Campbell, K. A., Cook, L. J., LaFleur, B. J., & Keenan, H. T. (2010). Household, Family, and Child Risk Factors After an Investigation for Suspected Child Maltreatment: A Missed Opportunity for Prevention. Archives of Pediatrics & Adolescent Medicine, 164(10), 943-949.
Over 3 million children are reported every year to Child Protection Services (CPS) in the United States, over 200,000 in Canada: do investigations lead to improvements in household, family and child risk factors? Using data from the Longitudinal Studies of Child Abuse and Neglect (LONSCAN), the authors of this study compared 164 children who experienced an investigation for suspected child maltreatment between ages four and eight years, to 431 non-investigated children from similar family backgrounds. Controlling statistically for any differences between the two groups in measures taken at age four, the authors examined the extent to which CPS investigations, with or without post investigation services, were associated with improvements in measures taken at age eight with respect to social support, family functioning, poverty, maternal education, maternal depressive symptoms, child anxious, depressive, aggressive or destructive behaviours. For all investigated children and the sub-group of substantiated cases, the authors found that there was no improvement and that there was a statistically significant increase in maternal depressive symptoms. While the study did not measure possible improvements related to the specific reasons that lead to CPS involvement, the lack of improvement in the “modifiable risk factors” measured by the study suggests that CPS services may be missing an opportunity for prevention.
The disappointing results must be interpreted with some caution because of the inherent difficulties of ensuring that unmeasured baseline differences may in fact explain the lack of difference in outcomes between CPS investigated and non-investigated children. As the authors note, it is possible that “CPS investigation occurs during periods of worsening household, caregiver, and child risk and that CPS investigation results in a recovery to expected levels of risk”, in other words, that the lack of difference between investigated and non-investigated children demonstrates that CPS investigations were successful in addressing the very problems that had led to the investigation. While the authors did not find evidence of such a pattern of worsening risk, the design of the LONGSCAN study limited their ability to account for changes that may have occurred between the four year and eight year measurement points. Regardless, given the lack of evidence to the contrary, this study challenges maltreatment researchers and CPS providers to demonstrate that CPS investigations are in fact addressing these important risk factors.
LONGSCAN is a pioneering five-site study that followed 1,249 high-risk children using information collected directly from the primary caregiver through interviews every two to four years from age four until age 18. This analysis was limited to the 595 children who had the same maternal caregiver responding to the interviews at the child’s ages of four and eight years. The design offers a unique opportunity to explore the antecedents and consequences of child abuse among high-risk children with and without CPS involvement.