Decision-Making 

in Unsubstantiated 

Child Protective 

Services Cases 

Synthesis of recent research 

June 2003 

U.S. Department of Health and Human Services 

Administration for Children and Families 

Administration on Children, Youth and Families 

Children’s Bureau 

Child Welfare Information Gateway 

Children’s Bureau/ACYF 

1250 Maryland Avenue, SW 

Eighth Floor 

Washington, DC 20024 

703.385.7565 or 800.394.3366 

Email: info@childwelfare.gov 

www.childwelfare.gov
This synthesis was made possible by the Children’s Bureau, Administration on Children, Youth 

and Families, Administration for Children and Families, U.S. Department of Health and Human 

Services. The conclusions discussed here are solely the responsibility of the authors. Suggested 

citation: Child Welfare Information Gateway. (2003). Decision-Making in Unsubstantiated Child 

Protective Services Cases: Synthesis of Recent Research. Washington, DC: U.S. Department of 

Health and Human Services. 
Decision-Making in Child Protective Services Cases www.childwelfare.gov

Introduction
 

In the year 2000, nearly twice as many referrals 

to child protective services (CPS) were unsubstantiated as substantiated.1

 However, many of 

the children in unsubstantiated cases become 

the subjects of subsequent CPS referrals. In a 

sample of 35,000 CPS cases in Missouri, threequarters of the children who were referred to 

CPS two or more times—including child fatalities—had cases that were initially unsubstantiated.2

 The decision to unsubstantiate a referral 

does not guarantee a child’s safety from future 

harm. To better protect children, decisionmaking and outcomes in unsubstantiated CPS 

cases warranted closer review. 

The meaning and use of the terms “substantiated” and “unsubstantiated” vary by State. 

For the purposes of this synthesis, “substantiated” means an investigation by child protective services determined there is reasonable cause to believe that the child has been 

abused or neglected. “Unsubstantiated” 

means an investigation determined no maltreatment occurred, or there was insufficient 

evidence under State law or agency policy 

to conclude that the child was maltreated. 

In deciding to substantiate a referral, some 

States require the caseworker to determine 

not only whether a specific incident of abuse 

or neglect occurred, but also whether the child 

is at risk of future maltreatment. 

To further explore this issue, the Children’s 

Bureau awarded three research grants in 

	 U.S.	Department	of	Health	and	Human	Services,	Administration	for	Children	and	Families,	Children’s	Bureau	(2002).	Child 

Maltreatment 2000.	Washington,	DC:	U.S.	Government	Printing	

Office,	p.	9.	

2	 Drake,	p.	74.

1998 on unsubstantiated CPS cases (detailed 

in Figure 1). The studies’ findings respond 

to two key questions: (1) What factors influence the decision to substantiate or unsubstantiate a CPS referral? and (2) How does 

that decision impact outcomes for children? 

In an effort to share with the field the knowledge gained from these studies, this paper 

synthesizes their findings around these two 

questions and presents some of the researchers’ suggestions for practical implications and 

future research. Readers are encouraged to 

read the full reports. A full-text version of each 

final report, containing additional findings not 

discussed here, is available by calling Child 

Welfare Information Gateway at 800.394.3366 

or emailing info@childwelfare.gov. 

Findings

The research studies are complex and touch 

on many issues. The following section summarizes some of the key findings. In some cases, 

the studies’ findings agree; occasionally they 

conflict. Taken together, these findings help 

develop a better understanding of the dynamics of unsubstantiated CPS cases. They do not, 

however, represent a national sample. Further 

exploration of these issues will be needed. 

In this section, findings regarding factors that 

influence CPS decision-making are presented 

first. Then the researchers’ findings regarding 

the impact of those decisions on outcomes for 

children are discussed, using re-referral as an 

indicator for outcomes. “Re-referral” indicates 

any situation in which a case (whether initially 

substantiated or not) returns to the system for 

a second or subsequent referral. In most cases 

in the research, re-referral has been identified 

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Figure1:ResearchStudiesonUnsubstantiatedCPSCases
 

Factors That Influence the Decision Not to Substantiate a CPS Referral. Phase I: 

Narrative and Empirical Analysis (English I); Phase II: Mail and Telephone Surveys of 

Child Protective Services Social Workers (English II); Phase III: Client Perceptions of 

