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U.S. Depatiment of Health and Human Services

Administration for Children and Families

‘% Administration on Children, Youth and Families 4.*”,,. National Center on Child Abuse and Neglect
This document repofis the findings from the Third National Incidence Stody of Child Abuse and Neglect

@lS-3), which was conducted by Westat, Inc., and its subcontractor James Bell Associates, under

contract number 105–91–1800 from the Depatiment of Health and Human Services. The authors were

Andrea J. Sedlak, Ph.D., and Diane D. Bmadhurst, M.L.A., Westat’s NI$3 Project Director and Senior

Researcher, respectively. Production semices were provided by Houston Associates, Inc., under contract

number ACF–1 05–9+1 840.

For additional copies of this document, any of the four technical repofis on the NIS–3 (Revised Stu@

Desigrr, Sample Selection Report, Data Collection Report, and Anafysis Report), reports on the NIS–3

policy substudies (Court Referral Study, CPS Screening Policy and Recordkeeping SIu~, Sentinel

Questionnaire Fe/low-up Study), or the NIS-3 public use data tape, contact the National Clearinghouse

on Child Abuse and Neglect Information, P.O. Box I I82, Washington, DC. 200 13–1182, (800) FYI–

3366.

The NIS–3 public use data tape is also available from the National Data Archive on Child Abuse and

Neglect, Cornell University, Family Life Development Center, Ithaca, ~ 14853, (607) 255–7794.

Material contained in this publication is in the public domain and maybe reproduced, fully or patiially,

without pemission of the Federal Government. The couflesy of source credit is requested.
THIRD NATIONAL ~C~ENCE STUDY

OF CHILD ABUSE AND NEGLECT

FINAL REPORT

Andrea J. SedlA, Ph.D.

& Diane D. Broadhurst. M.L.A,

U.S. Deptiment of Health and Human Sew ices

Administration for Children and Families

Administration on Children, Youth and Families

National Center on Child Abuse and Neglect

September 1996
CO~ENTS

1.

2.

3,

Foreword .......................................................................................................xvii

~TRODUCTION ........................................................................................l.l

ME~ODOLOGY .......................................................................................2.l

2.1 Study Design ........................................................................................2.l

2.1.1 Rationale ...................................................................................2.l

2.1.2 Approach ...................................................................................24

2.2 Data Collection .....................................................................................2+

2.3 Evaluation againat the Study Definitions .............................................2.7

2.3.1 Definitional Stindmds ..............................................................2.8

2.3.2 Categories of Maltreatment ......................................................2.lO

2.3.3 Countability Assessment ..........................................................2.2O

2.4 Unduplication .......................................................................................2.2l

2.5 Weighting and Estimation ....................................................................2.21

2.6 Data Analysis .......................................................................................2.23

2.7 Methodological Differences from the N1S.2 .......................................2.24

~CIDENCE OF C~LD ABUSE AND NEGLECT .......I...........................3–I

3.1 National Incidence of Child Maltreatment under the

Harm Stindwd ......................................................................................3.2

3.1.1 Overall Incidence of Maltreatment under the

Hm Standwd ..........................................................................3.2

3.1.2 Incidence of Abuse and Neglect under the

Harm Stindmd ..........................................................................34

3.1.3 Incidence of Types of Abuse under the

Harm S@ndard..........................................................................3.5

3.1.4 Incidence of Types of Neglect under the

Harm Stidard ..........................................................................3.8

3.1.5 Severi& of Outcomes from Maltreatment under the

Harm S@ndard..........................................................................3.l2

3,2 National Incidence of Child Maltreatment under the

Endangerment Standard .......................................................................3.l6

3,2.1 Overall Incidence of Maltreatment under the

Endangerment Standwd ............................................................3.l7

3.2.2 Incidence of Abuse and Neglect under the

Endangerrrrent Standard ............................................................3.l9

111
3.2.3 Incidence of Types of Abuse under the

Endangerment Stidmd ............................................................3.2O

3.2.4 Incidence of Types of Neglect under the

Endangerment S@ndard............................................................3.23

3.2.5 Severi~ of Outcomes from Maltreatment under the

Endangerment Stidwd ............................................................3.26

3.3 Implications of the Findings.. . .......... ..... ...... ......... ...........................3-30

4. DISTMBUTION OF ABUSE AND NEGLECT BY CHILD

C~WC~MSTICS ..................................................................................+l

4.1 Sex Differences in the Incidence of Maltreatnrent., .............................&2

4.1.1 Sex Differences in Maltreatment under the

Harm Stindard ..........................................................................&2

4.1.2 Sex Differences in Maltreatment under the

Endangerment Stindmd ............................................................ti

4.2 Age Differences in the Incidence of Maltreatnrent ..............................&l 1

4,2.1 Age Differences in Maltreatment under the

Harm Stindard ..........................................................................4ll

4,2.2 Age Differences in Maltreatment under the

Endangerment Swdard ............................................................&l9

4.3 Race Differences in the Incidence of Maltreatment .............................A28

4,4 Key Findings on the Distribution of Abuse and Neglect

by Child Characteristics .......................................................................&29

5. DISTRfBU~ON OF ABUSE AND NEGLECT BY FAMILY

cmMcTENsTIcs ..................................................................................5.l

5.1 Differences in the Incidence of Maltreatment Related

to Family Income .................................................................................S.2

S.1.1 Differences in Maltreatment As Defined by the

Harm Standard Related to Family Income ............................... 5–2

S.1.2 Differences in Maltreatment As Defined by the

Endmgemrent Standard Related to Family Income . ... ..........5–10

5.2 Family-Structure Differences in the Incidence of Maltreatment S–18

5.2,1 Family-Stmcture Differences in Maltreatment under the

Harm Stindard ..........................................................................S.l8

S.2.2 Family-Structure Differences in Maltreatment under the

Endangerment Standard ............................................................5.2S

5.3 Family-Size Differences in the Incidence of Maltreatment . ...... ... ....5–33

S.3.1 Fmnily-Size Differences in Maltreatment under the

Harm Standmd ..........................................................................S.33

S.3.2 Family-Size Differences in Maltreatment

under the Endangerment Standad ............................................S42

iv
6.

7.

5.4 Differences in the Incidence of Maltreatment Related

to County Metropolitan Status (Metrostitus) .......................................S46

5.4.I County Metrostatus Differences in Maltreatment As

Defined by the Harm Standard .................................................546

S.4.2 County Metrostatus Differences in Maltreatment As

Defined bytbe Endangerment Standard .,...............,..,.........,..,547

5.5 Key Findings and Implications of the Distribution of

Abuse and Neglect by Family Characteristics .....................................S48

DISTWBUTfON OF ABUSE AND NEGLECT BY PERPETRATOR

C~WCTENS~CS ..................................................................................&l

6.1 Information About Perpetmtor Identity ...............................................6l

6,2 Overall Distribution of Perpetrators of Countable

Maltreatment under the Harm Stidard ...............................................M

6.3 Perpetrators’ Relationship to the Child and Severity

of Hamr as a Function of the Type of Maltreatment ............................6S

6.4 Perpetrator’s Sex as a Function of the Maltreatment

and the Perpetrator’s Relationship to the Child ,..,...............................68

6.S Perpetrator’s Age as a Function of the Maltreatment

and the Perpetrator’s Relationship to Child ..,..,..,................................6l2

6.6 Perpetrator’s Employment Status as a Function of the

Maltreatment and the Pe~etrator’s Relationship to the

Child . ... . .. .. .. .. .. .. . .. .. .. .. .. .. ...... .,...,,,,,,,, ,,,615

6.7 Child’s Race as a Function of the Maltreatment and the

Perpetrator’s Relationship to the Child ................................................&l5

6.8 Implications of the Findings Regarding Perpetrator

Relationships and Characteristics ........................................................62O

RECOGNIZING AND lNVES~GATNG ABUSED AND NEGLECTED

CHILDmN ..................................................................................................I.l

7.1 Sources Recognizing Abused arrdNeglected Children ........................ 7–1

7.1,1 Sources Recognizing Children Maltreated under the

Hamr Stidard ..........................................................................7.2

7,1,2 Sources Recognizing Children Maltreated under the

Endangerment S@ndard............................................................7.1 O

7.2 CPS Investigation of Abused and Neglected Children ........................7-14

7.2.1 CPS Investigation of Children Maltreated under the

Harm Stindard ..........................................................................7.1 S

7.2.2 CPS Investigation of Children Maltreated under the

Endangerment Stindard ...........................................................7.29

7.3 Key Findings and Implications of Patterns of Recognition

and Investigation ..................................................................................74O
8. SUMMARY, =Y FWD~GS, AND IMPLICATIONS ..,.........................8-1

8.1

8.2

8.3

8,4

8.5

8.6

8.7

8.8

8.9

Background and Objectives .................................................................8.l

Design and Methods .............................................................................8.l

The National Incidence of Child Abuse snd Neglect ...........................8–3

Distribution of Child Abuse and Neglect by the Child’s

Characteristics ......................................................................................ti

Distribution of Child Abuse and Neglect by Family

Chwacteristics ......................................................................................g.8

Distribution of Child Abuse and Neglect by Perpetrator

Chmacteristics ......................................................................................8.l2

Sources of Recognition for Maltreated Children . .. ...... .......... ... ... .. 8–15

O~cial Reporting of Maltreated Children and Their

Investigation by Child Protective Services (CPS) ...... ...... .............. .. 8–16

Implications ..........................................................................................8.l7

vi
TNLES

3–2

3-3

34

41

42

5-1

5–2

5–3

54

5–5

54

National Incidence of Maltreatment under the Harm Standard

in the NIS–3 (1993), and Comparison with the NIS–2 (1986) and the

NIS-1 (1980) Harm Standard Estimates ......................................................3.3

Severity of Outcomes from Maltreatment under the Harm Standard

in the NIS–3 (1993), and Comparison with the NI$2 (1986) and the

NIS-1 (1980) Harm Standard Findings ........................................................3.l3

National Incidence of Maltreatment under the Endange~ent

Standard in the NI%3 (1993), and Comparison with the N*2 (1986)

Endangerment Stmrdard Estimates ...............................................................3.l8

Severi~ of Outcomes from Maltreatment under the Endangerment

Standard in theNI%3(1993), and Comparison with the NI&2 ( 1986)

Estimates .......................................................................................................3-27

Sex Differences in Incidence Rates per 1,000 Children for Maltreatment

under the Harm Standard in the NIS–3 (1993) .............................................43

Sex Differences in Incidence Rates per 1,000 Children for Maltreatment

under the Endangerment Standard in the NI>3 (1993) ,..,..,.......................47

Incidence Rates Per 1,000 Children for Maltreatment under the Harm

Standard in the NIS–3 (1993) for Different Levels of Family Income ........5–3

Incidence Rates Per 1,000 Children for Maltreatment under the

Endangerment Standard in the NIS–3 (1993) for Different Levels

of Family Income .......................................................................................... 5–1 1

Incidence Rates Per 1,000 Children for Maltreatment under the

Harm Standard in the NIS–3 (1993) for Different Family Structures .......... 5–19

Incidence Rates Per 1,000 Children for Maltreatment under the

Endangerment Standard in the NIS–3 (1993) for Different Family

Structures ......................................................................................................5.26

Incidence Rates Per 1,000 Children for Maltreatment under the Harm

Standard in,the NIS–3 (1993) for Different Family Sizes............................ 5–34

Incidence Rates Per 1,000 Children for Maltiatment under the

Endangerment Standard in the NIS–3 (1993) for Different Family

Sizes .................................................................................................54l

Categorization and Distribution of Perpetrators of Child

Mal&eatment ................................................................................................. 63

vii
7–2

7–3

74

7–5

Distribution of Perpetrator’s Relationship to Child and Severity

of Ham bythe Type of Maltreatment ..........................................................ti

Distribution of Perpetrator’s Sex by Type of Maltreatment and

Perpetrator’s Relationship to Child .............................................................. 69

Distribution of Perpetrator’s Sex by Severity of Outcome ad

Perpetrator’s Relationship to Child ..............................................................&l 1

Distribution of Perpetrator’s Age by Type of Maltreatment and

Perpetrator’s Relatimrshipto Child ..............................................................&l3

Distribution of Perpetrator’s Age by Severity of Outcome ad

Perpetrator’s Relationship to Child ..............................................................&l4

Distribution of Perpetrator’s Employment Status by Type of

Maltreatment and Perpetrator’s Relationship to Child ................................. &16

Distribution of Perpetrator’s Employment Stitus by Severity of

Outcome and Perpetrator’s Relationship to Child ........................................&l7

Distribution of Child’s Race by Type of Maltreatment and

Perpetrator’s Relationship to Child ..............................................................&l8

Distribution of Child’s Race by Severity of Outcome and

Perpetrator’s Relatimrshipto Child ..............................................................G2O

Sources Recognizing Maltreated Children Who Fit the Harm

Standard in the NI$3 (1993), and Comparisons with the

Estimated Numbers from Different Sources in the NIS–2 (1986)

and NI$l (1980) .........................................................................................7.3

Sources Recognizing Maltreated Children Who Fit the Endangerment

Standard in the NIS–3 (1993), and Compwisons with Recognition

Sources in the NIS–2 (1986) . .. .. .. .. ...... .. .. .. ... .. .. ..... ... ...... .. .. ... ... 7–1 1

Changes since the NIS–2 in Percentages of Children Receiving

CPS Investigation, by Maltreatment under the Harm Stmrdard 7–20

CPS Investigation of NI*3 (1993) Children Who Fit the Harm

Standard, According to Their Recognition Source ....................................... 7–22

Changes since the NI$2 and NIS–1 in Percentages of Children

Cmsntible under the Harm Standard Who Received CPS Investigation,

by Their Recognition Source ........................................................................7.29

.,. VIII
74 Changes since the NIS–2 in Percentages of Children Receiving

CPS Investigation by Maltreatment under the Endangerment

Stindwd ........................................................................................................7.33

1-7 CPS Investigation of NIS–3 (1993) Children Who Fit the Endangerment

Standwd, According to Their Recognition Source.,..,.., ...............................7-35

1–8 Changes since the NI%2 in Percentages of Children Countable

under the Endangerment Standmd Who Received CPS Investigation,

by Their Recognition Source ........................................................................74l

ix
1-1 ~S3 S~dy Design ..................................................................................... 14

2-1 Overview of Perpetrator and Harm Components of the Definitional

Stsmdwds Used in the NI$3 ........................................................................2.l 1

x
Figure

2–1

2-2

3-1

3-2

3-3

34

3-5

34

3–7

3–8

3–9

3-1o

&l

&2

Levels of Recognition of Child Abuse and Neglect,..,..,..,..,,.,...,..,.........,..,.2-2

Schematic Summary of the NIS Methodolo~ .............................................2.5

Changes across the Three National Incidence Studies in the

Incidence Rates of Types of Abuse under the Harm Standard .....................3–9

Changes across the Three National Incidence Studies in tbe

Incidence Rates of Types of Neglect under tie Harm Standard 3–12

Changes across the Three National Incidence Studies in the

Incidence Rates of Outcomes from Maltreatment under the

Harm S@ndard..............................................................................................3.l6

Components of the NI$3 Endangerment Standard Estimates for

Different Maltreatment Categories ...............................................................3.l9

Components of the NI$3 Endangerment Standard Estimates for

Different Abuse Types..................................................................................3.22

Changes across Two National Incidence Studies in the Incidence

Rates of Types of Abuse under the Endangerment Standard 3–23

Components of the NIS–3 Endangerment Standard Estimates

for Different Neglect Types..........................................................................3.25

Changes across Two National Incidence Studies in the Incidence

Rates of Types of Neglect under the Endangerment Standard ..................... 3–25

Components of Estimates for Different Severities of Outcomes

from Maltreatment under the Endangerment Standard 3–28

Changes across Two National Incidence Studies in the Incidence

Rates of Different Severities of Outcomes from Maltreatment

under the Endangerment Standwd ................................................................3.29

Changes from the NI$2 to the NIS–3 for Males and for Females

in the Incidence of Physical Neglect under the Harm Standard ...................45

Changes from the NIS–2 to the NI%3 for Males and for Females

in the Incidence of Fatalities from Maltreatment under the Harm

Standard ........................................................................................................%

xi
&5

49

&lo

&12

+13

Changes from the NIS2 to the NI%3 for Males and for Females

in the Incidence of Overall Maltreatment under the Endangerment

Stindard ........................................................................................................4lO

Changes from the NI$2 to the N1$3 for Males and for Females

in the Incidence of Emotional Abuse under the Endangerment

Standmd ........................................................................................................+l O

Age Differences in All Maltreatment, Abuse, and Neglect under

the Harm Standard ........................................................................................412

Age Differences in Abuse Types under the Harm Standard .. .. .......... ...... 413

Age Differences in Emotional Neglect under the Harm Standard ...............415

Age Differences in Moderate Injuries from Maltreatment under

the Harm Stidard ........................................................................................41 S

Age Differences in overall Maltreatment under the Harm Standard

inthe NIS.2and the N1S.3 ..........................................................................4l6

Age Differences in Abuse under the Harm Standard in the

NIS–2 and the NI$3 ....................................................................................4l7

Age Differences in Neglect under the Harm Standard in the NIS2 and

the NI%3 ......................................................................................................Ll8

Age Differences in Educational Neglect in the NIS–2 and theNI>3...,...,.418

Age Differences in Moderate Injuries from Maltreatment under the

Harm Standard inthe NIS–2 and the NIS–3 ................................................4l9

Age Differences in All Maltreatment, Abuse, and Neglect under the

Endangerment Stidard ................................................................................&2O

Age Differences in Abuse Types under the Endangerment Standard ..........421

Age Differences in Neglect Types under the Endangerment Standard .,......423

Age Differences in Outcomes from Maltreatment under the

Endangerment Standmd ................................................................................ 424

Age Differences in Overall Maltreatment under the Endangerment

Standard in the NIS–2 andthe NI%3 ..........................................................&2S

xii
419 Age Differences in Neglect under the Endangerment Standard in the

NI>2 and the NI~3 ....................................................................................L26

420 Age Differences in Emotional Abuse under the Endangerment

Standard in the NI%2 and the NI~3 ..........................................................427

621 ‘ Age Differences in Emotional Neglect under the Endangemrent

Standmd in the NIS–2 and the NIS–3 ..........................................................&27

622 Age Differences in Moderate Injuries from Maltreatment under the

Endangerment Standard in the NIS–2 and NIS.3 ........................................428

5-1 Incidence of Types of Abuse under the Ham S@ndard for

Different Levels of Fanrily Income ..............................................................5.5

5–2 Incidence of Types of Neglect under the Ham Standard for

Different Levels of Family Income ..............................................................5.7

5–3 Incidence of Injuries from Maltreatment under the Hamr

Standard for Different Levels of Family income .........................................5.9

54 Incidence of Types of Abuse under the Endangerment Standard for

Different Levels of Family Income .............................................................. 5-13

5-5 Incidence of Types of Neglect under the Endangerment Standard for

Different Levels of Fmily income .............................................................. 5–15

54 Incidence of Injuries from Maltreatment under the Endangernrent

Standwd for Different Levels of Fanrily Income ......................................... 5–15

5–7 Incidence of Endangered Children in the NI%2 and the NIS–3 for

Different Levels of FamiIy Income .............................................................. 5–17

5-8 Incidence of Overall Maltreatment and of Abuse and Neglect

under the Ham Standard for Different Family Stmctures..,.., ..................... 5–20

5-9 Incidence of Types of Abuse and Neglect under the Ham

Standard for Different Family Stiuctires ..................................................... 5–21

5-1o Incidence of Injuries from Maltreatment under the HH

Standmd for Different Family Stictures ..................................................... 5–23

5-11 Incidence of Physical Abuse under the Ham Standard in the NIS–2

and the NIS–3 for the Different Family Structures ...................................... 5-24

X111
b

5–12

5–13

5-14

5-15

5-16

5–17

5-18

5–19

5–20

5–2 1

5–22

5-23

5–24

5–25

7–1

Incidence of Overall Maltreatment and of Abuse and Neglect under tbe

Endangerment Standard for Different Family Structures ................... 5–27

Incidence of Two Specific Types of Neglect under the Endangerment

Standard for Different Family Stmctires ..................................................... 5–28

Incidence of Injuries from Maltreatment under tbe Endangerment

Standard for Different Family Stictures .....................................................5.3O

Incidence of Emotional Abuse under the Endangerment Standard in the

NIS–2 and the NIS–3 for Different Family Structures...,..,..., ...................... 5–31

Incidence of Inferred Injury from Maltreatment under the Endangerment

Standard in the NI%2 and the NIS–3 for Different Family Structures 5–32

Incidence of Endangerment from Maltreatment under the Endangerment

Standard in the NIS–2 and the NI$3 for Different Family Structures ....... 5–33

Incidence of Overall Maltreatment and Neglect under the Harm

Standwd for Different Family Sizes ............................................................. 5–35

Incidence of Two Specific Types of Neglect under the Harm Standard

for Different Family Sizes ............................................................................ 5–37

Incidence of Moderate Injuries from Maltreatment under the Harm

Standard for Different Family Sizes .............................................................5.38

Incidence of Neglect under the Harm Standard in the NIS–2 and

the N1%3 for Different Family Sizes........................................................... 5–39

Incidence of Emotional Neglect under the Harm Standard in tbe

NIS–2 and the NI$3 for Different Family Sizes ........................................540

Incidence of Overall Maltreatment and Neglect under the Endangerment

Standard for Different Family Sizes ............................................................. 542

Incidence of Two Specific Types of Neglect under the Endangerment

Standard for Different Family Sizes.............................................................544

Family Size Differences in Incidence Rates for Injuries from Neglect

under the Endangerment Standard ................................................................ 545

Recognition of Children Who Fit the Harm Standard in Investigatory

Agencies in the Three National Incidence Studies...,.., ................................ 7–7

xiv
7–3

74

7–5

74

7-7

7-8

7–9

7-10

7–1 I

7–12

7–13

7-14

7–15

7–16

Recognition of Children Who Fit the Hm Standard in Other

~mrinvestigatory) Study Agencies in the Three National Incidence

Studies .......................................................................................................... 7–7

Recognition of Children Who Fit the Harm Standwd in Other (CPS-only)

Sources inthe Three National Incidence Stidies .........................................7.9

Recognition of Children Who Fit the Ham Standard across the Main

Categories of Sources in the Three National Incidence Studies ..................7-9

Recognition of Children Who Fit the Endangerment Standard in

Investigato~ Agencies in the NI$2 mdtie NIS-3 ....................................7-l3

Recognition of Children Who Fit the Endangerment Standard in Other

@oninvestigatory) Study Agencies in the NI~2 and the NIS-3 ................7-13

Recognition of Children Who Fit the Endangerment Standard across the

Main Categories of Sources in the NIS–2 and the NIS–3 7–14

Changes across the Three National Incidence Studies in the Percentage

of Children Who Fit the Harm Standmd of Those Investigated by CPS 7–16

CPS Investigation of Children with Different Types of Maltreatment

under the Hm Standard and Different Degrees of hrju~ or Harm., .......... 7–17

Percentages Investigated by CPS of Those Children Who Fit the Harm

Standard, Classified by the Main Catego~ of Their Recognition Source ...7–23

Recognition Sources of Children Who Were Maltreated under the

Harm Standard Who Received CPS Investigation ... ..... ..... ...... .. .. ... ...... 7–26

Recognition Sources of Children Who Were Maltreated under the Hm

Standmd Who Were~ Investigated by CPS .............................................7.27

Changes from the NI$2 to the NIS–3 in the Percentage of Children

Investigated by CPS of Those Who Fit the Endangerment Standard ........... 7–30

CPS Investigation of Children with Different Types of Maltreatment under

the Endangerment Standard and Different De~ees of Injury or Hm 7–32

Percentages of Children Investigated by CPS of Those Who Fit the

Endangerment Standard, Classified by the Main Catego~ of Their

Recognition Source .......................................................................................7.36

Recognition Sources of Children Who Were Maltreated under the

Endangerment Standard Who Received CPS Investigation ......................... 7–38

xv
7–17 Recognition Sources of Children Who Were Maltreated under the

Endangerment Standard Who Were ~ Investigated by CPS . . 7-39

~ (Bound Sepmately)

A Hm S~ndsrd Estimates

B Endangerment Stsndard Estimates

c Within-Study Analyses

D BeWeen-Study Analyses

E NIS–3 Stiff and Expefi Resources

xvi
This report presents the results of the congressionally mmdated Third National

Incidence Study of Child Abuse and Neglect @lS–3). The NIS is the single most

comprehensive source of information about the current incidence of child abuse and neglect in

the United States. The NIS–3 findings are based on a nationally representative sample of over

5,600 professionals in 842 agencies sewing 42 counties. The study used WO sets of standardized

definitions of abuse and neglect. Under tbe Harm Standard, children identified to the study were

considered to be maltreated only if they had already experienced harm from abuse or neglect.

Under the Endangerment Standard, children who experienced abuse or neglect that “putthem at

risk of harm were included in the set of those considered to be maltreated, together with the

already-harmed children.

The NIS–3 provides us with important insights about the incidence and distribution

of child abuse and neglect and about changes in incidence since the previous studies,

Incidence

. There have been substantial and significant increases in the incidence of child

abuse and neglect since the last national incidence study was conducted in

1986.

. Under the Harm Standard definitions, the total number of abused and

neglected children was two-thirds higher in the NIS–3 than in the NIS–2,

This means that a child’s risk of experiencing harm-causing abuse or neglect

in 1993 was one and mre-halftimes the child’s risk in 1986.

● Under the Endangerment Standard, the number of abused and neglected

children nearly doubled from 1986 to 1993. Physical abuse nearly doubled,

sexual abuse more than doubled, and emotional abuse, physical neglect, and

emotional neglect were all more than two and one-half times their NIS–2

levels,

. The total number of children seriously injured and the total number

endangered both quadrupled during this time.

xvii
Child Characteristics

● Girls were sexually abused three times more often than boys

. Boys had a greater risk of emotional neglect and of serious inju~ than girls

. Children are consistently vulnerable to sexual abuse from age three on.

. There were no significant race differences in the incidence of maltreatment or

maltreatment-related injuries uncovered in either the NIS–2 or the NIS–3.

Family Characteristics ,’

● Children of single parents had a 77-percent greater risk of being harmed by

physical abuse, an 87-percent greater risk of being harmed by physical

neglect, and an 80-percent greater risk of suffering serious inju~ or harm

from abuse or neglect than children living with both parents.

. Children in the largest families were physically neglected at nearly three

times the rate of those who came from single-child families.

● Children from families with annual incomes below $15,000 as compared to

children from families with annual incomes above $30,000 per year were

over 22 times more likely to experience some form of maltreatment that fit

the Harm Standard and over 25 times more likely to suffer some form of

maltreatment as defined by the Endangerment Standard.

. Children from the lowest income families were 18 times more likely to be

sexually abused, almost 56 times more likely to be educationally neglected,

and over 22 times more Iikely to be seriously injured from maltreatment as

defined under the Harm Standard than children from the higher income

families.

Child Protective Sewices (CPS) Investigation

● CPS investigated only 28 percent of the recognized chiIdren who met the

Hamr Standard. This was a significant decrease from the 44 percent

investigated in 1986,

. Although the percentage of children whose abuse or neglect was investigated

declined, the actual number of children investigated remained constant.

. CPS investigated less than one-half of all Harnr Standard children recognized

by any source and less than one-half of all Endangerment Standard children

recognized by any source except police and sheriffs’ departments (52”A).

Xvlll
● Schools recognized the largest number of children maltreated under the Harm

Standard, but only 16 percent of these children were investigated by CPS.

. CPS investigated only 26 percent of the seriously injured and 26 percent of

the moderately injured children.

~is study would not have been possible without the support of hundreds of

agencies and individual caseworkers, teachers, police officers, social workers, probation officers,

nurses, and other professionals in the study counties who contributed their enthusiastic support

and much of their time in the effort to assess accurately the incidence, nature, and distribution of

child abuse and neglect in the United States. 1 extend my appreciation to these dedicated

respondents.

&AOlivia A. Golden

Commissioner

Administration on Children, Youth

and Families

xix
1. ~TRODUCTION

This report presents the findings of the Third National Incidence Study of Child Abuse and

Neglect @IS–3). It includes nontechnical descriptions of the study design and methodology and

presents the national estimates of the incidence of abused and neglected children, the nature and severity

of their maltreatment and its distribution by various demographic factors, the sources who recognized

their maltreatment, and the proportions of these children who were reported to and investigated by child

protective sewice (CPS) agencies.

This final report isaself-contained document, in that it is not necessary to refer to any

other reports or materials to understand the design, methods, and findings of the main NI>3 study.

However, there are wo series of other reports that provide further information for interested readers,

The first series comprises thetechnicaI repofis onthekey NIS-3 activities, detailing the procedures and

results at each stage of implementation. This series includes the following four repotis, which can be

read as a sequence tiat culminates in this, the final report:

. ~eRevisedSru@ Desi@presents the background fortie NIS-3effofi andthe process

of developing and revising the study design; describes the overall study design and its

component$ and presents the technical approach plan for the sampling, data collection,

and analysis phases,

● The Sample Selection Repori describes all the sample development and selection

procedures that were used in this project.

● The Data Collection Repor? includes a brief ovewiew of the study background and

design and describes all data collection activities, including the recruitment methods

anddegree ofsuccess, thedata collection procedures, andthenumbers ofdifferent data

forms ultimately received.

● The Analysis Report details the data processing steps, including basic and evaluative

coding; the data retrieval, keying, and cleaning processes; the unduplicatimr methods;

the weighting and nonresponse adjustment approaches; the derivation of the

annualization multipliers; and the development of the national estimates and variances,

The second series of additional reports presents the findings from policy-relevant

substudies, which were self-contained efforts directly devoted to addressing outstanding questions in the

legislative mandate that authorized the NIS–3, as described below, This second series comprises the

following three repotis:

1–1
● The report on the Court Referral Srudy presents the results of two approaches to

examine the involvement of civil and criminal courts in cases ofsubstmrtiated child

abuse and neglect. Oneapproach used case-level data from the NS-3CPS agencies to

generate estimates of the percentages of substantiated cases that were referred for civil

or criminal court action. The other approach used interviews with representatives of

the civil and criminal courts in the NI>3 counties in order to describe how these courts

process child abuse and neglect cases and to determine what records are maintained at

different points in the court system.

. The report on the CPS Screening Pol;cy and Recordkeeping Study provides the results

of special intewiews with intake supervisors at all CPS agencies that participated in the

NIS–3. This stidyexamines their criteria forscreening repotied cases ofchild abuse

and neglect prior to investigation and identified what records were kept regarding

screened-out cases.

. The report on the Sentinel Questionnaire Follow-up Study provides the findings from a

follow-up questimrnaire mailed toallthe NIS–3 sentinels in schools. It describes the

experiences of these sentinels in reporting or attempting to report cases of suspected

child abuse and neglect to CPS and analyzes the factors that affect the sentinels’

decisions on whether to report.

The remaining sections of this chapter describe the legislative mandate tiat authorized the

NIS–3 and provide an ovewiew of the complete NIS–3 design, including the various substudies and the

reasons that they were developed. This chapter ends with a brief orientatimr to the topics that will be

covered intheremaining chapters ofthis repoti.

1.1 Bac~rorsnd

The National Incidence Study @lS)isa congressionally mmdated, periodic effofl of the

National Center on Child Abuse and Neglect @CCAN), a center within the Administration for Children

and Families (ACF) in the U.S. Department of Health and Human Services. The first NIS @IS–1 ),

mandated under Public Law (P.L.) 93–247 (1974), was conducted in 1979 and 1980 and published in

1981, The second NIS @ISB2), mandated under P.L. 98457 (1984), was conducted in 1986 and 1987

and published in 1988. The third NIS @IS–3) was mandated under the Child Abuse Prevention,

Adoption, and Family Services Act of 1988 (P.L. 10W294, as amended), conducted between 1993 and

1995, and published in 1996.

I–2
The Third National Incidence Study of Child Abuse and Neglect ~lS–3) was designed to

meet several congressional mandates issued in the Child Abuse Prevention, Adoption, and Family

Sewices Act of 1988 (P,L. 10W294). Specifically, the NIS–3

● provides cument estimates of the incidence of child abuse and neglect in the United

States and measures changes in these estimates from earlier studies;

● examines the distribution of child maltreatment in relation to various demographic

factors;

. estimates the incidence of substantiated maltreatment cases that result in civiI and

criminal proceedings and their disposition; and

● develops an understanding of the relationships be~een an incident of maltreatment, its

obsewatimr, its repofi to a child protective service agency, and any actions taken by the

agency.

1.2 The NI%3 Study Design

Exhibit l–l presents the NIS–3 study design. To accomplish the N]S–3 objectives, Westat

and Westat’s subcontractor, James Bell Associates, Inc., ““detiook seven studies, These are shOwn in

the seven rectangular boxes in Exhibit 1–1, where they are also briefly described. Exhibit l–l also

describes an eighth study, which is shown in the rounded-comer oblong box and delineated with a dotted

line, This eighth study, which was primarily funded by the National Institute of Justice in the U.S.

Depa~ent of Justice, was nor fomally pan of the NIS–3 in its entirety, but it was directly relevant to

one of the NIS–3 objectives and was therefore coordinated with the NIS–3, with supplemental funding

from NCCAN.

Objective 1: Incidence of Child Abuse and Neglect. All three major studies Of the

national incidence of child abuse and neglect, the NIS–1, the NI$2, and the NIS–3, used similar

methodologies. The principal pu~ose of all three studies was to go beyond cases of child maltreatment

that come totheafiention of theoficial CPSsystem andatiempt toassess the overall national incidence

of the problem of child maltreatment.

I–3
Efiibit l–l. NIS–3 Study Design

Conductedfora 3-monthdatawlletion periodin40PSUS(42

munfies),parallelingthe NIS-1andthe NIS-2designSdata

includedallroses investigatedbyCPSand rewgnizedbynonCPSsentinelsinapproximate 800agenues Gndudinglaw

enformment,juvenileprobation,pubfichealth,hospitals,stiools,

daymre -ntem, mentalhealthand sodalSeti- agenties).

/

1, ‘,

o

‘,

, n

iAnnualization

AbstratiedrecordsonsubstantiatedCPS

Objective2: -ses andetiracted informationrelevantto

Toexami”ctie BmisStudy annuabzing3-monthsofdata,enab~ng

fwtomSWciatti estimatesto be madefora fullyear.

witimaltreatment ‘!

\

n

Aloated the NIS-3agen~ and sentinel

Analysisof samplestominimizethe influen= ofhidden

Hidden dupfiationMas,and designedanavses ofthe

D“pltcationBias finaldatabaseto estabflshan upperboundon

the amountofsuti has remaining.

J

m Bplored the effetiivenessofexpandingthe NIS NewSentinel

Aaenwc*~gOries

non-CPSsentinelsto includemnawayand battered

Study women’ssheltem,pediatictinim, HMOS,deqy,

and pubhchousingatihofities.

objective,: /M Q

Toe,t,matctie

incidenceof

c-s thatresult

““= m

Abstractedrecotis onsubstantiatedCPSroses and

etiratied informationpedainingto coutirefemalfor.tild

protectionandlorfflminalprosecution.Includedtelephone

tiswssions tith representativesofthe criminalwuti%inall

NISW“”tiestoIeamhow-s.s are pro-ssed and remrds

are maintained:obtainedaggregatestatisti= on numberof

timinal prosewtionsand theirdispositions.

Condutiedtelephonediscussionstith epresentativesofthe

dvilwutis inallNISmuntiesto learnhowroses are

pro-ssed and recordsare maintained;obtainedaggregate

statistimonthe numberofdvilctildoroletion roses

..––––– oroessed–..andtheirdisol

data inone ofthe NISu

and lawenfor=ment ag,

protetion ations andlof

,ositions.Aliowlletied ase-level

]untiesandtraded roses fromCPS

enties intothe wufls fortilld

r timinal prosecution.

~

Objective4:

m

Sent,nel &hed schoolsentinelsabouttheirdedsionsto repotinot

To“ndemtid Q“~;:on$; reponwses toCPSandlorlawenforwment,their

relationsipsamong experienmsinEpoting, andthe etient and natureof

incidenti,heir bamierstotheirrepotingroses theyobsewe.

obxwation,md

mtionstie”

n

CPSScreening hamined the pofiuesofCPSagenaes regatiingdetisions

Poliw& to investigaterepofled-Ses, and identifiedtiat rewrds are

R-ordk=p>”g establishedbemeen fimtagenq wntati andfinaldeusion

Study tohdv investigate.
To fulfill this goal, the~sWdies collected dati on maltreated children from CPS agency

workers and from “sentinels” in different sectors of community agencies such as law enforcement, public

health, juvenile probation, hospitals, schools, day-care, mental health, and volunta~ social sewices,

While the NIS–3 closely followed the same methodology, it also incorporated substantive improvements

inmethodology tostren@hen thequali~of the findings in several respects. Major improvements within

the NIS–3 Bm;c NIS Sentinel Stu@ included effotis

. toimprove theprecision of theoverall incidence estimates byincreasing the number of

counties (primary sampling units, or PSUS) included in the study,

● to enhance the precision of measures of change by ensuring that counties that

participated inthe NIS-2were also included inthe NIS-3; and

● to increase the efficiency of the agency samples by providing greater representation of

the more productive agency categories,

Three additional, sepwate studies were also inco~orated in the main NIS–3 design in order

to improve and/or examine the quality of the final incidence estimates derived from the Basic NIS

Sentinel SIu@ data and to guide future NIS effofls:

● The Annua/izalion Basis Study was included to update the basis for annualizing the

information reflecting a3-month data period in order to provide estimates reflectinga

complete year;

● The Analysis o~Hidden Dup/icafion Bimwasundefiken toestablish anupper bound to

theamount of bias inthe Misestimates duetohidden duplication of cases; and

. The New Sentinel Agency Categories Study was conducted to indicate the extent to

which the current configuration of NIS non-CPS sentinels provides comprehensive

coverage of abused and neglected children recognized by community professionals.

Because of the technical nature of these specialized substudies, thedehils of their design,

methodology, andtheir findings arerepofied and discussed intheseries of technical repofismr the main

NIS-3.

Objective 2: Factrrm Associated with Maltreatment. The data collected for the Basic

NIS Serrfinel Sfudy (Objective 1) provide sufficient infomratimr to reveal the relationship between

maltreatment and

● thecharacteristics of the children: their sex, age, and race;

I–5
. the chmacteristics of the families: their income, two-parent or single-pwent status,

number of children in the household, residence in a metropolitan versus mral wew, and

. the maltreatment circumstances: the pe~etrator’s relationship to the child; the

peWetrator’s sex, age, and employment status; the nature and severity of ham; and for

children investigated by CPS, whether any previous repotis of maltreatment in this

family had been substantiated by the agency.

In addition, the Bmic NIS Sentinel Stu@ provides infomration concerning the children who

experience different types of abuse and neglect, indicating the agencies that typically recognize the

maltreated children and the propofiimr of these children whose maltreatment was repofied to and

investigated by CPS.

Objective 3: Incidence of Civil and Criminal Proceedings. This objective addressed the

congressional mandate that required NCCAN to “conduct research on the incidence of substantiated

repofied child abuse cases that result in civil child protection proceedings or criminal proceedings,

including the number of such cases with respect to which the coufi makes a finding that abuse or neglect

exists and the disposition of such cases” (P.L. 10&294, Section 6).

In the NIS–3, this question was examined in the Court Rejerra/ Stu@, in which records on

substantiated CPS cases were abstracted in order to extract any information in the CPS case files

pefiaining to the refemal of the case to civil child protection or criminal proceedings. In addition, this

study included telephone discussions with prosecutors and criminal couti representatives in all the NIS–3

counties in order to identify tbe processing methods and records that are characteristic at various stages

of case flow.

As noted above, the findings obtained through this NIS–3 study were combined with

information obtained by the National Institute of Justice @IJ) in its study, Justice System Processing oj

Ch;/d Abuse Cases. The NIJ study tracked physical and sexual child abuse and serious neglect cases

from their oticial point of ent~ into either CPS or law enforcement agencies to their disposition in the

criminal and/or dependency couti, thereby providing case-level infomration about the factors associated

with different couti responses and dispositions. In addition, this NIJ study included intewiews with

representatives of the civil coutis in all NIS counties to learn how child abuse and neglect cases are

processed in the dependency coufls in the different jurisdictions and what records are maintained through

the various stages of the judicial process.

14
Objective 4: Relationships among Incidents, Their Observation, and Actions Taken.

This objective focuses on an improved unders~nding of whether or not abused and neglected children are

reported to CPS agencies and the response of CPS to reported cases. Key findings in both the NIS–1 and

the NIS-2 were that only a minority of the children who were countable as abused or neglected had been

reported to and investigated by CPS. The NIS-3 Basic Sentinel Stu@ was designed to provide comparable

estimates of tbe proportions of maltreated children wbo were reported to and investigated by CPS, so that

changes since the earlier stidies could be examined. In addition, the NIS–3 included two studies that

provided further information bearing on this objective by illuminating potential reasons that sentinels who

observe abused or neglected children may not submit official reports to the authorities and why a number

of the children whose maltreatment is repofled to CPS agencies may not have their maltreatment

investigated. The WONIS–3 substudies that provide information relevant to these issues are

. the Sent;rrel Quesl;onnaire Follow-up S/u@, which obtained responses from school

sentinels concerning their decision-making about repofling cases to CPS antior law

enforcement. This study also explored the nature of their experiences in reporting or

attempting to report cases to the authorities and the extent and nature of any barriers

that exist to their o~cial reporting of suspected case> and

● the CPS Screening Policy and Recordkeeping Study, which examined the policies of

CPS agencies that paflicipated in the NIS–3 concerning their criteria for deciding

whether or not to proceed with an investigation on a repofied case of child abuse and

neglect. This study also determined the nature of any records that are established on a

case between the time the agency is first contacted about the welfare of a child to the

time the final decision is made to proceed with a full investigation.

13 Focus of This Report

The remainder of this repot comprises seven chapters and five appendices,

Chapter 2, “Methodology,” summarizes the design and methodology of the NIS–3. It

provides an overview of the cmsceptial model that has guided the NIS methodology since its inception

and describes the approach taken in the NI*3, including the NIS–3 sample design, data collection, and

analysis activities.

Chapter 3, “Incidence of Child Abuse and Neglect: provides the current national incidence

of child abuse and neglect as defined using both the Harm Standard and the Endangerment Standard. It

I-7
discusses statistically significant changes in the incidence rates since the NISI and the N*2, describes

the distribution of children across different categories of maltreatment and across different levels of

severity of injuryharrn, and compares these distributions with the distributions found in the earlier

studies,

Chapter 4, “Distribution of Abuse and Neglect by Child Characteristics; examines the

relationship between child characteristics and the incidence and severity of abuse and neglect. It

discusses the NIS–3 findings on the relationship betieen maltreatment and the child’s sex, age, and race;

examines wbetber differences among children in terms of these characteristics systematically relate to

differences in incidence rates for different maltreatment categories or severities of outcome; and

describes statistically significant changes since the NI%2 in the distribution of child maltreatment by the

different characteristics.

Chapter 5, “Distribution of Abuse and Neglect by Family Characteristics; examines the

relationship beWeen specific characteristics of the children’s families and the incidence and severity of

abuse and neglect, It presents the NI>3 results concerning the incidence of different maltreatment

categories and severities of outcome for children who come from families with different income levels,

parent structures, and numbers of dependent children and whose counties of residence differ in degrees

of urbanimtims. This chapter also describes statistically significant changes since the NIS–2 in the

distribution of child maltreatment by these family characteristics.

Chapter 6, “Distribution of Abuse and Neglect by Perpetrator Characteristics; discusses

how the children who were abused and neglected according to the Harm Standard are distributed

according to their relationship with their perpetrator; their perpetrator’s sex, age, and employment statu~

and in relation to their maltreatment, its severity, and their own race.

Chapter 7, “Recognizing and Investigating Abused and Neglected Childrerr~ considers

what community sources recognize maltreated children as abused or neglected and what percentages of

these children are repotied to msd investigated by CPS agencies. The chapter also examines the changes

that have occumed in recognition at different agencies since the NIS-I and the NI>2 and compmes the

percentages of children who received investigation by CPS with tbe percentages found to receive CPS

investigation in the prior studies.

Chapter 8, “Summary, Key Findings, and lmplicatimrs~ summarizes the highlights of the

NIS–3 findings and discusses their policy implications.

1–8
2. ~~ODOLOGY

~is chapter summwizes the design and methodology of the NI$3. It provides err

ovewiew of the wnceptual model that has guided the MS methodology since its inception and indicates

the approach tien in the present study. Sections offer abb~viatcd descriptions of the study definitions,

the agency and sentinel samples, and the methods of data collection and processing. Futier details

about the study design and methodology are provided in the series of NI~3 technical mpo~: the

Revised St@ Desi~, the Sample Selection Report, the Data Collection Report, and the Analysis Report,

2.1 Study Design

Since the main pu~oses of the NI>3 wem identical to those of tbe N*1 and the NIS–2,

and because cross-study compmisons were a primasy interest, the study design for the N193

substantial Iy pmalleled the design of the previous studies. A simple conceptual model provided the

rationale for this design; it is explained in the next subsection. A description of the general approach

derived fmm the conceptual model follows.

2.1.1 Wtionale

Although substantial numbers of abused and neglected children we investigated by CPS

agencies, these children represent only the “tip of the iceberg.” me NIS methodology is based on the

five-level model given in Figure 2–1, which depicts the investigated children at Level 1. As the model

indicates, other abused and neglected children we at levels below this, with each succeeding level

associated with decreasing de~ees of offtcial recognition or public aw=ness.

At Level 2 me tiose children who me not investigated by CPS but who we recognized as

maltreated at other “investigator” agencies, such as police dep~errts, coufi, or public health

depmtrnents. ~ese agencies may have overlapping or even conflicting responsibilities concerning

cetiin situations, such as felonious assaul~ homicide, delinquency, dependency, domestic violence,

“children in need of cmrtiol,” or nutsition and hygiene problems. Children may remain at Level 2

because of questions of definition or disputes concerning the appropriate responsibilities of these

2-1
Level 1- Known to CPS

Level 2- Known to other

lnvestlgato~ agencies

Level 3- Known to professionals

in schools. hospitals and other

\

\

\

Level 4- Known to other

agencies and individuals

-—-— ———— —

Level 5- Known to no one

Figure 2–1. Levels of Recognition of Child Abuse and Neglect

different agencies in relation to CPS. Although Level 2 children are in some sense “officially known:

they me not necessarily regarded by the community as abused or neglected in the same sense as Level 1

children are, and they do not necessarily receive assistance that specifically targets their abuse or neglect

problems.

Lsvel 3 includes abused and neglected children who are not knowrr to CPS or toany Level

2 agency but wbo we known to professionals in other major community institutions, such as schools,

hospitals, day-care centers, and voluntary social sewice or mental health agencies. Children may remain

at this level because the professional who recognized them did not report them for any number of

reasons. One reason may he definitional ambiguities as to what ~pes of cases should be reported to CPS

(or to other investigatory agencies). Other reasons relate to the attitudes and assumptions of the

professionals who are aware of these situations. For example, they may feel that they are in the best

position to help, may not trust CPS to handle the problem appropriately, or may have apprehensions

2-2
about becoming involved in an official investigation. Children also can remain at this level when the

professional who recognized their maltreatment did report them, but CPS declined to accept their cases

for investigation. As with nmrreporting, there are multiple possible reasons for screen-outs. A child’s

case may not meet the agency’s criteria (e.g., the maltreatment is not in the CPS agency’s jurisdiction, or

it may not be sufficiently serious to warrant investigation). Another possibility is that the professional

did not provide suficient information to CPS to enable investigation.

The abused and neglected children at Level 4 are recognized as maltreated by someone

outside of the purview of the first three levels, such aa a neighbor, another member of the family, or by

one or both of the involved pafiies-the perpetrator and tbe child, However, none of the individuals

recognizing the maltreatment at this level has made it known to Levels 1 through 3. Here again, it is

possible that these Level 4 individuals did reveal the maltreatment to persons at Levels 1, 2, or 3, but that

the latter did not recognize the maltreatment aa such. (~is would include CPS screening mst’a Level 4

child.)

At Level 5 are those children who have not been recognized as abused or neglected by

anyone. These are cases where the individuals involved do not them%lves regard their behaviors or

experiences as child maltreatment arrd where their situations have not come to the attention of outside

obsewers who would recognize them as abuse or neglect.

This model conveys the inherent difficulty of any attempt to measure the incidence of child

abuse and neglect. Level 5 cases are by definition impossible to document (unless they can be brought

into Level 4). In principle, it should be possible to identifi children at Level 4 through methods such as

suweys of parents, children, antior neighbors, and several such surveys have been conducted. 1 me

possibility of using a general population survey methodology was, in fact, entetiained in the NIS-1, the

NIS–2, and the NIS–3 during early design stages. However, the stigmatizing nature of acknowledgments

of abuse and neglect introduces serious (and unknown degrees oo undemepofling bias into estimates of

cases at this level.2 As a result, all NIS effotis have focused on assessing the incidence of cases only at

Levels 1,2, and 3.

1For example,in 1995,the GallupOrsanimtion conducteda mdom telephonesuwey of puents in an anemptto -Iculate the

incidenceof physicalmd sexualabuseof children.

2 In the NIS-1, telephoneand in-personintewiewswith parentswerepretested,butthe approachwas abandonedbeforethe main

study was implemented. In the NI%2, a household intewiw imrmment ws developed, but the suwey i~lf was not

undetien. In tie NI>3, NCCAN’Soriginalrequestfor propmal includeda householdsuwey componentin the specified

2-3
2.1.2 Approach

me key components of the NIS design are schematically diagramed in Figure 2–2. me

assumption that the children investigated by CPS represent only the “tip of the iceberg” is apparent in the

fact that data are collected from both CPS and non-CPS sources.

me NIS uses a survey methodology that begins with a nationally representative sample of

counties. In the NI>3, the county sample comprised 42 counties, which included two pairs of adjacent

rural counties that were sampled as pairs. ~us, the NIS–3 sample included 40 independent primary

sampling units, or PSUS. me method used to sample these counties ensured that they would represent

different regions of the cmm~ and different degrees of urbani=timr.

In each county, both CPS and non-CPS agencies participate. CPS provides information

about all reported cases that are accepted for invcstigatimr during the study time-period. In the

N1%3, each county CPS agency ptiicipated (i.e., 42 CPS agencies). me NIS–3 study data period was

from September 5 to December 4, 1993, inclusive. In addition, community professionals at both Level 2

and Level 3 agencies served as “sentinels” by remaining on the lookout for child maltreatment cases

during the study data period.

Non-CPS participants in each county include professional stiff in public schools; day-care

centers; children’s and shofi-stay, general hospitals; municipal police departments; voluntary social

service agenciey the county juvenile probation and public health department% and the county sheriff or

state police division with jurisdiction over any unincorporated areas not served by municipal law

enforcement. me targeted staff are all professionals at every one of these agencies within each county

who are likely to come into contact with maltreated children during the normal course of their job duties,

and ,who would have suficient contact with these children to enable them to (1) recognize them as

maltreated and (2) provide the information necessary to evaluate them against the study criteria for

classifying children as abused or neglected. In implementing the NIS, however, it is ofien necessary to

sample the agencies in each county in a given category (rather than including all qualifying agencies in

the county) and to sample from among the qualifying staff within each agency. In the NIS–3, 98 I

design, but hat componentwas droppedbefore the study contractwas aw=ded. [n each insmce, the suwey wasjudged too

costly.
NaffonalfyRepmsen~tiw %mple ofCounties:

Ineachwunfy...

/

\

~her Soumes:

RepoflemtoCPS notrepraented among

Non-CPSSentinels.

Mer Protissionals

(pdvateph~icians, cfini~, thempists)

General Public

(friends,neighbom,anonymousallers)

~her GovernmentAgencies

(AFDC,WIC,etc.)

Data Collection

Non4PS Sentinels

~mmunify prof~ionak inspecificwtegod~ of agencies wth regular,

tir@ chiltiami~ Wnkti, gMng&ta tioti allchildrenthey e“~unter

uringthe smdyWriti whomthey susptiti to be Mtim ofmffreatment,

me professionalsrepresented:

tiw Enfomwent

(Po~ce,sheriff,juvenileprobation)

M&i~l Semites

(Hospitils,publichealth depatimen~)

Edumtion

(Publicschools)

~er Semims

(menhlhealth,dayHre, volunta~ smial sewic~)

/,rl\

Evaluation

\m/

/ ‘ndup’iron m

/

Weighting

—~

Rmre 2–2. Schemtic Sum of tie MS Methtiology,
eligible non-CPS agencies were sampled and asked to participate. Of these, 800 agreed to do so,

representing 81.5 percent of the sampled agencies. Within these recruited agencies, a total of 5,612

sentinels participated, representing 95.3 percent of the total sampled.

Note that in Figure 2–2 the CPS data include reports from the non-CPS sentinels, but also

include repofis from sources tiatare notrepresented intienon-CPS sector of the NIS design. These are

Level 3 sources that are outside of the NIS puwiew (e.g., private physicians and therapists) as well as all

Leve14sources (neighbors, friends, etc.). Bydefinition, Leve15sources menotobsewable through any

methodology.

