U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Center for Mental Health Services

www.samhsa.gov

 

 

Fourth National Incidence Study 

of Child Abuse and Neglect (NIS–4) 

Report to Congress 

U.S. Department of Health and Human Services (DHHS) 

Administration for Children and Families (ACF) 

Office of Planning, Research, and Evaluation (OPRE) 

and the Children’s Bureau 
This document reports the findings from the Fourth National Incidence Study of Child Abuse 

and Neglect (NIS–4), which was conducted by Westat, Inc., with the assistance of its 

subcontractor Walter R. McDonald and Associates, Inc. (WRMA), under contract number 

GS23F81144H, Order No. HHSP233200400058U, Requisition No. 04Y004193 from the 

Department of Health and Human Services. The authors were Andrea J. Sedlak, Jane 

Mettenburg, Monica Basena, Ian Petta, Karla McPherson, Angela Greene, and Spencer Li. 

This document, as well as the NIS–4 technical reports (NIS–4 Data Collection Report and NIS–4 

Analysis Report) and reports on six NIS–4 supplementary studies (CPS Structure and Practices 

Mail Survey, CPS Screening Policies Study, Sentinel Definitions Survey, Comparison of NIS–4 

and NCANDS, Supplementary Analysis of Race Differences in the NIS–4, and Incidence 

Projections in the 2009 Recession Economy) will be available at the Office of Planning, 

Research, and Evaluation (OPRE) website 

http://www.acf.hhs.gov/programs/opre/abuse_neglect/natl_incid/index.html. 

The NIS–4 public use data file will be available from the National Data Archive on Child Abuse 

and Neglect, www.ndacan.cornell.edu. 

Material contained in this publication is in the public domain and may be reproduced, fully or 

partially, without permission of the Federal Government. The courtesy of source credit is 

requested. The recommended citation follows: 

Sedlak, A.J., Mettenburg, J., Basena, M., Petta, I., McPherson, K., Greene, A., and Li, S. (2010). 

Fourth National Incidence Study of Child Abuse and Neglect (NIS–4): Report to Congress. 

Washington, DC: U.S. Department of Health and Human Services, Administration for Children 

and Families. 
 

 

 

Fourth National Incidence Study

of Child Abuse and Neglect (NIS–4) 

Report to Congress 

Andrea J. Sedlak 

Jane Mettenburg, Monica Basena 

Ian Petta, Karla McPherson 

Angela Greene, & Spencer Li 

U.S. Department of Health and Human Services (DHHS)
 

Administration for Children and Families (ACF)
 

Office of Planning, Research, and Evaluation (OPRE) and
 

the Children’s Bureau
 
 

ACKNOWLEDGEMENTS
 

The National Institute of Child Health and Human Development (NICHD) contributed funding 

for the NIS–4 Sentinel Definitions Survey (SDS). 

Walter R. McDonald and Associates, Inc. (WRMA) collaborated on several NIS–4 tasks under a 

subcontract to Westat, Inc. WRMA provided the 2004 data file from the National Child Abuse 

and Neglect Data System (NCANDS) to assist in sample design. Several WRMA staff recruited 

a number of the sampled CPS agencies to participate. The questionnaire for the supplementary 

study CPS Structure and Practices Mail Survey (SPM) was a modified version of the instrument 

WRMA developed for the 2002 Local Agency Survey in the CPS Systems and Reforms project; 

they helped the NIS–4 team modify that instrument and had a primary role in analyzing the SPM 

data and writing the SPM report. During NIS–4 weighting, WRMA staff constructed a special 

NCANDS file and computed the annualization factors. WRMA staff were also key collaborators 

on the Comparison of NIS–4 and NCANDS. Finally, they participated in the NIS–4 Consultant 

Group meetings, where they provided formative suggestions during the study design and offered 

feedback on the implications of the findings. 

The NIS–4 Consultant Group members provided their expertise and advice at the outset, on the 

study plans, and during the final stage, on the presentation of findings. Participating members 

were Mark Applebaum (University of California, San Diego), Steve Christian (Casey Family 

Programs), John Eckenrode (Cornell University), Diana English (University of Washington 

School of Social Work), Patrick Fagan (Family Research Council), Richard Heyman (State 

University of New York at Stony Brook), Brenda Jones-Harden (University of Maryland), 

Robert Ortega (University of Michigan), and Fred Wulczyn (Chapin Hall Center for Children, 

University of Chicago). 

Authors of this report include Westat staff with responsibilities for NIS–4 tasks: Andrea Sedlak 

(project director), Jane Mettenburg (team leader for CPS recruitment and evaluative coding and 

for the Comparison of NIS–4 and NCANDS), Spencer Li (manager and analyst of the NIS–4 

supplementary study, CPS Structure and Practices Mail Survey), Monica Basena (analyst for this 

report and a leader on Incidence Projections in the 2009 Recession Economy), Angela Greene 

(leader of the NIS–4 supplementary study, CPS Screening Policies Study), Karla McPherson 

(analyst for this report, leader of the NIS–4 supplementary study, Sentinel Definitions Survey and 

a leader on Supplementary Analysis of Race Differences in the NIS–4), and Ian Petta (analyst). 

Other senior Westat staff whose dedication and expertise contributed to the success of this study 

include John Brown (systems analyst), Janet Ciarico (unduplication team leader), Frances Gragg 

(sentinel recruitment team leader), John Hartge (field director), Elizabeth Quinn (leader of 

instrument design), Kristin Madden (lead programmer) and Marianne Winglee (lead statistician). 

This 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 accurately assess the incidence, nature, and distribution of child abuse 

and neglect in the United States. 
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TABLE OF CONTENTS
 

EXECUTIVE SUMMARY ................................................................... 1
 

1 INTRODUCTION ................................................................................. 1-1
 

1.1	 Background................................................................................ 1-1
 

1.2	 NIS Design Enhancements ........................................................ 1-2
 

1.3	 Focus of this Report................................................................... 1-4
 

2 METHODOLOGY ................................................................................ 2-1
 

2.1	 Study Design.............................................................................. 2-1
 

2.2	 Samples and Recruitment .......................................................... 2-7
 

2.3	 Data Collection .......................................................................... 2-9
 

2.4	 Evaluative Coding...................................................................... 2-10
 

2.5	 Unduplication............................................................................. 2-15
 

2.6	 Weighting and Estimation.......................................................... 2-16
 

2.7	 Data Analysis............................................................................. 2-17
 

2.8	 Supplementary Studies............................................................... 2-20
 

3 INCIDENCE OF CHILD ABUSE AND NEGLECT............................ 3-1
 

3.1	 National Incidence of Harm Standard Maltreatment................. 3-2
 

3.1.1	 Overall Incidence of Harm Standard Maltreatment....... 3-3
 

3.1.2	 Incidence of Harm Standard Abuse and Neglect........... 3-5
 

3.1.3	 Specific Categories of Harm Standard Abuse ............... 3-6
 

3.1.4	 Specific Categories of Harm Standard Neglect ............. 3-8
 

3.1.5	 Severity of Outcomes from Harm Standard
 

Maltreatment.................................................................. 3-11
 

3.2	 National Incidence of Endangerment Standard
 

Maltreatment.............................................................................. 3-14
 

3.2.1	 Overall Incidence of Endangerment Standard
 

Maltreatment.................................................................. 3-14
 

3.2.2	 Incidence of Endangerment Standard Abuse and 

Neglect .......................................................................... 3-16
 

3.2.3	 Specific Categories of Endangerment Standard
 

Abuse ............................................................................. 3-18
 

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3.2.4	 Specific Categories of Endangerment Standard
 

Neglect ........................................................................... 3-19
 

3.2.5	 Severity of Outcomes from Endangerment Standard
 

Maltreatment.................................................................. 3-21
 

4	 DISTRIBUTION OF ABUSE AND NEGLECT BY CHILD 

CHARACTERISTICS ........................................................................... 4-1
 

4.1	 Sex Differences in the Incidence of Maltreatment .................... 4-2
 

4.1.1	 Sex Differences in Harm Standard Maltreatment ......... 4-2
 

4.1.2	 Sex Differences in Endangerment Standard 

Maltreatment.................................................................. 4-4
 

4.2	 Age Differences in the Incidence of Maltreatment.................... 4-7
 

4.2.1	 Age Differences in Harm Standard Maltreatment ......... 4-7
 

4.2.2	 Age Differences in Endangerment Standard 

Maltreatment.................................................................. 4-13
 

4.3	 Racial and Ethnic Differences in the Incidence of 

Maltreatment.............................................................................. 4-22
 

4.3.1	 Racial and Ethnic Differences in Harm 

Standard Maltreatment................................................... 4-22
 

4.3.2.	 Racial and Ethnic Differences in Endangerment 

Standard Maltreatment................................................... 4-26
 

4.4	 Differences in the Incidence of Maltreatment Related to 

Child’s Disability Status ............................................................ 4-30
 

4.4.1	 Differences in Harm Standard Maltreatment 

Related to Child’s Disability Status............................... 4-31
 

4.4.2	 Differences in Endangerment Standard

Maltreatment Related to Child’s Disability Status ........ 4-32
 

4.5	 Differences in the Incidence of Maltreatment Related to 

Child’s Enrollment in School..................................................... 4-35
 

4.5.1	 Differences in Harm Standard Maltreatment 

Related to Child’s Enrollment in School ....................... 4-36
 

4.5.2	 Differences in Endangerment Standard Maltreatment 

Related to Child’s Enrollment in School ....................... 4-38
 

5	 DISTRIBUTION OF ABUSE AND NEGLECT BY
 

FAMILY CHARACTERISTICS........................................................... 5-1
 

5.1	 Differences in the Incidence of Maltreatment Related to
 

Parents’ Employment................................................................. 5-2
 

5.1.1	 Differences in Harm Standard Maltreatment Related 

to Parents’ Employment................................................. 5-2
 

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5.1.2	 Differences in Maltreatment under the
 

Endangerment Standard Related to Parents’
 

Employment Status ........................................................ 5-6
 

5.2	 Differences in the Incidence of Maltreatment Related to 

Socioeconomic Status (SES)...................................................... 5-10
 

5.2.1	 Differences in Harm Standard Maltreatment Related 

to Socioeconomic Status (SES) ..................................... 5-11
 

5.2.2	 Differences in Endangerment Standard Maltreatment 

Related to Socioeconomic Status (SES) ........................ 5-14
 

5.3	 Differences in the Incidence of Maltreatment
 

Related to Family Structure and Living Arrangement............... 5-18
 

5.3.1	 Differences in Incidence of Harm Standard 

Maltreatment Related to Family Structure and 

Living Arrangement....................................................... 5-19
 

5.3.2	 Differences in the Incidence of Endangerment
 

Standard Maltreatment Related to Family Structure
 

and Living Arrangement................................................ 5-30
 

5.4	 Differences in the Incidence of Maltreatment Related
 

to Grandparents as Caregivers ................................................... 5-39
 

5.4.1	 Differences in Harm Standard Maltreatment
 

Related to Grandparents as Caregivers.......................... 5-40
 

5.4.2	 Differences in Endangerment Standard 

Maltreatment Related to Grandparents as Caregivers ... 5-41
 

5.5	 Family Size Differences in the Incidence of Maltreatment ....... 5-43
 

5.5.1	 Family Size Differences in Harm Standard 

Maltreatment.................................................................. 5-43
 

5.5.2	 Family Size Differences in Endangerment Standard
 

Maltreatment ................................................................. 5-46
 

5.6	 Differences in the Incidence of Maltreatment Related to 

Metropolitan Status (Metrostatus) of County of Residence ...... 5-52
 

5.6.1	 Differences in Harm Standard Maltreatment Related
 

to Metropolitan Status (Metrostatus) of County of
 

Residence ....................................................................... 5-53
 

5.6.2	 Differences in Endangerment Standard Maltreatment
 

Related to Metropolitan Status (Metrostatus)
 

of County of Residence.................................................. 5-56
 

6 PERPETRATOR CHARACTERISTICS .............................................. 6-1
 

6.1	 Perpetrators of Maltreatment ..................................................... 6-1
 

6.2	 Perpetrator’s Relationship to the Child...................................... 6-3
 

6.2.1	 Perpetrator’s Relationship to the Child for Different
 

Maltreatment Categories ............................................... 6-4
 

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6.2.2	 Severity of Harm by Perpetrator’s Relationship
 

and Category of Maltreatment ....................................... 6-6
 

6.3	 Perpetrator’s Sex........................................................................ 6-7
 

6.4	 Perpetrator’s Age ....................................................................... 6-11
 

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

Perpetrator’s Relationship to the Child...................................... 6-13
 

6.6	 Perpetrator’s Alcohol Use, Drug Use, and Mental Illness 

as Factors in the Maltreatment................................................... 6-14
 

7 RECOGNIZING ABUSED AND NEGLECTED CHILDREN............ 7-1
 

7.1	 Sources Recognizing Abused and Neglected Children ............. 7-1
 

7.1.1	 Sources Recognizing Children Maltreated under the
 

Harm Standard ............................................................... 7-2
 

7.1.2	 Sources Recognizing Children Maltreated under the
 

Endangerment Standard................................................. 7-7
 

7.2	 Sentinels’ Expected Responses to Maltreatment Situations 

and the Implications for NIS Coverage ..................................... 7-11
 

8 INVESTIGATING ABUSED AND NEGLECTED CHILDREN ........ 8-1
 

8.1	 CPS Investigation of Abused and Neglected Children.............. 8-2
 

8.1.1	 CPS Investigation of Children Maltreated under the
 

Harm Standard ............................................................... 8-3
 

8.1.2	 CPS Investigation of Children Maltreated under the
 

Endangerment Standard................................................. 8-13
 

8.2	 Investigation Rates with an Extended CPS Period .................... 8-23
 

8.3	 Investigation Patterns Related to CPS Screening Policies........ 8-24
 

8.4	 Relationship between CPS Investigation and 

CPS Agency Structure and Practices ......................................... 8-34
 

8.5	 Sentinels’ Reporting to CPS ...................................................... 8-38
 

8.5.1	 Sentinels’ Training on Child Abuse and Neglect

 Reporting Requirements ............................................... 8-39
 

8.5.2	 Agencies’ Policies on Child Abuse and Neglect 

Reporting and Sentinels’ Reporting Histories ............... 8-39
 

8.5.3	 Sentinels’ Expectations About Their Reporting
 

to CPS ............................................................................ 8-41
 

9 CONCLUSIONS AND IMPLICATIONS............................................. 9-1
 

iv 
Table Page 

 ......... 

LIST OF TABLES
 

2–1 NIS–4 60-form Typology for Classifying Alleged Maltreatment 2-13 

3–1 National Incidence of Harm Standard Maltreatment in the NIS–4 

(2005–2006), and Comparison with the NIS–3 (1993) and the NIS–2 

(1986) Harm Standard Estimates........................................................... 3-4 

3–2 Severity of Outcomes from Harm Standard Maltreatment in the 

NIS–4 (2005–2006), and Comparison with the NIS–3 (1993) and 

the NIS–2 (1986) Harm Standard Findings ........................................... 3-11 

3–3 National Incidence of Endangerment Standard Maltreatment in the 

NIS–4 (2005–2006), and Comparison with the NIS–3 (1993) and 

the NIS–2 (1986) Endangerment Standard Estimates. .......................... 3-15 

3–4 Severity of Outcomes from Endangerment Standard Maltreatment 

in the NIS–4 (2005–2006), and Comparison with the NIS–3 

(1993) and the NIS–2 (1986) Estimates................................................. 3-22 

4–1 Sex Differences in Incidence Rates per 1,000 Children for Harm 

Standard Maltreatment in the NIS–4 (2005–2006)................................ 4-2 

4–2 Sex Differences in Incidence Rates per 1,000 Children for 

Endangerment Standard Maltreatment in the NIS–4 (2005–2006) ....... 4-5 

4–3 Race/ethnicity Differences in Incidence Rates per 1,000 Children 

for Harm Standard Maltreatment in the NIS–4 (2005–2006)................ 4-23 

4–4 Race/ethnicity Differences in Incidence Rates per 1,000 

Children for Endangerment Standard Maltreatment in the NIS–4 

(2005–2006)........................................................................................... 4-26 

4–5 Differences Related to Child’s Disability Status in Incidence 

Rates per 1,000 Children for Harm Standard Maltreatment in 

the NIS–4 (2005–2006).......................................................................... 4-31 

4–6 Differences Related to Child’s Disability Status in Incidence 

Rates per 1,000 Children for Endangerment Standard Maltreatment 

in the NIS–4 (2005–2006) ..................................................................... 4-33 

4–7 Differences Related to Child’s School Enrollment in Incidence 

Rates per 1,000 Children for Harm Standard Maltreatment in 

the NIS–4 (2005–2006).......................................................................... 4-36 

4–8 Differences Related to Child’s School Enrollment in Incidence 

Rates per 1,000 Children for Endangerment Standard Maltreatment 

in the NIS–4 (2005–2006) ..................................................................... 4-39 

5–1 Incidence Rates per 1,000 Children for Harm Standard 

Maltreatment in the NIS–4 (2005–2006) Related to Parents’ 

Employment........................................................................................... 5-3 

5–2 Incidence Rates per 1,000 Children for Endangerment Standard 

Maltreatment in the NIS–4 (2005–2006) Related to Parents’ 

Employment........................................................................................... 5-7 

5–3 Differences Related to Family Socioeconomic Status in Incidence 

Rates per 1,000 Children for Harm Standard Maltreatment in the 

NIS–4 (2005–2006) ............................................................................... 5-12 

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5–4 Differences Related to Family Socioeconomic Status in

Incidence Rates per 1,000 Children for Endangerment 

Standard Maltreatment in the NIS–4 (2005–2006)................................ 5-15 

5–5 Differences in Incidence Rates per 1,000 Children for Harm 

Standard Maltreatment in the NIS–4 (2005–2006) Related to 

Grandparents as Caregivers ................................................................... 5-41 

5–6 Differences in Incidence Rates per 1,000 Children for Endangerment 

Standard Maltreatment in the NIS–4 (2005–2006) Related to 

Grandparents as Caregivers . 5-42 

6–1 Categorization of Perpetrators of Child Maltreatment 6-3 

6–2 Perpetrator’s Relationship to Child and Severity 

of Harm by the Category of Maltreatment 6-5 

6–3 Perpetrator’s Sex by Category of Maltreatment and Perpetrator’s 

Relationship to Child 6-9 

6–4 Perpetrator’s Sex by Severity of Harm and Perpetrator’s 

Relationship to Child 6-10 

6–5 Perpetrator’s Age by Category of Maltreatment and 

Perpetrator’s Relationship to Child. 6-12 

6–6 Perpetrator’s Age by Severity of Harm and Perpetrator’s 

Relationship to Child 6-13 

7–1 Sources Recognizing Maltreated Children Who Fit the Harm Standard 

in the NIS–4 (2005–2006) and Comparisons with the Estimated 

Numbers from Different Sources in the NIS–3 (1993) ......................... 7-6 

7–2 Sources Recognizing Maltreated Children Who Fit the 

Endangerment Standard in the NIS–4 (2005–2006) and 

Comparisons with Recognition Sources in the NIS–3 (1993) 7-10 

7–3 NIS Coverage of Maltreatment Situations as Indexed by 

Sentinels’ Responses to SDS Vignettes 7-12 

8–1 Rates of CPS Investigation of Harm Standard Maltreatment, Actual 

and Presumptive (based on CPS Screening Standards) 8-28 

8–2 Rates of CPS Investigation of Endangerment Standard

Maltreatment, Actual and Presumptive 

(based on CPS Screening Standards) 8-32 

8–3 CPS Investigation Rates for Harm Standard Maltreatment Related 

to Whether a State or Regional Hotline Screens Referrals 8-34 

8–4 CPS Investigation Rates for Harm Standard Maltreatment 

Related to Whether the Agency Provided an Alternative Response. 8-37 

8–5 CPS Investigation Rates for Endangerment Standard Maltreatment 

Related to Whether the Agency Provided an Alternative Response 8-37 

8–6 Percentages of Uninvestigated Children with Harm Standard 

Maltreatment Recognized by Sentinels in NIS–4 and Percentages 

of SDS Sentinels Who Would Not Report the Vignette 

Situations to CPS ................................................................................... 8-42 

vi 
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................................................................................... 

.............................. 

LIST OF FIGURES
 

2–1 Levels of Recognition of Child Abuse and Neglect 2-2 

2–2 NIS Data Sources 2-5 

2–3 Schematic Summary of the NIS Methodology 2-6 

4–1 Percent Changes since the NIS–3 in Rates of Harm Standard

 Maltreatment by Child’s Sex 4-4 

4–2 Percent Changes since the NIS–3 in Rates of Endangerment

 Standard Maltreatment by Child’s Sex 4-6 

4–3 Age Differences in Incidence Rates for All Harm Standard

 Maltreatment, Abuse, and Neglect 4-8 

4–4 Age Differences in Incidence Rates for Harm Standard Physical and

 Emotional Abuse 4-9 

4–5 Age Differences in Incidence Rates for Harm Standard Emotional

 and Educational Neglect 4-10 

4–6 Age Differences in Incidence of Children Moderately Harmed by

 Harm Standard Maltreatment 4-11 

4–7 Percent Changes in Incidence Rates of Harm Standard Sexual

 Abuse Related to Age 4-12 

4–8 Age Differences in Incidence Rates for All Endangerment

 Standard Maltreatment, Abuse, and Neglect 4-13 

4–9 Age Differences in Incidence Rates for Endangerment Standard

 Physical and Emotional Abuse 4-14 

4–10 Age Differences in Incidence Rates for Endangerment Standard

 Physical, Emotional, and Educational Neglect 4-15 

4–11 Age Differences in the Incidence of Children Seriously Harmed, 

Moderately Harmed, and Endangered by Endangerment Standard 

Maltreatment 4-17 

4–12 Percent Changes since the NIS–3 in Rates of Endangerment Standard 

Maltreatment by Child’s Age................................................................. 4-19 

4–13 Percent Changes since the NIS–3 in Rates of Endangerment Standard 

Neglect by Child’s Age.......................................................................... 4-19 

4–14 Percent Changes since the NIS–3 in Rates of Endangerment Standard 

Emotional Neglect by Child’s Age ........................................................ 4-20 

4–15 Percent Changes since the NIS–3 in the Incidence of Children 

Endangered but Not Harmed by Endangerment Standard 

Maltreatment by Child’s Age 4-21 

4–16 Percent Changes in Incidence Rates for Harm Standard Maltreatment 

Related to Child’s Race/ethnicity .......................................................... 4-25 

4–17 Percent Changes in Incidence Rates for Endangerment 

Standard Maltreatment Related to Child’s Race/ethnicity..................... 4-29 

5–1 Incidence of Harm Standard Maltreatment by Family Structure 

and Living Arrangement 5-20 

5–2 Incidence of Harm Standard Abuse by Family Structure and 

Living Arrangement. 5-22 

5–3 Incidence of Harm Standard Neglect by Family Structure and 

Living Arrangement 5-24 

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 ........ 

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 .................................... 

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Percent Changes since NIS–3 in Rates of Harm Standard 

Maltreatment, Abuse, and Neglect by Family Structure..

........................................... 

5–4 Incidence of Outcomes from Harm Standard Maltreatment by 

Family Structure and Living Arrangement. 5-25 

5– 5

5-27 

5–6 Percent Changes since NIS–3 in Rates of Specific Categories 

of Harm Standard Abuse by Family Structure 5-28 

5–7 Percent Changes since NIS–3 in Rates of Specific Categories 

of Harm Standard Neglect by Family Structure 5-29 

5–8 Percent Changes since NIS–3 in Severity of Outcomes from 

Harm Standard Maltreatment by Family Structure 5-29 

5–9 Incidence of Endangerment Standard Maltreatment by Family 

Structure and Living Arrangement 5-30 

5– Incidence of Endangerment Standard Abuse by Family 

Structure and Living Arrangement 5-32 

5–11 Incidence of Endangerment Standard Neglect by Family 

Structure and Living Arrangement 5-34 

5–12 Incidence of Outcomes from Endangerment Standard 

Maltreatment by Family Structure and Living Arrangement 5-35 

5–13 Percent Changes since NIS–3 in Rates of Endangerment 

Standard Maltreatment, Abuse, and Neglect by Family Structure 5-37 

5–14 Percent Changes since NIS–3 in Rates of Specific Categories of 

Endangerment Standard Abuse by Family Structure. 5-38 

5– 15 Percent Changes since NIS–3 in Rates of Specific Categories of 

Endangerment Standard Neglect by Family Structure. 5-39 

5–16 Percent Changes since NIS–3 in Severity of Outcomes from 

Endangerment Standard Maltreatment by Family Structure 5-40 

5–17 Incidence of Harm Standard Maltreatment by Family Size................... 5-44 

5–18 Severity of Outcomes from Harm Standard Maltreatment 

by Family Size 5-45 

5–19 Changes since NIS–3 in the Incidence of Inferred Harm from 

Harm Standard Maltreatment Related to Family Size 5-47 

5– 20 Incidence of Endangerment Standard Overall Maltreatment, 

Abuse, and Neglect by Family Size 5-48 

5–21 Incidence of Specific Categories of Endangerment Standard 

Maltreatment by Family Size 5-49 

5–22 Severity of Outcomes from Endangerment Standard 

Maltreatment by Family Size 5-51 

5–23 Incidence of Harm Standard Abuse by County Metrostatus 5-54 

5–24 Incidence of Harm Standard Neglect and of Serious Harm from 

Harm Standard Maltreatment by County Metrostatus. 5-55 

5– 25 Incidence of Endangerment Standard Maltreatment by County 

Metrostatus. 5-56 

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...... 

 

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 ..................................................................................................... 

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................................................................................. 

................................................................................ 

............................................................ 

5–26 

5–27 

5–28 

6–1 

6–2 

6–3 

Incidence of Specific Categories of Endangerment Standard 

Abuse by County Metrostatus

Incidence of Specific Categories of Endangerment Standard 

Neglect by County Metrostatus .

Outcomes from Endangerment Standard Maltreatment by 

County Metrostatus

Race/ethnicity of Neglected Children by Their Most Closely 

Related Perpetrator

Perpetrator Problems in Overall Harm Standard Maltreatment, 

Abuse, and Neglect 

Perpetrator Problems in Specific Categories of Harm Standard 

Abuse

5-57 

5-58 

5-59 

6-14 

6-16 

6-16 

6–4 

6–5 

Perpetrator Problems in Specific Categories of Harm Standard Neglect 

Perpetrator Problems in Maltreatment of Children With Different 

Levels of Harm ...................................................................................... 

6-17 

6-18 

6–6 

7–1 

Perpetrator’s Problems in Harm Standard Maltreatment by 

Perpetrator’s Relationship to the Child.

Sources that Recognized Children Who Experienced Harm 

Standard Maltreatment........................................................................... 

6-19 

7-4 

7–2 

7–3 

8–1 

Sources that Recognized Children Who Experienced 

Endangerment Standard Maltreatment .................................................. 

Responses to Maltreatment Vignettes in the SDS by Sentinel 

Groups.................................................................................................... 

Changes in Rates of CPS Investigation of Children with Harm 

Standard Maltreatment........................................................................... 

7-8 

7-14 

8-4 

8–2 

8–3 

8–4 

8–5 

CPS Investigation of Maltreated Children in the NIS–4, by Harm 

Standard Maltreatment Category and Severity of Harm........................ 

Changes in Investigation Rates for Harm Standard Abuse Across 

NIS Cycles ............................................................................................. 

Changes in Investigation Rates for Harm Standard Neglect Across 

NIS Cycles .......................................................................................

Changes in Investigation Rates for Children by the Severity of 

Their Most Serious Harm from Harm Standard Maltreatment 

Across NIS Cycles ..........................................................................

8-6 

8-7 

8-8 

8–6 

8–7 

8–8 

....... 

CPS Investigation of Children with Harm Standard Maltreatment 

in the NIS–4, by Recognition Source .................................................... 

Changes since NIS–3 in Investigation Rates of Harm Standard 

Children by Recognition Source...............................................

Changes in Rates of CPS Investigation of Children with 

Endangerment Standard Maltreatment .................................................. 

8-9 

8-10 

8-13 

8-14 

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........ 

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.... 

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8-9 

8–10 

8–11 

8-12 

8–13 

8–14 

8–15 

8–16 

8–17 

CPS Investigation of Maltreated Children in the NIS–4, by 

Endangerment Standard Maltreatment Category and Severity

of Harm ....................................................................................

Changes in Investigation Rates for Endangerment Standard Abuse 

Across NIS Cycles .............................................................................

Changes in Investigation Rates for Endangerment Standard 

Neglect Across NIS Cycles.................................................................... 

Changes in Investigation Rates for Children by the Severity of 

Their Most Serious Harm from Endangerment Standard 

Maltreatment Across NIS Cycles........................................................... 

CPS Investigation of Children with Endangerment Standard 

Maltreatment in the NIS–4, by Recognition Source.............................. 

Changes since NIS–3 in Investigation Rates of Children with 

Endangerment Standard Maltreatment by Recognition Source.

Uninvestigated Maltreated Children in the NIS–4 Whom CPS 

Probably Would Investigate According to Agencies’ Screening 

Criteria, by Harm Standard Maltreatment Category.............................. 

Uninvestigated Maltreated Children in the NIS–4 Whom CPS 

Probably Would Investigate According to Agencies’ Screening 

Criteria, by Endangerment Standard Maltreatment Category........

Percentages of Sentinels Whose Agency’s Policy Permits 

Individuals to Report to CPS and Who Have Personally 

Reported a Case

8-15 

8-17 

8-18 

8-18 

8-20 

8-22 

8-26 

8-31 

8-40 

REFERENCES R-1 

APPENDICES 

A DESIGN AND METHODS SUMMARY ............................................. A-1 

B HARM STANDARD ESTIMATES...................................................... B-1 

C ENDANGERMENT STANDARD ESTIMATES ................................ C-1 

D COMPARISONS OF SUBGROUPS WITHIN THE NIS–4 ................ D-1 

E COMPARISONS BETWEEN THE NIS–3 AND NIS–4...................... E-1 

x 
 

 

 

EXECUTIVE SUMMARY
 

This executive summary describes the Fourth National Incidence Study of 

Child Abuse and Neglect (NIS–4). It discusses the NIS–4 background and objectives, 

reports on the design and methods, and presents the key findings and implications. 

1. Background and Objectives 

The National Incidence Study (NIS) is a congressionally mandated, periodic 

effort of the United States Department of Health and Human Services. In 1974, Public 

Law (P.L.) 93–247 mandated the first NIS (NIS–1), which collected data in 1979 and 

1980. The NIS–2 was mandated under P.L. 98–457 (1984) and collected data in 1986. 

The NIS–3, mandated by the Child Abuse Prevention, Adoption, and Family Services 

Act of 1988 (P.L. 100–294) and the Child Abuse, Domestic Violence, Adoption and 

Family Services Act of 1992 (P.L. 102–295), collected data in 1993. The Keeping 

Children and Families Safe Act of 2003 (P.L. 108-36) mandated the NIS–4, which 

collected data in 2005 and 2006. The principal objectives of the NIS–4 were to provide 

updated estimates of the incidence of child abuse and neglect in the United States and 

measure changes in incidence from the earlier studies. 

2. Design and Methods 

Main study. The NIS serves as the nation’s needs assessment on child abuse 

and neglect. It offers a unique perspective on the scope of the problem beyond the 

children that child protective service (CPS) agencies investigate. While the NIS includes 

children who were investigated by CPS agencies, it also obtains data on other children 

who were not reported to CPS or who were screened out by CPS without investigation. 

These additional children were recognized as maltreated by community professionals. 

Thus, the NIS estimates include both abused and neglected children who are in the 

official CPS statistics and those who are not. 

The NIS follows a nationally representative design, so the estimates reflect 

the numbers of abused and neglected children in the United States who come to the 

1
 
attention of community professionals. The fact that there have been three previous cycles 

using comparable methods and definitions means that one can compare NIS–4 estimates 

with those from the earlier studies in order to identify changes over time in the incidence 

and distribution of abused and neglected children. 

The NIS–4 data derive from a nationally representative sample of 122 

counties. The 126 CPS agencies serving these counties were key participants, providing 

basic demographic data on all the children who were reported and accepted for 

investigation during the 3-month study reference period (either September 4 through 

December 3, 2005 or February 4 through May 3, 2006). The NIS–4 obtained further 

details about the child’s maltreatment and the outcome of the CPS investigation for a 

representative sample of these cases. 

Like the earlier NIS cycles, the NIS–4 employed a sentinel survey 

methodology. In this approach, community professionals who work in certain categories 

of agencies and who typically encounter children and families in the course of their job 

duties serve as lookouts for victims of child abuse and neglect. In each county, these 

professionals, called “sentinels,” represent all staff that have contact with children and 

families in police and sheriffs’ departments, public schools, day care centers, hospitals, 

voluntary social service agencies, mental health agencies, the county juvenile probation 

and public health departments, public housing, and shelters for runaway and homeless 

youth and for victims of domestic violence. The participating sentinels in the NIS–4 

were 10,791 professionals in 1,094 sentinel agencies. They submitted data forms on any 

children they encountered who were maltreated during the study data period. The NIS–4 

collected a total of 6,208 completed data forms from sentinels and 10,667 completed 

forms on the investigation outcomes and the abuse and neglect involved in cases sampled 

at participating CPS agencies. 

The NIS uses standard definitions of abuse and neglect, so its estimates of the 

numbers of maltreated children and incidence rates have a calibrated, standard meaning 

across the various sites (multiple states and agencies), sources (CPS and community 

professionals), and NIS cycles. As in previous cycles, children submitted by sentinels 

and those described in the CPS sampled cases were evaluated according to standard study 

definitions of abuse and neglect, and only children who fit the standards were used in 

generating the national estimates. 

2
 
In the NIS classifications, maltreatment encompasses both abuse and neglect. 

Abuse includes physical abuse, sexual abuse, and emotional abuse. Neglect includes 

physical neglect, emotional neglect, and educational neglect. Each of these categories 

comprises more specific forms of abuse or neglect. The standardized NIS definitions 

describe the acts and omissions for each specific form. The NIS–4 applied a more 

differentiated system for classifying the specific forms of maltreatment than the earlier 

NIS cycles used. However, the NIS–4 definitional standards were identical to those used 

in the NIS–2 and NIS–3. These standards specify the criteria for deciding whether a 

child’s situation “counts” as maltreatment to include in the study estimates. The criteria 

specify a number of required features, such as the child’s relationship to the perpetrator 

(the abuse or neglect must be within the jurisdiction of CPS, perpetrated or permitted by a 

parent or caretaker), the severity of the injury or harm that resulted, and the degree of 

evidence for holding the alleged perpetrator(s) responsible for the maltreatment. 

The NIS applies two definitional standards in parallel: the Harm Standard 

and the Endangerment Standard. The Harm Standard has been in use since the NIS–1. 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. It permits exceptions in 

only a few specific maltreatment categories, where the nature of the maltreatment itself is 

so egregious that one can infer that the child was harmed. The chief advantage of the 

Harm Standard is its strong objectivity. Its principal disadvantage is that it is so stringent 

that it provides a perspective that is too narrow for many purposes, excluding even many 

children whom CPS substantiates or indicates as abused or neglected. 

The Endangerment Standard has been in use since the NIS–2. It includes all 

children who meet the Harm Standard but adds others as well. The central feature of the 

Endangerment Standard is that it counts children who were not yet harmed by abuse or 

neglect if a sentinel thought that the maltreatment endangered the children or if a CPS 

investigation substantiated or indicated their maltreatment. In addition, the 

Endangerment Standard is slightly more lenient than the Harm Standard in allowing a 

broader array of perpetrators, including adult caretakers other than parents in certain 

maltreatment categories and teenage caretakers as perpetrators of sexual abuse. 

Following procedures that corresponded to those used in earlier NIS cycles, 

the NIS–4 study team unduplicated the data (so the study estimates represent each 

maltreated child only once), weighted the records (so the sample data could generate 

3
 
 

 

national estimates of the number of maltreated children), and annualized the final weights 

(to enable the 3-month reference period to provide estimates reflecting a full year). 

Supplementary studies. In addition to the main study, the NIS–4 included 

several supplementary studies, three of which are used in this report to interpret the main 

study findings. Two were surveys of CPS agencies—one on their overall policies, 

procedures and practices and the second on their screening standards, to determine how 

they would treat referrals concerning the uninvestigated cases that sentinels identified. 

The third supplementary study was a survey of sentinels on their backgrounds and 

definitions of child abuse and neglect and concerning their standards for reporting 

suspected maltreatment to CPS or submitting data on maltreated children to the NIS. 

The CPS Structure and Practices Mail Survey (SPM) was modeled after the 

Local Agency Survey (LAS) in the 2002 National Study of Child Protective Service and 

Reform Efforts. The SPM questionnaire included 4 modules, each focused on a specific 

CPS function: Administration, Screening/Intake, Investigation, and Alternative CPS 

Response. CPS agencies that participated in the NIS–4 responded to the SPM. 

The CPS Screening Policies Study (SPS) involved telephone interviews with 

intake/screening supervisors (or their delegates) in participating NIS–4 CPS agencies to 

identify the criteria their agency used in deciding whether to investigate a referral. The 

SPS coders then applied these screening criteria to the uninvestigated children in the 

NIS–4 main study to infer whether CPS agencies would have screened these children in 

for an investigation according to their stated policies. 

The Sentinel Definitions Survey (SDS) asked sentinels who had participated 

in the NIS–4 about their characteristics and backgrounds—including their demographics, 

job title and tenure, whether they had received any written information or training on 

reporting child abuse and neglect while working at their agency, their agency’s policy on 

reporting to CPS, and whether they had made any reports while working at their agency. 

The questionnaire also included vignettes that described situations of Harm Standard 

abuse and neglect. Follow-up questions asked whether the respondent considered the case 

to be maltreatment, would report it to CPS, would submit it to a national study on child 

abuse and neglect, or would not respond in any of these ways. 

4
 
 

 

3. The National Incidence of Child Abuse and Neglect 

The findings of the Fourth National Incidence Study of Child Abuse and 

Neglect (NIS–4) show an overall decrease in the incidence of maltreatment since the 

NIS–3, as well as decreases in some specific maltreatment categories and increases in 

others. 

Incidence of Harm Standard maltreatment. Using the stringent Harm 

Standard definition, more than 1.25 million children (an estimated 1,256,600 children) 

experienced maltreatment during the NIS–4 study year (2005–2006). This corresponds to 

one child in every 58 in the United States. A large percentage (44%, or an estimated total 

of 553,300) were abused, while most (61%, or an estimated total of 771,700) were 

neglected. The NIS classifies children in every category that applies, so the components 

(here and throughout the NIS findings) sum to more than 100%. Most of the abused 

children experienced physical abuse (58% of the abused children, an estimated total of 

323,000). Slightly less than one-fourth were sexually abused (24%, an estimated 

135,300), while slightly more than one-fourth were emotionally abused (27%, an 

estimated 148,500). Almost one-half of the neglected children experienced educational 

neglect (47% of neglected children, an estimated 360,500 children), more than one-third 

were physically neglected (38%, an estimated 295,300 children), and one-fourth were 

emotionally neglected (25%, an estimated 193,400 children). 

Unlike the dramatic increase in the incidence of Harm Standard maltreatment 

that occurred between the NIS–2 and NIS–3, where the rate increased by 56%, the NIS–4 

reveals a smaller change since the NIS–3, in the opposite direction. The NIS–4 estimate 

of the incidence of overall Harm Standard maltreatment in the 2005–2006 study year 

reflects a 19% decrease in the total number of maltreated children since the NIS–3 in 

1993. Taking into account the increase in the number of children in the United States 

over the interval, this change is equivalent to a 26% decline in the rate of overall Harm 

Standard maltreatment per 1,000 children in the population. This decrease is close-tosignificant, meaning the probability that it is due to chance factors is less than 10%. This 

decrease returned the incidence of Harm Standard maltreatment to a level that does not 

differ from the NIS–2 estimate for 1986. 

The number of children who experienced Harm Standard abuse declined 

significantly, by 26%, from an estimated 743,200 in the NIS–3 to 553,300 in the NIS–4. 

5
 
 

 

This reflects a 32% decrease in the rate of Harm Standard abuse per 1,000 children in the 

nation. Moreover, the incidence of all specific categories of abuse decreased: The 

incidence of sexual abuse decreased significantly, while the declines in physical abuse 

and emotional abuse were both close-to-significant: 

•	 The estimated number of sexually abused children under the Harm

Standard decreased from 217,700 in 1993 to 135,300 in 2005–2006 (a 

38% decrease in the number of sexually abused children and a 44%

decrease in the rate of sexual abuse); 

•	 The number of children who experienced Harm Standard physical

abuse decreased from an estimated 381,700 at the time of the NIS–3 to 

an estimated 323,000 in the NIS–4 (a 15% decrease in number and a 

23% decline in the rate); 

•	 The estimated number of emotionally abused children under the Harm

Standard was 204,500 at the time of the NIS–3, which decreased to 

148,500 during the NIS–4 (a 27% decrease in number; a 33% decline in 

the rate). 

The incidence of Harm Standard neglect showed no statistically reliable 

changes since the NIS–3, neither overall nor in any of the specific neglect categories 

(physical, emotional, and educational neglect). 

Classifying these abused and neglected children according to the level of 

injury or harm they suffered from Harm Standard maltreatment revealed only one 

change: a significant decrease in the incidence of children for whom injury could be 

inferred due to the severe nature of their maltreatment. This group declined from 

165,300 children in the NIS–3 to 71,500 in the NIS–4 (a 57% decrease in number; a 60% 

decline in the rate in the population). 

Incidence of Endangerment Standard maltreatment. Defining 

maltreatment according to the more inclusive Endangerment Standard provides a very 

different picture of the incidence and distribution of child abuse and neglect. Nearly 3 

million children (an estimated 2,905,800) experienced Endangerment Standard 

maltreatment during the NIS–4 2005–2006 study year. This corresponds to one child in 

every 25 in the United States. While 29% (an estimated 835,000 children) were abused, 

more than three-fourths (77%, an estimated 2,251,600 children) were neglected. Most 

abused children (57%, or 476,600 children) were physically abused, more than one-third 

6
 
(36%, or 302,600 children) were emotionally abused, and less than one-fourth (22%, or 

180,500 children) were sexually abused. Under the Endangerment Standard definitions, 

more than one-half of the neglected children were physically neglected (53%, or 

1,192,200 children) and a similar percentage were emotionally neglected (52%, or 

1,173,800), whereas 16% (an estimated 360,500) were educationally neglected. 

Between 1993 and 2005–2006, the overall incidence of children who 

experienced Endangerment Standard maltreatment showed no statistically reliable 

change. However, within Endangerment Standard maltreatment, counterbalancing 

changes occurred in the incidence of abuse and neglect. Significant decreases in the 

incidence of abuse and all specific categories of abuse contrast with a significant increase 

in the incidence of emotional neglect: 

•	 The estimated number of children who experienced Endangerment 

Standard abuse decreased from 1,221,800 to 835,000 (a 32% decrease 

in number, a 38% decline in the rate); 

•	 The estimated number of physically abused children decreased from an

estimated 614,100 children to 476,600 (a 22% decrease in number, a 

29% decline in the rate); 

•	 The incidence of children with Endangerment Standard sexual abuse

decreased from 300,200 in 1993 to 180,500 in 2005–2006 (reflecting a 

40% decrease in number and a 47% decline in the rate); 

•	 The incidence of emotionally abused children decreased from 532,200 

to 302,600 (a 43% decrease in number, a 48% decline in the rate); and 

•	 The estimated number of emotionally neglected children more than

doubled in the interval between the studies, rising from 584,100 in 1993 

to 1,173,800 in 2005–2006 (a 101% increase in number, an 83%

increase in the rate). 

Classifying these children according to the severity of harm they suffered as a 

result of their Endangerment Standard maltreatment revealed no significant changes in 

the incidence of children with any specific level of injury or harm. 

7
 
 

 

 

 

4.	 Distribution of Child Abuse and Neglect by the Child’s

Characteristics 

The child’s sex, age, race, disability status, and school enrollment were all 

related to rates of maltreatment. 

Child’s sex. Girls were sexually abused much more often than boys, under 

both the Harm Standard and the Endangerment Standard. This finding is consistent with 

earlier NIS results, 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 injury 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. 

Boys’ rates of Harm Standard physical neglect and of serious harm under 

both standards decreased more since the NIS–3 than the corresponding rates for girls. 

The incidence of boys who experienced Endangerment Standard emotional neglect 

increased less since the NIS–3 than that of girls. Moreover, trends in the incidence of 

inferred harm from Endangerment Standard maltreatment moved in opposite directions 

for girls and boys—the incidence of girls with inferred harm declined slightly since the 

NIS–3, while the incidence of boys with inferred harm rose. 

Child’s age. A consistent feature of the age differences in NIS–4 incidence 

rates is the lower incidence of maltreatment among the youngest children in the Harm 

Standard abuse and neglect rates and in the rates of Endangerment Standard abuse. In 

most cases, the 0- to 2-year-olds had significantly lower maltreatment rates than older 

children. It is possible that the lower rates at these younger ages reflect some 

undercoverage of these age groups. That is, prior to attaining school age, children are 

less observable to community professionals. 

In contrast, the age differences in Endangerment Standard neglect (overall, as 

well as in the specific categories of physical neglect and emotional neglect) revealed a 

distinctly different pattern. In these categories, the oldest children (15- to 17-year-olds) 

have the lowest rates and 6- to 8-year-olds have the highest rates. This curvilinear age 

pattern may reflect the combination of opposing age distributions for different 

8
 
maltreatment outcomes—rates of children with serious and moderate harm from 

maltreatment generally increase with increasing age, whereas rates of children who were 

endangered, but not demonstrably harmed, by their maltreatment experiences sharply 

decrease across the age continuum. Because the endangered children are more prevalent 

among those who experienced Endangerment Standard physical and emotional neglect, 

this opposing age trend primarily affected the age distribution in these categories, shaping 

the curvilinear pattern. 

Another recurring theme in connection with age was that of disproportionate 

increases since the NIS–3 in the incidence of maltreatment among the youngest children 

(ages 0 to 2). This occurred for rates of Harm Standard sexual abuse and, in the 

Endangerment Standard, for overall maltreatment, neglect, emotional neglect, and the 

endangerment outcome. All of these are categories where the NIS–4 maltreatment rates 

for the youngest children are not lower than those for the older children. The changes 

since the NIS–3 have essentially flattened the age differences in incidence rates, 

evidencing broad vulnerability across the age spectrum. These changes may reflect true 

increases in maltreatment of the youngest children or could instead represent 

improvement in the NIS coverage of these maltreatment events among 0- to 2-year-olds. 

Race/ethnicity. Unlike previous NIS cycles, the NIS–4 found strong and 

pervasive race differences in the incidence of maltreatment. In nearly all cases, the rates 

of maltreatment for Black children were significantly higher than those for White and 

Hispanic children. These differences occurred under both definitional standards in rates 

of overall maltreatment, overall abuse, overall neglect, and physical abuse and for 

children with serious or moderate harm from their maltreatment. They also occurred in 

the incidence of Harm Standard sexual abuse, in the incidence of children who were 

inferred to be harmed by Harm Standard maltreatment, and in Endangerment Standard 

rates for physical neglect, emotional maltreatment, and children who were endangered 

but not demonstrably harmed by their maltreatment. 

In part, the emergence of race/ethnicity differences in the NIS–4 may stem 

from the greater precision of the NIS–4 estimates. Statistical tests are able to detect more 

of the underlying differences when estimates are more precise. However, the recently 

identified race/ethnicity differences are also consistent with changes in maltreatment rates 

since the NIS–3. While general declines in rates of maltreatment were noted since the 

NIS–3, these declines did not occur equally for all races and ethnicities. Rather, under 

9
 
 

 

both definitional standards, rates of maltreatment for White children declined more than 

the rates for Black and Hispanic children in the incidence of abuse, physical abuse, and 

children seriously harmed by maltreatment. For Harm Standard emotional neglect, 

maltreatment rates for White children declined while rates for Black and Hispanic 

children increased. For Endangerment Standard emotional neglect, rates for White 

children increased less than the rates for Black and Hispanic children. 

Disability. The NIS–4 is the first NIS cycle to examine the relationship 

between the incidence of maltreatment and children’s disability status. Under the Harm 

Standard, children with confirmed disabilities had significantly lower rates of physical 

abuse and of moderate harm from maltreatment, but they had significantly higher rates of 

emotional neglect and of serious injury or harm. Using the Endangerment Standard to 

define maltreatment revealed more extensive differences, some similar to the Harm 

Standard findings, but also some quite different results. Children with disabilities had a 

significantly lower rate of Endangerment Standard abuse overall, consistent with their 

lower rate of physical abuse under both standards. Children with disabilities also had 

significantly lower rates of Endangerment Standard sexual abuse, neglect, physical 

neglect, and emotional neglect; and they were significantly less likely to be moderately 

harmed or endangered but not demonstrably harmed by the maltreatment. Similar to the 

Harm Standard finding, the children with disabilities were significantly more likely to be 

seriously injured or harmed when they experienced maltreatment. The findings on the 

incidence of emotional neglect are exactly opposite under the two standards. This 

indicates that, although children with confirmed disabilities were less likely to be 

emotionally neglected, they more often suffered harm from that maltreatment (in fact, 

serious harm) and so were more often countable under the Harm Standard in this 

category. 

School enrollment. For the first time in the NIS, the NIS–4 gathered 

information about children’s enrollment in school. Across both definitional standards, 

school-aged children who were not enrolled in school were sexually abused more often 

than enrolled children and more often qualified for inferred harm, an outcome frequently 

associated with sexual abuse. Enrolled children had significantly higher rates of 

moderate harm as a result of maltreatment and they were at marginally higher risk of 

educational neglect. This latter finding warrants explanation. On the one hand, simply 

knowing that a school-age child is not enrolled in school is not sufficient to classify the 

child as educationally neglected in NIS. Data on most nonenrolled children lacked 

10
 
 

 

details that would exclude legitimate reasons for their circumstance, such as the child 

being seriously ill, suspended, expelled, or recently moved and not yet enrolled at a new 

location. On the other hand, since schools regularly track absences of enrolled children, 

NIS sentinels are likely to describe these to the study. 

Enrolled children had higher rates of Harm Standard physical abuse and of 

overall Harm Standard maltreatment. In contrast, nonenrolled school-age children had 

higher rates of Endangerment Standard maltreatment, overall and in the categories of 

neglect, physical neglect, and emotional neglect. The nonenrolled children were also 

more likely to be classified as endangered, but not demonstrably harmed, by their 

Endangerment Standard maltreatment. 

5.	 Distribution of Child Abuse and Neglect by Family

Characteristics 

The incidence of child maltreatment varied as a function of several 

characteristics of children’s families, including their parents’ employment, family 

socioeconomic status, family structure and living arrangement, grandparent caregivers, 

family size, and the metropolitan status of the county. 

Parents’ employment. Unemployed parents were those described as 

unemployed or laid off but looking for work either currently (at the time of maltreatment) 

or at any time during the past year. Employed parents were those who had steady full- or 

part-time work, with no reported unemployment currently or in the previous year. 

Parents who were not in the labor force were not employed or actively looking for work. 

These included parents who were retired, disabled, homemakers, receiving Temporary 

Assistance for Needy Families (TANF), on maternity leave, in the hospital, or in jail. 

Under both definitional standards, the incidence of maltreatment and of all severities of 

injury or harm was higher for children with no parent in the labor force and those with an 

unemployed parent and lowest for those with employed parents. Compared to children 

with employed parents, those with no parent in the labor force had 2 to 3 times the rate of 

maltreatment overall, about 2 times the rate of abuse, and 3 or more times the rate of 

neglect. Children with unemployed parents had 2 to 3 times higher rates of neglect than 

those with employed parents. 

11
 
 

 

 

 

Socioeconomic status. To contend with missing data on individual items, 

the NIS–4 analyses combined three indicators into a general measure of socioeconomic 

status: household income, household participation in any poverty program, and parents’ 

education. Low socioeconomic status households were those in the bottom tier on any 

indicator: household income below $15,000 a year, parents’ highest education level less 

than high school, or any member of the household a participant in a poverty program, 

such as TANF, food stamps, public housing, energy assistance, or subsidized school 

meals. Children in low socioeconomic status households had significantly higher rates of 

maltreatment in all categories and across both definitional standards. They experienced 

some type of maltreatment at more than 5 times the rate of other children; they were more 

than 3 times as likely to be abused and about 7 times as likely to be neglected. 

Family structure and living arrangement. Family structure reflects the 

number of parents in the household and their relationship to the child; living arrangement 

reflects their marital or cohabitation status. Considering both factors, the NIS–4 

classified children into six categories: living with two married biological parents, living 

with other married parents (e.g., step-parent, adoptive parent), living with two unmarried 

parents, living with one parent who had an unmarried partner in the household, living 

with one parent who had no partner in the household, and living with no parent. The 

groups differed in rates of every maltreatment category and across both definitional 

standards. Children living with their married biological parents universally had the 

lowest rate, whereas those living with a single parent who had a cohabiting partner in the 

household had the highest rate in all maltreatment categories. Compared to children 

living with married biological parents, those whose single parent had a live-in partner had 

more than 8 times the rate of maltreatment overall, over 10 times the rate of abuse, and 

nearly 8 times the rate of neglect. 

Comparable data were available to assess changes since the NIS–3 in 

maltreatment rates for two groups of children: those living with two parents and those 

living with one parent. In nearly all categories, the incidence of maltreatment and levels 

of harm increased since the NIS–3 for children living with one parent but decreased for 

those living with two parents. The largest rate increase for children with one parent was 

in Endangerment Standard neglect (58% higher in NIS–4 than in NIS–3), especially the 

specific category of emotional neglect (a 194% increase). The largest decrease for 

children living with two parents occurred in the rate of Harm Standard sexual abuse, 

which declined by 61% from its level at the time of the NIS–3. 

12
 
 

 

 

Grandparents as caregivers. The NIS–4 could identify a grandparent as a 

child’s caregiver under three conditions: when the grandparent was the child’s primary 

caregiver, when the primary caregiver did not have a spouse or partner and the 

grandparent was the secondary caregiver, and when the grandparent was a caregiver and 

maltreated the child. Children whose grandparent cared for them had lower rates of 

physical abuse compared to those with no identified grandparent caregiver: they had twothirds the rate of Harm Standard physical abuse and less than four-fifths the rate of 

Endangerment Standard physical abuse. 

Family size. The incidence of maltreatment was related to the number of 

dependent children in the family, in Harm Standard categories of overall maltreatment 

and all neglect and in Endangerment Standard maltreatment, abuse, neglect, and in 

physical and emotional maltreatment, both abuse and neglect. The general pattern was 

nonlinear: the incidence rates were highest for children in the largest families (those with 

4 or more children), intermediate for “only” children and those in households with 3 

children, and lowest for children in families with two children. The largest differences 

occurred in the Endangerment Standard maltreatment rates, especially for the neglect 

categories, where the incidence rates for children in the largest households were more 

than twice the rates for children in households with 2 children. 

County metropolitan status. Except for educational neglect, the incidence 

of all categories of Endangerment Standard maltreatment was higher in rural counties 

than in urban counties and similar patterns also emerged in rates of most categories of 

Harm Standard maltreatment. Rural children had a nearly 2 times higher rate of overall 

Harm Standard maltreatment and nearly 2 times higher rate of overall Endangerment 

Standard maltreatment. Whether this reflects better coverage of maltreated children in 

the rural counties or higher rates of actual maltreatment in rural communities is not clear. 

Nor is it clear how differential distribution of other factors, such as socioeconomic status 

and family size differences, may contribute to these metropolitan status differences. 

13
 
 

 

 

 

 

6.	 Distribution of Child Abuse and Neglect by Perpetrator

Characteristics 

The NIS–4 classified children who experienced Harm Standard maltreatment 

according to their perpetrator’s relationship to them. Analyses examined associated 

differences in the distributions of the perpetrator’s sex and age, type of maltreatment, 

severity of harm to the child, the child’s race, and the extent to which the perpetrators’ 

problems with alcohol use, drug use, or mental illness played a role in the maltreatment. 

Perpetrator’s relationship to the child. The majority of all children 

countable under the Harm Standard (81%) were maltreated by their biological parents. 

This held true both for the abused children (64% were abused by biological parents) and 

for those neglected (92% were neglected by biological parents). 

Biological parents were the most closely related perpetrators for 71% of 

physically abused children and for 73% of emotionally abused children. The pattern was 

distinctly different for sexual abuse. More than two-fifths (42%) of the sexually abused 

children were sexually abused by someone other than a parent (whether biological or 

nonbiological) or a parent’s partner, whereas just over one-third (36%) were sexually 

abused by a biological parent. In addition, severity of harm from physical abuse varied 

by the perpetrator’s relationship to the child. A physically abused child was more likely 

to sustain a serious injury when the abuser was not a parent. 

Perpetrator’s sex. Children were somewhat more likely to be maltreated by 

female perpetrators than by males: 68% of the maltreated children were maltreated by a 

female, whereas 48% were maltreated by a male. (Some children were maltreated by 

both.) Of children maltreated by biological parents, mothers maltreated the majority 

(75%) whereas fathers maltreated a sizable minority (43%). In contrast, male 

perpetrators were more common for children maltreated by nonbiological parents or 

parents’ partners (64%) or by other persons (75%). 

The predominant sex of perpetrators of abuse was different from that of 

neglect. Female perpetrators were more often responsible for neglect (86% of children 

neglected by females versus 38% by males). This finding is congruent with the fact that 

mothers (biological or other) tend to be the primary caretakers and are the primary 

persons held accountable for any omissions and/or failings in caretaking. In contrast, 

14
 
 

 

males more often were abusers (62% of children were abused by males versus 41% by 

females). The prevalence of male perpetrators was strongest in the category of sexual 

abuse, where 87% of children were abused by a male compared to only 11% by a female. 

Among all abused children, those abused by their biological parents were 

about equally likely to have been abused by mothers as by fathers (51% and 54%, 

respectively), but those abused by nonbiological parents or parents’ partners, or by other, 

perpetrators were much more likely to be abused by males (74% or more by males versus 

26% or less by females). 

Perpetrator’s age. Among all maltreated children, only a small percentage 

(11%) was maltreated by a perpetrator in the youngest age bracket (under 26 years of 

age). However, younger perpetrators were much more predominant among children who 

were maltreated by someone who was not a parent (34%). 

Child’s race and relationship to the perpetrator. The NIS–4 explored 

whether the children’s race was systematically related to the perpetrator’s relationship to 

them, either overall or in specific maltreatment categories. Overall, and across most 

maltreatment categories, the racial distribution of maltreated children did not vary with 

their perpetrator’s relationship. The exceptions were in overall neglect and in the specific 

category of physical neglect, which displayed the same pattern. The majority of children 

physically neglected by a biological parent were White (58%), whereas children 

neglected by a nonbiological parent or parent’s partner were predominantly Black (53%). 

Perpetrator’s alcohol use, drug use, and mental illness. CPS investigators 

and NIS–4 sentinels indicated whether they considered these issues to be factors in the 

child’s maltreatment. Perpetrator’s alcohol use and drug use were approximately 

equivalent factors in Harm Standard maltreatment, each applying to 11% of the countable 

children, while mental illness was a factor in the maltreatment of 7% of the children. 

Perpetrator’s alcohol use was slightly more often implicated in abuse situations than drug 

use (13% versus 10%), largely because alcohol was more frequently involved in physical 

abuse and emotional abuse. Alcohol use was most involved in emotional abuse (22% of 

the children), while drug use was most involved in emotional neglect (21% of the 

children). The perpetrator’s mental illness was most often cited as a factor in emotional 

abuse (17% of the children). All three factors were more often involved in maltreatment 

when the perpetrator was a biological parent. 

15
 
 

 

 

 

7.	 Sources of Recognition for Maltreated Children 

School staff predominated as a source of recognition for maltreated children. 

School sentinels recognized 52% of the children who suffered Harm Standard 

maltreatment and 39% of the Endangerment Standard total. Other important sources of 

abused and neglected children were hospitals (11% and 13%), police and sheriff 

departments (12% and 19%), and the general public (6% and 10%). For maltreatment 

defined under the Endangerment Standard, day care centers and mental health agencies 

also joined the group of agency categories that recognized more than an estimated 

100,000 abused and neglected children nationwide. 

Since the NIS–3, recognition rates of Harm Standard maltreatment decreased 

at three sources. They dropped by 70% at social service agencies (including 

runaway/homeless youth and domestic violence shelters), by 36% at schools, and by 41% 

among the general public. Recognition rates of Endangerment Standard maltreatment 

increased by 86% in police and sheriff departments, by 55% in juvenile probation 

departments, and by 81% in professional agencies not represented by NIS sentinels. 

Endangerment Standard recognition rates decreased by 53% at social service agencies 

(including runaway/homeless youth and domestic violence shelters) and by 33% at 

schools. To the extent that these changes represent real changes in the rates at which 

agency staff encounter and identify maltreated children, they may reflect changes in the 

incidence of maltreatment itself or derive from changes in maltreated children’s contacts 

with the agencies. To an unknown degree, these changes could also reflect shifts in 

agencies’ standards for submitting data on maltreated children to the NIS. 

8.	 Child Protective Services (CPS) Investigation of Maltreated

Children 

Throughout its history, the NIS has consistently found that child protective 

services agencies (CPS) investigate maltreatment of only a minority of the children the 

NIS identifies. The NIS–4 again verified that result, finding that CPS investigated the 

maltreatment of only 32% of children who experienced Harm Standard maltreatment and 

of 43% of those whose maltreatment fit the Endangerment Standard. Moreover, this was 

not an artifact of the relatively short (3-month) NIS reference period. The NIS–4 

examined an additional full month of CPS data to increase the opportunity for more 

16
 
 

 

maltreated children to enter CPS investigations. This additional time made essentially no 

difference to the percentages of children investigated. 

Overall, the percentages of maltreated children who received CPS 

investigation represented more than one-half of the children in only a few maltreatment 

categories except fatalities. Under both definitional standards, the highest investigation 

rates (50% or higher) occurred for physically abused (52% or more) and sexually abused 

children (55% or more), and for those with maltreatment so severe that their harm could 

be inferred (53% or more). Also, among children with Endangerment Standard 

maltreatment, those who were deemed to be endangered, but not demonstrably harmed, 

also had a high rate of CPS investigation (60%). Considering the sentinel sources that 

recognized the children as maltreated, investigation rates were above 50% only among 

children with Harm Standard maltreatment recognized in police or sheriff departments 

(53%) or at public housing agencies (68%) and among children with Endangerment 

Standard maltreatment recognized at juvenile probation departments (63%), police or 

sheriff departments (64%), mental health agencies (53%), social services agencies (94%), 

and public housing agencies (67%). The lowest rates of investigation occurred for 

children recognized at schools (20% or less across the definitional standards), day care 

(12% or less), or shelters (19% or less). 

The overall percentage of children with Harm Standard maltreatment who 

received CPS investigation did not statistically change since the NIS–3, but investigation 

rates did increase since the NIS–3 for Harm Standard abuse (from 40% to 50%), sexual 

abuse (from 42% to 55%), emotional abuse (from 21% to 36%), emotional neglect (from 

18% to 30%), and in children recognized as maltreated by juvenile probation (from 17% 

to 42%), public health (from 3% to 26%) or social services (from 25% to 91%). The 

investigation rate for Endangerment Standard maltreatment increased significantly, from 

33% in the NIS–3 to 43% in the NIS–4. Increased investigation rates were evident in all 

abuse (from 39% to 49%), sexual abuse (from 44% to 56%), emotional abuse (from 28% 

to 40%), all neglect (from 28% to 41%), emotional neglect (from 22% to 50%), and in 

children recognized as maltreated at juvenile probation departments (from 23% to 63%), 

public health departments (from 4% to 33%), day care centers (from 3% to 12%), or 

social services (from 33% to 94%). 

The NIS methodology generates information that speaks only to the end 

result of several processes, indicating whether or not a given maltreated child was among 

17
 
 

those children investigated by CPS. Children who do not receive a CPS investigation 

represent an enigma to the study, in that it is not possible to say whether sentinels who 

recognized their maltreatment did not report it to CPS or whether they did report it but 

CPS screened their reports out without an investigation. These alternatives have quite 

different implications for policy. The NIS–4 included several supplementary studies to 

help understand the countable children who do not receive CPS investigation. 

The CPS Screening Policies Study (SPS) obtained detailed information about 

CPS screening criteria to determine what role they might play in screening out countable 

children from CPS investigations. The NIS–4 reviewed the children identified in the 

main study as maltreated but not investigated at CPS to determine whether CPS probably 

would have investigated them, based on the screening criteria described in the SPS 

interviews. This exercise indicated that CPS probably would have investigated nearly 

three-fourths (72%) of the uninvestigated children who experienced Harm Standard 

maltreatment and two-thirds (66%) of the uninvestigated children with Endangerment 

Standard maltreatment. Therefore, if CPS agencies consistently apply the criteria they 

described, and if sentinels had reported the uninvestigated children to CPS, then CPS 

would have investigated the majority. The “presumptive investigation rates,” reflecting 

the percentages of maltreated children CPS would have investigated if sentinels had 

reported them to CPS, were 81% of all children with Harm Standard maltreatment and 

80% of those with Endangerment Standard maltreatment. 

Another NIS–4 supplementary study, the CPS Structures and Practices Mail 

Survey (SPM), collected information about various agency characteristics, examining 

whether these related to CPS investigation rates. Investigation rates were significantly 

lower when a state or regional hotline screened incoming referrals for children with Harm 

Standard physical abuse (48% versus 65%) or emotional neglect (25% versus 37%). 

When CPS had no assistance in investigating certain categories of maltreatment, 

investigation rates were lower: if the agency had sole responsibility for investigating nonsevere physical neglect, then the rate of CPS investigation was significantly lower for 

children with Harm Standard physical neglect (26% versus 43%); sole responsibility for 

investigating abandonment correlated with lower investigation rates for Endangerment 

Standard physical neglect (37% versus 50%). When CPS could provide a response other 

than an investigation (commonly termed an “alternative response”), then investigation 

rates were lower across a range of maltreatment categories under both definitional 

standards. Agencies with alternative responses investigated only 23% of the children 

18
 
 

 

 

 

 

with Harm Standard maltreatment and 29% of those with Endangerment Standard 

maltreatment, whereas agencies without any alternative response offering investigated 

38% and 52% of these groups, respectively. CPS agencies that did not prioritize 

recommended responses to referrals investigated more children who experienced Harm 

Standard physical abuse than did agencies that did (75% versus 55%) as well as more 

educationally neglected children (23% versus 8%). 

NIS sentinels also participated in the Sentinel Definitions Survey (SDS), 

which asked them about their training on mandated reporting, their specific agency’s 

policies governing CPS reporting, their personal experiences in reporting to CPS, and 

whether they would report a variety of maltreatment situations to CPS. One-fourth of the 

sentinels (24%) had neither received written instructions nor attended a workshop about 

their state’s reporting requirements while working in their current agencies. Training 

mattered, since more sentinels who received some form of training said they had reported 

suspected child maltreatment to CPS (67% versus 53%). More sentinels from health and 

law enforcement (96% or more) said their agencies allowed them to report directly to 

CPS (versus having to go through an agency representative or committee) than did 

sentinels in schools (80%) or other agencies (83%). Moreover, when allowed to do so, 

fewer sentinels in schools and other agencies said they had ever reported a case (54% and 

50%, respectively) compared to 87% of law enforcement sentinels and 77% of sentinels 

in health agencies. An average of nearly one-fourth (23%) of sentinels predicted they 

would not report described situations of Harm Standard maltreatment to CPS, verifying 

that sentinels recognize a substantial number of maltreated children whom they do not 

report to CPS. Nevertheless, whereas the NIS–4 found that majorities of countable 

children were not investigated, only minorities of sentinels said they would not report the 

countable cases presented in the SDS. The contrast was strong across all maltreatment 

categories. Thus, the SDS results cannot explain the large percentages of uninvestigated 

children in the NIS–4. 

9. Conclusions and Implications 

The NIS–4 revealed several important changes in the incidence of 

maltreatment since the time of the NIS–3. These observed changes may reflect real 

changes in the scope of the problem, or they may reflect changes in how sentinels and 

other reporters respond to the maltreated children they encounter. The current 

19
 
information suggests that both of these dynamics contributed to the observed changes, 

each dynamic affecting a different sector of the abused and neglected population. 

The NIS–4 documented declines in rates of all categories of abuse across 

both definitional standards. The declines in sexual abuse and physical abuse are 

consistent with trends in CPS data gathered by the National Child Abuse and Neglect 

Data System (NCANDS, U.S. Department of Health and Human Services, 

Administration on Children, Youth and Families, 2007) and they also parallel declines in 

victim self-reports. However, since no independent information is currently available that 

bears on the incidence of emotional abuse, it is not clear whether the NIS decline in this 

category reflects a real decrease in its occurrence. 

The increase in the rate of emotional neglect since 1993 could, in part, signify 

a real increase in the occurrence of maltreatment, but it is fairly clear that it also reflects 

some change in policy and focus. Since the NIS–3, a number of CPS systems have 

undertaken initiatives to increase collaboration between CPS and agencies that serve 

domestic violence and alcohol and drug problems (U.S. Department of Health and 

Human Services, Administration for Children and Families/Children's Bureau and Office 

of the Assistant Secretary for Planning and Evaluation, 2001, 2003). The increased 

emotional neglect incidence may predominantly reflect the heightened CPS attention to 

these problems, which are involved in certain types of emotional neglect. Further 

analyses will clarify whether the increases in emotional neglect primarily occurred in 

specific types of emotional neglect or for children recognized at specific types of 

agencies. 

Another area where further analyses can illuminate the implications of the 

NIS–4 findings is in the interrelationships among the different factors associated with the 

incidence of maltreatment. Factors such as parents’ labor force participation, household 

socioeconomic status, family size, and family structure and living arrangement are not 

only associated with the incidence of maltreatment but are also correlated with each 

other. Further analyses could determine their independent relationships to maltreatment, 

such as whether households with more children have higher incidence rates even when 

household socioeconomic status is taken into account. Moreover, for the first time in 

NIS, the NIS–4 found race differences in the incidence of maltreatment, with higher 

incidence rates for Black children. Future analyses should examine whether these race 

20
 
differences in maltreatment rates remain when the disadvantaging effects of these family 

circumstances are taken into account. 

The NIS–4 findings on the strong correlations between socioeconomic status 

and all categories of maltreatment are consistent with earlier NIS findings on household 

income. As with the previous results, the recent observations cannot be plausibly 

explained by the claim that lower socioeconomic families are simply more visible to the 

community professionals who provide most of the data. The NIS sentinels observe 

substantial numbers of children and families at the middle- and upper-income levels. 

Sentinels in schools alone recognized the majority of the maltreated children. 

Despite some increases in CPS investigation of maltreated children, the NIS– 

4 shows that investigation rates still remain fairly low. Similar to previous NIS findings, 

the NIS–4 again determined that the majority of maltreated children do not receive CPS 

investigation. The NIS–4 obtained information that shed additional light on this issue: 

•	 The NIS–4 determined that the finding is not an artifact of the relatively 

short (3-month) NIS reference period, since adding a full month of CPS 

data to increase the opportunity for more maltreated children to enter

CPS investigations made essentially no difference to the percentages of 

children investigated. 

•	 Certain features of CPS structure and practice were associated with

percentages of maltreated children who received investigation.

Children were less likely to receive CPS investigation if they were in 

the jurisdiction of CPS agencies that received their referrals about

suspected maltreatment through a centralized regional or state hotline,

that combined a new report into an ongoing open investigation on the

child or family, or that could offer an alternative response (other than 

an investigation) to the children and families referred to them for

suspected maltreatment. Also, children who experienced physical 

neglect were less likely to receive investigation if their CPS agency had

sole responsibility for investigating non-severe physical neglect. 

•	 The CPS Screening Policies Study found that if all maltreated children 

were reported to CPS and CPS agencies followed their current

screening policies, then a large majority of the maltreated children 

(80% or more) would receive CPS investigation. Assuming that 

agencies follow their stated screening policies, the implication is that 

mandated reporters do not report most of the uninvestigated children

(two-thirds or more). 

21
 
 

•	 In the Sentinel Definitions Survey, sentinels responded to descriptions

of maltreated children, indicating that they would not report some of

these to CPS. More sentinels who had received information or training 

on their state’s reporting requirement while working in their current

agency had reported suspected child maltreatment. 

Although schools predominated as a source of recognition for maltreated 

children, 20% or less of the maltreated children recognized at schools received CPS 

investigation. One factor that may contribute to the low investigation rate for schoolrecognized children is school policy barring staff from making direct reports to CPS. In 

the Sentinel Definitions Survey, 20% of school sentinels indicated that their schools do 

not permit them to report directly to CPS. However, other factors also contribute to low 

investigation rates for the school-recognized children, because even when agencies 

permitted direct reports, fewer sentinels in schools said they had reported a case (54%) 

compared to staff in health agencies (77%) or law enforcement (87%). Similar patterns 

emerged in the previous NIS cycles. To repeat the earlier recommendation: better 

working relationships should be forged between CPS agencies and schools, capitalizing 

on the unique role of school professionals as front-line observers. 

22
 
 

1.1 

1. INTRODUCTION
 

This report presents the findings of the Fourth National Incidence Study of 

Child Abuse and Neglect (NIS–4). It includes nontechnical descriptions of the study 

design and methodology and provides national estimates of the incidence of abused and 

neglected children, the nature and severity of their maltreatment, the relation between 

incidence rates and various demographic factors, characteristics of the perpetrators, the 

sources who recognized the maltreated children, and the percentages of these children 

investigated by child protective service (CPS) agencies. 

The NIS–4 meets several mandates in the Child Abuse Prevention and 

Treatment Act, as amended by the Keeping Children and Families Safe Act of 2003 (P.L. 

108-36). Specifically, the NIS–4: 

•	 provides current estimates of the incidence of child abuse and neglect in 

the United States; 

•	 measures changes in these estimates from earlier studies; and 

•	 examines the distribution of child maltreatment in relation to various 

demographic factors. 

Background 

The National Incidence Study (NIS) is a congressionally mandated, periodic 

effort of the United States Department of Health and Human Services (DHHS). The 

NIS–1 was mandated by Public Law (P.L.) 93–247 (1974) and collected data in 1979 and 

1980. The NIS–2 was mandated under P.L. 98–457 (1984) and collected data in 1986. 

The NIS–3 was mandated under both the Child Abuse Prevention, Adoption, and Family 

Services Act of 1988 (P.L. 100–294) and the Child Abuse, Domestic Violence, Adoption 

and Family Services Act of 1992 (P.L. 102–295). It collected data in 1993. This report 

presents findings from the NIS–4, which was mandated by the Keeping Children and 

Families Safe Act of 2003 (P.L. 108-36). The NIS–4 gathered data in 2005 and 2006. 

1–1
 
 

1.2 NIS Design Enhancements 

Over the course of the three previous implementations, the NIS design 

benefited from a series of intensive planning and pretest efforts, ongoing scrutiny, and 

input from a number of expert forums. While adhering to the same basic framework and 

approach, the design evolved through a range of enhancements. 

In responding to the original legislative mandate, the National Center on 

Child Abuse and Neglect (NCCAN) undertook a feasibility study, followed by two years 

of design and pretest. At the outset of the NIS–3, the Children’s Bureau convened a 

Conference of Experts to consider outstanding questions concerning the NIS findings and 

suggest additions and design improvements (Rogers, Gray, & Aitken, 1992). The NIS–3 

Advisory Board endorsed a number of the recommended additions, which NCCAN 

incorporated into the study design (Sedlak, 2001). 

Following the NIS–3, DHHS undertook efforts to examine and critique the 

NIS methodology, identify strategies to enhance the accuracy and precision of the NIS 

estimates, and increase the interpretability of the findings. These efforts comprised 

multiple phases, each building on previous developments. 

In February 1997, several months after the publication of the NIS–3 findings, 

the Children’s Bureau convened the NIS–3 Symposium (Children’s Bureau, 2000). In 

June 2000, DHHS convened a Focus Group of experts to identify issues the design of the 

next NIS should address. In October 2000, DHHS sponsored work to identify design 

options for the future NIS that would enhance the utility and interpretability of the 

findings, the adequacy of the definitions, the present-day relevance and feasibility of the 

methodology, and the coverage, reliability, and precision of the estimates (Sedlak, Bruce, 

& Hill, 2002). 

In 2002, DHHS issued a contract to conduct the NIS–4 Planning Project. 

The initial phases of this planning work involved a series of 5 conference calls and an inperson meeting with a Technical Advisory Group (TAG) comprising up to 26 experts 

from the private sector or local government and up to 17 federal agency staff with 

substantive interest in the NIS. Following these calls, the TAG met in-person to 

deliberate, classify, and prioritize the enhancement options. 

1–2
 
 

 

 

 

 

 

Incorporating the TAG input, DHHS directed that subsequent planning 

project activities conduct in-depth work on six proposed enhancements—two pertaining 

to the sample design, one examining and refining the NIS definitions, and three 

developing methodologies and materials for supplementary studies to help in 

understanding the main NIS findings: 

•	 Sample design enhancements. Statisticians explored the properties of

the NIS–3 sample and estimates and identified strategies for improving 

the efficiency of the sample and precision of estimates in the NIS–4.1 

•	 Definitions review and refinement. This effort began with

comprehensive review of all states’ statutes on mandated reporting of

child abuse and neglect and of maltreatment classifications in the recent

research literature. It compared the maltreatment events and category

distinctions in these classifications against those in the NIS definitions

and recommended ways to differentiate and clarify the typology for the

NIS–4. These modifications did not change NIS criteria for counting 

children as abused or neglected. Rather, they clarified the meaning of

the NIS classification codes in order to improve their reliability and

they identified the correspondence between NIS codes and the

maltreatment situations listed in states’ reporting statutes (Sedlak, 

Mettenburg, Schultz, & Cook, 2003). 

•	 Supplementary studies. The NIS–4 planning effort established 

methodologies for three studies to improve the interpretability and

clarify the policy implications of the main NIS findings. 

♦	 The CPS Structure and Practices Mail Survey (SPM) was modeled 

after the Local Agency Survey (LAS) in the National Study of 

Child Protective Service and Reform Efforts, which was conducted

in 2002 with CPS agencies in 375 counties in the United States 

(U.S. Department of Health and Human Services, Administration 

for Children and Families/Children's Bureau and Office of the 

Assistant Secretary for Planning and Evaluation, 2003). CPS 

agencies that participate in the NIS complete this mail 

questionnaire about their structure, responsibilities, work 

arrangements, and specific practices. In relation to the main NIS–4 

1

 Statisticians assessed the NIS design effect and the power needed to compare specific subgroups; they 

recommended strategies for reducing the design effect and improving the precision of estimates (Park,

Winglee, Clark, Sedlak, Morganstein, & Rust, 2003). A separate effort examined the NIS PSU selection,

explored the statistical efficiency of alternative size measures and stratification, and recommended

modifications for PSU selection in the NIS–4 (Park, Winglee, Clark, & Sedlak, 2003). 

1–3
 
 

1.3 Focus of this Report 

findings, this information can reveal whether differences in local

CPS agency structure and practice relate to local differences in 

CPS investigation coverage of maltreated children. 

♦	 The CPS Screening Policies Study (SPS) involves in-depth 

interviews with intake supervisors at all CPS agencies that

participated in the NIS–3. This study examines their criteria for

screening in reports of child abuse and neglect for CPS 

investigation. The goal, in relation to the main NIS findings, is to

determine whether CPS screening criteria would have screened out

the reports on the maltreated children who did not receive CPS

investigation in the main NIS. 

♦	 The Sentinel Definitions Survey (SDS) is a questionnaire mailed to

NIS–4 sentinels after the conclusion of the main study. The initial 

section asks about their training on mandated reporting, their

agency’s policies on individual reporting, and their personal 

experiences in reporting to CPS. The remainder of the 

questionnaire presents vignettes that represent the NIS typology

and asks whether respondents think the situation is maltreatment,

whether they would report the case to CPS, and whether they 

would submit it to a national study on child abuse and neglect.

The purpose is to identify barriers to CPS reporting; to understand

which maltreatment categories are less likely to be reported to CPS

or submitted to the study, and to provide a baseline of sentinels’

definitions of maltreatment at the time of the NIS–4. 

This final report is a self-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 NIS–4. Interested readers can find details in three technical reports: 

•	 The Design and Methods Summary (Appendix A) presents the study 

design and the special NIS–4 enhancements; gives details about the 

main study sample, recruitment, data collection, unduplication, 

evaluative coding, and weighting. It also summarizes the 

methodologies of three NIS–4 supplementary studies that helped in 

understanding important aspects of the main study findings, as

subsequent chapters will explain. 

1–4
 
 

•	 The NIS–4 Data Collection Report (Hartge, Basena, Cober et al., 2010)

provies all the study data forms and describes the procedures used to

collect both the CPS agency data and the sentinel data. 

•	 The NIS–4 Analysis Report (Sedlak, Mettenburg, Winglee et al., 2010)

gives considerable detail about the data processing steps, including 

basic and evaluative coding; the data retrieval, scanning, and cleaning

processes; the unduplication methods; the weighting and nonresponse

adjustment approaches; the development of the annualization 

multipliers; and the derivation of national estimates and variances. 

In addition, reports on the supplementary studies detail their methods and 

analyses and document their complete findings (Greene, McPherson, and Sedlak, 2010; 

McPherson and Sedlak, 2010; Mettenburg, Sedlak, Yuan et al., 2010; Sedlak, 

McPherson, Shusterman, and Li, 2010). 

The remainder of this report comprises eight chapters: 

Chapter 2, “Methodology,” summarizes the design and methodology of the 

NIS–4. It provides an overview of the conceptual model that has guided the NIS 

approach since its inception and describes the NIS–4, including the NIS–4 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 by both the Harm Standard and 

the Endangerment Standard. It discusses statistically meaningful changes in the 

incidence rates since the NIS–2 and the NIS–32 and describes the distribution of children 

across different categories of maltreatment and across different levels of severity of harm 

from maltreatment. 

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–4 findings on the incidence of maltreatment in 

2

 The earlier reports on the NIS–2 and NIS–3 findings documented that substantial changes occurred since 

the NIS-1 (Sedlak, 1991; Sedlak & Broadhurst, 1996). In the interests of brevity, simplicity, and clarity,

this NIS–4 report gives priority to the more recent changes in incidence. 

1–5
 
relation to the child’s sex, age, race, disability status, and school enrollment; examines 

whether 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 NIS–3 in the 

distribution of child maltreatment by the child’s sex, age, or race. 

Chapter 5, “Distribution of Abuse and Neglect by Family Characteristics,” 

examines the relationship between specific characteristics of the children’s families and 

the incidence and severity of abuse and neglect. It presents the NIS–4 results concerning 

the incidence of different maltreatment categories and severities of outcome for children 

who come from families with different socioeconomic levels, family structures and living 

arrangements, numbers of dependent children, and whose counties of residence differ in 

degrees of urbanization. In addition, the report examines incidence differences related to 

parents’ labor force participation and to whether a grandparent was a caregiver for the 

child. This chapter also describes statistically significant changes since the NIS–3 in the 

distribution of child maltreatment by family structure, family size, and county 

metropolitan status. 

Chapter 6, “Perpetrator Characteristics,” describes the children who 

experienced Harm Standard maltreatment according to their relationship with their 

perpetrator and how this differed depending on their maltreatment and its severity. The 

chapter also describes how the perpetrator’s sex and age and the child’s own race varied 

across categories and severities of maltreatment and by the perpetrator’s relationship to 

the child. In addition, the chapter reports whether the perpetrator’s alcohol use, drug use, 

or mental illness were considered to be factors in the maltreatment and how this varied by 

maltreatment category and the perpetrator’s relationship to the child. 

Chapter 7, “Recognizing Abused and Neglected Children,” considers what 

community sources recognized maltreated children as abused or neglected and what 

changes have occurred in recognition at different agencies since the NIS–3. The chapter 

also considers what the results of the Sentinel Definitions Survey (SDS) imply about the 

extent to which the NIS “covers” the population of maltreated children in the different 

abuse and neglect categories. 

Chapter 8, “Investigating Abused and Neglected Children,” reports what 

percentages of maltreated children receive investigation by CPS agencies and compares 

1–6
 
these with the percentages that received CPS investigation in the NIS–2 and the NIS–3. 

It also shows how CPS investigation rates vary by the category of maltreatment, the 

severity of harm, and by the source that recognized the child as maltreated. Additional 

analyses show that the rates of CPS investigation are not materially affected by extending 

the period of CPS data collection in the NIS. In the subsequent sections, the chapter 

considers what the findings from the three supplementary studies imply about the rates of 

CPS investigation observed in the main study. 

Chapter 9, “Conclusions and Implications,” reviews some highlights of the 

NIS–4 findings and discusses their policy implications. 

1–7
 

2.1 Study Design 

2. METHODOLOGY
 

Since its inception, the NIS has followed the same fundamental approach, 

applying a sentinel sample methodology to provide national estimates of child 

maltreatment and using standard definitions to ensure comparability of measurement 

across different data sources within a study as well as across the different NIS cycles. 

Successive NIS cycles have introduced various improvements, including larger and more 

efficient sample designs, refined definitional categories, and independent supplementary 

studies to help in understanding the findings from the main NIS. 

This chapter summarizes the design and methodology of the fourth National 

Incidence Study of Child Abuse and Neglect (NIS–4). It reviews the conceptual model 

that has always guided the NIS design and describes the specifics of the approach in the 

present study. Appendix A, Design and Methods Summary, gives further details. 

The NIS–4 measures the total number of children who are abused or 

neglected in the United States and indicates the degree to which this number has changed 

since the earlier cycles collected similar data (the NIS–1 in 1979, the NIS–2 in 1986, and 

the NIS–3 in 1993). As summarized in the previous chapter, the specifics of the NIS–4 

design are the product of an intensive, multi-year effort to identify, prioritize, and pilottest a number of refinements and enhancements. 

The NIS offers a unique perspective on the national scope of child abuse and 

neglect, in that it goes beyond the maltreated children who come to the attention of the 

child protective services (CPS) system. Annual national data on child abuse and neglect 

is available from the National Child Abuse and Neglect Data System (NCANDS), which 

gathers data on cases of child maltreatment that come to the attention of the child 

protective services (CPS) system. The NIS is an infrequent but critical study. It serves as 

the nation’s needs assessment on child abuse and neglect by measuring the scope of the 

problem beyond these official statistics. To do this, the NIS gathers and integrates data 

from multiple sources, using standardized definitions. 

2–1
 
Rationale. Although CPS investigates a substantial number of the maltreated 

children in the nation, these children represent only the “tip of the iceberg.” The NIS 

assumes that not all maltreated children are reported or investigated by CPS. The 

conceptual model in Figure 2–1 guided the NIS methodology. Children investigated by 

CPS are in the first level of recognition, while other abused and neglected children are at 

levels below this. Each successive level is associated with decreasing degrees of official 

recognition or public awareness. 

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

At the second level are those children that other “investigatory” agencies, 

such as law enforcement agencies, courts, or public health departments, recognized as 

2–2
 
 

maltreated but who are not investigated by CPS. These agencies may have overlapping 

or even conflicting responsibilities concerning certain situations, such as felonious 

assault, homicide, delinquency, dependency, domestic violence, those formerly called 

“children in need of control,” or nutrition and hygiene problems. Children may remain at 

this second level because of questions of definition or disputes concerning the appropriate 

responsibilities of these different agencies in relation to CPS. Although children in this 

second level are in some sense “officially known,” the community does not necessarily 

regard them as abused or neglected in the same sense as children in the first level, and 

they do not necessarily receive assistance that specifically targets their abuse or neglect 

problems. 

