Increase Seen in Subsequent Maltreatment in Children With Disabilities After an Unsubstantiated Report for Neglect

Caroline J. Kistin, M.D., M.Sc., of Boston Medical Center, and colleagues examined the incidence and timing of re-referral to child protective services, substantiated maltreatment, and foster care placement for any type of maltreatment after an initial unsubstantiated referral for neglect for children with and without disabilities. The study appears in the January 5 issue of JAMA.
 
According to background information in the article, children with disabilities are at increased risk for maltreatment, and neglect accounts for the majority of such cases. Although most cases of suspected neglect are unsubstantiated at the time of the initial report to child protective services (CPS), meaning there is insufficient legal evidence of maltreatment, these children are at risk for subsequent maltreatment.
 
For this study, the researchers analyzed data from the National Child Abuse and Neglect Data System, which collects data annually on all children reported to state-level CPS agencies in the 50 states, the District of Columbia, and Puerto Rico. Children were included if they had first-time unsubstantiated referrals for neglect in 2008; they were followed up for 4 years.
 
A total of 489,176 children from 33 states, Puerto Rico, and the District of Columbia were included (12,610 children with disabilities and 476,566 children without disabilities). Children with vs without disabilities were more likely to be re-referred (45 percent vs 36 percent, respectively; adjusted risk difference [ARD], 14 percent), experience substantiated maltreatment (16 percent vs 10 percent; ARD, 9 percent), and be placed in foster care (7 percent vs 3 percent; ARD, 4 percent). The median time to each outcome was shorter for children with disabilities.
 
“Our findings highlight the significant incidence of maltreatment experienced by children with unsubstantiated referrals for neglect, particularly children with disabilities. Such children may benefit from targeted interventions to prevent subsequent maltreatment,” the authors write.
 
doi:10.1001/jama.2015.12912;