Investigation (English III)
¬

Grantee: State of Washington Department of Social and Health Services
Ê

Principal Contact: Diana J. English
Ê

Other Researchers: J. Christopher Graham, Sherry C. Brummel, Laura K. Coghlan, 

Tim Clark 

Data source: Phase I—A cohort of 2,000 cases from the State of Washington 

(9/1/96 to 8/31/97)
Ê

Phase II—Telephone interviews with 223 CPS social workers; 

mail survey
Ê

Phase III—303 Telephone interviews with investigated CPS clients
Ê

The Dynamics of Unsubstantiated Reports: A Multi-State Study (Fluke) 

Grantee: The American Humane Association 

Principal Contact: John D. Fluke 

Other Researchers: Cynthia F. Parry, Patricia Shapiro, Dana Hollinshead, Vicky Bollenbacher, 

Donald Baumann, Karen Davis-Brown 

Data source: National Child Abuse and Neglect Data System (NCANDS) 1996 to 

1998, as well as more detailed case data from Connecticut, Texas, and 

Louisiana (1998 to 2000) 

Recidivism in Child Protective Services Among Substantiated and Unsubstantiated Cases 

(Drake) 

Grantee: Washington University, George Warren Brown School of Social Work
Ê

Principal Contact: Brett Drake
Ê

Other Researchers: Melissa Jonson-Reid, Ineke Way, Sulki Chung
Ê

Data source: Approximately 35,000 Missouri Department of Social Services cases 

with a first report in 1993 or 1994 

from the child’s perspective (often identified 

as “recurrence”). In some cases, re-referral has 

been identified from the perpetrator’s perspective (often identified as “recidivism”). 

FactorsThatInfluence

CPSDecision-Making

In general, the researchers agree that the 

decision-making process is complex, involving 

many layers and factors beyond the facts of 

the case itself. Factors found to influence CPS 

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decision-making can be grouped into the following four categories:3 

•Case factors are situations, events, or circumstances related to the child and family. 

• Decision-maker factors include caseworker 

characteristics such as training, experience, beliefs, their interactions with each 

other, and their perceptions about the 

organization. 

• Organizational factors are aspects of the 

CPS work environment such as the structure of the agency; its resources, tools, and 

training; workloads; and supervision. 

• External factors include State laws and 

other policies that govern the CPS system. 

Casefactors

Characteristics of the case, child, and family 

were found to have the greatest influence on 

decision-making. These include many factors 

often used by CPS caseworkers to assess 

risk to the child, such as the child’s age and 

development, the parent’s ability to care for 

the child adequately, and the severity of the 

alleged incident. 

One study examined how caseworkers’ assessments of risk impacted their decisions regarding substantiation. These caseworkers used 

a risk assessment matrix that grouped 37 

risk factors into 7 “domains.”4

 The domains 

included: 

•Child characteristics (e.g., age of child; 

physical, mental, and social development). 

	 CPS	Decision-Making	Ecology	(Baumann,	997),	cited	in	
 

Fluke,	p.	6-7.
 

4	 English	I,	p.	-4.
 

• Severity of child abuse or neglect (e.g., 

dangerousness of the act, provision of basic 

needs, adequacy of supervision). 

•Chronicity (frequency of occurrence). 

•Caretaker characteristics (e.g., substance 

abuse, history of domestic violence, recognition of the problem). 

•Caretaker/child relationship (attachment 

and bonding issues). 

• Social and economic factors (e.g., employment status, social support systems). 

• Perpetrator access to the child. 

Table 1 summarizes how particular risk factors 

were found to increase the likelihood of a 

particular finding decision. It should be noted 

that the relative importance of particular risk 

factors to the finding decision varied in some 

cases according to maltreatment type. Some 

of the more interesting findings are discussed 

in detail below. 

Multiple risk factors. When risk factors of 

significant severity were found in six to seven 

different domains, the likelihood of a substantiated finding was significantly increased. 

Unsubstantiated cases were more likely to 

have risk found in only one to five domains.5 

However, if any risk was identified using the 

risk assessment matrix, the case was significantly less likely to be unsubstantiated than if 

no risk was identified. 

	 English	I,	p.	.

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Table1:ImpactofRiskFactorsonDecision-Making

Factors associated with an 

increased likelihood of 

SUBSTANTIATION 

• Risk factors found in 6 to 7 domains. 

• Any risk indicated in the incident severity 

domain or the caretaker/child relationship 

domain 

• History of prior referrals. 

