Abstract
This paper examines the long-term placement trajectories of youth aged 10 to 17 years at initial investigation, with attention to the comparative trajectories of youth served for sexual abuse gender differences, and the mediating effects of behavioral difficulties experienced post investigation. This analysis draws administrative data on all youth served (N = 77,579) by child protection agencies in Quebec for the first time in the last 12 years. Hazard results suggest that youth served for CSA do not enter out-of-home care as quickly as other youth and once in out-of-home care, it takes longer for these youths to reunify with their families. Behavioral problems drive the increased risk of placement for all served youth but play a more influential role for youth served for CSA. Understanding the effects of CSA on youth placed in out-of-home care can help practitioners and program implementers offer more comprehensive and targeted services to improve reunification timelines, and possibly avoid out-of-home placement and placement instability.
This is a preview of subscription content, access via your institution.



Notes
Youth served by child protection agencies refers to youth 10-17 years receiving child protection services for reasons of suspected or confirmed abuse, neglect, or severe behavioral difficulties. Child protection services refer to actions that are least disruptive for youth, and may include: 1) offering support services to the youth and family; 2) protecting the youth through placement with relatives, a foster family or specialized residential resources, and; 3) clinical monitoring of the youth’s care.
References
Ahrens, K. R., Katon, W., McCarty, C., Richardson, L. P., & Mark, E. C. (2012). Association between childhood sexual abuse and transactional sex in youth aging out of foster care. Child Abuse & Neglect, 36(1), 75–80. doi:10.1016/j.chiabu.2011.07.009.
Banyard, V. L., Williams, L. M., & Siegel, J. A. (2004). Childhood sexual abuse: A gender perspective on context and consequences. Child Maltreatment, 9(3), 223–238. doi:10.1177/107755904266914.
Barth, R.P., & Miller, J.M. (2001). Children of color in the child welfare system: toward explaining their disproportionate involvement in comparison to their numbers in the general population. University of North Carolina, Chapel Hill: School of Social Work.
Bass, S., Shields, M. K., & Behrman, R. E. (2004). Children, families, and foster care: analysis and recommendations. The Future of Children, 14(1), 5–29. doi:10.2307/1602752.
Blackstock, C. (2009). Why addressing the over-representation of First Nations children in care requires new theoretical approaches based on First Nations ontology. Journal of Social Work Values & Ethics, 6(3), 1–18.
Blackstock, C., Trocmé, N., & Bennett, M. (2004). Child maltreatment investigations among Aboriginal and non-Aboriginal families in Canada. Violence Against Women, 10(8), 901–916. doi:10.1177/1077801204266312.
Cermak, P., & Molidor, C. (1996). Male victims of child sexual abuse. Child and Adolescent Social Work Journal, 13(5), 385–400. doi:10.1007/BF01875856.
Chiu, G. R., Lutfey, K. E., Litman, H. J., Link, C. L., Hall, S. A., & McKinlay, J. B. (2013). Prevalence and overlap of childhood and adult physical, sexual, and emotional abuse: a descriptive analysis of results from the Boston Area Community Health (BACH) survey. Violence and Victims, 28(3), 381. doi:10.1891/0886-6708.11-043.
Cutler, S. E., & Nolen-Hoeksema, S. (1991). Accounting for sex differences in depression through female victimization: childhood sexual abuse. Sex Roles: A Journal of Research, 24, 425–438. doi:10.1007/BF00289332.
Drake, B., Jolley, J. M., Lanier, P., Fluke, J., Barth, R. P., & Jonson-Reid, M. (2011). Racial bias in child protection? a comparison of competing explanations using national data. Pediatrics, 127(3), 471–8. doi:10.1542/peds.2010-1710.
Dube, S. R., Anda, R. F., Whitfield, C. L., Brown, D. W., Felitti, V. J., Dong, M., & Giles, W. H. (2005). Long-term consequences of childhood sexual abuse by gender of victim. American Journal of Preventive Medicine, 28(5), 430–8. doi:10.1016/j.amepre.2005.01.015.