2.2 Data Collection

The NI>3 study period began on September 5, 1993, for all agencies other than schools

and day-care centers, and on September 26, 1993, for those wo categories of agencies. The period

continued through December 4, 1993, for all agencies. Data collection was prospective in nature. CPS

agencies were asked to submit data forms on all cases that were reported during the period and accepted

for investigation by the agency. As was the case in tbe previous NIS efforts, two types of CPS data

forms were used: a Long Form, which obtained suficient details on tbe case to allow it to be assessed

for countability according to study definitions, and a Short Form, which was for the specific purpose of

identifying duplicate reports concerning the same child. Long Forms were filled out on all cases in small

CPS agencies and on representative samples of the targeted cases in the remaining CPS agencies. Short

Forms were filled out for all targeted cases in agencies where samples were drawn for the Long Forms.

All CPS data forms were “family-level” forms, which documented the information concerning all

children in the investigation of a given household or family.

As noted above, non-CPS participants are sentinels in that they are asked to remain on the

lookout for cases of child maltreatment that occur during the study data period. They are trained in the

study definitions of maltreatment and asked to submit a study data form on each maltreated child they

encounter during the study period. The Nmr-CPS Form was a “child-level” form, which recorded the

details on suspected maltreatment of an individual child.

2-6
The NI$3 received a total of 50,729 data forms (3,154 CPS hng Forms, 42,864 CPS

Short Forms, and 4,71 I Non-CPS Forms). ~is was over seven times the number of forms received in

the N1&2?

2.3 Evaluation against the Study Definitions

To a considerable extent, state legislatures have left it up to professionals in the field to

interpret what constitutes “abuse” or “neglect.” At the same time, consensus has yet to be reached as to

the precise meaning of these terms, with different professional groups and individuals maintaining

widely varying perceptions concerning the kinds and degrees of problems that constitute “child abuse”

and “child neglect.”4

As shown in Figure 2–2, reports received by the study undergo a process of evaluation in

which they are assessed for cmrfomity to the study definitions of abuse and neglect. All cases submitted

to the NIS are “screene&’ for conformity to specific definitional standards, and only those cases that fit

the standards are considered “countable” and,used as the basis for genemting incidence estimates.

Among the key achievements of the NI%l and the NIS–2 were the development and

expansion of operational definitions of child maltreatment that were both clear and able to be reliably

applied in order tO sPecifi whether or not a given situation should be included in the study. For the

N1%l, a single, objective set of definitions was developed and applied. In the NIS2, a second set of

definitions was also used and applied in parallel with the first set of definitions. ~is dual-standard

apprOach WaS alsO used in the NI*3. All data were assessed for conformity to both definitional

standards, and the findings reported in later chapters reflect estimates derived from cases of maltreatment

that were found to be “countable” under one or both sets of definitions,

3 Specifically,the totis reflect nearly twice the number of CPS Long Forms, ne=ly 44 pexent more Non-CPS Fomrs, ad

almost 19timesthe numberof CPSSbofiFonrrs. CPSShortFom data collectionwss mo~ compmbensivein the NI>3 rbm

it bad been in theNIS–2, SeetheSamp/eSe/ecfion Reporf for detiils,

4S=, for exmple, Beshamv,D.,ChildAbme Reporting and lmestigotion. W=hington: Americm Bw Association,1988.

2-7
2.3.1 Definitional Standards

In order for an alleged case of child maltreatment to be considered “countable; the

following definitional standards had to be met:

(1)

(2)

(3)

(4)

(5)

Childk Age: The child had to be live-born and under 18 yews of age at the time of

the maltreatment in questions

Ch;ld’s Res;dence: The child had to live in one of the stidy counties at some time

during the study period$

Cmto@ Status: The child had to be a nmrinstittttimralized dependent of parent(s)/

substitute at the time of the maltreatment.7

Time of Maltreatmerrj Maltreatment had to occur during the study period that

applied to the respondent agency.s

Purposive and Avoidable Acts/Omissions: The maltreatment behavior had to be

nmraccidental and avoidable.9

In addition to these five standards, there were requirements concerning the allowable

nature of the abwive acts or neglectfrd orrdssimrs that could be included, concerning the perpetrator of

the acts/omissions, and concerning the degree of harm to the child. A case was considered countable

only if it met all eight standards.

In assessing the countability of cases in the present study, two different sets of definitional

standards concerning harm and perpetrator criteria were used: both the original NIS–I standards (the

Harm Starrdar@ and the revised set of standards first used in the NIS–2 (the Endangerment Starrdar~.

The H- Standard provides a consistent basis of comparison among all three sttsdies. The

Endangerment Standard permits comparisons between the NIS–2 and the NIS–3 estimates concerning a

5ACSor omissionsthat occurredduring pregnmcy or deliverywere excluded.

6 Tempor~ residencein a study county(vacationingor visitingthere)WMincluded. It was trotnecessq for the maltreatment

itselfto have occurredin the studycounty.

7 Institutionalabusemd neglectwereexcluded.

8For CPSda@ a repofi concerningthe maltreatmenthad to have beenmade to CPSduting the study periodmd acceptedfor

investigationby CPS;for non-CPSda% the maltreatmentitselfhad to have occumd during the study data period.

9 The study excluded problemsor hwds that the p~entisubstitute lacked the finmcial meam to prevent or alleviate and for

which appropriate msistmce w= not available through public agencies. Also excluded war lack of care stemming from

pxentisubstitute death, hospitali=tion, incineration, or other circumstices that made it physically impossibleto provide or

mgc for adequatecue.

2-g
broader group of children, As a result of this approach, the NIS–3, like the NIS–2 before it, generated

two sets of national estimates: the Harm Standard estimates, based on the original N]S–l definitions,

and the Endangerment Standard estimates, based on the revised standards developed during the NIS–2.

Harm Standard Requirements, The NIS Harm Standard requirements are stringent. For

maltreatment to be countable under the Harm Standard, it is generally necessary that the child have

suffered demonstrable harm as a result of the maltreatment. In order to be countable under the Harm

Standard, an abused child had to have experienced the abuse at the hands of a parent or parent-substitute

(such as a foster parent, step-parent, or adult caretaker); a neglected child had to have experienced the

neglect at the hands of a parent or parent-substitute. [n addition, the Harm Standard generally required

that a child had been modera/e/y harmed by abuse in order to be included in the abuse total, whereas it

generally required that a child had been seriomly harmed by neglect before permitting the child to be

included in the neglect estimates,

Endangerment Standard Requirements. The Endangerment Standard requirements are

less stringent than the Harm Standard requirements. The Endangerment Standard includes all the Harm

Standard children, but adds others as well, by relaxing the definitional requirements in several respects,

The central feature of the Endangerment Standard is that it adds in those children wbo have not yet been

harmed by maltreatment but who experienced abuse or neglect that put them in danger of being harmed,

according to the views of community professionals or CPS agencies. Specifically, in order to qualify as

“endangered,” the child’s maltreatment had to have been substantiated or indicated by a CPS agency, or

a participating nmr-CPS sentinel had to have explicitly rated the child as having been endangered by the

abuse or neglect in question. In addition, the perpetrator criteria under the Endangerment Standard are

more inclusive than the perpetrator criteria under the Harm Standard in NO principal ways. First,

situations where adult caretakers other than parent(s)/substitute(s) permitted sexual abuse and situations

where nonparental teenage caretakers perpetrated or permitted sexual abuse also were countable,

Second, other adult caretakers, in addition to parent(s)/substitute(s), were allowable perpetrators for WO

forms of neglect: inadequate supervision and other physical neglect (such as inadequate food, clothing,

shelter, disregard of physical h-rds, and other inattention to the child’s physical safety and well-being).

2-9
2.3.2 Categories of Maltreatment

Based on the nature of the abusive acts or neglectful omissions, maltreatment situations are

classified into six major types: physical abuse, sexual abuse, emotional abuse, physical neglect,

emotional neglect, and educational neglect. With the exception of physical abuse, each of these

categories is then broken down into sub~pes, me categories, their subtypes, and their perpetrator and

ham requirements under each definitional standard are given in Efiibit 2–1. In this section, the

allowable abusive acts or neglectful omissions for each category (and where applicable, each subtype)

are described, together with actual examples drawn from the NIS–3 data.

Physical Abuse. me category of physical abuse is unique in that it is not broken down

into subtypes. Acts constituting physical abuse include hitting with a hand, stick, stiap, or other objec~

punching kickin~ shaking; throwing; burning; stabbing; or choking a child. As Efiibit 2–1 shows, only

the harm requirement for this form of maltreatment differs under the Endangerment Standard: the

criterion is relued from one of moderate demonstrable hm to one of endangerment.

In’the NIS–3, children who were classified as physically abused included a I-year-old child

who died of a cerebral hemomhage after being shaken by her fatheL a teen whose mother punched her

and pulled out her haiG a child who sustained second- and third-degree “stocking” bums to the feet after

being held in hot wateq a preteen whose grandfather gave her a black eye; a teen who sustained bmises

after being beaten with an extension cord; and a 3-yesr-old who had welts and bmises from being beaten

with a belt by his father.

Sexual Abuse. Children who experienced any one of three specific fores of sexual abuse

are counted in estimates of the overall incidence of sexual abuse. me three fomrs of sexual abuse reflect

different kinds of acts:

Intrusion

Evidenceio of oral, anal, or genital penile penetration or anal or genital digital or

other penetration was required for this fomr of malbeatment.

10~vi~e”ce ~cm~ ~re~~,e infoma~ion(e,g,, ~h~pcvetr~t~r ~k”owledged his actiom). AS i“ the previousstuties, the tem

does nothave a technicalmming here, eitherlegalor metical.

2-1o
Efiibit 2–1. Ovemiew of PeWetiator and Hm Components of the Definitional Standmds Used in the NIS3

WQUIWMENTS FOR THE EXPANSIONSALLOWD IN THE

MALT~ATMENT HARM STANDARD ENDANGERMENTSTANDARD

PERPETRATOR HARM PERPETRATOR HARM

Physical Assault

Committing Adult cmetier Modemte Endangerment

Pemitthg P~entisubstimte Modemte Endangerment

IntmsiOn

Commining Adult cmetier Assued Any cwetier

Pemining Pwendsubstimte Assmed Any cmetier

Genital molestation

Committing Adult caetier Assmned Any cwetier

y Pemitting Pmentisubstitite Assmed Any cmetier

Other or utiown

Committing Adult cmetier Modemte Any cmtier Endmgement

Peminhg Pmentisubstimte Modemte Any c-er Enticement

Close ConfmemenC Tying or binding

Committing

Pemining

Close COnfmemen~ Other

Committing

Pemintig

Verbal or emotional assault

Committing

Pemitig

Other or bow abm

Commitdng

Pemitting

Adult metier

Adult cwetier

Pmntisubstitite

Adult ctietier

Pmentisubsti~te

Adult cutier

Pmentisubstitite

Asmed

Assmed

Modemte

Modmte

Modemte

Modemte

Endmgement

Endangerment

Endmgement

En&gement

Endangerment

Endmgement
MALTREATMENT HA~ STANDARD ENDANGERMENTSTANDARD

PERPETRATOR HARM PERPETRATOR HARM

Refisal of health cme Pmentisubstimte Modemte En&gement

Delay in healti cze Pwentisubstimte Serious Endmgement

Abmdoment Pwentisubstimte Assumed Endgement

Expulsiotirefiwl of maway PwentisubSimte Assumed

Other custody-related mdtiea~ent Pmentisubstimte Modemte Enticement

hadequate supemision Pmentisubstimte SeriOua Adult cmetier Endwgement

Other physical neglect P~enVsubsitite Serious Adult cmetier En~gement

y Pemitted ckonic macy Pmentisubstitite Assi~ed

L Other timcylfailure to ewoll Pwentisubstitite Assi~ed

Inattention to special educational need Pmentisubstitite Assi~ed

Inadequate nutiracelaffection Pmentisubstimte Serious Endmgement

Chonic/ex&eme spouse abuse Pwentisubstimte Serious Paentisubstitnte Endmgement

tbeti paom md ex-spouses

Pemined ti~alcohol abuse P~entisubstimte Serious Endmgement

Pemined other maladaptive behavior P~entisubstitite Serious Engagement

Refisal of psychological cae Pmentisubstimte Modemte Endmgement

Delay/failwe of psychological cme Puendsubstimte Serious Enticement

Other inanention to emotional needs Pmentisubstimte Serious Endmgement
lnvOIM~ neglect’ NIA NIA NIA NIA

Geneml or us~cified neglec@ NIA NIA P~entisubstimte Enkgement

Dtber or unspecified malmea~entb NIA NIA Adult cwetier Enticement

Chemically Dependent Newborns NIA NIA NIA NIA

Nomal@ea~ent Csses NIA NIA NIA NIA

Not chmged. me H- Stidmd requtiemenc were used without revision.

,

Countible under tbe Endmgement Stid~d only md entered the malyses md esttiates for “All Neglect.”

“A Not applicable. ~is catego~ wu not counnble mder this definitional swdmd.

b Coumble uder the Endmgement Smdad only md entered the malyses md estfiates for “All Mal@eament.”
Molestation with Genital Contact

This fornr of maltreatment involved acts where some form of actual genital contact

had occumed, but where there was no specific indication of intmsion, When

intmsion had been coded for a given child, molestation also was not coded, unless it

reflected a distinctly different type of event in the child’s experience (e.g., involved

different perpetrators),

Other or Urrkuown Sexual Abuse

This catego~ was used for unspecified acts not known to have involved actual

genital contact (e.g., fondling of breasts or buttocks, exposure) and for allegations

concerning inadequate or inappropriate supewision of a child’s voluntary sexual

activities.

As Exhibit 2–1 shows, no direct evidence of injury is required for the first two forms of

sexual abuse to be countable under either definitional starrdard. That is, it is assumed that sexual abuse

involving intmsimr is inherently traumatic and injurious to a child; hence, when the situation fits the

definitional criteria in all other respects, injury is simply assumed to have occurred. For cases classified

under the third form of sexual abuse ~other or unknown”) to be countable under the Hm Standard,

circumstmrtial or direct evidence of at least moderate physical or emotional injury/impaiment is

required. The Endangerment Starrdard relaxes this criterion to allow cases where a child was considered

“endangered as a result of other or mrknowrrsexual abuse,

Under the Harm Standard, any of these three specific forms of maltreatment is countable

only when it is perpetrated by an adult caretaker or is either perpetrated or permitted by a

parentisubstitute, The Endangerment Standard expands the set of countable cases to include also cases

where a caretaker has permitted these forms of maltreatment and where the caretiker is a teenager or not

clearly of adult stares.

In the NIS–3, children who were classified as sexually abused included a 10-year-old who

was raped by her fatheL two sisters mrd a brother sexually molested by their mother’s live-in boyfriend;

a teen whose mother prostituted her a preteen who had to lie next to her father with his body pressed

against her after he watched a pornographic movie mrd who was afraid to sleep in her room as a resulq a

17-year-old fondled by her stepfather, who had emotional problems and ran away as a result; and a

4-year-old fondled by his father during weekend visitations.

2-14
Emotional Abuse. Tbe category of emotional abuse encompasses three distinct forms of

maltreatment:

Close Confinement (Tying or Binding and Other Forms)

Totious restriction of movement, as by tying a child’s arms or legs together or

binding a child to a chair, bed, or other object, or confining a child to an enclosed

area (such as a closet) as a means of punishment. II

Verbal or Emotional Assault

Habitial patterns of belittling, denigrating, scapegoating, or other nonphysical forms

of overtly hostile or rejecting treatment, as well as threats of other forms of

maltreatrrrent (such as threats of beating, sexual assault, abandonment, etc.), 12

Other or Unknown Abuse

Overtly punitive, exploitative, or abusive treatment other than those specified under

other forms of abuse, or unspecified abusive treatment. ~is form includes

attempted or potential physical or sexual assault,13 deliberate withholding of food,

shelter, sleep, or other necessities as a form of punishment, economic exploitation,

and unspecified abusive actions.

As Efiibit 2–1 shows, in order for cases to be countable under the Harm Standard these

forms of maltreatment have to be perpetrated by an adult caret~er or permitted by a parendsubstitute.

Moreover, except for the more extreme forms of close confinement (i.e., except for abuse involving tying

or binding, where harm could be assumed automatically), circumstantial or direct evidence of at least

moderate injury/impairment is required, The Endangerment Standard does not alter the pe~etrator

requirements on these forms of abuse, as Efiibit 2–1 indicates, but it does expand the harm requirement

to allow cases where the child was judged to have been endangered, though not yet actially injured or

impaired, by the maltreatment in question.

In the NIS–3, children who were classified as emotionally abused included a young child

strapped in a high chair all day while her parents went to work; a child forced by her parents to live in a

II Doesno, i“cl”de generallyacceptedpmtices such % “SCof mfety hmesses on toddlers,swaddlins of infme, Ordiscipline

involving“grounding”a child or restrictinga childto hi~er room.

12This ~ategoVW= not used if verballymsa”ltivc or ab”sivc treatient occurred simultaneouslywith other abusive behavior

(e.g., during a physical beating) unless adverse effects occumed that were separate md distinct from those in the other

catego~.

13WhereactualPhysicalcontict did “ot occur(e.g.,throwingsomethingatthe ctild).

2-15
basement, to use the floor as a toilet, and then to clean it up, and who suffered emotional problems,

including acting out, that required counseling as a result of her maltreatment a 4-year-old who was

locked in a closet as a means of discipline; children traumatized when their father took them to a store to

buy a gun with which he threatened to kill them and their motheq a child who ran away because his

mother punished him by refusing to feed him, by feeding him spoiled food, and by putting him out of the

house without a coat or shoes; and siblings whose emotional problems, which required professional

treatment, were a result of their mother’s constant verbal abuse.

Physical Neglect. As Exhibit 2–1 shows, there are seven specific varieties of physical

neglect. Of these, the first NO reflect inattention to remedial health care needs, tbe next three involve

custody-related maltreatment, and the last wo forms involve inadequate supewisimr and other types of

physical neglect. me acts or omissions that are classified under each of these forms of maltreatment are

Refusal of Health Care

Failure to provide or allow needed care in accord with recommendations of a

competent health care professional for a physical injury, illness, medical condition,

or impairment.14

Delay in Health Care

Failure to seek timely and appropriate medical care for a serious health problem that

any reasonable layman would have recognized as needing professional medical

attention, i5

Abandonment

Desertion of a child without arranging for reasonable care and supewisimr. This

category included cases in which children were not claimed within 2 days and cases

where children were left by parentdsubstitutes who gave no (or false) information

about their whereabouts.

Exprtlaion

Other blatant refusals of custody, such as permanent or indefinite expulsion of a

child from the home without adequate arrangement for care by others or refusal to

accept custody of a returned runaway.

14 This ~atego~ does not aPPly to treatment needs concerning educational, emotional,‘or behavior problems, which were

clwsified undereducationalneglectmtior emotionalneglecLas describedin subsquent sections.

15 Lack of preventiveheal~ ~Xe, ~“ch ss failure to have the child immunized,is not included here. It is clmsified under

“generalneglec<”definedin a latersection.

2-16
Other Custody ksues

Custody-related fornrs of inattention to the child’s needs other than those covered by

abandonment or expulsion. For example, repeated shuttling of a child from one

household to another, due to apparent unwillingness to maintain custody, or

chronically and repeatedly leaving a child with others for days or weeks at a time.

Inadequate Supervision

Child left unsupervised or inadequately supervised for extended periods of time or

allowed to remain away from home overnight without the parendsubstitute knowing

(or attempting to determine) the child’s whereabouts.lc

Other Physical Neglect

Conspicuous inattention to avoidable hazards in the home; inadequate nutrition,

clothing, or hygiene; and other forms of reckless disregard of the child’s safety and

welfare, such as driving with the child while intoxicated, leaving a young child

unattended in a motor vehicle, and so forth.17

Etiibit 2–1 presents the harm and perpetrator requirements for these fores of

maltreatment. As the efiibit shows, the harnr required for physical neglect cases to be countable under

the Harm Standard ranges from none (since harnr can be assumed to have occurred for the traumatic

occurrences of abandonment and expulsion), through evidence of moderate inju~fimpairnrent (for

refusal of health care and for “other” custody-related maltreatment), to serious injrrry/impairnrent (for

delay in health care, inadequate supervision, and other physical neglect). Under the Endangernrent

Standard, cases are countable if a respondent judges the child to have been endangered by the acts in

question or if CPS officially substantiates the case upon investigation. As Efiibit 2–1 further shows,

under the Harm Standard, all forms of physical neglect have to be perpetrated by parents/substitutes.

Under the Endangerment Standard, other adult caretakers are allowable perpetrators of the last WO fornrs

of physical neglect: inadequate supervision and other physical neglect.

In the NIS–3, children who were classified as physically neglected included a teen whose

mother refused to provide needed medication for his seizure> an infant whose parents delayed 24 hours

before seeking medical attention for his serious head injury and loss of consciousness; a 12-year-old

whose mother abandoned him; a preteen whose mother threw him out of their home and told him not to

return; a 2-year-old, reported as endangered, who was found wandering in the street late at night, naked,

and alone; an infant who had to be hospitalized for near-drowning after being left alone in a bath;

16TKIsfo~ OfmaItreame”t dm coverscmeswherethe child istempormilylockedout of the home.

11 This does not include ~it”atio”~hat ~e~”ltfrom tie pme”t~, fi”mciaj i“abili~ to pr~vide(or Obtii”throughAFDc)

rcuonably safe, hygieniclivingconditions.

2-17
a 3-year-old who had roaches in her leg cast; children endangered when their mother Iefi a 6-year-old in

charge of an infant and toddler so long that the older child feared her mother would not return and called

91 I for helm and children endangered by living in a home contaminated with animal feces and rotting

food.

Educational Neglect Educational neglect is hmken down into three specific forms, as

follows:

Permitted Chronic Truancy

Habitual tmancy averaging at least 5 days a month was classifiable under this form

of maltreatment if the parendguardian had been informed of the problem and had not

attempted to intervene.

Failure to EnrolVOther Truancy

Failure to register or enroll a child of mandatory school age, causing the child to

miss at least 1 month of school; or a pattern of keeping a school-age child home for

nmrlegitimate reasons (e.g., to work, to care for siblings, etc.) an average of at least 3

days a month.

Inattention to Special Education Need

Refusal to allow or failure to obtain recommended remedial education services, or

neglect in obtaining or following through with treatment for a child’s diagnosed

Ieaming disorder or other special education need without reasonable cause.

As Efiibit 2–1 shows, there are no differences be~een the Harm Standard and the

Endangerment Standard in the perpetrator and harm requirements for the category of educational neglect,

Under both sets of standards, the parendsubstitute is the required perpetrator for all three forms. Also,

under both standards and for all three forms, the harm criterion is considered to have been met (that is,

ham is automatically rated as moderate) if the case fulfills the descriptive requirements of the

classification, on the assumption that the circumstances would necessarily impair a child’s educational

development to at least a moderate degree,

In the NI$3, children who were classified as educationally neglected included an 11-yearold and a 13-year-old who were chronically truant a young teen, previously adjudicated as truant, whose

parents did not send him to school; a 12-year-old whose parents permitted him to decide whether to go to

school, bow long to stay there, and in which activities to participate; a young teen whose mother did not

enroll him in school afier be was returned from foster care to her custody; and a special education student

whose mother refused to believe he needed help in school.

2-18
Emotional Neglect. As Exhibit 2–1 shows, the catego~ of emotional neglect includes

seven specific forms of maltreatment:

Inadequate Nurturance/Affection

Marked inattention to the child’s needs for affection, emotional support, attention, or

competence. 1g

Chronic~xtreme Spouse Abuse

Chronic or extreme spouse abuse or other domestic violence in the child’s presence.

Permitted Dru~Alcohol Abuse

Encouragement or permitting of drug or alcohol use by the child cases of the child’s

dru~alcohol use were included in this category if it appeared that the

parendguardian had been informed of the problem and had not attempted to

intewene.lg

Permitted Other Maladsrptive Behavior

Encouragement or permitting of other maladaptive behavior (e.g., severe

assaultiveness, chronic delinquency) under circumstmrces where the psrentiguardian

had reason to be aware of the existence and seriousness of the problem but did not

attempt to intervene.

Refusal of Psychological Care

Refusal to allow needed and available treatment for a child’s emotional or

behavioral impaiment or problem in accord with competent professional

recommendation,

Delay in Psychological Care

Failure to seek or provide needed treatment for a child’s emotional or behavioral

impairment or problem that any reasonable layman would have recognized as

needing professional psychological attention (e.g., severe depression, suicide

attempt).

Other Emotional Neglect

Other inattention to the child’s developmenta~emotional needs not classifiable under

any of the above forms of emotional neglect (e.g., markedly overprotective

restrictions that foster immaturity or emotional overdependence, chronically

applying expectations clearly inappropriate in relation to the child’s age or level of

development, etc.).

18cwe~ of no”orgmic failure to firive ~e ~lmsified““dcr this fom of maltreatmentin addition tOother imtmces Ofpmsive

emotionalrejectionof a child or appmentlack of concern for a child’s emotionalwell-beingor development. Not included

herewere ovefl expressionsof hostilitymd rejection,whichwe clmsifiedunderverbaUemotiontiabuse.

lg Administefi”gdrugs to a child for “onnredicd or nonthempeuticpuvoses (e.g., giving a child alcohol Ormmiju~a) is

cl~sified here if the child W= of school age (md hence likely to predisposethe child behaviorallyto self-administerthe

dregs) but is clmsifiedunder“otherokunknownabuse”for youngerchildren.

2-19
As Efiibit 2–1 shows, the Endangerment Standmd makes no changes in the perpetrator

requirements for these fores of maltreatment but uniformly rel~es the ham criteria to endangernsent,

In the NIS–3, children who were classified as emotionally neglected included a child with a

diagnosis of failure to thrive; siblings reported as endangered, who were subjected to repeated incidents

of fmily violence bemeen their mother and fathe~ a 12-year-old whose parents pemitted him to drink

and use dregs; an S-yew-old whose parents pemitted him to smoke; a child whose mother helped him to

shoot out the windows of a neighbor’s house; and a 4-year-old whose caretiers refused to pernrit

evaluation and treatment of his severe behavior problems.

2.3.3 Countabili~ Asseaament

Cases recorded on CPS Long Fornrs and on Nmr-CPS Fornrs were assessed as to their

“countability” in relation to the study definitions, For each child substantiated by CPS or thought to

meet the stidy requirements on either ~pe of data fore, tie NIS–3 project staff rated the degree to

which the sitiatimr fit each of the WO sets of definitional standards: the Harnr Standmd and the

Endangernrent Standard. Each applicable form of suspected or substantiated maltrea~ent was assessed

as to its substance (who was alleged to have done what to whom, when, with what effect, and with what

quality of evidence). Ratings were made of the degree to which the situation fit each individual aspect of

the Hm Standard and of the Endangerment Standard. Following this, overall assessments were made

under each of the definitional standards, Maltreatment was judged to be “countable” under a given

standard if there was reasonable cause to believe that the child had experienced maltreatment that met all

of the requirements of the definitional standard in question.

Despite the complexity of this assessment, it was reliable. Measurements of the reliabili~

of these judgments on a random 10 percent of the coded data fores (i.e., on 737 data fornrs) showed that,

coders had an agreement of 95.1 percent overall, an agreement of 98,2 percent as to whether a case was

countable under the Harnr Standard, and an agreement of 98.9 percent as to whether a case was countable

under the Endangernrent Standmd. Details about the evaluative coding procedures and about the

assessment of coding reliability can be found in the NIS–3 technical volume, the Analysis Report.

2-20
2.4 Unduplicatimr

More than one data form could be submitted to the study concerning an individual child,

Such duplicates could occur because the same maltreatment event was reported by more than one smdy

source or because the same child had experienced more than one occurrence of maltreatment during the

study period that was reported by the same study source. In either case, it was necessary to identifi and

resolve all such duplicate reports in order to permit estimates based on the child as the unit of

measurement. At the same time, unduplicatimr had to be accomplished without the use of filly

identifying information, which had been avoided in the interests of confidentiality. Following the

apprOach @ken in the previOus studies, only enough close-to-identibing information was obtained in tbe

NIS–3 to allow fairly certain judgments as to whether or not two data forms described tie same child.

These decisions about duplicate data forms on a given child relied on the child’s sex, first name, last

initial, date of birth, race, city of residence, and number of other children in the child’s household, The

decisions were sometimes clarified by the nature of the maltreatment, the child’s relation to the

perpetrator, and the first names and dates of birth of other children in the family, ‘when these were

available.

Having determined which data forms were duplicates, only one record was retained to

represent an individual child. Also, whenever a child had been identified to the study as a maltreated

child both by CPS and by a non-CPS respondent, CPS was credited with having submitted the case. (For

details, see the Analys;s Repor/.) Non-CPS respondents were credited only with those children they

submitted to the study beyond those whose maltreatment was investigated by CPS. Moreover, within

each sector, duplicate records were credited according to a priori~ system that was based on the “level of

recognition” (iceberg) model described earlier in Section 2.1.1. Further details about this priority system

are provided later, in Chapter 7.

2.5 Weighting and Estimation

National estimates were obtained by “weighting” each child’s final record in accordance

with the probability of having selected the source who reported that child to the study. By use of

appropriate weights at each leveI, the cases Obtained were used to represent the much larger database that

would have been obtained if all potential data sources had participated and no sampling had been used.

2-21
A number of important issues were taken into account in the process of weighting,

including multiple sources for children who appeared in duplicate data forms, corrections for incomplete

or poor participation by nmr-CPS respondents, annualimtimr to provide estimates for a full 12-month

period, and calculation of sampling errors or variances to indicate the precision of estimates and to

permit significance tests.

Multiple Probabilities of Selection. When a child appeared in more than one data form,

these forms were unduplicated, as described shove, in order to ensure that the child was represented only

once in the final analyses. Besides selecting only a single record form among the multiple records

available, it was also necessary that the child’s final weight reflect the fact that he or she had come into

the study through multiple sources. me exact procedures used to unify the multiple probabilities of

selection in computing the child’s final weight are described in the Analys;s Report.

Correcting for Poor and Incomplete Participation. Efforts were made to compensate for

any incomplete or poor participation by non-CPS respondents in the weights assigned to the cases.

The sentinel nature of nmr-CPS data collection makes it particularly vulnerable to distortion

by low paniciprmt interest.20 Ideally, the number of cases submitted hy a participant should be

informative about the number of maltreated children he or she encountered. Participants with low

degrees of interest in or commitment to the study can easily distort the incidence estimates downward by

their failure to submit data forms on the cases they encounter, To minimize this source of distortion,

evaluations of each participant’s degree of interest in and commitment to the study were obtained, and

weighting adjustments were made for any who received particularly poor ratings.

A similar downward distortion was possible when an otherwise interested and committed

patiicipant did not participate for the full data period for whatever reason (e.g., sickness, vacation, etc.).

All such absences were monitored during the study, and the final weights were adjusted to correct for

any lost time. These corrections corresponded to analogous corrections that were computed in the

N1%2,

20sedl~, A“dma J., “Estimatingtie NationalPrevalenceof Child Abuse from SentinelDaq” 1993 Proceedin5 of the Social

Sfofislics Section, Alexmdriq VA: AmericmSti1istics3Association,1993.

2-22
Annualization. Data were collected for a 3-month period in most agencies (for only 10

weeks in schools arrd day-care centers). Data from all agencies wem weighted so as to represent the

number of cases that would have been obtained had the date period lasted for a full year. A special

study, the Anrrua/izat;on Basis Stud, provided updated infomatimr for translating the data gathered

during the 3-month data collection into estimates that reflected the number of children maltreated in the

course of a yeaf. The annualization data were used to calculate WO mnualization multipliers for NIS–3

cases: one for cases recognized by school sentinels and one for all other recognition sources, Details on

how the annualimtimr factors were calculated me provided in the Analysis Report.

Sampling Errom. There is some degree of uncefiainty associated with any estimate that is

made on the basis of a sample. The starrdmd emor provides some idea of how much uncertainty is

associated with a given estimate m a result of the use of a sample rather than a complete study of the

total poptrlation.21 (It does not reflect other sources of emor.) Thus, the standard emor indicates the

precision of an estimate, and having reliable estimates of the standard emor is a prerequisite for

conducting statistical comparisons of the estimates for different groups,

The standard error of estimate was calculated for all of the NIS–3 estimates reported in the

subsequent chapters of this repon. These can be found in Appendices A arrdB.

2.6 Data Analysis

The principal findings of the study are the incidence estimates themselves, and these

required no fufiher malysis after estimation and calculation of their standard emors. However, in order

to compare the findings “ofthe NIS–1, the NIS–2 and the NIS–3, or to examine patterns of differences

across subgroups within the NIS–3 (such as across the different age groups), some fufiher statistical

analysis was necess~. [n order to keep the text of this repoti accessible to readers without statistical

expenise, only the conclusions drawn from these analyses me provided in the following chapters.

Readers who are interested in examining the details of the atralyses themselves cm find them repofied in

Appendix C, which presents the within-NIS–3 tests of significance, and Appendix D, which presents the

be~een study tests of significance.

21 The ~mgc or C,window,,mO”nd ~ estimate within which one cm be confident the estimate lies is called a “confidence

intewal; One cm be 95-percent cenain that the tie incidence falls within the mge specified by the 95-percent confidence

intewal.

2-23
2.7 Methodological Differences from the ~&2

me N1%3 closely followed the methodology used in the NIS–1 and the NI%2 but

improved upon those previous s~dies in several ways:

. County sample: me county sample was increased from 29 counties comprising 28

Primary Sampling Units (PSUS) in the NIS–2 to 42 counties comprising 40 PSUS in the

NI*3. In addition, the NI$3 counties had maximum overlap with the NIS-2

counties.

. Agency sample: me more productive nmr-CPS agency categories were given

proportionally greater representation to increase the efficiency of the agency samples.

● Data forms: CPS Shofl Forms were obtained in all large counties to enhance the basis

for unduplicating be~een CPS and non-CPS sources.

~ese changes in the methodology were made in order to provide greater precision in the

NI%3 estimates. ~ey have no influence on the magnimde of the estimates.

2-24
3. ~C~ENCE OF C~D mUSE AND NEGLECT

This chapter is divided into tiree major sections. The first two sections are devoted to the

main Harm Standmd and Endangerment Standard estimates. Each section addresses the following

questions:

● What is the current national incidence of child abuse md neglect as defined by each

standard?

. Have there been any statistically significant changes since the NIS–2 (and for the

Harm Standard, since the NIS–1 ) in the annual incidence of children who experience

abuse or neglect?

. Among the children who experienced abuse or neglect under each standard, what

was their most serious injury or harm?

. How does this distribution of children across levels of severi~ of injuryfiarm

compare with the severity distribution found in the MS2 (and for the Harm

Standard with the NY])?

In addition, the Endangerment Standard estimates for different maltreatment ~eS and

outcomes are compared with the Harm Standard estimates in order to clarify the distribution of tbe

additional children who are considered to be abused or neglected under the more lenient Endangerment

Standard guidelines. Tbe third and final section summarizes the main findings and discusses their

implications,

Throughout this and the subsequent chapters, it is impotit to bear in mind that all

maltreatment in the NIS, by whatever standard, was perpetrated by a parent or cmetaker (i.e., the

maltreatment reflects circumstances that are within the jurisdiction of child protective service agencies).

That is, the NIS estimates systematically exclude maltreatment by non-cmetaker family members (e.g.,

siblings who were not in a caretaking role), non-caretaker neighbors, acquaintances, or strangers. Thus,

the incidence totals and rates given in this report do not reflect the children who were physically

assaulted or sexually abused by persons in any of these latter categories.

It is also important to note that the estimates presented in this section and throughout the

remainder of this report are baaed on the unduplicated numbers of maltreated children in the United

States who experienced the maltreatment in question. That ia, the unit of me=urement is the child, and

3-1
each estimate counts each child only once. The estimates are given both in temrs of the estimated totals

and in terms of rates per 1,000 children. Estimated totals reflect the number of children nationwide who

are maltreated annually. The incidence rates indicate the numbers of children maltreated annually per

1,000 children in the U.S. population. Readers should also note that this report follows the usage of the

congressional mandate and refers to the estimates as “incidence estimates.” In the epidemiOlOgical

literature,’ however, they would be more appropriately termed “annual prevalence estimates.”

Technically, they are period prevalence estimates, where the focal period is a year.z

3.1 National Incidence of Child Maltreatment under the Harm Standard

This section presents the estimates of the incidence of children who experienced

maltreatment under the Hamr Standard in 1993. The Ham Standard is relatively stringent in that it

generally requires a child to have already suffered demonstrable harrrr as a result of maltreatment in

order to be “cmmtible” (i.e., in order to be included in the estimated totals).

3.1.1 Overall Incidence of Maltreatment under the Harm Standard

Table 3–I presents the NIS estimates for maltreatment under the Harm Standard. The

NIS-3 estimates are given in the shaded section with bold text. These reflect annual estimates for 1993,

the year the NIS–3 data were collected. The right-hand side of tie table compares the NIS–3 figures

with the estimates for the comespmrding categories generated by the earlier studieethe NIS–2 estimates

reflect the incidence of maltreatment during 1986, and the NIS– I estimates index tbe incidence of

maltreatment in 1980. The statistical significance of the comparison in question is indicated by the

asterisk or letter, as explained in the table footnotes.

‘Ahlbom,A., &Norell,S. (1984). introduction To Modern @idemio/o~. ChestnutHill, MA: Epidemiology Resources, Inc.

2 In epidemiologicu%ge, “incidence”=fers to the number of new casesthat occur in tie population during a given period of

time. “Prevalence” cm mew a number of different things, depending on whether it is used with or without a modifying

adjective. Whenused without a qualifier, it is most ofien interpreted to mem “point prevalence,” wh!ch is the total number of

cases that exist in the population at a given point in time. Prevalence cm also be defined as “lifetime prevalence,” which refers

to the total number of pemons hewn to have been cases at some time in their lives, or “period prevalence,” which denotes the

total number of persons known to have been cazcs at my time durins a specified period.

3-2
As Table 3–1 shows, an estimated 1,553,800 children experienced some fom of

maltiatment under the Ham Stmrdsrd during 1993. This totsl reflected an rmnual incidence rate of 23.1

children per 1,000 children in the general population nationwide,3 This is equivalent to 2.31 children per

3Inthis md subsequent chapters, dl estimates concerning total numbers of children me rounded to the nemest hundred in order

to avoid conv~ing a false sense of precision. That is, all the estimates have ssmciated stmdmd emors that reflect their degree

of precision. For simplification, all the estimates together with their stmdmd emors md their upper md lower 95-percent

confidence bounds =e given in Appendices A md B.

3-3
100, or to 1 child in every 43 in the United States. The comparisons in the right-hand sections of the

table indicate that the 1993 incidence of all maltreatment under the Harm Standard is significantly higher

than the correspmrding estimates for 1986 and 1980.4 Specifically, there was a two-thirds increase

(67%) in the total number of maltreated children since the 1986 NIS–2 and a 149-percent increase since

the 1980 NI$l. Note that this latter increase means that the total number of children who experienced

maltreatment under the Harm Standard at the time of the NIS–3 was nearly two and one-half times the

number with similar experiences during the NISI.5

These increases correspond to a 56-percent rise in the rate per 1,000 of overall

maltreatment since the NIS–2 in 1986 and a 136-percent increase in the overall maltreatment rate since

the NI%l in 1980. The rate measure can be interpreted as reflecting a child’s degree of risk of

experiencing the maltreatment. This means one can say that a chiltis risk of suffering maltreatment

identified in the NIS under the Harm Standard was more than two and one-third times higher in 1993

than it was in 1980.

3.1.2 Incidence of Abuse and Neglect under the Harm Standard

In addition to the overall incidence estimates, Table 3–1 provides estimates for different

categories of maltreatment. Two main categories are presented: abuse and neglect. Each of these is, in

turn, divided into specific ~es. The main categories and the specific types are discussed individually.

In order to be countable under the Harm Standard, an abused child had to have experienced

the abuse at the hands of a parent (birth or adoptive), parent-substitute (e.g., foster parent, step-parent),

or adult caretaker a neglected child had to have experienced the neglect at the hands of a parent or

parent-substitute. Also, as detail~d further below, the Harm Standard generally required a child to have

been moderately hamred by abuse in order to be included in the abuse total, whereas it generally required

a child to have been seriomly harmed by neglect before permitting the child to be included in the neglect

estimates.

4 Compxisons across studies should be made with the mte measures (i.e., compting the number of children maltiated per

1,000) in order to tie account of my chmges in the size of the U.S. chtld population across the time intewds. Accordingly,

<atisticd differmces beween the 1993 Sudy ad tbe 1986 mrd 1980 stidies genemlly have been msessed by the use of the

f-statistic on Oremte memurcs. me dettils of these tests md of other significmce tests used me given in Appendix D.

>Note that m increme of 100 percent reflecb a doubling of the original figure.

34
As shown in Table 3–1, m estimated 743,200 children were abused under the Harro

Standard definitions in 1993, while an estimated 879,000 children were neglected during the course of

that year. These totals represent incidence rates of 11,1 abused children per 1,000 and of 13.1 neglected

children per 1,000 in the U.S. population. This means that the majori~ of Harm Starrdard children (57Yo)

were neglected, and slightly less than one-half (480/o)were abused. Note that the separate “all abuse”

and “all neglect” estimates sum to more than the total number of maltreated children given in the first

row. This is because children who were both abused and neglected (an estimated 68,400, or 1.1 per

1,000) are included in both of these estimates.

In comparison to the NI>2 estimates, the increase in neglect under the Hamr Standard was

statistically significant, but tbe increase in abuse, although substantial, was marginal (i.e., approached

statistical significmce but did not meet the traditional standard). There was a 46-percent increase in tbe

total number of abused children since the NIS–2, arsd an 85-percent increase in the total number of

children who were neglected. Alternatively, considering the changes in incidence rates in order to take

into account the increase in child population size since the earlier studies, there was a 37-percent increase

in the abuse rate since the NIS–2 and a 75-percent increase in the neglect rate, This means that children

in 1993 had a more thm one-third higher risk of being abused and a three-fourths greater risk of being

neglected compared to the corresponding risk~ for children in 1986.

Statistical analyses revealed that the 1993 NIS–3 incidence estimates were significantly

above the 1980 figures for both abuse and neglect. More than mice as many children experienced Ham

Standard abuse in 1993 compared to 1980, whether one indexes this by the estimated totals (which show

a 121‘/oincrease) or by the incidence rates (which show a 1090/0increase). The increase in the incidence

of neglect was even greater, with a 179-percent increase in the total number of neglected children since

1980, and a 167-percent increase in the neglect rate per 1,000 children nationwide over the 13-year time

interval. These findings mean that a child’s risk of abuse under the Hamr Standard in 1993 was more

than two times greater than in 1980, and his or her risk of neglect was NO and two-thirds times the 1980

risk level.

3.1.3 Incidence of Types of Abuse under the Harm Standard

Under the main category of abuse under the Harm Stidard, Table 3–1 provides tbe

incidence statistics for three specific types of abus~physical, sexual, aod emotional abuse. Children

3-5
who experienced more than one type of abuse are reflected in the estimates for each applicable type. As

a result, the estimates for the different abuse types sum to more than the total number of abused children.

Physical Abuse. In order to be classified as physically abused under the Harm Standard, a

child had to have suffered at least a moderate inju~ from physical abuse, Moderate injuries were

defined as physical, mental, or emotional injuries or conditions (or behavior problems) resulting from

physical abuse that were serious enough to persist in obsewable form for at least 48 hours. Examples

include bruises, nightmares, depression, and fearfulness.

Table 3–1 indicates that 5.7 children per 1,000 (or an estimated 381,700 children)

experienced physical abuse as defined by the Harm Standard in 1993, These children reflected just over

one-half (5 I‘A)of all abused children under the Harm Standard.

Sexual Abuse. Sexual abuse subsumed a rrmge of behaviors, including intrusion, genital

molestation, exposure, inappropriate fondling, and unspecified sexual molestation. For intrusion and

genital molestation, the Harm Standard guidelines permit the assumption that serious emotional injury

occurred even if explicit symptoms are not yet obsewable. However, for the remaining abusive actions,

at least moderate injury or harm (physical, emotional, m behavioral) is required before the child is

permitted to count as sexually abused under the Harm Standard.

An estimated 3,2 children per 1,000 (or a total of 2 17,700) were sexually abused under the

Harm Standard in 1993. Sexually abused children accounted for 29 percent of the total who suffered

abuse.

Emotional Abuse. In the NIS definitions, this &pe of abuse includes close confinement,

verbal or emotional assaults, and other or nonspecific abuse. Close confinement refers to tying, binding,

and other inappropriate confinement or physical restriction. Verbal or emotional assault involves

systematic patterns of belittling, denigrating, scapegoating, or other nonphysical forms of overtly

rejecting treatment, as well as threats of other forms of maltreatment, such as threats of abandonment,

beatings, or sexual assault. Emotional abuse also subsumes all varieties of abusive, exploitative, or

overtly punitive behaviors where actual physical contact did not occur (such as intentional withholding

of food, shelter, sleep, or other necessities, or excessive responsibilities or excessive demands for

income-producing work by a child). For the more extreme forms of tying and binding, the Harm

Standard guidelines permit the assumption that serious emotional injury occurred (that is, explicit

34
symptoms are not required for the child to qualify as emotionally abused under the Ham Standard).

However, for all other fores of emotional maltreatment, the Ham Standard requires direct or

circumstmrtial evidence of inju~ or impaiment of at least moderate severity.

Table 3–I indicates that, in 1993, an estimated 3.0 children per 1,000 (a totil of 204,500

children) suffered emotional abuse that fit the Ham Standard definitions. Tbe emotionally abused

children represented 28 percent of all abused children counted under the Ham Standard.

Changes since Earlier ~Ss in the Incidence of Abuse under the Harm Standard.

Among the different types of Ham Standard abuse, the only statistically significant increase since the

NIS–2 was in the incidence of sexual abuse, which rose in incidence from 1.9 children per 1,000 in 1986

to 3.2 chiIdren per 1,000 in 1993 (a 68°Aincrease in the rate of occumence). Because of the simultaneous

increases in the size of the general child population during that time intewal, the percentage increase in

the total number of sexually abused children was even greater. (The NIS-3 total of 217,700 children

reflects an 830/oincrease over the 1986 total of I I9,200 chiIdren,) The number of children who suffered

physical abuse also rose during the NIS–2NIS–3 intewal, but as Table 3–I indicates, that gain did not

match the sexual abuse increase, either in size or in statistical strength, The total number of children

who experienced physical abuse grew 42 percent since the NIS–2, while the incidence rate rose from 4,3

to 5,7 children per 1,000, constituting a 33-percent increase in rate. This increase approached, but did

not quite reach, the level traditionally required for statistical significance.

The NIS–3 Ham Standard estimates for both physical and sexual abuse are significantly

higher than the comesponding NIS–1 estimates. The total number of physically abused children nearly

doubled in the intewal be~een 1980 and 1993 (rising by 92%), Tbe increased incidence rate for

physical abuse under the Ham Standard meant that a child in tbe United States faced an 84-percent

higher risk of being bamed from physical abuse in 1993 than in 1980. At the same time, more than five

times the number of children were victims of sexual abuse under the Ham Standard in 1993 compared

with 1980 (that is, the NIS–3 estimated total is 4070/ohigher than the NIS–1 estimate). Taking into

account the changes in the child population size over that time period does little to ameliorate the

magnitude of this gain: the incidence rate increased by 357 percent during that intewal. In 1993, a

child’s risk of sexual abuse was more than four and one-half times greater than in 1980. Emotional

abuse showed a marginal increase of 43 percent in incidence rate during the 1980 to 1993 internal

(affecting 54% more children in the NI%3 than in the NIS-1.)

3-7
The incidence rates in the three incidence studies for the specific types of abuse under the

Harm Standard are graphed in Figure 3–1. Several features are noteworthy. First, emotional abuse as

defined by the Harm Standard is the one type of abuse with a relatively stable incidence throughout the

1980 to 1993 time period, showing only a statistically marginal increase across the studies. Second, the

chart conveys the predominance of physical abuse among the three Harm Standard abuse categories in all

three studies. Third, the incidence rate for sexual abuse in the NIS–3 (3.2 children per 1,000) is slightly

above the current incidence rate for emotional abuse (3.0 children per 1,000), and this reverses the

pattern of both earlier studies, where emotional abuse was more prevalent than sexual abuse. Fourth,

note that the current @I=3) rate for sexual abuse is on a par with the NIS–I incidence rate for physical

abuse. Fifth, the patterns illustrate that tbe increments in the incidence of physical abuse and sexual

abuse have been of comparable absolute magnitudes across these incidence studies—the incidence rates

for physical and sexual abuse have risen consistently by 1.2 to 1.4 children per 1,000 from one study to

the next.

3.1.4 Incidence of Types of Neglect under tbe Harm Standard

Under the main category of neglect in Table 3–1 are the incidence estimates for three

specific types of neglect under the Harm Standard—physical, emotional, and educational neglect. Again,

children are included in each type that applied to them, so the sum of the rows for these types is greater

than the total of all neglected children.

Physical Negleet. This type of neglect includes inadequate supervision; inadequate

attention to needs for food, clothing, or personal hygiene; disregard for safe~, medical neglecc

abandonment; and other custody-related maltreatment. In all categories, except the last three, the

maltreatment must have resulted in demonstrable injury or impairment that was serious or fatal for the

child to be countable under the Harm Standard. Serious harm was defined as life-threatening or

requiring professional treatment in order to prevent significant long-term impairment. The Harm

Standard criteria for the last three categories of physical neglect were somewhat less demanding,
permitting harm to be inferred or allowing moderately harmed children to count in tbe Harm Standard

estimates,6

6

5

z

0.

:4

:3

E

❑ NIS-I

n

6

❑ NIS-2

% ■ NIS-3

+2

5

1

0

Physkd Abuse Sexual Abuse Emoliond Abuse

Figure 3-1. Chmges acrossthe Three NationalIncidenceSrodies h the

Incidence Rates of Ty~s of Abuse ~der rhe Hm Stitid.

As shown previously in Table 3-1, physically neglected children are the second largest

subset in the neglected population under the Harm Standmd. An estimated 338,900 children experienced

physical neglect in 1993, reflecting an incidence rate of 5,0 children per 1,000 in the general population.

Emotional Neglect. Maltreatment of this type includes inadequate nurturance or affection,

chronic or extreme domestic violence in the child’s presence, knowingly permitting drug or alcohol

abuse or other maladaptive behavior, failure (or refusal) to seek needed treatment for an emotional or

behavioral problem, and other inattention to the child’s developmental or emotional needs. In all cases,

‘ For ace of blatml abmdonment or refusal of custody, tie Hm Stmdard guidelines pemit the -sumption that serious

emotional injuv occurred (that is, explicit symptoms are nol required), while for otier custody-related mdmarment modemtc

hm had to be demonstmted or the circumstmces must have strongly suppofled the inference that moderate hw hti pmbtily

occtmed. To be countable aa physical neglect under the Hm Stmdard, medical neglect hti to msutt in moderate harnr (if it

entailed m outright refusal to follow professional recommendations mgwding needed medical cue) or serious hm (if it

reflected a simple failure to obtiin needed txatient).

3-9
it was necessary for this maltreatment to have caused serious harm in order for the child to be countable

as emotionally neglected under the Harm Standard.

Although emotionally neglected children were the smallest of the neglect subgroups listed

in Table 3–1, their numbers were still substantial at an estimated total of 212,800 children (equivalent to

3.2 children per 1,000 in the general 1993 child population).

Educational Neglect. Children were included in this category when their parent (or

parent-substitute) knowingly permitted their chronic truancy for an average of at least 5 days per month;

exhibited a pattern of keeping the child home for nonlegitimate reasons; failed to register or enroll a

school-age child in school in violation of state law; or refused to allow or provide needed attention for a

diagnosed educational problem, learning disorder, or other special education need. In all of these

categories, if the evidence supported the conclusion that the acts or omissions in question had occurred,

then the child was countable as educationally neglected under the Harm Standard and the NIS guidelines

permitted the assumption that the child had experienced moderate educational harm.

Table 3–1 shows that educational neglect is the most prevalent type of neglect under the

Harm Standard, affecting an estimated 397,300 children, or 5.9 children in 1,000 in 1993, and involving

45 percent of all children who experienced neglect under the Harm Standard.

Changes since Eartier NSS in the Incidence of Neglect as Defined by the Harm

Standard. Two types of Harm Standard neglect evidenced substantial and significant increases since the

NIS–2. The estimated number of children who suffered Harm Standard emotional neglect in 1993 was

four and one-third times higher than the 1986 estimate. (There was a 333% increase from the NIS–2

estimated total of 49,200 children to the NIS–3 estimate of 2 12,800.) This means that children were at

four times higher risk of this maltreatment in 1993 compared with their risk in 1986. (There was a 300%

increase in the incidence rate.) At the same time, the number of physically neglected children who fit the

Harm Standard criteria more than doubled, from 167,800 in the NIS–2 to 338,900 in the NIS–3 (a 102%

increase), and there was an 85-percent increase in the risk rate per 1,000 for this type of maltreatment.

The only neglect category under the Harm Standard that failed to demonstrate change since the last NIS

was educational neglect. As Table 3–1 indicates, the fluctuation in the numbers of children who

experienced educational neglect was nonsignificant.

