Is Differential Too Deferential?

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Six months ago, the U.S. Department of Health and Human Services reported that fiscal 2008 statistics showed that child maltreatment in this country had dropped to the lowest level since 1990. And it was a sharp drop: In 2006, an estimated 903,000 children were maltreated; in 2008, 772,000. That is a decrease of 14.5 percent in just two years.

Some other numbers from the report: The rate of child victimization was 10.3 per 1,000 children in 2008, down from a high of 15.3 in 1993, and the lowest since the National Child Abuse and Neglect Data System began in 1990.

It seems like an incredible victory in the fight to reduce the abuse and maltreatment of children in this country, right? 

Not so fast. Just five months earlier, in October 2009, the advocacy group Every Child Matters Education Fund issued a report citing federal statistics showing that an estimated 1,760 children died in the U.S. from abuse and neglect in 2007, a 35 percent increase from 2001. Sen. Robert Casey (D-Pa.) called it an “epidemic of child abuse” in the U.S. when Every Child Matters released the report.

How does one make sense of these seemingly contradictory trends? The abuse and maltreatment of children is in decline – but the number of children dying due to maltreatment is increasing? 

Frankly, I am not sure what to make of it all, but I do worry that the purported drop in abuse is, in reality, a mirage, that the rate of maltreatment of children has not gone down at all – it’s just that the state agencies responsible for doing something about it have gotten better at ignoring it. If that’s the case, it may make the abuse and maltreatment statistics look better, but this grim truth remains: The more reports of maltreatment are ignored, the more children end up dead.

Are the state agencies responsible for investigating and dealing with allegations of child abuse purposely turning a blind eye? I doubt it, but the reality is that virtually every  Department of Children and Families (or whatever variation it is called) in the country has been hit hard with budget cuts, and those cuts take their toll. The departments have less staff – to receive the calls coming in; to go out and do an investigation; to remove and place a child or children in an out-of-home setting; to do the work of reunification, and if not reunification, then putting together a humane and workable plan for the child. 

I suspect another factor is involved in the “why are reports of abuse are going down while child deaths are increasing” dilemma: the increasing use of the differential response approach to child abuse reports. According to the American Humane Association, differential response “is an approach that allows child protective services to respond differently to accepted reports of child abuse and neglect, based on such factors as the type and severity of the alleged maltreatment, number and sources of previous reports, and willingness of the family to participate in services.” 

Using the differential response approach, social workers can dispose of reported neglect or abuse cases without conducting an investigation if the risk to the child or children is deemed to be low. And these cases are never recorded in any child abuse registry. The traditional method called for investigation of each and every report of child abuse and neglect.  

The Humane Association notes on its website, “It is suggested that families receiving the non-investigation assessment response are more likely to be receptive to and engaged in the receipt of services when approached in a non-adversarial, non-accusatory way. The incident-based, often perceived adversarial, investigation is reserved for those accepted reports that are high-risk and egregious.”

The problem is how to define and determine which situations are low-risk, moderate-risk, high-risk and egregious. That’s the challenge in our field – often you cannot. Even the best of us, those who have worked in this field for decades, have been fooled.

There are elements of differential response that are good, and I don’t mean to pin the entire increase in child maltreatment deaths on this approach. But I worry that this new way of responding to allegations of abuse and neglect is playing a role in the rise in child deaths. Because many times an “often perceived adversarial investigation” is just what is needed to save a child from a perilous home situation.

 

Mark Redmond is executive director of Spectrum Youth and Family Services, Burlington, Vt., and the author of “The Goodness Within: Reaching out to Troubled Teens with Compassion and Love.” He can be reached at mredmond@spectrumvt.org.

 

  • Richard Wexler

    Hard to know where to start here, but how about with the Fourth National Incidence Study of Child Abuse and Neglect. That study does not rely on official reports, but it, too, found a very real decline in child abuse. Our analysis, and a link to the full study, is on our website here: http://www.nccpr.org/reports/NIS4.pdf

    Also:

    –As Mr. Redmond points out, the decline in “substantiated” child abuse is nothing new, it’s been happening, almost continually, since 1993. Child welfare agency budgets have not suffered cuts every year since 1993. (A better question would be: with substantiated cases of child abuse peaking in 1993, why did the number of children torn from their homes each year keep escalating through 2005? Probably, in part, because of precisely the kind of fear mongering in Mr. Redmond’s column.)

    –Fatalities are, in fact, the worst measure of all. That’s partly for a reason for which we all should be grateful: Though each is a terrible tragedy, the number is low enough to fluctuate wildly because of things like changing the definition of when a fatality is due to maltreatment. (Example: A toddler manages to unlatch the back door one morning while mom and dad are asleep. He wanders away, falls into a body of water and drowns. Accident or neglect? Given how American child welfare systems work, it’s a lot more likely to be “neglect” if the water was a pond behind a trailer park than a pool in back of a McMansion.)

