chipley et al., 1999), but these rates may vary among local offices in a State (Loman & Siegel, 2004a; Virginia Department of Social Services, 2004). With the introduction of alternative response, many States or pilot areas have noted an increase in the proportion of investigations that are substantiated (Loman & Siegel, 2004a; Virginia Department of Social Services, 2004). For example, in Virginia the number of investigations and founded investigations decreased with the introduction of the assessment track; however, founded investigations increased from 23 percent (during 2 baseline years) to 36 percent in State Fiscal Year 2004 (Virginia Department of Social Services, 2004). The reasons for increased substantiations appear to reflect the policy intention for alternative response that more serious cases comprise a larger portion of those investigated or that in some States a case must be opened to receive services.
Child and Family Characteristics
Surprisingly little has been published regarding the demographics of the children assigned to alternative response, other than their age. Some emerging trends suggest that younger children are more likely to receive traditional investigations rather than alternative response. An early evaluation of the Missouri system during its pilot phase revealed that children under 6-years old who experienced physical abuse were more likely to be referred for investigation (Siegel & Loman, 2000). An evaluation of the alternative response system in Texas found that families with older children were more likely to be referred for alternative response and that hotline staff reported a greater propensity to assign cases with younger children to an investigation track (Chipley et al., 2004). Similarly, English et al. (2000) noted that children age 5 years old or younger were less likely to be referred to Washington States alternative response system as opposed to the investigative response system. English et al., (2000) also noted that the gender and ethnic composition of the alternative response families was comparable to the traditional response families.
The Missouri evaluation (Siegel & Loman, 2000) noted little difference in the case characteristics and demographics of those children and families who experienced traditional investigations versus those who received family assessments. Specifically, no significant differences were found between cases with respect to factors such as a prior contact with CPS, the type of maltreatment, the report source, race, a history of foster care placement, the identity of the perpetrator (most often a parent), family structure (single female parents predominated), parental unemployment, or the size of family.
To date, few published studies have examined the relationship between identity of the maltreatment reporter and the track to which a report is assigned (see Siegel & Loman, 2000; Loman & Siegel, 2004a; Virginia Department of Social Services, 2004; Center for Child and Family Policy, 2004; Chipley et al., 1999). A study of the Texas alternative response system identified a mandate to investigate reports from law enforcement (Chipley et al., 1999). English et al. (2000) found that although professional and community referents referred cases equally to CPS, none of the alternative response cases had been referred by law enforcement or medical personnel. The children and families served by alternative response were most likely to have been reported by social service professionals and educators.
Type of Maltreatment
Studies of individual States suggest that assignment to the alternative response track varies according to the type of maltreatment alleged. In Virginia, 72 percent of emotional abuse reports, 67 percent of neglect reports, 62 percent of medical neglect reports, and 61 percent of physical abuse reports were assigned to the assessment track. Investigations were mandated for sexual abuse reports, thus 98 percent of sexual abuse reports were investigated. Researchers also found that reports alleging multiple types of maltreatment were more likely to be investigated than assessed and the likelihood of investigation increased as the number of types of maltreatments increased (Virginia Department of Social Services, 2004).
In comparison, according to a pilot study of the Texas alternative response system, 40 percent of emotional abuse, 53 percent of medical neglect, 72 percent of neglectful supervision, 50 percent of physical abuse, 79 percent of physical neglect, and 54 percent of sexual abuse reports were assigned to the alternative response (Chipley et al., 1999). In Missouri, cases involving failure to supply basic needs, parent-child conflict, or less severe sexual abuse were more likely to be served by alternative response (Loman & Siegel, 2004a). Although English et al., (2000) did not report differences in the likelihood of being assigned to alternative response based on the type of maltreatment alleged, they analyzed maltreatment types by severity levels and identified that a notable portion of referrals with moderate severity ratings were assigned to alternative response, as were a small number of sexual abuse referrals.
Some studies have demonstrated that families in the assessment track are more likely to receive services in addition to case management than are families in the investigation track (Loman & Siegel, 2004a; Loman & Siegel, 2004b). For example, 54 percent of assessment track families in Minnesota received services other than case management, compared with 36 percent of investigation track families. Moreover, the number of services received by assessment track families exceeded that of investigation track families (Loman & Siegel, 2004b). Similarly, assessment cases in Missouri received more services compared to investigation track cases and the service recipients from the assessment track represented a broader array of families, including a larger proportion of low-risk families with no immediate threats to child safety (Loman & Siegel, 2004a).
The types of services may differ between assessment and investigation track children and families. For example, the Minnesota study noted that assessment track families who received services were poorer and received more assistance meeting basic needs (food, clothing, home repairs, utilities payments, and employment assistance) than the investigation families who received services. Similarly, in Missouri, a large proportion of the services offered to the assessment track families were targeted at meeting basic needs such as food, clothing, housing, or medical care assistance (Loman & Siegel, 2004a).