• Higher risk within the caretaker characteristics 

domain, including: 

- History of moderate or serious abuse or 

neglect of another child
Ê

- Significant physical, mental, or emotional 

impairments of caretaker 

- Caretaker incapacitated because of drugs 

or alcohol 

- Domestic violence that resulted in an injury 

- Significant caretaker history of victimization 

as a child 

- Significant gaps or gross deficits in parenting skills 

- Caretaker is withholding from or openly 

hostile to the child
Ê

- Caretaker denies problem or refuses 

responsibility
Ê

- Caretaker does not/is unable to protect the

child 

- Caretaker accepts intervention but is 

uncooperative
Ê

- Caretaker is hostile to the agency.
Ê

• Higher risk within the social and economic 

domain, including: 

- Significant or severe stress 

- Little prospect for employment 

- Sporadic or isolated 

supports
Ê

- Inability to meet basic needs. 

• Current substance 

abuse. 

• Child is afraid of the caretaker. 

• Professional referral 

source (e.g., law enforcement). 

• Child ages 0 to 2 or 13+. 

• Parental mental illness. 

Factors associated with an 

increased likelihood of a finding of 

INCONCLUSIVE 

• Low to moderate levels of risk for dangerous 

acts, physical harm, emotional maltreatment, 

and lack of supervision. 

• History of one or two prior referrals. 

• Lower risk within the caretaker characteristics 

domain, including: 

- Evidence of minor abuse by caretaker to 

another child 

- Caretaker had a minor physical/mental or 

emotional impairment that could interfere 

with capacity to parent 

- History of or reduced effectiveness associated with substance abuse 

- Sporadic incidents of domestic violence 

with minor injury 

- Minor history of victimization as a child 

- Some gaps in parenting skills 

- Parent recognizes the problem and is 

willing to take some responsibility. 

• Moderate risk is indicated for caretaker risk 

factors, but CPS worker identifies some “mitigating” or “protective” factor. 

• Within the social/economic domain, inadequate resources and stress on secondary 

caretaker (usually the male in the household). 

• Historical (past), or historical and current substance abuse. 

• Referral source is assessed as lacking 

credibility. 

Factors associated with an 

increased likelihood of 

UNSUBSTANTIATION 

• Risk factors found in 5 or fewer domains. 

• No history of prior referrals. 

• Lower risk within the caretaker characteristics 

domain, including: 

- Some, but not extensive, deficits in parenting skills or “unrealistic expectations” 

- Acknowledgement of problems 

- A degree of willingness to accept 

responsibility 

- Isolated incidents of domestic violence 

- Domestic violence that resulted in no physical harm 

- Spasmodic incidents of child abuse or 

neglect for the perpetrator as a child.
Ê

• Lower risk within the social/economic domain, 

including: 

- Mild stress 

- Underemployment but with some prospects 

- Some supports and use of community 

resources
Ê

- Ability to meet basic needs. 

• Historical substance 

abuse. 

• Child demonstrates no fear of the 

perpetrator. 

• Nonprofessional referral source (e.g., neighbor or relative). 

• Child ages 3 to 5.7 

• Child is able to protect him/herself.8 

7 8

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6	 English	I,	p.	7-9.
 

7	 English	I,	p.	2.
 

	 Defined	as	“child	is	able	(physically	and/or	mentally)	to	escape	or	hide	to	avoid	abuse,	or	the	child	may	be	able	to	resist,	but	the	child	
 

is	afraid	of	the	caregiver.”	Diana	English,	personal	email	communication,	December	0,	2002.
 

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Factors associated with an 

increased likelihood of 

SUBSTANTIATION 

Factors associated with an 

increased likelihood of a finding of 

INCONCLUSIVE 

Factors associated with an 

increased likelihood of 

UNSUBSTANTIATION 

• Parental history of assaultive behavior. 

• Unstable living situation. 

• Caretaker is arrested. 

• Child acts out sexually. 

• Child is the subject of a custody dispute. 

• Uncooperative caretaker. 

• The family cannot be located. 

• Child acts out sexually. 

• Child is the subject of a custody dispute. 

• Child demonstrates either “no risk” or “very 

high risk” for behavior problems.9 

9

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Prior referrals. A finding of unsubstantiated 

was more likely if there was no history of child 

abuse or neglect referrals. In one study, cases 

with any prior referrals were found to be 21 

percent less likely to be unsubstantiated.10 In 

a second study, when there was a history of 1 

or 2 prior referrals, the investigation was more 

likely to be found inconclusive. (In Washington State, “inconclusive” is a third option, 

in addition to substantiated or unsubstantiated, indicating there is insufficient evidence 

for the caseworker to conclude either that the 

child has or has not been maltreated.) Three 

or more prior referrals resulted in a high likelihood the case would be substantiated.

11 

Referral source. One study found that referrals from “community” sources (e.g., family, 

friends, neighbors) were more likely to be 

unsubstantiated,

12 while referrals from professionals were more likely to be substantiated.

