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We conducted systematic review and content analysis of measurement strategies related to child exposure to intimate partner violence (IPV). We searched nine electronic databases and supplementary sources for studies published between January 1984 and March 2016. Eligible studies were those that described a measurement strategy that was administered to children between, but not limited to, age 0 and 17, or administered to individuals who could report on youth of this age range. Measures were examined against a taxonomy of IPV exposure (direct involvement, direct eyewitness, and indirect exposure) and the four subtypes of IPV (sexual violence, physical violence, stalking, and psychological aggression). Twenty-eight measures met criteria for inclusion in the review; 18 measures were original, and 10 were modifications of the Conflict Tactics Scales. The majority of measures were published after 2008, demonstrating the considerable progress made in developing and substantially modifying measures over the last decade. Nonetheless, findings suggest important discrepancies in measurement strategies used in research efforts. Relatively few measures assess children's direct involvement in IPV, exposure to coercive control, and sexual violence. No measures found in our review examined children's exposure to stalking. The implications of these findings for research are discussed.

This study examined predictors of child maltreatment re-reports and recurrence (substantiated re-reports) using two nationally representative data sets: the National Survey of Child and Adolescent Well-Being (NSCAW II) and the National Child Abuse and Neglect Data System (NCANDS). Maltreatment data from the survey and administrative data sources were merged for children who participated in NSCAW II and had an NCANDS record. Re-report and recurrence data were examined among the sample of 4715 with an NCANDS record and a subsample of 1873 who received a caseworker interview at the NSCAW II 18-months' follow-up because the child was in out-of-home care and/or the family had been involved with child welfare services since the baseline interview. Many of the regression and hazard estimates of the predictors of re-report and recurrence differed across the two samples due to endogenous selection bias that arises from conditioning on the "collider" variable of caseworker interviews which is itself partially an outcome of re-report and recurrence. Similar estimates, on the other hand, were obtained: Children with prior involvement with child protective services were more likely to have re-reports and recurrence than children without prior involvement. Children that the child welfare agency reported as receiving services at the time of investigation were also less likely to have re-reports and recurrence when compared with children not receiving services. The threats to the validity of inferences that are drawn from statistical models and samples that condition on collider variables are reviewed, and the use of administrative data to supplement survey information that is unavailable from caseworkers are discussed.

This study compared child-level estimates of child maltreatment re-report and recurrence in two national sets of data on child maltreatment: state administrative data submitted to the National Child Abuse and Neglect Data System (NCANDS) and caseworker interviews from the National Survey of Child and Adolescent Well-Being (NSCAW). Maltreatment data from NCANDS and NSCAW were merged for 2230 children that had intersecting information from both sets. The percentage of child cases with at least one re-report of abuse or neglect over the study period differed depending on the data set. The NCANDS re-report estimate was 32.3% (95% CI 26.5%, 38.6%) whereas the estimate based on NSCAW caseworker interviews was 22.9% (95% CI 17.6%, 29.2%). More than a quarter of the children with observations from the union of the two data sets had a re-report identified by one source but not the other (set difference). Most often, the set difference in re-reports appeared in NCANDS, but was not reported by an NSCAW caseworker. When the set difference from NCANDS was added to the re-reports by NSCAW caseworkers, the resulting union of re-reports increased the point estimate in the NSCAW-NCANDS intersection to 40.9% (95% CI 34.3%, 47.8%). Restricting the comparisons to only substantiated re-reports (recurrence) narrowed the differences in absolute terms but the set difference in recurrence rates was proportionally similar. Potential explanations for non-intersecting re-reports and recurrence between the two data sets were examined. FINDINGS illuminate methodological challenges that may arise when child maltreatment re-report and recurrence data from administrative and survey sources are merged, and the value of the union of state-level administrative data with national survey data for studies of safety and well-being of children reported for maltreatment.

Infants and young children reported for maltreatment are a particularly vulnerable population. Many of these young children are maltreated by their own mothers. A mother’s description of her infant’s temperament can inform researchers’, practitioners’, and policy makers’ understanding of the relational problems between the mother and her young child and thereby sharpen the focus of intervention and treatment programs. We examine maternal perception of infants’ temperament, using data from the National Survey of Child and Adolescent Well-Being. The sample consisted of 1,001 biological mothers of children aged birth to 23 months and investigated for child maltreatment. About a fifth of the sample reported that for more than half the time their infants or toddlers were crying or upset and were difficult to soothe or calm. During the average day, about 40% of infants or toddlers were reportedly fussy and irritable half the time or longer. The most negative infant behaviors were consistently reported by 13.6% of the mothers. In multivariate analyses, variables significantly associated with the mother’s perception of difficult temperament were physical victimization by an intimate partner and the mother’s own childhood history of abuse and neglect. Knowledge about mothers’ perceptions of difficult temperament and about predictors of these perceptions can help identify mother-child dyads in need of dyadic-psychotherapy and domestic violence interventions, which can help heal the mother-child relationship and restore the capacity for mutual joy and protection of the child well-being.

