Research Watch

Increased risk factors with fewer service referrals? A critical mismatch found for child welfare-involved parents with an intellectual disability

Year of Publication
Reviewed By
Carolyn O’Connor
Citation

Slayter, E. M., & Jensen, J. (2019). Parents with intellectual disabilities in the child protection system. Children and Youth Services Review, 297-304.

Summary

Parents with intellectual disabilities are disproportionately represented in the child protection system. Using the 2013 National Child Abuse and Neglect Data System (NCANDS), a national-level data set which collects child maltreatment report information at the caseworker level, the study’s authors explored prevalence, associated clinical and environmental risk factors, the type of services offered, and whether appropriate service referrals were made based on the intellectually disabled parents’ risk factors. Intellectual disability was defined in the NCANDS as “a clinically diagnosed condition of significantly less than average general cognitive and motor functioning existing concurrently with deficits in adaptive behavior that adversely affect socialization and learning” (Children's Bureau, 2016, A-37).

In 2013, there were 1,013,464 cases of suspected child maltreatment with data on the parents’ intellectual disability status; of all those in which an investigation was conducted, 7,831 (0.8%) involved a parent who was identified as having an intellectual disability. Of the 7,831 investigated cases, 2,450 (31.3%) were substantiated; for parents without an identified intellectual disabilities, 209,543 (20.8%) of investigated cases were substantiated. Among the substantiated cases, parents with intellectual disabilities were more likely than those without to have all ten of the NCANDS risk factors than those without intellectual disabilities. Most notably, they were 13.31 times more likely to have an identified visual or hearing impairment as well as 6.16 times more likely to have an identified emotional disturbance. No differences in maltreatment types were found between groups for physical abuse, neglect, or medical neglect; however, results showed that parents with intellectual disabilities were more likely to perpetrate psychological/emotional abuse (OR=1.42) and “other” types of maltreatment (OR=4.71) and less likely to perpetrate sexual abuse (OR=0.53). In terms of service referrals, parents with intellectual disabilities were less likely to receive services in all but two of the categories: adoption and educational. Furthermore, the authors conducted bivariate analyses to determine the presence of mismatch regarding risk factor and service referral. It was found that when compared to parents without an intellectual disability, intellectually disabled parents with emotional problems were over six times more likely not to be referred for mental health care services (OR=6.35) and those with an alcohol use problems were 3.59 times more likely not to be referred to substance use treatment.

Methodological Notes

This study provides a valuable first estimate of the prevalence, characteristics, and service referrals among parents with identified intellectual disabilities with substantiated cases of child maltreatment in the U.S. Limitations of this research are those typically associated with use of secondary data, namely: missing data (caregiver disability is not a mandatory reporting field), unstandardized categories (i.e., “other” maltreatment type is defined discretely as per individual state laws), and lack of information regarding caseworker decision-making practices (to determine, for instance, why these parents are not receiving some service referrals). In addition, the authors note that due to the NCANDS requirement for clinical confirmation, actual rates of intellectual disability are likely to be higher than those identified through NCANDS.

References

Children's Bureau. (2016). National Child Abuse and Neglect Data System (NCANDS) child file codebook. Retrieved from: http://www.acf.hhs.gov/programs/cb/resource/ncands-child-file.