13 

In the same study, interviews with caseworkers 

suggested the issue of referrer credibility was 

less influential than other factors in the decision-making process.14 In another study, cases 

referred by professionals were found to be 45 

percent less likely to be unsubstantiated.

15 

9	 Despite	the	apparent	contradiction,	this	is	the	finding.
 

0	 Fluke,	p.	09,	.
 

	 English	I,	p.	.
 

2	 English	I,	p.	22.
 

	 English	I,	p.	9.
 

4	 English	II,	p.	02.
 

	 Fluke,	p.	09.
 

Neglect type. In one study, caseworkers indicated they were least likely to substantiate 

referrals for neglect.16 Among types of neglect 

cases, allegations of medical neglect (defined 

as failure to obtain or maintain medical and 

dental services necessary to a child’s continued health, welfare, and development) were 

found to result in the highest rate of substantiation, while allegations of lack of supervision resulted in the lowest. The researchers 

suggest this may be because medical neglect 

referrals often come from professional sources 

(which, as discussed above, are associated 

with an increased likelihood of substantiation). Meanwhile, referrals for lack of supervision often come from neighbors and relatives 

(community sources, which are associated with 

a decreased likelihood of substantiation).17 

Age of the child. One study found the likelihood of unsubstantiation increased incrementally with the age of the child.18 In another 

study, children ages 0 to 2 and older than 13 

were more likely to have their cases substantiated, while children ages 3 to 5 were more 

likely to have their cases unsubstantiated.19 

Types of information used in decisionmaking. One study found that caseworkers 

emphasized different types of information 

6	 English	II,	p.	9.

7	 English	I,	p.	9.

	 Fluke,	p.	09.

9	 English	I,	p.	2.

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in making each case decision (substantiated, inconclusive, or unsubstantiated). For 

example, issues of proof were emphasized in 

decisions to substantiate. Other factors—such 

as whether the child’s basic needs were met, 

whether a caregiver offered a plausible explanation, and supervisory input—were more significant in inconclusive cases. 

Findings regarding the decision not to substantiate a case were more complex. The 

types of information used varied according 

to the type of maltreatment alleged. In physical abuse cases, issues of proof and evidence (especially evidence of physical harm 

or medical evidence) were most important. In 

sexual abuse cases, caseworkers were more 

likely to rely on testimonial information and 

credibility issues in deciding not to substantiate. For physical neglect cases, observational 

information (such as condition of the home) 

was most significant.20 

Factors found to be insignificant. All other 

things being equal, no significant differences 

in rates of substantiation were found between 

children who were male or female, of an ethnic 

minority or majority, or from high- or lowincome families.21 

Decision-makerfactors

Certain caseworker characteristics were found 

to impact decision-making. These include 

both individual characteristics (such as a 

worker’s inherent tendency to decide one 

way or another in particular kinds of cases) 

and the context of the decision (including 

factors ranging from the caseworker’s level 

of experience to his or her relationship with 

co-workers). 

20	 English	II,	p.	0-06.

2	 English	I,	p.	9.

Caseworker tendencies. Caseworkers’ individual tendencies were found to have a direct 

impact on their decisions, which in some cases 

outweighed other factors or evidence. For 

example, a worker who observed a child with 

a severe behavior problem or a family under 

extreme stress might consider those to be 

“good excuses,” or acceptable reasons not 

to substantiate the referral, even if the caseworker believed that abuse or neglect had 

occurred.22 

Context. Other caseworker characteristics 

were found to affect decision-making in more 

complex ways. Characteristics such as more 

experience, higher self-assessments of skills, 

and more supportive relationships with coworkers were found to increase the likelihood of unsubstantiation.23 Caseworkers who 

agreed State policy was important to their 

decision-making also were found to be more 

likely not to substantiate a case.24 This may 

indicate that these caseworkers substantiate 

only in the most clear-cut cases. 

Organizationalfactors

Aspects of the organizational environment 

also were found to be significant factors in 

the decision-making context discussed above. 

Workload stress and supervisor behavior were 

two of the most significant organizational 

factors in decision-making. 

