Transcript Slideshow

Opportunities for
Prevention & Intervention in Child
Maltreatment Investigations Involving Infants
in Ontario
Barbara Fallon, PhD
Assistant Professor
Jennifer Ma, MSW
Doctoral Student
Outline
• Introduction to Ontario Incidence Study (OIS)
• Profile of young children and their caregivers in the OIS
• Current service provision patterns
• Intervention opportunities
• Prevention strategies
Ontario Incidence Study
• Core objectives:
– Determine rates of investigated and substantiated
maltreatment
– Document forms and severity of maltreatment
– Examine selected health determinants
– Monitor short-term investigation outcomes
– Compare rates and characteristics across cycles (93, 98,
03, 08)
• Specific to OIS-08
– Distinguish maltreatment incident investigations and risk
assessments
OIS-2008 Sample
OIS-2008 Sample
* = oversampling provinces
Methodological Considerations
• Limited to reports investigated by child welfare
• Information collected directly from investigating
child welfare workers
• No post-investigation follow-up
• Not designed to evaluate services
• Methodological changes across cycles
• Weighted annual estimates, percentages,
incidence of maltreatment
Home Visiting Programs in Ontario
• Healthy Babies Healthy Children (delivered by Ontario’s
37 public health units)
• Phone calls to every new mother shortly after the baby
is born offering information and a home visit
• Screening/assessment for pregnant women, all new
mothers, and for families with children up to age six
Research Literature
• Infants are most often referred to a child welfare
agency by professionals, with health professionals
being the most common referral source followed
by police (Williams et al., 2003; Palusci, 2011).
• Caregiver functioning concerns, including
substance use, lack of social support, parental
mental health issues, young parenthood and
domestic abuse are risk factors for infant
maltreatment (Harden and Klein, 2011; Zhou & Chilvers, 2010; Wu et al., 2004; Putnam-Hornstein
& Needell, 2011).
Study Objectives
• Examine the decision to provide child welfare
services to infants identified to the child welfare
system using a Canadian provincial data set.
• Identify and understand the importance of key
clinical factors in the decision to provide ongoing
child welfare services to infants and their
caregivers to inform effective practice and policy.
Child Maltreatment Related Investigations
Involving Infants 1993-2008
Referral Source for Infant Investigations
Rate of Infant Investigation in 2008
Type of Child Maltreatment Related Investigations Involving
Infants in 2008
Primary Caregiver Concerns in Infant Investigations
18 Years of age or younger
History of foster care/group home
Perpetrator of DV
Victim of DV
Few social supports
Physical health issues
Mental health issues
Cognitive impairment
Drug/solvent abuse
Alcohol abuse
0%
5% 10% 15% 20% 25% 30% 35% 40%
Child Functioning Concerns in Infant Investigations
Attachment issues
Intellectual/developmental disability
Failure to meet milestones
FAS/FAE
Positive toxicology at birth
Physical disability
0%
1%
2%
3%
4%
5%
6%
Household Concerns in Infant Investigations
One move
Two + moves
Other benefits/unemployment
Household runs out of money
At least one household hazard
0%
10%
20%
30%
40%
50%
60%
70%
Summary
•
23% of investigations referred from hospitals
•
22% of investigations referred from police
•
21% of investigations referred from non-professional referral sources
•
17% of investigations referred from community or social services.
•
45% of infants are identified to the child welfare system for a concern about their
future welfare
•
34% of their primary caregivers were identified as victims of domestic violence
•
42% of households with infants have moved within the past year
•
6% of infants have positive toxicology at birth
Multivariate Analysis
• Four main types of referrals: hospital, police,
non-professional, community or social
services
• Classification analysis
• Examining the relationship of clinical
predictors to service provision
Transfers to Ongoing Services
Among Hospital Referred
Investigations
Not Noted 76%
Closed 42%
Opened 59%
Caregiver Cognitive Impairment
Noted 24%
Chi-Square = 18.88***
Closed 52%
Opened 48%
Not Noted 56%
Closed 9%
Opened 91%
Caregiver Victim of Domestic
Violence
Noted 20%
Chi-Square = 16.45***
Closed 64%
Opened 36%
Noted Caregiver Few Social Supports Not Noted
Chi-Square = 7.64**
18%
38%
Closed 42%
Opened 58%
Closed 74%
Opened 26%
Closed 18%
Opened 82%
Transfers to Ongoing Services
Among Police Referred
Investigations
Closed 64%
Opened 36%
Noted 28%
Caregiver Few Social Supports
Not Noted 72%
Chi-Square = 4.68*
Closed 48%
Opened 52%
Closed 70%
Opened 30%
Transfers to Ongoing Services
Among Non-professional
Referred Investigations
Closed 57%
Opened 43%
Not Noted 76%
Caregiver Drug/Solvent Abuse
Noted 24%
Chi-Square = 9.68**
Closed 65%
Opened 35%
Noted 26%
Caregiver Few Social Supports
Chi-Square = 6.46*
Closed 46%
Opened 54%
Closed 29%
Opened 71%
Not Noted 50%
Closed 75%
Opened 25%
Transfers to Ongoing Services
Among Community or Social
Services Referred Investigations
Closed 56%
Opened 44%
Not Noted 60%
Caregiver Mental Health Issues
Noted 40%
Chi-Square = 16.33***
Closed 74%
Opened 26%
< = 19-21 (24%)
Caregiver Age
Chi-Square = 9.98**
Closed 50%
Opened 50%
Closed 29%
Opened 71%
> 19-21 (36%)
Closed 90%
Opened 10%
Conclusion
• Large % of risk cases
• Functioning of the caregiver is the strongest determinant of child welfare
involvement
• Rapid increase in infant cases speaks to effective early identification of high
risk cases and an opportunity to promote caregiver resiliency and prevent
maltreatment
• What interventions need to be targeted by whom to these families?
• North American child welfare continues to be driven by case finding, the
challenge of providing effective services remains
• Home visitation raises concerns in cases where domestic violence is present