Dubner, A. E., & Motta, R. W. (1999). Sexually and physically abused foster care children and posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 67(3), 367–373. doi:10.1037/0022-006X.67.3.367.
Early, T. J., & GlenMaye, L. F. (2000). Valuing families: social work practice with families from a strengths perspective. Social Work, 45(2), 118–30. doi:10.1093/sw/45.2.118.
Esposito, T., Trocmé, N., Chabot, M., Shlonsky, A., Collin-Vézina, D., & Sinha, V. (2013). Placement of children in out-of-home placement in Québec, Canada: when and for whom initial out-of-home placement is most likely to occur. Children and Youth Services Review, 35(12), 2031–39. doi:10.1016/j.childyouth.2013.10.010.
Esposito, T., Trocmé, N., Chabot, M., Shlonsky, A., Collin-Vézina, D., & Sinha, V. (2014a). Family reunification for placed children in Québec: a longitudinal study. Children and Youth Services Review, 44(2), 278–287. doi:10.1016/j.childyouth.2014.06.024.
Esposito, T., Trocmé, N., Chabot, M., Shlonsky, A., Collin-Vézina, D., & Sinha, V. (2014b). The stability of child protection placements in Québec, Canada. Children and Youth Services Review, 42(1), 10–19. doi:10.1016/j.childyouth.2014.06.024.
Farmer, E. M. Z., Mustillo, S., Burns, B., & Holden, E. (2008). Use and predictors of out-of-home placements within systems of care. Journal of Emotional and Behavioral Disorders, 16(1), 5–14. doi:10.1177/1063426607310845.
Finkelhor, D. (1994). Current information on the scope and nature of child sexual abuse. The Future of Children, 4(2), 31–53. doi:10.2307/1602522.
Gover, A. R. (2004). Childhood sexual abuse, gender, and depression among incarcerated youth. International Journal of Offender Therapy and Comparative Criminology, 48(6), 683–696. doi:10.1177/0306624X04264459.
Greeley, C. S., Chuo, C. Y., Kwak, M. J., Henin, S. S., Donnaruma-Kwoh, M., Ferrell, J., & Giardino, A. P. (2016). Community characteristics associated with seeking medical evaluation for suspected child sexual abuse in Greater Houston. The Journal of Primary Prevention, 37(1), 1–16. doi:10.1007/s10935-016-0416-9.
Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Archives of General Psychiatry, 67(2), 113–123. doi:10.1001/archgenpsychiatry.2009.186.
Gustafson, T. B., & Sarwer, D. B. (2004). Childhood sexual abuse and obesity. Obesity Reviews, 5(3), 129–135. doi:10.1111/j.1467-789X.2004.00145.x.
Hébert, M., et al. (2009). Prevalence of childhood sexual abuse and timing of disclosure in a representative sample of adults from Quebec. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 54(9), 631–6. doi:10.1177/070674370905400908.
Holmes, W. C., & Slap, G. B. (1998). Sexual abuse of boys: definition, prevalence, correlates, sequelae, and management. Journal of the American Medical Association, 280(21), 1855–62. doi:10.1001/jama.280.21.1855.
Itzhaky, H., & York, A. S. (2001). Child sexual abuse and incest: community-based intervention. Child Abuse & Neglect, 25(7), 959–72. doi:10.1016/S0145-2134(01)00249-6.
Johnson, R. J., Ross, M. W., Taylor, W. C., Williams, M. L., Carvajal, R. I., & Peters, R. J. (2006). Prevalence of childhood sexual abuse among incarcerated males in county jail. Child Abuse & Neglect, 30(1), 75–86. doi:10.1016/j.chiabu.2005.08.013.