However, a Virginia study suggests that the likelihood of receiving services may depend on the type of maltreatment alleged (Virginia Department of Social Services, 2004). Although the study identified 32 percent of cases that were assigned to the assessment track as needing services, this figure varied according to the maltreatment alleged. Information regarding the percent of investigation cases needing services was not provided. Still, researchers reported that assessment track families with identified needs were equally or more likely to receive services than were families involved in investigations.
With respect to the type of maltreatment alleged, family assessments of emotional abuse in Virginia were most likely to be identified as in need of services (44%), followed by physical abuse (39%), medical neglect (35%), and physical neglect (28%). Services most frequently identified as needed were counseling, parent education, and substance abuse evaluation or treatment. However, authors of the study cautioned that this list may better reflect available services than needed services. The authors hypothesized that this was possibly the result of the improved ability to engage families through use of the assessment tracks less adversarial approach. That said, the Virginia study noted that workers may be less likely to identify needed services if they know the services are not available in the area, even though they are able to note the problem when they record the service needs (Virginia Department of Social Services, 1999; Virginia Department of Social Services, 2004).
In addition, the timing of the service delivery may differ according to the track to which a case is assigned and may impact outcomes. Family assessment cases in Missouri received services earlier than those cases handled with traditional investigations (Loman & Siegel, 2004a). The Minnesota study found that early provision of services in these cases was shown to be effective in improving childrens safety and preventing further maltreatment (Loman & Siegel, 2004b).
In assessing foster care placement rates, studies varied regarding the length of time children were followed, thus making a comparison of rates difficult. For example, the Virginia study found that 12 percent of substantiated investigations resulted in foster care placement compared to only 2 percent of assessment cases over a 90-day followup period (Virginia Department of Social Services, 2004). The Texas study found 2.8 percent of investigations and 0.1 percent of assessments resulted in substitute care placement at the time of the assessment or investigation (Chipley et al., 1999). The Minnesota evaluation also showed that families assigned to the alternative response track were less likely to have a child subsequently placed than comparable families assigned to the traditional investigation track (Loman & Siegel, 2004b).
In contrast, the Missouri study found that during 5 years of followup, children who experienced the family assessment track were subsequently placed in out-of-home care more frequently than were children whose families experienced the investigation track (28% vs. 25%, respectively). The difference was more pronounced for those families originally identified as exhibiting fewer risk factors. Further analysis revealed that the demonstration families who were more likely to experience an out-of-home placement were those with no prior history of placement and whose families were composed only of teenage children at the time of the original report (Loman & Siegel, 2004a).
Rereports and Recurrence
A salient concern with the advent and expansion of alternative response systems is whether or not they might compromise child safety. Comparisons of relative rates of rereporting and recurrence of alternative response to investigation have been done to assess this concern. While in some studies the differences are marginal, overall findings from studies to date suggest that child safety is not compromised by alternative response and that children involved in alternative response systems are less likely to experience a subsequent report or investigation (Chipley et al., 1999; English et al., 2000; Loman & Siegel, 2004a; Loman & Siegel, 2004b; Virginia Department of Social Services, 2004; Center for Child and Family Policy, 2004). In part it may be that these children have already been identified as being at lower risk of maltreatment (Chipley et al., 1999; Loman & Siegel, 2004a; Virginia Department of Social Services, 2004; Center for Child and Family Policy, 2004). However, a recent report of an experimental study conducted in Minnesota suggests that when comparable families were randomly assigned to receive assessment or investigation, the assessment cases were still less likely (27%) than were the investigation cases (30%) to be rereported to the child welfare system (Loman & Siegel, 2004b).
In addition, one study found that alternative response families were less likely to be rereported for lack of supervision and proper parenting, severe physical abuse, and educational neglect (Loman & Siegel, 2004a), than were the comparison group of families who were investigated. This finding suggests that the opportunity to provide services during the alternative response facilitated more successful amelioration of these specific problems. Another study found that families with no prior history of CPS contact were less likely to be rereported if they had experienced the alternative response (Loman & Siegel, 2004b). Finally, the Texas study noted that of those children who were rereported, a larger proportion of assessment track children were reported for neglect and a smaller proportion for abuse than children who received a traditional investigation (Chipley et al., 1999).
The Objective of this Study
The objective of this study was to compare the children in each State who were referred to alternative response systems with those referred to traditional investigations. Comparisons were made in terms of response characteristics, the circumstances of their reported maltreatment, and their subsequent reports and dispositions.