Workload stress. In one study, workers noted 

that having adequate time to do a thorough 

investigation was a significant factor to both 

substantiated and unsubstantiated case 

decisions.25 

22	 English	I,	p.	2.

2	 Fluke,	p.	9-90.

24	 Fluke,	p.	72.

2	 English	II,	p.	i.

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In another study, increased stress resulting 

from heavy workloads tended to decrease the 

likelihood of unsubstantiation. The researchers noted several possible explanations for 

this seemingly contradictory finding. Because 

these workers feel overworked already, they 

may not have time to investigate to the extent 

they would like and, as a result, make a finding 

that is neither substantiated or unsubstantiated (such as “unable to determine”—a 

third decision-making category available in 

the State of Texas). Another possibility is that 

these caseworkers may be doing more indepth investigations, which may tend to result 

in a higher percentage of substantiated findings. Or, these caseworkers may focus on a 

few complicated cases that involve more time 

and labor to substantiate. Since these are not 

cleared as quickly, they build up over time and 

become a greater proportion of a caseworker’s workload. (Thus those workers will show 

a greater proportion of substantiated cases 

over time.)26 

Role of supervisors. Supervisor behavior 

tended to buffer caseworkers from some 

effects of the organizational environment, such 

as high stress. For example, when supervisors perceived their own work units as cohesive and themselves as supportive, there was 

an increased likelihood of unsubstantiation, 

suggesting that workers in units where the 

supervisors see themselves as supportive and 

work units as cohesive are more likely to define 

cases as unsubstantiated. These feelings of 

nurturance and support may offset the effect 

of a higher stress environment (noted above).27 

26	 Fluke,	p.	72,	7.

27	 Fluke,	p.	.

Externalfactors

Differences among State policies were found 

to affect rates of unsubstantiation from State 

to State. Whether State policies allowed for 

caseworker uncertainty regarding the occurrence of maltreatment (by offering options for 

case decisions that acknowledged indeterminacy) was found to be significant, as was the 

degree of evidence required by State policy to 

substantiate a case. 

Options for indeterminacy. “Two-tiered” 

States (where substantiated or unsubstantiated 

are the only two decision-making options) 

were found to have higher proportions of 

unsubstantiated cases than States where 

caseworkers have options that allow for some 

uncertainty, such as “unable to determine” 

or “insufficient evidence.” States that allow 

for an alternative response track that focuses 

more on identifying needs and providing services than on gathering evidence also have 

lower proportions of unsubstantiated cases.28 

Researchers suggest this may indicate that in 

States with more decision-making categories, 

ambiguous cases are isolated in those distinct 

categories. In two-tiered States, on the other 

hand, ambiguous cases may be more likely to 

be unsubstantiated whether or not unsubstantiation is explicitly defined in State policy to 

allow for ambiguity.29 

Standard of evidence. States’ standards of 

evidence required to substantiate a referral 

were found to fit one of three categories: 

• Ê“High” (e.g., requiring a “preponderance” 

of or “clear and convincing” evidence) 

2	 Fluke,	p.	2.

29	 Fluke,	p.	4.

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•“Low” (e.g., requiring “some credible evidence” or “credible evidence”) 

•“Vague or no clear evidentiary standard” 

Not surprisingly, in States where the evidence 

threshold to substantiate a case was higher, 

the rate of unsubstantiated cases also tended 

to be higher.

30 

Factors found not to influence substantiation rates. All other factors being equal, 

States that used a central registry, formal 

screening criteria, or a formalized risk assessment were not found to substantiate cases at 

significantly different rates than those that did 

not. Whether a State involves law enforcement 

in the investigation process also was found to 

be an insignificant factor in determining substantiation rates.31 

HowDecision-Making

ImpactsOutcomes

The rate at which cases re-refer to the CPS 

system is one way to measure outcomes. The 

studies synthesized here examined the connection between decision-making and rereferral in two ways: 

• Directly—by looking at the correlation 

between particular case decisions and re-referral rates. 

• Indirectly—by looking at how CPS decision-making impacts service provision and 

how services impact re-referral. 

Re-referral

Re-referral rates for substantiated and 

unsubstantiated cases. Two studies found 

substantiated cases were more likely than 

0	 Fluke,	p.	-4.

	 Fluke,	p.	7-42.

unsubstantiated cases to re-refer, although the 

degree to which this was found varied. One 

of these studies found families whose cases 

were substantiated or inconclusive were “significantly more likely” to re-refer than those 

determined to be unsubstantiated.32 

The second study categorized subsequent 

CPS referrals into three groups, when comparing the likelihood of initially substantiated and 

unsubstantiated cases to re-refer: 

•All subsequent referrals (substantiated 

or not) 

•Subsequent referrals that were 

substantiated 

•Subsequent referrals resulting in placement 

For most maltreatment types, researchers in 

the second study found rates of re-referral to 

be only slightly higher for initially substantiated cases, in the categories of all subsequent 

referrals or substantiated subsequent referrals.33 This differential was found to be greater 

when looking at subsequent referrals resulting 

in placement.34 

It is important to note that in the second 

study, despite the higher rates of re-referral 

among initially substantiated cases, the sheer 

numbers of subsequent referrals from initially 

unsubstantiated cases was found to be higher. 