This study examines depression among caregivers of young children involved in investigations of child maltreatment, in terms of 12-month prevalence of depression across 5 to 6 years. Data were from the National Survey of Child and Adolescent Well-Being, a national probability study of 5,501 children investigated for maltreatment. The study sample comprised 1,244 female caregivers (95.5% biological mothers) of children not placed out of home and younger than 5 years old. About a quarter of caregivers had, at any given point, a score indicating major depression in the previous 12 months; across all follow-ups, 46% of caregivers had a score indicating major depression at some point. Depression was associated with caregivers’ report of intimate-partner violence and fair or poor health status. Caregivers of maltreated children are at substantial risk for depression that does not diminish over the course of 5 years. Assessing and providing assistance for intimate-partner violence and health problems may help decrease depression prevalence.

This study examines mental health and special education needs and service use at school entry among children involved in maltreatment investigations as infants. Data are from the National Survey of Child and Adolescent Well-Being, a national probability study of 5,501 children investigated for maltreatment. The study sample comprised 959 children who were infants at baseline and 5 to 6 years old at the last follow-up. Half had behavioral or cognitive needs at entry to school. About a quarter received outpatient mental health or special education services. Logistic regression showed that compared to children residing with biological parents, adopted and foster children were more likely to receive mental health services, and children adopted or in kinship care were more likely to receive educational services. Increased monitoring of behavioral and cognitive needs of infants reported for maltreatment may facilitate their access to services and ease the transition to school.

The most common service provided to parents involved with Child Protective Services (CPS) is parenting training. Nevertheless, most of the programs currently in use with CPS families lack empirical research documenting the effect of parenting training. Moreover, studies of these programs lack observational data with independent reports about changes in parent–child behaviors. Using a nationally representative sample of families investigated by CPS, the authors assessed whether parenting training was related to changes in parenting practices 18 months after training, controlling for maternal, child, and family characteristics. Mothers who received parenting services were compared with mothers who did not receive services even though they had a similar need for services as determined by Propensity Score Matching. This study found some modest benefits in maternal responsiveness and total parenting scores for mothers of 3- to 5-year-old children when these mothers received parenting services, as compared with mothers that did not receive parenting services. However, these findings could not be confirmed with multivariate analysis. These results parallel previous findings that parent training obtained through the Child Welfare System lacks the requisite features to significantly change parenting practices, and they highlight the need for cohesive, national, evidence-based effective parenting training for families involved with CPS.

Children are overrepresented in households with intimate-partner violence (IPV), and many suffer the double burden of being the subject of maltreatment and bearing the consequences of abuse to their mothers. Despite this situation, little information exists concerning parenting by women who have been abused by an intimate partner. We examine the relationship between women’s experiences with IPV and the quality of maternal parenting using data from the National Survey of Child and Adolescent Well-Being. The sample consisted of 1,943 female caregivers of children younger than 10 years investigated for child maltreatment. Women who had experienced IPV in the past but were no longer victims of IPV had significantly better parenting scores than women who were currently experiencing IPV, when other risk factors were controlled. This study adds to the evidence that IPV does not necessarily impair maternal parenting. Women abused by an intimate partner deserve a thorough assessment of what services they need: parenting services should be offered as warranted on a case-by-case evaluation of the particular woman’s parenting skills.

This study examines levels of developmental need in young children investigated by child protective services, estimates early intervention service use, and examines need and service use variations during the 5-6 years after investigation on the basis of maltreatment substantiation status. Data were from the National Survey of Child and Adolescent Well-Being, the first nationally representative study of children investigated for maltreatment. The sample comprised 1,845 children aged 0 to 36 months at baseline. Logistic regression with covariate adjustment was used to examine the relationship between having an Individualized Family Service Plan (IFSP; a proxy and marker of early intervention services through Part C of the Individuals With Disabilities Education Act) and substantiation status. A high prevalence of developmental problems was found among children with substantiated cases and children with unsubstantiated cases. Few children with developmental needs had an IFSP. Substantiation status and level of child welfare system involvement were significantly associated with having an IFSP.