The key research questions for this study were the following:
- What are the characteristics of children who received an alternative response?Reported children were compared on whether they received an alternative response or an investigation response, based on the following demographic characteristics:
- Age of child;
- Sex of child;
- Race of child; and
- Whether the child had been previously victimized.(1)
- How are the circumstances of the reported maltreatment related to the chances that a child receives an alternative response or an investigation response? Reported children were compared on whether they received an alternative response or an investigation response, based on different circumstances of the reported maltreatment. Circumstances of the reported maltreatment that were considered included:
- The source of report:
- The number of children;
- The living arrangement of children;
- The type of maltreatment;
- Domestic violence in the home; and
- Caretaker drug and alcohol abuse.
- How do outcomes differ between children who receive an alternative response and children who receive an investigation response? Children who received an alternative response and those who received an investigation response were compared on the variables below related to the outcomes following the reported maltreatment:
- The services provided;
- Placement in foster care; and
- Any subsequent reports and dispositions within a fixed 6-month followup period (for reports between January and June, only).
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Case-level data from the 2002 NCANDS Child File were used as the basis for the analysis. These case-level data are submitted on a voluntary basis in a common record format to the Federal Government by State CPS agencies. The submissions are a rich source of information about children who are the subjects of child maltreatment investigations, including data about the investigations, child demographics, types of maltreatment, and services. Each year the U.S. Department of Health and Human Services prepares an annual report that analyzes the NCANDS data. For calendar year 2002, Child File data submissions from 42 States containing case-specific information on nearly 3 million reported children were submitted to NCANDS.
Data from six States Kentucky, Minnesota, Missouri, New Jersey,(2) Oklahoma, and Wyoming including 313,838 reported children, were used to create the data set for this research. These States were chosen because case-level data, including alternative response dispositions, were provided in sufficient numbers.(3)
The NCANDS Child Files from each State were used to create the data set. These files contain a record for each child in a report alleging child maltreatment. This is referred to as a report-child pair, indicating that a child is counted each time he or she is the subject of a maltreatment report that is investigated or assessed.
Several new variables were derived, and some were recoded into categorical variables, including:
- Response Type The report disposition was used to create a new variable, called response type. Reports with dispositions of substantiated, indicated, unsubstantiated, or closed with no finding were coded as investigation response. Dispositions of alternative response victim and alternative response nonvictim were coded as alternative response. All other dispositions were coded as other response; these cases were later excluded from analyses.(4)
- Maltreatment Type For each report-child pair, up to four maltreatment types can be reported in the Child File. These were recoded to mutually exclusive categories: physical abuse only, neglect or medical neglect only, sexual abuse only, emotional or other abuse only, and multiple maltreatment.
- Age of Victims The age of victims was recoded into categories. The categories for age were: younger than age 1, age 13, age 47, age 811, age 1215, and age 16 or older.
- Services The Child File includes data on what services were provided.(5) All of these services were combined into in-home services. Foster care was considered and analyzed separately.
The final data set was composed of 313,838 children in 6 States.(6) Because of the major differences as noted above in the literature review in State policy and implementation, and the level of use of alternative response as reported to NCANDS, data from each State were each analyzed separately.
For each of the variables pertaining to characteristics of the reported children, reports, and maltreatments, children in each category were compared on how many received alternative response and how many received traditional investigations. For example, the percentage of boys who received an alternative response was compared with the percentage of girls who received an alternative response.
For analyses of outcome variables such as service provision and placement in foster care, comparisons were made between children who received an alternative response and children who received investigations. For example, the percentage of children who received an alternative response whose families received in-home services was compared with the percentage of children who received an investigation whose families received in-home services.
For analyses of subsequent CPS responses, comparisons were made among children who received an alternative response and those who received an investigation as their first response during the reporting period. For these analyses, only children whose first response from the CPS system of the reporting year was during the first 6 months of the year were included.(7) Additionally, children who received an investigation and were found to be victims were analyzed separately from children who received an investigation and found not to be victims. These analyses included only children who received a response of some kind from CPS; those who were reported but screened out at intake, were considered not to have received a response.
For analyses of trends in CPS response in each State, the overall number of children in maltreatment reports was compared for each year between 1998 and 2002. These analyses examined the percentage of children who were found to be victims following an investigation, the percentage who were investigated but found not to be victims, the percentage with an alternative response, and the percentage with any other dispositions. Data from 1998 through 2000 were obtained from State submissions using the Summary Data Component, in which data were provided in aggregate form.
Interpretation of NCANDS Data on CPS Response
The designation of a reported child as having received an alternative response occurs within the disposition field in the NCANDS. Alternative response, however, is not a disposition; it is a response. When a report comes in, a case worker or supervisor determines whether the case will be handled in the traditional investigation track (called investigation in most States) or if it will be given an alternative response. Thus, alternative responses are most often separated out at an early stage. The only field in the NCANDS that captures the referral to alternative response is in the disposition field.