3-1o
When the NIS–3 incidence figures are compared with the incidence of Harm Startdard

neglect at the time of the N[S– I,’all three types of neglect efiibh significant increases, The estimated

total of 212,800 emotionally neglected children in 1993 is three and three-fmtfi times higher tharr the

1980 estimate of 56,900 (a 274% increase in the total), arrd the rate per 1,000 children was more than

three and one-half times higher (a 2560/oincrease in the incidence rate). Physical neglect under the Harm

Standard more than tripled from its 1980 level during the N]S–l, whether one indexes the rise on the

basis of total maltreated children in this category (which showed a 227~o increase from 103,600 in the

NISI to 338,900 in the NIS–3) or on the basis of the incidence rate (which increased by 2 13°Ain this

interim). Finally, although the increases in the incidence of educational neglect between tie NIS–I and

the NIS–2 and bemeen the NIS–2 and the NIS-3 (above) were not statistically significant as separate

increases,7 their cumulative effect is both substantial and significant. That is, the estimated total number

of educationally neglected children more than doubled in the NI%l to NIS–3 intewal (showing a 128°A

increase from 174,000 children to 397,300 children). The incidence rate increased by 119 percent during

the intervening time period, so that a child in the United States was more than Nice as likely to

experience educational neglect in 1993 as compared with 1980.

Figure 3–2 presents the incidence rates for the three types of neglect under the Harm

Standard across the NIS–1, the NIS-2, sod the NIS–3, The patterns illustrate that the relative prevalence

of the three categories of neglect under tbe Harm Standard have remained very stable across studies, with

educational neglect most prevalent, physical neglect second, and emotional neglect the least prevalent in

each NIS. The dramatic rise in the incidence rate of emotional neglect in the NIS–3 is also evident in the

figure, bringing the current incidence rate for emotional neglect above the level of physical neglect in

both previous studies and above the level of educational neglect in the NIS–1. The figure also conveys

the fact that the rise since the NIS–2 in incidence rates for physical neglect and emotional neglect under

the Harm Standard affected comparable numbers of additional children in each of these categories—an

additional 2.3 and 2.4 children per 1,000, respectively.

‘ Demils reg=ding the significmce of the differences between the NIS–I md the NIS–2 were mpofied in Sedl& A.J. (1991).

National Incidence and Prevalence of Child Abuse and Neglect: 1988, Revised. Rockville,MD: WestaC Inc.

3-11
61

J

❑ NIS-1

❑ NIS-2

■ NIS-3

Physical Emotional Educational

Neglect Neglect Neglect

Figure 3-2. Chmges across the ~ee National Incidence Smdies k the

Incidence Rates of T~es of Neglect under theHm Standad.

3.1.5 Severity of Outcomes from Maltreatment under the Harm Standard

Children were classified on the basis of the most severe injuW or hm they suffered fmm

Hamr Standmd maltreatment. Table 3–2 presents their distribution across different degrees of

inju~/impaimrent. Eachmaltreated child appewsin onlyone rowofthis tnble, sotherow entries sum to

the total number of children who were countable under the Hamr Standard.g

Fatal Injury. Unestimated l,500children diedin 1993 asnresult ofabuseor neglect as

defined bytbe Hamr Stidard. ~isreflected mmnualincidence rate ofmaltieatment-related facilities

of O.02perl,000 children inthe United States, which isequivalent to2childrenpereve~ 100,000, orl

in eve~ 50,000, in the U.S. child population.

$ Compme Table 3-2c`TomP with ``All Maltrea~ent'' in Table 3-l

3–12
Table 3-2. Severi~ofOutcomes from Malheatient udertie HmStidmd intie NI>3(1993), md

Comptison with the N1%2 (1986) md the NISI (1980) Hm Smndwd Findings.

j :t,NI*3;Estim8tes;~ Compmisons With Emlier Smdies

,,.,,:.:.:: ~.:!:. ,,‘...:.,,.:,

Severity of Inj~ ‘;IW3:’”” NI%2: 1986 NI>I: 1980

or Impatient From Hm ~StiM8tdI.: :Rutiper ~~timated Rateper

Stidwd Malmea~ent Estimated ‘fi~~

Totil’’’$;~c;,flfm Totsl 1,000

Children Total ‘

Children

Fatal ,,:’124;!;,: :.0.0;:,., 1,100 0.02 ns 1,000 0.02 ns

Serious 565;oW?;:;;.: ““8.4 141,700 2.3 ● 131,200 2.1 ●

Modemte 822,~ “:’”” 12.2 682,700 10,8 “s 393,400 6.2 ●

Infemd 165S00 . 2.5 105,500 1.7 m 97,500 1.5 *

Unbow” ,,, ,; :. ;.;,;;;: ..0.0 o 0.0 -- 2,000 0.0 --

TOTAL l;553j800’: 23.2 931,000 14,8 * 625,100 9.8 ●

● me diffemnwkwmn tits md tie NI%3 estimateissi~ificmt at or &low he p<.05Iwel.

m me differe.m km... tiis md tie NI%3 intimateisshtisticdly mmgi”d (i.e., IO>P>,05),

ns ~e diffe=”ce kmee” his md he N1*3 estimak isneitier sisnificmt normmgind (p>.10).

Note Estimakd mmls~ roundedto tie nc~st 100,

Seriou9 Inju~ or Harm. As noted above, an inju~ or impaiment is defined as serious

when it involveg a life-threatening condition; represents a Iorrg-temr impaiment of physical, mental, or

emotional capacities; or requires professional treatment aimed at preventing such Iong-temr impaiment.

Exmnples of gerioua injurieshmpaiments include loss of consciousness, stopping breathing, broken

bones, schooling loss that required special education gewices, chronic ad debilitating dm~alcohol

abuse, diagnosed casea of failure to thrive, third degree bums or extensive second degree bums, md ao

fotih.9 Serious injuries from Ham Standmd maltreatment occumed to 8.4 children per 1,000 in 1993,

representing 56S,000 children, or over one-third (36°/0) of all children who were countable under the

Hm Standard.

9See “Evaluative Coding Mmual; Appendix C in tie NI$3 Analysfi Report.

3–13
Moderate Injury or Harm. Moderate injuries or impairments were those that persisted in

obsewable form (including pain or impairment) for at least 48 hours (e.g., bruises, depression, or

emotional distress not serious enough to require professional treatment). Moderate degrees of

injuryhmpairment were experienced by 12.2 children per 1,000 (or 822,000 children) in 1993, and these

accounted for over one-half (530A)of all children countable under the Harm Stmrdard.

Inferred Harm. The nature of the maltreatment itself gave remonable cause to resume

that injury or impairment probably occurred for 2.5 children per 1,000 in the United States in 1993, or

165,300 children countable under the Harm Standard.’” Following the hiemrchy conveyed by the

ordering in Table 3–2, a Harm Standard child was placed in the “inferred harm” category only if he or

she had not sustained fatil, serious, or moderate harm. However, inferred injury should not be

interpreted as less serious than moderate injury, because the types of maltreatment that generally

warranted inferred harm (e.g., incest, abandonment) could actually have a devastating impact on a child.

Changes since Earlier N3SS in the Severity of Maltreatment Outcomes. Tests of

differences between the NIS–3 estimates for 1993 and the corresponding findings of the earlier NIS–2 in

1986 revealed a significant rise in the incidence of seriously injured children and a marginal increase in

those who could be presumed harmed based on the character of their abuse or neglect but showed no

significant changes in the incidence of fatalities or in the incidence of children who were moderately

harmed by maltreatment under the Harm Standard.

There was a substantial and significant increase in tbe incidence of children who were

seriously harmed by maltreatment under the Harm Standard. Specifically, tbe estimated number of

seriously injured children essentially quadrupled (incre=ing by 2990A) in the intewening 7 years

between the NIS-2 and the NIS-3. In terms of incidence rates, this increase meant that the risk of a child

being seriously injured by abuse or neglect under the Harm Standard was 282-percent higher in 1993

than in 1986.

[oASdescribed i“ the preceding sectiom, there were instmces where”the Hm Stmdwd guidelines pemitted the =sumPtiOn that

a child w~ hmed, even though obsewable symptoms were not yet evident. These conditions included the more serious

fores of sexual abuse, blatsnt abmdonment, ad extremely close confinement (tying or binding). In addition, the H=m

Stmdad guidelines pemitted circumstmtial evidence of hsmr to suppofi a child’s countability in connection with “other”

sexual abuse (i.e., beyond inmsion md genitsl molestation), “other” close confinement, verbal or emotional sssault, “other”

abuse or exploitation O.e., beyond the forms readily clmsifiable ~ sexual, physical, or verbal), md “other” custody related

neglect (i.e., outside ofoutight abandonment).

3-14
Also, there was a 57-percent increase since the NIS–2 in the estimated number of children

for whom inju~ could be infemed under the Hamr Standard guidelines, reflecting a rise of 47 percent

since 1986 in the incidence rate per 1,000 for this catego~ of inju~. This increase approached, but did

not attain, the level traditionally required for statistical significance.

Finally, the categories of fatal inju~ and moderate inju~ showed no significant changes

since tbe NIS–2. That is, although the NIS–3 estimate that 1,500 children were killed in 1993 by abuse

or neglect under the Hamr Standard appears to reflect an increase over earlier NIS findings, these

differences beWeen the 1993 estimate and earlier NIS estimates were not statistically significant.

Similarly, the finding that there were no significant changes in the incidence of children who were

moderately harnred by Ham Standard maltreatment despite the addition of 139,300 children to this

catego~ in the NIS–3 may seem pu~ling. Both of these results derive fmm the fact that the NIS

estimates in these categories are not precise enough for the differences in question to meet (or approach)

statistical significance. The conclusion in both categories (fatalities and moderate injuries) is that the

N]S–3 did not provide reliable evidence of change from the levels of the NIS–2 estimates,

More marked differences are apparent when one compwes the NIS–3 findings with the

1980 NIS–I estimates, The NIS–3 demonstrates significant increases since the NIS–1 in all but fatal

injuries from Ham Standard maltreatment. Specifical Iy, the estimated number of seriously injured

Hwm Standard children rose by 331 percent since the NIS–I (i.e., was 4,3 times the 1980 estimated

total), and the estimated number of moderately injured children more thm doubled (increasing by 109°A

since the NIS–1 ). Compared to the situation in 1980, children in 1993 had a 300-percent higher risk of

being seriously injured and a 97-percent higher risk of being moderately injured by Harm Standard

maltreatment. The number of children who experienced fores of maltreatment so egregious that one

could infer that they had been injured by it rose by 70 percent be~een 1980 and 1993. This means that a

child had a 67-percent higher risk of experiencing maltreatment with inferable hams in 1993 under the

Ham Standard, compared with the risk to a child in 1980;

Figure 3–3 graphically shows the incidence rates for children who suffered serious,

moderate, or inferred hamr from Hamr Standard maltreatment across the three national incidence studies.

The most notable aspect of this figure is the dramatic rise in the incidence of seriously injured children in

the NIS–3, In fact, the cument incidence rate for seriously injured children exceeds the NIS–1 incidence

rate for moderately injured children. The patterns also show that the three Ham Stmrdard severity

categories have maintained their same relative positions across the three studies, with moderately injured

3-15
children the most prevalent category, seriously injured children second, and children with inferred

injuries last.

14

1

12

+

+ + +

❑ NIS-1

❑ NIS-2

■ NIS-3

Serious Moderate Infemd

figure 3-3. Chmges across the Three National Incidence Studies in the

Incidence Rates of Outcomes from Maltreatment uder the

Hum Stmdard.

3.2 National Incidence of Child Maltreatment under the Endangerment Standard

This section presents the NIS–3 findings on the incidence of children who experienced

maltreatment under the Endangerment Standard in 1993. The Endangerment Standard est;mates ;nclude

all the Harm Standard children, but add others as well by relaing the definitional requirements in

several respects. The central feature of the Endangerment Standard is that it includes children who have

not yet been hmmed by maltreatment, but who have experienced abuse or neglect that put them in danger

of being hamed according to the views of community professionals or child protective sewice

agencies, 11 In addition, the Endangerment Standard slightly enlarges the set of allowable pe~etrators in

‘‘ Specifically, in order to qualify s ‘Gendmgercd; the child’s maltreatment had to have been substitiated or indicated by a

child protective sewice (CPS) agency, or a ptiicipating sentinel in a non-CPS agency (such ~ a teacher in a school, a nurse or

social worker in a hospitat, etc.) had to have explicitly mted the child % having been endmgered by the abuse or neglect they

described.

3–16
seveml categories and inco~omtes wo additional maltreatment classifications, as will be explained in

subsequent sections.

Each of tbe following subsections begins with a presentation of the full scope of the abuse

and neglect estimates that result when the Endangerment Standard is used. Following that, the

Endangerment Standard estimates are compmed with the Harm Standmd estimates given above, in order

to clarify the distribution of these additional children. Each subsection concludes with a comparison

be~een the NI$3 Endangerment Standard estimates and the Endangerment Standard findings in the

NIS–2. Note that whereas the Hm Standard was used in all three national incidence studies, the

Endangerment Standard has been applied only in the NIS–2 and the NIS–3.

3.2.1 Ovemll Incidence of Maltreatment under the Endangerment Standard

Table 3–3 presents incidence levels based on the Endangerment Standard definitions. The

shaded and bold-faced section repofi the NIS–3 findings, which provide annual estimates for 1993. The

right-hand section provides the NIS–2 findings for comparison. (As mentioned above, the Endangerment

Standard was not used in the NIS–1.)

The estimate of all maltreated children under the Endangerment Standwd includes all

children who were abused or neglected in all categories listed. In addition, the Endangerment Standard

enlwged the categories of allowable maltreatment by also including children who were considered to

have been endangered by their parents’ problems (such as alcoholism, dmg abuse, prostitution) without a

description of the specific abusive or neglectful actions that derived from those problems. 12

As the first row in Table 3–3 indicates, an estimated 2,815,600 children experienced some

fom of maltreatment under the Endangerment Standard during 1993. This comesponds to an incidence

rate of 41.9 children per 1,000, which is equivalent to 4.2 children per 100, or 1 child in 24 in the general

U.S. child population.

,ZThus be “AII MaItm~e”t,2 categoV includes dl children in the “AllAbuse,, total, all children in tbe “AllNeglect”10ts!,md

alsoother children wbo were endmgered by their pmnts’ probtems.

3-17
Table 3-3. National Incidence of Maltreatment under the Endmgement Stindud in the NI>3

(1993), and Comparison with the NIS-2 (1986) Endangerment Stindard Estimates.

Endangerment Stidwd

Mal@ea~ent Catego~

ALL MALTREATMENT

ABUSE:

ALL ABUSE

Physical Abuse

Sexual Abuse

Emotional Abuw

NEGLECT:

ALL NEGLECT

Physical Ne8!ect

Emotional Neglect

Educational Neglect

● me differencebeween this estimte a“d the NIS-3 estimateissignificantat or belowtbe p<.05 level,

Note Estimatd tom!, am ro”ndti to the “eaxst 100.

Comparison to the Werall Estimate under the Harm Standard. fie Endmgement

Standard included an additional 1,261,800 children in the total population of maltreated children beyond

those who were countable under the Hartn Standard. The Endangertnent Standard estimate of the

maltreated population of 2,815,600 (or 41.9 children per 1,000) is 81-percent ~eater than the Hartn

Stsndmd estimate of 1,553,800 (or 23.1 per 1,000). An alternative way of viewing this is to note that

Hm Standwd children represent 55 percent of the Endangerment Standard estimate of all maltreated

children. This is graphically illustrated in the first bar in Figure 34.

3-18
45

40

* 35

ti 30

BIE_Q~

❑ Cowtible Only in

Endmgement S~dwd

~ 25

6 20 ■ Cou”tile in Boti Hm

% S~dud ad Endmgement

& 15

5

Smdwd

z 10

5

0 +

All All Abuse All Neglect

Malweament

Figure 34. Componerrfi of the NIS3 Endmgement Stidwd Estimates

for Different Mal@ea~ent Categories.

Changes since 1986 in the Incidence of Maltreatment under the Endangerment

Standard. The right-hand section in Table 3–3 reveals that the 1993 Endmgerrrrent Stsndmd total

represents a significant increase over tbe 1986 estimate. In fact, tbe totsl number of children who were

abused or neglected under the Endangerment Standard nearly doubled since the NIS–2, increming by 9g

percent (from 1,424,400 in 1986 to 2,815,600 in 1993), The incidence rate increased by 85 percent (from

22.6 children per 1,000 to 41.9 children per 1,000). This rise in the incidence means that a child had a

more than one and four-fifihs times hi@er risk of being abused or neglected in accordance with the

Endangerrrrent Standmd in 1993 compared to a child’s risk in 1986.

3.2.2 Incidence of Abuse and Neglect nnder tbe Endangerment Standard

Table 3–3 gives estimates for different categories of maltreatment. In the second and third

sections of the table, the Endangerment Standard children are categorized into those who were abused

and those who were neglected, respectively. The Endangerment Standard neglect estimate includes all

the types of neglect described earlier, as well as neglect that wm not clwsifiable under the Harm

Stindwd, such as lack of preventive health care and unspecified fomrs of neglect.

3–19
An estimated 1,221,800 children were abused under the Endangerment Standard

definitions, while an estimated 1,961,300 children were neglected. These totals represent incidence rates

of 18.2 abused children per 1,000 in the U.S. population and of 29.2 neglected children per 1,000

nationwide. This means that the majority of Endangemrent Standard children (70°/0)were neglected and

less than one-half (43Yo)were abused. Again, children who were both abused and neglected are included

in both categories, so they sum to more than the total number of maltreated children. An estimated

367,S00 children (or 5.S per 1,000) experienced both abuse and neglect that fit the Endangerment

Standard,

Comparison with the Total Abused and Neglected under the Harm Standard. The

abuse estimate under the Endangerment Standard is 64-percent higher than the abuse estimate under the

Hamr Standard, while the neglect estimate under the Endangerment Standmd estimate is 123-percent

greater than the neglect estimate under the Harm Standard. The less stringent requirements reflected in

the Endangemrent Standard brought substantially more children into the neglect estimate (an additional

1,082,300 children) than into the abuse estimate (where 478,600 children were added). This pattern was

also the case in the NIS–2. The NO bars on the right-hand side of Figure 34 depict the pattern in the

NIS–3 estimates. Ham Standard children account for61 percent of the Endarrgement Standard total of

all abused children and 45 percent of the Endangerment Standard total of all neglected children.

Changes since 1986 in the Incidence of Maltreatment under the Endangerment

Standard. In compwismr to the NIS–2 estimates, both abuse and neglect under the Endangerment

Standard evidenced statistically significant increases. There was a 107-percent increase in the total

number of abused children fitting the Endangerment Standard since the NIS–2 and a 114-percent

increase in the total number of Endangerment Standard children who were neglected. In temrs of

incidence rates, there was a 94-percent increase in the rate of abuse under the Endangerment Standard

and a 100-percent increase in the rate of neglect under the Endangemrent Standard. Thus, from the

perspective of the Endangemrent Standard, children in 1993 had nearly double the risk of being abused

and exactly Wice the risk of being neglected compared to the corresponding risks for children in 1986.

3.2.3 Incidence of Types of Abuse under the Endangerment Standard

Table 3–3 provides the incidence statistics for the main types of abuse under the

Endangemrent Standard: physical, sexual, and emotional abuse. The estimates for the different abuse

3-20
types add up to more than the total number of abused children because children who experienced more

than one type of abuse are reflected in the estimates for each applicable type.

Physical Abuse. Table 3-3 shows that 9.I children per 1,000 (or an estimated 614,100

children) experienced Endangerment Standard physical abuse in 1993.

Sexual Abuse. The Endangerment Standard enlarges the set of allowable pe~etrators of

sexual abuse by pemitting children to count in the sexual abuse estimates if they are abused by teenage

(i.e., nonadult) caretakers. An estimated 4.5 children per 1,000 (or a total of 300,200) were sexually

abused in 1993 under the Endangerment Standard guidelines.

Emotional Abuse. Table 3–3 indicates that, in 1993, an estimated 7.9 children per 1,000

(532,200 children) suffered emotional abuse that fit the Endangerment Standard definitions.

Comparison with Estimates of Abuse under the Harm Standard. The estimates for the

different abuse types under the Endangerment Standard are all notably higher than the comesponding

estimates under the Ham Standard, but the largest difference is in the catego~ of emotional abuse,

Specifically, the number of physically abused children under the Endangerment Standard is 61-percent

higher than the number of children who count as physically abused under the Ham Standard; the number

of sexually abused children is 38-percent higher under the Endangerment Standard than under the Ham

Standard; and the number of emotionally abused children is 160-percent higher under the more lenient

Endangemrent Standard compared to the stringent Harm Standard criteria. Figure 3–5 presents the

Endangerment Standard estimates for each abuse type, showing the potiion represented by children who

were counted as maltreated under the Ham Standard. Specifically, Harm Standard children accounted

for 62 percent of the estimated total who suffered physical abuse, 73 percent of those who suffered

sexual abuse, and 38 percent of those who experienced emotional abuse,

Changes since the NI%2 in tbe Incidence of Abuse under the Endangerment

Standard. All types of abuse under the Endangerment Standard exhibited significant increases since the

NIS–2. The total number of physically abused children nearly doubled, from 311,S00 to 614,100, an

increase of 97 percent. A child in 1993 had an 86-percent greater risk of being physically abused under

the Endangerment Standard than his or her counterman had in 1986. Under the Endangerment Standard,

both the number and incidence rate of sexual abuse more than doubled since the NIS–2. There was also

a 125-percent increase in the estimated total number of children who had been sexually abused under the

3-21
10

9

Z8-. ,

L6

h-d

m

❑ CounrsbleOnly in

Endmgemen~ Smdmd

$5

G ■ Co.ntible in Both Hm

%4 Stidwd md Endm8ement

$3 Stidwd

.

22

I

o

Physical Sexual Emotional

Abuw Abuse Abuw

Figure 3-5. Component of the NIS-3 Engagement Stmdwd

Estimates for Different Abuse Types.

Endatrgement Standard: a child had a 114-percent higher risk of experiencing sexual abuse in 1993

compwed to 1986. Emotional abuse under the Endangerment Standwd showed the largest relative

increase since the NIS–2, with the total number of emotionally abused children rising by 183 percent and

the incidence rate per 1,000 children in the United States increasing by 163 percent. Thus, a child had a

newly two-and-mo-thirds greater risk in 1993 compared to 1986 of being the victim of emotional abuse

under the Endangerment Stidard.

The graph in Figure 3+ compares the NI%2 md NIS3 incidence rates for the abuse types

under the Endangerment Standard. Note that even in the face of significant increaaes in all categories,

the three types of abuse retained their relative prevalence ordering within each incidence study: physical

abuse > emotional abuse > sexual abuse. Also obsewe that, under the Endangerment Standmd, the 1993

incidence rate for sexual abuse (4.5 children per 1,000) approaches the 1986 incidence rate for physical

abuse (4.9 children per 1,000) and exceeds the NIS–2 incidence rate for emotional abuse (3,0 children

per 1,000). In absolute terns, the largest abuse increase since tie NIS–2 was in the catego~ of

emotional abuse under the Endangerment Standmd, which affected 4.9 more children per 1,000 in 1993

than it had in 1986. Moreover, its latest rate (7.9 children per 1,000) exceeds the NI%2 rates for botb

3-22
physical abuse and sexual abuse under the Endangemrent Standard. Physical abuse is a close second in

terns of the absolute size of its increase since the NI%2 (an additional 4.2 children per 1,000), now

affecting a total of 9.1 children per 1,000, or 1 out of every 110 children in tbe United States.

3.2.4

10

9

1

Physical Abuse Sexual Abuse Emotional Abuse

I

❑ NIS-2

■ NIS-3

F1~e 3-6, Changes acrossTwo Natimrd IncidenceSmdiesin the Incidence

Rates of Types of Abuseuder tie Endarrgement Stidmd.

Incidence of Types of Neglect under the Endangerment Standard

Table 3–3 presents the incidence estimates for the main types of Endangerment Standard

neglect—physical, emotional, and educational. Again, children are included in each type that applied to

them.

Physical Neglect. The Endangerment Standard enlarged the set of allowable pe~etiators

of this type of neglect by pemitting the inclusion of children who were neglected by an adult caretaker

(i.e., not necessarily a pment or parent-substitute) who inadequately supewised them; failed to meet

their needs for food, clothing, or personal hygiene; or demonstrated disregard for their safety. Physically

neglected children are the Iwgest neglect catego~ under the Endangerment Stmrdard, with an estimated

3-23
1,335,100 children physically neglected in 1993. This reflected an incidence rate of 19,9 children per

1,000 in the general population, or 2.0 children per 100, which is equivalent to 1 in every 50 children in

the United States.

Emotional Neglect. Children who were emotionally neglected are the second largest

sector of neglected children as defined by the Endangerment Standard. This category included an

estimated total of 584,100 children (equivalent to 8.7 children per 1,000 in the general 1993 child

population).

Educational Neglect. The same requirements for educational neglect were applied uuder

both the Harm and Endangerment standards. Thus, the estimated number of educationally neglected

children is the same under both standards. (Compare Tables 3–1 and 3–3.) The last row in Table 3–3

shows that educational neglect ia the least prevalent of all categories of neglect under the Endangerment

Standard-slightly less prevalent than emotional neglect under this standard. It affected an estimated

397,300 children, or 5.9 children in 1,000 in 1993,

Comparison with Estimates of Neglect under the Harm Standard. As could be

expected, estimates for both physical neglect and emotional neglect were higher with the more lenient

Endangerment Standard criteria than with the more restrictive Harm Standard requirements. Compared

to the corresponding Harm Standard estimates, the estimated incidence of physical neglect under the

Endangerment Standard is almost four times greater (294% higher), while the estimated incidence of

emotional neglect under the Endangerment Standard is nearly two and three-fourths times greater (174%

higher). Figure 3–7 graphs the Endangerment Standard estimates, showing the portion accounted for by

Harm Standard-countable children. Harm Standard children represent 25 percent of the estimated total

who suffered physical neglect and 36 percent of those who experienced emotional neglect,

Changes since the NI~2 in the Ineiderrce of Neglect under the Endangerment Standard. Figure 3–

8 presents the incidence rates in the NIS–2 and the NIS–3 for the different types of neglect under the

Endangerment Standard. Physical and emotional neglect evidenced substantial and significant increases

since the NIS–2. The estimated number of children who suffered emotional neglect under the

Endangerment Standard showed the largest percentage increase, with the 1993 estimated total 188-

percent higher than tbe 1986 estimate. There was a 172-percent increase in the incidence rate of

emotional neglect since the NIS–2. This means that children were at almost two and three-fourths times

greater risk of this maltreatment in 1993 compared with their risk in 1986. The number of physically

3–24
20- ,,

,,, ,,,

:. ~~ “ ‘“”’”

j;~ ~

~E

❑ Cou&ble Only in

Endmgement StidA

■ Coutilc in Boti Hm G

%

Swdmd md Endmgement

J :.

Stidmd

~ ~

2-

0

Pbysicd Emotional ~ucational

Neglect Neglect Negl=t

Rgw 3-7. ComponenS of the NI>3 Endmgement Stidwd Esttiates

for Different Neglect Types.

lg

s

16

-- 14

~ :;

~2~ N *

~

❑ NIS-2

g

■ MS-3

2

0

Physical Emotional SducatiOnd

Neglect Neglect Neglect

Figwe 3-g. Chmges across Two National Incidence Smdies in the Incidence

Wtes of T~es of Neglect mder the Endmgernrent Stid~d.

3–25
neglected children who fit the Endangerment Standard criteria was nearly two and two-thirds higher in

the NIS-3 than in the NIS-2 (a 163% increase), and there was a 146-percent increase in the risk ~ate

per 1,OM children for this type of maltreatment. The smallest percentage increase since the last NIS

was in the category of educational neglect, which rose 39 percent in the total nmnber of affected

children and 31 percent in incidence rate per 1,000 children,

3.2.5 Severity of Outcomes from Maltreatment under the Endangerment Standard

Children were classified on the basis of the most severe injury or harm they suffered from

Endangerment Standard maltreatment. Table 34 presents their distribution across different degrees of

injury\impaimrent. Because each maltreated child appears in only one row of this table, the row entries

sum to the total number of children who were countable under the Endangerment Standard, 13 This

section follows the structure of the preceding sections. The estimates themselves are presented first.

Afier that, they are examined in relation to the Harm Standard estimates in order to identi~ the

proportion of the Endangerment Standard estimate that reflects children who were countable under both

standards. Finally, they are compared with the Endangerment Standard estimates from the NIS–2 to

determine whether there have been any notable changes in incidence since that previous study.

Fatal Injury. An estimated 1,600 children died in 1993 as a result of abuse or neglect that

fit the more inclusive Endangemrent Standard guidelines. This reflected an annual incidence rate of

maltreatment-related fatalities of 0.02 per 1,000 children in the United States, which is equivalent to 2

children per every 100,000 in the U.S. child population,

Serions Injury or Harm. An estimated 569,900 children were seriously injured in 1993

due to maltreatment that fit tbe Endangerment Standard requirements. This total corresponds to an

incidence rate of 8.5 children per 1,000 in the United States,

Moderate Injury or Harm. Moderate injuries or impairments due to quali~ing

Endangerment Standard maltreatment occurred to an estimated 986,100 children in 1993. This means

that moderate injuries affected 14.7 children per 1,000 in 1993.

13CompmeTable 34 “To@~ with ‘fAllMaltreatment” in Table3-3

3-26
Table 34. Severity of Outcomes from Mal@eatient under the Endmgement Stidmd in

the NIS3 (1993), md Compmison With the NI>2 (1986) Estimates.

Nl~3 Estimat& : COmptisOn With NI%2

Severi~ of InjuW or Impaiment ‘1993 ‘:’ 1986

from Endmgement Stidmd TotilNo. Rateper TotalNo. ‘;;;

Maltieahent

Chi;ren”’ ;;;in ‘fchi’den Children ‘

Fa~l 1,6oO 0.02 1,100 0.02 ns

Serinus 569,900 &s 143,300 2.3 ●

Modemte 986,100 14.7 873,100 13.9 ns

Infcmd 226,000 ; 3.4 ~. 152,800 2.4 .s

Endmgered 1,032,000 15.4 254,000 4.0 *

TOTAL 2;815,600 41.9 1,424,400 22.6 ●

9 ~e dif-w W=. his estimtcmdtheN!>3 c$timfeissiwifimt atorktow tie v.OS1.-1.

m = diflemmtiw=” tis mdtie NIS-3etimateisstatistidlymztiti (i,,., 10?.05).

m me &@emeMm thismdhe N1>3cstimteis.ci&=siflifimt normtid W, 10).

Note Estimatedtold, m mndd $.thenmest IW.

Inferred Harm. An estimated 226,000 children were countable under the Endangerment

Standard with maltreatment experiences sufficiently severe that one could assume they had been hamed

by those events. In 1993, harm was inferable on the basis of Endangerment Standwd maltreatment for

3.4 children per 1,000 in the general U.S. child population.

Endangered. More than one million children (a total of 1,032,000) were endmgered,

though not yet hamed, by abuse or neglect in 1993, which reflects 15.4 children per 1,000 in the United

States.

Comparison with the Harm Standard Estimates for Different Outcome Levels. As

emphasized above, the key feature of the Endangerment Stand~d is that it includes both children who

are counted under the Ham Standard and children who were endangered, but not yet hamed, by abuse

or neglect. Thus, the “endangere~ row of Table 34 represents children who did not count in any of the

Ham Standard estimates in Section 3.1. However, recall that the Endangerment Standwd also pemits a

3–27
somewhat broader set of perpetrators and maltreating actions, as discussed above, thereby including

additional children in the totals of children who did experience injury or harm (fatal, serious, moderate,

or inferred) but who were excluded from the Harm Standard counts because of the identity of their

perpetrators or the specific nature of their maltreatment.

me more lenient guidelines for the Endangerment Standard resulted in estimates that were

7-percent higher for fatalities due to abuse or neglect, only l-percent greater for children seriously

injured from maltreatnren~ 20-percent higher for the number of chiIdren who experienced moderate

harm, and 37-percent higher for the number of children whose maltreatment was severe enough to permit

harm to be inferred. Alternatively, children countable under the Harm Standard are 94 percent of the

fatalities total, 99 percent of the seriously injured total, 83 percent of the moderately injured total; and 73

percent of the total for whom injury or harm could be inferred. Figure 3–9 graphs these relationships.

Note that all the children classified as “endangere~ are children who count only in the Endangerment

Standard because they have not yet experienced any harm or injury as a result of their abuse or neglect.

16 T

❑ Countable Only in

EndmgementStandmd

■ CounmbleinBothHsnn

StandsrdandEndmgennent

Stidsrd

Fi~e 3–9. Componentsof Estimatesfor DifferentSeveritiesof Outcomes

fromMaltreatmentunderthe EndangermentStandard.

Changes since the NIS2 in Outcomes from Maltreatment under the Endangerment

Standard. me analyses for the severity of outcomes using the definitions under the Endangerment

3–28
Standard revealed that the NIS3 estimates differed significantly from the NI%2 estimates for two

categories of maltreated children: those who had been seriously injured by their maltreatment and those

who had been endangered but not yet harmed. mere were only slight (and nonsignificant) increases in

the number of children who had been moderately injured and for whom harm could be inferred on the

basis of the severi~ of the abusive or neglectful actions they experienced.

Figure 3–10 offers a visual comparison of the incidence estimates in the MY2 and the

NIS–3. The NIS–3 estimate for the number of seriously injured children is nearly four times the NIS–2

estimate for this category (a 29g0/oincrease in the estimated total), Considering the incidence rates for

this group in the two studies, the NIS–3 rate is more than three and two-thirds times greater than the

NIS–2 estimated rate (a 270% increase in rate). Thus, a child had a more than three and two-thirds times

higher risk in 1993 than in 1986 of suffering serious injury from maltreatment as defined by the

Endangerment Standard. Recall from the previous subsection that nearly all (99%) of the seriously

injured children under the Endangerment Standard were children who had also been countable under the

Harm Standard in the NIS–3. This was also the case in the NIS–2 (that is, children countable under the

Harm Standard accounted for nearly all the seriously injured children in the Endangerment Standard).

16-

+

Serious Modemtc Infemd Endsngxd

+

A

❑ NIS-2

■ NIS-3

Figure 3-10. Changesacross Two Natiod bcidence Studiesin the hcidence

Rates of Different Severities of @rcomes from Mdtrearment

under the Endangerment Standard.

>29
Figure 3–10 also reveals the dramatic increase in the endangered category, The number of

children who were endangered by abuse or neglect increased by 306 percent since the NI*2, from

254,000 in 1986 to 1,032,000 in 1993, This reflects an incre~e in the incidence rate per 1,000 children

of 285 percent, which means that a child was nearly four times more likely to be endangered by

maltreatment in 1993 than his or her counterpart was in 1986.

3.3 Implications of the Findings

The NIS–3 reveals substantial and significant increases in the incidence of child abuse and

neglect since the last national incidence study, which was conducted in 1986, The increases were

demonstrated under both the Harm and Endangerment Standard definitions.

Using the same stringent Harm Standard definitions that had been used in both previous

national incidence studies, the total number of abused and neglected children was found to be two-thirds

higher in the NIS3 than the total found in the NS2. Taking into account the fact that the size of the

child population increased during the time intewal, the finding means that a child had more than one and

one-half times the risk of experiencing abuse or neglect that caused harm in 1993 compared to a child’s

risk in 1986. The most marked increases in harm-causing maltreatment occurred among the emotionally

neglected children and for those who were seriously injured. The estimated totals in both of these

categories quadrupled since the MS–2.

Using the Endangerment Standard definitions, which bring additional children into the

estimates by including those who have been endangered but not yet harmed by maltreatment, the

estimated total number of abused and neglected children nearly doubled since the NI>2. Physical abuse

newly doubled since its NI%2 level; the number of children who were sexually abused was NO and onefoufi times the NIS2 total; and emotional abuse, physical neglect, and emotional neglect were all more

than *O and one-half times their NI>2 levels. The total of children seriously injured and the total of

those endangered by maltreatment quadrupled since the N1>2.

What do these dramatic increases mean? Do the increases in the numbers of countable

children identified by the NIS mean that the number of children who are being abused and neglected has

increased since the NIS–2? Is .it that community professionals are more likely to recognize cases than

they were in 1986? The fact that the increases occumed among children who were seriously injured and

3-30
among children who were endangered suggests that the answer is “both.” That is, both of these

dynamics cmstiibuted to the NIS–3 findings, each in a different sector of tbe maltreated child population,

me first pti of the answer is that there has been a real increase in the number of children

who me abused and neglected. One can reasonably assume that seriously injured victims of abuse and

neglect we relatively unlikely to escape notice by communi~ professionals compared to their less

seriously injured counte~atis. A community professional who encounters a child who has been

seriously injured by abuse or neglect is ve~ likely to bring that child to the attention of the NIS, The rise

among the seriously injured children cannot be plausibly explained on the basis of heightened awweness

on the pati of NIS sentinels. Instead, the most reasonable inte~retatimr of the rise in the numbers of

seriously-injured children seen in the NIS–3 is that this reflects a real increase in the numbers of these

children nationwide. The fact that the numbers of these children quadmpled in the 7 years since the

NIS–2 and now include more than one-half million children is cause for serious concern.

The second pan of the answer is that the capability of community professionals to

recognize abuse and neglect has simultaneously improved in tbe intewal between the studies. That is, by

the same reasoning set fofih above, the rise in the number of endangered children could reflect increased

recognition of more subtle cues concerning abusive and neglectful behaviors. The endangered children

we precisely the ones who would escape notice when awareness of abuse and neglect is suboptimal. As

professionals pay greater attention to obtaining infomatimr about any abuse or neglect experiences

among the children they encounter, one would expect them to identify greater numbers of children who

we endangered by these experiences,

It is interesting to recall that, in the intewal between the N]S–l and the NIS–2, the increase

had been in the number of children who were moderately injured by maltreatment, In inte~reting the

meaning of that increase, the pattern had suggested that community professionals had improved their

attentiveness to indicators of moderate inju~. Since the NIS–2, there have been no notewofihy changes

in the incidence of moderately injured children (that is, the NI>3 did not document any overall reliable

change in the numbers in this catego~). This suggests that professionals had reached close to maximum

recognition rates for moderately injured children at the time of the NIS–2. However, the fact that the

NIS–3 demmsstiates a fourfold increase in the numbers of endangered children does suggest that

professionals have continued to increase their attentiveness to not-yet-injurious instances of abuse and

neglect.

3-31
@erall, then, the findings reported here imply both that more children are being seriously

injured by abuse or neglect md that community professionals sre better able to identi~ those children

who have been endangered, but not yet harmed, by abuse or neglect.

>32
4. DIS~UTION OF ABUSE ~ ~GLECT BY

Cm C~CTEWSTICS

~is chapter exsmines the relationship between child characteristics srrd the incidence and

severity of abuse srrd neglect. It is divided into three main sections that discuss the NI%3 findings on

tbe relationship between maltreatment msd, in turn, child’s sex, age, msd race. The discussion in each

section addresses the following questions:

● Do differences among children in terms of the characteristic systematically relate to

differences in incidence rates of different types of maltreatment or of different

severities of outcomes due to maltreatment?

● Have there been sny statistically significant chsnges since the NI~2 in the

distribution of child maltreatment by the characteristic in question?

In each section, these questions sre considered from the stidpoint of both the Harm and the

Endsngement Stmrdsrds. The chapter concludes with a discussion of the general implications of the

findings.

As in the previous chapter, tie tsbles here reflect unduplicated estimates: that is, each

estimate counts each child only once. Also, because the incidence rates adjust for differences across the

categories in the numbers of children in the general population with the characteristic of interest,’ all

tsbles srrd graphs presented in this chapter provide only the rate measures, For the same reason, all

statistical comparisons were based on the rate measures.2

‘ For instmrce, the incidence mte of Hm Stidsrd maltieament for males indicates the number of males who experience Hm

Smdmd abuse or neglect snrong every 1,000 males in the general population, Analogously, the incidence mti for females is

couched in terms of the number of maltr=td females wong eve~ 1,000 femties in the population. Compmisons of Ore

incidence mtes for males ad females thus the wcount of the fact that thm m differmt numbem of mrdes md females in the

geneti population of children snd provide a mo= valid comptisnn of their risks of ex~riencing the mdti~ent in question,

~Readen interested in the specific estimsred totis in Orediffe~nt mtegories should consult Appendius A md B, which provide

all NI>3 estimates including Ore estimatd rstcs m well m totis together with their ~dsrd emom of emimti md their

upper md lower 95-percent confidence bounds. me detiled results of dl stitistid comptimm we provid~ i“ Ap~ndices C

md D.
4.1 Sex Differences in the Incidence of Maltreatment

This section presents estimates of the incidence of maltreatment of males and females. The

findings that fit the relatively stringent Harnr Stidard are presented first, followed by the distribution

patterns for abuse and neglect under the more lenient Endangerment Standard.

4.1.1 Sex Differences in Maltreatment under the Harm Standard

The NIS3 incidence rates of abuse and neglect under the Harm Standard for males and

females are given in Table 41. The incidence rates for males and females are significarrtly different in

only two categories of maltreatment (all abuse and sexual abuse) and in one catego~ of outcome severi~

(inferred injury). The difference approaches significance in the categories of all maltreatment and

serious injury.

&emll Maltreatment under the Harm Standard

Girls were 13-percent more likely than boys to experience Harm Standard maltreatment.

(Harmful abuse or neglect occurred to 24.5 per 1,000 females versus 21.7 per 1,000 males.) This

difference is statistically marginal (i.e., it approaches, but does not quite reach, the level traditionally

required for statistical significance).

Abuse under the Harm Standard

Because of their higher risk of sexual abuse (see below), girls had a significantly higher risk

than boys for abuse overall: 12.6 females per 1,000 experienced some form of abuse that fit the Harm

Standard criteria, compared to 9.5 males per 1,000. Thus, girls’ risk of abuse was 33-percent higher than

that of boys.

Sexual Abuse. Sexual abuse is the only specific type of maltreatment where girls’ risk was

significantly higher than that of boys. Girls experienced sexual abuse under the Harm Standard at more

than three times the rate boys did 4.9 females per 1,000 in the general population were countable in this
maltreatment category, compared to 1,6 males per 1,000. In other words, girls were 206-percent more

likely than boys to be sexually abused under the Harm Starrdard,

Table +1. Sex Differences in Incidence Rates per 1,000 Children

for Maltreatment waler the Harm Stidard in the

NIS3 (1993).

Harm S@dard

Males ~ema,e~ Significance

Maltreatment Category of Difference

ALL MALTREATMENT 21.7 24.5 m

ABUSE:

All Abuse 9.5 12.6 *

Physical Abuse 5.8 5.6 .s

Sexual Abuse 1.6 4.9 ●

Emotional Abuse 2.9 3.I ns

NEGLECT

All Neglect 13.3 12.9 m

Physical Neglect 5.5 4.5 ns

Emotional Neglect 3.s 2.8 ns

Educational Neglect 5.5 6.4 ns

SEVERITY OF fNJURY:

Fatal 0.04 O.OJ “s

Serious 9.3 7,5 m

Moderate 11.3 13.3 ns

Inferred 1.1 3.8 *

, m. dK_u i,simifiwla ork!.w tie6,05level.

m ~e tiff-~ ismtiti~ly m~nd (i.e.,.lO>~.05).

.s ~c dK_ti isncihmsi~lfimt normw~indW. 10).
Severity of Outcomes from Maltreatment as Defined by the Harm Standard

Serious Injury. Boys were 24-percent more likely than girls to suffer serious iujury from

maltreatment under the Harm Standard. The incidence rates of serious injury from maltreatment under

the Harm Standard, given in Table 41, were 9.3 per 1,000 for males and 7.5 per 1,000 for females.

Because there was no category under the Harm Standard where boys were more likely to be maltreated,

this finding means that when boys are abused or neglected, their maltreatment must itself be more

severe.

Inferred Injury. Girls were significantly more likely than boys to experience

maltreatment of a type that justified tbe inference under the Harm Standard that they had been harmed.

Inferred injuries occurred to 3.8 per 1,000 females versus 1.1 per 1,000 males, meaning that females’ risk

of inferred injury was 245-percent greater than that of males. Note that this pattern is probably a result

of the fact that females are more often sexually abused and that the Harm Standard guidelines permit

injuries to be infemed for the more severe forms of sexual abuse. (See Chapter 3.)

Changes since the N*2 in the Distribution of Maltreatment as Defined hy the Harm Standard

in Relation to a Child’s Sex

Comparisons with the NIS–2 revealed WO areas where there were significant shifts in sex

differences in Hamr Standard maltreatment from that earlier study—physical neglect and fatal injuries.3

Interestingly, both of these were areas where neither study uncovered significant sex differences overall.

However, the analyses indicate that there have been important and reliable shifts in the sex-related

distribution of these categories of maltreatment since the last NIS.

Physical Neglect. Chapter 3 repofied a significant increase in the incidence of physical

neglect under the Harm Standard since the NIS–2. Analyses examining sex differences revealed that the

increase in this category was significant for males, but not for females. This is depicted in Figure 41,

which graphs the incidence rates of physical neglect under the Hamr Standard for males and females in

‘ For simplification, nonsignificant but mwginal shifis between the Nl~2 md the N1>3 that relate to chitd chamcteristics me

not described in this chapter. lnte~sted readcn cm locate information concerning mmginal between-study changes in the

results of the significmce tests in Appendix D.
the two incidence studies, Boys’ risk of physical neglect according to the Harm Stindard is WO and

one-half times ~eater in the NIS–3 than in the NIS–2. me NIS-3 incidence rate of 5.5 per 1,000 males

is 150-percent greater than the NIS–2 incidence rate of 2.2.4 In contiast, girls’ rate of physical neglect

under the Harm Standard shows no statistically notewotihy change since the NIS–2.

61

OL 1

u

❑ NIS-2

■ NIS-3

Males Females

Figure GI. Changes from the NIS-2 to the NI>3 for Males and for Females

in the Incidence of Physical Neglect under the Harm Standard.

Fatil Injuries. Figure 42 shows the changes between the NI*2 and the NIS–3 in the

incidence of fatalities due to maltreatment under the Harm Standard for the two sexes. Unlike the

situation with physical neglect described above, there were no significant changes in the incidence of

fatrditiea, either overall (see Chapter 3) or for either sex. However, Figure 42 indicates that, since the

NIS–2, rates of death from Harm Standard maltreatment have shifted in opposite directions for boys and

girls, with boys becoming more likely and girls becoming less likely to be fatally injured by abuse or

neglect.

4This percen~e w= computed Onthe more precise estimates of 2.173 i“ the NI&2 md 5.477 in the NI>3

45
0.04 T

0.035 t

4.1.2

0.005

0 L +

T

❑ NIS-2

■ NIS-3

Males Females

figue L2. Changes from the NI*2 to the NI*3 for Males and for

Females in the Incidenceof Fatalities from Malmeatnrent

under the Hm Standwd.

Sex Differences in Maltreatment under the Endangerment Standard

Incidence rates of maltreatment for malea and females under the Endangerment Standmd

are given in Table &2. As the last column indicatea, malea ad females differ significantly in two

maltieatroent categories (all abuse and sexual abuse) and in one category of outcome severi~ (inferred

injury). me difference is statistically marginal (not quite significant) in the categories of emotional

neglect and serious inju~. Note that, with few exceptions, the overall pattern here mimom that found

with Hm Stindwd estimates.

@emll Maltreatment under the Endangerment Standard

There is no sex difference in the overall incidence of maltieatnrent using tie Endangerment

Standwd, but there are differences in the main category of abuse mrd in one specific we of abuae arrd

one specific type of neglect.
Table 42. Sex Differences h Incidence Wtes per 1,000 Chiltien

for Maltreatment mder the EndmgemrentS@dwd

in the NI%3 (1993).

EndmgemrentStidwd Males ~ema,e~ Si~ificmce

Malheatruent Category of Difference

ALL MAL~AwENT 40.0 42.3 .s

MUSE:

All Abuse 16.I 20.2 *

Physical Abuse 9.3 9.0 ns

Sexual Abuse 2.3 6.8 *

Emotional Abuse 8.0 ?.7 ns

NEGLECT:

All Neglect 29.2 27.6 .s

Physical Neglect 19.7 18.6 ns

Emotional Neglect 9.2 7.8 *

Educational Neglect 5.5 6.4 ns

SEVERITYOF NJURY:

Fa@l 0.04 0.01 ns

Serious 9.4 7.6 m

Moderate 14.1 15.3 ns

Infemed 2,I 4,6 ‘*

Endmrgered 14.5 14.8 ns

. ~0 differenceissisifiat al.r klOWtieP<.OS!ewl,

m mediK_a ismtistitily ma~ (i.e.,.10- .05).

m ~c dffaeaccisnei*msi~ficmt “ormwjd (~. 1O).

Abuse under the Endangerment Standard

Girls were 25-percent more likely thm boys to be victims of abuse under the Endangerment

Stindard (20.2 females versus 16.1 males per 1,000 in the general U.S. child population). Thus, girls’

risk of Endangerment Strmdmd abuse ww one rmd one-qumter times boys’ risk.

Sexual Abuse. Paralleling the findings repofied above in relation to the Ham S@ndwd,

girls’ greater risk of overall abuse under the Endangerment Stindard essentially reflects their greater risk
of sexual abuse, which was newly three times greater tbarr that of boys, An estimated 6.8 females per

1,000 were victims of this maltreatment type, compared to 2.3 males per 1,000.

Neglect under the Endangerment Standard

Emotional Neglect. There was no sex difference in the rate of emotional neglect under the

Harm Standard (see previous section), but boys were marginally more often the victims of emotional

neglect under the Endangerment Standard. An estimated 9.2 males per 1,000 experienced this type of

maltreatmerrL compared with an estimated 7.8 females per 1,000. Thus, boys had an 18-percent higher

risk of this maltreatment (meaning their risk was more than one and one-sixth times girls’ risk of

emotional neglect under the Harm Standard).

Severi@ of Outcomes from Maltreatment as Defined by tbe Endangerment Standard

Serious lnjrrW. As noted in Chapter 3, almost all of the children who experienced serious

injury under the Endsrrgement Standard definitions are also countable as seriously injured under the

Harm Standard. It is not surprising, then, to see that Table&2 presents a nearly identical finding to that

given in Table 41 in this category. Boys’ risk of serious injury from maltreatment under the

Endangerment Standard was almost one and one-fourth times that of 8irls. (Males’ incidence rate of 9.4

per 1,000 was 24% higher than the rate of 7.6 per 1,000 for females.)

Inferred Injury. Girls were significantly more likely to be classified as having inferred

injuries due to maltreatment under the Endangerment $tsrrdsrd. Specifically, girls were almost wo and

one-fifth times more likely than boys to be in this catego~. As shown in Table L2, the girls’ incidence

rate was 4.6 per 1,000, compared to 2.1 per 1,000 for boys (i.e., the girls’ rate was 119°Agreater than the

boys’ rate). This pattern, which reiterates the Harm Starrdmd finding in this catego~, is probably related

to females’ greater risk of sexual abuse. Note that sexual abuse and inferred injuries are linked in that

the definitions under both standards pemit ham to be inferred when the evidence cited indicates that a

serious form of sexual abuse (intrusion or genital molestation) occumed.
Changes since the NIS2 in the Dlstribntims of Maltreatment as Defined by the Endangerment

Standard in Relation to a Child’g Sex

There were three Endangerment Standard categories where changeg from the NIS-2

revealed significant differences based on the child’s sex overall maltreatment, emotional abuse, and

fatalities.

Overall Maltreatment under the Endangerment Standard. There were no sex

differences in overall maltreatment under the Endangerment Standard in either the NIS-2 or NI%3,

Chapter 3 reported a significant increase in the incidence of this category since the NIS–2, and analyses

here verified that the incidence rate has, in fact, increased significantly for both males and females.

However, males and females differed in the magnitude of the increases they experienced, as charted in

Figure 43, and this difference proved to be statistically significant. The incidence rate of maltreatment

under the Endangerment Standard increased by 20.2 per 1,000 for males (from 19.8 in the NIS–2 to 40.0

in the NIS-3), whereas it increased by 17.1 per 1,000 for females (from 25.2 to 42.3).5

Emotional Abrtge. me situation in connection witi emotional abuse under the

Endangerment Standard was very similm that is, neither tbe NIS–2 nor the NIS–3 detected any sex

difference in the incidence of maltreatment in this category. me main NIS-3 analyses demonstrated a

significant increase in incidence overall, and subsidiary analyses showed that the incidence rates for both

males and females had increased significantly. Here again, the rise in incidence was larger and more

significant for males. me incidence rate of maltreatment under the Endangerment Standard increased by

5.5 per 1,000 for males (from 2.5 in the NIS–2 to 8.0 in the NIS–3), whereas it increased by 4.2 per 1,000

for females (from 3.5 to 7.7). Figure M graphs this pattern.

Fatal InjuW. As noted in Chapter 3, nearly all the children included in the Endangerment

Standard estimate for this harm level are also countable under the Harm Standard. For this reawn, the

finding regarding fatalities under the Endangerment Standard is nearly identical to the finding under the

Harm Standard, which was presented earlier in Figure &2.

‘ All incidence rates and differences are rounded to the nearest tenth afler estimation and comp”tatio”. Because of this,

differenms p~wntd in the text may differ by om-te”tb from the resulb obtained by mmputing using the mu”ded estimates.
45-

40.

g 35

:.

~ 30 --

n

~ 25 .-

D

❑ NIS-2

:

~ 20 ■ NIS-3

: 15 .-

5 10 .-

Z

5 .-

0.

Females Males

Flgwe 43 Chmges from the NI%2 to the NI>3 for Males

md for Females In the Incidence of Overall

Malhea~ent under the Endmgement Standad

9-

8.

Z70.

