U.S. DEPARTMENT OF MEALTMANO MUMANSERVICES

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Office of Human Development Sewices

CD-11794

Administration for Children, Youth a“d Familiea

Children’s Bureau

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National Center on Child Abuse and Neglect

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

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Administration for Children, Youth and Families s

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National Center on Child Abuse and Neglect >

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STUDY FINDINGS

NA~ONM CT.FmlNGHOUSE ON CM~

~USE AND NEGM.ff INFOM~ON

Study of National Incidence

and Prevalence of Child

Abuse and Neglect:

1988

The rcs~rch dcscrib~ in this rcpert was sponsor~ by tic National Center on Child Abuse and Neglect, Children’s Burcziu,Admini.

Slration for Cbildrcn, You[h and Families, office of Human Development Services, U.S. DEPART~NT OF HEWTH AND

HUMAN SERVICES, under Conuacl 105-85-1702,
TABLE OF CONTENTS

b

DHHS SUMMARY ....................................................................................ix

ACKNOWLEDGEMENTS ........................................................................xvii

EXECUTIVE SUMMARY .........................................................................xix

1 INTRODUaION ................................................................................ 1-1

1.1

1.2 Historical Background ............................................................ 1-1

1.3 Objectives .................................................. ............................. 1-4

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

2.1

2.2

2.3

2.4

2.5

2.6

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

2.1.1 Rationale ..................................................................... 2-1

2.1.2 Approach ..................................................................... 2-4

Study Definitions .................................................................... 2-4

2.2.1 Overview of Study Definltlons .................................. 2-5 . .

2.2.2 Original and Revised NIS-2 Definitions ................... 2-6

Data Collection ........................................................................ 2-8

Data Processing ....................................................................... 2-9

2.4.1 Countability Assessment ............................................. 2-]0

2.4.2 Unduplication ............................................................. 2-10

2.4.3 Weighting and Estimation .......................................... 2-11

2.4.4 Data Analysis .............................................................. 2-13

Methodological Differences from the NIS-I ........................ 2-14

The Meaning of thelrrcidence Estimates .............................. 2-15

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

3.1 Nationai Incidence of Countable Child Maltreatment .......... 3-2

3.2 Incidence and Types of Child Maltreatment ........................ 3-4

3.2.1 Types of Abuse ........................................................... 3-8

3.2.2 Types of Neglect ........................................................ 3-9

3.3 Severity of Outcomes from Countable Maltreatment ........... 3-10

111
TABLE OF CONTE~ (Continued)

4

5

3.4 Summary ..................................................................................

3-13

3.4.1 Original Definitions .................................................... 3-13

3.4.2 Revised Definitions .................................................... 3-14

3.4.3 Differences from the 1980 Findings ......................... 3-15

SPECIFIC FORMS OF MALTREATMENT ..................................... 4-1

4.1

4.2

4.3

4.4

4.5

4.6

4.7

4.8

4.9

Original vs. Revisal Oefirsitiom ............................................

Physical Abme ........................................................................

Sexual Abuse ...........................................................................

Emotional Abuse .....................................................................

Physical Neglect ......................................................................

Educational Neglect ................................................................

Emotional Neglect ...................................................................

Other Maltreatment .................................................................

Summary ..................................................................................

4-1

4-5

4-5

4-a

4-11

4-15

4-17

4-20

4-21

CHARACTERISTfa OF MALTREATED CHILDREN

AND THEIR FAMILIES .................................................................... 5-1

5.1 Chil&s Sex ............................................................................... 5-2

5.1. I %x Effects (Using Original Definitions) .................. 5-2

5.1.2 Sex Effects (Using Revised Definitions) ................... 5-6

5.1.3 19a0- 1986 Differences Related to Chil&s Sex ......... 5-9

5.1.4 Summary of Chil&s Sex as a Risk Factor ................ 5-9

5.2 Age of Child ........................................................................... 5-9

5.2.1 Age Effects (Using Original Definitions) ................. 5-10

5.2.2 Age EffecB (Using Revised Definitions) ................. 5-17

5.2.3 1980 -19a6 Differences Related to Chil&s Age ........ 5-20

5.2.4 Summary of Childs Age ss a Risk Factor ............... 5-24

5.3 Chil&s Race/Ethnicity .......................................................... 5-25

5.4 Family Income ......................................................................... 5-25

5.4.1 Family Income Effects (Usina Original

Definition:) ................................................................. 5-26

5.4.2 Family Income Effects (Using Revised

Definitions) ................................................................. 5-2a

5.4.3 19a0-1986 Differences Related to Family Income 5-31

5.4.4 Summary of Family Income as a Risk

Factor .......................................................................... 5-31

iv
TABLE OF CONTENTS (Continued)

6

J

5.5 Number of Children in Family ..............................................

5.5.1 Family Size Effects (Using Original

Definitions) .................................................................

5.5.2 Family Size Effects (Using Revised

OefinitiOns) .................................................................

5.5.3 1980-1986 Differences Related to Family

Size ..............................................................................

5.5.4 Summary of Family Size as a Risk Factor ...............

5.6 Metropolitan Status (Metrostatus) of County ........................

5.6.1 Effects of County Metrostatus ..................................

5.6.2 1980-1986 Differences Related to County

Metrostatus ..................................................................

5.6.3 Summary of Effects of County Metrostatus .............

5.J Summary ..................................................................................

5.7.1 Original OefinitiOns ....................................................

5.J.2 Revised Oefinitimrs ....................................................

5.7.3 Differences from the 1980 Findings .........................

SUBSTANTIATION AND REPORTING RATES ............................

6.1 Reports of Suspected Abuse and Neglect .............................

6.1.1 Patterns in CPS Reports Overall ................................

6,1.2 Substantiated/Indicated vs. Unfounded

CPS Cases ....................................................................

6.2 Patterns in Recognition and Reporting .................................

6.2.1 Overall Reporting Rate of Countable Cases .............

6.2.2 Recognition and Reporting of Countable

Cases by Different Agencies .....................................

6.2.3 Changes in Recognition and Reporting

Since 19g0 ...................................................................

6.3 Summary ..................................................................................

SUMMARY AND CONCLUSIONS ...................................................

7.1 Incidence of Child Abuse and Neglect .................................

7.2 Distribution of Child Abuse by Type and Severity .............

5-32

5-32

5-32

5-34

5-35

5-35

5-36

5-3J

5-39

5-39

5-40

5-42

5-44

6-l

6-1

6-2

6-4

6-8

6-8

6-11

6-19

6-25

J-1

J-1

J-4

v
TABLE OF CONTENTS (Continued)

3-2

3-3

3-4

3-5

4-1

4-2

4-3

4-4

4-5

4-6

5-1

5-2

5-3

5-4

7.3 Relation of Abuse and Neglect to Child,

Family, and County Characteristics ....................................... ~:~

7.4 Reporting and Substantiation .................................................

APPENDICES (bound separately)

List of Tables

National incidence and level of recognition of child

maltreatment ........................................................................................ 3-3

Distribution of child abuse and neglect ......

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

Distribution of child abuse ................................................................. 3-6

Distribution of child neglect ............................................................. 3-7

Incidence of injury fimpairment from child maltreatment ............... 3-11

Relationship of original definitional standards used in

NIS- 1 and in IS-2 for comparable estimates to the ~lnal

revised definitional standards used in NIS-2 for

supplementary estimates ..................................................................... 4-2

Incidence of specific forms of sexual abuse ..................................... 4-7

Incidence of specific forms of emotional abuse ............................... 4-10

Incidence of specific forms of physical neglect ................................ 4-13

Incidence of specific forms of educational neglect .......................... 4-16

Incidence of specific forms of emotional neglect ............................. 4-19

Sex differences in maltreatment original definitions ..................... 5-3

Distribution of forms of abuse by chil~s sex

. . . .

orlglnal deflnltlons .............................................................................. 5-5

Sex differences in maltreatment revised definitions ...................... 5-7

Distribution of forms of abuse by child’s sex

. . .

revised deflnltlons ............................................................................... 5-8

vi
TABLE OF CON~N~ (Continued)

List of Tabla (Continued)

5-6

5-7

6-l

6-2

6-3

6-4

6-5

6-6

6-7

6-a

Differences in maltreatment based on family income

original definitions .............................................................................. 5-27

Differences in maltreatment based on family income:

revised definitions ............................................................................... 5-2g

Family sim differences in maltreatment

revised definitions ............................................................................... 5-33

Reports received by CPS .................................................................... 6-3

Csaes Reported to Cm Substantiation Rates and

Proportions Countable Under Different Definitions ........................ 6-5

Countable cases of child maltreatment classified by

Cm and non-CPS tiurce .................................................................... 6-9

Rate of reporting to CPS by source cases countable

under original definitions ................................................................... 6-12

Rate of reporting to CPS by source cases countable

under revised definitions .................................................................... 6-17

Changes since 1980 in sources of reports to CPS ............................. 6-20

Changes since 1980 in sources of total recognized cases

countable under the original deflrritions ............................................ 6-22

Changes since 19a0 in rate of reporting to CPS by source

(cases countable by original definitions) ........................................... 6-24

-

2-1 Level of recognition of child abuse and neglect ............................... 2-2

5-1 Age differences in maltreatment (original definitions) .................... 5-11

5-2 Age differences in abuse (original definitions) ................................. 5-12

5-3 Age differences in neglect (original definitions) .............................. 5-14

5-4 Age differences in fatalities (original definitions) ............................ 5-15

vii
m

5-5

5-6

5-7

5-8

5-9

5-10

5-11

TABLE OF CONTENTS (Continued)

List of Figures (Continued)

Age differences in moderate injuries (original definitions) .............

Age differences in abuse (revised definitions) ..................................

Age differences in neglect (revised definitions) ...............................

Changes in all abuse by age group (original definitions) .................

Changes in physical abuse by age group (original definitions) .......

Changes in sexual abuse by age group (original definitions) ...........

Changes in all abuse by metrostatus (original definitions) ...............

~

5-16

5-18

5-19

5-21

5-22

5-23

5-38

...

Vlll
DEPARTMENT OF HEALTH AND HUMAN SERVICES!

SUWRY OF THE 1986 REPORT ON THE NATIONAL

INCIDENCE OF CHILD ABUSE AND NEGLECT

Background

The Study of National Incidence and Prevalence of Child Abuse and

Neglect, also called the second National Incidence Study (NIS-2),

was commissioned by the National Center on Child Abuse and Neglect

(NCCAN), Administration for Children, Youth and Families in the

Office of Human .Development Services, Department of Health and

Human Services. It was conducted in response to a specific

Congressional mandate in the Child Abuse Amendments of 1984 (P.L.

98-457). The purpose of the NIS-2 was to assess the current

national incidence of child abuse and neglect, and to determine

how the severity, frequency, and chacacter of child maltreatment

changed since the NIS-1, which was completed in 1980.

w

The NIS-2 followed essentially the same design as that used in the

NIS-1 study. Data were collected concerning cases of child

maltreatment which were recognized and reported to the study by

“community professionals” in a national probability sample of 29

counties throughout the United States. The “community

professionals” who participated in the study included the local

Child Protective Services (CPS) staff as well as key respondents

in a variety of other non-CPS agencies (such as schools,

hospitals, police departments, juvenile probation authorities,

etc.). CPS provided information about all reported cases accepted

for investigation during the study. Participating professionals

at other agencies served as ‘sentinels” by remaining on the

lookout during the study data period for cases meeting the study’s

definitions of child maltreatment.

All cases reported to the research study were assessed for their

conformity to two sets of standardized definitional criteria, and

only those cases which fit these criteria were considered

“countable” and used as the basis of national estimates. One, set

corresponded identically to the definitions used in the NIS-1 and

essentially reflected the number of children t?ho experienced

demonstrabl~ harm as a result of maltreatment. Assessing the

national indidence of cases countable under these standards

provided a ‘Core’ or minimum estimate of the Overall incidence of

child maltreatment. The core estimates are comparable with the

NIS-1 findings and allow us to determine whether there were any

statistically significant changes in child abuse and neglect

counted under those definition since lg80.

The second set of definitional standards used in the NIS-2 were

broader and more inclusive. It provided a supplementary estimate

which reflected the incidence of children who were endangered by

maltreatment (i.e., placed at risk for harm, but not necessarily

ix
harmed yet). The second definition was in response to concerns

that the NIS-1 definitions were no longer responsive to the

broader definitions of P.L. 98-457, enacted since 1980, which

include children threatened with harm. These data cannot be

compared with 1980 data because of the more inclusive definitions.

Relationship of the National Incidence Study to Other Child Abuse

and Negl ect Data Sources

Although substantial numbers of abused and neglected children are

recognized as such and reported to State or local Child Protective

Services (CpS) agencies, reported children represent only a part

of known or suspected child maltreatment.

The National Incidence Study methodology is based on a model which

depicts five levels of official recognition or public awareness

about abuse and neglect.

Level (1) Those children reported to CPS where the allegation of

abuse and neglect is either substantiated or

unsubstantiated after an investigation.

Level (2) Those children who are not known to CPS but who are

known to other “investigatory” agencies, such as

police, courts, or public health departments. These

agencies may have overlapping or even conflicting

responsibilities concerning certain situations, such as

felonious assault, homicide, delinquency, dependency,

domestic disputes, “children in need of control,” or

nutrition and hygiene problems. Although Level 2

children are, in some sense, “officially known,” they

are not necessarily regarded by the,community as abused

or neglected in the same sense as Level 1 children are,

and they do not necessarily receive assistance which

specifically targets the abuse or neglect problems.

Level (3) Abused and neglected children who are not known to CPS

or to any Level 2 agency, but who are known to

professionals in other major community institutions,

such as schools, hospitals, day care centers, and

social services and mental health agencies. Children

~y remain at this level for any number of reasons.