Occasionally, children and families are transferred back from the alternative response track to the investigation track and receive a disposition from within that track. This is unlikely to be indicated anywhere in the administrative record of the response process and would not be captured by NCANDS (in this instance the disposition would just reflect the results of the investigation and would be substantiated, indicated, or unsubstantiated). The original referral of such a case to the alternative response track would not be captured by these data.
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Even though some States have been implementing alternative response systems for several years, no large-scale, multistate, data-based research has been undertaken on the children who have received alternative response as compared with children who have received investigations. Findings from this research show that in some ways these groups are quite similar; however, some differences can be identified. The implications of these findings are discussed below.
This study compared children who were referred to alternative response systems with those referred to traditional investigations in terms of their own characteristics, the circumstances of their reported maltreatment, and their subsequent reports and dispositions.
Figure 1 shows children who were the subject of a report by the type of response that their report received in each of the six States represented in the data set. The number of children who were included in a maltreatment report, as well as the proportion of children who received an alternative response, varied across these States. Kentucky, Missouri, New Jersey, and Oklahoma all had large number of children who were subjects of a maltreatment report (between 60,000 and 80,000), but in Kentucky and Oklahoma, only 27 and 20 percent, respectively, were referred to alternative response, while in Missouri and New Jersey, 64 and 71 percent, respectively were referred to alternative response. Minnesota (26,344) and Wyoming (4,355) had much smaller number of children who were subjects of a report. In Minnesota, 20 percent were referred to alternative response, while in Wyoming, 58 percent were.
Figure 1. Children in Maltreatment Reports by State, 2002 (n = 318,838)
Variation was noteworthy between States and reinforces the need to examine the States separately. Separate case studies for each State, along with data tables, are presented in Appendices AF.
State Policies on Alternative Response
Based on a review of policy documents that were available as of April 1, 2005, table 1 shows the circumstances under which States will or will not provide alternative response. In New Jersey, where child welfare assessments are provided to families with a wide range of problems such as homelessness, domestic violence, child or parent substance abuse, their policies did not explicitly identify circumstances under which alternative response could not be provided. Other States take a more restrictive approach by aggressively extracting reports for which alternative response cannot be considered before identifying those for which it can. Alternatively, these differences may result from the style adopted by the State for describing its alternative response system. For example, in Wyoming where 58 percent of reported children were referred to alternative response the policy described only the circumstances precluding alternative response, not those that allow it.
|Per State Policy, Alternative Response Can Be Provided if:||KY||MN||MO||NJ||OK||WY|
|Physical Abuse||Any alleged inflicted physical injury to a child age five and under||No||Not Stated||Not Stated||Not Stated||No||Not Stated|
|Any alleged inflicted physical injury to a child age 6 or 7||No||Not Stated||Not Stated||Not Stated||Yes||Not Stated|
|Minor physical injury in non-critical areas resulting from discipline of a child age 8 and older||Yes||Not Stated||Not Stated||Not Stated||Yes||Not Stated|
|Child fatality||No||No||No||Not Stated||No||No|
|Neglect||Food, clothing, shelter, supervision, or hygiene needs are not adequately met||Yes||Not Stated||Not Stated||Yes||Yes||Not Stated|
|Educational neglect||Yes||Not Stated||Yes||Not Stated||Yes||Not Stated|
|Child is suicidal, and parents or caregiver not providing appropriate intervention||No||Not Stated||Not Stated||Not Stated||Yes||Not Stated|
|Abandonment||No||No||Not Stated||Not Stated||No||Not Stated|
|Child displaying self destructive behaviors such as eating disorders or self-mutilation, as a result of emotional abuse or neglect||No||Not Stated||Not Stated||Not Stated||No||Not Stated|
|Emotional Abuse||Emotional abuse or neglect that does not indicate risk of serious physical harm to the child||Yes||Not Stated||Yes||Not Stated||Yes||Not Stated|
|Sexual Abuse||Child sexual abuse (including solicitation or promotion of prostitution)||No||No||No||Not Stated||No||No|
|Unfit Parenting||Allegations that parent is violent or psychotic||Not Stated||Not Stated||Not Stated||Not Stated||No||Not Stated|
|Homelessness||Not Stated||Not Stated||Not Stated||Yes||Not Stated||Not Stated|
|Child's disability, or medical, emotional, or substance abuse problems||Not Stated||No||Not Stated||Yes||Not Stated||Not Stated|
|Risk of physical or sexual abuse||Yes||Not Stated||Not Stated||Not Stated||Not Stated||Not Stated|
|Baby born exposed to drugs/alcohol||Yes||Not Stated||Not Stated||Not Stated||No||Not Stated|
