Rereporting and Recurrence of Child Maltreatment: Findings from NCANDS. Findings

07/30/2005

This section is organized to address the topics posed by the research questions as stated in the introduction. The three topics include baselines for single and multiple subsequent rereport and recurrence events, factors associated with increased rereporting, and factors associated with increased recurrence.

Rereporting and Recurrence Baselines

This section presents findings regarding single subsequent rereports and recurrences, as well as for multiple rereports and recurrences.

  • A single subsequent rereport implies an examination of the first rereport event, regardless of the number of later rereports. A single recurrence implies an examination of the first revictimization, regardless of the number of later victimizations.
  • Multiple rereports implies that a child experienced at least more than one rereport. Multiple recurrence implies that a child experienced at least more than one recurrence.

Single Rereports and Recurrences

Most subsequent reports or victimizations occurred
within a few months after the initial report.

For this analysis we obtained estimates of the proportions of children who had a subsequent investigation or assessment within 60 months of the first investigation or assessment. Table 2 shows the distribution of rereports and recurrences for children who were rereported in 6-month time intervals over 5 years.

Table 2.
Cumulative Percentage of Children with Subsequent Reports or Revictimizations
Elapsed Months Cumulative Percent of Children Rereported
(n=1,396,998 reported children)
Cumulative Percent of Children Revictimized
(n=336,022 victims)
05 10.3% 5.2%
611 16.4% 8.2%
1217 20.6% 10.2%
1823 23.6% 11.9%
2429 26.0% 13.2%
3035 27.8% 14.2%
3641 29.4% 15.1%
4247 30.7% 15.8%
4853 31.7% 16.4%
5459 32.3% 16.7%

Of the 1,396,998 children reported, 32 percent were rereported within 60 months. Of the 336,022 victims, 17 percent became victims again within 60 months. From Table 2 it is apparent that subsequent events, whether rereporting or recurrence, were much more likely to occur soon after the initial report. For example, 16 percent of children were rereported during the first 12 months, but it took until the end of the study periods 5 years for the rereport rate to double to 32 percent. Similarly, 8 percent of children recurred within the first 12 months, but an additional 3 years was needed before this percentage doubled to 17 percent.

Multiple Rereports and Recurrences

After 3 years, 28 percent of children were rereported at least once,
and 11 percent were rereported two or more times.

Baseline analysis was also conducted on multiple subsequent events. The analytical tools require that children were followed for equal periods of time. Thus, the analysis used a cohort of children with initial reports from 1998 through 1999. Of the 803,320 children in this cohort, approximately 72 percent had no further contact with CPS after 3 years. Among the remaining 28 percent, almost 17 percent had one more report and 11 percent had multiple reports. The maximum number of rereport events was 22. The average number of rereports for all children in this data set was 1.7. The maximum number of recurrences was 8. The average number of recurrences across all children was 1.3.

Baseline Patterns of Multiple Rereporting and Recurrence
The objective of this aspect of the baseline analysis was to describe patterns of rereporting and recurrence through the CPS service delivery system. This analysis has methodological constraints due to the complex nature of the patterns of interest. Consequently, the analysis presented here is descriptive and more exploratory in nature.

For this analysis, the data were arrayed as patterns of victimization and nonvictimization events. For example, a child with three report events could have two nonvictim reports and then a victimization, or two victimizations and one nonvictim report, and so forth. A total of 819 unique patterns of victim and nonvictim report events were observed in the data set. Figure 1 illustrates the patterns of reporting for the initial report and up to three subsequent reports (as illustrated by tiers 1, 2, and 3). The diagram is read chronologically from top to bottom, and each circle represents a subsequent event and the determination of whether or not the child was victimized.

No matter how many times they were rereported,
children were more likely to become victims
if they were previously victims.

As expected, a childs likelihood of further contact with CPS declined with each tier. However, for children not returning the proportion was generally greater for children with only one report. Thus, approximately 70 percent of nonvictim and victim children did not come back after a first report, whereas around 60 percent of children did not come back after a second or third report. Children who were victims in their initial event were more likely to be identified as victims in subsequent events than were children initially identified as nonvictims. Interestingly, children who were initially victimized and then subsequently not identified as a victim were less likely to be identified as victims in a third event, compared with children who were victimized twice. These findings point to complex patterns associated with the chances of being identified as a nonvictim or victim across multiple rereports.

Risk Factors Associated with Rereporting

Similar to the previous section regarding baseline analysis, this section begins with a presentation of findings for single rereporting and then turns to multiple rereport events.

