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Beyond Maltreatment: Developing Support for Children in Multiproblem Families

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Part of the book series: Child Maltreatment ((MALT,volume 2))

Abstract

In the United States, the role of government is very limited in regulating and monitoring child rearing. Unless a parent’s behavior falls below a standard that is considered abuse or neglect (maltreatment) there is no government oversight of parenting. Yet, there is good reason to believe that 15–20 % of all children in the United States live in homes where the quality of parenting puts them at risk of very poor outcomes during childhood and into adulthood. Only about a third of these families are brought under the supervision of the CPS system. No system has responsibility for trying to help children whose development is adversely affected by problematic parenting that does not involve harms that fall within the definition of maltreatment. This chapter uses an outcomes-focused framework to examine types of state actions that might help all parents provide minimally adequate care. It divides parenting behaviors into two categories: (a) parental behaviors that should be labeled maltreatment because they require intervention through the child protection system and (b) other forms of highly inadequate parenting which should be addressed by systems other than CPS. It then examines the proper role of the CPS system, schools, and other social services in promoting the well-being of children. It concludes that none of these systems can adequately meet the needs of many children in homes where the parenting is highly inadequate. It proposes that a new system of coordinated services be created and explores the elements that should be included in such a system.

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Notes

  1. 1.

    This chapter focuses primarily on U.S. policy since issues related to regulating parenting must be viewed in light of a range of particular cultural and economic factors. However, many of the issues discussed here are similar to those facing policy makers in other in economically developed countries (Lonne et al. 2009).

  2. 2.

    While definitions vary by state, all statutes include parental conduct that results in physical injury (actual or threatened) to the child or engaging in sexual relations with the child or failing to protect a child from sexual relations with an adult. Most cases labeled “neglect” also involve the threat of physical harm due to inadequate supervision, unsafe home conditions, etc. Failure to send a child to school and some forms of parental conduct that lead to mental harms also are included in many states’ definitions.

  3. 3.

    There is still no agreed upon definition of maltreatment. In the U.S., each state uses its own definition of maltreatment for both mandatory-reporting laws and in establishing the bases for court involvement in child protection; definitions vary among countries as well (Waldfogel 1998; Lonne et al. 2009). There are widely varying rates of reported and substantiated maltreatment among the states (Appendix). It is highly unlikely that these variations reflect underlying differences in the levels of actual parental behaviors in each state.

  4. 4.

    I find the terms maltreatment or child abuse/neglect even more problematic, since they imply a willfulness that is often not present with respect to the parental behavior and certainly do not support a strengths-based approach.

  5. 5.

    The commitment to protecting mental health appears to be less strong than to physical health in terms of funding and legislative attention.

  6. 6.

    The separation is not as stark as I am drawing. There is considerable spending on other aspects of children’s current well-being other than safety, such as subsidizing health care expenses for children, trying to improve the quality of child care, and providing recreation and after-school care. But public expenditures on these services usually are justified and assessed in terms of preparation for adulthood, not in improving the quality of life for children.

  7. 7.

    I use the term parent to include other adults, such as grandparents, when they are the child’s primary care taker.

  8. 8.

    Approximately half of children born in the US in 1985 received a BA or 2 year degree by age 25.

  9. 9.

    In the 1970s, while serving as the reporter for American Bar Association’s Juvenile Justice Standards Project, I proposed at set of harms that should be the focus of the CPS system. They included a limited definition of emotional injury, in addition to physical harms and sexual misuse of a child (Wald 1975). I still believe these are the harms that should be the focus of CPS.

  10. 10.

    In the United States, issues related to child maltreatment are primarily within the purview of each state and often vary by county within states. Definitions of maltreatment vary, as do state policies regarding when to investigate and or substantiate an allegation of maltreatment. It is difficult to compare data across states because it often is unclear how a particular term is being used. All data should be approached with great caution.

  11. 11.

    The number of households is key, since the needed resources will be determined by the number of parents that must be served. The number of children in the total population has been increasing over the past 20 years, while referrals have remained relatively constant, so the percentage of children reported varies over time.

