In 1996, child protective services (CPS) agencies received more than 2 million reports of alleged child abuse and neglect involving more than 3 million children. CPS staff conducted approximately 1.6 million investigations of these reports and found evidence to substantiate that more than 970,000 children had been victims of child abuse and neglect that year. While a great many child abuse reports are received and investigated annually, studies show that most children recognized by community professionals as having experienced injury-causing child abuse or neglect (72 percent) had not been reported to (or, if reported, had not been investigated by) the local CPS agency (U.S. Department of Health and Human Services, National Center on Child Abuse and Neglect [HHS/NCCAN], 1996).
Most studies report that between one-third and two-thirds of substantiated child abuse and neglect reports involve substance abuse. Substance abuse is more likely to be a factor in reports regarding younger children, particularly infants, than older children. In addition, substance abuse is much more likely to be a factor in child neglect than in child abuse (Herskowitz et al, 1989; HHS/NCCAN 1993; Walker et al, 1991). In a recent survey of State child welfare administrators, the Child Welfare League of America (CWLA) found that at least 50 percent of substantiated child abuse and neglect reports involve parental abuse of alcohol or other drugs, and fully 80 percent of States reported that substance abuse and poverty are the top two issues contributing to abuse and neglect in their States (CWLA, 1998). The Indian Child Welfare Association estimates that 90 percent of Indian child welfare neglect cases and 60 percent of abuse cases involve families in which drinking or drug abuse is a major problem (Cross, 1997).
The National Child Abuse and Neglect Data System (NCANDS), operated by the Children's Bureau within HHS, compiles data voluntarily supplied by States regarding child abuse and neglect reports. In addition to aggregate data, a number of States (twelve in 1996) participate in the Detailed Case Data Component (DCDC) of the system which describes individual cases. Among the data elements in the DCDC, States are invited to report whether the parent or child has an alcohol or drug problem that contributed to the abuse or neglect report. Currently only two of the twelve States participating in the DCDC supply this information (New Jersey and South Carolina), and even in these States the information supplied appears to be incomplete. New Jersey reports that 20.3 percent of child abuse and neglect reports in 1996 involved caretaker drug abuse, and 7.3 percent involved caretaker alcohol abuse. South Carolina's figures were 10.9 percent caretaker alcohol abuse and 8.6 percent caretaker drug abuse. Each State also reports a handful of cases in which the child's alcohol or drug abuse were factors in the maltreatment allegation. In some cases these child drug abuse problems were in infants (presumably prenatally exposed), while in others the child in question was a teenager who was a drug user himself or herself. For the most part, the low substance abuse figures in NCANDS and some other tracking systems is related to the fact that agencies usually categorize cases by the type of maltreatment (e.g. physical neglect) rather than the reason(s) behind the maltreatment.
The 1993 Study of Child Maltreatment in Alcohol Abusing Families, based on a national probability sample of children with substantiated maltreatment reports, found that substance abuse was part of the presenting problem for 42 percent of children found to be victims of child abuse and neglect in 1989. Among the caretakers with substance abuse problems, alcohol was a problem substance for 77 percent, and, as shown in Figure 4-6, it was the primary (most harm-causing) substance for 64 percent. Cocaine was the primary problem substance for most of the rest (23 percent overall).
This study found that maltreatment cases involving alcohol and drugs had distinctive profiles (HHS/NCCAN, 1993). In particular:
- These cases involved younger children. Half of the cases in which a parent abused illicit drugs involved children under age 5, as compared to 29 percent in other cases. Alcohol-related cases were no more likely to involve preschoolers than other cases.
- Maltreatment cases involving illicit drug abuse had a distinctive profile in terms of the types of maltreatment involved. Drug-related cases were much more likely than others to involve physical neglect (46 percent of drug related cases versus 24 percent of others) and to have been based on a positive drug or alcohol toxicology (12 percent of drug-related cases versus 1 percent of others). Cases involving illicit drug abuse rarely involved sexual abuse (4 percent of drug-related cases versus 24 percent of non-drug-related cases) or physical abuse (13 percent of drug-related cases versus 32 percent of non-drug-related cases). Emotional abuse was reported in 20 percent of both drug and non-drug-related cases.
- Medical and hospital staff were important sources of CPS referrals of drug-related cases (accounting for 29 percent of these cases versus 9 percent of other cases), but not for alcohol-related cases. Mental health and substance abuse treatment staff were responsible for 7 percent of alcohol-related referrals but for fewer than 1 percent of the drug-related referrals.
- Both alcohol- and drug-related cases were more likely to result in foster care placements than other cases (nearly a third of cases involving substance abuse resulted in foster care, versus less than 20 percent of other cases).
In addition to national data and State reports to Federal information systems, several State-level reports contain data regarding substance abuse and child protection. In Illinois, where health professionals are required to report all substance exposed infants to child protective services, between 1985 and 1992 nearly 12,000 such reports were filed. Of these, 87 percent were indicated (similar to the "substantiated" category used by most States), and of indicated cases, 11 percent were taken into foster care immediately, while a total of 30 percent had child welfare cases opened. Many of these open cases involved children being served while remaining at home (Goerge and Harden, 1993). New York has reported that in 1990, 40 percent of substantiated child abuse reports involved a caretaker's drug abuse, and an additional 15 percent involved alcohol abuse (NYDSS 1992, cited in Magura et al, 1998). An early study in Massachusetts found that excessive alcohol or drug use was a factor in 64 percent of all substantiated child abuse and neglect reports and was even more common in reports of infants, where 89 percent were alcohol or drug related (Herskowitz et al, 1989).