The third level includes abused and neglected children who are not 

investigated by CPS and who are not recognized as maltreated at any agency in the 

second level but who are known to professionals in other major community institutions, 

such as schools, hospitals, mental health agencies, day care centers, shelters, public 

housing agencies, and other social services agencies. Children may remain at this level 

because the professional who recognized their maltreatment did not report it for any 

number of reasons. One reason may be definitional ambiguities as to what types of cases 

they should report 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, may fear the loss of trust from their client, or may have 

apprehensions about becoming involved in an official investigation. Children can also 

remain at this level (or other levels “below the waterline”) when the professional who 

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

investigation. As with nonreporting, there are multiple possible reasons for screen-outs. 

A child’s case may not meet the agency’s criteria for investigating (e.g., the maltreatment 

may not be in the CPS agency’s jurisdiction or sufficiently serious to warrant an 

investigation). Another possibility is that the professional did not provide sufficient 

information to CPS to enable an investigation or to meet the threshold for investigation. 

At the fourth level, someone outside of the purview of the first three levels 

recognizes the abused and neglected children as maltreated, such as a neighbor, another 

member of the family, or one or both of the involved parties—the perpetrator and the 

child victim. However, no one at this level has disclosed the maltreatment to anyone in 

the first three levels. Here again, it is possible that individuals in this fourth level did 

2–3
 
 

reveal the maltreatment to persons in the first, second, or third levels, but that the latter 

did not recognize the maltreatment as such. (This would include CPS screening out a 

child in the fourth level.) 

In the fifth level are those children no one recognizes as maltreated. These 

are cases where the individuals involved do not themselves regard their behavior or 

experiences as child maltreatment and where their situations have not come to the 

attention of outside observers who would identify them as abuse and neglect. 

The model conveys the inherent difficulty of efforts to measure the incidence 

of child maltreatment. Cases in the fifth level are by definition impossible to document 

(unless they can be brought into the fourth level). In principle, it should be possible to 

identify children in the fourth level through methods such as surveys of parents, children, 

and/or neighbors. Several such surveys have been conducted, but the stigmatizing nature 

of acknowledgments of abuse and neglect introduces serious (and unknown degrees of) 

underreporting bias into estimates of cases at this level. As a result, all NIS efforts have 

focused on assessing the incidence of cases identified only in the first, second, and third 

levels. 

Main study design. The NIS uses a survey methodology that begins with a 

nationally representative sample of counties. In each county, the NIS collects data on all 

children investigated by child protective service (CPS) agencies during the study 

reference period as well as on maltreated children identified in a specific set of 

community agencies by “sentinels.” Sentinels are professionals who regularly come into 

contact with children and families and who have sufficient contact to recognize children 

who are maltreated and provide the information needed to determine whether their 

situations fit the study definitions of abuse or neglect. They watch for maltreated 

children during the study reference period. 

Figure 2–2 depicts these NIS data sources, showing that both CPS and 

sentinels submit data to NIS. Sentinels report some children they recognize as maltreated 

to CPS and these children enter the NIS both through CPS data collection and directly 

from participating sentinels. Sentinels report other maltreated children only to NIS 

directly, which provides information about the numbers of children in the second and 

third levels of figure 2–1. Also, other sources report children to CPS who enter NIS only 

2–4
 
through the CPS data. These are children who would otherwise remain in level 4, outside 

of NIS purview. 

Figure 2–2. NIS Data Sources. 

The NIS gathers retrospective data from CPS, about children who were 

subjects of investigation during the study reference period, whereas NIS gathers sentinel 

data prospectively, with sentinels remaining on the lookout and submitting data as they 

encounter children they suspect were maltreated during the reference period. 

Figure 2–3 schematically diagrams the key components of the NIS 

methodology. The NIS unduplicates the data (so the study estimates represent each 

maltreated child only once), evaluates the case details against standardized definitions of 

abuse and neglect (so estimates are based only on “countable” children, whose 

maltreatment meets the study standards), and weights the records (so the sample data can 

provide national estimates of the numbers of maltreated children). 

2–5
 
 

Figure 2–3. Schematic Summary of the NIS Methodology. 

NIS–4 enhancements. The NIS–4 sample design improved on that used in 

the NIS–3 by tripling the number of counties (122 vs. 42) as well as increasing the 

number of sentinel agencies (nearly 1,100 vs. 800). The NIS–4 also expanded sentinel 

coverage through two new categories of sentinel agencies—public housing authorities 

and shelters for victims of domestic violence and for runaway or homeless youth. 

Statisticians conducted an extensive review of the NIS–3 data to identify the most 

efficient design for the NIS–4 county and sentinel agency samples. In evaluating the data, 

the NIS–4 evaluative coders applied a refined typology of abuse and neglect definitions, 

classifying situations into 60 separate forms of maltreatment. They also provided a more 

detailed coding of serious injury or harm that resulted from maltreatment. In computing 

annualization multipliers to transform the 3-months of data from the main NIS–4 into 

estimates of the numbers of children maltreated over a full year, the NIS–4 used data 

from the National Child Abuse and Neglect Data System (NCANDS). Finally, the NIS–4 

team designed and implemented a number of new computer systems to document, 

manage, and provide ongoing quality checks during recruitment, data collection, 

evaluative coding, and unduplication. Appendix A includes a complete list of these 

system enhancements. 

2–6
 
 

 

 

 

2.2 Samples and Recruitment 

Supplementary studies. In addition to the main study, the NIS–4 project 

included three supplementary studies, designed to enhance the interpretability of the NIS 

findings. Two were surveys of CPS agencies—one on their overall structure and 

practices and the second on their screening standards for deciding whether to investigate 

a referral of suspected maltreatment. The third supplementary study was a survey of 

sentinels on their backgrounds and definitions of child abuse and neglect and concerning 

their standards for reporting suspected maltreatment to CPS or submitting data on 

maltreated children to the NIS. A fourth study is also planned, which will compare the 

NIS information on CPS cases with parallel data collected by the NCANDS to crossvalidate these sources and identify any notable differences in the information they 

provide. 

The NIS target population is the set of children under 18 years of age who are 

maltreated during the study period, including all who are investigated by child protective 

services (CPS) agencies and others who come to the attention of community 

professionals working in specific categories of agencies. 

Samples. The NIS–4 first-stage sample comprised 122 counties. The 

method used to sample these counties ensured that they represented different regions of 

the country, degrees of urbanization, crime rates, percentage of households headed by 

single women, and CPS substantiation rates. The second stage of the sample consisted of 

agencies in the selected counties. Sampled agencies included all the 126 local CPS 

agencies that served the 122 NIS–4 counties, as well as 1,524 sentinel agencies in the 

counties. The sentinel agencies represented all county sheriff departments, county 

departments of juvenile probation, public health, and public housing, and samples of 

municipal police departments, hospitals, shelters, day care centers, schools, other social 

services and mental health agencies. The third stage of the sample entailed sampling 

investigated cases in CPS agencies to gather details about the children, families, and 

maltreatment and, in the sentinel agencies, selecting the staff to serve as sentinels and 

watch for children maltreated during the study period. The listing of CPS case 

investigations during the reference period totaled 140,206, and the NIS–4 sampled 11,930 

for the detailed maltreatment data. The NIS–4 identified 22,117 eligible staff in 

participating sentinel agencies and sampled 11,321 to be recruited as sentinels. 

2–7
 
 

 

 

 

 

CPS recruitment. In order to unduplicate data from sentinels against data 

on children in CPS investigations, the NIS design obtains a census of all children in CPS 

investigations in study counties during the reference period, using CPS Summary Data 

Forms for basic demographic information. Without this information, the NIS cannot use 

the data from sentinels in the county, and the entire county must be dropped from the 

study. All 126 CPS agencies provided Summary Data, so the NIS–4 obtained 100% 

participation in this component of the study. However, not all jurisdictions provided 

maltreatment data on the sampled cases. The NIS–4 obtained 10,667 completed 

Maltreatment Data Forms, or 89% of the cases sampled. As noted below, the completed 

CPS maltreatment data were weighted to correct for incomplete and absent forms. 

Sentinel recruitment. The sentinel agency sample in the NIS–4 was twice 

as large as that in the NIS–3. Of the 1,524 sampled sentinel agencies that were eligible 

for the study,3 1,094 participated, representing 72% of the eligible sample. Within these 

participating agencies, a total of 10,791 sentinels participated, representing 95% of the 

11,321 sentinels sampled. 

NIS–4 agency recruitment rates were lower than those attained in earlier NIS 

cycles.4 The lower rates were largely attributable to increased concerns with privacy and 

resulting changes in policies, procedures, and State and federal laws since the NIS–3. 

New laws, such as the Health Insurance Portability and Accountability Act (HIPAA), 

seriously limited access to data for any “voluntary” study. 

Nevertheless, compared with earlier NIS cycles, the NIS–4 substantially 

increased sample sizes and broadened sentinel agency coverage. Relative to the NIS–3, 

the NIS–4 essentially tripled the number of participating counties (from 42 to 122), CPS 

agencies (from 42 to 126), and the number of CPS cases with completed maltreatment 

details (from 3,154 to 10,667). The NIS–4 also substantially increased the number of 

3

 The original sample included 1,679 agencies. Of these, 1,524 were in-scope (serving the sampled

counties at the time of the NIS–4 data collection and with staff who regularly had contacts with children 

and families). Replacements for refusal agencies substituted for 221 of the original sample. 

4

 The NIS–3 achieved an 82% sentinel agency participation rate. The NIS–3 participation rate of sentinels 

within those agencies was the same as in the NIS–4—95%. 

2–8
 
 

 

 

 

 

 

 

participating sentinel agencies (from 800 to 1,094) and nearly doubled the number of 

participating sentinels (from 5,612 to 10,791). 

2.3 Data Collection 

The NIS–4 used two reference periods, one of which conformed to that used 

in the NIS–2 and NIS–3: a 3-month period from the first week in September 2005 

through the first week in December 2005 (for two-thirds of the counties). The second 

reference period occurred the following spring, from the first week in February 2006 

through the first week in May 2006 (for the remaining one-third of counties).5 CPS 

agencies provided data on all cases they accepted for investigation that were reported 

during their assigned reference period, whereas sentinels described all maltreated 

children they encountered whose maltreatment occurred during their assigned reference 

period. As an enhancement to the NIS–4, CPS agencies also provided summary level 

data about cases they accepted during the month following their reference period. As 

discussed later (Chapter 8), this extra month of data helped clarify the situation of 

uninvestigated children in the NIS findings, identifying the effects of allowing more time 

for sentinels to report children to CPS. 

The NIS–4 used three instruments: the CPS Summary data form, the CPS 

Maltreatment data form, and the Sentinel data form (available in both paper and webbased versions). CPS agencies used the CPS Maltreatment data form to provide details 

concerning the children and maltreatment events for a sample of cases reported to the 

agency during the study reference period that they accepted for investigation. The CPS 

Summary data form captured demographic information on all children in CPS 

investigated cases, for use in unduplication. Sentinels submitted a Sentinel data form on 

all children they suspected were maltreated during the reference period. The CPS 

Maltreatment and Sentinel data forms collected many of the same details, but differed in 

5

 The original plan called for the NIS–4 to use a single 3-month reference period (first week of September

to first week of December). However, as noted above, recruitment took considerably longer than

anticipated in a number of locales. In order to maximize participation rates, the NIS–4 used a delayed 

reference period for one-third of the sites, providing additional time to negotiate administrative clearances

and obtain IRB and research committee approvals at the selected agencies. 

2–9
 
 

 

format: the Sentinel data form described a single child, whereas the CPS data form 

described all children in the household, since CPS agencies typically organize records 

around household-level investigations rather than around individual children. 

The NIS–4 received a total of 157,081 data forms, including 140,206 CPS 

Summary Data Forms for cases investigated during the reference period, 10,667 

completed CPS Maltreatment Data Forms on the cases sampled for detailed information, 

and 6,208 completed Sentinel Data Forms. 

2.4 Evaluative Coding 

The NIS gathers data from diverse sources—cases investigated by CPS as well as 

children encountered by sentinels representing a broad spectrum of community 

professionals. Different CPS agencies use different standards when screening cases in 

for investigation and deciding their dispositions. Also, despite their brief training in the 

study’s definitions, sentinels have different perceptions about what constitutes child 

abuse and neglect. Consequently, the cases that NIS gathers reflect widely varying views 

as to whether a child should be considered maltreated and used to develop the study 

estimates (i.e., whether they are “countable” in the totals of maltreated children). A key 

achievement of the NIS has been operational definitions of child maltreatment that are 

both clear and objective in specifying the situations encompassed by the study. As 

shown in Figure 2–3, the data NIS gathers about maltreated children undergo evaluative 

coding, which assesses the children’s experiences for conformity to the study’s specific 

definitional standards, and only those children whose circumstances fit the standard 

definitions are considered “countable” and used as the basis for generating incidence 

estimates. 

The NIS definitions maintain a child protective services (CPS) perspective, 

covering the types of maltreatment that come under the purview of CPS. In preparing for 

the NIS–4, the U.S. Department of Health and Human Services undertook a systematic 

2–10
 
 

 

 

 

 

 

 

 

 

 

 

 

 

review of the NIS definitions.6 This led to refinements of the maltreatment typology, 

subdividing earlier forms of maltreatment that were too heterogeneous, clarifying the 

range of acts or omissions included in a given maltreatment form, and enhancing the 

coding guidelines to avoid confusion. Table 2–1 presents the resulting 60-form 

maltreatment typology that evaluative coders applied in the NIS–4. 

Definitional standards. Evaluative coders judge the details of each case of 

suspected maltreatment against the required elements (countability criteria) defined in 

two definitional standards, the Harm Standard and the Endangerment Standard. The 

Harm Standard has been used since the NIS–1 and is the more stringent. For children to 

be countable under the Harm Standard, for the most part, they have to have experienced 

observable harm from their maltreatment. The Endangerment Standard has been in use 

since the NIS–2. It is more lenient, counting children in the study estimates if the source 

(CPS or sentinel) considered the perpetrator’s actions or omissions to have placed the 

child at serious risk of harm. The Endangerment Standard includes all Harm Standard 

countable children, but adds in other children as well. 

The NIS definitional standards specify all the elements that must be met for 

the child to be countable. These include: 

1.	 Child’s Age: The NIS includes children whose maltreatment occurs 

after their birth and before their 18th birthday.7 

2.	 Custody Status: The NIS includes only abuse and neglect of children 

living in household settings (dependents of parent(s) or parent 

substitute(s) at the time of maltreatment).8 

6

 This review, undertaken during the NIS–4 Planning Project, explored whether, since the original

formulation of NIS definitions, increasing variation in CPS practices reduced the relevance of the NIS

definitions or categories, or emphasized new distinctions not captured in the NIS definitions. Reviewers 

examined the NIS classification system against current state definitions of child abuse and neglect (as

codified in the state statutes that mandate reporting) and against the carefully elaborated definitions used

in five recent studies of child abuse and neglect (Sedlak, Mettenburg, Schultz & Cook, 2003). They

identified gaps in the NIS specifications, categorical refinements, and additional criteria or boundary 

conditions to clarify the situations NIS includes as abuse or neglect. 

7

 The NIS classifies acts or omissions that occur during pregnancy as not countable. 

8

 The NIS excludes institutional abuse and neglect. 

2–11
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.	 Purposive and Avoidable Acts/Omissions: For maltreatment to count, 

it must be nonaccidental and avoidable.9 

4.	 Time of Maltreatment: The maltreatment has to have occurred during 

the study reference period.10 

5.	 Severity of Harm: For each form of maltreatment, the Harm Standard 

specifies a minimum level of harm that must be evident in order for 

the child to be countable.11 

6.	 Person(s) Responsible for the Maltreatment: For each form of 

maltreatment, both definitional standards specify whether the 

perpetrator must be an adult and how they must be related to the child 

(parent or other caregiver) in order for NIS to count the 

maltreatment.12 Evaluative coders also assess the degree of evidence 

for holding the alleged perpetrator responsible for the maltreatment. 

Maltreatment forms and categories. Based on the nature of the abusive 

acts or neglectful omissions, coders classify alleged maltreatment situations using the 60 

forms and eight major categories listed in Table 2–1. The NIS definitions specify the 

maltreatment acts or omissions included in each form and clarify important boundary 

conditions. 

Countability assessment. Coders reviewed all information submitted on 

CPS Maltreatment Data Forms and Sentinel Data Forms, assessing the maltreatment of 

9

 The NIS excludes problems or hazards that a parent or caregiver could not avoid, due to lack of financial

means (where appropriate assistance was not available through public agencies), or the caregiver’s death,

hospitalization, incarceration (where it was physically impossible to provide or arrange for adequate care). 

10 Study data are annualized using multipliers that assume a specific time period. The restriction on the 

time of maltreatment ensures that the annualization multipliers apply to the correct basis. For CPS data,

CPS has to receive the report during the study reference period and accept it for investigation; for sentinel

agencies, the maltreatment itself has to occur during the study reference period. 

11 To count a child in the study estimates, the Harm Standard generally requires moderate harm from abuse 

but serious harm from neglect. 

12 For maltreatment to count under the Harm Standard, the perpetrator of abuse must be a parent, parentsubstitute, or an adult caregiver; a neglect perpetrator must be a parent or parent-substitute. The 

Endangerment Standard relaxes these criteria in several respects. It includes situations where adult 

caregivers other than a parent or parent substitute permit sexual abuse and situations where nonparental

minor caregivers perpetrate or permit sexual abuse. In addition, it includes other adult caregivers (besides

parents and parent substitutes) as allowable perpetrators of two forms of neglect: inadequate supervision 

and other physical neglect (such as inadequate food, clothing, shelter, disregard of physical hazards, and 

other inattention to child’s physical safety and well-being). 

2–12
 
 

Table 2–1. NIS–4 60-form Typology for Classifying Alleged Maltreatment 

Sexual Abuse (10 codes) 

Intrusion sex without force 

Intrusion sex involving use of force 

Child’s prostitution or involvement in pornography 

with intrusion 

Molestation with genital contact 

Exposure/Voyeurism 

Providing sexually explicit materials 

Child’s involvement in pornography without 

intrusion 

Failure to supervise child’s voluntary sexual activity 

Attempted/threatened sexual abuse with physical 

contact 

Other/unknown sexual abuse 

Physical Neglect (12 codes) 

Refusal to allow or provide needed care for diagnosed 

condition or impairment 

Unwarranted delay or failure to seek needed care 

Refusal of custody/abandonment 

Other refusal of custody 

Illegal transfers of custody 

Other or unspecified custody-related maltreatment --

unstable custody arrangements 

Inadequate supervision 

Inadequate nutrition 

Inadequate personal hygiene 

Inadequate clothing 

Inadequate shelter 

Other/unspecified disregard of child’s physical needs and 

physical safety 

Physical Abuse (6 codes) 

Shake, throw, purposefully drop 

Hit with hand 

Hit with object 

Push, grab, drag, pull 

Punch, kick 

Other physical abuse 

Educational Neglect (4 codes) 

Permitted chronic truancy 

Other truancy 

Failure to register or enroll 

Other refusal to allow or provide needed attention to 

diagnosed educational need 

Emotional Abuse (8 codes) 

Close confinement: tying/binding 

Close confinement: other 

Verbal assaults and emotional abuse 

Threats of sexual abuse (without contact) 

Threats of other maltreatment 

Terrorizing the child 

Administering unprescribed substances 

Other/unknown abuse 

Emotional Neglect (11 codes) 

Inadequate nurturance/affection 

Domestic violence 

Knowingly permitting drug/alcohol abuse 

Knowingly permitting other maladaptive behavior 

Refusal to allow or provide needed care for diagnosed 

emotional or behavioral impairment/problem 

Failure to seek needed care for emotional or behavioral 

impairment/problem 

Overprotectiveness 

Inadequate structure 

Inappropriately advanced expectations 

Exposure to maladaptive behaviors and environments 

Other inattention to development/emotional needs 

Other Maltreatment (6 codes) 

Lack of preventive health care 

General neglect—other/unspecified neglect 

allegations 

Custody/child support problems 

Behavior control/family conflict issues 

Parent problem 

General maltreatment—unspecified/other (not 

coded above) 

Not Countable by any NIS Standard (3 codes) 

Involuntary neglect 

Chemically dependent newborns 

Non-maltreatment cases 

2–13
 
 

each child substantiated by CPS or thought to meet the study criteria on either type of 

data form and deciding their “countability” in relation to the study definitions. They 

assessed each alleged form of suspected or substantiated maltreatment as to its substance 

(who did what to whom, when, with what effect, and with what quality of evidence), 

rating the degree to which each required element met the countability criteria of the Harm 

Standard and of the Endangerment Standard. Overall assessments of the child’s 

countability under each definitional standard summarized the ratings across all alleged 

maltreatment forms. 

In the NIS–4, a specialized Computer-Assisted Evaluative Decision System 

(CAEDS) assisted evaluative coders as they assessed cases. CAEDS offered a number of 

advantages over the paper-processing approach used in previous NIS cycles: it offered 

automated reminders of the definitions and implemented consistency checks as the coders 

keyed their decisions; it allowed simultaneous and efficient electronic access to data 

forms by primary evaluative coders and reliability coders (as well as the unduplication 

team); it served as the management system for supervisors to allocate coding assignments 

and monitor reliability of individual coders in an ongoing way; and it protected 

confidential data by maintaining the forms electronically on a secure password-protected 

network, eliminating the need to provide specialized physical security during their use 

and transfer. 

The benefits of using CAEDS for ongoing monitoring of the consistency of 

codes and intercoder reliability measures are evident in the reliability of the NIS–4 

evaluative coding decisions. Despite the complexity of the assessments, results were 

quite reliable, as gauged by two measurements. The first was the simple percentage rate 

of agreement between the initial evaluative coder and another, reliability coder who 

blind-coded a random 40% of the child records (i.e., 12,334 children). The inter-coder 

reliability agreement rate was 97% for both Harm Standard countability and 

Endangerment Standard countability. The second reliability measure was the Kappa 

coefficient, which takes into account the level of agreement expected by chance, based on 

the overall distribution of the codes for the item. The Kappa scores were .95 for 

agreement on Harm Standard countability and .91 for agreement on Endangerment 

Standard countability. 

The NIS–4 Analysis Report (Sedlak, Mettenburg, Winglee et al., 2010) gives 

details of the NIS–4 definitions and the evaluative coding process. 

2–14
 
 

2.5 Unduplication 

The NIS provides estimates of the number of children who are maltreated 

during the study year. However, the NIS can receive more than one data form 

concerning an individual child. Such duplicates occurred when more than one study 

source recognized the same maltreatment event and when a given child experienced more 

than one maltreatment event during the study reference period. In either case, it was 

necessary to identify and resolve all such duplicate child records to ensure that the 

estimates would reflect the child as a unit of measurement. Following the approach taken 

in the previous studies, only enough close-to-identifying information was obtained in the 

NIS–4 to allow fairly certain judgments as to whether or not two data forms described the 

same child. Decisions about duplicates relied on matches on the child’s sex, first name, 

last initial, date of birth or age, race, city of residence, and number of other children in 

the household. 

Having identified duplicates, the NIS retained only one record to represent 

the individual child in the analysis database. Selecting a single record to represent an 

unduplicated child followed similar decision rules to those used in previous NIS cycles, 

giving preference to records with countable maltreatment under the definitional 

standards, to those with more complete demographic information, to records from 

sources higher in the traditional NIS hierarchy of recognition sources (iceberg model in 

Figure 2–1),13 and to those describing more forms of maltreatment. Statisticians assigned 

the unified child record a weight that adjusted for the multiple probabilities of sampling 

the child from the sources represented in the duplicate grouping. 

The NIS–4 unduplication team processed 30,543 child records. After 

identifying and unifying duplicate records, the final database contained 29,488 records on 

individual children. 

The NIS–4 Analysis Report (Sedlak, Mettenburg, Winglee et al., 2010) 

details the NIS–4 unduplication process. 

13 Chapter 7 provides further details about this recognition source priority system. 

2–15
 
 

 

 

 

2.6 Weighting and Estimation14 

The national estimates derive from weighted totals of the sampled children, 

with each child’s weight based on the probability of having selected the source that 

reported the child to the study. The final weights are complex because they: 

•	 account for the differential selection probabilities for the sample units 

at each successive sampling stage; 

•	 compensate for agency nonresponse, and for incomplete or partial 

participation by sentinels and CPS agencies; 

•	 adjust for multiple probabilities of identifying the same maltreated child 

through multiple reports to CPS or through multiple sentinel sources; 

and 

•	 include an annualization multiplier to allow the reference-period data to 

represent a full-year and to account for seasonality differences between 

the two study reference periods (fall 2005, spring 2006). 

Base weights and base weight adjustments. For each sample unit in the 

study (county, agency, sentinel, and case), the base weight is the reciprocal of the 

probability of including the unit in the sample. The NIS–4 also applied special weighting 

adjustments, including adjustments to ensure that study estimates are accurate relative to 

the size and distribution of the child population at the time of the NIS–4 reference 

periods, taking into account that the U.S. child population was larger during the NIS–4 

reference periods than it was at the time of the 2000 census (when sampling probabilities 

were set) and that the distribution had shifted somewhat as well (especially as a result of 

hurricanes Katrina and Rita). 

Nonresponse adjustments. Adjusting base weights for nonresponse 

compensated for lost data. The NIS–4 had three types of nonresponse: nonparticipating 

sentinel agencies, refusals or incomplete participation by sentinels, and missing CPS 

14 Appendix A summarizes the NIS–4 weighting and estimation procedures. The NIS–4 Analysis Report 

(Sedlak, Mettenburg, Winglee et al., 2010) provides additional detail. 

2–16
 
 

 

 

 

 

 

 

 

Maltreatment forms on sampled cases. These adjustments enlarged the weights for 

participating entities to make up for the loss of similar, nonparticipating entities. 

Multiplicity adjustments. The unduplication process identified and 

removed multiple forms on the same child, as described above, ensuring that just a single 

record on the child entered the final analyses. The process of unifying a single record to 

represent the child included the calculation of a unified weight for the child as well. The 

unified weight summarized the probability of having sampled a duplicated child, 

correcting for the fact that the child entered the study through multiple sources. 

Annualization adjustments. The NIS–4 gathered data for two 3-month 

study reference periods. Agencies participated in either the 3-month fall reference period 

or in the 3-month spring reference period. The annualization adjustments enabled the 

data from the two 3-month reference periods to provide estimates that reflect the numbers 

of children who experienced maltreatment over the course of 12-months during 2005— 

2006. The NIS–4 annualization adjustments used data from the National Child Abuse 

and Neglect Data System (NCANDS) on substantiated children in the NIS–4 counties. 

The NCANDS data provided four adjustment factors, two for children maltreated during 

each reference period (fall or spring), depending on the source that reported the child to 

CPS (school versus other sources).15 

The Design and Methods Summary (Appendix A) provides additional 

information about the weighting process, with further details available in the Analysis 

Report (Sedlak, Mettenburg, Winglee et al., 2010). 

2.7 Data Analysis 

The principal NIS–4 findings are estimates of totals and rates: the total 

number of maltreated children in the U.S. and the rate of maltreated children per 1,000 in 

15 The NIS targets children maltreated or reported to CPS during the reference period in question. In 

contrast, NCANDS annual data files include cases based on the date that CPS assigned a disposition.

Thus, in order to reflect all children reported to CPS during the 2005 calendar year, it was necessary to

integrate data from two NCANDS fiscal year files: 2005 and 2006. 

2–17
 
 

 

 

 

 

 

 

 

 

 

 

 

 

the population. The estimated totals are the weighted totals of the children’s records in 

the final analysis file, subset to those children who experienced the maltreatment in 

question. Incidence rates are computed by dividing the estimated total number of 

children who experience the maltreatment in question by the number of children in the 

U.S. population16 and by 1,000. This provides the rate per 1,000 children in the general 

population. The ensuing chapters present estimates for the incidence maltreatment as 

defined by the Harm Standard and by the Endangerment Standard, giving the estimated 

numbers of children who experienced the different categories of maltreatment as well as 

the corresponding rates per 1,000 children in the population. Analyses also produced 

estimated totals and rates for subgroups of children, defined by various child and family 

characteristics. In each case, the denominator used to compute the rate reflected the 

number of children in the general population with the corresponding characteristic.17 

The national estimates in this report derive from a sample of maltreated 

children. The final NIS–4 analysis file includes a sample of 12,408 children who 

experienced Endangerment Standard maltreatment, 5,226 of whom also experienced 

Harm Standard maltreatment. Any estimate based on a sample has some degree of 

associated uncertainty. Sample-based studies index the amount of uncertainty on 

estimates with the “standard error of estimate,” or S.E. The square of the standard error 

is the variance. The standard error or variance indicates the precision of the estimate. It 

is critical in understanding how reliable an estimate is and in deciding whether an 

observed difference in estimated rates is “statistically significant,” or whether it could 

simply be due to sampling error (due to chance fluctuations).18 Statisticians recommend 

16 In order to accommodate any changes in the size of the overall child population in the U.S. between the

NIS–4 reference periods (fall 2005 and spring 2006), NIS–4 incidence rates used the average of the July 

2005 and July 2006 U.S. Census Bureau annual estimates as the population denominator (U.S. Census

Bureau, 2008a). 

17 To provide estimates for the broad range of characteristics of interest, the NIS–4 used population 

statistics from various sources; subsequent chapters provide those details. In all cases, those sources

provided the information about the distribution of the characteristics in the child population. To establish 

the specific denominators for computing rates, that distribution was applied to the NIS–4 overall child

population denominator (based on the average of July 2005 and July 2006 child population estimates, as

described in an earlier footnote). This ensured that the subgroup denominators summed to the NIS–4 

child population denominator. 

18 Statistically significant differences have a very low probability of emerging by chance (probability of 5%

or less, or p<.05). Subsequent chapters also report “statistically marginal” differences, which have a

chance probability of more than 5% but less than 10% (i.e., .10>p>.05). 

2–18
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

special methods to compute standard errors or variances when data are from multi-stage 

sample designs, which are common in most national surveys.19 As noted above, the NIS 

design included multiple stages (i.e., counties, then agencies within those counties, then 

sentinels and cases within the agencies). The NIS–4 followed the approach of earlier NIS 

cycles and used a replication approach to compute standard errors for all estimates.20 

Appendixes B and C list all the Harm Standard and Endangerment Standard 

estimates, respectively, together with their standard errors. All within-study comparisons 

used these standard errors to compute the significance of differences between the 

estimated incidence rates for the subgroups under study.21 Appendix D reports the results 

of all within-study statistical tests. 

Appendix E gives the results of analyses that compared the NIS–4 estimates 

to previous NIS results. Cross-study comparisons always used the incidence rate 

measures, since that adjusted for any changes in the overall size of the child population 

between NIS cycles. Besides assessing changes in the overall incidence of different 

maltreatment categories, these analyses also examined the distribution of maltreatment 

across specific subgroups, defined on the basis of characteristics of the child and family 

and identified patterns of differences across subgroups within the NIS–4. Such 

comparisons identified statistically meaningful changes in the distribution of 

maltreatment since the NIS–3.22 

19 Traditional statistical software packages assume that the data derive from a simple random sample, which 

is not true in multi-stage designs; therefore, they do not compute correct standard errors (Brogan, 1998;

Kish, 1992; Korn & Graubard, 1995, 1999; Landis, Lepkowski, Iklund, & Stehouwer, 1982; Lee,

Forthofer, Lorimore, 1989; Skinner, 1989; Wolter, 1985). 

20 Although replication is not the only approach that can compute correct variances from complex samples,

it can handle situations that other methods cannot address easily and has several advantages even when 

other methods can readily apply (Brick & Morganstein, 1996, 1997; Rust & Rao, 1996; Shao, 1996;

Wolter, 1985). 

21 All within-study analyses computed t-tests comparing every pair of subgroups under study. As 

subsequent chapters indicate, these comparisons based conclusions about significance on the Bonferroni

critical values of t (Sankoh, Huque & Dubey, 1997), which corrected for the fact that conducting multiple 

comparisons increases the possibility of finding a difference that meets the standard for statistical

significance but is instead due to chance. 

22 These analyses computed the Chi square statistics on the rates in a two-way table, where the rows

reflected the study (NIS–4 versus NIS–3) and the columns corresponded to the levels of the characteristic

of interest (e.g., age groups, socioeconomic status levels, etc.). This determined whether any changes in 

rates since the NIS–3 occurred differentially for subgroups with specific characteristics. 

2–19
 
 

 

 

 

2.8 Supplementary Studies 

The NIS provides estimates of the percentage of maltreated children whose 

maltreatment is investigated by CPS. Throughout the previous NIS cycles, however, 

children who were not investigated represented an enigma because it was not possible to 

say whether they were not reported to CPS or whether they were reported to CPS but not 

investigated because they did not fit the agency’s screening criteria. The policy 

implications of these alternative situations are quite different. The supplementary studies 

obtained additional information from participating CPS agencies and sentinels to 

illuminate these findings. Appendix A, the Design and Methods Summary, provides 

further information about the methodologies used. In addition, separate reports, cited 

below, detail the instruments, procedures, and analyses and present complete results for 

each study. 

CPS Structure and Practices Mail Survey (SPM). The SPM (Sedlak, 

McPherson, Shusterman, and Li, 2010) employed a questionnaire that was modeled after 

the Local Agency Survey (LAS) in the National Study of Child Protective Services 

Systems and Reform Efforts, which was conducted in 2002 (U.S. Department of Health 

and Human Services, Administration for Children and Families/Children's Bureau and 

Office of the Assistant Secretary for Planning and Evaluation, 2003). 

The principal purpose of the SPM was to provide enhanced information about 

the CPS agency context that could shed light on the NIS–4 main study findings on rates 

of CPS investigation. The SPM questionnaire included 4 modules, each focused on a 

specific CPS function: Administration, Screening/Intake, Investigation, and Alternative 

CPS Response. Analyses identified several CPS agency characteristics that were 

associated with a maltreated child’s chances of receiving attention in a CPS investigation. 

CPS Screening Policies Study (SPS). The SPS (Greene, McPherson, and 

Sedlak, 2010) identified the criteria CPS agencies used in deciding whether to investigate 

a referral about alleged maltreatment and then applied these criteria to the main study 

data on maltreated children who were not investigated. Phase I involved telephone 

interviews with intake/screening supervisors (or their delegates) in participating NIS–4 

CPS agencies, asking how their agency would respond to a series of vignettes that 

reflected the full range of maltreatment situations in the NIS–4 typology. The SPS report 

uses these data to provide national estimates of CPS agencies’ screening policies at the 

2–20
 
 

 

time of the NIS–4. In Phase II, coders applied the SPS screening criteria to the 

uninvestigated children in the NIS–4 main study and decided whether, according to the 

screening criteria the local CPS agency used at the time of the study, CPS would have 

screened them in for investigation. 

Sentinel Definitions Survey (SDS). The NIS goes beyond maltreated 

children who come to the attention of CPS agencies by relying on community 

professionals (sentinels) who encounter child maltreatment in the course of their work in 

various agency sectors, including health, law enforcement, schools, social services and 

mental health, public housing, day care centers, and shelters. In most states, 

professionals in these sectors are mandated reporters, required by law to report any 

suspected child maltreatment to CPS. However, except for a supplementary survey of 

school sentinels in the NIS–3 (Sedlak & Schultz, 1997), previous NIS cycles have not 

directly asked sentinels about their training on mandated reporting or the standards they 

apply in deciding whether to report suspected maltreatment to CPS. Also, although NIS 

has always trained the sentinels to be on the lookout for the full scope of maltreatment 

situations that are, or could be, countable under the study definitions, NIS has never 

examined sentinels’ own definitions of maltreatment, or asked about their standards for 

submitting children to the study. This has hampered interpreting changes in the size of 

the maltreated child population from one NIS cycle to the next, since the study has had 

no means of determining whether or to what extent the changes reflected true changes in 

the occurrence of child maltreatment as opposed to shifts in sentinels’ definitions or in 

their standards for submitting data to the study. 

The Sentinel Definitions Survey (SDS) filled these important gaps 

(McPherson and Sedlak, 2010). Professionals who participated in the main NIS–4 as 

sentinels responded to a follow-up questionnaire about their background, experiences 

reporting to CPS, and reporting procedures in their agency. Using vignettes that 

described forms of maltreatment in the NIS–4 typology, the questionnaire also asked 

about the conditions that they identified as maltreatment and their standards for reporting 

a situation to CPS or submitting it to a national study, such as the NIS. 

2–21
 

 

 

 

3. INCIDENCE OF CHILD ABUSE AND NEGLECT
 

This chapter provides Harm Standard and Endangerment Standard estimates 

of child abuse and neglect, addressing the following questions: 

•	 What is the current national incidence of child abuse and neglect as

defined by the Harm Standard or the Endangerment Standard? 

•	 Have there been any statistically significant changes since the NIS–2 or 

since the NIS–3 in the annual incidence of children who experience 

abuse or neglect fitting the standard?23 

•	 Among the children who experienced abuse or neglect according to the 

standard, what was their most serious injury or harm from that 

maltreatment? 

•	 How does this distribution of children across levels of severity of

injury/harm compare with the severity distributions found in the NIS–2 

and the NIS–3? 

In addition, the discussion compares the Endangerment Standard estimates 

for different maltreatment types and outcomes with the Harm Standard estimates, 

indicating the additional children included as abused or neglected under the more lenient 

Endangerment Standard guidelines. The final section summarizes the main findings and 

discusses their implications. 

Throughout this and the subsequent chapters, it is important to bear in mind 

that the NIS definitions, under whatever standard, require all maltreatment to have been 

perpetrated by a parent or caretaker (i.e., to reflect circumstances that are within the 

jurisdiction of child protective services agencies). That is, the NIS estimates 

systematically exclude maltreatment by non-caretaker family members (e.g., siblings who 

were not in a caretaking role), by non-caretaker neighbors or acquaintances, and by 

strangers. Thus, the incidence totals and rates in this report do not reflect the children 

23 Reports on the findings from these previous studies were Sedlak (1991) and Sedlak and Broadhurst

(1996). 

3–1
 
 

 

 

 

 

 

 

physically assaulted or sexually abused by persons in any of these latter categories. They 

also exclude children who are not living in households. 

It is also important to note that the estimates in this report reflect the 

unduplicated numbers of children in the U.S. who experienced the maltreatment in 

question. That is, the unit of measurement is the child, and each estimate counts a child 

only once. The report provides both the estimated totals and the estimated rates per 1,000 

children. Estimated totals are annual estimates, reflecting the number of children 

nationwide who were maltreated in the course of the study year. The incidence rates 

indicate the numbers of children maltreated during the study year per 1,000 children in 

the U.S. population. This report also follows the usage of the Congressional mandate in 

referring 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.24 

3.1 National Incidence of Harm Standard Maltreatment 

This section presents the national estimates of the incidence of children who 

experienced Harm Standard maltreatment during the NIS–4 2005–2006 study year. The 

Harm Standard is relatively stringent in that, in general, it classifies a child as 

“countable” (i.e., counts the child in the study estimates) only if he or she has already 

experienced demonstrable harm as a result of maltreatment. 

24 In epidemiologic usage, "incidence" refers to the number of new cases that occur in the population during 

a given period of time (Ahlbom & Norell, 1984). "Prevalence" can mean a number of different things,

depending on whether it is used with or without a modifying adjective. When used without a qualifier, it

is most often interpreted to mean "point prevalence," which is the total number of cases that exist in the 

population at a given point in time. Prevalence can also be defined as "lifetime prevalence," which refers

to the total number of persons known to have been cases at some time in their lives, or "period

prevalence," which denotes the total number of persons known to have been cases at any time during a

specified period. 

3–2
 
 

 

 

 

 

3.1.1 Overall Incidence of Harm Standard Maltreatment 

Table 3–1 presents the estimates for Harm Standard maltreatment since the 

NIS–2. The shaded section gives the NIS–4 estimates. These represent annual estimates 

for 2005–2006, the period in which the NIS–4 data were collected. The right-hand side 

of the table compares the NIS–4 findings with the estimates for the corresponding 

categories from the earlier studies, the NIS–3 and the NIS–2. The NIS–3 estimates reflect 

the incidence of maltreatment during 1993, and the NIS–2 estimates index the incidence 

of maltreatment in 1986. The statistical significance of the comparison in question is 

indicated by an asterisk or letter(s), as the table footnotes explain. 

Table 3–1 shows that an estimated 1,256,600 children experienced Harm 

Standard maltreatment during the NIS–4 2005–2006 study year. This total reflects an 

incidence rate of 17.1 children per 1,000 children in the general population nationwide, 

which is equivalent to 1.71 children per 100, or to one child in every 58 in the United 

States.25,26 The comparisons in the right-hand sections of the table indicate that the 2005– 

2006 annual incidence of all Harm Standard maltreatment is lower than the 

corresponding estimate for 1993, a statistically marginal difference.27 Specifically, there 

was a 19% decrease in the total number of maltreated children since 1993. This decrease 

corresponds to a 26% decline in the rate of overall Harm Standard maltreatment since the 

NIS–3. The rate measure conveys a child’s risk of experiencing the maltreatment, so one 

can say that a child’s risk of suffering Harm Standard maltreatment was 26% lower in 

2005–2006 than it was in 1993. This decrease in incidence rate is statistically marginal, 

meaning that the estimated change closely approaches statistical significance but does not 

meet the traditional statistical standard for concluding that the difference is not due to 

chance factors. 

25 The incidence rates in this chapter used the average of the July 2005 and July 2006 annual estimates as

the population denominator (U.S. Census Bureau, 2008a). This computation yielded the estimate that a

total of 73,635,000 children ages 0 through 17 were living in the United States during the NIS–4 2005–

2006 study year. 

26 In this and subsequent chapters, all estimates concerning total numbers of children are rounded to the 

nearest hundred in order to avoid conveying a false sense of precision. All the estimates have associated 

standard errors which represent their degree of precision, given in Appendices B and C. 

27 Comparisons across studies use the rate measures (i.e., comparing the number of children maltreated per

1,000) in order to take account of any changes in the size of the U.S. child population across the time

intervals. Appendix E gives the details of the between-study significance tests and their specific results. 

3–3
 
 

 

The NIS–3 found a significant increase in Harm Standard maltreatment since 

the NIS–2. The NIS–4 findings indicate that the decrease in the overall incidence of 

Harm Standard maltreatment has returned to a level that does not differ from the NIS–2 

estimate for 1986. 

Table 3–1. National Incidence of Harm Standard Maltreatment in the NIS–4 (2005–2006), and 

Comparison with the NIS–3 (1993) and the NIS–2 (1986) Harm Standard Estimates 

Harm Standard 

Maltreatment Category 

NIS–4 Estimates 

2005–2006 

Comparisons With Earlier Studies 

NIS–3 Estimates 

1993 

NIS–2 Estimates 

1986 

Total No. 

of 

Children 

Rate per

1,000 

Children 

Total No. 

of 

Children 

Rate per

1,000 

Children 

Total No. 

of 

Children 

Rate per

1,000 

Children 

ALL 

MALTREATMENT 1,256,600 17.1 1,553,800 23.1 m 931,000 14.8 ns 

ABUSE: 

ALL ABUSE 553,300 7.5 743,200 11.1 * 507,700 8.1 ns 

Physical Abuse 323,000 4.4 381,700 5.7 m 269,700 4.3 ns 

Sexual Abuse 135,300 1.8 217,700 3.2 * 119,200 1.9 ns 

Emotional Abuse 148,500 2.0 204,500 3.0 m 155,200 2.5 ns 

NEGLECT: 

ALL NEGLECT 771,700 10.5 879,000 13.1 ns 474,800 7.5 m 

Physical Neglect 295,300 4.0 338,900 5.0 ns 167,800 2.7 m 

Emotional Neglect 193,400 2.6 212,800 3.2 ns 49,200 0.8 * 

Educational Neglect† 360,500 4.9 397,300 5.9 ns 284,800 4.5 ns 

* The difference between this and the NIS–4 incidence rate is significant at p<.05. 

m The difference between this and the NIS–4 incidence rate is statistically marginal (i.e., .10>p>.05). 

ns The difference between this and the NIS–4 incidence rate is neither significant nor marginal (p>.10). 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both 

tables because it is in the summary categories in both standards: All Neglect and All Maltreatment 

Note: Estimated totals are rounded to the nearest 100. 

3–4
 
3.1.2 Incidence of Harm Standard Abuse and Neglect 

In addition to the overall estimates of incidence and rates, Table 3–1 provides 

estimates for the two main categories of maltreatment: abuse and neglect. Each of these 

is, in turn, divided into more specific categories. 

The NIS only counts abused children under the Harm Standard if they 

experienced the abuse at the hands of their parent (birth or adoptive), parent-substitute 

(e.g., foster parent, step-parent), or an adult caretaker; the NIS counts neglected children 

only when they experienced the neglect at the hands of their parent or parent-substitute. 

Also, as detailed further below, the Harm Standard generally includes children in the 

abuse total if they were moderately harmed by abuse, whereas it generally includes only 

children who were seriously harmed in the neglect estimates. 

As Table 3–1 shows, an estimated 553,300 children experienced Harm 

Standard abuse during the 2005–2006 study year, while an estimated 771,700 children 

suffered Harm Standard neglect during the same period. These totals represent incidence 

rates of 7.5 abused children per 1,000 and of 10.5 neglected children per 1,000 in the 

United States population. Thus, the majority of Harm Standard children (61%) were 

neglected, and slightly less than one-half (44%) were abused. Note that the estimated 

numbers of children in the “all abuse” and “all neglect” rows sum to more than the total 

number of maltreated children in the first row. This is because children who were both 

abused and neglected (an estimated 68,400 children, or 0.9 per 1,000) are included in 

both estimates. 

Changes since the NIS–3 in the incidence of Harm Standard abuse and 

neglect. In comparison to the NIS–3 estimates, the NIS–4 decrease in Harm Standard 

abuse is statistically significant. There was a 26% decrease in the total number of abused 

children since the NIS–3. Alternatively, considering the changes in incidence rates in 

order to take into account the increase in child population size since that earlier study, 

there was a 32% decrease in the abuse rate since the NIS–3, indicating that children had a 

nearly one-third lower risk of being abused under the Harm Standard in the 2005–2006 

study year compared to their risk in 1993. 

The NIS–4 decrease in the rate of Harm Standard neglect since the NIS–3, 

although it may appear substantial, was not statistically significant. 

3–5
 
 

 

Changes since the NIS–2 in the incidence of Harm Standard abuse and 

neglect. The NIS–4 rate of Harm Standard abuse does not statistically differ from the 

NIS–2 rate for this maltreatment category. Thus, the NIS–4 decrease eradicated the 

increase seen in the NIS–3. The incidence of Harm Standard abuse has returned to a 

level that is indistinguishable from what it was in 1986. 

In the NIS–3, the incidence of Harm Standard neglect was significantly 

higher than it was at the time of the NIS–2. Table 3–1 indicates that the NIS–4 estimate 

of Harm Standard neglect was still higher than the 1986 NIS–2 estimate, a statistically 

marginal difference. The total number of neglected children was 63% higher in 2005– 

2006 than in 1986 and the neglect rate per 1,000 children was 40% higher in 2005–2006 

compared to 1986. This increase in the incidence rate means that a child’s risk of Harm 

Standard neglect in 2005–2006 was 1.4 times higher than his or her risk of suffering the 

same maltreatment in 1986. 

3.1.3 Specific Categories of Harm Standard Abuse 

Within Harm Standard abuse, Table 3–1 provides incidence statistics for 

three specific categories: physical, sexual, and emotional abuse. Children who 

experienced more than one category of abuse are reflected in the estimates for each 

applicable type, so the estimates for these specific abuse categories sum to more than the 

total number of abused children. 

Physical abuse. Physical abuse includes shaking, throwing, purposefully 

dropping a child; hitting; pushing, grabbing, dragging or pulling; punching or kicking; 

and other physical abuse. The NIS classifies children as physically abused under the 

Harm Standard if they suffered at least a moderate injury from physical abuse. Moderate 

injuries are defined as physical, mental, or emotional injuries or conditions (or behavior 

problems) resulting from physical abuse which are serious enough to persist in 

observable form for at least 48 hours. Examples include bruises, nightmares, depression, 

and fearfulness. 

Table 3–1 indicates that 4.4 children per 1,000 (or an estimated 323,000 

children) experienced Harm Standard physical abuse during the NIS–4 study year. These 

3–6
 
 

 

children represent 58% of all children who met the Harm Standard criteria for any type of 

abuse. 

Sexual abuse. Sexual abuse subsumes a range of behaviors, including 

intrusion, child’s prostitution or involvement in pornography, genital molestation, 

exposure or voyeurism, providing sexually explicit materials, failure to supervise the 

child’s voluntary sexual activities, attempted or threatened sexual abuse with physical 

contact, and unspecified sexual abuse. For intrusion and genital molestation, the Harm 

Standard guidelines permit assuming that serious emotional harm occurred even if 

explicit symptoms are not yet observable. (Ensuing sections refer to this maltreatment 

outcome as “inferred harm.”) However, for the remaining abusive actions, the NIS 

definitions count children as sexually abused under the Harm Standard only if they 

experienced moderate injury or harm (physical, emotional, or behavioral) from that 

maltreatment. 

An estimated 1.8 children per 1,000 (or a total of 135,300) experienced Harm 

Standard sexual abuse in the NIS–4 study year. Sexually abused children constitute 24% 

of the total who suffered Harm Standard abuse. 

Emotional abuse. In the NIS definitions, this category includes close 

confinement, verbal or emotional assaults, threats of sexual abuse (without contact) and 

threats of other maltreatment, terrorizing, administering unprescribed substances, 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. Emotional abuse also includes 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, Harm Standard guidelines permit “inferred 

harm.” That is, they permit assuming that serious emotional injury occurred in the 

absence of explicit symptoms, which allows the child to qualify as emotionally abused 

under the Harm Standard. However, for all other forms of emotional maltreatment, the 

Harm Standard requires direct or circumstantial evidence of moderate injury or 

impairment. 

3–7
 
 

 

Table 3–1 indicates that an estimated 2.0 per 1,000 (148,500 children) 

suffered Harm Standard emotional abuse in 2005–2006. Emotionally abused children 

represented 27% of all children counted as abused under the Harm Standard. 

Changes since the NIS–3 and NIS–2 in the incidence of Harm Standard 

abuse. Across the Harm Standard abuse categories, the only statistically significant 

change since the NIS–3 was in the incidence of sexual abuse, which declined by 38% in 

total numbers. This corresponds to a 44% decrease in the rate of sexual abuse, from 3.2 

children per 1,000 in 1993 to 1.8 children per 1,000 in 2005–2006. The incidence of 

Harm Standard physical abuse and emotional abuse also decreased since the NIS–3, but 

as Table 3–1 indicates, those decreases did not match the sexual abuse decrease, either in 

size or in statistical strength. The number of children who experienced physical abuse 

decreased by 15%, whereas the number who suffered emotional abuse decreased by 27%. 

The decreases in incidence rates were 23% for physical abuse (from 5.7 to 4.4 per 1,000 

children) and 33% for emotional abuse (from 3.0 to 2.0 per 1,000 children). These 

decreases are statistically marginal, approaching but not reaching the level traditionally 

required for statistical significance. 

The NIS–4 Harm Standard estimates for physical, sexual and emotional 

abuse do not differ statistically from the NIS–2 Harm Standard estimates for the 

component categories of abuse. Thus, the decreases since 1993 in the categories of Harm 

Standard abuse have returned their incidence rates to levels that are statistically 

equivalent to what they were at the time of the NIS–2 in 1986. 

3.1.4 Specific Categories of Harm Standard Neglect 

Harm Standard neglect includes three specific categories: physical, 

emotional, and educational neglect. Again, the estimates in Table 3–1 include children in 

each category that applied to them, so the sum of these neglect categories is greater than 

the total of all neglected children. 

Physical neglect. This type of neglect includes abandonment; refusal of 

custody; illegal transfer of custody; unstable custody arrangements; medical neglect; 

inadequate supervision; inadequate attention to needs for food, clothing, shelter, or 

personal hygiene; and other disregard for the child’s physical needs or physical safety. 

3–8
 
 

 

 

 

 

 

 

From inadequate supervision to the end of this list, the NIS includes the child in the Harm 

Standard estimates only if the maltreatment results in demonstrable injury or impairment 

that is serious or fatal. Serious harm is defined as life-threatening or requiring 

professional treatment in order to prevent significant long-term impairment. The Harm 

Standard criteria for the other categories of physical neglect are somewhat less 

demanding. For abandonment, refusal of custody, and illegal transfer of custody, the 

guidelines permit the inference that harm occurred. For unstable custody arrangements 

and medical neglect, the guidelines allow moderately harmed children to count in the 

Harm Standard estimates under certain conditions.28 

As shown in Table 3–1, physically neglected children make up the secondlargest group of children under Harm Standard neglect in the NIS–4. An estimated 

295,300 children experienced Harm Standard physical neglect in 2005–2006, reflecting 

an incidence rate of 4.0 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, overprotective 

treatment, inadequate structure, inappropriately advanced expectations, exposure to 

maladaptive behaviors and environments, and other inattention to the child’s 

developmental or emotional needs. In all cases, it is necessary for the maltreatment to 

cause serious harm in order for the child to be countable as emotionally neglected under 

the Harm Standard. 

Although emotionally neglected children constitute the smallest of the 

neglect subgroups listed in Table 3–1, their numbers are still substantial, an estimated 

28 For acts of blatant abandonment, illegal transfers of custody, and refusal of custody, the Harm Standard

guidelines permit assuming that serious emotional injury occurred (that is, explicit symptoms are not

required); while for unstable custody arrangements, moderate harm has to be demonstrated or the

circumstances must strongly support the inference that moderate harm has probably occurred. To be 

countable as physically neglected under the Harm Standard, medical neglect has to result in moderate

harm (if it entails an outright refusal to follow professional recommendations regarding needed medical

care) or serious harm (if it reflects a simple failure to obtain needed treatment). 

3–9
 
 

 

total of 193,400 children (equivalent to 2.6 children per 1,000 in the general 2005–2006 

child population). 

Educational neglect. Children are included in this category when their 

parent (or parent-substitute) knowingly permits their chronic truancy an average of at 

least 5 days per month; exhibits a pattern of keeping the child home without legitimate 

reason; fails to register or enroll a school-age child in school in violation of state law; or 

refuses to allow or provide needed attention for a diagnosed educational problem, 

learning disorder, or other special education need. In all such cases, if the evidence 

supports the conclusion that the acts or omissions in question occurred, then the child is 

countable as educationally neglected and the NIS guidelines permit assuming that the 

child experienced moderate educational harm. 

As Table 3–1 shows, educational neglect was the most prevalent category of 

neglect, affecting an estimated 360,500 children, or 4.9 children per 1,000 in 2005–2006, 

which represents 47% of all children who experienced Harm Standard neglect. 

Changes since the NIS–3 and NIS–2 in the incidence of Harm Standard 

neglect. Despite the apparent differences in estimated totals and incidence rates, no 

statistically reliable changes since the NIS–3 occurred in any Harm Standard neglect 

category. 

The NIS–3 found significant increases from the NIS–2 in the incidence of 

both Harm Standard physical neglect and Harm Standard emotional neglect. The NIS–4 

indicates that the 2005–2006 rates of these maltreatment categories were still elevated 

relative to their 1986 levels, but only emotional neglect was still significantly higher than 

its NIS–2 level. The estimated number of children who suffered Harm Standard 

emotional neglect in 2005–2006 is nearly four times as large as the 1986 estimate. There 

was a 293% increase in the total number of emotionally neglected children from the time 

of the NIS–2, and a 225% increase in the incidence rate. Harm Standard physical neglect 

was still higher than its 1986 level, by 76% in the number of children affected and by 

48% in the incidence rate per 1,000 children (2.7 versus 4.0 per 1,000 children). This 

difference is statistically marginal. 

Educational neglect is the only Harm Standard maltreatment category that did 

not demonstrate any significant or statistically marginal changes since the NIS–2. 

3–10
 
 

 

 

 

Severity of Injury or 

Harm 

NIS–4 Estimates 

2005–2006 

Comparisons With Earlier Studies 

NIS–3 Estimates 

1993 

NIS–2 Estimates 

1986 

Estimated 

Total 

Rate per

1,000 

Children 

Estimated 

Total 

Rate per

1,000 

Children 

Estimate 

d Total 

Rate per

1,000 

Children 

Fatal 

Serious 

Moderate 

Inferred 

TOTAL 

2,400 0.03 

487,900 6.6 

694,700 9.4 

71,500 1.0 

1,256,600 17.1 

1,500 0.02 ns 

565,000 8.4 ns 

822,000 12.2 ns 

165,300 2.5 * 

1,553,800 23.1 m 

1,100 0.02 m 

141,700 2.3 * 

682,700 10.8 ns 

105,500 1.7 * 

931,000 14.8 ns 

 

 

3.1.5 Severity of Outcomes from Harm Standard Maltreatment 

The NIS classifies children on the basis of the most severe injury or harm 

they suffered from maltreatment. Table 3–2 presents the distribution of the children who 

experienced Harm Standard maltreatment across the levels of outcomes resulting from 

their maltreatment. Each maltreated child appears in only one row of this table, so the 

row entries sum to the total number of children who were countable under the Harm 

Standard.29 

Fatal injury. An estimated 2,400 children died in 2005–2006 as a result of 

Harm Standard abuse or neglect. This reflects an annual incidence rate of maltreatmentrelated fatalities of 0.03 per 1,000 children in the U.S., which is equivalent to 3 children 

per every 100,000, or one in every 33,300, in the U.S. child population. 

Table 3–2. Severity of Outcomes from Harm Standard Maltreatment in the NIS–4 (2005–2006), 

and Comparison with the NIS–3 (1993) and the NIS–2 (1986) Harm Standard Findings 

* The difference between this and the NIS–4 incidence rate is significant at p<.05. 

m The difference between this and the NIS–4 incidence rate is statistically marginal (i.e., .10>p>.05). 

ns The difference between this and the NIS–4 incidence rate is neither significant nor marginal (p>.10). 

Note: Estimated totals are rounded to the nearest 100. 

29 Compare the Table 3–2 “Total” with “All Maltreatment” in Table 3–1. 

3–11 
 

 

 

 

 

 

 

 

 

 

 

Serious harm. As noted above, NIS defines an injury or impairment as 

serious when it involves a life-threatening condition, represents a long-term impairment 

of physical, mental, or emotional capacities, or requires professional treatment aimed at 

preventing such long-term impairment. Examples of serious injuries/impairments 

include: loss of consciousness, stopping breathing, broken bones, schooling loss that 

required special education services, chronic and debilitating drug/alcohol abuse, 

diagnosed cases of failure to thrive, third-degree burns or extensive second-degree burns, 

and so forth.30 Serious harm from Harm Standard maltreatment occurred to 6.6 children 

per 1,000 in 2005–2006, representing 487,900 children, or over one-third (39%) of all 

children who were countable under the Harm Standard. 

Moderate harm. Moderate injuries or impairments are those that persisted 

in observable 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 harm occurred to 9.4 children per 1,000 (or 694,700 children) in 2005–2006, 

and these accounted for over one-half (55%) of all children countable under the Harm 

Standard. 

Inferred harm. Under the NIS definitions, the nature of the maltreatment 

itself gave reasonable cause to assume that injury or impairment probably occurred for 1 

child per 1,000 in the United States in 2005–2006, or 71,500 children countable under the 

Harm Standard.31 Following the hierarchy conveyed by the ordering in Table 3–2, the 

NIS uses the “inferred harm” category only for qualifying children who did not also 

sustain fatal, serious, or moderate harm. However, inferred harm should not be 

30 Details are in the “Evaluative Coding Manual” in the NIS–4 Analysis Report (Sedlak, Mettenburg, 

Winglee et al., 2010). 

31 As described in the preceding sections, there are instances where the Harm Standard guidelines permit

inferring that a child was harmed, even though observable symptoms were not yet evident. These 

conditions include the more serious forms of sexual abuse, blatant abandonment, blatant refusal of

custody, illegal transfers of custody, and extremely close confinement (tying or binding). In addition, the

Harm Standard guidelines permit circumstantial evidence of harm to support a child’s countability in

connection with “other” sexual abuse (i.e., beyond intrusion and genital molestation), “other” close 

confinement, verbal or emotional assault and threats, terrorizing, administering unprescribed drugs,

“other” abuse or exploitation (i.e., beyond the forms readily classifiable as sexual, physical, or verbal),

unstable custody arrangements, and “other” custody-related neglect. 

3–12
 
interpreted as less serious than moderate injury, because the types of maltreatment that 

generally warrant inferred harm (e.g., incest, abandonment) could actually have a 

devastating impact on a child. 

Changes since the NIS–3 and NIS–2 in the severity of outcomes from 

Harm Standard maltreatment. Tests of differences between the NIS–4 estimates for 

2005–2006 and the corresponding NIS–3 findings for 1993 reveal a significant decline 

only in the incidence of children with inferred harm from their maltreatment. The number 

of children for whom injury could be inferred declined by 57% from 165,300 to 71,500 

while the rate of children with inferred harm declined by 60% from 2.5 to 1.0 child per 

1,000. Differences between the NIS–4 and the NIS–3 in the incidence of fatal, serious, 

and moderate injuries are not statistically significant. 

The NIS–3 identified a significant increase since 1986 in the incidence of 

children with serious maltreatment injuries and a statistically marginal increase in the 

incidence of children for whom injury could be inferred. The NIS–4 results show that the 

incidence of children with serious harm remains significantly higher than the 1986 levels, 

but that the decrease since 1993 in the incidence of children with inferred harm actually 

brought that rate significantly below its 1986 level as well. Specifically, the estimated 

number of seriously injured children increased by 244% between the NIS–2 and the NIS– 

4, from 141,700 to 487,900. In terms of incidence rates, this increase means that the risk 

of a child being seriously harmed by Harm Standard abuse or neglect was 187% higher in 

2005–2006 than in 1986. At the same time, there was a substantial and significant 

decrease in the number of children for whom injury could be inferred. This total 

declined by 32% between the NIS–2 and the NIS–4, from 105,500 to 71,500. The 

incidence rate declined by 42%, meaning that the risk of a child qualifying for inferred 

harm from Harm Standard maltreatment was 42% lower in 2005–2006 than in 1986. 

The NIS–4 also revealed a statistically marginal increase in the rate of fatal 

injury compared to the NIS–2 rate. The estimated number of children who were fatally 

injured under the Harm Standard increased by 118% since 1986, reflecting a rise of 50% 

in the incidence rate per 1,000 children in the United States. 

The incidence of children with moderate harm as a result of Harm Standard 

maltreatment has not measurably changed since the NIS–2. 

3–13
 
 

 

 

 

3.2 National Incidence of Endangerment Standard Maltreatment 

The Endangerment Standard estimates include all the Harm Standard 

children, but add others as well, by relaxing the definitional requirements in several 

respects. The central feature of the Endangerment Standard is that it includes children 

who were not yet harmed by maltreatment, but who experienced abuse or neglect that 

placed them in danger of being harmed, according to the views of community 

professionals or child protective service agencies.32 In addition, the Endangerment 

Standard slightly enlarges the set of allowable perpetrators in several categories and 

incorporates additional maltreatment classifications, as explained below. 

The following sections each begin with the NIS–4 Endangerment Standard 

estimates. Following that, the discussion compares these Endangerment Standard 

estimates to the NIS–4 Harm Standard estimates given above, clarifying the distribution 

of the additional children that the Endangerment Standard includes. Each section then 

compares the NIS–4 Endangerment Standard estimates to the NIS–3 and NIS–2 

Endangerment Standard findings. 

3.2.1 Overall Incidence of Endangerment Standard Maltreatment 

Table 3–3 presents the Endangerment Standard incidence estimates. The 

shaded section reports the NIS–4 estimates for the 2005–2006 study year. The right-hand 

sections give the NIS–3 and NIS–2 estimates for comparison. 

The estimate of all maltreated children using the Endangerment Standard 

includes the children who were abused or neglected in any of the categories listed. In 

addition, the Endangerment Standard measure of “All Maltreatment” subsumes a few 

additional forms of maltreatment allowable in this standard, including children 

32 Specifically, in order to qualify as “endangered,” the child’s maltreatment has to be substantiated or 

indicated by a child protective services (CPS) agency or the sentinel who submits the child to the study

has to explicitly rate the child as having been endangered by the abuse or neglect described. 

3–14
 
 

 

 

 

 

considered to be endangered by their parents’ problems (such as alcoholism, drug abuse, 

prostitution).33 

Table 3–3. National Incidence of Endangerment Standard Maltreatment in the NIS–4 (2005–2006), and 

Comparison with the NIS–3 (1993) and the NIS–2 (1986) Endangerment Standard Estimates. 

Endangerment Standard

Maltreatment Category 

NIS–4 Estimates 

2005–2006 

Comparisons With Earlier Studies 

NIS–3 Estimates 

1993 

NIS–2 Estimates 

1986 

Total No. 

of 

Children 

Rate per

1,000 

Children 

Total No. 

of 

Children 

Rate per

1,000 

Children 

Total No. 

of 

Children 

Rate per

1,000 

Children 

ALL 

MALTREATMENT 2,905,800 39.5 2,815,600 41.9 ns 1,424,400 22.6 * 

ABUSE: 

ALL ABUSE 835,000 11.3 1,221,800 18.2 * 590,800 9.4 m 

Physical Abuse 476,600 6.5 614,100 9.1 * 311,500 4.9 * 

Sexual Abuse 180,500 2.4 300,200 4.5 * 133,600 2.1 ns 

Emotional Abuse 302,600 4.1 532,200 7.9 * 188,100 3.0 m 

NEGLECT: 

ALL NEGLECT 2,251,600 30.6 1,961,300 29.2 ns 917,200 14.6 * 

Physical Neglect 1,192,200 16.2 1,335,100 19.9 ns 507,700 8.1 * 

Emotional Neglect 1,173,800 15.9 584,100 8.7 * 203,000 3.2 * 

Educational Neglect† 360,500 4.9 397,300 5.9 ns 284,800 4.5 ns 

* The difference between this and the NIS–4 incidence rate is significant at p<.05. 

m The difference between this and the NIS–4 incidence rate is statistically marginal (i.e., .10>p>.05). 

ns The difference between this and the NIS–4 incidence rate is neither significant nor marginal (p>.10). 

Note: Estimated totals are rounded to the nearest 100. 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both tables 

because it is in the summary categories in both standards: All Neglect and All Maltreatment. 

33 Thus, the "All Maltreatment" category includes all children in the "All Abuse" total, all children in the

"All Neglect" total, and also other children who were endangered by their parents’ problems. 

3–15 
 

An estimated 2,905,800 children experienced some form of Endangerment 

Standard maltreatment during the 2005–2006 study year. This corresponds to an 

incidence rate of 39.5 children per 1,000, which is equivalent to about 4 children per 100, 

or one child in 25 in the general U.S. child population. 

Comparison with the Harm Standard estimate of all maltreated 

children. The Endangerment Standard included an additional 1,649,200 maltreated 

children, beyond those who were countable under the Harm Standard. The 

Endangerment Standard estimate of the maltreated population of 2,905,800 (or 39.5 per 

1,000) is 131% higher than the Harm Standard estimate of 1,256,600 (or 17.1 per 1,000). 

An alternative way of viewing this is to note that Harm Standard children represent 43% 

of the Endangerment Standard estimate of all maltreated children. 

Changes since 1986 in the incidence of Endangerment Standard 

maltreatment. The right-hand section in Table 3–3 reveals that the NIS–4 estimate of 

Endangerment Standard maltreatment is not significantly different from the NIS–3 level, 

but is significantly higher than the NIS–2 level. In fact, the total number of children who 

experienced Endangerment Standard abuse or neglect more than doubled since the NIS–2 

(from 1,424,400 in 1986 to 2,905,800 in 2005–2006), while the incidence rate increased 

by 75% (from 22.6 to 39.5 children per 1,000). This rise in the incidence means that a 

child had one and three-quarters times greater risk of experiencing Endangerment 

Standard abuse or neglect in 2005–2006 than in 1986. 

3.2.2 Incidence of Endangerment Standard Abuse and Neglect 

Table 3–3 also gives estimates for children who were abused or neglected. 

As with the Harm Standard, the Endangerment Standard abuse estimate includes 

physical, sexual, and emotional abuse and the Endangerment Standard neglect estimate 

includes physical, emotional, and educational neglect. However, the Endangerment 

Standard neglect estimate also includes forms of neglect that are not countable under the 

Harm Standard, such as lack of preventive health care, unspecified neglect allegations, 

and child support problems. 

An estimated 835,000 children experienced Endangerment Standard abuse 

and an estimated 2,251,600 children suffered Endangerment Standard neglect. These 

3–16
 
 

 

totals represent national incidence rates of 11.3 abused children per 1,000 and 30.6 

neglected children per 1,000. The majority of children maltreated under the 

Endangerment Standard (77%) were neglected, whereas less than one-third (29%) were 

abused. Again, children who were both abused and neglected are included in both 

categories, so these estimates sum to more than the total number of maltreated children. 

Comparison with the Harm Standard abuse and neglect estimates. The 

Endangerment Standard abuse estimate is 51% higher than the Harm Standard abuse 

estimate, while the Endangerment Standard neglect estimate is 192% higher than the 

Harm Standard neglect estimate. The less stringent Endangerment Standard requirements 

brought substantially more children into the neglect estimates (an additional 1,479,900 

children) than into the abuse estimates (where the more lenient standard added 281,700 

children). This pattern was also true in the NIS–2 and the NIS–3. In the NIS–3, Harm 

Standard children accounted for 61% of the Endangerment Standard abuse total, and 45% 

of the Endangerment Standard neglect total. In the NIS–2, Harm Standard children 

represented 86% of the Endangerment Standard abuse total, and 52% of the 

Endangerment Standard neglect total. 

Changes since 1986 in the incidence of Endangerment Standard abuse 

and neglect. Endangerment Standard abuse decreased significantly since 1993. The 

total number of children who experienced Endangerment Standard abuse decreased by 

32% and the rate per 1,000 children in the population decreased by 38%. Although the 

NIS–4 estimate of the incidence of Endangerment Standard neglect appears slightly 

higher than the NIS–3 estimate for 1993, the rates do not differ statistically. 

The incidence of both Endangerment Standard abuse and neglect increased 

between the NIS–2 and the NIS–3. Despite the recent decrease between the NIS–3 and 

the NIS–4 in the incidence of Endangerment Standard abuse, the NIS–4 rate for this 

category is still 20% higher than it was in 1986 at the time of the NIS–2. This is a 

statistically marginal difference. Also, because the rate of Endangerment Standard 

neglect has shown no discernable change since 1993, it remains significantly higher than 

it was in 1986. Specifically, children’s risk of Endangerment Standard neglect in 2005– 

2006 is more than double its 1986 level (i.e., it is 110% higher than the earlier rate). 

3–17
 
 

 

 

 

 

3.2.3 Specific Categories of Endangerment Standard Abuse 

Table 3–3 provides the incidence statistics for the specific categories of 

Endangerment Standard abuse: physical, sexual, and emotional. The estimates for the 

different abuse categories sum to more than the total number of abused children because 

each estimate includes all children who experienced that type of abuse and some children 

experienced more than one type of abuse. 

Physical abuse. Table 3–3 shows that 6.5 children per 1,000 (or an 

estimated 476,600 children) experienced Endangerment Standard physical abuse in 

2005–2006. 

Sexual abuse. The Endangerment Standard enlarges the set of allowable 

perpetrators of sexual abuse by permitting children to count in the sexual abuse estimates 

if they are abused by teenage (i.e., non-adult) caretakers. An estimated 2.4 children per 

1,000 (or a total of 180,500) were sexually abused in 2005–2006 under the Endangerment 

Standard guidelines. 

Emotional abuse. Table 3–3 indicates that an estimated 4.1 per 1,000 

(302,600 children) suffered emotional abuse that fit the Endangerment Standard 

definitions in the 2005–2006 study year. 

Comparison with Harm Standard abuse estimates. The estimates for the 

different types of Endangerment Standard abuse are all notably higher than the 

corresponding estimates using the Harm Standard, but the largest difference is in the 

category of emotional abuse. Specifically, the number of children who experienced 

Endangerment Standard physical abuse is 48% higher than the number who count as 

physically abused under the Harm Standard; the number of sexually abused children is 

33% higher under the Endangerment Standard than under the Harm Standard; and the 

number of emotionally abused children is 104% higher using the more lenient 

Endangerment Standard compared to the stringent Harm Standard criteria. Children who 

also qualified under the Harm Standard were 68% of the total who suffered 

Endangerment Standard physical abuse; 75% of those who suffered Endangerment 

Standard sexual abuse; and 49% of those who experienced Endangerment Standard 

emotional abuse. 

3–18
 
 

 

 

Changes since 1986 in the incidence of Endangerment Standard abuse. 

The incidence of all categories of Endangerment Standard abuse decreased significantly 

since the NIS–3. The total number of physically abused children decreased by 22%, 

sexually abused children decreased by 40%, and emotionally abused children decreased 

by 43%. In terms of incidence rates, children in the 2005–2006 study year had a 29% 

lower risk of being physically abused, a 47% lower risk of being sexually abused, and a 

48% lower risk of being emotionally abused under the Endangerment Standard than their 

counterparts had in 1993. 

The NIS–3 found significant increases in all categories of Endangerment 

Standard abuse between 1986 and 1993. The NIS–4 estimates indicate that rates of 

Endangerment Standard physical and emotional abuse are still elevated relative to their 

1986 levels. Specifically, the total number of physically abused children is still 53% 

higher in 2005–2006 than in 1986. Taking changes in the size of the child population 

into account, a child in 2005–2006 had a 33% higher risk of experiencing Endangerment 

Standard physical abuse than his or her counterpart in 1986—a risk difference that is 

statistically significant. In 2005–2006, the incidence of Endangerment Standard 

emotional abuse remained higher than its 1986 level, affecting 61% more children in total 

number and reflecting a 37% higher risk in terms of its rate per 1,000 in the general child 

population. This difference is statistically marginal. As noted above, the NIS–4 found a 

significant decrease in Endangerment Standard sexual abuse compared to the NIS–3 

estimate for 1993. This recent decrease was large enough to return the rate for this 

category to close to its 1986 level. The slight difference in rates of Endangerment 

Standard sexual abuse between the NIS–2 and the NIS–4 is not statistically significant. 

3.2.4 Specific Categories of Endangerment Standard Neglect 

Table 3–3 presents the incidence estimates for the specific categories of 

Endangerment Standard neglect: physical, emotional, and educational. Again, these 

categories are not mutually exclusive; they include all children who experienced the 

neglect in question and some children experienced more than one category of neglect. 

Physical neglect. The Endangerment Standard enlarges the set of allowable 

perpetrators of this type of neglect by including children whose adult caretaker (i.e., not 

necessarily a parent or parent-substitute) inadequately supervised them; failed to meet 

3–19
 
 

 

 

 

their needs for food, clothing, or personal hygiene; or demonstrated disregard for their 

safety. Physically neglected children represent the largest group under Endangerment 

Standard neglect, with an estimated 1,192,200 children physically neglected in the 2005– 

2006 study year. This reflects an incidence rate of 16.2 children per 1,000 in the general 

population, or 1.6 children per 100, which is equivalent to one in every 62 children in the 

United States. 

Emotional neglect. Emotionally neglected children represent the secondlargest sector of neglected children under the Endangerment Standard. This category 

included an estimated total of 1,173,800 children, which is equivalent to 15.9 children per 

1,000 in the general child population during the 2005–2006 study year. 

Educational neglect. The NIS definitions of educational neglect are 

identical under the Harm and Endangerment standards, so the estimates are the same in 

Tables 3-1 and 3-3. Educational neglect is the least prevalent of the three specific 

Endangerment Standard neglect categories, affecting an estimated 360,500 children, or 

4.9 children per 1,000 in the 2005–2006 study year. 

Comparison with Harm Standard neglect estimates. Estimates for both 

physical neglect and emotional neglect are 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 using the Endangerment Standard is more than four times greater (305% higher), 

while the estimated incidence of emotional neglect using the Endangerment Standard is 

more than six times greater (507% higher). Harm Standard children represent 25% of 

those countable under Endangerment Standard physical neglect, and 16% of those who 

experienced Endangerment Standard emotional neglect. 

Changes since 1986 in the incidence of Endangerment Standard neglect. 

The incidence of emotional neglect evidenced a substantial and significant increase since 

the NIS–3. The estimated number of children who suffered Endangerment Standard 

emotional neglect increased 101%, corresponding to an 83% rise in the incidence rate per 

1,000 children. This means that a child had more than one and four-fifths times higher 

risk of this maltreatment in 2005–2006 than his or her counterpart had in 1993. The 

changes between the NIS–3 and the NIS–4 in physical neglect and educational neglect 

are not statistically significant. 

3–20
 
 

 

 

The NIS–3 found significant increases in both physical and emotional neglect 

under the Endangerment Standard. The differences in Table 3–3 between the NIS–2 and 

NIS–4 incidence rates reflect these earlier increases as well as the additional increase in 

Endangerment Standard emotional neglect that occurred since the NIS–3, as noted above. 

Thus, Endangerment Standard physical neglect and emotional neglect were both 

significantly higher in the NIS–4 2005–2005 study year than they were in 1986 at the 

time of the NIS–2. Specifically, the total number of children who suffered emotional 

neglect was 478% higher, while the number of children who suffered physical neglect 

was 135% higher. In terms of incidence rates, there was a 397% increase in the rate of 

emotional neglect and a 100% increase in the rate of physical neglect under the 

Endangerment Standard since 1986. As mentioned earlier, statistical tests show that the 

rate of educational neglect has not changed since the NIS–2. 

3.2.5	 Severity of Outcomes from Endangerment Standard

Maltreatment 

Children are classified on the basis of the most severe injury or harm they 

suffered from Endangerment Standard maltreatment. Table 3–4 presents their 

distribution across different degrees of injury/impairment. 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.34 This section follows the logical 

sequence used in preceding sections. The discussion first describes estimates themselves. 

Next, the presentation examines the Endangerment Standard estimates in relation to the 

Harm Standard estimates, identifying the percentage of the Endangerment Standard 

estimate that reflects children who were countable under both standards. The final 

paragraphs compare the NIS–4 Endangerment Standard estimates with those from the 

NIS–2 and NIS–3, describing notable changes in incidence across the three studies. 

34 Compare Table 3–4 “Total” with “All Maltreatment” in Table 3–3. 

3–21
 
 

 

 

 

 

 

 

 

Table 3–4. Severity of Outcomes from Endangerment Standard Maltreatment in the NIS–4 

(2005–2006), and Comparison with the NIS–3 (1993) and the NIS–2 (1986) Estimates 

Severity of Injury or

Harm 

NIS–4 Estimates 

2005–2006 

Comparisons With Earlier Studies 

NIS–3 Estimates 

1993 

NIS–2 Estimates 

1986 

Total No. 

of 

Children 

Rate per

1,000 

Children 

Total No. 

of 

Children 

Rate per

1,000 

Children 

Total No. 

of 

Children 

Rate per

1,000 

Children 

Fatal 2,400 0.03 1,600 0.02 ns 1,100 0.02 m 

Serious 509,300 6.9 569,900 8.5 ns 143,300 2.3 * 

Moderate 1,021,300 13.9 986,100 14.7 ns 873,100 13.9 ns 

Inferred 227,300 3.1 226,000 3.4 ns 152,800 2.4 ns 

Endangered 1,145,500 15.6 1,032,000 15.4 ns 254,000 4.0 * 

TOTAL 2,905,800 39.5 2,815,600 41.9 ns 1,424,400 22.6 * 

* The difference between this and the NIS–4 incidence rate is significant at p<.05. 

m The difference between this and the NIS–4 incidence rate is statistically marginal (i.e., .10>p>.05). 

ns The difference between this and the NIS–4 incidence rate is neither significant nor marginal (p>.10). 

Note: Estimated totals are rounded to the nearest 100. 

Fatal Injury. Endangerment Standard estimates for this outcome level are 

the same as the Harm Standard estimates.35 That is, an estimated 2,400 children died in 

2005–2006 as a result of Endangerment Standard abuse or neglect. This reflects an 

annual incidence rate of maltreatment-related fatalities of 0.03 per 1,000 children in the 

United States, which is equivalent to 3 children per 100,000 in the United States child 

population. 

Serious harm. An estimated 509,300 children were seriously harmed in 

2005–2006 due to Endangerment Standard maltreatment. This corresponds to an 

incidence rate of 6.9 per 1,000 children in the population. 

35 This has not always been true. The tables show that the NIS–3 the estimates for fatally injured children 

were slightly different in the two standards. In the NIS–4 data, the sample includes a few more fatally

injured children under the Endangerment Standard, but they do not affect the rounded estimates. 

3–22
 
 

 

 

Moderate harm. Moderate harm due to Endangerment Standard 

maltreatment occurred to an estimated 1,021,300 children in 2005–2006. This is 

equivalent to 13.9 children per 1,000 in the general child population. 

Inferred harm. An estimated 227,300 children experienced forms 

Endangerment Standard maltreatment that supported the inference that they were harmed 

as a result. An estimated 3.1 per 1,000 children qualified for inferred harm in the 2005– 

2006 study year. 

Endangered. Over one million children (an estimated 1,145,500) were 

endangered, but not yet harmed, by Endangerment Standard abuse or neglect in the 

2005–2006 study year, which corresponds to 15.6 children per 1,000 in the United States. 

Comparison with the Harm Standard outcome estimates. As emphasized 

above, the key feature of the Endangerment Standard is that it includes both children who 

are counted under the Harm Standard and children who were endangered, but not yet 

harmed by abuse or neglect. Thus, the “endangered” row of Table 3–4 represents 

children who did not count in any Harm Standard estimates. However, the 

Endangerment Standard also permits a somewhat broader set of perpetrators and 

maltreating actions, as discussed above, so it includes additional children who did 

experience injury or harm (fatal, serious, moderate, or inferred). The Harm Standard 

estimates excluded those children because their circumstances did not meet Harm 

Standard requirements concerning the identity of their perpetrators, the form of their 

maltreatment, or the threshold for harm from the specific form of maltreatment they 

experienced. 

The more lenient Endangerment Standard guidelines resulted in estimates 

that are 4% greater for children seriously harmed by maltreatment; 47% higher for 

children who experienced moderate harm; and 218% higher for children whose 

maltreatment was severe enough to permit harm to be inferred. (As noted above, the 

estimates for child fatalities are the same.) Among children with Endangerment Standard 

maltreatment, children countable under the Harm Standard reflect 100% of those fatally 

injured; 96% of children seriously harmed; 68% of those moderately harmed; and 31% of 

the children with inferred harm. 

3–23
 
Changes since 1986 in outcomes from Endangerment Standard 

maltreatment. The NIS–4 found no significant change since the NIS–3 in the incidence 

of any outcome from Endangerment Standard maltreatment. 

Previously, the NIS–3 revealed significant increases in the rates of children 

seriously harmed or endangered by Endangerment Standard maltreatment. Since no 

measurable changes in the incidence of these categories occurred since the NIS–3, the 

two statistically significant differences between the NIS–2 and the NIS–4 reflect those 

earlier changes. Specifically, the total number of children who were seriously harmed by 

Endangerment Standard maltreatment was still 255% higher in the 2005–2006 study year 

than it was in 1986. Even considering the larger child population at the time of the NIS– 

4, the incidence rate for this category was still 200% higher than in 1986. The total 

number of children who were endangered by Endangerment Standard maltreatment was 

351% higher at the time of the NIS–4 compared to the 1986 total, which corresponds to a 

290% higher incidence rate for this level of harm. The discussion above concerning the 

Harm Standard estimates described the increased incidence of children fatally injured by 

maltreatment. The Endangerment Standard estimates for this category are identical, so 

this discussion will not reiterate those percentage differences. 

3–24
 
4-1
 

 

 

 

 

 

 

 

 

 

 

 

4. DISTRIBUTION OF ABUSE AND NEGLECT BY CHILD 

CHARACTERISTICS 

This chapter examines the relationship between child characteristics and the 

incidence and severity of abuse and neglect. It is divided into five sections that discuss 

the NIS–4 findings on the relationship between maltreatment and child’s sex, age, race, 

disability status, and school enrollment. 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 any statistically significant changes since the NIS–3 in 

the distribution of child maltreatment by the characteristic in question? 

Each section considers these questions from the standpoint of both the Harm 

and the Endangerment Standards. 

As in the previous chapter, the tables here reflect unduplicated estimates: 

that is, each estimate counts a child only once. Also, because the incidence rates adjust 

for differences across the categories in the numbers of children with the characteristic of 

interest in the general population,36 the tables and graphs in this chapter provide only the 

rate measures. For the same reason, all statistical comparisons use the rate measures.37 

36 For instance, the incidence rate of Harm Standard maltreatment for males indicates the number of males

who experience Harm Standard abuse or neglect among every 1,000 males in the general child population.

Analogously, the incidence rate for females is couched in terms of the number of maltreated females

among every 1,000 females in the child population. Comparisons of the incidence rates for males and

females thus take account of the fact that there are different numbers of males and females in the general

population of children and provide a more valid comparison of their risks of experiencing the 

maltreatment in question. 

37 Appendices B and C provide the NIS–4 estimates, including the estimated rates, estimated totals, and 

standard errors of estimate. Appendices D and E report the detailed results of statistical comparisons. 
4-2
 

 

 

 

 

 

 

 

 

4.1 Sex Differences in the Incidence of Maltreatment 

This section reports the NIS–4 findings concerning sex differences in the 

incidence of maltreatment. It presents the relatively stringent Harm Standard estimates 

first, followed by the sex distribution of abuse and neglect under the more lenient 

Endangerment Standard.38 

4.1.1 Sex Differences in Harm Standard Maltreatment 

Table 4–1 gives the significant sex differences in the incidence of Harm 

Standard abuse and neglect. The incidence rates for boys and girls are significantly 

different in two maltreatment categories, all abuse and sexual abuse, and in one level of 

outcome severity, inferred harm. 

Table 4–1. Sex Differences in Incidence Rates per 1,000 Children for Harm Standard 

Maltreatment in the NIS–4 (2005–2006)* 

Harm Standard Maltreatment Category Boys Girls 

ABUSE: 

All Abuse 

Sexual Abuse 

SEVERITY OF HARM: 

Inferred 

6.5 

0.6 

0.6 

8.5 

3.0 

1.4 

* All differences are significant at p<.05. 

Abuse. Girls had a significantly higher rate of Harm Standard abuse than 

boys. An estimated 8.5 per 1,000 girls experienced Harm Standard abuse compared to 

6.5 per 1,000 boys. Thus, girls’ risk of abuse was 1.3 times that of boys. Girls’ higher 

risk of Harm Standard abuse is due primarily to their significantly higher risk of sexual 

abuse. 

38 As in Chapter 3, the incidence rates in this chapter used the average of the July 2005 and July 2006 U.S.

Census Bureau annual estimates for each group as the population denominators. Thus, computation of

incidence rates for girls and boys used the following population denominators, reflecting the number in

each group (in thousands) in the population: 37,685 boys and 35,950 girls (U.S. Census Bureau, 2008a). 
4-3
 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sexual Abuse. Girls experienced Harm Standard sexual abuse at a rate more 

than 5 times the rate for boys; 3.0 per 1,000 girls were countable in this maltreatment 

category compared to 0.6 per 1,000 boys. 