Jonson-Reid, M., Drake, B., Chung, S., & Way, I. (2003). Cross-type recidivism among child maltreatment victims and perpetrators. Child Abuse & Neglect, 27(8), 899–917. doi:10.1016/S0145-2134(03)00138-8.
Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychological Bulletin, 113(1), 164–80. doi:10.1037/0033-2909.113.1.164.
Kenny, M. C., & McEachern, A. G. (2000). Racial, ethnic, and cultural factors of childhood sexual abuse: a selected review of the literature. Clinical Psychology Review, 20(7), 905–922. doi:10.1016/S0272-7358(99)00022-7.
Lavergne, C., Dufour, S., Trocmé, N., & Larrivée, M. C. (2008). Visible minority, aboriginal, and Caucasian children investigated by Canadian protective services. Child Welfare, 87(2), 59.
Leathers, S. J. (2006). Placement disruption and negative placement outcomes among adolescents in long-term foster care: the role of behavior problems. Child Abuse & Neglect, 30(3), 307–324. doi:10.1016/j.chiabu.2005.09.003.
Lewis, T., et al. (2016). Does the impact of child sexual abuse differ from maltreated but nonsexually abused children? a prospective examination of the impact of child sexual abuse on internalizing and externalizing behavior problems. Child Abuse & Neglect, 51, 31–40. doi:10.1016/j.chiabu.2015.11.016.
Loh, C., & Gidycz, C. A. (2006). A prospective analysis of the relationship between childhood sexual victimization and perpetration of dating violence and sexual assault in adulthood. Journal of Interpersonal Violence, 21(6), 732–749. doi:10.1177/0886260506287313.
MacMillan, H. L., Fleming, J. E., Trocmé, N., Boyle, M. H., Wong, M., Racine, Y. A., Beardslee, W. R., & Offord, D. R. (1997). Prevalence of child physical and sexual abuse in the community: results from the Ontario Health Supplement. Journal of the American Medical Association, 278(2), 131–5. doi:10.1001/jama.278.2.131.
Maikovich-Fong, A. K., & Jaffee, S. R. (2010). Sex differences in childhood sexual abuse characteristics and victims’ emotional and behavioral problems: Findings from a national sample of youth. Child Abuse & Neglect, 34(6), 429–437. doi:10.1016/j.chiabu.2009.10.006.
Maluccio, A. N., Abramczyk, L. W., & Thomlison, B. (1996). Family reunification of children in out-of-home care: research perspectives. Children and Youth Services Review, 18(4/5), 287–305. doi:10.1016/0190-7409(96)00007-2.
Maniglio, R. (2015). Significance, nature, and direction of the association between child sexual abuse and conduct disorder: a systematic review. Trauma, Violence, and Abuse, 16(3), 241–2. doi:10.1177/1524838014526068.
Matta, O. K. M., Jonson-Reid, M., & Seay, K. D. (2014). The influence of childhood sexual abuse on adolescent outcomes: the roles of gender, poverty, and revictimization. Journal of Child Sexual Abuse, 23(4), 367–86. doi:10.1080/10538712.2014.896845.
McCrae, J. S., & Fusco, R. A. (2010). A racial comparison of Family Group decision making in the USA. Child & Family Social Work, 15(1), 41–55. doi:10.1111/j.1365-2206.2009.00636.x.
McGrath, S. A., Nilsen, A. A., & Kerley, K. R. (2011). Sexual victimization in childhood and the propensity for juvenile delinquency and adult criminal behavior: a systematic review. Aggression and Violent Behavior, 16(6), 485–492. doi:10.1016/j.avb.2011.03.008.
McLeer, S. V., Deblinger, E., Henry, D., & Orvaschel, H. (1992). Sexually abused children at high risk for post-traumatic stress disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 31(5), 875–879. doi:10.1097/00004583-199209000-00015.
Mennen, F. E. (1995). The relationship of race/ethnicity to symptoms in childhood sexual abuse. Child Abuse & Neglect, 19(1), 115–124. doi:10.1016/0145-2134(94)00100-9.
