Effect of Child Protective ServicesSystem Factors on Child

Effect of Child Protective Services
System Factors on Child
Maltreatment Rereporting
This study examined how child protective
services (CPS) systems respond to initial and
subsequent reports in the context of child
maltreatment rereporting and to what extent
CPS system factors are associated with the
risk of rereporting after controlling for abuse
type and child and family factors. This study
followed 67,243 families who were reported
to the CPS agencies in seven counties in
Florida for child abuse and neglect over a
period of 5.4 years and found that 14,218
families had one or more child maltreatment
rereports. Key findings include that CPS system factors were
significantly different from initial report to subsequent reports.
Five CPS system factors, reporting source, contact by CPS
workers, investigative level at intake, postinvestigation
services,
and duration of CPS involvement were significantly associated
with the risk of child maltreatment rereporting. Multivariate
analyses found that CPS system factors were substantially dif-
ferent for three categories of rereporting, unsubstantiated rere -
ports, substantiated rereports, and recurrence reports.
Interpretations and implications for practice are discussed.
Hwa-ok Bae
Gyeongsang National
University

Phyllis L. Solomon
University of Pennsylvania
Richard J. Gelles
University of Pennsylvania
Tammy White
Greater Philadelphia Urban
Affairs Coalition
33Child Welfare • Vol. 89, No. 3
Child protective services (CPS) systems are designed to
identifyvictims of maltreatment and protect them from further
victim-
ization. One core goal of CPS investigation and intervention is
to
prevent reoccurrence of maltreatment. Despite the extensive
services
provided by CPS, large numbers of children experience
subsequent
maltreatment. A study from National Child Abuse and Neglect
Data
System (NCANDS) found that, between 1998 and 2002,
approxi-
mately one-third of 1.4 million children reported in nine states
were rereported, and approximately 17% of victims were
revictim-
ized within five years (Fluke, Shusterman, Hollinshead, &
Yuan,
2005). These large rereport and revictimization rates suggest
that CPS
agencies serve the same abused and neglected children

repeatedly.
This cycle of rereporting and recurrence results in significant
costs for
CPS agencies and creates a major burden on CPS workers, many
of
whom are already struggling with heavy caseloads. More
importantly,
repeat cases suggest a failure of CPS’ intended mission to
adequately
protect children from revictimization. Accordingly,
identification of
factors for child maltreatment rereporting may be the logical
prereq-
uisite for developing effective interventions for children and
families.
Rereporting and Recurrence
Rereporting possibly results in the subsequent identification of
recur-
rence (substantiated or indicated maltreatment). Way, Chung,
Jonson-Reid, and Drake (2001) found that more than 10% of
those
whose index event was not substantiated were substantiated at
the
second report in a statewide administrative CPS data with
31,531
perpetrators of intrafamilial maltreatment. Drake, Jonson-Reid,
Way,
and Chung (2003) also found that 17.6% of the initially
unsubstan-
tiated neglect reports resulted in substantiated rereports.
Similarly,
Dorsey, Mustillo, Farmer, and Elbogen (2008) found that
casework-
ers assessed approximately one-third of the cases as having a
high

likelihood of maltreatment recurrence and one-fifth of the cases
in
the entire sample received subsequent reports of maltreatment.
All
of these findings confirm that rereporting leads to a significant
rate
of recurrence.
Vol. 89, No. 3Child Welfare
34
Ecological Model of Child Maltreatment Rereporting
Among the theoretical perspectives employed to identify risk
factors
for child maltreatment, one widely used framework is the
ecological
model. The ecological model explains that child maltreatment is
determined by a variety of factors operating through
transactional
processes at various levels (Belsky, 1993; Cash, 2001;
Sidebotham,
2001). Thus, the ecological model enables one to combine the
diver-
sity of factors known to be relevant to the etiology of child
maltreat-
ment rereporting. Child and family factors related to the risk of
child
maltreatment rereporting include the child’s age (Fluke, Yuan,
&
Edwards, 1999), the child’s sex (Fryer & Miyoshi, 1994), the
child or
perpetrator’s race or ethnicity (Lipien & Forthofer, 2004; Way
et al.,

2001), the family size or number of children ( Johnson &
L’Esperance,
1984; Wolock, Sherman, Feldman, & Metzger, 2001), and the
fam-
ily structure (Coohey, 2006; Fuller, Wells, & Cotton, 2001). In
addi-
tion to these child and family risk factors, the present study
included
CPS system factors into the research model to further explore
the
likelihood of child maltreatment rereporting from an enhanced
eco-
logical perspective.
CPS System Factors
CPS systems involve complex processes of investigation and
dis-
position, and therefore, it is important to examine what system
ele-
ments may be associated with the likelihood of rereporting
(Inkelas
& Halfon, 1997). One key element that is theorized to be associ -
ated with child maltreatment rereporting is a family’s continued
exposure to the CPS system. More than any other single factor,
prior abuse history or being known to the CPS system, was
found
to be a very strong predictor of rereporting in a number of
studies
(DePanfilis & Zuravin, 2002; Dorsey et al., 2008; Fuller et al.,
2001;
Inkelas & Halfon, 1997). Once the child and family are brought
to
the attention of the CPS system, they are subjected to a greater
degree of observation and inspection. As such, this increased
CPS
surveillance may be related to a higher risk of child

maltreatment
Child WelfareBae et al.
35
rereporting. The degree and extent of CPS surveillance can be
measured by examining both the frontline of the child
protection
system (i.e., reporting and investigation) and the next gate of
the
system (i.e., disposition and service). The present study selected
five
CPS system factors as indicators of CPS surveillance: (1) report
source, (2) contact by CPS workers, (3) investigative level at
intake,
(4) postinvestigation services, and (5) duration of CPS
involvement.
The researchers examined whether these CPS system factors
were
different from initial report to subsequent report(s) and to what
extent the risk of child maltreatment rereporting was associated
with these factors.
Report Source
The likelihood of rereporting may be influenced by who
initially and
subsequently reports a case of suspected child maltreatment.
Schools
and law enforcement agencies are more likely than any other
report
source to report physical abuse; medical professionals are more
likely
to report sexual abuse; and neighbors and friends mostly report

gen-
eral neglect (Barth, Courtney, Berrick, & Albert, 1994;
Giovannoni,
1995). Differential exposure to initial reporters may cause
differ-
ential rereporting rates. U.S. Department of Health and Human
Services (USDHHS), National Center for Child Abuse and
Neglect
(NCCAN), and NCANDS (2004) data indicate that children
reported by educational personnel were 25% more likely to be
reported for a recurrence, while children reported by law
enforce-
ment or legal personnel were 9% less likely to be rereported
than
those initially reported by social services personnel. Second,
families
with specific social problems such as poverty are increasingly
exposed to the CPS system (Drake, Jonson-Reid, & Sapokaite,
2006; Drake et al., 2003; Wolock et al., 2001), which may
increase
the likelihood of rereporting. Higher rates of rereporting were
found
for children with Medicaid mental health/substance-abuse
treatment
and special eligibility for emotional disturbance, whereas a
lower rate
of rereporting occurred among children with parents who were
per-
manently exited from their first spell on Aid to Families with
Dependent Children (Drake et al., 2006).
36

