ACF OPRE: National Survey of Child and Adolescent Well-Being (NSCAW)

Executive Summary

The Children's Bureau of the Administration on Children, Youth and Families, U.S. Department of Health and Human Services, has undertaken the National Survey of Child and Adolescent Well-Being (NSCAW) to learn about the experiences of children and families who come in contact with the child welfare system. NSCAW is gathering information associated with over 6,200 children from public child welfare agencies in a stratified random sample of 92 localities across the United States. The first national longitudinal study of its kind, NSCAW is examining the characteristics, needs, experiences, and outcomes for these children and families. The study, authorized under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,1 will provide information about crucial program, policy, and practice issues of concern to the Federal government, state and local governments, and child welfare agencies.

ES.1 The Child Protective Services Study

This report provides information about the characteristics of children and families who came into contact with the child welfare system through an investigation by child protective services. The sample includes children whose cases were closed after the investigation, and who remained at home; those who remained at home, but had a case opened to child welfare services; and those who were removed from their homes as a result of the investigation. The report addresses the following questions:

Who are the children who have had contact with the child welfare system (CWS)? What are their living situations? What types of maltreatment have they experienced?
What prior experiences have children had with the CWS? Among those who the CWS investigated or assessed, what were the family's strengths and risks at that time?
How does the development, functioning, and behavior of children who have had CWS contact compare to the development, functioning, and behavior of other children? Among children involved with the CWS, how do their development, functioning, and behavior vary across settings where they are placed after being investigated? How do they vary across key demographic characteristics, including age, race, and gender? Are there variations according to types of abuse?
Who are the caregivers of children involved with the CWS? What are their living situations? How well are they functioning?
What sorts of relationships do children involved with the CWS have with their caregivers and with their peers? What expectations do they hold for the future?
What services do these children and families need? What have they received?

Who are the children in families involved with the child welfare system?

Children's age, gender, and race. The average age of children in families assessed or investigated by the CWS after reports of child abuse or neglect is 7 years. Among these children:

19% are less than two years old;
20% are between the ages of 3 and 5;
36% are between the ages of 6 and 10; and
25% are 11 years old and older.

Children are evenly divided between males and females. White children make up the largest group (47%) of children involved with the CWS, followed by African American children (28%) and Hispanic children (18%).

Living situation. At the time data were collected, the vast majority—89 percent—of children whose families had been investigated for child abuse and neglect were living at home with their permanent primary caregiver, with 35% receiving services and 65% not receiving services from child welfare. Four percent were in foster care, 5% were living with relatives in kinship foster care arrangements, and 1% were in group care.2

For children in out-of-home placements, those under age 2 were more likely than other age groups to be in foster care than in kinship foster care or group homes; children over age 11 are more likely to be in group homes.

Services. The study determined whether the family had received services from the child welfare agency and examined differences according to child characteristics and living situations. The child's age, gender, and race/ethnicity were not associated with receipt of in-home services. Of children remaining in the home, about one-fourth had received child welfare services and nearly three-fourths had not.

Type and multiplicity of abuse. When asked about the most serious type of abuse reported during the current investigation of each child, child welfare workers said that nearly half (46%) came to the attention of the CWS because of neglect. Of the neglected children, “failure to provide” was the classification for about 40%, and “failure to supervise” was the classification for nearly 60%. The most serious types of abuse reported for the other children were identified as follows:

27%—physical abuse;
11%—sexual abuse;
11%—emotional, moral/legal, or educational abuse, or abandonment; and
5%—reasons other than abuse or neglect (e.g., for mental health services or domestic violence).

The most serious type of abuse reported for children differed significantly, depending on the child's age and gender: children under the age of 2 were more likely to have been neglected and less likely to have been physically or sexually abused; across age groups, males were more likely to be physically abused and females were more likely to have been sexually abused. Race and ethnicity were not associated with the most serious type of abuse reported.

About three-fourths of the children were reported to have only one type of abuse, and one-fifth have some combination of physical abuse, sexual abuse, neglect due to failure to provide, or neglect due to failure to supervise. Among children reported to have only one type of abuse, children who remain in the home are significantly more likely than children in out-of-home placements to have experienced physical abuse. Children reported to have two types of abuse are more likely to be in out-of-home placement.

Severity of abuse. For analytical purposes, within each of four types of maltreatment—physical abuse, sexual abuse, failure to provide, and failure to supervise—five levels of severity were determined. Among children whose most serious type of abuse was reported as sexual, failure to provide, or failure to supervise, more than half experienced a form of maltreatment that was classified in the least severe category. Among children whose most serious type of abuse was reported as physical, about four-fifths were in the two least severe categories. There were significant differences regarding severity between children who remain at home and children placed outside the home: children at home are, on average, reported as having experienced less severe maltreatment than those placed outside the home. About 27% of children in out-of-home care are reported as experiencing abuse or neglect in the lowest category of severity.