Single Rereports
For these analyses, a data set of 495,900 unique children from 8 States who were reported during 2001 or 2002 was created.(4) Cox regression analyses were conducted to determine which factors may have influenced the likelihood that each child would be rereported within a 2-year period. Table 3 presents the results of the data model for rereporting.(5)

Figure 1.
Subsequent Events within 3 Years: Children Reported 19981999 (N=803,320  9 States)

Figure 1. Subsequent Events within 3 Years: Children Reported 19981999 (N=803,320 - 9 States)

Table 3.
Factors Associated with Rereporting (N=495,900)
Variables Factor Categories Category Type Risk Ratio
with
Rereporting
P
Source of Initial Report Social and Mental Health Services Reference 1.0000 0.0000
Medical Personnel   0.8699 0.0000
Law Enforcement or Legal Personnel   0.8748 0.0000
Education Personnel   1.0346 0.0367
Daycare and Foster Care Providers   1.0049 0.8787
Nonprofessional and Other   1.1433 0.0000
Unknown   1.0611 0.0296
Child Age at Initial Report Infants Reference 1.0000 0.0000
1Year Olds   1.0106 0.4976
24   0.9186 0.0000
57   0.8273 0.0000
810   0.7419 0.0000
1113   0.7160 0.0000
1418   0.5257 0.0000
Over 18   0.1480 0.0000
Unknown   0.2544 0.0000
Child Sex Female Reference 1.0000 0.0000
Male   0.7626  
Child Race and Ethnicity White only Reference 1.0000 0.0000
American Indian and Alaskan Native only   1.0465 0.0352
Asian and Pacific Islander only   0.5979 0.0000
African-American only   0.8361 0.0000
Hispanic   0.8677 0.0000
Other and multiple race, non-Hispanic   1.2838 0.0000
Unable to determine and missing   0.5609 0.0000
Child With Indication of Disability No Reference 1.0000 0.0000
Yes   1.4667  
Caretaker Abuse of Alcohol No Reference 1.0000 0.0001
Yes   1.1086  
Childs Initial Investigation Victimization Status Nonvictim Reference 1.0000 0.0000
Victim   1.1102  
Postinvestigation Services Provided No Reference 1.0000 0.0000
Yes   1.3504  
Child Placement in Foster Care No Reference 1.0000 0.0000
Yes   2.1813  
Interaction of Victimization and Postinvestigation Services No Reference 1.0000 0.0006
Yes (child victim and services provided)   0.9342  
Interaction of Victimization and Placement in Foster Care No Reference 1.0000 0.0000
Yes (child victim and placed)   0.3547  
Initial reports by medical and law enforcement personnel
were associated with a lower likelihood of rereporting.

Source of Initial Report. Children who were rereported were less likely to have been initially reported by medical or law enforcement personnel than by report sources such as social services or mental health services providers. In contrast, reports by nonprofessional and other sources were tied to an increased likelihood of rereporting compared with social and mental health services providers.

White children had a greater likelihood of experiencing a rereport
compared with African-American children.

Child Demographics. In general, as the age of children at initial report increased, the likelihood of rereporting decreased. No distinction was observed between infants and children who were 1 year old. Girls were more likely to be rereported than boys. White children were more likely to be rereported compared with African-American, Asian or Pacific Islanders, and Hispanic children. However, children of other or multiple races were 1.3 times more likely than White children to be rereported. White children were just as likely as Native Americans and Alaska Natives to be rereported.

Family and Child Risk Factors. Children with disabilities were approximately 1.5 times more likely to be rereported than children without disabilities. Children with caretakers who abused alcohol were also more likely to be rereported. The presence of drug abuse among the childs caretakers did not statistically increase or decrease the likelihood of rereporting; therefore, this variable was excluded from the model.

Children who received services had an increased likelihood of being rereported
than children who did not receive services.

Outcomes of Initial Intervention. If, following an initial investigation, the child was found to be a victim, he or she was slightly more likely (1.11 times) to be rereported than children who were initially nonvictims. The receipt of postinvestigation services or foster care services elevated the likelihood of rereporting. In particular, the provision of foster care appears to double the likelihood of rereporting.

Victims who received services were less likely to be rereported
compared with nonvictims who received services.

A statistical interaction effect was found between the initial victimization of the child and the receipt of postinvestigation services. Figure 1 illustrates this interaction by displaying two survival distribution graphs: one for children who received postinvestigation services and one for those who did not. Both curves show that, overall, children who received services were more likely to be rereported than children who did not receive services, regardless of initial victimization. However, among children who did not receive services, victims were more likely to be rereported than nonvictims, while among children who received services, fewer victims were rereported than nonvictims.