Contact by CPS Workers
During the initial stages of investigation CPS workers typically
have contacts (e.g., home visits, phone calls) with the child and
fam-
ily reported for suspected maltreatment. The CPS workers have
more frequent contacts with younger children and complex,
large,
and multiproblem families (Freeman, Levine, & Doueck, 1996;
Jagannathan & Camasso, 1996). Since child neglect tends to be
chronic, with parental behaviors unlikely to change rapidly, a
CPS
worker’s ongoing contact with the family may increase the
likeli-
hood of detecting the recurrence of neglect. The number of in-
person visits to a family receiving CPS services affects the rates
of
recurrence (Cash, 2001; Johnson, 1994). Frequency of contact
with
a caseworker is positively associated with maltreatment
recurrence
(Fuller et al., 2001). This finding could be explained by the
detec-
tion of other maltreatment during the initial investigation or by
the
fact that maltreating families are more likely to be rereported to
CPS following initial contact with the system (DePanfilis &
Zuravin,
1998). However, the number of contacts or number of workers
has not
been found to predict recurrence of child maltreatment
(DePanfilis
& Zuravin, 2002).
Investigative Level at Intake
Once a report is screened into the system, CPS workers assign

an ini-
tial level of risk ranging from low to high risk. Low risk level
receives
a low standard of investigation, whereas cases with high risk
levels
receive a high standard of investigation. Sexual abuse cases are
typi-
cally classified as a higher response priority for investigations
com-
pared to any other abuse types (Drake, 1995; Karski, 1999).
Presence
of injury is most often deemed to indicate abuse and thus
investi-
gated (Karski, 1999; Wells, Fluke, & Brown, 1995). Reports
from
law enforcement personnel are more likely to be judged
emergen-
cies for physical abuse and neglect, although reports from an
anony-
mous source and school personnel were more likely to be judged
emergencies for sexual abuse (Drake, 1995). Age of child and
certain
family characteristics are associated with the investigative level
at
intake, with young children and high-risk families being more
likely
37
to receive higher levels of investigation (Wells et al., 1995;
Wells,
Lyons, Doueck, Brown, & Thomas, 2004). The overall family

risk
rating at initial intake was related to maltreatment rereporting,
with
families judged as no risk and low risk occurring less frequently
in
the recurring sample, and families judged as moderate risk
occur-
ring more frequently in the recurring group (Fuller et al.,
2001).
Meanwhile, others indicate that agreement between
caseworkers’
assessment of risk and rereport are low; only 16% of the cases
assessed
as low risk had a subsequent report of child maltreatment in the
study by Dorsey et al. (2008). Therefore, investigative level at
intake
is likely to be more intensive at the second reporting, leading to
the theory that rereporting will be associated with higher
investiga-
tive levels at intake.
Postinvestigation Services
Postinvestigation services are provided to families to reduce the
risk of future harm, offered on a voluntary basis by CPS
agencies, or
ordered by the courts (USDHHS, NCCAN, NCANDS, 2004).
The likelihood of child maltreatment rereporting may vary by
type
of CPS services, as the type of service signifies the degree of
CPS
involvement. Family support services were found to be
associated
with a lower risk of recurrence (DePanfilis & Zuravin, 2002),
whereas
families receiving less intensive in-home services have a higher
risk

of rereporting compared to those not receiving services (Lipien
&
Forthofer, 2004). Drake et al. (2003) found that family
preservation
service cases had higher rates of recidivism, whereas those
receiving
traditional child welfare services were no different from the
not-
served group in the rates of recidivism. Children are more likely
to
be replaced on an emergency basis during or after an
investigation of
abuse. More controlling services, such as foster care placement
and
court-ordered custody, will decrease the risk of rereporting
because
of the removal of the children from families at risk of future
mal-
treatment. Other researchers found that foster placements with a
relative were associated with lower risk of recurrent
maltreatment
reports than no services (Connell, Vanderploeg, Katz, Caron,
Saunders,
& Tebes, 2009; Lipien & Forthofer, 2004), and foster care
services
38
significantly decreased the risk of rereporting of neglect cases (
Jonson-
Reid, Drake, Chung, & Way, 2003).

Duration of CPS Involvement
CPS involvement includes the investigation period (from case
intake
and to case disposition) and the intervention period (from case
dis-
position to case closing). While the increased likelihood of rere -
porting may be associated with increased CPS surveillance, the
risk
for rereporting is higher during the early period of the CPS
inves-
tigation and then becomes lower as the duration of services is
extended. In other words, the risk for rereporting is not evenly
dis-
tributed across the time of CPS involvement. Studies using
survival
analysis confirm that the risk of child maltreatment recurrence
was greatest in the immediate period such as within the first
month
following an initial report (DePanfilis & Zuravin, 1999; Fryer &
Miyoshi, 1994), thus indicating the likelihood of rereporting in
the
early period of CPS involvement. Cases in which the family
received
no services within the first 60 days following case opening was
approximately twice as likely to recur than cases that received
at least
one service during this time (Fuller et al., 2001). Further, other
stud-
ies found that longer durations of services are associated with
lower
risks of child maltreatment rereporting (Marshall & English,
1999;
Johnson & L’Esperance, 1984).
This study, therefore, hypothesizes that the risk of child mal-
treatment rereporting will be associated with report source,

inves-
tigative level at intake, contact by CPS workers,
postinvestigation
services, and duration of CPS involvement after controlling for
abuse
type and child and family factors.
Method
The data source is the Florida Department of Children and
Families
Florida Abuse Hotline Information System (FAHIS). The data
available for this study included all FAHIS records starting
from
January 1, 1996, to May 31, 2002, in seven Florida counties
(Broward,
Hillsborough, Lee, Manatee, Palm Beach, Pasco, and Pinellas).
39
This study merged four datasets: (1) report dataset, (2) reporter
dataset, (3) dependent dataset, and (4) child-caretaker pair
dataset
from FAHIS by selecting the family as the unit of analysis
(Kinnevy,
Cohen, Huang, Gelles, Bae, Fusco, & Dichter, 2003). Since this
study
used the family as the unit of analysis rather than the child, a
ran-
dom selection of one child per family was conducted for those
families, where more than one child was reported on the same
day.
Consequently, multiple reports for more than one child in a

given
family on the same day were not counted as a rereport. All
variables
were based on the randomly selected child.
This study regarded a report without a prior CPS report in the
preceding one year of the study period as the first report.
Studies using
survival analysis have found that the greatest risk of recurrence
is
within the first month to four months following an initial
incident;
hence, a majority of rereporting tends to cluster in the early
period
of CPS involvement (DePanfilis & Zuravin, 1999; Fryer &
Miyoshi,
1994; Lipien & Forthofer, 2004). Accordingly, this study
regarded a
report of a family without a prior CPS report in the preceding
one
year as the starting point of the rereporting interval. Therefore,
this
study defines the rereporting period as an additional report of
phys-
ical abuse, sexual abuse, or neglect of any child in the family
that was
reported to a CPS agency during a 5.4-year period from the start
of
the first report or index report for purposes of this study.
The final dataset included 67,243 families who were tracked
until
May 31, 2002, to assess whether the family had any rereport of
child
maltreatment. Among them, 14,218 families (21.1%) were
rereported

one or more times, with a total of 21,219 rereports. Each
rereport for
a family was counted as a separate rereport whereby CPS had
under-
gone the procedures of intake, investigation, and disposition for
the
case. The 21,129 rereports were grouped into three categories
accord-
ing to prior and subsequent substantiation sequence: (1)
unsubstan-
tiated rereports, which included unsubstantiated-to-
unsubstantiated
reports (35.2%) and substantiated-to-unsubstantiated reports
(22.4%);
(2) substantiated rereports, which included unsubstantiated-to-
sub-
stantiated reports (21.5%); and (3) recurrence reports, which
included
substantiated-to-substantiated reports (20.9%; Fluke et al.,
2005).
40
Results
Univariate Results
The total sample was composed of 67,243 families. The
majority
of families (58%) were initially reported for neglect, and more
than
half (58%) of the initial reports were deemed unsubstantiated.
The majority of the children (61%) were white, and almost
three-

quarters were aged 12 and younger. Descriptive statistics,
including
abuse type and child and family characteristics of the sample,
are
presented in Table 1.
Bivariate Results
Bivariate Chi square analyses were conducted on the subsample
of
families (n � 14,218) who had rereports to explore differences
in the
five CPS system factors among the three categories of
rereporting
(Table 2).
Report Source
Overall, more than half of the unsubstantiated rereports were
reported by mandatory reporters at both initial report and subse -
quent reports, contrary to substantiated rereports, where the pre -
dominant number of families was made by nonmandatory
reporters.
Recurrence reports were least likely to be made by
nonmandatory
reporters. Among mandatory reporters, educational personnel
were
more likely to identify unsubstantiated rereports and
substantiated
rereports, whereas legal personnel were more likely to identify
recur-
rence reports both at initial report and at subsequent reports.
Across
all categories of rereporting, social services personnel were
more likely
to, and medical personnel and legal personnel were less likely
to iden-
tify all categories of rereports at subsequent reports.