~6

55

1

D

❑ NIS-2

:

54 ■ NIS-3

%3

5

%2 .

z

I

0.

Females Males

Flgwe H Chmges from the NI>2 to the NI$3 for Males md for FemalesIn

the Incidenceof EmotionalAbuseunderthe Endmgement Stidmd

410
4.2 Age Differences in the Incidence of Maltreatment

This section reports the NIS-3 findings concerning age differences in the incidence of

maltreatment. Children were categorized into one of six age groups on the basis of their age at the time

of their countable maltreatment O-to 2-year-olds, 3- to 5-yem-olds, & to 8-year-olds, 9- to 11-yew-oIds,

12-to 14-yew-olds, and 15-to 17-year-olds.

4.2.1 Age Differences in Maltreatment nnder the Harm Stindard

Significant age differences emer8ed in the incidence of overall maltreatment, abuse, and

neglect under the Harm Standard.6 The patterns we graphed in Figure &5,

Overall Maltreatment, Abuse, and Neglect under the Harm Standard

Children in the youngest age group (ages Oto 2) differed significantly fmrn children ages 6

and above in the rate at which they experienced overall maltreatment under the Harm S~ndmd. Only 10

per 1,000 children in this youngest age group were victims of maltreatment of some kind, whereas

maltreatment affected more than 22 per 1,000 children among those ages 6 and up. mere were no

differences among these older children in the incidence rates of overall maltreatment under the Harm

Standard,

The age differences in abuse under the Hamr Standad reflect the fact that the incidence

rate for the youngest children (ages Oto 2) was significantly below that of all but the 6- to 8-yew-olds.

The incidence rate of abuse of children ages Oto 2 was 4.4 children per 1,000. In cmrtmat, the incidence

of abuse for older children was 10.4 or more children per 1,000. As Figure &5 shows, the incidence rate

for the 6- to 8-year-olds was on a pm with that of the other older groups, but there was slightly greater

variability in tbe 6- to 8-year-olds’ estimate, which precluded the comparisons beween them and the

younger children from a~ining statistical significance,

‘ In each categoV of mdticatment or inj”V, tie a-level that w= used to detemine significmce adjusted for the multipliciV of

the compmiso”s involved. Details concerning the statistical tesrs for the significmce of age group d[ffemnces m given in

Appentix C.

4–1 1
35-

1

o~

Otoz 3t0S 6t08 9t011 12t0 14 Isto 17

Childs Age (m ye-)

Figure +5. Age Differences in All Malheatment, Abuse,md Neglect

underthe Hm Starrdwd.

In the catego~ of Hm Standad neglect, incidence rates essentially fell into WO overmching age brackek: children ages 6 to 14 were at greater risk than those age 5 and younger. fiere

were no significatrt differences within each of these age brackets (i.e., among children age 5 and younger

or among children ages 6 to 14). Fewer tharr 7 children per 1,000 in the age 5 and younger bracket

experienced Hm Standard neglect versus 14.9 or more children per 1,000 in the 6- to 14-year-old

bracket.

Specific Types of Abuse under the Harm Stindard

Significant age differences were found in all three specific types of abuse under the Hm

Standwd. These are depicted in Figure H.

4–12
o 3 6 9 12 15

to 10 to to to to

2 5 8 II 14 17

Childs A= (h yem)

Figue W. Age Differences in Abuse T~es under the Ha Stidwd,

Physical Abuse. In the catego~ of physical abuse under the Hm Stidmd, only one

significant comparison emerged. The incidence of physical abuse among 12- to 14-yew-olds (where it

affected 7.4 children per 1,000) is significmtly higher than among children ages O to 2 (where 3.2

children per 1,000 were victims). The estimated incidence rate for the 6- to 8-year-olds is less precise, so

it does not prove to be significantly or mmginally different from the rate of any other age group.

Sexual Abuse. There is significant age difference in the incidence rate of sexual abuse

under the Hm Stidard be~een children ages Oto 2 (where fewer than 1 per 1,000 were victims) and

children ages 12 to 14 (where 2.6 children per 1,000 were victims). The rate for the children ages Oto 2

is also marginally lower than that for the 15- to 17-yem-olds (where 2.7 children per 1,000 were victims).

The viability within the intewening age categories (children ages 3 to 11) means that their appwent

differences we statistically unreliable.

Emotional Abuse. Children ages Oto 2 were at significantly lower risk of emotional abuse

under the Hm Standmd compwed to all groups ages 6 to 14 (0.4 children per 1,000 versus 4.2 or more

children per 1,000), The incidence rate for 3- to 5-year-olds is mmginally lower than the rates for

413
children ages 6 to 11 (1.6 children per 1,000 versus 4.2 or more children per 1,000), but not reliably

different from the incidence rates for children age 12 or older.

Specific Types of Neglect under the Harm Standard

Among specific categories of neglect under the Harm Standard, only emotional neglect

reveals significant age differences.

Emotional Neglect. The pattern of age differences in emotional neglect under the Harm

Standard is shown in Figure +7. The differences generally follow the pattern described above for

neglect under the Harm Standard. Specifically, incidence rates fall into two classes reflecting two main

age brackets: children age 5 and younger were at lower risk than those age 6 and older (0.5 or fewer

children per 1,000 versus 3 or more children per 1,000). Again, there are no significant age differences

within these two main age brackets.

Severity of Outcomes fmm Maltreatment under the Harm Standard

Moderate Injury. Among the different severities of outcomes from maltreatment under

the Harm Standard, significant age differences were discovered only in tbe category of moderate injury.

Tbe incidence of moderate injuries from Harm Standard maltreatment was lower in the youngest age

group, ages O to 2 (where 3.1 children per 1,000 were victims), thao in all other age groups (where

incidence rates ranged from 8.4 to 20.3 children per 1,000, as seen in Figure &8). ‘No differences among

the older groups are significant.

Changes since the MS2 in the Distrihutirm of Maltreatment under the Harm Standard

in Relation to Child’s Age

Changes since the NI$2 in the distribution of five categories of maltreatment under the

Harm Standard were significantly related to child’s age: overall maltreatment, abuse, neglect,

educational neglect, and moderate injury.

414
b-

% 5- ■

:.

k 4-

2 3.

=

6

%2

J

g 1.

ID

0. !

ot02 3t05 bto8 9t011 12to 14 15t0 17

Chfl&s Age ~i yem)

Hgure *7. Age Differences in Emotional Neglect uder the Hm Stitid.

25 _

8 20.

:.

k ,5

8

~

u 10.

%

g

E 5..

z

0. I

ot02 3t05 bto8 9t011 12to 14 15t0 17

Childs Age (h yem)

Figure&S. Age Differences hModerate lnjwies from Maltiea~ent

under the Hm Stidmd.

415
Overall Maltreatment under the Harm Standard. Figure 49 presents the different age

groups’ incidence rates in the NI&2 and the NIS–3 for overall maltreatment under the Harm Standard.

Chapter 3 reported a significant rise in the overall incidence of maltreatment under the

Harm Standard since the NI>2. Figure +9 shows that this increase was not uniform across all ages.

Specifically, children age 12 and older did not exhibit a significant change since the NI%2 in their risk

of maltreatment. Children in all younger age groups (ages Oto 11) did experience significant increases,

with children ages 6 to 11 suffering the largest and most significant increases.

35.

— NIS-2

— NIS-3

o 3 6 9 12 15

to to to to to to

2 5 8 11 14 17

ChfltisAge (inyem)

Figure *9. Age Differencesin OverallMaltreatmentunderthe HarmStandard

in the N1%2 and theNI>3.

Abuse. In Figure &l O, age differences in incidence rates of abuse under the Harm

Standard are graphed for the NO most recent national incidence studies. Recall that the general increase

in abuse under the Harm Standard across all ages was statistically marginal. (See Chapter 3.) Here it

can be seen that the increase applied only to children under 12 years of age.

&16
14.

12.

10.

8.

pa

a NIS-2

6. _ NIS-3

44

27

o~

o 3 6 9 12 15

to to to to to to

2 5 8 11 14 17

Chflds Age (i yem)

FigureAl O. Age Differencesh Abme underthe Hm SMtid

in the NI$2 md the NI>3.

Neglect. Age differences in incidence rates of neglect under the Hw Stidwd in the

NIS–2 md NIS–3 are presented in Figure411. One of the general patterns described in Chapter 3 was a

significmt increase in neglect under the Hm Starrdmd since the NIS-2. Here, this effat is found to be

qualified by child’s age, occuming for some age groups arrd not others. Specifically, there were three age

groups with significant increases in incidence rates since the MS–2: children ages Oto 2, ages 6 to 8, and

ages 9 to 11. While other beween-group differences may appear compmable, they are not significant

because the estimates were less precise.

Educational Neglect. Educational neglect did not evidence my overall chmgc in

incidence since the NIS–2, but the analyses that explored the relation between child’s age and betweenstudy differences detemined that there were significant increases for two of the four school-aged groups:

6-to 8-yem-olds and 9- to 1l-yem-olds. me gaph in Figure 412 presents the finding.
25,

20.

15.

10.

5’ .!

?

o~

o 3 6 9 12 15

to to to to to to

2 5 8 11 14 17

Chflds Age (m yem)

— NIS-2

— NIS-3

I

Figue411. Age Differencesh Neglectuder the Hm Stidmd

h tie NI$2 md tie NI$3.

~ NIS-2

— NIS-3

o~

6t08 9t011 12t0 14 15t0 17

Childs Age (h yem)

Figwe +12. Age Differences h Educational Neglect h the NI$2 md the NI%3

+18
Moderate Injury. me only injury level where changes in incidence since the N$2 were

related to the child’s age was that of moderate injuries, presented in the graph in Figure A13. Withingroup tests showed that only 6- to 8-yew-olds’ rate of moderate injury from maltreatment under the

Harm Standard had increased significantly since the M$2, rising 80 percent from its NI$2 level of

11.3 children per 1,000 to 20.3 per 1,000 in the N*3. Also note that in the NI*3, 6- to 8-year-olds

had the highest rate of moderate injuries from abuse and neglect under the Harm Standard.

04

0 3 6 9 12 1s

to to to to to to

2 s 8 11 14 17

Childs Age (in yem)

I

Figure413. Age Differencesin ModemteInjuriesfrom Mal@eatrnent

underthe Hm Stmrdmd in the NI%2 and the NI%3.

I

4.2.2 Age Differences in Maltreatment under the Endangerment Standard

&erall Maltreatment, Abuse, and NWlmt under the Endangerment Standard

Figure 414 graphs the significant age differences in the incidence of overall maltreatment,

abuse, and neglect under the Endangerment Standard.

me incidence rate of overall maltreatment under the Endangerment S@d~d w= ]Owerfor

children ages Oto 2 than for children ages 6 to 14. Some form of maltreatment under the Endangerment

419
70

60

50

~n

~ Au Malwated

40

— Abused

30

20 _ Ne~etied

10

o~

o 3 6 9 12 15

to to to to to to

2 5 8 11 14 17

Cbflds Age(myem)

Figure +14. Age Differences in All Malmeament, Abuse,ad

Neglectunderthe Endmgement Stidmd.

Stsndwd affected 26 per 1,000 children ages Oto 2, compared to more thm 44 per 1,000 children ages 6

to 14. me incidence was also ~latively low for the oldest age group, where 29.7 children per 1,000

were estimated to be victims of maltieatient under the Endarrgement Stsndmd. ~is rate is

significantly lower than the rate mnmrg children ages 6 to 8 (60.2 children per 1,000) and marginally

lower tha the rate mong children ages 12 to 14 (44.4 children per 1,000).

me age dishibution of abuse under the Endmgement Stidwd, also shorn in Figure

&14, p~dominsrrtly reflected si~ificrmt differences between the youngest children, ages O to 2, srrd

those in the older woups (except for the 6- to 8-yem-olds, for whom the estimate wm somewhat less

precise), An estimated 7.4 per 1,000 children ages Oto 2 were abused in ways that fit the Endrmgement

Stmrdwd requirements vemrrs 15.8 or more children per 1,000 in the older groups.

In the catego~ of neglect as defined by the Endmgement Stsodmd, the prima~ feature

wm the compmatively higher incidence rate for the 6- to 8-year-olds. With an incidence rate of 44.2

children per 1,000, more children in this group experienced neglect that fit the Endangerment Standard

thsrr children age 5 or younger md thm children age 12 or older, for whom the incidence rates were all

below the level of 27 children per 1,000.

420
Spwific Types of Abuse under tbe Endangerment Stindati

As show in Figure Al 5, significant age differences were uncovered in connection with all

three specific types of abuse as defined by the Endangerment Standmd,

14,

12

10.

8.

6.

2

0

0 3 6 9 12 15

to 10 10 to to to

2 5 8 11 14 17

Chflds A& (h yem)

I

Figure415. Age Differencesin AbuseTypes under the Endangemre”t Standmd,

Physical Abuse. The incidence rate of physical abuse under the Endangerment Standard is

significantly higher for children 12 to 14 yem old, with 12.8 children per 1,000 physically abused, ~an

it is for the youngest children, ages Oto 2, with an estimated 4.8 children per 1,000 physically abused.

Sexual Abuse. Under the Endangerment Standard, sexual abuse exhibited significant

differences in incidence based on child’s age. As the graph in Figure +15 suggests, children ages Oto 2

were sexually abused less often than older children. While only 1.1 children per 1,000 in this age group

suffered sexual abuse under the Endangerment Starrdmd, this fom of maltreatment affected 3.8 or more

children per 1,000 in the older age groups. The incidence rate for children ages Oto 2 differed horn the

rates for all but the 9- to 1l-year-olds (for whom there was a slightly less precise estimate than for the

other age groups). One of the more striking aspects of this age distribution is the lack of any differences

&21
among the incidence rates in the older groups. fiat is, children’s risk of sexual abuse as defined by the

Endangerment Standard is relatively constant from age 3 on.

Emotional Abuse. As Figure +15 shows, emotional abuse under the Endangerment

Standard was substantially less frequent among the youngest children, ages Oto 2, than among children

ages 3 to 5 and ages 12 to 14. An estimated 1,9 per 1,000 children ages Oto 2 experienced emotional

abuse that fit the Endangerment Standard compared to 5.3 per 1,0003- to 5-year-olds and 9.6 per 1,000

12-to 14-year-olds.

Specific Types of Neglect under the Endangerment Standard

Age differences in incidence rates of specific types of neglect under the Endangerment

Standard are graphed in Figure +16. Educational neglect is absent from this graph because there were

no significant age differences in the incidence rates of educational neglect among school-age children

(age 6 and older).

Physical Neglect. [n the category of physical neglect under the Endangerment Standard,

children ages Oto 11 had higher incidence rates than those in the oldest age group, the 15- to 17-yearolds. me younger children experienced physical neglect at a rate of 19.3 or more per 1,000, whereas the

rate for the oldest group was only 8.5 per 1,000. Among children age 11 or younger, there were no

significant differences in incidence rates, but the especially high rate for the 6- to 8-year-olds (29.2 per

1,000) did prove to be significantly higher than the rate for 12- to 14-year-olds (15.5 per 1,000). Note

that the overall pattern in this maltreatment category, with disproportionate vulnerability at the younger

ages, undoubtedly derives from tbe fact that younger children have greater requirements than older

children for physical care and supervision under normal circumstances, so that there is a greater

oppotinity for failing to meet their needs.

Emotional Neglect. Age differences in emotional neglect as defined under the

Endangerment Standard reflect the fact that children age 5 and under had significantly lower incidence

rates than children ages 6 to 11. The incidence rates in the younger age brackets were 4,3 or fewer

children per 1,000, whereas the rates among 6- to 11-year-oIds were 12.1 children per 1,000 or higher.

422
o~

o 3 6 9 12 15

to to to to to to

2 5 8 tt 14 17

Figwe+16. Age Differences h Neglect Types mrder the

Entigemrent Stitid.

Severity of Outcomes fmm Maltreatment under the Endangerment Standard

There are sigrrificarrt age differences in incidence mtes within two categories of outcomes

from maltreatment under the Endarrgemrent Starrdmd: moderate injuries and endarrgered (but not yet

injured). These are graphed in Figure417.

Moderate Injury. Modemte injuries due to maltreatment that fit the Endangerment

Starrdard were more prevalent among older children. Analyses showed that for the youngest children,

those ages O to 2, them was a reliably lower incidence rate tharr for arry of the older age groups.

Specifically, 5.0 per 1,000 chiltien ages O to 2 were moderately injured, compmed to 10.5 or more

children per 1,000 in the older age groups.

Endangerment. In marked contrast to the above patterns, the incidence rates for children

perceived to be endangered by maltreatment were higher among the younger age groups: children ages

15 to 17 had sigrrificantly lower mtes than children ages Oto 11. Arr estimated 15.8 or more children per

1,000 in these younger groups were considered endarrgemd (but not yet harmed) by maltreatment,

+23
whereas only 6.3 children per 1,000 in the 15- to 17-year-old age ~oup were classified with this

outcome.

— Moderate

_ Endangered

o 3 b 9 12 15

to to to to to to

2 5 8 11 14 17

Chil&s Age (i years)

Figure+17. Age DifferencesirrOutcomesfromMaltreatmentundertie

EndangermentStandard.

Changes since the ~*2 in the Distribution of Maltreatment under the Endangerment Standard

in Relation to Child’s Age

Changes since the N1%2 in the incidence of six categories of maltreatment under the

Endangerment Standard were significantly related to child’s age: overall maltreatment, neglect,

emotional abuse, emotional neglect, educational neglect, and moderate injury.

Overall Maltreatment under the Endangerment Standard. As reported in Chapter 3,

the overall incidence of maltreatment as defined by the Endangerment Standard increased substantially

and significantly since the NIS-2. mere, it was reported that the total number of children who were

abused or neglected under the Endangerment Standard nearly doubled since the NIS-2 (increasing from

1,424,400 in 1986 to 2,81S,600 in 1993) and that the incidence rate increased by 8S percent (from 22.6

children per 1,000 to 41.9 children per 1,000). me finding of a significant relation between chil~s age

424
snd the chsnge in incidence across s~dies mesns that the increase was not equivalent at all ages: that is,

some age levels experienced more substmrtial increments thm others. The actual pattern is graphed in

Figure &18.

~

I g: -.

k 50”

$ 40”

: 30.

z

01

A

I

-— NIS-2

— NIS-3

o 3 6 9 12 15

to to to to to to

2 5 8 11 14 17

Chil&s Age (i yem)

I Figure 4- I8, Age Differences in Ovemll Maltreatment under the Endmeemrent

S&dmd in the NI%2 md the NI$3.

-

The figure indicates that the increase occumed in all but the 15- to 17-year-old age group.

Within-group tests of significance bear this out—the increase from the NIS–2 to the NIS–3 incidence

rate is significant in all age groups from O to 14, but the incidence rates for the oldest age group me

virtually identical across the two studies. Note the similwity bemeen this pattern mrd that shown in

Figure 49 concerning age-related chmrges in the incidence of overall maltreatment using the Harm

Stindard. The increase in maltreatment since the NIS–2 haa fallen disproportionately on preteens,

Neglect. Figure 419 shows the age differences in incidence rates of neglect under the

Endsrrgerment Stsndsrd in the NI>2 msdthe NIS–3. As reported in Chapter 3, the neglect rate under the

Endangemrent Stmrdsrd doubled since the NI>2. The graph in Figure 419 indicates that, again, the

increase occurred primarily among the younger children. The between-study differences are significant

for all children ages Oto 11; the difference is statistically mmginal for the 12- to 14-yem-olds; and there

is no statistical difference between the NO studies’ incidence rates for the 15-to 17-year-olds,

625
o~

or02 3t05 6b8 9r011 12b 14 15t0 17

Child’sMC (in yems)

Figure 419. Age Differences in Neglecturrderthe EndangermentStandard

h theNI*2 and the N1S3.

Emotional Abuse. Chapter 3 reported that the incidence rate of emotional abuse as defined

by the Endangerment Standard increased by 163 percent since the NIY2. Figure ~20 demonstrates that

this increaae differentially affected children ages 3 to 11. Within-group tests indicated that the increase

is significant only in these age groups. me very youngest (i.e., ages Oto 2) and the older children (ages

12 and up) also experienced increases in the incidence of Endangerment Standard emotional abuse, but

in these groups the increaaes were statistically marginal (i.e., tiey approached, but did not quite reach,

tie level traditionally required for significance).

Educational Neglect. As mentioned in Chapter 3, the definition of educational neglect is

tbe same under both the Harm S@dard and the Endangerment Standard. For this reason, the results

presented above in Figure 412 describing the findings in connection with educational neglect are not

reiterated hem.

Emotional Neglect. mere was a 172-percent increase in the incidence rate of emotional

neglect since the NI*2. (See Chapter 3.) ~is means that children were at almost NO and three-fourths

times greater risk of this maltreatment in 1993 than in 1986. However, this finding is qualified by age

differences, as shorn in Figure +21.

626
14-

8

12.

-.

k

10.

5 8’ — MS-2

~

u 6. b MS-3

%

j 4.

Z2

o

ot02 3t05 6t08 9t011 lzto 14 Is to 17

ChiWsA= (h yem)

Figure &20. Age Differences h Emotional Abuse uder tie Endmgement

Stitid h the N1~2 md the N1S3,

16-

14.

z-“ 12

i ‘:: :

n

— NIS-2

~

u ~ NIS-3

%6

J 4

9

Z2

0! 1

om2 3t05 6t08 9toll 12t0 14 15m 17

Chfld’sA& (my-)

Figwe A21. Age Differences hEmotional Neglect uderthe Endmgement

Stitid h the N1~2 md tie NI%3.
me figure shows that the increase in the incidence of emotional neglect as defined by the

Endangerment Standard was particularly severe for children in their middle childhood years, ages 6 to

11. It was significant for all age groups except the 15- to 17-year-olds, for whom there was no

statistically reliable change in the incidence of this maltreatment since the NIS–2.

Modemte InjuW. mere were no changes since the NI%2 in the overall incidence of

children who were moderately injured by maltreatment that fit the Endangerment Standwd (see

Chapter 3), so it is interesting to note that there were changes in incidence in this catego~ for specific

age groups and not others. Figure 422 shows the statistically significant increase for the 6- to 8-yearold children in this category as well as the significant decreose in the incidence of this outcome category

among 15- to 17-year-olds. Note that this is one of only WO instances in the NIS3 findings where a

notable decrease in incidence since the NI$2 is reported,

25.

20. .

15.

n

— NIS-2

10. ~ NIS-3

5

o~

Otoz 3t05 6t08 9t011 12to 14 15t0 17

Childs Age ~myem)

Figure+22. Age Differences in Moderate Injties fromMaltreatmentunderthe

EndangermentStandardh the NI$2 and theNI>3.

43 kce Differences in the Incidence of Maltreatment

No significant or marginal race differences in the incidence of maltreatment were found

either within the NI%3 data or in the comparison of changes since the NIS–2. ~is was true for both the

628
Harm Standard and the Endangerment Standard findings. It is interesting to note that this was also the

case in the NIS–2. That is, there were no significant race differences in any category for either standard,

and none oftbe changes between the NI%l and the NIS2 were modified by child’s race.

4.4 Key Findings on the Distribution of Abuse and Neglect by Child Characteristics

Children’s sex and age were related to their rate of Ma[tieafient, but different races Wem

found nor to have different rates of maltreatment.

Under both the Harm and the Endangerment Standards, girls were sexually abused about

three times more ofien than boys. This result is virtually identical to the NIS2 finding concerning sex

differences in rates of sexual abuse, so the disproportionate risk of sexual abuse for females has been

quite stable over time, It is this difference in rates of sexual abuse that leads to the higher rates of abuse

in general among girls and to their higher incidence of inferred injury.

On the other hand, the NI%3 also reveals some arenas where there is a higher incidence of

maltreatment among boys and where maltreatment risks have iocreased for boys. Specifically, the

N[S–3 found a statistically marginal tendency for boys to have a greater risk of serious injury (24%

higher than girls’ risk under both definitional standards), and boys were significantly more likely to be

emotionally neglected. (Boys had an 18%0greater risk than girls.) Also, changes since NI&2 show

greater increases in males’ risk of physical neglect as defined by the Harm Standard and of emotional

abuse as defined by the Endangerment Standard. Moreover, trends in the incidence of fatal injuries from

maltreatment moved in opposite directions for girls and boys: the incidence of fatally injured girls has

slightly declined since the NIS–2, while the incidence of fatally injured boys has risen.

A consistent feature of the age differences in incidence rates within tbe NI>3 is the lower

incidence of maltreatment among the younger children under both definitional standards. In most cases,

the differentiation was between children ages Oto 2 and older children or between children ages Oto 5

and older children, It is possible that the lower rates at these younger ages reflect undercoverage of these

age groups. That is, prior to attaining school age, children are less obsemable to community

professionals,

629
Another recurring theme that emerged in the discussion of age-related changes in the

incidence of maltreatment since the NfS-2 concerned disproportionate increases in the incidence of

maltreatnrent among the younger children (under age 12), especially children in their middle-childhood

years (ages 6 to 11). Note that these disproportionate changes altered the overall profiles of age

differences in maltreatment described in the NIS–2. During that earlier study, the risk of maltreatment

generally increased with the age of the child. With the lopsided increases seen here, which differentially

affected younger children and children in middle childhood, the profile has changed toward a flatter

(even sometimes hump-shaped) configuration. Note that as circumstances deteriorate and maltreatment

becomes more prevalent and more severe, older children have a greater opportunity of escape. This

dynamic may have moderated the obsewed increases at the higher age levels.

Also note that the relatively flattened-out profile of incidence rates across the age spectrum

is especially striking in the context of sexual abuse. The rate of sexual abuse under the Endangerment

Standard was relatively consistent for age 3 and older, a finding that attests to the vulnerability

throughout childhood, from preschool age on.

The lack of any race differences in maltreatment incidence may he somewhat surprising in

view of the disproportionate representation of children of color in the child welfare population. This

underscores the fact that the NIS methodology identifies a much broader range of children than those

who come to the attention of child protective sewice agencies and the even smaller subset of those who

subsequently receive child protective sewices. The NIS findings suggest that the different races receive

differential attention somewhere during the process of referral, investigation,’ and sewice allocation and

that their differential representation in the child welfare population does not derive from inherent

differences in their rates of abuse and neglect. It is also important to recognize that the NIS–3 reiterates

the NI%2 findings in this regard. That is, the NIS–2 also found no significant race differences in the

incidence of maltreatment or maltreatment-related injuries. Thus, the NIS–2 and the NIS–3 have both

cmtsiatently failed to uncover any evidence of dispropotiimrate victimimtimr in relation to children’s

race.

7 For instice, subsequent analyses of the NI%2 data found that younger minoriw children who were physically abused,

sexually abu%d, or educationally neglected wem more likely to receive CPS investigation tbm their white countewm.

(Sdlak, A.]., 1993. N1~2 Reamlysis Report. Appendix B to the Stidy of High Risk Child Abuse and Neglect Groups.

Wmhington, DC.: U.S. Depment of Health md Humm Sewices, 1993.)

&30
5. DIST~UTION OF MUSE ~ ~GLECT BY

F-Y C~C~WSTICS

This dhapter examines the relationship bemeen specific characteristics of the children’s

families and the incidence and severi~ of abuse and neglect. It is divided into four main sections that

present the NIS–3 results concerning the incidence of maltreatment for children who come from families

with different income levels, parent structures, and numbers of dependent children, and from families

liVirtg in counties of different levels of “rbani~tio”. ne discussion i“ each section addre~~e~ the

following questions:

● Do children who come from families with different characteristics have

systematically different incidence rates for the various types of maltreatment or for

the different seventies of outcomes due to Malfieatment?

● Have there been any statistically significant changes since the NIS-2 in the

distribution of child maltreatment by the family characteristic in question?

In each section, these questions are considered from the standpoint of both the Harm and

Endangerment Standards. The chapter concludes with a discussion of the general implications of the

findings.

Despite tie fact that the topics in this chapter all concern characteristics of families, the unit

of measurement for the estimates continues to be the children (and not their families). 1 Thus, the

incidence rates reflect the number of children per 1,000 in the general population who live in families

with the characteristic of interest (e.g., children who live in families with incomes less than $15,000 per

year, children who come from families with four or more dependent children, etc.).

Consistent with previous chapters, the findings presented here reflect unduplicated

estimates; that is,,each estimate counts each child only once. Also, only incidence rates (rather than total

‘ The technical volumes that describe the NIS methodology (the Revised Study Design, the Sample Selection Report, the Data

Collection Report, and the Analysis Report) detiil the multiple ways in which the NIS design md method were consistc”tly

gemd toward the child as the unit of measurement. Thus, the NIS dam a orgmizd md weighted with the god of providing

estimates of tie numbers of child=n in different categories, A considerably different methodology would be needed

tbmughout in order to provide estimates on metier mezuremcnt buis, such ~ fanrilies.

5-1
numbers of children) are discussed.2 As mentioned earlier, the rate measures were preferable, both for

the analyses and for the presentation here, because they adjust for differences in the numbers of children

in the general population who are in the different categories of interest. For the same reason, all

statistical comparisons were based on the rate measures.3

5.1 Differences in the Incidence of Maltreatment Related to Family Income

The findings discussed in this section focus on the relationship between family income and

the incidence of child abuse and neglect. Children were categorized into one of three groups on the basis

of the income level of their family less than $15,000 per year, between $15,000 and $29,999 per year,

and $30,000 or more per year.4

5.1.1 Differences in Maltreatment As Defined by the Harm Standard

Related to Family Income

The NIS–3 revealed significant and pewasive differences in the incidence of maltreatment

as defined by the Harm Standard in relation to family income. Significant differences in incidence rates

for children in the different family income classes occurred in all maltreatment categories except

emotional neglect and fatal injuries.s Table 5–1 provides the incidence rates of the various categories of

maltreatment for children in families with different income levels.6

2 Appen~ces A and B de~il all N1~3 estimates. including tie estimated mtes as well as totals, together with their standard

emors of estimate md their upper md lower 95-percent confidence bounds.

3 The detiiled msulk of all within-N1%3 statistical comparisons we pmvidcd in Appendix C. Appendix D contiins the

statistical demils of all beween-stidy compwisons.

4 Income information was obtained by meam of a four-catego~ response or responses on the study questionnaires. The $30,000

or more category comprised two categories ($30,000 to $44,999 md $45,000 or more), which were combined because of the

low frequency of responses in the highest income catego~.

s A subsmtial percenee of children who were counmble under the Hanrr Swdmd were missing income data (35Y. of the

weighted total). TO ensure that the income-related findings were not distofled by the missing daq special malyses were

conducted in whtch all children with missing income information were hypothetically resigned to the higher family income

bracket. The findings indicated no need to modify the conclusions about income-related differences repofied here. These

malyses w detiiled in Appendix C.

6 In each categoV of mtirr=ment or inju~, Orea-level that was used to determine significance adjusted for the multiplicity of

the compwisons involved. Details concerning the sratistid tests for the significance of income group differences are given in

Appendix C.

5-2
rable 5–1. Incidence Rates per 1,000 Children for Maltreatment under the

Harm Standard in the NI*3 (1993) for Different bvels of

Family Income.

Harm Standard

415wyr $15-29Wyr $30K+lyr

Significance of

Maltreatment Category Differences

ALL ~L~A~ENT 47.0 20.0 2.1 a

ABUSE:

All Abuse 22.2 9.7 1.6 a

Physical Abu~ 11.0 5.0 0.7 a

Sexual Abuse 7.0 2.8 0.4 b

Emotional Abuse 6.5 2.5 0.5 b

NEGLECT

All Neglect 27.2 11.3 0.6 a

Physical Neglect 12.0 2.9 0.3 a

Emotional Neglect 5,9 4.3 0.2 ns

Educational Neglect 11.1 4.8 0.2 a

SEVEW~ OF ~3URY:

Fatal 0.060 0.002 0.001 ns

Serious 17.9 7.8 0.8 a

Moderate 23.3 10.5 1.3 a

Inferred 5.7 1.6 0.1 b

, N]--rep &N_w m sitifi=t * mMowtie v.05 Imel.

b ~e hi@min-e VP (S30.Wmmm) dffm dmifimfly ~ tie tim WS<.05),

butbe tirr-a W- h 615,W -P mdti $!S,W wS29.WWP is

stitisidly mmtindO,..,.1*.05).

“s Notim.mup &ff_ti i, Si@ifimtormutind (dl P,*.10).

@erssll Maltreatment As Defined by the Harm Standard

Ignoring subgroup differences, the N[=3 found that some type of maltreatment as defined

by the Harm Standard occurred to an estimated 23.1 children per 1,000 in 1993. (See Chapter 3.)

5-3
However, higher incidence rates were directly associated with lower income levels, and all differences

among the income groups were statistically significant. Children in families at the lowest income level

had the highest incidence rate for maltreatment under the Harrrr Standard, with 47.0 children per 1,000

affected. This rate is equivalent to 4.7 children per 100, involving nearly 1 in 21 children among those

who live in families with the lowest incomes. This was more than WO and one-third times the incidence

rate for children in families with incomes beWeen $15,000 and $29,999 per year (where the rate was

20.0 children per 1,000) and 22 times the incidence rate for children in families with incomes of $30,000

or more per year (where the rate was only 2.1 children per 1,000).7 The incidence rates for these other

children also differed significantly, with children in families with incomes of $15,000 to $29,999 per

year abused at over nine and one-half times the rate of children in families with incomes of $30,000 or

more per year.

Abuse under tbe Harm Stindard

All differences among the income groups were also significant in relation to the main

category of abuse under the Harm Standard. Children in families with annual incomes lower than

$15,000 had the highest rate of abuse under the Harm Standard (22.2 per 1,000). Their rate was more

than two and one-quarter times the rate for children in families with annual incomes of $15,000 to

$29,999 (where 9.7 children per 1,000 were abused) and nearly 14 times the rate for children in families

with annual incomes of $30,000 or more (among whom only 1.6 children per 1,000 were abused). The

children in these other WO groups also had significantly different incidence rates of abuse under the

Harm Sbndard. Those living in families with incomes beWeen $15,000 and $29,999 per year were

abused at just over six times the rate of those living in families with incomes of $30,000 or more.

Children living in families with incomes less than $15,000 per year were also at

consistently higher risks for all specific types of abuse under the Harm Standard. The patterns were

consistent across all specific types of abuse and are graphed in Figure 5–1. (The rates are given in the

abuse section of Table 5–1.)

7 Computations of how mmy times greater one rate is thm mother, or of what percentage change occumed from one study to

another, arc made on the basis of the rounded estimates given in the tables and text of this report. Similar, but shghtly different

results would be obkined if one we= to usc the nonmund~ estimates, provided in Appendices A md B.

54
12

10

z

:.

~8

n

❑ 615,000/yr

g6 ❑ $15,000-29,999/yr

6

%4

8

■ $30,000+/yr

z

52

0

Physical Sexual Emotional

Abuse Abuse Abuse

Figure 5-1, Incidence of T~es of Abuse under the Hamr Stmdmd

for Different Levels of Fmily Income,

Physical Abuse. The overall rate of physical abuse under the Hm Standard in tbe NIS–3

was 5.7 children per 1,000. (See Chapter 3.) However, as show in Figure 5–1, this was not evenly

distributed across the different income levels. The incidence rate for children in the [owe~t income

farrrilies was newly wo and one-qutier times that for children in the middle-income group and almost

16 times the incidence rate for children in the highest income voup. me difference be~een the latter

@o income groups was also significsm~ with children from failies with incomes be~een $15,000 and

$29,999 per yem experiencing physical abuse at more thmr seven times the rate of children from families

with incomes of $30,000 or more per yew.

Sexual Abuse. The rates of sexual abuse as defined by the Hm Standmd (shown in Table

5–1 and in the center of Figure 5–1) should be considered in relation to the overall rate for this

maltreatment, which was 3.2 children per 1,000. (See Chapter 3.) There were strong income-related

differences in the distribution of this type of abuse as well, and only children in tbe middle-income group

aPPrOxlmated fie general rate. Children living in fmilies with incomes less than $15,000 per year

experienced sexual abuse under the Hm Stidmd at more than 17 times the rate of children in fanrilies

with incomes of $30,000 or more per yew. Children from families in the middle-income bracket had

seven times the incidence of sexual abuse as children from families with incomes of $30,000 or more per

5-5
year. The difference between the less-than-$ 15,000 income group and the $15,00&$29,999 income

group in tbe rates of sexual abuse was not significant according to tbe traditional standard, but it did

apprOach significance (i.e., it was marginal, with a probability of less than 10 percent that it was due

solely to chance sample fluctuations). The children from families whose annual incomes were less than

$15,000 had two and one-half times the incidence rate of children in families with yearly incomes

between $15,000 and $29,999.

Emotional Abuse. Chapter 3 reported that emotional abuse under the Harm Standard

affected 3.0 children per 1,000 overall, but Table 5–1 and Figure 5–1 reveal the substantial subgroup

differences in the rate of this maltreatment in relation to family income. There was a significant

difference beween the lowest and highest income groups: children in families with incomes less than

$15,000 per year had a 13 times greater rate of emotional abuse than children in families with incomes of

$30,000 or more per year. The rates for children in families in the WO higher income groups also

differed significantly, with children in families in the middle-income group having a five times greater

rate of emotional abuse than children in families in the highest income group.

Neglect under the Harm Standard

The incidence of overall neglect under the Harm Standard, which is 13.1 children per 1,000

when subgroup differences are ignored (see Chapter 3), was disproportionately higher among children

living in the lower income groups. As presented in Table 5–1, the rate is actually 27.2 per 1,000 children

in families in the lowest income group. This is two and two-fifths times the rate of 1I,3 per 1,000 for

children in families in the middle-income group and 45 times the rate of 0.6 per 1,000 for children from

families in the highest income group. The incidence rates for the latter two groups of children also differ

significantly. Children living in families in the middle-income group had almost 19 times the incidence

of Harm Standard neglect compared with children living in families in the highest income group.

When the specific forms of neglect were examined, significant income-related differences

were found in the incidence of physical, emotional, and educational neglect. These are chtied in

Figure 5–2.

5-6
14.0

0.0

T

❑ a15,000/y

❑ $15,000-29,999/ys

Physical Emotional Educational

Neglect Neglect Neglect

Figu~ S-2. Incidence of Types of Neglect mder the Hmm

S~dwd for Different Levels of Family Income

Physical Neglect. Across allchildren, physical neglect redefined bytie HmS@dwd

occumed atarate of5.Ochildmn per 1,000, ss described in Chapter3. However, Table 5–1 and Fi@re

5-2underscom tiattiem wemwked differences inthisrate ma finction of fmily income. Children

living in impoverished fsmilies (those with incomes less than $15,000 peryew) were over four times

mom likely to be physically neglected &an children in fmilies with incomes between $15,000 srtd

$29,999 per yew, the poorest children were 40 times mom likely to be physically neglected thsn chilhn

in fsrnilies with yewly incomes of$30,000 or more. Income-mlated differences wem also significsrrt

among the children where mmual family incomes were $15,000 or mom: children in fsmilies with

annual incomes be~een $15,000 and $29,999 had nine and ~mthirds times the physical neglect rate of

children in fmilies with mmual incomes of $30,000 or more.

Emotional Neglect. ~epoorest children experienced emotional neglect redefined bytie

Hm Stmrdwd at 29 times the rate for children in fsmilies in the highest income catego~ (i.e., families

with incomes $30,000 peryem or more). Children in fmnilies inthemiddle-income grmrp($15,000to

$29,999 per yew) wem 21 times mom likely to be emotionally neglected thsn those in families in the

higher income woup.

5-7
Educational Neglect. Although 5.9 children per 1,000 were educationally neglected

among the overall child population, there me considerable sod significant differences in incidence among

children living in different economic circumstmrcesL Educational neglect wm most prevalent among

children in families with incomes less than $15,000 per yew, where the rate is 11.1 children per 1,000.

These poorest children are nearly NO mrd one-third times more likely to be educationally neglected than

are children in families in the next income bracket (with incomes beWeen $15,000 md $29,999 per

year), and they are almost 56 times more likely to be educationally neglected tian are children in

families with incomes of$30,000per year or more, tncome-related differences in educational neglect

extended to the other income brackets as well. Children Iivingin families ofmore modest means (witb

incomes beWeen $15,000 and $29,999 per year) had a rate of educational neglect that was 24 times that

of children in families with incomes of $30,000 per year or more.

Severity of Outcomes from Maltreatment As Defined by the Harm Standard

As Table5–1 indicates, there wemsignificant income-related differences in the incidence

ofchildren who were injured seriously ormoderately bymaltreatment asdefinedby tie Ham Standwd

andinthe incidence ofchildren for whom harm cmddbeinfemedbe causeof theex~emena tureof their

maltreatment. These income group differences aregraphed in Figure 5-3.

Serious Injury. In general, 8.4 children per 1,000 inthe U.S. child population suffered

serious injury from some type of maltreatment that fit the Harm Standwd. (See Chapter 3.) Incomerelated differences, however, strongly qualify that finding, as evidenced in Figure 5–3. The poorest

children were victims ofscrious injury at a rate of 17.9 per 1,000, a rate that is more than NO and mrefmsrthtimes therate of serious injury ammrg children in fmnilies with incomes he~een $15,000 and

$29,999 peryear andmore than 22times therate of serious injury mnong children in families with

incomes of$30,0000r more per year. Children in fmilies with incomes beWeen$15,000 and$29,999a

year were seriously injured by maltreatment meeting the Ham Standard at a rate of 7.8 children per

1,000, which is nine and three-fourths times the rate for children in families with incomes of $30,000 or

more.

5-8
25.

I

I n

m

serious Modemte Infemd

Figme 5–3. Incidence of Injties from Maltreatment under the

H= Stidwd for Different Levels of Family Income

Moderate InjuW. In fiegeneral child population, 12,2 children perl,OOO were victims of

moderate inju~as aresult ofabuse orneglect asdefinedby tie Ham Standwd, Among cbildren living

in the poorest fmilies, the rate W= 23.3 children per 1,000. ~is is more thm two msd one-fifih times

the rate for children in farrrilies making between $15,000 and $29,999 a yew md almost 18 times the rate

for children in fnnrilies m~ing $30,000 a yew or more. me latter WO income groups also differed in

their rates of moderate inju~, An estimated 10.5 per 1,000 children in families making $15,000 to

$29,999 a yeas suffered moderate inju~ fmm abuse or neglect meeting the Ham Stidwd, which is

more thm eight times the rate of 1.3 children per 1,000 in families earning $30,000 or more mnually,

Issfermd Issjuw. me Ham Stidmd definitions pemitted inju~ to be infemed for an

estimated 2.5 children per 1,000, based on the severe nature of the maltrea~ent events they experienced,

But this overall rate maaks significant income-related differences in the incidence of children with

infemed inju~. me infemed inju~ incidence rate was 5.7 per 1,000 mong the poorest children, which

is more than three and one-half times tbe rate among children in fmilies with incomes between $15,000

and $29,999 a yew md 57 times the rate among children in families with incomes of at leaat $30,000 a

yew. me incidence rate of infemed inju~ was 1.6 per 1,000 for children in families with incomes

5-9
between $15,000 and $29,999 a year. This is 16 times the rate among children in families with incomes

of $30,000 a year or more, a difference which is also significant.

Changes since the MS2 in the Distribution of Maltreatment A Defined by the Harm Standard

in Relation to Family Income

Comparisons between the NI%2 and the NIS–3 did not detect any significant or marginal

shifts in income-related differences in the incidence of maltreatment under the Harm Standard.

5.1.2 Differences in Maltreatment& Defiaed by the Endangerment Standard

Related to Family Income

me general findings reported in Chapter 3 concerning the incidence of maltreatment as

defined by the Endangerment Standard are qualified by significant and pervasive differences in its

distribution baaed on family income. Significant differences in incidence rates were found among all

income brackets in all categories of maltreatment and severity of outcome, except fatil injuries.8 The

incidence rates for children in fmnilies with different income levels are given in Table

5–2.9

~erall Maltreatment under the Endangerment Standard

In general, as reported in the main M>3 results presented in Chapter 3, an estimated 41.9

children”per 1,000 experienced some form of maltieatme~t under the Endangerment Standard. However,

that finding is qualified by significant differences in children’s rate of victimimtimr based on their family

8 For a substantial pc=nrage of children who were countable under the Endmgement Smdwd, income dam wem missing

(31% of the weighted toti). To ensure thti the income-related findings were not distofied by the missing da% spwial sndyscs

were conducti in which all children for whom income information wss missins were hypothetically msisned to the higher

fmily income brscket. The findings indicated no nd to moditi the conclusions about income-related differences repotied

here. These malyses sre detsiled in Appendix C.

‘As in tie preceding =ction, the a-level that wss used to determine significmce adjusted for the multipliciw of the comptisons

involvd in -h categov. (See Appendix C.)

5-1o
Table 5-2, Incidence Rates per 1,000 Children for Maltreatment under the

Endangerment S@ndsrd in the NIS–3 (1993) for Different Levels of

Fmily Income.

Endangerment Stidard Significmrce of

Maltreatment Category <$15Wyr $15-29Uyr $30K+lyr Differences

ALL MAL~ATMENT 95.9 33.1 3.8 ●

ABUSE:

All Abuse 37.4 17.5 2.5 *

Physical Abuse 17.6 8.5 1.5 *

Sexual Abuse 9.2 4.2 0,5 *

Emotional Abuse 18,3 8.1 1.0 *

NEGLECT:

All Neglect 72.3 21.6 1.6 *

Physical Neglect 54.3 12.5 1.1 *

Emotional Neglect 19.0 8.2 0.7 *

Educational Neglect 11.1 4,8 0.2 *

SEVENTY OF ~~RY:

Fatsl 0.060 0.002 0.003 ns

Serious 17.9 7.9 0.8 *

Moderate 29.6 12.1 1.5 *

Inferred 7.8 2.7 0.2 *

Endangered 40.5 10,3 1.3 *

● All beWmn-group differences msig"ificmt atorklow tiep<.05 level.

ns No beWcen-group difference issignificmt ormmgind (all p3Q.lO).

income. Table 5–2 shows that an estimated 95.9 per 1,000 children from the poorest fsmilies, in which

annual incomes are below $15,000, suffered maltreatment under the Endmgerment Standard. ~is

incidence rate is nearly three times the rate of maltreatment found for children in families with annual

5-11
incomes between $15,000 and $29,999. ~e poorest children had amoretban25 times greater risk of

maltreatment under the Endangerment Standard compared to children in families in tie highest income

classification (i.e., that made $30,000 or more per year). In turn, children from families with annual

incomes between $15,000 and $29,999 had a more than eight and one-half times greater risk of

maltreatment under the Endangerment Standard than children from families making $30,000 or more.

Abuse under tbe Endangerment Standard

me general incidence rate of abuse under the Endangerment Standard was 18.2 children

per 1,000 across the U.S. child population. However, there were significant differences among all

income groups in relation to this category of maltreatment. Children in the most impoverished families

had the highest rate of abuse (37.4 children per 1,000), more than twice the rate for children in families

with incomes of $15,000 to $29,999 per year and almost 15 times the rate for children in families with

incomes of at least $30,000 per year. Children in the $15,00@$29,999 income group had an incidence

rate of abuse under the Endangerment Standard of 17.5 children per 1,000, which is seven times the rate

for children in the higher income families (those making $30,000 or more a year).

~is general pattern pemaded all specific types of abuse as defined by the Endangerment

Standard, as shown in Figure 54.

Pbysieal Abuse. me poorest children had more than twice the rate of physical abuse under

the Endangerment Standard as children in families with annual incomes of $15,000 to $29,999 and

almost 12 times the rate of those in families with annual incomes of $30,000 or more. Children in

families in the middle-income range, which make between $15,000 and $29,999 annually, had a five and

two-thirds greater rate of physical abuse thm those in families in the highest income category.

Sexual Abuse. In this maltreatment category, the risk for children in the lowest income

families was more than twice that for children in families at the next income level ($15,000 to $29,999

per year) and more than 18 times the risk for children in families at the highest income level ($30,000

per year or more). Children in families in the middle and upper income ranges also differed significantly

in their risk of Endangerment Standard sexual abuse: those in families mtilng $15,000 to $29,999 per

year had more than eight times the risk of experiencing this type of maltreatment.

5-12
20

18

o

1- n

u

❑ Q15,000/yr

❑ $15,00&29,999iyr

■ $30,00Wlyr

Physical sexual Emotional

Abuse Abuse Abose

Figure 5+. Incidence of Types of Abuse uoder rbe Endmgennent

Stmdmd for ~fferent Levels of Fmily Income.

Emotional Abuse. Children in the poorest fsmilies had more than a NO and one-foufi

times greater risk of being emotionally abused compared to children in fsmilies with incomes between

$15,000 and $29,999 per yew, mrd their risk ww more tbm 18 times g~ater tbarr that of cbildmn whose

fmnilies made $30,000 per yea or more. The children in fmilies in the middle-income group were

more than eight times as likely to be emotionally abused as those in fmilies in the higher income group,

Neglect under the Endangerment Standard

An estimated 29.2 children per 1,000 were neglected under the Endangemrent Stindwd

definitions in 1993 (see Chapter 3), but stiong differences across children bsaed on the incomes of their

fmnilies qualified this general finding. Again, those who live in the poorest fsnrilies, with incomes less

thm $15,000 per year, were more thmr three mrd one-third times more likely to be neglected thm those in

fsmilies at the next level of income ($15,000 to $29,999 a yew). ~ese poorest children were more thsrr

45 times more likely to be neglected thm those whose fmrrilies mske $30,000 a yew or more. me

income-ba=d differences among children in tieir risk of Endangemrent Stmrdmd neglect also extend

into the other income brackets: children whose fmilies mke $15,000 to $29,999 a yew had more than

13 times the neglect rate of those in the upper income fanrilies.

5.13
This configuration of risk differences also characterized every specific type of neglect

under the Endangerment Standard, a fact that is evident in the graph in Figure 5–5. Note that the

incidence rates for the highest income children in the categories of emotional and educational neglect are

almost undetectable on the scale of this graph. (See Table 5–2 for the actoal values.)

Pbysiul Neglect. The poorest children were physically neglected more than four and onethird times more often than those in families with incomes of $15,000 to $29,999 a year and more than

49 times more often than children in families with incomes of $30,000 a year or more. Those in the

middle-income group had, in turn, a more than 11 times greater risk of physical neglect than those in the

upper income group.

Emotional Neglect. Children in families in the lowest income group (less than $15,000

annually) were almost WO and one-third times more likely to be emotionally neglected than those in

families in the middle-income group ($ 15,000 to $29,999 annually). Compared to children in families in

the highest income group ($30,000 or more annually), children in families in the lowest income group

were over 27 times more likely to be emotionally neglected. Among children in the middle-income

families, the risk of emotional neglect was almost 12 times greater than among those in families in the

highest income group.

Educational Neglect. Children from families with the lowest incomes were almost two

andone-third times more likely to beeducationally neglected compared to children from families in the

middle-income group. Theincidence rate ofeducational neglect wassosmall intheupper income group

that, incomparismr, the lowest income group hada more than 55 times greater risk and the middleincome group had a 24 times greater risk.

Severity of Outcomes from Maltreatment As Defined by the Endangerment Standard

There were significant differences based on family income in the incidence of all categories

of outcomes from Endangerment Standard maltreatment, except fatalities. The findings are shown in

Figure 54; again, the incidence rates for children in the highest income group are sometimes only barely

visible on the scale of the graph in comparison to the rates for the other income groups.

5.14
60

T

0

Physical Emotional Educational

Neglect Neglect Neglect

❑ +15,000/yr

❑ $15,00&29,%/yr

■ $30,00w/yr

I

Figure 5–5, Incidence of Types of Neglect under the Endmgement

S~dwd for Different Levels of Fmily Income.

45,

❑ <$15,000/yr

❑ $15,000-29,999/yr

■ $30,000+/yr

Figure 5+, Incidence of Injuries from Malbea~ent under tie

Endmgement Stidud for Different Levels of Fmily Income.

5-15
Serious Inju~. Thedistributimr ofserious injury wasstiongly related to family income.

For children in families with the lowest incomes, the rate of serious injuries was more than WO and onefoufih times greater than for children in families in the middle-income group. me poorest children had

over 22 times the rate of serious injury from maltreatment compared to children in families in tbe highest

income group. Children in tbe middle-income families had a rate of serious injury that was almost 10

times higher than the rate of serious injury for children in families in the upper income group.

Moderate Injury. Children whose families make under $15,000 a year had nearly two and

one-half times the rate of moderate injury of children in families making $15,000 to $29,999 a year and

almost 20 times ‘tie rate of moderate injury of children in families making $30,000 a year or more.

Children from families in the middle-income bracket had more than eight times the rate of moderate

inju~ from maltreatment under the Endangerment Standard compared to children from families in the

upper income bracket.

Inferred Injury. There were significant income-related differences in the incidence of

children countable under the Endangerment Standard for whom injury could be inferred on the basis of

the extreme nature of their maltreatment. The poorest children qualified for this classification nearly

three times more often than those from families with incomes between $15,000 and $29,999 a year. The

poorest children were also 39 times more likely to be classified in the inferred injury category than

children in families making $30,000 a year or more. Children from families in the middle-income

bracket were more than 13 times as likely to be classified in the inferred injury category as children

whose families fell into the upper income bracket.

Endangerment. The incidence rates for children who had been endangered, but not yet

harmed, as a result of maltreatment differed significantly across the three family income brackets. The

poorest children had almost four times tbe incidence rate of children in the middle-income bracket, and

they had more than 31 times tbe incidence rate of children in the highest income group. Children from

families making be~een $15,000 and $29,999 a year were almost eight times more likely to be

endangered by abuse or neglect than were children from families making $30,000 a year or more.