O~e reason may be definitional ambiguities as to what

types of cases should be reported to CPS (or to other

investigatory agencies). Other reasons relate to the

attitudes and assumptions of the professionals who are

aware of these situations. For example, they may feel

that they are in the best position to help, may not

trust CPS to handle the problem appropriately, or may

have apprehensions about becoming involved in an

official investigation.

x
Level (4) Abused and neglected children who are recognized by

someone outside the purview of the first three levels,

such as a neighbor, another member of the family, or by

“One OK both of the involved parties -- the perpetrator

and the child. However, none of the individuals

recognizing the maltreatment at this level have made it

known to persons at Levels 1 through 3.

Level (5) Children who have not been recognized as abused or

neglected by anyone. These are cases where the

individuals involved do not regard their behaviors or

experiences as child maltreatment and where the

situations have not yet come to the attention of

outside observers who would recognize them as such.

Since 1975, the Department has funded a data collection effort

which attempts to obtain information about Level 1. Through a

grant with the American Humane Association, this annual report

collects data about child abuse and neglect reported to the CPS

system in the State.

In addition, this study also reports the percentage each year of

those reported cases which are substantiated as a result of

investigation, as well as certain demographic characteristics of

the maltreated child and the perpetrator. (The fact that a case

is not substantiated does not always mean abuse did not occur, but

rather that there may not have been enough information to

establish whether it did occur). However, this data is somewhat

limited in that State~ave different definitions of child abuse

and neglect and thus collect varying types of information. Also

since the information is collected on a voluntary basis, some

States do not report any data.

This National Incidence Study addresses data pertaining to Levels

1 through 3. It only includes ‘countable’ data which pertains to

child abuse and neglect that is reported, or seen by some official

or professional, or is reported to CPS. @

At least one other national incidence study, conducted by Richard

J. Genes and Murray A. Straus, has been completed which addresses

the abuse and neglect covered by Level 4. The National Institute

of Mental Eaalth largely funded the Gelles-Straus study, which was

a telephone survey of two parent families with children over three

years of age. Through interviews with parents it attempted to

determine whether physical abuse occurred and at what levels of

severity. This study originally conducted in 1975, was repeated

in’ 1985, and provided information about patterns of violence among

the categori+ of person interviewed. The study found a decrease

in the self-report~d incid[

between 1975 and 1985. To

decline as opposed to less

the unacceptability of adm

nce of physical abuse by parents

what extent this is due to an actual

cendid responses by parents because of

tting to abusive behavior, is not known.

xi
Problems Arising from Conflictln.g Definitions of child muse and

Neglect h

Child Protection Services is a State child welfare program.

Nearly all States adliere to the definitions provided in the Child

Abuse and Neglect Prevention and Treatment Act, as amended, as the

basis for receipt of basic State grants. However, each State has

its own definitions which, while incorporating the Federal

definition, may vary in other ways from State to State. Even

beyond the official definitions established by Federal and State

laws, CPS agencies, professionals in schools, hospitals, mental

health agencies and child care centers appear to have widely

differing interpretations ofi these laws regarding the types and

severity of child maltreatment, what needs to be reported, and how

to treat it.

One of the key activities of the NIS-1 and the NIS-2 was the

development of operational definitions of child maltreatment which

were both clear and objective in specifying cases at the first

three levels uf recognition mentioned above. All of the data

collected in the study were screened for conformity to these

definitional standards, and only those cases which fit the

standards were “countable” and used as the basis for generating

incidence estimates. While these definitions of countable

maltreatment have been criticized by some child advocates as being

too narrow, and thus screening out some cases of abuse and neglect

which these advocates believe are real, the definitions have the

advarltage of providing a common yardsticK to measure all cases

identified in each of the 29 counties. However, due to this

approach, differences in definitions of child abuse and neglect in

State law and as used in this study, “countable” cases under

demonstrable harm do not include all cases “substalltiateu” upon

investigation by local CPS; but “countable” cases under the

revised definitions do include all cases substantiated upon

investigation by CPS. Therefore, these data cannot be compared

directly with reports from the American Humane Association which

only summarize numbers of child abuse and neglect cases reported

to and investigated by CPS.

The incidence of child abuse and neglect discussed in the study is

that which is recognized by professionals in various community

agencies and was compiled by using a standard set of definitions.

It does not include all maltreatment of children +L the hands of

their parents and caretakers.

While the issues regarding definition do make it difficult to

compare different types of studies of incidence and annual

occurrence of child abuse and neglect, it is interesting to note

that the finaings of the NIS-1 and NIS-2 and the annu~l uata

collection done by the ~erican Humane Association on reports of

child abuse and neglect are, to a great extent, comparable in

their findings.

xi
Summary of Key Findings

National Incidence

current national (countable) child abuse and neglect as seen by

study respondents:

o In 1986, an estimated 16.3 children per 1,000 or a total of

more than one million children nationwide experienced abuse

or neglect in 1986 which met the original standardized

study definitions of maltreatment.

o Under the revised expanded definitions, an estimated 25.2

children per 1,000 or a total of more than one and one-half

million children nationwide experienced abuse or neglect in

1986.

Changes Since 1980 Using Original Definition of Demonstrable Harm

o Countable cases of maltreatment which have come to the

attention of survey respondents increased significantly

(66%) over their 1980 incidence rate for a total of

1,025,900 children. The 462,000 increase in countable

cases primarily reflected a significant increase of 74% in

the incidence of abuse.

o Among the abuse cases, there were significant rises in the

incidence of physical and sexual abuse, with physical abuse

increasing by 58% and sexual abuse occurring at more than

triple its 1980 rate in 1986.

0 The only significant change in level of maltreatmentrelated injuries occurred in the category of moderate

injury, which showed an 89% increase in its rate of

incidence, which is almost double that of the 1980 study.

o Neither emotional abuse nor any form of neglect showed

reliable changes in incidence rate since the earlier study.

Findings of the 1986 Study Using Expanded Definitions

Distribution of child maltreatment by type--

o The m-ajority of cases encompassing the expanded definitions

(63%) involved neglect, and fewer than half (43%) involving

abuse. There were 15.9 countable neglected children per

1,000 numbering 1,003,600 children nationwide, there were

10.7 abused children per 1,000 representing 675,000

children nationwide.

XU1
o me most frequent type of i~.b,l:c. ‘:!=..- ~~hysical., followed

by emotional abuse and thej! kty .s(:xl~?s.l abuse, with

‘-.l 2.5 children per 1,000, incidence rates of 5.7, 3.<., ~IA!.~

respectively.

o Physical neglect was by far the most frequent form of

neglect, followed by educational ne91ect/ and then

emotional neglect, with incidence rates of 9.1, 4.6 and

3.5 children per 1,000 respectively.

o Moderate injuries predominated, occurring in 60% of the

countable cases; these were followed in frequency by

children believed to be endangered by the maltreatment

they experienced (19%) then by probable injuries (11%),

serious injuriee (10%), and fatalities (0.1%).

Recognition and reporting patterns--

0 Noninvestigatory agencies (which included schools,

hospitals, social services, and mental health)

recognized more than fivetimes the number of children

victims than did investigatory agencies

(probation/courts, police/sheriff, and public health).

o Of the cases countable under original study definitions,

only 40% or 6.5 children per 1,000, were known to CPS

through official reports.

o hong all cases which involved maltreatment, the

proportion that was known to CPS showed ~ statistically

reliable changes since 1980.

0 Of all the cases which had been recognized by agencies

of the types included in the study, only 31% had been

reported to and accepted by CPS; this was not

significantly different from the 21% that had been known

to CPS in the 1980 study.

o tiut 44% of the cases which investigatory agencies

recognized were among official, cpS reports, whereas

thi”9 statistic was estimated to be only 28% for the

nonnveetigatory agencies. For revised definitional

standards, the corresponding estimates were 49% and 28%,

respectively.

o Using the original study definitions, tne proportion of

unsubstantiated CPS cases which were countable under the

original study definitions increased slightly but

significantly since 1980, raising some concern about an

increasing tendency to exclude cases which in the past

would have received intervention and services.

xiv
Implications to This Study and Related Departmental Efforts

The NIS-2 Study indicates that the increase in incidence of child

abuse and neglect between 1980 and 1986 is probably due more to an

increase in the recognition of child maltreatment by community

professionals than it is due to an increase in the actual

occurrence of maltreatment. Two observations suggest that greater

recognition of previously undetected cases may have played an

important role in this increase: the emphasis of the 1980’s on

community awareness of the existence of abuse and neglect as well

as the need to report suspected maltreatment, and the fact that

the greatest increase was in moderate abuse. Recognition of

suspected child sexual abuse is particularly increasing, which

undoubtedly’ is due to the greater community awareness of this

problem.

Along with the annual data collection on reporting published by

the American Humane Association, NIS-2 confirms that the number of

suspected child maltreatment cases being reported to CPS has

increased steadily. On the other hand, the study points out two

interesting pehnomena concerning reporting. First, although more

professionals are recognizing child maltreatment, they are not

necessarily reporting it to CPS. Second, there are many suspected

cases reported to CPS which, after investigation, are not

substantiated.

The study alao highlights problems arising as a result of multiple

and overlapping definitions of child abuse and neglect. Although

there is a core definition of child abuse and neglect which is set

by the Federal legislation and which states must incorporate into

State law in order to receive Federal funds, there is further

variance among State definitions. In addition, the practice of

professional groups in identifying child maltreatment using these

definitions is also varied.

The Department has a number of efforts already underway to address

many of the issues which arise from the increased reporting of

child maltreatment. For example, NCCAN has funded a research

study to examine how screening practices, which are employed to

determine which cases should be investigated, are being

implemented :by CPS staff; co-sponsored, with the American Bar

AssociationT,and the American Enterprise Institute, a consensus

building sy~oalum of child maltreatment professionals to address

child abuse and neglect reporting and investigation policies; and

is conducting research on some widely used CPS risk assessment

models to determine how successfully they are differentiating

those children who are most endangered.

xv
The Department has funded many efforts to respond to 9rowin9

awarenees of child sexual abuee and the increase in the number of

substantiated cases. TWO recently completed studies address

eexual abuse in day care settings and sexual abuse allegations in

custody disputes. We have also funded a eeries of projects to

develop, demonstrate and study the effects of school-~sed

prevention programs designed to help children defend themselves

against eexual victimization, as well as research studies to

examine issues of interviewing children who are victims of sexual

abuse. Currently, we are considering applications ‘or

demonstrations of treatment approaches for intrafamilial child

sexual abuse, as well as services for families who adopt children

who have been sexually abused.

The 1986 Incidence Study data will be used for a number of

secondary analyses by the Department, including:

0 an examination of the impact of educational neglect on the

total incidence of child maltreatment, and whether there is

a correlation between educational neglect and other forme

of child maltreatment;

o an analysis of perpetrators to determine whether we can

develop more precise descriptive predictors of

perpetrators: and

o an analysis of reporting practices, to determine how

various professional groups of mandated reporters are

carrying out this responsibility.

The public-use data tapes are available for duplication from the

National. Clearinghouse on Gild Abuse and Neglect, for other

interested researchers.

xvi
The Study of National Intiden@ mdPredeou of CMd Ab~emd Ne@ect wm designed and

mnducted by Watat, Inc., uder tbe spomorshlp md &ection of the National Center on Chfld Abuse and

Ne@ect (NC-. Westat sttimdcomuftmts whose time ad e~rtkewntributed to the success of this

study we hted klow.

~ study wotid not have ken pxible tithout tie suppofi of a ~eat mmy organimtions,

agenties, md bditiduk. The W=tat tea k particolmly tidebted to NCM for critid help and support

thoughout tbe study. S~tidth~me &emended tothehwdreds ofagen&es and indltidud aseworkers,

teachers, potice officers, soeid workers, probation officers, nur~, and other professionals in the study counties

who mntributed theh enthusimtic support and much of their time in the effort to accurately assess the

htidenm, nature, md d~tribution of tilld abuse and neglect in the U.S.

Co~rme Oficm.ti.CtiW hj-t Diretom

R %1~ K B.@od (Desip Phaw)

A >d!ak (Implcme”tation and Analpis)

FkldDtimrom

R Patch.” (A~nq %Icclion)

E AIldmd@ (Rccmitment a“d Data Gllwtion)

A~ J. L~ch

A8..q ~~1 ht. Ma..gemengRep.tatioq Amesme,tt

R Cueltar,J. Po.lin, J, Warn”, C. tin, N. Lu% R M. Feinstei., J. Po.fin, V, H“dmk, T. Gppzi,

hc”dariz, M, Goldstein F. Horlick, P, Bi.gham, L big

SWuim Computmhmesh~

E B~”t & J, Gme”blat (%mpti”g) J. B-, B. Reed, H, Go&l (Spiems Design)

K R=t ~eiahti.g and btimalion) K Mcfitim, S. Miller (Pmpmming)

xvii
EXECUTIVE SUMMARY

The Study of National Incidence and Prevalence of Child Abuse and Neglect, also

called the second National Incidence Study (NIS-2), was conducted in response to a specific

Congressional mandate given in the Child Abuse Amendments of 1984 (P.L. 98-457). The

purpose of the NIS-2 w to assess the current national incidence of child abuse and neglect,

and to determine how the severity, frequency, and character of child maltreatment changed

since the NIS- 1.

The NIS-2 represents a follow-up to the NIS- 1, completed in 1980, and it followed

essentially the same design as that earlier study. ~ta were collected concerning cases of child

maltreatment which were recognized and reported to the study by “community professionals” in

a national probability sample of 29 counties throughout the U.S. The “community professionals”

who participated in the study included the local Child Protective Services (CPS) staff as well as

key respondents in a variety of other non-cps agencies (such ss schoo]s, hospitals, police

departments, juvenile probation authorities, etc.). CPS provided infOrmatiOn about aII repOrted

cases accepted for investigation during the study. Participating professionals at Other agencies

served as “sentinels” by remaining on the lookout during the study data period for cases meeting

the study’s definitions of child maltreatment.