|Baby born dependent on drugs/alcohol||No||Not Stated||Not Stated||Not Stated||Not Stated||Not Stated|
|Domestic violence||Yes||Not Stated||Not Stated||Yes||Not Stated||Not Stated|
|History of Maltreatment||History of prior reports of abuse or neglect that were not serious, or with no indication of escalating seriousness of reports||Not Stated||Not Stated||Not Stated||Not Stated||Yes||Not Stated|
|History of serious allegations of abuse or neglect whether the investigation was confirmed or not||Not Stated||Not Stated||Not Stated||Not Stated||No||Not Stated|
|Ongoing CPS Involvement||Abuse or neglect in a child care facility.||No||No||No||Not Stated||No||No|
|Concerns in a foster family or trial adoptive home including abuse or neglect, physical discipline of a child under age 3, or risk of sexual behavior.||No||No||No||Not Stated||No||No|
|Concerns in a foster family or trial adoptive home including corporal punishment of a child 35 years of age, or supervision concerns regarding an older school-aged child.||Not Stated||No||No||Not Stated||Yes||Not Stated|
|Children are in imminent danger and need to be removed from the home||No||Not Stated||No||Not Stated||No||No|
|Allegations of abuse or neglect, or a new baby born in an open permanency planning or prevention case||Not Stated||Not Stated||Not Stated||Not Stated||No||Not Stated|
|Severity of Maltreatment||Mild, moderate, or first-time, non-criminal reports of physical abuse or neglect||Not Stated||Not Stated||Yes||Not Stated||Not Stated||Not Stated|
|Abuse, neglect, or malicious punishment resulting in serious injury, near death, risk for significant harm or injury or requiring medical treatment||No||No||No||Not Stated||No||No|
|Criminal charges are likely||Not Stated||Not Stated||No||Not Stated||No||Not Stated|
Overall Referral Trends
States use of alternative response varied considerably. During 2002, referrals to alternative response ranged from 20 and 71 percent across these six States. Viewing these trends over 5 years, it appears that States were generally increasing or maintaining steady levels of alternative response referrals. The differences between States most likely reflect several factors, including whether the program was in the process of being implemented; whether the program is statewide or a pilot; the criteria is specified for determining to which track a case may be referred; the number of alternative tracks to which a case may be assigned; and the degree to which a State documents the outcomes of these alternative track assignments in their NCANDS data. In general, a review of multiyear trends suggests that States using alternative response have been either experiencing growth or steady use of the optional approach to responding to child maltreatment reports.
Still, the use of alternative response appears to have an impact on the numbers of both victims and nonvictims identified by these States when comparing 19982002 disposition data. In general, the use of alternative response resulted in a decrease in the numbers of victims and nonvictims identified by States using alternative response. The impact of the alternative response system on States victim identification ranged from a 6 percent decrease (in a State in which the program is being piloted) to a 36 percent decrease. The impact of alternative response systems on the number of nonvictims identified generally was reflected by a decrease of nonvictims (ranging from 18% to 57%); however, the rate of nonvictims in Oklahoma rose by 30 percent.
Figure 2. Trends in Alternative Response and Investigation, 19982002
What are the characteristics of children who received an alternative response?
This research examined whether demographic characteristics such as age, sex, race, and ethnicity distinguished children who were referred to alternative response from those who received traditional investigations. As shown in figure 3, older children were more likely to receive an alternative response than were younger children, similar to findings in earlier studies in Missouri (Loman & Siegel, 2004a), Texas (Chipley et al., 1999), and Washington (English et al., 2000). These findings suggest that the criteria that lead to the assignment of a report for an alternative response or investigation may take into account the age of the child as a vulnerability factor. This assessment may be guided by policy directives, a formalized risk or safety assessment, or it may reflect the decisionmakers proclivity to opt for a more formalized response in reports involving younger children. Other studies have found that the use of formal risk or safety assessment directives guide decisions regarding track assignment (English et al., 2000; Loman & Siegel, 2004b; U.S. Department of Health and Human Services, 2003a).
Figure 3. Percentage of Children Referred to Alternative Response, by Age, 2002
Similar to findings by Loman & Siegel (2004b), race and ethnicity did not strongly distinguish between children who received an alternative response and those who received an investigation. Some differences were evident in the likelihood of alternative response for children of different races; however, the variation in the number of children of different races within the CPS population and the population as a whole render these differences difficult to interpret. In general, the sex of the child was not a major factor in determining whether a child received alternative response or investigation, although in Missouri and Wyoming, boys were more likely to be referred to alternative response than were girls.