5-16
Changes since the N%2 in the Distribution of Endangerment Standard Maltreatment

in Relation to Family Income

Comparisons between the NI%3 and the NI%2 income-based differences used tbe simple

dichotomous classification that had been used in the earlier NI%2. That is, the comparisons emined

the differences in incidence rates between children in families with incomes less than $15,000 per year

and tiose in families with incomes of $15,000 a year or more. The only significant between-study

change in the relation between family income and maltreatment was among endangered children (i.e.,

those who bad been endangered but not yet harmed by ma]tieahent). me finding is ~h~ed ‘in

Figure 5–7.

45 ~

40 +

g 35

~30.

g25- ‘

~ 20

215.

$

g 10

z

5..

OL

~15,000/yr $15,00W/yr

a

❑ NIS-2

■ NIS-3

Fi~e 5–7. Incidence of Endangered Children in the NI>2

and the NI$3 for Different Levels of Family Income.

Although there were significant increases in the incidence of endangered children in both

income groups, the figure makes it evident that the increase was much geater among the lower income

children.

5-17
5.2 Family-Structure Diflererrces in the Incidence of Maltreatment

This section presents the NIS-3 results on the relationship beWeen the incidence of child

abuse and neglect and family stmcture in terms of the number of parents in the child’s household.

Children were categorized into groups according to whether they lived with both their parents, only their

mother, only their father, or neither mother nor father. The definition of parent followed tiat used by the

Bureau of the Census, which includes bitih parents, adoptive pwents, and step-pwents.’”

S.2.1 Family-Structure Differences in Maltreatment under the Harm Standard

The incidence of maltreatment under the Ham Standard differed significantly across

different family stmctures in seven of the nine maltreatment categories and for WO of the four severity

levels. Table 5–3 gives the incidence rates for children in families with different parent configurations

for all categories of maltreatment and severity. 1I The last COIumnindicates the pattern Of anYsignificant

or marginal differences across the different family-stmcture categories. Note that in all categories where

differences emerged, children living in single-parent households were at higher risk than those living

with both pments. The specific findings in this table are discussed in the subsections that follow.

Overall Maltreatment under the Harm Standard

Figure 5–8 graphs the differences related to family structure in the incidence of overall

maltreatment and of the main categories of abuse and neglect as defined by the Hamr Standard.

Among children living with a single parent, an estimated 27.3 per 1,000 suffered some

fomr of maltreatment under the Harm Stindard in 1993. This rate is more than one and three-foutihs

‘oFmily stmcture wm unknown for IS percent of the weighted total of children who were counhble under the Hm Stsndmd

md for 19 percent of the weighted total of children countable under the Endmserrnent Stsndsrd* ither because it was not

known whether one or the other pwent was living in the child’s household or because the child’s exact relationship to the

mother-substitute or to the father-substitute in the household w~ not known.

]‘ In each mtego~ of maltreatment or inju~, the a-level that w= used to detemine significance adjusted for the multiplicity of

the compwisons involved. Details concerning the statistical tess for the significance of differences b~ed on family stmcture

ze given in Appendix C.

5-18
Table 5-3. Incidence ~tes per 1,000 Children for Maltieament under the Hm Stidwd

in the NI>3 (1993) for Different Fmily Sticmres.

Single Pment

H- Stidmd Maltrea~e”t ‘oth ‘m’”t’ Either Significmceof

Motheror Mother-only Father-only Neither

Category Differences

Fatier Pment

ALL MALTREATMENT 15.5 27.3 26.I 36.6 22.9 A, C, D

ABUSE:

All Abuse 8.4 11,4 10.5 17.? /3. 7 D, e

PhysimlAbuse 3.9 6.9 6.4 10.5 7,0 %D, e

Sexual Abuse 2.6 2,5 2.5 2.6 6.3 ns

Emotional Abuse 2.6 2.5 2.1 5.7 5.4 ns

NEGLECT

All Neglect 7,9 17.3 16.7 21.9 [0.3 A, C, D

Physiml Neglect 3.1 5.8 5.9 4.7 4.3 A, C

Emotional Neglect 2.3 4.0 3.4 8.8 3.1 4G

Educational Neglect 3.0 9.6 9.5 10.8 3.1 A, B, f

SEVEWTY OF INWRY

Fatil 0.019 0.015 0.017 0.005 0.016 m

Serious 5.8 10.5 10.0 14.0 8.0 A, C

Moderate 8.I 15.4 14.7 20.5 10.I A

lnfemed 1.6 1.4 1.3 2.1 4.8 ns

A DiffercwW=” ‘Bob Parem- ti .EiherMetieror Fatier”issigninmt atorklow he p<,05 level.

a Diffecem We. “Bob Pare.&”d “&tier Metier or Fa&cr”issmti$tiallymargimlG.e., ,1O>P> ,05),

B Differmm hm=o - titier Motiecor Fa&er”ad - Neitier Parent- is$istifimt atO,belowtie p<.05 level.

C Dtffeww W=” ‘Bob Parcnm-d ‘Metier OAy- isSig”ifimt atork]ow tie p<.05 Iwel.

D Dtiemm tie” “Boti Parem” d ‘Faticr o“!y- issi~fimt at.r klow he p<,05 !evcl.

e Dfferem tiwm ‘Metierody- d ‘Fatir only-issmtisti~llymrglti fi.e.,.1O>P>.M).

f DIffcrcmeb- “Mohero“lY”d “NtihcrPa~nt-issmtistlallymrgiml O,.,, 10>p>.05),

G D!fferewetiw~n -Fatie,onlynati -Neitierhre”t- is$ignifiat ator~tow tie p< .05level.

.s No&w~n.grouptiffemm is$ig”ifia”tormargiml(allp,s>, 10).

times the rate of overall maltreatment under the Harm Standard for children living with both parents

(1 5.5 per 1,000), a difference which is significant. Moreover, the higher risk for children of single

parents held true for botb mother-only arsd father-only housebDlds. Children living with only their

mothers experienced maltreatment under the Ham Standard at a rate of 26.1 per 1,000, which is more

I

5–19
40.0

1

❑ Both PmenG

~ titier Motheror Father

■ Mother-only

~ Father-only

■ NeitherPment

All Abuse Neglect

Mdtieatment

Figue 5–8. Incidenceof OverallMaltiea~ent md of Abusemd Neglect

underthe Hm SMdwd for DifferentFmily Stmctmes.

than one md We-thirds times the rate of children living with both pments. An estimated 36.6 per 1,000

of children who we living with only their fathers suffered some fores of maltreatment under the Hm

Stmsdad. ~is rate is more tbm wo asrd one-third times higher thm that of children in w~pment

fsmilies.

Abuse under the Harm Standard

Children in father-only families had more tha Wice the risk of abuse as defined by the

Hw Starsdardcompmed to children living in both-pa~nt families. ~eir risk was more tbarr one smd

tw-thirds that of children in mother-only fmrrilies, a mmginal difference in this malwatment catego~.

~us, the pattern in connection with abuse essentially reflects the higher risk of children who live with

only their fathers.

Physical Abuse. men specific types of abuse under the H- Starsdwd me e-ined, it is

appment hat the findings described in the previous pumgraph stem from the dispmpofiimrate incidence

5–20
of physical abuse among children in father-only households, The Waph in Figure 5–9 shows this pattern.

An estimated 10.5 per 1,000 children living with only their fathers wem hmed by physical abuse in

1993, which is more than two and two-thirds higher than the incidence rate of 3.9 per 1,000 for children

living with both their paents. Children in mother-only families were not statistically different fmm

those in both-pment households in their risk of physical abuse under the Harm Standard.

12.0 T

8 10.0 L

❑ Both Pwents

:.

~ 8.0 ❑ Etier Motieror Father

z

z 6.0 ■ Motber~n~

6

% 4.0 ❑ Father~n~

$ 2.0

z

■ NeitherPwnt

0.0

Figure 5–9. Incidence of Types of Abuse and Neglectmrder

the Hamr Srandwd for Different Family Stmctures.

No incidence differences relating to family stmcture were uncovered in any of the other

specific types of abuse under the Ham Standmd.

N~lect under the Harm Standard

The incidence of overall neglect under the Ham Standwd is significantly higher among

children living with a single pwent, a pattern which was graphed earlier in Figure 5–8. An estimated

17.3 per 1,000 among single-pmented children were neglected, which is almost two and one-fifib times

the rate of 7.9 per 1,000 for children in two-parent households,

5-21

This pattern was tme for children from
both mother-only and father-only families, who were not statistically different in their rates of negl;ct

under the Harm Standard.

All three specific types of neglect under the Harm Standard evidenced disproportionately

high rates of incidence among children of a single parent, but other aspects of the family stmcture

differences varied across these maltreatment categories, as documented in Figure 5–9.

Physical Neglect. In Chapter 3 it was reported that physical neglect as defined by the

Harm Standard occurred at a rate of 5.0 children per 1,000. Children living with both of their parents

had a lower incidence rate than this (3.1 children per 1,000). An estimated 5.8 per 1,000 children of

single parents were harmed by physical neglect, a significantly higher incidence rate. Note that the

higher risk for children of single parents in this catego~ predominantly reflects a higher incidence of

physical neglect among children living only with their mothers, among whom 5.9 children per 1,000

were physically neglected, mere was no statistical difference between the incidence of physical neglect

among children in father-only households and those in both-parent households.

Emotional Neglect. me incidence of this type of maltreatment was marginally higher

among children living with single parents than among children living with both parents. However, in

this case, it was also found that children living only with their fathers had a two and four-fifihs times

greater risk than children who were living with neither parent.

Educational Neglect. Across all family structures, educational neglect occurred to 5.9

children per 1,000 in the U.S. population, but there were differences in incidence rates depending on

family stictire. Children living with a single parent had a three and one-fifth times greater risk of being

educationally neglected than those living with both parents. Children living with only their mothers were

over three times more likely to be educationally neglected as those living with two parents. Singleparented children also had a more than three times greater risk of educational neglect compared to

children who do not live with either parent. Although incidence rates for both mother-only and fatheronly households were notably high, statistical comparisons showed that children living only with their

mothers had a reliably higher risk than children living with neither parent.

5–22
Severity of Outcomw from Maltreatment h Defined by the Harm Standard

As Table 5–3 indicated, there are significant family structure differences in the incidence of

children who were seriously or moderately injured by Harm Standard maltreatment. Figure 5-10 ch~

25.0

T

%

20.0

-.

0.0

❑ Both Parcnta

❑ Etier Motheror Faticr

■ Mother-only

❑ Fatber+rdy

■ Nefier Pwnt

ScriOus Moderati

Figm 5–10. Incidenceof InjuriesfromMaltreatmentunder

the Harm Standard for Different Family Structures,

Serious Injury. Children living in single-parent households had a more than one and fourfitis times greater risk of suffering serious injury or harm from maltreatment that fit the Harm Standard

than their peers living with both parents. Separate analyses comparing children in mother-only and

father-only households with those living with both parents showed that this pattern was statistically

reliable only for children in mother-only householdsCthe father-only estimates were not sufficiently

precise to support the statistical reliability of the apparently higher rate in that group as well.

Moderate Injury. Children of single parents had nearly twice the risk of moderate injury

from Harm Standard abuse or neglect in comparison to children living with two parents.

5–23
Changes since the NfS-2 in the Distribution of Maltreatment under the Harm Standard

in Relation to Family Structure

Compmisons between the N>3 ad the NIS–2 examined the differences in incidence rates

among children in families with both parents, a single p~ent, and neither parent. A sepmate analysis

also examined whether incidence rates for children in mother-only households differed from those for

children in father-only households.

Only one category of maltreatment as defined by the Hamr Stidard evidenced a

significmt charrge since the NI$2 in relation to family stmcture. As Figure 5–1 1 shows, the increase in

physical abuse under the Hw Stmrdmd was greatest among children living with neither pwent, where

the rate increased from 0.5 children per 1,000 in the NI%2 to 7.0 children per 1,000 in the NI$3. ~is

was the only family s~ctore where this maltreatment showed a significant charrge since the NI&2.

7.00

6.00

z

:. 5.00

5

~ 4.00

~ 3.00

%

j 2,00

s

1.00

0.00 +

1

BothPaents SinglePment Neither Pwent

❑ NIS-2

■ NIS-3

Figure 5–11, Incidenceof PhysicalAbuseunderthe Hamr Stindmd

in the NI>2 md the NI>3 for DifferentFamily Stmctures,

5–24
5.2.2 Family-Structure Differences in Maltreatment under the Endangerment Standard

Similar patterns characterized the distribution of maltreatment as defined by the

Endangerment Standard across the different categories of family structure, Significant or marginal

differences in incidence rates based on family structure emerged in seven of the nine categories of

maltreatment and in three of the five categories of outcomes. Specifically, differences emerged in the

incidence of overall Endangerment Standard maltreatment, the main categories of abuse and neglect

physical abuse, physical neglect, emotional neglect, educational neglect, serious injuries, moderate

injuries, and endangerment. The incidence rates for children in families with different parent structures

are provided in Table 54.12

Overall Maltreatment under the Endangerment Standard

In Chapter 3 it was reported that some form of maltreatment as defined by the

Endangerment Standard occurred to an estimated 41.9 children per 1,000 nationwide. Significant

differences in relation to family structure quali~ that general finding. Table 54 shows that children in

single-parent households experienced a higher rate of maltreatment under the Endangerment Standard

compared to children living in No-parent households. The graph in Figure 5–12 depicts the incidence

rates for overall maltreatment as defined by the Endangerment Standard and for the main categories of

abuse and neglect. Children living with a single parent had nearly twice the rate of overall maltreatment

under the Endangerment Standard compared to children who live with both parents (i.e., 52 children per

1,000 versus 26.9 children per 1,000).

‘2 As in rhe prding s=tion, the a-level tit was used to detemrine signifiww adjustd for rhe multiplici~ of Ure

comparisonsinvolvti in ach mtego~. (S= AppmdixC.)

5–25
Table 54, Incidence %tes per 1,000 Childen for Maltieatient under the

Endmgement Stidwd in the NI$3 (1993) for Different Fmily S~ctires,

Endmgement Stidwd

Malheament Catego~

ALL ~L=A~ENT

ABUSE

All Abuse

PhysicalAbuse

SexurdAbuse

EmotionalAbuse

NEGLECT

All Neglect

PhysicalNeglect

EmotionalNeglect

EducationalNeglect

SEVER3TY OF fN3URY:

Fati

SetiOus

Modemte

Infend

Endmgemd

orbP~nt

26.9

13.5

6.J

3.2

6.2

17.6

10.8

6.4

3.0

0.020

J.9

9.6

2.1

9.3

tither

Mother or

Father

52.0

19,6

10.6

4.2

8.6

38.9

28.6

/0.5

9.6

0.0/5

IO,J

18.J

2.J

20.J

,ngle Pwmt

lotier-only

50.1

18.1

9.8

4.3

7.7

37.6

27.5

9.7

9.J

0.017

10.0

17.7

2.0

20.4

‘arber-only

65.6

31.0

16.5

3.1

14.6

47.9

36.4

16.2

10.8

0.005

14.0

24.8

6.0

20.7

Pant

39.3

17.3

9.2

6.6

7.1

24,1

17.1

8.3

3.1

0.016

8.0

11.5

4.7

15.1

igrrifimce of

Diffe~n=s

&C, D,G

a

d

ns

ns

A, C, D, G

A, C,D

a

~B, C,f

ns

Ac

&b

ns

kc

5–26
70.0 T

o 60.0

s

;- 50.0

j 40’0

5 30.0

%

J 20.0

~

z 10.0

0.0

❑ Both Pmenfi 1

❑ EitherMotheror Fafier

■ Mother-only

❑ Father-only

■ Neitier Punt

All Abuse Neglect

Maltreatment

Fi~e 5–12. Incidenceof OverallMaltiea~ent md of Abusemd Neglectunder

the Endmgement Stidmd for DifferentFmily S~c~s.

Abuse uuder the Eudaugermeut Standard

Abuse of some type as defined by the Endungement Stidmd occumed to rm estimated

1g.2 chil&en per 1,000 across the United S@tes. However, the single-psrent fmnily w= associated with

a mmginally higher incidence rate compmed to the Wo-pmnt fmily. Children living with only one of

their pwents were abused at a 4S-percent higher rate (19.6 versus 13.S children per 1,000).

Physical Abuse. me only specific type of abuse under the Endmgerment Stidmd that

revealed systematic differences in incidence in relation to fsmily sticture is physical abuse. Similm to

the pattern described above in relation to Hm Standmd physical abuse, children who live with only

their fathers are ut a mwginally higher risk of physical abuse thm those who live with MO pwents. (me

father-only household is associated with a two md one-half times greater risk,)

No other specific type of Endmgement Standmd abuse evidenced systematic fluctuations

in incidence in association with family sticture.

S–27
Neglect under the Endangerment Standard

Althou@ some type of neglect conforming to the Endangerment Standard occurred to an

estimated 29.2 children per 1,000 nationwide in 1993 (see Chapter 3), this is qualified hy the finding that

there were significant differences related to family structure. Children living with only one parent had an

incidence rate of 38.9 children per 1,000, which is more than NO and one-fifth times the rate of neglect

under the Endangerment Standard found among children in We-parent families (17.6 children per

1,000). ~is pattern is depicted in Figure 5–12. Additionally, both the mother-only group and the fatheronly group had significantly higher incidence rates than the We-parent group, and children living only

with their fathers had a significantly higher rate of neglect under the Endangerment Standard tian those

living with neither of their parents.

Variations in this pattern characterized the distrihutimr of the specific types of

Endangerment Standard neglect, as presented in Figure 5–13. (Recall that the definition of educational

neglect is identical under both the Harm and Endangerment standards, so the graph in Figure 5–9 above,

together with its accompanying discussion, should suffice to describe the pattern for tiat maltreatment

type.)

40

1

❑ Both Parents

❑ EhherMotfrwor Father

■ Mother-only

❑ Father-only

w NeitherParent

Physicrd Emotional

Neglect Neglect

Figure 5–13. Incidenceof Two SpecificTypesof Neglectunderthe

EndangermentStandard for DifferentFamily Smctures

5–28
Physical Neglect. Those children living with single parents were physically neglected at a

rate of 28.6 children per 1,000, which is nearly WO and two-thirds times as often as children who live

with NO parents (10.8 children per 1,000). Significantly higher incidence rates for single-parent

households held true for both mother-only and father-only households. Children living with only their

mothers were more than wo and one-half times as likely to be physically neglected as those with two

parents, while the risk for children living with only their fathers was more than three and one-third times

that of We-parent children.

Emotional Neglect. Figure 5–1 3 also shows a similar pattern of family-structure

differences in the incidence of emotional neglect under the Endangerment Standard, The likelihood of

this maltreatment was more than one and three-fifths times greater for children who lived with a single

parent (where 10.5 children per 1,000 were emotionally neglected) than for children who lived in woparent families (where 6.4 children per 1,000 were emotionally neglected).

Severity of Outcomes from Maltreatment As Defined by the Endangerment Standard

There were significant or marginal differences related to family structure in the incidence

of three outcomes due to maltreatment using the Endangerment Standard: serious injury, moderate

inju~, and endangerment. These results are given in Figure 5–14.

Serious Injury. The risk of serious injury from abuse or neglect as defined by the

Endangerment Standard was more than one and three-fourths times greater for children who live with

only one parent than for children living with two parents. The greater risk to single-parent children was

statistically suppotied for children in mother-only households. Despite the higher estimated incidence

rate of seriously injured children among those who live only with their father, the lack of precision in

that estimate made the comparison with that group statistically inconsequential.

Moderate Injury. The incidence rate of moderate injury due to Endangerment Standard

abuse or neglect was significantly higher for children in single-parent families (18.5 children per 1,000)

than for children in families with two pments residing in the home (9.6 children per 1,000). Children

who live in single-parent households were nearly twice as likely to be moderately injured compared to

those in two-parent families. The distribution of moderately injured children evidenced one additional

5–29
feature: their incidence was marginally higher in single-parent households than’ in households where

neither parent was present.

25

! ❑ Ehher Mother or Father

■ Mother_.&

❑ Father+nly

■ Nehher Pmrtt

Serious Moderate Endangered

Figure 5–14, Incidence of Injuries fmm Maltieament under the

Endmgement Standmd for Different Family Stmcties.

Endangerment. me estimated incidence for children who had been endangered, but not

yet hmed, by abuse or neglect differed significantly between children in single-pwent fasnilies and

those in fmilies with two parents present. me endangerment incidence rate for children living with

only a single parent (20.5 children per 1,000) was more than twice the mte for those living with hth

parents (9.3 children per 1,000). Again, the comparison bo~ up for children in mother-mtlyhouaeholds,

but not for those in father-only households (where the M~3 estimate is less precise), despite the fact

that the estimated incidence of endangered children in these WO categories was nemly identical.

Changes since the N3%2 in the Incidence of Maltreatment under the Endangerment Standard

in Relation to Family Structure

Significant changes since the NI*2 in the incidence of maltreatment based on family

structure emerged in only one of the nine categories of maltreatment under the Endangerment Standard

S-30
and in ,wo categories of outcomes from this maltreatmen~ emotional abuse, inferred injury, and

endangerment.

Emotional Abuse. Chapter 3 reported a significant increase in emotional abuse under the

Endangerment Standard since the NI~2. Analyses of how family structure modified increases between

the N1S2 and the NIS–3 revealed that although the increase in this category was significant for all

groups, it was smaller among children living with a single parent. This pattern is shown in Figure 5–15.

The NIS–3 incidence rate of 6.2 per 1,000 for children living with both parents is almost two and mretbird times the NIS–2 incidence rate of 2.7 children per 1,000. The NIW3 incidence among children

living with a single parent of 8,6 children per 1,000 is nearly three and one-fifth times the NIS–2 rate of

2.7 children per 1,000. Finally, among children living with neither parent, emotional abuse evidenced its

most dramatic increase: the NIS–3 incidence rate of 7.1 children per 1,000 is almost 12 times the NIS–2

incidence rate of 0.6 children per 1,000.

9.00 ~

8.00 I

I,00

0.00 t + +

❑

❑ NIS-2

■ NIS-3

+

Both Parents Single Parent Neither Parent

Figure 5–1 5, Incidence of Emotional Abuse under tbe Endangerment Standard

in OreNI>2 and the NI~3 for Different Fmily Structures.

~erred ~w. Changes between the NIS-2 and the NIS-3 in the ficidence of inferred

injury related to family stmcture are presented in Figure 5-16 for maltreatment as defined by the

I

Endangerment Starrdard. The NIS-3 incidence rate of 2.5 children per 1,000 for children living with a

5–3 1
single pment was a significant decrease from the NI*2 rate of 4.7 children per 1,000. ~is was one of

only wo categories in the study where M*3 mtes wem found to be significantly lower tiarr Nf*2

rates. In cmrtmst, the infemed inju~ incidence rate for children living with neither pment significantly

4,50 t

‘g:’;

~ti.

~ 2,00-

$ 1.50-

z 1.00-

0.50-

0.00 L +M

,.,., ,,<, .,:. +

M

❑ NIS-2

■ NIS-3

+

Both Pments Stigle Pwent Neither Pwent

Figwe 5–16. Incidenceof hfemed Injury from Mal&eatment mrder the

Endmgement Standad in the NI$2 md the NI%3 for

Different Family Smcmes.

increased fmm tie NI*2 to the Nf$3. me NI>3 rate of 4.7 children per 1,000 was more than five

times the Nf*2 rate of 0.9 children per 1,000. me incidence rate for children in families where both

pmenta wem present was mmginally higher in the NIS–3 (2. 1 children per 1,000) than in the NI~2 (1.2

children per 1,000).

Endangerment. Figure 5–17 shows the si~ificmrt relation between fanrily sbcture and

changes in incidence be~een the NIS2 and the NIW3 in the catego~ of endarrgement. Although there

wem sigrrificant increases in the incidence of endarrgemd children among those living in both motherortly and father-only households, the increase was relatively greater for those who live only with their

fatbem. For children living in father-only households, the NI*3 incidence rate (20.7 children per 1,000)

was more than six times geater than the comesponding NI*2 rate (3.4 children per 1,000). Children

living in mother-only households evidenced an almost twofold increase, from 10.9 children per 1,000 in

the Nf$2 to 20.4 children per 1,000 in the NS3.

5-32
:20’00

j 15.00

5

g 10.00

.

j

5.00

0.00k +

n

❑ NIS-2

■ NIS-3

i

Mo&er Only Father Only

Figure 5-17, Incidence of Endmgeme”t fiom Mal@ea~e”t ““der tie

Endmgement Stidwd h the NI>2 md the NI$3 for

Different Fmily Sticties.

5.3 Family-Stie Differences in the Incidence of Maltreatment

This section describes the NfS-3 findings concerning the relationship between fssnily size

mrd the incidence of child abuse ssrd neglect. Children were categorized into one of three groups on the

basis of the number of dependent children in their family those in families where they were the only

child, those in fmilies with two or three children, md those in families with four or more children.

5.3.1 Family-Siie Differences in Maltreatment under the Harm Standard

There were several differences in the incidence of malbeatment under the Hm Stidwd

across these three fsmrily-size uoups. Sigrrificmt or mwginal differences in incidence rates mong the

fsmily-size woups were found for four categories of malmeatment and in the categories of moderate and

infemed injuries. Table 5-5 gives the incidence rates for children in different-sized fmilies for all

5–33
Table 5-5. Incidence Wtes per 1,000 Chiltien for Mal~a~ent waler the

Hm Stidwd h the NIS-3 (1993) for Different Fmily Stis.

Hm Stidwd

tie child 20r3 4+ Sigtrificmw of

Malhea~ent Categow Children Children Dlfferen=s

ALL MALTREA~ENT 22.0 1?. ? 34.5 qb, C

ABUSE

All Abuse 10.5 9.9 13.9 ns

Physiml Abu% 5.1 5.2 6.4 ns

SCXUd Abuw 3.2 2.5 5,8 ns

EmotionalAbu= 3.2 2.8 3.4 ns

~GLECT

All Neglect 12.6 8.8 21.5 Ab, C

Physid Neglect 4.4 3.8 9.1 c

EmotionalNeglect 3.9 2.4 3.7 ns

Mucationd Neglect 6.0 3.2 9.2 c

SEVER2TY OF N2URY:

Fakl 0.019 0.024 0.018 .s

Serious 8.1 7.3 9.8 ns

Modemte //,4 8.9 18.6 &c

Infemed 2.5 1.5 6.0 ns

A Wf cfilh diffad nitificmtly ~m *o= inf=ilies witi 2-3ctilk W.05).

a ,~$ Ailti difld -IY * how h ftilics M* 2.3 tilti (.10~.05).

b ,%19 cMltin cliff-d mtidly b tiw h ftilies %* 4+ cfilh (,20+,05).

C ~ilti in2 w 3 childf-i!i” d~d simifi-tly tim tiw h fmi!i= titi 4+ Ail& @.05).

c ~ilb in2 or3 ctild ftilics dffd mw@ly tim ho= b ftifies rnti 4+ ctilti (.10w.05).

m NoWcm-pw di~-= issidfi-t orad (dl p,-. 10).

categories of maltreatment md severity.13 Note that in all cases where statistically sigr3ificmt or

mmginal fmily-size differences emerged in connection with maltiatment under the Hm S@dmd, the

‘] In wh mtigow of mdti-ment or inju~, the a-level hat wm uti to detemine simifimw tijuwd for the multiplicityof

the comptisons involved. Detils conwming the ~tistid teztzfor the simifimce of fmily-sim diffemnws w given in

Appndims C ad D.

5-34
pattern was the same: the incidence rates were highest for children in the lwgest fanrilies, intemrediate

for “only” children, and lowest for children in families with two or three children.

@emll Maltreatment under the Harm Standard

Figure 5–18 presents the patterns of family-size differences in incidence for overall

maltreatment and for the main category of neglect as defined by the Hamr Standmd.

Among children in families with four or mom children, en estimated 34.5 children per

1,000 suffered some form of maltreatment under the Harm Standard in 1993. ~is rate is equivalent to

3,4 children per 100, or nearly 1 in 30 children in the linger families. ~is is significantly higher than the

rates for the other family-size groups, me incidence rate for children from the larger families is nearly

twice the rate for children in families with two or three children (where the rate was 17.7 children per

1,000). Children from lager families had marginally higher incidence mtes than “only” children

35.0

30.0

g

;“ 25,0

~ 20.0

5 15,0

%

2 10.0

~

z ~,o

0.0 +

All Neglwt

Maltieatient

One Child

2 to 3 Childen

4+ Chiltien

Figwe 5-18. Incidence of Overall Malmeatment end Neglect under the

Harm Standwd for DifferentFamilySims.

5-35
(34.5 per 1,000 compwed to 22.0 per 1,000). The incidence rates for children in these smaller fsmilies

also differed mmginally fmm each other, with the incidence rate for “only” children almost one snd mrefoutih times greater thsn that of children in families with wo or three children.

No incidence differences relating to family size were uncovered in the mea of abus~ither

for abuse overall or for any specific category of abuse as defined by the Harm Stindwd.

Neglect under the Harm Standard

me incidence of overall neglect under the H- Stidwd is also notibly higher among

children living in families with four or more children. As presented in Table 5-5 and graphed in Figure

5-18, the rate is 21.5 per 1,000 children in the lager fsmilies. This is almost one and three-foutihs times

the rate of 12.6 per 1,000 for “only” children, and it is almost NO and one-half times the rate of 8.8 per

1,000 for children who have one or two siblings. The incidence rates for children in smaller families also

differ significantly. The incidence of neglect under the Hm Standmd smmrg children in one-child

families is more thmr one and @o-fifihs times greater than the neglect rate among children in families

with two or three children.

When the specific fores of neglect were emined, mwginal or significmrt differences

related to fmrrily size were found in the incidence of physical neglect and educational neglect. These are

depicted in Figure 5-19. As evident in this graph, the patterns we ve~ similar in these two categories.

Physical Neglect. In Chapter 3, it was repofied that physical neglect as defined by the

Hsrm Stundard occumed at a rate of 5.0 children per 1,000. Figure 5-19 shows that the incidence rate for

children in lager families is considerably higher thsn this, while the rates for children in fmilies with

three or fewer children are slightly lower. The only notewofiy difference from a statistical standpoint is

the difference be~een children in families with two or three children and those in fsmilies with four or

more children. Specifically, children living in families with four or more children were newly WO and

~o-fifths times mom likely to be physically neglected than children who had just one or WO siblings,

srrd this difference approached, but did not quite reach, the level traditionally required for s~tistical

significance.

5-36
Physical

Neglect

Educational

Ne@ect

❑ One Child

❑ 2 to 3 Children

■ 4+ Children

Figwe 5-19. Incidence of Two Soecific —. Types ofNeglect “nde~ the HStidwd for Different Fmily Sims

Educational Neglect. While educational neglect occumed, in general, to 5.9 chilc m per

1,000 in the U.S. population, differences related to family size quali~ this overall finding. The rate for

“only” children is ve~ close to this geneml figure, but the rates for children who we not alone in their

families differ, depending on the number of children involved. Children in relatively large families (i.e.,

those with four or more children) have the highest rate, with 9.2 per 1,000 of these children educationally

neglected. This rate is more than MO and four-fifths times the incidence rate for children who have only

one or wo siblings, a difference that is significant. No other fmily-size differences in educational

neglect rates we significmrt or marginal.

Severity of Outcomes from Maltreatment Aa Defined by the Harm Standard

As Table 5-5 indicates, there are significant family-size differences in the incidence of

children moderately injured by maltreatment as defined by the Hamr Standmd. These differences are

displayed in Figure 5-20.

Moderate Injury. Analyses showed that’’only’’ children andthose in the Iargest families

(where there were four or more children) experienced moderate injuries from maltreatment as defined by

5-37
the Harm Standard at significantly higher rates than did children living in families where there were two

or three children. Among children living in the largest families, the rate was 18.6 children per 1,000.

~is is more than two times the rate for children in families with two or three children, where an

estimated 8.9 children per 1,000 experienced moderate inju~ from maltreatment under the Harm

Standard. An estimated 11.4 children per 1,000 among those who were the “only” children in their

families suffered moderate injury from abuse or neglect that fit the Harm Standard, which is more than

one and one-fourth times the rate of moderate injury among children who had one or two other children

with them in their families.

20.0 ~

2.0

0.0

❑ 2 to 3 Children

Figure 5-20. Incidence of Moderate Injuries from Maltreatment under the

Harm Standard for Different Family Sims.

Changes since the MS-2 in the Distribution of Maltreatment under the Harm Standard

in Relation to Family She

Comparisons with the NIS-2 identified two categories (overall neglect and emotional

neglect) where the increases in the incidence of maltreatment under the Harm Standard since that earlier

study depended significantly on family size. me relationships are graphed in Figures 5-21 and S-22.

S–38
NWlect. As Figure 5-21 shows, the increase in the incidence of neglect under the Harm

Standard was greatest among children living in the largest families (i.e., those with four or more

children). In fact, this was the only family-size group where this maltreatment evidenced a significant

increase since the NIS-2. For the children from families with four or more children, the incidence of

neglect under the Harm Standard increased 172 percent, from 7.9 children per 1,000 in the NfS-2 to 21.5

children per 1,000 in the NIS-3.

I

I

25

T

-“ I

+

❑

❑ NIS-2

■ NIS-3

I

One Child 2 to 3 Chfldren 4+ Chfidmn

I

Flgwe 5-21. Incidence of Neglect under OreHamr Srandmd in the NIS-2

and the NIS-3 for Different Family Sizes,

Emotional NWlect. Figure 5-22 depicts the relation between family size and changes

from the NIS-2tothe NIS-3 intheincidence ofemotimral rreglect under the Hm Standard. Tes&of

between-stu~y changes in incidence within each group showed that children living in families of all sizes

had experienced significant increases in the incidence ofemotimral neglect = defined bytbe Harm

Standard. However, tielmgest incremes occumed for`'only'' children and fortiose in fmilieswith four

or more children. There wasa more than 19-fold increase intbe irrcidence of emotional neglect among

“only” children (from 0.2 to 3.9 children per 1,000) and a nearly fivefold increase anrmrg children in

fmilies tiathad fourormore children (0.8t03.7children perl,OOO). Although tberewas a substantial

between-stidy increase among children who were one of two or three children in their families, it was

somewhat smaller (less than threefold, from 0,9 to 2,4 children per 1,000). Although there were no

1’

differences in the incidence of emotional neglect under the Harm Standard related to family size within

5-39
either the NfS-2 or the NIS-3, the distribution of emotional neglect across the three fsnrily-si= groups

has essentially reversed. mat is, in the NI%2, children in the middle-sized families had the highest

incidence of emotional neglect under the Harm Staudsrd, whereas, in the M*3, these are tbe children

with the lowest incidence rate for this type of maltreatment.

4

3.5 1

OL + +

9

-

1

NIS-2

NIS-3 I

One Child 2 to 3 Chfldren 4+ Children

Figure 5–22, Incidence of Emotional Neglect under the Harm Standard

in the N1%2 and the N1>3 fm Different Family Stis.

5.3.2 FamilySize Differences in Maltreatment under the Endangerment Stindard

mere were several categories of maltreatment and outcomes as defined by the

Endangerment Standard where significant or marginal differences based on family size qualified the

general findings described in Chapter 3. Significant or marginal differences in incidence rates based on

family size were found in five of the nine categories of maltreatment and in three of the five categories of

outcomes. Specifically, differences emerged in the incidence of overall Endangerment Standard

maltreatment, the main category of neglect, physical neglect, emotional neglec~ educational neglec~

540
moderate injuries, inferred injuries, and endangerment. The incidence rates for children in different.

sized families Me provided in Table 5-6.14

Table 54. Incidence Rates per 1,000 Children for Maltreatment under the

Endangemrent Standard in the NIS3 (1993) for Different Family Sims.

Endangemrent Standard

One child 20r3 4+ Slgnificarrce

Maitreatnrent Catego~ Children Children of Differences

ALL MALTREATMENT 34.2 34.1 68.1 LB

ABUSE:

All Abuse 16.9 16.3 23.5 .s

Physid Abme 8.6 8,4 /0,6 ns

Sexual Abuse 4.7 3.6 7.0 ns

Emotional Abuse 6.4 7,5 10,6 ns

NEGLECT:

All Neglect 22.3 22,7 52,2 A, B

Physical Neglect 13.2 16.1 38.9 AB

Emotional Neglect 7.5 7.5 12.6 b

Education Neglect 6.0 3.2 9.2 B

SEVERfTY OF fN~RY:

Fatal 0.023 0.024 0.O18 ns

Serious 8.2 7.4 9.8 ns

Mademte 12.5 11.4 22.1 B

Itrfemd 3.6 2.1 7.6 b

Endmgemd 9.9 13.1 28.6 A, B

A .,~y,. ctilk Md si~fimdy ti & inftilia Mb 4+ Ailti K.05).

a Chilh h 2 m 3 childffia diKd si~fimdy fim k intilim titi 4+ c~lb w,O$),

b ~ilh h 2 or3 childftii~ tiffed _@y tim box inrtilics Mfi 4+ dilk (.IOZ.05).

“s Na kw~~p cliff- issitifiat m~~ (dl fl~. 10),

1’ As in the p%ceding section, the a-level that was used to detenrrine significance adjusted for the multiplicity of Ore

comparisons involved in e=h catego~, (See Ap~ndix C.)

541
Endangerment Standard Maltreatment Overall

Chapter 3 indicated that an estimated 41.9 children per 1,000 nationwide experienced some

form of Endangerment Standard maltreatment. That general result ia qualified hy significant differences.

among the incidence rates for children living in families of different sizes. Table 5-6 shOwsthat, ~Qng

children in the largest familiea, the incidence rate is much higher than that general rate and that the rates

for children in the other family-size groups are equivalent and somewhat below the nationwide rate.

These results are graphed in Figure 5-23, which charts the incidence rates both for overall maltreatment

and for the main category of neglect under the Endangerment Standard.

70.0

0.0

D

❑ One Child

❑ 2 to 3 Children

■ 4+ Children

All Neglect

Maltreatment

Figure 5-23. Incidence of Overall Maltreatment and Neglect under the

Endsngemrent Standardfor DifferentFamilySizes.

Children in families with four or more children have essentially twice the rate of overall

maltreatment as defined by the Endangerment Standard when compared with other children (i e., 68.1

children per 1,000 versus 34.1 or 34.2 children per 1,000).

542
Neglect under the Eudsmgermeut Standard

Based on the Endarrgemrent Standwd definition of maltieatrnent, neglect of some we

occumed to mr estimated 29.2 children ~r 1,000 nationwide in 1993 (see Chapter 3), but this general

finding does not convey the fact that there were significant differences based on family size. Children in

families with four or more children had an incidence rate of 52.2 children per 1,000, which is about WO

and one-third times the rates of neglect under the Endarrgemrent Standwd found among children in

smaller families (22.3 and 22.7 per 1,000). This pattern cm be viewed in the graph in Figure 5-23. Tbe

rates of neglect under the Endangemrent Standard for children in the smaller families were not

statistically different.

The general pattern described in the previous pwagraph also characterized the distribution

of physical neglect as defined by the Endarrgerment Standard, and there was a mwginal difference

consistent with the same pattern in the disbibutimr of emotional neglect. Both of these findings we

presented in Figure 5-24. Because the definition of educational neglect was identical under the Harm

and Endangemrent standwds, readers should consult the educational neglect findings presented

previously in Figure 5-19 and discussed in connection with that figure, as this section will not reiterate

them.

Physical Neglect. The children living in the Imgest families were physically neglected at a

rate of 38.9 children per 1,000, which is nearly three times as ofien as “only” children (13.2 children per

1,000) and over two arrd two-fifths times more ofien than those in families with only two or tbme

children (16. 1 children per 1,000). Both of these comparisons were significant. There were no

differences in the incidence rates of physical neglect under the Endangemrent Standard for “only”

children and for children from families with two or three children.

Emotimral Neglect. Also shown in Figure 5-24 is the similw, statistically mmginal pattern

of family-size differences in the incidence of emotional neglect as defined by tbe Endangerment

Strmdwd. Children were about one and two-thirds times more likely to be emotionally neglected when

they lived in larger families (where 12.6 children per 1,000 were emotionally neglected) than when they

lived in smaller families (those with three or fewer children, where 7.5 children per 1,000 were

emotionally neglected),

543
40

35I

+ i

m

Physical Emotionti

neglect neglect

Figure 5-24. Incidence of Two Specific Types of Neglect mder the

Endangerment Stidard for Different Family Sizes.

Severi@ of Outcomes from Maltreatment As Defined by the Endangerment Standard

There were significant or marginal differences relating to family size for the incidence of

moderate inju~, infemed injUV, and endangemrent from maltreatment aa defined by the Endangemrent

Standwd. These results me ~ven in Figure 5-25.

Modemte Injury. The incidence rate of moderate injrr~ due to abuse or neglect as defined

by the Endangemrent Stsrrdard waz significarrtly higher for children in families with four or more

children (22. 1 children per 1,000) than the rate for children in families with two or three children (11.4

children per 1,000). Children who live in lmge families were nearly twice as likely to he moderately

injured by maltreatment that fit the Endangerment Standwd than those in medirrm:sized families.

Inferred Injury. The incidence rate of infemed inju~ due to maltreatment as defined by

the Endangerment Standard was mwginally greater for children in large families tharr tie rate for those

in two- or three-child fam;lies. An estimatti 7.6 children per 1,000 from large families experienced

544
maltreatment of a type sufficiently severe that injury could be inferred. ~is was more than three md

one-half times the rate for children horn families with NO or three children, where only 2.1 children per

1,000 experienced such tieatment.

Endangerment. me estimated incidence of children who had been endartgered, but not yet

harmed, by abuse or neglect differed significantly beween children in the largest fmnilies and those in

families with three or fewer children. me endangerment incidence rate for the large-family children

(28.6 children per 1,000) was nearly triple the rate for “only” children (9.9 children per 1,000) and more

than Wice that for children from wo- or three-child families (13.1 children per 1,000). mere was no

statistical difference beween the incidence rates for children in tbe WO smaller family categories,

Moderate Inferred

■ 4+ Chfidrcrt

fidagered

Figure5-25, Family-SizeDifferencesh IncidenceWtes forInjuries

fromNeglectunderthe EndangermentStidard.

Changes since the MS-2 in the Distribution of Maltreatment under the Endangerment Standard

in Relation to Family Size

mere were no statistically significant relationships be~een family size arrd changes in the

incidence and distribution of maltreatment as defined by the Endmrgerment Standard since the NIS-2.

545
5.4 Differences in the Incidence of Maltreatment Related to County Metropolitan Status

@etrostatus)

This section describes the NIS-3 findings concerning the relationship beween the

metropolitan status of a county (termed “metmstatus”) and the incidence of child abuse and neglect.

Children were categorized into one of three groups on the basis of the metrostams of their county of

residence: those in ve~ large urban counties, those in moderate-sized urban and suburban counties, and

those in mral counties. More detailed definitions of these categories are provided in the MS-3 technical

volume, the Sample Selection Report. 15

5.4.1 Cmm~ Metrostatus Differences in Maltreatment As Defined by the Harm Standard

The only significant difference in the incidence of maltreatment as defined by tie Harm

Standwd relating to county metmstatus was between large urban and other urban counties in the

incidence of children who suffered moderate injury from maltreatment as defined by the Harm Standard.

Moderate Injury. Children living in major urban counties were significantly less likely to

experience moderate inju~ from maltreatment as defined by the Harm Standard than those living in

other urban counties. An estimated 7.1 children per 1,000 among those residing in large urban counties

were classified as moderately injured by abuse or neglect, whereas an estimated 16.5 children per 1,000

in the other urban counties had been victims of moderate injuries from malt~atment that fit the Harm

Standard. 16 The estimated rate of moderate injury among children in rural counties, 14.0 children per

1,000, was not different from these other rates, chiefly because it was less precise.

15Results of the suppotiing mstyses %Cgiven in Appendices C ad D.

‘6 A special malysis wm conducted to dctemine whether the incidence e~imatc far the large urbm countia may have been

tiificially depressed by data collection problems in schools in several of the large urbm counties in the sample. This pmsible

explmatirm was not home out, became the =e pattern of metmstatus differen=s emerged when the problem counties were

appropriately factored out of a recomputation of tbe national estimates.

5A6
Changes since the ~S-2 in the Distribution of Maltreatment under the Harm Standard

in Relation to Cmm~ Metrostatus

None of the changes since the NIS-2 in the incidence of maltreatment as defined by the

Haml Standard or its outcomes showed any systematic differences in relation to county metrostatus,

5.4.2 County Metrostatus Differences in Maltreatment As Defined by the Endangerment

Standard

The only significant difference in the incidence rate for moderate injuries from

maltreatment as defined by tbe Endangerment Standard was between the large urban counties and the

other urban counties.

Moderate Injury. The incidence of children who experienced moderate injury due to

abuse or neglect as defined by the Endangemrent Standard was significantly lower among children living

in large urban counties (8.2 children per 1,000) than the rate for children in other urban counties (19,8

children per 1,000),1‘ Although the rate for rural children (17.2 children per 1,000) appeared comparable

to the rate for children in other urban counties, it did not differ from the large urban county rate, due to

its lack of precision.

Changes since the MS-2 in the Distrihutimr of Maltreatment under the Endangerment Standard

in Relation to County Metrostatus

As was tbe case for tbe Harm Standard, there were no changes in the incidence of

maltreatment as defined by the Endangerment Standard since the NIS-2 that systematically related to

county metrostatus.

‘7See note 16,

547
5.s Key Findings and Implicating of the Distribution of Abnge and NWlect by

Family Characteristics

The incidence of child maltreatment was found to be related to family income, family

structure, family size, and county metrostatus. The overview in this section is organized in terms of

these different factors, with the discussion concerning family income deferred until the last pti of the

section, where it is given more extensive treatment.

Family Strncture. Children of single parents are at higher risk of physical abuse and of all

types of neglect. They are disproportionately represented among the seriously injured, moderately

injured, and endangered children. Compared with their counterparts living with both parents, children in

single-parent families had

●

●

●

●

✎

✎

●

a 77-percent greater risk of being harmed by physical abuse (under the stringent Harm

Standard) and a 63-percent greater risk of experiencing any countable physical abuse

(under the Endangerment Standard);

an 87-percent greater risk of being harmed hy physical neglect and a 165-percent greater

risk of experiencing any countable physical neglect

a 74-percent greater risk of being harmed by emotional neglect and a 64-percent greater

risk of experiencing any countable emotional neglec~

a 220-percent (or more than three times) greater risk of being educationally neglected;

an approximately 80-percent greater risk of suffering serious injury or harm from abuse or

neglec~

an approximately 90-percent greater risk of receiving moderate injury or harm as a result of

child maltreatrnen~ and

a 120-percent (or more than two times) greater risk of being endangered by some type of

child abuse or neglect.

Among children in single-parent households, a clear difference emerged in the category of

physical abuse between those in father-only households and those in mother-only households. Children

living in father-only households were approximately one and two-thirds times more likely to be

physically abused than those living with only their mothers.

548
It is impofiant to recognize that the configuration of psrents in the child’s household is a

separate question from who the peWe&ators of maltreatment me. That is, pwents are not necessari Iy, nor

even most frequently, the perpetrators of maltreatment, especially in cefiain categories—a point that will

be seen in the following chapter, Nevetieless, the relationship be~een psrent stmcture and

maltreatment incidence is understandable, considering the added responsibilities (hence stresses)

involved in single-parenting and the greater potential that personal resources as well as sumounding

social and practical suppoti may be insufficient to meet the demands,

Family Size. The association between the number of dependent children in a family and

the incidence of maltreatment primarily reflects differences in incidence breed on family size in the

categories of physical and educational neglect. For educational neglect, and for physical neglect as

defined by the Ham Standard, the pattern is nonlinear the incidence rates were highest for children in

the lmgest families, intermediate for “only” children, and lowest for children in families with NO or

three children. Compming the highest incidence rate with the lowest, children in the largest families

(with four or more children) we~ almost three times more likely to be educationally neglected and

nearly WO and We-fifths times more likely to be hamed by physical neglect compared with children in

fsmilies where there we NO or three children. In the catego~ of physical neglect under the

Endangerment Stindwd, the pattern is one of increasing incidence with increasing numbers of children.

Children in the largest families were physically neglected at nearly three times the rate of those who

came from single-child families.

Additional children in a household mean additional tisks mrd responsibilities a“d additional

demands; from this perspective, it is understandable why incidence rates of child abuse and neglect are

higher when there are more children. To account for why, at least in some categories, the incidence rate

for “only” children is greater than that for children in medium-sized families (i.e., those with NO or three

children) requires a different explanation. One possibility is that “only” children may more ofien be in

circumstances where too many expectations are focused on a single individual, whereas expecbtimss

(and disappointments) can be diffused better when there are multiple children. Another possibility is that

many “only” child households represent the early stiges in their families’ development, since a number

of these fsmilies will have additional children in time. Thus, many “only” children are in families with

relatively young and inexperienced parents and care~kers.

County Metroatatns. The only effect of county metrostatus was in the incidence of

children who had been moderately injured by maltreatment, using either definitional standard. The

549
incidence was lower than expected among children living in large urban counties, significantly lower

than the incidence in other urban counties. ~is appeared to be characteristic of large urban counties in

general, even those without data collection difficulties in the NIS-3. One is hwd-pressed to fathom ways

in which children who live in large urban counties would be protected from experiencing the same

degree of abuse or neglect as children in other urban counties. Instead, the most likely explanation for

their lower incidence of maltreatment-related moderate injury is that there is a certain degree of

undercoverage in the large urban counties in general. One possibility is that maltreated children do not

come to the attention of communi~ professionals to the same degree that they do in other counties.

Another is that the community professionals who participated in the NIS-3 large urban counties were

burdened with the normal responsibilities of their jobs and less likely to provide the NIS with

information about all the maltreated children they encountered. Note that any explanation in terms of

undercoverage implies that the tie incidence of abuse and neglect is somewhat higher than the estimates

given by the NIS-3 data.

Family Income. Despite the fact that only a rather gross index of family income was

available, and despite a substantial percentage of cases with missing data on family income, this factor

was found to have a significant association with the incidence of nearly every category of maltreatment.

Compared to children whose families earned $30,000 per year or more, children in families with annual

incomes below $15,000 per year were

● more than 22 times more likely to experience some form of maltreatment under tbe Harm

Standard and more than 25 times more likely to suffer maltreatment of some type as

defined by the Endarrgerment Standard;

● almost 14 times more likely to be harmed by some variety of abuse and nearly 15 times

more likely to be abused as defined by the Endangerment Standard criteria,

● more than 44 times more likely to be neglected, by either standard;

● almost 16 times more likely to be a victim of physical abuse under the Hamr Standard and

nearly 12 times more likely to be a victim of physical abuse as defined by the

Endangerment Standard,

● almost 18 times more likely to be sexually abused as defined by either definitional

standard;

● thirteen times more likely to be emotionally abused under the Harm Standard criteria and

more than 18 times more likely to be emotionally abused in a manner that fit Endangerment

Standard requirements;

5–50
● forty times more likely to experience physical neglect under the Harm Standard and over 48

times more likely to be a victim of physical neglect as defined by the Endangerment

Stmrdard;

● over 29 times more likely to be emotionally neglected under Harm Standard definitions and

over 27 times more likely to be emotionally neglected by Endangerment Standard criteria,

● nearly 56 times more likely to be educationally neglected as defined by either standard;

● sixty times more likely to die from maltreatment of some type under the Harm Standard

and over 22 times more likely to die from abuse or neglect under the Endangerment

Standard;

● over 22 times more likely to be seriously injured by maltreatment under the Harm Standard

and almost 22 times more likely to be seriously injured by maltreatment that fit the

Endangerment Standard requirements;

● about 18 times more likely to be moderately injured by abuse or neglect that fit the Harm

Standard and nearly 20 times more likely to have a moderate injury from maltreatment

circumstances as defined by the Endangerment Standard;

m fi@-seven times more likely to be classified as having an inferred injury due to

maltreatment as defined by the Harm Standard and 39 times more likely to meet the criteria

for inferred injury as defined by the Endangerment Sbdard; and

● over 31 times more likely to be considered endangered, although not yet injured, by some

type of abusive or neglectful treatment.

The NIS-3 findings on the correlation between family income and child maltreatment are

entirely consistent with the earlier findings of tbe NIS-2 in this connection. Given the stren@h and

stability of these findings, some discussion of the possible underpinnings of this correlation may clarify

its implications. A key issue is whether this correlation might stem from the higher visibility of lower

income families to community professionals.

Although one might initially suppose that children in lower income families more

frequently come to the attention of the types of community professionals who are recruited as NIS

sentinels, differential observation of the different income sectors does not provide a very plausible

account of the findings reported here. That explanation fails on NO important grounds: it ignores the

substantial degree to which the NIS sentinels observe children and families at the middle- and

5-51
uPPer-income levels, and it requires that one assume that there is an astounding number of stillundetected children in the nation who experience countable maltreatment.

The NIS sentinels regularly obsewe a ve~ lwge sector of children whose families have

incomes greater than $15,000 (or $30,000) per year. Althmtgb the NIS sentinel agency categories do

include some that may dispropofiimrately encounter low-income families (such as police and sheriff

deptiments, juvenile probation depafiments, and public health agencies), Chapter 7 will reveal that

those sources recognized only a relatively small sector of the countable abused and neglected child

population (only 12% of the Ham Standard countable children and only 14% of the Endangemrent

Standard total). The large majority of maltreated children were recognized by professionals likely to

encounter children and families at all income levels, such as sentinels in hospitals, schools, day-care

centers, mental health agencies, and vohsnta~ social sewice agencies; professionals not represented by

NIS sentinel categories; and the general public.