Investigative Level
The majority of families were investigated at a medium
intensity
level both at initial report and subsequent reports for all
categories
of rereporting.
41
42
Variables Number of Families Percent
Substantiation
Substantiated 39,217 41.7
Not substantiated 28,026 58.3
Abuse type
Neglect 39,240 58.4
Physical abuse 22,244 33.1
Sexual abuse 5,759 8.6
Age of child
�2 10,363 15.4
2– 5 12,126 18.0
6– 12 26,397 39.3
13– 18 18,357 27.3
(Mean) (8.0)

Sex of child
Girls 34,155 50.8
Boys 33,088 49.2
Race/ethnicity
Blacks 19,749 29.4
Latinos 5,336 7.9
Whites 41,058 61.1
Others 1,100 1.6
Family structure
Both parents 27,056 40.2
Stepparents 7,081 10.5
Mother only or with other 26,943 40.1
Father only or with other 3,501 5.2
Relatives and others 2,662 4.0
Number of dependents
1 23,923 35.6
2 21,954 32.7
3� 21,366 31.8
(Mean) (2.2)
Total 67,243 100.0
Table 1
Description of the Sample
43
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Number of Contacts
At both initial report and at subsequent report, the majority of
fam-
ilies were contacted once by CPS across all three categories of
rere-
porting. Families with recurrence reports significantly received
more
frequent contacts with CPS relative to those with
unsubstantiated
rereport and substantiated rereport.
Postinvestigation Services
More than half of the families with substantiated rereports did
not
receive postinvestigation services, whereas a majority of
families with

recurrence reports received postinvestigation services at both
initial
report and subsequent reports. Across all three categories of
rere-
porting, families were more likely to receive court-ordered
services
and general CPS services at subsequent reports.
Involvement Period
Families with recurrence reports had longer periods of CPS
involve-
ment compared to those with unsubstantiated or substantiated
rere-
ports. Across all three categories of rereporting, the
involvement
period was shorter following a subsequent report than at initial
report.
In summary, the CPS system factors differently responded to
initial report and subsequent reports. Overall, the CPS system
was
likely to provide more intensive surveillance to subsequent
reports
than to initial reports, and families were more intensely
investigated,
more frequently contacted, and more likely to receive some
postin-
vestigation services at subsequent reports across all three
categories
of rereporting.
Multivariate Results
Nonproportional Cox regression analyses included 67,243
families
and their 88,372 reports and rereports to examine the impact of
the

five CPS system factors on the risk of unsubstantiated rereport,
sub-
stantiated rereport, and recurrence report, when controlling for
abuse
type and child and family factors (Table 3). The analyses
incorporated
one time-dependent covariate (duration of CPS involvement)
that
45
46
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1
changes the hazard at different rates for families and has
different
effects on rereporting (Allison, 1995).
Unsubstantiated Rereports
Abuse type and child and family factors. Results indicate that
phys-
ical abuse or sexual abuse was less likely to be associated with

an
unsubstantiated rereport than neglect. The child’s age was
signifi-
cantly associated with an unsubstantiated rereport, but the
child’s
gender was not. Family race or ethnicity, structure, and size
were sig-
nificantly associated with an unsubstantiated rereport.
Compared to
black families, Latino and other families were significantly less
likely,
but white families were more likely, to have an unsubstantiated
rere-
port. All types of family structure than both-parent families
were
more likely to have an unsubstantiated rereport. The greater the
number of dependents, the greater the likelihood of
unsubstantiated
rereports.
CPS system factors. When controlling for abuse type and child
and family factors, families with unsubstantiated rereports were
significantly less likely to be made by medical personnel, legal
per-
sonnel, and child care and foster care personnel than those by
non-
mandatory reporters. Statistically, the risk ratios of
unsubstantiated
rereport for families reported by medical personnel and legal
per-
sonnel were 21.2 and 21.5% lower than those reported by non-
mandatory reporters (e�0.2380�1, e�0.2427�1). Investigative
level was
not significantly associated with the likelihood of
unsubstantiated
rereporting. Families with unsubstantiated rereports were more

likely
to have frequent contacts of CPS workers and were more likely
to
receive postinvestigation services. Duration of CPS involvement
was
not significantly associated with the likelihood of
unsubstantiated
rereporting.
Substantiated Rereports
Abuse type and child and family factors. Nonproportional Cox
regression analyses on substantiated rereporting produced very
few
different results compared to unsubstantiated rereporting. For
exam-
ple, white families and stepparent families lost statistical
significance,
48
but other child and family factors did not substantially differ
from
the ratios found in the examination of unsubstantiated rereports.
CPS system factors. Report sources risk ratios were compara-
ble to the ratios found by the unsubstantiated rereport analyses.
Investigative level was significantly associated with the
likelihood of
substantiated rereporting. An increase in the investigative level
from
initial report to rereport (from low to medium, or from medium
to

high) was significantly and positively associated with
unsubstanti-
ated rereport, meaning that the family was investigated at a
higher
level. In contrast, number of contacts by CPS workers, and CPS
serv-
ices and other programs lost statistical significance. Families
with
substantiated rereports were 58.9% less likely to receive court
serv-
ices (e�0.8893�1). A longer duration of CPS involvement was
nega-
tively associated with a substantiated rereport. In other words,
each
one month increase of the involvement period decreased the risk
of
a family having a substantiated rereport by 0.7% (e�0.0068�1).
Recurrence Reports
Abuse type and child and family factors. Nonproportional Cox
regression analyses on recurrence reports produced similar
results
found by the unsubstantiated rereport analyses. Abuse type,
child’s
age, and family race or ethnicity, structure, and size
significantly
predicted the risk of a family having a recurrence report. White
families were less likely to have a recurrence report compared
to
black families.
CPS system factors. All of the CPS system factors were signifi -
cantly associated with the likelihood of recurrence report.
Families
with recurrence reports were more likely to be made by
mandatory

reporters than by nonmandatory reporters. Families with
recurrence
reports were more likely to be intensively investigated, more
fre-
quently contacted by CPS workers, more likely to receive any
serv-
ices, and more likely to be involved in the CPS system longer.
In summary, multivariate analyses indicate that abuse type and
child and family factors were not much different for the three
cate-
gories of unsubstantiated rereports, substantiated rereports, and
recurrence reports. Across three categories of rereporting, large,
49
single-parent families reported for neglect were more likely to
be
rereported to the CPS system.
The system factors significantly differed, however, by
categories
of rereporting. Medical personnel and legal personnel were less
likely
to be associated with the risk of unsubstantiated rereports and
sub-
stantiated rereports, but were more likely to be associated with
the
risk of recurrence reports. Higher investigative level positively
pre-
dicted the risk of substantiated rereports and recurrence reports.
Number of contacts by CPS workers and all types of

postinvestiga-
tion services positively predicted the risk of unsubstantiated
rereports
and recurrence reports. Duration of CPS involvement negatively
pre-
dicted the risk of substantiated rereport but positively predicted
the
risk of recurrence reports.
Discussion
The present study found that the five CPS factors tested were
sig-
nificantly associated with the risk of child maltreatment
rereporting
after controlling for abuse type and child and family factors.
The
results of the multivariate analyses were quite consistent with
those
from the bivariate analyses. These findings suggest that the risk
of
rereporting is to some extent explained by the CPS system
factors.
These results indicate, however, that the risk ratios for these
system
factors were different for unsubstantiated rereports,
substantiated
rereports, and recurrence reports.
There are two plausible explanations. One is that the CPS sys-
tem differently responds to substantiation status of initial report
and
subsequent reports. More importantly, substantiation of initial
report
seems to be critical in differentiating the degree of response by
the
CPS system. The CPS system seems to provide more intensive

sur-
veillance to children and families of the initially substantiated
cases.
For example, families with substantiated rereports were least
likely
to be identified by mandatory reporters and were less likely to
receive
contacts by CPS workers and some postinvestigation services.
Among the families with unsubstantiated rereports, a significant
proportion of families had substantiated initial reports (22.4%).
If
50
the unsubstantiated rereports were categorized into two groups
according to the substantiation status of initial report, there may
be
greater clarity in interpreting the findings.
The second explanation is that the three categories of
rereporting
may represent different characteristics of the children and
families
involved. In other analyses of the same dataset, researchers
found that
families with recurrence reports were more likely to have
multiple
rereporting compared to those with unsubstantiated rereports
and
substantiated reports, while families with unsubstantiated
rereports
were more likely to have single rereporting (� � 42012.42, p �

.001).
Families with recurrence reports inherently had different
character-
istics; younger age of child victims, single mother or
stepparent, and
large family significantly increased the odds of multiple child
mal-
treatment recurrence relative to single recurrence and no
recurrence
(Bae, Solomon, & Gelles, 2009).
Given the design of this study, researchers cannot say defini -
tively that the CPS system factors cause the risk of rereporting.
It
is impossible to establish a causal relationship between
explanatory
variables (CPS system factors) and dependent variables
(categories
of rereporting) using state administrative data with a
retrospective
research design. However, it can be suggested that the CPS
system
factors respond differently to initial report and subsequent
reports;
further, researchers can conjecture that CPS system factors are
likely
associated with the risk of child maltreatment rereporting. Thus,
the future risk of child maltreatment rereporting can be
predicted.
For example, if the initially unsubstantiated report was made by
medical personnel or legal personnel, it was associated with
decreas-
ing likelihood of rereporting. Sexual abuse and emergency cases
were not likely rereported, as sexual abuse was mostly reported
by
medical personnel and removal to foster care or custody was

dealt
by legal personnel.
Implications for Practice
Study results indicate that the likelihood of a family being
rereported
is greater for families that have higher degrees of exposure to
and
51
involvement with CPS agencies. While this may indicate that a
sys-
tem designed to protect children from continued maltreatment is
falling short of its duties, results actually can be interpreted
more pos-
itively. In fact, if children known to the CPS system are under
more
intense scrutiny and thus more likely to be rereported, then one
inter-
pretation is that the CPS system is being extra diligent in
monitor-
ing children under its care.
One caveat, however, is that each rereport requires a repeated
procedure of intake, investigation, and disposition. This
repetition
of CPS procedures, therefore, can result in significant costs for
CPS
agencies and can create additional burden on CPS workers who
may already be struggling with heavy caseloads. A key
implication

resulting from this study is that CPS agencies may need to
provide
additional training to its workers or create or modify policies
that
explicitly outline when rereporting is indicated. Given that this
study
found that 58% of the 21,129 rereports were unsubstantiated, it
would behoove CPS agencies to carefully weigh the benefits of
rereporting against the human and capital costs associated with
rere-
porting. More intensive input of both time and energy into
identi-
fying and substantiating initial reports may possibly prevent the
occurrence of subsequent reports.
Findings from this study suggest additional research is needed
to
explore the extent to which other CPS system factors not
included
here may be associated with the risk of rereporting. It is evident
that
the CPS system plays a crucial and significant role in the
likelihood
of a child being rereported for maltreatment, and the more the
sys-
tem factors associated with rereporting are understood, the more
effi-
cient the rereporting system can be.
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Reproduced with permission of the copyright owner. Further
reproduction prohibited without permission.
Child sexual abuse remains a problem in
society, often resulting in the long-term
placement of children in the foster care
system. In Kentucky, children placed in
foster care due to sexual abuse spent more
time in care when compared with children
removed for any other reason (AFCARS,
2013). Given the cost of long-term foster
care placement in both human and eco-
nomic terms, few studies have specifically explored if any
factors
help to predict why this vulnerable population spends signifi -
cantly more time in foster care. The overarching goal of this

exploratory study was to use binary logistic regression to
investi-
gate whether any child demographic or environmental character -
istics predicted the discharge of a child placed in Kentucky’s
foster
care system for child sexual abuse. Results indicated that
children
in the most rural areas of the state were over 10 times more
likely
to be discharged from foster care during the federal fiscal year
than
those residing in the most urban areas. Given this stark reality,
a focus must be allocated in understanding this phenomenon.
Future research must examine whether the results speak to the
necessity of systematic improvement in urban areas or if they
are
illustrating a unique strength found in rural areas.
Child Sexual Abuse and the Impact of
Rurality on Foster Care Outcomes:
An Exploratory Analysis
Austin Griffiths
Western Kentucky University
April L. Murphy
Whitney Harper
57
Journal_Vol95_1R2_July_Aug 2007 6/1/17 3:40 PM Page 57

In federal fiscal year (FFY) 2014, 3.6 million child abuse and
neglectreferrals were made alleging the maltreatment of 6.6
million children
in the United States. Of these, approximately 3.2 million
(48.5%)
received either an investigation or alternative response,
resulting in
702,208 (21.6%) victims of maltreatment (U.S. Department of
Health
and Human Services, 2016). A majority (75.0%) of these
children suf-
fered neglect, followed by physical abuse (17.0%), sexual abuse
(8.3%),
other types of abuse (6.8%), and psychological abuse (6.0%)
(U.S.
Department of Health and Human Services, 2016).
Approximately
one-fourth of all cases investigated by child protective services
are sub-
stantiated (Walsh & Mattingly, 2012), resulting in difficult
decisions
about whether or not the child can remain safe in their current
home
environment. At times, decisions are made to seek court
intervention
and children are placed in foster care. While many studies have
con-
sidered factors pertaining to reasons for placement, little to no
research
has been published on factors impacting the length of stay in
placement
specifically for children experiencing sexual abuse.
Child abuse is costly, in both economic and human terms. Wang
and Holton (2007) have estimated the annual financial cost of

child
abuse and neglect was $103.8 billion. However, this annual
calculation
of direct costs from hospitalizations, mental health services,
child wel-
fare services, and law enforcement is a conservative estimate,
only
accounting for the costs related to the victims (Wang & Holton,
2007). Although the economic costs associated with child abuse
and
neglect are substantial, it is essential to recognize the prevailing
“intan-
gible losses” that can impact the individual, such as pain,
suffering, and
reduced quality of life. Although difficult to quantify, these
losses may
represent the largest component of violence against children and
should be taken into account when allocating resources (Miller,
1993).
Seeking insight into areas to improve the foster care system and
its
relationship with the young lives depending on it, it is
important to
explore any factors that may explain longer stays in foster care
and if any
variables can be found that help children to achieve timely
permanency.
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According to Child Welfare Information Gateway (2013),
children who
have been sexually abused have had both their physical and
emotional
boundaries violated, possibly resulting in a lack of trust and
safety
(Wang & Holton, 2007). The adverse consequences for
children’s devel-
opment often are evident immediately, encompassing multiple
domains
including physical, emotional, social, and cognitive. These
children
experience significant disruptions in normal development, often
having
a lasting impact and leading to dysfunction and distress well
into adult-
hood (Hall & Hall, 2012). The purpose of this study was to
specifically
examine child sexual abuse in the state of Kentucky. The
research ques-
tion guiding this study was exploratory in nature and aimed to
identify
any factors that may influence the probability of whether a child
who
was placed in foster care for sexual abuse in the state of
Kentucky will be
discharged from the child welfare system.
Literature Review
Although the substantial reports of child sexual abuse are
dishearten-
ing, they must be understood in context. For example, the
aforemen-
tioned only reflects the children who have been placed in foster

care.
Further, not all abuse is reported. If child sexual abuse does get
reported,
child welfare practitioners often find that it is “easier” to
protect a child
by meeting a different standard of evidence in court (e.g.
neglect).
Doctors and other health professionals may question whether
CPS
intervention is likely to benefit the children and their families
or
instead cause harm. Levi and Portwood (2011) found that it is
factors
such as these that introduce significant variability in reporting
and are
also compounded by the absence of a clear standard to report
suspect-
ed child abuse. Nonetheless, child sexual abuse does occur and,
accord-
ing to Townsend and Rheingold (2013), about one in 10
children will
be sexually abused before the age of 18. Although systematic
chal-
lenges continue to limit the possibility of accurately quantifying
the
occurrence of child sexual abuse, individuals continue to be
impacted
by the consequences of this behavior.
59
Griffiths et al. Child Welfare