In most of the States, prior victimization was related to a decreased likelihood of alternative response. In Minnesota and Missouri, this difference was quite dramatic none of the children with prior victimization received alternative response. In Oklahoma and Kentucky, only 7 percent and 16 percent (respectively) of the children with prior victimization received alternative response. In New Jersey only, children with prior victimization were equally likely to receive alternative response. It is plausible that concerns about a familys responsiveness to system interventions, or about the chronic nature of problems, may factor into the assignment.
How are the circumstances of the reported maltreatment related to the chances that a child receives an alternative response or an investigation response?
As described above, State policy regarding criteria for the use of alternative response is based on the circumstances of the report, particularly on the type or severity of the alleged maltreatment. Previous research has shown that some circumstances of alleged maltreatment are related to whether a child receives an investigation or an alternative response, while others are not. Research has focused mainly on the source of the report and type of maltreatment (Siegel & Loman, 2000; Loman & Siegel, 2004a; Virginia Department of Social Services, 2004; Chipley et al., 1999, English et al., 2000). Earlier studies have not reported on whether the other characteristics of the maltreatment report such as number of children reported, living arrangement, or the presence of risk factors such as family violence or caretaker substance abuse were associated in any way with a referral to alternative response. Findings from this study confirm that most of these variables are relevant in distinguishing which track is chosen.
Source of Report
The connection between a referral to alternative response and the source of the report was confirmed by the present study. Alternative response more often resulted from referrals from parents, relatives, friends, schools, or the children themselves. (See figure 4.) Referrals from social workers, medical personnel, legal, or criminal justice sources were less likely to be referred to alternative response. These findings coincide in part with earlier research. English et al., (2000) found that the children and families served by alternative response in Washington were most likely to have been reported by social service professionals and educators and never by law enforcement or medical personnel. In Texas, reports from law enforcement were mandated to receive investigations (Chipley et al., 1999).
Presumably, the specific policies at the State level regarding referral to alternative response are responsible in part for establishing the relationship between report source and alternative response referral. However, it may also be that reports received from professional sources present a more thorough and formalized assessment of the problems that prompted the report, as well as greater knowledge about the types of reports to which the traditional CPS system may respond, thus assignment to the investigation track may be more likely. Another study has suggested that professional reporters are more inclined to report more serious allegations of child maltreatment. Thus, the greater use of the investigation track in such cases may also be explained by severity considerations (Zellman, 1990).
Figure 4. Percentage of Children Referred to Alternative Response, by Report Source, 2002
The connection between maltreatment type and referral to alternative response in each State was strong, but varied across States, reflecting different reporting strategies for alternative response. For two States in this study Missouri and Wyoming all children referred to alternative response had the same maltreatment characteristics; in Missouri, all were children with no reported maltreatment, and in Wyoming all had been reported for other abuse. In the other States Kentucky, Minnesota, New Jersey, and Oklahoma a portion of children with all different maltreatment types were referred to alternative response. (See figure 5.) However, neglect/medical neglect and emotional/other/unknown maltreatment types were more highly represented among children who were referred to alternative response.(8) In these four States, children for whom sexual abuse was the only maltreatment type had the lowest rate of referral to alternative response. With the exception of New Jersey, virtually none of the children who were reported to be sexually abused were referred to alternative response. These findings suggest that an alternative response system generally reflects the purpose of the system to serve families with less immediate safety concerns and therefore may not warrant a traditional CPS response.
Figure 5. Percentage of Children Referred to Alternative Response, by Maltreatment Type, 2002
Other Circumstances of the Reported Maltreatment
In the States that provided data on the reported childs living arrangement, children living at home with their families were more likely to be referred to alternative response than were children in foster care or institutional settings. In all States but Minnesota, a higher percentage of children were referred to alternative response when other children were included in the same maltreatment report than when only one child was included in the report. (See figure 6.) In Wyoming, children were more likely to be referred to alternative response when there were more children in the report. It may be that cases involving neglect are more likely to include more children who are in need of intervention than those cases in which physical or sexual abuse is alleged. In Minnesota children who were alone in the maltreatment report were more likely to be referred to alternative response. In the family risk assessment of abuse and neglect that is used in Minnesota, families with more children are given a higher-risk score, resulting in a lower likelihood that they would be referred to alternative response. Further research is needed to identify what underlies the association between number of children in the report and the referral to alternative response or investigation.
Figure 6. Percentage of Children Referred to Alternative Response, by Number of Children in the Report, 2002
In New Jersey only the presence of family violence and caretaker substance abuse were associated with an increase in the proportion of children referred to alternative response, which is consistent with the focus of New Jerseys alternative response system on families with these issues. In all other States, the presence of family violence was not associated with an increase in the likelihood that a child would be referred to a response or a particular type. Also, children whose caretakers had a history of drug abuse had a lower rate of referral to alternative response than those children with no history of caretaker drug abuse. When only caretaker alcohol abuse was present, children were referred to alternative response at approximately the same rate, or slightly lower, than those with no history of caretaker substance abuse. Generally, these findings are in keeping with the alternative response systems premise to serve those cases that appear to be at lower risk or presenting less severe allegations regarding child maltreatment.