Sentinels in schools recognized the majority of the mal&eated children who are counted in

the NIS-3 estimates—59 percent of the Hm Standard total and 53 percent of the Endangerment

Standard total were recognized as maltreated by professionals in schools. Even though the NIS design

includes only public schools, approximately 89 percent of the U.S. population of school-age children

attend public schools,’8 so those attending the public schools represent a broad spectrum of family

income levels. 19 Similarly, the NIS hospitals encounter a broad spectim of the population. The

hospitals in the NIS-3 include any hospitals in study counties (private as well as public) that provide

general medical and surgical sewices, are primarily shofi-stay facilities, and meet the required minimum

number of annual admissions. Also, social sewice and mental health agencies me limited to those that

provide sewices on a volunta~ basis, including private agencies. Thus, it would seem improbable that

the ve~ strong relationship be~een income and child maltreatment stems from differences in the client

sectors seen at the types of agencies that pafiicipate in the NIS.

Fufiher, if the income finding is assumed to be an afiifact of selective obsewation of lowincome families, then this means that the incidence of abused and neglected children is far higher than

‘8 U.S. Depment of Education, National Center for Education Statistics. Historical Tren&: State Educotion Facts, 1992.

Common Core ofData: Digest ofEducarion Statistics, 1992, Toble 3.

‘9Note that private schools include religiously affiliated schools, which ofien have sliding scales for their tuition fees. Privateschool attendees me not necessuily from better economic circumstices thm children attending public schools.

5–52
the NIS-3 estimates convey. If maltreatment is not differentially connected with income, then there have

to be enough undetected abused and neglected children in the middle- and upper-income brackets used

here to equalize the incidence rates across different income categories.

Specifically, if the same incidence rates found for children in families with incomes less

than $15,000 per year were also to apply to children in families with higher incomes, this would mean

that [m additional 2,138,700 children would have to have suffered maltreatment as defined by the Harm

Standard yet remained hidden to the NIS sentinels (i.e., beyond those included in the estimates given in

Chapter 3).20 That is, one would have to assume that the NIS-3 identified only 42 percent of the actual

total of maltreated children in the United States as defined by the Harm Standard and that the incidence

rate found for children from the lowest income families (equivalent to 1 child in eve~ 21.3 in the general

population) applies equally to all children. Similarly, applying the same logic to the findings under the

Endangerment Standard, if the incidence rates for the different income categories are essentially equal,

but the maltreated children differentially come to the attention of community professionals, then an

additional 4,500,700 children in 1993 who experienced maltreatment as defined by the Endangerment

Standard escaped observation by community professionals, ~is would mean that the NIS-3 tapped only

3g percent of the “true” maltreated child population as defined by the Endangerment Standard and that

approximately I in eveV 10 children in tie United States “actually” experiences maltreatment as defined

by the Endangerment Standwd during the course of a year.

Thus, to assume that there is no real relationship between family income and maltreatment

is also to assume that there are really more than two end one-third times as many children abused and

neglected as defined by the Harm Standard as the NIS-3 estimates indicate and that there are really NO

and three-fifihs times the NIS-3 estimated total of maltreated children as defined by the Endangerment

Standard.

Finally, note that the finding concerning a strong association betieen income and

maltreatment is consistent with findings from numerous other studies beyond the NIS-3. For example,

‘0TO equalize incidence rates across income groups for all maltreatment snd severity categories would require there to be 3,100

more fatalities md 812,S00 more setiously injured children under the Hm SMdmd. This would ma that the NIS-3

identified only one.tird of the “actua~ total of Hm Standmd fatalities in the United States, and only 41 percent of those

who suffered serious inju~ under the Hm Stidsrd.

5-53
Pelton’s research21’22concerning socioeconomic factors in child maltreatment suggests a stiong

association beween economic and cul~ral impoverishment and maltreatment, as does the work of

Klnard and Klemran23 and the findings of Gil,24 the American Humarre Association,25 atrd Smith,

Hanson, and Hoble,26 among others. While some continue to argue that even the diverse set of

comoborating evidence on the greater risk of maltreatment at the lower socioeconomic levels reflects

biases in detecting and investigating cases,z’ there nevetiheless area number of problems associated with

pove~ that me also plausible causal contributors to child maltreatment-including factors such as social

mobility, lack of education, and all the stiessors that pove~ adds to daily life. LOW income is alsO

associated with substance abuse and emotional disorders, problems likely to contribute to child

maltreatment. Forinstance, pwentswith income below thepove@ level areovemepresented mong the

dreg-using section of the population,2s’29and substance-abusing families me, in turn, ovemepresented

among the child-abusing populatiorr.30 Persons receiving suppoti from the Aid to Families with

Dependent Children Program (AFDC) are significantly more likely to seek help for emotional

21Pelton, L.(1978). Child abuse mdneglect Themyth ofcluslcssness. American JOurnalOfOrfhOp~chiat~, 48,608-617.

22PeltOn, L.(Ed.). (1981). The Socia/Cont~t o/Chi/dAbwe and Neglecf. New York: Human Sciences Press.

2] Kln=d, E. M., & Klemm, L. V. (1980). Teenage pxentingmd child abuse. Are they related? American Journal 0~

OrthOpWhiat~, 50,481488.

24Gil, D.G. (1970). Violence Agaimt Children. Cmbridge, MA Hmmd University Press.

2s Russell, A. B., & Trainer, C. M. (19g4). Trend in Child Abuse and Neg/ecf: A National Perspective. Denver, CO:

Americm Association for Protecting Children, Amcricm Hummc Association,

26 Smith, S., Hmson, R., & Hoble, S. (1975). Pmenls of battered children: A contiollcd study. In A. Fmklin (Ed.),

Concerning ChildAbwe. Edinburgh: Churchill Livingstone.

27Forexmple, somcattribute theovemepresentation of the 10wersociOeconomic fmilies intbemaltreatment statistics to the

relucwce ofchild protective workento intctierein the Iivesofmoreamucnt ad influentird individuals mdtothefacttiat

middle-income fmilies have resources (such s the ftnmcial wherewithal to get treament by private sewice pmvidem) for

preventing CPSfmmhe%ing about tie incident. CJU.S. Depwment Of Healti, Education, md Welfwe. (1977). Child

Abuse and Neglecl Programs: Practice and TheO~. Washington, D.C.: U.S. Government Printing Offtce.

28 U.S. Deptiment of Health md Humm Sewices, OffIce oftbe Assistaot SecreW for Plmning md Evaluation atrd the

NatiOnal Institute on Dwg Abuse. (July 1994). Substance Abuse Among WOmenand Parents. Wwhington, D.C.

‘9 U.S. Deptiment Of Health md Humm Sewices md the National Institute on Dmg Abuse. (De.. 1994). Patterm of

Substame Use and Subsfance-Re[ated Impairment Among Participants in the Aid tO Families with Dependent Children

PrOgram(AFDC). Wmhington, D.C.

10 National Center on child ~b”~e ~d ~eg]ect, (]993), S,u@ ~/ Chj/d Ma/,reatment in A/coho[ Abwing Fami/ies.

Wrohington, D.C.

5–54
problems.31 Garbarino32,33 noted that socioeconomic factors are also associated with the availability of

social suppofi systems that can assist parents in their child care responsibilities.

The idea that child maltreatment has an essentially classless distribution has persisted in the

face of repeated findings, using widely va~ing methods and da~ that the distribution is strongly related

to socioeconomic class. As suggested by Biller and Solomon,34 the longevity of the myth of

classlessness may stem from the popularity of models of the etiology of child maltieatient that focus on

internal, psychodynamic factors andview theproblem as a disease, Also cmrtributing tothis belief may

be the fact that income per se is assumed to influence the occurrence of abuse or neglect only indirectly

through intemrediary factors (such as heightened stress, lack of social network suppoti, or lower levels of

educational achievement), while it is these intemedi~ factors that have stronger causal connection to

abuse or neglect and speak to unmet service needs.

In conclusion, it should be recognized that the findings reported here have focused on a

single characteristic at a time, yet the reality is that these characteristics are correlated and may either

potentiate orameliorate each otbers’ effects. Forexample, single-parent fmilies generally have lower

incomes, and it is possible that the differences in the incidence of maltieatrnent relating to family

structure really derive from differences in income levels. To assess more clearly the relation between

family structure and maltreatment incidence independent of family income, more complex, multivariate

analyses wmddbeneeded. Inanother vein, differencesin incidence relating to family size would be less

ambiguous if the effect of family income were held constant when examining the relation be~een

family size and maltreatment, Future analyses of the NIS-3 data shmtld pursue multivwiate analyses

35 such as tiese.

“ LeOn,A. C., md Weissmm, M, M, (1993). AnalysisOfNIMH>fiis:ing Epidemiologic Catchment Area (ECA) Data O.

Depression and Other Affective DisOrdersin We~area& Disabled Population. Reponon Gmt HHS-100-92-0032 from

the U.S. Depmment of Health md Humm Sewices, Wshingto”, D.C.

‘2Gwbxino, J. (1980). Whatkind ofsocietypemits child ab.se? Infant Mental Heahh JO.r~l, l,270-281

‘] Garbadno, J. (1981). Anecologicd appmacb tochild maltreatnrent. lnL. H, PeltOn(Ed.), The Saial COnt~to/ChildAbwe

and Neglect. New York: Humm Sciences Press.

“C~Biller,H .,& Solomon,R. (1986). Chi/d Mahreatmen/ and Paterna/ Deprivation. AManfestO/or Research, Prevention,

and Treatment. Lexington, MA: Lexington Books.

5–55

‘5Analyses of two-way tables such as these require that all tabulations of interest (e.g., fmily income by fanrily stmcmm, fmily

income by fmi Iy si~, etc.) be extiacted from appropriate census data.
6. DIS~UTION OF ABUSE AND ~GLECT BY PERPE~TOR C~CTEMSTICS

This chapter discusses how the children who suffer maltreatment defined under the Harm

Standard are related to their pe~etrators and describes their distribution for each category of relationship

and for each ~pe and severity of maltrea~ent in temts of their perpetrators’ sex, age, and employment

status and in terns of the children’s race.

6.1 Information About Perpetmtor Identi~

As part of evaluating cases for their countability in the NIS–3, it was necessary to identi~

the perpetrator(s) of every alleged fom of maltreatment and to detemine that at least one of the persons

responsible for the maltreatment qualified as an allowable perpetrator for that fornr of maltreatment

under the study definitions. Cases of alleged abuse had to have been committed by an adult caretaker of

the child (such as a parent, adult baby-sitter, etc.) or, if committed by someone other than a caretier,

had to have been pemitted by a parent or custodian in order to be countable.’ Cases of alleged neglect

had to have been committed by a parent or custodian in order to be counted in tbe national estimates.

Parents and custodians included the child’s natural, foster, step- or adoptive parent, or other person, such

as a family member, who had legal custody of the child or at least the primary responsibility for the dayand-night supervision and care of the child at the time of his or her maltreatment.

Readers should be aware of several aspects of the classifications used in the analyses

reported in this chapter. First, a parent, a custodian, or a caretaker was included in the tables here only if

she or he actually committed the maltreatment itself, so the tables given here reflect who acwally does

the maltreatment in question. Thus, where a parent simply permitted someone else to maltreat the child,

that parent was not counted for the purposes of these analyses,2

Second, because multiple parties were sometimes involved in malbeating a child, a

classification hierarchy was established for the tables presented here. To begin with, if a child had

suffered multiple fores of a particular type of maltreatment with different severities of injury or

] These wem the pe~etrator requirements that we= applied in conjunction with the Harnr Standard, as dewrihed in Chapter 2.

‘ Although, m described in Chapter 2, there xc categories of maltreatment where children were countable on tbe basis of their

parents’ or cwet&en’ permitting their maltreatment.
impaiment, then the perpetrators of that type of maltreatment were considered to be those persons who

had been responsible for the most severe injury or impairment. For example, if a child who was

physically neglected had been both seriously hamed by inadequate supervision and fatally harmed by

delay of medical care, then only the person (or persons) responsible for the physical neglect that had the

fatal result (in this case, the delay of medical care) were included in this analysis. This strategy applied

in a similar way at the summary levels of “all abuse, “ “all neglect,” and “all maltreated.” For instance,

for a child who was both sexually abused and physically abused, the “all abuse” analyses focused on the

perpetrator (or pe~etrators) of the abuse that caused the more serious injury or impairment. Next, even

within this more focused set of perpetrators, multiple perpetrators were sometimes involved in the

maltreatment. For the analyses here, the child was considered to have been maltreated by the most

closely related pe~etrator who was involved, To determine the most closely related perpetrator for these

analyses, a hierarchy of relationships was established. This hierarchy is given by the ordering of

perpetrator categories shown in Table G]. Menever multiple categori=tions of the child’s perpetrators

were possible, those who fit the earlier categories in this listing were given precedence over those who fit

categories later in the listing.

Third, because some of the types of perpetrators were involved in maltreating only small

percentages of the children, the hierarchy shown in Table 61 was further simplified for presentation

purposes by combining the categories as shown by the brackets in that table.

Foutih, all findings continue to use the child as the unit of measurement, as presented in

earlier chapters and as explained in the discussion in subsequent sections. This was necessa~ because

the weights that were constructed to provide national-level estimates in the NIS have all been geared to

the child as the unit of analysis. (If perpetrators were to be “counter and distributed in their own right,

a different approach to sample design and statistical weighting would have been required.) Thus, all NIS

findings concerning pe~etiators must be couched in temrs of the child, such as “the percentage of

children maltreated by perpetrators who... .“

Fifth, this chapter provides only descriptive tabulations concerning the perpetrators of

Harm Standard maltreatment. [t is intended as a preliminary exploration of NI*3 perpetrator

characteristics. Because pe~etrator analyses of tbe NIS data are very complex and because project

resources were limited, no statistical tests of the significance of between-group differences have been

conducted, nor have tabulations of the Endangerment Standard perpetrators been undemaken.
Table 6.1 Categorintion and Distribution of Perpetrators of Child Maltreatment.

Perpetrator Category

In-home birth parent

Out of home birth parenta

In-home step-parent

Other in-home parents and psrentsubstitutes, (foster, adoptive, etc.)

Separatd/divorced spouse of in-home

parent

Parent’s boyfriend or girlti]end

Other family members

Other unrelated adults

Others

Percentage of Children with Closest-Related

Perpetrator of Most Severe, Countable Maltreatment

74.0%

3.8%

4.6%

5.9%

0.02%

3.1%

5.5%

3.1%

0,1%

Birth Parents

77.8%

Other parents and

parent-substitutes

13.6%

Others:

a.7%

N = 1,553,800

6-3
6.2 Overall Distribution of Perpetrators of Countable Maltreatment

under tbe Harm Standard

Table 61 lists the hierarchy of perpetrator categories used io the analyses given in this

chapter and indicates the percentage of children whose most closely related perpetrator was in a given

category in the hierarchy. Note that the majority of countable children (740A)were maltreated by their

in-home, birth parent(s) and that other in-home parents and parent-substitutes, such as adoptive, foster,

and step-parents, make up the next Iwgest perpetrator categories (5 .9°4 and 4.6%, respectively). Very

small percentages of children were maltreated by an out-of-home birth parent (3 .8Yo), by a separated or

divorced spouse of a parent who is not related to the child (only about 0.02%), or by a boytilend or

girltilend of a parent (3.l~o). Other family members or relatives were the most closely related

perpetrators of maltreatment for 5.5 percent of the countable children. The next-to-last category of

perpetrators in this hierarchy comprises other adults known to be unrelated to the child, accounting for

another 3.1 percent of the children’s maltreatment and other individuals (who may or may not have been

adults) make up the last category, which represents the most closely related perpetrator for only 0.1

percent of the children.

Because of the small numbers of children in the database whose most closely related

pe~etrators were persons other than their birth parents, the perpetrator categories listed in Table &l

were further consolidated for purposes of presentation here, as shown by the brackets in the table, into

three major groupings of perpetrators:

● Mrth parent(s): includes both in-home birth parents and out-of-borne bitib parents;

. Other parents or parent-substitutes: .inchrdes in-borne adoptive parents and stepparents, and other in-home parents and parent-substitutes, such as foster parents,

separateddivorced spouses of in-home parents, and parents’ boyfriends or girlfriends

(paramours); and

● Others: includes all other adults (both those who were and those who were not family

members) as well as other perpetrators (persons whose adult status or whose family

status in relation to the child waa unclear, persons who were clearly not

adultsCincluding relatives of the child, and others whose identity was unknown).
6.3 Perpetrators’ Relationship to the Child and Severity of Harm as a Function of the

Type of Maltreatment

The first two columns in Table 62 show the distribution of maltreated children according

t6 their most closely related perpetrator for each category of maltreatment. The bottom-most section in

this table corresponds to the bracketed categories shown in Table 61, again showing that the majority of

all children with countable maltreatment (780A)were maltreated by their bitih parents and that relatively

small minorities were maltreated by other parents or parent-substitutes (140A)or by others (9Yo). Table

62 also shows a marked difference between the distribution of the abused children by their perpetrators

and the distribution of neglected children by their perpetrators. Among children who experienced some

form of countable abuse, 62 percent had been abused by their bifi parents, 19 percent by otier parents

or parent-substitutes, and 18 percent by someone else, In contrasL 91 percent of all neglected children

had been maltreated by their birtb parents, only 9 percent by other parents and parent-substitutes, and

none by other perpetrators. This pattern accords with countability rules associated with the Harm

Standard (as discussed in Chapter 2). According to those rules, neglect could be perpetrated only by a

parent or ,custodian, whereas abuse could, in principle, be committed by anyone (as long as tbe

perpetrator was a caretaker of the child or the abuse had been permitted by a parent or parent-substitute).

Also note that perpetrators of sexual abuse appear to be distinctly different from

perpetrators of the other types of abuse (physical and emotional). Slightly more than one-fourth of

sexmdly abused children were sexually abused by a birth parent (290A), One-fourth were sexually

abused by other parents or parent-substitutes, such as step-parents, fathers’ girlfriends, etc. (25Y.).

Nearly one-half (46%) had been sexually abused by.someone other than a parent or parent figure. In

contrast, birth parents were the perpetrators for most of the physically abused children (720%)and for

most of the emotionally abused children (81‘A),followed by other parents and parent-substitutes (2 lY. of

physically abused children and 13% of emotionally abused children). Only small fractions of physically

and emotionally abused children suffered these forms of maltreatment at tbe hands of someone other

than a parent or parent figure.

The remaining three columns of Table 62 show the distribution of the maltreated children

in each category of maltreatment and for each perpetrator relationship, according to the severity of their

injury or impairment. When all maltreated children are considered (the bottom-most section of tbe

table), the nature of the perpetrator does appear to be systematically related to differences in the severity
‘able 62. Distribution of Perpetrator’s Relationship to Child and Severity of Hm by the Type of

Maltrea~ent.

Percent Percent of Children in Row

CategO~ Children in Total with lnj~flmpairrnent.

Maltiea~ent Maltreated Fatal or

Category Children Serious Moderate Inferred

iBUSE: 100VO 743,200 21% b3Y 16Y

Natural Parents 62% 461,800 22% 73Y: 4Y:

Other Pwents md Pmentisubstitutes I9% I44,900 12% 62% 27%

Others 18% 136,600 24% 307. 46Y.

‘hysical Abuse 100% 381,700 13% 87% +

Natural Parents 72% 273,200 137. 87% +

Other Parenb md Pwentisubstitutes 21% 78,700 13% 87% +

Others 8% 29,700 * 82% +

;exual Ahwe 1Oov. 217,700 34% 12Y. 53%

Natural Pments 29% 63,300 blah 1o% 28%

Other Pwenw and Pmentisubstitutes 25% 53,800 19% 18% 63Y.

Others 46% 100,500 26V0 I 1% 63%

%motionalAbuse 100% 204,500 26Y. 68% bYo

Natural Pwenb 81% 166,500 27% 7070 2%

Other Pments and Pmentisubstitutes I3% 27,400 * 57% 24%

Others 5% 10,600 *

* *

NEGLECT: I00% 879,000 50% 44% by.

Natural Pwents 91% 800,600 5170 43% 6%

Other PmenS md Pwentisubstitutes 9% 78,400 35% 59% *

Others A A A . .

Physical Neglect I00% 338,900 64V0 I5% 21%

Natural Pmenk 95% 320,400 64% Ib% 20%

Other Parenk and Pmentisubstitutes 5% 18,400 ●

* *

Others A A A . A

Emotional Neglect 100% 212,800 97% 3~0 +

Natural Paren@ 91% 194,600 99% * +

Other Pments and Pmentisubstitutes 9% * * * +

Othem A . A A +

Educational Neglect 100% 397,300 7% 93% +

Natural Pments 89% 354,300 8Y. 92% +

Other Pmenw and Pmentisubstitutes I l% 43,000 * 99% +

Others A A A A +

ALL MALTWATMENT: I00% 1,553,800 36% 53% l1%

Natural PmenE 78% 1,208,100 41% 54% 5%

Other Parenb md Pwentisubstitutes I4% 21 I,200 20% 61% I9%

Others 9% 134,500 24% 30% 46%

:~is scveriwlevelnotapplicablefortits fom of mdmament.

“Fewerrbm 20 cmes witi wtich m calculateestimate;estimatetm un=fiable 10be given.

~cse Fvwatom we= not allowedby munti!liw Equimme”k for cmesof neglect.
of injury or impairment: 4 I percent of children who were maltreated by their natural parents suffered

fatal or serious injuries, compared to 20 percent of those maltreated by other parent figures and 24

percent of those maltreated by others. Upon further inspection of the table, however, it is evident that

this overall difference is due entirely to the fact that birth parents are by far the perpetrators for the

majority of the neglected children and neglect, in turn, is associated with a relatively higher incidence of

fatal and serious injuries to the children (facts that both derive from the countability rules for the Hams

Standard as explained earlier in Chapters 2 and 3), ~us, the overall pattern that suggests a correlation

between the relationship of the perpetrator to the victim and the severity of injury or impairment

apparently stems entirely for the nature of the countability rules under tbe Harm Standard. ne patiem

may reveal more about the study methodology, and the consistency with which that methodology was

followed, than it necessarily does about the distribution of child abuse and neglect. For this reason, it

may not be as inherently interesting as it may first appear.

To determine whether or not there are interesting patterns of relationship between the

perpetrator’s relation to the child and the severity of injury or impairment one should look across the

different perpetrator categories within each specific type of abuse.3 In fact, when one does SO,some

interesting patterns emerge: it appears that a sexually abused child was more likely to sustain fatal or

serious injury or impairment when he or she was sexually abused by a birth parent,4 but more likely to

suffer moderate or inferred injury or impairment when the perpetrator was someone other than the

child’s birth parent, In contrast, an emotionally abused child was more likely to sustain moderate injury

or impairment when the perpetrator was a bifih parent, but more likely to sustain inferred injury or

impairment when the perpetrator was another type of parent or parent-substitute. There are no notable

differences across the perpetrator categories in the severities of injuries or impairments in relation to

physical abuse.

‘ Because neglect is largely committed by biti pant3 (by definition), the= is IiUle oppo~ni~ to exmine differen~s in

severities of injurie~impaimcnta within the different subtypes of neglect.

0Fatal md serious injuV or impaiment WCRcombined in Table &2,
6.4 Perpetrator’s Sex as a Pnnction of the Msdtreatrnent mrd the Perpetrator’s

Relationship to the CMd

Table 63 presents the distribution of children according to the sex of their pe~etrators for

each type of maltreatment and category of pe~etrator relationship. Note that Table G3 resembles Table

62, except for the last three columns. Also observe that a given child who was maltreated by both male

and female pe~etrators fitting all the classification constraints described earlier was counted under borh

columns, so the percentages shown in the last three columns of this table can sum to more than 100

percent. For example, a child who was physically abused by both his natural mother and his natural

father was included under both “male” and “female” columns under “physical abuse by birth parents?’s

Children were classified as having been maltreated by a pe~etrator of unknown sex only if sex was

unknown for all perpetrators under consideration. Thus, a child who was sexually abused by two “other”

pe~etrators, one male and one of unknown sex, was classified under the “male” cOlumn fOr Other

pe~etrators of sexual abuse, and not under the “unknown” column.

As the bottom-most section of Table 63 shows, the majority of children who were

maltreated by their bid parents were maltreated by their mothers (7S0A),and a sizable minority were

maltreated by their fathers (460/0). In contrast, children who were maltreated by other parents and parentsubstittrtes were more likely to have been maltreated by a male (8S”Aby male other parents and parentsubstitutes and only 41‘A by female other parents and parent-substitutes). The pattern is similar for

children who were maltreated by other pe~etrators (80Yowere maltreated by males, and only 14°Awere

maltreated by females). For 7 percent of the children maltreated by others, there was no information

about the sex of their perpetrators. This is congruent with the fact that the “other” perpetrator category

was the general catch-all in this classification scheme and included those cases where the information

was insufficient to detemrine whether or not the perpemator was a family member or even an adult.

Note that there are different patterns concerning perpetrator’s sex for abuse and for neglect.

Children tended to suffer neglect from female peWetrators—87 percent of those neglected in any way

‘ In malyses concemins pe~etmtor’s sex, age, and employment stitus, this type of multiple-categotimtion of children ws

possible. Note, however, that h was minimi=d s fw % possible by following the nine-catego~ pe~etrator hiemrchy (shown

in Table &l) in identifying the child’s pe~etmtotis). For exmple, consider the cse where a child w= seriously physically

abused by two pe~etiato~-a ste~pxent md a pwent’s boyfriend. According to the nine-categow hiermchy, tbe malyses

would focus on tbe step-pmnt (since this w= tbe mmt closely related pepetitor according to tbe hiemchy), snd only the

sex, age, md employment status of this pe~etmtor would be considered in the hbulations. Thus, multiple cl~sifications of the

child were limited to those cmes where there were two (or more) pe~ctmtom of exactly the sme degree of relationship

=cording to the nine-mtego~ K!emchy.

6-8
rable G3. Distribution of Perpetrator’s Sex by Type of Maltreatment and Perpetrator’s Relationship to

Child.

Perwnt of Children in ROWwith

Category Percent ChOdren Total Pe~trator Whose Sex wm

in Maltreatment Maltreated

Category Children Male Female UnhOwn

ABUSE: 10070 743,200

Natural Pwents

67% 40% ●

62% 461,800 56% 55% *

Other Parents md Parentisubstitutes 1Yh 144,900 90% Is% *

Others 18% 136,600 80% 14% ●

Physical Abuse 100Y. 381,700 58%

Natural Psrents

50% *

72Y. 273,2oo 48% 60% *

Other Psrents and Psrentisubstitutes 21%

Gshers

78,700 90% 19~h *

8% 29,700 57% 39Y. *

Sexual Abuse I0070 217,700 89%

Natursl Pwents

12% *

29Y, 63,3oo 87% 287. ●

Other Pwents md Psrentisubstitutes 25Y. 53,800 97% ●

●

~hers 46% 100,500 86% 8% *

Emotional Abuse I00% 204,500 63%

Natural Pments

50V0 *

81% 166,500 60% 55% *

~her Parents and Pmendsubstitutes I 3%

~hers

27,400 74% * *

5% 10,600 * * *

ALL NEGLECT 100% 879,000 43% 87% *

Natumi Parents 91% 800,600 40% 87% *

Other Pwents md Pmentisubstitutes Yh

Others

78,400 76% 88% ●

. A . A A

Physical Neglect 100% 338,900 35%

Natural Psrents

93% ●

95Y. 320,400 34% 93% ●

Other Parents md Pwentisubstitutes 5%

Others

18,400 ● 90% *

A A . A A

Emotional Neglect Ioovo 212,800 47%

Natural Pmnw

77% ●

91% 194,600 44% 78% *

Other Parents srrd Parendsubstitutes Yh 18,200 ● ●

Gthem

*

. A A A A

Educational Neglect 100% 397,300 47% 88% *

Natural Parents 89% 354,300 43% 86% ●

Other Parents md Parentisubstitutes 1170

Others

43,000 82% I00% ●

A A A A A

ALL MALTREATMENT Ioovo 1,553,800 54% 65%

Natural Parents 78%

IY,

1,208,100 46V0 75% ●

Other Parents md Pwentisubstitutes 14% 211,200

Others

85% 41% ●

Yh 134,500 SOY. 14% 7%

:Fewertin 20caxs witi whichmcalctiak, estimwm wlkble mk given

~ese ~pmmrs W.Wmt all.w~ by c.”nmbiliw ~imme”e for U=S of negl~t,
were neglected by a female. This finding is congruent with the fact that mothers and mother-substitutes

tend to be the primary caretakers and are the primary persons held accountable for any omissions andor

failings in caretaking. In contrast, children are more often abused by males (67Yoof all abused children

were abused by males), The predominance of males as pe~etrators of abuse held true for each of the

specific types of abuse and is most pronounced for sexual abuse, where 89 percent of the children

experienced abuse from a male pe~etrator.

Also observe that there are sex differences across the different perpetrator categories in

abuse overall and in the various types of abuse. Among all abused children, those abused by their birth

parents were about equally likely to have been abused by mothers (55%) as by fathers (56%), but those

abused by other parents and pwent-substitutes or by others were much more likely to be abused by males

(90Y0 versus 15% and 80% versus 14Y0,respectively). For emotional abuse, the pattern is largely

congruent with the overall abuse pattern. For physical abuse, the pattern is slightly different, with

children more likely to be physically abused by their mothers than by their fathers (60°Aversus 480A),but

much more likely to be abused by a male when the perpetrator was an other parent or parent-substitute

(90% versus 19%), and somewhat more likely to be abused by a male when the perpetrator was related to

them in some other way (57% versus 390A). For sexual abuse, however, the differences across the

pe~etrator categories are diminished, since males clearly predominate as perpetrators in that

maltreatment category.

Table H presents an overview of the sex of the perpetrators as a function of their

relatimrsbips to the children and the severity of the children’s injuries or impairments. The bottom-most

section of this table is identical to the bottom-most section of Table 63, showing that, overall, children

tend to be maltreated by female perpetrators more often than by male pe~etrators (65”/0 versus 540A,

respectively). Note, however, that there appears to be a progressive decline in the predominance of

female perpetrators moving down the rows of the table, from those children who were fatally injured

(78Y0 by female perpetrators), to those seriously injured (75% by female perpetrators), to those

moderately injured (66°A by female perpetrators), to those with inferred inju~ or impairment (where

only 30% were by female perpetrators). To a large extent, this pattern probably reflects both the fact that

female perpetrators predominate in neglect, where greater proportions of the children are more seriously

injured, and the fact that infemed injury or impairment is most ofien associated with sexual abuse, which

is most often perpetrated by males.

610
‘able W. Distribution of Perpetrator’s Sex by Severi~ of Outcome and Perpetrator’s Relationship to

Child.

Percentof Ctildren h Rowwith

catego~ PercentCMdren Totil Perpetrator Mose Sex wm

k Mdtreament Mrdtrcated

category Ctildren Mtie Fede UtiOwn

:ATA L 100% 1,500 *

NaNIA Pments

78% *

80% 1,200 * * *

Other Parents and ParenUsubstimtes * * * * *

Orbcrs ● * * * *

;ERIOUS 100% \ 565,~ 48%

NaNrd Parents

75% *

87% 4w,m 43% 81% *

Other Pments ~d Parendsubstimtes 8%

Otiers

43,000 77% 49% *

6% 32,~ 77% * *

dODERATE lm % 822,000 55%

NaNrd Parents

bb% *

80% b53,7M 48% 72% *

Otier Parents sod Parendsubsthotes 16% 128,000

Otiers

87% 47% *

s% 40,300 b9% 31% *

NFERRED Iw% lb5,300 72%

Nawrd Paents

30% *

38% 63,300 4s % bS% ●

OtherParents and Parentlsubstitmes 24%

Otiers

40,000 86% * *

38% b2,100 w% *

●

kLL MALTWATMENT 100% 1,S53,800 S4% b5% 1%

NaNrd Parents 78% 1,208,1W 46% 7s% *

Other Parents snd Parentisubstimtes 14% 211,2M

Orbers

85% 41% *

9% 134,500 80% 14% 7%

.Fewerh 20-s withwtich w tic”lsw esdmw, estim m Umlmble m h give”.

One other aspect of this table deserves comment: the overall pattern of sex differences

across the perpetrator categories appesrs to hold at each severi~ level. Overall, more of the children

maltreated by their birth parents were maltreated by heir mothers, wheress those maltreated by other

parents and parent-substi~tes or by other perpetrators were more often maltreated by males, From what

can be determined, this appesrs to be me for children who suffered inferred injuries or impairments,

those who suffered moderate injuries or impairments, artd those who suffered serious injuries or

impairments, The dats were insu~cient to allow this question to be addressed for children who suffered

fatil injuries or impairments.

611
6.5 Perpetrator’s Age as a Function of the Maltreatment and the Perpetrator’s

Relationship to the Child

The NIS-3 examined perpetrator age to determine whether pe~etrators of specific ages

were predominant as perpetrators of any specific type of maltreatment. Table 6-5 shows the

distribution of children countable under the Harm Standard according to the age of the perpetrator for

each type of maltreatment and category of perpetrator. The classification here was treated just as in

Tables 6-3 and 64, in that children were counted under every age category that applied to the

perpetrators who fit the classification constraints. As a consequence, the row percentages can sum to

more than 100 percent. Thus, a child who was physically abused by two other parents and parentsubstitutes of different age groups was counted in each applicable column, and a child was classified as

maltreated by a perpetrator of unknown age mdy if age was unknown for all perpetrators under

consideration. The bottom-most section of Table 6-5 indicates that the age of the perpetrator was

entirely unknown for one-third of the countable children, which represents a substantial minority of the

database. ~ls proportion is even higher for the category of “other” perpetrators, which (as noted

above) tended more often to include cases with missing information about various characteristics of the

perpetrator. Given the prevalence of children maltreated by pe~etrators of unknown age, other

aspects of the patterns in ti]s table (and in Table 6-6, which follows) must be read very cautiously,

since they could easily be eradicated if all pe~etrators’ ages were known.

Two aspects of Table &5 are especially striking-and both of these concern the relative

prevalence of perpetrators in the youngest age group. First, younger perpetrators (those under 26 years

of age) are relatively more predominant among perpetrators of sexual abuse (maltreating 22°A of all

sexually abused children) than among perpetrators of any other specific type of maltreatment (where they

maltreated be~een 3°/0 and 190/0of the children). Second, younger perpetrators are relatively more

predominant as perpetrators of children maltreated by “other” perpetrators than among children

malbeated by their parents or other parents and parent-substitutes. Note that a higher proportion of the

children maltreated by “other” types of perpetrators were maltreated by a person in the youngest age

group, and this pattern appears in connection with overall maltreatment (where they maltreated 40% of

the other-maltreated children), abuse overall (where they maltreated 40% of the other-maltreated

children), physical abuse (where they maltreated 35°Aof the other-maltreated children), and sexual abuse

(where they maltreated 39% of the other-maltreated children).

6-12
Table 65, Distribution of Perpetrator’s Age by Type of Maltreatment and Perpetrator’s Relationship to

Child.

Percentof Children in ROWwith

Percent Perpetrator Whose Age was

catego~ Children in Total

Maltreatment Maltreated <26 26-35 >35

Category Children Years Years Years Unknown

ABUSE: 100Y, 743,200 14Y, 29% 25% 31%

Natural~arents 62V0 461,800 9% 34% 28% 29V0

Other Parenti and Parentisubstitutes I9V0 144,800 9% 32% 28% 31%

Others 1870 136,600 407. 8% I3% 39%

Physical Abuse 100% 381,700 I3% 34% 24% 29%

Natural~arents 72% 273,200 1o% 38% 26%

Other Parents and Parentisubstitutes

26%

21% 78,700 11%

Others

28% 26% 35%

8% 29,700 47% * * 36%

Sexual Abuse 100%0 2 I7,700 22% 21% 26% 31%

Natuml~arents 29% 63,300 lo% 25% 41% 24%

Other Parenw and Parentisubstitutes 25% 53,800 ● 38% 29Y.

Others

28%

46% 100,500 39% 8% I 5% 38%

Emotional Abuse 100% 204,500 7% 28% 24% 41%

Natural~arenE 81% 166,500 7Y. 31% 25% 37%

Other Parents and Parentisubstitutes 13V0

Others

27,400 ****

5% 10,600 ● ***

NEGLECT 100% 879,000 11% 34% 22% 37Y.

Natuml~aren@ 91V0 800,600 12% 37% 21% 35%

Other Parents and Parentisubstitutes 9%

Others

78,400 ** 32%

A

59%

A A A . A

Physical Neglect I 00% 338,900 19% 37% 18% 32%

Natural~arents 95% 320,400 20Y. 39% 16% 33%

Other Parens and Parentisubstitutes 5% 18,400 * * * *

Others A A A . . A

Emotional Neglect 10070 212,800 3% 32% 31% 36%

Natural~arens 91% 194,600 * 35% 30% 35%

Other Parenk and Parentisubstitutes 9%

Others

18,200 ****

A A A A A A

Educational Neglect I 00% 397,300 7Y. 30%0 20Y. 45%

Natural~arenk 89% 354,300 ● 33% 21% 41%

Other Parents and ParenUsubstitutes I l%. 43,000 ● ** 82%

Others A A A A . A

ALL MALTREATMENT I00% 1,553,800 13% 32% 23% 34%

Natural~arents 78% 1,208,100 I 1% 36V0 23% 33%

Other Parents and ParenVsubstitutes I4% 2 I I,200 7% 22% 30% 41%

Others 9% 134,500 40V. 8% 13Y. 38%

:Fewer h“ 20 ~~s witi wtich m ~lc”lati estim~; estim tw umeliablem k given.

Thesep~mmrs wcm mt dlowd by commbtii~ requimme”B for casesof wglect,

613
Table H gives the distribution of children according to the ages of the perpetrators for

each outcome severity and each perpetrator relationship. Most differences across the vwious rows and

sections of this table me slight and probably inconsequential-specially in view of the relatively high

propofiions of children with perpetrators of unkrrom age. However, one aspect of the table is striking.

Note that, again, the youngest perpetrators are relatively more predominant among “other” perpetrators

of children than among pwerrts or parent-substitutes.

rable 6-6. Distribution of Pe~etrator’s Age by Severity of titcome and Perpetrator’s Relatiomhlp to

Child.

Percent of Children in ROWwith

Percent Pe~etrator Whose Age was

CategOV Children in Total

Maltreatment Maltreated <26 26-35 >35

CategO~ Children Yems Yems yems Unknmvn

?ATAL 1OWA 1,500 ● **’

Natural Parents 8070 1,200 *

* * *

Other Parents and Parentisubstitutes ● 200 ****

Othem ● 100  

5ENOUS 100Y. 565,000 12% 31% 26% 33”h

Natuml Pments 87V0 490,000 ll% 34% 25% 32%

Other Pnrrts and Parentisubstitutes 8% 43,000 **  47% 36%

Othem 6% 32,000 34% ● ● 430h

MODERAE 100% 822,000 11% 33% 22V0 36%

Natural Parents 80% 653,700 ll% 37% 22% 34%

Other P=nts and Parentisubstitutes 16% 128,000 ● 21% 27% 46V0

Others 5% 40,300 38% * 16% 39%

NFE_D 100% 165,300 24% 2YA 19% 2Yh

Natuml Pwents 387. 63,300 1o% 43% 25% 22”h

Other Parents ~nd Parentisubstitutes 24% 40,000 ● 37% 20% 31%

Othem 38% 62,100 45% * I 1% 36%

ALL MALTREATMENT 100VO 1,553,800 13Y. 32% 23% 34%

Natural Parents 78% 1,208,100 I l% 36% 23% 33%

Other Pwents and Parentisubstitutes 14% 211,200 7% 22% 30% 41Y.

Others 9% 134,500 4070 8V0 13V0 38%

.Fewer ti 20 caseswiti wtich m calculati estime; estimte mOumliablemk given

6-14
6.6 Perpetrator’s Employment Status as a Function of the Maltreatment and the

Perpetrator’s Relationship to the Child

Tables 67 and 68 present the distributions of the children who were countable under the

Harm Standard according to the perpetrators’ employment status for each type and severi~ of

maltreatrrrent andeach perpetrator relationship. When more tharrone person hadmaltreated achild, the

perpetrators’ employment was classified in the first category that applied to any members in the group,

reading from Iefi to right across the employment columns. Multiple classifications were avoided.

“Employe&’ included all those perpetrators who were employed full-or part-time or were on active duty

forthe military. 'Unemployed'' included those whowere unemployed butcumntly looking for work.

“Other” was a betemgenemss category, It included perpetrators who were unemployed but not

technically in the active Iaborforce (e.g., housewife, unemployed and not looking for work, disabled,

receiving Aid to Families with Dependent Children, on maternity leave, in hospital, in jail), and those

with livelihoods that were criminal in nature and therefore did not fit Legitimate employment categories

(e,g., drug dealer, pimp, etc.). ``Unknot'' included those peWetiators whose emplo~ent stitus could

not be determined.

As these tables show, the “Unknown” category is very prevalent, involving the perpetrators

ofoverone-tbird ofallmaltreated children arrd all neglected children (38°Aand36Yo, respectively), arrd

of40percent ofall abused children. ~erefore, only tentative conclusions about therelation beWeen tie

perpetrator’s employment status and type of maltreatment and relationship can be made. With that

proviso in mind, it can be seen in Table 67 that nearly one-half of all maltreated children (47Yo), all

abused children (46Yo), and all neglected children (48Yo) were abused by a perpetrator who was

employed. As Table 68 shows, of the children who sustained serious injury, the majority (54Yo)were

maltreated by an employed perpetrator.

6.7 Child’s Wce as a Function of the Maltreatment and the Perpetrator’s

Relationship to the Child

615

~eNI*3 analyses explored whether thechildren’s race was inarry way systematically

mlatedto the~eofmaltiea~ entmdtie pe~etrator's mlationship to the child. Since perpetrator race

was not known for perpetrators who had been reported to the study solely through non-CPS sources,
able 6-7. Distribution of Perpetrator’s Employment S@~s by TWe of Maltreatment and

Perpetrator’s Relationahlp to CMld.

Percent of Chldren in ROWwithPe~trator

Who% Employment

Percent status Wm .

Category Children in Total

Maltreatment Malt~ated

Category Children Employed Unemployed Other UnhOwn

4BUSE: I00% 743,238 46% 7% 7% 40%

Natuml Pments 62% 461,825 52% 9% 8% 317.

Other Pments md Parentisubsthutes 19% 144,850 37% 4V0 ● 52%

Others 1870 136,564 32% *

* 60%

Physical Abuse 100% 381,675 41% 9V. 8% 42%

Natural Pments 72% 273,244 46% lo% 9% 35Y.

Other Paents md Puentisubstitutes 21Y. 78,741 36V0 $

* 51Y.

Others 8% 29,690 ●

● * 82%

Sexual Abuse 100% 217,655 43% 4Y. 5Y. 48%

Namml Parents 29% 63,270 57Y. 8% ● 29%

Other Pwents md Parentisubstitutes 25% 53,850 30% *

● 62%

Others 46% 100,535 40% ●

● 53Y.

Emotional Abuse 100% 204>486 55Y. 5% 8% 32V0

Natural Pments 8170 166,518 59V. 7% 7% 28%

Other Pwents md Pwentisuhstitutes 13V. 27,389 *

* ● ●

Others ● * * ● * *

NEGLECT IOovo 879,003 48% 9% 6% 36%

Namra) Pments 91% 800,565 50% ~ 1WA 6V0 3470

Other Pments md Parendsubstitutes 9V0 78,438 30% “

* 62%

Otbem A A . A A A

Physical Neglect I00% 338,888 45% 12% 9% 34%

Natural Parents 95% 320,450 46Vn I 3Y. 8% 33%

Other Pzenk md Parentisubstimtes 5Y. 18,440 *

* * ●

Otbem A A . A A .

Emotional Neglect 100Y. 212,844 61% 7V. ● 27%

Natural Pments 91% I94,597 62% *

* 27%

Other P%ents md PaenVsubstimtes 97. 18,246 55% ●

● ●

Others A A A A A .

Educational Neglect I00% 397,324 46% 8% 4% 43%

Natural Pments 89% 354,292 SOY. 9“A 4% 38%

Other Pwents md Pwetrtisubstitut= 1170 43,031 ●

● ● 83%

Others A A 6 A A .

ALL MALTREATMENT IOovo 1,553,786 47Y. 8% 6% 38V0

Natural Pments 78% 1,208,144 SIYO 1o% 7% 32%

Other Pments md Pwentisubstimtes 14% 211,179 35% 3Y. 6% S6%

Othem 9% 134,464 33% ●

● Syh

~Fewerti 20 caxs witi whichD cdculati esti=; estiue m umlmble m k siven.

~ese pwmmrs W.X not allowd by couutitiv =quircmenn for ca=s of neglect.

—

6-16
rable 68, Distribution of PeWetrator’s Employment Status by Severity of Outcome and Pe~etrator’s

Relationship to Child.

—

Percent of Children in Row with

Perpetrator Whose Employment

Percent status was .

Category Children in Total

Maltreatment Maltreated Other{

Category Children Employed Unemployed Unk”Ow”

FATAL I0070 1,500 * * 82%

Natural Parents 81% 1,200 ● ● ●

Other Parents and Parentisubstitutes ● 200 * ● ●

Others * 100 ● * *

SEWOUS 1Oovo 565,000 54V. 8V0 38%

Natural Pments 87”A 490,000 57°A Yh 34%

Other Parents and Parentis”bstit”tes 8% 43,000 42V0 * 53%

Others 6% 32,000 ●

● 77°h

MODERATE 100% 822,000 45% 9V0 46%

Natural Parents 80% 653,700 48% IIOA 41V0

Other Parents and Parentisubstitutes 16% 128,000 36% * 61%

Others 5% 40,300 22% ● 74V0

NFEWD 1OWA 165,300 35% 4% 61%

Natural Parents 38% 63,300 32V0 7Y. 62%

Other Parents and Parentisubstitutes 24% 40,000 23°A * 730A

Others 38% 62,100 47% * 51%

ALL MAL~ATMENT I0070 1,553,800 47% 8V0 44QA

Natural Parenb 78% 1,208,100 51% Io% 39%

Other Parents and Parentisubstitutes 14% 211,200 35% 3%0 62%

Others Ph 134,500 33% * 64%

.Fewertin 20caseswiti wKchtocticula~estimw, estimti tm Umtiablc to k given.

child’s race was used as the basis for this exploration. Table G9 presents the race distribution of the

children within each perpetrator category for each type of maltreatment,

The predominance of biflh pwents as perpetrators of neglect makes it unfeasible to examine

perpetrator differences in connection with neglect or any of its subcategories, as can be seen by the

preponderance of cells with asterisks and cwets in that wction of the table. However, some interesting

patterns are apparent in connection with abuse.

617
rable 6-9. Distribution of Ctid’s Race by Type of Mdtreatruent arrdPe~trator’s Relatiotip to Child.

Percent of Children in ROW

Percent with Race~thnicity

Category Childrenin Total

Mdtratment Maltreated

Category CMldren White Non-White Unkrrom

ABUSE: 100”A 743,200 75% 23% 3~0

Natural Parcrrta 62% 461,800 77% 21”A *

Other Parents md Parentisubstitutes I9% 144,900 79% 17% *

Others 18% 136,600 63”h 33% *

Physical Abuse I00% 381,700 73% 26”A *

Natural Parents 72% 273,200 72% 27°k *

Other Parents and ParenVsubstitutes 21% 78,700 80”A 18% ●

Others 8% 29,700 5g% 42% *

Sexual Abuse I00% 217,700 77% 19% ●

Natural Parents 29% 63,300 93”h 7% *

Other Parents arrdParentisubstitites 25°h 53,800 837. 13% *

Others 46% 100,500 64% 31”A *

Emotional Abuse 100% 204,500 78% 19% *

Natural Paents 81% 166,500 79% 19% *

Other Parents mrd ParenVsubstitutes 13°A 27,400 79% *

*

Others 5% 10,600 *

* *

ALL NEGLECT: 10070 879,000 71% 287. 2%

Natural Parents 9170 800,600 71% 28% 2%

Other Parents mrd Parentisubstitutes 9% 78,400 73% 26% *

Others A A A A A

Physical Neglect IOO”A 338,900 72% 27% *

Natural Parents 95% 320,400 71”A 27% *

Other Parents mrd ParenVsubstitutes 5% 18,400 *

* *

Others A A A * A

Emotional Neglect 100% 212,800 76% 21% *

Natural Parents 91% 194,600 76% 21% ●

Other Parents arrd Pmerrtiaubstitutea 9% 18,200 *

* *

Others . A A A A

educational Neglect 100% 397,300 68% 31% *

Natural Parenta 89% 354,300 68% 31% ●

Other Pments mrd Parentisubstitutes 11% 43,000 70% *

*

Others A A A o A

ALL MALTWATMENT 100% 1,553,800 72% 26% 2%

Natural Parents 78% 1,208,100 73”h 26% 2%

Other Parents arrd ParenVsubstitutes 14% 211,200 77V0 20% *

Others 9% 134,500 63% 34% *

~Fewertin 20ca%s witi whichmdctia~esti=; estimti mumliablemk given.

~t% Fwtimm were not dlowd by commbiliy quiremnu for ca%s of neglect.

6-18
First, for abuse overall, the distribution of children does not reflect any notable connection

beWeenthe child' sraceand thepe~etrator's relationship to the child. However, ammrg the specific

types of abuse, there do appear to be differences in the race distributions of the children who are

maltreated hy the different types of pe~etrators. Of children who were physically abused, white

children appear to account for a higher proportion of those physically abused by other parents and

parent-substitutes (80%) than of those physically abused by their birth parents (72Y.) and of those

physically abused byother types ofperpetrators (58Yo), Adifferent patterrr appears in connection with

sexual abuse, which is the maltreatment catego~ with the greatest proportion of white children (77°/0

overall). Among sexually abused children, wbite children m~eup agreaterproportimr of children who

were sexually abused by their birth parents (93Y.) as compared to their representation among the children

whowere sexually abused byother parents and parent-substitutes (83°/o)or byothers (640/o). In contrast,

non-white children account for a greater proportion of those who were physically abused or sexually

abused byothers (42°Aofthose physically abused and 31°Aofthose sexually abused, respectively) than

of those who were maltreated by their birth pwents or byother parents and parent-substitutes (270/oand

18% of those physically abused and 7% and 13% of those sexually abused, respectively).

Table 610 presents the race distribution of the children with pe~etrators in each

relatimrship category for each level ofinjury or impairment. For the most part, there appear to be only

trivial differences across the different peWetiator categories. However, WO patterns are of interest.

White children account foragreater propotiion ofthose whosuffered other-than-fabl injuries by other

parents and parent-substitutes than of those who suffered fatal injuries by bitih parents or by others.

(That is, 81% of those who suffered serious injury, 79% of those who suffered moderate injury, and 67%

of those who suffered inferred injrr~ were injured by other parents and parent-substitutes.) Incmrtrast,

non-white children account for a greater proportion of those children who suffered serious injury by their

birth parents than of those who suffered serious injury by other parents and parent-substitutes or by

others (22Yoversus 16°Aand 19°A,respectively). Non-white children account foragreater propomionof

those who suffered moderate or inferred injury by others than of those who suffered moderate or inferred

injury by biflh parents or other parents and pwent-substitutes (38°Awere moderately injured by others

versus 280/0by birth parents and 200/0by other parents and parent-substimtes; 390/osuffered inferred

injury by others versus 32% by bitih parents and 24% by other parents and parent-substitutes).

619
rable 6-10. Distribution of Child' sRaceby Severi~of Outcome and Peqetrator's Relatiomhlpto

Child.

Percent Percent of Children in ROW

CategO~ Children in Total with Race

Maltreatment Maltreated

CategO~ Children White Non-White U*nown I

FATAL: 100Y. 1,500 ●

* *

Natural Parenta 81% I,200 *

* * I

Other Parents and Parcrrtisubstitutes 14% 200 *

* *

Others 5% 100 * * *’

SERIOUS: 100% 565,000 ?7% 21% *

Natural Pmenta 87% 490,000 76% 22Y. *

Other Parents and P~entisubstitutes 8% 43,000 81% 16% *

Others 6% 32,000 76% 19% *

MODERATE: IooOA 822,000 72% 2?% *

Natmal Parents 8070 653,700 71% 28% *

Other Parents and Parentisubstitutes 16°h 128,000 79% 20% *

Others 5% 40,300 62% 38% *

INFE-D: I00% 165,300 62% 33% 6“A

Natural Pments 38% 63,300 64% 32% *

Other Pments and Parentisubstitutes 24% 40,000 67% 24% *

Others 38% 62,100 56% 39% *

ALL MALTREATMENT: 100% 1,553,786 72% 26% 2Y.

Natural P~ents 78°h 1,208,144 73% 26% 2%

Other Pmenta and Parentisubstitutes I4% 211,179 77% 200A *

Others 9% 134,464 63% 34% *

.Fewer tian 20 cases witi whichm calculateestim=; estimfi mo umlkble m k given.