While this may appear contradictory, the discrepancy is due to the much higher number of 

cases that were initially unsubstantiated.35 

Neglect and re-referral. Neglect cases that 

were initially substantiated were found to be 

highly likely to re-refer.36 Regardless of the 

2	 English	I,	p.	42.

	 Drake,	p.	74.

4	 Drake,	p.	42.

	 Drake,	p.	69.

6	 Drake,	p.	4.

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type of maltreatment alleged in the initial 

referral, subsequent referrals were found to be 

most often due to allegations of neglect.37 

Case factors affecting re-referral. Younger 

children were more likely to be re-referred 

to the system, for all types of maltreatment 

except sexual abuse.38 On average, a case in 

which the youngest child was age 15 would be 

50 percent less likely to re-refer than a case in 

which the youngest child was age 5. Younger 

perpetrators were also found to be at higher 

risk for re-referral.39 Researchers suggest two 

possible explanations for this: older parents 

may be more likely to have their children 

age out of the study, or younger parents 

may experience a greater lack of knowledge 

and resources. 

A parent as perpetrator increased the risk of 

re-referral dramatically in sexual abuse cases, 

moderately in physical abuse cases, and 

seemed to have little impact on re-referral rates 

for emotional abuse cases. Lower community 

income-levels were associated with a moderate increase in the likelihood of re-referral for 

all types of maltreatment except emotional 

abuse.40 Families with fewer resources were 

also more likely to be re-referred.41 

Decision-maker factors affecting re-referral. 

Caseworkers’ perceptions that State policy 

was important to their decision-making significantly increased the likelihood of re-referral.42 

This coincides with the finding that caseworkers who felt State policy was important to their 

decision-making were more likely to unsubstantiate, and may indicate the tendency to 

7	 Drake,	p.	4.

	 Drake,	p.	42.

9	 Drake,	p.	.

40	 Drake,	p.	4.

4	 English	III,	p.	6.

42	 Fluke,	p.	.

substantiate only the most clear-cut cases 

results in less protective decisions. 

Organizational factors affecting re-referral. 

Some findings regarding organizational 

factors that predicted re-referral contradicted 

researchers’ expectations. Although researchers originally assumed high workloads for 

caseworkers might lead to increased re-referral rates due to what they called “inadequate 

decisions,” this was not found to be the case. 

High job satisfaction among supervisors, on 

the other hand, was found to increase rereferral—also contrary to what researchers 

expected, having assumed that job satisfaction would equate to “better performance” 

and therefore lower re-referral rates.43 

Services

Impact of CPS decision-making on service 

provision. Decisions regarding substantiation impact both the degree to which workers 

are able to provide services and the level of 

investment families are likely to feel in the services offered. Several studies suggest there 

may be children and families who are at risk 

but underserved because of a decision to 

unsubstantiate.44 One study found families 

whose referrals were substantiated and whose 

children were offered in-home services were 

more likely to take advantage of services than 

were families whose referrals were classified 

as “inconclusive” but who were also offered 

services.45 

Impact of services on re-referral. When 

caseworkers reported a lack of agency 

resources to provide services for clients, rereferral rates increased.46 Although neglect 

4	 Fluke,	p.	-2.

44	 Fluke,	p.	20;	English	III,	p.	6.

4	 English	I,	p.	42.

46	 Fluke,	p.	26.

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cases were found to be highly likely to re-refer, 

any form of services was found to reduce that 

risk.47 Though there was not statistical significance, one study did find all cases that later 

returned as child fatalities received no services 

after the initial finding.48 

Type of services. One study examined the 

impact of the following three types of services 

on re-referral rates: 

• Family preservation services were defined 

as brief, intensive in-home services provided to those families whose children were 

at greatest risk for foster care placement. 

• Family centered services were less intensive in-home services provided over several 

months to families whose children were at 

lower risk for foster care placement. 

• Foster care was defined as out-of-home 

services provided to children who needed 

to be removed from their families. 