All cases reported to the study were assessed for their conformity to a set of

standardized definitional criteria, and only those cases which fit tbe standards were considered

“countable” and used as the basis of national estimates. The N15-2 used two sets of definitional

standards of abuse and neglect. One set corresponded iden~ically to the definitions used in the

NIS- 1 and essentially reflected the numbers of children wbo experienced demonstrable harm as

a result of maltreatment. Assessing the national incidence of cases countable under these

standards provided a “core” or minimum estimate of the overall incidence of child maltreatment.

The second set of definitional standards used in the NIS-2 was broader, or more inclusive. It

provided a supplementary estimate which reflected the incidence of children who were

endangered by maltreatment (i.e., placed at risk for harm, but not necessarily harmed yet). The

core estimates were able to be compared with the NIS- 1 findings to determine whether there

were any statistically significant changes in incidence since 1980. The supplementary estimates

xix
indicated the potential magnitude of the problem of abuse and neglect as perceived by

community professionals.

The major objectives of the NIS-2 were to

m estimate the national incidence/prevalence of child abuse and neglecc

■ determine the distribution and severity of child abuse and neglecc

■ assess changes since the NIS- 1 in the frequency, severity, and character of

maltreatment;

■ identify the relationship between the incidence of child abuse and neglect

and child, family, and county characteristics and

s determine the proportion of recognized child maltreatment known to CPS

through official repnrts and the reporting rates for recognized cases by

different types of agencies.

Key findings related to each of these objectives are as follows

Current national incidence of countable child abuse and neglect--

■ In 1986, an estimated 16.3 children per 1,000 or a total of more than one million

children nationwide experienced abuse or neglect in 1986 which met the original

standardized study definitions of maltreatment.

● Under the revised definitions, an estimated 25.2 children per 1,000 or a total of

more than one and one-half million children nationwide experienced abuse or

neglect in 1986.

Dlstributimr of child maltreatment by type--

● The majority of cases countable under the original definitions (56%) involved

abuse, and just under half (48%) involved neglect. Abused children represented an

incidence rate of 9.2 per 1,000 and numbered about 580,400; there were 1.9

neglected children per 1,000 in 1986, representing about 498,000 children

nationwide. Estimated incidence of the subcategories of abuse and of neglect were

also determined

■ The most frequent category of abuse was physical, followed by emotional

abuse and then by sexual abuse, with incidence rates of 4.9, 2.8, and 2.2

children per 1,000, respectively.

■ The frequency ranking of the subcategories of neglect was educational,

physical, and emotional, with incidence rates of 4.6, 2.9, and 0.8 children per

1,000, respectively.

xx
■ The majority of cases countable under tbe revised definitions (63%) involved

neglect, aod fewer than half (43%) involved abuse, reversing the pattern found

under the original definitions. There were 15.9 countable neglected children per

1,000, numbering 1,003,600 chiIdren nationwide, there were 10.7 abused children

per 1,000, representing 675,000 children nationwide. Estimates for the

subcategories of abuse and of neglect under the revised definitions were--

■ The most frequent type of abuse was physical, followed by emotionaI abuse

and then by sexual abuse, with incidence rates of 5.7, 3.4, and 2.5 children

per 1,000, respectively;

● The frequency rarrking of the subcategories of neglect differed from the

pattern obtained under the original definitions. Using the revised definitions,

physical neglect was by far the most frequent form of neglect, followed by

educational neglect, and then emotional neglect, with incidence rates of 9.1,

4.6, and 3.5 children per 1,000 respectively.

%verity of lrsJuries/impalrmeots from cmmtab]e maltreatment--

■ Among cases countable under the original definitions, moderate i“j”ries

predominated, occurring in 72% of the countable cases; these were folIowed in

frequency by serious injuries (]5%), probable injuries (12%), and fatalities (O.I%).

■ Among cases countabIe by revised standards, moderate injuries also predominated,

occurring in 60% of the countable cases; these were followed in frequency by

children believed to be endangered by the maltreatment they experienced (19%),

then by probable injuries (11%), serious injuries (IO%), and fatalities (O.1%).

Changes since 1980 in incidence (under origioal deflnitions)--

■ Countable cases of maltreatment increased significantly (by 66%) over their 1980

incidence rate.

■ The increase in countable cases primarily reflected a significant increase (of 74%)

irr the incidence of abuse.

■ Among the abuse cases, there were significant rises in the incidence of physical and

sexual abuse, with physical abuse increasing by 5g% and. sexual abuse occurring at

more than triple its 1980 rate in 1986.

■ Neither emotional abuse nor any form of oeglect showed reliable changes in

incidence rate since the earlier study.

● The only significant change in level of maltreatment-related injuries occurred in

the category of moderate injury, which showed an 89% increase in its rate of

incidence since the 1980 study. This suggested that the overall increase in

countable cases of maltreatment may have largely been due to an increased

xxi
likelihood that professionals will recognize maltreatment, rather than to any increase

in incidence per se.

Child, family, and county characteristics* related to incidence, type, or severity of

maltreatment--

Child’s Sex:

Under both original and revised definitions, females experienced more abuse overall

than did males and this reflected primarily their greater susceptibility to being

sexually abused. They were also more likely to experience “probable”

injury/impairment in comparison to males. Sex of child did not relate to any of

the changes observed between 1980 and 1986 study findings.

Child’s Age

Under original definitions, the overall incidence of maltreatment increased with

age, and this was reflected in both abuse and neglect. Within abuse, the age-related

increme in maltreatment appeared for all subcategories of abuse. Within neglect,

the increase was localized to the area of educational neglect. With the revised

definitions, abuse, specifically physical abuse, did positively correlate with age.

Although neglect under revised definitions had no overall msociation with age, two

of the subcategories of neglect did relate to age educational neglect and emotional

neglect. Again, children were at greater risk for these forms of maltreatment with

increasing age.

Under both sets of definitions, fatal and moderate injuries showed age

relationships, but of reversed patternx fatalities were more numerous among the

younger children, whereas moderate injuries were more prevalent among older age

brackets. When the younger children were maltreated, however, it resulted in mOre

serious injuries, perhaps due to their greater physical fragility in comparison to

older children.

The 1980-1986 changes in the incidence of abuse and of two of its subcategories

(physical and sexual) proved to have occurred disproportionately among the older

age groups. Successive age groups generally showed progressively larger increases

in the incidence of abuse over the 1980 levels. The fact that the’ relationship

between maltreatment and age changed in these respects since 1980 implies that age

may be more related to the reco~ nitiorr of physical and sexual abuse than to their

actual gc currence.

Child’s Race/Ethnicitv

There were no significant relationships between the incidence of maltreatment and a

child’s race/ethnicity.

●I” ddition to the typs of chx=tetistiti rewtid .“ here, the Co”wemio.al mmdat. also rq.ired that the study

amine the relationship b.twee” chtld malt rest me”t a“d the no”payme”t of child s“pvti. Because the ktnds of agency

mswnde”ts -mitd i“ the NIS d-ign ge”erdly hd “o infomatio” on this pint, a sep-ate *tudy comwnent w=

desimed -d implemented to tidress kMs q“estio”. That study, to~ether with its findti”p, i. the subject of a Sep-ate

mprt (R,w* OnNo.gnvment of Child S. Dooti and Child Maltmatme”t).

xxii
Family Incomti

Low income was a significant risk factor for child maltreatment under the both sets

of definitions. Children from families whose 1986 income was less than S1 5,000

experienced substantially more maltreatment in all categories compared to those

from families earning $15,000 or more. There were also more frequent

injury/impairments at every level among the lower income children.

Family Size:

Although family size made no difference for the incidence of maltreatment under

the original definitions, it did affect estimates under the revised definitions,

Children in families with four or more children showed higher rates of

maltreatment on a variety of measures, especially in the areos of physical abuse and

physical neglect. They were also more likely to be regarded as endangered--a fact

which was thought to possibly be the basis for all the other differences they

exhibited. That is, greater rates of perceived endangerment for children in the

larger families probably resulted in generally higher rates of countable cases for

these children, overall.

County Nfetropolllan Status (Nlelroslatus):

The metrostatus of the county had no reliable impact on the incidence of

maltreatment according to any measure of type or severity. County metrostatus ~

related to the size of the 1960-1986 increases in incidence, but tilere was some

question about the reliability of this finding.

Recognition and reporting patterns--

Recognition:

m Noninvestigatory agencies (which included schools, hospitals, social services, and

mental health) recognized more than two times the number of children countable

under original definitions recognized by investigatory agencies (probation/courts,

police/sheriff, and public health).

8 Among investigatory agencies, police/sherifrs departments recognized the greotest

number of children countable by original definitions (an estimated 96, ?00

nationwide); probation/courts and public health departments did not differ in their

recognition of maltreated children.

8 Among noninvestigatory agencies, the ordering of the different types of agencies

according to the numbers of children (countable by original definitions) they

recognized was schools > social services = hospitals > daycare centers = menial

health agencies.

m The different agency categories showed the same relative patterns of recognition fOr

cases defined by revised definitions as they had when cases were defined by the

original standards.

..

m
Reporting:

Of the cases countable under original study definitions, only 40%, or 6.5 children

per 1,000, were known to CPS through official screened-in reports. Of the cases

countable under revised definitions, 46%, had been reported to CPS and screened-in

by that agency.

Among all cases which involved maltreatment countable by original standards, the

proportion that was known to CPS showed ~ statistically reliable changes since

1980.

Of all the cases countable under original definitions which had been recognized by

agencies of the types included in the study, only 31% had been reported to and

accepted by CPS; this was not significantly different from the 21% that had been

known 10 CPS in the 1980 study. The comparable figure for cases countable under

revised definitions was 33%.

About 44% of the cases countable under original definitions which investigatory

agencies recognized were among official, screened-in CPS rePorts, whereas this

statistic was estimated to be only 28% for the noninvestigatory agencies. For

revised definitional standards, the corresponding estimates were 49% and 28%,

respectively.

Screened-in CPS Reports--

The number of children reported to CPS increased nearly 57% since 19k0. In 1986,

CPS received reports concerning nearly one and two-thirds million children.

25% of all the cases in screened-in CPS reports were countable under original study

definitions; about 44% of the children reported to and screened-in CPS were

countable under revised study definitions.

A significantly greater proportion of cases reported to (~nd screened-in by) CPS

were countable in 1986 than had been countable in 1980 (i.e., 25% vs. 19%),

indicating that cases are now selected into CPS by more stringent criteria.

In 1986, CPS either considered indicated or officially substantiated about 53”/0 of

the cases for which it received and investigated reports. This reflected a significant

increase from the 43% of screened-in cases which had been substant iated/indicoted

in 1980.

An estimated 39% of all cases substantiated or indicated by CPS were countnble

under the original study definitions; ah estimated 73% of all cases substantiated or

indicated by CPS were countable by revised study standards. reflecting the imPact

of the definition rl!le that considered all officially substantiated cases as

automatically meeting the revised harm requirement.

xxiv
m

identified

■

■

■

■

The proportion of unfounded CPS cases which were countabIe under the original

study definitions increased slightly but significantly since 1980, raising some

concern about an increasing tendency to exclude cases which in the past would have

received intervention and services.

Implications of the study. The following implications of these findings were

The increase in countable cases since 1980 probably reflected an increase in the

Likelihood that professionals wiIl recognize maltreatment rather than an increase in

the actual occurrence of maltreatment (i.e., in incidence per se). Potential reporters

have become better attuned to the cues of maltreatment--particularly to cues

concerning physical and sexual abuse, to cases involving moderate injuries, and

especially for the older children. (There is also some suggestion that recognition

gains in rural areas may have lagged behind those in the more metropolitan

locations).

Although there has been an increase in the likelihood that abused and neglected

children will be recognized, these children are not reliably more likely to appear

among the screened-in reports to CPS. This may be the fault of those who

recognize maltreatment not submitting reports to CPS, or it may be due to CPS

screening out cases. These alternative explanations have different policy

implications

If potential reporters are not reporting, it means that it has not been enough

to merely increase their recognition of maltreated children. Reporting

behaviors themselves must be addressed--as by conveying the beneficial

results of CPS involvement.

If due to CPS screening out reported cases, it means that CPS resources

provide insufficient support for the current high rate of recognition of

maltreatment, which may jeopardize the gains in recognition that have been

made thus far.

The fact that a significantly greater proportion of reported children are now

officially substantiated/indicated implies that there is now greater selectivity of

cases into CPS, which is most Iikely due to the use of more stringent ‘screening

standards.

The finding that a significantly greater proportion of the set of unfounded CPS

cases were cases which were countable by the study’s original standards indicates

that some of the children who would, in the past, have had their cases

substantiated/indicated (and possibly received services as a result) are now excluded

as unfounded.

xxv
1. INTRODUCTION

This is the final report in a series of three major reports on the 1986 Study of

National Incidence and Prevalence of Child Abuse and Neglect. It begins with an overview of

the background and methods but its principal focus is upon the study findings. Readers

interested in further detail concerning the data collection or analysis are referred to the prior

reports in the sequence.l

This introductory chapter offers a brief historical perspective anda summary of the

study’s primary objectives. Chapter 2 summarizes the methodology, including the conceptual

model which guided the study design, the design itself, the definitions of maltreatment, and

important aspects of the methods of data collection. Chapter 3 presents estimates of the overall

incidence of child maltreatment, of the different types of abuse aod neglect, and of the severity

of maltreatment. Chapter 4 clarifies the definitions on which the overall estimates were based

and provides incidence estimates for each of the specific forms of abuse and neglect. In

Chapter 5, relationships between child abuse and neglect and various child, family, and county

characteristics are examined. Chapter 6 discusses patterns in the recognition and reporting of

child maltreatment. Finally, Chapter 7 summarizes key findings and discusses their

implications.