6.8 Implications of the Findings Regarding Perpetrator Relationships and Characteristics

In considering the findings ffipofied here, one should continue to bear in mind the various

assumptions on which these analyses were based. Perhaps most impo~t, these analyses were designed

to provide a child-based cmmt, not a pe~etiator-based count, so they reflect only the most closely related

person or persons responsible for the maltreatment with the most serious outcome. This means that other

peqetrators who are not described here also may have been involved in a child’s maltreatment. A

different series of analyses would be needed to describe these children’s pe~etrators comprehensively

(i.e., they would need to categorize each child in connection with all involved pe~etrators, regardless of

6-20
outcume severi~ or closeness of relationship to the child). Moreover, without very differently designed

sample selection, data collection, and analysis approaches, the NIS cannot provide perpetrator-based

counts and distributions.

In view of the fact that the NIS–3 focused on the kinds of abuse and neglect that would be

in the puwiew of CPS, it is not surprising to see that the majority of countable children (74Yo) were

maltreated by their in-home birth parents and that another 13.6 percent were maltreated by in-home other

parents and parent-substitutes such as step-parents and foster parents. Thus, even though other persons

also might have been involved in maltreating these children, their parents or parent-substitutes were

directly involved in committing the maltreatment that had caused the children the most serious harm.

Key differences in perpetrators were found among the categories of abuse, where nearly

one-half of the sexually abused children had been abused by persons other than parents or parent figures

in contrast to only small fractions of those children who had been physically or emotionally abused by

“other” perpetrators, However, sexually abused children appeared to be more likely to suffer fatal or

serious injury or impairnrent6 when they were sexually abused by their birth parent.

Consistent with the fact that mothers and mother-substitutes tend to be the primary

caretakers, 87 percent of all neglected children and 93 percent of physically neglected children suffered

their neglect at the hands of female perpetrators. In contrast, abused children in all categories were more

ofien maltreated by males: 67 percent of all abused children, 89 percent of sexually abused children, 63

percent of emotionally abused children, and 58 percent of physically abused children were maltreated by

males,

Due to the prevalence of cases where the perpetrators’ age or employment status was

unknown or “other,” only tentative conclusions could be made about the relationship of these

characteristics to maltreatment. However, it appears that sexually abused children were more ofien

victimized by the younger perpetrators and that nearly one-half of all maltreated children were

maltreated by a perpetrator who was employed,

6-21

I

6Fatal and serious injuV categories were combined.
Finally, there appear to be differences in the racial distributions of the children who were

maltreated by the different types of perpetrators. White children made up a higher proportion of those

physically abused by other parents and parent-substitutes than of those physically abused by their birth

pwents or by others, whetess white children made up a greater proportion of those sexually abused by

birth parents than of those sexually abused by other parents and parent-substitutes or other types of

Pwfiators. In contras~ non-white children accounted for a greater proportion of children who were

physically or sexually abused by perpetrators wbo were related to them in some other way tian of those

who were physically or sexually abused by parents and parent-substitutes.

6-22
7. RECOG~~G AND ~STIGAT~G ~USED AND NEGLECTED CWLD~N

This chapter considers what community sources recognize maltreated children aa abused or

neglected and what percentage of maltreatment comes to the attention of CPS agencies. The chapter is

divided into two major sections, addressing the following questions:

● What agency sources encountered and recognized these abused or neglected

children? What changes have occurred in the number of maltreated children

encountered and recognized at different agencies since the NIS–2 (and for children

who were countable under the Harm Standard, since the NIS– I)?

. What percentage of the abused and neglected children had their maltreatment

investigated by CPS agencies? How does this compare with the percentage who

received CPS investigation in the NIS–2 (and for children under the Harm Standard,

in the NI>l )? How does the percentage who were investigated relate to the agency

source that recognized the abuse or neglect? What community sources recognized

the abuse or neglect of maltreated children who were and who were not investigated

by CPS?

The chapter concludes with an overview of the key patterns identified in recognition and

investigation patterns and a discussion of their implications. This last section also emphasizes an

important limitation of the NIS: it cannot determine the reasons children were not investigated by

CPWwhether it was because they were not reported to CPS or because CPS screened-out a report about

them without an investigation.

7.1 Sources Recognizing Abused and Neglected Children

This section examines the distribution of the abused and neglected children according to the

sources that recognized them as maltreated and identifies changes in this distribution since the earlier

national incidence studies, the NIS–1 and the NIS–2. There are two main subsections, one considering

the source distribution of the children who were maltreated as defined by the Ham Standard and the

other focusing on the source distribution of children who were defined as maltreated under the

Endangerment Standard. Throughout this section, our use of the tem “recognition” subsumes both

encountering maltreated children and identi~ing them as maltreated.

7–1
As was the case in Chapter 3, the estimates presented here are based on the unduplicated

numbers of maltiated children in the United States who experienced the type of maltreatment in

question (Harm Standard or Endangerment Standmd); that is, the unit of measurement is the child, and

each estimate counts each child only once. The estimates in the tables in this section are given both in

terns of the estimated totals and in terns of the rates per 1,000 children in the U.S. population.

Estimated totals reflect the number of children nationwide who were maltreated during the year in

question, whereas the incidence rates indicate the number of children maltreated during the year Per

1,000 children in the U.S. population, Comparisons across studies are based on the rate measures, in

order to tie account of any changes in the size of the U.S. child population across the time intewals. 1

As described in Chapter 2, the NIS design involved collecting data about suspected cases of

abused and neglected children fmm CPS agencies as well aa from communi~ professionals in a number

of different agency categories. Children identified to the study were categorized according to their

recognition source by considering: (1) the source(s) who had submitted the data fom on the child to the

NIS, or (2) the source(s) who had repotied the child to CPS, for those children whose maltreatment had

been investigated by CPS agencies. Thus, a child who had been submitted to the NIS by a sentinel in a

hospital was classified as having been recognized at a hospital; a child who was submitted to the NIS by

a participating CPS agency, who had been reported to the CPS agency by staff at a hospital, was also

classified as having been recognized at a hospital. Children who had been recognized at more than one

catego~ of agency were assigned to one of their recognition sources by applying a hierarchical ordering

of the sources. The hiermchy, which is described below, was identical to the one used in the NIS–1 and

the NI>2 for this purpose.

7.1.1 Sources Recognizing Children Maltreated under the Harm Standard

Children who met the criteria for maltreatment under the Hw Standard are listed in Table

7–1 according to their recognition source. Children who had been recognized by more than one of the

sources listed were put into the first source listed, following the ordering given in the table, from top to

bottom, with one provis~sources of reports to CPS were given preference over sources that

‘ The estimates, together with their standmd emors md upper snd lower 95-percent confidence bounds, =e given in Appendices

A md B. The details of the significmce tests for the cross-study comparisons me given in Appendix D.

1–2
‘able 7–1. Sources Reco@izing Malti~ted Children Who Ht the Hm Stidwd in the NI>3 (1993), md

Compmisons with the Estimated Numbers from Different Sowces i. the NI>2 (1986) md NISI (1980),

Hm Sti&d Children Reco@imd by the Source in the.,..

Source Reco@izi”g y ~~,; ,..,. NI@;1993:i+ NI~2: 1986 NI$l : 1980

.:.:,.

the Maltim~ent

‘“T:;;:~;:””y;g’; Toti No, of ~;; TotiNo. of ‘~’~~

~.;.:,+{:Chi@ren?iChildren Chifdren Cbil&n “

Children

.:::. :

lnvestigato~ Agencies:

Juvenile Probtiio” 36;6~, 0.s ~ 44,100 0.7 ns 41,600 0.7 “s

Poli&Sheriff ,1ll;,5q:., 1:7:. 76,100 1,2 ns 52,100 0.8 ●

~.::,

.,.

Public Health “27300 0.4 26,100 0.4 “s 8,900 0.1 ●

lnvestig~o~ Age”~ S“btOti: 175,6~;,. 2.6 ~~~ 146,300 2,3 nS 102,500 1,6 ●

)ther Sti& Agencies:

Hospitis 113JO0 I. 7 32,700 0.5 ● 35,300 0.6 ●

Schmls 920$@: ;: 13.7 ,: 507,400 8,1 ● 348,3oo 5.J ●

:. *:’?:.,;z., “.~..

Day-- Centers 59,1ti:’” 0,9”‘“ 24,300 0.4 ns NIA N/A --

Mend Health A@ncies 5090f:. 0.8 13,400 0.2 m 27,900 0.4 ns

Social Sewiw Agencies %,o~:j,..l.{ ~~ 77,000 1.2 ns 21,500 0.3 ●

&ber Stidy Agen~ S.btotd: 1X9JO0 ‘ 18.5 654,700 10.4 ● 433,100 6.8 ●

All Smdy Non-CPS Sowces ,,.1,415,400 21.1 801,000 12.7 ● 535,6oo 8.4 ●

,..

lther Sources (only through CPS): ~‘“

DSSNelfa kp~e”t 15,000 0.2 16,700 0.3 ns 11,800 0.2 .s

~her Professional or Ageny >

,7,0~::. ;.,..l.’{; 9,300 0.1 “s I I,300 0.2 a

All @er SOurUs ,, ~,4w”ii I. 7 104,100 1.7 ns 66,300 1.0 ●

Other (CPS-only ) Subtobl: 138,400,. 2.3 130,000 2.I .s 89,400 1.4 ●

,. ,,:,:,.

ALL MAL~A~E~ 1,553,800 ::””23.1 ““ 931,000 14.8 ● 625,100 9.8 ●

● ~c N1$3 ~timati is sipifiantly hi&er &m &is wlim mtimale (i,.,, p<.05).

m ~e NIS3 intimate is m~inally hi&er thm tiis slier estimati (i.e., 10>p>.05),

a me NI%3 ~timati issiflifia”tiy l.- tim his mlier &imak (i.e., ~,05).

m me diff-ce ~-n tiis md tie N1=3 estimateis “eitiw si~ifiat .or mqi”al ~>. 10).

N.w bli”atd tows n m“ndd t. tic “wet IW; -timated mm we m.ndti t. the .e_t k“ti,

7-3
were based solely on non-CPS sentinels in the NIS. Thus, a child submitted to the NIS by a police

depafiment and a CPS agency, who had been repotied to CPS by a hospital, was classified as having

been recognized at the hospital. 2 The hospital was identified as the recognition source because it was

given preference as the source of the repofi to CPS. Alternatively, a child whose maltreatment had not

been investigated by CPS, but who was submitted to the NIS by both a police dep~ent and a hospital,

was classified as having been recognized at the police depmment. me police depafiment was selected

in this case because it comes first in the hierarchy given by the ordering of sources in Table 7–1.

This classification scheme first credits sources with recognizing those children whom they

repofied to CPS and who were accepted by CPS for investigation. For the not-repotied children and for

those who were repotied but not investigated by CPS, the scheme assigns recognition credit to the source

who submitted the child to the NIS.

Note that this hierarchy distinguishes investigatory agencies, those in the second tier of the

“iceberg” model described in Chapter 2, from other study agencies, those in the third tier of the

“iceberg,” that are included in the NIS design. Also note that the hierwchy distinguishes be~een

children who are known through a source that is represented in the NIS design through the sample of

non-CPS sentinels, “All Study Non-CPS Sources,” and children wbo come into the NIS solely through

the CPS agencies “Other (CPS-only) Sources? This distinction is impotint because the NIS does not

recmit special, non-CPS sentinels to obtain children whom “Other (CPS-only) Sources” see beyond

those who we investigated by CPS.3

The NI>3 estimates, given in the shaded section in bold text, indicate that, of the estimated

total of 1,553,800 children who experienced some fom of maltreattnent countable under the Hamr

Standmd in 1993, an estimated 175,600, or 11 percent, had been recognized by staff in investigato~

agencies. Most of these were recognized in law enforcement agencies, municipal police or sheriffs’

depatiments.

2 For this cl-sification to apply, it W%also necess~ for W!s ch!ld’s maltreatment to have been investigated by CPS md for the

child tOhave been recognized ss maltreated by the CPS agency. Operationally, this memt that either the child was m alleged

or indicated victim or the CPS investigation ~cord described his Or her countable malticament. See the discussion in the

subsequent section, 7.2, concerning CPS recognition of children’s maltreatment.

] Readers should recall Figure 2–2, which showed that cetiain categories of repoflers to CPS ~e not included in the non-CPS

sentinels in the NIS (e.g., the gencml public, ce~in categories of professionals md agencies, such ~ physicians or therapists in

private pmctice, and the county welfue deptient).

74
Four-fifths (80%) of the total (an estimated 1,239,800 children) were recognized at other,

noninvestigatory agencies of the kind represented by the NIS sentinels—hospitals, schools, day-care

centers, and mental health and social sewice agencies. Thus, the vast majority of children who were

maltreated as defined by the Harm Standard were recognized by sources represented by NIS sentinels—a

combined total of 1,415,400, or91 percent of all children maltreated under the Ham Standard. Note that

the single greatest source of children who fit the Harm Standard is professional staff in schools.

Teachers, nurses, and counselors at public schools recognized by far the greatest proportion of children

who fit the Harm Standard (an estimated 920,000 children nationwide). In their own right, school staff

recognized nearly three-fifths of the children who fit the Harm Standard—59 percent. Bearing in mind

that this categorization is hierarchical, it means that more children were recognized as abused or

neglected by schools than are credited here. When schools recognized a child who W= also recognimd

by a source higher in the hierarchy, or when a school sentinel recognized a child who had been reported

to CPS by another source, the child was classified as having been recognized by that other source, rather

than by the school sentinel, This means that 59 percent should be regarded as a minimum estimate of the

recognition contribution made by school professionals.

Only 9 percent of the children maltreated according to the Harm Standard (an estimated

138,400 children) came into the NIS through sources that are reflected only among cases investigated by

CPS. Most of these (1 16,400 children, or 7% of the Harm Standard total) had been repotied to CPS by

the general public, including neighbors, friends, family, the parents and children themselves, and

anonynrous callers.

Changes since NIS1 and NI&2 in Recognition Smsrces of Maltreatment under the

Harm Standard. In comparison to the NI%2 estimates, the significant increase in the total of children

whose maltreatment fit the Harm Standard derived from significant increases in the recognition of these

children at hospitals and at schools and a mmginal increase in their recognition at mental health

agencies.4 Recognition of children maltreated according to the Harm Smndard at hospitals more than

tripled since the NIS–2, and recognition at schools was 69-percent higher in 1993, during the NIS–3,

than it had been in 1986, when the NIS–2 was conducted. Mentil health professionals quadrupled their

recognition of these children since the NIS–2. However, mental health sources still, account for a very

‘ Changesover time are best measurd in terns of inciden= rates (i.e., number per 1,~ children in tie population) in order

to take account of simultaneous changes in the overall size of the child ppulation, so all ktween-study comparisons were

done using the rate maures.

7–5
small propofiion of the total (only 30A), and their estimates m comparatively less precise as a

consequence of that fact, so this increase is statistically marginal, but not significant. Note that because

all three of these sources, hospitals, schools, and mental health agencies, are in the category “Other Study

Agencies” and in the larger sector “All Study Non-CPS Sources: significant increases in recognition in

these larger categories were also observed.

Further insight into tbe nature of changes in the recognition of children who counted under

the Hamr Standard can be afforded by compmismts with tie NI*l and by examining all three national

studies in relation to each other. Compwing the recognition source estimates in the NI*3 with those

found in the NI*I, there were significant increases in recognition at police/sheriffs’ departments, public

health dep-ents, hospitals, schools, social service agencies, and “other sources” to CPS (i.e., the

general public), but there was a significant decreae in the contribution from the CPS-mrly category of

other professionals and agencies (i.e., beyond those who are represented through non-CPS sentinel

groups in the NS). Day-care centers had not been a specific category of sentinels in the NI&l, so no

comparison can be made in that category.5

Figure 7–1 presents the recognition patterns at investigatory agencies in the three national

incidence studies. Recognition by juvenile probation departments has essentially remained stable over

the 13-year period represented by these studies (i.e., there were no significant or mwginal changes).

There were significant increases between the NIS–1 and the NIS–3 in recognition by law enforcement

and by public bealtb departments, but the patterns of change over the course of the three studies differed.

Law enforcement agencies have evidenced a steady rise in their recognition of children who were

maltreated according to the Harm Standard, whereas the increase in recognition in public health all

occumed during the early part of this period, beWeen the NI%l and the NI&2.

Recognition levels in other (nmrinvestigato~) study agencies are gaphed in Figure 7–2.

One of the most striking features of this figure is the overall predominance of schools as a recognition

source in all three studies, overshadowing all other recognition sources. Schools are also the source that

evidences the largest increases across the three national incidence studies. The recognition of children

s In the N1%I, dapcwe centers had been included in the mixed categoV “social sew ice agencies,” mtber than u a separate

catego~. Compuimns with the NI>I estimates of the subtotis in Table 7- I appropriatelyadjustedfor the factthat daycme

ccntemhti not been independently represented in that study. (See Appcnd!x D.)
1.8

1.6

:1.4

k 12

gl

n

❑ NIS-1

~ 0.8

❑ NIS-2

~ 0.6 ■ NIS-3

x

g 0.4

z 0.2

0

Juventie Pofice/She~ Wbhc HeaM

Probation

Figure 7-1. RecoWition of Chiltien MO Fit the Hm Stitid h

Investigator Agencies ti the ~ee National Incidence Smdles,

14

12

z

:. ,0

k

u

❑ NIS-1

gs ❑ NIS-2

86

%

$4

■ NIS-3

z

2

0

Hospibls Schools Day-cme Menal Social

Centers Health Semites

Figure 7-2. Recognition of Chiltien MO Fit the Hm Stitid ti ~er @onkvestigato~) Smdy Agencies in the ~ee National Incidence Smdies.

7–7
whose maltreatment fit the Harm Standard at schools in the NIS–3 was almost NO and one-half times

the NIS–1 level.

Figure 7–2 also shows that the increase in recognition at hospitals is a recent development,

occurring since the time of the NIS–2, in contrast to the rise in recognition at social service agencies,

which occurred during the early part of the 13-year period and has essentially not changed since the time

of the NIS–2. Mental health agencies present an interesting pattern. Their recognition of children who

counted under the Harm Standard actually decreosed marginally be~een the NI%l and the NIS–2,6 but

then it increased marginally be~een the NIS–2 and the NIS–3, such that the net result was no significant

change beWeen the NIS–I and the NIS–3 recognition levels in this agency sector.

Changes in recognition across sources that are only know through their reports to CPS are

given in Figure 7–3. Across the three national incidence studies, there have been essentially no changes

in recognition within the department of social services (i.e., referrals to CPS from AFDC, etc.). Other

professionals or agencies (i.e., beyond the ones that are represented in the NIS via special sentinels)

actually evidenced a significant decline be~een the NIS–1 and the NI*3 in their recognition of chiIdren

countable by the Harm Standard. These sources included physicians and therapists in private practice.

This significant decline in their recognition of maltreated children counted by the Harm Standard

occurred despite the fact that there were no significant or marginal shifts in recognition from the NIS–I

to the NI%2 or from the NIS–2 to the NI*3 (i.e., the cumulative effect is nevertheless significant).

Finally, note that the general public showed a significant increase in recognition be~een the NIS–1 and

the NIS–2~ but there has been essentially no change in this level since the time of the NIS–2.

Figure 7A gives a visual overview of changes in the absolute and relative contributions to

the Harm Standard estimates from the three main groupings—investigato~ agencies, other nmt-CPS

study agencies, and CPS-mrly sources of children who were counted under the Harm Standard. Overall,

changes in recognition at investigatory agencies and in CPS-mtly sources had occurred between the

6 This finding emerged whm a one-tailed test is used, in contract to the more stringent Wo.tailed test, which wm used - the

basis of the results presented in the NI$2 findinss report. Because the more stringent test W= applied in the NI%2, that

exlier report does not indicate a chmge bewecn the NIS–I md NIS–2 in recognition at menkl health ascncies.

7–8

7The chagc is significmt when a one-tiiled test is used; it W= repofled m mmginal in the NIS–2 findings repoti, where a twotailed test wss used.
1.8

1,6

,:. 1.4

g 1,2

u

❑ NIS.1

~ ~,: ❑ NIS-2

u

% 0.6

$ 0,4

■ NIS-3

z 0,2

0

DSS Welfw Dther AUother

Dept. professional or souxes

agency (geneml pubtic)

Figure 7-3. RecoWition of Cbiltien MO Fit the H- Stidmd in Dther

(CPS-only) Sources h the wee National Incidence Smdies.

20

18

~ 16

; 14

n

G 12

n

❑ NIS.1

~ 10 ❑ NIS-2

58

%6 ■ NIS-3

j;

o

hvestigato~ @her Smdy ~her Soumes

Agencies Agencies (only tbmugb

CPS)

Figwe 74. Reco~ition of Chiltien MO Fit the Hm Stidzd across the Main

Categories of Sources ti tie ~ree National Incidence Smdies,

7–9
NIS–1 mdtie NS2, butthere have been essentially nochanges inrecognition inthese sectors since the

time of the NI>2.

The dramatic changes in recogrritimr by other (noninvestigatory) study agencies seen in

Figure 74 largely reflect the contributions to this sector by personnel at schools. (Also see Figure 7–2.)

More tharr two-thirds (68%) of the increase since the NIS–2 in the incidence of abuse and neglect under

the Harm Starrdard reflects additional children who were recognized at schools.

7.1.2 Sources Recogntilng Children Maltreated under the Endangerment Standard

Table 7–2 provides a breakdow of the children who were countable under the

Endangerment Stmrdard according to their recognition source, This table follows the same structure as

Table 7–1, described in the previous section, with children assigned to a recognition source based on the

source who submitted them to the study or who reported them to CPS. (See the description above

regarding children’s classification by their recognition source.) The sum in Table 7–2 reiterates that an

estimated total of 2,815,600 children experienced abuse or neglect according to the Endangerment

Stmrdard in 1993. (Also see Chapter 3.) An estimated 372,400 of these children, or 13 percent, were

recogrrized by investigatory agency staff. Similar to the pattern that was seen in connection with

recognition sources of maltreatment under the Harm Standard, these children had come predominantly

from law enforcement agencies.

@her study agencies, without investigatory authority of any kind, accounted for threefourths (75%) of the total (an estimated 2,102,500 children). Taken together, all sources represented by

non-CPS sentinels recognized an estimated 2,474,800 children whose maltreatment fit the Endangerment

Standard, or 88 percent of the total. Again, it is very apparent that schools are the strongest contributors,

recognizing more than 1.5 million of these abused and neglected children (an estimated 1,510,700), or 54

percent of the Endangerment Stidard total. This figure should be regarded as a minimum estimate of

the total number of children counted under the Endangerment Standard who were actually recognized by

school personnel, because some children recognized at schools were credited to agency sources that are

higher in the assignment hierarchy. (See the discussion above on this issue in connection with schools’

recognition of Harm Standard children.)

7–lo
Table 7-2. Sowces Recogoiztig Malheated Chiltien Who Fit the Endmgement Stitid

in the NIS3 (1993), md Compmisons With Reco~ition Sowces

in the NI>2 (1986).

7–1 1
Twelve percent of the children counted under the Endmrgement Standard (an estimated

340,800) were recognized by sources that me not represented in the NIS design except through their

repofis to CPS agencies~ther branches of the county social sew ices deptient, other professionals or

agencies not recmited as sentinels in the NIS design (e.g., physicians in private practice), and the general

public. The majority of these children (an estimated 295,700 children, or 1lY. of the Endangerment

Standard total) were repotied to CPS hy the general public.

Changes since the N%2 in Recognition Sources of Maltreatment under the

Endangerment Standard. The increase since the NIS2 in the overall incidence of maltreated children

who fit the Endmsgemrent Standmd criteria derived fmm significant increases in the recognition of these

children in law enforcement agencies, hospitals, schools, and mental health agencies and a marginal

increase in their recognition at day-care centers.

Figure 7–5 reveals that recognition by law enforcement of maltreatment as defined by the

Endangemrent Standmd more than doubled since the NI>2. Also evident here is the fact that essentially

no change occumed in recognition at juvenile probation or public health depatients.

Figure 7A illustrates the changes since the NIS–2 in the recognition of children whose

maltreatment fit the Endangerment Standard by noninvestigato~ study agencies. As was the case with

the Ham Standard, recognition of Endangerment Standwd maltreatment increased most dramatically in

schools. Given that schools had recognized almost one-half (48Y.) of the Endangerment Standard

children in the NIS2, the magnitude of the increased recognition in schools dwtis increases in other

study sources. Although smaller in absolute magnitude, relative increases in other categories are

notable: recognition in hospitals and day-care centers more than tripled, and it increased fivefold in

mental health agencies.

An ovewiew of the changes in patterns of recognition for Endangemrent Standard

maltreatment is offered in Figure 7–7. This graph reiterates the fact that there were no changes in the

recognition patterns among those sources that cmrtiibuted to the NIS estimates solely through their

repotis to CPS (e.g., private practice physicians, the general public, etc.). It also indicates the relative

impact of changes in recognition in the investigato~ and noninvestigato~ sectors of the study agencies.

The overwhelming influence of the increased recognition in schools is evident. In fact, at least 61

percent of the increase in incidence of children who were countable by the Endangemsent Standard

derives from children who were recognized as maltreated in schools.

7–12
4.5 -

4-

~ 3.5

:.

g3 -

~ 2.5 --

a

~ NIS-2

~

V2 -- ■ NIS-3

%

~ 1.5 -

z

1

Juvenile Police/Sheriff Wblic Health

hobation

Figure 7-5. Reco~ition of Chtltien Mo Flt the Engagement Stidwd

h Investigator Agencies in the NI%2 md the NI%3.

25

g. 20

k

15

1

han

Q ~,s.2

=

6

~ 10 ■ NIS-3

{

25

0 -.

Hospitals Schools Day-ewe Mentil Social

Centem Health Sewices

Figure 7+. Reco~ition of Chil&en MO Fit the Endmgement Stidad in Other

@oninvestigatoW) SWdy Agencies in the NI>2 md the NI>3.

7-13
35 1

a +

m❑ NIS-2

lnvestigato~ Other Smdy Other SOwces

Agencies Agencies (only through

CPS)

Figure 7–7, Reco~ition of Children MO Fit the Endmgement Stitid across

the Mati Categories of Sources h the NI%2 rmd the NI>3.

7.2 CPS Investigation of Abused and Neglected Children

As described in Chapter 2, the NIS design m~es it possible to discover which of the

cmmtsble children repofied to tie s~dy = smmrg those whose maltreatment was investigated by CPS.

Using that information, estimates crm be made of the numbers ad percentages of maltreated children

whose maltreatment receives attention in a CPS investigation. ~is section repofi these estimates for

both the Hm Stidmd and the Endangerment Stmrdmd srrd exsmines chmges since the NIS–1 srrd the

NIW2 in the distribution of the maltreated population who received CPS investigations.

For pu~oses of the srralyses repotied here, children who qualified m abused or neglected

under either the Hm or Endsrrgement S~dwd were classified according to whether or not their

maltreatment received attention in a CPS investigation. According to the criteria used here, tie only

children who were clmsified ss not having received CPS investigation for their maltreatment were those

who were clewly not alleged or indicated victims in CPS investigation= ither because they were not

listed at all in my CPS investigation or because, although they were listed, the investigation record

7-14
clearly omitted any mention of their countable maltreatment.g Note that this strategy takes the

conservative approach of assuming that a child received CPS investigation for his or her maltreatment

whenever complete information on this question was unavailable,9

Readers should bear in mind that children whose maltreatment does not receive CPS

attention in an investigation represent an enigma to the study: it is not possible to determine the reason

they were not investigated. mat is, the NIS methodology only provides su~cient information to

conclude that they were not among the children investigated by CPS (or that they were merely listed as

uninvolved children during a CPS investigation of their family). me irrrormarion gatheredfor the sr@

does not address whether a child wa not investigated by CPS became no one reported the chiId as a

suspected victim or becawe CPS screened out the child’s cme prior to investigation, For this reason,

this repon does not use the phrase “reporting rate; but instead refers simply to “CPS investigation” of

the children. 10 ~is ambiguity was the motivation for two of the special NI%3 stsbstudies, the results of

which are described in independent reports, aa mentioned in the concluding chapter,

7.2.1 CPS Investigation of Children Maltreated under the Harm Standard

Figure 7–8 graphs the overall incidence of children whose maltreatment fit the definitions

under the Harm Standard in each of the three national incidence studies, showing the percentage of

children in each study whose maltreatment was investigated by CPS.

‘ Note that this classification nde was actually slightly more lenient thm the nde used in the NI%2. In order to clmsi~ a child

as having received CPS investigation for mattreaunent the N1S2, it W= necessary for a child to have hem clewly m alleged

or indicated victim or for the CPS investigation record to have described his or her countible mattreatient. In the NIS3, in

order to be clmsified as having received CPS investigation, whether or not a child wbo w% listed i“ a CPS investigation W=

m indicated victim could be unkno~. This slightly mom lenient approach was tien because it made a slightly greater

difference here in the NIY3, where there we~ more cases missing i“fomatio” abO”t indicated victim status, wherein its ~ffect

in the NI%2 would have been so small as to be undetectable.

9 AISOnote that this mle is broadly inclusive in that it cl~sifies a child as having received CPS attention for countable

maltreatment even in those c~es where the investigation focused on a different maltreatment allegation md even when the

maltieatient the investigation had focused on W= concluded to be unfounded.

10The NIS–I repO* did “se tie phr~e “rePotii”g rate,,, b“t that is misleding for the re=ons discussed here. me N1%2 rePOrtS

attempted to clmify this by variously refeming to ‘-CPS awmness” of the childKn, or to child.en who we~ “officially known

to CPS,” but those labels could have been misinte~~ed to refer to all reponed cses, whether or not CPS acwpted them for

investigation. The current stidy preferred the phrme “CPS investigation” because it more clearly inticates that screened-out

cmes ~e not included, despite the fact that CPS had been made awxe of them to some extent. R=ders should note rha~ except

for the slightly greater leniency of the N1Y3 approach as described in foomote 8, all of these phmes opemtionally mem the

me thing in that they all refer to the conclusion of the sme classification role, described above (i.e., including atleged

victims, indicated victims, and those children whose countable maltieatient was described inthe CPS investigation record),

7-15
25 ~

20

15

!

10

5

!

m❑ Not repo-d, or repmted

■ Investigated by CPS

NIS-1 NIS-2 NIS-3

Figure 7–8. Chmges across the ~ee National Incidence Studies in the

Percentage of Chiltien WO Fit the Hm Stsndmd of ~ose

Investigatedby CPS.

me percen~ge of children maltreated under the Ham Stmrdad who receive CPS investigation of their

maltreatment has decreased from its level of 44 percent in the NI$2 to 28 percent

in the NI%3. ~is decreme is statistically significant. Note that the subtotil of children who m

investigated (given in this graph in tesms of the totil number per 1,000 children in the U.S. population)

h= remained at its N*2 level, while the totil population of children who fit the Hm Stidwd bm

increased. Also, despite the fact that CPS now investigates considerably more of these children than it

did in the Nf*l, the percentage of all children included under the Hm Stindmd who received CPS

investigation has declined to below the NfS-1 level of 33 percent (altbmrgb the difference be~een the

NIS–1 sssdN>3 percentages is not statistically significant). Clewly, CPS investigation hss not kept up

with the rise in the totil population of children who we maltreated as defined by the Hm Stmrdmd.

Again, this could be due to nonrepofiing by sources who encounter these children or instead due to CPS

screening out repofis on these children without investigation. Both the low penetration of CPS

investigation into this population and the enigma it represents to policymskers md sewice providers m

issues that will be discussed in this chapter’s conclusion.

7-16
CPS Investigation htes by Nature aud Severi~ of Maltreatment under the Harm Standard

Figure 7–9 subdivides the NIS–3 children who count under the Harm Standard based on the

natire and severity of their maltreatment. As with the maltreatment tabulations md graphs given in

earlier chapters, children are included in every maltreatment category that applied to them, but they are

classified into only one level of harm, based on their most serious injury from their countable

maltreatment. The figure excludes fatalities because their numbers were too small to be discerned on the

graph. The absolute sizes of the bars in the figure reflect the total number of children per 1,000 who

experienced the maltreatment or injury noted, The percentage witten on the right end of each bar

indicates the percentage of the bar that is situated on the right side of the graph, reflecting tie percentage

of children in the category whose maltreatment received attention in a CPS investigation.

In understanding this figure, readers should bear in mind that some of these children were

maltreated in multiple ways md that these children are included in every category that applied to them,

At the same time, the classification of children as having received CPS investigative attention was a

geneml, child-level conclusion, not specifically associated with any one category of the maltreatment

they experienced. This means, for example, that educationally neglected children who are classified as

having had their maltreatment investigated by CPS may have been multiply maltreated, and the CPS

investigation may have, in fact, focused on one of the other types of maltreatment they suffered, while

ignoring their educational neglect. Thus, the extent of CPS investigation for each maltreatment type has

been generously measured here, including children who received CPS investigation for something other

than the specific maltreatment in question, 1]

Nevertheless, despite this overstatement of CPS investigation, it is notably low throughout

all categories shown in the graph. As described above, among all children who experienced

maltreatment under tbe Harm Standard, 28 percent had their maltreatment reported to mrd investigated

by CPS. In none of the categories of maltreatment or levels of harm show in Figure 7–9 bad a majority

of the children received CPS investigation. The only catego~ in which a majority of the children did

have their maltreatment investigated by CPS were the fatalities (not shown), where 76 percent of

children maltreated as defined by the Harm Standard had their maltreatment repotied to and investigated

7-17

II

Moreover, the maltreatment that w= the focus of the CPS investigation need not ever have been countable under the study

definitions.
❑ Not reprtd, or re~rted but not investi~ted ■ Investigated by CPS

Nmber of Children Per 1,000

Figure 7–9. CPS Investigation of Children with Different TWes of Maltreatment uder the

H- Stidsrd snd Different Degrees of Inj~ or Hm.
by CPS. Those children who died as a result of Harm Standard maltreatment whom CPS did not

investigate were essentially of three types. One me were children whose fatalities were not referred for

CPS investigation by the police because there were no other children in their households. Since there

were no remaining children left to protect, their deaths were treated solely as police matters, and they did

not enter the CPS investigation caseload. A second type were cases where the police did not choose to

involve the CPS investigation process, even though there were other surviving children in the household,

In these cases, the remaining children were provided protective services through foster-care placement

made directly by dependency court. The third type were children whose families were already involved

with child welfare services in some manner. Some had had previous substantiated reports of

maltreatment and were receiving in-home services at the time of the fatality. For all three types, there

was no CPS investigation of the dead child’s maltreatment. Together, the three types were 24 percent of

the fatalities due to maltreatment that counted under the Harm Standard in the NIS3 estimates.

Returning to Figure 7–9, it is not surprising to see that a larger percentage of the abused

children than of the neglected children received CPS investigation (400/. versus 180/0). Also not

surprising is the relatively low percentage of emotionally abused children whose maltreatment was

investigated (210/0)in comparison to those who had been physically abused (48°/0) or sexually abused

(42%), and the extremely low percentage of educationally neglected children who received CPS

investigation (70A).

It is remarkable, however, that only mre-foufih of the children who were seriously harmed

by maltreatment had their maltreatment investigated by CPS. Further analyses may help to clarify what

type of maltreatment these children suffered and what sources recognized them as maltreated—factors

that might contribute to their unreasonably low rate of CPS investigation.

Chmrgea since the NI&2 in Mtes of CPS Investigation for Different Categories of

Maltreatment under the Harm Standard. Table 7–3 compares the percentages of different

maltreatment and outcome categories that were investigated by CPS in the NIS–3 with the analogous

percentages found in the NIS–2. As noted above, the percentage who received CPS investigation of all

children who counted under the Hamr Standard was significantly lower in the NIS–3 (where it was 28Y.)

than the NIS–2 level of 44 percent. Table 7–3 indicates that the decline in percentages of CPS

investigations occurred primarily among children who were abused. In the NI>2, CPS investigated a

7–19
Table 7–3. Chmges stice the NI>2 h Percen@ges of Chiltien Receiving

CPS Investigation,by Malmeamentunderthe Hm Stidud.

Hm Stid~d Malmea~ent NI%3 N1*2 Si~ificmce

CategnV 1993 1986 of Difference

ALLMALTREATMENT 28% 44% *

ASUSE:

All Abuw 40% 60% *

Physical Abuse 48% 62% m

Sexual Abuse 42% 72% *

Emotional Abuse 21% 44% ●

NEGLE~

All Neglect 18% 24V0 m

Physical Neglect 30% 38% ns

Emotional Neglect 18% 24% ns

Education Neglect 7% /5% m

SEVERITY OF R4JURY:

FaM 76% 70% ns

Serious 26% 38% tr

Modemte 26% 40% *

In femed 48% 73% m

, ~c tiffcrm= issitificm a orblow he F.05 1-!.

m ~e cliff-m isstatiticdly-w (i.e., .10?.05).

e ~e dfi-e is“01-@d, buttie- isa statisticalmd (,12?.10).

m ~c dffemnmisncitiersipifimt normtiti W, 12).

clea majority (600A)of the children who had suffered some fom of abuse under the Hm Standard,

whereas at the time of the NI$3, only 40 percent of the children wbo suffered abuse under the Hm

Starrdwd were receiving CPS investigation of their malheatment. Physically abused children were

mmginally less likely to receive CPS investigation at the time of tie NIS–3 (4gYo)than at the time of the

NIS–2 (62%). CPS investigations of sexual abuse defined under the Ham Stidard declined

significmtly fmm 72 percent in the NI%2 to 42. percent in the NIS–3. Children who had experienced

emotional abuse under the Hamr Stidmd were also sigtrificmtly less likely to receive CPS investigation

7–20
of their maltreatment in the NIS3 (where 21Yowere investigated) than in the NIS2 (where 44% had

been investigated).

The only category of outcome severity where the decline in the percentage of CPS

investigation was not statistically noteworthy was fatalities: children who had died as a result of

maltreatment that counted under the Harm Standard, Table 7–3 shows that the decrease in the

percentage of seriously injured children who were investigated hy CPS is a statistical ‘bend,” having just

missed the cutoff that has been used throughout this repofl for being classified as “marginal.” As seen

earlier in Chapter 3, the incidence rate for seriously injured children essentially quadrupled since the

NIS–2, rising from an estimated 2.2 children per 1,000 to 8,4 children per 1,000 in the intervening 7-year

period, During the same interval, CPS investigation of seriously injured children also rose, from 0.9

children per 1,000 to 2.1 children per 1,000. However, the rise in CPS investigation was not suficient to

keep pace with the rise in the overall rate, so the percentage of seriously injured children who received

CPS investigation of their serious injuries actually fell during this time interval, from 38 percent at the

time of the NI%2 to 26 percent when the NIS–3 was conducted. The decline in the percentage of

moderately injured children, from 40 percent in the NIS–2 to 26 percent in the NIS–3 was statistically

significant. The decrease in the percentage of children with inferred injuries under the Harm Standard

definitions was substantial, though statistically only marginal, from 73 percent to 48 percent.

CPS Investigation Mtes by the Source Recognizing Maltreatment under the Harm Standard

Children who qualified as abused or neglected as defined by the Harm Standard were

classified according to the source that recognized their maltreatment, according to the system described

in the previous section of this chapter. Table 7A provides the totals and rates per 1,000 in the

population of children who fit the Harm Standard according to their recognition source and according to

whether or not CPS investigated their maltreatment. The columns entitled “Investigated hy CPS” and

‘Not Investigated by CPS” total to the entry given earlier in Table 7–1 for the total recognized in the

NIS-3. Percentages of children countable by the Harm Standard whose maltreatment received attention

during CPS investigations were computed for each recognition source. These are given in the last

column in Table 74,

7–2 1
Table 74. CPS Investigation of NI~3 (1993) Chil&en MO Fit the

Hm Stidmd, According to Thek Reco~ition Sowce.

Investigated by CPS

Not Investigated by

Somce Reco~izhg CPS Percent

the Maltieament ‘a’e per Total ~0, of

Rate per Investigated

Toti No. of

Children

/,000 Children 1,000 by CPS

Children Chi/&en

Iwmtigato~ Agencies:

Juvenile Probation 6,300 0,I 30,300 0.5 I 7%

PolicdShetiff 50,300 0.7 6I,1OO 0.9 45%

Public HA* 700 0.0 26,900 04 3V.

Investigator Agency Subto@l: 57,300 0,9 118,300 1.8 33%

Other Sti~ Agemia:

Hospitis 45,600 0.7 67,600 1.0 40%

Schools 149,900 2.2 770,000 11.5 16%

Daycme Centem 2,400 0.0 57,300 0.9 4%

Menml Healti Agencies 19,700 0.3 31,200 0.5 39%

Social Scwice Agencies 24,100 0.4 71,900 1.I 25%

Other Stidy Agency SubtoM: 241,700 3.6 998,100 14.9 I9V0

All Smdy Non-CPS Sowces 299,000 4.5 1,116,500 16.6 21%

Otkr Sowca (onfy though CPV:

DSSWelfwe Depment I5,000 0.2 0 0.0 I00%

OtherProfessionalor Agency 7,000 0.1 0 0.0 100%

All Other Sources 116,400 1.7 0 0.0 I00Y.

Other (CPS-only ) Subtotil: 138,400 2.1 0 0.0 100%

ALL MALTMA~ENT 437,300 6.5 1,116,500 16.6 28%

NOW Estimtid mds w roundedto the newst 10% cstimakd mes me roundd to tie newt troth.

7–22
Figure 7–1Odepicts the pattern of CPS investigation rates across the three major categories

of recognition sources given in Table 74. Across the group of children who were recognized as

maltreated in investigatory agencies ~uvenile probation, police/sheriffs’ departments, public health

depurtrnenfi), one-third of the children had their maltreatment investigated by CPS. These agencies have

their own investigatory responsibilities that must sometimes be coordinated with those of CPS, a factor

that may dispose them to maintain a closer relationship with CPS in general. Despite this, it is

noteworthy that tw-thirds of the children are not investigated by CPS among those whom they

recognize as maltreated, whom they submit to the NIS because of this, and who me countable under the

Harm Standard.

20,

Investigator Orber Stidy Nomrudy

Agencies Agencies (CPS4nly)

Soumes

Figure 7-10. Percentages Investigated by CPS of ~ose Children MO Fit

the Harm Standard, Classified by the Main Category of ~eir

Recognition Source.

me second main category, termed “Wer Study Agencies,” comprises nmsinvestigatory

agencies that me represented among the NIS sentinels (hospitals, schools, day-care centers, mental health

agencies, and voluntary social service agencies). Less than one-fifih ( 19“/o)of the children whom they

recognized as maltreated and who fit the Harm Standard received CPS investigation of their

maltreatment. These services are, as a group, the predominant contributor to the recognition of children

7-23
counted in the Harm Standard in general, and this group also saw the vast majority of those who did not

receive investigation by CPS, a point that will be revisited below.

Finally, the children recognized by ‘Nmrstudy (CPS-mrly) Sources” universally received

CPS attention for their maltreatment. This is true by definition. Children who were recognized by these

sources could be found only in the CPS sector of the NIS–3 data, because the NIS did not recruit any

special nmr-CPS sentinels to represent these sources. Thus, these sources could only contribute

maltreated children to the study who were investigated by CPS. Note that the rates of CPS investigation

presented in the preceding sections all included the children seen by these “CPS-only” sources. Because

of that, these rates all are inflated so they overstate the rate of CPS investigation to some degree. Also

note that a further implication of this is that the NIS estimates of the incidence of abused and neglected

children in the United States are underestimates. There is yet another pati of the “iceberg” of children

not investigated by CPS who are not addressed in the NIS, and therefore not represented in any of the

tables or figures presented in this report (i.e., children who are countable under the study definitions and

are recognized by professionals in private practice or by the general public but who are not investigated

by CPS)

Returning to Table 74 for more detailed infomatiorr, observe the CPS investigation rates

for children recognized by the different sources within the investigato~ agency sector—juvenile

probation, policelsheriffs’, and public health departments. One of the su~rising features is how low the

percentages of CPS investigation were for children fitting the Harm Standard who were recognized hy

juvenile probation and public health departments (17% and 3Y0, respectively). It was only among

children recognized at law enforcement agencies (municipal police and sheriffs’ depafiments) that a

substantial minority (450A)received official attention from CPS for their maltreatment.

The second section of Table 74 shows the percentages of children who received CPS

investigation from among the total set of those who were recognized as maltreated at nmrinvestigatory

agencies included in the MS sentinel design whose maltreatment fit the Harm Standard definition.

Hospitals and mental health agencies had the highest rates of CPS investigation for the children they

recognized (40Y0and 390A,respectively), but note that even in these source categories, only minorities of

children received CPS investigative attention. Social service agencies ranked third in this sector, with

one-fourth of the children maltreated under the Harm Standard whom they recognized investigated by

CPS. Children who counted under the Harm Standard and who were recognized by staff at schools were

ve~ unlikely to receive CPS attention for their maltreatment (only 16°Adid so). However, given that

7–24
schools make such a substantial cmrtiibutimr to the recognition of children whose maltreatment fit the

Harm Standard, even this ve~ low percentage reflected the largest voup of CPS-investigated children

from any single recognition source. (See below.) Finally, day-cae centers bad by far the lowest rate of

CPS investigation for the children they recognized, only four percent of whom received CPS attention

for their maltreatment.

Figure 7–11 shows therelative conkibutions of thedifferent recognition sources to the set

ofchildren cmmtahleundertheHam Standard whose maltreatment wasinvestigated by CPS. This isa

graph of the breddown shown earlier in Table 74intie column entitled ``Investigated by CPS,'' In

cmrtmst, Figure 7–12 shows the relative prevalence of children recognized by different sources among

those who did not have their maltreatment investigated by CPS (i.e., the “Not Investigated by CPS”

column in Table 74).

The predominance of schools as a recognition source of children countable under the Ham

Standard is seen in both figures. Children recognized at schools account for about one-third of these

countable children whose maltreatment was investigated by CPS, and more than two-thirds of these

children who did not receive CPS investigation. The general public was a relatively large contributor to

children who were investigated at CPS, accounting for27percent of thechildren countiblebythe Hm

Standard whoreceived that attentimr. Lawenforcement agencies and hospitals contributed 12 percent

and 10 percent, respectively, to the group whom CPS investigated. Social sewice and mental health

agencies were the recognition sources for six percent and five percent of these children, respectively.

Other recognition sources cmrtibuted three percent orlessto the total of children countable under the

Hamr Standmd wbo received CPS attention.

Considering the ovemhelming predominance of schools as the source ofrecognitimr for

children whose maltreatment was not investigated by CPS, cmrtiibutimrs from all other sources appear

meager by compmison. Hospitals and social sewice agencies each accounted for six percent of this

group, with law enforcement agencies and day-cme centers each recognizing five percent of these

children. Ohersources recognized three percent orlessofthe children inthiscatego~.

7-25
Nonstudy

professional

agency

Juvenile Probation

Day-care

Centers

0

ental Health

34%

Fi~e 7-11. Recognition Sources of Children ~o Were Maltreatd uder tie Harnr Standard Deffitiom

~o Received CPS hvestigation.
I Juvenile Probation

care Centers

ental Health

‘g%i ... /

Figure 7-12. Recognition Sources of Children Who Were Mdtratd under the Ha Standard Deftitions

~o Were~fnvestigated by CPS.
Changes since the NIS2 in -tes of CPS Investigation of Children Who Fit the Harm

Standard Recognized hy Different Sources. The percentages of children recognized by each source in

tbe NIS-3 who fittbe Hm Starrdmd and were investigated byCPS were compared to the analogous

percentages in the NI>2 and the NI%l. Note that these are the same N1&3 percentages that are given

above in Table 74.

Table 7–5 indicates that the significant drop since the NI%2 in CPS investigation rates for

overall maltieatrnent under the Harm Starrdwd held tme for both the main categories of “Investigato~

Agencies” and “Other Study Agencies.’” 1 In the NIS–2, 52 percent of children who were recognized by

investigatory agencies and fit the Harm Standard had their maltreatment investigated by CPS, whereas

only 33 percent of this sector received CPS investigation in the NIS-3. The nmrinvestigatov agencies

represented by NIS sentinels also evidenced a significant reduction in rates of CPS investigation, from 35

percent in the NIS–2 to21 percent in the NI%3.

Within ~ese main agency categories, there was a decline in the rates of CPS investigation

for the children recognized at eve~ specific type of agency, but the decline was statistically reliable in

only @o specific agency types: police/sheriffs’ dep~ents and hospitals. In the NIS–2, children

maltreated under the Hams Standard who were recognized at law enforcement agencies were very likely

to receive CPS investigation of their maltiatment (78Yo),whereas in the NI*3, only a minority of these

children received CPS investigation (450A). The same was tme for hospitals, where the CPS

investigation rate dropped precipitously from 100 percent in the NIS–2 to 40 percent in tbe NIS–3.

The last column in Table 7–5 compares tbe NIS–3 rates of CPS investigation of the

children countable under the Harm Standard with the analogous rates found in the NI*I. One of the

remarkable featires of these comparisons is how little difference there is between the NIS–3 and the

NIS–1 percentages. Statistically notewofihy differences emerged only for children recognized by public

health depatiments arrd by hospital-and in both cases the NI%3 rates were lower than those in the

NIS–1.

II Note that children recognized by sources in the “Other (CPS-only~ ~tegoV we, by definition, always 100-percent

investigated by CPS, as discussed earlier.

7–28
7.2.2 CPS Investigation of Children Maltreated under the Endangerment Standard

Figure 7-13 presents the overall incidence of children who wers maltreated under the

Endangerment Standwd in the N1%2 and the NIS3, indicating the percentages of these children who

had their maltiatment investigated by CPS.

TAle 7-5. Changessincethe NI$2 and NIS1 h Percentages of Children Countable

under tie Hsms Stidwd Mo Received CPS Investigation, by Their

Recognition Source.

Sowce Reco@izing tie Maltreatment

NIS3 NIS2 NISI

1993 1986 1980

lw~tigalo~ Agencies:

Juvenile Probation 17V0 23% ns 24% ns

PolicdSberiff 45?0 78% ● 42°A ns

Public Health 3% 26Y. ns 26% ●

Investigator Agency S“bioml: 33V. 52% ● 33V0 ns

Other Stu~ Agencies:

Hmpihls 407. IOov. ● 56% m

Schools 16% 26Y. ns 13°A ns

Day-c= Centers 40A 17% ns

Mental Health Agencies 39% g2V0 ns 31V0 ns

Social SeNice Agencies 25% 29% M 31% ns

Other Smdy Agency Subtohl: 19Y. 31% m 19A ns

All Smdy Non-CPS Sources 21Y. 35% ● 21% m

Other (CPS-only) Subtoml: IOOY. 100% ns 100VO m

ALL MALTMATMENT 2gv. 44QA ● 33°A ns

● me Nl~3 cstimti dtffcm si~ifiwdy from &is alicr stime (i.e., pc.05).

m Tbe NIS3 estimatediffemm~indly fromhis wlicr ~timx (i.e., .lO>p>.05),

“s TheditTerenwkws. fbismd theNI%3 =Iimak is netier significmt “or mmgi”d (p>.10).

7-29
45 T

40

35

30 !

NIS-2

Figure 7-13.

m❑ Not repotied,or repertied

NIS-3

Chaoges horn the N1%2 to tie NI%3 in the Percentage of

Children Investigatedby CPS of~ose MO Fit the

Endmgemrent Stand~d.

The incidence of children whose maltreatment was investigated by CPS actually rose

slightly, from 11.6 children per 1,000 to 13.7 children per 1,000, a statistically mwginal increace.

However, that increaae was not sufficient to address the concomitit rise in the total numbers of children

who were countable under the Endmgement Stmrdwd, so the percentage investigated in fact decreaaed.

me decrease from 51 percent investigated in the NIS–2 to 33 percent investigated in the NI%3 is

statistically significmt.

CPS Investigation ~tes by Nature and Severity of Maltreatment under the Endangerment

Standard

me children who experienced maltreatment at the time of the NI%3 under the

Endmrgement Stidmd me chtied in Figure 7–14 according to the nature and severity of their

maltreatment md according to whether CPS investigated their maltreatment. As waa the case with

7–30
Figure 7–9 above, fatalities are excluded here because the scale of this graph is ton large to convey the

size and component makeup of this group. Similar to Figure 7–9, the sizes of the bars in Figure 7–14

reflect the total number of children per 1,000 who experienced the maltreatment or injury in question,

and the percentage mitten at the right end of each bar indicates the percentage of children in the category

whose maltreatment received CPS investigation.

Again, one of the most striking aspects of the findings is the uniformly low rate of CPS

investigation for all the abused and neglected children. Only among fatalities (excluded from the graph

for the reason given above) did CPS investigate a majority of the children (77Yo). In each catego~

graphed in Figure 7–14, CPS investigated the malheatment of only a minority of the children.

As was the case with the Harm Standard, for the Endangerment Standard, the rate of

investigation of the abused children is higher than that of the neglected children (39Y0versus 280A),,

Within the abused sector, children who experienced physical or sexual abuse were more likely to have

their maltreatment investigated (45”Aand 44Y0,respectively) than those who were emotionally abused

(28%). Among neglected children, those who were physically neglected were more likely to receive

CPS investigation (35Yo)than those who were emotionally neglected (21Y.). The criteria for educational

neglect is the same under both definitional standards, so the educationally neglected children graphed in

Figure 7–14 are identical to those graphed earlier in Figure 7–9, Note tha~ in comparison to all the

maltreated children under botb standards, the educationally neglected children are the least likely to

receive CPS investigation of their maltreatment (only 7Y. were among children whose maltreatment

received CPS attention).