    The very fact that opinions will vary widely means the judgment is far too subjective to use as an actual measure of trends in maltreatment. But don’t take my word for it, check out this report from the Center for Public Policy Priorities in Texas, a group whose views on these issues are far closer to Mr. Redmond’s than to my own. There’s a link from our Child Welfare Blog here: http://nccpr.blogspot.com/2010/01/reposting-family-preservation-and.html

    –Were there a hotline to report Statistics Abuse, the people at Every Child Matters would have their rights to their pocket calculators terminated. What wasn’t flat wrong, and only corrected after we kept hammering away at them, is incredibly misleading. Details are here: http://nccpr.blogspot.com/search/label/Every%20Child%20Matters

    –As for differential response, those programs get out of the coercive child welfare system cases that never should have been in it – cases in which family poverty is confused with “neglect.” (At the same time, they also make voluntary help available in cases that, without differential response would have been screened out entirely.) Again, research trumps speculation: A review of the literature by the highly-respected Vera Institute of Justice found that every evaluation of differential response across the country has found that it does not compromise child safety: http://www.vera.org/files/Rethinking%20Educational%20Neglect.pdf Is it really too much to ask that Mr. Redmond check the research before smearing a program based on what he “suspects” might be the case?

    And finally, it’s not just members of the Vast Family Preservation Conspiracy, like me, who recognize that the decline in child maltreatment is real. This has been the topic of a vigorous debate on a listserv used mostly by child welfare “scholars.” Even people like the University of New Hampshire’s Prof. David Finkelhor, a man with impeccable “child saving” credentials says the change is real.

    One of my favorite comments on this was from a professor of pediatrics. It’s particularly relevant here in light of the extent to which Mr. Redmond relies on what he “suspects” might be the case. This professor argued that serious cases of child maltreatment are overlooked, and always have been. But when it comes to trends, he said:

    “People always believe that cases are getting worse–I’ve never met a practitioner who believed otherwise about anything—it’s like a badge of honor. So, I think we need hard data on this one, and I’m not sure that impressions are trustworthy, given the difficulty human beings have with these current vs. old days contrasts.

    “Most of all, I would like to comment on the recurrent idea that if indeed rates are going down, that this takes the wind out of our advocacy sails. If this is the case, I strongly recommend that we get new sails. After all, the main alternative conclusion is that our efforts have been disastrous failures. I think if we tie our advocacy to the rather thin notion that “our intervention and prevention efforts are wonderful and effective, but it’s all hidden and we can never trust good news, so it’s really a crisis and getting worse by the day” that this is an unsustainable contradiction.”

    Richard Wexler
    Executive Director
    National Coalition for Child Protection Reform
    http://www.nccpr.org

  • Ruth White

    Mr. Redmond’s view of differential response and other methods to sort issues of poverty out of formal child protection investigations is troubling and extraordinarily short-sighted, especially given his wealth of experience working with runaway and homeless youth. I have a great deal of respect for the work of Spectrum Youth Services, and indeed many of the transitional housing and basic centers programs nationwide. Such programs allow young people who’ve been disenfranchised by nearly everyone to use solid programming and support to capitalize on their own industriousness. Many of these young people will use such access to move on to a better economic future, advanced education, and build families of their own. But the given economic reality of the wages many will be qualified to earn and the cost of living, making ends meet will be a life-long struggle. And of course, they won’t have access to all the opportunities to move up the corporate ladder and improve their income available to their more wealthy, well-connected peers. This means that many of these young people will experience poverty, low-wages, and encounter various public assistance systems. Despite that, many of the young people served by the runaway and homeless youth programs will be grow up to experience the joy of being mothers, aunts, wives, fathers, uncles, and husbands.
    Under the traditional child welfare system advocated by Mr. Redmond, these families, headed by former foster homeless youth and former homeless youth (the youth served at Spectrum, for example) are the most likely adults to face child protection involvement with their own children, nieces, and nephews. Wouldn’t we all want the professionals at the front-lines of the child welfare system to recognize the strengths that they bring to the table and apply community resources appropriately to help them keep their family intact? Or should we assume that once these young people grow up and start their own families that they will reach the doors of the child welfare system as potential predators?
    Let’s agree also not to distort the meaning of “non-investigation assessment” for sensationalist purposes. This does not mean that family problems are being ignored. It is quite the opposite. Identified problems are being appropriately matched with services such as affordable housing, job training, child care vouchers, education liaisons, car repairs, budgeting, and family counseling. Is Mr. Redmond suggesting that foster care is an appropriate response to poverty or that entry into the central registry of abuse is a step toward a better economic future? Let’s agree to recognize these parents as people who, like ourselves, are trying to make ends meet under daily economic uncertainty – only with less social capital to buffer their children from the effects of these struggles. How would we want to be treated if we ended up at the department of children services in our community? How would we want the young people in the runaway and homeless youth system to be served as parents?
    If we can’t imagine ourselves on the other side of the front desk, perhaps we could put ourselves in the shoes of the worker. Do we really believe that that a professional child welfare worker would willingly send a child home to his death? Mr. Redmond’s piece implies that the state would actively encourage front-line workers to ignore high-risk families in order to balance the budget. This is ridiculous. However, if such an order came down from a child welfare commissioner an individual child welfare worker would not comply. No. I’m sorry. They wouldn’t. No more than I would. No more than Mr. Redmond would. Prediction is at best an inexact science but when a child dies in their home or in foster care, it isn’t because a worker or a child welfare commissioner agreed to let it happen.
    Better services and screening for families in economic distress to sort them out of child welfare would allow for more time, attention, and quality out-of-home placement options for children who must be separated from their families in order to be safe, to thrive, and to ultimately find loving, permanent homes – and at the risk of being as hyperbolic as recent reports from Every Child Matters – to stay alive.