Molnar, B. E., Berkman, L. F., & Buka, S. L. (2001a). Psychopathology, childhood sexual abuse and other childhood adversities: relative links to subsequent suicidal behaviour in the US. Psychological Medicine, 31(6), 965–77. doi:10.1017/S0033291701004329.
Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001b). Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. American Journal of Public Health, 91(5), 753–60. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446666/.
Murrell, A., Christoff, K., & Henning, K. (2007). Characteristics of domestic violence offenders: associations with childhood exposure to violence. Journal of Family Violence, 22(7), 523–532. doi:10.1007/s10896-007-9100-4.
Neumark-Sztainer, D., Story, M., Hannan, P. J., Beuhring, T., & Resnick, M. D. (2000). Disordered eating among adolescents: associations with sexual/physical abuse and other familial/psychosocial factors. International Journal of Eating Disorders, 28(3), 249–258. doi:10.1002/1098-108X(200011)28:3<249::AID-EAT1>3.0.CO;2-H.
Park, J. M., & Ryan, J. P. (2009). Placement and permanency outcomes for children in out-of-home care by prior inpatient mental health treatment. Research on Social Work Practice, 19(1), 42–51. doi:10.1177/1049731508317276.
Pereda, N., Guilera, G., Forns, M., & Gómez-Benito, J. (2009). The international epidemiology of child sexual abuse: a continuation of Finkelhor (1994). Child Abuse & Neglect, 33(6), 331–342. doi:10.1016/j.chiabu.2008.07.007.
Public Health Agency of Canada (2010). Canadian incidence study of reported child abuse and neglect – 2008: Major findings. Catalogue no: HP5-1/2008E-PDF. Ottawa. Retrieved from: http://www.phac-aspc.gc.ca/cm-vee/csca-ecve/2008/index-eng.php.
Raj, A., Rose, J., Decker, M. R., Rosengard, C., Hebert, M. R., Stein, M., & Clarke, J. G. (2008). Prevalence and patterns of sexual assault across the life span among incarcerated women. Violence Against Women, 14(5), 528–41. doi:10.1177/1077801208315528.
Romano, E., & DeLuca, R. V. (2001). Male sexual abuse: a review of effects, abuse characteristics, and links with later psychological functioning. Aggression and Violent Behavior, 6(1), 55–78. doi:10.1016/S1359-1789(99)00011-7.
Saleebey, D. (1996). The strengths perspective in social work practice: extensions and cautions. Social Work, 41(3), 296–305. doi:10.2105/AJPH.91.5.753.
Saleebey, D. (2006a). Introduction: Power in the people. In D. Saleebey (Ed.), The strengths perspective in social work practice (4th ed., pp. 1–24). Boston: Pearson/Allyn & Bacon.
Saleebey, D. (2006b). The strengths approach to practice. In D. Saleebey (Ed.), The strengths perspective in social work practice (4th ed., pp. 77–92). Boston: Pearson/Allyn & Bacon.
Shaw, T. V., Putnam-Hornstein, E., Magruder, J., & Needell, B. (2008). Measuring racial disparity in child welfare. Child Welfare, 87(2), 23–36. Retrieved from http://search.proquest.com/docview/213807892?accountid=12339.
Siegel, J. A., & Williams, L. M. (2003). The relationship between child sexual abuse and female delinquency and crime: a prospective study. Journal of Research in Crime and Delinquency, 40(1), 71–94. doi:10.1177/0022427802239254.
Simpson, T. L., & Miller, W. R. (2002). Concomitance between childhood sexual and physical abuse and substance use problems. a review. Clinical Psychology Review, 22(1), 27–77. doi:10.1016/S0272-7358(00)00088-X.
