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February 19, 2015

Are child welfare services helping the kids?


Is America’s child welfare system still working to provide safe solutions for children subject to abuse or neglect at home?

The evidence doesn’t quite prove it, said Richard P. Barth, dean of the University of Maryland School of Social Work said. Barth delivered the annual Raymond R. Webb Jr. Lecture, titled “Outcomes of Child Welfare Services: How Much Are We Really Helping?” in the School of Social Work on Feb. 10. It honors a 1963 school alumnus who was prominent in local and statewide community health work.

“There are still debates in child welfare about how important safety is” versus family preservation, Barth said. Finding a permanent home for the child, ideally the child’s original family home, once was thought to outweigh other factors. But, as codified in state and federal law, child safety should be the premier goal of the child welfare system today, he said.

However, as Barth outlined, the services available in cities and counties across the United States do not always serve all children well.

He cited his seven-year study of nearly six million reports from child welfare agencies that let researchers “estimate the likelihood that a child will experience a confirmed case of child maltreatment. Our findings indicate that maltreatment will be confirmed for one in eight U.S. children by 18 years of age, far greater than the one in 100 children whose maltreatment is confirmed annually” by other means.

Children who enter the child welfare system when their families have been investigated for possibly maltreating these youngsters have “lower cognitive and academic ability, fewer social skills, more problem behaviors and poorer physical health than children in the general population.”

The National Survey of Child and Adolescent Well-Being, running 1997-2014, found that 23 percent of children with a single investigation report in a child welfare system had at least one additional report. Of those with additional reports, 30 percent had two and 7 percent had three. Kids 6 years old and younger and those already receiving child welfare services (beyond the investigation engendered by a report) were more likely to have multiple reports.

In that study, 8 percent of caregivers reported using severe violence against their child or children (from hitting to burning or throwing a child), even after at least one contact with child welfare services. But “a large proportion of severe violence remains unreported,” Barth added. “This is especially true for infants and toddlers.” The same study discovered that “youth 7 and up … report no decreases in violence at home following child welfare services.

“These are pretty surprising rates of violence against children,” Barth said. “We are intervening with some … [but] we know we have improvement to make to reach more children. Even when we intervene, we are leaving children unprotected, and they are not coming back to the attention of the child welfare system.”


“High rates of officially confirmed and self-reported child maltreatment indicate that the U.S. lacks an effective public health campaign to prevent child maltreatment,” Barth added. “Child welfare services do not seem to be markedly reducing rates of re-abuse among families who continue to care for their children at home.” A public health approach — following and serving kids not just when they report violence, but regularly — may have a preventive effect.

One study of children who ended up in the California Youth Authority (CYA) — the state’s juvenile correction system for serious and violent offenders — examined those who first were seen by city or county child welfare services. While only 1 percent of kids subject to child welfare service reports ended up in CYA, they represented 20 percent of the kids in CYA. And among African-American kids, 15 percent who received child welfare services entered CYA by age 17. Overall, the chances of entering a CYA program after a child welfare services report was 1.5 times greater than for kids without such reports.

Among the kids in the above group, 70 percent had received two or more child welfare services reports and entered CYA three or four years later. But African-American children who received two or more reports from the child welfare system were two times less likely to enter CYA than black peers who had been investigated by child welfare but had received no services. So child welfare services “seemed to buffer” these kids from further trouble, Barth said.

Other studies of juvenile justice show that up to 70 percent of those who end up in the court system had previous involvement with child welfare services. Local research in 2013, for instance, showed that 20 percent of juveniles seen by Allegheny County’s child welfare services ended up in trouble later.

Another California study compared deaths of children currently or previously in foster care to mortality in the general population. It found that white and Hispanic children in foster care died more frequently from preventable deaths than children outside that system, while African-American kids in foster care died less frequently than average. Younger children were more likely to die from foster care maltreatment than older children.

A third California study of children in foster care found that more than 50 percent of kids staying with non-relatives had three or more moves — twice the rate for those staying with relatives. If you follow kids without behavior problems through three or more moves, Barth said, you find the kids developing behavior problems.

“When things are not going well, the probability of things not going well increases,” he explained. Additional studies found that “placement instability precedes high problem behaviors more than the other way around.”

Barth concluded: “Safety for children is routinely compromised, even and especially for very young children. Tragically serious outcomes — especially higher mortality rates — are evident with underservice” by child welfare agencies.

Poor performance among social welfare programs compounded bad outcomes for foster kids, he said. Child welfare systems must work more closely with housing services, public welfare, schools and health care providers, for instance.

Frequent changes in child placement with foster families can be harmful by themselves. Of course, he cautioned, “We have to understand that kids are coming into child welfare doing poorly.

“Child maltreatment has enduring long-term effects,” he said, citing several studies that concluded: “Adult survivors of child maltreatment are more likely to have a lower quality of life in terms of their physical health … Adults who were exposed to abuse as children have increased odds for developing adult obesity, adverse lifestyle behaviors like tobacco and alcohol use, and cardiovascular disease.”

The highest priority of child welfare services should be kids with emotional and behavioral problems, he said.

Barth is involved in a new service model in Maryland called Project Keep, which gives caregivers training in how best to serve their kids, including home visits and weekly phone consultations, with an emphasis on giving them a support group as well as expert advice. Project Keep has reduced the frequency of placement changes drastically, as well as the number of reported incidents of problems between foster parents and children.

Overall, he concluded, child welfare services are worthwhile for kids who have been subject to the severest maltreatment, yet other kids are slipping through the cracks. Too little research about the societal benefits of child welfare services has been done, he said.

—Marty Levine