Inferred Harm. Girls were significantly more likely than boys to experience 

Harm Standard maltreatment that justified the inference they had been harmed. The 

estimated incidence rate of Harm Standard inferred injuries was 1.4 per 1,000 girls, 

whereas boys’ rate was 0.6 per 1,000. Girls’ risk of inferred harm was 2.3 times that of 

boys. This pattern is probably a result of the fact that girls are more often sexually 

abused and that the Harm Standard guidelines permit inferring harm for the more severe 

forms of sexual abuse, such as intrusion or genital molestation. (See Chapter 3.) 

Changes since the NIS–3 in the Distribution of Harm Standard 

Maltreatment Related to Child’s Sex 

Comparisons with the NIS–3 revealed two areas where there were significant 

shifts in sex differences in Harm Standard maltreatment from that earlier study—physical 

neglect and serious harm. Interestingly, both were areas where neither study uncovered 

significant sex differences overall. 

Physical neglect. The incidence of Harm Standard physical neglect did not 

change since the NIS–3 (cf. §3.1.4). However, as shown in Figure 4–1, the sexes 

evidenced different changes in rates of this maltreatment.39 The boys’ rate declined by 

32% since the NIS–3, whereas the girls’ rate of Harm Standard physical neglect declined 

by only 10%. 

39 In this and other sections that report changes since the NIS–3 for different subgroups, the figures present

only those maltreatment categories where the change in rates is different for the subgroups in question, as

indexed by a chi square test on the incidence rates in the 2-way table of study (NIS–3 vs. NIS–4) by 

subgroup (here, girls vs. boys). Significant chi square values indicate that groups differ in the degree of 

change in their incidence rate. Appendix E gives these 2-way tables and their chi square test results. 
4-4
 

 

 

Figure 4–1.	 Percent Changes since the NIS–3 in Rates of Harm Standard 

Maltreatment by Child’s Sex. 

Serious harm. A similar pattern is evident in the changes since the NIS–3 in 

the incidence of serious harm from Harm Standard maltreatment. In the NIS–3, boys 

were more likely than girls to suffer serious harm from Harm Standard maltreatment, but 

the NIS–4 found no significant difference between boys’ and girls’ rates of experiencing 

serious harm under the Harm Standard. The incidence rates for both sexes declined, but 

boys’ rate declined more than that of girls; boys’ rate declined by 33%, whereas girls’ 

rate declined by just 11%. 

4.1.2 Sex Differences in Endangerment Standard Maltreatment 

The sexes differ on the Endangerment Standard rates given in Table 4–2. 

Boys and girls incidence rates differ significantly in one maltreatment category, sexual 

abuse, and in one level of outcome severity, inferred harm. The difference is statistically 

marginal for overall abuse. 
4-5
 

 

 

 

 

Table 4–2. Sex Differences in Incidence Rates per 1,000 Children for Endangerment 

Standard Maltreatment in the NIS–4 (2005–2006) 

Endangerment Standard 

Maltreatment Category Boys Girls Significance of Difference 

ABUSE: 

All Abuse 

Sexual Abuse 

SEVERITY OF HARM: 

Inferred 

10.0 

1.0 

2.5 

12.0 

3.8 

3.4 

m 

* 

* 

* The difference is significant at p<.05. 

m The difference is statistically marginal (i.e., .10>p>.05). 

Abuse. Girls’ rate of Endangerment Standard abuse is 1.2 times that of boys. 

This difference is statistically marginal (p < .10). 

Sexual abuse. Again, girls’ greater risk of Endangerment Standard abuse 

essentially reflects their greater risk of sexual abuse, which is 3.8 times that of boys. 

Inferred Harm. Girls were significantly more likely to have inferred harm 

due to Endangerment Standard maltreatment. As shown in Table 4–2, girls’ incidence 

rate for Endangerment Standard inferred injury is 1.4 times the boys’ rate. This pattern, 

which is also discussed in the Harm Standard finding in this category, is most likely 

related to girls’ greater risk of sexual abuse. Sexual abuse and inferred injuries are linked 

in that the definitions under both standards permit harm to be inferred when the evidence 

cited indicates that a serious form of sexual abuse occurred. 

Changes since the NIS–3 in the Distribution of Endangerment Standard 

Maltreatment Related to Child’s Sex 

Comparisons between the NIS–3 and NIS–4 revealed that changes in the 

incidence of one category of Endangerment Standard maltreatment and two levels of 

outcome severity were statistically related to child’s sex: emotional neglect, serious 

harm, and inferred harm. 
4-6
 

 

 

 

 

Emotional neglect. As reported earlier (§3.1.4), the incidence rate of 

emotional neglect increased significantly since the NIS–3. Further analyses reveal a 

statistically marginal relationship to child’s sex, with differential increases for boys and 

girls. As shown in Figure 4–2, the incidence rate of emotional neglect increased more for 

girls (88%) than for boys (64%). 

Figure 4–2.	 Percent Changes since the NIS–3 in Rates of Endangerment Standard 

Maltreatment by Child’s Sex. 

Serious harm. As described in Chapter 3 (§3.2.5), nearly all the children 

who were seriously harmed by Endangerment Standard maltreatment were also countable 

under the Harm Standard. For this reason, the findings regarding serious harm from 

Endangerment Standard maltreatment are very similar to the Harm Standard findings, 

with changes since the NIS–3 significantly related to child’s sex. Boys’ risk of serious 

harm from Endangerment Standard maltreatment declined by 30% since the NIS–3, 

whereas girls’ risk declined by just 9%. 

Inferred harm. Changes in incidence rates of inferred harm under the 

Endangerment Standard were also significantly related to child’s sex. Boys’ incidence 

rate increased by 39% since the NIS–3, but the rate for girls declined by 26%. 
4-7
 

 

 

 

 

 

 

 

 

 

 

 

 

4.2 Age Differences in the Incidence of Maltreatment 

To examine differences in the incidence of maltreatment related to age, 

analyses classified children into six groups based on their age at the time of their 

countable maltreatment: 0 to 2 years, 3 to 5 years, 6 to 8 years, 9 to 11 years, 12 to 14 

years, and 15 to 17 years.40 

4.2.1 Age Differences in Harm Standard Maltreatment 

Significant age differences emerged in the incidence of overall Harm 

Standard maltreatment, and in several categories of Harm Standard abuse and neglect.41 

Overall Harm Standard Maltreatment, Abuse, and Neglect 

Figure 4–3 shows that the youngest children (ages 0 to 2 years) experienced 

Harm Standard maltreatment at a significantly lower rate than children ages 6 or older 

(8.5 per 1,000 vs. 17.6 per 1,000 or higher). Only the 9- to 11-year-old children do not 

differ from the youngest group, primarily because their estimated rate is less precise than 

the rates for other older children.42 No other age differences in the graph of overall Harm 

Standard maltreatment are statistically significant. 

40 Computation of incidence rates used the following population denominators, reflecting the number (in

thousands) of children in the general population: 12,292 children 0 to 2 years old, 12,069 children 3 to 5

years old, 11,682 children 6 to 8 years old, 12,067 children 9 to 11 years old, 12,643 children 12 to 14 

years old, and 12,772 children 15 to 17 years old (U.S. Census Bureau, 2008f). 

41 In each category of maltreatment or injury, decisions about the significance of differences relied on the 

Bonferroni critical values for t. This adjusted for the multiplicity of the comparisons involved. Appendix 

D gives details concerning the statistical tests for the significance of age group differences. 

42 That is, the sampling error associated with their rate is much larger, which may be a random result of the

way they came into the NIS–4 sample; their rate varies across the different components of the NIS–4 

sample more than the rates of the other older groups. 
4-8
 

Figure 4–3.	 Age Differences in Incidence Rates for All Harm Standard 

Maltreatment, Abuse, and Neglect. 

Similarly, the rate of Harm Standard abuse is significantly lower for the 

youngest children (0 to 2 years) than for children ages 6 and older (3.7 vs. 7.7 per 1,000, 

respectively). The 3- to 5-year-old children do not differ from any other age group, nor 

do the older age groups differ from one another. 

Categories of Harm Standard Abuse 

The NIS–4 found significant age differences in Harm Standard physical 

abuse and emotional abuse. Figure 4–4 shows the incidence rates for these two 

categories of abuse. 
4-9
 

 

 

 

 

Figure 4–4.	 Age Differences in Incidence Rates for Harm Standard Physical and 

Emotional Abuse. 

Physical abuse. The incidence of Harm Standard physical abuse is 

significantly lower for the youngest children (2.5 per 1,000 children ages 0 to 2 years) 

compared to children ages 6 to 14 (whose rates were 4.6 per 1,000 or higher). 

Emotional abuse. The youngest children (ages 0 to 2) were at significantly 

lower risk of Harm Standard emotional abuse compared to children ages 6 or older. The 

incidence rate for children ages 2 years or younger was 0.3 per 1,000 children, whereas 

for children ages 6 or older the rate was at least 2.4 children per 1,000. Also, children 

ages 3 to 5 years experienced a significantly lower risk of emotional abuse (at a rate of 

1.0 child per 1,000) compared with children ages 12 to 14 years (where 2.7 children per 

1,000 were victims).43 

43 The estimates for children younger than 9 are less reliable because fewer than 100 sample children are in

each of those age categories. 
4-10
 

 

 

 

 

 

 

 

Categories of Harm Standard Neglect 

Figure 4–5 depicts the significant age differences in NIS–4 incidence rates 

for Harm Standard emotional and educational neglect. 

Figure 4–5.	 Age Differences in Incidence Rates for Harm Standard Emotional and 

Educational Neglect. 

Emotional neglect. As Figure 4–5 shows, the incidence rate of emotional 

neglect gradually increases with age. The incidence rate for children 0 to 2 years (0.6 per 

1,000) differs significantly from those for children 6 years and older (2.1 or more 

children per 1,000). In addition, the incidence rate for children ages 3 to 5 (1.3 per 1,000) 

differs significantly from rates for children ages 12 and older (3.7 or more children per 

1,000).44 

Educational neglect. Educational neglect is not defined for children age 0 to 

2, so statistical comparisons omit this age group. The incidence rate for children age 3 to 

5 differs significantly from the rate for those age 12 to 14 (2.3 vs. 7.3 per 1,000). As the 

44 The estimates for children younger than 12 years old are less reliable because fewer than 100 sample

children are in each of those age categories. 
4-11
 

 

 

 

 

 

 

 

graph shows, the incidence rate for children age 9 to 11 is highest, at 7.5 per 1,000. 

However, this rate does not differ significantly from the other rates because, again, the 

estimate for this age group is less precise compared to the others.45 

Severity of Outcomes from Harm Standard Maltreatment46 

Moderate harm. Figure 4–6 shows the pattern for the single outcome from 

Harm Standard maltreatment where age differences emerged: moderate injury or harm. 

The youngest children (ages 0 to 2) had significantly lower risk of experiencing moderate 

harm as a result of Harm Standard maltreatment compared to all other children. The 

incidence of children moderately harmed by Harm Standard maltreatment was 1.8 per 

1,000 in the 0- to 2-year-old group, in contrast to 7.0 per 1,000 children 3 to 5 years old 

and 9.8 or more per 1,000 children ages 6 and older. 

Figure 4–6.	 Age Differences in Incidence of Children Moderately Harmed by Harm 

Standard Maltreatment. 

45 The estimates for children younger than 6 years old are less reliable because they derive from fewer than

100 children in each age category. 

46 Estimates of risk of fatal injury for separate subgroups are very unreliable, since they are based on

considerably fewer than 100 children in the sample. Thus, this report provides no numeric estimates

regarding subgroup differences in risk of fatal injury. 
4-12
 

 

 

 

 

 

 

 

Changes since the NIS–3 in the Distribution of Harm Standard 

Maltreatment Related to Child’s Age 

Changes since the NIS–3 in the age distributions of Harm standard sexual 

abuse were statistically significant.47 

Sexual abuse. Chapter 3 reported a statistically significant decline since the 

NIS–3 in the incidence of Harm Standard sexual abuse. Figure 4–7 shows that this 

decline was not uniform across age groups. It is most evident among children ages 3 to 

11 years and 15 to 17 years (where rates decreased by 42% to 68%). Children in puberty 

(12 to 14 years old) experienced only a small decline in their risk of Harm Standard 

sexual abuse (9%). As the graph shows, among children ages 0 to 2, the incidence of 

Harm Standard sexual abuse increased by 33%. However, this last result is less reliable, 

since fewer than 100 sample children support the component estimated rates. 

Figure 4–7.	 Percent Changes in Incidence Rates of Harm Standard Sexual Abuse 

Related to Age. 

47 Statistically marginal age differences in changes occurred in rates of Harm Standard emotional neglect 

and inferred harm from Harm Standard maltreatment. This report does not present those results because

the separate age estimates for those categories are unreliable, based on small samples (fewer than 100 

children). 
4-13
 

 

 

 

 

4.2.2 Age Differences in Endangerment Standard Maltreatment 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

As Figure 4–8 illustrates, significant age differences emerged in the incidence 

of overall Endangerment Standard maltreatment, abuse, and neglect. 

Figure 4–8.	 Age Differences in Incidence Rates for All Endangerment Standard 

Maltreatment, Abuse, and Neglect. 

The NIS–4 found only one significant age difference in overall 

Endangerment Standard maltreatment. The rate for children 15 to 17 years old (29.0 per 

1,000) is significantly lower than the rate for the 6 to 8 year olds (42.4 per 1,000). 

The rate of Endangerment Standard abuse was significantly lower for the 

youngest children (ages 0 to 2) compared to children ages 6 and older. Harm Standard 

abuse revealed a similar pattern (cf. §4.2.1). Children ages 2 or younger experienced 

Endangerment Standard abuse at a rate of 6.1 per 1,000 children compared to 10.0 or 

more per 1,000 children ages 6 or older. The rate for the 3 to 5 year olds does not differ 
4-14
 

 

significantly from the rates for other age groups and the rates of the older groups do not 

differ from one another. 

The estimated rates of Endangerment Standard neglect are less precise than 

the estimated abuse rates. Only one statistically marginal age difference emerged for 

neglect. As Figure 4–8 shows, the lowest rate of Endangerment Standard neglect, 21.6 

per 1,000 children ages 15 to 17, is lower than the rate of 33.1 per 1,000 children ages 6 

to 8. 

Categories of Endangerment Standard Abuse 

The NIS–4 identified significant age differences in Endangerment Standard 

physical abuse and emotional abuse. Figure 4–9 presents the incidence rates for these 

two abuse categories. 

Figure 4–9. Age Differences in Incidence Rates for Endangerment Standard Physical 

and Emotional Abuse. 
4-15
 

 

 

 

 

 

 

Physical abuse. The incidence of Endangerment Standard physical abuse 

was significantly lower for the youngest children, at 3.7 per 1,000 children ages 0 to 2 

years, compared to its levels among children ages 6 to 14, who were physically abused at 

rates of 6.2 or more per 1,000. 

Emotional abuse. The youngest children (ages 0 to 2) had a significantly 

lower risk of Endangerment Standard emotional abuse (1.6 children per 1,000) compared 

to the rates for children ages 6 years or older (4.1 or more children per 1,000). 

Categories of Endangerment Standard Neglect 

The NIS–4 found significant age differences in the incidence of all categories 

of Endangerment Standard neglect: physical, emotional, and educational neglect. Figure 

4–10 displays these findings. 

Figure 4–10. Age Differences in Incidence Rates for Endangerment Standard 

Physical, Emotional, and Educational Neglect.
 
4-16
 

 

 

 

 

Physical neglect. Children ages 15 to 17 experienced a significantly lower 

rate of Endangerment Standard physical neglect compared to 3- to 8-year-old children. 

As the graph shows, the incidence rate for the 15- to 17-year-old children is the lowest, at 

8.7 per 1,000 children, whereas the rates were 15.3 or more per 1,000 for children ages of 

3 to 8. The rate of physical neglect for 15- to 17-year-old children is also lower than the 

rate for those ages 9 to 11 (15.7 per 1,000), a statistically marginal difference. 

Emotional neglect. As Figure 4–10 shows, age differences in the incidence 

rates for Endangerment Standard emotional neglect are less pronounced (the curve is 

flatter) compared to age differences in the other categories of neglect. The oldest 

children, ages 15 to 17, experienced a lower rate of emotional abuse (11.4 per 1,000 

children) compared to children ages 6 to 8, who were emotionally neglected at a rate of 

17.0 children per 1,000. This difference is statistically marginal. 

Educational neglect. The NIS definitions of educational neglect are 

identical for the Harm and Endangerment Standards. The age differences are identical to 

those in Figure 4–5, so the discussion here does not reiterate them. 

Severity of Outcomes from Endangerment Standard Maltreatment 

Figure 4–11 shows the NIS–4 significant age differences in three levels of 

outcomes from Endangerment Standard maltreatment: serious harm, moderate harm, and 

endangered. 

Serious harm. Children ages 3 to 5 years were at lower risk of experiencing 

serious harm or injury from Endangerment Standard maltreatment (4.3 children per 

1,000) compared to children ages 12 to 14 (7.4 children per 1,000), a statistically 

marginal difference. 

Moderate harm. The youngest children, ages 0 to 2, had a significantly 

lower risk of moderate injury or harm from Endangerment Standard maltreatment (4.5 

per 1,000 children) compared to children ages 3 or older (11.2 or more children per 

1,000). 
4-17
 

 

 

Figure 4–11. Age Differences in the Incidence of Children Seriously Harmed, 

Moderately Harmed, and Endangered by Endangerment Standard

Maltreatment. 

Endangered. As Figure 4–11 shows, the incidence of older children who 

were endangered, but not yet harmed, by Endangerment Standard maltreatment (6.2 per 

1,000 children ages 15 to 17) is significantly lower than the incidence of this outcome 

among younger children (12.0 or more children per 1,000 ages 11 or younger). Also, 

children 9 through 14 differ from other age groups: Children ages 12 to 14 experienced a 

higher rate of endangerment (10.2 per 1,000 children) than the oldest children, ages 15 to 

17 years. That difference is statistically marginal. However, their rate was significantly 

lower than rates for children 5 years old or younger (where 16.0 or more children per 

1,000 were endangered, but not yet harmed). Children ages 9 to 11 years had a lower rate 

of endangerment (12.0 per 1,000 children) than the youngest children (20.7 per 1,000 

children ages 0 to 2), a statistically marginal difference. 
4-18
 

 

 

Changes since the NIS–3 in the Distribution of Endangerment Standard

Maltreatment Related to Child’s Age 

Child’s age was related to changes since the NIS–3 in the incidence of overall 

Endangerment Standard maltreatment, neglect, emotional neglect, and in the incidence of 

children who were endangered by Endangerment Standard maltreatment. 

Overall Endangerment Standard maltreatment. As Chapter 3 reported, 

the overall incidence of Endangerment Standard maltreatment decreased significantly 

since the NIS–3. Child’s age is significantly related to the change since the NIS–3, 

meaning that the decrease was not uniform across ages. Figure 4–12 displays the percent 

changes in incidence rates for the different age groups. 

Incidence rates decreased for all but the 0 to 2 age group, where the incidence 

of Endangerment Standard maltreatment increased by 28% between the studies. The 

other age groups all exhibited overall declines in risk of Endangerment Standard 

maltreatment, but children ages 6 to 8 showed the largest decrease (by 30%). Children 

ages 9 to 11 and those ages 12 to 14 experienced moderate declines in risk, 17% and 

15%, respectively. Children ages 3 to 5 years showed a more modest decrease in risk of 

9%, whereas the incidence rate for children ages 15 to 17 years revealed only a negligible 

change since the previous NIS. 

Neglect. The relation between child’s age and the between-study changes in 

rates of Endangerment Standard neglect was statistically marginal. Four age groups 

showed increases in risk of neglect, whereas two age groups evidenced declines, as 

displayed in Figure 4–13. 
4-19
 

 

 

Figure 4–13. Percent Changes since the NIS–3 in Rates of Endangerment Standard 

Neglect by Child’s Age. 

Figure 4–12. Percent Changes since the NIS–3 in Rates of Endangerment Standard 

Maltreatment by Child’s Age. 
4-20
 

 

 

 

 

Children ages 0 to 2 experienced the largest increase (25%), with 15- to 17-

year-old children showing the second-largest increase (14%). There were also slight 

increases in neglect risk for children ages 3 to 5 (5%) and ages 12 to 14 (8%). In 

contrast, risk decreased for children ages 6 to 11, with those ages 6 to 8 showing the 

larger decline in risk (25%). 

Emotional neglect. Chapter 3 reported a 101% increase in the incidence rate 

of emotional neglect since the NIS–3. The statistically significant age-related differences 

in changes in rates of this maltreatment category (Figure 4–14) qualify this finding. 

Figure 4–14.	 Percent Changes since the NIS–3 in Rates of Endangerment Standard 

Emotional Neglect by Child’s Age. 

The increase in incidence of Endangerment Standard emotional neglect was 

particularly severe among the younger children. The risk for children ages 0 to 2 was 

259% higher at the time of the NIS–4 compared to its level at the time of the NIS–3. The 

increase in incidence rate was nearly as great for children ages 3 to 5 (214%). The 

between-study increase was also large for the 12 to 14 age group, who experienced an 

85% increase in the incidence of Endangerment Standard emotional neglect. The 

remaining age groups display smaller but notable between-study increases in risk of 

maltreatment in this category. 
4-21
 

 

 

 

Endangered. Chapter 3 reported that 15.6 children per 1,000 were 

endangered, but not yet harmed by abuse or neglect, during the NIS–4 study year. 

Although this rate did not differ from the NIS–3 rate of 15.4 children per 1,000, this was 

because changes in the incidence of endangered children across the different age groups 

counterbalanced each other, as Figure 4–15 illustrates. 

Figure 4–15. Percent Changes since the NIS–3 in the Incidence of Children 

Endangered but Not Harmed by Endangerment Standard Maltreatment

by Child’s Age. 

Children ages 0 to 2 had a 50% increase in the incidence of endangerment 

between the NIS–3 and the NIS–4. In contrast, the incidence of children who were 

endangered but not yet harmed declined for all other age groups. The largest decline was 

among children ages 6 to 8 (34%). Children ages 9 to 14 also showed notable declines in 

the incidence of this outcome from Endangerment Standard maltreatment. However, the 

decline was much smaller for 3 to 5 year olds (8%) and negligible for 15- to 17-year-old 

children (2%). 
4-22
 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.3	 Racial and Ethnic Differences in the Incidence of 

Maltreatment 

This section reports differences in the incidence of maltreatment related to 

three major racial and ethnic groups: White (non-Hispanic), Black (non-Hispanic), and 

Hispanic.48 

4.3.1	 Racial and Ethnic Differences in Harm Standard 

Maltreatment 

The NIS–4 revealed several significant and statistically marginal differences 

across the racial/ethnic groups in the incidence of Harm Standard maltreatment. 

Table 4–3 provides the incidence rates for those categories of Harm Standard 

maltreatment where these racial/ethnic differences emerged.49,50 

Overall Harm Standard Maltreatment, Abuse, and Neglect 

White and Black children differed significantly in their rates of experiencing 

overall Harm Standard maltreatment during the 2005–2006 NIS–4 study year. An 

estimated 12.6 per 1,000 White children experienced Harm Standard maltreatment 

compared to 24.0 per 1,000 Black children. Thus, the incidence rate for Black children 

was nearly 2 times the rate for White children. The rate for Black children was also 

48 Each of the other race categories had too few sample children to support independent estimates for those

groups (i.e., American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and 

mixed race), so analyses excluded those. Children in these groups represent a total of 11% of those

countable under the Harm Standard and 9% of the children countable under the Endangerment Standard.

The findings also exclude children with missing race/ethnicity information (9% of children countable

under the Harm Standard and for 15% of those countable under the Endangerment Standard). 

49 In each category of maltreatment or injury, decisions about the significance of differences relied on the

Bonferroni critical values for t. This adjusted for the multiplicity of the comparisons involved. Appendix

D gives details concerning the statistical tests for the significance of racial/ethnic group differences. 

50 The incidence rate calculations used the following denominators, reflecting the average number (in

thousands) of children in the general population in these groups during 2005 and 2006: 42,623 White

children, 10,797 Black children, and 14,752 Hispanic children (U.S. Census Bureau, 2008e). 
4-23
 

significantly higher than that for Hispanic children (14.2 per 1,000), with Black children 

1.7 times more likely to experience Harm Standard maltreatment than Hispanic children. 

The rate of Harm Standard abuse was also significantly higher for Black 

children than for children in the other two racial/ethnic groups. An estimated 10.4 per 

1,000 Black children suffered Harm Standard abuse during the NIS–4 study year 

compared to 6.0 per 1,000 White children and 6.7 per 1,000 Hispanic children. The abuse 

rate of Black children is 1.7 times that of White children and 1.6 times that of Hispanic 

children. 

Table 4–3. Race/ethnicity Differences in Incidence Rates per 1,000 Children for Harm 

Standard Maltreatment in the NIS–4 (2005–2006). 

Harm Standard 

Maltreatment Category White Black Hispanic Significance of Differences 

ALL MALTREATMENT 

ABUSE: 

12.6 24.0 14.2 A, C 

All Abuse 6.0 10.4 6.7 A, C 

Physical Abuse 3.2 6.6 4.4 A, C 

Sexual Abuse 

NEGLECT: 

1.4 2.6 1.8 a 

All Neglect 

SEVERITY OF HARM: 

7.5 14.7 8.3 a 

Serious 4.6 8.8 5.2 A, C 

Moderate 7.2 13.7 8.1 A 

Inferred 0.7 1.5 0.8 a 

A Difference between "White" and "Black" is significant at p<.05. 

a Difference between "White" and "Black" is statistically marginal (i.e., .10>p>.05). 

C Difference between "Black" and "Hispanic" is significant at p<.05. 

An estimated 14.7 per 1,000 Black children experienced Harm Standard 

neglect during the NIS–4 study year compared to 7.5 per 1,000 White children, a 

statistically marginal difference. Thus, Black children had nearly 2 times the risk of Harm 

Standard neglect compared to White children. 
4-24
 

 

 

Specific Categories of Harm Standard Abuse 

Black children had a significantly higher rate of physical abuse than children 

in the other groups. An estimated 6.6 per 1,000 Black children experienced Harm 

Standard physical abuse, which is more than 2 times the rate for White children (3.2 per 

1,000). The rate of physical abuse for Black children is also 1.5 times that of the 

Hispanic children (4.4 per 1,000). 

The difference between Black and White children in their rates of sexual 

abuse is statistically marginal. An estimated 2.6 per 1,000 Black children were sexually 

abused according to the Harm Standard, which is nearly 2 times the rate of 1.4 per 1,000 

White children. 

Severity of Outcomes from Harm Standard Maltreatment 

White and Black children differed significantly in their risk of suffering 

serious harm from Harm Standard maltreatment. The incidence of children seriously 

harmed by Harm Standard maltreatment was 8.8 per 1,000 Black children compared to 

4.6 per 1,000 White children. Black children also had a significantly higher rate of 

experiencing serious harm than Hispanic children, whose rate was 5.2 per 1,000. 

The rates of moderate harm differed significantly for White and Black 

children, with 13.7 per 1,000 Black children versus 7.2 per 1,000 White children 

suffering this level of outcome from Harm Standard maltreatment. 

Inferred harm occurred at different rates for White and Black children; this 

difference is statistically marginal. The incidence rate of inferred harm was 1.5 per 1,000 

Black children compared to 0.7 per 1,000 White children. 
4-25
 

 

 

 

Changes since the NIS–3 in Rates of Harm Standard Maltreatment

Related to Child’s Race and Ethnicity 

Figure 4–16 shows significant changes since the NIS–3 related to the child’s 

race and ethnicity. These occurred in three categories of Harm Standard maltreatment 

and one outcome level: all abuse, physical abuse, emotional neglect, and serious harm. 

Figure 4–16.	 Percent Changes in Incidence Rates for Harm Standard Maltreatment 

Related to Child’s Race/ethnicity. 

Abuse. Changes in the incidence rate of Harm Standard abuse were 

significantly related to race/ethnicity. The differential decreases were 43% for White 

children, 27% for Hispanic children, and 17% for Black children. 

Physical abuse. The incidence of physical abuse also decreased by different 

degrees for the three racial/ethnic groups, a significant relationship. Again, the largest 

decrease occurred for White children (38%), with smaller decreases for Black children 

(15%) and Hispanic children (8%). 

Emotional neglect. Rates of emotional neglect changed in opposite 

directions for White children and for children in the other racial/ethnic groups, a pattern 

that is statistically significant. Whereas the incidence rate decreased by 33% for White 

children, it increased by 30% and 31% for Black and Hispanic children, respectively. 
4-26
 

 

Serious harm. The relationship between child’s race/ethnicity and changes 

in the incidence of serious harm from Harm Standard maltreatment is also significant. 

The rate of serious harm decreased substantially for White children (by 43%) and 

Hispanic children (by 31%), but increased for Black children (by 8%). 

4.3.2	 Racial and Ethnic Differences in Endangerment Standard

Maltreatment 

The incidence of nearly all categories of Endangerment Standard 

maltreatment differed significantly by the child’s race/ethnicity. Table 4–4 provides the 

differing incidence rates for the racial/ethnic subgroups. 

Table 4–4. Race/ethnicity Differences in Incidence Rates per 1,000 Children for 

Endangerment Standard Maltreatment in the NIS–4 (2005–2006). 

Endangerment Standard 

Maltreatment Category White Black Hispanic Significance of Differences 

ALL MALTREATMENT 

ABUSE: 

28.6 49.6 30.2 A, C 

All Abuse 8.7 14.9 9.4 A, C 

Physical Abuse 4.6 9.7 5.9 A, C 

Emotional Abuse 3.5 4.5 2.4 B, C 

NEGLECT: 

All Neglect 22.4 36.8 23.0 A, C 

Physical Neglect 12.2 17.9 9.9 a, C 

Emotional Neglect 

SEVERITY OF HARM: 

12.1 18.2 13.2 A 

Serious 4.8 9.1 5.7 A, C 

Moderate 11.0 18.6 11.2 a 

Inferred 2.6 3.7 2.1 C 

Endangered 10.2 18.1 11.2 A, C 

A Difference between "White" and "Black" is significant at p<.05. 

a Difference between "White" and "Black" is statistically marginal (i.e., .10>p>.05). 

B Difference between "White" and "Hispanic" is significant at p<.05. 

C Difference between "Black" and "Hispanic" is significant at p<.05. 
4-27
 

 

 

 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

Black children differed significantly from children in the other racial/ethnic 

groups in their overall risk of Endangerment Standard maltreatment. Endangerment 

Standard maltreatment affected 49.6 per 1,000 Black children, versus 28.6 per 1,000 

White children and 30.2 per 1,000 Hispanic children. The rate of Endangerment 

Standard maltreatment for Black children is 1.7 times the rate for White children and 1.6 

times the rate for Hispanic children. 

The same pattern applies to Endangerment Standard abuse and neglect. In 

both categories, the incidence rate for Black children is significantly higher than the rates 

for White and Hispanic children. Black children experienced Endangerment Standard 

abuse at a rate 1.7 times the rate for White children (14.9 versus 8.7 per 1,000) and 1.6 

times the rate for Hispanic children (9.4 per 1,000). 

Endangerment Standard neglect affected Black children at a rate 1.6 times the 

rates for White and Hispanic children (36.8 versus 22.4 and 23.0 per 1,000, respectively). 

Specific Categories of Endangerment Standard Abuse 

Black children had a significantly higher rate of Endangerment Standard 

physical abuse. Their rate is 2.1 times the rate for White children (9.7 versus 4.6 per 

1,000) and 1.6 times the rate for Hispanic children (5.9 per 1,000). 

Both White and Black children had significantly higher incidence rates of 

emotional abuse than Hispanic children. The rate of Endangerment Standard emotional 

abuse for White children was 1.5 times the rate for Hispanic children (3.5 versus 2.4 per 

1,000). Black children were emotionally abused at a rate of 4.5 per 1,000, which is 

almost 2 times the rate for Hispanic children. 

Specific Categories of Endangerment Standard Neglect 

An estimated 17.9 per 1,000 Black children were victims of physical neglect, 

which is 1.8 times the rate of 9.9 per 1,000 for Hispanic children, a significant difference. 
4-28
 

 

 

 

 

 

The rate for Black children is also 1.5 times the rate of 12.2 per 1,000 White children, a 

difference that is statistically marginal. 

One significant difference emerged in the incidence of emotional neglect: 

Black children had a 1.5 times higher risk of experiencing this maltreatment (18.2 per 

1,000) compared to White children (12.1 per 1,000). 

Severity of Outcomes from Endangerment Standard Maltreatment 

Statistically meaningful race/ethnicity differences occurred in four levels of 

harm attributable to Endangerment Standard maltreatment. 

Serious harm. The incidence of Black children seriously harmed (9.1 per 

1,000) is nearly 2 times the incidence of White children with this outcome (4.8 per 

1,000), and it is 1.6 times the incidence rate for Hispanic children (5.7 per 1,000); both 

differences are statistically significant. 

Moderate harm. The rate of Black children who suffered moderate harm 

was 1.7 times the rate of White children (18.6 per 1,000 Black children versus 11.0 per 

1,000 White children), a statistically marginal difference. 

Inferred harm. Black children were significantly more likely than Hispanic 

children to experience maltreatment where harm could be inferred. The incidence rate of 

inferred harm for Black children was 3.7 per 1,000, which is 1.8 times the rate of 2.1 per 

1,000 for Hispanic children. 

Endangered. Black children were considered to be endangered by 

maltreatment at a significantly higher rate than either White children or Hispanic 

children. An estimated 18.1 per 1,000 Black children were endangered by maltreatment 

during the NIS–4 study year, which is 1.8 times the rate of 10.2 per 1,000 White children 

and 1.6 times the rate of 11.2 per 1,000 Hispanic children. 
4-29
 

 

 

 

Changes since the NIS–3 in Rates of Endangerment Standard 

Maltreatment Related to Child’s Race and Ethnicity 

Figure 4–17 shows the categories of Endangerment Standard maltreatment 

where changes since the NIS–3 are significantly related to child’s race and ethnicity: all 

abuse, physical abuse, sexual abuse, emotional neglect, and serious harm. 

Figure 4–17.	 Percent Changes in Incidence Rates for Endangerment Standard

Maltreatment Related to Child’s Race/ethnicity. 

Abuse. Decreases in the incidence rate of Endangerment Standard abuse 

differed across the racial and ethnic groups. The largest decreases occurred for White 

children (50%) and Hispanic children (47%), with the decrease in the rate for Black 

children less than half the level for White and Hispanic children (22%). 

Physical abuse. The incidence rate of Endangerment Standard physical 

abuse also decreased differentially across the racial/ethnic groups. The incidence rate for 

White children decreased by 46%, the Hispanic rate decreased by 25%, and Black 

children again had the smallest rate decrease (15%). 

Sexual abuse. The pattern of decreases observed in the incidence rates of 

physical abuse also applies to sexual abuse. The incidence of sexual abuse of White 
4-30
 

 

 

 

 

 

 

 

 

4.4 Differences in the Incidence of Maltreatment Related to 

Child’s Disability Status 

children decreased the most (57%), followed by the decrease in the sexual abuse rate for 

Hispanic children (39%), while the smallest decrease in the sexual abuse rate occurred for 

Black children (25%). 

Emotional neglect. Chapter 3 reported that, whereas abuse rates decreased 

since the NIS–3, the rate of emotional neglect increased. Figure 4–17 shows that the 

increase was not equivalent across the different race/ethnicity groups. Rather, changes in 

the rate of Endangerment Standard emotional neglect since the NIS–3 are significantly 

related to the child’s race/ethnicity. Rates of this maltreatment category increased 

substantially for both Hispanic and Black children (117% and 100%, respectively), but 

the increase was much less for White children (40%). 

Serious harm. The incidence of serious harm from Endangerment Standard 

maltreatment decreased 41% for White children and 25% for Hispanic children. In 

contrast, the incidence rate increased 11% for Black children. 

The NIS–4 CPS Maltreatment and Sentinel data forms asked about the 

disability status of maltreated children. The findings here refer to children with one or 

more confirmed disabilities; they do not include children with only suspected 

disabilities.51 

51 Incidence rate calculations used the following population denominators in thousands: 6,689 children with

any confirmed disability and 66,946 children without a confirmed disability (Office of Special Education

and Rehabilitative Service, 2006, 2008). The Office of Special Education and Rehabilitative Service is

the only known source of information concerning the numbers of children with disabilities in the general 

population. These population statistics include children living both in and outside of household settings.

In contrast, the NIS–4 data pertain only to children who live in household settings. For this reason, the

NIS–4 incidence rates for children with disabilities should be treated as minimum estimates. 
4-31
 

 

 

 

 

 

4.4.1	 Differences in Harm Standard Maltreatment Related to 

Child’s Disability Status 

Categories of Harm Standard Maltreatment 

Table 4–5 shows the categories of Harm Standard maltreatment with 

significant differences in incidence related to child’s disability status. 

Table 4–5. Differences Related to Child’s Disability Status in Incidence Rates per 1,000 

Children for Harm Standard Maltreatment in the NIS–4 (2005–2006)* 

Harm Standard Maltreatment Category Without Disability With Confirmed 

Disability 

ABUSE: 

Physical Abuse 

NEGLECT: 

Emotional Neglect 

SEVERITY OF HARM: 

Serious 

Moderate 

4.2 

2.3 

5.8 

9.0 

3.1 

4.7 

8.8 

6.2 

* All differences are significant at p<.05. 

Physical abuse. Children with a confirmed disability experienced Harm 

Standard abuse at a significantly lower rate (3.1 children per 1,000) than children with no 

confirmed disability (4.2 children per 1,000). Thus, children without a confirmed 

disability were 1.4 times more likely than those with a disability to experience Harm 

Standard physical abuse. 

Emotional neglect. Children with a confirmed disability were at 

significantly higher risk of Harm Standard emotional neglect. An estimated 4.7 per 1,000 

children with confirmed disabilities experienced emotional neglect, which is more than 2 

times the rate of 2.3 per 1,000 children without disabilities. 
4-32
 

 

 

 

 

Severity of Outcomes from Harm Standard Maltreatment 

Significant disability differences emerged in two levels of outcomes 

attributable to Harm Standard maltreatment: serious harm and moderate harm. 

Serious harm. An estimated 8.8 per 1,000 children with a confirmed 

disability were seriously harmed by Harm Standard maltreatment, which is more than 1.5 

times the rate of 5.8 per 1,000 children without a disability. 

Moderate harm. The opposite pattern emerged in this level of harm, with 

children without a disability having a significantly greater risk of suffering moderate 

harm due to Harm Standard maltreatment. An estimated 9.0 per 1,000 children without a 

disability experienced moderate harm compared to 6.2 per 1,000 children with a 

confirmed disability. The incidence rate for children without disabilities is almost 1.5 

times the rate for children with a disability. 

4.4.2	 Differences in Endangerment Standard Maltreatment Related

to Child’s Disability Status 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

In contrast to the Harm Standard findings, significant differences related to 

child’s disability status emerged in rates of overall Endangerment Standard maltreatment, 

abuse, and neglect. In all three categories, children with no disability had significantly 

higher maltreatment rates compared to children with a confirmed disability, as Table 4–6 

shows. The estimated incidence rate for any category of Endangerment Standard 

maltreatment was 38.2 per 1,000 children with no disability, whereas the rate was 22.4 

per 1,000 children with a confirmed disability. The risk of Endangerment Standard 

maltreatment for children with no disability is 1.7 times the risk of children with a 

confirmed disability. 

An estimated 10.9 per 1,000 children with no disability experienced 

Endangerment Standard abuse compared to 7.8 per 1,000 children with a confirmed 

disability. The risk of abuse for children with no disability is 1.4 times that of children 

with a confirmed disability. 
4-33
 

 

 

 

 

Table 4–6. Differences Related to Child’s Disability Status in Incidence Rates per 1,000 

Children for Endangerment Standard Maltreatment in the NIS–4 (2005–2006)* 

Endangerment Standard Maltreatment 

Category Without Disability With Confirmed Disability 

ALL MALTREATMENT 

ABUSE: 

38.2 22.4 

All Abuse 10.9 7.8 

Physical Abuse 6.2 4.3 

Sexual Abuse 

NEGLECT: 

2.4 1.4‡ 

All Neglect 29.5 17.4 

Physical Neglect 15.5 9.6 

Emotional Neglect 

SEVERITY OF HARM: 

15.6 9.1 

Serious 6.0 9.1 

Moderate 13.3 8.5 

Endangered 15.9 3.3 

* All differences are significant at p<.05. 

‡ This estimate is less reliable because it derives from fewer than 100 sample children. 

The estimated incidence rate for Endangerment Standard neglect was 29.5 

per 1,000 children with no disability, in comparison to the rate of 17.4 per 1,000 children 

with a confirmed disability. Children without a disability had almost 1.7 times the risk of 

Endangerment Standard neglect than children with a confirmed disability. 

Categories of Endangerment Standard Abuse 

Significant differences related to the child’s disability status emerged for 

Endangerment Standard physical abuse and sexual abuse. 

Physical abuse. Children with no disability experienced Endangerment 

Standard physical abuse at a rate more than 1.4 times the rate of children with a 
4-34
 

 

 

 

 

 

 

confirmed disability. The incidence rate was estimated at 6.2 per 1,000 children with no 

disability compared to 4.3 per 1,000 children with a confirmed disability. 

Sexual abuse. Children with no disability had 1.7 times the risk of being 

sexually abused than those with a disability (2.4 versus 1.4 children per 1,000). 

Categories of Endangerment Standard Neglect 

Significant differences related to child’s disability status occurred in rates of 

two categories of the Endangerment Standard neglect, physical neglect and emotional 

neglect. 

Physical neglect. An estimated 15.5 per 1,000 children with no disability 

experienced Endangerment Standard physical neglect, whereas the rate was 9.6 per 1,000 

children with a confirmed disability. Children with no disability were more than 1.6 

times more likely to be physically neglected than children with a confirmed disability. 

Emotional neglect. Children with no disability were at significantly greater 

risk of Endangerment Standard emotional neglect; they were 1.7 times more likely to be 

emotionally neglected than children with a confirmed disability. An estimated 15.6 per 

1,000 children with no disability experienced emotional neglect compared to 9.1 per 

1,000 children with a confirmed disability. 

Severity of Outcomes from Endangerment Standard Maltreatment 

Significant differences related to the child’s disability status occurred in three 

levels of outcomes from Endangerment Standard maltreatment: serious harm, moderate 

harm, and endangerment. 

Serious harm. In contrast to their lower risk of experiencing different 

categories of Endangerment Standard maltreatment, children with a confirmed disability 

were at greater risk of suffering serious harm from Endangerment Standard maltreatment 

than children with no disability. An estimated 9.1 per 1,000 children with a confirmed 

disability were seriously harmed compared to 6.0 per 1,000 children with no disability. 
4-35
 

 

 

 

 

 

 

 

 

 

 

 

 

Thus, the incidence rate for children with a confirmed disability is more than 1.5 times 

higher than the rate for children with no disability. 

Moderate harm. Children without a disability were at significantly greater 

risk of suffering moderate harm from Endangerment Standard maltreatment than children 

with a confirmed disability. An estimated 13.3 per 1,000 children with no disability 

experienced moderate harm compared to 8.5 per 1,000 children with a confirmed 

disability. Thus, children with no disability had more than 1.5 times the risk of suffering 

moderate harm compared to children with a confirmed disability. 

Endangered. The estimated incidence of children who were endangered, but 

not yet harmed, as a result of maltreatment was 15.9 per 1,000 children with no disability 

compared to 3.3 per 1,000 children with a confirmed disability. The risk of 

endangerment as an outcome of maltreatment for children with no disability is 4.8 times 

that of children with a confirmed disability. 

4.5 Differences in the Incidence of Maltreatment Related to 

Child’s Enrollment in School 

This section presents the NIS–4 results concerning differences in the 

incidence of maltreatment related to the child’s enrollment status, focusing on school-age 

children. In accordance with Census data on enrollment status in the general child 

population, these analyses define school-age children as those ages 3 to 17 years.52,53 

General population information on enrollment status relies on interview responses to the 

Current Population Survey, while Child Protective Services caseworkers and NIS 

sentinels provide information on the enrollment status of the maltreated children.54 

52 Incidence rate calculations used the following population denominators, in thousands: 5,119 school-age 

children not enrolled in school and 56,225 school-age children enrolled in school (U.S. Census Bureau,

2005). 

53 This report does not present enrollment differences for the more delimited age range of 5- to 15-year-olds

(i.e., ages that are mandated to attend school) because there were too few (<100) maltreated children in

this narrower age range who were not enrolled in school in most maltreatment categories. 

54 Neither source necessarily classifies home-schooled children as not enrolled. Census interviewers count

children as enrolled if they are enrolled at any time during the current term or school year in any type of

public, parochial, or other private school in the regular school system. If a child’s courses are counted for

credit at a regular school then Census considers them to be enrolled even if they are not physically present

(Footnote continues on next page.) 
4-36 

 

 

 

 

4.5.1	 Differences in Harm Standard Maltreatment Related to 

Child’s Enrollment in School 

Table 4–7 displays the Harm Standard incidence rates that differed by child’s 

enrollment status. 

Table 4–7. Differences Related to Child’s School Enrollment in Incidence Rates per 

1,000 Children for Harm Standard Maltreatment in the NIS–4 (2005–2006) 

Harm Standard Maltreatment 

Category 

School-Aged 

Children Not 

Enrolled in 

School 

School-Aged 

Children 

Enrolled in 

School 

Significance of 

Difference 

ALL MALTREATMENT 

ABUSE: 

13.0 16.6 m 

Physical Abuse 2.5 4.3 * 

Sexual Abuse 

NEGLECT: 

2.3 1.4 * 

Educational Neglect† 

SEVERITY OF HARM: 

3.1 5.7 m 

Moderate 4.9 10.4 * 

Inferred 1.4 0.6 * 

* The difference is significant at p<.05. 

m The difference is statistically marginal (i.e., .10>p>.05). 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both 

tables because it is in the summary categories in both standards: Neglect and All Maltreatment. 

(Continued from previous page.)

in a regular school (U.S. Census Bureau, 2004). Similarly, NIS respondents (caseworkers and sentinels)

may consider a home-schooled child to be enrolled if their school district certified their home-schooling 

program. 
4-37
 

 

 

 

 

Overall Harm Standard Maltreatment 

School-aged children enrolled in school were more likely to experience some 

type of Harm Standard maltreatment, a statistically marginal difference. An estimated 

16.6 per 1,000 school-aged children enrolled in school experienced Harm Standard 

maltreatment compared with 13.0 per 1,000 children not enrolled. The risk of Harm 

Standard maltreatment for enrolled children is 1.3 times that of children not enrolled. 

Categories of Harm Standard Abuse 

Significant differences related to child’s enrollment status emerged in the 

incidence of two Harm Standard abuse categories, physical abuse and sexual abuse. 

Physical abuse. Enrolled children were significantly more likely to 

experience Harm Standard physical abuse compared to children not enrolled (4.3 versus 

2.5 per 1,000, respectively). Children enrolled in school were 1.7 times more likely to be 

physically abused than school-aged children not enrolled in school. 

Sexual abuse. In contrast, children not enrolled were at greater risk of Harm 

Standard sexual abuse. The non-enrolled children experienced this category of 

maltreatment at more than 1.6 times the rate of the enrolled children (2.3 versus 1.4 per 

1,000 children, respectively). 

Categories of Harm Standard Neglect 

Among categories of Harm Standard neglect, only the incidence of 

educational neglect varied with enrollment status. 

Educational neglect. Children enrolled in school were at greater risk of 

educational neglect, a statistically marginal difference. Perhaps this is because their 

absence from classes is tracked regularly, and thus sentinels are more likely to note it 

during the delimited study reference period. An estimated 5.7 per 1,000 enrolled schoolaged children were countable in this maltreatment category, which is 1.8 times the rate of 

3.1 per 1,000 children not enrolled. 
4-38
 

 

 

 

 

 

 

 

Severity of Outcomes from Harm Standard Maltreatment 

Significant enrollment differences occurred in two levels of outcomes from 

Harm Standard maltreatment: moderate harm and inferred harm. 

Moderate harm. School-aged children enrolled in school were significantly 

more likely to suffer moderate harm from Harm Standard maltreatment (10.4 per 1,000) 

compared to their non-enrolled age peers (4.9 per 1,000). Specifically, school-aged 

children enrolled in school were 2.1 times more likely than children not enrolled in 

school to be in this category. 

Inferred harm. Non-enrolled children had a significantly higher rate of 

inferred harm as a result of Harm Standard maltreatment than enrolled children (1.4 

versus 0.6 per 1,000, respectively). Their risk of inferred harm is 2.3 times higher than 

that of the enrolled children. This may reflect the fact that specific forms of sexual abuse 

permit harm to be inferred and the non-enrolled children were sexually abused at a higher 

rate. 

4.5.2	 Differences in Endangerment Standard Maltreatment Related

to Child’s Enrollment in School 

Table 4–8 shows the significant and statistically marginal enrollment 

differences in incidence rates of Endangerment Standard abuse and neglect. 

Overall Endangerment Standard Maltreatment 

An estimated 37.8 per 1,000 school-age children not enrolled in school 

experienced Endangerment Standard maltreatment compared with 30.2 per 1,000 

enrolled children, a statistically marginal difference. In other words, the non-enrolled 

children had almost 1.3 times greater risk of Endangerment Standard maltreatment than 

children enrolled in school. 
4-39
 

 

 

 

 

 

 

Table 4–8. Differences Related to Child’s School Enrollment in Incidence Rates per 1,000 

Children for Endangerment Standard Maltreatment in the NIS–4 (2005–2006) 

Endangerment Standard 

Maltreatment Category 

School-Aged 

Children Not 

Enrolled in 

School 

School-Aged 

Children 

Enrolled in 

School 

Significance of 

Difference 

ALL MALTREATMENT 

ABUSE: 

37.8 30.2 m 

Sexual Abuse 

NEGLECT: 

2.9 1.8 * 

All Neglect 30.9 23.2 m 

Physical Neglect 19.3 11.4 * 

Emotional Neglect 16.9 11.5 m 

Educational Neglect† 

SEVERITY OF HARM: 

3.1 5.7 m 

Moderate 8.2 14.8 * 

Inferred 4.4 1.9 m 

Endangered 18.6 7.8 * 

* The difference is significant at p<.05. 

m The difference is statistically marginal (i.e., .10>p>.05). 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both 

tables because it is in the summary categories in both standards: Neglect and All Maltreatment. 

Differences related to the child’s enrollment status also emerged in rates of 

Endangerment Standard neglect. The incidence rate of neglect for non-enrolled children 

was 30.9 per 1,000, which is 1.3 times the rate of 23.2 per 1,000 enrolled children. 

Categories of Endangerment Standard Abuse 

Sexual abuse. Endangerment Standard sexual abuse is the only 

Endangerment Standard abuse category where incidence rates differ significantly in 

relation to the child’s enrollment status, closely paralleling the Harm Standard result in 

this category. Children not enrolled in school were significantly more likely to be 
4-40
 

 

 

 

 

 

 

 

 

sexually abused than children enrolled in school (2.9 versus 1.8 per 1,000). Thus, the rate 

for children not enrolled in school is 1.6 times higher than the rate for those enrolled. 

Categories of Endangerment Standard Neglect 

The incidence of all three specific Endangerment Standard neglect categories 

varied in relation to the child’s enrollment status. 

Physical neglect. The incidence of Endangerment Standard physical neglect 

for school-aged children not enrolled in school was significantly higher (19.3 per 1,000) 

than the rate for enrolled children (11.4 per 1,000). The non-enrolled children were 1.7 

times more likely to be physically neglected. 

Emotional neglect. School-aged children not enrolled were more likely to 

suffer Endangerment Standard emotional neglect (16.9 versus 11.5 per 1,000), a 

statistically marginal difference. The non-enrolled children had a 1.5 times greater risk 

of this maltreatment than the enrolled children. 

Educational neglect. The findings concerning educational neglect are 

identical under the Harm and Endangerment Standards. They are discussed above (cf. 

§4.5.1). 

Severity of Outcomes from Endangerment Standard Maltreatment 

Differences associated with child’s school enrollment affected three levels of 

outcome severity: moderate harm, inferred harm, and endangered. 

Moderate harm. Enrolled children were at greater risk of suffering 

moderate harm due to Endangerment Standard compared to children not enrolled in 

school (14.8 versus 8.2 per 1,000, respectively). The enrolled children were 1.8 times 

more likely than non-enrolled children to suffer moderate harm. 

Inferred harm. In contrast, the non-enrolled school-aged children were 

more likely than enrolled children to experience inferred harm in connection with 
4-41
 

 

 

 

Endangerment Standard maltreatment, a statistically marginal difference. The incidence 

of inferred harm was an estimated 4.4 per 1,000 non-enrolled children compared to 1.9 

per 1,000 enrolled children. This risk of inferred harm for non-enrolled children is 2.3 

times higher than the risk for enrolled children. 

Endangered. The incidence of children who were endangered, but not yet 

harmed, by Endangerment Standard maltreatment, was 18.6 per 1,000 school-aged 

children not enrolled, whereas the rate was 7.8 per 1,000 enrolled children. This risk of 

endangerment for the non-enrolled children is almost 2.4 times greater than the risk for 

enrolled children. 

5–1
 

 

 

 

 

 

 

 

 

 

 

5. DISTRIBUTION OF ABUSE AND NEGLECT 

BY FAMILY CHARACTERISTICS
 

This chapter examines how the incidence and severity of abuse and neglect 

vary by specific characteristics of the children’s families, including their parents’ 

employment, socioeconomic status, family structure and living arrangement, any 

grandparent caregiver, family size, and the metropolitan status of their county of 

residence. The ensuing sections address the following questions for both the Harm 

Standard and the Endangerment Standard: 

•	 Do children in families with different characteristics have 

systematically different incidence rates for the various types of 

maltreatment or for the different severities of outcomes due to 

maltreatment? 

•	 (If applicable): Have there been any statistically significant changes

since the NIS–3 in the distribution of child maltreatment by the family 

characteristic in question?55 

Although the topics in this chapter are family characteristics, the units of 

measurement for all NIS estimates are the children. 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 of low socioeconomic status, 

children in households with four or more children, etc.). 

As in Chapter 4, the findings here reflect unduplicated estimates; that is, each 

estimate counts each child only once. Also, all differences between subgroups refer only 

to incidence rates.56 As mentioned earlier, the rate measures adjust for differences in the 

numbers of children in the general population who are in the different subgroups of 

interest, so all statistical comparisons use the rate measures.57 

55 The measures available in the NIS–3 allowed analyses to address this question for three characteristics:

family structure, family size, and metropolitan status of the county of residence. 

56 Appendices B and C detail all NIS–4 estimates, including the estimated rates as well as totals, together 

with their standard errors of estimate. 

57 Appendix D provides the detailed results of all within-NIS–4 statistical comparisons. Appendix E 

contains the details of all between-study comparisons. 
5–2
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.1	 Differences in the Incidence of Maltreatment Related to 

Parents’ Employment 

Analyses distinguished three groups of children based on their parents’ 

employment: those with any parent who was unemployed, those with employed parents, 

and those with no parent in the labor force.58 In order to minimize the number of cases 

with missing information, the classification combined information about the parents’ 

employment at the time of maltreatment and during the past year.59 Parents who were 

unemployed were those described as unemployed or laid off but looking for work. 

Parents who were employed included those employed full- or part-time and those who 

were on active military duty. “Not in the labor force” included parents who were not 

employed and who were not technically in the active labor force (e.g., retired, 

homemaker, unemployed and not looking for work, disabled, receiving Temporary 

Assistance for Needy Families (TANF), on maternity leave, in the hospital, or in jail).60 

5.1.1	 Differences in Harm Standard Maltreatment related to 

Parents’ Employment 

Table 5–1 shows that parents’ employment was related to the incidence of 

most Harm Standard maltreatment categories and severities.61 Unless noted otherwise, 

58 These analyses excluded children who did not live with any parent (3% of children in the United States). 

59 The classification applied employment information hierarchically: First, it assigned children who had any

parent unemployed during these timeframes to the “Parent(s) Unemployed” category. Next, it assigned 

children with any parent employed to the “Parent(s) Employed category. Finally, it assigned children 

with parent(s) not in the labor force to that category. These analyses excluded 6% of the children

countable under either definitional standard because they lived in households with no parents present.

They also excluded children who lived with parents but who were missing information on parents’ labor

force participation. Despite the effort to minimize the number of unknown cases by combining 

information across timeframes, parents’ employment remained unknown for 29% of the children 

countable under the Harm Standard and for 27% of those countable under the Endangerment Standard. 

60 Incidence rate computations used the following population denominators, reflecting the number (in

thousands) of children in the general population: 8,986 children with any parent currently unemployed or

unemployed in the past year, 58,218 children with parent(s) employed and none unemployed currently or

during the past year, and 3,982 children with no parent in the labor force during these time periods (U.S.

Census Bureau, 2008a, 2008b, 2008c). 

61 As noted in the previous chapter, analyses did not assess subgroup differences in fatality rates, because

the total number of sample children who died as a result of their maltreatment was fewer than 100, too

few to permit reliable subgroup estimates. 
5–3
 

 

Table 5–1. Incidence Rates per 1,000 Children for Harm Standard Maltreatment in the 

NIS–4 (2005–2006) Related to Parents’ Employment 

Harm Standard 

Maltreatment Category 

Parent(s) 

Unemployed 

Parent(s) 

Employed 

Parent(s) 

Not in the 

Labor Force 

Significance 

of Differences 

ALL MALTREATMENT 

ABUSE: 

15.9 7.6 22.6 A, B 

All Abuse 4.8 3.9 9.6 B 

Emotional Abuse 

NEGLECT: 

2.3 1.2 2.9 B 

All Neglect 12.1 4.1 14.8 A, B 

Physical Neglect 5.6 1.4 6.1 A, B 

Emotional Neglect 2.7‡ 1.4 4.9‡ a, B 

Educational Neglect† 

SEVERITY OF HARM: 

5.8‡ 1.8 4.8‡ B 

Serious 6.9 3.0 11.0 A, B 

Moderate 8.2 4.2 9.3 B 

Inferred 0.7‡ 0.3‡ 2.2‡ b 

A Difference between “Unemployed” and “Employed" is significant at the p<.05 level. 

a Difference between “Unemployed” and “Employed" is statistically marginal (i.e., .10>p>.05). 

B Difference between “Employed” and “Not in the Labor Force" is significant at the p<.05 level. 

b Difference between “Employed” and “Not in the Labor Force" is statistically marginal (i.e., 

.10>p>.05). 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both 

tables because it is in the summary categories in both standards: All Neglect and All Maltreatment. 

‡ This estimate is less reliable because it derives from fewer than 100 sample children. 

any differences described in the text are statistically significant. In all cases, children 

with employed parents had the lowest rate of maltreatment. 

Overall Harm Standard Maltreatment, Abuse, and Neglect 

Children with no parent in the labor force and those with an unemployed 

parent were at significantly higher risk of Harm Standard maltreatment compared to those 

whose parents were employed. An estimated 15.9 per 1,000 children with an 

unemployed parent suffered some form of Harm Standard maltreatment. This rate is 
5–4
 

 

 

 

more than 2 times the rate for children with an employed parent (7.6 children per 1,000). 

The rate for children with no parent in the labor force (22.6 children per 1,000) is almost 

3 times the rate for children an employed parent. 

Children with no parent in the labor force were also more likely to suffer 

Harm Standard abuse than those with employed parents. The rate for children with no 

parent in the labor force is more than 2 times that of children with employed parents (9.6 

per 1,000 versus 3.9 per 1,000). 

The incidence of overall Harm Standard neglect is significantly higher among 

children with an unemployed parent and those with no parent in the labor force. Children 

with an unemployed parent had almost 3 times greater risk of suffering Harm Standard 

neglect compared to children with employed parents (12.1 versus 4.1 children per 1,000), 

and children with no parent in the labor force had more than 3 times greater risk than 

children with employed parents (14.8 versus 4.1 children per 1,000). 

Specific Categories of Harm Standard Abuse 

Rates of specific categories of Harm Standard physical and sexual abuse did 

not statistically differ in relation to parents’ employment. However, children with no 

parent in the labor force had a higher rate of emotional abuse than those with employed 

parents (2.9 versus 1.2 children per 1,000), a statistically marginal difference. 

Specific Categories of Harm Standard Neglect 

All three specific categories of Harm Standard neglect evidenced significant 

differences related to parents’ employment. 

Physical neglect. Children with employed parents had a significantly lower 

rate of Harm Standard physical neglect (1.4 children per 1,000) compared to those in the 

other groups. The rate for children with no parent in the labor force is more than 4 times 

higher than the rate for children with employed parents (6.1 versus 1.4 children per 

1,000), while the rate for children with unemployed parents (5.6 per 1,000) is exactly 4 

times higher. 
5–5
 

 

 

 

 

Emotional neglect. Children with no parent in the labor force had the 

highest risk of Harm Standard emotional neglect (4.9 per 1,000), almost 3.5 times higher 

than the rate for children with an employed parent (1.4 per 1,000), a statistically 

significant difference. Children with an unemployed parent had nearly 2 times the rate of 

Harm Standard emotional neglect compared to those with employed parents (2.7 versus 

1.4 children per 1,000), which is a statistically marginal difference. 

Educational neglect. The incidence of educational neglect was nearly 2.7 

times higher for children with no parent in the labor force compared to those with 

working parents (4.8 versus 1.8 children per 1,000), a significant difference. No other 

differences in this category are statistically reliable. 

Severity of Outcomes from Harm Standard Maltreatment 

As Table 5–1 indicates, the incidence of children who were seriously or 

moderately harmed by Harm Standard maltreatment or for whom harm could be inferred 

related to their parents’ employment status. 

Serious harm. Children with an unemployed parent and those with no 

parent in the labor force suffered serious harm from Harm Standard maltreatment at 

significantly higher rates (6.9 and 11.0 per 1,000, respectively) compared to children with 

working parents (3.0 per 1,000. 

Moderate harm. Children with no parent in the labor force had more than 2 

times the risk of suffering moderate harm from Harm Standard abuse or neglect 

compared to children whose parents were steadily employed (9.3 versus 4.2 per 1,000). 

(Although the rate of moderate harm for children with unemployed parents appears 

almost as large, that estimate is too unreliable for the difference to be statistically 

meaningful.) 

Inferred harm. The incidence of children with inferred harm due to 

maltreatment was statistically marginally higher for those with no parent in the labor 

force compared to children with working parents. An estimated 2.2 children per 1,000 

with no parent in the labor force experienced maltreatment sufficiently severe to permit 
 

 

 

inferring that they were harmed. This was over 7 times the rate of inferred harm for 

children with employed parents (0.3 children per 1,000, respectively). 

5.1.2	 Differences in Maltreatment under the Endangerment

Standard Related to Parents’ Employment Status 

Table 5–2 indicates the statistically meaningful differences in incidence rates 

based on parental employment in all categories of maltreatment and outcome severity. 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

Chapter 3 reported that an estimated 39.5 children per 1,000 nationwide 

experienced some form of Endangerment Standard maltreatment. That general result is 

qualified by significant differences in the incidence rates for children depending on their 

parents’ employment status. 

Children with no parent in the labor force had the highest rate of 

Endangerment Standard maltreatment, an estimated 57.7 per 1,000 children. This rate is 

more than 3 times the rate for children whose parents were working (17.1 per 1,000). 

Children with an unemployed parent experienced Endangerment Standard maltreatment 

at more than 2 times that of children with employed parents (39.9 versus 17.1 per 1,000). 

Both of these differences are statistically significant. The Endangerment Standard 

maltreatment rate for children with no parent in the labor force was also higher than for 

children with an unemployed parent (57.7 versus 39.9 per 1,000), a statistically marginal 

difference. 

Children with no parent in the labor force had the highest the incidence of 

Endangerment Standard abuse (15.2 per 1,000), 2 or more times higher than the rates for 

children of working parents (5.8 per 1,000) or with an unemployed parent (7.5 per 1,000). 

Rates of Endangerment Standard neglect were significantly higher for 

children whose parents did not have steady work. The estimated incidence of 

Endangerment Standard neglect was 46.4 per 1,000 children with parent in the labor 

force, which is 3.6 times the rate of 12.8 per 1,000 children with employed parents. The 

5–6
 
5–7
 

rate for children with an unemployed parent is 2.7 times the rate for children whose 

parents were consistently employed (35.0 versus 12.8 per 1,000). 

Table 5–2. Incidence Rates per 1,000 Children for Endangerment Standard 

Maltreatment in the NIS–4 (2005–2006) Related to Parents’ Employment 

Endangerment Standard 

Maltreatment Category 

Parent(s) 

Unemployed 

Parent(s) 

Employed 

Parent(s) 

Not in the 

Labor Force 

Significance 

of Differences 

ALL MALTREATMENT 39.9 17.1 57.7 A, B, c 

ABUSE: 

All Abuse 7.5 5.8 15.2 B, C 

Physical Abuse 3.5 3.4 7.3 B, c 

Sexual Abuse 0.9 1.1 3.7 b, c 

Emotional Abuse 4.1 2.3 7.1 B 

NEGLECT: 

All Neglect 35.0 12.8 46.4 A, B 

Physical Neglect 23.0 6.0 25.5 A, B 

Emotional Neglect 19.1 7.4 25.3 A, B 

Educational Neglect† 5.8‡ 1.8 4.8‡ B 

SEVERITY OF HARM: 

Serious 7.3 3.2 11.3 A, B 

Moderate 12.1 6.3 15.7 A, B 

Inferred 3.0‡ 1.1 6.0‡ B 

Endangered 17.5 6.5 24.8 A, B 

A Difference between “Unemployed” and “Employed" is significant at the p<.05 level. 

B Difference between “Employed” and “Not in the Labor Force" is significant at the p<.05 level. 

b Difference between “Employed” and “Not in the Labor Force" is statistically marginal (i.e., 

.10>p>.05). 

C Difference between “Unemployed” and “Not in the Labor Force" is significant at the p<.05 level. 

c Difference between “Unemployed” and “Not in the Labor Force" is statistically marginal (i.e., 

.10>p>.05). 

‡ This estimate is less reliable because it derives from fewer than 100 sample children. 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both 

tables because it is in the summary categories in both standards: All Neglect and All Maltreatment. 
5–8
 

 

 

 

Specific Categories of Endangerment Standard Abuse 

In the Endangerment Standard, all specific abuse categories revealed 

statistically meaningful differences in incidence related to parents’ employment status. 

Physical abuse. Children with no parent in the labor force had the highest 

rate of Endangerment Standard physical abuse (7.3 per 1,000), more than 2 times the 

rates for other children. The difference is statistically significant in comparison to 

children with employed parents (3.4 per 1,000), but it is statistically marginal in 

comparison to children with an unemployed parent (3.5 per 1,000) because that estimate 

is slightly less reliable. 

Sexual abuse. Children with no parent in the labor force have a notably 

higher rate of Endangerment Standard sexual abuse (3.7 per 1,000) compared to those 

with an unemployed parent (0.9 per 1,000) or steadily employed parents (1.1 per 1,000). 

Both these differences are statistically marginal. 

Emotional abuse. Compared to children with employed parents, children 

with no parent in the labor force had more than 3 times the rate of Endangerment 

Standard emotional abuse (2.3 versus 7.1 per 1,000, respectively). 

Specific Categories of Endangerment Standard Neglect 

Significant differences related to parents’ employment emerged in all specific 

categories of Endangerment Standard neglect. 

Physical neglect. Children with an unemployed parent were physically 

neglected at a rate of 23.0 per 1,000, which is almost 4 times the rate of physical neglect 

for children with employed parents (6.0 children per 1,000). Children who had no parent 

in the labor force (25.5 per 1,000) were physically neglected at more than 4 times the rate 

of children with employed parents. Both of these differences are statistically significant. 

Emotional Neglect. The differences in rates of Endangerment Standard 

emotional neglect follow the consistent pattern. Children with an unemployed parent and 

those with no parent in the labor force suffered maltreatment at the highest rates (19.1 
5–9
 

 

 

and 25.5 per 1,000, respectively). Their rates are 2.6 and 3.4 times the rate for children 

with employed parents, respectively, who had lowest rate (7.4 per 1,000). Again, both of 

these differences are significant. 

Educational neglect. The subgroup differences in rates of educational 

neglect are identical to those given earlier, so the discussion here does not reiterate them. 

Severity of Outcomes from Endangerment Standard Maltreatment 

As Table 5–2 indicates, parents’ employment significantly related to the 

incidence of children with all levels of harm from Endangerment Standard maltreatment. 

Serious harm. Children with steadily employed parents suffered serious 

injury or harm from Endangerment Standard maltreatment at a significantly lower rate 

(3.2 per 1,000) compared to children with an unemployed parent or with no parent in the 

labor force (7.3 and 11.3, respectively). Compared to children with employed parents, the 

rate of serious harm for children with an unemployed parent is 2.3 times higher, and the 

rate for children with no parent in the labor force is 3.5 times higher. 

Moderate harm. The incidence of moderate harm from Endangerment 

Standard abuse or neglect was almost 2 times higher among children with an unemployed 

parent compared to the incidence among children whose parents were employed (12.1 

versus 6.3 children per 1,000). Children with no parent in the labor force were 2.5 times 

more likely to be moderately harmed by Endangerment Standard maltreatment compared 

to those with employed parents (15.7 versus 6.3 children per 1,000). Again, both 

differences are significant. 

Inferred harm. The incidence of children with inferred harm from 

Endangerment Standard maltreatment was significantly greater for those with no parent 

in the labor force than for those with employed parents. An estimated 6.0 per 1,000 

children with no parent in the labor force experienced maltreatment of a type sufficiently 

severe that harm could be inferred. This was almost 4.5 times the rate of 1.1 per 1,000 

children with working parents. 
5–10
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.2 Differences in the Incidence of Maltreatment Related to 

Socioeconomic Status (SES) 

Endangered. The estimated incidence of children endangered but not yet 

harmed by abuse or neglect differed significantly in relation to their parents’ 

employment. The rates of endangerment for children with an unemployed parent (17.5 

per 1,000) and for children with no parent in the labor force (24.8 per 1,000) were both 

significantly higher than the rate for children with employed parents (6.5 children per 

1,000); both of these differences are statistically significant. 

The NIS–4 collected data on several indicators of economic well-being or 

socio-economic status: household income, household poverty-related program 

participation,62 and parents’ education. However, initial analyses revealed that majorities 

of the countable NIS–4 children were missing data on these measures.63 In order to 

minimize missing values, final analyses used a composite measure of family 

socioeconomic status (SES) that integrated any available information across these three 

measures.64 The composite measure defined children to be in families of low economic 

status (low SES) if they were in the bottom tier on any indicator: household income was 

below $15,000 a year, parents’ highest education level was less than high school, or any 

household member participated in a poverty-related program.65,66 

62 Study data forms asked whether anyone in the child’s household was participating in any poverty-related 

program. Instructions defined poverty-related programs to include subsidized school breakfasts or

lunches, Temporary Assistance for Needy Families (TANF), food stamps, public housing, energy 

assistance, and public assistance. 

63 Household income was missing for 68% of the children who experienced Harm Standard maltreatment

and for 66% of those who experienced Endangerment Standard maltreatment. Household poverty

program participation was missing for 58% of children who were countable under the Harm Standard and 

54% of those countable under the Endangerment Standard. Information about parents’ education was

missing for 76% of children who were countable under the Harm Standard and 77% of those whose

maltreatment fit the Endangerment Standard. 

64 This hybrid measure integrates information at the household and family levels. It is termed “family

socioeconomic status” for purposes here, since a family-level measure (parents’ education) is the lowest

level in the combined index. The index assumes that if either household income or poverty-program

participation indicates low socioeconomic status then this status applies to all families living in the

household. 

65 Although this strategy reduced the percentage of children with missing data to just under 50%, the

composite low socioeconomic status measure was still missing for those children who were missing data 

on all three component measures: 48% of children who experienced Harm Standard maltreatment and

45% of those who suffered Endangerment Standard maltreatment. Missing data can bias NIS findings if

(Footnote continues on next page.) 
5–11
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Analyses of changes in this composite measure since the NIS–3 were not 

possible because the NIS–3 did not obtain information about household poverty program 

participation and parental education. 

5.2.1	 Differences in Harm Standard Maltreatment Related to 

Socioeconomic Status (SES) 

As Table 5–3 reveals, household SES was significantly related to incidence 

rates in all categories of Harm Standard maltreatment and levels of outcome severity. 

Overall Harm Standard Maltreatment, Abuse, and Neglect 

Children in families of low SES were at significantly greater risk of Harm 

Standard maltreatment overall. An estimated 22.5 children per 1,000 children in lowSES families experienced Harm Standard maltreatment, which is more than 5 times the 

rate of 4.4 per 1,000 children in families that were not of low SES. 

Children in families of low SES were also at significantly greater risk of 

Harm Standard abuse. An estimated 7.7 children per 1,000 children in low-SES families 

experienced Harm Standard abuse compared to 2.5 per 1,000 children not in low-SES 

(Continued from previous page.)

the cases that are missing information are predominantly in a specific subgroup, since that would cause

NIS to systematically underestimate the incidence of maltreatment in that subgroup. To gauge the 

robustness of the findings on socioeconomic status, hypothetical analyses examined the worst-case 

scenario regarding the potential bias of the missing data, by allocating all the children still missing values

on this measure to the higher socioeconomic category (i.e., the subgroup with lower incidence rates across

all maltreatment categories). Statistically significant differences remained for half of the maltreatment

categories under both the Harm and Endangerment Standards. Specifically, the hypothetical subgroups

still differed, under both definitional standards, in the incidence of all maltreatment, emotional abuse, all

neglect, physical neglect, emotional neglect, and serious harm. In addition, the hypothetical subgroups

differed significantly in their rates of experiencing moderate harm and endangerment from Endangerment

Standard maltreatment. 

66 Calculations of incidence rates used the following population denominators, in thousands: 19,750

children in	 families of low socioeconomic status and 53,885 children not in families of low 

socioeconomic status (U.S. Census Bureau, 2008a, 2008b, 2008c). 
5–12
 

families. The incidence rate for children in low-SES families is more than 3 times the 

rate for children not in low-SES families. 

Children in families of low SES had a significantly higher rate of Harm 

Standard neglect than those not in low-SES families (16.1 versus 2.2 per 1,000 children, 

respectively). Thus, the risk of Harm Standard neglect for children in low-SES families 

was over 7 times the risk for children not in families of low SES. 

Table 5–3. Differences Related to Family Socioeconomic Status in Incidence Rates per 

1,000 Children for Harm Standard Maltreatment in the NIS–4 (2005–2006)* 

Harm Standard Maltreatment 

Category 

Children not in low SES 

Families 

Children in Low SES 

Families 

ALL MALTREATMENT 4.4 22.5 

ABUSE: 

All Abuse 2.5 7.7 

Physical Abuse 1.5 4.4 

Sexual Abuse 0.6 1.7 

Emotional Abuse 0.5 2.6 

NEGLECT: 

All Neglect 2.2 16.1 

Physical Neglect 0.8 6.9 

Emotional Neglect 0.8 3.8 

Educational Neglect† 1.0 7.1 

SEVERITY OF HARM: 

Serious 1.7 9.9 

Moderate 2.4 11.7 

Inferred 0.2‡ 0.9 

* All differences are significant at p<.05. 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both 

tables because it is in the summary categories in both standards: All Neglect and All Maltreatment. 

‡ This estimate is less reliable because it derives from fewer than 100 sample children. 
5–13
 

 

 

 

Specific Categories of Harm Standard Abuse 

The NIS–4 found significant socioeconomic status differences in all 

categories of Harm Standard abuse: physical, sexual, and emotional. 

Physical abuse. Children in families of low SES were at significantly higher 

risk of Harm Standard physical abuse compared to children not in low-SES families (4.4 

versus 1.5 per 1,000, respectively). The incidence rate for children in low-SES families 

is almost 3 times the rate for children not in low-SES families. 

Sexual abuse. Children in families of low socioeconomic status also 

experienced a significantly higher risk of Harm Standard sexual abuse. The estimated 

incidence rate for children in low-SES families was 1.7 per 1,000 children, which is more 

than 2 times the rate of 0.6 children per 1,000 children not in low-SES families. 

Emotional abuse. The incidence of emotional abuse for children in low-SES 

families was more than 5 times the rate for children not in families of low SES (2.6 

versus 0.5 children per 1,000, respectively). 

Specific Categories of Harm Standard Neglect 

The socioeconomic subgroups had significantly different incidence rates in 

all specific categories of Harm Standard neglect. 

Physical neglect. Children in low-SES families had a significantly higher 

rate of Harm Standard physical neglect compared to those not in families of low SES. 

The risk of physical neglect for children in families of low SES is over 8 times the rate 

for children not in families of low SES (6.9 versus 0.8 per 1,000 children, respectively). 

Emotional neglect. Children in families of low SES had a significantly 

higher risk of Harm Standard emotional neglect. The estimated incidence rate in families 

of low SES was 3.8 children per 1,000 compared to 0.8 per 1,000 children not in families 

of low SES. The incidence rate for children in low-SES families is more than 4 times the 

rate for children not in low-SES families. 
5–14
 

 

 

Educational neglect. Children in families of low SES were over 7 times 

more likely to experience educational neglect than children not in families of low SES. 

The incidence of educational neglect was 7.1 per 1,000 children in low-SES families, 

whereas the rate was 1.0 per 1,000 children not in low-SES families. 

Severity of Outcomes from Harm Standard Maltreatment 

Socioeconomic status was significantly related to incidence in three levels of 

outcomes due to Harm Standard maltreatment: serious, moderate, and inferred harm. 

Serious harm. Children in families of low SES had a significantly higher 

rate of serious injury or harm from Harm Standard maltreatment compared to children 

not in low-SES families. The incidence rate for children in families of low SES was 9.9 

per 1,000 children, which is more than 5 times the rate of 1.7 per 1,000 children not in 

low-SES families. 

Moderate harm. The incidence of children moderately harmed by Harm 

Standard maltreatment was 11.7 per 1,000 children in low-SES families, compared to 2.4 

per 1,000 children not in low-SES families. The incidence of moderate injury or harm 

for children in families of low SES is nearly 5 times the rate for children not in families 

of low socioeconomic status. 

Inferred harm. Children in families of low SES were more than 4 times 

more likely than those in families not of low SES to experience maltreatment sufficiently 

severe that harm could be inferred (0.9 versus 0.2 per 1,000 children, respectively). 

5.2.2	 Differences in Endangerment Standard Maltreatment Related

to Socioeconomic Status (SES) 

The two socioeconomic subgroups differed significantly in their risk of 

maltreatment under the less stringent Endangerment Standard, as Table 5–4 shows. 

Significant differences in incidence rates emerged for all Endangerment Standard 

categories of abuse and neglect and the four levels of outcome severity. 
5–15
 

 

 

Table 5–4. Differences Related to Family Socioeconomic Status in Incidence Rates per 

1,000 Children for Endangerment Standard Maltreatment in the NIS–4 (2005– 

2006)* 

Endangerment Standard 

Maltreatment Category 

Children not in Low-SES 

Families 

Children in Low-SES 

Families 

ALL MALTREATMENT 9.5 55.1 

ABUSE: 

All Abuse 3.6 12.1 

Physical Abuse 2.2 6.5 

Sexual Abuse 0.7 2.4 

Emotional Abuse 1.0 5.5 

NEGLECT: 

All Neglect 6.7 46.5 

Physical Neglect 3.1 27.0 

Emotional Neglect 4.0 23.5 

Educational Neglect† 1.0 7.1 

SEVERITY OF HARM: 

Serious 1.8 10.3 

Moderate 3.5 18.7 

Inferred 0.7 3.4 

Endangered 3.5 22.6 

* All differences are significant at p<.05. 

† Educational neglect is identical under the Harm and Endangerment Standards. It is included in both 

tables because it is in the summary categories in both standards: All Neglect and All Maltreatment. 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

Children in low-SES families were at significantly higher risk of 

Endangerment Standard maltreatment overall compared to children not in families of low 

SES. An estimated 55.1 children per 1,000 children in families of low SES experienced 

one or more categories of Endangerment Standard maltreatment, which is more than 5 

times the rate of 9.5 per 1,000 children not in families of low SES. 
5–16
 

 

 

 

 

 

The incidence rate of Endangerment Standard abuse for children in families 

of low SES is more than 3 times the rate for children not in families of low SES (12.1 

versus 3.6 per 1,000 children, respectively). 

Children in families of low SES had a significantly higher rate of 

Endangerment Standard neglect than children not in families of low SES. The estimated 

incidence rate for children in low-SES families was 46.5 children per 1,000 children, 

which is almost 7 times the rate of 6.7 per 1,000 children not in low-SES families. 

Specific Categories of Endangerment Standard Abuse 

The NIS–4 found that children in families in the lowest socioeconomic tier 

had significantly higher risk in all three categories of Endangerment Standard abuse: 

physical, sexual, and emotional. 

Physical abuse. Children in families of low SES had a significantly higher 

risk of Endangerment Standard physical abuse. Their estimated incidence rate, 6.5 per 

1,000 children, was 3 times the rate of 2.2 per 1,000 for children not in low-SES families. 

Sexual abuse. Children in families of low SES had a significantly higher 

rate of Endangerment Standard sexual abuse (2.4 children per 1,000) compared to 

children not in families of low SES (0.7 per 1,000 children). Thus, the incidence rate for 

children in families of low SES is more than 3 times the rate for children not in families 

of low SES. 

Emotional abuse. The incidence of Endangerment Standard emotional 

abuse for children in low-SES families was more than 5 times the rate for children not in 

families of low socioeconomic status (5.5 versus 1.0 per 1,000 children, respectively). 

Specific Categories of Endangerment Standard Neglect 

Differences between the socioeconomic groups were significant in all three 

categories of Endangerment Standard neglect. 
5–17
 

 

 

Physical neglect. Children in families of low SES were significantly more 

likely to experience Endangerment Standard physical neglect than children not in lowSES families. The risk of physical neglect for children in families of low SES was over 8 

times that of children not in families of low socioeconomic status (27.0 per 1,000 

children compared to 3.1 per 1,000 children not in families of low SES). 

Emotional neglect. Children in families of low SES had a significantly 

higher rate of Endangerment Standard emotional neglect, 23.5 children per 1,000, 

compared to 4.0 children per 1,000 children not in families of low SES. Children in lowSES families were more than 5 times more likely to experience emotional neglect than 

children not in families of low SES. 

Educational neglect. The subgroup differences in rates of educational 

neglect are identical to those given earlier, so information is not reiterated here. 

Severity of Outcomes from Endangerment Standard Maltreatment 

The NIS–4 revealed significant differences related to family socioeconomic 

status in the incidence of four levels of outcomes from Endangerment Standard 

maltreatment: serious harm, moderate harm, inferred harm, and endangered. 

Serious harm. An estimated 10.3 per 1,000 children in families of low SES 

experienced serious harm from Endangerment Standard maltreatment, which is more than 

5 times the rate for children not in families of low SES (1.8 children per 1,000). 

Moderate harm. Children in families of low SES experienced a 

significantly higher risk of moderate harm from Endangerment Standard maltreatment 

(18.7 versus 3.5 children per 1,000). Thus, children in families of low SES were more 

than 5 times more likely to experience moderate harm from Endangerment Standard 

maltreatment than children not in low–SES families. 

Inferred harm. The incidence of Endangerment Standard maltreatment for 

children in families of low SES was almost 5 times the rate for children not in families of 

low SES (3.4 versus 0.7 per 1,000 children, respectively). 
5–18
 

 

 

 

 

 

 

 

 

 

 

 

 

Endangered. Children in families of low SES were significantly more likely 

to be endangered, but not yet harmed, by maltreatment. The incidence of endangerment 

for children in families of low SES was 22.6 per 1,000 children, which is more than 6 

times the rate of 3.5 per 1,000 children whose families were not of low SES. 

5.3 Differences in the Incidence of Maltreatment Related to 

Family Structure and Living Arrangement 

This section presents differences in the incidence of child maltreatment 

related to the combination of family structure and parents’ living arrangement, including 

the number of parents in the household, their relationship to the child, and their marital or 

cohabitating status. 

The definition of parent follows that used by the U.S. Census Bureau, which 

includes birth parents, adoptive parents, and stepparents. Children may live with two 

parents, one parent, or neither parent. In two-parent households, parents can be both 

biologically related to the child or one or both may have another legal parental 

relationship to the child (e.g., adoptive parent, step-parent). A child may have two 

unmarried cohabiting parents, biological or with other relationships to the child. A single 

parent (of any relationship to the child) may or may not have a cohabiting partner. These 

variations in family structure and living arrangement classified children into six 

categories: (1) living with two married biological parents, (2) living with other married 

parents (not both biological but both having a legal parental relationship to the child), (3) 

living with two unmarried parents (biological or other), (4) living with one parent who 

had an unmarried partner (not the child’s parent) in the household, (5) living with one 

parent who had no partner in the household, and (6) living with no parent.67,68 

67 The incidence rate calculations used population denominators derived from the 2005 and 2006 Annual

Estimates of the Population (U.S. Census Bureau, 2008a) and the 2007 March Supplement of the Current

Population Survey (U.S. Census Bureau, 2008d). Combined information from these three sources 

indicated that, during the NIS–4 reference periods, an average of 44,799,000 children were living with

two married biological parents; 5,152,000 children were living with other married parents; 2,192,000

children were living with two unmarried parents; 2,081,000 children were living with one parent who had

an unmarried partner in the household, 16,962,000 children were living with one parent who had no

partner in the household, and 2,449,000 children were living with no parent. These groups represent 61%,

7%, 3% 3%, 23% and 3% of the general child population in the United States, respectively. 
5–19 

 

 

 

 

 

 

 

5.3.1	 Differences in the Incidence of Harm Standard Maltreatment 

Related to Family Structure and Living Arrangement 

Overall Harm Standard Maltreatment, Abuse, and Neglect 

Figure 5–1 shows the incidence rates of overall Harm Standard maltreatment, 

abuse, and neglect for children in the six conditions of family structure and living 

arrangement. 

All maltreatment. Children living with two married biological parents had 

the lowest rate of overall Harm Standard maltreatment, at 6.8 per 1,000 children. This 

rate differs significantly from the rates for all other family structure and living 

arrangement circumstances. Children living with one parent who had an unmarried 

partner in the household had the highest incidence of Harm Standard maltreatment (57.2 

per 1,000). Their rate is more than 8 times greater than the rate for children living with 

two married biological parents. 

The incidence of Harm Standard maltreatment also is significantly higher for 

children living with one parent and that parent’s unmarried partner than for children in 

three other conditions: children living with other married parents (24.4 children per 

1,000), those living with two unmarried parents (23.5 children per 1,000), and those 

living with a single parent with no partner in the household (28.4 children per 1,000). 

The risk of Harm Standard maltreatment for children whose single parent has an 

unmarried partner is more than 2 times greater than the risk for children living in these 

other living arrangements. 

(Continued from previous page.) 

68 In each category of maltreatment or level of harm, decisions about the significance of differences relied 

on the Bonferroni critical values for t. This adjusted for the multiplicity of the comparisons involved. 