Sinha, V., Trocmé, N., Fallon, B., MacLaurin, B., Fast, E., & Shelley Thomas Prokop, S.T., et al (2011). Kiskisik Awasisak: Remember the children. Understanding the overrepresentation of First Nations children in the child welfare system. Ontario: Assembly of First Nations. Retrieved from: http://cwrp.ca/sites/default/files/publications/en/FNCIS-2008_March2012_RevisedFinal.pdf.
Sousa, L., Ribeiro, C., & Rodrigues, S. (2006). Intervention with multi‐problem poor clients: towards a strengths‐focused perspective. Journal of Social Work Practice, 20(2), 189–204. doi:10.1080/02650530600776913.
Stoltenborgh, M., van, I. M. H., Euser, E. M., & Bakermans-Kranenburg, M. J. (2011). A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreatment, 16(2), 79–101. doi:10.1177/1077559511403920.
Trocmé, N. (2008). The Epidemiology of child maltreatment. In D. Lindsey & A. Shlonsky (Eds.), Child Welfare Research (pp 15–24). Oxford University Press.
Ullman, S. E., Najdowski, C. J., & Filipas, H. H. (2009). Child sexual abuse, post-traumatic stress disorder, and substance use: predictors of revictimization in adult sexual assault survivors. Journal of Child Sexual Abuse, 18(4), 367–385. doi:10.1080/10538710903035263.
Widom, C. S. (1995). Victims of childhood sexual abuse – later criminal consequences. Department of Justice. National Institute of Justice: Research Brief. Retrieved from: https://www.ncjrs.gov/pdffiles/abuse.pdf.
Widom, C. S. (1996). Childhood sexual abuse and its criminal consequences. Society, 33(4), 47–53. doi:10.1007/BF02700307.
Widom, C. S., & Ames, M. A. (1994). Criminal consequences of childhood sexual victimization. Child Abuse & Neglect, 18(4), 303–318. doi:10.1016/0145-2134(94)90033-7.
Widom, C. S., Czaja, S. J., & Dutton, M. A. (2008). Childhood victimization and lifetime revictimization. Child Abuse & Neglect, 32(8), 785–796. doi:10.1016/0145-2134(94)90033-7.
Wray, M., & Sinha, V. (2015). Foster care disparity for Aboriginal children in 2011. CWRP Information Sheet #165E. Montreal: Centre for Research on Children and Families. Retrieved from: http://cwrp.ca/sites/default/files/publications/en/165e.pdf.
Youth Protection Act (2016). Law as amended by Bill 125, R.S.Q. Retrived from: http://www2.publicationsduquebec.gouv.qc.ca/dynamicSearch/telecharge.php?type=2&file=/P_34_1/P34_1_A.HTM.
Acknowledgments
This study was supported by a grant from the Social Sciences and Humanities Research Council of Canada (430-2014-00299) and the Canada Research Chair in Social Services for Vulnerable Children (950-230680) to Tonino Esposito, Principal Investigator.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosure of Interest
Tonino Esposito declares no conflict of interest. Ashleigh Delaye declares no conflict of interest. Martin Chabot declares no conflict of interest. Nico Trocmé declares no conflict of interest. Delphine Collin-Vézina declares no conflict of interest. Megan Simpson declares no conflict of interest. The authors of this article declare no conflict of interest.
Ethical Standards and Informed Consent
This article contains secondary analysis of data approved (CÉR CJM-IU: 11/06/003 and CJQ-IU-2011-07) for the purposes of understanding the placement trajectories of children served by child protection in the province of Quebec. This article does not contain any studies with human participants performed by any of the authors.
Rights and permissions
About this article
Cite this article
Esposito, T., Delaye, A., Chabot, M. et al. The Placement Trajectories of Youth Served by Child Protection for Sexual Abuse. Journ Child Adol Trauma 10, 63–76 (2017). https://doi.org/10.1007/s40653-016-0128-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40653-016-0128-6
Keywords
- Child sexual abuse
- Out-of-home placement
- Placement instability
- Family reunification
- Clinical administrative data
- Longitudinal analysis