When the family in an initially substantiated 

case received family centered services or 

foster care, the risk of a subsequent referral 

was frequently reduced to a level no higher 

than for an initially unsubstantiated case. This 

despite the fact that substantiation, on its 

own, has been found to increase the likelihood of re-referral.49 By contrast, it was found 

that family preservation services, which are 

intended to keep high-risk families together 

and avoid foster care placement, were associated with an increased risk of re-referral involving eventual out-of-home placement.50 

Length of stay in foster care. Longer stays 

in out-of-home care resulted in decreased 

47	 Drake,	p.	4.

4	 Drake,	p.	6.

49	 Drake,	p.	4.

0	 Drake,	p.	42.

re-referral rates over time. Children remaining in foster care fewer than 3 months experienced the highest rates of re-referral among 

those children who spent time in out-of-home 

care. Those in care between 7 and 11 months 

experienced the lowest rates of re-referral 

over time.51 

Implications

The researchers presented a number of practical implications of their findings. These 

included strategies that might improve both 

the accuracy of decision-making and the provision of services, ultimately resulting in more 

positive outcomes for children. 

StrategiesforImproving

Decision-Making

Risk assessment. The high number of unsubstantiated cases that are re-referred suggests 

that including risk assessment in the decisionmaking process, rather than basing substantiation purely on the question of “what happened,” is likely to reduce re-referral assuming 

services are then provided to address identified issues. This is particularly critical, one 

study’s authors suggest, where there is insufficient evidence, according to State law 

and agency policy, to support a decision to 

substantiate.52 

Consistency in decision-making. Due to 

variations in both State decision-making policies and individual caseworker behaviors, consistent decision-making within CPS agencies 

was not found to be a realistic expectation in 

at least one study. If consistency is important 

	 Drake,	p.	.

2	 English	I,	p.	22.

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to a CPS agency, that agency might begin 

with a review of policies and laws related to 

indeterminacy (i.e., decision-making categories and levels of evidence). Where dispositional options are limited, or where the level 

of evidence required is more restrictive, consistently higher levels of unsubstantiation are 

more likely. 

Training to address individual decision-making 

behaviors and the consequences to children of 

particular decisions may also be helpful. Given 

the apparent impact of caseworker behavior 

on decision-making, this could be an opportunity to identify thresholds for action, clarify differences in personal tendencies, and provide 

better direction to workers on the impact of 

decision-maker discretion.53 To achieve consistency, understanding the effects of workload 

stress may also need to be addressed.54 

Use of central registries. At least two studies 

point to an important link between prior referrals and decision-making. Researchers in one 

study suggest that agencies may therefore 

want to re-think policies that require purging 

all unsubstantiated cases from central registries. Since a large number of families with 

previously unsubstantiated cases will return to 

the system, allowing caseworkers to scan for 

all prior referrals when assessing risk can help 

agencies evaluate ways to improve outcomes 

for the children in these cases.55 

Role of the supervisor. Supervisors play a 

pivotal role in providing information about 

agency policy and setting the tone for workers 

regarding organizational consequences of 

decision-making.56 Supervisors can also play 

	 Fluke,	p.	2-26.

4	 English	II,	p.	0.

	 Drake,	p.	4.

6	 Fluke,	p.	24.

an important role in buffering workers from 

job stress.57 When supervisors are responsive 

to and knowledgeable about their role in the 

agency, more consistent interpretation and 

application of policy is likely to result. Higher 

percentages of unsubstantiation may also 

result, if workers feel more supported. 

StrategiesforImproving

ServiceProvision

Resource development. Further consideration needs to be given to the impact 

resource limitations have on practice, as these 

limitations have been shown to impact both 

decision-making and re-referral outcomes. 

Not surprisingly, at least one study found rereferral rates increased when decision-makers 

reported inadequate services for families.58 

Targeting services. Certain risk factors for rereferral, revealed through this research, might 

support the development of more targeted 

community resources. For example, lower 

community income levels were associated with 

a moderate increase in the likelihood of rereferral for most types of maltreatment. This 

may indicate a need for child welfare agencies to participate in efforts to build support 

systems (both informal and formal) within 

lower-income communities or find other ways 

to provide services for those families.59 

Services for unsubstantiated cases. As 

mentioned earlier, due to the sheer number 

of initially unsubstantiated cases, more children return to the system from unsubstantiated than substantiated cases. As a result, 

CPS agencies may wish to give consideration to offering services to families in those 

7	 Fluke,	p.	.

	 Fluke,	p.	26.