Exposure to violence in the home. Children ages 5 and over reported on their exposure to violence in their homes. Over their lifetimes, these children have witnessed or experienced high rates of violence. About one-third have seen adults shove, slap, or throw things at each other; one-fourth have been slapped by an adult; over one-fifth have seen an adult beat another adult; 15% have been beaten by an adult; and more than one-tenth have seen an adult point a gun at others. Among children who reported experiencing a given form of violence, those in the home have more recent experiences than those who have been removed from the home. Children ages 11 and older reported on parent discipline or maltreatment. About half the children aged 11 and older said they had at some point received corporal punishment or had experiences with minor physical assaults, about one-third reported experiencing severe physical assault, and about one-fifth reported very severe physical assault. Older children living in group care are significantly more likely than others to have experienced the more severe forms of parent discipline or maltreatment.

What risks do children face?

Previous involvement with the child welfare system. Child welfare workers reported that about half of all families involved with the CWS had previously been reported to their agencies for child maltreatment. Of these families, 94% had previously been investigated for child abuse or neglect, and over half had substantiated incidents of abuse or neglect.

Risk assessment. The study asked child welfare workers about their perceptions of caregivers' risk factors in eight areas. At the time that investigations of child abuse or neglect were being conducted, caseworkers' perceptions were that about 8% of caregivers were abusing alcohol, 9% were abusing drugs, and 12% had recently been arrested. About 15% had a serious mental health problem, 7% had a cognitive impairment, and 5% had a physical impairment. Child welfare workers estimated that about one-third had poor parenting skills, almost one-fifth had unrealistic expectations of their children, and almost one-tenth used excessive discipline.

These caregiver risks vary considerably by setting—caregivers of children who remained at home following the investigation and who received in-home services are significantly more likely to have been identified by the child welfare worker as abusing alcohol or other drugs or as having a recent history of arrest than caregivers of children who remained at home and did not receive services. Further, caregivers of children who live out of the home are significantly more likely to abuse alcohol or other drugs or have a recent history of arrest than caregivers of children who live at home. Caregivers of children in kinship foster care are significantly more likely to abuse drugs or have a recent history of arrest than caregivers of children in foster care or group care.

Child welfare workers use various factors as they make decisions regarding particular cases. Of the risk factors assessed in NSCAW, the most frequent factors cited by child welfare workers in making decisions on these cases were the degree of cooperation from caregivers, the child's ability to protect him/herself against future episodes of abuse or neglect, the presence of another supportive caregiver in the home, previous investigations of abuse or neglect, the existence of high stress on the family, and the child's special needs or behavior problems.

How are children functioning and behaving?

Developmental Indicators for infants and pre-school children. Standardized assessments indicate that large numbers of very young children who come into contact with the child welfare system are at high risk for compromised development, as indicated. This is true for children who are left at home, either with or without child welfare services, as well as for children who are placed out of the home.

The Bayley Infant Neurodevelopmental Screener (BINS) was used to assess the risk of developmental delay or neurological impairment in children aged 3 to 24 months. Fifty-three percent of all children aged 3 to 24 months whose families were investigated for maltreatment are classified by BINS as high risk for developmental delay or neurological impairment.
The cognitive domain of the Battelle Developmental Inventory (BDI) was used to assess cognitive development in children aged 3 years and younger. The mean T scores for the total cognitive domain for children whose families were investigated for maltreatment are close to one standard deviation under the normed mean, and 31% of all children aged 3 and younger whose families were investigated for maltreatment have a T score on the total cognitive domain of the BDI that is lower than two standard deviations below the normed mean.
The Preschool Language Scale-3 (PLS-3) was used to measure language skills of children aged 5 years and younger. In general, average scores for children whose families were investigated for maltreatment are below the normed mean but within one standard deviation, yet 14% of all children aged 5 and younger whose families were investigated for maltreatment have a total score on PLS-3 that is lower than two standard deviations below the mean.

Cognitive and Achievement test scores. Among children ages 4 and older, cognitive and achievement test scores generally fell within the normal range, although at the lower end. Five percent scored at least two standard deviations below the mean on the Kaufman Brief Intelligence Test. On the Woodcock Mini-Battery of Achievement, reading and math scores of children ages 6 and older tend to be at or slightly below the mean, but 5% have a reading score and 12% have a math score at least two standard deviations below the mean.