Appendix D gives the details concerning the statistical tests for significance of differences in 

maltreatment incidence related to family structure and living arrangement. 
5–20
 

Figure 5–1.	 Incidence of Harm Standard Maltreatment by Family Structure and

Living Arrangement. 

Abuse. The rate of Harm Standard abuse for children living with two 

married biological parents (2.9 children per 1,000) is significantly lower than the rate for 

children living in all other conditions of family structure and living arrangement (10.2 or 

more children per 1,000). Again, the highest rate was among children living with just 

one parent and that parent’s unmarried partner (33.6 per 1,000 children). The rates in the 

highest and lowest risk groups differ by more than a factor of 11. 

The risk of Harm Standard abuse for children whose single parent has an 

unmarried partner is more than twice that of children in three other circumstances. Their 

risk is significantly higher than the risks for children living with a single parent who has 

no cohabiting partner (10.2 per 1,000 children), for children living with two unmarried 

parents (12.1 per 1,000 children), and for those who live with neither parent (15.3 per 

1,000 children). The rate of Harm Standard abuse among children whose single parent 

lives with an unmarried partner is almost twice the rate for children living with other 

married parents (33.6 versus 17.4 children per 1,000), a statistically marginal difference. 

Children living with other married parents experienced Harm Standard abuse 

at a significantly higher rate than those living with a single parent with no partner (17.4 

versus 10.2 children per 1,000). 
5–21
 

 

 

 

Neglect. The pattern of group differences is somewhat different for the 

incidence of Harm Standard neglect. Children living with just one parent, under any 

living arrangement, had significantly higher rates of Harm Standard neglect (27.0 and 

19.6 per 1,000 children) than those living with two married biological parents (4.2 per 

1,000 children). The estimated rates in the single-parent conditions are more than 4 times 

the rate among children living with their married biological parents. Also, children 

whose single parent had no partner had a significantly higher Harm Standard neglect rate 

than children living with other married parents (19.6 versus 9.3 children per 1,000). 

In addition, children living with their two married biological parents 

experienced Harm Standard neglect at a lower rate than children with other married legal 

parents, children with unmarried parents, and children living with neither parent (4.2 

versus 9.3, 12.6, and 20.4 children per 1,000, respectively), although these differences are 

statistically marginal. 

Specific Categories of Harm Standard Abuse 

Physical abuse.69 As Figure 5–2 shows, the incidence of Harm Standard 

physical abuse was significantly lower for children living with two married biological 

parents compared to children living in all other conditions. An estimated 1.9 per 1,000 

children living with two married biological parents suffered Harm Standard physical 

abuse, compared to 5.9 or more per 1,000 children in other circumstances. In addition, 

children whose single parent had an unmarried, live-in partner were at significantly 

higher risk of Harm Standard physical abuse (19.5 children per 1,000) compared to 

children in 4 other arrangements: children whose single parent had no partner in the 

home (5.9 children per 1,000), children with other married parents (9.8 children per 

1,000), children with unmarried parents (8.2 children per 1,000), and children living with 

no parent (6.8 children per 1,000). 

69 The estimate for children who lived with neither parent is less reliable, as it derives from fewer than 100

sample children. 
5–22
 

 

 

Figure 5–2.	 Incidence of Harm Standard Abuse by Family Structure and Living 

Arrangement. 

The rate of Harm Standard physical abuse was also higher for children in 

homes with other married parents than for children living with a single parent who had no 

cohabiting partner (9.8 versus 5.9 children per 1,000), a statistically marginal difference. 

Sexual abuse.70 Children living with two married biological parents were 

sexually abused at a significantly lower rate (0.5 per 1,000) than children living in all but 

one of the other conditions. The exception is children living with unmarried parents 

whose incidence rate of sexual abuse does not differ from that of children living with 

married biological parents. 

In addition, children living with a single parent who had no cohabiting 

partner had a lower sexual abuse rate than children living with other married parents and 

than children living with a single parent with a partner in the home (2.4 versus 4.3 and 

9.9 children per 1,000, respectively), both statistically marginal differences. 

70 Estimates for children living with unmarried parents and for children living with neither parent are less

reliable because each derives from fewer than 100 sample children. 
5–23
 

 

 

 

 

 

Emotional abuse.71 Only three significant differences emerged in emotional 

abuse rates. Children living with other married parents and those living with a single 

parent, whether with or without a partner, were emotionally abused at significantly higher 

rates than those living with two married biological parents (2.9 or more children per 

1,000 versus 0.8 children per 1,000, respectively). The rates differ by a factor of more 

than 3; the highest rate, for children whose single parent lived with a partner, is more than 

10 times greater than the lowest rate, for children living with two married biological 

parents. 

Specific Categories of Harm Standard Neglect 

Physical neglect.72 Figure 5–3 indicates that the rate of Harm Standard 

physical neglect was 1.8 per 1,000 for children living with two married biological 

parents, compared to rates of 6.3 per 1,000 for children living with two unmarried 

parents, 6.5 or more per 1,000 for children living with one parent, and 9.1 per 1,000 for 

children with no parent. All these differences are statistically significant. 

Emotional neglect.73 Children living with other married parents and those 

living with one parent (with or without a cohabiting partner) had significantly higher 

rates of emotional neglect than children living with two married biological parents. An 

estimated 3.9 per 1,000 children living with other married parents suffered Harm 

Standard emotional neglect, as did 10.9 per 1,000 children living with one parent with an 

unmarried partner and 4.9 per 1,000 children living with one parent without a partner, 

compared to just 0.9 per 1,000 children with two married biological parents. Compared 

to the Harm Standard emotional neglect rate for children with two married biological 

parents, the rate for children whose single parent had a cohabiting partner is 12 times 

71 Estimates are less reliable for children living with unmarried parents, those whose single parent had a

cohabiting partner, and those who lived with neither parent, as each derives from fewer than 100 sample 

children. 

72 Estimates are less reliable for children with other married parents, those whose single parent had no

partner, and those who lived with neither parent, since each relies on fewer than 100 sample children. 

73 Estimates are less reliable for children with other married parents, those living with unmarried parents,

those whose single parent had a partner, and those who lived with neither parent, since each relies on

fewer than 100 sample children. 
5–24
 

 

 

 

 

higher, the rate for children whose single parent had no partner is more than 5 times 

higher, and the rate for children with other married parents is over 4 times higher. 

Figure 5–3.	 Incidence of Harm Standard Neglect by Family Structure and Living 

Arrangement. 

Educational neglect.74 The incidence of educational neglect for children 

living with one parent without a partner was more than 6 times higher than the rate for 

children living with two married biological parents (11.9 versus 1.9 children per 1,000), a 

significant difference. 

Severity of Outcomes from Harm Standard Maltreatment 

Figure 5–4 shows significant differences in three levels of severity of harm 

attributable to Harm Standard maltreatment. 

74 Estimated rates of educational neglect and of Harm Standard emotional neglect are unreliable for the

same family structure and living arrangement conditions. 
5–25
 

Figure 5–4.	 Incidence of Outcomes from Harm Standard Maltreatment by Family

Structure and Living Arrangement. 

Serious harm. The incidence of children who suffered serious harm due to 

Harm Standard maltreatment was significantly lower for children living with two married 

biological parents (2.6 per 1,000 children) compared to children living with parents under 

all other circumstances (9.1 or more children per 1,000). 

Children living with a single parent who had a cohabiting partner had more 

than 2 times the risk of suffering serious harm compared to children living with other 

married parents (20.8 versus 9.1 per 1,000 children), a statistically marginal difference. 

Moderate harm. Children living with their married biological parents had a 

significantly lower rate of moderate harm from Harm Standard maltreatment compared to 

children in any other condition. The highest risk of moderate harm was among children 

who lived with one parent who had an unmarried partner (33.0 children per 1,000); their 

risk was 8 times higher than that of children who lived with their married biological 

parents, a considerable rate differential. Additionally, the rate of moderate harm for 

children whose single parent was cohabiting with a partner was significantly higher 

compared to the rates for children with other married parents and for children with 

unmarried parents (33.0 versus 11.1 or more children per 1,000). Children living with one 

parent with a cohabiting partner experienced moderate harm from Harm Standard 
5–26
 

 

 

 

 

 

maltreatment at a reliably higher rate than those living with one parent without a partner 

(33.0 versus 14.8 children per 1,000), a statistically marginal difference. 

Inferred harm.75 Although the rates of this outcome appear small, the 

relative differences across the subgroups are considerable and statistically reliable. 

Children living in any circumstance other than with their two married biological parents 

had significantly higher risks of inferred harm from Harm Standard maltreatment 

compared to children living with their two married biological parents. Consistent with 

the patterns for other categories of maltreatment and outcome, the highest risk was for 

children whose single parent had an unmarried partner (3.3 per 1,000). These children 

experienced maltreatment that warranted the inference they were harmed at 33 times the 

rate of children living with two married biological parents. 

Changes since the NIS–3 in the Distribution of Harm Standard 

Maltreatment Related to Family Structure 

The NIS–3 did not obtain information about marital status or the presence of 

an unmarried partner, so analyses could only assess changes in the incidence of Harm 

Standard maltreatment in relation to whether one or two parents were present in the 

household. Further, because the NIS–3 included too few sample children who lived with 

neither parent to provide reliable estimates for most maltreatment categories,76 the 

between-study analyses compared changes in maltreatment rates for two categories of 

children: those living with two parents and those living with a single parent.77 

Harm Standard maltreatment. Figure 5–5 shows significant changes since 

the NIS–3 in the overall incidence of Harm Standard maltreatment in relation to this 

binary family structure classification. Whereas incidence rates increased for children 

75 Except for children who lived with a single parent who had no partner, estimates for children in all other

conditions are less reliable because each derives from fewer than 100 sample children. 

76 NIS–3 data include fewer than 100 sample children who meet the Harm Standard requirements. 

Endangerment Standard estimates in the NIS–4 derive from fewer than 100 sample children in all but two 

categories: overall maltreatment and all abuse. 

77 The definition of “parent” here includes step-parents and adoptive parents as well as all biological

parents, regardless of their marital status. Appendix E provides the actual estimates and results of the 

statistical tests. 
5–27
 

living with one parent, they decreased for children living with two parents. For children 

living with a single parent, the rate of overall Harm Standard maltreatment increased by 

30%, abuse increased by 22%, and neglect increased by 36%. At the same time, these 

rates decreased for children living with both parents, by 39%, 42%, and 33%, 

respectively. 

Figure 5–5.	 Percent Changes since NIS–3 in Rates of Harm Standard Maltreatment, 

Abuse, and Neglect by Family Structure. 

Abuse. Figure 5–6 presents the changes since the NIS–3 in specific 

categories of Harm Standard abuse that were related to family structure. Family structure 

was significantly related to the changes in rates of Harm Standard sexual abuse and 

emotional abuse, while for physical abuse the relationship is statistically marginal. Here 

again, the figure indicates increased incidence rates for children living with one parent 

and decreased rates for those living with two parents. Rates of maltreatment for children 

with one parent increased for Harm Standard physical abuse by 14%, for sexual abuse by 

49%, and for emotional abuse by 43%. Rates in these same categories decreased for 

children living with two parents, by 24% in physical abuse, by 62% in sexual abuse, and 

by 48% in emotional abuse. 
5–28
 

 

Figure 5–6.	 Percent Changes since NIS–3 in Rates of Specific Categories of Harm 

Standard Abuse by Family Structure. 

Neglect. Figure 5–7 shows that rates of two specific categories of Harm 

Standard neglect changed since the NIS–3 in different ways for children living in 

different family structures. The relationship between family structure and the changes in 

incidence rates is significant for emotional neglect and statistically marginal for physical 

neglect. Children with single parents had a 42% higher risk of Harm Standard physical 

neglect and a 48% higher risk of emotional neglect at the time of the NIS–4 compared to 

their levels of risk during the NIS–3. Rates in these same categories decreased for 

children living with both parents, by 28% in physical neglect and by 44% in emotional 

neglect. 

Severity of outcomes from Harm Standard maltreatment. Figure 5–8 

displays the changes since the NIS–3 in the incidence of children who suffered serious 

harm, moderate harm, or inferred harm that differed significantly by family structure. 

The incidence of children living with single parents who were seriously harmed by Harm 

Standard maltreatment increased 34%, those moderately harmed increased 25%, 
5–29
 

Figure 5–7.	 Percent Changes since NIS–3 in Rates of Specific Categories of Harm 

Standard Neglect by Family Structure. 

and those who were maltreated in ways that warranted the inference of harm increased by 

65%. Opposite changes occurred for children living with both parents: the incidence of 

children seriously harmed decreased 37%, those moderately harmed decreased 33%, and 

those whose maltreatment warranted inferred harm decreased 77%. 

Figure 5–8. Percent Changes since NIS–3 in Severity of Outcomes from Harm 

Standard Maltreatment by Family Structure. 
5–30
 

 

5.3.2	 Differences in the Incidence of Endangerment Standard

Maltreatment Related to Family Structure and Living

Arrangement 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

All Maltreatment. Figure 5–9 shows the incidence rates of Endangerment 

Standard maltreatment for the different family structure and living arrangement 

subgroups. The rate of overall Endangerment Standard maltreatment for children living 

with two married biological parents (15.8 children per 1,000) is significantly lower than 

the rates for children in all other circumstances (51.5 or more children per 1,000). 

Children living with one parent whose unmarried partner was in the household had the 

highest incidence of Endangerment Standard maltreatment (136.1 children per 1,000). 

This is equivalent to more than 13 per 100 children, or more than 1 child in 8 whose 

single parent has a cohabiting partner in the general child population. Their risk of 

Endangerment Standard maltreatment is more than 8 times higher than that of children 

living with two married biological parents. 

Figure 5–9. Incidence of Endangerment Standard Maltreatment by Family Structure

and Living Arrangement. 
5–31
 

Children whose single parent cohabited with a partner had significantly 

higher rates of Endangerment Standard maltreatment compared to children living with 

other married parents, children with a single parent who had no partner in the home, and 

children who lived with neither parent. When children had a single parent living with an 

unmarried partner, their risk of experiencing Endangerment Standard maltreatment was 

more than twice their risk in these other conditions. In addition, children who lived with 

two unmarried parents had significantly higher risk of Endangerment Standard 

maltreatment compared to those who lived with other married parents. 

Abuse. Again, children living with two married biological parents had a 

significantly lower rate of this maltreatment (4.3 per 1,000 children) than those in all 

other conditions of family structure and living arrangement (15.9 or more per 1,000 

children). The highest rate again occurred for children whose single parent had a live-in 

partner (45.8 per 1,000 children), which is more than 10 times higher than the rate for 

children with married biological parents. The Endangerment Standard abuse rate for 

children living with one parent who had a partner was also significantly higher than the 

rates for children in all the other living arrangements. Moreover, children living with 

other married parents had significantly higher risk of Endangerment Standard abuse than 

children living with a single parent who had no partner. 

Neglect. The incidence of Endangerment Standard neglect was significantly 

lower for children living with two married biological parents (12.8 children per 1,000) 

compared to the risk for children living in all other family structure and living 

arrangement circumstances (34.0 children or more per 1,000). Children whose single 

parent had an unmarried partner experienced the highest risk of Endangerment Standard 

neglect (100.8 children per 1,000), which is nearly 8 times the rate in the lowest risk 

group. 

Children living with one parent with a cohabiting partner had a significantly 

higher rate of Endangerment Standard neglect than children living with other married 

parents, children living with a single parent with no partner, and children living with 

neither parent (100.8 versus 34.0, 51.7, and 48.7 children per 1,000, respectively). The 

incidence of Endangerment Standard neglect for children living with two unmarried 

parents is significantly higher than the rate for children living with other married parents 

(74.4 versus 34.0 children per 1,000). 
5–32
 

Specific Categories of Endangerment Standard Abuse 

As Figure 5–10 shows, significant differences related to family structure and 

living arrangement occurred in all specific categories of Endangerment Standard abuse. 

Figure 5–10.	 Incidence of Endangerment Standard Abuse by Family Structure and 

Living Arrangement. 

Physical abuse. The incidence of Endangerment Standard physical abuse 

was significantly lower for children living with two married biological parents (2.5 

children per 1,000) than for those living in all the other family structures and living 

arrangements (9.0 or more children per 1,000). Children living with a single parent with 

an unmarried partner had the highest incidence of physical abuse by far, more than 10 

times the lowest rate, and also significantly higher than the rates for children living with 

other married parents, with unmarried parents, with a single parent without a partner, or 

with neither parent. In addition, children living with other married parents experienced 

Endangerment Standard physical abuse at a significantly higher rate than those whose 

single parent had no live-in partner (15.4 versus 9.0 children per 1,000). 
5–33
 

 

Sexual abuse.78 Sexual abuse rates also differed significantly for children 

living with two married biological parents compared to children living in all but one of 

the other conditions. The exception is the comparison with children living with 

unmarried parents, whose rate of sexual abuse does not statistically differ from the rate 

for children with married biological parents. Only 0.7 per 1,000 children living with two 

married biological parents were sexually abused, compared to 12.1 per 1,000 children 

living with a single parent who had an unmarried partner and at least 3.4 per 1,000 

children in the other living arrangements with different rates. In addition, children whose 

single parent lived with a cohabiting partner were at significantly higher risk of 

Endangerment Standard sexual abuse than those living with two unmarried parents and 

than those whose single parent had no live-in partner (12.1 versus 3.2 and 3.4 children 

per 1,000, respectively). Children whose parent had a cohabiting partner were also 

sexually abused at a higher rate than those with other married parents (12.1 versus 5.5 

children per 1,000), a statistically marginal difference. 

Emotional abuse.79 The subgroups exhibit a similar profile in their rates of 

Endangerment Standard emotional abuse. This category of maltreatment occurred to 1.8 

per 1,000 children who were living with two married biological parents, which is 

significantly lower than the rates for children living with other married legal parents and 

for those living with just one parent under any arrangement. The rate of 15.0 per 1,000 

children living with a single parent with an unmarried partner is more than 8 times higher 

than the rate for children with two married biological parents. Children whose single 

parent had a cohabiting partner were also at significantly higher risk of emotional abuse 

than those whose single parent had no partner (15.0 versus 5.9 children per 1,000) 

Specific Categories of Endangerment Standard Neglect 

Figure 5–11 displays the statistically meaningful differences in rates of 

specific categories of Endangerment Standard neglect related to family structure and 

living arrangement. 

78 The estimate for children living with unmarried parents is less reliable because it derives from fewer than

100 sample children. 

79 The estimate for children living with unmarried parents is less reliable because it derives from fewer than

100 sample children. 
5–34
 

Figure 5–11.	 Incidence of Endangerment Standard Neglect by Family Structure and 

Living Arrangement. 

Physical neglect. The lowest incidence of Endangerment Standard physical 

neglect occurred for children living with two married biological parents (6.5 children per 

1,000), which is significantly lower than the rates for children in all other living 

arrangements. The highest rate occurred for children living with a single parent with a 

cohabiting partner (47.4 children 1,000), which is over 7 times greater than the lowest 

rate. In addition, the rates of physical neglect for children living with two unmarried 

parents and for those living with a single parent, with or without an unmarried partner, 

are significantly higher than that for children living with other married parents. 

Emotional neglect. The incidence of emotional neglect was 6.7 per 1,000 

children with two married biological parents, which is significantly lower than the rates 

for children in any other living arrangements (20.3 or more per 1,000 children). Children 

whose single parent had an unmarried partner again had the highest rate, at 68.2 per 1,000 

children, which is a factor of more than 10 times higher than the lowest rate. This rate is 

also significantly higher than the rates for children in all other conditions. Children 

whose single parent had a live-in partner also had a significantly higher rate than those 

with other married parents, those whose single parent had no partner, and those who lived 

with neither parent. Children living with two unmarried parents had the second-highest 
5–35
 

 

rate of Endangerment Standard emotional neglect (46.9 per 1,000 children), which is 

significantly higher than the rates in all conditions except that in the highest-risk group 

(i.e., children whose single parent had a live-in partner). 

Educational neglect. Rates of educational neglect are identical under the 

Harm and Endangerment Standards, so the discussion here does not reiterate those 

findings. 

Severity of Outcomes from Endangerment Standard Maltreatment 

Figure 5–12 shows the statistically meaningful differences related to the 

child’s family structure and living arrangement that emerged in the incidence of different 

outcomes attributable to Endangerment Standard maltreatment. 

Figure 5–12.	 Incidence of Outcomes from Endangerment Standard Maltreatment by 

Family Structure and Living Arrangement. 

Serious harm. The incidence of children who suffered serious harm from 

Endangerment Standard maltreatment was significantly lower among those living with 

their married biological parents (2.8 children per 1,000), compared to the incidence rates 

for children living under any other conditions (9.5 children or more per 1,000). Children 
5–36
 

 

 

living with a single parent who had a cohabiting partner were at the highest risk of 

serious harm from Endangerment Standard maltreatment (21.5 children per 1,000). 

Children with a cohabiting single parent were also at higher risk of serious harm from 

Endangerment Standard maltreatment than children with other married parents (9.5 

children per 1,000), but this difference is statistically marginal. 

Moderate harm. The incidence of children moderately harmed by 

Endangerment Standard maltreatment was significantly lower when they lived with 

married biological parents (6.0 children per 1,000) than under any other family 

arrangement (17.0 or more children per 1,000). Across these subgroups, the highest rate, 

for children whose single parent cohabited with a partner (49.3 children per 1,000) is 

more than 8 times higher than the lowest rate. Children whose single parent had a live-in 

partner were at significantly higher risk than those living with other married parents and 

than those living with unmarried parents (17.0 and 17.8 children per 1,000, respectively). 

Also, children whose single parent had a cohabiting partner had a higher rate of moderate 

harm from Endangerment Standard maltreatment than those whose single parent had no 

partner, but this difference was statistically marginal. 

Inferred harm.80 Risk of experiencing Endangerment Standard maltreatment 

that permitted the inference of harm was lower for children who lived with two married 

biological parents (0.9 children per 1,000) compared to those who lived in any other 

arrangement (5.2 or more children per 1,000). These differences are significant except 

for the comparison with children living with two unmarried parents (7.8 children per 

1,000), where the difference is statistically marginal. 

In addition, children living with a single parent who cohabited with a partner 

had a significantly higher rate of inferred harm from Endangerment Standard 

maltreatment than those with other married parents, those with a single parent with no 

partner, and those living with neither parent (5.3, 5.2 and 5.5 children per 1,000, 

respectively). 

80 The estimate for children living with unmarried parents is less reliable because it derives from fewer than 

100 sample children. 
5–37
 

 

 

Endangered. The rate of children who were endangered but not yet harmed 

by Endangerment Standard maltreatment was significantly lower for children living with 

two married biological parents compared to children living in all other family 

arrangements (6.1 versus 17.5 or more children per 1,000). The highest rate, 55.0 per 

1,000 children who lived with a single parent with partner, is over 9 times the lowest rate. 

The endangerment rate for children whose single parent had a cohabiting partner is 

significantly higher than the rate for all except those living with unmarried parents. 

Children with unmarried parents had a significantly higher rate of endangerment than 

children in all other conditions except those whose single parent had a cohabiting partner. 

Changes since the NIS–3 in the Distribution of Endangerment Standard 

Maltreatment Related to Family Structure 

Changes in Endangerment Standard maltreatment since the NIS–3 

significantly related to family structure in all summary categories of maltreatment, all 

specific categories of abuse, two categories of neglect, and four levels of outcome 

severity. 

Figure 5–13.	 Percent Changes since NIS–3 in Rates of Endangerment Standard 

Maltreatment, Abuse, and Neglect by Family Structure. 

Endangerment Standard maltreatment. As Figure 5–13 shows, the rates 

of overall maltreatment and of neglect increased substantially for children living with one 

parent (by 56% and 61%, respectively), whereas the rates for children who lived with 
5–38
 

both parents showed much smaller changes in those categories (a 15% decrease and 2% 

increase, respectively). The pattern for changes in rates of Endangerment Standard abuse 

is somewhat different, however. There, the rate for children in single-parent homes 

showed negligible change (just a 6% increase), whereas the rate for children living with 

two parents decreased substantially (by 46%). 

Abuse. Figure 5–14, which gives the percent changes in rates for specific 

abuse categories, demonstrates that the pattern of smaller changes in rates for singleparent children and large rate decreases for two-parent children carries through in all 

abuse categories. The rates for children in one-parent households increased by 11% in 

Endangerment Standard physical abuse and by 21% in sexual abuse. The rate of 

emotional abuse for single-parent children actually decreased by 17%. By contrast, the 

rates for children in two-parent homes decreased substantially in all abuse categories— 

physical abuse decreased by 34%, sexual abuse decreased by 60%, and emotional abuse 

decreased by 55%. 

Figure 5–14.	 Percent Changes since NIS–3 in Rates of Specific Categories of 

Endangerment Standard Abuse by Family Structure. 

Neglect. Figure 5–15 shows that the overall neglect pattern, whereby singleparent children showed a large rate increase and two-parent children showed a lesser 

increase, only applied to emotional neglect. The rate of Endangerment Standard 

emotional neglect increased 200% for single-parent children, whereas it increased 58% 

for two-parent children. The relationship between family structure and changes since 

NIS–3 in rates of physical neglect was less dramatic, although still statistically 
5–39
 

significant. Whereas the rate increased by 21% for single-parent children, it decreased by 

18% for children living with two parents. 

Figure 5–15.	 Percent Changes since NIS–3 in Rates of Specific Categories of 

Endangerment Standard Neglect by Family Structure. 

Severity of outcomes from Endangerment Standard maltreatment. As 

Figure 5–16 shows, the changes in the incidence of children with serious harm, moderate 

harm, and inferred harm from Endangerment Standard maltreatment, and of children who 

were endangered by their maltreatment differed significantly by family structure. In all 

cases, the rates for children living with one parent increased. In contrast, the rates for 

children living with two parents decreased in three outcome categories (serious, 

moderate, and inferred harm). Although the incidence of endangered two-parent children 

increased, this rate increase was much smaller than the rate increase for single-parent 

children in this outcome category (6% versus 50%, respectively). 

5.4 Differences in the Incidence of Maltreatment Related to 

Grandparents as Caregivers 

This section describes the relationship between whether or not children had 

grandparents as caregivers in their household and their incidence of abuse and neglect. 

The analyses classified children on the basis of whether the information identified a 

grandparent as a caregiver for the children in the household. The NIS–4 only identified a 

grandparent as a child’s caregiver under three conditions: when the grandparent was the 
5–40
 

 

 

 

 

 

 

 

child’s primary caregiver, when the primary caregiver did not have a spouse or partner 

and the grandparent was the secondary caregiver, and when the grandparent was a 

caregiver and maltreated the child.81 Because the NIS–4 did not exhaustively identify all 

cases where a maltreated child had a grandparent as caregiver, these findings provide 

minimum estimates of the rates of child maltreatment in grandparent-caregiver 

circumstances. Also note that grandparents who are caregivers in these analyses are not 

necessarily the primary caregivers in the households. 

Figure 5–16.	 Percent Changes since NIS–3 in Severity of Outcomes from 

Endangerment Standard Maltreatment by Family Structure. 

5.4.1	 Differences in Harm Standard Maltreatment Related to 

Grandparents as Caregivers 

Table 5–5 shows that two categories of Harm Standard maltreatment— 

overall abuse and physical abuse—revealed statistically meaningful differences related to 

whether or not the child had grandparents as caregivers in the household.82 

81 Incidence rate calculations used the following population denominators in thousands: 5,877 children with

an identified grandparent as a caregiver and 67,759 children without an identified grandparent (U.S.

Census Bureau, 2006). 

82Appendix D gives the details concerning the statistical tests for the differences in incidence of 

maltreatment that relate to whether a grandparent was a caregiver. 
5–41
 

 

 

Harm Standard abuse. The incidence of overall Harm Standard abuse for 

children who had a grandparent caregiver was lower than the rate for children with no 

identified grandparent caregiver (6.1 versus 7.6 children per 1,000), a statistically 

marginal difference. Children with no identified grandparent caregiver were 1.2 times 

more likely to experience Harm Standard abuse than children who had a grandparent 

caregiver. 

Table 5–5. Differences in Incidence Rates per 1,000 Children for Harm Standard 

Maltreatment in the NIS–4 (2005–2006) Related to Grandparents as Caregivers 

Harm Standard 

Maltreatment Category 

Children With 

Grandparents as 

Caregivers 

Children Without 

Grandparents as 

Caregivers 

Significance of 

Difference 

ABUSE: 

All Abuse 

Physical Abuse 

6.1 

3.0 

7.6 

4.5 

m 

* 

* The difference is significant at p<.05. 

m The difference is statistically marginal (i.e., .10>p>.05). 

Physical abuse. Children whose grandparent cared for them were at 

significantly lower risk of Harm Standard physical abuse compared to children with no 

identified grandparent caregiver. An estimated 3.0 children per 1,000 who had a 

grandparent caregiver experienced Harm Standard physical abuse, whereas the rate was 

4.5 per 1,000 children with no identified grandparent caregiver. Thus, the risk of Harm 

Standard physical abuse for children with no identified grandparent caregiver was 1.5 

times the risk for children cared for by a grandparent. 

5.4.2	 Differences in Endangerment Standard Maltreatment Related

to Grandparents as Caregivers 

Table 5–6 shows the relationship between incidence rates for Endangerment 

Standard maltreatment and the presence of a grandparent caregiver. Only three 

statistically meaningful differences emerged: for physical abuse and for inferred and 

endangered outcomes resulting from Endangerment Standard maltreatment. 
5–42
 

 

 

 

 

 

 

 

 

Table 5–6. Differences in Incidence Rates per 1,000 Children for Endangerment Standard 

Maltreatment in the NIS–4 (2005–2006) Related to Grandparents as Caregivers 

Endangerment Standard 

Maltreatment Category 

Children With 

Grandparents as 

Caregivers 

Children Without 

Grandparents as 

Caregivers 

Significance of 

Difference 

ABUSE: 

Physical Abuse 

SEVERITY OF HARM: 

Inferred 

Endangered 

5.2 

2.3‡ 

12.2 

6.6 

3.2 

15.8 

m 

m 

* 

* The difference is significant at p<.05. 

m The difference is statistically marginal (i.e., .10>p>.05). 

‡ This estimate is less reliable because it derives from fewer than 100 sample children. 

Physical abuse. Children whose grandparent cared for them had a lower risk 

of Endangerment Standard physical abuse; this is a statistically marginal difference. An 

estimated 5.2 children per 1,000 with a grandparent caregiver experienced Endangerment 

Standard physical abuse compared to 6.6 per 1,000 for children with no identified 

grandparent caregiver. Children with no identified grandparent caregiver were 1.3 times 

as likely to experience Endangerment Standard physical abuse. 

Inferred harm. Children with a grandparent caregiver had a lower risk of 

inferred harm from Endangerment Standard maltreatment than children without a 

grandparent caregiver (2.3 versus 3.2 children per 1,000), a statistically marginal 

difference. Thus, children without a grandparent caregiver experienced maltreatment that 

warranted the inference they were harmed at 1.4 times the rate of children who lived with 

a grandparent caregiver.83 

Endangerment. The incidence of children who were endangered, but not yet 

harmed, by maltreatment was significantly lower for those who had a grandparent 

caregiver, at 12.2 children per 1,000, compared to children with no identified grandparent 

caregiver, at 15.8 children per 1,000. Thus, children with no identified grandparent 

83 The estimate for children with a grandparent caregiver for Endangerment Standard inferred harm is less

reliable because there are fewer than 100 sample children. 
5–43
 

 

 

 

 

 

 

 

 

 

 

 

caregiver were 1.3 times more likely to experience endangerment compared with children 

with a grandparent caregiver. 

5.5 Family Size Differences in the Incidence of Maltreatment 

Analyses examining the relationship between family size84 and the incidence 

of child abuse and neglect categorized children into one of four groups on the basis of the 

number of children in their family: those in families where they were the only child, those 

in families with two children, three children, and four or more children.85,86 

5.5.1 Family Size Differences in Harm Standard Maltreatment 

The incidence of a few categories of Harm Standard maltreatment varied 

across the family-size groups. Figure 5–17 graphs these categories, showing that they 

have a consistent pattern: incidence rates are higher for children in the largest families, 

intermediate for “only” children, and lowest for children in families with two or three 

children. 

Harm Standard Maltreatment Categories 

Overall Harm Standard maltreatment. An estimated 21.2 children in 

households with four or more children suffered some form of Harm Standard 

maltreatment, which is equivalent to 2.1 children per 100, or 1 in 48 children in these 

larger families. This, the highest rate, is 1.8 times the lowest rate (11.9 per 1,000 children 

84 As in previous NIS reports, “family size” reflects the number of children in the household rather than the

number of children within separate family units in a household. 

85 Computations of incidence rates used the following population denominators, reflecting the number (in

thousands) of children in the general population: 16,791 children in one-child households, 28,919 children 

in two-child households, 17,413 children in three-child households, 10,511 children in four-child 

households (U.S. Census Bureau, 2008a, 2008b, 2008c). 

86 In each category of maltreatment or level of harm, decisions about the significance of differences relied 

on the Bonferroni critical values for t. This adjusted for the multiplicity of the comparisons involved. 

Appendix D gives the details concerning the statistical tests for significance of family size differences. 
5–44
 

 

 

 

in households with two children), a significant difference. In addition, the incidence rate 

for “only” children (17.9 per 1,000 children) was 1.5 times the rate for children in 

households with two children, a statistically marginal difference. 

Neglect. The incidence of overall Harm Standard neglect is significantly 

higher among children living in households with four or more children compared to those 

in households with two children. The rate was 13.8 per 1,000 children in the larger 

households, which is more than twice the rate of 6.4 per 1,000 children in two-child 

households. 

Physical abuse. The rate of physical abuse in the largest families (5.0 per 

1,000 children) is higher than the rate in two-child families (3.4 per 1,000 children), a 

statistically marginal difference. 

Physical neglect. Children in households with four or more children 

suffered physical neglect at a higher rate than those in households with three children (5.9 

versus 2.6 children per 1,000, respectively), a difference that is statistically marginal. 

Figure 5–17. Incidence of Harm Standard Maltreatment by Family Size. 
5–45
 

 

 

Severity of Outcomes from Harm Standard Maltreatment 

The incidence of children who suffered serious harm or moderate harm from 

Harm Standard maltreatment differed depending on the number of children in their 

households, as Figure 5–18 shows. 

Figure 5–18.	 Severity of Outcomes from Harm Standard Maltreatment by Family

Size. 

Serious harm. Children in the largest households (four or more children) 

had a greater risk of suffering serious harm as a result of their Harm Standard 

maltreatment than children in households with just two children. An estimated 8.4 per 

1,000 children in the largest families were seriously harmed, which is nearly 1.8 times the 

rate for children in families with two children, where an estimated 4.8 children per 1,000 

experienced serious harm from Harm Standard maltreatment. This difference is 

statistically marginal. 

Moderate harm. An estimated 9.4 children per 1,000 “only” children had 

moderate injuries as a result of their Harm Standard maltreatment, which is 1.5 times the 

rate of children who had moderate injuries among those with in two-child families (6.2 
5–46
 

 

 

 

 

per 1,000). Also, the rate of moderate harm in the largest families (11.7 per 1,000 

children) is almost twice the rate in families with two children (6.2 per 1,000). Both 

differences are statistically marginal. 

Changes since the NIS–3 in the Distribution of Harm Standard

Maltreatment Related to Family Size 

Changes in maltreatment rates since the NIS–3 related to family size only for 

the incidence of children with inferred harm from Harm Standard maltreatment.87 Figure 

5–19 displays this finding. 

Inferred harm. The incidence of children with inferred harm as a result of 

their Harm Standard maltreatment decreased differentially across the three family size 

groups in the graph, eradicating their differences from the earlier study. The decline was 

greatest among children living in the largest households, where the rate of inferred harm 

decreased by 82% (from 6.0 children per 1,000 in the NIS–3 to 1.1 child per 1,000 in the 

NIS–4). Declines in the other subgroups, although noteworthy, were less dramatic. 

Among “only” children, the incidence of inferred harm declined by 52% (from 2.5 to 1.1 

children per 1,000), and among children in households with two to three children, the rate 

declined by 47% (from 1.5 to 0.8 children per 1,000). 

5.5.2	 Family Size Differences in Endangerment Standard 

Maltreatment 

Endangerment Standard incidence rates in several categories of maltreatment 

and levels of outcome severity differed significantly by family size. Specifically, 

significant family size differences emerged in the incidence of overall Endangerment 

Standard maltreatment, the main category of neglect, physical neglect, emotional neglect, 

moderate harm, inferred harm, and endangerment. Statistically marginal differences 

87 Analyses of changes since the NIS–3 examined the three family size groups used in that earlier study:

one child, 2 to 3 children, and 4 or more children. 
5–47
 

Figure 5–19.	 Changes since NIS–3 in the Incidence of Inferred Harm from Harm 

Standard Maltreatment Related to Family Size. 

related to family size occurred in the incidence of overall abuse, physical abuse, 

emotional abuse, and serious harm. 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

Chapter 3 indicated that an estimated 39.5 children per 1,000 nationwide 

experienced some form of Endangerment Standard maltreatment. Significant differences 

among the incidence rates for children living in families of different sizes qualify that 

general result. Figure 5–20 shows that the incidence is much higher for children in the 

largest families and that rates are lower for children in the other family-size groups. 

Overall Endangerment Standard maltreatment. Children in families with 

four or more children have a significantly higher rate of overall Endangerment Standard 

maltreatment compared to children in all smaller family groups (62.9 versus 38.2 or 

fewer children per 1,000). The rate of Endangerment Standard maltreatment for children 

in households with four or more children is 2.3 times the rate for children in families with 
5–48
 

two children, 1.7 times the rate for “only” children, and 1.6 times the rate for children in 

three–child households. The difference in the incidence rates for children in two-child 

versus three-child households is statistically marginal. 

Figure 5–20.	 Incidence of Endangerment Standard Overall Maltreatment, Abuse, and 

Neglect by Family Size. 

Abuse. Children in families with four or more children had a higher rate of 

Endangerment Standard abuse compared to those in families with two children. The 

incidence rate for children in families with four or more children is 1.5 times the rate for 

children in families with two children (13.9 versus 9.4 children per 1,000). This 

difference is statistically marginal. 

Neglect. In contrast to the small and statistically marginal family-size 

differences in rates of Endangerment Standard abuse, the differences in neglect rates are 

substantial and significant. Children in families with four or more children had an 

incidence rate of 52.2 per 1,000 children, which is significantly higher than the rate of 

neglect found among children in all smaller families. Children in the largest families 

have an incidence rate of neglect that is almost 2.7 times the lowest rate of neglect, an 

estimated 19.6 children in two-child families. The difference in rates of Endangerment 
5–49
 

 

Standard neglect for children in three-child families and those in two–child families is 

also significant. 

Specific Categories of Endangerment Standard Abuse and Neglect 

The incidence rates in four specific categories of Endangerment Standard 

maltreatment varied significantly or marginally in relation to family size. Figure 5–21 

displays these findings. 

Figure 5–21.	 Incidence of Specific Categories of Endangerment Standard 

Maltreatment by Family Size. 

Physical abuse. The pattern of family size differences observed above in 

rates of overall Endangerment Standard abuse emerged in the specific category of 

physical abuse. Children in larger families had a significantly higher rate of 

Endangerment Standard physical abuse compared to those in families with two children 

(7.8 versus 5.0 per 1,000 children). Children in families with four or more children had a 

more than 1.5 times higher rate of physical abuse than those in two-child families. 
5–50
 

 

Emotional abuse. The incidence of Endangerment Standard emotional 

abuse among children in families with four or more children was significantly higher than 

among children who were the only child. Children in the larger families had twice the 

rate of emotional abuse observed for “only” children (5.8 versus 2.8 per 1,000 children). 

Physical neglect. The rate of Endangerment Standard physical neglect was 

31.1 per 1,000 children in families with four or more children, which is 2.3 times the rate 

for “only” children (13.3 children per 1,000), 3.1 times the rate for children in families 

with two children (10.0 children per 1,000), and 2.0 times the rate for those in families 

with three children (15.2 children per 1,000). All these differences are statistically 

significant. In addition, children in families with three children had a higher rate than 

those in two-child families, a statistically marginal difference. 

Emotional neglect. The rate of Endangerment Standard emotional neglect 

was highest for children in the largest families (27.4 children per 1,000). This rate differs 

significantly from the rates for children in families with one child (13.9 children per 

1,000) and families with two children (10.9 children per 1,000), and differs marginally 

from the rate for children in three-child families (17.7 children per 1,000). The rate of 

emotional neglect among children in the largest families is 2.0 times greater than the rate 

for “only” children, 2.5 times greater than the rate for children in two-child families, and 

1.5 times greater than the rate for children in three-child families. In addition, the midsize family groups had significantly different rates of Endangerment Standard emotional 

neglect: children in three-child families had 1.6 times the rate of emotional neglect 

compared to children in two-child families. 

Severity of Outcomes from Endangerment Standard Maltreatment 

The incidence of children who suffered moderate harm, inferred harm, and 

endangerment from Endangerment Standard maltreatment differed significantly 

depending on the number of children in their households. Differences in relation to the 

incidence of serious harm are statistically marginal. Figure 5–22 graphs these patterns. 

Serious harm. The incidence of children who suffered serious harm from 

Endangerment Standard maltreatment was higher in the largest families compared to the 
5–51
 

incidence of seriously harmed children in families with two children (8.8 versus 5.0 

children per 1,000). This is a statistically marginal difference. 

Figure 5–22.	 Severity of Outcomes from Endangerment Standard Maltreatment by

Family Size. 

Moderate harm. The rates of children moderately harmed by abuse or 

neglect were higher in families with four or more children (17.9 per 1,000 children) and 

in families with one child (13.8 per 1,000 children) than in families with two children 

(9.3 per 1,000 children). Compared to children in two-child households, those in the 

largest families had 1.9 times the incidence of moderate harm from their maltreatment (a 

significant difference) and “only” children had 1.3 times the rate of moderate harm (a 

statistically marginal difference). 

Inferred harm. The incidence of children with inferred harm as a result of 

Endangerment Standard maltreatment was significantly greater in large families 

compared to the incidence in families with two children. The estimated rate of 4.7 per 

1,000 children in families with four or more children is more than twice the rate of 2.3 

per 1,000 children in two-child families. 
5–52
 

 

 

 

 

 

 

 

 

 

5.6 Differences in the Incidence of Maltreatment Related to 

Metropolitan Status (Metrostatus) of County of Residence 

Endangered. The estimated incidence of children who were endangered, but 

not yet harmed, by abuse or neglect was significantly higher among children in the 

largest families compared to those in families with three or fewer children. The 

incidence of endangered children in the largest families (31.5 children per 1,000) is 2.6 

times the rate among “only” children (12.0 children per 1,000), 3.0 times that in families 

with two children (10.5 children per 1,000), and almost 2.0 times the rate in families with 

three children (16.1 children per 1,000). Moreover, children in the mid-size families also 

had significantly different rates: the incidence of children endangered by their 

maltreatment in three-child families is more than 1.5 times the incidence of endangered 

children in two-child families. 

Changes since the NIS–3 in the Distribution of Endangerment Standard

Maltreatment Related to Family Size 

Changes since the NIS–3 in the incidence of Endangerment Standard 

maltreatment did not differ by family size. 

The findings in this section apply a three-way classification of the 

metrostatus of children’s county of residence: large (major) urban counties, other urban 

(including suburban) counties, and rural counties.88 

Although the NIS–3 used a similar classification, the Office of Management 

and Budget (OMB) recently revised metrostatus definitions. These definitional changes, 

along with updated population data from Census 2000, reclassified a number of counties 

in the United States.89 The NIS–4 analyses of metrostatus differences in maltreatment 

88 Computations of incidence rates used the following population denominators, reflecting the number of

children (in thousands) in the general population: 40,161 in major urban counties, 21,768 in urban

counties and 11,706 in rural counties. (U.S. Census Bureau, 2008a; U.S. Department of Agriculture,

Economic Research Service, 2003, 2004). 

89 In 2000, OMB published new standards for defining metropolitan areas. After applying these new

standards to Census 2000 data, OMB announced the new area definitions for U.S. counties (U.S. 

(Footnote continues on next page.) 
5–53
 

5.6.1	 Differences in Harm Standard Maltreatment Related to 

Metropolitan Status (Metrostatus) of County of Residence 

 

 

 

 

 

 

 

 

 

 

 

rates used these revised definitions and county classifications. However, the analyses 

regarding changes in metrostatus since the NIS–3 used the earlier metrostatus definitions. 

Significant and marginal differences related to county metrostatus emerged in 

several categories of Harm Standard maltreatment.90 As detailed below, incidence rates 

were consistently higher in rural counties. 

Harm Standard Abuse 

Figure 5–23 displays the incidence rates for Harm Standard abuse by the 

metrostatus of the child’s county of residence. 

Overall abuse. The incidence of overall Harm Standard abuse in rural 

counties was 1.7 times the rate in major urban counties (10.8 versus 6.4 children per 

1,000), a statistically significant difference. 

Sexual abuse. The rate of Harm Standard sexual abuse in rural counties (2.8 

per 1,000 children) was twice the rate in urban counties (1.4 children per 1,000), a 

difference that is significant. The rural rate is also 1.6 times the sexual abuse rate in 

major urban areas (1.8 children per 1,000), a difference that is statistically marginal. 

(Continued from previous page.)

Department of Agriculture, Economic Research Service, 2003). The new system defines metropolitan

areas for all urbanized areas regardless of total area population and it includes outlying counties if they

meet a commuting threshold of 25%, with no additional requirement. This affected the NIS classification 

of urban versus rural. In addition, the Census Bureau, using updated population data, modified the RuralUrban Continuum Codes, which distinguished among counties based on population size (Department of

Agriculture, Economic Research Service, 2004). This affected the NIS–4 classification of major urban 

versus urban, the former being counties in the top tier of this system (i.e., those in metro areas with

populations of 1 million or more). 

90 In each category of maltreatment or harm, decisions about the significance of differences relied on the

Bonferroni critical values for t. This adjusted for the multiplicity of the comparisons involved. Appendix 

D gives the details concerning the statistical tests for significance of metrostatus differences. 
5–54
 

 

Figure 5–23. Incidence of Harm Standard Abuse by County Metrostatus 

Emotional abuse. The pattern of significantly higher maltreatment rates for 

children in rural areas also applies to emotional abuse. The risk of emotional abuse for 

children in rural counties was 2.6 times that in major urban counties (3.4 versus 1.3 

children per 1,000). 

Harm Standard Neglect 

Only the rate of emotional neglect differed by county metrostatus and this 

difference was statistically marginal. Figure 5–24 displays the pattern, which conforms 

to the differences in other categories. 

The incidence of emotional neglect among children living in rural counties 

(4.7 children per 1,000) is higher than for children living in major urban counties (1.8 

children per 1,000), a statistically marginal difference. Thus, the risk of Harm Standard 

emotional neglect for children in rural counties was 2.6 times that of children in major 

urban counties. 
5–55
 

 

 

 

Figure 5–24.	 Incidence of Harm Standard Neglect and of Serious Harm from Harm

Standard Maltreatment by County Metrostatus 

Severity of Outcomes from Harm Standard Maltreatment 

Serious harm. Figure 5–24 also shows that the incidence of children who 

were seriously harmed by Harm Standard maltreatment in rural counties is 2.2 times the 

incidence in major urban counties (11.5 versus 5.3 children per 1,000). This difference is 

statistically marginal. 

Changes since the NIS–3 in the Distribution of Harm Standard

Maltreatment Related to County Metrostatus 

None of the changes since the NIS–3 in the incidence of Harm Standard 

maltreatment categories or outcomes differed by county metrostatus. 
5–56
 

 

5.6.2	 Differences in Endangerment Standard Maltreatment Related

to Metropolitan Status (Metrostatus) of County of Residence 

Children in rural counties had higher incidence rates in all categories of 

Endangerment Standard maltreatment. In nearly every category of maltreatment and 

level of severity, children living in rural counties had higher rates than those in major 

urban counties. Also, in four maltreatment categories, children in rural counties had 

higher incidence rates than those in urban counties. Across all maltreatment categories 

and levels of outcome severity, the incidence of Endangerment Standard maltreatment in 

major urban counties did not differ from the incidence in urban counties. 

Overall Endangerment Standard Maltreatment, Abuse, and Neglect 

The rate of Endangerment Standard maltreatment overall was significantly 

higher in rural counties than in major urban areas, with children in rural counties 2.2 

times as likely to experience Endangerment Standard maltreatment as children residing in 

major urban counties (68.1 versus 31.3 children per 1,000). Figure 5–25 shows this 

consistent pattern. The difference in incidence between the rural areas and (nonmajor) 

urban areas (where the rate was 39.1 children per 1,000) is statistically marginal. 

Figure 5–25. Incidence of Endangerment Standard Maltreatment by County 

Metrostatus 
5–57
 

 

The incidence of Endangerment Standard abuse among rural children is 1.7 

times the incidence among children in major urban areas. This difference (16.5 versus 

9.5 per 1,000 children) is statistically significant. 

Endangerment Standard neglect revealed metrostatus differences similar to 

those observed for Endangerment Standard maltreatment overall, with a rural rate of 57.4 

children per 1,000, an urban rate of 30.0 children per 1,000, and a major urban rate of 

23.1 children per 1,000. Children in rural counties were 2.5 times more likely to be 

neglected than children in major urban counties, a significant difference, and they were 

1.9 times as likely as children in urban counties, a statistically marginal difference. 

Specific Categories of Endangerment Standard Abuse 

The same general pattern of higher incidence rates in rural counties is evident 

in Figure 5–26, which graphs the incidence of specific categories of Endangerment 

Standard abuse by county metrostatus. 

Figure 5–26.	 Incidence of Specific Categories of Endangerment Standard Abuse by 

County Metrostatus. 

Physical abuse. A statistically marginal difference emerged between the 

physical abuse rate for children in rural counties (8.5 children per 1,000) and the rate for 

children in major urban counties (5.6 children per 1,000). Children living in rural areas 
5–58
 

 

were 1.5 times more likely to be physically abused than children living in the major 

metropolitan areas. 

Sexual abuse. The differences between the rate of sexual abuse in rural 

areas and the rates in major urban and urban areas are statistically marginal. Children in 

rural counties were about 1.5 times more likely to be sexually abused than children living 

in the large metropolitan areas or in urban areas. 

Emotional abuse. The incidence of emotional abuse in rural counties was 

significantly higher, at 6.9 children per 1,000, than the rate in major urban counties, at 3.0 

children per 1,000. Thus, the children in rural counties were 2.3 times as likely to be 

emotionally abused as the children in major metropolitan areas. 

Specific Categories of Endangerment Standard Neglect 

Figure 5–27 depicts the statistically meaningful differences in specific 

categories of Endangerment Standard neglect related to county metrostatus. 

Figure 5–27. Incidence of Specific Categories of Endangerment Standard Neglect by 

County Metrostatus 
5–59
 

 

Physical neglect. Children in rural counties were 2.8 times more likely to be 

physically neglected than children in major urban counties and 2.2 times more likely than 

urban children. Both differences are statistically significant. 

Emotional neglect. Children who live in rural counties are also at 

significantly higher risk of Endangerment Standard emotional neglect compared to 

children living in major urban counties. The emotional neglect rate of 27.9 per 1,000 

rural children is 2.3 times the rate of 11.9 per 1,000 children living in major metropolitan 

counties. 

Severity of Outcomes from Endangerment Standard Maltreatment 

Figure 5–28 shows the differences in incidence rates for outcomes from 

Endangerment Standard maltreatment. 

Figure 5–28.	 Outcomes from Endangerment Standard Maltreatment by County

Metrostatus 

Serious harm. The incidence of children who were seriously harmed by 

Endangerment Standard maltreatment is higher in rural counties compared to major urban 

counties. In rural counties, children were 2.1 times as likely to suffer serious harm from 

maltreatment compared to children in major urban counties (11.8 versus 5.6 children per 

1,000). This difference is statistically marginal. 
5–60
 

 

 

Moderate harm. Children residing in rural counties had a 2.7 times greater 

rate of moderate harm from maltreatment compared to children in major urban counties 

(27.9 versus 10.4 children per 1,000), a significant difference. 

Inferred harm. The incidence of children who experienced Endangerment 

Standard maltreatment sufficiently severe to permit the inference that they were harmed 

was significantly higher among children in rural areas than among those in major urban 

counties. An estimated 4.7 children per 1,000 living in rural counties experienced 

maltreatment that allowed inferred harm, which is twice the rate of 2.4 per 1,000 children 

living in large urban counties. 

Endangered. The estimated incidence of children who had been 

endangered, but not yet harmed, by abuse and neglect was significantly higher for 

children living in rural areas compared to those living in large metropolitan areas. The 

rate of endangered rural children (23.8 per 1,000) was 1.8 times the rate for major urban 

area children (12.9 per 1,000). 

No significant differences in severity of maltreatment outcomes occurred 

between children in rural and (nonmajor) urban counties or between children in major 

urban counties and other urban counties. 

Changes since the NIS–3 in the Distribution of Endangerment Standard 

Maltreatment Related to County Metrostatus 

Similar to the findings for the Harm Standard, no significant or marginal 

differences emerged in the analyses of changes in the rates of Endangerment Standard 

maltreatment by county metrostatus. 
 

 

 

 

 

6. PERPETRATOR CHARACTERISTICS
 

This chapter examines perpetrators of Harm Standard maltreatment. The 

analyses classify children who experienced different categories of Harm Standard 

maltreatment and different levels of harm according to the perpetrator’s relationship to 

them and by the perpetrator’s age and sex, by the child’s race, and by whether alcohol 

use, drug use, or mental illness were factors in the maltreatment.90 

6.1 Perpetrators of Maltreatment 

In the process of deciding whether children qualified as countable in the 

NIS–4, evaluative coders identified the perpetrator(s) of every alleged form of 

maltreatment and determined that at least one person who was responsible for the 

maltreatment met the perpetrator requirement for that form of maltreatment under the 

Harm Standard. The perpetrator of alleged abuse had to be an adult in charge of the 

child’s care (such as a parent, adult baby-sitter, etc.) or, if the abuser did not meet this 

requirement, then a parent or caregiver had to permit the abuse for the child to be 

countable as abused under the Harm Standard. Qualifying perpetrators included the 

child’s biological parent, foster parent, step-parent, or adoptive parent, another person 

with legal custody of the child or someone with primary responsibility for the care of the 

child at the time of his or her maltreatment. The perpetrator of alleged neglect had to be 

a parent or guardian for the child to be countable as neglected under the Harm Standard. 

Several special features of these analyses and tables warrant discussion. 

First, the tables only classified a parent as the perpetrator if she or he committed the 

maltreatment directly. When a parent permitted someone else to maltreat the child, that 

parent was not considered to be the perpetrator for purposes of these analyses.91 

90 Too many children had missing information about their perpetrator’s employment to support analyses of

that characteristic. Perpetrator employment information was missing for 49% of all children with Harm

Standard maltreatment, 51% of those who were abused, and 46% of those who were neglected. 

91 Although, as Chapter 2 described, children were countable on the basis of a parent or caregiver

permitting maltreatment in certain categories. 

6-1
 
 

Second, because multiple persons sometimes maltreated a child, the tables 

here classify the perpetrator’s relationship according to a hierarchy. When a child 

suffered multiple maltreatment events in a specific maltreatment category with different 

levels of resulting harm, then the perpetrator was the person whose abuse or neglect 

caused the most severe outcome. For example, if a physically neglected child was both 

seriously harmed by inadequate supervision and fatally harmed by delay of medical care, 

then only the person responsible for the fatal result (i.e., the delay of medical care) was 

considered to be the perpetrator of the physical neglect. 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 perpetrator 

in the “all abuse” category was the abuser who caused the more serious harm. Even after 

applying this strategy to winnow down the number of perpetrators, some children still 

had multiple perpetrators. The analyses here identified a single perpetrator from the set 

by selecting the perpetrator who was most closely related to the child. The definition of 

“most closely related perpetrator” followed the hierarchy given by the ordering of 

perpetrator categories in Table 6–1. 

Third, because some types of perpetrators in the listing on the left-side of 

Table 6–1 maltreated only small percentages of the children, that hierarchy was 

simplified by collapsing it into the three categories shown to the right of the brackets. 

Fourth, as in earlier chapters, all findings continue to use the child as the unit 

of measurement. This was necessary because the NIS sample design and weighting 

strategies, which are fundamental to providing national-level estimates, are all predicated 

on the child as the unit of analysis. (In order to provide estimates of perpetrators, a 

different approach to sample design and statistical weighting would be required.) Thus, 

all NIS findings concerning perpetrators are couched in terms of the child, as in “the 

percentage of children maltreated by perpetrators who....” 

Fifth, this chapter merely describes the perpetrators of Harm Standard 

maltreatment in the NIS–4. Perpetrator analyses of NIS data are very complex and 

resource intensive, so the chapter does not provide tabulations of Endangerment Standard 

perpetrators or assessments of changes since the NIS–3 in the characteristics of Harm 

Standard perpetrators. 

6-2
 
 

Table 6–1. Categorization of Perpetrators of Child Maltreatment 

Perpetrator Category 

Percentage of Children with Closest-Related 

Perpetrator of Most Severe, Countable

Maltreatment 

In-home biological parent 77.5% 

Out-of-home biological parent 3.3% 

Biological

parents

80.8% 

In-home step-parent 3.2% 

Other in-home nonbiological parent

(foster, adoptive, etc.) 

6.7% 

Other out-of-home nonbiological

parent 

0.1% 

Parent’s boyfriend or girlfriend 2.4% 

Nonbiological

parents and

parents’ partners

12.4% 

Other family members 3.6% 

Other unrelated adults 3.0% 

Others 0.2% 

Others 

6.8% 

N = 1,256,600 

6.2 Perpetrator’s Relationship to the Child 

Table 6–1 lists the hierarchy of relationships that classified perpetrators for 

this chapter and shows the percentages of children by the most closely related perpetrator 

of their Harm Standard maltreatment. The large majority of countable children (77.5%) 

were maltreated by their in-home, biological parent(s), while in-home step-parents and 

other nonbiological parents (such as adoptive or foster parents), make up the next largest 

perpetrator categories (3.2% and 6.7%, respectively). Only small percentages of children 

were maltreated by an out-of-home biological parent (3.3%), by out-of-home 

nonbiological parent (0.1%), or by their parent’s boyfriend or girlfriend (2.4%). Other 

family members or relatives were the most closely related perpetrators of maltreatment 

for 3.6% of the countable children. The next-to-last category of perpetrators in this 

6-3
 
 

 

 

 

 

 

 

 

hierarchy comprises other adults known to be unrelated to the child, accounting for 

another 3.0% of the children. Other individuals (who may or may not have been adults) 

make up the last category, which represents the most closely related perpetrator for only 

0.2% of the Harm Standard children. 

Because of the small numbers of children in the database whose most closely 

related perpetrators were persons other than their biological parents, the perpetrator 

categories described above were further consolidated into 3 major groupings for the 

analyses here, as shown by the brackets in Table 6–1:92 

•	 Biological parent(s): includes both in-home and out-of-home 

biological parents; 

•	 Nonbiological parents or parents’ partners: includes step-parents, 

and other nonbiological parents, such as foster parents, 

separated/divorced spouses of parents not biologically related to the 

child, and parents’ boyfriends or girlfriends (partners); 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 relation to the child was unclear, persons who

were clearly not adults including relatives of the child, and others 

whose identity was unknown). 

6.2.1	 Perpetrator’s Relationship to the Child for Different

Maltreatment Categories 

The first two columns in Table 6–2 show the most closely related perpetrator 

for children with each category of maltreatment. The bottom-most section in this table 

corresponds to the bracketed categories shown in Table 6–1, again showing that 

biological parents were the perpetrators for the majority of children (81%) and that 

92 The majority of children maltreated by biological parents were maltreated only by biological parents.

That is, the group of children who experienced Harm Standard maltreatment by a biological parent (81%

in Table 6–1) includes the 72% of all children with Harm Standard maltreatment who were maltreated 

only by a biological parent, another 6% who were maltreated by a biological parent as well as by a

nonbiological parent or their parent’s partner, and another 2% who were maltreated by a biological parent

as well as by someone else, not a nonbiological parent or their parent’s partner. 

6-4
 
 

 

nonbiological parents or parents’ partners and other persons maltreated relatively small 

percentages of children (12% and 7%, respectively). 

Table 6–2. Perpetrator’s Relationship to Child and Severity of Harm by the Category of

Maltreatment 

Maltreatment Category/

Most Closely Related Perpetrator 

Percent 

Children in 

Maltreatment 

Category 

Total 

Maltreated 

Children 

Percent of Children in Row with Harm. . .

Fatal or 

Serious Moderate Inferred 

ABUSE: 100% 553,300 26% 66% 8% 

Biological Parent 64% 354,900 25% 71% 4% 

Nonbiological Parent or Partner 20% 108,100 29% 62% 9% 

Other Person 16% 90,300 28% 48% 24% 

Physical Abuse 100% 323,000 22% 78% + 

Biological Parent 72% 231,100 22% 78% + 

Nonbiological Parent or Partner 19% 61,400 17% 83% + 

Other Person 9% 30,600 31% 69% + 

Sexual Abuse 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

100% 

37% 

23%

40% 

135,300 

49,500 

31,300 

54,500 

33% 35% 

No 

Relationship 

32% 

 

 

 

 

Educational Neglect 100% 360,500 17% 83% + 

Biological Parent 94% 337,500 18% 82% + 

Nonbiological Parent or Partner 6% 22,900 * 94% + 

Other Person ^ ^ ^ ^ ^ 

ALL MALTREATMENT: 100% 1,256,600 39% 55% 6% 

Biological Parent 81% 1,015,600 41% 55% 4% 

Nonbiological Parent or Partner 12% 155,900 34% 58% 8% 

Other Person 7% 85,100 26% 50% 24% 

Emotional Abuse 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

100% 148,500 

73% 108,400 

20% 29,400 

7% 10,700 

30% 69% * 

No 

Relationship 

NEGLECT: 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

100% 771,700 

92% 708,900 

8% 62,800 

^ ^ 

50% 46% 4% 

No 

Relationship 

Physical Neglect 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

100% 295,300 

91% 268,000 

9% 27,300 

^ ^ 

64% 25% 11% 

No 

Relationship 

Emotional Neglect 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

100% 193,400 

90% 173,800 

10% 19,600 

^ ^ 

92% 8% + 

No 

Relationship 

+ This severity level not applicable for this form of maltreatment. 

* Fewer than 20 cases with which to calculate estimate; estimate too unreliable to give. 

^ These perpetrators were not allowed under Harm Standard neglect criteria. 

6-5
 
 

 

Table 6–2 also reveals a marked difference in the perpetrators of abuse and 

neglect. Among abused children, biological parents maltreated 64%, nonbiological 

parents or parents’ partners maltreated 20%, and someone else maltreated 16%. In 

contrast, biological parents neglected 92% of all neglected children while nonbiological 

parents or parents’ partners neglected only 8%. Other persons are not allowable 

perpetrators of neglect under the Harm Standard criteria, so those table cells are empty by 

definition. As Chapter 2 discussed, the Harm Standard criteria require that a parent or 

guardian to be the perpetrator of neglect, whereas anyone, in principle, can abuse a child 

(if they were the child’s caregiver or if the child’s parent or caregiver permitted the 

abuse). 

Biological parents were the most closely related perpetrators for most 

children who were physically abused (72%), emotionally abused (73%), physically 

neglected (91%), emotionally neglected (90%), and educationally neglected (94%). In 

contrast, the most common perpetrators of sexual abuse were persons other than parents 

or parents’ partners (40% of sexually abused children). Fewer children were sexually 

abused by a biological parent (37%) or by nonbiological parents or parents’ partners 

(23%). 

6.2.2	 Severity of Harm by Perpetrator’s Relationship and Category

of Maltreatment 

The last three columns in Table 6–2 display the most serious outcome 

children suffered from their Harm Standard maltreatment, depending on the category of 

maltreatment. If the severity of harm also depended on their relationship to the most 

closely related perpetrator, the table provides those percentages as well. Considering all 

maltreated children (the bottom-most section of the table), the severity of injury or harm 

to the child does differ significantly depending on the perpetrator: 41% of children who 

were maltreated by their biological parents suffered fatal or serious injuries, compared to 

34% of children maltreated by nonbiological parents or parents’ partners and 26% of 

children maltreated by other persons. This overall difference may stem from the fact that 

biological parents are by far the perpetrators of neglect and neglected children, in turn, 

have a relatively higher incidence of fatal and serious injuries. Both of these associations 

derive from the Harm Standard criteria, as Chapter 2 explained). 

6-6
 
 

 

 

 

 

 

 

 

 

 

 

6.3 Perpetrator’s Sex 

The perpetrator’s relationship to the child is associated with the severity of 

harm in overall abuse and in the specific category of physical abuse. Children who are 

abused by another person (not a parent) more often have inferred harm. This pattern may 

stem from the fact that other persons are most often the perpetrators of sexual abuse 

which is one of the few categories that permit inferred harm. Physically abused children 

sustained severe harm when someone other than a parent or parent’s partner was the 

perpetrator, but they tended to suffer moderate harm when their parent (biological or 

other) physically abused them. 

Table 6–3 presents children according to the sex of their perpetrators for each 

category of maltreatment and perpetrator relationship. Children who were maltreated by 

both male and female perpetrators are included under both columns, so the percentages in 

the last three columns can sum to more than 100%. For example, a child who was 

physically abused by both his biological mother and his biological father is included 

under both “male” and “female” columns in the “physical abuse by biological parent” 

row.93 

Table 6–3 shows that a biological parent was the perpetrator, the majority of 

children were maltreated by their mothers (75%), but a sizable percentage were 

maltreated by their fathers (43%). In contrast, when a nonbiological parent or parent’s 

partner was the perpetrator, this was typically a male (for 64% of children versus only 

female for only 48%). The pattern is similar when other persons were perpetrators (75% 

of children were maltreated by males and only 20% by females). 

The predominant perpetrator’s sex differs for abuse and neglect. The 

majority of neglected children (86%) had female perpetrators. This finding is consistent 

93 This type of multiple-categorization of children was possible in analyses of perpetrator’s sex and age. 

However, it was minimized by applying the nine-category perpetrator hierarchy (in Table 6–1) when 

identifying the child’s perpetrator(s). For example, consider a child who was seriously physically abused

by two perpetrators—a step-parent and a parent’s boyfriend. According to the nine-category hierarchy,

the analyses here focus on the step-parent (the most closely related perpetrator according to the 

hierarchy), and only that person’s sex, age, and employment status are tabulated. Thus, multiple

classifications only occurred when there were two (or more) perpetrators of exactly the same degree of

relationship according to the nine-category hierarchy. 

6-7
 
 

 

 

 

with the fact that mothers tend to be the primary caregivers and are typically held 

accountable for any omissions and/or failings in the child’s care. In contrast, children 

typically had male abusers (62%). The predominance of males as the perpetrators of 

abuse holds true for each specific abuse category and is most pronounced for sexual 

abuse, where 87% of sexually abused children had male perpetrators. 

Table 6–3 further reveals sex differences across the different perpetrator 

relationships, for overall abuse and for the specific abuse categories. Among all abused 

children, those abused by their biological parents were nearly equally likely to have been 

abused by mothers (51%) as by fathers (54%), but those abused by nonbiological parents 

or parents’ partners and those abused by other persons were much more commonly 

abused by males (79% and 74%). This pattern applies for emotionally abused children, 

where the percentages of children with male perpetrators differ across the relationship 

categories. However, there are no differences across relationship categories for female 

perpetrators of emotional abuse. Moreover, the pattern is also different among physically 

abused children. When biological parents or other persons were perpetrators, males were 

the abusers for only about one-half of the children (48% and 56%, respectively), whereas 

when the perpetrator was a nonbiological parent, nearly three-fourths of the children were 

abused by a male (74%). The mirror image of this pattern is evident in the differences in 

percentages of children with female perpetrators across the relationship categories. When 

the perpetrator was a nonbiological parent, then this was a female for less than one-third 

of the children (29%); when the perpetrator was a biological parent or other person, then 

it was more likely to be a female perpetrators (for 56% and 43% of the children, 

respectively). 

Among sexually abused children, the majority of perpetrators were male, 

regardless of their relationship to the child. However, they were much more likely to be 

male when they were the child’s nonbiological parent. Also, the percentage of female 

perpetrators differs significantly depending on their relationship to the child. Children 

who are sexually abused by their biological parents have the highest percentage of female 

perpetrators (22% versus 6% or less in other relationship categories). 

Table 6–4 provides the percentages of children by their perpetrator’s sex for 

each level of outcome severity and perpetrator relationship.94 The bottom-most section is 

94 Analyses did not subdivide the fatally injured children because of the small sample size. 

6-8
 
 

 

 

identical to the last section in Table 6–3, showing that children more commonly have 

female perpetrators than male perpetrators (68% versus 48%, respectively). 

Table 6–3. Perpetrator’s Sex by Category of Maltreatment and Perpetrator’s

Relationship to Child 

Maltreatment Category/

Most Closely Related Perpetrator 

Percent of Children in Row with 

Perpetrator Whose Sex was. . . † 

Male Female 

ABUSE: 62% 41% 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

54% 

79% 

74% 

51% 

26% 

21% 

 

 

 

 

 

 

 

Physical Abuse 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

54% 50% 

48% 56% 

74% 29% 

56% 43% 

Sexual Abuse 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

87% 11% 

80% 22% 

97% 3% 

86% 6% 

Emotional Abuse 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

60% 50% 

56% 

76% 

60% 

No 

Relationship 

NEGLECT: 

Biological Parent

Nonbiological Parent or Partner 

Other Person^ 

38% 86% 

No 

Relationship 

Physical Neglect 

Biological Parent

Nonbiological Parent or Partner

Other Person^ 

39% 87% 

No 

Relationship 

Emotional Neglect 

Biological Parent

Nonbiological Parent or Partner

Other Person^ 

41% 80% 

No 

Relationship 

Educational Neglect 

Biological Parent

Nonbiological Parent or Partner

Other Person^ 

36% 89% 

No 

Relationship 

ALL MALTREATMENT: 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

48% 68% 

43% 75% 

64% 48% 

75% 20% 

† 

 Information about perpetrator sex was entirely missing for 2% of children including 6% of those with Other

Person perpetrators. 

* Fewer than 20 cases with which to calculate estimate; estimate too unreliable to give. 

^ These perpetrators were not allowed under Harm Standard neglect criteria. 

6-9
 
 

 

 

 

Table 6–4. Perpetrator's Sex by Severity of Harm and Perpetrator's Relationship to

Child 

Maltreatment Category/

Most Closely Related Perpetrator 

Percent of Children in Row with 

Perpetrator Whose Sex was. . . † 

Male Female 

FATAL/SERIOUS 

Biological Parents 

Nonbiological Parent or Partner 

Others 

48% 70% 

45% 75% 

61% 59% 

80% 15% 

MODERATE 

Biological Parents 

Nonbiological Parent or Partner 

Others 

45% 70% 

41% 76% 

62% 45% 

63% 32% 

INFERRED 

Biological Parents 

Nonbiological Parent or Partner 

Others 

64% 41% 

40% 68% 

86% * 

93% * 

ALL MALTREATMENT: 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

48% 68% 

43% 75% 

64% 48% 

75% 20% 

† 

 Information about perpetrator sex was entirely missing for 2% of children including 6% of those 

with Other Person perpetrators. 

* Fewer than 20 cases with which to calculate estimate; estimate too unreliable to give. 

Children who were seriously injured or moderately injured more often had 

female perpetrators than male perpetrators (70% in each case versus had female 

perpetrator 48% and 45% with male perpetrators, respectively). This pattern differs for 

children with inferred harm, who tended to have more male perpetrators than female 

perpetrators (64% versus 41%). These patterns probably reflect both the fact that female 

perpetrators predominate in neglect, where more children are severely harmed, and the 

fact that inferred harm is typically associated with sexual abuse, which males most often 

perpetrate. 

Another feature of the patterns in this table is that the overall sex differences 

across the relationship categories holds at all the severity levels. Overall, more children 

maltreated by a biological parent were maltreated by their mother, whereas those 

6-10
 
 

 

6.4 Perpetrator’s Age 

maltreated by a nonbiological parent, parent’s partner or by another person were 

generally maltreated by males. This applies to children at every level of harm. 

Table 6–5 shows the percentages of children by their perpetrator’s age for 

each category of Harm Standard maltreatment and perpetrator relationship. As in Tables 

6–3 and 6–4, the table includes children with multiple perpetrators in all applicable 

perpetrator age categories. When this occurred, the row percentages sum to more than 

100%. Thus, a child who was physically abused by both biological parents, one 22 years 

old and the other 29 years old, is included in percentages in both the “< 26 years” and 

“26–35 years” age columns. This table also provides a column for children whose 

perpetrators were of unknown age, because their percentages are not trivial. Children are 

in the last column (perpetrator of unknown age) only if age was unknown for all 

perpetrators in the category. The bottom-most section of Table 6–5 indicates that the 

perpetrator’s age was unknown for almost one-fifth of children with Harm Standard 

maltreatment (18%). This percentage is highest (25%) for “other” perpetrators, who 

more often had missing information about their characteristics. 

Table 6–5 shows that, overall, more children experienced Harm Standard 

maltreatment at the hands of perpetrators 26 years of age or older (35% or more) than by 

perpetrators younger than 26 years old (11%). The oldest perpetrators (over 35 years of 

age) predominated in the category of nonbiological parents or parents’ partners. For well 

over one-half (57%) of children who were abused or neglected by a nonbiological parent 

or parent’s partner, this person was in the oldest perpetrator age group. Moreover, this 

pattern appears in every category of Harm Standard maltreatment. The youngest 

perpetrators (under 26 years old) predominated among nonparents (other persons). These 

persons can only perpetrate abuse, since NIS definitions require only parents or guardians 

to be perpetrators of countable neglect. 

Table 6–6 presents the percentages of children with perpetrators in different 

age groups by severity of harm and perpetrator relationship. Perpetrators age 26 and 

older predominate among children seriously or moderately harmed (35% or higher), but 

for children with inferred injury or impairment, perpetrators were most commonly older 

than 35 years of age (42%). Again, differences are apparent across the categories of 

6-11
 
 

 

 

 

 

 

 

Table 6–5. Perpetrator's Age by Category of Maltreatment and Perpetrator's 

Relationship to Child 

Maltreatment Category/

Most Closely Related Perpetrator 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

6% 

* 

^ 

42% 

* 

^ 

38% 

55% 

^ 

18% 

* 

^ 

 

perpetrator relationship, with the oldest perpetrators most typical among nonbiological 

parents and parents’ partners. The oldest parents and partners maltreated 63% of the 

children who sustained fatal or serious harm, 53% of those with moderate harm, and 63% 

Percent of Children in Row with Perpetrator Whose

Age was. . . 

< 26 Years 26 – 35 

Years > 35 Years Unknown 

ABUSE: 12% 33% 37% 18% 

Biological Parent 9% 36% 37% 19% 

Nonbiological Parent or Partner 6% 36% 51% 7% 

Other Person 35% 17% 24% 25% 

Physical Abuse 13% 34% 36% 17% 

Biological Parent 11% 35% 35% 19% 

Nonbiological Parent or Partner 7% 35% 50% 8% 

Other Person 40% 21% 18% 22% 

Sexual Abuse 15% 27% 32% 27% 

Biological Parent 5% 35% 25% 35% 

Nonbiological Parent or Partner * 36% 48% 11% 

Other Person 30% 14% 29% 29% 

Emotional Abuse 7% 36% 47% 10% 

Biological Parent 5% 39% 47% 10% 

Nonbiological Parent or Partner * 31% 62% * 

Other Person 36% * * * 

NEGLECT: 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

9% 37% 38% 18% 

10% 40% 36% 18% 

* 8% 66% 25% 

^ ^ ^ ^ 

Physical Neglect 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

15% 35% 35% 18% 

16% 38% 31% 18% 

* * 81% 14% 

^ ^ ^ ^ 

Emotional Neglect 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

8% 36% 46% 13% 

8% 38% 44% 13% 

* * 68% * 

^ ^ ^ ^ 

Educational Neglect 5% 39% 39% 20% 

ALL MALTREATMENT: 

Biological Parents 

Nonbiological Parent or Partner 

Other Person 

11% 35% 38% 18% 

10% 39% 36% 18% 

4% 25% 57% 15% 

34% 18% 24% 25% 

* Fewer than 20 cases with which to calculate estimate; estimate too unreliable to give. 

^ These perpetrators were not allowed under Harm Standard neglect criteria. 

6-12
 
 

 

 

 

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

Perpetrator’s Relationship to the Child 

Table 6–6. Perpetrator's Age by Severity of Harm and Perpetrator's Relationship to 

Child 

Maltreatment Category/

Most Closely Related Perpetrator 

Percent of Children in Row with Perpetrator

Whose Age was. . . 

< 26 

Years 

26 – 35 

Years 

> 35 

Years Unknown 

SERIOUS 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

12% 35% 38% 17% 

11% 38% 36% 17% 

* 20% 63% 14% 

33% 15% 22% 30% 

MODERATE 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

9% 37% 37% 19% 

8% 40% 35% 19% 

3% 28% 53% 16% 

35% 19% 21% 27% 

INFERRED 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

20% 24% 42% 15% 

19% 28% 38% 18% 

* 22% 63% * 

31% 20% 35% 15% 

ALL MALTREATMENT: 

Biological Parent 

Nonbiological Parent or Partner 

Other Person 

11% 35% 38% 18% 

10% 39% 36% 18% 

4% 25% 57% 15% 

34% 18% 24% 25% 

* Fewer than 20 cases with which to calculate estimate; estimate too unreliable to give. 

of children whose maltreatment was so severe that their harm could be inferred. Other 

(nonparental) persons who perpetrated Harm Standard maltreatment were primarily 

younger than 26 years old. 

The analyses explored whether the children’s race was systematically related 

to the perpetrator’s relationship to them, either overall or in specific maltreatment 

categories. Overall, and across most maltreatment categories, the racial distribution of 

maltreated children simply reflected the race differences in risk of maltreatment reported 

6-13
 
 

 

6.6 Perpetrator’s Alcohol Use, Drug Use, and Mental Illness as

Factors in the Maltreatment 

earlier (Chapter 4) and did not vary with their perpetrator’s relationship. The one 

exception was physical neglect.95 Figure 6–1 graphs the pattern. 

Figure 6–1.	 Race/ethnicity of Neglected Children by Their Most Closely Related 

Perpetrator. 

The majority of children who were neglected by their biological parent were 

white, whereas children neglected by a nonbiological parent or parents’ partner were 

predominantly Black. Like white children, Hispanic children are more prevalent among 

those whose biological parents neglect them than among children neglected by 

nonbiological parents (21% versus 11%). 

The NIS–4 added systematic questions about the perpetrator’s alcohol use, 

drug use, or mental illness, so analyses could examine the extent to which sentinels or 

CPS investigators considered these issues to be factors in the maltreatment. Figures 6–2 

95 Sample sizes were too small in some cells to support reliable tests of the relationship in specific neglect

categories. 

6-14
 
 

 

 

 

 

 

 

 

through 6–6 give the percentages of children whose maltreatment involved their most 

closely related perpetrator’s alcohol use, drug use, or mental illness. The percentages 

include children under factors that applied to all their perpetrators in the closest-related 

category. For example a child who was emotionally abused by two biological parents, 

one of whom was known to have used alcohol and the other of whom used drugs, is 

included under emotional abuse (and all abuse, and all maltreatment) in both the 

percentage of children whose perpetrator used alcohol and the percentage of children 

whose perpetrator used drugs. 

Figure 6–2 shows the percentages of children whose perpetrator’s alcohol 

use, drug use, or mental illness was believed to be a factor in their Harm Standard 

maltreatment, abuse, or neglect. The perpetrator’s alcohol use and drug use were 

approximately equivalent factors in the maltreatment of children with any Harm Standard 

maltreatment (11.4% and 10.8%, respectively) and in neglect (12.1% and 12.5%, 

respectively). In contrast, the perpetrator’s alcohol use was implicated in the abuse of 

more maltreated children (12.7%) than was perpetrator’s drug use (9.5%). The graph 

shows that the perpetrator’s mental illness was a less common factor in Harm Standard 

maltreatment and that it was essentially equally involved in both abuse and neglect (7.1% 

and 7.7%, respectively).96 

Figure 6–3 shows the involvement of perpetrator problems in specific 

categories of Harm Standard abuse. Their perpetrator’s alcohol use was more prevalent 

in children’s physical abuse than were the other two perpetrator problems (11.1% versus 

6.8% or less); a higher percentage of physically abused children had perpetrators with 

drug use than with mental illness (6.8% versus 4.5%). In contrast, children who are 

sexually abused are about equally likely to have perpetrators using alcohol and drugs 

(8.4% and 9.1%, respectively), but appear less likely to have perpetrators who are 

mentally ill. The situations of emotionally abused children are quite different. Substantial 

percentages of emotionally abused children have perpetrators with these problems. Onesixth of the emotionally abused children had perpetrators who used drugs (16.7%) and an 

equal percentage were emotionally abused by mentally ill perpetrators. Their 

96 As noted earlier, all analyses in this chapter concern the child’s most closely related perpetrator(s). If the 

analyses concerning the involvement of drug use, alcohol use, and mental illness had considered all

perpetrators, the results would be essentially the same as those reported here. For instance, considering 

all perpetrators, the percentages in Figure 6–2 would be 11.7% for alcohol involvement (higher by 0.3% 

from the 11.4% in the figure), 11.2% for drug involvement (higher by 0.4% from the 1he 10.8% in the

figure), and 7.3% for mental illness (higher by 0.1% from the 7.2% given in the figure). 

6-15
 
perpetrator’s alcohol use was a factor in the maltreatment events for more than one in 

five children who were emotionally abused (21.8%). 

Figure 6–2. Perpetrator Problems in Overall Harm Standard Maltreatment, Abuse, 

and Neglect. 

Figure 6–3. Perpetrator Problems in Specific Categories of Harm Standard Abuse. 

6-16
 
The graph in Figure 6–4 presents the incidence of different perpetrator 

problems in specific Harm Standard neglect categories. For the physically neglected 

children, their perpetrator’s use of drugs appears to be the most common problem 

(14.7%), followed by perpetrator’s alcohol use (11.3%). Both alcohol and drug use are 

factors in physical neglect for more children than their perpetrator’s mental illness 

(7.5%). The patterns for emotionally neglected and educationally neglected children are 

similar, with fairly similar percentages having perpetrators with alcohol use and drug use, 

but notably smaller percentages with mentally ill perpetrators. However, the overall 

incidence of all perpetrator problems is much higher among the emotionally neglected 

children. About one-fifth of emotionally neglected children have perpetrators whose 

drug use or alcohol use were factors in their maltreatment (19.9% and 20.7%, 

respectively), and more than one-eighth (13.0%) had perpetrators who were mentally ill. 

Figure 6–4. Perpetrator Problems in Specific Categories of Harm Standard Neglect. 

Figure 6–5 provides the incidence of perpetrator problems among children 

who experienced different severities of harm as a result of their Harm Standard 

maltreatment. Both alcohol and drug use by perpetrators are prevalent among children 

with fatal or serious harm from their maltreatment, affecting more than one in seven 

children with this outcome severity (14.7% and 14.9%, respectively). Although fewer 

children have mentally ill perpetrators, this is a factor for nearly one in ten (9.6%) 

children who were fatally or seriously harmed. 

6-17
 
More of the moderately harmed children have perpetrators who used alcohol 

(9.4%) compared to the other types of problems. This is higher than the percentages of 

moderately harmed children who had mentally ill perpetrators (5.7%) or whose 

perpetrators used drugs (7.5%). 

Perpetrator’s drug use is notably high among children for whom harm could 

be inferred based on the severity of their maltreatment events (14.7%). This is higher 

than the percentages of children in this group who have perpetrators with other problems. 

Figure 6–5.	 Perpetrator Problems in Maltreatment of Children with Different Levels 

of Harm. 

The incidence of problems with alcohol use, drug use, or mental illness also 

varies with the perpetrator’s relationship to the child, as Figure 6–6 illustrates. Across all 

three perpetrator problems, the factor was involved in the maltreatment of higher 

percentages of children when the perpetrator was a biological parent. Alcohol use was a 

factor in maltreatment for 12.4% of children maltreated by their biological parents, 

compared to 8.6% of those maltreated by other (nonbiological) parents and just 5.5% of 

those maltreated by other persons. Drug use played a role in the maltreatment for 11.8% 

of children whose biological parents were perpetrators, compared to 6.9% or less of 

children with other relationships to their perpetrators. When biological parents were 

6-18
 
perpetrators, mental illness was a factor for 7.7% of children, as compared to just 5% of 

those children who were maltreated by someone else. 

Figure 6–6.	 Perpetrator’s Problems in Harm Standard Maltreatment by Perpetrator’s 

Relationship to the Child. 

Small numbers of children in the sample in different combinations of 

conditions prevented most other analyses examining how the incidence of problems 

varied by the perpetrator’s relationship to the child. However, when there were sufficient 

children in the sample, the several percentages that did emerge followed the patterns in 

Figure 6–6, with problems more common when biological parents were perpetrators. 

6-19
 

 

 

 

 

7.1 Sources Recognizing Abused and Neglected Children 

7. RECOGNIZING ABUSED AND NEGLECTED CHILDREN 

This chapter examines the sources that recognize maltreated children as 

abused or neglected. The initial sections address the following questions for children 

who experienced Harm Standard and Endangerment Standard maltreatment: 

•	 What sources, in agencies or in the general community, encountered 

these children and recognized their maltreatment? 

•	 What changes have occurred since the NIS–3 in the numbers of 

maltreated children that different sources identified? 

The last section reports on and considers the implications of findings from 

the Sentinel Definitions Study for NIS coverage of the maltreated child population. 

•	 What types of maltreatment situations do sentinels say they would

submit to a national study such as the NIS? What situations would they 

submit to CPS but not to the study? Are there situations they would not 

submit to either venue (neither the NIS nor CPS)? 

•	 What do these answers suggest about how well the NIS estimates cover

the population of children who experience different types of 

maltreatment? 

This section examines the sources that recognized abused and neglected 

children in the NIS–4 and considers how recognition patterns have changed since the 

NIS–3. It first reports the recognition sources for children who experienced Harm 

Standard maltreatment, and then focuses on the sources that recognized children whose 

maltreatment fit the Endangerment Standard. In this context, the term “recognition” 

subsumes both encountering maltreated children and identifying them as maltreated. 

As in previous chapters, all estimates reflect unduplicated numbers of 

children in the United States who experienced the type of maltreatment in question 

(Harm Standard or Endangerment Standard). The unit of measurement is the child and 

each estimate counts each child only once. The tables in this section give estimates both 

7-1
 
 

 

 

 

in terms of the total numbers of children in the U.S. population and in terms of rates per 

1,000 children in population. Estimated totals reflect the number of children nationwide 

who were maltreated during the study year in question, whereas the incidence rates 

indicate the number of children maltreated during the study year per 1,000 children in the 

U.S. population during that time period. Comparisons of recognition source 

contributions in the NIS–4 with their contributions in the NIS–3 used only incidence rate 

measures because they factor out changes in the overall size of the U.S. child population 

between studies. 

As detailed in Chapter 2, the NIS gathers data about suspected cases of 

abused and neglected children from CPS agencies as well as from sentinels—community 

professionals in a number of different agency categories. The NIS classifies maltreated 

children according to their recognition source by considering: (1) the source(s) who had 

submitted the data form on the child to the NIS, and (2) for children investigated by CPS 

agencies, the source(s) who reported the child to CPS. Thus, if a hospital sentinel 

submitted the child to the NIS, the NIS classifies the child as recognized at a hospital. 