Investigating disparities in child maltreatment is important.
Dispari-
ties in foster care have been well documented when it comes to
race
(Derezotes, Poertner, & Testa, 2004; Font, 2013; Putnam-
Hornstein,
Needell, King, & Johnson-Motoyama, 2013; Summers, 2015;
Wells,
2011); however, regional location may also matter. Specifically,
do the
distinct differences of living in a rural community provide
valuable
insight when compared with the life experiences of living in an
urban
area? Although one may posit that both rural and urban areas
can be
fraught with common risk factors of abuse (e.g. family
stressors, men-
tal health problems, alcohol dependency, history of family
violence),
the Carsey Institute Report (Walsh & Mattingly, 2012)
identified
important substantiation differences emerging between rural and
urban areas in the United States. Higher income children (that
is, in
families with incomes greater than 200 percent of the federal
poverty
level) in rural areas are significantly more likely to have a
report sub-
stantiated than they are in urban places. Older children in rural
places
are more likely to have a report substantiated (35%) than those
in
urban areas (23%) (Walsh & Mattingly, 2012). Children in rural
areas

whose caregivers are either experiencing active domestic
violence or
have cognitive impairments are more likely to have a case
substantiated
than similar urban children (Walsh & Mattingly, 2012).
Child sexual abuse remains a problem in society, often resulting
in
the long-term placement of children in the foster care system.
The crit-
ical examination of the child’s demographic and environmental
charac-
teristics may provide insight into understanding what predicts
longer
placements in foster care for children who have experienced
sexual
abuse, and if any factors can help to predict a timely discharge
from
care. This study will specifically focus on exploring these
variables in
Kentucky, as this state’s regional differences may help to
further iden-
tify any prevailing concerns for consideration related to this
challenge.
Child Sexual Abuse in Kentucky
Kentucky Revised Statute (KRS) 600.020 defines a child as
being
maltreated when “his or her parent, guardian, person in a
position of
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authority or special trust, as defined in KRS 532.045, or other
person
exercising custodial control or supervision of the
child…commits or
allows to be committed an act of sexual abuse, sexual
exploitation, or
prostitution upon the child; creates or allows to be created a
risk that
an act of sexual abuse, sexual exploitation, or prostitution will
be com-
mitted upon the child” (KRS 600.020 (1)(a)(5-6)). There are
several
terms inherent in this definition that warrant further
explanation.
Child sexual abuse “includes but is not necessarily limited to
any con-
tacts or interactions in which the parent, guardian, person in a
position
of authority or special trust…uses or allows, permits, or
encourages the
use of the child for the purposes of the sexual stimulation of the
per-
petrator or another person” (KRS 600.020 (58)). Sexual
exploitation
“includes but is not limited to a situation in which a parent,
guardian,
person in a position of authority or special trust…allows,
permits, or
encourages the child to engage in an act of obscene or
pornographic
photographing, filming, or depicting of a child as provided for
under

Kentucky law” (KRS 600.020 (59)).
Child sexual abuse is unique, often eliciting a visceral public
response. The specifics of such an act, complicated by the
perception
of a trusted caretaker willingly taking the innocence of an
underage
victim, generally create an overwhelmingly adverse community
reac-
tion. However, it continues to happen. There were 22,269
children
maltreated in FFY 2014 with 3.9% being victims of sexual
abuse in the
state of Kentucky during FFY 2014 (U.S. Department of Health
and
Human Services, 2016).
Foster Care in the United States
Foster care is temporary, a step in the process of achieving
permanency
for children who have experienced maltreatment. In FFY 2014,
there
were 415,129 children in foster care in the United States (Child
Welfare
Information Gateway, 2016), with 7,506 children specifically
from the
state of Kentucky (Annie E. Casey Foundation, 2016).
Conditions
influencing high levels of foster care placement speak to the
current
61

climate of poverty, inequality, and social injustice in America.
Macro-
level challenges faced by social systems, such as child welfare,
perpetuate
family violence and delinquent behavior, resulting in broken
families
and communities (Agnew, Matthews, Bucher, Welcher, &
Keyes,
2008; Snyder & Merritt, 2014). When placed in out-of-home
care,
families are obligated to work with protective service agencies
to iden-
tify the prevailing high-risk behaviors and develop a plan to
minimize
the potential for reoccurrence.
A prominent federal law guiding child welfare practice is the
Adoption and Safe Families Act (ASFA) of 1997 (P.L. § 105-
89).
ASFA directs the development of the child’s permanency plan,
contin-
gent upon timelines and the safety of the child. According to
ASFA,
the five options for permanency are: return to parent, adoption,
referral
for legal guardianship, permanent placement with a fit and
willing rel-
ative, and other planned permanent living arrangement. This
federal
law was enacted to implement a consistent system of oversight
to expe-
dite permanency and keep children from becoming “lost” in the

system.
When children are placed in foster care, the initial goal is return
to
parent (reunification). However, ASFA allows the agency to
request to
change the child’s permanency goal after placement in foster
care for
15 of 22 months or through the uncommon finding of
“reasonable
efforts” before meeting this timeframe. For example, if a child
was
placed in foster care due to child sexual abuse, the agency is
mandated
to work to reunify the family. After 15 months, the agency can
petition
the court to change the child’s formal permanency goal to
adoption. If
this formal request is granted, the agency can now move toward
termi-
nating parental rights, which opens new avenues for the child’s
perma-
nency. With the clear and unquestionable ramifications of not
making
expedient progress to reunify the family, ASFA guides practice
and
shapes the social landscape of this country. States receiving
Title IV-E
funds are obligated to comply with federal guidelines largely
due to
ASFA. Federal oversight creates a culture of compliance,
influencing
procedures and policies when agencies work with families and
children.
Given this reality, compliance with continuous federal
evaluation is a

62
Child Welfare
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Figure 1. Conceptual framework
driving force behind service delivery and agency program
implementa-
tion. Acknowledging the varying interests and the critical
importance
of children staying in foster care, it is valuable to understand
any factors
that may contribute to a child’s stay in foster care.
Conceptual Framework
Research has identified factors influencing foster child
outcomes for
decades. However, differences in research purpose may create a
chal-
lenge when attempting to generalize the findings. It is suspected
that a
number of variables may influence the outcomes of children in
foster
care, including child demographic characteristics, permanency
charac-
teristics, and environmental characteristics (McDonald,
Poertner, &
Jennings, 2007; Akin, 2011; Snowden, Leon, & Sieracki, 2008;
Sinclair

& Wilson, 2003; Smith, Stormshak, Chamberlain, & Whaley,
2001).
Few studies have specifically examined factors leading to
children who
have experienced sexual abuse resulting in longer placements in
the
foster care system. If one can better understand the factors that
predict
63
discharge from foster care for this unique population, one can
inform
practice and policy reducing time in placement for these
children. As
a result of the wide range of focus in the literature, this study
exam-
ined the impact of the child’s demographic characteristics,
permanency
characteristics, and environmental characteristics on length of
stay in
foster care for children who have experienced sexual abuse in
the state
of Kentucky in the FFY 2013 (see Figure 1).
Child’s Demographic Characteristics
Age matters, as the older a child gets the less likely they are to
exit to
any type of permanency (Barth, 1997). In a longitudinal study,