1.2 Historical Background

Federal involvement in addressing the problems of child abuse and neglect dates

from 1935, when the Social Security Act first funded public welfare services “for the protection

and care of homeless, dependent and neglected children and children in danger of becoming

delinquents.”z It was not until the mid-19@’s, however, that the first state laws were enacted

mandating reporting to public agencies of suspected cases of child abuse and neglect and

1

Pmviomrewtis wem the Remtion Data Collectio” a“d the Reootio” Dnta Proce#ai”x a”d A”alvsis. Wdemcanobtsin

copies of Ihesempotia rmm the Cleari”gho”seo” Child Ab”ae and Neglect I“formatio”, 8201 Gree”eboro Dr., M. Lea”, VA

22102. (703)821-2086.

ZcMld ~e,fare ~trate w in the Comin~ Yearn, U.S. Chtldren-s B“rea”, 1978, DHEW P“blicatio” No. (DHDS) 78-S0158,

p. 5,

1-1
offering reporters protection from retaliatory litigation (e.g., slander suits, suits alleging breach

of confidentiality). Between 1963 and 1966, 49 states enacted such reporting laws.s

In the early 1970’s, with the awakening of public concern about child abuse and

neglect, questions arose about both the overall magnitude of the problems of child abuse and

neglect in the United States and the adequacy of existing mechanisms for the identification and

protection of abuaed and neglected children. A series of hearingson these subjects, held by the

Serrate Subcommittee on Children and Youth in 1973, resulted in the passage of P.L. 93-247, the

Child Abuse Prevention and Treatment Act, which was signed into Iaw in early 1974.4 The Act

created the National Center on Child Abuse and Neglect (NCCAN), which was placed within

the Children’s Bureau of the (then entitled) Department of Health, Education and Welfare

(HEW). The Center was to support state and local efforts for the prevention and treatment of

child abuse and neglect. The Act specifically mandated the Secretary of HEW, through

NCCAN, to”makea full andcomplete study and investigation of the national incidence of child

abuse and neglect, including a determination of the extent to which incidents of child abuse and

neglect are increasing in number or severity” (Section 2(b)(6)).

To respond to this mandate, NCCAN awarded a contract in 1976 for the design and

implementation of the first national study of the incidence and severity of child abuse and

neglects After two years of design and pretest work, the first National Incidence Study (the

s

S“mmm, A. -d Cohen, S., &potii”c Chtld Ah”me and Neglect: Guideh”es forhrnslatio”. Balfi”gex Cambridge, MMa.,

1975.

4.

~. U.S. Co”Wss, Senate Committee on Lsbor and

Pubhc Welf=, S.kohktaeon Children md Youth, 93ti Conwesa, Mamh 2a, 27, S1, April 24. Wtihtngto”, D. C.:

U.S. Government Printi”s O~c.,197S. The Actw-a”b.que”tly mend& in1978a”d19a4.

‘This bd ben pmded by a fe=ibihty study in 1975.

1-2
NIS-l)e was conducted in 1979-80. The NIS-1 was the first Iarge-scale, comprehensive research

on this important subject.’

The NIS-1 collected data concerning cases of child maltreatment which were

recognized and reported to the study by “community professionals” in a probability sample of 26

counties throughout the U.S. The “community professionals” who participated in the study

included the local Child Protective Services (CPS) staff as well as key respondents in a variety

of other non-CPS agencies (such as schools, hospitals, police departments, juvenile probation

authorities, etc.). Cases reported to the study were assessed for their conformity to a set of

standardized definitional ctiteria, and only those cases which fit the standards were considered

“countable” and used as the basis of national estimates.

The N]S-l provided first-time national estimates of the incidence, severity, and

demographic/geographic distribution of recognized child abuse and neglect in the U.S. An

estimated 625,100 children under age lg nationwide were found to have experienced child abuse

and/or neglect meeting the study definitions during the 12-month period from the second baif

of 1979 through the first half of 1980. 8 A secondary, but vitally important, finding of the NIS1 was that two-thirds of the countable abuse and neglect cases identified by that study had M

been reported to CPS.1O I“ light of this, it was clear that reliable estimates regarding the full

6OK,cidly titled the Natio”d Study of the bcide”ce md Saverity of Child Abuse a“d Ne~lact,

7

The fin&n@ oftwoocher l~@-~de =ewhefiotis wemavtilable, b“t these htibe”lem compmbe”sive i” their topical

f-us ontheissue ofchild maltmatme”t. Thetiericm H”ma”etimiatio”,o Child Ab”aeand Ne81ect Reporting St”dy

htih””nde-ay since 1976. 1“ that st”dy, A~compilea st.tiaticson the””mher mdcbSWteristics ofc~.sin CPS

c-lotis. The NIS-1 methdoloW ~- well byo”d mwti. to CPS. 1. 1976, StrS”S, Gelles, md Steinmets conducted a

sum.y of a national sample of ho”~holds, wh,eb they p“b~,shed in 1980 (Beh,”d Closed Doom: Vsole”ce i“ the America”

-. G~e. Ctty, NY ~ch.,). Their inte~i.w f=.sed o. violence, and so provided infom.tion only covering

phyaicdtibuse, The NISmetbdolo~ e”comp~ses all form of child mdtteatme”t.

i

~eorid"al p.blicatio" of the NIS-lfi"di"m placed $hewtimste at652,~, Th. estimate ~ven in the text here i, bwed

onwalc”lstio”. o(the NIS-1 estimates, -d”crib&in Chapter2 (S~tio”2.S.3).

9

Thete_”in-,eow” md”to”mable. mfertocwem which fitthedefi”itio”s of theat”dy.

1-3
scope of child maltreatment could not be derived solely from information officially reported to

and recorded by state and local CPS agencies.

As was intended, the’ NIS-1 data provide a baseline agaiost which subsequent

research findings can be compared in assessing changing national patterns in the frequency,

severity, and distribution of child abuse and neglect. Since the NIS-1, there have been several

studies designed to explore the extent of child maltreatment, but ,these have not been

comparable to the NIS-1 because of a more limited topical focus (e.g., examining only a

subcomponent of the problem, such as only physical abuse or only cases reported to CPS).ll At

the same time, the NIS-I results are now seriously out of date.

Recognizing the need for updated information on the national incidence of child

maltreatment, Congress mandated a new study in the Child Abuse Amendments of 1984 (P.L.

98-457). The purpose of this second National Incidence Study (NIS-2)12 was not only to assess

the current national incidence of child abuse and neglect, but also to determine how the

severity, frequency, and character of child maltreatment changed since the NIS-1.

1.3 Objectives

The NIS-2 represents a follow-up to the NIS-1, and like the earlier study was

undertaken in response to a specific Congressional mandate (Child Abuse Amendments of 1964,

P.L. 98-457). As noted above, its purposes were to assess the current national incidence of

child abuse and neglect and to determine how the severity, frequency, and character of child

maltreatment have changed since the NIS-I. In addressing these goals, the NIS-2 extended the

NIS-1 methodology as discussed later, in Chapter 2.

First, the central question addressed in the NIS-2 was: What is the current national

incidence of countable cases of child abuse and neglect? (Where “countable” cases are those

11AHA h- co”ti”.ed its repotiing study (see footnote 7) to the time of this wtitin~. Stra”a and Genes conducted a

“ationd s“wey of household. sgai” i“ 1986, .oncemin# phy,ic.1 viol. ”.. toward chtldre” (see R.A. Gellen & M.A. Stra.s,

.h viote”ce towd eh,ldmn i“cremi”~?” Jo”mal of Inte mmo.al Violence, 1987,1, 212-222.).

12Off,cidly titled the Study of the Natio”d I“cide”ce a“d Prevalence of Ch,ld Abuse .nd Neglect

1-4
which conform to the standardized study definitions.) As further described in Chapter 2, the

NIS-2 used two sets of definitional standards of abuse and neglect. One set corresponded

identically to the definitions used in the NIS-1 and essentially reflected the numbers of children

wbo experienced demonstrable harm as a result of maltreatment. Assessing the national

incidence of cases countable under these standards provided a “core” or minimum estimate of

the overall incidence of chiId maltreatment. The second set of definitional standards used in

the NIS-2 was broader, or more inclusive. It provided a supplementary estimate which reflected

the incidence of children who were endangered by maltreatment (i.e., placed at risk for harm,

but not necessarily harmed yet). The core estimates were able m be compared with the NIS. I

findings to determine whether there have been any statistically significant changes in incidence

since the 1980 study. The supplementary estimates indicated the potential magnitude of the

problem of abuse and ne81ect as perceived by community professionals.

Second, in addition to providing overall estimates of incidence, the NIS-2 examined

the distribution of child maltreatment by type (abuse vs. neglect) and by major subtypes

(physical, sexual, and emotional abuse; physical, emotional, and educational neglect). The

distribution of cases according to the severity of injuries/impairments from maltreatment “as

also determined and compared with that found in the NIS-1.

Third, the NIS-2 identified those child. family, and county characteristics which

were related to the incidence, type, or severity of maltreatment and explored any changes in

incidence since 1980 that were related to these factors. Among the factors explored in this

connection were the child’s a8e, sex, and ethnicity, the family’s economic status and

composition, and the rural/urban character of the county of residence. The Congressional

mandate also required that the study examine the relationship between child maltreatment and

the nonpayment of child support. Because the kinds of agency respondents recruited in the NIS

design generally had no information on this point, a separate study component was designed and

implemented to address this question. That study, together with its findings, is the subject of a

separate report (Report on Nonpayment of Child Support and Child Maltreatment).

Fourth, apart from examining incidence rates per se, the distributions of

recognition and reporting patterns were also of interest. Thus, as in the NIS-1, the proportion

of countable cases that were known to Cm through reports to that agency was determined. The

NIS-I had indicated that a considerable proportion of recognized cases were not reported to

1-5
CPS. The NIS-2 identified the current proportion of unreported cases overall, and for each

major category of non-CPS agencies studied, noting any changes in the ratios of

reported/unreported cases since 1980.

In summary, the major objectives of the NIS-2 were to

estimate the national incidence/prevalence of child abuse and neglect;

determine the distribution and severity ofchiid abuse and neglect;

identify the relationship between the incidence of child abuse and neglect

and child, family, and county characteristics;

assess changes since the NIS-1 in the frequency, severity, and character of

maltreatment; and

determine the proportion of recognized child maltreatment known to CPS

through official reports and the reporting rates for recognized cases by

different types of agencies.

1-6
2. METHODOLWY

This chapter summarizes the design and methodology of the study. It overviews the

conceptual model that guided the development of the NIS- 1 methodology, and indicates the

apprOach taken in the Present study. Sections briefly orient the reader to the study definitions,

the county sample, and the methods of data collection and processing. Additional information

on all these issues is given ‘in Appendix A, which also includes copies of the data forms.

Further details concerning the study definitions are also included later in Chapter 4, which

reports on incidence estimates for the speci~lc forms of maltreatment.

2.1 Study Design

Since the main purposes of the NIS-2 were identical to those of the NIS- 1, the

study design was essentially the same. A simple conceptual model provided the ratiOnale for

this design, as detailed in the ensuing subsection. Fnllowing that is a description of the general

apprOach derived from the conceptual model.

2.1.1 Rationale

Although substantial numbers of abused and neglected children are recognized as

such and reported to state and/or local Child Protective Services (CPS) agencies,l reported

children represent only the “tip of the iceberg.” The NIS methodology is based on the model

given in Figure 2-1, which depicts these reported children at Level 1. As the model indicates,

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

associated with decreasing degrees of nfficial recognition or public awareness.

At Level 2 are those children who are not known to CPS but who are known to

other “investigatory” agencies, such as police, courts, or public health departments. These

agencies may have overlapping nr even conflicting responsibilities concerning certain situations,

1

Lw.I co””ty CPS .ge”ciea are mandated to handle reports co”cer”i”g .Mld .b”se and neglect i“ .11 stake.

2-1
~ i Level 1- Known to CPS \

Level 2-Known to other

in schools, hospitals and other

\

\

\

—-—— ———— -—— —--

Level 5-- Known to no one

FIGURE 2-1

Levels of Recognition of Child Abuse and Neglect

2-2
such as felonious assault, homicide, delinquency, dependency, domestic disputes, “children in

need of control,” or nutrition and hygiene problems. Children may remain at Level 2 because

Of qUeSdOnS Of definition or disputes concerning the appropriate respo”sibjlj[jes of th~~e

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

known,” they are not necessarily regarded by the cnmmunity as abused/neglected in the same

sense as Level 1 children are, and they do not necessarily receive assistance which specifically

targets their abuse/neglect problems.

Level 3 includes abused and neglected children who are not known to CPS or to

any Level 2 agency, but who are known to professionals in Other majOr cOmmunjtY j“stjtutjons,

such as schools, hospitals, daycare centers, and social services and mental health agencies,

Children may remain at this level for any number of reasons. One reason may be definitional

ambiguities as to what types of cases should be reported to CPS (or to other investigatory

agencies). Other reasons relate to the attitudes and assumptions of the professionals who are

aware of these situations. For example, they may feel that they are i“ the best positjOn tO help,

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

becoming involved in an official investigation.

The abused and neglected children at Level 4 are recognized as abused and/or

neglected by someone outside of the purview of the first three levels, such as a neighbor,

another member of the family, or by one or both Of the i“vOlved parties--the perpetrator a“d

the child. However, none of the individuals recognizing the maltreatment at this level have

made it known to persons at Levels 1 through 3.

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

by anYOne. These are cases where the individuals involved do not regard their behaviOrs or

experiences as child maltreatment and where the situations have not (yet) come tO the atte”tjo”

of outside observers who would recognize them as such.