How do outcomes differ between children who receive an alternative response and children who receive an investigation response?
This research compares children who received alternative response with those who received investigations on two variables pertaining to the course of action following a report whether children or their family members received services, if children were placed, and whether they experienced an additional report of maltreatment within 6 months and, if so, how the CPS system responded. Findings illustrate that these two groups differed on these outcome variables.
Similar to previous findings in Missouri (Loman & Siegel, 2004a), and Virginia (Virginia Department of Social Services, 2004), in-home services were provided more often to children and families in the alternative response track. These findings may support the notion that families who are engaged using a less adversarial approach may be more inclined to utilize services that are offered. Moreover, if cases assigned to alternative response are those that present less pressing needs, this trend may also reflect that more services are available to address the needs of these families compared with what is available for families presenting more serious needs. Children were more likely to be placed in foster care if they received investigations, similar to earlier findings in Virginia (Virginia Department of Social Services, 2004), Texas (Chipley et al., 1999), and Minnesota (Loman & Siegel, 2004b). This studys finding reinforces the idea that more serious cases, with more pressing safety concerns are likely to be referred for investigation.
Reentry or Reresponse
Overall findings from earlier studies suggest that child safety is not compromised when alternative response is provided rather than a traditional investigation, and that children involved in alternative response systems are less likely to experience a subsequent report or investigation (Chipley et al., 1999; English et al., 2000; Loman & Siegel, 2004a; Loman & Siegel, 2004b; Virginia Department of Social Services, 2004; Center For Child And Family Policy, 2004). The findings from this research demonstrate that the rate of recurrence within 6 months was comparable for children who received an alternative response and those who received an investigation, or, in the case of Oklahoma, the rate of reentry was lower.
If children received an investigation as their initial response from CPS, the likelihood of their receiving an alternative response was lower for a second report, but not at all out of the question. Among children who were found to be victims, fewer than 5 percent were referred to alternative response for a subsequent report in most States; although in Missouri and New Jersey with their high overall rate of alternative response 9 and 11 percent of victims were subsequently referred to alternative response. Similarly, among nonvictims in New Jersey, 13 percent were subsequently referred to alternative response while in other States this rate was less than 10 percent.
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In general, these findings demonstrate that implementation of an alternative response system reflects its intention to serve children and families who appear to be at lower risk or who present less immediate safety concerns. The findings are consistent with the expectation that these families circumstances may not warrant a traditional CPS response, but can benefit from some intervention to prevent potential or future maltreatment.
These analyses of child, report, and maltreatment characteristics suggest that States are implementing their alternative response systems somewhat differently. Some of this may be due to the stage and scope of implementation in each State. Other explanations may include the degree to which policies clearly specify how the response assignment is made. It is also unknown if the profile of cases referred for alternative response changes as a system matures and workers become more comfortable with employing a less adversarial approach for intervention. Still, some discretion by individual caseworkers is likely responsible for much of the variation between alternative response and investigations, as much as client and report characteristics. Further, State population demographics and availability of resources may also factor in the decisions made and outcomes observed. A closer examination of the types of services utilized by families assigned to alternative response, compared with families assigned for investigation, may reveal more distinctive characteristics.
Presumably, the specific State-level policies regarding referral to alternative response are responsible in part for the differences evident in these findings. The guidelines for determining whether cases should be referred to alternative response are typically based on the severity and type of maltreatment, but may vary considerably by State. These variations may reflect not only differences in policies, but also decisionmaking processes for assessing cases for response assignment, system capacity, and organizational philosophy.
It appears that services are being provided to a greater proportion of families who receive an alternative response. It also appears from this data that even though children who had been previously referred to alternative response do experience subsequent reports and responses by CPS, in general they are not at any greater risk for subsequent reports than those who received an investigation. Furthermore, they are not at any greater risk for subsequent victimization. With this knowledge, at the system level, agencies that refer children and families to the alternative response or investigation track may be confident that, if specified guidelines guide the decision, the childs future safety is no more likely to be compromised.
Clearly, many factors influence the processes and outcomes of alternative response systems, and it may be helpful to more closely examine the interaction between these factors. Generally, the findings from this study demonstrate that alternative response has been provided in situations in which the severity of the problems is less extreme. The results are also broadly consistent with those found in evaluations of individual States alternative response systems. This study provides a more textured understanding of alternative response systems across States and the outcomes associated with families and children who benefit from such systems.