Alternatively, if the child entered the NIS on a CPS data form (because CPS investigated 

the child’s maltreatment) and the record shows that the report to CPS came from hospital 

staff, then the NIS also classifies that child as recognized at a hospital. For children 

recognized by more than one source in the list, NIS assigns them to a single source by 

selecting the first source in a classification hierarchy. This hierarchy reflects the agency 

tiers in the “iceberg model” (cf. Chapter 2) in that it prioritizes agencies with 

investigatory authority (juvenile probation, law enforcement, public health) over the 

remaining, non-investigatory agencies.97 

7.1.1	 Sources Recognizing Children Maltreated under the Harm

Standard 

Figure 7–1 shows the sources that recognized children who met the criteria 

for Harm Standard maltreatment. These categories are mutually exclusive, with children 

included in the estimate in only one row. Starting with juvenile probation at the top of the 

figure, the order of sources clockwise around the figure corresponds to the NIS 

97 Within these two major tiers, the ordering of agency categories is not based on theoretical considerations, 

but is the standard ordering that NIS has applied since its inception. 

7-2
 
 

 

 

 

classification hierarchy. If more than one source recognized a child’s maltreatment, NIS 

procedures place the child in the first applicable source in this sequence, with one 

proviso—sources of reports to CPS take precedence over sources of NIS sentinel data 

forms. This classification scheme first credits sources that reported children to CPS who 

were accepted by CPS for investigation. For children not investigated by CPS, the 

scheme assigns recognition credit to the source who submitted the child to the NIS. 

Thus, if both a police department and a CPS agency submitted a child to the 

NIS, and the CPS received the report on the child from a hospital, NIS classified the 

hospital as the source that recognized the child.98 As the source of the report to CPS, the 

NIS identifies the hospital as the recognition source. With this exception, the hierarchy 

applies to resolve multiple sources of reports to CPS and submissions from multiple 

sentinel sectors. For example, if the NIS received two sentinel data forms on a child, one 

from a police department and the other from a hospital, the hierarchy applies credit to the 

police as the recognition source. Similarly, if a child entered the NIS through CPS 

investigation data and the CPS record shows that CPS received two reports on the child, 

one from shelter staff and the other from a neighbor, then the hierarchy applies to credit 

the shelter staff as the recognition source (since the neighbor comes under “All Other 

Sources,” the lowest source in the hierarchy). 

98 For this classification to apply, it was not sufficient for the CPS investigation record to simply list the

child as a member of the household. It was also necessary that the CPS record show that CPS recognized

this child’s maltreatment. Operationally, this meant that the CPS record either identified the child as an

alleged or indicated victim or described details of the child’s countable maltreatment. See the discussion 

in Chapter 8 concerning CPS recognition of children’s maltreatment. 

7-3
 
 

Figure 7–1. Sources that Recognized Children Who Experienced Harm Standard 

Maltreatment. 

The first three agency categories in the hierarchy—juvenile probation, law 

enforcement, and public health—are investigatory agencies. Investigatory agencies are 

those in the second tier of the “iceberg” model described in Chapter 2. Figure 7–1 

indicates that staff in investigatory agencies recognized 17% of the estimated total 

number of children who experienced Harm Standard maltreatment during the NIS–4 

study year. Staff in law enforcement agencies, municipal police or sheriffs departments 

recognized most of these, 12% of all maltreated children. Sentinels in other, noninvestigatory agencies (hospitals, schools, day care centers, mental health and social 

service agencies, shelters, and public housing agencies) recognized 75% of the total 

maltreated children. Non-investigatory agencies in the NIS design are those in the third 

tier of the “iceberg” model. Taken together, NIS sentinels recognized the large majority 

of children who experienced Harm Standard maltreatment—92% of all the Harm 

Standard maltreated children. 

Professional staff in schools (teachers, nurses, and counselors) recognized 

more children than any other single sentinel group, over one-half (52%) of the children 

who fit the Harm Standard. Considering that this categorization is hierarchical, this 

estimate does not reflect all the children school sentinels recognized as abused or 

7-4
 
 

 

neglected. That is, when school sentinels recognized a child who was also recognized by 

a source higher in the hierarchy, or when a school sentinel recognized a child reported to 

CPS by another source, the NIS identified that other agency as the recognition source, 

rather than the school. 

The remainder of the children came from sources that only enter the NIS 

through CPS investigations. These include children who are recognized as maltreated by 

DSS/Welfare agencies (e.g., CPS agencies in other counties or other divisions of the 

county welfare agency such as food stamps or Medicaid), by other non-sentinel 

professionals or agencies (e.g., community health clinics not affiliated with a hospital, 

private practice pediatricians, physicians, therapists), and all other sources (primarily the 

general public, such as neighbors, friends, family, anonymous callers, and the victims 

themselves). Taken together, these CPS-only sources recognized 8% of the total number 

of children maltreated under the Harm Standard. 

Whereas the NIS estimates represent all maltreated children that sentinels 

recognize as maltreated, the NIS has no information on maltreated children that “Other 

(CPS-only) Sources” see beyond the ones CPS investigates. The uninvestigated children 

that these other sources recognize remain unknown to NIS, in the deepest tier of the 

Chapter 2 “iceberg” model. 

Changes since the NIS–3 in Recognition Sources of Harm Standard 

Maltreatment 

Table 7–1 presents the contributions of different sources to the NIS–4 overall 

Harm Standard estimate of maltreated children, giving the total number and rate per 

1,000 children in the general population each source recognized. The table also provides 

the NIS–3 recognition rates. 

Public housing and shelters for battered women and for runaway and 

homeless youth are new sentinel agency categories in the NIS–4. The table gives the 

7-5
 
 

 

 

 

 

 

 

 

 

 

 

 

Table 7–1. Sources Recognizing Maltreated Children Who Fit the Harm Standard in the NIS–4 

(2005–2006) and Comparisons with the Estimated Numbers from Different Sources 

in the NIS–3 (1993) 

Source Recognizing the

Maltreatment 

NIS–4: 2005–2006 NIS–3: 1993 

Total 

No. of 

Children 

Rate per

1,000 

Children 

Total 

No. of 

Children 

Rate per

1,000

Children 

Investigatory Sentinel Agencies: 

Juvenile Probation 35,500 0.5 36,600 0.5 ns 

Police/Sheriff 152,200 2.1 111,500 1.7 ns 

Public Health 23,800 0.3 27,500 0.4 ns 

Investigatory Agency Subtotal: 211,400 2.9 175,600 2.6 ns 

Other Sentinel Agencies: 

Hospitals 134,200 1.8 113,200 1.7 ns 

Schools 648,800 8.8 920,000 13.7 * 

Day care Centers 65,500 0.9 59,700 0.9 ns 

Mental Health Agencies1 59,000 0.8 50,900 0.8 ns 

Social Service Agencies2 18,000 0.2 96,000 1.4 * 

Shelters 12,800 0.2 N/A N/A --

Public Housing 1,500 0.02 N/A N/A --

Other Sentinel Agency Subtotal:3 939,800 12.8 1,239,800 18.5 m 

All Sentinel Sources:4 1,151,300 15.8 1,415,400 21.1 m 

Other Sources (only through CPS): 

DSS/Welfare Department 18,500 0.3 15,000 0.2 ns 

Other Professional or Agency 11,200 0.2 7,000 0.1 m 

All Other Sources 75,600 1.0 116,400 1.7 * 

Other (CPS-only) Subtotal: 105,300 1.4 138,400 2.1 * 

ALL MALTREATMENT5 1,256,600 17.1 1,553,800 23.1 m 

* The difference between the NIS–3 and the NIS–4 recognition rates is significant at or below the p<.05 level. 

m The difference between the NIS–3 and the NIS–4 recognition rates is statistically marginal (i.e., .10>p>.05). 

ns The difference between the NIS–3 and the NIS–4 recognition rates is neither significant nor marginal (p>.10). 

Note: Estimated totals are rounded to the nearest 100. 1 Mental Health and Social Service Agencies are shown separately but have always been sampled together as a single category. 2 The cross study comparison included children reported by shelters in this category in NIS–4 (an estimated 30,800 children, or 

0.4 per 1,000), because shelters were included under Social Services in the past studies. 3 The cross-study comparison included 938,300 children (12.7 per 1,000) in this category in NIS–4, excluding Public Housing. 4 The cross-study comparison included 1,149,800 children (15.6 per 1,000) in this category in NIS–4, excluding Public Housing. 5 The cross-study comparison included 1,255,100 children (17 per 1,000) in this category for NIS–4, excluding Public Housing. 

7-6
 
 

 

NIS–4 estimates and rates per 1,000 children for these new sources of recognition, but the 

cross-study comparisons adjust for their different statuses in the different NIS cycles, as 

the table footnotes describe. 

Investigatory agencies’ recognition of Harm Standard maltreatment did not 

change since the NIS–3. However, rates of recognizing these maltreated children at 

schools and at social service agencies decreased significantly. Staff at social service 

agencies decreased their recognition of children maltreated according to the Harm 

Standard by 70% since the NIS–3, while the recognition of children by school personnel 

dropped by 36%. Recognition rates for the “Other Sentinel Agencies” and the “All 

Sentinel Sources” decreased marginally from the NIS–3 to the NIS–4 (from 18.5 to 12.8 

children per 1,000 and from 21.1 to 15.8 children per 1,000, respectively). Among CPSonly sources, the recognition contribution from the general public decreased significantly. 

Since this group accounts for the largest proportion of the CPS-only category, the overall 

CPS-only category also showed a significant decrease of 33% between the NIS–4 and the 

NIS–3. Finally, a statistically marginal decrease occurred in the “Other Professional or 

Agency” category. 

7.1.2	 Sources Recognizing Children Maltreated under the

Endangerment Standard 

Figure 7–2 shows the sources that recognized children who met the criteria 

for Endangerment Standard maltreatment. These categories are mutually exclusive, with 

children included in the estimate in only one recognition source, which was assigned 

according to the same classification hierarchy described earlier in Section 7.1.1. 

Figure 7–2 indicates that the staff in the investigatory agencies (juvenile 

probation, law enforcement, and public health) recognized 24% of the estimated total 

number of children who experienced Endangerment Standard maltreatment during the 

NIS–4 study year. Similar to the Harm Standard findings, staff in law enforcement 

(municipal police or sheriffs’ departments) recognized the highest percentage of children, 

19% of all maltreated children. Sentinels in other, non-investigatory agencies (hospitals, 

schools, day care centers, mental health, social services, shelters, and public housing) 

contributed almost two-thirds (63%) of the total maltreated children. Altogether, the NIS 

7-7
 
 

sentinels recognized an estimated 87% of the total number of children who experienced 

Endangerment Standard maltreatment. 

Figure 7–2.	 Sources that Recognized Children Who Experienced Endangerment 

Standard Maltreatment 

As in the NIS–4 Harm Standard and in previous NIS cycles, school staff 

dominated sentinels in all other categories, recognizing 39% of the children who 

experienced Endangerment Standard maltreatment. As noted earlier, because of the NIS 

hierarchical classification system, this percentage does not include all the children that 

school sentinels recognize as abused and neglected; it excludes children that school staff 

recognized when other sources higher in the hierarchy also recognized those children as 

maltreated. 

Sources that only enter the NIS through CPS investigations recognized 13% 

of children maltreated under the Endangerment Standard. As described above (§7.1.1), 

these sources include DSS/Welfare agencies (e.g., CPS agencies in other counties or 

other divisions of the county welfare agency) other (non-sentinel) professionals or 

agencies (e.g., community health clinics not affiliated with a hospital, private practice 

pediatricians, physicians, therapists) and all other sources (primarily the general public, 

such as neighbors, friends, family, anonymous callers, and the victims themselves). The 

7-8
 
 

 

largest contributor in this sector, providing 10% of the Endangerment Standard total, was 

the general public. 

Changes since the NIS–3 in Recognition Sources of Endangerment

Standard Maltreatment 

Table 7–2 presents the contribution of the different sources to the NIS–4 

overall Endangerment Standard estimate of maltreated children, giving the total number 

and rate per 1,000 children in the general population each source recognized. The table 

also provides the NIS–3 recognition rates. 

Public housing and shelters (for battered women and for runaway and 

homeless youth) are new sentinel agency categories in the NIS–4. The table gives the 

NIS–4 estimates and rates per 1,000 children for these two new sources, but the cross 

study comparisons adjust for their different treatment in the different NIS cycles, as the 

table footnotes describe. 

Overall the investigatory agencies’ recognition of Endangerment Standard 

maltreatment significantly increased by 76% from the NIS–3 rate of 5.5 children per 

1,000 to 9.7 children per 1,000 in the NIS–4. Both law enforcement and juvenile 

probation significantly contributed to the increased recognition by sentinels at 

investigatory agencies. The largest increase of 83% came from law enforcement 

agencies, where recognition increased from 4.1 children per 1, 000 to 7.5 children per 

1,000. Juvenile probation recognition grew by 50% from 0.8 children per 1,000 to 1.2 

children per 1,000. Other professionals or agencies that contributed to NIS only through 

CPS investigation records also increased by 50%, from 0.2 children per 1,000 to 0.3 

children per 1,000. A statistically marginal increase occurred in the contribution from 

DSS/welfare departments. 

However, the recognition rates of children experiencing Endangerment 

Standard maltreatment significantly decreased since the NIS–3 among professionals at 

7-9
 
 

 

 

 

 

 

 

 

 

 

 

 

 

Table 7–2. Sources Recognizing Maltreated Children Who Fit the Endangerment Standard in the

NIS–4 (2005–2006), and Comparisons with Recognition Sources in the NIS–3 (1993) 

Source Recognizing the

Maltreatment 

NIS–4: 2005–2006 NIS–3: 1993 

Total 

No. of 

Children 

Rate per

1,000 

Children 

Total 

No. of 

Children 

Rate per

1,000 

Children 

Investigatory Sentinel Agencies: 

Juvenile Probation 90,900 1.2 53,300 0.8 * 

Police/Sheriff 553,900 7.5 272,000 4.1 * 

Public Health 69,400 0.9 47,000 0.7 ns 

Investigatory Agency Subtotal: 714,200 9.7 372,400 5.5 * 

Other Sentinel Agencies: 

Hospitals 370,600 5.0 181,300 2.7 ns 

Schools 1,112,900 15.1 1,510,700 22.5 * 

Day care Centers 127,300 1.7 138,000 2.1 ns 

Mental Health Agencies1 104,500 1.4 97,800 1.5 ns 

Social Service Agencies2 56,200 0.8 174,600 2.6 * 

Shelters 33,400 0.5 N/A N/A --

Public Housing 5,800 0.1 N/A N/A --

Other Sentinel Agency Subtotal:3 1,810,600 24.6 2,102,500 31.3 ns 

All Sentinel Sources:4 2,524,800 34.3 2,474,800 36.9 ns 

Other Sources (only through CPS): 

DSS/Welfare Department 55,100 0.7 32,200 0.5 m 

Other Professional or Agency 25,500 0.3 12,900 0.2 * 

All Other Sources 300,400 4.1 295,700 4.4 ns 

Other Sources Subtotal: 381,000 5.2 340,800 5.1 ns 

ALL MALTREATMENT5 2,905,800 39.5 2,815,600 41.9 ns 

* The difference between the NIS–3 and the NIS–4 recognition rates is significant at or below the p<.05 level. 

m The difference between the NIS–3 and the NIS–4 recognition rates is statistically marginal (i.e., .10>p>.05). 

ns The difference between the NIS–3 and the NIS–4 recognition rates is neither significant nor marginal (p>.10).

Note: Estimated totals are rounded to the nearest 100. 1 Mental Health and Social Service Agencies are shown separately but have always been sampled together as a single category. 2 The cross study comparison included children reported by shelters in this category in NIS–4, because shelters were included 

under Social Services in the past studies. 3 The cross-study comparison included 1,804,800 children (24.5 per 1,000) in this category in NIS–4, excluding Public Housing. 4 The cross-study comparison included 2,519,000 children (34.2 per 1,000) in this category in NIS–4, excluding Public Housing. 5 The cross-study comparison included 2,900,000 children (39.3 per 1,000) in this category for NIS–4, excluding Public Housing. 

7-10
 
 

7.2 Sentinels’ Expected Responses to Maltreatment Situations and

the Implications for NIS Coverage 

 

 

 

 

schools and social services agencies. Schools recognized maltreatment at the rate of 22.5 

children per 1,000 in the NIS–3 but dropped by 33% in the NIS–4 to a rate of 15.1 

children per 1,000. Similarly, recognition by sentinels in social service agencies 

significantly decreased by more than one half (54%) since the NIS–3 (2.6 to 1.2 children 

per 1,000).99 

The Sentinel Definitions Study (SDS), as described in Chapter 2, surveyed 

sentinels about their expected reactions to the kinds of maltreatment situations covered in 

the NIS, asking whether they would report these situations to CPS and whether they 

would submit them to a national study such as the NIS (McPherson and Sedlak, 2010). 

The SDS respondents were participating sentinels in the NIS–4 and the SDS questions 

represented the entire range of situations included in the NIS–4 maltreatment definitions. 

The SDS findings can, therefore, provide some insight into how well the NIS estimates 

cover the population of maltreated children. 

Sentinels are critical to the NIS because they are the only source of 

information about maltreated children that CPS does not investigate. Moreover, as 

presented in the preceding sections, sentinels recognize the majority of countable 

children. Overall, sentinel sources accounted for 92% of the children who experienced 

Harm Standard maltreatment and 87% of those countable under the Endangerment 

Standard. The NIS receives sentinel-recognized children both directly from sentinels and 

through data on CPS investigations. 

NIS coverage of the population of maltreated children. How complete is 

NIS coverage of the maltreated children that sentinels encounter? The NIS has strong 

coverage of cases that sentinels submit directly to the study. NIS coverage of cases that 

the sentinels report to CPS but do not submit to the study is mixed—NIS will only obtain 

99 The calculation of the change in social services used a combined total estimate of the children reported

by shelters and social service agencies (an estimate of 89,600 at a rate of 1.2 per 1,000 children). 

7-11
 
 

 

 

data on those cases if CPS screens them in for investigation.100 Finally, NIS has no 

coverage of cases that sentinels neither report to CPS nor submit to the study. 

Table 7–3 presents sentinels’ answers to the SDS questions about how they 

would respond to the maltreatment situations presented in the vignettes. The table 

indicates what the sentinels reported they would do, providing the average percentage 

who said they would respond in the manner specified to the vignettes within each 

maltreatment category. (It is important to note that these percentages do not reflect the 

percentage of maltreated children that the sentinels would report; they are percentages of 

sentinels who said they would report the cases in each maltreatment category. The report 

on the Sentinel Definitions Survey (McPherson and Sedlak, 2010) provides further details 

on the SDS analyses and findings. 

Table 7–3. NIS Coverage of Maltreatment Situations as Indexed by Sentinels’ Responses

to SDS Vignettes* 

Maltreatment 

Category 

NIS Coverage 

Strong 

Give to national 

study 

Mixed 

Give to CPS but not 

to national study 

None 

Give to neither CPS 

nor national study 

Physical Abuse 

Sexual Abuse 

Emotional Abuse 

Physical Neglect 

Emotional Neglect 

Educational Neglect 

59 

67 

56 

55 

48 

41 

27 

28 

26 

28 

29 

30 

15 

5 

18 

16 

22 

30 

All Maltreatment 53 28 19 

* Cell entries are the average percentages of sentinels providing the indicated response to vignettes in the

maltreatment category, computed by first determining the percentage of sentinels giving the response

to each vignette (among those who received the vignette) and then averaging the percentages across

the vignettes within each maltreatment category. 

Overall, an average of just over one-half of the sentinels across all 

maltreatment vignettes (53%) said they would submit the situations to the study. An 

average of slightly more than one-fourth of the sentinels (28%) said they would give the 

100 This depends on CPS screening policy, as discussed in Chapter 8. 

7-12 
 

 

 

 

 

maltreatment situations only to CPS. Just under one-fifth of the sentinels (19%), on 

average, would not give the situations described to either the study or to CPS. 

While there are important limitations to these SDS findings, as noted below, 

they do suggest that sentinels encounter maltreatment situations that do not enter the NIS. 

The NIS clearly cannot cover situations that the sentinels do not give either to CPS or to 

the study. Moreover, the percentages across the maltreatment categories point to areas 

where coverage may be stronger or weaker than others. It appears that NIS coverage is 

probably best for the sexual abuse cases that sentinels encounter, since an average of 67% 

of sentinels said they would give these cases to the study and only 5% would not submit 

the described situations to either the study or CPS. Physical abuse, emotional abuse, and 

physical neglect appear to have similar coverage profiles in the table, with an average of 

slightly more than one-half of the sentinels saying they would submit the situations to the 

study and only between one-seventh and one-sixth saying they would not give the 

situation to either the study or CPS. 

These findings suggest that the NIS coverage may be relatively weak for 

educational and emotional neglect. Although an average of about 41% of the sentinels 

said they would give the educational neglect situations to the NIS, almost one in three 

sentinels said they would give these cases to neither CPS nor the study. In response to 

the emotional neglect vignettes, although an average of 49% of sentinels say they would 

submit such situations to the study, more than one-fifth (22%) would not submit these 

cases to either a national study or CPS. 

Completeness of data from school sentinels. The SDS also looked at selfpredicted responses to maltreatment according to the type of agency in which the sentinel 

worked, classifying sentinels into four broad groups: school, health, law enforcement, 

and other. As previous sections reported, school sentinels overwhelmingly predominate 

as a recognition source of maltreated children in the NIS. Their preeminence among the 

NIS recognition sources might imply that school sentinels are most likely to submit their 

suspected cases to the NIS. However, the SDS findings suggest otherwise, as Figure 7–3 

illustrates. 

The NIS coverage should be strong for those cases that sentinels submit 

directly to a national study. In the SDS, school sentinels were the least likely of the four 

SDS sentinel groups to say they would submit the maltreatment situations to a study such 

7-13
 
 

 

 

 

 

as the NIS. Figure 7–3 shows that only 41% of school sentinels said they would submit 

the cases to a national study, compared to between 44% and 58% of sentinels in the other 

groups. As noted above, the NIS has mixed coverage of cases that sentinels submit to 

CPS, depending on whether CPS investigates them. The SDS also reveals that the school 

sentinels were least likely to say they would report maltreatment to CPS. Two-thirds 

(67%) of school sentinels said they would report countable maltreatment to CPS, 

compared to about three-fourths (73% to 77%) of sentinels in the other three groups. 

Figure 7–3. Responses to Maltreatment Vignettes in the SDS by Sentinel Groups. 

Limitations of these findings. The SDS methodology provided an artificial 

context and had three important limitations that qualify the implications of the findings. 

First, the study design equally represented the range of situations included in the NIS 

definitions. It is unlikely that this distribution of maltreatment types corresponds to the 

distribution of maltreatment situations that sentinels encounter in real life. The sentinel 

percentages in Table 7–3 would undoubtedly look quite different if the component 

vignettes contributed to the averages in proportion to sentinels’ real-world encounters 

with situations corresponding to those described. Thus, it is not possible to apply the 

table percentages to the main NIS findings to calibrate the undercoverage of the 

maltreated child population. The SDS findings are useful in highlighting in a general 

way those areas where the NIS may have stronger or weaker coverage (following the 

model of the discussion above). Second, the artificial context may establish expectations 

7-14
 
 

 

 

that influence sentinels’ responses in unintended ways. Most vignettes in the SDS were 

countable under the Harm Standard. If participants believed that their answers to 

different vignettes should discriminate across the set in their questionnaire, they may 

have attempted to meet this expectation rather than to convey what they honestly thought 

they would do if they encountered the situation described in each vignette.101 Finally, the 

SDS findings represent what sentinels say they would do; the accuracy of their 

predictions is not known through this study. 

101 A phenomenon known as “demand characteristics” (Weber & Cook, 1972). 

7-15
 

 

8. INVESTIGATING ABUSED AND NEGLECTED CHILDREN 

This chapter examines to what degree abused or neglected children had their 

maltreatment investigated by CPS agencies and what community sources encountered 

and recognized these children. The chapter is divided into five sections and addresses the 

following questions: 

•	 To what extent did CPS agencies investigate the maltreated children 

who experienced Harm Standard or Endangerment Standard

maltreatment? Specifically: 

 What percentages of abused or neglected children had their

maltreatment investigated by CPS agencies? How do these 

investigation rates compare with those found in the NIS–3 and in 

the NIS–2? 

 What were the rates of CPS investigation for different

maltreatment categories? How have these investigation rates

changed since the NIS–3 and the NIS–2? 

 What were the rates of CPS investigation for maltreated children 

who were recognized by different sources? How have these 

investigation rates changed since the NIS–3? 

•	 Did extending NIS CPS data collection by an additional month beyond

the reference period improve the observed rates of CPS investigation? 

•	 What are the implications of CPS agencies’ screening standards for 

understanding why some maltreated children do not receive CPS

investigation? 

•	 What is the relationship between CPS investigation patterns and CPS

agencies’ structure and policies? 

•	 What is the relationship between CPS investigation patterns and

sentinels’ self-reported standards for reporting maltreated children to 

CPS? 

The chapter concludes with an overview of the recognition and investigation 

patterns identified in the NIS–4 and a discussion of their implications. 

8–1
 
 

 

 

 

 

 

 

 

 

 

 

 

8.1 CPS Investigation of Abused and Neglected Children 

The NIS design makes it possible to discover whether CPS investigated the 

maltreatment of the countable children reported to the study. Using that information, the 

NIS provides estimated totals and percentages of maltreated children whose maltreatment 

receives attention in a CPS investigation. This section reports on these estimates, first 

considering the investigation of children whose maltreatment was countable under the 

Harm Standard and then considering those countable under the Endangerment Standard. 

For each standard, further analyses also examined changes since the NIS–3 and the NIS– 

2 in the percentages of children who received CPS investigations. 

The standard for identifying children who received a CPS investigation was 

relatively lenient. It included any children listed on an investigation record that described 

the child’s countable maltreatment, or at least did not deny that the child was an alleged 

or indicated victim. Thus, uninvestigated children were only those who did not appear in 

any CPS investigation record or appeared only in records that clearly omitted any 

mention of their countable maltreatment and explicitly denied that they were indicated or 

alleged victims.102 This method is conservative in that it assumes that a child received 

CPS investigation when the CPS record listed the child but omitted any information 

about the child’s status as an alleged or indicated victim.103 

Because the NIS simply identifies whether or not a maltreated child is within 

the set of children CPS investigated, those who were not investigated represent an enigma 

to the study. The NIS data only indicate that they were not among the children listed in 

CPS investigations or that they were merely listed as uninvolved children in a CPS 

investigation of their household. There is no means, within the study itself, to determine 

the reason a maltreated child was not investigated—whether it was because no one 

102 The NIS–3 used this same rule. It is slightly more lenient than the NIS–2 classification rule, which 

required an “investigated” child to have been clearly an alleged or indicated victim or for the CPS

investigation record to have described his or her countable maltreatment. The NIS–3 and the NIS–4 

approaches included children who were listed in CPS investigations but whose alleged or indicated victim

status in the investigation was unknown. This approach made a slightly greater difference in the NIS–4 

and in the NIS–3, where more listed children had missing information about their victim status, whereas

the effect of using this lenient rule in the NIS–2 would have been so small as to be undetectable. 

103 Also note that this rule is broadly inclusive in that it classifies a child as having received CPS attention

for countable maltreatment even in those cases where the investigation focused on a different 

maltreatment allegation and even when the maltreatment the investigation had focused on was concluded

to be unfounded. 

8–2
 
 

 

 

 

 

 

 

 

 

 

 

 

 

reported the child to CPS or because CPS received a report but did not screen it in for 

investigation. For this reason, the NIS does not use the phrase “reporting rate,” but 

instead refers to the “investigation rate” of children.104 

As Chapters 1 and 2 discussed, this ambiguity motivated three independent 

NIS–4 supplementary studies: the CPS Structure and Practices Mail Survey (SPM), the 

CPS Screening Policies Study (SPS), and the Sentinel Definitions Survey (SDS). 

Subsequent sections in this chapter discuss the implications of these supplementary 

studies’ findings for understanding the CPS investigation rates observed in the main NIS 

data. Independent reports on the supplementary studies provide further details about their 

methodology and full descriptions of their findings. 

8.1.1	 CPS Investigation of Children Maltreated under the Harm

Standard 

Figure 8–1 shows the overall incidence of children who experienced Harm 

Standard maltreatment across all the NIS cycles, identifying the percentage of children as 

well as the rate per 1,000 children in each study whose maltreatment was investigated by 

CPS. 

The percentage of children with Harm Standard maltreatment who received 

CPS investigation showed negligible change between the NIS–3 (28%) and the NIS–4 

(32%). The slight increase in the percentage is not statistically meaningful. The 

comparison of the percentage of children investigated between the NIS–4 (32%) and the 

NIS–2 (44%) is statistically marginal. In terms of the percentage of Harm Standard 

children investigated, the NIS–4 percentage is very close to the 33% investigated in the 

NIS–1, however, the total number of children maltreated and investigated was much 

lower in the NIS–1. 

104 The NIS–1 report did use the phrase “reporting rate,” but that is misleading for the reasons discussed 

here. The NIS–2 report attempted to clarify this by variously referring to “CPS awareness” of the 

children, or to children who were “officially known to CPS,” but those labels could have been 

misinterpreted to refer to all reported cases, whether or not CPS accepted them for investigation. The 

NIS–4 and the NIS–3 preferred the phrase “investigation rate” because it more clearly indicates that cases

screened-out from investigation are not included, despite the fact that a reporter had attempted to bring 

them to CPS attention. Nor does the NIS “investigation rate” include those children who receive forms of

CPS attention other than an investigation, such as assessments or what the field calls “alternative 

response” services. 

8–3
 
 

 

Figure 8–1.	 Changes in Rates of CPS Investigation of Children with

Harm Standard Maltreatment 

Figure 8–1 also shows that the total number of maltreated children who are 

investigated per 1,000 children in the population has remained approximately level since 

the NIS–2, at 6.5 per 1,000 children in the NIS–2 and NIS–3 and at the statistically 

equivalent rate of 5.5 per 1,000 children in the NIS–4. Subsequent sections consider 

various factors that may affect the investigation rate: sentinels not reporting maltreated 

children to CPS, or CPS screening out reports on these children or assigning them for a 

non-investigation agency response. 

CPS Investigation Rates by Harm Standard Maltreatment Categories

and the Nature and Severity of Harm 

Figure 8–2 shows the NIS–4 investigation rates for children with different 

categories of Harm Standard maltreatment and different levels of harm from their 

maltreatment. As in earlier chapters, children are included in every maltreatment 

category that applied to them, but they are included in only one level of outcome severity, 

8–4
 
 

 

based on the most serious harm they suffered from countable maltreatment. The figure 

excludes children who died as a result of their maltreatment, because their numbers are 

too small to appear 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 harm noted. The 

percentage shown next to each category label indicates the portion of the bar on the left 

side of the graph, reflecting the percentage in the category that CPS investigated. 

Categorizing children as having received CPS investigative attention is a 

child-level conclusion, not specifically associated with the specific categories of 

maltreatment they experienced. This means, for example, that educationally neglected 

children who are classified as having been investigated by CPS may have been 

maltreated in multiple ways, and the CPS investigation may, in fact, have focused on one 

of the other categories of maltreatment they suffered, not on their educational neglect. 

Thus, the extent of CPS investigation for each maltreatment category is a generous 

measure, including children who may have received a CPS investigation for something 

other than the specific maltreatment in question.105 

Despite the fact that these percentages overstate the extent of CPS 

investigation, they are still notably low. As reported above, 32% of all children 

countable under the Harm Standard had their maltreatment investigated by CPS. Figure 

8–2 shows that one-half of all a children who experienced abuse were investigated. 

Slight majorities of children who were physically abused (53%) or sexually abused (55%) 

received an investigation. Emotionally abused children and neglected children had lower 

rates of CPS investigation (36% and 20%, respectively). As previous NIS studies also 

found, educationally neglected children had the lowest investigation rate (9%). 

105 Moreover, the maltreatment that was the focus of the CPS investigation need not have been countable

under the study definitions. 

8–5
 
8–6
 

Figure 8–2. CPS Investigation of Maltreated Children in the NIS–4, by Harm Standard Maltreatment Category and 

Severity of Harm 
 

 

Less than one-third of the children who experienced serious harm (30%) or 

moderate harm (29%) due to Harm Standard maltreatment received CPS investigation. 

However, CPS investigated maltreatment of 69% of those children whose maltreatment 

was so extreme that their harm could be inferred. 

Changes since the NIS–2 and the NIS–3 in Rates of CPS Investigation of

Harm Standard Maltreatment. 

As the above discussion of Figure 8–1 reported, the rate of investigation of 

overall Harm Standard maltreatment did not statistically change between the NIS–3 

(28%) and the NIS–4 (32%), while the decrease since the NIS–2 (44%) was statistically 

marginal. Figure 8–3 shows the categories of Harm Standard abuse with statistically 

meaningful changes in investigation rates since the NIS–2. 

Figure 8–3.	 Changes in Investigation Rates for Harm Standard Abuse 

Across NIS Cycles 

The 10% increase in the rate of investigation for overall Harm Standard 

abuse between the NIS–3 (40%) and the NIS–4 (50%) was a statistically marginal 

change. This increase brought the NIS–4 investigation rate up to level that is not 

statistically different from its level during the NIS–2 (60%). 

8–7
 
 

 

 

CPS investigated more than one-half the children who were sexually abused 

under the Harm Standard in the NIS–4, which reflects a marginal increase since the NIS– 

3 in the investigation rate for this category (55% vs. 42%). This latest rate is not 

statistically different from the NIS–2 level (72%), largely because of the wide margin of 

error on that earlier estimate. 

CPS investigation of emotionally abused children significantly increased 

since the NIS–3, from 21% to 36%. The new rate does not differ from the NIS–2 

investigation rate for emotional abuse. 

Two statistically meaningful changes occurred in CPS investigation of Harm 

Standard neglect, depicted in Figure 8–4. CPS investigated children with Harm Standard 

emotional neglect at a significantly higher rate in the NIS–4 (30%) than in the NIS–3 

(18%). Here, too, the NIS–4 investigation rate for emotional neglect does not differ from 

the NIS–2 rate. 

Figure 8–4.	 Changes in Investigation Rates for Harm Standard Neglect

Across NIS Cycles 

Although the CPS investigation rate for educational neglect showed 

essentially no change since the NIS–3, the NIS–4 rate of 9% remains marginally below 

the NIS–2 level, when CPS investigated 15% of educationally neglected children. 

8–8
 
 

 

Figure 8–5 shows that CPS investigation rates changed since the NIS–2 for 

children whose most serious harm from Harm Standard maltreatment was at the moderate 

level or whose harm could be inferred from the severity of their maltreatment events. 

The investigation rate for children whose harm from maltreatment could be inferred rose 

significantly from 48% in the NIS–3 to 69% in the NIS–4. The NIS–4 investigation rate 

for children with inferred harm does not differ from the NIS–2 investigation rate for this 

category. 

Figure 8–5.	 Changes in Investigation Rates for Children by the Severity of

Their Most Serious Harm from Harm Standard Maltreatment 

Across NIS Cycles 

The CPS investigation of children who suffered moderate harm due to their 

Harm Standard maltreatment showed no change since its level during the NIS–3, but the 

NIS–4 rate (29%) is marginally lower than the rate observed at the time of the NIS–2 

(40%). 

CPS Investigation Rates by the Source Recognizing Harm Standard

Maltreatment. 

Figure 8–6 shows the investigation rates for children who experienced Harm 

Standard maltreatment according to their recognition source. 

8–9
 
8–10
 

Figure 8–6. CPS Investigation of Children with Harm Standard Maltreatment in the NIS–4, by Recognition Source 
 

As Chapter 7 described (§7.1.1), the strategy for assigning recognition 

sources uses a hierarchy (shown by their ordering in the figure) and defines mutually 

exclusive categories, allocating each child to the first applicable source in the listing. 

Similar to the approach in Figure 8–2, the absolute size of a bar in this figure reflects the 

total number of children per 1,000 who experienced Harm Standard maltreatment and 

were recognized by the source in question. The percentage displayed next to the label for 

each recognition source indicates the portion of the bar that is on the left side of the 

graph, reflecting the percentage of children from that recognition source whom CPS 

investigated. 

The first three recognition sources in this figure (juvenile probation, 

police/sheriff, and public health) are investigatory agencies. Taken together, CPS 

investigated 48% of the children recognized as maltreated by staff in these investigatory 

agencies. Within this group, CPS investigated more than one-half (53%) of the children 

recognized by law enforcement, whereas investigation rates were lower for children 

recognized by staff in juvenile probation and public health departments (42% and 26% 

respectively). 

CPS investigated only 21% of the children identified by sentinels in noninvestigatory agencies (hospitals, schools, day care centers, mental health agencies, 

voluntary social service agencies, shelters, and public housing). In general, the agencies 

in this group recognized the greatest proportion of Harm Standard maltreated children, 

and this group also had the vast majority of those who did not receive a CPS 

investigation. Social service agencies had the highest rate of CPS investigation (91%). 

Public housing, a new category in the NIS–4, ranked second with CPS 

investigating 68% of the Harm Standard countable children they recognized. However, 

this source recognized a considerably smaller number of countable children compared to 

other agencies, as evidenced by the almost indiscernible size of its bar in the figure. 

Among the children recognized by mental health agencies, 43% received official 

attention from CPS for their maltreatment. Hospitals ranked fourth in this category with 

CPS investigating slightly more than one-fourth of the maltreated children they 

recognized (27%). Children recognized by school personnel were comparatively unlikely 

to receive CPS attention for their Harm Standard maltreatment. Although schools ranked 

as the predominant contributor to the recognition of children whose maltreatment fit the 

Harm Standard, CPS investigated only a small minority of these children (16%). Finally, 

8–11
 
 

 

children recognized at shelters, also a new sentinel category in the NIS–4, and day care 

had by far the lowest rates of CPS investigation for the children they recognized (14% 

and 10% respectively). 

The last category in Figure 8–6, CPS-only sources, includes children who 

only enter the NIS through CPS investigations of reports from agencies and individuals 

that are not represented among the NIS sentinels. As detailed in Chapter 7, these sources 

include private practice physicians, friends, neighbors, and anonymous reporters, among 

others. Because NIS represents these sources only through the children they report to 

CPS, the investigation rate for the children they recognize is, by definition, 100%. 

Note that the rates of CPS investigation presented in the preceding sections 

all included the children contributed to NIS by these “CPS-only” sources. As a result, 

those rates are inflated to some degree, overstating the rate of CPS investigation. If one 

excludes the CPS-only sources and computes a revised rate based only on children from 

sources that can also contribute uninvestigated maltreated children to NIS, the overall 

rate of investigation for Harm Standard maltreatment reduces to 26% (compared to 32% 

based on all maltreated children, as presented earlier). 

A further implication of the fact that NIS cannot observe the uninvestigated 

children who are known to CPS-only sources is that the NIS underestimates the total 

population of maltreated children to an unknown degree. There are “deeper” sectors 

within the “iceberg” of maltreated children not investigated by CPS not included in the 

NIS, and therefore, not represented in any of the tables or figures presented in this report 

(i.e., children who would be countable under the study definitions and who are 

recognized by professionals in private practice or by the general public but who are not in 

any CPS investigation). 

Changes since the NIS–3 in CPS Investigation Rates by the Source

Recognizing Harm Standard Maltreatment. 

Analyses compared the NIS–4 investigation rates for Harm Standard children 

recognized by each source with the corresponding investigation rates in the NIS–3. In 

the NIS–3, 33% of children recognized by investigatory agencies had their maltreatment 

investigated by CPS, whereas 48% of these children received CPS investigation in the 

8–12
 
 

8.1.2	 CPS Investigation of Children Maltreated under the

Endangerment Standard 

 

NIS–4, a significant increase. By contrast, the non-investigatory sentinel agencies, as a 

group, evidenced no statistically reliable change in CPS investigation rates between the 

NIS–3 and NIS–4. 

Figure 8–7 displays the significant increases in the investigation rates for 

specific recognition sources. NIS–4 investigation rates were significantly higher for 

children recognized by staff in juvenile probation, public health, and social services 

agencies. 

Figure 8–7.	 Changes since NIS–3 in Investigation Rates of Harm Standard Children 

by Recognition Source 

CPS investigations of Endangerment Standard maltreatment increased 

significantly from 33% in the NIS–3 to 43% in the NIS–4. The NIS–4 Endangerment 

Standard investigation rate does not differ statistically from its level at the time of the 

NIS–2 (51%), primarily because there was a relatively large margin of error around that 

earlier estimate. Figure 8–8 shows these patterns. 

8–13
 
 

 

Figure 8–8.	 Changes in Rates of CPS Investigation of Children with Endangerment 

Standard Maltreatment. 

CPS Investigation Rates by Endangerment Standard Maltreatment

Categories and the Nature and Severity of Harm 

Figure 8–9 shows the NIS–4 investigation rates for children with different 

categories of Endangerment Standard maltreatment and different levels of harm due to 

their maltreatment. As in Figure 8–2 (which provides the corresponding information for 

children with Harm Standard maltreatment), children are included in every maltreatment 

category that applied to them, but they are classified into only one level of harm, based 

on the most serious harm from countable maltreatment. The figure excludes fatalities 

because their numbers are too small to be discerned on the graph. The absolute sizes of 

the bars reflect the total number of children per 1,000 who experienced the maltreatment 

or harm, while the portion of the bar to the left side of the graph shows number of 

children in the category whom CPS investigated. For each category, the label indicates 

the percentage of children the left portion of the bar represents. 

8–14
 
8–15
 

Figure 8–9. CPS Investigation of Maltreated Children in the NIS–4, by Endangerment Standard Maltreatment Category 

and Severity of Harm 
 

 

 

Just as in the Harm Standard, the investigation rate for abused children is 

higher than the rate for neglected children, but the difference (49% versus 41%) is not as 

dramatic. The rates of investigation in all categories of Endangerment Standard abuse are 

similar to the corresponding categories in the Harm Standard (cf. Figure 8–2). However, 

the investigation rates for Endangerment Standard neglect are notably higher than those 

for Harm Standard neglect in all categories except educational neglect (which follows 

identical definitions under the Harm and Endangerment standards). Under both standards, 

the educationally neglected children are the least likely to receive CPS investigation of 

their maltreatment (9%). 

Also similar to the Harm Standard pattern, CPS investigated less than onethird of the children who experienced serious harm (31%) or moderate harm (29%) due to 

their maltreatment. CPS investigated 53% of the children whose harm could be inferred 

based on the severity of their Endangerment Standard maltreatment. Sixty percent of the 

children, who were endangered, but not yet harmed, received a CPS investigation. 

Changes since the NIS–2 and the NIS–3 in Rates of CPS Investigation of

Endangerment Standard Maltreatment. 

Figure 8–10 displays the statistically reliable changes in CPS investigation 

rates for Endangerment Standard abuse. Nearly one-half (49%) of the children countable 

as abused under the Endangerment Standard had their maltreatment investigated by CPS 

in the NIS–4, a marginal increase from the 39% investigation rate of abused children in 

the NIS–3. However, this NIS–4 rate remains significantly below the investigation rate 

for this category during the NIS–2, when CPS investigated 63% of children with 

Endangerment Standard abuse. 

Within specific categories of Endangerment Standard abuse, the only 

significant change in investigation rates occurred for emotionally abused children. CPS 

investigations of emotional abuse significantly increased from 28% in the NIS–3 to 40% 

in the NIS–4. This new rate does not differ statistically from the NIS–2 rate of 51%. 

8–16
 
 

Figure 8–10.	 Changes in Investigation Rates for Endangerment Standard Abuse

Across NIS Cycles 

The sexual abuse investigation rate increased marginally in the NIS–4, up to 

56% from its NIS–3 level of 44%, but it remained marginally lower than its high of 75% 

at the time of the NIS–2. 

CPS investigation of Endangerment Standard physical abuse showed no 

statistically reliable change since the NIS–3; it remained marginally lower than its level 

during the NIS–2 (52% versus 64%). 

Figure 8–11 depicts the changes in rates of CPS investigation of 

Endangerment Standard neglect since the NIS–2, the study that first introduced the 

Endangerment Standard. Compared to NIS–3 CPS investigation rates for Endangerment 

Standard neglect, the NIS–4 investigation rates for overall neglect and emotional neglect 

were significantly higher (41% versus 28% and 50% versus 22%, respectively). These 

recent increases brought the investigation rates for these categories to levels that are 

statistically equivalent to the NIS–2 rates. 

Because the definition of educational neglect is identical under the two 

definitional standards, the pattern in Figure 8–11 is identical to that shown in Figure 8–4. 

The discussion of that earlier figure provides the details. 

8–17
 
Only the rate of investigation for children who were endangered, but not yet 

harmed, increased significantly since the NIS–3 (from 40% to 60%). The new NIS–4 

Figure 8–11.	 Changes in Investigation Rates for Endangerment Standard Neglect 

Across NIS Cycles 

Figure 8–12 shows the statistically meaningful changes since the NIS–2 in 

CPS investigation of children with different outcomes from Endangerment Standard 

maltreatment. 

Figure 8–12.	 Changes in Investigation Rates for Children by the Severity of Their 

Most Serious Harm from Endangerment Standard Maltreatment 

Across NIS Cycles 

8–18
 
 

 

rate is still marginally lower than the very high rate of investigation of endangered 

children at the time of the NIS–2 (79%). 

The NIS–4 found no discernable change in the rate of CPS investigation of 

children who were moderately injured by their Endangerment Standard maltreatment. 

These children were still significantly less likely to be investigated by CPS in the NIS–4 

than they had been during the NIS–2 (29% versus 43%). 

CPS Investigation Rates by the Source Recognizing Endangerment

Standard Maltreatment 

Figure 8–13 shows the investigation rates for children who experienced 

Endangerment Standard maltreatment according to the source that recognized their 

maltreatment. This figure is analogous to the earlier Figure 8–6, which presented this 

graph for the subset of children who experienced Harm Standard maltreatment. Details 

concerning the hierarchical strategy for assigning recognition sources can be found in 

Chapter 7 (§7.1.1). 

The majority of the children who experience Endangerment Standard 

maltreatment that comes to the attention of juvenile probation (63%) or law enforcement 

(64%) staff receive CPS investigation for their maltreatment. The rate of CPS 

investigation for children recognized by public health departments is much lower (33%). 

This pattern is very similar to the Harm Standard findings (cf. Figure 8–6). Taken 

together, 61% of all the maltreated children investigatory agency staff recognized 

received CPS investigation. 

By contrast, children whose maltreatment was recognized by sentinels in 

non-investigatory agencies had much lower CPS investigation rates. Considering all 

children recognized by sentinels in non-investigatory agencies, only one-fourth (25%) 

had their maltreatment investigated by CPS. However, the investigation rates in the noninvestigatory agencies have a relatively wide range, from 12% to 94%; this also mirrors 

the Harm Standard findings described above. 

8–19
 
8–20
 

Figure 8–13. CPS Investigation of Children with Endangerment Standard Maltreatment in the NIS–4, by Recognition Source. 
 

 

 

Sentinels in only three non-investigatory agency categories had CPS 

investigate the majority of the children they recognized as maltreated: social services, 

public housing, and mental health agencies. Children recognized at social services 

agencies had the highest rate of CPS investigation (94%). Children recognized at public 

housing authorities (a new sentinel category in the NIS–4) ranked second with 67% 

receiving CPS investigation. Here again, as was the case for the Harm Standard findings, 

this source contributed very few countable children to the NIS, so the bar representing 

these children is almost indiscernible in the figure. Among children recognized by 

mental health sentinels, 53% received investigative attention from CPS. 

Hospitals ranked fourth among the non-investigatory agencies in the 

investigation of children they recognized as maltreated, with only one-quarter of the 

children they recognized receiving CPS investigation (25%). 

Only one-fifth (20%) of the children with Endangerment Standard 

maltreatment recognized at schools received CPS investigation. In view of the sheer 

magnitude of their contribution to the NIS estimates of recognized maltreated children, 

this low investigation rate contributes disproportionately to the investigated versus not 

investigated subgroups. School sentinels rank third as a source of investigated 

Endangerment Standard children (i.e., the size of their contribution to the investigated 

population, on the left side of the figure). They contribute 17% of the total investigated 

Endangerment Standard children. In contrast, the contribution of school sentinels to the 

right-hand side of the figure, which represents the Endangerment Standard children who 

are not investigated, far outweighs the contribution of all the other groups. School 

sentinels contribute 52% of all the children represented on the right-hand side of the 

figure: the Endangerment Standard children who are not investigated. 

Children recognized by professional staff in shelters, another new sentinel 

source in the NIS–4, and those recognized by day care center personnel were unlikely to 

receive CPS investigation of their maltreatment (only 19% and 12%, respectively). 

As noted above in connection with Figure 8–6, children recognized by “CPSonly Sources” can only enter the NIS through a CPS investigation. These children, by 

definition, universally receive CPS investigation. Including these children in the CPS 

investigation rates gives an overestimate of the extent of CPS investigation of countable 

8–21
 
 

 

 

 

maltreated children. With these children excluded, the overall rate of CPS investigation 

of Endangerment Standard maltreatment drops to 35% (compared to 43%, based on all 

Endangerment Standard children, as given previously). 

Changes since the NIS–3 in CPS Investigation Rates by the Source

Recognizing Endangerment Standard Maltreatment. 

Figure 8–14 displays the four sentinel categories where CPS investigation 

rates evidenced significant changes since the NIS–3—all categories display increases. 

The investigation rate rose from 23% to 63% for those children recognized as maltreated 

by juvenile probation staff. The rate increased from 4% to 33% for maltreated children 

whom public health agency personnel identified. The investigation rate also increased 

greatly for children seen as maltreated by workers in social services agencies, from 33% 

to a sizeable 94%. The smallest reliable change occurred for children recognized by day 

care staff—the investigation rate rose from just 3% in the NIS–3 to 12% in the NIS–4. 

Figure 8–14. Changes since NIS–3 in Investigation Rates of Children with 

Endangerment Standard Maltreatment by Recognition Source 

8–22
 
 

8.2 Investigation Rates with an Extended CPS Period 

The NIS obtains a full census of all cases participating CPS agencies 

investigated during the study reference period and uses this to identify which of the 

countable children are among those in CPS investigation records with identified 

maltreatment. As Chapter 2 discussed, an enhancement to the NIS–4 design obtained an 

additional month of data on CPS investigated cases to see whether the information from 

this extended period would identify significantly more countable children as having 

received CPS investigation. The hypothesis was that the maltreated children that 

sentinels encounter near the end of the study reference period have less time to appear in 

CPS investigations during the standard reference period, so the extended month of CPS 

data would especially affect their investigation rate. 

Following this plan, the NIS–4 collected CPS Summary Data Forms for an 

additional month, from all NIS–4 sampled CPS agencies (n=126). These forms totaled 

38,398 and listed an additional 77,995 child records. 

Special analyses identified those countable children whose investigation 

status changed on the basis of the extended month of CPS data. As the ensuing 

paragraphs indicate, nearly all countable children in the NIS–4 were investigated during 

the study reference period or not at all. Extending the CPS data period by an additional 

month had negligible effect on investigation rates under either definitional standard. 

Harm Standard. The extended month of CPS investigation data changed 

the investigation status of just 25 children in the NIS–4 sample who experienced 

countable maltreatment under the Harm Standard. (An additional 18 sample children with 

Harm Standard maltreatment had CPS investigations both during the main reference 

period and during the extended month; the additional month did not change their 

investigation status.) The reallocation of these 25 sample children increased the estimated 

total number of Harm Standard children in the United States who received CPS 

investigation by 16,400. This increased the estimated percentage of Harm Standard 

children who received CPS investigation by 1.3%, from 31.8% to 33.1%. 

Endangerment Standard. Among the more than 12,000 children in the 

NIS–4 sample with Endangerment Standard maltreatment, the extra month of data 

affected the classification of just 50 children. (An additional 27 of them were investigated 

8–23
 
8.3 Investigation Patterns Related to CPS Screening Policies 

during the extra month but were already classified as investigated during the study 

reference period.) These 50 additional children increased the national estimate of the 

number of Endangerment Standard children who received CPS investigation by 22,800. 

This increased the investigation rate for Endangerment Standard children by 0.8% from 

43.4% to 44.2%. 

Thus, extending the period for seeking maltreated children in CPS 

investigations by an additional month (from 3-months to 4-months) raised the NIS–4 

investigation rates across definitional standards by only about 1%. 

The NIS–4 provides estimates of the numbers and percentages of maltreated 

children who received CPS investigation. Because of the limitations of the NIS data, the 

children who were not investigated have always represented an enigma to the study, in 

that it is not possible to say whether the sentinels who recognized their maltreatment did 

not report it to CPS or whether they did report it to CPS but CPS did not investigate the 

child because the circumstances did not fit the agency’s criteria for screening the case in 

for investigation. These alternatives have quite different implications for policy. 

As Chapter 2 discussed, the NIS–4 includes supplementary studies to help 

understand the situation of countable children who do not receive CPS investigation. 

One of these, the CPS Screening Policies Study (SPS), obtained detailed information 

about CPS screening criteria to determine what role they might play in screening out 

countable children from CPS investigations (Greene, McPherson, and Sedlak, 2010).. 

In the first phase of the SPS, project staff interviewed the intake supervisors 

in NIS–4 CPS agencies about their agencies’ screening criteria, asking them how their 

agency would respond to situations described in a series of vignettes. The vignettes 

represented all specific forms of maltreatment specified in the NIS–4 maltreatment 

typology. In the second phase of the study, NIS–4 evaluative coders examined the data 

forms for countable children in the main study who had not received a CPS investigation. 

Considering children in the jurisdiction in each CPS agency, the coders applied the 

agency’s screening criteria to the maltreatment situations on the children’s data forms and 

decided whether, according to the criteria CPS purportedly used, the agency would have 

8–24
 
 

 

screened these children in for CPS investigation. This design assumes that the agency 

consistently applied the criteria the screening supervisor described in the interview. If so, 

then CPS would have screened these uninvestigated children in for an investigation, so 

the fact that they were not investigated indicates that they were probably not reported to 

CPS. Children whom the screening criteria would have screened out may or may not 

have been reported to CPS. It is possible that they were reported to the CPS agency in 

their jurisdiction, but CPS assigned them for an alternative response or screened them out 

with no agency response. It is also possible that they were not reported to CPS. 

This section presents the results of Phase 2 of the CPS Screening Policies 

Study, indicating how the agencies’ screening criteria would apply to the maltreatment 

described for the uninvestigated countable children. As in previous chapters and sections, 

this section first describes the findings for children who experienced Harm Standard 

maltreatment and then gives the findings for children who were countable under the more 

inclusive Endangerment Standard. For each standard, a figure and a table provide the 

findings from alternative perspectives. The figure focuses on the uninvestigated children 

who are countable under the standard. It shows the percentages of the uninvestigated 

children in different maltreatment categories that CPS probably would have investigated, 

based on the agencies’ screening policies. The qualifier “probably,” as used here, 

conveys the judgment of the evaluative coders, based on weighing the information on the 

data forms against the clarity of the screening criteria in the SPS interview responses. 

The subsequent table considers all the children who were countable as maltreated under 

the standard and displays, for each maltreatment category, the percentage that CPS 

actually investigated, the percentage that CPS probably would have investigated if CPS 

had received a report about them, and the sum of these percentages. The sum is termed 

the “presumptive investigation rate,” since it reflects what the investigation rate would be 

if all the countable children were reported to CPS and CPS consistently followed the 

criteria that the screening supervisor described in the SPS interview. 

CPS Screening Policies and Harm Standard Maltreatment. Figure 8–15 

shows the results of applying the CPS screening policies to sentinel reports of 

uninvestigated children with Harm Standard maltreatment. This figure subdivides the 

children who were not investigated in Figure 8–2 into those that CPS would have 

investigated, if the CPS agencies followed the screening standards the supervisors 

described in the SPS interviews, and the remaining uninvestigated children. The 

8–25
 
8–26
 

Figure 8–15. Uninvestigated Maltreated Children in the NIS–4 Whom CPS Probably Would Investigate According to 

Agencies’ Screening Criteria, by Harm Standard Maltreatment Category 
 

 

 

 

 

remaining children include those who did not reside in a NIS–4 county, those that the 

CPS screening criteria would have screened out from an investigation (whether screening 

them out without any agency response or assigning them for an alternative agency 

response, such as an assessment), as well as children whose classification according to 

the CPS criteria was unclear.106 

Figure 8–15 indicates that CPS would have probably investigated nearly 

three-fourths (72%) of the uninvestigated children who experienced maltreatment under 

the Harm Standard. Moreover, across all categories of Harm Standard maltreatment, 

CPS probably would have investigated the majority of uninvestigated children in each 

category. CPS would have probably investigated more than three fourths (79%) of 

uninvestigated children with Harm Standard abuse, and the same percentage (79%) of 

uninvestigated children who were physically abused. The percentage of uninvestigated 

children CPS would have investigated is even higher in the sexual abuse category (82%) 

and only slightly lower (75%) in the category of Harm Standard emotional abuse. 

CPS probably would have investigated 70% of uninvestigated children who 

experienced Harm Standard neglect. Majorities of the uninvestigated children would 

probably have been investigated in each specific category of neglect as well. CPS 

probably would have investigated 80% of uninvestigated physically neglected children. 

The percentage of uninvestigated children who would have been investigated, if reported, 

is highest for Harm Standard emotional neglect (85%), across all Harm Standard 

maltreatment categories. The percentage that CPS probably would have investigated is 

lowest for educational neglect (60%), but is still a majority of the uninvestigated children 

who experienced this maltreatment in this category. 

Table 8–1 displays the actual and presumptive CPS investigation rates for 

children with Harm Standard maltreatment. The first column shows the percentages of 

children whom CPS investigated, while the second column shows the additional 

percentages of the Harm Standard children who, based on CPS screening policies, 

probably would have received CPS investigation.107 The third column sums the first two 

106 This last group included children whose records had insufficient information to decide how the

screening criteria applied to their case as well as children in the jurisdiction of CPS agencies with unclear

criteria in relation to the child’s maltreatment. 

107 These percentages differ from those in Figure 8–15 because they are computed with different 

denominators. Figure 8–15 provides the percentages of children CPS would have investigated from all 

8–27
 
 

 

 

 

columns, providing the presumptive investigation rate, if all countable children were 

reported to CPS. The last column shows the percentage of children in the category that 

remain; these were not investigated. They include children CPS would have screened out 

from investigation, children the SPS coders could not evaluate because they did not 

reside within the jurisdiction of a NIS–4 CPS agency, and children whose classification 

according to the CPS screening criteria was unclear. 

Table 8–1. Rates of CPS Investigation of Harm Standard Maltreatment, Actual and 

Presumptive (based on CPS Screening Standards) 

Harm Standard 

Maltreatment Category 

A 

Observed 

Investigation

Rate 

B 

Inferred % 

CPS Would 

Have 

Investigated 

(A + B) 

Presumptive

Investigation

Rate 

C 

Remaining

Children 

ALL 

MALTREATMENT 32% 49% 81% 19% 

ABUSE: 

All Abuse 50% 39% 89% 11% 

Physical Abuse 53% 36% 90% 11% 

Sexual Abuse 55% 36% 92% 9% 

Emotional Abuse 36% 48% 84% 16% 

NEGLECT: 

All Neglect 20% 55% 75% 25% 

Physical Neglect 27% 58% 85% 15% 

Emotional Neglect 30% 59% 89% 11% 

Educational 

Neglect 9% 54% 63% 37% 

Notes: Columns A + B + C = 100%. 

The remaining children include children who did not reside in a NIS–4 county, children CPS

probably would have screened out or referred to an alternative response track, and children whose

classification according to the CPS screening criteria was unclear. 

those in the category who were not investigated, whereas Table 8–1, Column B, provides the percentages

these children represent among the total of children in the category (i.e., including those who actually

received a CPS investigation). 

8–28 
 

 

 

As reported at the outset of this chapter (§8.1), 32% of children who 

experienced Harm Standard maltreatment received CPS investigation. According to the 

CPS Screening Policies Study findings, CPS probably would have investigated an 

additional 49% of these children, if it had received a report describing their maltreatment. 

Taking these groups together (children investigated by CPS and children whom one can 

infer CPS probably would have investigated (based on the operative screening standards), 

the presumptive investigation rate is 81% of children with Harm Standard maltreatment. 

Table 8–1 also shows that, while CPS investigated 50% of the children who 

experienced any category of Harm Standard abuse, an additional 39% probably would 

have been investigated if reported to CPS, for a presumptive investigation rate of 89%. 

Similarly, the presumptive investigation rates are 90% and 92% for the physically and 

sexually abused children, respectively. Interestingly, only 36% of children with Harm 

Standard emotional abuse received CPS investigation. However, CPS probably would 

have investigated an additional 48% of children in this category, based on CPS screening 

standards, which results in a presumptive investigation rate of 84%. 

Among children with Harm Standard neglect, only 20% received CPS 

investigation. However, based on what CPS screening supervisors said their agency 

would do in the SPS interviews, CPS probably would have investigated an additional 

55% of the neglected children, increasing the presumptive investigation rate for the 

neglected children to 75%. The presumptive rates are 85% and 89% for physical neglect 

and emotional neglect, respectively. Although the presumed gain in percentages of 

investigated neglected children is high across all three neglect categories, it is most 

striking for children who were educationally neglected. 

CPS investigated only 9% of the educationally neglected children, but an 

additional 54% probably would have received CPS investigation if someone had reported 

them to the CPS agency with jurisdiction for their cases. This dramatic difference 

warrants further explanation. As described earlier, some children are maltreated in 

multiple ways and all are included in every maltreatment category that applies to them. 

As a result, CPS may have investigated an educationally neglected child because the 

child also experienced another category of maltreatment. The same dynamic applies to 

the inference that CPS would have investigated a maltreated child. The SPS coders 

separately assessed how the CPS screening criteria would apply to each category of 

maltreatment the child experienced. However, the final classification is at the child level, 

8–29
 
determining whether the child would have received CPS investigation for any 

maltreatment described on the data form. Thus, the conclusion that CPS probably would 

have investigated an educationally neglected child may derive from maltreatment other 

than educational neglect. 

CPS Screening Policies and Endangerment Standard Maltreatment. 

Figure 8–16 shows the results of applying CPS screening policies to sentinel reports of 

uninvestigated children with Endangerment Standard maltreatment. This figure 

subdivides the children who were not investigated in Figure 8–9 into the set that CPS 

would have investigated if someone had reported them to CPS, and the remaining 

uninvestigated children. Similar to the findings for uninvestigated children with Harm 

Standard maltreatment, CPS probably would have investigated the majority of children in 

each Endangerment Standard maltreatment category. 

CPS probably would have investigated 66% of the uninvestigated children 

who experienced Endangerment Standard maltreatment, more than three-fourths (76%) of 

those with Endangerment Standard abuse, and 67% of those neglected under the 

Endangerment Standard. 

Considering the specific categories of Endangerment Standard abuse, CPS 

probably would have investigated 76% of physically abused uninvestigated children and 

71% of those emotionally abused. The largest percentage of probable investigation 

occurred in the category of Endangerment Standard sexual abuse, where CPS probably 

would have investigated a full 83% of the uninvestigated children. 

Within specific categories of Endangerment Standard neglect, CPS probably 

would have investigated 70% of those who were physically neglected but not investigated 

and 74% of the emotionally neglected uninvestigated children. Educational neglect is 

identical under the two definitional standards, so the finding here is identical to that 

reported earlier in connection with the Harm Standard: CPS probably would have 

investigated 60% of the uninvestigated children who were educationally neglected. 

8–30
 
8–31
 

Figure 8–16. Uninvestigated Maltreated Children in the NIS–4 Whom CPS Probably Would Investigate According to 

Agencies’ Screening Criteria, by Endangerment Standard Maltreatment Category 
 

 

 

 

 

Table 8–2 shows the actual and presumptive CPS investigation rates for 

children with Endangerment Standard maltreatment. As presented for the Harm Standard 

findings (Table 8–1), the first column shows the percentages of children CPS actually 

investigated, while the second column shows the percentages of uninvestigated children 

who, based on agencies’ screening policies, CPS probably would have investigated if 

anyone had reported the children’s maltreatment to CPS. The third column is the sum of 

the first two columns, indicating the presumptive investigated rate, and the last column 

gives the percentage of remaining children. 

Table 8–2. Rates of CPS Investigation of Endangerment Standard Maltreatment,

Actual and Presumptive (based on CPS Screening Standards) 

Endangerment Standard

Maltreatment Category 

A 

Observed 

Investigation

Rate 

B 

Inferred % 

CPS Would 

Have 

Investigated 

(A + B) 

Presumptive

Investigation

Rate 

C 

Remaining

Children 

ALL 

MALTREATMENT 43% 37% 80% 20% 

ABUSE: 

All Abuse 49% 38% 87% 13% 

Physical Abuse 52% 36% 88% 12% 

Sexual Abuse 56% 36% 92% 8% 

Emotional Abuse 40% 42% 82% 18% 

NEGLECT: 

All Neglect 41% 39% 80% 20% 

Physical Neglect 41% 41% 82% 18% 

Emotional Neglect 50% 37% 87% 13% 

Educational 

Neglect 9% 54% 63% 37% 

Notes: A + B + C = 100% 

The remaining children (Column C) include children who did not reside in a NIS–4 county, children whom 

CPS probably would have screened out or referred to an alternative response track, and children whose

cases and/or corresponding CPS screening criteria were unclear. 

8–32
 
 

 

 

Similar to the patterns for the more stringent Harm Standard, findings from 

the CPS Screening Policies Study reveal the potential for major increases in the 

percentages of investigated children, if all were reported to CPS and CPS agencies 

consistently apply the screening criteria they identified in the SPS interviews. Among all 

children maltreated under the Endangerment Standard, the main NIS found that 43% 

percent actually received CPS investigation (§8.1.2). After applying the agencies’ 

screening criteria, however, the SPS found that an additional 37% probably would have 

received CPS investigation if they had been reported, resulting in a presumptive 

investigation rate of 80%. 

Among those children with Endangerment Standard abuse, CPS actually 

investigated 49%, but probably would have investigated an additional 38%, which sums 

to a presumptive investigation rate of 87%. More specifically, CPS probably would have 

investigated an additional 36% of both physically abused and sexually abused children, 

which yields presumptive investigation rates for these categories of 88% and 92%, 

respectively. Among emotionally abused children, the inferred percentage is somewhat 

higher, but when this is combined with the observed investigation rate which was the 

lowest among categories of abuse, the resulting presumptive investigation rate is the 

lowest across the specific abuse categories. Nevertheless, it is still notably high, 

including the large majority (82%) of the children with Endangerment Standard 

emotional abuse. 

Table 8–2 also shows that reports to CPS probably would have resulted in 

CPS investigations for large percentages of children classified as neglected under the 

Endangerment Standard. While 41% of all neglected children actually received CPS 

investigation, CPS probably would have investigated an almost equivalent number, an 

additional 39%, if anyone had reported them. CPS probably would have investigated an 

additional 41% of children with Endangerment Standard physical neglect and an 

additional 37% of those with emotional neglect, resulting in presumptive investigation 

rates in these categories of 82% and 87%, respectively. For the educationally neglected 

children, as given earlier in Table 8–1, CPS would have investigated 54% more children, 

yielding a presumptive investigation rate of 63%, according to the SPS findings. 

8–33
 
 

 

 

8.4 Relationship between CPS Investigation and CPS Agency 

Structure and Practices 

As described in Chapter 2, the CPS Structures and Practices Mail Survey 

(SPM) collected information about various agency characteristics (Sedlak, McPherson, 

Shusterman, and Li, 2010). A series of special analyses examined the extent to which the 

characteristics agencies reported in this survey related to the rates of CPS investigation 

for children in their jurisdiction. The percentages of investigated children presented here 

are based on all countable maltreated children in the main NIS. 

State or regional hotline.108 Table 8–3 lists those Harm Standard 

maltreatment categories for which rates of investigation differed when a state or regional 

hotline screened referrals. 

Table 8–3. CPS Investigation Rates for Harm Standard Maltreatment Related to 

Whether a State or Regional Hotline Screened Referrals. 

Maltreatment Category 

Any State or 

Regional

Hotline 

Screening 

Local 

Screening Only 

Significance of

Difference 

ABUSE: 

All Abuse 

Physical Abuse 

NEGLECT: 

Emotional Neglect 

Educational Neglect† 

46 

48 

25 

13 

59 

65 

37 

7 

m 

* 

* 

m 

* The difference is significant at p<.05. 

m The difference is statistically marginal (i.e., .05 < p ≤ .10). 

† Educational neglect is identical under the Harm and Endangerment Standards. 

When a state or regional hotline screened referrals, rates of investigation 

differed for children who experienced Harm Standard abuse, physical abuse, emotional 

108 The CPS Screening Policies Study (SPS) also obtained information about hotline use. The analyses in

this section used the SPS hotline data, since it was verified by multiple sources at the state and local

agency levels. 

8–34 
 

 

 

neglect, and educational neglect. Except for educationally neglected children, maltreated 

children living in jurisdictions where a state or regional hotline conducted screening were 

less likely to receive a CPS investigation than children in jurisdictions with all screening 

by the local agency. However, CPS was marginally more likely to investigate 

educationally neglected children in places where a state or regional hotline did screening. 

State or regional hotline screening was related to the investigation rate of 

only one Endangerment Standard maltreatment category: physical abuse. Similar to the 

Harm Standard, physically abused children were less likely to receive CPS investigation 

when a state or regional hotline screened referrals (48% versus 61%), a statistically 

marginal difference. 

Sharing of responsibility for investigation. Agencies answered a series of 

questions asking whether they had sole responsibility for investigating different 

categories of maltreatment or whether they shared that responsibility with law 

enforcement or with another agency. Analyses found that whether CPS had sole 

responsibility or shared responsibility for investigating a given type of maltreatment was 

not related to investigation rates for the following maltreatment categories: non-severe 

physical abuse, severe physical neglect, and emotional abuse/neglect.109 However, when 

the agency had sole responsibility for investigating non-severe physical neglect, CPS 

investigation rates were significantly lower for children with Harm Standard physical 

neglect (26% versus 43%) and marginally lower for children with Endangerment 

Standard physical neglect (41% versus 51%). CPS was more likely to investigate 

educationally neglected children when it had sole responsibility for investigating truancy 

(17%) than when it shared this responsibility with another agency (7%), a statistically 

marginal difference. Also, when the agency had sole responsibility for investigating 

abandonment, children who experienced Endangerment Standard physical neglect (the 

NIS category that includes abandonment) were less likely to receive a CPS investigation 

(37% versus 50%), a significant difference. 

Treatment of new reports on open cases. In some agencies, a new report 

on a child or family that is already the focus of an open investigation is combined into the 

ongoing investigation. Other agencies establish a separate investigation record for these 

new reports. In agencies that combined new reports into existing investigations, 

109 The sample included too few sexual abuse cases to support a reliable statistical test for this category. 

8–35
 
 

 

 

 

 

 

 

 

 

 

investigation rates were lower for children with Harm Standard physical abuse (50% 

versus 70%), those with Endangerment Standard physical abuse (50% versus 64%), and 

those who experienced educational neglect (7% versus 14%). 

Excessive workload during the NIS reference period. Agencies reported 

whether they had an excessive workload in either screening or investigation during the 

NIS reference period.110 Their answers related to investigation rates in only a few 

maltreatment categories. 

When agencies reported that they had an excessive screening workload, 

children in their jurisdiction who suffered Harm Standard emotional neglect or 

Endangerment Standard emotional abuse had significantly higher investigation rates 

(37% versus 21% and 48% versus 30%, respectively). Children who experienced 

Endangerment Standard physical abuse received CPS investigation at a marginally higher 

rate (59% versus 47%). 

When agencies reported that they had an excessive investigation workload 

during the NIS reference period, children with educational neglect were significantly less 

likely to receive CPS investigation (7% versus 17%), and those with Harm Standard 

emotional neglect were marginally more likely to have CPS investigate their 

maltreatment (35% versus 24%). 

Alternative response track. An alternative response track is a means by 

which agencies can refer cases for assessment or services without conducting an 

investigation.111 As Tables 8–4 and 8–5 show, whether or not an agency had an 

alternative response track related to investigation rates across a wide range of 

maltreatment categories under both the Harm and Endangerment Standards. In all cases, 

maltreated children were much less likely to receive an investigation in jurisdictions that 

had an alternative response track. The investigation rate for educational neglect did not 

vary with the presence of an alternative response track.112 

110 The survey did not define the phrase “excessive workload,” but left it to the agencies’ interpretation. 

111 CPS agencies reported whether they could provide a response other than an investigation on two NIS–4 

supplementary surveys: both the SPM and the SPS. Generally, different agency staff responded to these

surveys and, in some instances, they offered contradictory responses. The analyses here classified an

agency as providing an alterative response if any respondent indicated this. 

112 The sample included too few sexual abuse cases to support a reliable statistical test for this category. 

8–36
 
Table 8–4. CPS Investigation Rates for Harm Standard Maltreatment Related to

Whether the Agency Provided an Alternative Response. 

Maltreatment Category 

Agency Provided Alternative 

Response Significance of

Difference

Yes No 

ALL MALTREATMENT 

ABUSE: 

All Abuse 

Physical Abuse 

Emotional Abuse 

NEGLECT: 

All Neglect 

Physical Neglect 

Emotional Neglect 

23 

40 

42 

26 

12 

14 

20 

38 

57 

63 

43 

25 

39 

35 

* 

m 

* 

* 

* 

* 

* 

* The difference is significant at p<.05. 

m The difference is statistically marginal (i.e., .05 < p ≤ .10). 

Table 8–5. CPS Investigation Rates for Endangerment Standard Maltreatment

Related to Whether the Agency Provided an Alternative Response. 

Maltreatment Category 

Agency Provided Alternative 

Response Significance of

Difference

Yes No 

ALL MALTREATMENT 

ABUSE: 

All Abuse 

Physical Abuse 

Emotional Abuse 

NEGLECT: 

All Neglect 

Physical Neglect 

Emotional Neglect 

29 

36 

38 

22 

26 

26 

32 

52 

58 

62 

51 

50 

53 

58 

* 

* 

* 

* 

* 

* 

* 

* The difference is significant at p<.05. 

8–37
 
 

 

 

•

•

•

•

•

 

Prioritizing recommended responses to referrals. Children who 

experienced Harm Standard physical abuse were investigated significantly more often in 

the jurisdiction of CPS agencies that did not prioritize responses to referrals (75%) than 

in jurisdictions where CPS did prioritize responses (55%). Educationally neglected 

children were more likely to receive CPS investigation in jurisdictions of agencies that 

did not prioritize responses (23%) than in jurisdictions where CPS did prioritize 

responses (8%), a statistically marginal difference. 

Agency characteristics not related to CPS investigation rates. Analyses 

found no significant relationship between investigation rates and several agency 

characteristics or practices, including whether or not the agency 

Maintained a record of all calls; 

Had sole responsibility for screening; 

Had a mandated limit on caseload size; 

Covered calls during off-hours (nights and weekends); and 

Had a dedicated investigation unit or investigation workers.113 

8.5 Sentinels’ Reporting to CPS 

The foregoing sections of this chapter indicated that substantial percentages 

of maltreated children do not receive CPS investigation and explored how investigation 

rates relate to CPS agencies’ screening policies, structure and practices. This section 

considers how sentinels’ non-reporting may contribute to the sector of maltreated 

children who did not receive a CPS investigation of their maltreatment. 

As Chapter 2 described, sentinels in the main NIS also participated in the 

Sentinel Definitions Survey (SDS) (McPherson and Sedlak, 2010). The first section of the 

SDS asked sentinels about their training on mandated reporting, their specific agency’s 

policies governing CPS reporting, and their personal experiences in reporting to CPS. 

The second section of the SDS presented a series of vignettes representing the 

113 This last characteristic marginally related to the rate of investigation of Harm Standard abuse, with the

investigation rate higher in jurisdictions with no dedicated investigation unit/workers. 

8–38
 
 

maltreatment situations that NIS classifies as countable and includes in the study 

estimates. Respondents indicated how they would respond to the circumstance described 

in each vignette, including whether they would report the situation to CPS. 

8.5.1	 Sentinels’ Training on Child Abuse and Neglect Reporting

Requirements 

Nearly two-thirds (67%) of sentinels said they had received written 

information about child abuse and neglect reporting requirements while working in their 

current agencies. Just over one-half (52%) of sentinels had attended a workshop or 

training on child abuse and neglect reporting. Taken together, about three-fourths (76%) 

of the sentinels participating in the SDS reported that they had either received written 

instructions or attended a workshop about their state’s reporting requirements, leaving 

about one-fourth (24%) who had neither form of training while working in their current 

agencies. 

Training was significantly related to sentinels’ reports to CPS, which are 

described below. Sentinels who indicated they had received training at their current 

agency (whether written materials or a workshop or other training session) were more 

likely to say they had reported suspected child maltreatment (67% versus 53%) while 

working at their current agency. 

Of those who had received written information, more than one-fourth (27%) 

reported that it had been more than two years since they last received it. Of those who 

said they had attended a workshop or other training session while working at their current 

agency, more than one-third (36%) said this had been more than two years earlier. 

8.5.2	 Agencies’ Policies on Child Abuse and Neglect Reporting and

Sentinels’ Reporting Histories 

In order to better understand sentinels’ actual reporting of child maltreatment, 

the SDS also obtained information about the sentinels’ reporting histories and their 

agencies’ policies on whether they permitted employees to make direct reports to CPS. 

Overall, 86% of the sentinels said their agencies allowed them to report child 

8–39
 
 

maltreatment directly to CPS. Among the sentinels whose agencies permitted direct 

reporting, 62% said they had personally reported suspected child abuse or neglect directly 

to CPS. 

Similar to the approach earlier (cf. Figure 7–3), the SDS analyses also 

subdivided sentinels into four broad groups, according to their agency category: health 

(hospitals and public health), law enforcement (sheriff, police, juvenile probation), 

school, and other (day care, social services, shelters, public housing). Figure 8–17 shows 

the percentage of sentinels in each group who worked at agencies that allowed them to 

report directly to CPS and, of those who were allowed to do so, the percentage who had 

actually reported a case of suspected child maltreatment to CPS while working for their 

current agencies. 

Figure 8–17.	 Percentages of Sentinels Whose Agency’s Policy Permits Individuals to 

Report to CPS and Who Have Personally Reported a Case. 

More sentinels from health (96%) and law enforcement (98%) said their 

agencies allowed direct reporting than did those from “other” agencies (83%) and schools 

(80%). Compared to sentinels in health agencies and law enforcement, fewer sentinels 

from both schools and the “other” agencies said that they were allowed to report 

suspected child maltreatment directly to CPS. More importantly, however, when 

sentinels were allowed to report directly to CPS, fewer school and “other” sentinels said 

they had ever reported a case (54% and 50%, respectively, compared to 87% among law 

enforcement sentinels and 77% among those in health agencies). 

8–40
 
 

 

 

 

 

 

 

8.5.3 Sentinels’ Expectations About Their Reporting to CPS 

The SDS questioned sentinels about their expected reactions to the kinds of 

maltreatment covered in the NIS, presenting vignettes that represented Harm Standard 

maltreatment situations and asking whether the sentinels would report these situations to 

CPS. The last column in Table 8–6 presents the average percentages of SDS respondents 

who said they would not report the category vignettes to CPS.114 For comparison, the 

center column provides the percentages of uninvestigated children with Harm Standard 

maltreatment in the NIS–4 who were recognized by sentinels. (These exclude children 

who entered the NIS–4 through CPS-only sources, as discussed earlier in relation to 

Figure 8–6.) 

The two columns derive from independent studies and reflect very different 

units and measures; therefore, they are not directly comparable.115 However, one 

important contrast is of interest, as are some notable similarities. 

The percentages in the two columns are starkly different. Whereas the NIS–4 

found that majorities of countable children were not investigated, only minorities of 

sentinels say they would not report the countable situations in the vignettes to CPS. The 

contrast is strong across all maltreatment categories. The sheer magnitude of these 

differences suggests that sentinels’ failures to report to CPS (as they describe in their 

SDS responses) are not sufficient to explain the large percentages of uninvestigated 

children in the NIS–4. 

Despite the important difference in overall percentages, the two columns 

share some similar patterns. In both columns, the percentages for neglect are higher than 

those for abuse. Thus, more neglected children are uninvestigated (85% versus 57% of 

abused children) and more sentinels say they would not report neglect situations to CPS 

(an average of 28% versus 15% who would not report the abuse situations). Also, in both 

114 The SDS questionnaire asked sentinels to select all applicable responses from a list of alternatives,

which included reporting the situation to CPS. Table 8–6 provides the percentages of sentinels who did 

not choose the “report to CPS” option. 

115 The “Limitations” discussion in Chapter 7 (§7.2) is relevant here as well. 

8–41
 
 

 

columns, the educational neglect percentage is highest, while the sexual abuse percentage 

is lowest. Educationally neglected children are least likely to receive CPS investigation 

(93% versus 80% or less of children with other maltreatment) and more sentinels say they 

would not report educational neglect to CPS (35% versus 28% or less who would not 

report other maltreatment). Among sexually abused children in the NIS–4, 53% do not 

receive CPS investigation (which is equivalent to the uninvestigated percentage of 

children with Harm Standard physical abuse but notably below the 70% or more who are 

not investigated in other specific maltreatment categories). Similarly sexual abuse was 

the category where the smallest percentage of sentinels (6%) predicted they would not 

report the vignette situations to CPS. 

Table 8–6. Percentages of Uninvestigated Children with Harm Standard

Maltreatment Recognized by Sentinels in NIS–4 and Percentages of SDS

Sentinels Who Would Not Report the Vignette Situations to CPS. 

Maltreatment Category 

Percentage of

Uninvestigated

Children Recognized

by Sentinels in NIS–4* 

Percentage of SDS

Sentinels Who Would 

Not Report to CPS† 

ALL MALTREATMENT 74 23 

ABUSE: 

All Abuse 57 15 

Physical Abuse 53 19 

Sexual Abuse 53 6 

Emotional Abuse 70 22 

NEGLECT: 

All Neglect 85 28 

Physical Neglect 80 20 

Emotional Neglect 76 28 

Educational Neglect 93 35 

* Excluding children identified to NIS–4 by CPS-only sources. 

† Average percentage of sentinels across all vignettes representing the category and across all sentinel 

groups. 

8–42
 
Finally, the fact that an overall average of nearly one-fourth (23%) of 

sentinels predicted they would not report Harm Standard maltreatment cases to CPS 

indicates that sentinels recognize a substantial number of maltreated children whom they 

do not report to CPS. Sentinels in all agency categories contribute to this reservoir of 

unreported children, but (according to their SDS responses) school sentinels contribute 

disproportionately. Whereas an average of 23% of all sentinels said they would not 

report the countable maltreatment cases to CPS, 29% of school sentinels did so. The 

school sentinels differ most from other sentinel groups in what they say about reporting 

neglect to CPS. An average of 33% of school sentinels say they would not report 

situations described in neglect vignettes compared to 21%–26% of sentinels in the other 

three agency groups (health, law enforcement, and other). By contrast, an average of 

only 18% of school sentinels said they would not report abuse situations, compared to 

12%–15% of sentinels in the other groups. 

8–43
 

 

 

9. CONCLUSIONS AND IMPLICATIONS
 

The NIS–4 revealed several important changes in the incidence of 

maltreatment since the time of the NIS–3. Are the observed changes in the incidence of 

child abuse and neglect real changes in the scope of the problem, or do they instead 

reflect changes in how sentinels and other reporters to CPS respond to the maltreated 

children they encounter? Before drawing fully informed conclusions on this question, 

further analyses of the NIS–4 data will be needed to see whether observed changes are 

localized to specific subtypes, to less severe forms of the maltreatment, or to certain 

recognition sources. However, the current information suggests that both of these 

dynamics contributed to the observed changes, each dynamic affecting a different sector 

of the abused and neglected population. 

The NIS–4 documented declines in rates of all categories of abuse across 

both definitional standards. The declines in sexual abuse and physical abuse are 

consistent with trends in CPS data gathered by the National Child Abuse and Neglect 

Data System (NCANDS, U.S. Department of Health and Human Services, 

Administration on Children, Youth and Families, 2007). As Finkelhor (2008) noted, 

several indicators suggest that these declines are real, including parallel declines in victim 

self-reports and the fact that the declines occurred broadly across abuse subtypes and 

sources in CPS data. This implies that the declines in NIS estimates of physical and 

sexual abuse are also real. However, since no independent information is currently 

available that bears on the incidence of emotional abuse, it is not clear whether the NIS 

decline in this category reflects a real decrease in its occurrence. 

The increase in the rate of emotional neglect since 1993 could, in part, signify 

a real increase in the occurrence of maltreatment, but it is fairly clear that it also reflects 

some change in policy and focus. Whereas the incidence of emotionally neglected who 

received CPS investigation rose significantly since the NIS–3, the incidence of 

emotionally neglected children who did not receive CPS investigation showed no 

statistical change from the NIS–3 level. Since the NIS–3, a number of CPS systems have 

undertaken initiatives to increase collaboration between CPS and agencies that serve 

domestic violence and alcohol and drug problems (U.S. Department of Health and 

Human Services, Administration for Children and Families/Children's Bureau and Office 

of the Assistant Secretary for Planning and Evaluation, 2001, 2003). The increased 

9–1
 
 

 

emotional neglect incidence may predominantly reflect the heightened CPS attention to 

these problems, which are involved in certain types of emotional neglect. Further 

analyses will clarify whether the increases in emotional neglect primarily occurred in 

specific types of emotional neglect or for children recognized at specific types of 

agencies. 

Another area where further analyses can illuminate the implications of the 

NIS–4 findings is in the interrelationships among the different factors associated with the 

incidence of maltreatment. Factors such as parents’ labor force participation, household 

socioeconomic status, family size, and family structure and living arrangement are not 

only associated with the incidence of maltreatment but are also correlated with each 

other. Further analyses could determine their independent relationships to maltreatment, 

such as whether households with more children have higher incidence rates even when 

household socioeconomic status is taken into account. Moreover, for the first time in 

NIS, the NIS–4 found race differences in the incidence of maltreatment, with higher 

incidence rates for Black children. Similar to the approach used in exploring the NIS–3 

data (Sedlak & Schultz, 2005), future analyses should examine whether these race 

differences in maltreatment rates remain when the disadvantaging effects of these family 

circumstances are taken into account. 

The NIS–4 findings on the strong correlations between socioeconomic status 

and all categories of maltreatment are consistent with earlier NIS findings on household 

income. As with the previous results, the recent observations cannot be plausibly 

explained by the claim that lower socioeconomic families are simply more visible to the 

community professionals who provide most of the data. The NIS sentinels observe 

substantial numbers of children and families at the middle- and upper-income levels. The 

people who recognize the large majority of maltreated children are likely to encounter 

maltreatment in all income levels, since they include sentinels in hospitals, schools, day 

care centers, mental health agencies, voluntary social service agencies, as well as 

professionals not represented by NIS sentinel categories and the general public. Sentinels 

in schools alone recognized the majority of the maltreated children. Although the NIS 

design includes only public schools, approximately 90% of school-age children attend 

public schools (Shin, 2005), so they represent a broad spectrum of socioeconomic status 

levels. Moreover, since the majority (more than 80%) of children in private schools 

(those not reflected in the NIS) are in religiously affiliated schools (Provasnik, 

KewalRamani, Coleman, Gilbertson, Herring, & Xie, 2007), which frequently have 

9–2
 
sliding scales for the poorer children, they are not necessarily from better economic 

circumstances than children enrolled in public schools. 