2Recent debate on the appropriate limit. of CPS reapo”sibility for th,ld abuse and neglect c~es emph-ized the lack of

COnsen.us on thin s.bjmt. (Cf. .NamowinE the defi”itio”~ of child ab”ae a“d .eslect,” Ple”aw Session 1, 1Ilth A“”.al

Meeti”s a“d C.” fere”ce of the American hawiati.” for Protecti”s Childrc”, October 1987, A“ati”, TX, A tape .f this

session is available fmm America” Humane, 9725 Ewt Hampde. Ave””e, Denver, Colorado 802S1),

2-3
The model conveys the inherent difficulty of any attempts to measure the incidence

of child abuse and neglect. Level 5 cases are by definition impossible to document (unless they

can be brought into Level 4). In principle, it should be possible to identify children at Level 4

through methods such as surveys of parents, children, and/or neighbors.s This Possibility was.

in fact, entertained in both the NIS- 1 and the NIS-2 during early design stages. However, the

stigmatizing nature of acknowledgements of abuse and neglect introduces serious (and unknown

degrees of) underreporting bias into estimates of cases at this level.’ AS a result, both the NIS1 and the NIS-2 focussed on assessing the incidence of cases only at Levels 1, 2, and 3.

2.1.2 Approach

Since the main purposes of the NIS-2 were identical to those of the NIS- 1, its

design was essentially the same. It used an agency survey methodology in which both CPS and

non-CPS agencies participated. CPS provided information about all reported cases. In addition,

community professionals at both Level 2 and Level 3 agencies served as “sentinels” by remaining

on the lookout for child maltreatment cases during the study data period.

2.2 Study Definitions

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

the field to interpret specifically what constitutes “abuse” or “neglect.” At the same time,

consensus has yet to be reached as to the precise meaning of these terms, with different

professional groups maintaining widely varying perceptions concerning the kinds and degrees of

problems which constitute “child abuse” and “child neglect.”s

s

h noted i“ Chapter 1 (... fmt”otes 7 a“d 10 i“ that chapter), Str.”s a“d his colle.g”es have .o”d”cted two “.tio”wide

s“meys of h.”aeh.lds whtch tim to me=.re i“cide”ce at thts level.

4

I. the NIS-1, telephone -d i“-pmon i“temiew. with p-.ts were pretested, b“t the approach w- .ba.do.ed. 1. the

Pre.,.t *t.dy, a ho...hold int.~iew i..kr.ment W= developed, b.t the su~ey it*elf W= .Ot undertaken. The NIS - 1

Pr.t.~t result. r.ised ve~ *erio.a .o...s.s about the reti.b!fity and validity of nel[- report dat., p.rti.”1.rty i“ are.. of

s.x”4 and ●moti.nd abuse and i“ dl are= of “egle.t.

5

See, for example, Giovan”.”i, J.M. md Becema, R., Defi”i”K Child Ab.ae, Free Pres.: N.Y., 1979.

2-4
One of the key achievements of the NIS- 1 was the development of operational

definitions of child maltreatment which were both clear and objective in Specifying the kjndS of

situations that were encompassed by the study. All data collected in the study were “screenefl

for conformity to these definitional standards, and only those cases which fit the standards were

considered “countable” and used as the basis for generating incidence estimates. This same

approach wss used in the present study. All data were assessed for conformity to study

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

maltreatment which were found to be “countable.”

2.2.1 Overview of Study Definitions

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

following definitional standards had to be met:

(1) Child’s Age The child was live-born and under 18 years of age at the time

of the maltreatment io question.e

(2) Ch;/d’s Res;dence The child lived in one of the study counties at some time

during the study period.’

(3) Cusfody Sf@us: The child was a non-institutionalized dependent of parent(s)/

substitute(s) at the time of the maltreatments

(4) T;m~ of Mallreafmenc Maltreatment occurred during the study period which

applled to the respondent agency.g

6Act. or omin.io”e which occurred duri”~ pceg”a”cy or deUvew were .x.l”ded

7

Temporw mside”ce in . study co””ty (v~.tioni”g or visiting there) W- i“cl”ded, It wu “.t ~eceSS.V for the

mdtm.tme”t itself t. have ~c”md i“ the at”dy co””ty.

8

l“stit”ti.n.l .b”se .“d .egl.ct wem m.l”d=d

9

F.r CPS datw a report co”cemi”g the m.ltre.tme”t had k.” retie to CPS during the twelve-month study period; for

non-CPS data the maltreatment itself hd mcumd d.ri”s the ep-ifi. four-month petid duri.~ which the agency

p.rti.ip.~.d in the study.

2-5
(5) Purposive and avoidable acts/omissions The maltreatment behavior was

nonaccidental and avoidable.10

Maltreatment situations were classified into a number of specific forms, which were

then categorized into six major types physical abuse, sexual abuse, emOtional abuse. physical

neglect, emotional neglect, and educational neglect. Definitions of each of the specific forms of

maltreatment are given in conjunction with incidence estimates in Chapter 4.

2.2.2 Original and Revised NIS- 2 Definitions

In addition to the five standards listed above, there were requirements concerning

both the wroet rater of the acts/omissions and the degree of b to the child. A case was

considered countable only if it met all seven standards. In assessing the countability of cases in

the present study, two different sets Of definitional standards concerning ~ and perDet rater

criteria were used both the original NIS- 1 standards and a revised set of standards. The

original NIS- I definitional standards were used in order to provide a consistent basis of

comparison between tbe two studies. At the same time, in order to respond to serious criticisms

of the original definitions, the NIS-2 also implemented revised versions of these standards. As

a result of this strategy, the present study generated two sets of national estimates--one set

based on original definitions which could be compared to the NIS- 1 findings. and a

supplementary set of estimates using the revised NIS-2 standards.

Revised Harm Requirements. For a given form of maltreatment to be countable in

the NIS- 1, it was generally necessary that the child have suffered demonstrable harm as a result

of the ~altreatme”t 11 The NIS- I did nOt deal with situations where a chil~s health or ‘afety

was endangered through abusive or neglectful treatment, only cases where demonstrable injury

had already resulted from such treatment. Because of this very stringent requirement, the

10The study a.l”dd pmbie~ . . hind. which the parent/s”bstik”te Iwkd the finmcial me.”, t. prevent .r .Uevi.te

md f.r wht.h appmpri.te msi.tmce w= “ot avtilable thm”gh public .se”cies, Al.. ●xcluded w- lack of care stemming

fmm parent/s”bstit”te death, h..pit.b.atio”, i“camer.ti.n .r .ther .i=”=tm.es which m.de it physically impssible to

pmvid. Or .mmse for tieq”at. cm..

11k de.cribd further i“ Chapter 4, certain specific form .1 m.ltr..tme”t were c.naidered s. i.here”tly traumatic that

whenever the cixumtmce. met .ther stmdards of c..”tability, :m.tion.l ham W- automatically ws.med tohave

~c”md.

2-6
majority of the cases substantiated or indicatedlz as abuse or neglect by CPS did ~ meet the

NIS- 1 standards for “countability” and so were not used in generating estimates of the national

1S Critics of that first natinnaI incidence study viewed incidence of maltreatment in that study.

this as a serious shortcoming. To address this criticism, the original standard of demonstrable

harm was replaced by the endangerment stand ard in the revised definitions, allowing inclusion

Of Cmes where a child’s health or safety was endangered through abusive Or neglectful

treatment. According to the revised standard, all cases were considered to meet the revised

harm criterion if maltreatment was officially substantiated by Cps Or if nOn-cps professionals

judged the child’s health or well-being to have been seriously endangered by the Maltreatment

they reported. 14 By using both the original and the revised standards Simultaneously, it was

possible to include all substantiated CPS cases in the supplementary counts without forfeiting

the core objective meaning of the national estimates based on the original definitions.

Revised Perpetrator Requirements. The revised definitional standards also

incorporated less stringent requirements as to the perpetrator of maltreatment.

The NIS-2 revised perpetrator criteria were more inclusive than the NIS- I

perpetrator standards in two principal ways. First, in addition to parent(s)/substitute( s),

situations where other adult caretakers permitted sexual abuse were also “considered countable.

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

for two forms of neglecc inadequate supervision and other physical neglect (such as inadequate

food, clothing, shelter, disregard of physical hazards, and other inattention to the child’s

physical safety and well-being).

Revisions of the NIS- 1 requirement on the perpetrator’s age were primarily

motivated by a concern that cases not be automatically excluded from Countability simply

1s‘I”di. ated. .=.s were th.se f.? which the find CPS -aess”e”t hti n.t bee” made at the time tbe study data f.rm ww

mq”ired, but where the i“ve.ti~a~t”s CPS c-ew.rker regdd the available evidence w s“~tcie”t t. warrant c.”ti”.ed

i“ves~t~ati.”.

1sAcc.rdi”g tothe m-estim.tio”s .f NIS-1 fi”di”m, 69 percent .f s“bstanti.ted .r indicated .-es were excluded as n.t

..””t able hy the .riti”al defl”iti.”d stmdwds.

14For example, B tw.-y.m .Id child who w- left h.m. d.”. for sever.1 h.”m may bav. ●merged fr.m the i“cide”t

““scathed, but the plic. .ficer or .ther c.mm.”ity pr.fesai.”d who submitted a data f.m .“ the c-e may have judged

thts tmstme”t w h.ving seri.”sly e“d.”gered the child.

2-7
because the perpetrator was not legally of adult status (i.e., 18 or older). Under the original

NIS- 1 requirements, maltreatment Perpetrated by teenagers was included when they were the

chilts parents/substitutes, but not when they were other caretakers of the child. Under the

revised NIS-2 perpetrator requirements, cases of sexual abuse were also countable if nonparental

15 Further details concerning harm teenage caretakers had perpetrated or permitted the abuse.

and perpetrator criteria revisions are treated in Chapter 4, where specific forms of maltreatment

are discussed.

2.3 Data Collecting

A total of 29 counties (reflecting 28 primary sampling units, or PSUS) were selected

for the study, using a method which insured that the final sample would represent different

regions of the country and different degrees of county urbanimtion. In each county,

participants included the county CPS agency and professional staff in a number of non-CPS

agencies who were likely to come into contact with maltreated children. Non-CPS agencies

included

■

■

■

■

■

■

■

■

Public schools -- a sample of 10 per PSU,

Daycare centers -- a sample of 5 per PSU,

Short-stay general and children’s hospitals -- an average sample of 4 per

Psu,

Municipal police departments -- an average sample of 3 per PSU,

Social services/mental health agencies -4 per PSU,

The county juvenile probation department (generally one per county),

County sheriff/state police -- wherever the county had unincorporated

jurisdictions which were not served by municipal law enforcement agencies,

The county public health department - one per county.

1sl“cl.ai.n of tee”.ee pewetr.tom d,d “ot tiect the numkr of .ou”t.ble cues i“ other c.te~.ries of maltreatment, so the

Fwtr.tor criteria were not chmged for the other maltmatme”t c.teg.tim.

2-8
Overall, 706 non-CPS agencies participated in the study, representing 88.5% of the

798 eli8ib1e agencies asked to participate.

The study period began September 7, 1986, for all agencies other than schools and

daycare centers, where it began September 28. The period continued through December 6,

1986, for all agencies. Data collection was prospective in nature. CPS agencies were asked to

submit data forms on cases which were reported during the period and which were accepted for

investigation by the agency. Nms-CPS participants were trained in the study definitions of

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

during the study period. Two types of CPS data forms were used a long form, which obtained

sufficient details on the case to allow it be assessed for countability according to study

definitions, and a short form, which was for the specific purpose of identifying duplicate

reports concerning the same child. CPS data forms were “family lever forms, which

documented allegations concerning all children in a report on a given household or family. A

separate non-CPS data form was designed for use by all non-CPS participants. The non-CPS

data form was a “child lever form which recorded suspected maltreatment to an individual

child. Copies of these data forms are given in Appendix A.16

The study received a final total of 7,185 data forms ( 1,624 long CPS data forms,

2,285 short CPS data forms, and 3,276 non-CPS data forms). Because of sampling, the CPS data

forms represented a total of 36,719 official reports which had been received and accepted fOr

investigation by participating CPS agencies during the course of the study.

2.4 Data Processing

Readers should be aware of three key aspects of data processing countability

assessment, unduplicatimr, and certain aspects of the weighting.l’

16Details c.ncemi”g aampb”g .m.”gementa t. minimize the b“tie” .“ CPS a“d non-CPS agencies are cive” i“ Appendix

A .“d i“ the Rew~ . . Dat. C.ll=ti.”,

17Further detaila c.”c.rni”~ weishti”g a“d data .“.lysis me @v.” i“ Appe”dm A, .“d m.re c.mplete treatment of .11 data

P~e..i.g and =dYsis ia.ues cm & found in the RenOd O“ Data Pme,si”z a“d A“aly ai..

2-9
2.4.1 Countability Assessment

Cases recorded on CPS long forms and on non-CPS forms were assessed as to their

“countability” in relation to the study definitions. For each child substantiated by CPS, or

thought to meet the study requirements on either type of data form, the NIS-2 project staff

rated the degree to which the situation fit each of the two sets of definitional standards--the

original NIS- 1 definitions and the revised NIS-2 definitions, discussed above and further

detailed in Chapter 4. Each applicable form of suspected or substantiated maltreatment was

assessed as to its substance (who was alleged to have done what to whom, when, with what

effect, and with what quality of evidence). Ratings were made of the degree to which the

situation fit each individual aspect of the original NIS- 1 and revised NIS-2 standards.

Following this, overall assessments were made under each of the definitional standards.

Maltreatment was judged to be “countable” under a given set of standards if there was

reasonable cause to believe that the child had experienced maltreatment which met all of the

requirements of the definitional standards in question.

Despite the complexity of this assessment, it was reliable. Measurements of the

reliability of these judgments on a random ten percent of the data forms (i.e., on 534 data

forms) showed that coders had an 86% agreement as to whether a case was countable or not

countable. This percent agreement held whether the decision concerned countability according

to original NIS- 1 standards or according to the revised NIS-2 criteria.

2.4.2 Unduplication

More than one data fopm could be submitted to the study concerning an individual

child. Such duplicates could occur because the same maltreatment event was reported by more

than one study source, or because the same child had experienced more than one occurrence of

maltreatment during the study period. In either case, it was necessary to identify aod resolve

all such duplicate reports in order to permit estimates in which the child was the unit of

measurement. At the same time, unduplication had to be accomplished without the use of fully

identifying information, which had been avoided in the interests of confidentiality. Exactly

2-10
following the NIS- 1 approach, enough close-to-identifying information was obtained to allow

fairly certain judgments as to whether or not two data forms described the same child.