Figure 2.
Interaction of Victimization with Postinvestigation Services

Figure 2. Interaction of Victimization with Postinvestigation Services

Multiple Rereports
Beyond the question of whether a child was rereported or not, this analysis focuses on how many subsequent events occurred for an individual child, and the impact of the passage of time and the age of the child on this number of events. A total of 803,320 children who were initially reported during 1998 and 1999 in 9 States were included in the analysis.

Time from Initial Report. This analysis examined how many events per child occurred for each 6-month period after the first report. Table 4 illustrates that the number of subsequent CPS rereports per child declined steadily during each additional 6 months of followup. For all reported children, the average number of subsequent reports was 0.13 per child during the first 6 months of followup whereas the number dropped to 0.05 reports during months 3136.

Table 4.
Number of Rereports, by Time from Initial Report
Event Category Time from Initial Report
6 Months or Less 712 Months 1318 Months 1924 Months 2530 Months 3136 Months
Children with no Further Reports 714,695 737,411 749,177 759,030 765,497 771,411
Children Subsequently Reported During Interval 88,625 65,909 54,143 44,290 37,823 31,909
Total Rereports During Interval 106,348 77,388 63,439 51,412 43,576 36,316
Total Unique Children Reported 803,320 803,320 803,320 803,320 803,320 803,320
Rereports Per Child During Interval 0.13 0.10 0.08 0.06 0.05 0.05

Age of the Child. As shown in Table 5, the number of subsequent reports was examined for children, grouped by age at the time of the initial report.(6) The number of rereports declined as the age of the child increased. Infants had the highest number of rereports with an average of 0.59 per child, compared with children age 1418 at 0.38 per child. Both the timing of rereports and the age of children appear to be associated with the number of rereports that a child experiences. These findings also appear to be consistent with what is observed for single rereports.

Table 5.
Number of Rereports, by Age of Child
Event Category Age of Child at Initial Report
Infants 1 24 57 810 1113 1418 Age Unknown Total
Children Reported for Age Group 70,160 51,779 155,913 153,677 128,844 105,532 34,325 5,100 705,330
Total Rereports for Age Group 41,475 28,936 83,580 78,815 59,926 47,919 13,061 8,416 362,128
Rereports Per Child for Age Group 0.591 0.559 0.536 0.513 0.465 0.454 0.381 1.650 0.513

Factors Associated With Increased Recurrence

Findings on single recurrences are presented in this section, followed by findings on multiple recurrent events. As noted previously, all children included in these analyses had not been found to be victims based on any report prior to the first victimization event in the data set.

Single Recurrences
For this analysis, 190,552 unique children from 8 States who were reported between 1998 and 2002, and found to be victims, were included.(7) Cox regression analyses were conducted to determine which factors may have influenced the likelihood that each of these victims would be revictimized within a 5-year period. Table 6 presents the results of the model for recurrence.

Table 6.
Factors Associated with Recurrence
(N=190,552)
Variables Factor Categories Category Type Risk Ratio
Associated with
Recurrence
P
Source of Initial Report Social and Mental Health Services Reference 1.0000 0.0000
Medical Personnel   1.0168 0.7203
Law Enforcement or Legal Personnel   0.9245 0.0816
Education Personnel   1.1222 0.0093
Daycare and Foster Care Providers   1.5347 0.0000
Nonprofessional and Other   1.2678 0.0000
Unknown   1.2866 0.0000
Child Age at Initial Report Infants Reference 1.0000 0.0000
1Year Olds   0.8610 0.0001
24   0.7430 0.0000
57   0.7006 0.0000
810   0.6683 0.0000
1113   0.6469 0.0000
1418   0.4591 0.0000
Over 18   0.0014 0.6072
Unknown   0.7020 0.0001
Child Race and Ethnicity White only Reference 1.0000 0.0000
American Indian and Alaskan Native Only   1.3784 0.0283
Asian and Pacific Islander Only   0.6792 0.0324
African-American Only   0.8994 0.0011
Hispanic   1.0074 0.7807
Other and multiple race, non-Hispanic   1.1296 0.1418
Unable to determine and missing   0.6291 0.0000
Maltreatment Type Physical Abuse Only Reference 1.0000 0.0000
Neglect or Medical Neglect Only   1.3457 0.0000
Sexual Abuse Only   0.9311 0.0938
Other Abuse Only   1.1955 0.0000
Multiple Abuse Types   1.1195 0.0034
Postinvestigation Services Provided Nonvictim Reference 1.0000 0.0000
Victim   1.5774  
Child Placement in Foster Care No Reference 1.0000 0.0000
Yes   0.8785  
Caretaker Abuse of Alcohol No Reference 1.0000 0.0025
Yes   1.1023  
Victims reported by daycare providers, foster care providers or nonprofessionals
had a greater likelihood of experiencing recurrence compared with victims reported
by other professional sources.

