Lefebvre, R. (2012). Caregiver Risk Factors by Primary Substantiated Maltreatment and Risk. Based on, Trocmé, N., Fallon, B., MacLaurin, B., Sinha, V., Black, T., Fast, E. et al. (2010). Chapter 5: Characteristics of Children and Families. In Public Health Agency of Canada (Ed.), Canadian Incidence Study of Reported Child Abuse and Neglect-2008: Major Findings. Ottawa: PHAC. Canadian Child Welfare Research Portal: Toronto, ON.
Introduction
The Canadian Incidence Study of Reported Child Abuse and Neglect-2008 (CIS-2008) is the third nation-wide study to examine the incidence of reported child maltreatment and the characteristics of children and families investigated by child welfare authorities in Canada. In addition to the tables presented in the Major Finding report [fn value=1]Public Health Agency of Canada (PHAC). (2010). Canadian incidence study of reported child abuse and neglect, 2008: Major findings. Ottawa: Authors.[/fn], the Supplementary Tables Information Sheet Series describes key child, household and investigation characteristics by primary category of substantiated maltreatment including confirmed risk. This Information Sheet examines primary caregiver risk factors.
Findings
There were an estimated 235,842 maltreatment-related investigations conducted in Canada in 2008. An estimated 174,411 investigations were for an incident of maltreatment and an estimated 61,431 were risk-only investigations. At the end of the initial investigation, 49% of maltreatment investigations were substantiated (85,440 investigations) and in 20% of risk investigations, the worker determined there was a risk of future maltreatment (12,018 investigations). At least one primary caregiver risk factor was noted in 78% of substantiated maltreatment investigations (66,282 investigations) and in 87% of confirmed risk investigations (10,460 investigations).
Figure 1 outlines noted primary caregiver risk factors in substantiated maltreatment and confirmed risk investigations. Few social supports was the most frequently noted primary caregiver risk factor in all categories of substantiated maltreatment except exposure to intimate partner violence (IPV), where victim of domestic violence was the most frequently noted primary caregiver risk factor. Few social supports was also the most frequently noted primary caregiver risk factor in confirmed risk investigations.
Mental health issues were noted in 41% of confirmed risk investigations and in just over a third of substantiated emotional maltreatment investigations (35%) and substantiated neglect investigations (34%). Alcohol abuse was noted in one third (33%) of substantiated neglect investigations, 27% of confirmed risk investigations, 24% of substantiated emotional maltreatment investigations, 18% of substantiated exposure to intimate partner violence (IPV) investigations, and under ten percent of substantiated physical abuse (9%) and sexual abuse (6%) investigations.
Drug/solvent use, cognitive impairment and history of foster care/group home were more likely to be noted in confirmed risk investigations than in any other category. Physical health issues were most likely to be noted in substantiated emotional maltreatment investigations than any other category and perpetrator of domestic violence was more likely to be noted in exposure to intimate partner violence (IPV) investigations than any other category.
Figure 1: Primary caregiver risk factors by primary category of substantiated maltreatment, including confirmed risk of future maltreatment, in Canada in 2008
Background to the CIS-2008
Responsibility for protecting and supporting children at risk of abuse and neglect falls under the jurisdiction of the 13 Canadian provinces and territories and a system of Aboriginal child welfare agencies which have increasing responsibility for protecting and supporting Aboriginal children. Because of variations in the types of situations that each jurisdiction includes under its child welfare mandate as well as differences in the way service statistics are kept, it is difficult to obtain a nation-wide profile of the children and families receiving child welfare services. The Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) is designed to provide such a profile by collecting information on a periodic basis from every jurisdiction using a standardized set of definitions. With core funding from the Public Health Agency of Canada and in-kind and financial support from a consortium of federal, provincial, territorial, Aboriginal and academic stakeholders, the CIS-2008 is the third nation-wide study of the incidence and characteristics of investigated child abuse and neglect across Canada.
Methodology
The CIS-2008 used a multi-stage sampling design to select a representative sample of 112 child welfare agencies in Canada and then to select a sample of cases within these agencies. Information was collected directly from child protection workers on a representative sample of 15,980 child protection investigations conducted during a three-month sampling period in the fall of 2008. This sample was weighted to reflect provincial annual estimates.
For maltreatment investigations, information was collected regarding the primary form of maltreatment investigated as well as the level of substantiation for that maltreatment. Thirty-two forms of maltreatment were listed on the data collection instrument, and these were collapsed into five broad categories: physical abuse (e.g., hit with hand), sexual abuse (e.g., exploitation), neglect (e.g., educational neglect), emotional maltreatment (e.g., verbal abuse or belittling), and exposure to intimate partner violence (e.g., direct witness to physical violence). Workers listed the primary concern for the investigation, and could also list secondary and tertiary concerns.
For each form of maltreatment listed, workers assigned a level of substantiation. Maltreatment could be substantiated (i.e., balance of evidence indicated that the maltreatment had occurred), suspected (i.e., maltreatment could not be confirmed or ruled out), or unfounded (i.e., balance of evidence indicated that the maltreatment had not occurred).
For each risk investigation, workers determined whether the child was at risk of future maltreatment. The worker could decide that the child was at risk of future maltreatment (confirmed risk), that the child was not at risk of future maltreatment (unfounded risk), or that the future risk of maltreatment was unknown.
Concerns related to caregiver risk factors were reported by workers using a checklist of nine items that were asked about each caregiver. Where applicable, the reference point for identifying concerns about caregiver risk factors was the previous six months. Workers rated caregiver risk factors as “confirmed”, “suspected”, “no”, and “unknown”. For the purposes of this analysis, the categories of confirmed and suspected have been collapsed.
A detailed presentation of the study methodology and of the definitions of each variable is available at www.cwrp.ca/sites/default/files/publications/en/CIS-2008_StudyMethods.pdf.
Limitations of the CIS-2008
The CIS collects information directly child welfare workers at the point when they completed their initial investigation of a report of possible child abuse or neglect, or risk of future maltreatment. Therefore, the scope of the study is limited to the type of information available to them at that point. The CIS does not include information about unreported maltreatment nor about cases that were investigated only by the police. Also, reports that were made to child welfare authorities but were screened out (not opened for investigation) were not included. Similarly, reports on cases currently open at the time of case selection were not included. The study did not track longer-term service events that occurred beyond the initial investigation.
Three limitations to estimation method used to derive annual estimated should also be noted. The agency size correction uses child population as a proxy for agency size; this does not account for variations in per capita investigation rates across agencies in the same strata. The annualization weight corrects for seasonal fluctuation in the volume of investigations, but it does not correct for seasonal variations in types of investigations conducted. Finally, the annualization weight includes cases that were investigated more than once in the year as a result of the case being re-opened following a first investigation completed earlier in the same year. Accordingly, the weighted annual estimates represent the child maltreatment-related investigations, rather than investigated children.
Comparisons across CIS reports must be made with caution. The forms of maltreatment tracked by each cycle were modified to take into account changes in investigation mandates and practices. Comparisons across cycles must in particular take into consideration the fact that the CIS-2008 was the first to explicitly track risk-only investigations. In addition, readers are cautioned to avoid making direct comparisons with provincial and First Nations oversampling report because of differences in the way national and oversampling estimates are derived.