Having determined which data forms were duplicates, only one record was retained

to represent an individual child. Also, whenever a child had been identified to the study both

by CPS and by a non-CPS respondent, CPS was credited with having submitted the case.18

Non-CPS respondents were credited only with those children they submitted to the study

M thOse known to CPS. Moreover, within the non-CPS sector, duplicate records were

credited according to a priority system which was based on the “level of recognition” model

described above in Section 2.1.1. Further details about this priority system are provided later,

in Chagter 6.

2.4.3 Weighting and Estimation

National estimates were obtained by “weighting” each individual case in accordance

with the probability of having selected the source who reported it tn the study. By use of

appropriate weights at each level, the cases obtained were used to represent the much larger

database that would have been obtained if all potential data sources had participated and no

sampling had been used.

A number of important issues were taken into account in the process of weighting,

including annualization, calculation of sampling errors or variances, and corrections for

incomplete or poor participation by non-CPS respondents.

Annualization. Data were collected for a three-month period in most agencies (for

only ten weeks in schools and daycare centers). Data from all agencies were weighted so as to

represent the number of cases which would have been obtained had the data period lasted for a

full year. The NIS- 1 database provided the only available source of information about

annualizing the data in the current study, and so was used as the basis for calculating

annualization factors.

18Apart f~m d.cidi.s what record to use to rep-sent the c=. a“d wtieh sgency categoq to credtt for having a“bmitted

the CU., it W- .1.. “.c..s.v to decide how t.weight the .s.. This is.”. is detailed i. the Re..rt .“ Data Pr.ce,sinc

and A“.lysis, Chapter VI.

2-11
Sampling Errors. There is some degree of uncertainty associated with any estimate

that is made on the basis of a sample. The standard error provides some idea of much

uncertainty is associated with a given estimate aa a result of the use of a sample rather than a

complete study of the total population (it does not reflect other sources of error). 19 Thus, the

standard error indicates the precision of an estimate, and having reliable estimates of the

standard error is a prerequisite for conducting statistical comparisons of the estimates for

different groups.

The standard error of estimate was calculated for all estimates reported in

subsequent chapters. In addition, because the method of calculating totals and rates in the NIS2 differed slightly from the approach used in the NIS-1, the NIS- I estimates themselves were

recalculated using this same method. This provided a uniform basis for comparisons between

NIS-2 and NIS- 1 findings. The recalculations used a method which maximized the precision of

estimates and at the same time capitalized on the availability of updated population figures. For

these reasons, the 1980 figures given in this report do not exactly correspond to those in the

original NIS- 1 report of findings, but are more precise and more accurate than the original

figures.zo Standard errors and 9S confidence intervals for each of the incidence measures

reported in subsequent chapters of this report can be found in Appendices B, C, and D.

Correcting for Poor and Incomplete Participation. Efforts were made to

compensate for any incomplete or poor participation by nms-CPS respondents in the weights

assigned to the cases.

The “sentine~ nature of non-CPS data collection makes it particularly vulnerable to

distortion by low participant interest. Ideally, the numbers of cases submitted by a participant

should be informative about the numbers of maltreated children s/he encountered. Participants

with low degrees of interest in or commitment to the study can easily distort the incidence

estimates downward by their failure to recognize and/or submit data forms on the cases they

19The r.”ce or “wi”dow” around - estimate within wtich .“. ..” be confident the estimate he, is called a “confidence

intew.l.- 0“. ..” b. 95 percent certsi” that the i“eide”.e fall, within the range specified by the 9S percent confidence

i“tem al,

20The methtis used are fully detailed i. the Remrt .“ Data Prmessin= a“d Analysis.

2-12
~“co”nter,sl To minimize this SO”rCe of distortion, evaluations of each Participants degree Of

interest in and commitment to the study were obtained, and weighting adjustments were made

for any who received particularly poor ratings.

A similar downward distortion was possible when an otherwise interested and

committed participant did not participate for the full data period for whatever reason (e.g.,

sickness, vacation, etc.). All such absences were monitored during the study, and the final

weights were adjusted to correct for any lost time.

2.4.4 Data Analysis

The principal findings of the study are the incidence estimates themselves, and

these required no further analysis after estimation and calculation of their standard errors.

However, in order to compare the findings of the NIS- 1 and the N1S:2, or to examine patterns

of differences across subgroups within the NIS-2 (such as across the different age groups), some

further statistical analysis was necessary. In order to keep the text of this report accessible to

readers without statistical expertise, only the conclusions drawn from these analyses are

provided in the following chapters. Readers with some background in statistics who are

interested in examining the details of the analyses themselves can find them repOrted in

Appendix D.

21Note that the study methdol.m makea the estimat~ b~ed .“ the oti~”d defi”iti.ne vul”er.b]e to downward, h“t “ok

“pwati, di.totion. %tn.e .11 cm.. wew reviewed for their conrommce to stmdardized .t”dy deftinitio”. and since tbe

orisi”d deC,niCto”ai“cl”ded obj~tive ham criteria, .11 c-.* not meeting these criteria .o”ld be ide. t,rted a“d excluded.

Thus, the oriain.l defi”itio”a provided an im~ti.”t protection ngti”st upward hi-. 1“ co”trmt, ●stimates breed .“ the

r.visd d. fi”itio”s ~ k b,md upward, .i”ce the revised definitions relied .“ .“ i“hemntly subjective ha- criterion.

That is, CU.. which met .11 other study criteria w.= ..””table if thereap”de”tdeemed thechildto havebee”

.nda”gerd by the maltm.tm.”t i“ q.eeft.”.

2-13
2.5 Methodological Differences from the NIS- 1

It is important to note that the methods used in the NIS-2 reflected several

revisions of those which had been used in the NIS- 1. There were six principal areas of

difference

■ County samplti The NIS-2 sample of study counties waa selected by

probability proportionate to size. This insured a better representation of the

more populous counties.zz

■ More extensive use of sampling strategies To accommodate larger and more

complex agencies in more POPU1OUScounties and those with heavy child abuse

and neglect caseloads, far more extensive case sampling arran ements were

implemented in the NIS-2 in both CPS and non-CPS agencies. ,~ The use of

these methodological revisions to accommodate large agencies was remarkably

successful.z’

■ Nmz-CPS agencies represented Non-CPS agencies from an expanded set of

categories were recruited in the NIS-2, adding daycare centers and

considerably increasing the representation of mental health and social services

agencies. This afforded a more thorough search for cases at Levels 2 and 3

of the “iceberg,” in the model presented earlier.

9 Quality control of non-CPS participation: There was a closer monitoring of

non-CPS participants’ level of involvement throughout the study, with

corrections made for participants who had especially low ratings of interest

and commitment and adjustments made for absences during the data period. zs

221“ the NIS-1, O“IYtwo of the 26 s.mpled co.”ties had pop.1.tions of 7S0,000 or more, 1“ the NIS-2, there were ten such

..””ties i. the sample of 2S PSUS,

2s Wher.u in the NIS-1 it hti k“ Wmibl. to .btai” a data form for evev .-a i“vestis.ted by participating CPS

.Se”ciea, the NIS-2 d,d not attempt t.do . . i“ those counties where mom than 2,0W re~fi. were inventig. ted per Year.

Ml elitible “0”-CPS agency .tafl we= ide”tifid u key pa~icipmta in the NIS - 1, but k.”.. of the large ““mber of staff

.Ktible for the NIS-2 in many “0”-CPS agencies, it W= frq”e”tly “eces.aq to sample participant. in the NIS-2. The

NM-2 dso m~e more extensive uae of CM. sampfi”s i“ “0”-CPS .Vencies comp.red t. the NIS - 1.

241. the NIS-1, “o.p.flicipatio” w= . problem in that those .Se”.ies which -Pcted to e“co.nter substantial numbem of

children meeting the study rquimments had bee” more likely to ref”.e participation. 1“ the preae”t study, .ge”cy

p~ticip.tion rnt~ wem comparable t- those i“ the NIS-1 despite the f=t that co”.idersbly more of the age”ciee were

larser, mom complex, .“d hd be.vier child ab”.e and neglect c=.lo.ds--a”d refusals were “.t “ot.bly concentrated i“

such .Ce”cies,

251“ the NIS-1, it w- noted that the q“.hky of p.rticipatio” varied c.”sider.bly mm.. agencies, but there w- n.

available me.hs”ism for r-tifyi”g thts problem.

2-14
■ Dual definitions The study applied both the original definitional standards

and a set of revised definitions which applied less stringent requirements in

defining the set of “countable” cases, thereby generating two sets of incidence

estimates. Use of the less stringent revised definitions required broader

reporting guidelines for non-CPS participants concerning the cases of interest

to the study.

■ Time framu In the NIS- 1, CPS agencies participated for 12 months and

nms-CPS agencies for 4 months, whereas the NIS-2 data period was only

three months and even this was abbreviated to ten weeks in the case of

schools and daycare centem. This allowed the NIS-2 to be conducted in less

time and at lower cost, but made it necessary to apply an ann”ali=tion factor

in generating estimates.

2.6 The Meaning of the Incidence Estimates

This report provides estimates of the numbers of children whO experienced

countable (nr “in-scope”) maltreatment according to original NIS- 1 definitions of maltreatment

and according to revised definitions, as described above. Key features of these estimates are:

■ The incidence estimates use the child as the unit of measurement. They were

based on the (weighted) numbers of children who met study requirements in

one or more maltreatment categories. There was no attempt to “count”

families, incidents (i.e., episodes), or reports. The ultimate “count” was of

children how many different children met the study requirements in at least

one category of maltreatment?

■ The incidence estimates are annualized figures which reflect a 12-month

period, but they were based on data from only a 3-month period,

specifically, September 7 to December 6, 1986. In the course of the yemr

(even in the course of the data period itself), many different incidents of

several different forms of maltreatment may have occurred, but any

particular child was “counted only once in any individual incidence estimate,

Repeat reports concerning a single child, whether from the same study source

or from different study sources, were “unduplicated and the child was

represented in the final analyses only once.

■ Estimates of incidence are given both in terms of numbers and in terms of

U. That is, estimates are given both for the total numbers of children and

tbe numbers of children per 1,000 in the U.S. who experienced countable

maltreatment.

2-15
3. INCIDENCE OF CHILD ABUSE AND NEGLECT

For the results presented in this and subsequent chapters, each child reported to the

study was represented by a single record. The unit of measurement was the child, and each

table provides estimates in terms of incidence rate (numbers of children maltreated annually per

1,000 children in the U.S. population) and in terms of incidence per se (total numbers of

children nationwide who are maltreated annually).l

The findings reported in this chapter address the following principal questions:

■ What is the current national incidence of cases of child abuse and neglect

defined as countable according to the same objective standards “Seal in the

original incidence study? Have there been any statistically significant

changes in incidence since the original study in 1980?

■ What is the current national incidence of cases of child abuse and neglect,

defined as countable according to the revised NIS-2 Sta”dards?z

■ What is the current national incidence of each of the major categories of

child abuse and neglect, as defined by both the original and revised

standards? How does their current incidence compare with the 1980

incidence figures?

■ How are the outcomes of child maltreatment, countable under each set of

definitions, currently distributed across levels Of severity? HOW dOeS the

distribution here compare with that fo””d the NIS-I?

1

Sp..ifi. det.il. con.er.i.g how thedat. were proce8aed, u.duplicated, weighted, .“d .“.lysed c.” be f..”d in the-

.“ Data Processi”~ and A“alysi..

2

The reader will recall that . critical -pect of these revisions w= the cel~.tio. of the h..” requirement from that of

demo.ntrable h- to o“, of e“d.”germe”t. That is, c-e. where . child w= co”,idered to have bee” seri..aly

endangered by maltreatment (but had not yet been i.j.red /impaired) were i“cl”ded under the revised NIS-2 st.”dards.

Bec.”se themvi.ed den”itio”. wece broader, they res.lted i“ higher estimates of the i“cide”ce o[m.ltre.tme”t tha. th.se

baed o“ the origin.ldefi”itio”s.

3-1
The following sections address each of these issues in turns

3.1 National Incidence of Countable Child Maltreatment

Table 3-1 presents incidence levels breed on both the original definitional standards

used in the NIS-I and the NIS-2 and the revised standards developed for NIS-2.4 Here it can

be seen that, in 1986, 16.3 children per 1,000 nationwide met the original definitional standards

and were classified ES countable cases of maltreatment. This represented an estimated 1,025,900

children.

The 1980 vs. 1986 comparisons indicated that cases countable under the original

standards have increased significantly in the interim since 1980,5 from about 9.8 to about 16.3

children per 1,000 (a 66% increme), representing an increase from 625,100 to 1,025,900 children

(a 64% increase). Whether or not this reflects an increase in the actual occurrence of child

maltreatment or simply an increase in the ability of professionals to recognize countable cases

will be ‘discussed later in this chapter. Also note that, based on the revised definitions, the

overall rate of countable maltreatment in 1986 was 25.2 children per 1,000, representing

1,584,700 total countable cases.

‘~ti,.n inApw.d~ E diff.mnc- ~t~.en the 1Qa6 -d lgsn Studi- have ~en =-~d by the use of the t-~tatis~c.

Only them diffem”.- which met the standard critetio” of having les. than . five perce”k pmb.bitity of occurring by

chmca m explicitly noted in the t-t and tables even here. Because incide”c. rates take =co.”t of any changes in the

Wput.tio. since 1980, dl EtatiBtic.1 comparisons between the two studies were retie with this me~.re. 1“ tfis and

s“b=q”ent cb.ptem, dl -tim.t” .“.eming total n“mhm of ch$ldm” w. rounded to the “e.rest hundred. The precise

estim.t=, together with th.ir”pper .”dlower9Sperce”t .o”fidenc. bo.nds, ca”befo.”d i” Appe”d,ces B, C a“d D.