Connell,
Vanderploeg, and colleagues (2006) found that a child’s age
was the
primary characteristic associated with risk in placement change,
as the
older a child gets the more likely they were found to have a
change in
placement. Furthermore, a common finding is that as a child’s
age
increases, their probability of being adopted significantly
decreases
(Snowden, Leon, & Sieracki, 2008; Connell, Katz, Saunders, &
Tebes,
2006). Age as a risk factor in increasing days in care is an
important
variable to consider with this population.
Race and ethnicity are critically important factors, especially
related to the experience of minority populations in foster care.
Becker, Jordan, and Larsen (2007) found that non-white
children
were less likely to exit foster care successfully than white
children.
Also, Barth (1997) found that the reunification of African
American
children was less likely than that of White or Latino children.
Further,
African American children were found to be less than half as
likely to
achieve permanency as a White child (Kemp & Bodonyi, 2002).
When considering the specific permanency option of adoption,
African American children were found to be notably less likely
to be
adopted than Latino or White children (Barth, 1997).
The impact of a child’s sex does not appear to be as clearly
under-

stood. When studying factors associated with the speed of
reunification,
Fernandez and Lee (2011) found no difference when considering
the
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Child Welfare
Vol. 95, No. 1
child’s sex. In a six-year study with 3,873 children, Barth
(1997) found
no sex based effects when examining the likelihood of a child
being
adopted or remaining in long term care. Also, Becker, Jordan,
and
Larsen (2007) did not find sex as a significant predictor when
exploring
variables that contribute to a successful exit from foster care.
On the
contrary, Kemp and Bodonyi (2002) found boys to be 32% less
likely to
achieve permanency than girls. Harris and Courtney (2003) also
found
that boys were significantly less likely than girls to achieve
reunification.
Permanency Characteristics
Permanency characteristics have long been posited to influence
the

experience and the outcome of children in foster care.
Specifically relat-
ed to child sexual abuse, Connell, Katz, Saunders, and Tebes
(2006) uti-
lized a longitudinal study and found that children who were
placed in
foster care for child sexual abuse had a consistent delay in
establishing
permanency. Additionally, Nalavany, Ryan, Howard, and Smith
(2008)
found that children with pre-adoptive histories of sexual abuse
were at a
greater risk of difficulties related to permanency (adoption
disruptions,
inconsistent parental commitment, moves while in care).
Regardless of
the child’s permanency outcome, individual level difficulties
may be
apparent for children who have been placed in foster care for
child sex-
ual abuse. For example, Yampolskaya , Armstrong, and McNeish
(2011)
studied risk factors for foster children in Florida and found a
significant
association between being placed in care for sexual abuse and
involve-
ment with the juvenile justice system.
Environmental Characteristics
Environmental characteristics, such as geographic location,
remain an
important consideration in child welfare literature. However,
the impact of
one’s geographic location has been conflicting. In their study,
Glisson and

colleagues (2000) found that children residing in urban areas of
Tennessee
were 50% more likely to be discharged from the system than
those
65
children residing in rural counties. On the other hand, Becker
and col-
leagues (2007), found that rurality may serve as a protective
factor. Given
the importance of a child’s environment on outcomes and the
uncer-
tainty of its impact, it is an important factor to consider in any
model.
It is understood that children who have been sexually abused
repre-
sent a unique population with specific challenges and critical
needs.
Yet, previous research focuses on the child’s reason for removal
as an
independent and predictive variable, rather than as population
for the
sample. There are a number of studies that examine the effects
of child
sexual abuse on future adjustment (e.g., depression, sexual
abusing own
children, etc.). However, no studies were located that explicitly
exam-

ined children who were placed in foster care by the court due to
child
sexual abuse and the impact on foster care outcomes (i.e.,
discharge).
Method
Procedure
This exploratory study utilized secondary data, Adoption and
Foster
Care Analysis and Reporting System (AFCARS), obtained from
the
National Data Archive on Child Abuse and Neglect (NDACAN).
AFCARS is a federally mandated reporting system that requires
each
state to electronically submit semi-annual data for the purposes
of pol-
icy development and state foster care and adoption analysis. It
contains
case specific information on children who are covered by the
protection
of the Social Security Act (Title IV-B/E). This study was
reviewed and
approved by the University’s Institutional Review Board (IRB).
Data were taken from the 2013 AFCARS Foster Care file, which
was
composed of all children in foster care in the United States in
the fed-
eral fiscal year (FFY) of 2013 (October 1, 2012 through
September 30,
2013). Data were downloaded into the Statistical Package for
the
Social Sciences (SPSS), Version 23. In order to address the
aforemen-

tioned research question, only child sexual abuse cases in the
state of
Kentucky were selected for inclusion in this study.
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Child Welfare
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Measures
Outcome Variable
The outcome variable in this study was whether a child had
been dis-
charged from foster care at the end of the FFY 2013. This was
deter-
mined using the “Discharge Reason” variable in the AFCARS
dataset.
Ultimately, this variable was recoded using a dichotomous
coding
structure (i.e., 0 = not discharged; 1 = discharged).
Predictor Variables
Predictor variables fell into two main categories: (a) child
demographic
characteristics; and (b) environmental characteristics.
Demographic
characteristics included the child’s sex, race/ethnicity, and age.
Child’s
sex was recoded into a dummy variable (1 = female) where

males
served as the reference category. Child’s race/ethnicity was
recoded
into a dummy variable (1 = non-minority) where minority
served as
the reference category (see Table 1 for included groups).
Child’s age
was a continuous variable and represented the child’s age on the
first
day of the FFY 2013. Number of placement settings was also a
con-
tinuous variable representing the number of placement settings
during
the current foster care episode.
Environmental characteristics included the rural/urban
continuum
code. The rural/urban continuum code was an ordinal variable
ranging
from 1 (Metro) to 9 (Rural); therefore, higher scores would be
indica-
tive of more rural settings.
Analysis
Data were downloaded into the SPSS, Version 23. Descriptive
statis-
tics were conducted to describe the sample included in this
analysis.
Then, a binary logistic regression was conducted in order to
determine
the probability of discharge for children who experienced
sexual abuse
in the state of Kentucky during FFY 2013.
67

Results
Sample Characteristics
There were 430 children who entered foster care as a result of
sexual
abuse in the state of Kentucky during the FFY 2013. Of the 430
chil-
dren included in this analysis, a majority (67.7%) were female
(n = 291)
and Caucasian (77.0%, n = 331). The child’s age on the first day
of the
FFY 2013 ranged from 0 to 18, with an average of 10.6 (SD =
4.8).
Number of placement settings for children in foster care as a
result of
child sexual abuse ranged from 1 to 24, with an average of 2.9
(SD= 3.2)
(see Table 1). With regard to rurality, almost half (49.7%)
resided in
metro areas (n = 214), 34.0% resided in non-metro areas (n =
146), and
16.3% resided in rural areas (n = 70) (see Table 1).
Logistic Regression
A binary logistic regression was conducted in order to
determine the
likelihood of a child being discharged from foster care within

FFY
2013. Block 0 reported that 158 (36.7%) children had been
discharged
and 272 (63.3%) were still in foster care at the end of FFY 2013
in
Kentucky. The initial -2 Log Likelihood score was 565.519 and
the
overall percentage correctly classified was 63.3%. Adding the
predic-
tors (i.e., sex, race, age, number of placements, rural/urban
continuum)
produced a lower -2 Log Likelihood of 531.536 and the
Omnibus Chi-
Square score represented a statistically significant difference
between
Block 0 and Block 1 (X
2
= 33.983, p < .001). Further, the Hosmer and
Lemeshow test indicated a goodness of fit between the predictor
vari-
ables and the dependent variable (X
2
= 12.153, p = .145).
Overall, results indicated that there were four statistically
significant
predictors of discharge from foster care (i.e., race, age,
rural/urban con-
tinuum, number of placements). Sex was the only predictor that
was
not a statistically significant predictor of discharge. Results
indicated
that Caucasian children were about half as likely to be

discharged from
foster care than non-white children (OR = 0.544, p = .015). For
every
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Child Welfare
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Table 1. Sample Characteristics
Variable f (%) Range M
(SD)
Child Characteristics:
Sex
Male 139 (32.3)
Female 291 (67.7)
Race/Ethnicity
Non-Hispanic (NH) White 331 (77.0)
NH Black 43 (10.0)
NH American Indian/Alaskan Native 1 (0.2)
NH Hawaiian/Other Pacific Islander 1 (0.2)