Moreover, if the higher maltreatment rates for children in families of low 

socioeconomic status were to be simply an artifact of selective observation, then it would 

mean there have to be enough undetected abused and neglected children in the higher 

socioeconomic status category to equalize the incidence rates across the upper and lower 

status groups. That would require a large number of still-undetected children in the 

nation who experience countable maltreatment. Specifically, it would mean that an 

additional 975,300 children suffered maltreatment according to the Harm Standard yet 

remained hidden to the NIS. Similarly, it would mean there were an additional 

2,457,200 children in 2005–2006 who experienced Endangerment Standard maltreatment 

but who escaped observation by community professionals. This would require an 85% 

higher overall estimate of the incidence of Endangerment Standard maltreatment, an 

estimated total of 5,363,000 children. That number is more than 7% of the total U.S. 

child population or more than 1 in every 14 children. Considering these implications, it 

appears more plausible to assume that the observed socioeconomic status differences in 

the incidence of maltreatment reflect real differences in the extent to which children in 

different socioeconomic conditions are being abused or neglected. 

Despite some increases in CPS investigation of maltreated children, the NIS– 

4 shows that investigation rates still remain fairly low. Similar to previous NIS findings, 

the NIS–4 again determined that the majority of maltreated children do not receive CPS 

investigation. The NIS–4 obtained information that shed additional light on this issue: 

•	 The NIS–4 determined that the finding is not an artifact of the 

relatively short (3-month) NIS reference period, since adding a full 

month of CPS data to increase the opportunity for more maltreated

children to enter CPS investigations made essentially no difference to

the percentages of children investigated. 

•	 Certain features of CPS structure and practice were associated with 

percentages of maltreated children who received investigation.

Children were less likely to receive CPS investigation if they were in

the jurisdiction of CPS agencies that received their referrals about

suspected maltreatment through a centralized regional or state hotline, 

that combined a new report into an ongoing open investigation on the

child or family, or that could offer an alternative response (other than

an investigation) to the children and families referred to them for 

9–3
 
suspected maltreatment. Also, children who experienced physical 

neglect were less likely to receive investigation if their CPS agency had

sole responsibility for investigating non-severe physical neglect. 

•	 The CPS Screening Policies Study found that if all maltreated children 

were reported to CPS and CPS agencies followed their current

screening policies, then a large majority of the maltreated children

(80% or more) would receive CPS investigation. 

•	 In the Sentinel Definitions Survey, sentinels responded to descriptions

of maltreated children, indicating that they would not report some of 

these to CPS. About one-fourth of sentinels (24%) had not received 

either written instructions nor attended a training on their state’s

reporting requirements while working in their current agency. More of 

those who had received information or training had reported suspected

child maltreatment. 

Schools predominated as a source of recognition for maltreated children, 

recognizing the maltreatment of 52% of the children with Harm Standard maltreatment 

and 39% of those with Endangerment Standard maltreatment. At the same time, 

however, 20% or less of the maltreated children recognized at schools received CPS 

investigation. As a result, schools recognized the majority of uninvestigated children 

under both definitional standards (64% under the Harm Standard and 55% under the 

Endangerment Standard). One factor that may contribute to the low investigation rate for 

school-recognized children is school policy barring staff from making direct reports to 

CPS. In the Sentinel Definitions Survey, 20% of school sentinels indicated that their 

schools do not permit them to report directly to CPS. However, other factors also 

contribute to low investigation rates for the school-recognized children, because even 

when agencies permitted direct reports, fewer sentinels in schools said they had reported 

a case (54%) compared to staff in health agencies (77%) or law enforcement (87%). 

Similar patterns emerged in the previous NIS cycles. To repeat the earlier 

recommendation: better working relationships should be forged between CPS agencies 

and schools, capitalizing on the unique role of school professionals as front-line 

observers. 

9–4
 
REFERENCES
 

Ahlbom, A., & Norell, S. (1984). Introduction to modern epidemiology. Chestnut Hill, 

MA: Epidemiology Resources, Inc. 

Brick, J.M., and Morganstein, D. (1996). WesVarPC: Software for Computing 

VarianceEstimates from Complex Designs. Proceedings of the 1996 Annual 

Research Conference, Bureau of the Census, 861-866. 

Brick, J.M., and Morganstein, D. (1997). Computing sampling errors from clustered 

unequally weighted data using replication: WesVarPC. Bulletin of the 

International Statistical Institute, Book 1, pp 479-482. 

Brogan, D.J. (1998). Pitfalls of Using Standard Statistical Software Packages for Sample 

Survey Data. In P. Armitage and T. Colton (Eds.), Encyclopedia of Biostatistics. 

New York: John Wiley and Sons. 

Children’s Bureau. (2000). Symposium on the Third National Incidence Study of Child 

Abuse and Neglect: A Summary Report on Proceedings, February 24-25, 1997. 

Washington, D.C.: U.S. Department of Health and Human Services. 

Finkelhor, D. (2008). Childhood victimization: Violence, crime, and abuse in the lives 

of young people. New York: Oxford University Press. 

Greene, A.D., McPherson, K., and Sedlak, A.J. (2010). Fourth National Incidence Study 

of Child Abuse and Neglect (NIS–4): CPS Screening Policies Study (SPS). 

(Prepared by Westat under contract to the Administration for Children and 

Families.) Washington, DC: Administration for Children and Families. 

Hartge, J., Basena, M., Cober, C. Klein, S., and Sedlak, A.J. (2008). Fourth National 

Incidence Study of Child Abuse and Neglect (NIS–4):Data Collection Report. 

(Prepared by Westat under contract to the Administration for Children and 

Families.) Washington, DC: Administration for Children and Families. 

Kish,L, (1992). Weighting for Unequal Pi

, Journal of Official Statistics, Vol. 8, pages 

183-200. 

Korn, E.L., and Graubard, B.I. (1995). Examples of Differing Weighted and Unweighted 

Estimates from a Sample Survey. The American Statistician, 49, 291-295. 

Korn, E.L., and B.I. Graubard. (1999). Analysis of Health Surveys. New York: Wiley. 

R–1
 
Landis, R.J., Lepkowski, J.M, Eklund, S.A., and Stehouwer, S.A. (1982). A Statistical 

Methodology for Analyzing Data from a Complex Survey: The First National 

Health and Nutrition Examination Survey. Vital and Health Statistics, 2(92), 

Washington, DC: National Center for Health Statistics. 

Lee, E.S., Forthofer, R.N. & Lorimor, R.J. (1989). Analyzing Complex Survey Data. 

Newbury Park, CA: Sage Publications. 

McPherson, K. and Sedlak, A.J. (2010). Fourth National Incidence Study of Child Abuse 

and Neglect (NIS–4): Sentinel Definitions Survey (SDS). (Prepared by Westat 

under contract to the Administration for Children and Families.) Washington, DC: 

Administration for Children and Families. 

Office of Management and Budget. (2000). Standards for defining metropolitan and 

micropolitan statistical areas; notice. Federal Register, Vol. 65, No. 249, 

December 27, 2000, 82228-82238. 

Office of Special Education and Rehabilitative Services, Department of Education. 

(2006). Individual with Disabilities Education Act (IDEA) Data. Available online: 

https://www.ideadata.org/PartBTrendDataFiles.asp [Tables B2A & B2B]. 

Office of Special Education and Rehabilitative Services, Department of Education. 

(2008). Individual with Disabilities Education Act (IDEA) Data. Available online: 

https://www.ideadata.org/arc_toc8.asp#partbCC [Tables 1-2, 1-4, 1-5 & 7-1.] and 

https://www.ideadata.org/arc_toc7.asp#partcCC [Table 6–1.] 

Park, I., Winglee, M., Clark, J., & Sedlak, A. (2003). Enhancement Option 4: NIS–3 PSU 

Sample Selection Analyses. Deliverable 10 for Task 9b under Contract No. 282-

98-0015, Task 40, Planning for the NIS–4. Report prepared for the Children’s 

Bureau, Administration on Children, Youth and Families, Administration for 

Children and Families, U.S. Department of Health and Human Services. 

Rockville, MD: Westat, Inc. 

Park, I., Winglee, M., Clark, J., Sedlak, A., Morganstein, D., & Rust, K. (2003). 

Enhancement Options 1 and 2: NIS–3 Sample Design Analyses. Deliverables 3 

and 5 for Task 9a under Contract No. 282-98-0015, Task 40, Planning for the 

NIS–4. Report prepared for the Children’s Bureau, Administration on Children, 

R–2
 
 

Youth and Families, Administration for Children and Families, U.S. Department 

of Health and Human Services. Rockville, MD: Westat, Inc. 

Provasnik, S., KewalRamani, A., Coleman, M.M., Gilbertson, L., Herring, W., and Xie, 

Q. (2007). Status of Education in Rural America (NCES 2007-040). National 

Center for Education Statistics, Institute of Education Sciences, Washington, DC: 

U.S. Department of Education. Available at: 

http://nces.ed.gov/pubs2007/2007040.pdf 

Rogers, C.M., Gray, E., & Aitken, S. (1992). Final Report: Summary Proceedings and 

Recommendations of the National Incidence Study Expert Conference. (Prepared 

under a contract to CSR, Inc., from the National Center on Child Abuse and 

Neglect). Washington, D.C.: CSR, Incorporated. 

Rust, K.F. and Rao, J.N.K. (1996). Variance estimation for complex estimators in sample 

surveys. Statistics in Medical Research, 5, 381-397. 

Sankoh, A.J., Huque, M.F., Dubey, S.D. (1997). Some comments on frequently used 

multiple endpoint adjustments methods in clinical trials. Statistics in Medicine;16: 

2529-2542. 

Sedlak, A.J. (1991). National incidence and prevalence of child abuse and neglect: 1988 

(revised report). Rockville, MD: Westat. 

Sedlak, A.J. (2001). A History of the National Incidence Study of Child Abuse and 

Neglect. [Deliverable 20 under Contract No. HHS-100-97-0017, Special Studies 

and Strategic Planning: National Incidence Study of Child Abuse and Neglect. 

Submitted to the Children’s Bureau, Administration of Children, Youth and 

Families, Administration for Children and Families, U.S. Department of Health 

and Human Services, Washington, D.C.] Rockville, MD: Westat. 

Sedlak, A.J. and Broadhurst, D.D. (1996). Third National Incidence Study of Child Abuse 

and Neglect: Final Report. Washington, D.C.: U.S. Department of Health and 

Human Services. 

Sedlak, A.J., Bruce, C., & Hill, R. (2002). Design Options for the Future NIS. 

[Deliverable 9 under Contract No. HHS 100-97-0017, Delivery Order No. 19, 

National Incidence Study of Child Abuse and Neglect: Projection Models, Data 

Extracts, and Recommendations. Submitted to the Children’s Bureau, 

R–3
 
Administration on Children, Youth and Families, Administration for Children and 

Families, U.S. Department of Health and Human Services.] Rockville, MD: 

Westat, Inc. 

Sedlak, A.J., McPherson, K., Shusterman, G., and Li, S. (2010). Fourth National 

Incidence Study of Child Abuse and Neglect (NIS–4): CPS Structure and 

Practices Mail Survey (SPM). (Prepared by Westat under contract to the 

Administration for Children and Families.) Washington, DC: Administration for 

Children and Families. 

Sedlak, A.J., Mettenburg, J., Schultz, D., and Cook, D. (2003). NIS definitions review. 

(Prepared under contract to the Administration for Children and Families, U.S. 

Department of Health and Human Services). Rockville, MD: Westat. 

Sedlak, A.J., Mettenburg, J., Winglee, M., Ciarico, J., and Basena, M. (2010). Fourth 

National Incidence Study of Child Abuse and Neglect (NIS–4): Analysis Report. 

(Prepared by Westat under contract to the Administration for Children and 

Families.) Washington, DC: Administration for Children and Families. 

Sedlak, A.J. and Schultz, D. (1997). Follow-up to the NIS–3 and NCANDS Studies: 

Sentinel Questionnaire Follow-up Study. (Prepared under contract to the National 

Center on Child Abuse and Neglect, Administration for Children and Families, 

U.S. Department of Health and Human Services). Rockville, MD: Westat 

Sedlak, A.J. and Schultz, D. (2005). Race differences in risk of maltreatment in the 

general child population. In D.M. Derezotes, J. Poertner, and M.F. Testa (Eds.), 

The overrepresentation of African American children in the system: Race matters 

in child welfare (pp.47-61). Washington, DC: Child Welfare League of America 

Press. 

Shao, J. (1996). Resampling methods in sample surveys. Statistics 27, 203–254. 

Shin, H.B. (2005). School enrollment: Social and economic characteristics of students: 

October 2003. Washington, DC: U.S. Census Bureau, Economics and Statistics 

Administration, U.S. Department of Commerce. 

Skinner, C. J. (1989). Domain means, regression and multivariate analysis. In C. J. 

Skinner, D. Holt & T. M. Smith (Eds.), Analysis of Complex Surveys, New York: 

Wiley, chapter 3, pp. 59–88. 

R–4
 
U.S. Census Bureau. (2004). Current Population Survey (CPS)—Definitions and 

Explanations. U.S. Census Bureau, Population Division, Fertility & Family 

Statistics Branch. Available online: 

http://www.census.gov/population/www/cps/cpsdef.html 

U.S. Census Bureau. (2005). School Enrollment—Social and Economic Characteristics 

of Students: October 2005. Available online: 

http://www.census.gov/population/www/socdemo/school/cps2005.html 

U.S. Census Bureau. (2006). America’ Families and Living Arrangements: 2006. 

Available online: http://www.census.gov/population/www/socdemo/hhfam/cps2006.html [Table C3.] 

U.S. Census Bureau. (2008a). Annual Estimates of the Population by Selected Age 

Groups and Sex for the United States: April 1, 2000 to July 1, 2006 (NCEST2006–02). Available online: http://www.census.gov/popest/national/asrh/NCEST2006-sa.html 

U.S. Census Bureau. (2008b). CPS March Supplement, 2005 Data File. Available online: 

http://www.bls.census.gov/cps_ftp.html#cpsbasic_extract 

U.S. Census Bureau. (2008c). CPS March Supplement, 2006 Data File. Available online: 

http://www.bls.census.gov/cps_ftp.html#cpsbasic_extract 

U.S. Census Bureau. (2008d). CPS March Supplement, 2007 Data File. Available online: 

http://www.bls.census.gov/cps_ftp.html#cpsbasic_extract 

U.S. Census Bureau. (2008e). State by Age, Sex, Race, and Hispanic Origin. Available 

online: http://www.census.gov/popest/archives/2000s/vintage_2006/ 

U.S. Census Bureau. (2008f). State Single Year of Age and Sex Population Estimates: 

April 1, 2000 to July 1, 2006 – RESIDENT. Available online: 

http://www.census.gov/popest/archives/2000s/vintage_2006/, data at 

http://www.census.gov/popest/states/asrh/files/SC_EST2006_AGESEX_RES.csv 

U.S. Department of Agriculture, Economic Research Service. (2003). Briefing Rooms, 

Measuring Rurality: New Definitions in 2003. Available online at 

http://www.ers.usda.gov/Briefing/Rurality/NewDefinitions/ 

R–5
 
U.S. Department of Agriculture, Economic Research Service. (2004). Briefing Rooms, 

Measuring Rurality: Rural-Urban Continuum Codes. Available online at 

http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/ 

U.S. Department of Health and Human Services, Administration on Children, Youth and 

Families. (2007). Child Maltreatment 1990–2005: Reports from the states to the 

National Child Abuse & Neglect Data System. Washington, D.C.: U.S. 

Government Printing Office. 

U.S. Department of Health and Human Services. Administration for Children and 

Families/Children's Bureau and Office of the Assistant Secretary for Planning and 

Evaluation. [HHS/ACF and OASPE] National Study of Child Protective Services 

Systems and Reform Efforts: Literature Review. (Washington, DC: U.S. 

Government Printing Office, 2001). Available at: 

http://aspe.hhs.gov/hsp/protective01/index.htm 

U.S. Department of Health and Human Services. Administration for Children and 

Families/Children's Bureau and Office of the Assistant Secretary for Planning and 

Evaluation. [HHS/ACF and OASPE] National Study of Child Protective Services 

Systems and Reform Efforts: Findings on Local CPS Practices. (Washington, DC: 

U.S. Government Printing Office, 2003). Available at 

http://aspe.hhs.gov/hsp/cps-status03/cps-practices03 

Weber, S. J., & Cook, T.D. (1972). Subject effects in laboratory research: An 

examination of subject roles, demand characteristics, and valid inference. 

Psychological Bulletin, 77, 273-295. 

Wolter, K.M. (1985). Introduction to Variance Estimation. New York: Springer-Verlag. 

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Appendix A 


Design and Methods Summary 


Appendix A Authors: 

Andrea Sedlak, Frances Gragg 

Jane Mettenburg, Janet Ciarico 

Marianne Winglee. Gary Shapiro 

John Hartge, Spencer Li 

Angela Greene, Karla McPherson 
OVERVIEW 

The fourth National Incidence Study of Child Abuse and Neglect (NIS–4) is a 

congressionally mandated study designed to measure the total number of children who are 

abused or neglected in the United States. It was also designed to indicate the degree to which 

this number has changed since the earlier cycles collected similar data (the NIS–1 in 1979, the 

NIS–2 in 1986, and the NIS–3 in 1993). In 2001, DHHS contracted with Westat to plan the 

NIS–4. With input from a large Technical Advisory Group, that effort identified, prioritized, and 

pilot-tested a number of enhancements to the NIS design. The NIS–4 incorporates these 

improvements. 

NIS–4 main study design. The NIS–4 main study provides the basis for estimating 

the overall incidence of maltreated children and for assessing changes in incidence from the 

earlier studies. In contrast to the National Child Abuse and Neglect Data System (NCANDS), 

which captures annual statistics on cases of child maltreatment that come to the attention of the 

child protective services (CPS) system, the NIS measures the scope of child maltreatment in a 

way that goes beyond these official statistics. To do so, NIS gathers and integrates data from 

multiple sources, using standardized definitions. 

The NIS–4 used a national sample of 122 counties. In each county, NIS collected 

data on all children investigated by child protective service (CPS) agencies as well as on 

maltreated children who were identified in 1,094 community agencies by professionals 

(“sentinels”) who regularly come into contact with children and families. Participants included 

the 126 local CPS agencies that serve the NIS–4 counties, as well as sentinels in the county 

sheriff’s office, the county departments of juvenile probation, health, and public housing, 

municipal police departments, hospitals, public schools, day care centers, shelters, and voluntary 

social services and mental health agencies. Data collection focused on maltreatment that took 

place during specific 3-month reference periods—either in the fall of 2005 (for two-thirds of the 

counties) or in the spring of 2006 (for the remaining one-third of counties). CPS submitted data 

on children they investigated during the reference period and sentinels submitted data on 

children they suspected to be maltreated during the reference period. The NIS–4 study team 

unduplicated the data (so the study estimates represent each maltreated child only once), 

evaluated the case details against standardized definitions of abuse and neglect (so estimates are 

based only on “countable” children, whose maltreatment meets the study standards), and 

A-1
 
 

weighted the records (so the sample data can provide national estimates of the numbers of 

maltreated children). 

NIS–4 enhancements. The NIS–4 sample design improved on that used in the 

NIS–3 by tripling the number of counties (122 vs. 42) as well as increasing the number of 

sentinel agencies (nearly 1,100 vs. 800). The NIS–4 also expanded sentinel coverage through 

two new categories of sentinel agencies—public housing authorities and shelters for victims of 

domestic violence and for runaway or homeless youth. In evaluating the data, the NIS–4 

evaluative coders applied a refined typology of abuse and neglect definitions, using 60 separate 

forms of maltreatment. They also provided a more detailed coding of serious injury or harm 

resulting from maltreatment. Finally, the NIS–4 team designed and applied a number of new 

computer systems to manage, implement, track, and apply quality checks during recruitment, 

data collection, evaluative coding, and unduplication. These included a NIS website for the 

public and participants, a Sample Tracking and Recruitment System (STARS) for recruiters, an 

FTP website for file transfers from CPS agencies, an online sentinel data form to facilitate 

sentinels’ submissions, several sampling and receipt control systems to support various study 

components, a Collection Activity Tracking System (CATS) for managing and monitoring field 

operations, a data form viewing system that offered quick and simultaneous access to electronic 

images of detailed data forms to authorized users as needed while maintaining data security on 

password-protected drives, a Computer-Assisted Evaluative Decision System (CAEDS) to 

facilitate the evaluative coding operations and record the detailed codes, and an unduplication 

system that supported coders in identifying candidate record pairs and documenting their 

decisions about true duplicates. 

Supplementary studies. In addition to the main study, the NIS–4 project included 

several supplementary studies that were designed to enhance the quality and/or interpretability of 

the NIS findings (as discussed in the Final Report). Two were surveys of CPS agencies—one on 

their overall policies, procedures and practices and the second on their screening standards, to 

determine how they would treat referrals concerning the uninvestigated cases identified to the 

study by sentinels. The third supplementary study was a survey of sentinels on their 

backgrounds and definitions of child abuse and neglect and concerning their standards for 

reporting suspected maltreatment to CPS or submitting data on maltreated children to the NIS. 

A-2
 
SAMPLES 

The NIS target population is the set of children under 18 years of age who are 

maltreated during the study period, including all who are reported to child protective services 

(CPS) agencies and accepted for investigation by those agencies and any others who come to the 

attention of community professionals working in specific categories of agencies (such as police, 

teachers, social workers, nurses, and child care providers). 

The three-stage sample design involves: (1) a first-stage, nationwide sample of 

primary sampling units (PSUs) that are single counties or clusters of contiguous counties, (2) a 

second-stage selection of all CPS agencies and samples of sentinel (non-CPS) agencies within 

the selected PSUs, and (3) case-level samples of abused and neglected children in CPS agencies 

and samples of sentinels (professionals who have direct contact with children) in sentinel 

agencies. The sampled sentinels are asked to report on all abused and neglected children that 

they encounter in the course of their work during the study reference period. 

The NIS–4 used two reference periods, one of which conformed to that used in the 

NIS–2 and NIS–3: a 3-month period from the first week in September 2005 through the first 

week in December 2005. The second reference period occurred the following spring, from the 

first week in February 2006 through the first week in May 2006. The CPS case samples were 

selected retrospectively from records on all cases reported during the study reference period that 

the agency accepted for investigation. Sentinel data collection was prospective, with sampled 

sentinels asked to be on the lookout for maltreated children during the study reference period and 

to submit detailed data forms describing any such children they encounter. 

Compared with earlier NIS cycles, the NIS–4 substantially increased sample sizes 

and broadened sentinel agency coverage. Relative to the NIS–3, the NIS–4 essentially tripled the 

samples of counties (from 42 to 122), CPS agencies (from 42 to 126), and CPS cases (from 3,368 

to 11,930) and nearly doubled the samples of sentinel agencies (from 981 to 1,679) and sentinels 

(from 5,889 to 11,321). 

Counties. The NIS–4 Primary Sampling Units (PSUs) were constructed from the 

list of 3,141 counties in the 2000 Census. This list was updated to reflect county definitions and 

boundaries at the time of NIS–4 sampling in 2004. The NIS–4 selected a sample of 110 PSUs 

(122 counties) using a probability-proportional-to-size (PPS) sampling method and a stratified 

A-3
 
design. The measure of size was the population of children under 18 years old in Census 2000. 

Large counties with a child population over 400,000 were selected with certainty. Undersized 

counties (those with fewer than 4,000 children) were combined with contiguous counties to form 

geographically compact PSUs with sufficiently large populations to justify data collection 

efforts. Constructing multi-county PSUs considered local CPS agency jurisdictions (which 

usually, but not always, follow county boundaries) and limited the number of counties in a PSU 

to no more than six. 

Under this scheme, the 14 largest counties were selected with certainty, leaving a 

listing of 2,282 noncertainty PSUs nationwide, 1,685 of which were single-county and rest 

multiple-county PSUs. Statisticians allocated these noncertainty PSUs to 48 strata, based on 

Census region, metro status, the NCANDS child victim substantiation rate, FBI crime rate, and 

percentage of households headed by single females with children. (Choice of these factors 

derived from prior analyses on predictors of child maltreatment rates.) Two PSUs were selected 

from each stratum, using probability-proportionate-to-size (PPS) of the Census 2000 population 

of children, which identified 96 noncertainty PSUs: 88 single-county PSUs, 6 two-county PSUs, 

1 three-county PSU and 1 five-county PSU. Thus, the final NIS–4 sample consisted of 110 

PSUs (14 certainty and 96 noncertainty), which included 122 counties—14 certainty and 108 

noncertainty counties. 

CPS agencies and cases. The CPS agency sample comprised all 126 CPS agencies 

serving all or part of a sampled county. Most were county-level agencies serving individual 

counties. Eligible CPS cases were those reported to these CPS agencies during the 13-week 

study reference period and assigned for investigation. CPS case sampling followed the approach 

used in the NIS–3. Fatality cases were included with certainty. An approximately equalprobability sample was randomly selected from the remaining eligible cases. Sampled cases 

were assigned to receive CPS Maltreatment data forms, while CPS Summary data forms were 

assigned to the remaining eligible cases for use during unduplication and weighting, as described 

in those sections. (The Data Collection section describes the different data forms.) These 

procedures resulted in listings of 140,206 CPS case investigations during the study reference 

periods, and identified a sample of 11,930 of these for CPS Maltreatment data forms. To support 

special analyses examining whether any of the children not investigated during the study period 

were reported to CPS and investigated later, the NIS–4 also obtained Summary data forms on all 

cases reported and assigned for investigation during the month following the reference period. 

The NIS–4 gathered an additional 38,398 Summary data forms for this component. 

A-4
 
Sentinel agencies. Sentinel agency categories in the NIS–4 included: 

•	 Law enforcement agencies—sheriff and county police departments, municipal 

police agencies, and juvenile probation departments; 

•	 Health services—children’s hospitals, short-stay general hospitals, and public 

health departments; 

•	 Schools and day care centers—public K-12 schools and licensed day care 

centers; and 

•	 Housing, shelters and others—public housing departments, shelters for 

battered women and runaway and homeless youth, social service and mental 

health agencies. 

Agencies in these categories that were physically located in NIS–4 counties were 

eligible for the study (with one exception—the study also included children’s hospitals within 25 

miles of a NIS–4 county that had none of its own). The above list broadens sentinel coverage by 

including two new agency categories: Public housing and shelters for battered women and for 

runaway and homeless youth. Both of these new categories were introduced based on the results 

of explorations in several counties during the NIS–3. Whereas public housing was entirely new, 

shelters were previously included in NIS but only as part of the varied group of social service 

and mental health agencies. 

The NIS–4 sentinel agency samples were structured according to local CPS 

agency/county clusters. For the most part, a cluster reflected a single county. However, small 

counties that were served by the same local CPS agency were handled as a single cluster. There 

were 115 local CPS agency county clusters in the NIS–4. 

The NIS–4 aimed to approximately double the NIS–3 sentinel agency sample. 

However, rather than simply doubling the sample in every category, statisticians computed an 

optimum allocation of the doubled-sample across the sentinel agency categories. The optimum 

allocation first took into account both the within-category precision of estimates of 

uninvestigated maltreated children and the relative costs of recruiting and collecting data from an 

agency in the category. The resulting allocation was then modified to attempt to provide each 

agency category with at least one representative in each CPS agency-county cluster—with the 

exception of the law enforcement agencies. Because these computations determined that the 

A-5
 
 

optimal sample sizes from law enforcement agencies were relatively small (with little gain to be 

had in the precision of national estimates by adding more of these agencies), they were included 

in a sample of 62 PSUs (the 14 certainty PSUs and one-half, or 48, of the noncertainty PSUs). 

With two exceptions, the final allocation plan targeted a sample of one agency for 

each category in every CPS agency-county cluster. The allocation plan dictated that more 

agencies be sampled to represent day care centers (2 per cluster) and schools (5 per cluster). In 

actually implementing this plan, statisticians selected the sentinel agencies in five categories with 

certainty—sheriff departments, juvenile probation departments, public health departments, 

children’s hospitals, and public housing agencies—because there is typically only one such 

agency per county. Agencies in the other categories are generally more numerous, so they were 

sampled for the study. Because size measures were available for schools, general hospitals, and 

municipal police departments, agencies in those categories were sampled by the PPS method. 

Simple random sampling was applied in the other sampled agency categories (day care centers, 

shelters, and social service/mental health agencies). 

On average, 14.6 sentinel agencies were sampled in a given CPS-county cluster, but 

this varied, ranging from 5 in a very small site to more than 40 in the largest county. Despite the 

broad range, however, the distribution was fairly tight: only 6 clusters had fewer than 10 sentinel 

agencies sampled, and only 6 had more than 18. 

The numbers of sentinel agencies selected for the NIS–4 in the different agency 

categories are listed in the Sentinel Recruitment discussion. 

Sentinels. Within each sentinel agency, staff who were eligible to serve as sentinels 

were identified and sampled. This process required identifying eligible units within the agency, 

listing (and sometimes sampling) those units, enumerating the eligible staff, and sampling staff 

to be recruited as sentinels. Sampling from the staff roster used a probability-based method. 

First, sentinels in certainty selection units (as defined by the particular job category, such as 

school counselors and truancy officers) were all included in the sample. The remaining sentinels 

were sampled from the roster of eligible staff using a predetermined sampling rate for the agency 

or following standards for targeted minimum sample sizes (e.g., at least one sentinel per 

functional unit and no fewer than two sentinels per agency). For each agency category, 

Table A–1 identifies the eligible units and eligible staff positions and gives the numbers of 

eligible staff that were listed on rosters and sampled as sentinels in each category. 

A-6
 
A-7

Table A–1. Definitions of Eligible Units and Staff Within Each Agency Type; Total Eligible Staff in Participating Sen

and Numbers of Staff Sampled to Serve as Sentinels 

Agency Category Eligible Units Eligible Staff 

Num

Eli

S

County Sheriff and/or State Police Departments 

Criminal Investigation, Homicide, Sex Crimes, Juvenile, Child/Family Crimes, Domestic Violence 

Officers assigned to investigate child crimes, usually detectives. 

1,6

Juvenile Probation Departments Supervision, Investigation, Intake, Other Juvenile Probation Officers 2,7

Municipal Police Departments Criminal Investigation, Homicide, Sex Crimes, 

Juvenile, Child/Family Crimes, Domestic Violence 

Officers assigned to investigate child crimes, usually detectives 

1,6

Short-Stay General and Children’s Hospitals 

Emergency Room, Pediatric or Acute Care Head Nurses, Acute Care/Pediatric 

Social Workers. 

1,6

Public Health Departments Units where staff has sufficient interaction with 

children and families to learn about maltreatment events, effects, outcomes, and perpetrators. 

Public Health Nurses, Social Workers. 

1,6

Voluntary Social Service/ Mental Health Agencies 

Units where staff has sufficient interaction with children and families to learn about maltreatment events, effects, outcomes, and perpetrators. 

Professional Staff working with children and families. 

9

Shelters for Runaway and Homeless Youth Shelters or Domestic Violence Victims 

Shelter, Other Counselors/ Caseworkers 3

Licensed Day Care Centers Classrooms/ Service units Day Care Teachers/ Aides 6

Elementary and Secondary Public Schools 

Non-rotating/Rotating Classrooms, Units with targeted professionals 

Teachers, Counselors, Nurses, Truancy Officers. 

10,7

Public Housing Authorities Units where staff has sufficient interaction with 

children and families to learn about maltreatment events, effects, outcomes, and perpetrators. 

Public Housing Social Workers/ Caseworkers 

1

Total 22,1
 

CPS RECRUITMENT 

In order to develop child-level estimates and to quantify the number of abused and 

neglected children in the U.S. beyond those that come to the attention of CPS, it is critical to 

unduplicate data from sentinels against data on children in CPS investigations. Because of this, 

the NIS design requires 100 percent participation by CPS agencies, at least to the extent needed 

to accomplish this unduplication. The NIS–4 met this goal by achieving 100 percent 

participation for CPS agency Summary Data (N=126 agencies). This ensured the usability of 

sentinel data in all sampled counties. However, state offices (in 3 states) declined to permit 6 

local CPS agencies to complete the CPS Maltreatment data form. Data forms are described in 

the Data Collection section. The Weighting section explains how CPS Maltreatment data forms 

from participating agencies were weighted to correct for the loss of these nonrespondent 

agencies. 

Attaining this high participation rate required time, persistence in negotiating and 

renegotiating, and the addition of a second reference period.1 CPS recruiters were senior staff 

both from Westat and Walter R. McDonald and Associates (WRMA). These staff had expertise 

in child welfare programs; most specifically in CPS. During the height of recruitment, 14 senior 

staff (10 at Westat and 4 at WRMA) actively recruited CPS agencies for participation. 

Recruiters attended a 2-day training session in September 2004 and received additional training 

as recruitment proceeded and negotiations with agencies progressed to more advanced stages. 

Recruitment meetings were held weekly during the first 5 months, and biweekly after that. In 

these meetings, staff discussed common problems, identified emerging issues, and determined 

modified NIS participation arrangements the study could accommodate without compromising 

the core integrity of the study design and estimates. 

It took about as much time to gain approval from agencies requiring state approval as 

from county-administered agencies that did not need state clearance. For the former agencies, it 

took an average of 245 days (median=204 days) to obtain the needed state-level approval and an 

additional 95 days on average (median=30 days) to get local-level approval. For agencies that 

did not require state approval, approval took a 276 days on average (median=288 days). 

1

 Primary Sampling Units were assigned to one of two reference periods (Sept.4—Dec.3, 2005 or Feb.4—May 3, 

2006. 

A-8
 
From September 2004 through September 2005 (slightly after the start of the first 

reference period), 107 agencies had approved participation (85%). The remaining CPS agencies 

took an additional 12 months to recruit. The last agency agreed to participate September 2006. 

This extended recruitment period was possible because CPS data were retrospective, as 

explained in the Data Collection section. 

Some of these delays were caused by the need to submit applications for IRB 

reviews (n=26), research committee reviews (n=27), court orders (n=4), and to establish 

workable data transfers. However, refusal conversion efforts also explain much of these delays. 

Reasons agencies gave for refusing included the burden associated with the CFSR or the state’s 

resulting Performance Improvement Plan, their participation in another study, staff shortages, 

court-ordered improvement efforts underway, scheduling conflicts, changes in directors, and 

level of burden. There were five initial state-level refusals (affecting 18 agencies) that took an 

average of more than 17 months (514 days) from their first contact to final approval. There were 

initial refusals by four local agencies that took an average of more than 14 months (431 days). 

The project director personally visited all five initially refusing state agencies and two of the 

initially refusing local agencies to further explain the study and explore the possibilities of 

accommodations that might allow them to participate. These visits were successful in 

negotiating some degree of participation from all the agencies. 

A-9
 
SENTINEL AGENCY RECRUITMENT 

The sentinel agency sample in the NIS–4 was twice as large as that in the NIS–3. 

The project team developed the NIS–4 Sample Tracking and Recruitment System (STARS) to 

manage and support this large-scale effort. Recruiters used STARS to receive their assignments, 

maintain and update agency contact information, record all communications and any special 

requirements or arrangements, document progress in finalizing participation agreements, and 

identify or sample the individual staff who would serve as sentinels within the agency. 

The NIS–4 used professional-level hourly staff to recruit sentinel agencies, a proven 

cost effective strategy in previous Westat studies. Recruiters were male and female with strong 

interviewing skills and work experience in many of the sentinel categories—police, teachers, day 

care providers, and juvenile probation officers. The work team ranged from 10 to 20 recruiters 

over the course of recruitment. Recruiters were hired in waves, in response to variations in 

workload and recruiter attrition over time. New recruiters were trained over an intensive 2-week 

period. Training sessions first provided an overview of the study, administrative procedures, 

recruitment goals and objectives, and the use of the computerized tracking system. Next, 

training focused on strengthening their interviewing skills and recruitment strategies, 

understanding the different agency structures, and detailed procedures for sampling agency units 

and individual sentinels. Finally, new trainees were carefully observed to ensure their 

competency in all aspects of the recruitment process. 

The first set of columns in Table A–2 show the number of NIS–4 agencies originally 

sampled, number of agencies in-scope in the original sample, the number of replacements for 

refusals, and the number of agencies agreeing to participate. Out-of-scope agencies were those 

who did not qualify as representatives of their category for various reasons (e.g., they no longer 

existed, were not located in the sampled county or PSU, or had no staff with direct contact with 

children or families). Note that some in-scope replacement agencies also refused, which is why 

column C plus column D does not equal column E. 

The last series of columns in Table A–2 give unweighted and weighted participation 

rates. The different participation rate computations correspond to different response rate 

formulas (see the table footnotes). The weighted response rates are higher than the unweighted 

response rates for all agency types except social service/mental health agencies and shelters, 

indicating that sample agencies with larger weights were more willing to participate. Agencies 

A-10
 
 

with larger weights are those in smaller PSUs or are themselves smaller in size; they represent 

more others like themselves in the national estimates. The participation rate for all sentinel 

agencies was 71.8% unweighted (76.9% weighted). 

Table A–3 shows the final participation rates achieved for all four NIS cycles. 

NIS–4 rates were lower than those attained in earlier NIS cycles. The lower rates were largely 

attributable to increased concerns with privacy and resulting changes in policies, procedures, and 

state and Federal laws since the NIS–3. New laws, such as the Health Insurance Portability and 

Accountability Act (HIPAA), seriously limited access to data for any “voluntary” study. 

Recruitment staff developed 35 IRB applications and 23 school district research 

committee reviews (affecting 73 schools). Figure A–1 summarizes the number of days from 

initial contact to approval, final refusal and out-of-scope classification, by agency type and 

overall. Public health took the longest to win approval (an average of 306 days, ranging from 39 

to 546 days). County law enforcement followed (averaging 273 days to gain approval); hospitals 

were next (averaging 254 days). School recruitment was a lengthy process, in part because of 

the need to go to three levels of authority for approval (state, district, and individual school). 

State level recruitment took an average of 38 days (all states agreed to participate). Districts 

took 82 days and schools took 129 days. 

Recruiters always attempted to convert an initial refusal, so refusals occupied 

considerable time as well. Refusal conversion work ranged from minor adjustments to the 

protocol to intervention by senior staff and site visits. Refusing hospitals averaged 322 days 

until final disposition. County law enforcement averaged 340 days. Refusing school districts 

were pursued for an average of 173 days and individual refusing schools took an average of 113 

days. The number of contacts involved also varied. Contacts for approvals ranged from 13 for 

juvenile probation agencies to 40 for hospitals. Contacts for refusals ranged from 15 for juvenile 

probation to 44 for hospitals. The average number of contacts for all agencies and levels was 16 

for approvals and 22 for refusals. 

A-11
 
A-12

Table A–2. NIS–4 Agency Participation, Numbers and Rates 

Agency category 

Agencies Rates

Sample 

size 

In-scope 

original 

agencies 

Participa 

-ting 

original 

agencies 

In-scope 

replacements 

for 

refusals 

Total 

participating 

agencies1 

Unweighted 

Cooperation 

Rate2 

Unweighted 

participation 

rate before 

replacement3 

Weighted 

participation 

rate before 

replacement 

A B C D E F=E/(B+D) G=C/B G (wtd) 

County Sheriff/State Police 71 58 44 0 44 76 76 88 

Juvenil Probati e on 65 65 54 0 54 83 83 88 

Municipal Police 83 81 55 17 63 64 68 76 

Hospitals 159 152 104 1 105 69 68 81 

Public Health 117 106 82 0 82 77 77 82 

Social Service/Mental Hlth 106 88 60 0 60 68 68 64 

Shelters 95 83 69 2 71 84 83 76 

Day Care 240 217 170 11 176 77 78 78 

Schools 670 657 336 190 423 50 51 54 

Publi Housingc 73 17 16 0 16 94 94 100 

Total 1,679 1,524 990 221 1,094 63 65 68 

1This column includes all in-scope agencies (both from the original sample or replacement sample) that participated for all or part of the reference peri2The formula used for this column computes the percentage of all participating agencies of all eligible agencies targeted for recruitment, including rep

numerator and denominator. This is defined by the American Association for Public Opinion Research (AAPOR) as formula COOP4. See AAPOR’s 

Available online at http://www.aapor.org/uploads/standarddefs_4.pdf, p.34. 

3The formula used for this column is based solely on the eligible agencies in the original sample, disregarding replacements. Also known as the “effec

equivalent to AAPOR formula RR6 (Ibid., p33). 

4This is equivalent to the “after replacement” participation rate measure used in the National Assessment of Educational Progress (NAEP), an example 

http://nationsreportcard.gov/science_2005/s0117.asp?printver= 
Table A–3. Sentinel Agency Participation Rates NIS–1 through NIS–4 

(Unweighted, After Replacement) 

Agency Category 

NIS–4 

Participation 

Rate (%) 

NIS–3 

Participation 

Rate (%) 

NIS–2 

Participation 

Rate (%) 

NIS–1 Participation 

Rate(%) 

County Sheriff/State Police 76 97 92 

92a 

Juvenile Probation 83 93 94 

Municipal Police 78 96 93 82 

Hospitals 69 100 96 76

Public Health 77 100 100 

Social Service/Mental Health 

Shelters

68 

86 

91b 88b 91c 

Day Care Centers 81 100 89 

Schools 64 75 82 89

Public Housing 94 NA NA NA 

Total 72 82 88 87

a

In the NIS–1 these agency categories were combined with the county medical examiner in a single “Other 

Law Enforcement” category . 

b

These categories were combined with the “Social Service/Mental Health” category in the NIS–2 and NIS–3. c

These agency categories were combined in a single “Other Agencies” category in the NIS–1. 

All Agencies 

Public Housing 

Schools 

Schools-Districts* 

Day Care Centers 

Shelters 

Social Service/Mental Health 

Public Health 

Hospitals 

Municipal Police 

Juvenile Probation** 

County Law Enforcement 

0 100 200 300 400 

Number of Days 

Approvals Refusals Out of Scope 

Figure A–1. Average Days from First to Last Contact for Approvals, Refusals, and Out-of-Scopes 

*One hundred and ninety-four schools were lost due to district-level refusals. No contact was made with these schools. 

**Three county probation offices were associated with state refusals. No contact was made with these agencies. 

A-13 
DATA COLLECTION 

The goals of the NIS–4 data collection were to maximize agency and sentinel 

participation and to collect complete and accurate data forms on every maltreated child whom 

sentinels identified or whom CPS agencies accepted for investigation during the NIS–4 reference 

periods. The NIS–4 used two 3-month reference periods (9/4/05–12/3/05 and 2/4/06–5/3/06). 

Table A–4 shows the distribution of the NIS–4 sample across these reference periods. 

Table A–4. Distribution of PSUs, Counties, and Agencies 

by Reference Period 

Reference Period PSUs Counties CPS 

Agencies 

Sentinel 

Agencies 

Fall 2005 

Spring 2006 

72 

38 

83 

39 

85 

41 

754 

340 

Total 110 122 126 1,094

CPS agencies provided data on all cases they accepted for investigation that were 

reported during their assigned reference period, whereas sentinels described all maltreated 

children they encountered whose maltreatment occurred during their assigned reference period. 

CPS agencies also provided summary level data about cases they accepted during the month 

following their reference period for special analyses to explore the effects of allowing more time 

for reports to CPS, especially on children sentinels observed late in their reference period. 

The fall and spring reference periods required two cohorts of field managers in the 

home office and local coordinators in the field. Local coordinators lived in or near the NIS–4 

counties. They trained sentinels, motivated them throughout the data collection period, collected 

sentinel data forms, trained CPS agency staff (as needed), and coordinated CPS data collection 

tasks (as needed). Subsets of local coordinators were actively working over a 22-month period 

from September 2005 through June 2007. Most sentinel data collection activity coincided with 

the two 13-week reference periods, but CPS data collection extended for more than a year 

beyond the end of the second reference period due to agencies’ schedule, budget, or staffing 

constraints and the challenges of negotiating data extracts from agencies’ electronic information 

systems. 

A-14
 
 

 

The NIS–4 used three primary data collection instruments: the CPS Maltreatment 

data form, the CPS Summary data form, and the Sentinel data form. CPS agencies used the CPS 

Maltreatment data form to provide details concerning the children and maltreatment events for a 

sample of cases reported to the agency during the study reference period that they accepted for 

investigation. They used the CPS Summary data form to capture primarily demographic 

information on the remaining, unsampled cases, for use in unduplication. Sentinels used the 

Sentinel data form for all children they suspected were maltreated during the reference period. 

The CPS Maltreatment and Sentinel data forms collected many of the same details, but differed 

in format: the Sentinel data form described a single child, whereas the CPS data form described 

all children in the household, since CPS agencies typically organize records around householdlevel investigations rather than around individual children. 

During training, sentinels and CPS agency staff were given booklets with general 

instructions, definitions, and item-by-item specifications for completing their data forms. Local 

coordinators reinforced the sentinels’ role in the study through regular agency visits. Local 

coordinators visited 70% of the agencies biweekly and 18% of the agencies every three weeks or 

monthly. Four percent of the agencies permitted the local coordinator fewer than three visits 

during the reference period or did not allow the local coordinator on site. (For 8%, records on 

frequency of visits were incomplete.) 

Both CPS agencies and sentinels had multiple options for submitting data to the 

NIS–4. Almost all CPS agencies submitted their summary data via electronic file uploads and 

about one-half also submitted a portion or all of the case maltreatment details electronically. The 

NIS–4 collected completed Maltreatment data forms on 10,667 sampled cases and Summary data 

on all 140,206 listed cases.2

 Sentinels could submit hardcopy data forms or complete data forms 

online. They provided almost one-half of Sentinel data forms online. Table A–5 shows the 

1,094 participating agencies, 10,791 sentinels, and 6,208 completed data forms submitted by 

sentinel agency type. 

2

 These covered the 3-month reference periods. The NIS–4 collected an additional 38,398 CPS Summary Data 

Forms for cases reported to CPS during the extra month. 

A-15
 
Table A–5. Participating Sentinel Agencies, Sentinels, and Data Forms 

by Agency Type 

Agency Type Agencies Sentinels Data Forms 

County Sheriff/State Police 

Juvenile Probation 54 364 251 

63 499 606 

105 853 1,986

82 340 268 

60 254 198 

71 123 403

176 624 59 

423 7,372 1,845

16 49 18

Municipal Police 

Hospitals

Public Health 

Social Service/Mental Health 

Shelters

Day Care 

Schools

Public Housing

44 313 574 

Total 1,094 10,791 6,208 

At the end of data collection, local coordinators contacted each sentinel one final 

time to collect any outstanding data forms; they also completed an exit evaluation form assessing 

the sentinel’s level of commitment and enthusiasm for the study. Local coordinators rated 35% 

of sentinels as “enthusiastic and supportive” or “cooperated with interest” and 46% as 

“cooperative.” They classified 13% as begrudging or unresponsive. The sentinel agency did not 

permit local coordinators direct contact with 3% of sentinels, and 2% of sentinels had no ratings 

information. Statisticians examined these ratings and determined that, except for classifying 3 

sentinels as nonrespondents, no additional adjustments to sentinel weights were needed. 

A-16
 
EVALUATIVE CODING 

The purpose of evaluative coding is to judge the details of each case of suspected 

maltreatment reported to the NIS–4 against the required elements of the countability criteria 

defined for the study. The NIS definitions specify all of the elements that must be met for the 

child to be countable. Separate evaluations are made as to whether the case fits each of these 

elements and only children who fit the standardized definitions are classified as countable and 

used as the basis for the study estimates of the number of children maltreated in the nation. 

Evaluative coding procedures. The CPS Maltreatment Data form and the Sentinel 

Data form gathered details on maltreatment. These data forms required respondents to answer 

pre-coded questions about the maltreatment and to briefly describe certain details about the 

maltreatment event(s). Evaluative coders used these narratives and the respondent-assigned 

codes to classify the form(s) of maltreatment according to the NIS–4 60-form typology shown in 

Table A–6. In doing so, they also evaluated the circumstances against definitional criteria, and 

judged the child’s overall countability under the study standards. As in past NIS cycles, two 

definitional standards were used in parallel—the Harm Standard and the Endangerment 

Standard. The Harm Standard has been used since the NIS–1 and is the more stringent. For the 

most part, it requires that the child have experienced observable harm from maltreatment in order 

to be deemed countable. The Endangerment Standard has been in use since the NIS–2. It is 

more lenient, requiring that source of the study report (CPS or the sentinel) consider the 

perpetrator’s actions or omissions to have placed the child at serious risk of harm. The key 

decisions elements included: 

•	 The age of the child (the NIS includes all maltreatment events that occurred to 

children from birth to their 18th birthday); 

•	 The custody status of the child (NIS includes only abuse and neglect in the 

purview of CPS, that is, maltreatment of children living in household settings); 

•	 Child victim status (applies on CPS forms only)—whether an alleged victim 

(child was an alleged victim or the CPS investigation record described his or 

her countable maltreatment), substantiated/indicated victim, or not a victim of 

maltreatment; 

•	 The relevant form(s) of maltreatment; 

•	 The certainty with which the events met the study’s time-period eligibility; 

A-17
 
•	 The nature of harm (injuries to the child); 

•	 The severity of harm to the child and whether it met the required harm for the 

form of maltreatment according to the standard under consideration—Harm or 

Endangerment; 

•	 The person(s) responsible for the maltreatment, their role in the maltreatment 

(maltreated, permitted), and whether they met the requirement for who the 

perpetrator has to be according to the definitional standard under consideration 

(Harm Standard or Endangerment Standard); 

•	 Degree of evidence for holding alleged perpetrator(s) responsible for 

maltreatment event(s); 

•	 Whether alcohol, drugs, or mental illness were factors in the maltreatment 

events; 

•	 Countability of each form of maltreatment according to the Harm Standard and 

the Endangerment Standard; and 

•	 Overall countability of the child according to the Harm and Endangerment 

Standards. 

A-18
 
Table A–6. NIS–4 60-form Typology for Classifying Maltreatment 

Sexual Abuse (10 codes) 

Intrusion sex without force 

Intrusion sex involving use of force 

Child’s prostitution or involvement in pornography 

with intrusion 

Molestation with genital contact 

Exposure/Voyeurism 

Providing sexually explicit materials 

Child’s involvement in pornography without 

intrusion 

Failure to supervise child’s voluntary sexual activity 

Attempted/threatened sexual abuse with physical 

contact 

Other/unknown sexual abuse 

Physical Neglect (12 codes) 

 Other or unspecified custody-related maltreatment -- 

unstable custody arrangements 

Refusal to allow or provide needed care for diagnosed 

condition or impairment 

Unwarranted delay or failure to seek needed care 

Refusal of custody/abandonment 

Other refusal of custody 

Illegal transfers of custody 

Inadequate supervision

Inadequate nutrition

Inadequate personal hygiene 

Inadequate clothing

Inadequate shelter 

Other/unspecified disregard of child’s physical needs and 

physical safety 

Physical Abuse (6 codes) 

Shake, throw, purposefully drop 

Hit with hand

Hit with object 

Push, grab, drag, pull 

Punch, kick 

Other physical abuse

Educational Neglect (4 codes) 

 

Permitted chronic truancy

Other truancy 

Failure to register or enroll 

Other refusal to allow or provide needed attention to 

diagnosed educational need 

Emotional Abuse (8 codes) 

Close confinement: tying/binding 

Close confinement: other 

Verbal assaults and emotional abuse 

Threats of sexual abuse (without contact) 

Threats of other maltreatment 

Terrorizing the child

Administering unprescribed substances 

Other/unknown abuse 

Emotional Neglect (11 codes) 

Inadequate nurturance/affection 

Domestic violence 

Knowingly permitting drug/alcohol abuse 

Knowingly permitting other maladaptive behavior 

Refusal to allow or provide needed care for diagnosed 

emotional or behavioral impairment/problem 

Failure to seek needed care for emotional or behavioral 

impairment/problem

Overprotectiveness 

Inadequate structure 

Inappropriately advanced expectations 

Exposure to maladaptive behaviors and environments 

Other inattention to development/emotional needs 

Other Maltreatment (6 codes) 

Lack of preventive health care 

General neglect -- other/unspecified neglect 

allegations 

Custody/child support problems 

Behavior control/family conflict issues 

Parent problem 

General maltreatment -- unspecified/other (not 

coded above) 

Not Countable by any NIS Standard (3 codes) 

 I

 

nvoluntary neglect 

Chemically dependent newborns 

Non-maltreatment cases 

A-19
 
The evaluative coders recorded these key decision elements using a specially 

designed Computer Assisted Evaluative Decision System (CAEDS). CAEDS offered several 

advantages over the paper transmittal forms that were used to record evaluative coding decisions 

in previous NIS cycles: it offered automated reminders and consistency-checks as the coder 

entered the key decision elements for each maltreatment form; it allowed simultaneous and 

efficient electronic access to a particular scanned data form by anyone who needed it at the time 

(the primary evaluative coder, the reliability coder, the unduplication team); it served as the 

management system for allocating coding assignments and monitoring reliability; and it provided 

a secure paperless process in which all confidential details on data forms were stored 

electronically on a secure password-protected network, eliminating the need for transport of 

confidential paper forms. 

Reliability coding procedures. After the initial evaluative coding was completed 

for a child, the case could be sampled for assignment to another evaluative coder for reliability 

coding. The reliability coder completed the case without knowledge of the initial coder’s 

decisions. Inter-coder reliability was assessed throughout the evaluative coding operation. 

Two measures of inter-coder reliability were applied. The first was the simple 

percentage rate of agreement between the initial evaluative coders and the reliability coders on 

each decision element. The second was a computation of the Kappa coefficient for each 

decision, which took account of the level of agreement expected by chance, based on the 

distribution of codes on the item. The Kappa also helped identify coders who were performing 

below the average level relative to other coders. 

The evaluative coding task leader and all evaluative coders participated in bi-weekly 

“Committee Review” meetings. The primary purpose of these meetings was to resolve the 

discrepancies found through reliability coding, review the difficult-to-code cases, and to clarify 

any questions concerning coding procedures or instructions. These ongoing assessment 

procedures only tracked important information about the overall reliability of the evaluative 

coding decisions, but the team meetings also alerted the coders to any slippages or discrepancies 

in their standards, ensuring that they applied the criteria evenhandedly across all forms of 

maltreatment and all children. 

A-20
 
Evaluative coding statistics. The evaluative coding began with the first training 

session on August 28, 2006 and ended with the final resolution of discrepant cases on October 

10, 2007. The tables below present the number of cases coded and the overall agreement rates 

and Kappa. Although 12,334 children were reliability coded, not all these children met the preevaluative eligibility requirements for full evaluative coding. Of these children, 6, 950 met the 

pre-evaluative coding eligibility requirements and moved on to full evaluative coding of their 

maltreatment(s). Table A–8 provides the number of children who were reliability coded by their 

pre-evaluative coding status. 

Table A–7. Numbers of Child-level Records Completed During Each Phase of 

Evaluative Coding. 

Initial 

Evaluative 

Coding (EC) 

Blind Reliability 

Coding (RC1) 

Blind 

Reliability 

Coding Rate 

Committee 

Review (CR) 

Cases 

Completed 30,543 12,334 40% 3,874

Table A–8. Number of Children Reliability Coded by Pre-Evaluative Coding 

Status 

Pre-Evaluative Coding Status 

Child Cases 

Completed 

Reliability Coded – Pre-Evaluative Coding of Child’s Eligibility 12,334 

Reliability Coded – Child not eligible for full Evaluative Coding 5,384 

Reliability Coded – Child eligible for full Evaluative Coding 6,950 

A-21
 
 

Table A–9. Agreement Rates for Overall Countability of Child-level Records 

Measure Cases in 

Agreement 

Total Cases Agreement 

Rate 

Pre-Evaluative Coding Decision 12,202 12,334 0.989

Countability of Child: 

Countability under the Harm Standard 

Countability under the Endangerment Standard 

6,765

6,783

6,950

6,950

0.973

0.976

Table A–10. Kappa Scores for Countability of Maltreatment 

Forms and Child-level Records 

Measure Kappa Score

Child Case: 

Countability Harm Standard agreement 0.95 

Countability Endangerment Standard agreement 0.91 

Forms of Maltreatment: 

Countability Harm Standard agreement 0.96 

Countability Endangerment Standard agreement 0.95 

A-22
 
UNDUPLICATION 

NIS provides estimates of the numbers of maltreated children, so it is critical for the 

study to avoid counting the same child more than once. The purpose of unduplication is to 

identify children who enter the study data on multiple data forms and reduce their information to 

a single record for analysis. Unduplicating NIS–4 data consisted of three main steps: 

• Identifying child-level records that may be duplicates (candidate pairs) 

• Deciding whether the candidate pair records were true duplicates 

• Unifying duplicate records 

Candidate pairs. Matches on subsets of 8 key data items helped to identify 

candidate pairs: 

First name Age 

Last name initial Ethnicity/race 

Gender City of residence

Date of birth Number of children in household 

Candidate pairs for child-level records from CPS Maltreatment and Sentinel data 

forms were identified 3 ways: 

• Manually using a computerized sorting system 

• Using the NIS–3 rule-based algorithm that identified 2 of 3 matching patterns 

• Using a probability-based matching software designed to identify matches 

During the first stage, all data forms in 9 small counties were examined manually. 

This entailed unduplication staff sorting all the child-level records in each county by various key 

data items and flagging pairs of records that appeared to be potential duplicates. Statisticians 

used the data in these counties and these initial candidate-duplicate decisions to guide the 

settings of parameters on the probability-based matching software so that it would, as closely as 

possible, identify the same candidate pairs. In addition, the unduplication task leader adjusted 

the NIS–3 rule-based algorithm so that it would not generate numerous false-positive candidates. 

Once these preparations were completed, the adjusted NIS–3 rule-based algorithm and the 

A-23 
probability-based matching software were applied to the remaining counties to generate the 

candidate duplicate pairs in those locales. 

True duplicates. Staff examined details on the records in candidate pairs and 

decided whether they were true duplicates. During this process, they accessed the scanned data 

forms electronically, using the form viewer system that also supported the evaluative coding 

operation. As discussed there, this offered simultaneous and efficient electronic access to a 

particular scanned data form by anyone who needed it at the time (the primary evaluative coder, 

the unduplication coder, or reliability coders); and the paperless process it supported secured all 

confidential details on data forms on a password-protected network. 

Table A–10 shows that the unduplication team processed 3,236 candidate pairs, 

deciding that 40% of these pairs were true duplicates. 

Table A–10. Unduplication Decisions on Candidate Pairs 

True duplicates 1,280 

Not duplicates 1,956 

Total Number of candidate pairs 3,236 

Reliability. Reliability of unduplication decisions was tested by obtaining a second 

blind decision on all candidate duplicate pairs in the nine manual sites and on a 10 percent 

sample for the remaining sites. The reliability rate for manual unduplication was 100 percent 

and 99.9 percent for the remaining sites. 

CPS Summary data form duplicates. CPS Summary data forms had no 

information beyond the key demographic data items, so a different method was used to decide 

candidate pairs and resolve duplicates among them and between them and the more detailed data 

forms. Statisticians used the information about the true duplicate decisions on the detailed data 

forms to adjust the parameters of the probability-based matching software so that it could 

generate, as closely as possible, the same final decisions about true duplicate status. They then 

applied the software, with these parameters, to generate true duplicate pairs involving CPS 

Summary data form records. Table A–11 gives the results of this fully-automated unduplication 

process with the CPS Summary data forms. 

A-24 
 

Table A–11. Unduplication Results for CPS Summary Data Forms 

CPS maltreatment and CPS summary form true duplicates 1,520 

Sentinel and CPS summary form true duplicate 1,534 

Total Number of true duplicates 3,054 

Unifying duplicates. In order to resolve records classified as true duplicates, 

analysts selected one record to represent the child in the final database and “credited” the child’s 

recognition to a particular source, while statisticians assigned the record a unified weight. 

Selecting a single record to represent an unduplicated child followed similar decision 

rules to those used in previous NIS cycles, giving preference to records with countable 

maltreatment under the Harm and/or Endangerment standards, to those with more complete 

demographic information, to records from sources higher in the traditional NIS hierarchy of 

recognition sources, and to those describing more forms of maltreatment. Statisticians assigned 

the unified child record a weight that adjusted for the multiple probabilities of sampling the child 

from the sources represented in the duplicate grouping. 

The NIS–4 unduplication team processed 30,543 child records. After identifying and 

unifying duplicate records, the final database contained 29,488 records on individual children. 

Improved methodology. The NIS–4 unduplication process mimicked methods used 

in prior NIS cycles, but also introduced innovations to identify potential duplicate pairs and 

determine duplicates more efficiently. Substantive differences from earlier NIS cycles included 

using probability-based matching software both to identify candidate pairs and decide true 

duplicate status of CPS Summary data records, and adjusting the rules of the NIS–3 algorithm. 

These improvements were tested to verify their comparability with previous NIS studies. 

Extended CPS unduplication. As an enhancement to earlier NIS methods, the 

NIS–4 collected CPS Summary forms for an additional month after the study reference period. 

Statisticans, using the probability-based matching software, unduplicated the uninvestigated 

Sentinel cases against this added month of CPS data to identify any additional duplicates. This 

special analysis ensured that the study would not underestimate the percentage of countable 

children investigated by CPS. 

A-25 
 

WEIGHTING 

Sampling weights were developed so the NIS–4 data can provide national estimates 

of the incidence of child abuse and neglect in the U.S. in 2005-2006. The weights: 

•	 account for the differential selection probabilities for the sample units at each 

successive sampling stage, 

•	 compensate for unit nonresponse from sentinel agencies, and for incomplete or 

partial response from sentinels and CPS agencies, 

•	 adjust for multiple probabilities of identifying the same maltreated child 

through multiple reports to CPS or through multiple sentinel sources, and 

•	 provide an annualization adjustment to transform reference-period data to 

represent a full-year and account for seasonality differences between the two 

study reference periods (fall 2005, spring 2006). 

Base weights. For each sample unit, the base weight is the reciprocal of the 

probability of including the unit in the sample. In the NIS–4, the first-stage primary sampling 

units (counties or county clusters) were selected with probability proportional to the Census 2000 

population of children under age 18 in the PSU. The PSU base weight is the reciprocal of the 

probability of selection of the PSU. Within PSUs, the agency weight is a function of the sample 

design used to select agencies in the PSU. The agency base weight is a product of the PSU 

weight and the reciprocal of the conditional selection probability of the agency given the sample 

PSU. Likewise, the base weight for sentinels, maltreatment case reports and children are derived 

in the same manner, taking into consideration the sample design used to select the sample units 

in each successive sampling stage. 

Special weighting adjustments. There were two adjustments to the PSU base 

weight. First, the PSU sample was divided into two subsamples. A subsample of 62 PSUs (69 

counties) was selected for a full-scale survey involving all 11 sentinel agency categories in the 

NIS–4. The remainder sample of 48 PSUs (53 counties) was allocated for a reduced-load survey 

to include 8 sentinel agency categories only and exclude the three law enforcement agency 

types—juvenile probation, sheriff/county police, and municipal police. As a result, a PSU 

subsample weight was computed for estimation involving law enforcement agencies. 

A-26 
Second, population adjustment factors were applied to the PSU base weights to 

ensure that study estimates would be accurate relative to the size and distribution of the child 

population at the time of the NIS–4 reference periods. The NIS–4 survey was conducted in the 

fall 2005 and the spring 2006. The U.S. child population was larger at this time than it was at the 

time of the 2000 census (when sampling probabilities were set). Moreover, Hurricanes Katrina 

and Rita caused relatively large population mobility within the U.S. just prior to the NIS–4 

reference periods. To estimate incidence rates, the NIS–4 uses the average of the Census child 

population estimates for July 2005 and July 2006 as the reference population. To simplify 

analyses relative to this population, population adjustment factors were used to update the PSU 

base weights. To address the effects of the hurricanes on the distribution of the child population, 

PSU base weights were also adjusted to reflect the proportion of the national child population in 

the NIS–4 counties in July 2006 (i.e., after the hurricanes). 

Nonresponse adjustments. The objective of adjusting base weights for 

nonresponse is to reduce bias by compensating for lost data. The NIS–4 had three types of 

nonresponse: nonparticipating sentinel agencies, refusals or incomplete participation by 

sentinels, and missing CPS Maltreatment data forms on sampled cases. 

Nonresponse adjustments were developed within homogeneous weighting classes. 

Statisticians defined adjustment factors by using a sample-based method to distribute the base 

weights of the nonresponding units to the responding sample units. With this adjustment, the 

sum of the adjusted weights divided by the sum of the responding units equals the sum of the 

base weights for the entire sample. 

Multiplicity adjustments. All duplicate records were identified and, where 

appropriate, linked together in a “duplicate grouping” in order to adjust for multiplicity of 

sampling. The multiplicity adjustments used the same modified single-frame approach 

developed in the NIS–3, correcting for a duplicated child’s multiple chances of coming into the 

study through all the sources that submitted records on the child. In each PSU, duplicate 

groupings predominantly included duplicates among CPS data forms and between CPS and 

sentinel data forms. This reflects a dual-frame design, where frame A was the frame of 

maltreated children investigated by CPS and frame B was the list of maltreated children reported 

by sentinels, with the large majority of duplicates involving overlap between these frames. 

Based on the special Hidden Duplication substudy in the NIS–3, children duplicated on records 

from multiple sentinel sources but never reported to CPS are rare. This finding is consistent with 

the dynamics of recognizing and reporting maltreated children: when more community 

professionals recognize a child as maltreated, it is more likely that one or more of them will 

A-27 
 

 

 

 

report the child to CPS, which in turn makes it more likely that CPS will investigate the child’s 

maltreatment. 

Annualization adjustments. Statisticians developed annualization adjustment 

factors using a calendar year of maltreatment child data from the National Child Abuse and 

Neglect Data System (NCANDS). Walter R. McDonald and Associates prepared a calendar year 

file from the FY2005 and FY2006 NCANDS child files, including child records where the (1) 

county of report was in the NIS–4 (2) date of report was in calendar year 2005, and (3) report 

disposition was substantiated or indicated. Four adjustment factors were derived, distinguished 

by season (fall versus spring) and by source of report (school versus other sources). In each 

case, the multiplier was the unduplicated total number of substantiated/indicated children 

reported during the full calendar year divided by the unduplicated total reported during the 2005 

months that corresponded to the months of the NIS–4 reference periods (i.e., September 4— 

December 3 or February 4—May 3).3 

3

 At the time of the annualization work, the NCANDS FY2006 file was not yet finalized, but it was deemed 

sufficiently complete and accurate to cover the full calendar year and these reference periods in 2005. Comparing 

multipliers derived from this file to multipliers computed from the NCANDS 2004 data showed only small 

differences (school multipliers were 3.50 in the NCANDS FY2005 data and 3.64 in the 2004 NCANDS data; 

multipliers for all other sources were 3.99 in the NCANDS FY2005 data and 3.90 in the 2004 data). This indicated 

that the multipliers change only slightly from one year to the next, implying that little would be gained by delaying 

the analyses to integrate multipliers from the finalized NCANDS FY2006 file. The forthcoming Analysis Report 

provides further details. 

A-28 
CPS STRUCTURE AND PRACTICES MAIL SURVEY (SPM) 

The CPS Structure and Practices Mail Survey (SPM) is a NIS–4 supplementary 

study, designed to assist in interpreting the main study findings. The SPM was modeled after the 

Local Agency Survey (LAS) in the National Study of Child Protective Service and Reform 

Efforts, which was conducted in 2002 with CPS agencies in 375 counties in the United States. 

The SPM used a slightly modified version of the LAS questionnaire. 

The principal purposes of the SPM are to provide a basis for understanding the 

findings of the NIS–4 main study by identifying differences in local CPS agency structures and 

practices that relate to 

• local differences in CPS investigation coverage, and 

• differences in rates of abuse and neglect the agencies’ jurisdictions. 

The SPM questionnaire included 4 modules, each focused on a specific CPS 

function: Administration, Screening/Intake, Investigation, and Alternative CPS Response. Table 

A–12 lists the topics covered in each module. Survey instructions were to describe the agency’s 

organization and practices as they were during the NIS–4 reference period. The instructions also 

specified that the person(s) most knowledgeable about the topics covered in a given module 

should complete the survey questions. Respondents were told that, if they encountered any 

question beyond the scope of their knowledge, they should consult with persons who could 

provide the most informed response. 

The SPM surveys were mailed to CPS agencies only after firm agreements to 

participate were in place and the agency had determined who on their staff would complete or 

coordinate their agency's responses to the SPM survey modules. Because the SPM schedule 

followed CPS recruitment for the main NIS–4 study and that recruitment occurred over an 

extended period, the SPM data collection period was also lengthy. The first set of SPM mailings 

occurred in February 2006 and the last completed survey was returned in May 2007. 

After the initial mailing, there were a number of follow-up contacts, depending on 

the agency’s responses and circumstances: to verify that they received the survey, to provide 

them another copy, to ask about its status and about when they would return the completed 

modules. To facilitate progress in some agencies, the survey was administered via telephone. 

A-29 
Table A–12. Topics Covered in the 4 SPM Modules 

Module 1: Administration/ organization 

number of staff, their education and years of experience 

budget for CPS activities 

whether any CPS staff were located in satellite offices or in other agencies 

whether a citizen review panel or community board reviewed local agency practice 

whether the agency contracted with other agencies to provide any CPS functions 

whether the agency collaborated with other agencies in providing CPS services 

Module 2: Screening/Intake 

whether the agency had specialized screening/intake workers 

the number of staff who handled the screening/intake functions during the NIS–4 reference period 

whether the agency experienced an excessive screening/intake workload during the NIS–4 reference period 

the relative rank of referral sources according to the volume of referrals they provided to the agency 

whether any referrals came from a state hotline and if so what percent of referrals the hotline provided 

mechanism(s) for handling calls during non-business hours and from non-English speakers 

whether the agency maintained records on all calls received 

whether the agency shared responsibility for screening referrals with any other agency 

what the available response options were for different types of referrals 

whether the agency prioritized responses to referrals 

whether the agency had any mandated limit on caseload size when responding to referrals 

what response options were available for screened-out referrals 

whether the agency automatically accepted referrals from certain types of reporters 

Module 3: Investigation 

whether the agency had specialized investigation workers 

whether different workers conducted screening/intake and investigations 

the number of staff who handled the investigation functions during the NIS–4 reference period 

preferences for assigning workers with different experiences depending on the referred child or household 

whether the agency experienced an excessive investigative workload during the NIS–4 reference period 

the agency’s role in investigating different types of maltreatment and different kinds of perpetrators 

standard activities of workers who investigate referrals 

standard activities during investigation for different types of cases 

the agency’s use of structured instruments or tools during the investigation process 

factors considered in determining whether maltreatment had occurred or the child was at risk of maltreatment 

factors that present problems for the agency in completing investigations in a timely and accurate manner 

actions taken after a determination that maltreatment had occurred 

treatment of investigations that are not completed within the time frame specified by agency policy 

provision of short term services after an investigation is completed 

Module 4: Alternative CPS Response (if applicable) 

objective of the alternative response as it operated during the NIS–4 reference period 

differences between the agency’s investigation response and the alternative response 

numbers of alternative response cases and children handled during the NIS–4 reference period 

whether the children receiving alternative response were alleged victims of maltreatment in the referral 

whether the agency had specialized alternative response workers 

whether workers conducting alternative response are different from those conducting other CPS functions 

the number of staff who handled the alternative response function during the NIS–4 reference period 

whether the agency experienced an excessive alternative response workload during the NIS–4 reference period 

the agency’s methods for managing excessive workload demands 

the agency’s role in providing the alternative response to referrals involving different types of maltreatment 

criteria used to assign cases to alternative response 

standard activities of workers who conduct the alternative response 

the agency’s use of structured instruments or tools during the alternative response 

factors that present problems for the agency in conducting the alternative response 

services provided as part of the alternative response 

A-30 
 

The survey achieved a 98 percent response rate, receiving 118 completed responses 

(94%) and 5 partially completed responses (4%). Only 3 agencies (2%) refused to participate in 

the survey. 

Statisticians weighted the survey data to permit national estimates concerning local 

CPS structure and practices. An agency’s final weight was the product of its PSU weight (the 

reciprocal of the conditional selection probability of the agency’s PSU from the stratified list as 

described in the section on Samples), and a nonresponse adjustment within weighting classes to 

compensate for the lost data from the nonresponding agencies. The final analysis file contained 

123 records, one for each responding agency. 

The SPM data will be analyzed in conjunction with the main study findings, 

determining whether features of CPS organization and practice relate to the percentage of 

maltreated children that CPS investigates or to the overall rates of different categories of 

maltreatment in the local jurisdiction. 

A-31 
CPS SCREENING POLICIES STUDY (SPS) 

The CPS Screening Policies Study (SPS) is a NIS–4 supplementary study, designed 

to aid in interpreting the main study findings. The NIS–4 main study provides estimates of the 

numbers and percentages of maltreated children who were investigated by CPS. However, 

children who were not investigated represent an enigma to the NIS because it is not possible to 

say whether they were not reported to CPS or whether they were reported to CPS but not 

investigated because they did not fit the agency’s screening criteria. The policy implications of 

these alternative situations are quite different. This supplementary study obtained detailed 

information about CPS screening criteria to illuminate the main study findings. 

The NIS–3 included a limited precursor to SPS: a brief questionnaire that examined 

general CPS agency policies and practices. Analyses that examined relationships between 

responses on this survey and patterns in the NIS–3 main study data suggested the value of further 

developing this strategy for the NIS–4. Two pilot studies during the NIS–4 Planning Project 

helped to shape the final SPS design and content. 

The SPS included two phases. Phase I entailed conducting the survey itself, as an 

independent study to characterize CPS screening criteria in the United States at the time of the 

NIS–4. This involved telephone interviews with intake/screening supervisors (or their delegates) 

in participating NIS–4 CPS agencies and analyzing those data to provide national estimates of 

the percentages of local CPS agencies that apply different screening criteria to specific 

allegations of abuse or neglect. In Phase II, coders applied the SPS screening criteria to the 

uninvestigated children in the NIS–4 main study to decide whether the criteria in their 

jurisdiction would have screened these children in for CPS investigation during the NIS–4 study 

period. 

Phase I. The interview instrument used for Phase I data collection consists of 60 

vignettes, each reflecting one of the forms of maltreatment in the refined NIS–4 maltreatment 

typology. All of the vignettes described the child’s parent as the alleged perpetrator and 

described circumstances of maltreatment and outcomes to the child that would qualify the 

scenario as countable under the NIS–4 Harm Standard. After each vignette was a series of 

questions asking whether the agency would 

• accept the case described for CPS investigation, 

A-32 
 

• assign the case for agency assessment or services but not investigation, 

• screen the case out with no further agency action, or 

• take other action (if so, specify what other action the agency would take). 

If the respondent said the agency would need additional information in order to 

decide how to respond, they were asked what additional information the agency would need and 

what activities staff would undertake to gather that additional information. A series of follow-up 

questions then asked how changes in key features of the base vignette would affect the agency’s 

response; specifically, would the agency’s response be different depending on who the 

perpetrator was alleged to be (not a parent but another adult left in charge of the child, or an 

adolescent left in charge, or another person not responsible for the child’s care) or depending on 

the child’s age, the harm or injury that resulted, whether there was a history of similar events, or 

the duration or frequency of the event. 

The SPS was viewed and presented as an in-depth follow-up to the SPM 

Screening/Intake module, so SPS data collection began in a CPS agency only after that SPM 

module was complete. In some cases, SPS interviewers facilitated completing that SPM module 

by administering it via telephone. SPS data collection occurred began in February 2006 and 

ended in August 2007. 

Trained interviewers conducted the telephone interviews with the CPS agency’s 

screening supervisor or other expert on screening decisions. They first administered a 

background screener to determine whether the jurisdiction screened referrals at the local CPS 

agency level, the state hotline level or both. Interviews proceeded at all levels where screening 

occurred in order to gather information about all screening decision making that affected which 

children received investigation in the jurisdiction. 

The interviewers obtained the SPS data on the screening policies in 123 (98%) of the 

local CPS agencies in the NIS–4 sample; the remaining 3 NIS–4 CPS agencies refused to 

participate in the SPS. However, because a number of agencies relied solely on centralized 

screening at the state hotline, while several others applied the same state-wide screening policies, 

the interviewers were able to achieve this coverage through only 81 individual interviews, as 

follows: 

• for 50 agencies SPS data were gathered via 13 state hotline interviews, 

• for 11 agencies SPS data were obtained by 2 local agency proxies, 

A-33 
•	 52 agencies provided their own SPS data through direct interviews, and 

•	 for 10 agencies SPS screening data were obtained through two interviews at 

different levels—through a direct interview with the local intake/screening 

supervisor and through an interview with their state hotline (this entailed 4 

state hotline interviews) 

NIS–4 analysts designed a detailed coding system to identify the specific factors that 

affected decisions about whether to screen a referral in for investigation and whether to assign a 

referral to the agency’s alternative response track. The SPS data analysis used the same weights 

that were developed for the SPM and described in that section. These weights allow the SPS 

agency-level data to provide estimates that characterize the screening policies in all local CPS 

agencies in the United States. 

Phase II. In Phase II of the SPS, coders applied each agency’s screening criteria to 

the NIS–4 countable uninvestigated maltreated children in the agency’s jurisdiction to identify 

those who (if they had been reported to their local CPS) would have been screened in for an 

investigation. If the agency consistently applied the screening criteria described in the SPS 

interview, then one can assume that these children were never reported to CPS. CPS may or may 

not have received a report on the remaining children. 

SPS coders had been NIS–4 evaluative coders, so they were thoroughly familiar with 

the data forms and the complexity of information in the records. For the SPS, they revisited data 

forms from the NIS–4 main study on all children who were countable by NIS standards but not 

investigated by CPS. From November 2007 to February 2008, they reviewed all specific forms 

of maltreatment described on these data forms, whether or not they were countable in the NIS–4 

classifications. This was done to be certain to identify any reason the agency would have 

screened the child in for investigation, regardless of whether this agreed with the reason the child 

was considered countable in the NIS. Coders were assisted in this task by a computerized 

system where they could view complete images of the data forms (see CAEDS in the Evaluative 

Coding section) and could directly enter their decisions about whether the agency’s policies 

would have screened the case in for investigation of the alleged maltreatment. 

Cases were coded in relation to all screening policies that could apply to them. That 

meant that records on 721 uninvestigated countable children were coded at both the local agency 

and state hotline levels. Including these, coders assessed 3,962 uninvestigated child records, 

which entailed 6,683 separate assessments of how agency policy would have responded to the 

specific forms of maltreatment described in these records. For reliability purposes, a second 

A-34 
coder independently processed 429 child records (including 726 forms of maltreatment). The 

kappa statistic, used to index inter-coder reliability on these decisions, was .61, indicating a 

moderate level of inter-coder agreement on this complex task. 

Tabulations based on the SPM Phase II codes will be analyzed to help in 

understanding the NIS–4 main study findings on the percentages of uninvestigated maltreated 

children. These results will indicate the degree to which sentinel nonreporting contributes to the 

set of uninvestigated countable children as well as the extent to which these uninvestigated 

children may be referred elsewhere or would qualify for services under alternative response 

tracks at agencies that have this option. 

A-35 
 

SENTINEL DEFINITIONS SURVEY (SDS) 

The NIS goes beyond maltreated children who come to the attention of CPS agencies 

by relying on community professionals (sentinels) who encounter child maltreatment in the 

course of their work in various agency sectors, including health, law enforcement, schools, and 

other agencies such as social services and mental health agencies, day care centers, and shelters. 

In most states, the sectors of professionals represented by NIS sentinels are mandated to report 

maltreated children they identify to CPS. However, except for a supplementary survey of school 

sentinels in the NIS–3, previous NIS cycles have not directly asked sentinels about their training 

on mandated reporting or the standards they apply in deciding whether to report suspected 

maltreatment to CPS. Also, although NIS has always trained the sentinels to be on the lookout 

for the full scope of maltreatment situations that are, or could be, countable under the study 

definitions, NIS has never examined sentinels’ own definitions of maltreatment, or asked about 

their standards for submitting children to the study. This has hampered interpreting changes in 

the size of the maltreated child population from one NIS cycle to the next, since the study has 

had no means of determining whether or to what extent the changes reflected true changes in the 

occurrence of child maltreatment as opposed to shifts in sentinels’ definitions or in their 

standards for submitting data to the study. The purpose of the Sentinel Definitions Survey (SDS) 

was to fill these important gaps. 

Instrument. The SDS used multiple versions of a questionnaire. Each version 

began with an introductory section that asked the sentinels about their characteristics and 

background—including their sex, age, ethnicity, race, level of education, job title and tenure, 

their agency’s setting (rural, suburb, city, etc.), whether they had received any written 

information or training on reporting child abuse and neglect while working at their agency, their 

agency’s policy on reporting to CPS, and whether they had made any reports while working at 

their agency. 

The rest of each questionnaire included vignettes (selected, as described below, from 

the 60 vignettes used in the SPS—see the CPS Screening Policies section). Every vignette 

described a situation where a parent abused or neglected a child in a way that corresponded to a 

specific maltreatment form in the NIS typology and each vignette included features that qualified 

the child as countable under the Harm Standard. After each vignette, follow-up questions asked 

the respondent whether they considered the case to be maltreatment, whether they would report it 

to the local CPS agency, whether they would submit it to a national study on child abuse and 

neglect, or whether they would not respond in any of these ways. Then, paralleling the SPS 

A-36 
 

strategy, additional follow-up questions asked how changes in key features of the base vignette 

would affect the sentinel’s response; specifically, would their answers be different depending on 

who the perpetrator was (not a parent but another adult left in charge of the child, or an 

adolescent left in charge, or another person not responsible for the child’s care) or would their 

answers differ depending on features such as the child’s age, the harm or injury that resulted, 

whether there was a history of similar events, the duration or frequency of the maltreatment 

event, or the family’s financial resources. 

Samples and method. The SDS included all 60 SPS vignettes. However, in order 

to reduce respondent burden, the SDS used a factorial design in which each questionnaire 

included only a subset of 10 of the 60 vignettes. Thus, the 60 vignettes were divided into 6 

groups of 10 vignettes each. The allocation of vignettes across these subsets attempted to 

distribute examples of the major categories of maltreatment (physical, sexual and emotional 

abuse, and physical, educational, and emotional neglect). Also, in order to minimize any 

influence that unique combinations of vignettes might have, 4 different divisions of the 60 

vignettes were constructed. Thus, there were 24 unique versions of the questionnaire (4 

divisions of the set of 60 vignettes, with 6 groups of 10 vignettes in each division). 

Respondents for the SDS were actual sentinels who had participated in the NIS–4. 

They were eligible for the SDS if they had participated during the last two weeks of the NIS–4 

reference period and the sentinel sampling system included their name and address information. 

Survey questionnaires were mailed to all eligible sentinels in all agencies except schools. 

Because there were many more school sentinels (see the Samples section) and because the 

second reference period in spring 2006 ended just before the start of summer break, school 

sentinels were sampled from those eligible in the first reference period (fall 2005). Sentinels 

were classified into the four main groups listed in Table A–13, which also gives the sample size 

of each group. 

To avoid any potential influence on sentinels’ submissions during the NIS–4 main 

study, SDS questionnaires were mailed after the end of the sentinels’ reference period. The 

mailings ensured that the 24 questionnaire versions were evenly distributed across the 4 sentinel 

groups. The instructions assured sentinels that, after they returned their completed questionnaire, 

their names and addresses would be destroyed, so their survey responses would be anonymous. 

Until then, their contact information was used to send follow-up mailings to those who had not 

yet responded. The initial mailing was followed by a series of follow-ups (a postcard reminder, 

another full mailing containing a paid Fed-Ex return envelope, and a final postcard reminder). 

A-37 
The first surveys were mailed in March 2006 and nearly all returns were receipted by September 

2006, with only a few late arrivals. 

As shown in Table A–13, 41% of the sentinels responded, for a total of 2,455 

completed questionnaires. Response rates were similar across the four sentinel groups. 

Analyses will examine variations in responses to different types of maltreatment and 

will identify differences across the sentinel groups. In addition, the data will be examined to 

determine whether changing the perpetrator makes a difference and which factors, such as age 

and harm, are most important to sentinels in deciding what to do about cases of suspected child 

maltreatment. 

Table A–13. SDS Samples and Response Rates 

Sentinel Group SDS Sample Completed 

Surveys Response Rate 

Health (children’s hospitals, general hospitals, 

public health agencies) 929 405 44%

Law Enforcement (sheriffs, county police, 

municipal police, juvenile probation agencies 939 395 42%

School (teachers, administrators, counselors) 3,499 1389 40%

Other (day care centers, shelters, public housing, 

social services, mental health services) 682 266 39%

Total 6,049 2,455 41%

A-38 
Appendix B 


Harm Standard Estimates 

TABLE B-1. 

CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN COUNTABLE 

UNDER THE HARM STANDARD; INCIDENCE RATES (Per 1,000 Children)
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 17.065 1.732 

ALL ABUSED 7.514 0.616 

PHYSICALLY ABUSED 4.387 0.370 

SEXUALLY ABUSED 1.838 0.167 

EMOTIONALLY ABUSED 2.016 0.230 

ALL NEGLECTED 10.481 1.449 

PHYSICALLY NEGLECTED 4.011 0.588 

EMOTIONALLY NEGLECTED 2.627 0.273 

EDUCATIONALLY NEGLECTED 4.896 1.089 

SEVERITY, FATAL 0.033 0.006 

SEVERITY, SERIOUS 6.635 0.654 

SEVERITY, MODERATE 9.426 1.151 

SEVERITY, INFERRED 0.971 0.111 

TABLE B-2. 

PROPORTION OF HARM STANDARD CHILDREN WHOSE MALTREATMENT 

WAS INVESTIGATED BY CPS 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

PROPORTION 

STANDARD 

ERROR 

ALL MALTREATED 0.318 0.028 

ALL ABUSED 0.498 0.040 

PHYSICALLY ABUSED 0.534 0.045 

SEXUALLY ABUSED 0.551 0.056 

EMOTIONALLY ABUSED 0.358 0.035 

ALL NEGLECTED 0.200 0.023 

PHYSICALLY NEGLECTED 0.273 0.038 

EMOTIONALLY NEGLECTED 0.297 0.032 

EDUCATIONALLY NEGLECTED 0.089 0.018 

SEVERITY, FATAL 

SEVERITY, SERIOUS 

SEVERITY, MODERATE 

SEVERITY, INFERRED 

0.805 

0.302 

0.289 

0.691 

0.137 

0.029 

0.031 

0.073

 B-1 
TABLE B-3. 