As described in Chapter 3, 99 percent of the seriously injured children under the

Endangerment Standard were also countable as seriously injured under the Harm Standard. Thus, the

discussion above concerning the low rates of CPS investigation for seriously injured children under the

Harm Standard is applicable here as well and will not be repeated in this section.

Changes since the N3%2 in ~tes of CPS Investigation for Different CatWories of

Maltreatment under the Endangerment Standard. In Table 7+, the MS–3 CPS investigation rates

for different maltreatment categories are compared with those found in the earlier NI~2. The first row

in this table records the significant drop obsewed in Figure 7–13 above, from 51 percent to 33 percent, in

the overall maltreatment category.

7-31
❑ Not repotied, or reported but not investigated ■ Investigated by CPS

1

All Abused p:iF’:Jk:3.’iiJi’?$iJ:’’!’i?:i:2*:3$~$~ 39~0

Physical w

s Sexual

3 Emotional

28%

b Physical

u

w

~ Emotional

Number of Children Per 1,000

Figure 7–14. CPS Investigation of Children With Different Types of Maltreatment under the

Endangerment Standwd snd Different Degrees of Injury or Harm.
Table 7+. Chmges sfice the NI$2 irrPercentages of Chiltien

Receiviog CPS Investigation by Maltieahent

under tie Endmgemrent S~dad.

Endmgerrrrent Staodmd N1~3 NI%2 Si~ificsrrce

Malmeahent Catego~ 1993 1986 of Diffe~nce

ALL MALTREA~ENT 33% 51% ●

~USE:

All Abme 39% 63% ●

Physical Abuse 45% 64% ●

Sexml Abuse 44% 75% *

Emotional Abuse 28% 51% *

NEGLE~

All Neglect 28% 44% ●

Physical Neglect 35% 57% ●

Emotional Neglect 22% 40% ●

Educational Neglect 7% 15% m

SEVERtTYOFrNJURY:

Faml 77% 70% ns

SeriOm 26% 40% m

Modemte 26% 43% ●

Infemed 46% 65% m

Endmgered 40% 79% .

, ~. dff- u simmt * m k!w h 6.05 lwcI.

m n. dff- u tiddy & (i.e.,,1OW,O5),

w ~e tiK_e u neihmti~ifiwt nor-w w. 12).

In corrtmst to the situation obsewed above in connection with the Hm Strrndmd, where the

decline in rates of CPS investigation wu predominantly in the abuse categories, CPS investigation rates

of children whose maltrea~ent fit the Endmgement Stidwd have dropped in all maltreatment

categories md all levels of outcome except facilities. In the NI$2, CPS investigated a majority of the

children in all categories of abuse, but in the NIS–3, there wm no category of abused children where the

majority received CPS investigation of their maltreatment. The rate of investigation of physically abused

7–33
children dropped by 19 percent, the CPS investigation rate of sexually abused children dropped by 31

percent, and the investigation rate of emotional abuse declined by 23 percent from its NIS–2 level.

Neglect had been relatively less likely than abuse to receive CPS investigation at the time

of the NI%2, but even there, CPS investigation rates decreased in all categories. There was a 22-percent

drop in CPS investigation of physically neglected children. Emotionally neglected children saw a

decline of 18 percent in their investigation rate. Even educational neglect, which had been extremely

low to begin with, dropped even lower by eight percent—a difference that proved statistically marginal

despite its relatively small size.

me category of fatal injuries stands out as a notable exception, even etiibiting an increase

in its rate of investigation over the interim between studies, albeit not a statistically reliable increase

because of the comparative lack of precision on such small estimates. Nevertheless, CPS investigation

of seriously injured children declined by 14 percent. Moderately injured children saw a drop in their

investigation rate of 17 percent. The rate of CPS investigation dropped by 19 percent for children whose

maltreatment was sufficiently severe to warrant the inference that they must have been injured in some

manner, and children who had been endangered but not yet harmed by maltreatment experienced a 39-

percent reduction in their CPS investigation rate.

CPS Investigation Rates by the Source Recogntilng Maltreatment under the Endangerment

Standard

Children who were defined as maltreated using the Endangerment Standard were

categorized by both their recognition source and by whether or not CPS had investigated their

maltreatment. The estimated totals and rates per 1,000 for these children are given in Table 7–7,

according to both the source who recognized their maltreatment and according to whether or not CPS

investigated their maltreatment. The columns reflecting totals and rates investigated and not investigated

by CPS sum to the total of all children recognized by the source, given emlier in Table 7–2.

7–34

The rates of CPS investigation for the three main categories of recognition sources are

given in Figure 7–15. Considering children whose maltreatment was recognized by staff in investigatory

agencies ~uvenile probation, policelsheriffs’ departments, public health departments), 42 percent

received CPS investigation. Among children recognized by noninvestigatory agencies represented in the
Table 7-7, CPS Investigation of NI>3 (1993) Cbil&en MO Fit tbe Endmgement Stidmd,

According to Their Recogttition Sowce.

Investigated by CPS Not Investigated by

Sowce Reco~izing CPS Percent

tie Malmea~ent

TOUNo, of ‘~:; TotiNo. .’ ‘~:~ ‘n:~;d

Chil&cn

Children Children

Children

lmestigato~ Agenci~:

Juvenile Probation 12,000 0.2 41,300 0.6 23V0

PolicdSheriff I 40,900 2.I I3I,1OO 2.0 52%

Public Health 2,000 0.0 45,100 0.7 4%

lnvestigato~ Agency S“btoti: I 54,900 2.3 217,500 3.2 42%

Other Stu@ Agencies:

Hospimls 83,900 1.2 97,400 1.5 46%

Schools 246,100 3.7 1,2U,600 18.8 16%

DaYcwe Centers 3,8oo 0.1 134,300 2.0 3%

Mentil Health Agencies 40,600 0.6 57,200 0.9 42%

Social Sewice Agencies 57,000 0.8 117,600 1.8 33Y.

Other Study Agency Subtotil: 431,400 6.4 1,671,100 24.9 21%

All Stidy Non-CPS Sources: 586,300 8.7 1,888,600 28.1 24V0

Other Sources (onJythrough CP~:

DSS/Welf~ Deptiment 32,2oo 0.5 0 0.0 100Y.

Other Professional or Agency 12,900 0.2 0 0.0 100Y.

All Other Sources 295,700 4.4 0 0.0 100%

Other (CPS-only ) Subtotil: 340,800 5,1 0 0.0 1o@A

ALL ~LTREATMENT 927,000 f3.8 1,888,600 28.1 33Y.

Note: Estimamdtomlsa m“nded 10the nemest IOR estimtid raws a rou”dti to the n~l Wnth.

7–35
35 T

H

❑ Not repofied, or repo~d

, IOWA

lnvestigato~ Otier Stidy Nonstudy

Agencies Agencies (CPS-Only)

Sourms

Figure 7–15, Percentages of Chilhn Investigated by CPS of nose

MO Fit the Endmgement Stidwd, Cl=sified by

the MainCatego~ of ~eir Reco@itionSowce.

NS (hospitals, schools, day-ewe centem, mental health agencies, md volun~ social sewice agencies),

just over one-fifi (21%) had their maltreatment investigated by CPS. As noted above, those children

who came into the NIS through CPS-only sources were investigated by CPS by definition, so that group

is shown with a 100-percent investigation rate. Also discussed above was the fact that the inclusion of

this sector in the CPS investigation rates, overall and by maltreatment catego~, provides rm overly

positive pictire of the extent of CPS investigation of countable maltreated children. Subsequent mralyses

should be undetien with this group excluded, in order to provide a noninflated estimate of the rate of

CPS investigation of the maltreated child population.

Among children maltreated under the Endarrgement Standmd who we recognimd by

sources in the investigatory agency sector, the group that comes to the attention of law enfomement

agencies is the only woup where the majority of the abused and neglected children (S2YO) receive CPS

investigation for their maltreatment. Much lower rates of CPS investigation occur for those children

recoqized by juvenile probation arrd public health dep~ents (23YDand 4Y0,respectively), a fact that

echoes the findings described above in connection with the Hamr Stsndmd children.

7–36
There is a relatively wide range in the rates of CPS investigation for those children whose

maltreatment was recognized by sentinels at noninvestigatory study agencies, but in each category only a

minority of the children received investigation. Mirroring the findings described above in connection

with Harm Standard maltreatment, hospitals and mentil health agencies had the highest rates of CPS

investigation in this sector of recognition sources, 46 percent and 42 percent respectively, while social

sewice agencies ranked third, with 33 percent of the children they recognized receiving CPS

investigation of their maltreatment. Note that for children recognized at schools, exactly the same

percentage received CPS investigation here (16%) as was obsewed for the children countable under tbe

Harm Starrdard+espite the fact that school staff recognized 64 percent more children who counted

under the Endangerment Standard than under the Harm Standard. Children recognized by day-care

centers were very unlikely to receive CPS investigation of their maltreatment (only 3% here), another

aspect of this pattern that follows the Harm Standard picture quite closely.

The relative contributions of the various recognition sources to the total of children

countable by the Endangerment Standard who received CPS investigations are graphed in Figure 7–I 6,

A comparable chart showing the recognition sources for those children who did not receive CPS

investigation is given in Figure 7–17.

One of the most remarkable features of these figures is their close resemblance to Figures

7–1 1 and 7–12, given earlier, which depict tbe mtalagous distributions for children whose maltreatment

fit the Harm Standard. The crucial role of schools in recognizing both sets of children is evident.

Children whose maltreatment was recognized at schools account for more than one-fourth (27%) of the

childre]) maltreated under the Endangerment Standard who are investigated by CPS and two-thirds (670A)

of those who are not. The general public accounts for almost one-third (320/o)of the set of children under

the Endangerment Standard whose maltreatment received CPS attention, Law enforcement agencies and

hospitals recognized 15 percent and 9 percent of the investigated children. Social sewice and mental

health agencies were the sources of recognition for six percent and four percent, respectively, of the

CPS-investigated children, Other types of sources (nonstudy professionals, other branches of the

department of social sewiceslwelfare) each contributed only three percent or less to the children with

CPS investigation.13

13 ~bli~ heal~ ~d day.cwc contibute so little that their percents would be indiscernible on tiiS gyh, S0 theY have been

excluded.

7–37
Juvenile Probation

1%. /

Nonstudy

professional or

agency

F

1%

\ Mental

3%

Health

~,,,w=ljare~

27%

FiWre 7-16. Recognition Sources of Ctildren ~o Were Maltreated uder tie Endangerment Standard

~o Received CPS Investigation.
Juvenile Probation Public Health

Mental Health

Figure 7-17. Recognition Sources of Children Who Were Maltreated under tie Endangerment Standard

Who Were investigated by CPS,
In Figure 7-17, the involvement of communi~ professionals at schools in recognizing the

abused and neglected children dwarfs that of all other sources combined. School professionals see 67

percent of those children countable under the Endangerment Standard who do not receive CPS

investigation of their maltreatment, which is more than @ice the combined total of children seen by all

other sources. bw enforcement and day-care center staff each account for seven percent of the

uninvestigated children, voluntary social services provide six percent, and hospitals contribute five

percent. Other sources (mental health agencies and juvenile probation departments) recognize three

percent or less of the uninvestigated sector.

Changes since the N*2 in Rata of CPS Investigation of Children Who Rt the

Endangerment Standard Recognbed by Different Sources. In Table 7–8, the percentages of children

maltreated under the Endangerment Standard recognized by each source whose maltiatnrent was

investigated by CPS are compared to the corresponding percentages found in the earlier NI%2. me

overall patterns revealed in this table are very similar to those presented earlier in connection with

children who were countable under the Harm Standard in Table 7–5. Decreases in the percentages of

CPS investigation were found for all specific recognition sources, but only police and hospitals

evidenced a significant drop in the percentage ‘ofCPS investigation of the children they recognized.

7.3 Key Findings and Implications of Patterns of Recognition and Inveatigatimr

One of the most striking features of the findings presented in this chapter is the

overwhelming predominance of schools as a recognition source of maltreated children. School sentinels

recognized 59 percent of the children who suffered maltreatment under the Harm Standard and 54

percent of the total counted under the Endangerment Standard. Other important sources of abused and

neglected children were hospitals, police departments, social service agencies and the general public.

For Endangerment Standard maltreatment, day-care centers also joined in the group of agency categories

that encountered more thmr 100,000 abused and neglected children.

740
Table 7+. Chmges since the N1S2 ti Percenhges of Childen Commble

uder the Endmgement Stidmd MO Received CPS Investigation,

by Tbeti Recognition Sowce.

Sowce Reco~izing the Maltiea~ent

NIS3 NI*2

1993 1986

Im~tigato~ Agencia:

Juvenile Probation 23% 26% ~S

PolicdSberiff 52% 96% ●

Public Haiti 4% 24% ns

Investigator Agency Subtoml: 42% @% ●

Other Stu+ Agencies:

Hospi@ls 46% IO@% *

Schools 16% 25Y* ns

Day-cue Centem 3% 117. ns

Menwl Health Agencies 42% 80% ns

Social Sewice Agencies 33% 35% ns

Other Study Agency Subtoti: 21% 31% ns

All Smdy Non-CPS Sources: 24% 38% m

Other (CPS-only ) Subtoml: IO@% 100% ns

ALL MALTWATMENT 33% 51% *

● ~e NI*2 md NIS3 estimtis difler si~ificmdy (i.e., p<.05),

m ~e N1%2 md NIS3 cstimaks differ mqi”d!y ~.e.,. 10>p>.05).

ns ~e N1>2 md NI&3 =timtis do not tiffm (p>, 10).

741
Changes since the earlier incidence studies in what are here called “recognition rates” may

reflect changes in the rates at which maltreated children are identified or encountered. Using this

terminology, one sees that hospitals more than tripled the rate at which they recognized maltreated

children since the NIS–2. Mental health agencies quadrupled their rate of recognition of children whose

maltreatment fit the Harm Standard and increased their recognition fivefold of children who fit the

Endangerment Standard. Schools more than doubled their rate of recognition of children countable by

the Endangerment Standard, which included a 70-percent increase in their recognition rate for the sector

who counted under the Harm Standard. Recognition of children maltreated under the Endangemrent

Standard more than doubled in law enforcement agencies. Interestingly, there were no changes in the

contributions of sources that are only tapped in the NIS through their reports to CPS (e.g., private

physicians, the general public). ~is last finding probably reflects the relatively stable level of CPS

involvement with the abused and neglected children countable in the NIS over the time period, which is

discussed below,

me relatively low percentages of abused and neglected children whose maltreatment

receives CPS investigation are cause for serious concern. me NIS–3 found that only a minority of

abused and neglected children, by either definitional standard, received CPS attention for their

maltreatment. CPS investigated the maltreatment of only 28 percent of children who were countable

under the Harm Standard and of only 33 percent of the children whose maltreatment fit the

Endangerment Standard. Moreover, percentages reflected less than one-half of the maltreated children in

all categories of maltreatment except fatalities, and very generally across nearly all sources of

recognition (except that a majority of children who fit the Endangerment Standard and were recognized

by police received CPS investigation). Especially remarkable was the finding that CPS investigation

extended to only slightly more than mre-fourth of the children who were seriously harmed or injured by

abuse or neglect. As revisited in the next chapter, this fact raises questions about the need for better

targeting, whether by repofiers in referring children to CPS, by CPS screening practices in connection

with reports, or by both.

Another important finding was that the percentages of maltreated children who receive CPS

investigation have decreased significantly since the NIS–2, fie percentage of children countable under

the Harm Standard receiving CPS investigation dropped from 44 percent to 28 percent, while the

percentage of CPS investigation of the children countable under the Endangerment Standard fell from 5I

percent to 33 percent. me decline was significant in law enforcement agencies and hospitals, but it cut

across every type of recognition source, and it affected abuse as defined by the Harm Standard, all

742
categories of maltreatment as defined by the Endangerment Standard, and all levels of outcomes except

fatalities. At the same time, the actual numbers of countable children investigated by CPS remained

stable (when considering Harm Standard totals) or even slightly increased (considering the

Endangerment Standmd totals). Thus, as the total number of maltreated children has risen, it means that

a larger percentage of these children have not had access to CPS investigation of their maltreatment.

This picture suggests that the CPS system has reached its capaci~ to respond to the maltreated child

population.

It is important to reiterate a point made earlier in this chapter abOut the limitations of the

NIS information: the NIS data concerning CPS investigation speaks only to the end-result of a number

of processes and do not reveal any details concerning these processes themselves. That is, tbe low

percentages of CPS investigation might be due to low percentages of refemal to CPS by the community

professionals who recognize the children as abused or neglected, due to low percentages of acceptance

for CPS investigation afier a report is received, or due to some combination of both dynamics.

743
This final chapter summarizes the Third National Incidence Study of Child Abuse and

Neglect @IS–3), It gives a synopsis of the study’s background and objectives, its design and methods,

and its key findings and implications,

8.1 Bae@rmrnd and Objectives

The National Incidence Study @IS) is a congressionally mandated, periodic effort of the

National Center on Child Abuse and Neglect @CCAN). The first NIS ~IS–1 ), mandated under P.L.

93-247 (1974), was conducted in 1979 and 1980 and published in 1981, The second NIS @lS-2),

mandated under P.L. 98457 (1984), was conducted in 1986 and 1987 and published in 1988. The third

NIS @IS–3) was mandated under P,L. 10W294 (as amended). The NIS–3 data were collected in 1993

and 1994, analyses conducted in 1995 and 1996, and these results published in 1996, A key objective of

the NIS–3 was to provide updated estimates of the incidence of child abuse and neglect in the United

Statea and measure changes in incidence from the earlier studies,

8.2 Design and Methnds

The NIS–3 offers an important perspective on the scope of child abuse and neglect, The

NIS includes children who were investigated by child protective service (CPS) agencies, but it also

obtains data on children seen by community professionals who were not reported to CPS or who were

screened out by CPS without investigation. This means that the NIS estimates provide a more

comprehensive measure of the scope of child abuse and neglect known to community professionals,

including both abused and neglected children who are in the official statistics and those who are not. The

NIS follows a nationally representative design, which means that the estimates represent the numbers of

abused and neglected children in the United States who come to the attention of community

professionals. The fact that there have been three similar national incidence studies that have used

comparable methods and definitions means that one can compare NIS–3 estimates with those from the

earlier studies in order to identi~ any changes over time in the incidence and distribution of abused and

neglected children,

8-1
The NIS–3 was conducted in a nationally representative sample of 42 counties. In every

county, the CPS agency was a key participarrt, providing basic demographic data on all the children who

were reported and accepted for investigation during the 3-month study data period, September 5 through

December 4, 1993. Further details about the child’s maltreatment and tbe outcome of the CPS

investigation were obtained for a representative sample of these cases.

Like the NI>l and NI%2 before it, the NIS–3 employed a sentinel suwey methodology, in

which communi~ professionals seining children and families in various categories of non-CPS agencies

were also recruited into the study. In each county, these sentinels were a representative sample of all

professional staff who were likely to come into contact with maltreated children in police and sheriffs’

departments, public schools, day-care centers, hospitals, voluntary social sewice agencies, mental health

agencies, and the county juvenile probation and public health departments. The patiicipating sentinels in

the NI%3 were 5,612 professionals in 800 nmr-CPS agencies who remained on the lookout for

maltreated children during the study period, They were trained in the starrdard NIS definitions of abuse

and neglect at the outset, and they submitted data forms on any children they encountered who were

maltreated during the study data period. The NIS–3 collected a total of 50,729 data forms: 4,711 from

non-CPS sentinels; 3,154 on the investigation outcomes and the abuse and neglect involved in cases

sampled at participating CPS agencies; and 42,864 capturing the basic demographic data on all cases

reported to ptiicipating CPS agencies during the study period.

Children who were submitted to the study by nmr-CPS sentinels and those who were

investigated in the CPS sampled cases were evaluated according to standard study definitions of abuse

and neglect, and only children who fit the stidards were used in generating the national estimates. The

definitional standards used in the NIS–3 were identical to those used in the NIS–2. These standards

imposed a number of requirements, including the restriction that the abuse or neglect be within the

jurisdiction of CPS (i.e., perpetrated or permitted by a parent or caretaker), and they applied uniform

classification systems to index the type of maltreatment and the severity and type of injury or harm.

Two sets of definitional standards were applied: the Harm Standard and the Endarsgerrnent

Standard. The Harm Standard was developed for the NIS–I, and it has been used in all three national

incidence Stidies. It is relatively stringent in that it generally requires that an act or omission result in

demonstrable harm in order to be classified as abuse or neglect. Exceptions are made in only a few

categories where the nature of the maltreatment itself is so egregious that the standard permits harm to be

inferred when direct evidence of it is not available. The chief advantage of the Harm Standard is that it
is strongly objective in character. Its principal disadvantage is that it is so stringent that it provides a

view of abuse and neglect that is too narrow for many purposes, excluding even many children whose

maltreatment is substantiated or indicated as abuse or neglect by CPS.

To meet the need to include the full set of substantiatedindicated children in tbe incidence

statistics, the Endangerment Standard was developed as a definitional standard during the NI%2 to

supplement the perspective provided by the Harm Standard. me Endangerment Standard ;nc/udes all

chiltiren who meet the Harm Standard but adds others as well. The central feature of the Endangerment

Standard is that it allows children who were not yet harmed by maltreatment to be counted in the abused

and neglected estimates if a non-CPS sentinel considered them to be endangered by maltreatment or if

their maltreatment was substantiated or indicated in a CPS investigation. In addition, the Endangerment

Standard is slightly more lenient than the Harm Standard concerning the identity of allowable

perpetrators in that it includes maltreatment by adult caretakers other than parents in certain categories as

well as sexual abuse perpetrated by teenage caretakers, The Endangerment Standard was used in both

the NIS–2 and the NIS–3.

Duplicate forms about the same child were identified and unduplicated, so that each child

was included in the database only once, Finally, the data were weighted to represent the total number of

children maltreated in the United States and annualized to transform the information from the 3-mmrth

data period into estimates reflecting a full year.

8.3 The National Incidence of Child Abuse and Neglect

The findings of the Third National Incidence Study of Child Abuse and Neglect @I>3)

show a sharp increase in the scope of the problem, whether maltreatment is defined using the Harm

Standard or the Endangerment Standard.

Estimated Incidence As Defined by the Harm Standard. An estimated 1,553,800

children in the United States were abused or neglected under the Harm Standard in 1993. The NIS–3

total reflects a 67-percent increase since the NIS–2 estimate, which indicated that the total was 931,000

children in 1986, and it corresponds to a 149-percent increase since the NIS–I estimate for 1980 of

625,100 children. Significant or close-to-significant increases were found in both abuse and neglect.

The number of abused children who were countable under the Harm Standard rose by 46 percent from an

8-3
estimated 507,700 in the NIS–2 to 743,200 in the NI$3. The number of neglected children who fit the

Harm Standard increased significantly from 474,gO0 during the NIS–2 data collection in 1986 to 879,000

at the time of the NfS-3 data period in 1993. In the estimates given here and below, children are

included in all categories that apply to them (i.e., those who were both abused and neglected are included

in both estimates).

Considering specific types of abuse and neglect as defined by the Harm Standard,

significant increases since the NIS–2 were found in the’incidence of sexual abuse, physical neglect, and

emotional neglect, and a close-to-significant (i.e., statistically marginal) increase was observed in the

incidence of physical abuse:

● The estimated number of sexually abused children under the Harm Standard rose from

119,200 in 1986to217,700 in 1993 (an 83V. increase)

● The number of physically neglected children under the Harm Standard increased from an

estimated 167,800 at the time of the NIS–2 to an estimated 338,900 in the NIS–3 (a 102°A

rise in incidence]

● There was a 333-percent increase in the estimated number of emotionally neglected

children using the Harm Standard, from 49,200 in theNIS–2to212,800 in the NIS–3; and

● The estimated number of physically abused children under the Harm Standard was 269,700

at the time of the NIS–2, but it had increased to 381,700 during the NIS–3 (a 420/o

increase).

When these abused and neglected children were classified according to the injury or harm

they suffered from maltreatment that fit the Harm Standard, there was a substantial and significant

increase in the incidence of children who were seriously harmed and a statistically marginal increase in

the number for whom injury could be inferred due to the severe nature of their maltreatment. The

estimated number of seriously injured children essentially quadrupled from 141,700 to 565,000 in the

intervening 7 years between the NIS–2 and the NIS–3 (a 299°A increase). The number for whom injury

could be inferred increased from an estimated 105,500 children in the NIS–2 to an estimated 165,300

children in the NIS–3 (a S7Y0increase).

Estimated Incidence Using the Endangerment Standard. Between 1986 and 1993, the

total estimated number of abused and neglected children in the United States who fit the Endangerment

Standard nearly doubled: in 1986, there were an estimated 1,424,400 abused and neglected children in

the United States. The NIS–3 estimate of 2,815,600 reflects a 98-perceit increase over the NIS–2 figure.
Significant increases were found in both abuse and neglect. The number of abused children more than

doubled from an estimated 590,800 to 1,221,800 (a 107% increase), while the estimated number of

neglected children also more than doubled from 917,200 to 1,961,300 (a 114°Aincrease).

The increases were substantial and significant in all @es of abuse and neglect except

educational neglect:

. The estimated number of physically abused children rose from 311,500 to 614,100 (a 97%

increase}

. The estimated number of sexually abused children increased from an estimated 133,600

children to 300,200 (a 125% increase);

● The more recent estimate of the number of emotionally abused children was 183 percent

higher than the previous estimate (188,100 in 1986 versus 532,200 in 1993);

. The estimated number of physically neglected children increased from 507,700 to

1,335,100 (a 163% increase); and

● The estimated number of emotionally neglected children nearly tripled in the interval

between the studies, rising from 203,000 in 1986 to 585,100 in 1993 (a 188% increase).

When the children whose abuse or neglect met the Endangerment Standard were classified

according to tbe injury or harm they suffered, significmt increases were evident in two categories. First,

the 1993 estimate of the number of children who were endangered by their maltreatment (but not yet

harmed) was more than four times the corresponding 1986 estimate, That is, the number of endangered

children rose from an estimated 254,000 in 1986 to an estimated 1,032,000 in 1993 (a 306% increase).

Second, the number of children who were seriously injured or harmed by abuse or neglect that fit the J

Endangerment Standard in 1993 was well over one-half million, which is nearly quadruple the 1986

estimate for this category. In 1986, an estimated 143,300 children had been seriously injured by abuse or

neglect in 1993, the figure was 569,900 children (a 298% increase), Note that nearly all (990A)of the

children who counted as seriously injured here were also countable under the Harm Standard, so the

near-quadrupling of their numbers since 1986 essentially reiterates what was reported above in

connection with the Harm Standard,

8-5
8.4 Distribution of Child Abuse and Neglect by the Child’s Characteristics

The child’s sex and age were related to the rate of maltreatment, but race was rrof

Child’s Sex. Girls were sexually abused about three times more often than boys, under

both the Harm Standard and the Endangerment Standard, This finding reiterates the NIS2 result, so

females’ disproportionately greater risk of sexual abuse has been stable over time. This sex difference in

incidence rates of sexual abuse leads to higher rates of abuse in general among girls. Also, because the

definitional guidelines permit the inference that injrr~ or harm occurred in connection with the more

extreme forms of sexual abuse, girls’ greater risk of sexual abuse also accounts for their higher incidence

rates for inferred injury.

At the same time, boys had higher incidence rates than girls in some arenas, and boys’

maltreatment risks also demonstrated some increases since the NIS–2. Boys were at somewhat greater

risk of serious injury (24°A higher than girls’ risk under both definitional standards), and boys were

significantly more likely to be emotionally neglected (boys’ risk was 18% greater than girls’). Also,

boys’ rates of physical neglect defined by the Harm Standard and of emotional abuse using the

Endangerment Standard increased more since the NI%2 than girls’ rates did. Moreover, trends in the

incidence of fatal injuries from maltreatment moved in opposite directions for girls and boys—the

incidence of fatally injured girls declined slightly since the NIS–2, while the incidence of fatally injured

boys rose.

Child’s Age. A consistent feature of the age differences in incidence rates within the

NIS–3 was the lower incidence of maltreatment among the younger children under both definitional

standards. In most cases, the differentiation was be~een the O- to 2-year-olds and older children or

between the O-to 5-year-olds and older children. It is possible that the lower rates at these younger ages

reflect undercoverage of these age groups. mat is, prior to attaining school age, children are less

observable to community professionals.

Another recurring theme in connection with age was that of disproportionate increases in

the incidence of maltreatment among the younger children (under 12 years old) and especially among

children in their middle-childhood years (ages 6 to 11). Note that as circumstances deteriorate and

maltreatment becomes more prevalent and more severe, older children have greater opportunities for
escape. Also, older children me more able to defend themselves antior retaliate. These factors may

have moderated the increases in maltreatment that were obsewed among the older age groups,

The disproportionate increases during the younger and middle-childhood years meant that

the overall profiles of age differences in maltreatment were different in the NIS–3 than they had been in

the NIS–2. During the NIS–2, the risk of maltreatment generally increased with the age of the child in a

close-to-linear fashion. With the lopsided increases among the younger children and among children in

their middle-childhood years, the profile has changed toward a cumilinear configuration-where the

middle-years of childhood are associated with the m=imum risk of maltreatment—and toward a

somewhat flatter distribution-where age differences are somewhat attenuated overall compared to their

NIS-2 panems,

One of the most striking findings was the age distribution of sexual abuse, which combined

the general flattening of the age differences in incidence rates with a ve~ low age transition in the

distribution of incidence rates. The rate of sexual abuse as defined under the Endangerment Standard was

very low for O-to 2-year-olds, but then relatively constant for children ages 3 and older, indicating a ve~

broad age range of vulnerability from preschool age on.

Race. The NIS–3 found no race differences in maltreatment incidence. The NIS–3

reiterates the findings of tbe e~lier national incidence studies in this regard. That is, the NISI and the

NIS-2 also found no sigrri~cant race dtferences in the incidence of maltreatment or maltreatmentrelated injuries.

Sewice providers may find these results somewhat suWrising in view of the

dispropotiionate representation of children of color in the child welfare population and in the clientele of

other public agencies. However, it should be recognized that the NIS methodology identifies a much

broader range of children than those who come to the attention of any one type of service agency or the

even smaller subset who receive child protective and other child welfare sewices. The NIS findings

suggest that the different races receive differential attention somewhere during the process of refemal,

investigation, and sewice allocation, and that the differential representation of minorities in the child

welfare population does not derive from inherent differences in the rates at which they are abused or

neglected. It is also important to recognize that while there are no overall race differences in the

inciden~ of child abuse and neglect in the NIS–3 findings, subsequent analyses that simultaneously

g-7
consider multiple characteristics may reveal race differences in maltreatment incidence among specific

subsets of children (e.g., for children of certain ages, for one sex but not the other, etc.).

8.5 Distribution of Child Abuse and Neglect by Family Characteristics

The incidence of child maltreatment varied as a function of family income, family

structure, family size, and the metropolitan status of the county.

Family Structure. Children of single parents were at higher risk of physical abuse and of

all types of neglect and were overrepresented among seriously injured, moderately injured, and

endangered children. Compared with their counterparts living with both parents, children in singleparent families had

●

✎

●

●

●

●

●

a 77-percent greater risk of being harmed by physical abuse (using the stringent Harm

Standard) and a 63-percent greater risk of experiencing any countable physical abuse (using

the Endangerment Standard);

an 87-percent greater risk of being harmed by physical neglect and a 165-percent greater

risk of experiencing any countable physical neglecc

a 74-percent greater risk of being harmed by emotional neglect and a 64-percent greater

risk of experiencing any countable emotional neglec~

a 220-percent (or more than three times) greater risk of being educationally neglected;

an approximately 80-percent greater risk of suffering serious injury or harm from abuse or

neglect;

an approximately 90-percent greater risk of receiving moderate injury or harm as a result of

child maltreatment; and

a 120-percent (or more than wo times) greater risk of being endangered by some type of

child abuse or neglect.

Among children in single-parent households, those living with only their fathers were

approximately one and Wo-thirds times more likely to be physically abused than those living with only

their mothers.

8-8
Although parents are not necessarily, nor even host frequently, the perpetrators of

maltreatment, the relationship between parent structure and maltreatment incidence is understandable,

considering the added responsibilities and stresses of single-parenting together with the likelihood that

surrounding social and practical support may be inadequate.

Family Size. The incidence of maltreatment was related to the number of dependent

children in the family, especially in the categories of physical and educational neglect. For educational

neglect, and for physical neglect according to the Harm Standard, the pattern was norrlineac the

incidence rates were highest for children in the largest families (those with four or more children),

intermediate for “only” children, and lowest for children in families with two to three children, Children

in the largest families were almost three times more likely to be educationally neglected, and nearly two

and two-fifis times more likely to be physically neglected under the Harm Standard, compared to

-,

children in families with two or three children. Under the Endangerment Standard, the pattern was one

of increasing incidence of physical neglect with greater numbers of children. Children in the largest

families were physically neglected at nearly three times the rate of those who came from “only” child

families,

Additional children in a household mean additional tisks and responsibilities, so it is

understandable why incidence rates of child abuse and neglect may be higher when there are more

children. Accounting for why “only” children have higher rates of educational neglect and of physical

neglect under the Harm Standard than children in families with two or three children requires a different

explanation. One possibili~ is that there may be too many expectations focused on “only” children,

wherein expectations (and disappointments) are diffused over multiple children in the larger families.

Another possibility is that many “only” child households represent the early stages in their families’

development, since a number of these families will have additional children, in time. Thus, many “only”

children are in families with relatively young and inexperienced parents and caretakers.

County Metropolitan Status. The incidence of children who had been moderately harmed

by maltreatment was significantly lower among children in large urban counties than among children

who lived in other urban counties. This was interpreted as reflecting a general undercoverage of

moderately injured maltreated children in the large urban counties. It was not clear whether this was

because the moderately injured children are less likely to be encountered by community professionals in

the large urban centers, because community professionals in these locales are less likely to identi$ these

8-9
children as maltreated, or because the NIS information sources in these counties are less likely to submit

data about these maltreated children.

Family Income. Despite the fact that only a rather gross index of family income was

available, and despite a substantial percentage of cases with missing data on this factor, family income

was significantly related to incidence rates in nearly every category of maltrea~ent. Compared to

children whose families earned $30,000 per year or more, those in families with annual incomes below

$15,000 per year were

● more than 22 times more likely to experience some form of maltreatment under the Harm

Standard and over 25 times more likely to suffer maltreatment of some type using the

Endangerment Standard;

● almost 14 times more likely to be harmed by some variety of abuse and nearly 15 times

more likely to be abused using the Endangerment Standard criteria,

. more than 44 times more likely to be neglected, by either definitional standard;

● almost 16 times more likely to be a victim of physical abuse under the Harm Standard and

nearly 12 times more likely to be a victim of physical abuse using the Endangerment

Standard;

● almost 18 times more likely to be sexually abused by either definitional standard;

● thirteen times more likely to be emotionally abused under the Harm Standard criteria and

more than 18 times more likely to be emotionally abused in a manner that fit Endangerment

Standard requirements;

. forty times more likely to experience physical neglect under the Harm Standard and over 48

times more likely to be a victim of physical neglect using the Endangerment Standard;

● over 29 times more likely to be emotionally neglected under the Harm Standard definitions

and over 27 times more likely to be emotionally neglected by Endangerment Standard

criteria,

● nearly 56 times more likely to be educationally neglected, .byeither definitional standard;

. sixty times more likely to die from maltreatment of some type under the Harm Standard

and over 22 times more likely to die from abuse or neglect using the Endangerment

Standard;

● over 22 times more likely to be seriously injured by maltreatment under the Harm Standard

and almost 22 times more likely to be seriously injured by maltreatment that fit the

Endangerment Standard requirements;

8-10
. about 18 times more likely to be moderately injured by abuse or neglect under the Harm

Standard and nearly 20 times more likely to have a moderate injury from maltreatment as

defined by the Endangerment Standard;

. fifty-seven times more likely to be classified as having an inferred injury under the Harm

Standard and 39 times more likely to meet the criteria for inferred injury as defined by the

Endangerment Stidard; and

● over 31 times more likely to be considered endarrgered, although not yet injured, by some

type of abusive or neglectful treatment.

The NIS-3 findings on the correlation be~een family income and child maltreatment are

entirely consistent with the earlier findings of the NIS–2. Moreover, they cannot be plausibly explained

on the basis of the higher visibility of lower-income families to community professionals.

On the one hand, the NIS sentinels observe substantial numbers of children and families at

the middle- and upper-income levels, The large majority of maltreated children were recognized by

professionals likely to encounter children and families at all income levels, such as sentinels in hospitals,

schools, day-care centers, mental health agencies, voluntary social service agencies; by professionals not

represented by NIS sentinel categories; and by the general public. Sentinels in schools alone recognized

the majority of the maltreated children. Although the NIS design includes only public schools,

approximately 89 percent of the U.S. population of school-age children attend public schools, so children

attending the public schools represent a broad spectrum of family income levels. Moreover, the private

schools not reflected in the NIS include religiously affiliated schools, which have sliding scales for

poorer children, so children who attend private schools are not necessarily from better economic

circumstances than children enrolled in public schools.

On the other hand, if the income finding is interpreted as an artifact of selective obsewatimr

of low-income families, then it would mean that there have to be enough undetected abused and

neglected children in the middle- and upper-income brackets used here to equalize the incidence rates

across different income categories. That would require an astounding number of still-undetected

children in the nation who experience countable maltreatment. Specifically, it would mean that arr

addidonal 2,138,700 children suffered maltreatment according to the Harm Standard yet remained

hidden to the NIS. Similarly, it would mean there were an addifiorral 4,500,700 children in 1993 who

experienced maltreatment under the Endangerment Standard but who escaped observation by community

professionals. To add some perspective as to what this would entail, consider that almost seven percent

of the total U.S. chiId population would be maltreated in countable ways yet entirely escape the attention

8-11
of the spectrum of community professionals who sene as NIS sentinels, and all of these additional

children would have to be in families with incomes of $15,000 per year or more.

Considering the implications of the alternative, it appears more plausible to assume that the

income-related differences in incidence found in the NIS reflect real differences in the extent to which

children in different income levels are being abused or neglected. Note that there we a number of

problems associated with pove~ that may contribute to child maltreatment: more transient residence,

poorer education, and higher rates of substance abuse and emotional disorders. Moreover, families at the

lower socioeconomic levels have less adequate social support systems to assist parents in their child care

responsibilities.

8.6 Distribution of Child Abuse and Negleet by Perpetrator Charaeteristiw

Children who had been maltreated as defined by the Harm Standard were categorized

according to their relationship to the most closely related perpetrator and according to this perpetrator’s

sex, age, and employment status; these categorimtions were examined in relation to the tYPe Of

maltreatment and the severity of the child’s injury or harm. Perpetrators’ relationships to the children

also were examined in relation to the children’s race. me findings represent only a preliminary

exploration of perpetrator characteristics in the NIS–3 data, since they lack significance tests concerning

potential relationships and substantial percentages of the children were missing information concerning

certain of the perpetrator characteristics.

Perpetrator’s Relationship to tbe Child. me majority of all children countable under tie

Harm Standard (78Y.) were maltreated by their birth parents, and this held true both for children who

were abused (62°Awere maltreated by birth parents) and for those who were neglected (9 IYO experienced

neglect by birth parents).

Birth parents were the most closely related pe~etrators for 72 percent of the physically

abused children and for 81 percent of the emotionally abused children. The pattern was distinctly

different for sexual abuse. Nearly one-half of the sexually abused children were sexually abused by

someone other than a parent or parent-substitute, while just over one-fourth were sexually abused by a

birth parent, and one-fourth were sexually abused by other than a birth parent or parent-substitute. in

8-12
addition, a sexually abused child was most likely to sustain a serious injury or impairment when a birth

parent was the perpetrator.

Perpetrator’s Sex. Children were somewhat more likely to be maltreated by female

pe~etrators than by males: 65 percent of the maltreated children had been maltreated bya female,

whereas 54 percent had been maltreated by a male. Of children who were maltreated by their birth

parents, the majority (75V0) were maltreated by their mothers and a sizable minori~ (46Yo) were

maltreated by their fathers (some children were maltreated by both pments). In contrast, children who

were maltreated by other parents or parent-substitutes, or by other persons, were more likely to have

been maltreated by a male than by a female (80 to 8S% were maltreated by males; 14 to 41% by

females).

Abused children presented a different pattern in connection with the sex of their

perpetrators than didthe neglected children. Children were more often neglected by female pe~etrators

(87% by females versus 43% by males). This finding incongruent with the fact that mothers mrd

mother-substitutes tend to be the prima~ caretakers and are the primary persons held accountable for

anyomissimrs and/or failings in caretaking. Incmrtmst,c hildrenweremoreo ftenabusedb ymales(67oA

were abused bymales versus 40Yoby females). TheprevaIence ofmalepc~etrators wasstrongest in the

category ofsexual abuse, where 89percent of thechi1dren were abused byamale compwed to only 12

percent by a female.

Among all abused children, those abused by their birth parents were about equally likely to

have been abused by mothers as by fathers (50Y0and S8%, respectively), but those abused by other

parents, parent-substitutes, or other, nonparental perpetrators were much more Iikelyto be abused by

males (80t090°A by males versus 14to 15°Aby females). This general pattemheld foremotional abuse,

butwasslightly different inthearea ofphysical abuse. Children whohadbeen physically abused by

their bifih parents were more likely to have suffered at the bands of their mothers than their fathers (60Y.

versus 480%),while those who had been physically abused by other parents or parent-substitutes were

much more likely tohavebeen abused bytheir fatiers or father-substitutes (9O0Abytheir fathers versus

19V. bytheirmotbers). For sexual abuse, the child’s relationship tothepe~etrator made very little

difference, since males clearly predominated aspe~etrators, whatever their relationship to the child.

Moreover, the severity of the injury or impaiment that the child experienced as a result of maltreatment

did not appear to bear any relationship to the sex of the perpetrator.

8-13
Perpetrator’s Age. me perpetrator’s age was entirely unknown for one-third of the

children whowere cmurtableunderthe Ham Standard. Giverrthe prevalence ofchildren mrdtreatedby

perpetrators of unknown age, the findings here are tentative, since they could easily be eradicated if all

perpetrators’ ages were known.

Among all maltreated children, only a small percentage (13~o) had been maltreated bya

perpetrator in the youngest age bracket (under26 years of age). However, younger perpetrators were

slightly more predominant among children who had been sexually abused (where 22°/0had been sexually

abused byape~etrator under 26years ofage)and among children whohad been maltreated in any way

by someone who was nor their parent or parent-substitute (among whom 40% had been maltreated by a

perpetrator in the youngest age bracket).

A child’s severity of injury or harm from maltreatment appeared not to be associated with

the age of the perpetrator.

Perpetrator’s Employment Status. Perpetrator’s employment status was unknown for

more than mre-third of the maltreated children, Iimiting the value of the findings on this issue. Nearly

one-half of all maltreated children were abused by a perpetrator who was employed, and this held true

for both abuse and neglect. Ofthechildren whosustained serious inju~, themajori@ were maltreated

byan employed perpetrator. lnnocatego~ were themajori& ofchildren maltreated byape~etrator

who was unemployed.

Child’s Race and Relationship to the Perpetrator. Because the perpetrator’s race was

not known for children submitted to the study solely through non-CPS sources, the child’s race was

examined in connection with the relatimrshipto the perpetrator and with the nature and severity of the

maltreatment.

For overall abuse, child’s race reflected no notable connection to the relationship with the

perpetrator. However, ammrgsexuallya busedchildren, white children cmrstituted a greater proportion

of children who were sexually abused by their birth parents than of those sexually abused by other

parents and parent-substitutes, and by others. Ammrgphysicallya busedchildren, white children were

more prevalent among those who were physically abused by other parents and parent-substitutes than

among those who were physically abused by their birth parents or among those physically abused by

other types of perpetrators. Although rims-white children were theminority of victims in all categories,

8–14
they were more prevalent among children who tiere physically or sexually abused by perpetrators other

than parents or parent-substitutes,

White children are a larger majority of those who suffered serious injury, whereas nonwhite children’s representation wasstrongest among those who experienced moderate inju~and among

those for whom injrr~ could be inferred based on the severity of their maltreatment.

8.7 Sources of Recognition for Maltreated Children

School staff predominated as a source of recognition for maltreated children, School

sentinels recognized S9 percent of the children who suffered maltreatment as defined by the Harm

Standard and 54percent of the Endangement Standard total, Other importarrt sources ofabused and

neglected children were hospitals, police departments, social service agencies, and the general public.

For maltreatment defined under the Endangerment Standard, day-care centers also joined in the group of

agency categories that encountered rnorethan 100,000 abused and neglected children.

Changes since the earlier incidence studies in what are here called “recognition rates” may

reflect changes in the rates at which maltreated children are identified or encountered. Using this

terminology, one sees that hospitals more than tripled the rate atrwhich they recognized maltreated

children since the NIS–2. Mental health agencies quadrupled their rate ofrecognition of children whose

maltreatment fit the Harm Standard and increased their recognition fivefold of children who fit the

Endangerment Standard. Schools more than doubled their rate ofrecognition ofchildren coun@bleby

the Endangerment Standard, which included a 70-percent increase intheir recognitimrratefort hesector

who counted under the Harm Standard. Recognition of children maltreated under the Endangerment

Standard more than doubledin Iaw enforcement agencies. Interestingly, there were no changes in the

contributions of sources that are only tapped in the NIS through their reports to CPS (e.g., private

physicians, the general public). ~is last finding probably reflects the relatively stable level of CPS

involvement with theabused andneglected children countable in the NIS over the time period, which is

discussed below.

8-IS
8.8 Official Reporting of Maltreated Children and Their Investigation by Child Protective

Services (CPS)

The NIS methodology provides informatimrt hat speaks oniyto the end result of several

processes, indicating whether or not a given maltreated child was or was not among the children whose

maltreatment was investigated by CPS. Children who do not receive CPS investigation of their

maltreatment represent an enigma to the study, as it cannot be determined whether this was because they

were not reported to CPS or because CPS screened their reports out without an investigation.

Despite that limitation, the NIS–3 findings concerning tbe percentages of abused and

neglected children whose maltreatment received CPSinvestigation arecause forseriousconcem. Onlya

minority of the children who were abused or neglected, by either definitional standard, received CPS

attention for their maltreatment, CPS investigated themaltreatment ofmdy28 percent of children who

were countable under the Harm Standmd and of only 33 percent of those whose maltreatment fit the

Endangerment Standard. Moreover, the percentages of those who received CPS investigation

represented less than one-half of the maltreated children in all categories of maltreatment except

fatalities, andacross nearly all recognition sources. Especially remarkable wastbe finding that CPS

investigation extended toonlyslightly more than one-fouflb of the children who were seriously harmed

or injured by abuse or neglect.

Another importmrt finding was that the percentages of maltreated children who receive CPS

investigation have decreased significantly since the NIS–2. The percentage of children receiving

investigation among those who met the Harm Standard dropped from 44 percent to 28 percent, while the

percentage of CPS investigation of children who met the Endangerment Standard fell from 51 percent to

33 percent. Although the decline was significant only among children recognized in law enforcement

agencies and hospitals, it nevertheless cut across every type of recognition source. The decline in rates

of CPS investigation affected abuse under the Harm Standard, all categories of maltreatment under the

Endangerment Standard, and all levels of outcomes except fatalities.

At the same time, the actual numbers of countable children investigated by CPS remained

stable (when considering Harm Standard totals) or even slightly increased (considering the

Endangerment Standard totals). Thus, as the total number of maltreated children has risen, it means that

a larger percentage of them have not had access to CPS investigation of their maltreatment. This picture

suggests that the CPS system has reached its capacity to respond to the maltreated child population.

8-16
8.9 Implications

Are the observed increases in the incidence of child abuse and neglect, especially the

quadrupling of the numbers of children who were seriously injured or endangered by maltreatment, real

increases in the scope of the problem, or do they instead reflect improved recognition on the part of

sentinels and other reporters to CPS? The fact that the increases occumed where they did—among

children who were seriously injured and among children who were endangered-suggests that both of

these dynamics contributed to the observed increases, each dyoamic affecting a different sector of the

abused and neglected population.

More Children Are Now Being Abused and Neglected Than in 1986, and Their

Injuries Are More Serious. The rise in the number of seriously injured children probably reflects a real

increase in child abuse and neglect, because it cannot plausibly be explained on the basis of heightened

sensitivity, It is unreasonable to suppose that quadruple the number of seriously injured victims of abuse

and neglect existed at the time of the NIS–2 and somehow escaped notice by community professionals.

The fact that the seriously injured group has quadrupled during the 7 yems since the NIS–2, and now

comprises more than one-half million children, appears to herald a me rise in the scope and severity of

child abuse and neglect in the United States.

Although the NIS does not address the causes of abuse and neglect, it was stiiking how

ofien illicit drug use was noted in tbe narrative descriptions on the NIS data forms. The increase in illicit

drug use since tbe fall of 1986 when the NIS–2 data were collected may have contributed to the rise in

incidence observed in the NI~3, Economics is another factor that may have enlarged the problem.

Family income is tbe strongest comelate of incidence in nearly all categories of abuse and neglect, with

the lowest income families evidencing the highest rates of maltreatment. Increases in incidence since

1986 may partially derive from decreased economic resources among the poorer families and the

increase in the number of children living in poverty,

Community Professionals Are Better at RecognWlng Abused and Neglected Children,

Especially Those Endangered but Not Yet Harmed by Maltreatment. The rise in the number of

endangered children probably stems from improved recognition of more subtle cues—tho~ that indicate

abusive and neglectful behaviors that have not yet resulted in harm or injury. It is quite plausible to

suppose that some (even sizable) potiion of the endangered children escaped attention in the NIS–2, but

that by the time of the NIS–3, community professionals had learned to pay better attention to infomatimr

8-11
that might indicate endangering maltreatment. Note that this explanation also completes an account of

consistent progression in recognition across the three national incidence studies. The NIS-2

demonstrated an increase in the number of moderately injured children. In interpreting that finding, it

was considered likely to have derived from improved attentiveness to moderate-inju~ indicators of

abuse and neglect. The NIS–3 found no statistical change in tie numbers of moderately injured children,

which suggests that professionals had reached close-to-maximum recognition rates for this category of

children at the time of the NIS–2. The fourfold increase in the number of endangered children in the

NIS–3 implies that the subsequent further improvements in recognition have now shifted toward even

subtler cues: those associated with not-yet-injurious abusive actions and neglectful omissions.

Better Targeting Is Needed To Ensure CPS Investigation for the Children Who Most

Need It. The number of NIS-cmmtab[e children who are investigated by CPS has remained fairly stable,

or risen slightly, since the last national incidence study in 1986. As a result, CPS investigation has not

kept up with the dramatic rise in the incidence of these children, so the percentages who receive CPS

investigation of their maltreatment have fallen significantly. The low rates of CPS investigation of the

maltreated children, especially of those already seriously injured by maltreatment, warrant immediate

attention.

These findings emphasize the need for better targeting, whether by reporters in referring

children to CPS, by CPS screening practices in connection with reports, or by both. One possibility is

that, although reporters now demonstrate considerable perceptiveness in identi~ing maltreated children,

they have not reliably translated this into reports to CPS, or are unclear as to how to do so. Another

possibility is that CPS, which has increasingly turned to screening cases in order to keep its workload

manageably within the range of its resources, has not been using effective screening criteria or has been

unclear or inconsistent about the criteria to be applied. Note that these are not independent dynamics,

because the response of CPS to a report provides feedback that has consequences for future reporting

behaviors. Information bearing on these issues is provided by repofis on WO of the NIS–3 special

substudies: the Serrtirrel Qrresf;ormaire Follow-up Sfudy, which asked school sentinels about their

decisions to repoti cases to CPS, and the CPS Screening Policy and Recordkeeping Stu&, which

examined the screening policies and practices of CPS agencies that participated in the NIS–3.

8–18

The main NIS–3 data can offer some guidance in targeting. Neglect warrants more

attention. It affects the greatest number of maltreated children, and their injuries are ofien serious.

Children from the poorest families are at the greatest risk of maltreatment, so these children may warrant
increased CPS attention as well, Children in single-parent families also experienced higher rates of

maltreatment. A number of characteristics explored here are not unrelated to each other-for instance,

single-parent families often have lower incomes. Further analyses of the NIS-3 data can address the

independent contributions of different characteristics to better clari~ risk factors that can guide CPS

screening activities. Narratives on the NIS data forms can also be more systematically explored. The

namatives often included spontaneous comments about illegal drug use, indicated whether the perpetrator

had a history (sometimes a criminal record) of sexually or physically abusin~assaulting other children or

adults, or noted that the incident described was not the first time the child had been abused or neglected.

As pan of improving CPS targeting of the more serious cases, efforts should also focus on

achieving better consensus about what types of cases should nor receive CPS investigation, VeW few of

the educationally neglected children currently have their malmeatment investigated by CPS, and those

who do may have been maltreated in multiple ways, with the CPS investigation focusing on abuse or

other types of neglect. The current role of CPS in relation to educational neglect might be the

cente~iece of an emerging consensus on what specific forms of abuse or neglect should not receive CPS

investigation,

Forging WorMng Relationships Betieen CPS Agencies and Schools. The NIS has

consistently demonstrated that professionals in schools play a central and critical role in identifying

children who are abused and neglected. As policies are developed to address the burgeoning problem of

child abuse and neglect, they should capitalim on the unique role of school professionals as front-line

obsewers.

8–19 *US GoVERNMEM PRINmNQ OFFICE 1%72S%5