9	 Drake,	p.	-6.

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cases where a degree of risk is present but 

the worker may not deem it high enough to 

warrant substantiation. Researchers point particularly to the need for preventive services 

for neglect in initially unsubstantiated cases of 

any type, because neglect is “almost always 

the most common type of second report.”60 

More States also may wish to consider a 

“two-track” approach. In States that take 

this approach, gathering evidence to substantiate a case (and involving the courts) is 

only an issue in the more severe cases. In less 

severe cases, caseworkers are able to focus 

on providing support to families who need 

it (including families that might otherwise be 

unable to receive services because their cases 

do not meet the evidence requirements for 

substantiation).61 

Multiple maltreatment types. Since most 

children who return to the system are eventually referred for multiple types of maltreatment, 

caseworkers should monitor carefully for the 

risk of multiple maltreatment types in chronically maltreating families. State or county policies and resources also must allow for caseworkers to provide chronically maltreating 

families with broad assessment and support, 

rather than to focus services only on the specific type of maltreatment currently identified.62 

Longer-term services. Because shorter-term 

services for the highest risk cases (family preservation services) were not found in this research 

to reduce re-referral, agencies should strategize ways to provide longer-term services to 

these cases. Researchers in one study suggest 

decision-making and service planning are best 

based upon the capacity of the family. For 

60	 Drake,	p.	-4.

6	 Drake,	p.	9.

62	 Drake,	p.	7-.

example, this may require extending the length 

of stay for some children in foster care, rather 

than returning a child to the home before the 

family is fully ready (e.g., this particular study 

found better outcomes for children who stayed 

in foster care longer than 3 months).63 

Recommendationsfor

FutureResearch

The researchers acknowledge many questions 

regarding decision-making require further 

research. Such research would ideally provide 

the field with evidence-based information 

about the consequences of decisions, and ultimately result in better outcomes for children 

and families. 

Complexity of the decision-making process. 

The researchers agree that the decisionmaking process is complex, involving layers 

of factors that are not always acknowledged. 

Future research could further explore the 

various contexts, factors (e.g., case, personal, 

organizational, and external), and case features from which decision-making emerges.64 

Risk factors. Because the researchers generally agree that case factors are the most 

significant factors in decision-making, more 

research into risk factors is warranted. Risk 

factors currently used in assessment should 

be evaluated regarding their contribution to 

predicting case outcomes. Although no specific factors were proposed in these studies, 

additional research could be designed to 

explore whether certain factors now used in 

6	 Drake,	p.	6-7.

64	 Diana	English,	personal	email	communication,	December	0,	

2002.

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risk assessment could be dropped due to 

the minimal association they have with child 

outcomes, or whether additional factors or 

domains should be included or given greater 

weight in the assessment process.65 

Decision-making in unsubstantiated cases. 

More needs to be known about why so many 

families that return repeatedly to the system 

have initially unsubstantiated cases. Because 

chronic maltreatment, particularly neglect, 

has been found to be devastating, one study 

recommends reconsidering the evidence 

required to substantiate cases of families who 

are referred frequently.66 

Services. Engagement in services has been 

shown to be critical to outcomes for families, and, in at least one study, substantiation 

was positively associated with engagement. 

Both decision-making and engagement are 

to some degree dependent on the availability and effectiveness of services. Researchers 

therefore suggest the need for more information about how the availability of effective 

services affects both caseworkers’ decisions to 

substantiate cases and, ultimately, outcomes 

for children and families.67 

Outcomes in unsubstantiated cases. 

These studies suggest that although one can 

be fairly certain that substantiation means 

maltreatment more than likely occurred, a 

finding of unsubstantiated does not guarantee that abuse or neglect did not occur.68 As 

a result, the use of case findings and recurrence as CPS outcome measures may need to 

be explored further.69 Future research should 

continue to look at child and family outcomes 

6	 Fluke,	p.	27;	English	I,	p.	22.

66	 English	I,	p.	22.

67	 English	I,	p.	22;	Fluke,	p.	26.

6	 English	I,	p.	22.

69	 English	II,	p.	07.

not only in substantiated cases but in unsubstantiated cases, as well.70 

Conclusion
 

The three studies discussed here have identified a number of factors—relating to the 

child and family, as well as to the caseworker, 

organizational environment, and external 

environment—that make an unsubstantiated 

case finding more or less likely. They have 

also begun to illuminate how children fare in 

those cases, in terms of repeated reports to 

CPS agencies, as compared to children whose 

cases are substantiated. This research points 

to the fact that substantiation is not the only 

valid way to identify “true” cases of abuse or 

neglect and may not be the only or best predictor of future harm. 

These studies, however, do not represent 

a national sample. All of the researchers 

acknowledge the complexity of the CPS decision-making process and the limitations of the 

interpretability and generalizability of their 

data. More research will be needed to refine 

further our understanding of these issues and 

continue to promote the safety of children 

who come to the attention of the State child 

welfare agency. 

70	 Drake,	p.	.

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