SEX BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN 

COUNTABLE UNDER THE HARM STANDARD; INCIDENCE RATES (Per 1,000 Children) 

SEX = MALE 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 16.033 1.566 

ALL ABUSED 6.462 0.625 

PHYSICALLY ABUSED 4.553 0.477 

SEXUALLY ABUSED 0.647 0.102 

EMOTIONALLY ABUSED 1.855 0.246 

ALL NEGLECTED 10.411 1.226 

PHYSICALLY NEGLECTED 3.704 0.567 

EMOTIONALLY NEGLECTED 2.703 0.334 

EDUCATIONALLY NEGLECTED 4.995 0.945 

SEVERITY, FATAL 0.034 0.012 

SEVERITY, SERIOUS 6.266 0.580 

SEVERITY, MODERATE 9.172 1.102 

SEVERITY, INFERRED 0.561 0.085 

SEX = FEMALE 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 17.522 2.015 

ALL ABUSED 8.454 0.662 

PHYSICALLY ABUSED 4.134 0.304 

SEXUALLY ABUSED 3.043 0.337 

EMOTIONALLY ABUSED 2.105 0.273 

ALL NEGLECTED 10.079 1.767 

PHYSICALLY NEGLECTED 4.059 0.636 

EMOTIONALLY NEGLECTED 2.438 0.309 

EDUCATIONALLY NEGLECTED 4.692 1.329 

SEVERITY, FATAL 0.018 0.006 

SEVERITY, SERIOUS 6.619 0.779 

SEVERITY, MODERATE 9.524 1.368 

SEVERITY, INFERRED 1.361 0.189

 B-2 
TABLE B-4. 

AGE BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN 

COUNTABLE UNDER THE HARM STANDARD; INCIDENCE RATES (Per 1,000 Children) 

AGE CLASS = 0-2 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 8.510 1.947 

ALL ABUSED 3.691 0.797 

PHYSICALLY ABUSED 2.494 0.42 

SEXUALLY ABUSED 0.997 0.437 

EMOTIONALLY ABUSED 0.305 0.1 

ALL NEGLECTED 5.124 1.224 

PHYSICALLY NEGLECTED 4.701 1.232 

EMOTIONALLY NEGLECTED 0.620 0.112 

EDUCATIONALLY NEGLECTED 0.090 0.079 

SEVERITY, FATAL 0.100 0.027 

SEVERITY, SERIOUS 5.872 1.601 

SEVERITY, MODERATE 1.830 0.412 

SEVERITY, INFERRED 0.709 0.188 

AGE CLASS = 3-5 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 12.120 1.548 

ALL ABUSED 6.080 0.749 

PHYSICALLY ABUSED 3.638 0.502 

SEXUALLY ABUSED 1.755 0.381 

EMOTIONALLY ABUSED 0.980 0.229 

ALL NEGLECTED 6.433 1.334 

PHYSICALLY NEGLECTED 3.043 0.991 

EMOTIONALLY NEGLECTED 1.276 0.43 

EDUCATIONALLY NEGLECTED 2.308 0.637 

SEVERITY, FATAL 0.007 0.004 

SEVERITY, SERIOUS 4.209 0.76 

SEVERITY, MODERATE 6.985 0.961 

SEVERITY, INFERRED 0.919 0.169

 B-3 
TABLE B-4. (Continued) 

AGE CLASS = 6-8 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 17.560 2.027 

ALL ABUSED 8.745 0.986 

PHYSICALLY ABUSED 5.463 0.727 

SEXUALLY ABUSED 1.576 0.337 

EMOTIONALLY ABUSED 2.650 0.559 

ALL NEGLECTED 9.924 1.76 

PHYSICALLY NEGLECTED 4.014 0.766 

EMOTIONALLY NEGLECTED 2.141 0.442 

EDUCATIONALLY NEGLECTED 4.889 1.045 

SEVERITY, FATAL 0.003 0 

SEVERITY, SERIOUS 5.564 0.814 

SEVERITY, MODERATE 11.476 1.558 

SEVERITY, INFERRED 0.516 0.083 

AGE CLASS = 9-11 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 19.501 4.431 

ALL ABUSED 7.708 0.782 

PHYSICALLY ABUSED 4.644 0.499 

SEXUALLY ABUSED 1.417 0.161 

EMOTIONALLY ABUSED 2.676 0.595 

ALL NEGLECTED 12.653 4.255 

PHYSICALLY NEGLECTED 3.957 1.108 

EMOTIONALLY NEGLECTED 2.961 0.565 

EDUCATIONALLY NEGLECTED 7.519 3.535 

SEVERITY, FATAL 0.000 0 

SEVERITY, SERIOUS 6.735 1.542 

SEVERITY, MODERATE 12.242 2.987 

SEVERITY, INFERRED 0.524 0.109

 B-4 
TABLE B-4. (Continued) 

AGE CLASS = 12-14 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 21.267 3.068 

ALL ABUSED 9.106 1.066 

PHYSICALLY ABUSED 5.006 0.645 

SEXUALLY ABUSED 2.403 0.474 

EMOTIONALLY ABUSED 2.687 0.413 

ALL NEGLECTED 13.671 2.802 

PHYSICALLY NEGLECTED 3.977 2.127 

EMOTIONALLY NEGLECTED 3.690 0.475 

EDUCATIONALLY NEGLECTED 7.314 1.573 

SEVERITY, FATAL 0.009 0.007 

SEVERITY, SERIOUS 7.062 0.687 

SEVERITY, MODERATE 12.557 2.601 

SEVERITY, INFERRED 1.639 0.494 

AGE CLASS = 15-17 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 18.485 1.95 

ALL ABUSED 7.471 0.702 

PHYSICALLY ABUSED 4.305 0.544 

SEXUALLY ABUSED 1.567 0.16 

EMOTIONALLY ABUSED 2.389 0.47 

ALL NEGLECTED 12.255 1.766 

PHYSICALLY NEGLECTED 3.178 0.448 

EMOTIONALLY NEGLECTED 4.083 0.759 

EDUCATIONALLY NEGLECTED 6.399 1.515 

SEVERITY, FATAL 0.037 0.028 

SEVERITY, SERIOUS 7.649 1.006 

SEVERITY, MODERATE 9.831 1.424 

SEVERITY, INFERRED 0.968 0.159

 B-5 
TABLE B-5. 

RACE/ETHNICITY BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR 

CHILDREN COUNTABLE UNDER THE HARM STANDARD; INCIDENCE RATES (Per 

1,000 Children) 

RACE/ETHNICITY = WHITE 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 12.597 1.121 

ALL ABUSED 5.993 0.454 

PHYSICALLY ABUSED 3.241 0.291 

SEXUALLY ABUSED 1.357 0.139 

EMOTIONALLY ABUSED 1.951 0.221 

ALL NEGLECTED 7.451 0.922 

PHYSICALLY NEGLECTED 2.779 0.38 

EMOTIONALLY NEGLECTED 2.197 0.324 

EDUCATIONALLY NEGLECTED 3.264 0.5 

SEVERITY, FATAL 0.019 0.01 

SEVERITY, SERIOUS 4.639 0.422 

SEVERITY, MODERATE 7.219 0.854 

SEVERITY, INFERRED 0.72 0.089 

RACE/ETHNICITY = BLACK 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 23.967 3.372 

ALL ABUSED 10.408 1.035 

PHYSICALLY ABUSED 6.626 0.608 

SEXUALLY ABUSED 2.606 0.538 

EMOTIONALLY ABUSED 2.235 0.485 

ALL NEGLECTED 14.654 3.101 

PHYSICALLY NEGLECTED 4.83 0.892 

EMOTIONALLY NEGLECTED 3.77 0.728 

EDUCATIONALLY NEGLECTED 7.423 2.471 

SEVERITY, FATAL 0.021 0.005 

SEVERITY, SERIOUS 8.782 1.115 

SEVERITY, MODERATE 13.695 2.425 

SEVERITY, INFERRED 1.469 0.325

 B-6 
TABLE B-5. (Continued)
 

RACE/ETHNICITY = HISPANIC
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 14.162 1.447 

ALL ABUSED 6.713 0.768 

PHYSICALLY ABUSED 4.411 0.573 

SEXUALLY ABUSED 1.82 0.318 

EMOTIONALLY ABUSED 1.321 0.245 

ALL NEGLECTED 8.255 1.056 

PHYSICALLY NEGLECTED 2.714 0.58 

EMOTIONALLY NEGLECTED 2.144 0.397 

EDUCATIONALLY NEGLECTED 4.001 0.734 

SEVERITY, FATAL 0.05 0.017 

SEVERITY, SERIOUS 5.247 0.763 

SEVERITY, MODERATE 8.082 1.075 

SEVERITY, INFERRED 0.782 0.1 

TABLE B-6. 

NUMBER OF CHILDREN BY CATEGORIES OF MALTREATMENT AND SEVERITY 

FOR CHILDREN COUNTABLE UNDER THE HARM STANDARD; INCIDENCE RATES 

(Per 1,000 Children) 

NCHILDR = 1CHILD 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 17.894 2.042 

ALL ABUSED 7.56 0.631 

PHYSICALLY ABUSED 4.869 0.556 

SEXUALLY ABUSED 1.813 0.158 

EMOTIONALLY ABUSED 1.519 0.244 

ALL NEGLECTED 11.134 1.753 

PHYSICALLY NEGLECTED 4.165 0.845 

EMOTIONALLY NEGLECTED 3.24 0.471 

EDUCATIONALLY NEGLECTED 5.085 0.984 

SEVERITY, FATAL 0.027 0.02 

SEVERITY, SERIOUS 7.379 1.38 

SEVERITY, MODERATE 9.384 1.011 

SEVERITY, INFERRED 1.104 0.148

 B-7 
TABLE B-6. (Continued) 

NCHILDR = 2 CHILDREN 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 11.92 1.099 

ALL ABUSED 6.368 0.734 

PHYSICALLY ABUSED 3.419 0.391 

SEXUALLY ABUSED 1.867 0.346 

EMOTIONALLY ABUSED 1.72 0.228 

ALL NEGLECTED 6.416 0.792 

PHYSICALLY NEGLECTED 2.948 0.407 

EMOTIONALLY NEGLECTED 1.912 0.334 

EDUCATIONALLY NEGLECTED 2.443 0.544 

SEVERITY, FATAL 0.03 0.011 

SEVERITY, SERIOUS 4.781 0.482 

SEVERITY, MODERATE 6.232 0.694 

SEVERITY, INFERRED 0.878 0.189 

NCHILDR = 3 CHILDREN 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 15.691 1.779 

ALL ABUSED 7.474 0.833 

PHYSICALLY ABUSED 4.062 0.469 

SEXUALLY ABUSED 1.729 0.341 

EMOTIONALLY ABUSED 2.446 0.518 

ALL NEGLECTED 9.177 1.411 

PHYSICALLY NEGLECTED 2.565 0.471 

EMOTIONALLY NEGLECTED 2.717 0.391 

EDUCATIONALLY NEGLECTED 4.67 1.065 

SEVERITY, FATAL 0.038 0.016 

SEVERITY, SERIOUS 6.011 0.603 

SEVERITY, MODERATE 8.909 1.369 

SEVERITY, INFERRED 0.733 0.142

 B-8 
TABLE B-6. (Continued) 

NCHILDR = 4 OR MORE CHILDREN
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 21.168 2.719 

ALL ABUSED 8.507 0.851 

PHYSICALLY ABUSED 4.969 0.482 

SEXUALLY ABUSED 1.766 0.298 

EMOTIONALLY ABUSED 2.533 0.556 

ALL NEGLECTED 13.836 2.427 

PHYSICALLY NEGLECTED 5.927 1.269 

EMOTIONALLY NEGLECTED 3.021 0.629 

EDUCATIONALLY NEGLECTED 6.041 1.861 

SEVERITY, FATAL 0.028 0.016 

SEVERITY, SERIOUS 8.362 1.343 

SEVERITY, MODERATE 11.702 2.001 

SEVERITY, INFERRED 1.076 0.248 

TABLE B-7. 

METROPOLITAN STATUS OF COUNTY BY CATEGORIES OF MALTREATMENT AND 

SEVERITY FOR CASES COUNTABLE UNDER THE ENDANGERMENT STANDARD; 

INCIDENCE RATES (Per 1,000 Children)
 

METROSTATUS = MAJOR URBAN 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 13.593 1.987 

ALL ABUSED 6.375 0.942 

PHYSICALLY ABUSED 3.826 0.565 

SEXUALLY ABUSED 1.762 0.295 

EMOTIONALLY ABUSED 1.333 0.221 

ALL NEGLECTED 7.856 1.37 

PHYSICALLY NEGLECTED 3.301 0.889 

EMOTIONALLY NEGLECTED 1.835 0.232 

EDUCATIONALLY NEGLECTED 3.348 0.833 

SEVERITY, FATAL 0.038 0.008 

SEVERITY, SERIOUS 5.31 0.846 

SEVERITY, MODERATE 7.339 1.252 

SEVERITY, INFERRED 0.905 0.161

 B-9 
TABLE B-7. (Continued) 

METROSTATUS = URBAN 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 15.984 2.757 

ALL ABUSED 7.832 1.201 

PHYSICALLY ABUSED 4.678 0.71 

SEXUALLY ABUSED 1.447 0.24 

EMOTIONALLY ABUSED 2.537 0.576 

ALL NEGLECTED 9.156 1.831 

PHYSICALLY NEGLECTED 3.166 0.645 

EMOTIONALLY NEGLECTED 2.985 0.656 

EDUCATIONALLY NEGLECTED 3.872 1.01 

SEVERITY, FATAL 0.037 0.014 

SEVERITY, SERIOUS 6.441 1.204 

SEVERITY, MODERATE 8.599 1.573 

SEVERITY, INFERRED 0.907 0.162 

METROSTATUS = RURAL 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 30.988 8.117 

ALL ABUSED 10.83 1.538 

PHYSICALLY ABUSED 5.769 0.89 

SEXUALLY ABUSED 2.828 0.384 

EMOTIONALLY ABUSED 3.391 0.803 

ALL NEGLECTED 21.949 7.627 

PHYSICALLY NEGLECTED 8.015 2.243 

EMOTIONALLY NEGLECTED 4.679 1.152 

EDUCATIONALLY NEGLECTED 12.107 6.048 

SEVERITY, FATAL 0.006 0.006 

SEVERITY, SERIOUS 11.488 2.458 

SEVERITY, MODERATE 18.178 5.753 

SEVERITY, INFERRED 1.315 0.309

 B-10 
TABLE B-8. 

CHILDREN COUNTABLE UNDER THE HARM STANDARD--RECOGNIZED OVERALL, 

INVESTIGATED BY CPS, AND NOT INVESTIGATED BY CPS, BY RECOGNITION 

SOURCE; INCIDENCE RATES (Per 1,000 children) 

CLASS = ALL RECOGNIZED 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 0.482 0.096 

POLICE/SHERIFF 2.067 0.202 

PUBLIC HEALTH 0.323 0.100 

INVESTIGATORY AGENCY SUBTOTAL: 2.871 0.257 

HOSPITALS 1.823 0.693 

SCHOOLS 8.811 1.368 

DAY CARE CENTERS 0.890 0.255 

MENTAL HEALTH 0.801 0.172 

SOCIAL SERVICES 0.244 0.039 

SHELTERS 0.174 0.037 

PUBLIC HOUSING 0.021 0.014 

OTHER SENTINEL AGENCY SUBTOTAL 12.763 1.651 

ALL SENTINEL SOURCES TOTAL 15.635 1.712 

DSS/WELFARE DEPT. 0.251 0.037 

OTHER PROFESSIONAL OR AGENCY 0.153 0.027 

ALL OTHER SOURCES 1.026 0.075 

OTHER (CPS ONLY) SUBTOTAL 1.430 0.089 

TOTAL, ALL SOURCES 17.065 1.732

 B-11 
TABLE B-8. (Continued)
 

CLASS = INVESTIGATED BY CPS
 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 0.202 0.041 

POLICE/SHERIFF 1.092 0.085 

PUBLIC HEALTH 0.084 0.023 

INVESTIGATORY AGENCY SUBTOTAL: 1.379 0.120 

HOSPITALS 0.496 0.051 

SCHOOLS 1.428 0.102 

DAY CARE CENTERS 0.092 0.016 

MENTAL HEALTH 0.344 0.035 

SOCIAL SERVICES 0.222 0.038 

SHELTERS 0.024 0.008 

PUBLIC HOUSING 0.014 0.013 

OTHER SENTINEL AGENCY SUBTOTAL 2.621 0.164 

ALL SENTINEL SOURCES TOTAL 3.999 0.237 

DSS/WELFARE DEPT. 0.251 0.037 

OTHER PROFESSIONAL OR AGENCY 0.153 0.027 

ALL OTHER SOURCES 1.026 0.075 

OTHER (CPS ONLY) SUBTOTAL 1.430 0.089 

TOTAL, ALL SOURCES 5.430 0.284

 B-12 
TABLE B-8. (Continued)
 

CLASS = NOT INVESTIGATED BY CPS
 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 0.279 0.078 

POLICE/SHERIFF 0.975 0.214 

PUBLIC HEALTH 0.239 0.095 

INVESTIGATORY AGENCY SUBTOTAL: 1.493 0.256 

HOSPITALS 1.327 0.687 

SCHOOLS 7.383 1.323 

DAY CARE CENTERS 0.798 0.256 

MENTAL HEALTH 0.457 0.166 

SOCIAL SERVICES 0.022 0.015 

SHELTERS 0.149 0.036 

PUBLIC HOUSING 0.007 0.005 

OTHER SENTINEL AGENCY SUBTOTAL 10.142 1.600 

ALL SENTINEL SOURCES TOTAL 11.635 1.602 

DSS/WELFARE DEPT. 0.000 0.000 

OTHER PROFESSIONAL OR AGENCY 0.000 0.000 

ALL OTHER SOURCES 0.000 0.000 

OTHER (CPS ONLY) SUBTOTAL 0.000 0.000 

TOTAL, ALL SOURCES 11.635 1.602

 B-13 
TABLE B-9. 

PROPORTION OF HARM STANDARD CHILDREN WHOSE MALTREATMENT 

WAS INVESTIGATED BY CPS, BY RECOGNITION SOURCE
 

ESTIMATED 

PROPORTION 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 0.420 0.070 

POLICE/SHERIFF 0.528 0.065 

PUBLIC HEALTH 0.261 0.097 

INVESTIGATORY AGENCY SUBTOTAL: 0.480 0.052 

HOSPITALS 0.272 0.135 

SCHOOLS 0.162 0.021 

DAY CARE CENTERS 0.103 0.036 

MENTAL HEALTH 0.430 0.087 

SOCIAL SERVICES 0.911 0.058 

SHELTERS 0.139 0.048 

PUBLIC HOUSING 0.683 0.336 

OTHER SENTINEL AGENCY SUBTOTAL 0.205 0.025 

ALL SENTINEL SOURCES TOTAL 0.256 0.024 

DSS/WELFARE DEPT. 1.000 0.000 

OTHER PROFESSIONAL OR AGENCY 1.000 0.000 

ALL OTHER SOURCES 1.000 0.000 

OTHER (CPS ONLY) SUBTOTAL 1.000 0.000 

TOTAL, ALL SOURCES 0.318 0.028

 B-14 
TABLE B-10. 

FAMILY STRUCTURE AND PARENTS' LIVING ARRANGEMENT BY CATEGORIES OF 

MALTREATMENT AND SEVERITY FOR CHILDREN COUNTABLE UNDER THE 

HARM STANDARD; INCIDENCE RATES (Per 1,000 Children)
 

FAMILY STRUCTURE/LIVING ARRANGEMENT = MARRIED PARENTS, 

BOTH BIOLOGICAL 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 6.759 0.867 

ALL ABUSED 2.901 0.392 

PHYSICALLY ABUSED 1.865 0.279 

SEXUALLY ABUSED 0.504 0.094 

EMOTIONALLY ABUSED 0.840 0.152 

ALL NEGLECTED 4.216 0.702 

PHYSICALLY NEGLECTED 1.803 0.382 

EMOTIONALLY NEGLECTED 0.854 0.156 

EDUCATIONALLY NEGLECTED 1.927 0.530 

SEVERITY, FATAL 0.021 0.010 

SEVERITY, SERIOUS 2.642 0.427 

SEVERITY, MODERATE 3.951 0.654 

SEVERITY, INFERRED 0.146 0.033 

FAMILY STRUCTURE/LIVING ARRANGEMENT = OTHER MARRIED PARENTS 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 24.443 2.519 

ALL ABUSED 17.427 1.759 

PHYSICALLY ABUSED 9.776 1.117 

SEXUALLY ABUSED 4.265 0.573 

EMOTIONALLY ABUSED 4.985 0.998 

ALL NEGLECTED 9.281 1.635 

PHYSICALLY NEGLECTED 3.230 0.834 

EMOTIONALLY NEGLECTED 3.923 0.789 

EDUCATIONALLY NEGLECTED 3.567 1.082 

SEVERITY, FATAL 0.056 0.036 

SEVERITY, SERIOUS 9.148 1.122 

SEVERITY, MODERATE 13.617 1.901 

SEVERITY, INFERRED 1.622 0.273

 B-15 
TABLE B-10. (Continued)
 

FAMILY STRUCTURE/LIVING ARRANGEMENT = UNMARRIED PARENTS
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 23.456 3.531 

ALL ABUSED 12.147 2.182 

PHYSICALLY ABUSED 8.245 1.314 

SEXUALLY ABUSED 2.371 1.220 

EMOTIONALLY ABUSED 2.497 0.816 

ALL NEGLECTED 12.637 2.695 

PHYSICALLY NEGLECTED 6.301 1.343 

EMOTIONALLY NEGLECTED 4.105 1.460 

EDUCATIONALLY NEGLECTED 4.067 2.179 

SEVERITY, FATAL 0.152 0.082 

SEVERITY, SERIOUS 10.765 2.127 

SEVERITY, MODERATE 11.141 2.504 

SEVERITY, INFERRED 1.398 0.485 

FAMILY STRUCTURE/LIVING ARRANGEMENT = SINGLE PARENT WITH PARTNER 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 57.166 8.504 

ALL ABUSED 33.602 5.292 

PHYSICALLY ABUSED 19.453 2.828 

SEXUALLY ABUSED 9.919 2.570 

EMOTIONALLY ABUSED 8.234 2.277 

ALL NEGLECTED 26.970 5.981 

PHYSICALLY NEGLECTED 8.649 2.152 

EMOTIONALLY NEGLECTED 10.857 3.045 

EDUCATIONALLY NEGLECTED 11.853 4.363 

SEVERITY, FATAL 

SEVERITY, SERIOUS 

SEVERITY, MODERATE 

SEVERITY, INFERRED 

0.036 

20.796 

33.006 

3.327 

0.015 

3.983 

5.840 

0.882

 B-16 
TABLE B-10. (Continued)
 

FAMILY STRUCTURE/LIVING ARRANGEMENT = SINGLE PARENT, NO PARTNER
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 28.419 3.551 

ALL ABUSED 10.160 1.249 

PHYSICALLY ABUSED 5.893 0.701 

SEXUALLY ABUSED 2.390 0.332 

EMOTIONALLY ABUSED 2.906 0.542 

ALL NEGLECTED 19.585 2.938 

PHYSICALLY NEGLECTED 6.515 0.965 

EMOTIONALLY NEGLECTED 4.945 0.641 

EDUCATIONALLY NEGLECTED 9.977 2.341 

SEVERITY, FATAL 0.034 0.014 

SEVERITY, SERIOUS 11.899 1.455 

SEVERITY, MODERATE 14.786 2.236 

SEVERITY, INFERRED 1.699 0.224 

FAMILY STRUCTURE/LIVING ARRANGEMENT = NEITHER PARENT 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 33.175 6.210 

ALL ABUSED 15.339 2.493 

PHYSICALLY ABUSED 6.810 0.996 

SEXUALLY ABUSED 5.280 1.002 

EMOTIONALLY ABUSED 4.034 1.653 

ALL NEGLECTED 20.419 5.570 

PHYSICALLY NEGLECTED 9.075 2.254 

EMOTIONALLY NEGLECTED 4.782 1.690 

EDUCATIONALLY NEGLECTED 8.493 2.868 

SEVERITY, FATAL 0.009 0.001 

SEVERITY, SERIOUS 11.435 2.697 

SEVERITY, MODERATE 18.516 3.562 

SEVERITY, INFERRED 3.215 0.760

 B-17 
TABLE B-11. 

FAMILY STRUCTURE BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR 

CHILDREN COUNTABLE UNDER THE HARM STANDARD; INCIDENCE RATES (Per 

1,000 Children) 

FAMILY STRUCTURE= SINGLE PARENT 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 35.635 3.991 

ALL ABUSED 13.802 1.607 

PHYSICALLY ABUSED 7.831 0.848 

SEXUALLY ABUSED 3.750 0.589 

EMOTIONALLY ABUSED 3.636 0.536 

ALL NEGLECTED 23.458 3.150 

PHYSICALLY NEGLECTED 8.257 1.272 

EMOTIONALLY NEGLECTED 5.981 0.678 

EDUCATIONALLY NEGLECTED 11.576 2.383 

SEVERITY, FATAL 0.035 0.013 

SEVERITY, SERIOUS 14.058 1.528 

SEVERITY, MODERATE 19.203 2.494 

SEVERITY, INFERRED 2.339 0.378 

FAMILY STRUCTURE= BOTH PARENTS 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 9.515 1.030 

ALL ABUSED 4.841 0.444 

PHYSICALLY ABUSED 3.007 0.290 

SEXUALLY ABUSED 0.978 0.119 

EMOTIONALLY ABUSED 1.330 0.200 

ALL NEGLECTED 5.271 0.863 

PHYSICALLY NEGLECTED 2.219 0.402 

EMOTIONALLY NEGLECTED 1.301 0.187 

EDUCATIONALLY NEGLECTED 2.287 0.681 

SEVERITY, FATAL 0.033 0.008 

SEVERITY, SERIOUS 3.678 0.409 

SEVERITY, MODERATE 5.438 0.811 

SEVERITY, INFERRED 0.366 0.041

 B-18 
TABLE B-11. (Continued)
 

FAMILY STRUCTURE= NEITHER PARENT
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 33.175 6.210 

ALL ABUSED 15.339 2.493 

PHYSICALLY ABUSED 6.810 0.996 

SEXUALLY ABUSED 5.280 1.002 

EMOTIONALLY ABUSED 4.034 1.653 

ALL NEGLECTED 20.419 5.570 

PHYSICALLY NEGLECTED 9.075 2.254 

EMOTIONALLY NEGLECTED 4.782 1.690 

EDUCATIONALLY NEGLECTED 8.493 2.868 

SEVERITY, FATAL 0.009 0.001 

SEVERITY, SERIOUS 11.435 2.697 

SEVERITY, MODERATE 18.516 3.562 

SEVERITY, INFERRED 3.215 0.760 

TABLE B-12. 

SOCIOECONOMIC STATUS (SES) BY CATEGORIES OF MALTREATMENT AND 

SEVERITY FOR CHILDREN COUNTABLE UNDER THE HARM STANDARD; 

INCIDENCE RATES (Per 1,000 Children)
 

SOCIOECONOMIC STATUS= NOT LOW SOCIOECONOMIC STATUS (SES) 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 4.402 0.379 

ALL ABUSED 2.472 0.21 

PHYSICALLY ABUSED 1.504 0.166 

SEXUALLY ABUSED 0.587 0.085 

EMOTIONALLY ABUSED 0.537 0.063 

ALL NEGLECTED 2.222 0.323 

PHYSICALLY NEGLECTED 0.829 0.133 

EMOTIONALLY NEGLECTED 0.778 0.138 

EDUCATIONALLY NEGLECTED 1 0.257 

SEVERITY, FATAL 0.003 0.001 

SEVERITY, SERIOUS 1.746 0.192 

SEVERITY, MODERATE 2.414 0.284 

SEVERITY, INFERRED 0.239 0.041

 B-19 
TABLE B-12. (Continued)
 

SOCIOECONOMIC STATUS= LOW SOCIOECONOMIC STATUS (SES)
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 22.524 3 

ALL ABUSED 7.725 0.655 

PHYSICALLY ABUSED 4.401 0.481 

SEXUALLY ABUSED 1.687 0.2 

EMOTIONALLY ABUSED 2.634 0.427 

ALL NEGLECTED 16.101 2.784 

PHYSICALLY NEGLECTED 6.917 1.066 

EMOTIONALLY NEGLECTED 3.819 0.549 

EDUCATIONALLY NEGLECTED 7.092 2.446 

SEVERITY, FATAL 0.042 0.014 

SEVERITY, SERIOUS 9.884 1.15 

SEVERITY, MODERATE 11.661 2.135 

SEVERITY, INFERRED 0.937 0.179 

TABLE B-13. 

PARENTS' EMPLOYMENT BY CATEGORIES OF MALTREATMENT AND SEVERITY 

FOR CHILDREN COUNTABLE UNDER THE HARM STANDARD; INCIDENCE RATES 

(Per 1,000 Children) 

PARENTS' EMPLOYMENT = UNEMPLOYED 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 15.855 2.743 

ALL ABUSED 4.774 0.775 

PHYSICALLY ABUSED 2.286 0.542 

SEXUALLY ABUSED 0.774 0.198 

EMOTIONALLY ABUSED 2.252 0.609 

ALL NEGLECTED 12.12 2.499 

PHYSICALLY NEGLECTED 5.585 1.159 

EMOTIONALLY NEGLECTED 2.717 0.546 

EDUCATIONALLY NEGLECTED 5.835 2.04 

SEVERITY, FATAL 0.008 0.003 

SEVERITY, SERIOUS 6.913 1.027 

SEVERITY, MODERATE 8.204 2.045 

SEVERITY, INFERRED 0.731 0.26

 B-20 
TABLE B-13. (Continued)
 

PARENTS' EMPLOYMENT = NOT IN THE LABOR FORCE
 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 22.627 3.658 

ALL ABUSED 9.61 2.128 

PHYSICALLY ABUSED 5.366 1.414 

SEXUALLY ABUSED 2.963 1.11 

EMOTIONALLY ABUSED 2.858 0.715 

ALL NEGLECTED 14.78 2.151 

PHYSICALLY NEGLECTED 6.127 1.63 

EMOTIONALLY NEGLECTED 4.918 1.364 

EDUCATIONALLY NEGLECTED 4.833 0.91 

SEVERITY, FATAL 0.041 0.039 

SEVERITY, SERIOUS 11.042 1.967 

SEVERITY, MODERATE 9.325 1.918 

SEVERITY, INFERRED 2.219 0.798 

PARENTS' EMPLOYMENT = EMPLOYED 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 7.572 0.739 

ALL ABUSED 3.871 0.387 

PHYSICALLY ABUSED 2.307 0.243 

SEXUALLY ABUSED 0.795 0.105 

EMOTIONALLY ABUSED 1.172 0.188 

ALL NEGLECTED 4.139 0.602 

PHYSICALLY NEGLECTED 1.442 0.281 

EMOTIONALLY NEGLECTED 1.418 0.167 

EDUCATIONALLY NEGLECTED 1.76 0.493 

SEVERITY, FATAL 0.015 0.007 

SEVERITY, SERIOUS 3.047 0.335 

SEVERITY, MODERATE 4.244 0.542 

SEVERITY, INFERRED 0.265 0.039

 B-21 
TABLE B-14. 

GRANDPARENTS AS CAREGIVERS BY CATEGORIES OF MALTREATMENT AND 

SEVERITY FOR CHILDREN COUNTABLE UNDER THE HARM STANDARD; 

INCIDENCE RATES (Per 1,000 Children)
 

GRANDPARENTS AS CAREGIVERS = GRANDPARENT PRESENT 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 15.859 2.878 

ALL ABUSED 6.072 0.847 

PHYSICALLY ABUSED 3.022 0.35 

SEXUALLY ABUSED 1.592 0.311 

EMOTIONALLY ABUSED 1.856 0.576 

ALL NEGLECTED 11.167 2.695 

PHYSICALLY NEGLECTED 5.278 1.287 

EMOTIONALLY NEGLECTED 3.722 1.179 

EDUCATIONALLY NEGLECTED 4.537 1.784 

SEVERITY, FATAL 0.056 0.032 

SEVERITY, SERIOUS 7.038 1.58 

SEVERITY, MODERATE 7.555 1.893 

SEVERITY, INFERRED 1.21 0.303 

GRANDPARENTS AS CAREGIVERS = GRANDPARENT NOT PRESENT 

CATEGORY OF 

MALTREATMENT OR 

SEVERITY 

ESTIMATED 

INCIDENCE 

RATE 

STANDARD 

ERROR 

ALL MALTREATED 17.127 1.704 

ALL ABUSED 7.632 0.648 

PHYSICALLY ABUSED 4.499 0.397 

SEXUALLY ABUSED 1.859 0.175 

EMOTIONALLY ABUSED 2.03 0.229 

ALL NEGLECTED 10.385 1.4 

PHYSICALLY NEGLECTED 3.898 0.584 

EMOTIONALLY NEGLECTED 2.532 0.276 

EDUCATIONALLY NEGLECTED 4.893 1.059 

SEVERITY, FATAL 0.031 0.006 

SEVERITY, SERIOUS 6.584 0.644 

SEVERITY, MODERATE 9.562 1.148 

SEVERITY, INFERRED 0.95 0.114

 B-22 
Appendix C 


Endangerment Standard Estimates 

TABLE C-1. 

CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN COUNTABLE UNDER 

THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 1,000 Children)
 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 39.463 3.526 

ALL ABUSED 11.340 0.876 

PHYSICALLY ABUSED 6.472 0.484 

SEXUALLY ABUSED 2.452 0.191 

EMOTIONALLY ABUSED 4.109 0.426 

ALL NEGLECTED 30.578 2.778 

PHYSICALLY NEGLECTED 16.190 1.605 

EMOTIONALLY NEGLECTED 15.941 1.299 

EDUCATIONALLY NEGLECTED 4.896 1.089 

SEVERITY, FATAL 

SEVERITY, SERIOUS 

SEVERITY, MODERATE 

SEVERITY, INFERRED 

SEVERITY, ENDANGERED 

0.033 

6.925 

13.861 

3.086 

15.557 

0.006 

0.666 

1.480 

0.346 

1.506 

TABLE C-2. 

PROPORTION OF ENDANGERMENT STANDARD CHILDREN WHOSE MALTREATMENT WAS 

INVESTIGATED BY CPS
 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

PROPORTION 

STANDARD 

ERROR 

ALL MALTREATED 0.434 0.035 

ALL ABUSED 0.494 0.038 

PHYSICALLY ABUSED 0.523 0.039 

SEXUALLY ABUSED 0.564 0.050 

EMOTIONALLY ABUSED 0.396 0.039 

ALL NEGLECTED 0.415 0.034 

PHYSICALLY NEGLECTED 0.414 0.042 

EMOTIONALLY NEGLECTED 0.498 0.044 

EDUCATIONALLY NEGLECTED 0.089 0.018 

SEVERITY, FATAL 

SEVERITY, SERIOUS 

SEVERITY, MODERATE 

SEVERITY, INFERRED 

SEVERITY, ENDANGERED 

0.807 

0.311 

0.288 

0.527 

0.601 

0.136 

0.029 

0.029 

0.070 

0.056

 C-1 
TABLE C-3. 

SEX BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN COUNTABLE UNDER 

THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 1,000 Children) 

SEX = MALE 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 36.6063 3.147 

ALL ABUSED 9.9654 0.949 

PHYSICALLY ABUSED 6.6566 0.613 

SEXUALLY ABUSED 1.0483 0.121 

EMOTIONALLY ABUSED 3.8567 0.528 

ALL NEGLECTED 29.0468 2.61 

PHYSICALLY NEGLECTED 15.1481 1.508 

EMOTIONALLY NEGLECTED 15.0183 1.266 

EDUCATIONALLY NEGLECTED 4.9948 0.945 

SEVERITY, FATAL 0.0344 0.012 

SEVERITY, SERIOUS 6.5425 0.593 

SEVERITY, MODERATE 13.825 1.501 

SEVERITY, INFERRED 2.4649 0.269 

SEVERITY, ENDANGERED 13.7395 1.192 

SEX = FEMALE 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 37.946 3.453 

ALL ABUSED 12.0063 0.864 

PHYSICALLY ABUSED 5.9264 0.428 

SEXUALLY ABUSED 3.844 0.38 

EMOTIONALLY ABUSED 3.9778 0.429 

ALL NEGLECTED 28.6172 2.708 

PHYSICALLY NEGLECTED 15.1902 1.621 

EMOTIONALLY NEGLECTED 14.6864 1.043 

EDUCATIONALLY NEGLECTED 4.6924 1.329 

SEVERITY, FATAL 0.0184 0.006 

SEVERITY, SERIOUS 6.8921 0.796 

SEVERITY, MODERATE 13.6431 1.682 

SEVERITY, INFERRED 3.4418 0.348 

SEVERITY, ENDANGERED 13.9507 1.461

 C-2 
TABLE C-4. 

AGE BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN COUNTABLE UNDER 

THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 1,000 Children) 

AGE CLASS = 0-2 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 33.4318 5.186 

ALL ABUSED 6.0665 0.929 

PHYSICALLY ABUSED 3.7016 0.481 

SEXUALLY ABUSED 1.2784 0.451 

EMOTIONALLY ABUSED 1.5885 0.303 

ALL NEGLECTED 27.2705 4.081 

PHYSICALLY NEGLECTED 17.5535 3.334 

EMOTIONALLY NEGLECTED 13.1745 1.072 

EDUCATIONALLY NEGLECTED 0.0902 0.079 

SEVERITY, FATAL 0.1017 0.027 

SEVERITY, SERIOUS 6.1834 1.625 

SEVERITY, MODERATE 4.4774 0.847 

SEVERITY, INFERRED 2.007 0.385 

SEVERITY, ENDANGERED 20.6623 2.657 

AGE CLASS = 3-5 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 34.9032 3.155 

ALL ABUSED 9.9188 1.015 

PHYSICALLY ABUSED 5.8457 0.688 

SEXUALLY ABUSED 2.483 0.408 

EMOTIONALLY ABUSED 2.9542 0.606 

ALL NEGLECTED 26.8042 2.791 

PHYSICALLY NEGLECTED 15.3445 1.791 

EMOTIONALLY NEGLECTED 13.4301 1.62 

EDUCATIONALLY NEGLECTED 2.3082 0.637 

SEVERITY, FATAL 0.007 0.004 

SEVERITY, SERIOUS 4.3458 0.761 

SEVERITY, MODERATE 11.2208 1.559 

SEVERITY, INFERRED 3.3423 0.75 

SEVERITY, ENDANGERED 15.9873 1.065

 C-3 
TABLE C-4. (Continued) 

AGE CLASS = 6-8 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 42.3939 3.701 

ALL ABUSED 13.1373 1.273 

PHYSICALLY ABUSED 7.7157 0.812 

SEXUALLY ABUSED 2.3835 0.387 

EMOTIONALLY ABUSED 5.1623 0.82 

ALL NEGLECTED 33.1135 3.406 

PHYSICALLY NEGLECTED 18.9427 2.285 

EMOTIONALLY NEGLECTED 16.998 1.317 

EDUCATIONALLY NEGLECTED 4.8888 1.045 

SEVERITY, FATAL 0.003 0 

SEVERITY, SERIOUS 5.9192 0.832 

SEVERITY, MODERATE 19.3279 2.816 

SEVERITY, INFERRED 3.4363 0.554 

SEVERITY, ENDANGERED 13.7075 0.948 

AGE CLASS = 9-11 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 38.3065 4.943 

ALL ABUSED 10.92 0.723 

PHYSICALLY ABUSED 6.1881 0.572 

SEXUALLY ABUSED 1.9493 0.223 

EMOTIONALLY ABUSED 4.4954 0.578 

ALL NEGLECTED 30.3687 4.763 

PHYSICALLY NEGLECTED 15.7395 2.235 

EMOTIONALLY NEGLECTED 15.2092 1.279 

EDUCATIONALLY NEGLECTED 7.5185 3.535 

SEVERITY, FATAL 0.0003 0 

SEVERITY, SERIOUS 7.0847 1.541 

SEVERITY, MODERATE 16.703 3.372 

SEVERITY, INFERRED 2.5303 0.425 

SEVERITY, ENDANGERED 11.9881 1.041

 C-4 
TABLE C-4. (Continued) 

AGE CLASS = 12-14 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 37.5518 4.402 

ALL ABUSED 12.5598 1.463 

PHYSICALLY ABUSED 7.0735 0.726 

SEXUALLY ABUSED 2.9742 0.511 

EMOTIONALLY ABUSED 4.7134 0.663 

ALL NEGLECTED 28.6471 3.936 

PHYSICALLY NEGLECTED 13.0198 2.692 

EMOTIONALLY NEGLECTED 15.0853 1.74 

EDUCATIONALLY NEGLECTED 7.3143 1.573 

SEVERITY, FATAL 0.0085 0.007 

SEVERITY, SERIOUS 7.369 0.719 

SEVERITY, MODERATE 16.8301 3.056 

SEVERITY, INFERRED 3.1333 0.595 

SEVERITY, ENDANGERED 10.2108 1.231 

AGE CLASS = 15-17 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 28.9514 2.346 

ALL ABUSED 10.0249 0.873 

PHYSICALLY ABUSED 5.876 0.648 

SEXUALLY ABUSED 1.8789 0.188 

EMOTIONALLY ABUSED 4.1017 0.559 

ALL NEGLECTED 21.5627 1.901 

PHYSICALLY NEGLECTED 8.7185 0.777 

EMOTIONALLY NEGLECTED 11.3908 1.2 

EDUCATIONALLY NEGLECTED 6.3989 1.515 

SEVERITY, FATAL 0.0369 0.028 

SEVERITY, SERIOUS 7.8405 1.005 

SEVERITY, MODERATE 12.5287 1.435 

SEVERITY, INFERRED 2.3359 0.284 

SEVERITY, ENDANGERED 6.2095 0.634

 C-5 
TABLE C-5. 

RACE/ETHNICITY BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN 

COUNTABLE UNDER THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 1,000 Children)
 

RACE/ETHNICITY = WHITE 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 28.582 2.086 

ALL ABUSED 8.73 0.582 

PHYSICALLY ABUSED 4.632 0.379 

SEXUALLY ABUSED 1.859 0.163 

EMOTIONALLY ABUSED 3.51 0.301 

ALL NEGLECTED 22.418 1.895 

PHYSICALLY NEGLECTED 12.202 1.234 

EMOTIONALLY NEGLECTED 12.134 1.025 

EDUCATIONALLY NEGLECTED 3.264 0.5 

SEVERITY, FATAL 0.019 0.01 

SEVERITY, SERIOUS 4.837 0.441 

SEVERITY, MODERATE 10.97 1.226 

SEVERITY, INFERRED 2.569 0.261 

SEVERITY, ENDANGERED 10.187 0.707 

RACE/ETHNICITY = BLACK 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 49.553 5.178 

ALL ABUSED 14.905 1.312 

PHYSICALLY ABUSED 9.664 0.818 

SEXUALLY ABUSED 3.125 0.583 

EMOTIONALLY ABUSED 4.49 0.729 

ALL NEGLECTED 36.828 4.387 

PHYSICALLY NEGLECTED 17.867 2.101 

EMOTIONALLY NEGLECTED 18.161 1.703 

EDUCATIONALLY NEGLECTED 7.423 2.471 

SEVERITY, FATAL 0.023 0.005 

SEVERITY, SERIOUS 9.102 1.129 

SEVERITY, MODERATE 18.648 3.231 

SEVERITY, INFERRED 3.727 0.551 

SEVERITY, ENDANGERED 18.054 1.623

 C-6 
TABLE C-5. (Continued) 

RACE/ETHNICITY = HISPANIC 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 30.245 3.035 

ALL ABUSED 9.38 1.292 

PHYSICALLY ABUSED 5.852 0.776 

SEXUALLY ABUSED 2.488 0.442 

EMOTIONALLY ABUSED 2.419 0.321 

ALL NEGLECTED 22.972 2.311 

PHYSICALLY NEGLECTED 9.938 1.233 

EMOTIONALLY NEGLECTED 13.246 1.639 

EDUCATIONALLY NEGLECTED 4.001 0.734 

SEVERITY, FATAL 0.051 0.017 

SEVERITY, SERIOUS 5.665 0.78 

SEVERITY, MODERATE 11.197 1.367 

SEVERITY, INFERRED 2.123 0.259 

SEVERITY, ENDANGERED 11.209 1.409 

TABLE C-6. 

NUMBER OF CHILDREN BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILDREN 

COUNTABLE UNDER THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 1,000 Children)
 

NCHILDR = 1CHILD 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 36.634 5.446 

ALL ABUSED 10.598 0.797 

PHYSICALLY ABUSED 6.594 0.604 

SEXUALLY ABUSED 2.474 0.185 

EMOTIONALLY ABUSED 2.797 0.336 

ALL NEGLECTED 27.341 4.369 

PHYSICALLY NEGLECTED 13.28 2.3 

EMOTIONALLY NEGLECTED 13.902 2.271 

EDUCATIONALLY NEGLECTED 5.085 0.984 

SEVERITY, FATAL 0.027 0.02 

SEVERITY, SERIOUS 7.612 1.387 

SEVERITY, MODERATE 13.782 1.451 

SEVERITY, INFERRED 3.253 0.822 

SEVERITY, ENDANGERED 11.96 2.463

 C-7 
TABLE C-6. (Continued) 

NCHILDR = 2 CHILDREN 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 27.156 2.26 

ALL ABUSED 9.368 0.951 

PHYSICALLY ABUSED 5.024 0.576 

SEXUALLY ABUSED 2.478 0.367 

EMOTIONALLY ABUSED 3.46 0.376 

ALL NEGLECTED 19.599 1.485 

PHYSICALLY NEGLECTED 10.009 0.826 

EMOTIONALLY NEGLECTED 10.85 0.952 

EDUCATIONALLY NEGLECTED 2.443 0.544 

SEVERITY, FATAL 0.03 0.011 

SEVERITY, SERIOUS 4.991 0.498 

SEVERITY, MODERATE 9.332 0.869 

SEVERITY, INFERRED 2.283 0.256 

SEVERITY, ENDANGERED 10.52 1.11 

NCHILDR = 3 CHILDREN 

CATEGORY OF MALTREATMENT ESTIMATED STANDARD 

OR SEVERITY INCIDENCE RATE ERROR 

ALL MALTREATED 38.176 3.411 

ALL ABUSED 12.151 1.205 

PHYSICALLY ABUSED 6.681 0.537 

SEXUALLY ABUSED 2.137 0.375 

EMOTIONALLY ABUSED 5.072 0.97 

ALL NEGLECTED 30.107 3.115 

PHYSICALLY NEGLECTED 15.197 1.927 

EMOTIONALLY NEGLECTED 17.691 1.692 

EDUCATIONALLY NEGLECTED 4.67 1.065 

SEVERITY, FATAL 0.038 0.016 

SEVERITY, SERIOUS 6.261 0.607 

SEVERITY, MODERATE 13.089 1.886 

SEVERITY, INFERRED 2.692 0.289 

SEVERITY, ENDANGERED 16.096 1.384

 C-8 
TABLE C-6. (Continued) 

NCHILDR = 4 OR MORE CHILDREN 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 62.904 5.628 

ALL ABUSED 13.862 1.38 

PHYSICALLY ABUSED 7.813 0.832 

SEXUALLY ABUSED 2.502 0.318 

EMOTIONALLY ABUSED 5.763 1.026 

ALL NEGLECTED 52.181 5.107 

PHYSICALLY NEGLECTED 31.127 3.088 

EMOTIONALLY NEGLECTED 27.442 3.268 

EDUCATIONALLY NEGLECTED 6.041 1.861 

SEVERITY, FATAL 0.028 0.016 

SEVERITY, SERIOUS 8.799 1.356 

SEVERITY, MODERATE 17.894 2.714 

SEVERITY, INFERRED 4.659 0.794 

SEVERITY, ENDANGERED 31.523 3.436 

TABLE C-7. 

METROPOLITAN STATUS OF COUNTY BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR 

CASES COUNTABLE UNDER THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 1,000 

Children)
 

METROSTATUS = MAJOR URBAN 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 31.285 5.315 

ALL ABUSED 9.527 1.36 

PHYSICALLY ABUSED 5.606 0.745 

SEXUALLY ABUSED 2.235 0.331 

EMOTIONALLY ABUSED 2.963 0.551 

ALL NEGLECTED 23.087 3.756 

PHYSICALLY NEGLECTED 11.919 2.324 

EMOTIONALLY NEGLECTED 11.939 1.886 

EDUCATIONALLY NEGLECTED 3.348 0.833 

SEVERITY, FATAL 0.039 0.008 

SEVERITY, SERIOUS 5.592 0.853 

SEVERITY, MODERATE 10.353 1.823 

SEVERITY, INFERRED 2.441 0.566 

SEVERITY, ENDANGERED 12.859 2.536

 C-9 
TABLE C-7. (Continued) 

METROSTATUS = URBAN 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 39.135 5.502 

ALL ABUSED 11.891 1.694 

PHYSICALLY ABUSED 6.969 1.04 

SEXUALLY ABUSED 2.268 0.343 

EMOTIONALLY ABUSED 4.715 0.789 

ALL NEGLECTED 29.958 4.4 

PHYSICALLY NEGLECTED 15.005 2.389 

EMOTIONALLY NEGLECTED 16.878 2.37 

EDUCATIONALLY NEGLECTED 3.872 1.01 

SEVERITY, FATAL 0.037 0.014 

SEVERITY, SERIOUS 6.753 1.254 

SEVERITY, MODERATE 12.799 2.256 

SEVERITY, INFERRED 3.423 0.501 

SEVERITY, ENDANGERED 16.123 1.886 

METROSTATUS = RURAL 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 68.128 11.257 

ALL ABUSED 16.535 2.101 

PHYSICALLY ABUSED 8.522 1.027 

SEXUALLY ABUSED 3.537 0.454 

EMOTIONALLY ABUSED 6.917 1.447 

ALL NEGLECTED 57.434 11.024 

PHYSICALLY NEGLECTED 33.05 6.011 

EMOTIONALLY NEGLECTED 27.925 4.576 

EDUCATIONALLY NEGLECTED 12.107 6.048 

SEVERITY, FATAL 0.006 0.006 

SEVERITY, SERIOUS 11.763 2.521 

SEVERITY, MODERATE 27.929 6.614 

SEVERITY, INFERRED 4.674 0.515 

SEVERITY, ENDANGERED 23.757 3.564

 C-10 
TABLE C-8. 

CHILDREN COUNTABLE UNDER THE ENDANGERMENT STANDARD--RECOGNIZED OVERALL, 

INVESTIGATED BY CPS, AND NOT INVESTIGATED BY CPS, BY RECOGNITION SOURCE; INCIDENCE 

RATES (Per 1,000 children) 

CLASS = ALL RECOGNIZED 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 1.235 0.167 

POLICE/SHERIFF 7.522 0.803 

PUBLIC HEALTH 0.943 0.218 

INVESTIGATORY AGENCY SUBTOTAL: 9.700 0.852 

HOSPITALS 5.033 2.409 

SCHOOLS 15.113 1.851 

DAY CARE CENTERS 1.729 0.365 

MENTAL HEALTH 1.419 0.250 

SOCIAL SERVICES 0.763 0.085 

SHELTERS 0.453 0.097 

PUBLIC HOUSING 0.078 0.026 

OTHER SENTINEL AGENCY SUBTOTAL 24.589 3.313 

ALL SENTINEL SOURCES TOTAL 34.289 3.479 

DSS/WELFARE DEPT. 0.748 0.098 

OTHER PROFESSIONAL OR AGENCY 0.347 0.046 

ALL OTHER SOURCES 4.079 0.253 

OTHER (CPS ONLY) SUBTOTAL 5.174 0.281 

TOTAL, ALL SOURCES 39.463 3.526

 C-11 
TABLE C-8. (Continued) 

CLASS = INVESTIGATED BY CPS 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 0.775 0.116 

POLICE/SHERIFF 4.834 0.366 

PUBLIC HEALTH 0.315 0.066 

INVESTIGATORY AGENCY SUBTOTAL: 5.925 0.471 

HOSPITALS 1.269 0.115 

SCHOOLS 2.955 0.195 

DAY CARE CENTERS 0.216 0.033 

MENTAL HEALTH 0.750 0.077 

SOCIAL SERVICES 0.719 0.075 

SHELTERS 0.085 0.028 

PUBLIC HOUSING 0.052 0.022 

OTHER SENTINEL AGENCY SUBTOTAL 6.045 0.355 

ALL SENTINEL SOURCES TOTAL 11.970 0.724 

DSS/WELFARE DEPT. 0.748 0.098 

OTHER PROFESSIONAL OR AGENCY 0.347 0.046 

ALL OTHER SOURCES 4.079 0.253 

OTHER (CPS ONLY) SUBTOTAL 5.174 0.281 

TOTAL, ALL SOURCES 17.144 0.856

 C-12 
TABLE C-8. (Continued) 

CLASS = NOT INVESTIGATED BY CPS 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 0.459 0.118 

POLICE/SHERIFF 2.688 0.839 

PUBLIC HEALTH 0.628 0.207 

INVESTIGATORY AGENCY SUBTOTAL: 3.775 0.871 

HOSPITALS 3.765 2.386 

SCHOOLS 12.158 1.759 

DAY CARE CENTERS 1.514 0.367 

MENTAL HEALTH 0.668 0.242 

SOCIAL SERVICES 0.044 0.031 

SHELTERS 0.368 0.091 

PUBLIC HOUSING 0.026 0.015 

OTHER SENTINEL AGENCY SUBTOTAL 18.544 3.208 

ALL SENTINEL SOURCES TOTAL 22.319 3.254 

DSS/WELFARE DEPT. 0.000 0.000 

OTHER PROFESSIONAL OR AGENCY 0.000 0.000 

ALL OTHER SOURCES 0.000 0.000 

OTHER (CPS ONLY) SUBTOTAL 0.000 0.000 

TOTAL, ALL SOURCES 22.319 3.254

 C-13 
TABLE C-9. 

PROPORTION OF ENDANGERMENT STANDARD CHILDREN WHOSE MALTREATMENT WAS 

INVESTIGATED BY CPS, BY RECOGNITION SOURCE
 

ESTIMATED 

PROPORTION 

STANDARD 

RECOGNITION SOURCE ERROR 

PROBATION/COURTS 0.628 0.066 

POLICE/SHERIFF 0.643 0.083 

PUBLIC HEALTH 0.334 0.091 

INVESTIGATORY AGENCY SUBTOTAL: 0.611 0.065 

HOSPITALS 0.252 0.172 

SCHOOLS 0.196 0.020 

DAY CARE CENTERS 0.125 0.033 

MENTAL HEALTH 0.529 0.091 

SOCIAL SERVICES 0.942 0.039 

SHELTERS 0.187 0.060 

PUBLIC HOUSING 0.671 0.161 

OTHER SENTINEL AGENCY SUBTOTAL 0.246 0.033 

ALL SENTINEL SOURCES TOTAL 0.349 0.034 

DSS/WELFARE DEPT. 1.000 0.000 

OTHER PROFESSIONAL OR AGENCY 1.000 0.000 

ALL OTHER SOURCES 1.000 0.000 

OTHER (CPS ONLY) SUBTOTAL 1.000 0.000 

TOTAL, ALL SOURCES 0.434 0.036

 C-14 
TABLE C-10. 

FAMILY STRUCTURE AND PARENTS' LIVING ARRANGEMENT BY CATEGORIES OF 

MALTREATMENT AND SEVERITY FOR CHILDREN COUNTABLE UNDER THE ENDANGERMENT 

STANDARD; INCIDENCE RATES (Per 1,000 Children)
 

FAMILY STRUCTURE/LIVING ARRANGEMENT = MARRIED PARENTS, BOTH BIOLOGICAL 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 15.760 1.520 

ALL ABUSED 4.322 0.500 

PHYSICALLY ABUSED 2.488 0.293 

SEXUALLY ABUSED 0.685 0.123 

EMOTIONALLY ABUSED 1.800 0.241 

ALL NEGLECTED 12.844 1.272 

PHYSICALLY NEGLECTED 6.472 0.811 

EMOTIONALLY NEGLECTED 6.736 0.695 

EDUCATIONALLY NEGLECTED 1.927 0.530 

SEVERITY, FATAL 0.021 0.010 

SEVERITY, SERIOUS 2.760 0.429 

SEVERITY, MODERATE 5.961 0.782 

SEVERITY, INFERRED 0.879 0.123 

SEVERITY, ENDANGERED 6.140 0.648 

FAMILY STRUCTURE/LIVING ARRANGEMENT = OTHER MARRIED PARENTS 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 51.459 5.165 

ALL ABUSED 25.299 2.172 

PHYSICALLY ABUSED 15.374 1.570 

SEXUALLY ABUSED 5.547 0.662 

EMOTIONALLY ABUSED 8.605 1.608 

ALL NEGLECTED 33.964 4.901 

PHYSICALLY NEGLECTED 15.068 2.281 

EMOTIONALLY NEGLECTED 21.559 3.448 

EDUCATIONALLY NEGLECTED 3.567 1.082 

SEVERITY, FATAL 0.056 0.036 

SEVERITY, SERIOUS 9.477 1.139 

SEVERITY, MODERATE 17.042 2.054 

SEVERITY, INFERRED 5.282 0.728 

SEVERITY, ENDANGERED 19.602 3.198

 C-15 
TABLE C-10. (Continued)
 

FAMILY STRUCTURE/LIVING ARRANGEMENT = UNMARRIED PARENTS
 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 88.924 8.717 

ALL ABUSED 21.962 3.538 

PHYSICALLY ABUSED 13.507 2.018 

SEXUALLY ABUSED 3.234 1.315 

EMOTIONALLY ABUSED 8.774 2.546 

ALL NEGLECTED 74.439 8.074 

PHYSICALLY NEGLECTED 37.173 5.300 

EMOTIONALLY NEGLECTED 46.904 5.292 

EDUCATIONALLY NEGLECTED 4.067 2.179 

SEVERITY, FATAL 0.152 0.082 

SEVERITY, SERIOUS 11.359 2.149 

SEVERITY, MODERATE 17.766 2.897 

SEVERITY, INFERRED 7.813 2.348 

SEVERITY, ENDANGERED 51.833 5.601 

FAMILY STRUCTURE/LIVING ARRANGEMENT = SINGLE PARENT WITH PARTNER 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 136.065 17.193 

ALL ABUSED 45.753 5.507 

PHYSICALLY ABUSED 26.220 2.989 

SEXUALLY ABUSED 12.140 2.570 

EMOTIONALLY ABUSED 15.049 2.725 

ALL NEGLECTED 100.815 13.359 

PHYSICALLY NEGLECTED 47.388 7.771 

EMOTIONALLY NEGLECTED 68.241 9.328 

EDUCATIONALLY NEGLECTED 11.853 4.363 

SEVERITY, FATAL 0.036 0.015 

SEVERITY, SERIOUS 21.543 3.946 

SEVERITY, MODERATE 49.307 9.012 

SEVERITY, INFERRED 10.156 1.365 

SEVERITY, ENDANGERED 55.023 7.028

 C-16 
TABLE C-10. (Continued)
 

FAMILY STRUCTURE/LIVING ARRANGEMENT = SINGLE PARENT, NO PARTNER
 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 66.319 7.553 

ALL ABUSED 15.850 1.816 

PHYSICALLY ABUSED 8.974 0.830 

SEXUALLY ABUSED 3.413 0.369 

EMOTIONALLY ABUSED 5.867 0.996 

ALL NEGLECTED 51.720 5.668 

PHYSICALLY NEGLECTED 29.401 3.473 

EMOTIONALLY NEGLECTED 24.485 2.870 

EDUCATIONALLY NEGLECTED 9.977 2.341 

SEVERITY, FATAL 0.035 0.014 

SEVERITY, SERIOUS 12.352 1.478 

SEVERITY, MODERATE 22.360 3.034 

SEVERITY, INFERRED 5.226 0.770 

SEVERITY, ENDANGERED 26.346 3.483 

FAMILY STRUCTURE/LIVING ARRANGEMENT = NEITHER PARENT 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 65.958 7.360 

ALL ABUSED 22.905 3.143 

PHYSICALLY ABUSED 10.647 1.312 

SEXUALLY ABUSED 6.327 1.146 

EMOTIONALLY ABUSED 8.364 2.343 

ALL NEGLECTED 48.695 6.942 

PHYSICALLY NEGLECTED 28.566 4.432 

EMOTIONALLY NEGLECTED 20.340 3.341 

EDUCATIONALLY NEGLECTED 8.493 2.868 

SEVERITY, FATAL 0.009 0.001 

SEVERITY, SERIOUS 11.778 2.808 

SEVERITY, MODERATE 31.180 4.574 

SEVERITY, INFERRED 5.502 0.801 

SEVERITY, ENDANGERED 17.489 1.824

 C-17 
TABLE C-11. 

FAMILY STRUCTURE BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR 

CHILDREN COUNTABLE UNDER THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 

1,000 Children) 

FAMILY STRUCTURE= SINGLE PARENT 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 81.157 8.539 

ALL ABUSED 20.865 2.134 

PHYSICALLY ABUSED 11.764 0.995 

SEXUALLY ABUSED 5.078 0.587 

EMOTIONALLY ABUSED 7.141 0.961 

ALL NEGLECTED 62.664 6.093 

PHYSICALLY NEGLECTED 34.555 3.453 

EMOTIONALLY NEGLECTED 31.446 3.175 

EDUCATIONALLY NEGLECTED 11.576 2.383 

SEVERITY, FATAL 0.036 0.013 

SEVERITY, SERIOUS 14.700 1.568 

SEVERITY, MODERATE 28.297 3.384 

SEVERITY, INFERRED 6.692 1.063 

SEVERITY, ENDANGERED 31.432 3.698 

FAMILY STRUCTURE= BOTH PARENTS 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 22.941 2.009 

ALL ABUSED 7.309 0.611 

PHYSICALLY ABUSED 4.335 0.350 

SEXUALLY ABUSED 1.311 0.146 

EMOTIONALLY ABUSED 2.802 0.357 

ALL NEGLECTED 17.962 1.743 

PHYSICALLY NEGLECTED 8.855 1.048 

EMOTIONALLY NEGLECTED 10.071 0.925 

EDUCATIONALLY NEGLECTED 2.287 0.681 

SEVERITY, FATAL 0.033 0.008 

SEVERITY, SERIOUS 3.837 0.411 

SEVERITY, MODERATE 7.786 0.923 

SEVERITY, INFERRED 1.655 0.172 

SEVERITY, ENDANGERED 9.631 0.940

 C-18 
TABLE C-11. (Continued)
 

FAMILY STRUCTURE= NEITHER PARENT
 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 65.958 7.360 

ALL ABUSED 22.905 3.143 

PHYSICALLY ABUSED 10.647 1.312 

SEXUALLY ABUSED 6.327 1.146 

EMOTIONALLY ABUSED 8.364 2.343 

ALL NEGLECTED 48.695 6.942 

PHYSICALLY NEGLECTED 28.566 4.432 

EMOTIONALLY NEGLECTED 20.340 3.341 

EDUCATIONALLY NEGLECTED 8.493 2.868 

SEVERITY, FATAL 0.009 0.001 

SEVERITY, SERIOUS 11.778 2.808 

SEVERITY, MODERATE 31.180 4.574 

SEVERITY, INFERRED 5.502 0.801 

SEVERITY, ENDANGERED 17.489 1.824 

TABLE C-12. 

SOCIOECONOMIC STATUS (SES) BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR CHILD 

COUNTABLE UNDER THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 1,000 Children) 

SOCIOECONOMIC STATUS= NOT LOW SOCIOECONOMIC STATUS (SES) 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 9.476 0.562 

ALL ABUSED 3.585 0.238 

PHYSICALLY ABUSED 2.235 0.2 

SEXUALLY ABUSED 0.743 0.093 

EMOTIONALLY ABUSED 1.009 0.104 

ALL NEGLECTED 6.668 0.483 

PHYSICALLY NEGLECTED 3.056 0.218 

EMOTIONALLY NEGLECTED 3.959 0.312 

EDUCATIONALLY NEGLECTED 1 0.257 

SEVERITY, FATAL 0.003 0.001 

SEVERITY, SERIOUS 1.795 0.194 

SEVERITY, MODERATE 3.474 0.39 

SEVERITY, INFERRED 0.719 0.102 

SEVERITY, ENDANGERED 3.486 0.235

 C-19 
TABLE C-12. (Continued)
 

SOCIOECONOMIC STATUS= LOW SOCIOECONOMIC STATUS (SES)
 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 55.087 4.689 

ALL ABUSED 12.116 1.063 

PHYSICALLY ABUSED 6.451 0.637 

SEXUALLY ABUSED 2.355 0.265 

EMOTIONALLY ABUSED 5.467 0.663 

ALL NEGLECTED 46.525 4.247 

PHYSICALLY NEGLECTED 26.981 2.839 

EMOTIONALLY NEGLECTED 23.489 2.241 

EDUCATIONALLY NEGLECTED 7.092 2.446 

SEVERITY, FATAL 0.042 0.014 

SEVERITY, SERIOUS 10.321 1.185 

SEVERITY, MODERATE 18.716 2.232 

SEVERITY, INFERRED 3.439 0.442 

SEVERITY, ENDANGERED 22.569 2.316 

TABLE C-13. 

PARENTS' EMPLOYMENT BY CATEGORIES OF MALTREATMENT AND SEVERITY FOR 

CHILDREN COUNTABLE UNDER THE ENDANGERMENT STANDARD; INCIDENCE RATES (Per 

1,000 Children) 

PARENTS' EMPLOYMENT = UNEMPLOYED 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 39.896 5.111 

ALL ABUSED 7.452 1.312 

PHYSICALLY ABUSED 3.544 0.684 

SEXUALLY ABUSED 0.904 0.21 

EMOTIONALLY ABUSED 4.075 0.884 

ALL NEGLECTED 35 4.573 

PHYSICALLY NEGLECTED 23.028 3.767 

EMOTIONALLY NEGLECTED 19.105 3.233 

EDUCATIONALLY NEGLECTED 5.835 2.04 

SEVERITY, FATAL 0.008 0.003 

SEVERITY, SERIOUS 7.289 1.058 

SEVERITY, MODERATE 12.061 2.2 

SEVERITY, INFERRED 2.994 1.018 

SEVERITY, ENDANGERED 17.544 3.386

 C-20 
TABLE C-13. (Continued)
 

PARENTS' EMPLOYMENT = NOT IN THE LABOR FORCE
 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 57.741 6.091 

ALL ABUSED 15.193 2.434 

PHYSICALLY ABUSED 7.334 1.523 

SEXUALLY ABUSED 3.709 1.124 

EMOTIONALLY ABUSED 7.089 1.432 

ALL NEGLECTED 46.448 4.599 

PHYSICALLY NEGLECTED 25.478 3.432 

EMOTIONALLY NEGLECTED 25.267 2.967 

EDUCATIONALLY NEGLECTED 4.833 0.91 

SEVERITY, FATAL 0.041 0.039 

SEVERITY, SERIOUS 11.281 1.97 

SEVERITY, MODERATE 15.702 2.31 

SEVERITY, INFERRED 5.962 1.307 

SEVERITY, ENDANGERED 24.755 2.726 

PARENTS' EMPLOYMENT = EMPLOYED 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 17.099 1.452 

ALL ABUSED 5.802 0.597 

PHYSICALLY ABUSED 3.424 0.327 

SEXUALLY ABUSED 1.066 0.122 

EMOTIONALLY ABUSED 2.255 0.392 

ALL NEGLECTED 12.784 1.189 

PHYSICALLY NEGLECTED 6.05 0.586 

EMOTIONALLY NEGLECTED 7.351 0.722 

EDUCATIONALLY NEGLECTED 1.76 0.493 

SEVERITY, FATAL 0.016 0.007 

SEVERITY, SERIOUS 3.176 0.337 

SEVERITY, MODERATE 6.318 0.724 

SEVERITY, INFERRED 1.113 0.129 

SEVERITY, ENDANGERED 6.477 0.593

 C-21 
TABLE C-14. 

GRANDPARENTS AS CAREGIVERS BY CATEGORIES OF MALTREATMENT AND SEVERITY 

FOR CHILDREN COUNTABLE UNDER THE ENDANGERMENT STANDARD; INCIDENCE RATES 

(Per 1,000 Children) 

GRANDPARENTS AS CAREGIVERS = GRANDPARENT PRESENT 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 35.338 3.57 

ALL ABUSED 10.358 1.413 

PHYSICALLY ABUSED 5.165 0.787 

SEXUALLY ABUSED 2.287 0.325 

EMOTIONALLY ABUSED 4.545 1.043 

ALL NEGLECTED 27.849 3.416 

PHYSICALLY NEGLECTED 17.381 2.158 

EMOTIONALLY NEGLECTED 14.935 1.967 

EDUCATIONALLY NEGLECTED 4.537 1.784 

SEVERITY, FATAL 0.056 0.032 

SEVERITY, SERIOUS 7.184 1.593 

SEVERITY, MODERATE 13.625 2.199 

SEVERITY, INFERRED 2.283 0.467 

SEVERITY, ENDANGERED 12.189 1.024 

GRANDPARENTS AS CAREGIVERS = GRANDPARENT NOT PRESENT 

CATEGORY OF MALTREATMENT 

OR SEVERITY 

ESTIMATED 

INCIDENCE RATE 

STANDARD 

ERROR 

ALL MALTREATED 39.747 3.683 

ALL ABUSED 11.418 0.923 

PHYSICALLY ABUSED 6.579 0.515 

SEXUALLY ABUSED 2.466 0.199 

EMOTIONALLY ABUSED 4.071 0.445 

ALL NEGLECTED 30.745 2.86 

PHYSICALLY NEGLECTED 16.051 1.646 

EMOTIONALLY NEGLECTED 16.027 1.347 

EDUCATIONALLY NEGLECTED 4.893 1.059 

SEVERITY, FATAL 0.031 0.006 

SEVERITY, SERIOUS 6.887 0.656 

SEVERITY, MODERATE 13.855 1.517 

SEVERITY, INFERRED 3.155 0.375 

SEVERITY, ENDANGERED 15.82 1.632

 C-22 
Appendix D 


Comparisons of Subgroups Within the NIS–4 

APPENDIX D
 

WITHIN STUDY ANALYSES 

This appendix describes the analyses and presents the statistics for the within-study 

analyses of the NIS–4 results. This introduction discusses the computation and assessment of 

the t-statistics used to identify subgroup differences within the NIS–4. The tables that follow 

provide the specific results of all statistical tests that support the findings presented in the NIS–4 

Report to Congress. 

All within-study statistical differences were assessed by the t-statistic on rate 

measures. To address the fact that the NIS–4 data derive from a complex sample design 

(stratified and multi-stage), the computations were performed using WesVar (Westat, 2007). 

This program calculated the estimated rates (r1 and r2) and (using the replicate weights in the 

NIS–4 analysis data file) the standard error of these rates (SEr1 and SEr2). The t-statistic was 

then calculated as follows: 

r1-r2 

t = √ 2 SEr1

2

 + SEr2 

The analyses examined all subgroup differences in maltreatment rates in each 

category of maltreatment and for each level of harm or injury resulting from maltreatment. In 

order to adjust for the higher likelihood of observing significant differences when conducting 

multiple comparisons in this way, the significance of the resulting t-statistics was assessed using 

the Bonferroni critical value for t (Sankoh, Huque & Dubey, 1997). The appropriate significance 

levels with their corresponding alpha levels (i.e., probability of observing the result by chance) 

are also presented for each series of tables in the next section. 

References 

Sankoh, A.J., Huque, M.F., Dubey, S.D. (1997). Some comments on frequently used multiple 

endpoint adjustment methods in clinical trials. Statistics in Medicine, 16, 2529-2542. 

Westat, Inc. (2007). WesVar 4.3 User’s Guide. Rockville, MD. Available online at 

http://www.westat.com/westat/statistical_software/WesVar/pdf/WV_4-3_Manual.pdf 

D-i 
 

 

 

 

 

 

 

 

 

All Maltreatment 0.2868 

All Abuse 1.5902 d 

Physical Abuse 0.9767 

Sexual Abuse 7.0103 a 

Emotional Abuse 0.1780 

All Neglect 0.1142 

Physical Neglect 0.0190 

Emotional Neglect 0.2023 

Educational Neglect 0.1854 

Severity, Fatal 1.1926 

Severity, Serious 0.3522 

Severity, Moderate 0.0807 

Severity, Inferred 2.2210 c 

Severity, Endangered 0.1120 

Table D-1. T-statistics for sex differences in NIS-4 incidence rates for harm 

standard maltreatment 

T-Value 

All Maltreatment 0.5837 

All Abuse 2.1885 c 

Physical Abuse 0.7395 

Sexual Abuse 6.8038 a 

Emotional Abuse 0.6814 

All Neglect 0.1547 

Physical Neglect 0.4169 

Emotional Neglect 0.5828 

Educational Neglect 0.1854 

Severity, Fatal 1.2000 

Severity, Serious 0.3637 

Severity, Moderate 0.2004 

Severity, Inferred 3.8628 a 

Table D-2. T-statistics for sex differences in NIS-4 incidence rates for endangerment 

standard maltreatment 

T-Value 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-1
Table D-3. T-statistics for age differences in NIS-4 incidence rates for harm standard

 maltreatment 

Age 0-2 vs 3-5 Age 0-2 vs 6-8 Age 0-2 vs 9-11 

All Maltreatment 1.4512 3.2199 c 2.2710 

All Abuse 2.1842 3.9862 b 3.5977 b 

Physical Abuse 1.7478 3.5362 c 3.2959 c 

Sexual Abuse 1.3085 1.0494 0.9018 

Emotional Abuse 2.7021 4.1296 b 3.9303 b 

All Neglect 0.7227 2.2388 1.7004 

Physical Neglect 1.0487 0.4737 0.4488 

Emotional Neglect 1.4754 3.3340 c 4.0645 b 

Educational Neglect 3.4555 c 4.5789 a 2.1008 

Severity, Fatal 3.3926 c 3.5778 c 3.6778 b 

Severity, Serious 0.9380 0.1713 0.3886 

Severity, Moderate 4.9296 a 5.9857 a 3.4531 c 

Severity, Inferred 0.8315 0.9352 0.8513 

Age 0-2 vs 12-14 Age 0-2 vs 15-17 

All Maltreatment 3.5107 c 3.6198 b 

All Abuse 4.0684 b 3.5584 c 

Physical Abuse 3.2636 c 2.6351 

Sexual Abuse 2.1810 1.2250 

Emotional Abuse 5.6060 a 4.3370 a 

All Neglect 2.7951 3.3185 c 

Physical Neglect 0.2946 1.1621 

Emotional Neglect 6.2898 a 4.5133 a 

Educational Neglect 4.5868 a 4.1585 b 

Severity, Fatal 3.2661 c 1.6119 

Severity, Serious 0.6832 0.9397 

Severity, Moderate 4.0733 b 5.3975 a 

Severity, Inferred 1.7610 1.0527 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-2
Table D-3. Continued 

Age 3-5 vs 6-8 Age 3-5 vs 9-11 Age 3-5 vs 12-14 

All Maltreatment 2.1330 1.5728 2.6618 

All Abuse 2.1523 1.5036 2.3228 

Physical Abuse 2.0657 1.4208 1.6737 

Sexual Abuse 0.3529 0.8186 1.0647 

Emotional Abuse 2.7643 2.6604 3.6147 b 

All Neglect 1.5808 1.3949 2.3323 

Physical Neglect 0.7751 0.6152 0.3980 

Emotional Neglect 1.4021 2.3739 3.7676 b 

Educational Neglect 2.1086 1.4506 2.9498 d 

Severity, Fatal 1.0000 1.6750 0.1861 

Severity, Serious 1.2164 1.4694 2.7844 

Severity, Moderate 2.4539 1.6756 2.0096 

Severity, Inferred 2.1372 1.9652 1.3802 

Age 3-5 vs 15-17 

All Maltreatment 2.5565 

All Abuse 1.3544 

Physical Abuse 0.9011 

Sexual Abuse 0.4562 

Emotional Abuse 2.6946 

All Neglect 2.6305 

Physical Neglect 0.1239 

Emotional Neglect 3.2179 c 

Educational Neglect 2.4891 

Severity, Fatal 1.0571 

Severity, Serious 2.7278 

Severity, Moderate 1.6572 

Severity, Inferred 0.2112 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-3
Table D-3. Continued 

Age 6-8 vs 9-11 Age 6-8 vs 12-14 Age 6-8 vs 15-17 

All Maltreatment 0.3985 1.0081 0.3288 

All Abuse 0.8239 0.2487 1.0531 

Physical Abuse 0.9291 0.4702 1.2753 

Sexual Abuse 0.4260 1.4220 0.0241 

Emotional Abuse 0.0321 0.0534 0.3575 

All Neglect 0.5927 1.1324 0.9349 

Physical Neglect 0.0419 0.0163 0.9423 

Emotional Neglect 1.1444 2.3880 2.2116 

Educational Neglect 0.7134 1.2844 0.8205 

Severity, Fatal - 0.7857 1.2107 

Severity, Serious 0.6718 1.4064 1.6109 

Severity, Moderate 0.2273 0.3564 0.7794 

Severity, Inferred 0.0526 2.2419 2.5167 

Age 9-11 vs 12-14 Age 9-11 vs 15-17 

All Maltreatment 0.3275 0.2101 

All Abuse 1.0574 0.2263 

Physical Abuse 0.4443 0.4588 

Sexual Abuse 1.9698 0.6613 

Emotional Abuse 0.0150 0.3789 

All Neglect 0.1998 0.0864 

Physical Neglect 0.0081 0.6525 

Emotional Neglect 0.9869 1.1854 

Educational Neglect 0.0528 0.2911 

Severity, Fatal 1.1714 1.3071 

Severity, Serious 0.1935 0.4960 

Severity, Moderate 0.0795 0.7285 

Severity, Inferred 2.2057 2.3042 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-4
Table D-3. Continued 

All Maltreatment 

Age 12-14 vs 15-17 

0.7653 

All Abuse 1.2816 

Physical Abuse 0.8308 

Sexual Abuse 1.6711 

Emotional Abuse 0.4766 

All Neglect 0.4275 

Physical Neglect 0.3677 

Emotional Neglect 0.4390 

Educational Neglect 0.4192 

Severity, Fatal 0.9840 

Severity, Serious 0.4815 

Severity, Moderate 0.9191 

Severity, Inferred 1.2941 

Table D-4. T-statistics for age differences in NIS-4 incidence rates for endnagement 

maltreatment 

Age 0-2 vs 3-5 Age 0-2 vs 6-8 Age 0-2 vs 9-11 

All Maltreatment 0.2424 1.4067 0.6804 

All Abuse 2.7997 4.4867 a 4.1230 b 

Physical Abuse 2.5541 4.2533 b 3.3271 c 

Sexual Abuse 1.9807 1.8596 1.3335 

Emotional Abuse 2.0157 4.0881 b 4.4543 a 

All Neglect 0.0943 1.0992 0.4940 

Physical Neglect 0.5837 0.3437 0.4519 

Emotional Neglect 0.1316 2.2516 1.2192 

Educational Neglect 3.4555 c 4.5789 a 2.1008 

Severity, Fatal 3.4695 c 3.6556 b 3.7556 b 

Severity, Serious 1.0241 0.1447 0.4025 

Severity, Moderate 3.8007 b 5.0501 a 3.5164 c 

Severity, Inferred 1.5839 2.1186 0.9125 

Severity, Endangered 1.6332 2.4653 3.0397 d 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-5
Table D-4. Continued 

Age 0-2 vs 12-14 Age 0-2 vs 15-17 

All Maltreatment 0.6057 0.7871 

All Abuse 3.7468 b 3.1051 c 

Physical Abuse 3.8718 b 2.6944 

Sexual Abuse 2.4881 1.2290 

Emotional Abuse 4.2868 a 3.9526 b 

All Neglect 0.2428 1.2678 

Physical Neglect 1.0580 2.5808 

Emotional Neglect 0.9350 1.1085 

Educational Neglect 4.5868 a 4.1585 b 

Severity, Fatal 3.3414 c 1.6659 

Severity, Serious 0.6672 0.8673 

Severity, Moderate 3.8953 b 4.8318 a 

Severity, Inferred 1.5893 0.6875 

Severity, Endangered 3.5691 c 5.2910 a 

Age 3-5 vs 6-8 Age 3-5 vs 9-11 Age 3-5 vs 12-14 

All Maltreatment 1.5403 0.5804 0.4890 

All Abuse 1.9768 0.8034 1.4832 

Physical Abuse 1.7571 0.3827 1.2275 

Sexual Abuse 0.1769 1.1478 0.7512 

Emotional Abuse 2.1656 1.8404 1.9585 

All Neglect 1.4328 0.6457 0.3819 

Physical Neglect 1.2394 0.1379 0.7190 

Emotional Neglect 1.7089 0.8620 0.6962 

Educational Neglect 2.1086 1.4506 2.9498 d 

Severity, Fatal 1.0000 1.6750 0.1861 

Severity, Serious 1.3954 1.5936 2.8877 d 

Severity, Moderate 2.5187 1.4757 1.6350 

Severity, Inferred 0.1008 0.9419 0.2183 

Severity, Endangered 1.5990 2.6854 3.5488 c 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-6
Table D-4. Continued 

Age 3-5 vs 15-17 

All Maltreatment 1.5138 

All Abuse 0.0793 

Physical Abuse 0.0321 

Sexual Abuse 1.3447 

Emotional Abuse 1.3918 

All Neglect 1.5522 

Physical Neglect 3.3940 c 

Emotional Neglect 1.0115 

Educational Neglect 2.4891 

Severity, Fatal 1.0571 

Severity, Serious 2.7722 

Severity, Moderate 0.6173 

Severity, Inferred 1.2549 

Severity, Endangered 7.8890 a 

Age 6-8 vs 9-11 Age 6-8 vs 12-14 Age 6-8 vs 15-17 

All Maltreatment 0.6619 0.8419 3.0677 c 

All Abuse 1.5146 0.2978 2.0163 

Physical Abuse 1.5380 0.5896 1.7709 

Sexual Abuse 0.9721 0.9215 1.1728 

Emotional Abuse 0.6647 0.4257 1.0687 

All Neglect 0.4688 0.8581 2.9613 d 

Physical Neglect 1.0022 1.6774 4.2363 b 

Emotional Neglect 0.9744 0.8765 3.1471 c 

Educational Neglect 0.7134 1.2844 0.8205 

Severity, Fatal --- 0.7857 1.2107 

Severity, Serious 0.6655 1.3184 1.4726 

Severity, Moderate 0.5975 0.6011 2.1513 

Severity, Inferred 1.2975 0.3727 1.7676 

Severity, Endangered 1.2212 2.2505 6.5745 a 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-7
Table D-4 Continued 

Age 9-11 vs 12-14 Age 9-11 vs 15-17 

All Maltreatment 0.1140 1.7098 

All Abuse 1.0048 0.7897 

Physical Abuse 0.9580 0.3611 

Sexual Abuse 1.8383 0.2414 

Emotional Abuse 0.2478 0.4896 

All Neglect 0.2786 1.7171 

Physical Neglect 0.7773 2.9672 d 

Emotional Neglect 0.0574 2.1772 

Educational Neglect 0.0528 0.2911 

Severity, Fatal 1.1714 1.3071 

Severity, Serious 0.1672 0.4108 

Severity, Moderate 0.0279 1.1391 

Severity, Inferred 0.8247 0.3803 

Severity, Endangered 1.1024 4.7410 a 

Age 12-14 vs 15-17 

All Maltreatment 1.7242 

All Abuse 1.4879 

Physical Abuse 1.2306 

Sexual Abuse 2.0116 

Emotional Abuse 0.7054 

All Neglect 1.6208 

Physical Neglect 1.5351 

Emotional Neglect 1.7479 

Educational Neglect 0.4192 

Severity, Fatal 0.9840 

Severity, Serious 0.3816 

Severity, Moderate 1.2741 

Severity, Inferred 1.2095 

Severity, Endangered 2.8897 d 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-8
Table D-5. T-statistics for racial/ethnic differences in NIS-4 incidence rates for harm 

standard maltreatment 

White vs Black White vs Hispanic 

All Maltreatment 3.1997 b 0.8550 

All Abuse 3.9064 a 0.8070 

Physical Abuse 5.0219 a 1.8206 

Sexual Abuse 2.2478 d 1.3341 

Emotional Abuse 0.5329 1.9094 

All Neglect 2.2265 d 0.5735 

Physical Neglect 2.1154 0.0937 

Emotional Neglect 1.9740 0.1034 

Educational Neglect 1.6497 0.8298 

Severity, Fatal 0.1789 1.5718 

Severity, Serious 3.4751 b 0.6973 

Severity, Moderate 2.5189 c 0.6286 

Severity, Inferred 2.2228 d 0.4631 

Black vs Hispanic 

All Maltreatment 2.6721 c 

All Abuse 2.8670 c 

Physical Abuse 2.6512 c 

Sexual Abuse 1.2577 

Emotional Abuse 1.6821 

All Neglect 1.9534 

Physical Neglect 1.9887 

Emotional Neglect 1.9609 

Educational Neglect 1.3275 

Severity, Fatal 1.6366 

Severity, Serious 2.6164 c 

Severity, Moderate 2.1160 

Severity, Inferred 2.0204 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-9
Table D-6. T-statistics for racial/ethnic differences in NIS-4 incidence rates for 

endangerment standard maltreatment 

White vs Black White vs Hispanic 

All Maltreatment 3.7566 b 0.4516 

All Abuse 4.3023 a 0.4587 

Physical Abuse 5.5816 a 1.4127 

Sexual Abuse 2.0913 1.3352 

Emotional Abuse 1.2426 2.4793 c 

All Neglect 3.0154 c 0.1854 

Physical Neglect 2.3250 d 1.2978 

Emotional Neglect 3.0322 c 0.5752 

Educational Neglect 1.6497 0.8298 

Severity, Fatal 0.3578 1.6225 

Severity, Serious 3.5188 b 0.9241 

Severity, Moderate 2.2218 d 0.1236 

Severity, Inferred 1.8993 1.2130 

Severity, Endangered 4.4439 a 0.6483 

Black vs Hispanic 

All Maltreatment 3.2170 b 

All Abuse 3.0005 c 

Physical Abuse 3.3809 b 

Sexual Abuse 0.8707 

Emotional Abuse 2.6000 c 

All Neglect 2.7944 c 

Physical Neglect 3.2548 b 

Emotional Neglect 2.0795 

Educational Neglect 1.3275 

Severity, Fatal 1.5801 

Severity, Serious 2.5047 c 

Severity, Moderate 2.1238 

Severity, Inferred 2.6345 c 

Severity, Endangered 3.1848 b 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-10
Table D-7. T-statistics for parent's employment differences in NIS-4 incidence rates 

for harm standard maltreatment 

Unemployed vs. 

Not in Labor 

Force 

Unemployed vs. 

Employed 

All Maltreatment 3.6061 b 0.4124 

All Abuse 2.2080 d 0.8537 

Physical Abuse 0.9290 1.0698 

Sexual Abuse 0.7927 1.5121 

Emotional Abuse 2.1761 0.5757 

All Neglect 3.5320 b 0.9593 

Physical Neglect 3.8066 a 1.0892 

Emotional Neglect 2.9245 c 0.3966 

Educational Neglect 2.1677 1.3041 

Severity, Fatal 0.6202 0.7442 

Severity, Serious 4.3437 a 0.0623 

Severity, Moderate 2.3859 d 0.9581 

Severity, Inferred 2.0169 1.1914 

Employed vs. 