Social functioning. As measured by the Vineland Adaptive Behavior Skills Screener, about 30% of the children have low or moderately low scores for daily living skills, substantially more than the general population. Overall, as indicated by the Social Skills Rating System, 38% are classified as having “fewer” social skills—twice the rate for the normative sample.

Psychosocial well-being. Children in the study are at least five times more likely than the normative sample to have problem behaviors, as indicated by reports from caregivers, teachers, or the young people themselves on the Achenbach scales. Caregiver reports of problem behaviors are significantly more likely for older children and those living in out-of-home settings. Depression, as assessed by the Children's Depression Inventory, is more common for children in the child welfare system than for children in the general population (15% and 9%, respectively).

Delinquency. Caregivers classified about one-fourth of all children ages 6 to 15 as having delinquent behaviors, which is five times greater than the general population. One-fifth of young people ages 11 and older said they had engaged in at least one violent act within the previous six months; 10% said they had been arrested during that time period.

Sexual behavior. About one-fourth of children between the ages of 11 and 15 reported they had had sexual intercourse.

What environments are children living in?

Demographics. The caregiver's average age is 34; over half are between the ages of 25 and 44. Over half of the out-of-home caregivers are 45 years or older, compared with less than 10% of in-home caregivers; these older out-of-home caregivers are predominantly foster and kinship caregivers. Most are female (90%) and white (51%). In terms of education, the highest educational level they achieved is as follows: 29% did not complete high school, 44% have a high school diploma or equivalent, 19% have an associate's or technical degree, and 5% graduated have a bachelor's degree or more. Almost half work outside the home. About two-thirds of African American children, 92% of white children, and 42% of Hispanic children have a foster parent of the same racial or ethnic background.

Income. Fully 65% of the households in the study had an income of less than $25,000; one-fourth had household income under $10,000. Taking into account family size, more than half of all families had an income below the federal poverty guidelines; 21% had income at less than half of the poverty level. There are substantial numbers of families living in poverty across all settings, although households with children remaining in the home are more likely to be below the poverty line than households where children live with foster parents or relatives as foster parents.

Household size. Across the study population, children involved with the CWS live in households that have an average of 4.4 members (including themselves). Children in foster care live in households that have an average of 5.5 members, and children who live with relatives live in foster care in households that have an average of 4.9 members. The average number of children in households where the child remains at home is significantly less than the average number of children in out-of-home care. Again, this significant difference is accounted for largely in nonkinship foster homes, which have a significantly higher average number of children than do kinship care homes.

Living environment. Among children under the age of 6, those living out of the home had more positive aspects in their environments, as measured by the HOME, than those who remain living at home. There were few differences in quality of the living environment for in-home versus out-of-home placements among children ages 6 to 10.

Exposure to domestic violence. Almost half (45%) of in-home caregivers reported experiencing either minor or severe domestic violence during their lifetimes, a rate about double that found in the general population. Among in-home caregivers, 17% had experienced severe domestic violence in the previous year.

Arrest history. Nearly one-third of in-home caregivers had been arrested during their lifetimes, with an average of 2.3 arrests . About 13% had been arrested within 3 months of contact with the child welfare system.

What relationships do children have with caregivers and peers?

Relationship with caregiver. Children generally reported a sense of relatedness to their caregivers, reflecting how the child feels with the caregiver, the quality of involvement, the extent to which the child feels controlled, and perceptions of expectations for behavior. Overall, children felt very close to their caregivers, although those living in foster care felt less close to caregivers than those living at home.

Activities with caregiver. Children in the study, according to their self-reports, seem to engage more frequently in some activities—playing sports, attending an event, working on a school project—with their caregivers than children in the general population.

Peer and school relationships. Children ages 5 to 7 have some dissatisfaction with peer relationships, as do some children ages 8 to 10; those 11 to 15 were rarely dissatisfied with their peer relationships. Most report positive engagement with their schools, although males had more disciplinary problems than females.

Protective factors. Over 80% of the children in the sample said adults were available to help with problems. Children in foster care say that religion is more important to them than children remaining at home; this applies for both kinship (nearly four times more likely) and other types (nonrelative foster care, nearly three times more likely).

What services do caregivers of children who remain at home receive?

Cash assistance. About 21% of caregivers whose children remain at home receive cash assistance from TANF, the nation's welfare program. Among in-home caregivers, over three-fifths have ever received cash assistance.

Mental health services. Caregivers of children who remained at home reported on their own mental health services. Almost 8% of in-home caregivers report they are currently receiving counseling or therapy for a mental health problem; 12% report needing this kind of service but not receiving it. Two percent are currently receiving drug or alcohol treatment services; those who are receiving these services are more likely to also be receiving in-home child welfare services.