  12. 12.

    The 8–10 % estimate assumes that some of the children who have a substantiated case after they are five also will have had a previous substantiated case before age 5.

  13. 13.

    There is out of six million reported children. There is little research indicating why reports are screened out. Some studies find that a high percentage of these cases get reported again, but anecdotal evidence indicates that many are situations that do not involve inadequate parenting. Given the absence of good data, I have not included these cases in my estimates.

  14. 14.

    Not all these cases involve safety, however. Some are situations of educational neglect and many cases involving teens are situations of high family conflict. In addition, not all of these cases involved maltreatment by parents. Some physical and sexual abuse cases involve actions by other caretakers or people not in the parent’s household.

  15. 15.

    The rate in Pennsylvania reflects the fact that its reporting law includes only abuse. However, under a separate law state agencies do deal with thousands of cases of “general neglect.”

  16. 16.

    If anything, those states with the highest percentage of poor, young, low-educated parents generally have lower reporting rates.

  17. 17.

    These figures are only for children in persistently poor families; not ever-poor families (Duncan et al. 2010b).

  18. 18.

    Bartholet and Dwyer, as well as some other commentators, argue that the child protection system is based on a presumption for parental autonomy and undervalues children’s rights and interests. I believe that the recommendations I am making here flow from a children’s interest perspective. However, it is beyond the scope of this chapter to address fully the parental autonomy-child’s rights debate.

  19. 19.

    There also is reasonable clarity in situations involving refusal to provide critical medical treatment and active failure to send children to school.

  20. 20.

    My discussion focuses largely on services for younger children, primarily birth to five and to a lesser extent 6–12 year olds. Many of the issues regarding teens are different and have received little attention, except for teens in foster care.

  21. 21.

    Minnesota is developing outreach to screened-out cases. See Minnesota PSOP program. http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&dID=143876

  22. 22.

    The program resembles the Abecedarian Project, conducted in the 1970s. In Abecedarian, a group of “high-risk” new parents were provided home-based parenting support; their children also received very high quality childcare and preschool from infancy until kindergarten. A long-term follow-up of the participants indicates that the program led to better long-term outcomes for many of the children. However, even with a program of this intensity and quality, 28 % of the children did not graduate high school and there was no apparent impact on the level of criminal convictions or substance abuse (Campbell et al. 2012). Interestingly, Abecedarian had stronger impact on college going and social mobility than on helping the bottom group, indicating that it might be best for poor, but reasonably functioning, parents.

  23. 23.

    There are a few such efforts being tried on an experimental basis, such as the Durham Initiative (Dodge et al. 2004; Daro 2009) and the well-known Harlem Children’s Zone. Community-wide initiatives are difficult to implement and sustain; a number have failed (Daro et al. 2009a, b; Walker et al. 2012).

  24. 24.

    Designing a system, or even individual programs, that can provide quality services may be especially hard in rural areas, as well as in cities with high levels of poverty. Yet, a large percentage of the target parents and children live in these areas. Policy proposals, and legislation, often ignore the special challenges created by geography.

  25. 25.

    This is primarily true for premature or low birth weight children who live with low-income parents.

  26. 26.

    One possibility that has been proposed is to license parents (Westman 1994). There are a number of reasons this is problematic (Wald and Sandmire 1990).

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Acknowledgments

  I wish to thank David Chambers, Brett Drake, Emily Putnam-Hornstein, David Kirp, and Dee Wilson for their very helpful comments on earlier drafts and Nisha Kishyap for her research assistance.

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Correspondence to Michael S. Wald .

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Appendix

Appendix

Child maltreatment victims aged 0–5 per 1,000 population in FFY 2009, by state.

figure 00132

Source: USDHHS (2010)

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Wald, M.S. (2014). Beyond Maltreatment: Developing Support for Children in Multiproblem Families. In: Korbin, J., Krugman, R. (eds) Handbook of Child Maltreatment. Child Maltreatment, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7208-3_13

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