Not in Labor 

Force 

All Maltreatment 3.6025 b 

All Abuse 2.2843 d 

Physical Abuse 1.8036 

Sexual Abuse 1.7984 

Emotional Abuse 1.9381 

All Neglect 4.3299 a 

Physical Neglect 2.6437 c 

Emotional Neglect 2.3346 d 

Educational Neglect 2.5135 c 

Severity, Fatal 0.5800 

Severity, Serious 3.6831 b 

Severity, Moderate 2.0967 

Severity, Inferred 2.3783 d 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-11
Table D-8. T-statistics for parent's employment differences in NIS-4 incidence rates 

for endnagement standard maltreatment 

Unemployed vs. 

Not in Labor 

Force 

Unemployed vs. 

Employed 

All Maltreatment 5.1419 a 0.5020 

All Abuse 2.1886 d 1.0845 

Physical Abuse 1.2894 0.9411 

Sexual Abuse 0.4067 1.9515 

Emotional Abuse 2.5296 c 0.3375 

All Neglect 5.4227 a 1.0127 

Physical Neglect 4.8586 a 1.5728 

Emotional Neglect 4.1212 a 0.8165 

Educational Neglect 2.1677 1.3041 

Severity, Fatal 0.6202 0.7442 

Severity, Serious 4.4786 a 0.0752 

Severity, Moderate 3.1985 b 0.7890 

Severity, Inferred 2.0999 0.6038 

Severity, Endangered 3.6935 b 0.4785 

Employed vs. 

Not in Labor 

Force 

All Maltreatment 5.8827 a 

All Abuse 3.2502 b 

Physical Abuse 2.0576 

Sexual Abuse 2.1461 

Emotional Abuse 2.9127 c 

All Neglect 6.4676 a 

Physical Neglect 5.2060 a 

Emotional Neglect 5.3284 a 

Educational Neglect 2.5135 c 

Severity, Fatal 0.5800 

Severity, Serious 3.7186 b 

Severity, Moderate 3.2986 b 

Severity, Inferred 3.5169 b 

Severity, Endangered 6.0344 a 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-12
Table D-9. T-statistics for family socioeconomic status (SES) differences in NIS-4 incidence rates for 

harm standard maltreatment 

T-Value 

All Maltreatment 5.9930 a 

All Abuse 7.6369 a 

Physical Abuse 5.6934 a 

Sexual Abuse 5.0618 a 

Emotional Abuse 4.8584 a 

All Neglect 4.9521 a 

Physical Neglect 5.6671 a 

Emotional Neglect 5.3720 a 

Educational Neglect 2.4770 b 

Severity, Fatal 2.7786 b 

Severity, Serious 6.9799 a 

Severity, Moderate 4.2933 a 

Severity, Inferred 3.8010 a 

Table D-10. T-statistics for family socioeconomic status (SES) differences in NIS-4 incidence rates for 

endangerment standard maltreatment 

T-Value 

All Maltreatment 9.6581 a 

All Abuse 7.8315 a 

Physical Abuse 6.3146 a 

Sexual Abuse 5.7398 a 

Emotional Abuse 6.6428 a 

All Neglect 9.3246 a 

Physical Neglect 8.4025 a 

Emotional Neglect 8.6316 a 

Educational Neglect 2.4770 b 

Severity, Fatal 2.7786 b 

Severity, Serious 7.1004 a 

Severity, Moderate 6.7269 a 

Severity, Inferred 5.9963 a 

Severity,Endangered 8.1975 a 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-13
Table D-11. T-statistics for family structure and living arrangement differences in 

NIS-4 incidence rates for harm standard maltreatment 

Married Parents, 

Both Biological vs 

Single Parent 

W/Partner 

Married Parents, 

Both Biological vs 

Other Married Parents 

Married Parents, 

Both Biological vs 

Unmarried Parents 

All Maltreatment 6.6381 a 4.5923 a 5.8969 a 

All Abuse 8.0604 a 4.1706 b 5.7855 a 

Physical Abuse 6.8713 a 4.7495 a 6.1892 a 

Sexual Abuse 6.4771 a 1.5258 3.6610 b 

Emotional Abuse 4.1060 b 1.9963 3.2400 c 

All Neglect 2.8466 d 3.0238 d 3.7784 b 

Physical Neglect 1.5556 3.2214 c 3.1323 c 

Emotional Neglect 3.8159 b 2.2141 3.2808 c 

Educational Neglect 1.3612 1.4022 2.2584 

Severity, Fatal 0.9368 1.8568 0.8321 

Severity, Serious 5.4194 a 5.7267 a 4.5319 a 

Severity, Moderate 4.8081 a 3.0621 c 4.9443 a 

Severity, Inferred 5.3675 a 4.3906 a 3.6041 b 

Married Parents, 

Both Biological vs 

Single Parent, No 

Partner 

Married Parents, 

Both Biological vs 

Neither Parent 

All Maltreatment 5.9256 a 4.2129 b 

All Abuse 5.5452 a 4.9286 a 

Physical Abuse 5.3388 a 4.7808 a 

Sexual Abuse 5.4659 a 4.7456 a 

Emotional Abuse 3.6702 b 1.9241 

All Neglect 5.0879 a 2.8861 d 

Physical Neglect 4.5401 a 3.1809 c 

Emotional Neglect 6.2012 a 2.3144 

Educational Neglect 3.3538 c 2.2513 

Severity, Fatal 0.7556 1.1940 

Severity, Serious 6.1047 a 3.2202 c 

Severity, Moderate 4.6509 a 4.0218 b 

Severity, Inferred 6.8590 a 4.0344 b 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-14
Table D-11. Continued 

Other Married Parents 

vs Single Parent 

W/Partner 

Other Married 

Parents vs Single 

Parent, No Partner 

Other Married Parents 

vs Unmarried Parents 

All Maltreatment 0.2276 3.6895 b 0.9132 

All Abuse 1.8839 2.9005 d 3.3685 c 

Physical Abuse 0.8877 3.1826 c 2.9445 d 

Sexual Abuse 1.4052 2.1473 2.8313 d 

Emotional Abuse 1.9300 1.3069 1.8306 

All Neglect 1.0647 2.8529 d 3.0646 c 

Physical Neglect 1.9426 2.3480 2.5756 

Emotional Neglect 0.1097 2.2044 1.0053 

Educational Neglect 0.2055 1.8433 2.4855 

Severity, Fatal 1.0720 0.5128 0.5696 

Severity, Serious 0.6724 2.8149 d 1.4973 

Severity, Moderate 0.7876 3.1570 c 0.3983 

Severity, Inferred 0.4025 1.8467 0.2180 

Other Married Parents 

vs Neither Parent 

All Maltreatment 1.3030 

All Abuse 0.6843 

Physical Abuse 1.9819 

Sexual Abuse 0.8793 

Emotional Abuse 0.4925 

All Neglect 1.9187 

Physical Neglect 2.4320 

Emotional Neglect 0.4606 

Educational Neglect 1.6070 

Severity, Fatal 1.3051 

Severity, Serious 0.7829 

Severity, Moderate 1.2134 

Severity, Inferred 1.9726 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-15
Table D-11. Continued 

Unmarried Parents vs 

Single Parent 

W/Partner 

Unmarried Parents vs 

Single Parent, No 

Partner 

Unmarried Parents 

vs Neither Parent 

All Maltreatment 3.6610 b 0.9911 1.3605 

All Abuse 3.7481 b 0.7903 0.9635 

Physical Abuse 3.5942 b 1.5793 0.8703 

Sexual Abuse 2.6532 0.0150 1.8426 

Emotional Abuse 2.3718 0.4175 0.8338 

All Neglect 2.1849 1.7427 1.2577 

Physical Neglect 0.9256 0.1294 1.0573 

Emotional Neglect 1.9995 0.5268 0.3031 

Educational Neglect 1.5965 1.8479 1.2288 

Severity, Fatal 1.3915 1.4185 1.7438 

Severity, Serious 2.2215 0.4400 0.1951 

Severity, Moderate 3.4410 c 1.0858 1.6938 

Severity, Inferred 1.9164 0.5634 2.0154 

Single Parent 

W/Partner vs Single 

Parent, No Partner 

Single Parent 

W/Partner vs Neither 

Parent 

All Maltreatment 3.1194 c 2.2783 

All Abuse 4.3113 a 3.1220 c 

Physical Abuse 4.6541 a 4.2168 b 

Sexual Abuse 2.9054 d 1.6818 

Emotional Abuse 2.2763 1.4927 

All Neglect 1.1083 0.8015 

Physical Neglect 0.9048 0.1367 

Emotional Neglect 1.8999 1.7444 

Educational Neglect 0.3789 0.6435 

Severity, Fatal 0.0975 1.7960 

Severity, Serious 2.0981 1.9461 

Severity, Moderate 2.9136 d 2.1182 

Severity, Inferred 1.7890 0.0962 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-16
Table D-11. Continued 

Single Parent, No 

Partner vs Neither 

Parent
 

All Maltreatment 0.6648
 

All Abuse 1.8574
 

Physical Abuse 0.7529
 

Sexual Abuse 2.7379
 

Emotional Abuse 0.6484
 

All Neglect 0.1324
 

Physical Neglect 1.0441
 

Emotional Neglect 0.0902
 

Educational Neglect 0.4009
 

Severity, Fatal 1.7812
 

Severity, Serious 0.1514
 

Severity, Moderate 0.8869
 

Severity, Inferred 1.9134
 

Table D-12. T-statistics for family structure and living arrangement differences in NIS-4 

incidence rates for endangerment standard maltreatment 

Married Parents, 

Both Biological vs 

Other Married Parents 

Married Parents, 

Both Biological vs 

Unmarried Parents 

Married Parents, 

Both Biological vs Single 

Parent W/Partner 

All Maltreatment 6.6306 a 8.2685 a 6.9701 a 

All Abuse 9.4118 a 4.9368 a 7.4925 a 

Physical Abuse 8.0683 a 5.4037 a 7.9019 a 

Sexual Abuse 7.2208 a 1.9300 4.4521 a 

Emotional Abuse 4.1852 b 2.7270 4.8431 a 

All Neglect 4.1711 b 7.5359 a 6.5555 a 

Physical Neglect 3.5508 c 5.7260 a 5.2368 a 

Emotional Neglect 4.2143 b 7.5257 a 6.5754 a 

Educational Neglect 1.3612 0.9543 2.2584 

Severity, Fatal 0.9368 1.5858 0.8321 

Severity, Serious 5.5188 a 3.9240 b 4.7321 a 

Severity, Moderate 5.0418 a 3.9341 b 4.7918 a 

Severity, Inferred 5.9636 a 2.9491 d 6.7689 a 

Severity, Endangered 4.1257 b 8.1040 a 6.9261 a 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-17
Table D-12. Continued 

Married Parents, 

Both Biological vs 

Single Parent, No 

Partner 

Married Parents, 

Both Biological vs 

Neither Parent 

All Maltreatment 6.5623 a 6.6794 a 

All Abuse 6.1203 a 5.8391 a 

Physical Abuse 7.3688 a 6.0692 a 

Sexual Abuse 7.0136 a 4.8951 a 

Emotional Abuse 3.9688 b 2.7868 

All Neglect 6.6924 a 5.0798 a 

Physical Neglect 6.4291 a 4.9037 a 

Emotional Neglect 6.0106 a 3.9865 b 

Educational Neglect 3.3538 c 2.2513 

Severity, Fatal 0.8137 1.1940 

Severity, Serious 6.2326 a 3.1747 c 

Severity, Moderate 5.2340 a 5.4347 a 

Severity, Inferred 5.5748 a 5.7047 a 

Severity, Endangered 5.7035 a 5.8630 a 

Other Married Parents 

vs Single Parent 

W/Partner 

Other Married Parents 

vs Unmarried Parents 

Other Married Parents vs 

Single Parent, No Partner 

All Maltreatment 3.6976 b 4.7129 a 1.6240 

All Abuse 0.8038 3.4552 c 3.3375 c 

Physical Abuse 0.7302 3.2124 c 3.6038 b 

Sexual Abuse 1.5711 2.4843 2.8157 d 

Emotional Abuse 0.0561 2.0366 1.4475 

All Neglect 4.2853 a 4.6980 a 2.3697 

Physical Neglect 3.8310 b 3.9907 b 3.4495 c 

Emotional Neglect 4.0127 b 4.6941 a 0.6522 

Educational Neglect 0.2055 1.8433 2.4855 

Severity, Fatal 1.0720 0.5128 0.5437 

Severity, Serious 0.7738 2.9378 d 1.5408 

Severity, Moderate 0.2039 3.4907 c 1.4515 

Severity, Inferred 1.0296 3.1506 c 0.0528 

Severity, Endangered 4.9973 a 4.5874 a 1.4263 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-18
Table D-12. Continued 

Other Married Parents 

vs Neither Parent 

All Maltreatment 1.6125 

All Abuse 0.6266 

Physical Abuse 2.3103 

Sexual Abuse 0.5894 

Emotional Abuse 0.0848 

All Neglect 1.7335 

Physical Neglect 2.7080 

Emotional Neglect 0.2539 

Educational Neglect 1.6070 

Severity, Fatal 1.3051 

Severity, Serious 0.7594 

Severity, Moderate 2.8197 d 

Severity, Inferred 0.2033 

Severity, Endangered 0.5739 

Unmarried Parents vs 

Single Parent 

W/Partner 

Unmarried Parents vs 

Single Parent, No 

Partner 

Unmarried Parents vs Neither 

Parent 

All Maltreatment 2.4455 1.9599 2.0130 

All Abuse 3.6347 b 1.5369 0.1993 

Physical Abuse 3.5251 c 2.0774 1.1882 

Sexual Abuse 3.0850 c 0.1311 1.7732 

Emotional Abuse 1.6826 1.0633 0.1185 

All Neglect 1.6898 2.3030 2.4177 

Physical Neglect 1.0860 1.2265 1.2458 

Emotional Neglect 1.9895 3.7240 b 4.2445 b 

Educational Neglect 1.5965 1.8479 1.2288 

Severity, Fatal 1.3915 1.4065 1.7438 

Severity, Serious 2.2665 0.3807 0.1185 

Severity, Moderate 3.3320 c 1.0951 2.4775 

Severity, Inferred 0.8627 1.0469 0.9315 

Severity, Endangered 0.3550 3.8642 b 5.8304 a 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-19
Table D-12. Continued 

Single Parent 

W/Partner vs Single 

Parent, No Partner 

Single Parent 

W/Partner vs Neither 

Parent 

All Maltreatment 3.7141 b 3.7486 b 

All Abuse 5.1568 a 3.6033 b 

Physical Abuse 5.5595 a 4.7707 a 

Sexual Abuse 3.3613 c 2.0658 

Emotional Abuse 3.1648 c 1.8602 

All Neglect 3.3831 c 3.4620 c 

Physical Neglect 2.1132 2.1040 

Emotional Neglect 4.4834 a 4.8344 a 

Educational Neglect 0.3789 0.6435 

Severity, Fatal 0.0487 1.7960 

Severity, Serious 2.1812 2.0163 

Severity, Moderate 2.8338 d 1.7936 

Severity, Inferred 3.1457 c 2.9406 d 

Severity, Endangered 3.6560 b 5.1694 a 

Single Parent, No 

Partner vs Neither 

Parent 

All Maltreatment 0.0342 

All Abuse 1.9436 

Physical Abuse 1.0776 

Sexual Abuse 2.4204 

Emotional Abuse 0.9808 

All Neglect 0.3375 

Physical Neglect 0.1483 

Emotional Neglect 0.9411 

Educational Neglect 0.4009 

Severity, Fatal 1.8524 

Severity, Serious 0.1809 

Severity, Moderate 1.6069 

Severity, Inferred 0.2484 

Severity, Endangered 2.2527 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-20
 

 

 

 

 

 

 

 

 

 

 

All Maltreatment 0.8596 

All Abuse 0.6281 

Physical Abuse 1.5034 d 

Sexual Abuse 0.4697 

Emotional Abuse 0.4180 

All Neglect 0.6500 

Physical Neglect 0.4900 

Emotional Neglect 0.4581 

Educational Neglect 0.1716 

Severity, Fatal 0.7679 

Severity, Serious 0.1724 

Severity, Moderate 0.0861 

Severity, Inferred 1.4559 d 

Severity, Endangered 1.8846 c 

Table D-13. T-statistics for grandparents as caregivers in NIS-4 incidence rates for harm 

standard maltreatment 

T-Value 

All Maltreatment 0.3791 

All Abuse 1.4628 d 

Physical Abuse 2.7907 b 

Sexual Abuse 0.7482 

Emotional Abuse 0.2807 

All Neglect 0.2575 

Physical Neglect 0.9764 

Emotional Neglect 0.9828 

Educational Neglect 0.1716 

Severity, Fatal 0.7679 

Severity, Serious 0.2661 

Severity, Moderate 0.9065 

Severity, Inferred 0.8031 

Table D-14. T-statistics for grandparents as caregivers in NIS-4 incidence rates for endangerment 

standard maltreatment 

T-Value 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-21
Table D-15. T-statistics for family size differences in NIS-4 incidence rates for harm standard 

maltreatment 

One Child vs Two 

Children 

One Child vs Three 

Children 

All Maltreatment 2.5762 d 0.8134 

All Abuse 1.2315 0.0823 

Physical Abuse 2.1332 1.1094 

Sexual Abuse 0.1420 0.2235 

Emotional Abuse 0.6019 1.6190 

All Neglect 2.4527 0.8697 

Physical Neglect 1.2976 1.6539 

Emotional Neglect 2.2999 0.8544 

Educational Neglect 2.3498 0.2862 

Severity, Fatal 0.1314 0.4295 

Severity, Serious 1.7773 0.9084 

Severity, Moderate 2.5704 d 0.2791 

Severity, Inferred 0.9415 1.8088 

One Child vs Four or 

More Children 

All Maltreatment 0.9628 

All Abuse 0.8939 

Physical Abuse 0.1359 

Sexual Abuse 0.1393 

Emotional Abuse 1.6700 

All Neglect 0.9025 

Physical Neglect 1.1557 

Emotional Neglect 0.2787 

Educational Neglect 0.4541 

Severity, Fatal 0.0390 

Severity, Serious 0.5105 

Severity, Moderate 1.0339 

Severity, Inferred 0.0970 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-22
Table D-15. Continued 

Two Children vs Three 

Children 

Two Children vs Four 

or more children 

All Maltreatment 1.8034 3.1534 c 

All Abuse 0.9962 1.9033 

Physical Abuse 1.0530 2.4974 d 

Sexual Abuse 0.2841 0.2212 

Emotional Abuse 1.2828 1.3529 

All Neglect 1.7063 2.9064 c 

Physical Neglect 0.6153 2.2354 

Emotional Neglect 1.5654 1.5572 

Educational Neglect 1.8622 1.8557 

Severity, Fatal 0.4120 0.1030 

Severity, Serious 1.5933 2.5097 d 

Severity, Moderate 1.7441 2.5827 d 

Severity, Inferred 0.6134 0.6350 

Three Children vs 

Four or more children 

All Maltreatment 1.6856 

All Abuse 0.8675 

Physical Abuse 1.3487 

Sexual Abuse 0.0817 

Emotional Abuse 0.1145 

All Neglect 1.6596 

Physical Neglect 2.4838 d 

Emotional Neglect 0.4105 

Educational Neglect 0.6394 

Severity, Fatal 0.4419 

Severity, Serious 1.5970 

Severity, Moderate 1.1520 

Severity, Inferred 1.2002 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-23
Table D-16. T-statistics for family size differences in NIS-4 incidence rates for endangerment standard 

maltreatment 

One Child vs Two 

Children 

One Child vs Three 

Children 

All Maltreatment 1.6074 0.2400 

All Abuse 0.9913 1.0749 

Physical Abuse 1.8811 0.1076 

Sexual Abuse 0.0097 0.8059 

Emotional Abuse 1.3148 2.2162 

All Neglect 1.6778 0.5155 

Physical Neglect 1.3385 0.6389 

Emotional Neglect 1.2394 1.3379 

Educational Neglect 2.3498 0.2862 

Severity, Fatal 0.1314 0.4295 

Severity, Serious 1.7785 0.8923 

Severity, Moderate 2.6311 d 0.2912 

Severity, Inferred 1.1267 0.6438 

Severity, Endangered 0.5330 1.4640 

One Child vs Four or 

More Children 

All Maltreatment 3.3544 b 

All Abuse 2.0482 

Physical Abuse 1.1857 

Sexual Abuse 0.0761 

Emotional Abuse 2.7473 c 

All Neglect 3.6960 b 

Physical Neglect 4.6351 a 

Emotional Neglect 3.4023 b 

Educational Neglect 0.4541 

Severity, Fatal 0.0390 

Severity, Serious 0.6119 

Severity, Moderate 1.3361 

Severity, Inferred 1.2303 

Severity, Endangered 4.6275 a 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-24
Table D-16. Continued 

Two Children vs Three 

Children 

Two Children vs Four 

or more children 

All Maltreatment 2.6932 d 5.8943 a 

All Abuse 1.8130 2.6815 d 

Physical Abuse 2.1041 2.7561 c 

Sexual Abuse 0.6499 0.0494 

Emotional Abuse 1.5495 2.1076 

All Neglect 3.0450 c 6.1261 a 

Physical Neglect 2.4745 d 6.6065 a 

Emotional Neglect 3.5237 b 4.8745 a 

Educational Neglect 1.8622 1.8557 

Severity, Fatal 0.4120 0.1030 

Severity, Serious 1.6175 2.6361 d 

Severity, Moderate 1.8092 3.0045 c 

Severity, Inferred 1.0594 2.8481 c 

Severity, Endangered 3.1429 c 5.8166 a 

Three Children vs 

Four or more children 

All Maltreatment 3.7575 b 

All Abuse 0.9339 

Physical Abuse 1.1431 

Sexual Abuse 0.7424 

Emotional Abuse 0.4894 

All Neglect 3.6901 b 

Physical Neglect 4.3765 a 

Emotional Neglect 2.6497 d 

Educational Neglect 0.6394 

Severity, Fatal 0.4419 

Severity, Serious 1.7083 

Severity, Moderate 1.4539 

Severity, Inferred 2.3279 

Severity, Endangered 4.1647 a 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-25
Table D-17. T-statistics for metrostatus differences in NIS-4 incidence rates for harm standard 

maltreatment 

Major Urban 

vs Urban 

Major Urban 

vs Rural 

All Maltreatment 0.7036 2.0816 

All Abuse 0.9546 2.4701 c 

Physical Abuse 0.9390 1.8431 

Sexual Abuse 0.8283 2.2014 d 

Emotional Abuse 1.9516 2.4710 c 

All Neglect 0.5685 1.8187 

Physical Neglect 0.1229 1.9538 

Emotional Neglect 1.6527 2.4202 d 

Educational Neglect 0.4002 1.4347 

Severity, Fatal 0.0620 3.2000 b 

Severity, Serious 0.7686 2.3766 d 

Severity, Moderate 0.6267 1.8410 

Severity, Inferred 0.0088 1.1767 

Urban vs Rural 

All Maltreatment 1.7503 

All Abuse 1.5364 

Physical Abuse 0.9583 

Sexual Abuse 3.0497 c 

Emotional Abuse 0.8642 

All Neglect 1.6310 

Physical Neglect 2.0776 

Emotional Neglect 1.2778 

Educational Neglect 1.3430 

Severity, Fatal 2.0352 

Severity, Serious 1.8440 

Severity, Moderate 1.6061 

Severity, Inferred 1.1694 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-26
Table D-18. T-statistics for metrostatus differences in NIS-4 incidence rates for endangerment 

standard maltreatment 

Major Urban 

vs Urban 

Major Urban 

vs Rural 

All Maltreatment 1.0262 2.9596 c 

All Abuse 1.0882 2.8001 c 

Physical Abuse 1.0654 2.2983 d 

Sexual Abuse 0.0692 2.3173 d 

Emotional Abuse 1.8205 2.5537 c 

All Neglect 1.1877 2.9492 c 

Physical Neglect 0.9259 3.2789 b 

Emotional Neglect 1.6307 3.2299 b 

Educational Neglect 0.4002 1.4347 

Severity, Fatal 0.1240 3.3000 b 

Severity, Serious 0.7655 2.3187 d 

Severity, Moderate 0.8433 2.5619 c 

Severity, Inferred 1.2991 2.9181 c 

Severity, Endangered 1.0328 2.4914 c 

Urban vs Rural 

All Maltreatment 2.3140 d 

All Abuse 1.7207 

Physical Abuse 1.0625 

Sexual Abuse 2.2302 d 

Emotional Abuse 1.3361 

All Neglect 2.3148 d 

Physical Neglect 2.7897 c 

Emotional Neglect 2.1437 

Educational Neglect 1.3430 

Severity, Fatal 2.0352 

Severity, Serious 1.7793 

Severity, Moderate 2.1651 

Severity, Inferred 1.7412 

Severity, Endangered 1.8932 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 D-27
Table D-19. Chi-squared Results for Perpetrator's Relationship to Child and Severity of Harm 

by the Category of Maltreatment 

Percent of Children in Row with 

Injury/Impairment..... Chi-square

Category Fatal/Serious Moderate Inferred Value Probability 

ABUSE: 26% 66% 8% 45.59 <.001 

Biological Parents 25% 71% 4% 

Nonbiological Parents and Partners 29% 62% 9% 

Others 28% 48% 24% 

Physical Abuse: 22% 78% + 5.304 0.062 

Biological Parents 22% 78% + 

Nonbiological Parents and Partners 17% 83% + 

Others 31% 69% + 

Sexual Abuse: 33% 35% 32% 2.974 0.342 

Biological Parents 38% 38% 24% 

Nonbiological Parents and Partners 32% 37% 31% 

Others 30% 30% 40% 

Emotional Abuse: 30% 69% 1% ** 

Biological Parents 27% 72% 1% 

Nonbiological Parents and Partners 41% 57% 2% 

Others 27% 73% 0% 

NEGLECT: 50% 46% 4% 1.125 0.549 

Biological Parents 49% 47% 4% 

Nonbiological Parents and Partners 53% 41% 6% 

Others ^ ^ ^ 

Physical Neglect: 64% 25% 11% 0.825 0.58 

Biological Parents 63% 26% 11% 

Nonbiological Parents and Partners 69% 18% 13% 

Others ^ ^ ^ 

Emotional Neglect: 92% 8% + 0.598 0.439 

Biological Parents 93% 7% + 

Nonbiological Parents and Partners 86% 14% + 

Others ^ ^ ^ 

Educational Neglect: 17% 83% + 6.892 0.009 

Biological Parents 18% 82% + 

Nonbiological Parents and Partners 6% 94% + 

Others ^ ^ ^ 

ALL MALTREATMENT: 39% 55% 6% 50.305 <.001 

Biological Parents 41% 55% 4% 

Nonbiological Parents and Partners 34% 58% 8% 

Others 26% 50% 24% 

+ This severity level not applicable for this form of maltreatment. 

** Chi-square could not be calculated due to low cell numbers 

D-28 
Table D-20. Chi-squared Results for Perpetrator's Sex and Perpetrator's Relationship to Child 

Category 

Percent of Children in Row 

with Perpetrator whose Sex 

was..... 

Male Female Unknown 

Male 

Chi-Square 

Female 

Value Prob Value Prob 

ABUSE: 62% 41% 1% 54.909 <.001 66.039 <.001 

Biological Parents 54% 51% 0% 

Nonbiological Parents and Partners 79% 26% 1% 

Others 74% 21% 6% 

Physical Abuse: 54% 50% 0% 31.356 <.001 43.302 <.001 

Biological Parents 48% 56% 0% 

Nonbiological Parents and Partners 74% 29% 1% 

Others 56% 43% 1% 

Sexual Abuse: 87% 11% 5% 4.756 0.051 11.078 0.001 

Biological Parents 80% 22% 2% 

Nonbiological Parents and Partners 97% 3% 0% 

Others 86% 6% 10% 

Emotional Abuse: 60% 50% 0% 4.761 0.075 1.362 0.407 

Biological Parents 56% 53% 0% 

Nonbiological Parents and Partners 76% 41% 0% 

Others 60% 42% 0% 

NEGLECT: 38% 86% 2% 0.115 0.734 0.614 0.433 

Biological Parents 38% 86% 2% 

Nonbiological Parents and Partners 40% 83% 5% 

Others ^ ^ ^ 

Physical Neglect: 39% 87% 2% 0.249 0.618 1.216 0.27 

Biological Parents 38% 88% 2% 

Nonbiological Parents and Partners 45% 81% 1% 

Others ^ ^ ^ 

Emotional Neglect: 41% 80% 0% 0.521 0.47 0.808 0.369 

Biological Parents 40% 79% 0% 

Nonbiological Parents and Partners 51% 85% 0% 

Others ^ ^ ^ 

Educational Neglect: 36% 89% 3% 0.188 0.665 0.338 0.561 

Biological Parents 36% 89% 2% 

Nonbiological Parents and Partners 30% 84% 12% 

Others ^ ^ ^ 

ALL MALTREATMENT: 48% 68% 2% 60.063 <.001 91.863 <.001 

Biological Parents 43% 75% 1% 

Nonbiological Parents and Partners 64% 48% 2% 

Others 75% 20% 6% 

D-29 
Table D-21. Chi-squared Results for Perpetrator's Sex by Severity of Harm and Perpetrator's Relationship to Child 

Children in 

Maltreatment 

Category 

Total 

Maltreated 

Children 

with Perpetrator whose Sex 

was..... Male 

Chi-Square 

Femal

Category Male Female Unknown Value Prob Value P

FATAL or SERIOUS 100% 490,300 48% 70% 2% 12.733 0.002 25.258 <

Biological Parents 85% 415,300 45% 75% 2% 

Nonbiological Parents and Partners 11% 52,700 61% 59% 2% 

Others 5% 22,300 80% 15% 7% 

MODERATE 100% 694,700 45% 70% 2% 25.763 <.001 69.67 <

Biological Parents 81% 562,200 41% 76% 1% 

Nonbiological Parents and Partners 13% 90,200 62% 45% 3% 

Others 6% 42,300 63% 32% 7% 

INFERRED 100% 71,500 64% 41% 1% 34.311 <.001 40.406 <

Biological Parents 53% 38,000 40% 68% 0% 

Nonbiological Parents and Partners 18% 13,000 86% 24% 0% 

Others 29% 20,500 93% 3% 4% 

ALL MALTREATMENT: 100% 1,256,600 48% 68% 2% 60.063 <.001 91.863 <

Biological Parents 81% 1,015,600 43% 75% 1% 

Nonbiological Parents and Partners 12% 155,900 64% 48% 2% 

Others 7% 85,100 75% 20% 6% 

D-30 
Table D-22. Chi-squared Results for Perpetrator's Age by Type of Maltreatement and Perpetrator's Relationship to Child 

Category < 26 

Years 

26 - 35 

Years 

> 35 

Years Unknown 

Percent of Children in Row with 

Perpetrator Whose Age was..... 

Chi-Square 

< 26 Years 26 - 35 Years > 

Value Probability Value Probability Value 

ABUSE: 

Biological Parents Nonbiological Parents and Partners Others 

12% 33% 37% 18% 

9% 36% 37% 19% 6% 36% 51% 7% 

35% 17% 24% 25% 

57.511 <.001 14.448 0.001 22.50

Physical Abuse: 

Biological Parents Nonbiological Parents and Partners Others 

13% 34% 36% 17% 11% 35% 35% 19% 

7% 35% 50% 8% 

40% 21% 18% 22% 

21.723 <.001 5.093 0.073 25.87

Sexual Abuse: 

Biological Parents Nonbiological Parents and Partners Others 

15% 27% 32% 27% 

5% 35% 25% 35% 4% 36% 48% 11% 

30% 14% 29% 29% 

36.238 <.001 5.489 0.045 5.11

Emotional Abuse: 

Biological Parents Nonbiological Parents and Partners Others 

7% 36% 47% 10% 

5% 39% 47% 10% 3% 31% 62% 3% 

36% 21% 13% 30% 

10.094 0.002 1.842 0.317 12.23

NEGLECT: 

Biological Parents Nonbiological Parents and Partners Others 

9% 37% 38% 18% 

10% 40% 36% 18% 

2% 8% 66% 25% 

^ ^ ^ ^ 

16.457 <.001 26.852 <.001 28.93

Physical Neglect: 

Biological Parents Nonbiological Parents and Partners Others 

15% 35% 35% 18% 16% 38% 31% 18% 

2% 4% 81% 14% 

^ ^ ^ ^ 

9.286 0.002 11.61 0.001 19.36

Emotional Neglect: 

Biological Parents Nonbiological Parents and Partners Others 

8% 36% 46% 13% 

8% 38% 44% 13% 3% 18% 68% 13% 

^ ^ ^ ^ 

3.02 0.082 3.793 0.051 4.12

Educational Neglect: 

Biological Parents Nonbiological Parents and Partners Others 

5% 39% 39% 20% 

6% 42% 38% 18% 0% 3% 55% 42% 

^ ^ ^ ^ 

** 22.714 <.001 3.30

ALL MALTREATMENT: 

Biological Parents Nonbiological Parents and Partners Others 

11% 35% 38% 18% 10% 39% 36% 18% 

4% 25% 57% 15% 

34% 18% 24% 25% 

49.575 <.001 20.149 <.001 43.3

** Chi-square could not be calculated due to low cell numbers D-31 
Table D-23. Chi-squared Results for Perpetrator's Age by Severity of Harm and Perpetrator's Relationship to Child 

Category < 26 

Years 

26 - 35 

Years 

> 35 

Years Unknown 

Percent of Children in Row with Perpetrator Whose Age 

was..... 

Chi-squa

< 26 Years 26 - 35 Years 

Value Prob Value Pro

FATAL or SERIOUS 12% 35% 38% 17% 6.319 0.018 9.428 0.00

Biological Parents 12% 38% 36% 17% 

Nonbiological Parents and Partners 4% 20% 63% 14% Others 35% 15% 22% 30% 

MODERATE 9% 37% 37% 19% 29.193 <.001 15.828 <.00

Biological Parents 8% 40% 35% 19% Nonbiological Parents and Partners 3% 28% 53% 16% Others 35% 19% 21% 27% 

INFERRED 20% 24% 42% 15% 12.585 0.001 1.039 0.47

Biological Parents 19% 28% 38% 18% 

Nonbiological Parents and Partners 7% 22% 63% 8% 

Others 31% 20% 35% 15% 

ALL MALTREATMENT: 11% 35% 38% 18% 49.575 <.001 20.149 <.00

Biological Parents 10% 39% 36% 18% 

Nonbiological Parents and Partners 4% 25% 57% 15% Others 34% 18% 24% 25% 

D-32 
Table D-24. Chi-squared Results for Child's Race by Type of Maltreatment and Perpetrator's 

Relationship to Child 

Category 

Percent of Children in Row 

with Race..... 

White Black Hispanic 

Chi-square 

Value Probability 

ABUSE: 55% 24% 21% 3.708 0.333 

Biological Parents 55% 23% 23% 

Nonbiological Parents and Partners 57% 22% 21% 

Others 53% 30% 16% 

Physical Abuse: 50% 26% 24% 4.959 0.235 

Biological Parents 49% 25% 26% 

Nonbiological Parents and Partners 57% 25% 18% 

Others 45% 34% 20% 

Sexual Abuse: 51% 25% 24% 3.93 0.253 

Biological Parents 47% 23% 30% 

Nonbiological Parents and Partners 50% 19% 31% 

Others 55% 30% 15% 

Emotional Abuse: 66% 19% 15% 0.943 0.825 

Biological Parents 66% 19% 15% 

Nonbiological Parents and Partners 61% 19% 20% 

Others 73% 16% 11% 

NEGLECT: 

Biological Parents 

Nonbiological Parents and Partners 

Others 

53% 26% 20% 

54% 24% 21% 

40% 49% 11% 

^ ^ ^ 

3.736 0.077 

Physical Neglect: 56% 25% 19% 5.567 0.032 

Biological Parents 58% 22% 20% 

Nonbiological Parents and Partners 35% 53% 12% 

Others ^ ^ ^ 

Emotional Neglect: 56% 25% 19% 3.439 0.092 

Biological Parents 57% 22% 21% 

Nonbiological Parents and Partners 53% 46% 1% 

Others ^ ^ ^ 

Educational Neglect: 50% 29% 21% 2.589 0.163 

Biological Parents 52% 27% 22% 

Nonbiological Parents and Partners 29% 55% 16% 

Others ^ ^ ^ 

ALL MALTREATMENT: 53% 26% 21% 3.45 0.322 

Biological Parents 54% 24% 22% 

Nonbiological Parents and Partners 50% 32% 18% 

Others 55% 29% 16% 

D-33 
Table D-25. Chi-squared Results for Perpetrator's Alcohol Use, Drug Use, and Mental Illness by Type of Maltreatement and 

Perpetrator's Relationship to Child Category 

Alcohol Use Drug Use Mental 

Illness 

% of Children in Row with Perpetrator 

where any of the following was a 

factor in maltreatment...... 

Chi-Square 

Alcohol Use Drug Use Mental Illnes

Value Prob Value Prob Value P

ABUSE: 13% 9% 7% 7.927 0.014 1.97 0.317 3.739 

Biological Parents 15% 10% 8% 

Nonbiological Parents and Partners 12% 10% 6% 

Others 6% 5% 5% 

Physical Abuse: 11% 7% 5% 6.669 0.025 2.814 0.186 0.526 

Biological Parents 12% 7% 5% 

Nonbiological Parents and Partners 12% 8% 3% 

Others 3% 3% 5% 

Sexual Abuse: 8% 9% 5% 0.904 0.574 2.103 0.242 0.527 

Biological Parents 10% 14% 3% 

Nonbiological Parents and Partners 10% 7% 5% 

Others 6% 6% 5% 

Emotional Abuse: 22% 17% 17% 2.831 0.221 0.204 0.758 5.069 

Biological Parents 24% 17% 20% 

Nonbiological Parents and Partners 16% 18% 10% 

Others 11% 10% 4% 

NEGLECT: 12% 12% 8% 8.325 0.004 14.189 <.001 4.237 

Biological Parents 13% 13% 8% 

Nonbiological Parents and Partners 4% 3% 4% Others ^ ^ ^ 

Physical Neglect: 11% 15% 8% 7.542 0.006 9.362 0.002 0.579 

Biological Parents 12% 16% 8% 

Nonbiological Parents and Partners 2% 1% 5% Others ^ ^ ^ 

Emotional Neglect: 21% 20% 13% 5.854 0.016 7.695 0.006 6.488 

Biological Parents 22% 21% 14% 

Nonbiological Parents and Partners 8% 7% 3% Others ^ ^ ^ 

Educational Neglect: 10% 10% 6% 3.537 0.06 8.426 0.004 0.113 

Biological Parents 11% 10% 6% 

Nonbiological Parents and Partners 3% 0% 5% Others ^ ^ ^ 

ALL MALTREATMENT: 11% 11% 7% 10.235 0.005 6.157 0.031 5.144 

Biological Parents 12% 12% 8% 

Nonbiological Parents and Partners 9% 7% 5% Others 6% 5% 5% 
Appendix E 


Comparisons Between the NIS–3 and NIS–4 

 

 

APPENDIX E 

BETWEEN-STUDY ANALYSES 

This appendix describes the analyses comparing the distribution of maltreatment in 

the NIS–4 with its distribution in the NIS–3 and NIS–2 across a number of subgroups defined by 

the characteristics of the child and family. This introduction describes the t-statistics and chisquared tests used in the analyses. The tables that follow provide the results of all statistical tests 

that support the findings given in the NIS–4 Report to Congress. 

To address the fact that the NIS–4 data derive from a complex sample design 

(stratified and multi-stage), all the computations were performed using WesVar (Westat, 2007). 

Comparisons of Two Estimates. Comparisons of the differences between single 

estimates in two studies followed the same approach outlined in the introduction to Appendix D. 

That is, using the estimated rate in each study (r1 and r2) and the standard error of these rates 

(SEr1 and SEr2) as computed by WesVar, the t-statistic was then calculated as follows: 

r1-r2 

t = √ 2 SEr1

2

 + SEr2 

Analyses comparing single estimates from NIS–4 to a corresponding estimate from 

an earlier study used one-tailed tests of significance with 82 degrees of freedom for comparisons 

with NIS–3 and 89 degrees of freedom for comparisons with NIS–2.1 

Comparisons Involving More than Two Estimates. The chi-squared test was used 

to determine whether between-study changes in incidence rates differed for different subgroups. 

WesVar computes a chi-squared statistic that takes account of the complex sample design, the 

Rao-Scott approximation (RS3). This modified chi-squared statistic relies on modifying the 

Pearson chi-squared statistic using an estimated “design effect” (Rao & Scott, 1981, 1984) For 

the NIS–4 analyses, conclusions about the significance of between-study changes related to 

1

 These degrees of freedom depend on the combined total number of replicate weights in each study analysis file. 

E–i 
specific characteristics used the RS3 probability levels, as recommended by the WesVar 

developers (Westat, 2007). 

It should be noted that all statistics were calculated on measures of incidence rates, 

since the incidence rate measures took into account any differences in overall population size 

between the 1986 and 1993 studies and also equated the different comparison subgroups (e.g., 

different age groups, different income groups, etc.) for differences in their relative numbers in 

the general population. 

References 

Rao, J.N.K. and Scott, A.J. (1981). The analysis of categorical data from complex sample 

surveys: Chi-Squared tests for goodness of fit and independence in two-way tables. 

Journal of the American Statistical Association, 76, 221-230. 

Rao, J.N.K. and Scott, A.J. (1984). On Chi-Squared tests formultiway contingency tables with 

cell proportions estimated from survey data. Annals of Statistics, 12, 46-60. 

Westat, Inc. (2007). WesVar 4.3 User’s Guide. Rockville, MD. Available online at 

http://www.westat.com/westat/statistical_software/WesVar/pdf/WV_4-3_Manual.pdf 

E–ii 
Table E-1a. T-statistics for comparisons between NIS-4 and NIS-3 incidence rates 

for Harm Standard maltreatment 

T-Value 

All Maltreatment 1.5040 d 

All Abuse 1.9247 c 

Physical Abuse 1.3456 d 

Sexual Abuse 2.0528 c 

Emotional Abuse 1.6186 d 

All Neglect 0.9491 

Physical Neglect 0.8337 

Emotional Neglect 0.7195 

Educational Neglect 0.6374 

Severity, Fatal 0.5981 

Severity, Serious 1.0050 

Severity, Moderate 1.2521 

Severity, Inferred 3.3569 a 

Table E-1b. T-statistics for comparisons between NIS-4 and NIS-2 incidence rates 

for Harm Standard maltreatment 

All Maltreatment 0.7999 

All Abuse 0.4722 

Physical Abuse 0.1880 

Sexual Abuse 0.1588 

Emotional Abuse 0.8042 

All Neglect 1.3411 d 

Physical Neglect 1.5915 d 

Emotional Neglect 5.2494 a 

Educational Neglect 0.2459 

Severity, Fatal 1.4710 d 

Severity, Serious 5.5393 a 

Severity, Moderate 0.7188 

Severity, Inferred 2.1268 c 

T-Value 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 

E-1
Table E-2a. T-statistics for comparisons between NIS-4 and NIS-3 incidence rates 

for Endangerment Standard maltreatment

All Maltreatment 0.3648 

All Abuse 2.2422 c 

Physical Abuse 1.7573 c 

Sexual Abuse 2.5479 b 

Emotional Abuse 2.2202 c 

All Neglect 0.2747 

Physical Neglect 1.1901 

Emotional Neglect 3.4514 a 

Educational Neglect 0.6374 

Severity, Fatal 0.5190 

Severity, Serious 0.8789 

Severity, Moderate 0.3076 

Severity, Inferred 0.3827 

Severity, Endangered 0.0785 

Table E-2b. T-statistics for comparisons between NIS-4 and NIS-2 incidence rates 

for Endangerment Standard maltreatment

All Maltreatment 3.7645 a 

All Abuse 1.4382 d 

Physical Abuse 2.3694 b 

Sexual Abuse 0.9600 

Emotional Abuse 1.5148 d 

All Neglect 4.5315 a 

Physical Neglect 4.2679 a 

Emotional Neglect 9.1051 a 

Educational Neglect 0.2459 

Severity, Fatal 1.4710 d 

Severity, Serious 5.8110 a 

Severity, Moderate 0.0005 

Severity, Inferred 1.2021 

Severity, Endangered 7.0272 a 

T-Value 

T-Value 

Alpha Levels 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 

E-2
Table E-3. Chi-squared tables for sex differences between NIS-3 and NIS-4 incidence 

rates for harm standard maltreatment. 

All Maltreatment 

NIS-3 

NIS-4 

Male 

21.7176 

16.0327 

Female 

24.5058 

17.5222 

Chi-Square 

RS3 

Value 

0.115 

Probability 

0.734 

All Abuse 

Male Female 

NIS-3 9.5062 12.6419 

NIS-4 6.4617 8.4542 

Chi-Square 

RS3 

Value 

0.015 

Probability 

0.902 

Physical Abuse 

Male Female 

NIS-3 5.7962 5.5581 

NIS-4 4.5525 4.1342 

Chi-Square 

RS3 

Value 

0.123 

Probability 

0.726 

Sexual Abuse 

Male Female 

NIS-3 1.6198 4.9401 

NIS-4 0.647 3.0426 

Chi-Square 

RS3 

Value 

1.48 

Probability 

0.224 

E-3
Table E-3. (Continued) 

Emotional Abuse 

Male Female 

NIS-3 2.9343 3.0984 

NIS-4 1.8546 2.105 

Chi-Square 

RS3 

Value 

0.135 

Probability 

0.714 

All Neglect 

Male Female 

NIS-3 13.2562 12.8569 

NIS-4 10.4114 10.0786 

Chi-Square 

RS3 

Value 

0 

Probability 

0.987 

Physical Neglect 

Male Female 

NIS-3 5.4767 4.5338 

NIS-4 3.7038 4.059 

Chi-Square 

RS3 

Value 

2.869 

Probability 

0.09 

Educational Neglect 

Male Female 

NIS-3 5.4524 6.4074 

NIS-4 4.9948 4.6924 

Chi-Square 

RS3 

Value 

0.771 

Probability 

0.38 

E-4
Table E-3. (Continued) 

Emotional Neglect 

Male Female 

NIS-3 3.5152 2.8068 

NIS-4 2.7033 2.4381 

Chi-Square 

RS3 

Value 

0.417 

Probability 

0.518 

Severity, Fatal 

Male Female 

NIS-3 0.0355 0.0093 

NIS-4 0.0341 0.018 

Chi-Square 

RS3 

Value 

0.696 

Probability 

0.404 

Severity, Serious 

Male Female 

NIS-3 9.2999 7.4566 

NIS-4 6.2656 6.6188 

Chi-Square 

RS3 

Value 

4.488 

Probability 

0.034 

Severity, Moderate 

Male Female 

NIS-3 11.2593 13.2685 

NIS-4 9.172 9.524 

Chi-Square 

RS3 

Value 

0.758 

Probability 

0.384 

E-5
Table E-3. (Continued) 

Severity, Inferred 

Male Female 

NIS-3 1.123 3.7714 

NIS-4 0.5609 1.3614 

Chi-Square 

RS3 

Value 

1.451 

Probability
 

0.228
 

Table E-4. Chi-squared tables for age differences between NIS-3 and NIS-4 incidence 

rates for harm standard maltreatment. 

All Maltreatment 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 10.0235 17.7842 33.0889 25.9334 29.5605 22.3213 

NIS-4 8.5098 12.1195 17.5597 19.5014 21.2665 18.4845 

Chi-Square 

RS3 

Value 

6.489 

Probability 

0.196 

All Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 4.3702 11.3934 13.77160 12.6607 13.7491 10.4114 

NIS-4 3.6913 6.0802 8.7452 7.7084 9.1064 7.4706 

Chi-Square 

RS3 

Value 

3.664 

Probability 

0.456 

Physical Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 3.2186 5.1694 8.0224 5.1463 7.3762 5.4834 

NIS-4 2.4943 3.6383 5.4633 4.644 5.0063 4.3053 

Chi-Square 

RS3 

Value 

1.482 

Probability 

0.799 

E-6
Table E-4. (Continued) 

Sexual Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 0.7479 5.41 3.4906 4.1638 2.6423 2.6866 

NIS-4 0.9965 1.7551 1.5756 1.4165 2.4026 1.5666 

Chi-Square 

RS3 

Value 

9.235 

Probability 

0.047 

Emotional Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 0.4118 1.5573 4.492 4.1618 4.3614 3.335 

NIS-4 0.3047 0.9799 2.6498 2.676 2.6869 2.3887 

Chi-Square 

RS3 

Value 

0.816 

Probability 

0.929 

All Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 6.2175 6.7214 20.0468 14.9256 16.9314 13.7344 

NIS-4 5.1244 6.4329 9.9239 12.6529 13.6708 12.2548 

Chi-Square 

RS3 

Value 

5.153 

Probability 

0.267 

Physical Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 5.8495 4.9524 7.334 2.8378 5.0278 4.026 

NIS-4 4.701 3.0429 4.0138 3.9574 3.9769 3.1776 

Chi-Square 

RS3 

Value 

2.752 

Probability 

0.519 

E-7
Table E-4. (Continued) 

Educational Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 0.0129 1.5818 10.3524 7.5058 9.5703 7.0824 

NIS-4 0.0902 2.3082 4.8888 7.5185 7.3143 6.3989 

Chi-Square 

RS3 

Value 

4.827 

Probability 

0.249 

Emotional Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 0.5308 0.3423 3.0406 5.0594 4.8918 4.9671 

NIS-4 0.6203 1.2759 2.1405 2.9614 3.6899 4.083 

Chi-Square 

RS3 

Value 

8.47 

Probability 

0.078 

Severity, Fatal 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 0.0998 0.0182 0.0010 0.0010 0.0040 0.0033 

NIS-4 0.0996 0.007 0.003 0.0003 0.0085 0.0369 

Chi-Square 

RS3 

Value 

2.662 

Probability 

0.346 

Severity, Serious 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 5.5981 5.5898 10.6477 8.8509 11.0197 8.5103 

NIS-4 5.8716 4.2093 5.5639 6.7353 7.0619 7.6485 

Chi-Square 

RS3 

Value 

5.086 

Probability 

0.232 

E-8
Table E-4. (Continued) 

Severity, Moderate 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 3.0857 8.4486 20.2872 14.3890 16.2521 11.8417 

NIS-4 1.8301 6.9845 11.4764 12.2422 12.5569 9.8314 

Chi-Square 

RS3 

Value 

3.902 

Probability 

0.397 

Severity, Inferred 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 1.2398 3.7277 2.153 2.6926 2.2847 1.966 

NIS-4 0.7085 0.9187 0.5163 0.5235 1.6393 0.9677 

Chi-Square 

RS3 

Value 

7.062 

Probability
 

0.076
 

Table E-5. Chi-squared tables for racial/ethnic differences between NIS-3 and NIS-4 

incidence rates for harm standard maltreatment. 

All Maltreatment 

White Black Hispanic 

NIS-3 20.3861 31.6142 22.7932 

NIS-4 12.5972 23.9673 14.1615 

Chi-Square 

RS3 

Value 

3.215 

Probability 

0.155 

All Abuse 

White Black Hispanic 

NIS-3 10.4829 12.5115 9.2021 

NIS-4 5.9931 10.408 6.7126 

Chi-Square 

RS3 

Value 

8.313 

Probability 

0.013 

E-9
Table E-5. (Continued) 

Physical Abuse 

White Black Hispanic 

NIS-3 5.1921 7.7663 4.7727 

NIS-4 3.2415 6.626 4.4112 

Chi-Square 

RS3 

Value 

11.295 

Probability 

0.003 

Sexual Abuse 

White Black Hispanic 

NIS-3 3.1695 3.4404 2.7423 

NIS-4 1.357 2.6064 1.8195 

Chi-Square 

RS3 

Value 

3.386 

Probability 

0.11 

Emotional Abuse 

White Black Hispanic 

NIS-3 3.0528 2.1558 2.4021 

NIS-4 1.9513 2.2347 1.3213 

Chi-Square 

RS3 

Value 

1.652 

Probability 

0.415 

All Neglect 

White Black Hispanic 

NIS-3 10.91 19.6157 14.4904 

NIS-4 7.4509 14.6542 8.2549 

Chi-Square 

RS3 

Value 

0.856 

Probability 

0.586 

E-10
Table E-5. (Continued) 

Physical Neglect 

White Black Hispanic 

NIS-3 4.2788 7.5527 5.5276 

NIS-4 2.7793 4.8304 2.7142 

Chi-Square 

RS3 

Value 

0.298 

Probability 

0.795 

Educational Neglect 

White Black Hispanic 

NIS-3 4.3713 10.5269 8.236 

NIS-4 3.2644 7.4232 4.0012 

Chi-Square 

RS3 

Value 

0.055 

Probability 

0.968 

Emotional Neglect 

White Black Hispanic 

NIS-3 3.2655 2.9056 1.633 

NIS-4 2.1975 3.7699 2.144 

Chi-Square 

RS3 

Value 

9.913 

Probability 

0.014 

Severity, Fatal 

White Black Hispanic 

NIS-3 0.0085 0.0439 0.0668 

NIS-4 0.0188 0.0212 0.0504 

Chi-Square 

RS3 

Value 

0.454 

Probability 

0.635 

E-11
Table E-5. (Continued) 

Severity, Serious 

White Black Hispanic 

NIS-3 8.0818 8.1558 7.5595 

NIS-4 4.6388 8.7823 5.2474 

Chi-Square 

RS3 

Value 

8.353 

Probability 

0.012 

Severity, Moderate 

White Black Hispanic 

NIS-3 10.4633 18.5127 13.043 

NIS-4 7.2193 13.6953 8.082 

Chi-Square 

RS3 

Value 

1.524 

Probability 

0.423 

Severity, Inferred 

White Black Hispanic 

NIS-3 1.8325 4.9017 2.1239 

NIS-4 0.7203 1.4685 0.7817 

Chi-Square 

RS3 

Value 

0.842 

Probability
 

0.48
 

E-12
Table E-6. Chi-squared tables for parent structure differences between NIS-3 and NIS-4 

incidence rates for harm standard maltreatment. 

All Maltreatment 

One parent Two parents 

NIS-3 27.3301 15.5246 

NIS-4 35.6348 9.5151 

Chi-Square 

RS3 

Value 

23.7940 

Probability

< .001 

All Abuse 

One parent Two parents 

NIS-3 11.3553 8.3999 

NIS-4 13.8017 4.8413 

Chi-Square 

RS3 

Value 

16.732 

Probability 

< .001 

Physical Abuse 

One parent Two parents 

NIS-3 6.8624 3.9473 

NIS-4 7.8306 3.0067 

Chi-Square 

RS3 

Value 

3.159 

Probability
 

0.076
 

E-13
Table E-6. (Continued) 

Sexual Abuse 

One parent Two parents 

NIS-3 

NIS-4 

2.52 

3.7505 

2.585 

0.9779 

Chi-Square 

RS3 

Value 

18.246 

Probability 

< .001 

Emotional Abuse 

One parent Two parents 

NIS-3 

NIS-4 

2.5395 

3.6365 

2.567 

1.3296 

Chi-Square 

RS3 

Value 

9.1390 

Probability 

0.003 

All Neglect 

One parent Two parents 

NIS-3 

NIS-4 

17.3072 

23.4583 

7.8943 

5.2713 

Chi-Square 

RS3 

Value 

10.882 

Probability 

0.001 

Physical Neglect 

One parent Two parents 

NIS-3 

NIS-4 

5.8024 

8.257 

3.0628 

2.2191 

Chi-Square 

RS3 

Value 

3.6100 

Probability 

0.057 

E-14
Table E-6. (Continued) 

Educational Neglect 

One parent Two parents 

NIS-3 

NIS-4 

9.6182 

11.5759 

2.9744 

2.2869 

Chi-Square 

RS3 

Value 

1.9940 

Probability 

0.158 

Emotional Neglect 

One parent Two parents 

NIS-3 

NIS-4 

4.047 

5.981 

2.3108 

1.301 

Chi-Square 

RS3 

Value 

15.3250 

Probability 

< .001 

Severity, Fatal 

One parent Two parents 

NIS-3 

NIS-4 

0.0153 

0.0348 

0.0188 

0.033 

Chi-Square 

RS3 

Value 

0.035 

Probability 

0.852 

Severity, Serious 

One parent Two parents 

NIS-3 

NIS-4 

10.4938 

14.0576 

5.8375 

3.6781 

Chi-Square 

RS3 

Value 

21.334 

Probability 

< .001 

E-15
Table E-6. (Continued) 

Severity, Moderate 

One parent Two parents 

NIS-3 

NIS-4 

15.4035 

19.2029 

8.0941 

5.438 

Chi-Square 

RS3 

Value 

7.118 

Probability 

0.008 

Severity, Inferred 

One parent Two parents 

NIS-3 

NIS-4 

1.4174 

2.3395 

1.5742 

0.366 

Chi-Square 

RS3 

Value 

35.627 

Probability
 

< .001
 

E-16
Table E-7. Chi-squared tables for family size differences between NIS-3 and NIS-4 

incidence rates for harm standard maltreatment. 

All Maltreatment 

1 child 2-3 children 

4+ 

children 

NIS-3 22.0419 17.7212 34.493 

NIS-4 17.8936 13.3373 21.1682 

Chi-Square 

RS3 

Value 

2.667 

Probability 

0.175 

All Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 10.5256 9.8783 13.9459 

NIS-4 7.5602 6.7838 8.5067 

Chi-Square 

RS3 

Value 

0.705 

Probability 

0.597 

Physical Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 5.0749 5.2443 6.3956 

NIS-4 4.8693 3.6604 4.9694 

Chi-Square 

RS3 

Value 

3.078 

Probability 

0.182 

Sexual Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 3.2461 2.5075 5.8092 

NIS-4 1.8135 1.8150 1.7658 

Chi-Square 

RS3 

Value 

3.974 

Probability 

0.113 

E-17
Table E-7. (Continued) 

Emotional Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 3.2142 2.8111 3.4289 

NIS-4 1.5188 1.9931 2.5326 

Chi-Square 

RS3 

Value 

1.535 

Probability 

0.463 

All Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 12.5914 8.7718 21.5337 

NIS-4 11.1338 7.4535 13.8355 

Chi-Square 

RS3 

Value 

2.496 

Probability 

0.23 

Physical Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 4.4009 3.7806 9.0807 

NIS-4 4.1646 2.8044 5.9267 

Chi-Square 

RS3 

Value 

1.249 

Probability 

0.472 

Educational Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 5.9956 3.2463 9.2453 

NIS-4 5.0851 3.2799 6.0409 

Chi-Square 

RS3 

Value 

2.044 

Probability 

0.32 

E-18
Table E-7. (Continued) 

Emotional Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 3.8984 2.4466 3.7148 

NIS-4 3.2401 2.2149 3.021 

Chi-Square 

RS3 

Value 

0.097 

Probability 

0.941 

Severity, Fatal 

1 child 2-3 children 

4+ 

children 

NIS-3 0.0193 0.024 0.0178 

NIS-4 0.0271 0.0328 0.0282 

Chi-Square 

RS3 

Value 

0.009 

Probability 

0.989 

Severity, Serious 

1 child 2-3 children 

4+ 

children 

NIS-3 8.1267 7.3463 9.8087 

NIS-4 7.3789 5.2432 8.3618 

Chi-Square 

RS3 

Value 

1.379 

Probability 

0.477 

Severity, Moderate 

1 child 2-3 children 

4+ 

children 

NIS-3 11.3981 8.8853 18.6431 

NIS-4 9.3837 7.2382 11.7024 

Chi-Square 

RS3 

Value 

1.709 

Probability 

0.295 

E-19
Table E-7. (Continued) 

Severity, Inferred 

1 child 2-3 children 

4+ 

children 

NIS-3 2.4978 1.4657 6.0234 

NIS-4 1.1039 0.8232 1.0758 

Chi-Square 

RS3 

Value 

7.201 

Probability
 

0.019
 

Table E-8. Chi-squared tables for metrostatus differences between NIS-3 and NIS-4 

incidence rates for harm standard maltreatment. 

All Maltreatment 

Large Urban Urban Rural 

NIS-3 14.0347 29.4356 28.2251 

NIS-4 13.4005 15.1133 27.7245 

Chi-Square 

RS3 

Value 

1.582 

Probability 

0.399 

All Abuse 

Large Urban Urban Rural 

NIS-3 6.5753 14.55 12.9158 

NIS-4 6.6216 7.0261 10.1343 

Chi-Square 

RS3 

Value 

2.131 

Probability 

0.318 

Physical Abuse 

Large Urban Urban Rural 

NIS-3 3.6356 7.2198 6.6172 

NIS-4 4.1953 4.1332 5.2523 

Chi-Square 

RS3 

Value 

2.034 

Probability 

0.332 

E-20
Table E-8. (Continued) 

Sexual Abuse 

Large Urban Urban Rural 

NIS-3 

NIS-4 

1.5309 

1.7544 

4.4108 

1.6036 

4.2202 

2.4679 

Chi-Square 

RS3 

Value 

3.328 

Probability 

0.169 

Emotional Abuse 

Large Urban Urban Rural 

NIS-3 

NIS-4 

1.8654 

1.2627 

4.2894 

1.9563 

2.9466 

3.5128 

Chi-Square 

RS3 

Value 

1.95 

Probability 

0.305 

All Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

8.1522 

7.332 

16.0605 

8.9914 

16.6359 

19.2572 

Chi-Square 

RS3 

Value 

1.131 

Probability 

0.492 

Physical Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

3.2329 

3.6444 

5.3045 

2.976 

7.824 

6.7857 

Chi-Square 

RS3 

Value 

0.613 

Probability 

0.68 

E-21
Table E-8. (Continued) 

Educational Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

3.5911 

2.516 

8.1334 

4.5592 

6.1405 

9.9216 

Chi-Square 

RS3 

Value 

2.099 

Probability 

0.278 

Emotional Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

2.2082 

1.7101 

3.7338 

2.2804 

3.8856 

5.0063 

Chi-Square 

RS3 

Value 

1.065 

Probability 

0.497 

Severity, Fatal 

Large Urban Urban Rural 

NIS-3 

NIS-4 

0.0414 

0.0321 

0.0168 

0.0469 

. 

0.0045 

Chi-Square 

RS3 

Value 

---

Probability 

---

Severity, Serious 

Large Urban Urban Rural 

NIS-3 

NIS-4 

5.2336 

5.58 

9.7257 

5.489 

11.7588 

10.8509 

Chi-Square 

RS3 

Value 

0.858 

Probability 

0.598 

E-22
Table E-8. (Continued) 

Severity, Moderate 

Large Urban Urban Rural 

NIS-3 

NIS-4 

7.062 

6.8467 

16.473 

8.6739 

13.984 

15.7065 

Chi-Square 

RS3 

Value 

1.854 

Probability 

0.343 

Severity, Inferred 

Large Urban Urban Rural 

NIS-3 

NIS-4 

1.6978 

0.9417 

3.2201 

0.9035 

2.4823 

1.1626 

Chi-Square 

RS3 

Value 

1.509 

Probability

0.45 

E-23
Table E-9. Chi-squared tables for sex differences between NIS-3 and NIS-4 

incidence rates for endangerment standard maltreatment. 

All Maltreatment 

Male Female 

NIS-3 40.0371 42.2621 

NIS-4 36.6063 37.946 

Chi-Square 

RS3 

Value 

0.097 

Probability 

0.756 

All Abuse 

Male Female 

NIS-3 16.131 20.2475 

NIS-4 9.9654 12.0063 

Chi-Square 

RS3 

Value 

0.148 

Probability 

0.7 

Physcial Abuse 

Male Female 

NIS-3 9.2707 8.9806 

NIS-4 6.6566 5.9264 

Chi-Square 

RS3 

Value 

0.459 

Probability 

0.498 

Sexual Abuse 

Male Female 

NIS-3 2.278 6.7707 

NIS-4 1.0483 3.844 

Chi-Square 

RS3 

Value 

0.552 

Probability 

0.458 

E-24
Table E-9. (Continued) 

Emotional Abuse 

Male Female 

NIS-3 8.0392 7.6937 

NIS-4 3.8567 3.9778 

Chi-Square 

RS3 

Value 

0.208 

Probability 

0.649 

All Neglect 

Male Female 

NIS-3 29.239 27.6269 

NIS-4 29.0468 28.6172 

Chi-Square 

RS3 

Value 

0.4250 

Probability 

0.5150 

Physical Neglect 

Male Female 

NIS-3 19.7314 18.5904 

NIS-4 15.1481 15.1902 

Chi-Square 

RS3 

Value 

0.466 

Probability 

0.495 

Educational Neglect 

Male Female 

NIS-3 5.4524 6.4074 

NIS-4 4.9948 4.6924 

Chi-Square 

RS3 

Value 

0.771 

Probability 

0.38 

E-25
Table E-9. (Continued) 

Emotional Neglect 

Male Female 

NIS-3 9.1616 7.79950 

NIS-4 15.0183 14.6864 

Chi-Square 

RS3 

Value 

3.012 

Probability 

0.083 

Severity, Fatal 

Male Female 

NIS-3 0.0372 0.0093 

NIS-4 0.0344 0.0184 

Chi-Square 

RS3 

Value 

0.884 

Probability 

0.3470 

Severity, Serious 

Male Female 

NIS-3 9.3529 7.5524 

NIS-4 6.5425 6.8921 

Chi-Square 

RS3 

Value 

4.398 

Probability 

0.0360 

Severity, Moderate 

Male Female 

NIS-3 14.0803 15.2583 

NIS-4 13.825 13.6431 

Chi-Square 

RS3 

Value 

0.511 

Probability 

0.475 

E-26
Table E.9. (Continued) 

Severity, Inferred 

Male Female 

NIS-3 2.0738 4.6244 

NIS-4 2.4649 3.4418 

Chi-Square 

RS3 

Value 

7.979 

Probability 

0.005 

Severity, Endangered 

Male Female 

NIS-3 14.4928 14.8177 

NIS-4 13.7395 13.9507 

Chi-Square 

RS3 

Value 

0.002 

Probability 

0.969 

E-27
Table E-10. Chi-squared tables for age differences between NIS-3 and NIS-4 

incidence rates for endangerment standard maltreatment. 

All Maltreatment 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 26.0362 38.5549 60.1692 46.3972 44.4148 29.6148 

NIS-4 33.3998 34.9032 42.3939 38.3065 37.5518 28.9514 

Chi-Square 

RS3 

Value 

9.937 

Probability 

0.048 

All Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 7.3953 17.2862 24.6613 21.2892 22.5870 15.7361 

NIS-4 6.0665 9.9188 13.1373 10.92 12.5598 10.0249 

Chi-Square 

RS3 

Value 

3.46 

Probability 

0.38 

Physical Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 4.8351 7.1311 12.2535 9.4588 12.7901 8.6885 

NIS-4 3.7016 5.8457 7.7157 6.1881 7.0735 5.876 

Chi-Square 

RS3 

Value 

1.655 

Probability 

0.721 

Sexual Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 1.1053 6.6294 5.16070 5.2358 4.7267 3.7667 

NIS-4 1.2784 2.483 2.3835 1.9493 2.9742 1.8789 

Chi-Square 

RS3 

Value 

6.907 

Probability 

0.141 

E-28
Table E-10. (Continued) 

Emotional Abuse 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 1.9763 5.28830 12.9455 10.5514 9.5619 6.9785 

NIS-4 1.5885 2.9542 5.1623 4.4954 4.7134 4.1017 

Chi-Square 

RS3 

Value 

3.799 

Probability 

0.38 

All Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 21.7954 25.5535 44.1821 32.27690 26.6055 18.8495 

NIS-4 27.2385 26.8042 33.1135 30.3687 28.6471 21.5627 

Chi-Square 

RS3 

Value 

8.57 

Probability 

0.078 

Physical Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 19.3063 21.1116 29.2255 19.2955 15.4805 8.5276 

NIS-4 17.5375 15.3445 18.9427 15.7395 13.0198 8.7185 

Chi-Square 

RS3 

Value 

4.309 

Probability 

0.325 

Educational Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 0.0129 1.5818 10.3524 7.5058 9.5703 7.0824 

NIS-4 0.0902 2.3082 4.8888 7.5185 7.3143 6.3989 

Chi-Square 

RS3 

Value 

4.827 

Probability 

0.249 

E-29
Table E-10. (Continued) 

Emotional Neglect 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 3.6608 4.2788 15.4484 12.0946 8.1537 7.9967 

NIS-4 13.1585 13.4301 16.998 15.2092 15.0853 11.3908 

Chi-Square 

RS3 

Value 

25.071 

Probability 

< .001 

Severity, Fatal 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 0.0998 0.0182 0.0010 0.0063 0.0040 0.0033 

NIS-4 0.1017 0.007 0.003 0.0003 0.0085 0.0369 

Chi-Square 

RS3 

Value 

3.205 

Probability 

0.365 

Severity, Serious 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 5.6988 5.7360 10.7391 8.8906 11.0654 8.5203 

NIS-4 6.1834 4.3458 5.9192 7.0847 7.369 7.8405 

Chi-Square 

RS3 

Value 

5.043 

Probability 

0.237 

Severity, Moderate 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 4.9627 10.4977 24.78980 18.269 17.4111 12.6101 

NIS-4 4.4774 11.2208 19.3279 16.703 16.8301 12.5287 

Chi-Square 

RS3 

Value 

2.438 

Probability 

0.634 

E-30
Table E-10. (Continued) 

Severity, Inferred 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 1.4788 4.9839 3.8536 3.4791 3.559 2.1512 

NIS-4 2.007 3.3423 3.4363 2.5303 3.1333 2.3359 

Chi-Square 

RS3 

Value 

2.0800 

Probability 

0.491 

Severity, Endangered 

0-2 3-5 6-8 9-11 12-14 15-17 

NIS-3 13.796 17.3192 20.7857 15.7523 12.3753 6.3299 

NIS-4 20.6304 15.9873 13.7075 11.9881 10.2108 6.2095 

Chi-Square 

RS3 

Value 

13.939 

Probability 

0.004 

E-31
Table E-11. Chi-squared tables for racial/ethnic differences between NIS-3 and NIS-4 

incidence rates for endangerment standard maltreatment. 

All Maltreatment 

White Black Hispanic 

NIS-3 36.494 54.957 41.963 

NIS-4 28.582 49.553 30.245 

Chi-Square 

RS3 

Value 

2.676 

Probability 

0.202 

All Abuse 

White Black Hispanic 

NIS-3 17.3227 19.052 17.784 

NIS-4 8.7297 14.9054 9.3803 

Chi-Square 

RS3 

Value 

6.353 

Probability 

0.031 

Physical Abuse 

White Black Hispanic 

NIS-3 8.5998 11.3414 7.7649 

NIS-4 4.6315 9.6636 5.8518 

Chi-Square 

RS3 

Value 

11.006 

Probability 

0.003 

Sexual Abuse 

White Black Hispanic 

NIS-3 4.3604 4.1476 4.0789 

NIS-4 1.8591 3.1251 2.4876 

Chi-Square 

RS3 

Value 

4.8 

Probability 

0.062 

E-32
Table E-11. (Continued) 

Emotional Abuse 

White Black Hispanic 

NIS-3 7.7483 6.6375 8.3472 

NIS-4 3.5097 4.4899 2.4185 

Chi-Square 

RS3 

Value 

1.507 

Probability 

0.373 

All Neglect 

White Black Hispanic 

NIS-3 24.4481 41.0933 29.6244 

NIS-4 22.4178 36.8285 22.9717 

Chi-Square 

RS3 

Value 

1.339 

Probability 

0.433 

Physical Neglect 

White Black Hispanic 

NIS-3 16.6221 27.5806 20.1133 

NIS-4 12.2024 17.8671 9.9383 

Chi-Square 

RS3 

Value 

0.207 

Probability 

0.866 

Educational Neglect 

White Black Hispanic 

NIS-3 4.3713 10.5269 8.236 

NIS-4 3.2644 7.4232 4.0012 

Chi-Square 

RS3 

Value 

0.055 

Probability 

0.968 

E-33
Table E.11. (Continued) 

Emotional Neglect 

White Black Hispanic 

NIS-3 8.6398 9.0982 6.1048 

NIS-4 12.1344 18.1613 13.2456 

Chi-Square 

RS3 

Value 

9.55 

Probability 

0.006 

Severity, Fatal 

White Black Hispanic 

NIS-3 0.0085 0.0439 0.0735 

NIS-4 0.0188 0.0227 0.051 

Chi-Square 

RS3 

Value 

0.492 

Probability 

0.635 

Severity, Serious 

White Black Hispanic 

NIS-3 8.1715 8.2336 7.5747 

NIS-4 4.8371 9.1017 5.6647 

Chi-Square 

RS3 

Value 

8.811 

Probability 

0.009 

Severity, Moderate 

White Black Hispanic 

NIS-3 12.4954 22.1442 16.1276 

NIS-4 10.9699 18.6482 11.1968 

Chi-Square 

RS3 

Value 

0.732 

Probability 

0.636 

E-34
Table E-11. (Continued) 

Severity, Inferred 

White Black Hispanic 

NIS-3 2.7223 6.2125 2.6685 

NIS-4 2.5693 3.7267 2.1233 

Chi-Square 

RS3 

Value 

1.037 

Probability
 

0.414
 

Severity, Endangered 

White Black Hispanic 

NIS-3 13.096 18.3228 15.5189 

NIS-4 10.1872 18.054 11.2093 

Chi-Square 

RS3 

Value 

3.575 

Probability
 

0.138
 

E-35
Table E-12. Chi-squared tables for parent structure differences between NIS-3 and NIS-4 

incidence rates for endangerment standard maltreatment. 

All Maltreatment 

Two 

One parent parents 

NIS-3 51.988 26.8531 

NIS-4 81.1572 22.9408 

Chi-Square 

RS3 

Value 

23.135 

Probability 

< .001 

All Abuse 

Two 

One parent parents 

NIS-3 19.6302 13.4842 

NIS-4 20.8655 7.3091 

Chi-Square 

RS3 

Value 

16.083 

Probability 

< .001 

Physical Abuse 

Two 

One parent parents 

NIS-3 10.6089 6.5442 

NIS-4 11.764 4.3352 

Chi-Square 

RS3 

Value 

7.011 

Probability 

0.0080 

Sexual Abuse 

Two 

One parent parents 

NIS-3 4.1856 3.243 

NIS-4 5.0777 1.3108 

Chi-Square 

RS3 

Value 

16.5070 

Probability 

< .001 

E-36
Table E-12. (Continued) 

Emotional Abuse 

Two 

One parent parents 

NIS-3 8.5791 6.1643 

NIS-4 7.1412 2.802 

Chi-Square 

RS3 

Value 

4.674 

Probability 

0.031 

All Neglect 

Two 

One parent parents 

NIS-3 38.8901 17.5972 

NIS-4 62.6644 17.9623 

Chi-Square 

RS3 

Value 

8.147 

Probability 

0.004 

Physical Neglect 

Two 

One parent parents 

NIS-3 28.5896 10.8231 

NIS-4 34.5555 8.855 

Chi-Square 

RS3 

Value 

3.888 

Probability 

0.049 

Educational Neglect 

Two 

One parent parents 

NIS-3 9.6182 2.9744 

NIS-4 11.5759 2.2869 

Chi-Square 

RS3 

Value 

1.994 

Probability 

0.158 

E-37
Table E-12. (Continued) 

Emotional Neglect 

Two 

One parent parents 

NIS-3 10.4782 6.3663 

NIS-4 31.4459 10.0713 

Chi-Square 

RS3 

Value 

12.626 

Probability 

< .001 

Severity, Fatal 

Two 

One parent parents 

NIS-3 0.0153 0.0201 

NIS-4 0.0356 0.0331 

Chi-Square 

RS3 

Value 

0.079 

Probability 

0.779 

Severity, Serious 

Two 

One parent parents 

NIS-3 10.5211 5.9099 

NIS-4 14.7002 3.8371 

Chi-Square 

RS3 

Value 

22.207 

Probability 

< .001 

Severity, Moderate 

Two 

One parent parents 

NIS-3 18.536 9.5939 

NIS-4 28.2973 7.7855 

Chi-Square 

RS3 

Value 

8.191 

Probability 

0.004 

E-38
Table E-12. (Continued) 

Severity, Inferred 

Two 

One parent parents 

NIS-3 2.4542 2.0584 

NIS-4 6.692 1.6545 

Chi-Square 

RS3 

Value 

16.7510 

Probability 

< .001 

Severity, Endangered 

Two 

One parent parents 

NIS-3 20.4615 9.2709 

NIS-4 31.4321 9.6306 

Chi-Square 

RS3 

Value 

4.938 

Probability
 

0.026
 

E-39
Table E-13. Chi-squared tables for family size differences between NIS-3 and NIS-4 

incidence rates for endangerment standard maltreatment. 

All Maltreatment 

1 child 2-3 children 

4+ 

children 

NIS-3 34.215 34.0907 68.0864 

NIS-4 36.6345 31.2976 62.9037 

Chi-Square 

RS3 

Value 

1.581 

Probability 

0.389 

All Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 16.9145 16.2631 23.5473 

NIS-4 10.5983 10.4141 13.8616 

Chi-Square 

RS3 

Value 

0.401 

Probability 

0.7720 

Physical Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 8.5787 8.3794 10.6274 

NIS-4 6.594 5.6467 7.8134 

Chi-Square 

RS3 

Value 

0.828 

Probability 

0.534 

Sexual Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 4.7383 3.556 7.0115 

NIS-4 2.4742 2.3501 2.5024 

Chi-Square 

RS3 

Value 

3.188 

Probability 

0.179 

E-40
Table E-13. (Continued) 

Emotional Abuse 

1 child 2-3 children 

4+ 

children 

NIS-3 

NIS-4 

6.3825 

2.7972 

7.4783 

4.0663 

10.55690 

5.7631 

Chi-Square 

RS3 

Value 

0.377 

Probability 

0.805 

All Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 22.2967 22.6978 52.1824 

NIS-4 27.3406 23.5484 52.1806 

Chi-Square 

RS3 

Value 

1.683 

Probability 

0.418 

Physical Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 13.2343 16.12970 38.9146 

NIS-4 13.2796 11.959 31.1273 

Chi-Square 

RS3 

Value 

2.165 

Probability 

0.318 

Educational Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 5.9956 3.2463 9.2453 

NIS-4 5.0851 3.2799 6.0409 

Chi-Square 

RS3 

Value 

2.044 

Probability 

0.32 

E-41
Table E-13. (Continued) 

Emotional Neglect 

1 child 2-3 children 

4+ 

children 

NIS-3 

NIS-4 

7.526 

13.9023 

7.5412 

13.4209 

12.60530 

27.442 

Chi-Square 

RS3 

Value 

0.553 

Probability 

0.672 

Severity, Fatal 

1 child 2-3 children 

4+ 

children 

NIS-3 0.0234 0.024 0.01780 

NIS-4 0.0273 0.0333 0.0282 

Chi-Square 

RS3 

Value 

0.021 

Probability 

0.977 

Severity, Serious 

1 child 2-3 children 

4+ 

children 

NIS-3 8.2392 7.4208 9.8212 

NIS-4 7.6124 5.4686 8.7987 

Chi-Square 

RS3 

Value 

1.397 

Probability 

0.474 

Severity, Moderate 

1 child 2-3 children 

4+ 

children 

NIS-3 12.52180 11.377 22.0739 

NIS-4 13.7818 10.7437 17.8944 

Chi-Square 

RS3 

Value 

2.129 

Probability 

0.237 

E-42
Table E-13. (Continued) 

Severity, Inferred 

1 child 2-3 children 

4+ 

children 

NIS-3 3.557 2.1343 7.5814 

NIS-4 3.2527 2.4364 4.6595 

Chi-Square 

RS3 

Value 

2.798 

Probability 

0.221 

Severity, Endangered 

1 child 2-3 children 

4+ 

children 

NIS-3 9.8737 13.1346 28.5921 

NIS-4 11.9602 12.6157 31.523 

Chi-Square 

RS3 

Value 

1.249 

Probability 

0.505 

E-43
Table E-14. Chi-squared tables for metrostatus differences between NIS-3 and NIS-4 

incidence rates for endangerment standard maltreatment. 

All Maltreatment 

Large Urban Urban Rural 

NIS-3 25.5377 54.9054 48.1884 

NIS-4 31.8563 34.9157 62.6003 

Chi-Square 

RS3 

Value 

2.621 

Probability 

0.263 

All Abuse 

Large Urban Urban Rural 

NIS-3 11.2526 24.3234 19.7261 

NIS-4 9.774 10.6948 15.5101 

Chi-Square 

RS3 

Value 

1.953 

Probability 

0.35 

Physical Abuse 

Large Urban Urban Rural 

NIS-3 6.0788 11.4414 10.5492 

NIS-4 5.8444 6.1961 8.1803 

Chi-Square 

RS3 

Value 

1.172 

Probability 

0.529 

Sexual Abuse 

Large Urban Urban Rural 

NIS-3 2.4317 6.0238 5.3561 

NIS-4 2.3139 2.3027 3.0078 

Chi-Square 

RS3 

Value 

2.826 

Probability 

0.227 

E-44
Table E-14. (Continued) 

Emotional Abuse 

Large Urban Urban Rural 

NIS-3 

NIS-4 

4.58280 

2.9674 

10.9899 

3.8199 

8.46420 

6.7814 

Chi-Square 

RS3 

Value 

1.805 

Probability 

0.36 

All Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

17.7017 

23.2763 

37.4444 

26.3166 

35.1405 

52.5799 

Chi-Square 

RS3 

Value 

2.4210 

Probability 

0.278 

Physical Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

12.53130 

12.7506 

24.5484 

12.8684 

24.72740 

29.2321 

Chi-Square 

RS3 

Value 

2.852 

Probability 

0.237 

Educational Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

3.5911 

2.516 

8.1334 

4.5592 

6.1405 

9.9216 

Chi-Square 

RS3 

Value 

2.852 

Probability 

0.237 

E-45
Table E-14. (Continued) 

Emotional Neglect 

Large Urban Urban Rural 

NIS-3 

NIS-4 

4.6808 

11.8782 

11.2565 

14.2341 

11.3323 

26.8271 

Chi-Square 

RS3 

Value 

1.4490 

Probability 

0.429 

Severity, Fatal 

Large Urban Urban Rural 

NIS-3 

NIS-4 

0.0414 

0.033 

0.0191 

0.0469 

---

0.0045 

Chi-Square 

RS3 

Value 

---

Probability 

---

Severity, Serious 

Large Urban Urban Rural 

NIS-3 

NIS-4 

5.2364 

5.9153 

9.8744 

5.7253 

11.8268 

11.1685 

Chi-Square 

RS3 

Value 

0.946 

Probability 

0.565 

Severity, Moderate 

Large Urban Urban Rural 

NIS-3 

NIS-4 

8.2266 

9.8933 

19.7618 

12.1839 

17.2154 

24.5607 

Chi-Square 

RS3 

Value 

2.729 

Probability 

0.23 

E-46
Table E-14. (Continued) 

Severity, Inferred 

Large Urban Urban Rural 

NIS-3 

NIS-4 

2.5534 

1.812 

4.4314 

3.0823 

2.9247 

4.9781 

Chi-Square 

RS3 

Value 

2.153 

Probability 

0.282 

Severity, Endangered 

Large Urban Urban Rural 

NIS-3 

NIS-4 

9.47990 

13.3813 

20.8187 

14.2498 

16.2214 

22.1866 

Chi-Square 

RS3 

Value 

2.611 

Probability 

0.265 

E-47
 

 

 

 

 

 

 

 

Table E-15. T-statistics for Source of Recognition Differences Between NIS-4 and NIS-3 

for harm standard maltreatment 

Recognition Source T-value 

PROBATION/COURTS 0.3788 

POLICE/SHERIFF 1.0670 

PUBLIC HEALTH 0.6118 

INVESTIGATORY AGENCY SUBTOTAL 0.5241 

HOSPITALS 0.1747 

SCHOOLS 1.7032 c 

DAYCARE CENTERS 0.0011 

MENTAL HEALTH 0.0986 

SOCIAL SERVICES AND SHELTERS** 1.8481 c 

PUBLIC HOUSING --

OTHER SENTINEL AGENCY SUBTOTAL*** 1.5175 d 

ALL SENTINEL SOURCES TOTAL*** 1.3412 d 

DSS/WELFARE DEPT. 0.3677 

OTHER AGENCY OR PROFESSIONAL 1.2938 d 

ALL OTHER SOURCES 3.4666 a 

SUBTOTAL (CPS ONLY) 2.5512 b 

TOTAL, ALL SOURCES *** 1.5080 d 

Table E-16. T-statistics for Source of Recognition Differences Between NIS-4 and NIS-3

 for endangerment standard maltreatment 

Recognition Source T-value 

PROBATION/COURTS 

POLICE/SHERIFF 

PUBLIC HEALTH 

1.7818 c 

3.4044 a 

0.8988 

INVESTIGATORY AGENCY SUBTOTAL 3.7094 a 

HOSPITALS 0.9463 

SCHOOLS 1.6960 c 

DAYCARE CENTERS 0.3338 

MENTAL HEALTH 0.0529 

SOCIAL SERVICES AND SHELTERS** 1.7048 c 

PUBLIC HOUSING --

OTHER SENTINEL AGENCY SUBTOTAL*** 1.0768 

ALL SENTINEL SOURCES TOTAL*** 0.3878 

DSS/WELFARE DEPT. 

OTHER AGENCY OR PROFESSIONAL 

1.4133 d 

2.6385 b 

ALL OTHER SOURCES 0.5996 

SUBTOTAL (CPS ONLY) 

TOTAL, ALL SOURCES *** 

0.1556 

0.3758 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 

** For comparison across studies Social Services and Shelters are combined into one category 

*** For comparison purposes, totals exclude Public Housing which was a new category in the NIS4 

E-48
 

 

 

 

 

 

 

 

 

 

 

 

 

Table E-17. T-statistics for Source of Recognition Differences Between NIS-4 and NIS-3 in 

children who received CPS investigation for harm standard maltreatment 

Recognition Source T-value 

PROBATION/COURTS 2.8206 b 

POLICE/SHERIFF 0.7493 

PUBLIC HEALTH 2.4007 b 

INVESTIGATORY AGENCY SUBTOTAL 2.2769 c 

HOSPITALS 0.8418 

SCHOOLS 0.0246 

DAY CARE CENTERS 1.2805 

MENTAL HEALTH 0.1091 

SOCIAL SERVICES AND SHELTERS** 1.9701 c 

PUBLIC HOUSING --

OTHER SENTINEL AGENCY SUBTOTAL*** 0.2325 

ALL SENTINEL SOURCES TOTAL*** 1.1521 

TOTAL ALL SOURCES*** 0.7545 

Table E-18. T-statistics for Source of Recognition Differences Between NIS-4 and NIS-3 in 

children who received CPS investigation for endangerment standard maltreatment 

Recognition Source T-value 

PROBATION/COURTS 4.9139 a 

POLICE/SHERIFF 1.1915 

PUBLIC HEALTH 3.0906 b 

INVESTIGATORY AGENCY SUBTOTAL 2.5926 b 

HOSPITALS 1.1530 

SCHOOLS 0.9165 

DAY CARE CENTERS 2.6159 b 

MENTAL HEALTH 0.3221 

SOCIAL SERVICES AND SHELTERS** 2.1001 c 

PUBLIC HOUSING --

OTHER SENTINEL AGENCY SUBTOTAL*** 0.8362 

ALL SENTINEL SOURCES TOTAL*** 2.3797 b 

TOTAL ALL SOURCES*** 1.8536 c 

** For comparison across studies Social Services and Shelters are combined into one category 

*** For comparison purposes, totals exclude Public Housing which was a new category in the NIS4 

a: 0.001 

b: 0.010 

c: 0.050 

d: 0.100 E-49