Other services. Child welfare workers reported on the services that they provided to families of children who had come into contact with the system, whether or not the children remained at home or were placed out of the home. Child welfare workers reported that they provided, arranged, or recommended services at the time of intake to CWS for 43% of in-home caregivers. The most frequently cited services are counseling or mental health treatment (for 54% of in-home caregivers), parenting classes (30%), family support center or services (20%), and concrete services such as housing, transportation, and food (18%).

Contact with child welfare staff. Over one-fourth (28%) of caregivers for children remaining in the home and receiving services report they had no verbal contact with a child welfare worker since the investigation into their case began. Among caregivers of children remaining in the home, fewer African Americans than whites said they had spoken with a child welfare worker since the case had been opened. Children whose most serious maltreatment is sexual abuse have caregivers who have less verbal contact with child welfare workers than children whose most serious form of maltreatment is neglect. Although there are potential explanations for the relatively high proportion of caregivers who report not having verbal contact with child welfare staff, the possibility remains that many families are receiving few timely services, or none at all, from the agency responsible for helping provide safe and continuous care for children.

Quality of relationship with child welfare staff. In-home caregivers' opinions about the quality of relationships with child welfare workers were higher when they had interacted with fewer numbers of child welfare staff and had recent contact with a child welfare worker. Caregivers generally were more dissatisfied with help offered by the child welfare worker, compared to the personal interactions they have. Caregivers reported low levels of satisfaction in receiving necessary, helpful, and prompt services.

What are children's health and educational needs?

Health status. Nearly all caregivers (94%) report that their children are in good, very good, or excellent health, but children involved with the CWS are three times more likely to be in fair or poor health than children in the general population. Over one-fourth (28%) of caregivers said their child has a chronic health problem. Among children in out-of-home care, 21% had visited an emergency department due to an illness or injury since the CWS investigation began; over one-third (37%) of children remaining at home had done so during the preceding 12 months.

Mental health. Overall, 11% of all children in the study are receiving outpatient mental health services for emotional, behavioral, learning, attention, or substance abuse problems, although a range of 37-44% scored in the borderline or clinical ranges on accepted measures of children's mental health and behavioral and emotional functioning (the Parent, Teacher, and Self Reports of the Child Behavior Checklist). Children in out-of-home settings are more likely to receive mental health services than those remaining at home. Among all children remaining at home, those receiving CWS services and those not receiving services were equally likely to get mental health services.

Special education. Over one-fourth of caregivers said an education or health professional told them their child had learning problems, special needs, or developmental disabilities. Fifteen percent are receiving special education services. Children remaining at home are significantly less likely than those in out-of-home care to have been assessed for special education needs since the CWS investigation began.

What are the characteristics of child welfare workers?

On average, child welfare workers in this study have 7 years of experience, with no statistically significant differences according to the types of residential settings for their cases. Most are between the ages of 30 and 39. Most have at least a bachelor's degree (75% of African American, 72% of white, and 61% of Hispanic workers), and 12% have a master's degree.

ES.2 Implications for Child Welfare Services

For most children who come to the attention of child welfare services and are the subject of an investigation, the investigation is the primary service that they will receive—and the vast majority (nearly 90%) of those investigations result in closed cases, with children remaining at home, receiving no other CWS services. Whether or not the investigation results in an open case, however, children in contact with the child welfare system are likely to have substantial developmental disadvantages, and more attention to the opportunities for providing or coordinating services appears warranted. The consistency of low levels of performance on assessments of physical, cognitive, emotional, and skill-based measures suggests that the minimal interventions that many receive will not be sufficient to ameliorate the long-term risks they probably will face.

Risk assessment analyses found that child welfare agencies are very concerned about substance abuse and serious mental health problems among family members. Poor parenting—and the related facets of motivation to change and degree of cooperation with the CWS—is most significant in influencing case workers' decisions about whether to leave children in the home or remove them. The study found evidence that adult mental illness contributes to parenting problems, but relatively few caregivers reported current mental health services. High levels of poverty and domestic violence add to the challenges that child welfare workers face in trying to provide or arrange services for the families they encounter.

This report provides a snapshot of the functioning and the potential service needs of children and families soon after a child protective services investigation has taken place. NSCAW will continue to follow the life course of these children to gather data about services received during subsequent periods, measures of child well-being, and longer-term results for the study population. This information will provide a clearer understanding of life outcomes for children and families that come into contact with the child welfare system.

1 Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Sec. 429A, National Random Sample Study of Child Welfare (PL No. 104-193). (back)

2 The percentages of living arrangements outside the home do not total to 11 points due to rounding. (back)

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