NH More than One Race 13 (3.0)
Hispanic 34 (7.9)
Race/Ethnicity Unknown 7 (1.6)
Child Age
On First Day of FFY 2013 0–18 10.6 (4.8)
Number of placement settings 1–24 2.9 (3.2)
Environmental Characteristics:
Rural/Urban Continuum Code
Metro: > 1 million population 109 (25.3)
Metro: 250K – 1 million population 50 (11.6)
Metro: < 250 K population 55 (12.8)
NonMetro: Urban > 20K pop; Adjacent 14 (3.3)
NonMetro: Urban > 20K pop; Non-adjacent 13 (3.0)
NonMetro: Urban 2.5K – 20K; Adjacent 63 (14.7)
NonMetro: Urban 2.5K – 20K; Non-adjacent 56 (13.0)
Rural or < 2.5K population; Adjacent 24 (5.6)
Rural or < 2.5K population; Non-adjacent 46 (10.7)
Outcome Variable: Discharge

Discharge Reason
Not applicable (i.e., discharged) 272 (63.3)
Reunified with parent, primary caretaker 68 (15.8)
Living with other relative(s) 37 (8.6)
Adoption 18 (4.2)
Emancipation 32 (7.4)
Guardianship 1 (0.2)
Transfer to another agency 2 (0.5)
69
Table 2. Regression Coefficients for Predictors of Probability
of
Discharge (N = 430)
Predictor B Wald Odds Ratio p-value
Constant -1.033 8.257 0.356 .004**
Female -0.078 0.122 0.925 .727
White -0.609 5.861 0.544 .015*

Age 0.049 4.729 1.050 .030*
Rural/Urban Continuum 0.167 18.917 1.182 .000***
Number of Placements -0.102 5.972 0.903 .015*
* p < .05, ** p < .01, *** p < .001
Discussion
The impact of child abuse and neglect are not only debili tating
to the
victims and their families, but also society. Although the
economic
costs associated with child abuse and neglect are substantial, it
is
essential to recognize that it is impossible to calculate the
impact of
the pain, suffering, and reduced quality of life that victims of
child
abuse and neglect experience. Children in Kentucky’s foster
care sys-
tem for sexual abuse spent more time in foster care when
compared to
1-year increase in a child’s age, they were slightly more likely
to be dis-
charged from foster care (OR = 1.050, p = .030). There was an
inverse
relationship between number of placements and probability of
dis-
charge from foster care. As the child’s number of placements
increased, his or her odds of being discharged from foster ca re
decreased (OR = 0.903, p = .015). Lastly, for every one-unit
increase on
the rural/urban continuum (i.e., more rural), children were 1.182

times
more likely to be discharged from foster care (OR = 1.182, p <
.001).
Thus, children in the most rural areas of the state were more
than 10
times more likely to be discharged from foster care than those
children
in the most urban areas of the state.
70
Child Welfare
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children removed for any other reason. Children in foster care
for child
sexual abuse were in care for an average of 573.82 days
compared to an
average of 494.44 days for any other type of maltreatment ( F =
1.608,
p = .004). Seeking insight into areas to improve the foster care
system
and its relationship with the young lives depending on it, it is
impor-
tant to explore any variables that may help us to better
understand
what contributes to a longer stay in foster care and what helps
children
achieve permanency.
The overarching goal of this study sought to unravel this
complex

situation and explore the experiences of Kentucky children
placed in
foster care for child sexual abuse. This study supports the
argument
that rurality may in fact be a protective factor, as indicated by
Becker
and colleagues (2007). This is an interesting finding in that
most rural
areas offer few services and have fewer resources for families.
In fact,
Belanger and Stone (2008) found that rural areas have reduced
service
availability and accessibility, which negatively impacted
outcomes for
children and families involved with the child welfare system.
Interestingly, both race and age exhibited contradictory results
compared to the literature. There is a plethora of literature that
reports
that Caucasian children are more likely to exit care than
minority chil-
dren (Barth, 1997; Kemp & Bodonyi, 2002; Becker, Jordan, &
Larsen,
2007); however, this study suggested that Caucasian children
were less
likely to exit care compared to minority children. This may have
been
a result of the unequal sample size with respect to race. The
majority
of the sample were Caucasian (n = 331, 77.0%), which may
have
impacted the results. With regard to age, literature suggests that
as
children get older, they are less likely to be discharged from
care
(Barth, 1997; Connell, Katz, Sanders, & Tebes, 2006; Snowden,

Leon, & Sieracki, 2008); however, this study suggested the
opposite.
This may be due to the cross-sectional nature of this study and
the
fact that this study was looking at a snapshot of children in care
dur-
ing FFY 2013. Thus, both race and age results should be
interpreted
with caution.
71
Limitations
A primary limitation in utilizing secondary data is the
possibility of
inconsistencies in the methods used for data collection,
reliability
issues, and missing data. Administrative data may not
effectively facil-
itate the evaluation of the research question, as the researcher
has no
control over the questions asked. Additionally, an important
consider-
ation when evaluating the applicability of the findings is that
the data
is cross-sectional, and although the child may have left foster
care
there is no way to tell if their return/exit was successful as they
may

have had been placed back into foster care. Future research
should
focus on examining whether the child’s discharge from foster
care was
permanent and successful. A longitudinal study would fortify
the find-
ings from this study, as re-entry is always a risk and a reality.
Finally,
to get a comprehensive grasp of the rural and urban aspect to
this
study, it would help if each child’s county of residence was
identified.
Implications for Research and Practice
Children in Kentucky’s foster care system as a result of sexual
abuse are
more likely to exit care if they reside in more rural areas. Given
this
stark reality, future consideration should be given to exploring
why this
occurs and exploring the need for any potential avenues for
systematic
improvement in metropolitan areas. For example, Kentucky’s
court
approved and preferred gold standard of treatment for
perpetrators of child
sexual abuse providers (i.e., Sex Offender Risk Assessment
Advisory
Board) are almost exclusively located in the state’s most urban
areas,
are very expensive, and are prohibitively lengthy. In practice,
frontline
social workers see this as a significant barrier when developing
treat-
ment plans with those living and working in Kentucky’s rural

areas.
However, the findings of this study suggest that this logistical
concern
may be irrelevant. Or is it? Are kids leaving care sooner in rural
Kentucky because the system has no services to offer? Future
research
should evaluate the success and participation rates of such
specialized
72
Child Welfare
Vol. 95, No. 1
programs, and determine whether their completion actually
results in
any difference related to a child’s permanency. If not, there may
be pro-
found implications related to child welfare policy and practice.
Considering the evident differences, are there strengths to be
iden-
tified when examining the child welfare system in Kentucky’s
most
rural areas? Or, are the findings more about the prevailing
issues in
Kentucky’s metropolitan areas? The child welfare system in
Kentucky
functions quite differently in its two metropolitan areas (i.e.,
Louisville
and Lexington). Specifically, the court systems are unique and
the child

welfare workforces in these locations are highly specialized. In
rural
Kentucky, workers are primarily “generalist” and operate within
a
smaller court system with familiar and local faces. Does the
“rurality” of
professional social work practice make a difference? Of
additional con-
sideration, Kentucky suffers from the national problem of high
child
welfare worker turnover. Worker turnover deeply affects
families and
communities by hindering the timeliness and effectiveness of
services
(GAO, 2003). Future efforts should investigate the current
climate of
employee retention in Kentucky and its empirical relationship to
serv-
ice outcomes for foster children in different areas of the state.
The findings of this study highlight the need for a better under -
standing of how location impacts length of stay for children
who expe-
rienced sexual abuse. Future research must examine whether the
results
speak to the necessity of systematic improvement in urban areas
or if
they are illustrating a unique strength found in rural areas. For
exam-
ple, in 2013, Kentucky terminated a majority of the Kinship
Care
Program, which was in place to provide financial support for
relatives
taking legal custody of children and eliminating the need for
placement
in state foster care. Has this financially driven policy change

hindered
relative placement as the primary option for discharging
children from
the state foster care system? In the end, children who have been
sexu-
ally abused are in need of thorough and consistent services and
any
effort made into achieving their safety and stability should be a
primary
duty of this country. Any efforts made to identify avenues for
improve-
ment are worth the time and energy, as children’s lives depend
on it.
73
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Child Welfare
Vol. 95, No. 1
Reproduced with permission of copyright owner. Further
reproduction prohibited without permission.
Bureaucratic Neglect and Oppression in Child Welfare:
Historical
Precedent and Implications for Current Practice
Jessica L. Yang1 • Debora Ortega1
Published online: 9 May 2016
� Springer Science+Business Media New York 2016

