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Families investigated for child maltreatment by Child Protective Services are no better off years later in seven key areas than other at-risk families, which a new national study co-authored by a Utah pediatrician says underscores a "missed opportunity" in responding to households at high risk for violence, dysfunction and abuse.
The study looked at 595 children who had the same primary caregiver at ages 4 and 8. During that period, 164 of those families were investigated for suspected child maltreatment; allegations were substantiated in 74 cases. None of the study data came from Utah.
The study compared families in seven areas: social support, family functioning, poverty, maternal education, maternal depression, anxious or depressed child behavior and aggressive or destructive child behavior.
The families that were involved with Child Protective Services were no better off in any of those areas, despite the state intervention, and even had a higher risk for family violence and other problems. A CPS investigation was linked to higher levels of poverty, depression in mothers and child behavior problems at age 8, the study found.
Kristine A. Campbell, a University of Utah pediatrician and lead author of the study published Monday in the Archives of Pediatrics and Adolescent Medicine, said that while CPS "does a great job," the study shows "what we need to do is support that and build more of a safety net around families."
But the journal's editor took a stronger position, suggesting in an accompanying editorial that 40 years after its inception, CPS has "outlived its usefulness."
In the early 1970s, concerns about battered children drove the creation of CPS. But today, neglect is by far the most commonly substantiated problem, leading child welfare officials to intervene in a family, wrote Abraham B. Bergman, a pediatrician at Harborview Medical Center in Seattle, Wash.
Substantiated reports of physical abuse and sexual abuse declined by half between 1992 and 2007, he noted.
"The classic 'battered child' is now rarely seen," Bergman wrote.
Meanwhile, neglect with poverty as an underlying issue accounted for nearly three-fourths of substantiated maltreatment investigations in 2008 nationwide.
Richard Wexler, executive director of the National Coalition for Child Protection Reform, said the study confirms what his organization has argued for years.
"Child Protective Services won't be effective until it becomes Child Poverty Services," he said in an e-mail. "That doesn't mean you have to eliminate poverty to eliminate child maltreatment though whoever does the first will come closer than anyone else to doing the second. You can make enormous strides simply by ameliorating the worst effects of poverty."
In Utah, neglect accounts for 43 percent of children in state custody, according to the state Division of Child and Family Services.
In fiscal 2010, Utah CPS investigated nearly 20,000 complaints of neglect and abuse. Less than half 8,342 were found to have merit. The most frequently supported allegation, at 31 percent, was witnessing domestic violence, followed by sexual abuse, "other" which includes dependency, failure to protect and child endangerment and physical abuse. Neglect accounted for 17 percent of cases.
"Is the investigation piece perfect? No," said Brent Platt, DCFS director on Monday. "But we put a lot of focus and energy into linking up families with services when we do go out to them. [Campbell] makes some good points. I don't know if we've outlived our usefulness, but can we do a better job? Yeah, we can."
In the Archive of Pediatrics study, Campbell found only 38 percent of children investigated for maltreatment received any subsequent services. The services most commonly offered addressed threats to safety, such as substance abuse or domestic violence.
"It's not CPS' job to solve poverty or depression for parents," Campbell said. "CPS is taking care of the family in an acute crisis situation. The rest of us need to identify other interventions that may help these families over a longer time frame."
Platt points out, though, that other community players that help at-risk families face the same challenge his agency does: Having adequate funding to do what is needed.
The journal's editor suggested that abuse investigations should be led by law enforcement, eliminating expensive, duplicative review by child welfare investigators. It also proposes that public health nurses be drafted as first-line responders in allegations of child neglect and their services be made available to at-risk families to reduce chance of abuse before it occurs.
"Public health nurses possess skills to assess child and family functioning and are more apt to be accepted in homes than CPS workers," the journal said. Likewise, social workers should be integrated into the child protection team.
None of this is likely, the journal acknowledges, because "child neglect is not a popular action item for politicians or the public." Also, public health nurses are a "dispirited, vanishing species" and child welfare agencies have shown little interest in hiring trained social workers.
"This gloomy prognosis notwithstanding, the changed picture of child maltreatment in the United States demands, at the very least, that we begin a wide-ranging discussion and testing of alternative responses," wrote Bergman.
At a glance The study
The study looked at 595 children who had the same primary caregiver at ages 4 and 8 and found despite the state's intervention, families involved with Child Protective Services were no better off than other
at-risk families in seven areas measured in the study.