4Tablem 9-2 tbm.gh 3-S follow the same fomat: Incide”.e rat=am tive” in theupperh.lfof the table, while estimated

t.tds .pp=i” thelowerhdf. The fo”r.ol”m”nof n~msmpme”t, r.apectively (1) fi”dt”~from NIS-1 d.t. collected

i“ 1980 (M notd in Chapter 11, NIS-1 eatimatea were recalculated uai”g pmcedurea whtch c.nfom to tho.e used in the

present ~kudy)i (2) 1986 =tim.t.. b=ed Onth. Oritin~NIS-l d. fi.itions; (3) the~lfferencesin 1980 .nd 1ga6estimate*i

md (4) 1986 -tim.t- b=ed o. the myisd NIs-2 defi”itio”s.

5Me.ni”gth.t the pmbabitity ulesa than one i“ twenty that the i“cce=e i“ count.ble .=.s ai”ce 1960 occ”med due to

chmc. done.

3-2
Table 3-1. National incidence and level of recognition of child maltreatment

Original Definitions 1986

1980 1986 1980-1986 Revised

Category Increase Definitions

2

T

Total Countable

E.

9.8 16.3 6.5. 25.2

6

Total Countable 625,100 1,025,900

;

400,800* 1,584,700

b

“The 1980-1986 d,flerence i“ estimated incide”.e r.te w= .i~ific.”t at the p < .05 1...1.

%er 1,000 childte” i. the Wp”lation,

b

Total ““mber of .htldre” robndd to the nearest 10U “ot adjusted by pop”latio” totals

3-3
3.2 Incidence of Types of Child Maltreatment

In Table 3-2, countable cases of child maltreatment are categorized into those

involving some form of countable abuse and those involving some type of countable neglect.

Cases which involved both abuse and neglect are included in both categories, so the categories

sum to more than the total number of countable caaes given in Table 3-1.

Table 3-2 indicates that the majority of cases countable under the original

definitions (56%) involved abuse (9.2 per thousand, or 580,400 children), and just under half

(48%) involved neglect (7.9 per 1,000 or 498,000 children). This table also indicates that the

significant increase since 1980 in total number of maltreatment cases reflected a significant

increaae in countable cases of abuse--but that there h= been no significant change in the

incidence rate of countable cmes of neglect under the original definitions.

Applying the revised definitions resulted in a shift in these proportions. Less than

half (43%) of the countable cases under the revised definitions involved abuse (10.7 per 1,000 or

675,000 children), whereas almost two-thirds (63%) involved neglect ( 15.9 per 1,000 or

1,003,600 children). This reflects the fact that the revised definitions made far more of a

difference in the countability of neglect cases than in the countability of abuse cases. That is,

in many cases involving neglect countable under the revised definitions, the child in question

had not (yet) experienced any demonstrated injuryjimpairment (and so had not been countable

m maltreated under the original definitions), whereas s/he had been considered as endangered

by the maltreatment. In abuse cases, however, children were more likely to have already

experienced some injury/impairment, and so to be already countable under the original

definitional standards.

Tables 3-3 and 3-4 further detail the distribution of the incidence of child

maltreatment, presenting the estimated rates and totals for the major subcategories of abuse and

neglect, respectively. Again, a given case could be included in more than one of the

subcategories, so the subcategories in each table total to more than the corresponding category

total given in Table 3-2.

3-4
Table 3-2. Distribution of child abuse and neglect

Original Definitions 1986

1980 1986 1980-1986 Revised

Category Increme Definitions

Abuse

i

5.3 9.2 3.9” 10.7

T

:

Neglect

.

4.9 7.9 3.0 15.9

Abuse

;

336,600 580,400 243,800 675,000

;

Neglect

Sb

315,400 498,000 182,600 1,003,600

.

The diKere”ce in rate of i“cide”.. between 1986 a“d 1980 ww si~inc.”t at the p < ,05 level.

‘Pet 1,000 children i“ the pop.latio”.

b

Total n“mbr of chi!dce. mu”ded t.the nearent 100; not dj.st.d by p.p.latio” tot.in. /

3-5
Table 3-3. Distribution of child abuse

Original Definitions 1986

1980 1986 1980-1986 Revised

Category Increase Definitions

Physical Abuse 3.1 4.9 1.8* 5.7

R

A

; Sexual Abuse 0.7 2.2 1.5* 2.5’

Sa

Emotional Abuse 2.1 2.8 0.7 3.4

Physical Abuse 199,100 311,200

6

112,100” 358,300

I Sexual Abuse 42,900 138,000

L

95,1OO* I55,900’

Sb

Emotional Abuse 132,700 174,400 41,700 211,100

●

The 1986 a“d 1980 i“cide”.e rates diKerd aimificantly at the p <.05 level.

‘Per 1,000 children in the mpulation.

b

Total .umbm of cfildmn rounded to the nearest 100; “.t adj”std by Fp”latio” totals.

‘I”cl”dea tee”.se Frpetr.tom.
Table 3-4. Distribution of child neglect

Original Definitions 1986

1980 1986 1980-1986 Revised

Category Increme Definitions

Physical Neglect

R

1.6 2.9 +1.3 9.1

A

: Emotional Neglect 0.9 0.8 -0.1 3.5

Sa

Educational Neglect 2.7 4.6 +1.9 4.6

Physical Neglect 103,600 182,100 +78,500 571,600

Emotional Neglect 56,900 52,200 -4,700 223,100

Educational Neglect 174,000 291,100 +117,100 292,100

*No statistically simir,cmt d,flere”.es b.tw.e” 1980 and 1986 i“cide”c. f,wre@.

%er 1,000 childr.” in the Pp”latio”,

b

Total ““mbem of .hildmn m“”dti to the ne-t lw “.t tij”std by pp”latio” totals.
3.2.1 Types of Abuse

Table 3-3 provides the incidence statistics for subcategories of abuse. There it can

be seen that 4.9 children per 1,000 (or 311,200 children) experienced physical abuse which was

countable under the original definitions in 1986, accounting for the greatest proportion of all

the abuse cases. Physical abuse was also the most frequent subcategory of abuse under the

revised definitions, with 5.7 children per 1,000 (or 358,300 children) countable under those

criteria.

The next most frequently-occurring subcategory of abuse was emotional, with 2.8

children per 1,000 (or 174,400 children) suffering this type of maltreatment under the original

definitions. As one would expect, the use of the revised definitions led to a higher estimate for

the incidence of countable emotionally abused children (3.4 children per 1,000, or 211,100

children). As was noted above concerning ne81ect, emotional abuse often had not yet resulted

in injury/impairment in many cases where the child was nevertheless perceived as endangered

and hence was countable under revised definitions but not under original standards.

Sexual abuse was the least frequent of all three major subcategories of abuse under

both definitions. However, it was not much below emotional abuse in incidence in the 1986

data. Under the original definitions, 2.2 children per 1,000 (or 138,000 children) experienced

some form of countable sexual abuse durin8 the year. As noted earlier (see Section 2.2), the

revised 1986 standards included teenage perpetrators of sexual abuse. Under the new

definitions there were 2.5 sexually abused children per 1,000 in the population, or 155,900

countable cases of sexual abuse nationwide in 1986.

Concerning changes in the different forms of abuse since the 1980 study, note th~t

there were significant increases in the incidence of both physical abuse and sexual abuse, but

that emotional abuse did not change in incidence. Remarkably, the incidence of countable

sexual abuse more than tripled since 1980, and this increase was highly statistically significant.

3-8
3.2.2 Types of Neglect

Subcategories of neglect are presented in Table 3-4. [t can be seen that under the

original definitions, educational neglect was the most frequently occurring form of neglect,

involving 4.6 children per 1,000 (or 291,100 children) and accounting for 58% of all countable

neglect cases in the current study. The second most frequent subcategory was that of physical

neglect, with 2.9 children per 1,000 (or 182,100 children) having experienced this type of

maltreatment in 1986. Physically neglected children represented 37% of all neglected children

countable under original definitions in this study. Finally, the least frequently occurring

subcategory of neglect (reflecting only 10% of all neglected children under the original

definitions) was that of emotional neglect, having occurred to 0.6 children per 1,000 (or 52,200

children nationwide).

Just as the use of the revised deflnidons revealed a greater incidence of overall

neglect (see above), so did it dramatically shift the distribution of’ neglect across the

subcategories. As can be seen in Table 3-4, under the revised definitions, physical neglect

represented by far the largest subcategory of countable neglect. There were 9.1 children per

1,000 (or 571,600 children) who experienced countable physical neglect under the revised

definitions, representing 57% of all neglected children under these standards. Educational

neglect was the second most frequent subcategory, with 4.6 children per 1,000 (or 292,100

children) experiencing this type of maltreatment. This represented 29% of the total countable

neglect cases. Finally, while emotional neglect was the least frequent subcategory under the

revised as well as the original definitions, it nevertheless did represent a much larger proportion

of the estimated total neglect cases under the new definitions, where countable emotional

neglect was experienced by 3.5 children per 1,000 (or 223,100 children), representing 22% of

all neglected children.

Finally, note that there were ~ statistically reliable differences between the 1980

and 1986 studies when the subcategories of neglect were compared (using, of course, the

original definitions).

3-9
3.3 Severity of Outcomes from Countable Maltreatment

Table 3-5 presents the distribution across different degrees of injury/impairment of

all those cases where countable maltreatment of some form occurred to a Child.e The entries in

this table total to those in Table 3-1.

An estimated 1,100 children died in 1986 as a result of maltreatment countable

under the original definitions. This reflected an incidence rate of 0.02 maltreatment-related

fatalities per 1,000 children and involved O.1% of the countable maltreatment cases.

Injury/impairment was defined as serious when it involved a life-threatening

condition, represented a long-term impairment of physical, mental, or emotional capacities, or

required professional treatment aimed at preventing such long-term impairment. Examples of

serious injuries/impairments include loss of consciousness, stopping breathing, broken bones,

schooling loss which’ required special education services, chronic and debilitary drug/alcohol

abuse, diagnosed cases of failure to thrive, third degree burns or extensive second degree burns,

and so forth.7 Serious maltreatment-related injuries occurred to 2.5 children per 1,000 in 1986,

representing 157,100 children, or 15% of all children maltreated according to the original

definitions. The corresponding figures under the revised definitions were similar, with

2.5 children per 1,000 (or 160,000 children) estimated to have received serious injuries. They

represented 10% of all children maltreated according to the revised definitions.

Moderate injurieslimpairments were those which persisted in observable fOrm

(including pain or impairment) for at least 48 hours. For example, bruises, depression or

emotional distress (not serious enough to require professional treatment), and the like. Moderate

degrees of injury/impairment were experienced by 11.7 children per 1,000 (or 740,000 children)

in 1986, and these accounted for 72% of the children countable as maltreated under original

definitions. Considering children countable under the new definitions yielded a slightly greater

incidence estimate for moderate injuries, with 15.1 children per 1,000 receiving moderate

6Th.se children who exptienced multiple i“j”tiea of dtffem”t de~es of severity were .Imsified ““de. the most serious

injuwfimp.im.nt for this mdy.ia. Note that end.”sement .-” were only .o”nt.ble under the revined NIS-2

stmdmds.

7

S- .Guidefi”es for Evd..tive Codtns,” ApP”dtx C in the Remti . . D.t. P=easi.e .nd A“.lvsia.

3-1o
Table 3-5. Incidence of injury/impairment from child maltreatment

original Defi”jtjon~ 1986

1980 19a6 1980-1986 Revised

Category Increase Definitions

Fatal 0.02 0.02 0.0 0.02

Wrious

:

2.1 2.5 0.4 2.5

T Moderate 6.2 11.7 5.5* 15.1

:. Probable 1.5 2.0 0.5 2.a

Endangered N/A NjA N/A 4,7

Unknownc 0.0 --- --- ---

Total 9.a 16.3 6.5* 25.2

I

.

Fatal 1,000 1,100 100 1,100

Vrious 131,200 157,100 25,900 160,000

Moderate 393,400 740,000 346,600 ● 952,600

Probable 97,500 127,800 30,300 173,700

Endangered N/A N/A N/A 297,200

Unknownc 2,000 --- --- ---

Total 625,100 1,025,900 4oo,aoo ● t,5a4,700

.

The dirfere”te htwee” 1986 a“d 1980 i“cide”c. rate. ia si~ific.”t at the p < .05 level.

%.r1,000 childm” i“ the popul.tie”.

bN“mbem of children ro””ded to the nearest 100; not tij.sted by pp.lation totals

‘For 0,31% of all maltreated childce” i“ the NIS - 1, severity of l“j.w/lmpairme”t w- ““k”ow”

N/A--Not applicable in original NIS- 1 definitional ata”dards.

3-11
injuries, or 952,600 children nationwide, representing 60% of all children maltreated according

to revised standards.

The nature of the maltreatment itself gave reasonable cause to assume that

injury/impairment probably occurred8 to 2 children per 1,000 in the U.S. in 19g6, or 127,800

children countable under original definitions. Here, probable injuries/impairments involved

12% of all maltreated children. The breakdown under the new definitions was similar, with 2.8

children per 1,000 or (173,700 children) counted as probably injured/impaired, representing

11% of all maltreated children.

The revised definitions allowed estimates to include those children believed to have

been endangered but not yet injured/impaired (see Section 2.2). g An estimated 4.7 children per

1,000 (or 297,200 children) were endangered, representing 19% of all maltreated children under

the revised definitions.

Tests of differences between the 1980 and 1986 results (using original definitions)

showed no significant changes in the incidence of fatalities, serious injuries/impairments, or

probable injuries. There was, however, an g9% increase in the incidence rate of moderate

injuries due to maltreatment, and this increase was statistically significant.

This configuration of differences between the two studies in rates of

injury/impairment implies that the overall increase in cases countable under original definitions

may have reflected an increase in the likelihood that professionals would recognize

maltreatment, rather than an increase in actual maltreatment occurrence, or incidence per se.