Source of Initial Report. Victims reported initially by daycare providers, foster care providers, or nonprofessionals were associated with a greater likelihood of experiencing recurrence compared with those reported by social services or mental health services providers.

Child Demographics. Generally, as the age of child victims at initial report increased, their likelihood of experiencing recurrence declined. Although the gender of the victim was tested as a factor in the model, it was not found to impact recurrence. While the effect of race and ethnicity on the likelihood of repeat victimization approached statistical significance, no single category except "unable to determine" and "missing" met the cutoff for statistical significance used in this study.

As the age of victims increased, the likelihood of recurrence decreased.

Circumstances of Maltreatment. Victims who were neglected were 1.3 times more likely to experience recurrence, compared with physically and sexually abused victims.(8) Victims who experienced an "other" form of abuse or multiple forms of abuse tended to have a higher likelihood of experiencing recurrence.

Victims were more likely to experience recurrence
if their caregivers abused alcohol.

Family and Child Risk Factors. Victims whose caregivers abused alcohol were more likely to experience recurrence. The influence of parental substance abuse and victims with disabilities was tested but was not found to contribute significantly to the likelihood of recurrence. That said, the results suggested that the presence of these factors was associated with higher likelihood of recurrence.

Victims who received services had a higher likelihood of experiencing recurrence,
but victims placed in foster care were at lower risk of experiencing recurrence.

Outcomes of Initial Intervention. Victims who received postinvestigation services were 1.5 times more likely to experience recurrence than those who had not. However, victims placed in foster care were less likely to experience recurrence.

Multiple Recurrences
Similar to the analyses of multiple rereporting events, this analysis focuses on how many subsequent victimizations occurred for an individual victim, and the impact of the passage of time and the age of the child on this number of events. A total of 189,557 children who were victimized the first time between 1998 through 1999 in 9 States were included in the analyses.

Time from Initial Report. This analysis examined how many victimization events per child occurred for each 6-month period after the first report. As shown in Table 7, the number of recurrences per child declined steadily during each additional 6 months of followup. In a pattern similar to rereports, among children who were initially found to be victims, the number of recurrences during the first is 6 months was 0.05 per child and declined to 0.02 per child by month 3136. Thus, just as the likelihood of a single recurrence declined over time, the longer children were observed, the number of recurrences experienced by children declined as well.

Table 7.
Number of Revictimizations, by Time from Initial Report
Event Category Time from Initial Report
6 Months or Less 712 Months 1318 Months 1924 Months 2530 Months 3136 Months
Child Victims With No Further Victimizations 180,383 183,332 184,389 185,142 186,028 186,678
Child Victims Subsequently Victimized During Interval 9,174 6,225 5,168 4,415 3,529 2,879
Total Revictimizations During Interval 10,231 6,744 5,619 4,788 3,802 3,079
Total Child Victims 189,557 189,557 189,557 189,557 189,557 189,557
Revictimizations Per Child During Interval 0.05 0.04 0.03 0.03 0.02 0.02
Younger children had more rereports and recurrences compared with older children.

Age of Child. The same pattern found for rereporting was found for recurrence, where generally the number of recurrences per child declined as age at first victimization increased. As shown in Table 8, infants experienced 0.19 recurrences per child and 1418 year olds had 0.09 events per child. However, unlike rereporting, children between age 1 and age 7 had more recurrences than infants.

Table 8.
Number of Revictimizations, by Age of Child
Event Category Age at Initial Report
Infants 1 24 57 810 1113 1418 Age Unknown Total
Child Victims For Age Group 25,554 12,161 35,370 35,422 30,099 24,957 24,371 1,544 189,478
Total Revictimizations For Age Group 4,909 2,630 7,466 7,103 5,418 4,327 2,241 167 34,261
Recictimizations Per Child For Age Group 0.19 0.22 0.21 0.20 0.18 0.17 0.09 0.11 0.18

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