Abstract Historically, child maltreatment has been seen as
an issue warranting the involvement of the American
government. However, over time, the definition of child
maltreatment has changed; typically, maltreatment is often
understood as a violation of the parental right to care for
and protect a child. Consequently, the government, through
systems such as child protective services is expected to be
the acceptable parental alternative. As illustrated by the
numerous negative outcomes experienced, it is clear that
the system is not meeting the needs of abused and
neglected children. This bureaucratic neglect is allowed to
occur because of population primarily served by the child
welfare system, the poor and families of color. In this way,
dynamics of power and privilege manifest in the differing
expectations of appropriate care between biological parents
and the foster care system.
Keywords Child welfare � System � Bureaucratic neglect
Introduction

The American child welfare system was created to protect
children from abuse and neglect at the hands of their bio-
logical parents or guardians. In some instances, it is
deemed necessary to remove children from the care of their
biological parents in order to protect them. In America, the
foster care system serves nearly 400,000 children per year,
with over 50% either returning home to live with their
biological parents (US Department of Health and Human
Services, 2015). However, for many of the children that do
enter foster care, the experience will be less than positive
both while in care, and after. The literature is quite clear
that they are substantially more likely to experience abuse
and neglect while in care. Additionally, they are likely to
experience negative outcomes related to overall function-
ing including, education, health (mental and physical), and
wellbeing (Barber & Delfabbro, 2003; Courtney et al.,
2007; Herrenkohl, Herrenkohl, & Egolf, 2003; Jonson-Reid
& Barth, 2000; Kools, 1997; Perry, 2006; Stott, 2012;

Vacca, 2008). There is an apparent disconnect in these
findings, why is it that in a system designed to protect
children from harm, youth are continuing to experience
maltreatment and negative outcomes?
This paper explores the bureaucratic policies and
behaviors that perpetuate neglect and abuse in the lives of
children for who the system is the legal guardian, as well
differential expectations about appropriate parenting
behavior between biological parents and the foster care
system (as the legally designated parent). Additionally, this
paper will explore issues related to the oppression of bio-
logical families and children by the foster care system
based on their status of class and race. Finally, we conclude
with a discussion of strategies to ameliorate bureaucratic
neglect and oppression for these children and their families.
Parenthood and Discipline: Rights
and Responsibilities of Biological Parents
Parental Rights and Parenthood
Throughout history, parents have had the freedom to raise

their child in any manner they choose, so long as it does not
& Jessica L. Yang
[email protected]
1
Graduate School of Social Work, University of Denver,
2148 S. High Street, Denver, CO 80208, USA
123
Child Adolesc Soc Work J (2016) 33:513–521
DOI 10.1007/s10560-016-0446-4
http://crossmark.crossref.org/dialog/?doi=10.1007/s10560-016-
0446-4&domain=pdf
http://crossmark.crossref.org/dialog/?doi=10.1007/s10560-016-
0446-4&domain=pdf
violate the norms of society. This freedom, often referred
to as parental rights, has been echoed throughout a variety
of cultures and societies around the world (Huntington,
2006). In ancient Greece, for example, fathers had such
extensive and exclusive parental rights; they had the power
to decide if their child was allowed to live (Huntington,
2006). While this example pushes the idea of parental

rights to the extreme, it serves to illustrate the relative
freedom afforded to parents with regard to child rearing
relative to their culture.
In the context of American society, parental rights,
while vast, are limited in that a parent may not abuse or
neglect their child. Abuse and neglect is defined by societal
expectations regarding parental and child behavior, and is
therefore susceptible to change and determined by state
level statutes. However, the Child Welfare League of
America (CWLA) generally defines neglect as the ‘‘failure
of parents or other caregiver, for reasons not solely due to
poverty, to provide the child with needed, age-appropriate
care, including food, clothing, shelter, protection from
harm, supervision appropriate to the child’s development,
hygiene, education, and medical care (Child Welfare
League of America, n.d.).’’ The factors influencing that
definition are culturally and contextually bound, and inti -
mately tied to the concept of parental rights. In American

culture, factors influencing the spectrum parental rights, in
the normative sense, are factors generated from biological,
ethical, and religious influences (Hill, 1991; Huntington,
2006; Schoeman, 1980).
For many, the largest influencer of what constitutes
parenthood is biology (Hill, 1991). Biological parents, until
the invention of artificial insemination, were exclusively
responsible for the creation of their children. From a bio-
logical perspective, once a child is born, it is logical that a
parent would seek to ensure all of their child’s needs are
met. In mainstream America, typically it is the responsi-
bility of the parent to determine the needs of their child,
and take actions to ensure that those needs are fulfilled.
However, the larger goal is to raise the child to become a
self-sufficient being, in a manner deemed appropriate by
the parent within the context of their society and culture.
This serves to create the greatest possibility that the child
will grow up to become a healthy reproductive adult and

ensures the continuation of the human race (Hill, 1991).
This fundamental, biologically, and culturally rooted con-
struct of parenting helps to understand the deeply entren-
ched notion that parents should have the freedom to raise
their children with little interference from the outside world
and that this is their parental right (Schoeman, 1980).
In addition to the biological implications of parenthood
and parental rights, the familial relationship between the
parent and child generates a moral imperative in which the
parent is morally obligated to protect the interests of the
child until such time when their child is capable of doing so
themselves (Huntington, 2006). This relationship, in which
the parent cares for the child and the child grows and
matures, is rewarding and beneficial to both parents and
children (Schoeman, 1980). Furthermore, the notion that
parents are supposed to love, care for, and protect their
children is seen as a critical American societal obligation
(Schoeman, 1980).

In some religious cultures, the relationship between
parent and child is seen as a unique, sacred, and an intimate
relationship, and safe from outside interference (Schoe-
man, 1980). Yet, religious institutions frequently prescribe
methods of child rearing, including discipline, in order to
preserve these bonds, promote positive development, and
teach children social norms (Gershoff, Miller, & Holder,
1999; Hoffman, 1983).
In America, the use of religious teachings as a guide to
parenting is deeply entrenched, with roots extending back
before the Declaration of Independence (Gershoff et al.,
1999). Within Christianity, there are several distinct ide-
ologies about the relationship between the parent and the
child concerning discipline (Mahoney, Pargament,
Tarakeshwar, & Swank, 2008). Within Christianity and
Judaism, there are two core beliefs about parental rights
and discipline. On the one hand, some believe it is the role
of the parents to model God’s love for a child by

employing discipline strategies to promote obedience and
faith (Mahoney et al., 2008). However this is a relationship
to be maintained between the parent and the child only
involving religious leaders for spiritual guidance. Con-
versely, some followers of Christianity and Judaism
believe that it is the spiritual duty of the parents to exert
power and control over their children, including the use of
corporal punishment, as a way of ensuring proper social
and spiritual development (Gershoff et al., 1999; Mahoney
et al., 2008). Interestingly, many Christian denominations
do not expressly oppose the use of corporal punishment,
however they believe parents should only discipline chil -
dren in this manner when the parent is calm, and the dis-
cipline is purposeful (Mahoney et al., 2008). Given that
discipline is more likely to cross into the realm of physical
abuse when an angry parent (Vasta, 1982) delivers pun-
ishment, this prescription may be a subtle attempt at dis-
tinguishing between the parental right to discipline and the

safety of the child. However, Mahoney et al. (2008) sug-
gest that the phenomenon is much more complex. They
suggest that the propensity of Christian parents to use
corporal punishment with their children may be a function
of the teachings of their particular denomination in com-
bination with how deeply religious the parents are. Fur-
thermore, the number of behaviors that parents deem
worthy of such punishment is also dictated by religious
beliefs and the degree to which they accept these teachings
514 J. L. Yang, D. Ortega
123
(Gershoff et al., 1999). Regardless of the specific ideology
and affinity for corporal punishment, it is clear that a
parent’s religion is a deeply influential factor in the deci -
sion of how and why to discipline a child, but ultimately
that relationship remains sacred and exclusively between
the parent, the child, and their higher power.

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