9. Conclusions and Implications

The NIS-4 revealed several important changes in the incidence of maltreatment since the time of the NIS-3. Are the observed changes in the incidence of child abuse and neglect real changes in the scope of the problem, or do they instead reflect changes in how sentinels and other reporters to CPS respond to the maltreated children they encounter? Before drawing fully informed conclusions on this question, further analyses of the NIS-4 data will be needed to see whether observed changes are localized to specific subtypes, to less severe forms of the maltreatment, or to certain recognition sources. However, the current information suggests that both of these dynamics contributed to the observed changes, each dynamic affecting a different sector of the abused and neglected population.

The NIS-4 documented declines in rates of all categories of abuse across both definitional standards. The declines in sexual abuse and physical abuse are consistent with trends in CPS data gathered by the National Child Abuse and Neglect Data System (NCANDS, U.S. Department of Health and Human Services, Administration on Children, Youth and Families, 2007). As Finkelhor (2008) noted, several indicators suggest that these declines are real, including parallel declines in victim self-reports and the fact that the declines occurred broadly across abuse subtypes and sources in CPS data. This implies that the declines in NIS estimates of physical and sexual abuse are also real. However, since no independent information is currently available that bears on the incidence of emotional abuse, it is not clear whether the NIS decline in this category reflects a real decrease in its occurrence.

The increase in the rate of emotional neglect since 1993 could, in part, signify a real increase in the occurrence of maltreatment, but it is fairly clear that it also reflects some change in policy and focus. Whereas the incidence of emotionally neglected who received CPS investigation rose significantly since the NIS-3, the incidence of emotionally neglected children who did not receive CPS investigation showed no statistical change from the NIS-3 level. Since the NIS-3, a number of CPS systems have undertaken initiatives to increase collaboration between CPS and agencies that serve domestic violence and alcohol and drug problems (U.S. Department of Health and Human Services, Administration for Children and Families/Children’s Bureau and Office of the Assistant Secretary for Planning and Evaluation, 2001, 2003). The increased emotional neglect incidence may predominantly reflect the heightened CPS attention to these problems, which are involved in certain types of emotional neglect. Further analyses will clarify whether the increases in emotional neglect primarily occurred in specific types of emotional neglect or for children recognized at specific types of agencies.

Another area where further analyses can illuminate the implications of the NIS-4 findings is in the interrelationships among the different factors associated with the incidence of maltreatment. Factors such as parents’ labor force participation, household socioeconomic status, family size, and family structure and living arrangement are not only associated with the incidence of maltreatment but are also correlated with each other. Further analyses could determine their independent relationships to maltreatment, such as whether households with more children have higher incidence rates even when household socioeconomic status is taken into account. Moreover, for the first time in NIS, the NIS-4 found race differences in the incidence of maltreatment, with higher incidence rates for Black children. Similar to the approach used in exploring the NIS-3 data (Sedlak & Schultz, 2005), future analyses should examine whether these race differences in maltreatment rates remain when the disadvantaging effects of these family circumstances are taken into account.

The NIS-4 findings on the strong correlations between socioeconomic status and all categories of maltreatment are consistent with earlier NIS findings on household income. As with the previous results, the recent observations cannot be plausibly explained by the claim that lower socioeconomic families are simply more visible to the community professionals who provide most of the data. The NIS sentinels observe substantial numbers of children and families at the middle- and upper-income levels. The people who recognize the large majority of maltreated children are likely to encounter maltreatment in all income levels, since they include sentinels in hospitals, schools, day care centers, mental health agencies, voluntary social service agencies, as well as professionals not represented by NIS sentinel categories and the general public. Sentinels in schools alone recognized the majority of the maltreated children. Although the NIS design includes only public schools, approximately 90% of school-age children attend public schools (Shin, 2005), so they represent a broad spectrum of socioeconomic status levels. Moreover, since the majority (more than 80%) of children in private schools (those not reflected in the NIS) are in religiously affiliated schools (Provasnik, KewalRamani, Coleman, Gilbertson, Herring, & Xie, 2007), which frequently have sliding scales for the poorer children, they are not necessarily from better economic circumstances than children enrolled in public schools.

Moreover, if the higher maltreatment rates for children in families of low socioeconomic status were to be simply an artifact of selective observation, then it would mean there have to be enough undetected abused and neglected children in the higher socioeconomic status category to equalize the incidence rates across the upper and lower status groups. That would require a large number of still-undetected children in the nation who experience countable maltreatment. Specifically, it would mean that an additional 975,300 children suffered maltreatment according to the Harm Standard yet remained hidden to the NIS. Similarly, it would mean there were an additional 2,457,200 children in 2005-2006 who experienced Endangerment Standard maltreatment but who escaped observation by community professionals. This would require an 85% higher overall estimate of the incidence of Endangerment Standard maltreatment, an estimated total of 5,363,000 children. That number is more than 7% of the total U.S. child population or more than 1 in every 14 children. Considering these implications, it appears more plausible to assume that the observed socioeconomic status differences in the incidence of maltreatment reflect real differences in the extent to which children in different socioeconomic conditions are being abused or neglected.

Despite some increases in CPS investigation of maltreated children, the NIS-4 shows that investigation rates still remain fairly low. Similar to previous NIS findings, the NIS-4 again determined that the majority of maltreated children do not receive CPS investigation. The NIS-4 obtained information that shed additional light on this issue:

• The NIS-4 determined that the finding is not an artifact of the relatively short (3-month) NIS reference period, since adding a full month of CPS data to increase the opportunity for more maltreated children to enter CPS investigations made essentially no difference to the percentages of children investigated.
• Certain features of CPS structure and practice were associated with percentages of maltreated children who received investigation. Children were less likely to receive CPS investigation if they were in the jurisdiction of CPS agencies that received their referrals about suspected maltreatment through a centralized regional or state hotline, that combined a new report into an ongoing open investigation on the child or family, or that could offer an alternative response (other than an investigation) to the children and families referred to them for suspected maltreatment. Also, children who experienced physical neglect were less likely to receive investigation if their CPS agency had sole responsibility for investigating non-severe physical neglect.
• The CPS Screening Policies Study found that if all maltreated children were reported to CPS and CPS agencies followed their current screening policies, then a large majority of the maltreated children (80% or more) would receive CPS investigation.
• In the Sentinel Definitions Survey, sentinels responded to descriptions of maltreated children, indicating that they would not report some of these to CPS. About one-fourth of sentinels (24%) had not received either written instructions nor attended a training on their state’s reporting requirements while working in their current agency. More of those who had received information or training had reported suspected child maltreatment.

Schools predominated as a source of recognition for maltreated children, recognizing the maltreatment of 52% of the children with Harm Standard maltreatment and 39% of those with Endangerment Standard maltreatment. At the same time, however, 20% or less of the maltreated children recognized at schools received CPS investigation. As a result, schools recognized the majority of uninvestigated children under both definitional standards (64% under the Harm Standard and 55% under the Endangerment Standard). One factor that may contribute to the low investigation rate for school-recognized children is school policy barring staff from making direct reports to CPS. In the Sentinel Definitions Survey, 20% of school sentinels indicated that their schools do not permit them to report directly to CPS. However, other factors also contribute to low investigation rates for the school-recognized children, because even when agencies permitted direct reports, fewer sentinels in schools said they had reported a case (54%) compared to staff in health agencies (77%) or law enforcement (87%). Similar patterns emerged in the previous NIS cycles. To repeat the earlier recommendation: better working relationships should be forged between CPS agencies and schools, capitalizing on the unique role of school professionals as front-line observers.

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