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1. The NCANDS data includes a field that indicates whether a child has previously been a victim of child maltreatment. There is no indication, however, whether a child has previously been included in a report of maltreatment, though not found to be a victim. When working with a single year of data it is not possible to identify children who may have been reported during previous years, but not victimized.
2. In New Jersey all alternative response-nonvictim reports were concerned with family problems such as homelessness, domestic violence, child or parent substance abuse, or parenting issues that pose a risk to the child. The majority of these cases only received a child welfare assessment. In instances where there was a family problem and an alleged maltreatment, an investigation was conducted, but if the allegations were not substantiated, these cases were considered to be family problem cases and were reported to NCANDS with an alternative response nonvictim disposition.
3. Louisiana and Ohio were excluded because less than 1 percent of dispositions in 2002 were alternative response.
4. These other dispositions included unsubstantiated due to intentionally false reporting, other, and unknown or missing.
5. These services include: post investigation services; family support services; family preservation services; adoption services; case management; counseling services; child daycare services; educational and training services; employment services; family planning services; health-related and home health services; home-based services; housing services; independent and transitional living services; information and referral services; legal services; mental health services; pregnancy and parenting services for young parents; respite care services; special services disabled; special services juvenile delinquent; substance abuse services; transportation services; and other services.
6. Nine children with unknown dispositions were excluded.
7. It is not known whether these children experienced previous reports, investigations, or alternative response in previous years, because these data were not linked to data from previous years. The prior victimization field was not considered.
8. In New Jersey, families that were reported for parenting issues that pose a risk for the child were given a family assessment (alternative response) and reported to NCANDS as having an unknown maltreatment type rather than neglect.
9. The number of children whose families had a reported history of family violence was very small (7% of children), so the percentage of children without such a history who received an alternative response mirrors the percentage in the full dataset.
10. The decision points in the figure indicate whether the child received an alternative response or an investigation in response to his or her first report of maltreatment within the reporting period. Among those in each group, as well as those investigated children who were found to be either victims or nonvictims, the figure separates those who experienced a second response from the CPS system within 6 months of the first report with those who did not. Next, groups split into those for whom this second response was alternative, and those who received an investigation, and finally those who received an investigation were separated into victims and nonvictims.
11. Less than 10 percent of children had any of these risk factors, so the percentage of children without such risk factors who received an alternative response mirrors the percentage in the full dataset.
12. This is considered an information and referral call.
13. Approximately 6 percent of children had a history of family violence and 15 percent had evidence of caretaker substance abuse, so the percentage of children without such risk factors who received an alternative response mirrors the percentage in the full dataset.
14. These other dispositions were not alternative response; they included uncertain, a disposition made when an investigation was completed, but there was still insufficient information to confirm or rule out the maltreatment.
15. Less than 1 percent of children had a recorded history of caretaker substance abuse, so the percentage of children without this risk factor who received an alternative response mirrors the percentage in the full dataset.
This report is the second in a series of three reports, based on the Secondary Analysis On Child Abuse and Neglect Topics of Current Policy Interest, which was conducted by Walter R. McDonald & Associates, Inc. (WRMA), under contract number 233-02-0093, task order 5, for the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. Analyses are based on 2002 data from the National Child Abuse and Neglect Data System (NCANDS), maintained by WRMA under contract with the Children's Bureau, Administration on Children, Youth, and Families, U.S. Department of Health and Human Services (contract HHSSP233200400052U). The opinions expressed in this paper are those of the authors and do not necessarily represent positions of the U.S. Department of Health and Human Services.
This issue paper was prepared by Gila R. Shusterman, Dana Hollinshead, John D. Fluke, and Ying-Ying T. Yuan of Walter R. McDonald & Associates, Inc. (WRMA). Editorial and technical assistance was provided by Anja Maguire and Kristen Stafford.
For further information contact the Secondary Analysis on Child Abuse and Neglect Topics of Current Policy Interest Federal Project Officer at the following address:Laura Radel, M.P.P. Senior Social Science Analyst Office of the Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services 200 Independence Avenue, SW, Room 450-G Washington, DC 20201 202-690-5938 firstname.lastname@example.org
This publication also is available on the Internet at: http://aspe.hhs.gov/hsp/05/child-maltreat-resp/.
Material contained in this publication is in the public domain and may be reproduced, fully or partially, without permission of the Federal Government. The courtesy of attribution is requested. The recommended citation follows:
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U.S. Department of Health and Human Services, Administration for Children and Families/Children's Bureau and Office of the Assistant Secretary for Planning and Evaluation. (2003b). National Study of Child Protective Services Systems and Reform Efforts: Review of State CPS Policy. (Washington, DC: U.S. Government Printing Office).
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