This research examines whether women who have experienced intimate partner violence (IPV) during pregnancy have a higher child abuse potential than women who have not experienced IPV. Data were analyzed from a longitudinal investigation of IPV during pregnancy. This study recruited 88 pregnant women during prenatal care and followed them for 1½ years. IPV was assessed using the Conflict Tactics Scale 2 (CTS2). The woman's potential for child abuse was assessed using the Child Abuse Potential Inventory (CAPI). There was a significant positive association between IPV and child abuse potential scores ( p = .003), even after controlling for sociodemographics. The odds of having a high level of child abuse potential were 3 times greater for women who were victims of IPV compared to nonvictims. Higher child abuse potential scores of the victimized women resulted mainly from the Distress and Problems with Others CAPI scales.

This study examined the associations between intimate partner violence (IPV) and children's use of the emergency room (ER) for an illness or injury, and care of the child by a doctor or nurse for a serious injury, accident or poisoning. We hypothesized that a mother's mental health (depression, alcohol abuse and drug abuse) and a child's lack of supervision would mediate these associations. Data were from the National Survey of Children and Adolescent Well-Being (NSCAW), a national probability study of children investigated for abuse and neglect. The analysis was limited to 2929 female caregivers who were the biological, adoptive, or stepmothers of the children. Exposure of the mother to current severe intimate partner violence was positively associated with children's use of the ER. There was no association between maternal current or past exposure to IPV and children's injuries. Current moderate IPV, current severe IPV and past severe IPV were significantly and positively associated with maternal depression. Maternal depression was not associated with child's lack of supervision. However, maternal alcohol abuse and drug abuse were positively associated with child's lack of supervision. The relationship between IPV and children's use of the ER was mediated by maternal depression. Maternal depression and lack of supervision of the children were positively associated with children's injuries. Identification of maternal IPV and depression during children's ER visits can help guide services to prevent future use of the ER and injuries to children.

Despite the high prevalence of violence in the lives of women of reproductive age, and the adverse consequences posed to pregnant women suffering from PTSD, few studies have examined violence-related trauma and PTSD among pregnant women. A structured research interview was administered to a convenience sample of 85 prenatal care women to collect information regarding their experiences of violence victimization, PTSD symptoms related to violence-related traumatic events, and whether these symptoms impaired various aspects of the women's daily functioning. Results indicated that 69% of the women experienced a violent traumatic event, with the majority of events occurring before the current pregnancy and being perpetrated by the women's intimate partners. The traumatized women evidenced high levels of PTSD symptoms during pregnancy, with 58% of the women meeting criteria for a PTSD diagnosis. Moreover, many of the women with PTSD symptoms reported that the symptoms adversely affected aspects of their daily functioning.

This study aimed to determine if identification of intimate partner violence (IPV) has improved by caseworkers that investigate reports of child maltreatment and if mothers who are victims of IPV are more likely to report receipt of services. The study data were drawn from the two cohorts of the National Survey of Child and Adolescent Well-Being (NSCAW I and II), the first in 1999-2000 with a sample of 5,501 children reported for maltreatment and the second in 2008-2009 with a sample of 5,872 children reported for maltreatment. The analyses focused on IPV victimization of 3,625 mothers in NSCAW I and 3,351 mothers in NSCAW II whose children remained in home after the maltreatment investigation. Multiple group logistic regression was used to compare NSCAW I and II. A significant decrease in mother-reported IPV victimization (28.9-24.7%) was observed, representing a 15% decline. There were no significant changes in caseworker identification of history of domestic violence or active domestic violence. In both cohorts, substance abuse by the secondary caregiver was associated with a lower likelihood for the caseworker to miss a history of active domestic violence, while substantiation reduced the likelihood that the caseworker will miss active domestic violence. There were no changes in caseworkers' service referral, or service receipt among victims. The next decade of efforts to reduce IPV and child maltreatment should focus simultaneously on increasing caseworkers' ability to identify IPV and on funding needed services for families impacted by IPV and child maltreatment. Language: en

This study describes the extent of caregiver instability (defined as a new placement for 1 week or longer in a different household and/or with a new caregiver) in a nationally representative sample of infants, followed for 5-7 years. Data were drawn from the National Survey of Child and Adolescent Well-Being (NSCAW), a longitudinal study of 5,501 children investigated for child maltreatment. The analysis sample was restricted to 1,196 infants. Overall, 85.6% of children who were infants at the time of the index maltreatment experienced at least one caregiver instability event during their first 2 years of life. Caregiver instability was associated with the child having a chronic health condition and the caregiver being older than 40 years of age at baseline. The levels of instability reported in this study from infancy to school entry are extremely high. Children with more risk factors were significantly more likely to experience caregiver instability than children with fewer risk factors. The repeated loss of a young child's primary caregiver or unavailable, neglectful care can be experienced as traumatic. Some evidence-based programs that are designed to work with young maltreated children can make a substantial positive difference in the lives of vulnerable infants. Language: en

Substantiation can have an important effect on what interventions are pursued for children investigated for maltreatment, but researchers lack knowledge about how the decision to substantiate is made. Using information from 4,515 children from a national probability study of children investigated for maltreatment, this study examined how caseworker judgments of harm, risk, and evidence predicted substantiation. The substantiation rate was 29.9%, but the majority of cases were substantiated when caseworkers reported at least moderate harm, at least moderate risk, and/or probably to clearly sufficient evidence. Each judgment variable significantly predicted substantiation in a multivariable model, with evidence the strongest predictor. Child gender and age were significant predictors beyond harm, risk, and evidence, suggesting that other judgments also influence substantiation. In 9 of 100 cases, reports were not substantiated despite moderate to severe harm. Thus, substantiation is generally based on judgments of harm, risk, and evidence but not exclusively. The findings underline previous researchers' conclusions that substantiation is a flawed measure of child maltreatment and suggest that policy and practice related to substantiation are due for a fresh appraisal by state child welfare service agencies.

OBJECTIVE. The aim of this study was to determine levels of special health care need among children in the child welfare system and how these needs may affect children's functioning. METHODS. Data were from the National Survey of Child and Adolescent Well-being, a national probability study of children investigated for child maltreatment. The sample consisted of 5496 children aged 0 to 15 years at baseline. For analysis, we used descriptive statistics to determine special health care needs and children's functioning from baseline to 3-year follow-up. Logistic regression was used to examine correlates of special health care needs. RESULTS. At any point in the study period, approximately one third of the children were identified as having special health care needs. Overall, across 3 years of follow-up data, 50.3% of the children were identified as having special health care needs. Boys were significantly more likely than girls to have had special health care needs, and children aged 0 to 2 years at baseline were significantly less likely to have had special health care needs than older children. Adopted and foster children were significantly more likely to have had special health care needs than children never placed out of the home. The most commonly reported type of chronic health condition was asthma. The most commonly reported type of special need was a learning disability. CONCLUSIONS. Special health care needs are prevalent among children in the child welfare system. Many children with special health care needs have cognitive, language, adaptive, social, or behavioral functional impairments. Mechanisms are needed to ensure that this vulnerable population has access to and receives coordinated health and related social services.

Depressive symptoms of 95 prenatal care patients were examined relative to thewomen's experiences of intimate partner violence. Women who were victims of psychological aggression during the year before pregnancy were not at elevated risk for depression except when the psychological aggression was very frequent. However, during pregnancy, psychological aggression was more closely tied to women's depression levels, regardless of its frequency. In addition, women who experienced any level of physical assault or sexual coercion by their intimate partners (before or during pregnancy) had higher levels of depressive symptoms compared to nonvictims.

OBJECTIVES: To determine the prevalence of intimate partner violence (defined as any physical violence during the last 12 months or previously) among mothers who maltreat their children, and to examine whether mothers' experiences of intimate partner violence (IPV) are associated with repeated reports (rereports) of children to Child Protective Services (CPS) during the following 18 months. METHODS: Data for the analyses were from the National Survey of Child and Adolescent Well-Being (NSCAW), a national probability study of children investigated for child maltreatment. The sample of 5,501 children (ages 0-14) was randomly selected from the families who entered the US child welfare system between October 1999 and December 2000. The analysis sample was restricted to 1,236 families in which caregivers were: (1) the alleged perpetrators of the child maltreatment at baseline (independently of substantiation status) and (2) the biological mothers (n=1,212 or 98.6%), adoptive mothers (n=17 or 1%), or stepmothers (n=7 or 0.3%) of children not placed in out-of-home care. RESULTS: Children of mothers physically abused by an intimate partner during the last 12 months or previously at the intake interview (44%) were twice as likely as children of mothers who had not experienced such violence to be rereported to CPS (29% vs. 14%, Odds Ratio=2.0, 95% Confidence Interval=1.1-3.4). Rereports occurred almost twice as quickly for children of mothers who experienced IPV compared to children of mothers who had not experienced IPV (Hazard Ratio=1.9, 95% Confidence Interval=1.1-3.0). CONCLUSIONS: The higher risk and speedier rereports of child maltreatment associated with intimate partner violence highlights the need for universal assessment and provision of services for IPV among families that are investigated by CPS. Language: en