That is, had maltreatment per se increased in incidence since 1980, one would expect an

increase at ~ levels of injury/impairment. [f, however, it was the likelihood of recognition

that increased, as speculated here, then one would expect a pattern of results similar to the one

8The label “probable inj”V/imp.irme”t” in fact means that the “.ture of the m.ltre.tme”t ww used u the basis for

i“femi”g that i.j”q/impairment hti probably occurred to tbe child. Thus, “probable” .hould “ok be interpreted as I.**

serio”a thm .mderate .. . M.”y of the types of maltreatment used = the b=ia for inferring probable injuries (e. g.,

aba”d.nme”t, i“ceat, extreme close co. fi”ement) could re=o” ably lead to Serious i“j”w or impairment.

‘Cbildre” who were not .thewise i“juried/impairment were defined u endangered by the .lle~ed acts or omiasio”a of

maltreatment if (a) they were ●xplicitly rated by the respo”de”t who completed tbe data form .“ their cue m having been

e“dan~ered by the m.ltreatme”t, or (b) they had been reported to CPS and their cue had bee” .Kt.i.l!y s“b.ta”ti. ted.

3-12
actually reported: highly noticeable harm such as fatalities and serious injuries/impairments

should show little change, as these would have been at or near their maximum level of

recognition in 1980. Increases should be most dramatic at the level of moderate

injury/impairment, where there was greater potential for improved recognition of cases. Also

note that the Iocalimtion of increased maltreatment to physical abuse and sexual abuse is

consistent with an explanation of the increase as one in recognition rather than incidence per se.

It seems reasonable to assume that, in the interim since 1980, professionals have become better

attuned to the cues of these types of maltreatment.10

overall, the majority of children who experienced countable maltreatment had

suffered moderate degrees of injury jimpairment as a result of their abuse and/or neglect and

increases in the incidence of injuries since 1980 predominated at this level of moderate injury.

This pattern of change suggested that the increase in countable cases since 1980 may have been

due largely to increased recognition of moderate maltreatment on the part of professionals.

3.4 Summary

3.4.1 Original Definitions

The following were notable findings of the NIS-2 using the original definitions

which were established in the NIS- 1:

■ In 1986, an estimated 16.3 children per 1,000 or a total of more than one

million children nationwide experienced abuse or neglect in 1986 which met

the original standardized study definitions of maltreatment.

■ The majority of countable cases (56%) involved abuse, and just under half

(48%) involved neglect. Abused children represented an incidence rate of 9.2

per 1,000 and numbered about 580,400; there were 7.9 neglected children

per 1,000 in 1986, representing about 498,000 children nationwide.

10Unfoti.n.tely, however, the evidence di..”saed e.rtier i“ the chapter .1.. ind,c.tes that they are no more likely to report

the CMeathey rec.-i.. than they were i“ 19S0.

>13
m The most frequent category of abuse was physical, followed by emOtional

abuse and then by sexual abuse, with incidence rates of 4.9, 2.8, and 2.2

children per 1,000, respectively.

■ The frequency ranking of the subcategories of neglect was educational,

physical, and emotional, with incidence rates of 4.6, 2.9, and 0.8 children per

1,000, respectively.

■ Moderate injuries predominated, occurring in 72% of the countable cases;

these were followed in frequency by serious injuries (15%), prnbable injuries

(12%), and fatalities (O.l%).

3.4.2 Revised Defini lions

Because the revised definitions were more inclusive than the original definitions,

being based on an endangerment rather than a demonstrable harm standard, estimates usif18 the

revised definitions were generally higher across the board than the corresponding estimates

based on the original definitions. The following were notable findings of the NIS-2 using the

revised definitions

■ Under the revised definitions, an estimated 25.2 children per 1,000 or a total of

more than one and one-half million children nationwide experienced abuse or

neglect in 1986

■ The majority of countable cases (63%) involved neglect, and fewer than half (43%)

involved abuse, reversing the pattern found under the original definitions. There

were 15.9 countable neglected children per 1,000, numbering 1,003,600 children

nationwide, there were 10.7 abused children per 1,000, representing 675,000

children nationwid~

■ The most frequent type of abuse was physical, followed by emotional abuse and

then by sexual abuse, with incidence rates of 5.7, 3.4, and 2.5 children per 1,000,

respectivel~

■ The frequency ranking of the subcategories of neglect differed from the pattern

obtained under the original definitions. Using the revised definitions, physical

neglect was by far the most frequent form of neglect, followed by educational

neglect, and then emotional neglect, with incidence rates of 9.1, 4.6, and 3.5

children per 1,000 respectively; and

m Moderate injuries predominated, occurring in 60% of the countable cases; these

were followed in frequency by children believed to be endangered by the

maltreatment they experienced (19%), then by probable injuries (1 l%), serious

injuries ( 10%), and fatalities (0.1%).

3-14
3.4.3 Differences from the 1980 Hndings

Since sampling errors both for the present study and for the NIS- 1 were estimated,

the differences reported here between the two studies as statistically significant are, with high

probability, ~real iff rent ea h study. Moreover, the present

study was designed to provide the best possible estimates of the current incidence of child

maltreatment, in less time and at lower cost than the NIS- 1. Considerable effort was directed

toward insuring that the estimates include all cases of child maltreatment recognized by

participants during the study period. To this end, the earlier design was modified in a variety

of ways (see Chapter 2) in order to maximize the validitv of current estimates of incidence,

The following were reliable (i.e., statistically significant) differences between the

findings of the two studies

■ Countable cases of maltreatment increased significantly (by 66%) over their

1980 incidence rate.

■ The increase in countable cases primarily reflected a significant increase (of

74%) in the incidence of abuse.

m Among the abuse cases, there were significant rises in the incidence of

physical and sexual abuse, with physical abuse increasing by 58V0 and sexual

abuse occurring at more than triple its 1980 rate in 1986.

■ Neither emotional abuse nor any form of neglect showed reliable changes in

incidence rate since the earlier study.

■ The only significant change in level of maltreatment-related injuries occurred

in the category of moderate injury, which showed an 89% increase in its rate

of incidence since the 1980 study. This suggested that the overall increase in

cnuntable cases of maltreatment may have largely been due to an increased

likelihood that professionals would recognize maltreatment, rather than to any

increase in incidence per se.

3-15
4. SPECIFIC FORMS OF MALTREATMENT

This chapter presents incidence estimates for each of the specific forms within the

more general maltreatment categories--physical abuse, sexual abuse, emotional abuse, physical

neglect, educational neglect, and emotional neglect. It is organized into seven sections. The

firSt section Presents a tabulation of the perpetrator and harm requirements under the different

definitional standards for each specific form of maltreatment. The following six sections focus

on the general maltreatment categories. Each discusses the specific forms within one of these

general subcategories, overviewing the definitions of each specific form, presenting incidence

estimates under both original and revised standards, and considering any statistically significant

changes in incidence since 1960.

As in previous chapters, tables given here provide incidence estimates in terms of

both rates (number of maltreated children per 1,000 children in the population) and total

number of maltreated children nationwide. Children are included under each applicable fOrm

of maltreatment,l so the entries within each table sum to more than the total children who

experienced maltreatment in the general category in question.

4.1 Original vs. Revised Definitions

As was indicated in Chapter 2, the original and revised definitions differed in the

requirements concerning the ~ to the child and the perpetrator of maltreatment. Within

each set of definitional standards, harm and perpetrator requirements also differed across the

specific forms of maltreatment. Table 4-1 indicates these requirements under the original and

revised standards for each speci~lc form of maltreatment. Throughout this chapter, the text

refers back to the entries in this table, as definitions and estimates are given for each specific

form of maltreatment. z

lUp to three diati”ct form of m.ltre.tme”t were ctied for any give” child.

2

For more detailed specifications .on.emi”g definitions, s- Re~ort .“ Data Processin~ a“d Analysis.

4-1
Table 41. Reladonship of original definitional standards wd h NIS-1 and in NIS-2 for mmparable estimates to the fmd retied defitidond stmdwds

used in NIS-2 for supplementa~ estimates.

I.

11,

+&

111.

MALTREATMENT 9RIG1NAL STANDARDS REWSED STANDARDS

PHYSICAL ABUSE PERPETWTOR HARM PERPETRATOR HARM

COmmitthg Adult mretaker Moderate Endmgerment

Permitting Ptient Mtierate Endmgerment

S=UAL ABUSE

Intrusion

Committing

Permitting

Genital molestation

Committing

Permitting

Other or unknow

Committing

Permitting

EMOTIONAL ABUSE

Tfing or binding

Committing

Permitting

Other close confinement

Committing

Permitting

Verbal or emotional assault

Committing

Permitting

Other or unknown abuse

Committing

Pcrmilting

Adult mretaker

Parent

Asumed Teen/adult wetaker

Assumed Teen/adult metaker

Adult mretaker

Parent

Asumed Teen/adult wet&er

Assumed Teen/addt wet&er

Adult metaker

Parent

Moderate Teen/adult wet~er Endmgerment

Mderate Teen/adult met&er Endmgement

Adult caretaker

Parent

Adult caretaker

Parent

Adult mretaker

Parent

Adult caretaker

Paren(

Assumed

Assumed

Moderate

Moderate

Moderate

Moderate

Moderate

Moderate

Endangerment

Endmgerment

Endangerment

Endangerment

Endangerment

Endangerment
MALTREATMENT

Iv. PHYSIML NEGLE~

Refusal of health care

Delay in health care

Abandonment

Expulsion/refusal of runaway

Other custody-rela(ed maltreatment

Inadequate supetision

Other physical neglect

v. EDUCATIONAL NEGLE~

&& Permitted chronic lrumq

Other trumcy/failure to enroll

inattention to special educational need

VI. EMOTIONAL NEGLE~

Inadequate nurturance/affection

Chronicjenreme spouse abuse

Permitted drug/alcohol abuse

Permitted olher maladaptive behatior

Refusal of psychological care

9RIG1NAL STANDARDS

PERPETRATOR

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

Parent

HARM

Moderate

Serious

Assumed

Axttmed

Moderate

Serious

Serious

Assumed

Assmed

Assumed

Serious

Serious

Serious

Serious

Moderate

REVISED STANDARDS

PERPETWTOR HARM

Endangerment

Endangerment

Endangerment

Adult metaker Endangerment

Adult wetaker Endangerment

Endangerment

Endangerment

Endangerment

Endangerment

Endangerment
MALTR~TMENT ORIGINAL STANDARDS

PERPETWTOR HARM

Delay/ftiure of psycholugicd mre Parent Serious

Other inattention to emotional needs Puent Seriom

VII. OTHER

General or unspecified ne~ecta N/A N/A

Other or umpdfied mdtreatmentb N/A N/A

REMSED STANDARDS

PERPETUATOR ~RM

End~gement

Endmgement

Pment Endmgerment

Adult aet&er Engagement

Not changed, orighd NIS-1 standards were used

tithout retilon.

& N/A Not apphmble, ori~nal ~S-1 standards did not

& include thii m a countable mtego~ of maltreatment.

a Claaaified under “N neglect” h Retised Definitional

Standards. (Not countable under Orighal Standmds).

b Classified under .All Maltreatment” in Retised Definitional

Standards. (Not countable under Original Standards).
4.2 Physical Abuse

The category of physical abuse was unique in that it was not broken down into any

more specific forms of maltreatment. Since the findings for the category of physical abuse

were presented and discussed in the previous chapter, they are not reiterated here. Table 4-l

indicates that only the harm requirement for this form of maltreatment was changed under the

revised standards -- relaxing the criterion from one of moderate demonstrable harm to one of

endangerment.

4.3 Sexual Abuse

Children who experienced any one of three specific forms of sexual abuse were

counted in estimates of the overall incidence of sexual abuse. The three forms of sexual abuse

reflected different kinds of acts

Intrusion

Evidence3 of actual penile penetration--whether oral, anal, or genital,

homosexual or heterosexual--was required for this form of maltreatment,

Molestation with Genital Contact

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

contact had occurred, but where there was no specific indication of intrusion.

When intrusion had been coded for a given child, molestation was not also

coded unless it reflected a distinctly different type of event in the child’s

experience (e.g., involved different perpetrators).

Other or Unknown Sexual Abuse

This category was used for unspecified acts not k“Own tO have involved

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

allegations concerning inadequate or inappropriate supervision of a child’s

voluntary sexual activities.

As given in Table 4-1, no direct evidence of injury was required for the first two

forms of sexual abuse to be countable under either the original or revised definitional standords.

That is, it was assumed that sexual abuse involving intrusion is inherently traumatic and

injurious to a child, hence when the situation fit the definitional criteria in all other respects,

3Evide”ce mea”, credible i“for”atio” (e.g., the perpetrator acknowledged his actiona). An in the NIS - 1, the term does ~

have . technic.1 meaning here, either legal or medical.

4-5
injury was simply assumed to have occurred. For cases classified under the third form of

sexual abuse ~other or unknown”) to be countable according to the original definitional

standards, circumstantial or direct evidence of at least moderate physical or emotional

injury/impairment was required. The revised definitions relaxed this criterion to allow cases

where a child was considered “endangered” as a result of other or unknown sexual abuse.

Under the original definitions, any of these three specific forms of maltreatment

was countable only when it was perpetrated by an adult caretaker or had been either perpetrated

or permitted by a parent/substitute. The revised definitional standards expanded the set of

countable cases to also include cases where a caretaker had permitted these forms of

maltreatment and where the caretaker was a teenager or not clearly of adult status.’

Table 4-2 presents the estimates for the specific forms of sexual abuse, under all

definitions and for both the NIS- I and the NIS-2. As indicated earlier, the specific forms can

sum to more than the total of children who were sexually abused, because a given child could

experience more than one form of sexual abuse and so be counted in more than one row of the

table. This table shows that among cases of sexual abuse which were countable under the

original definitions in 1986, genital molestation was the most commonly-occurring form, with

intrusion and “other or unknown” sexually abusive acts representing progressively smaller

components of the total. Specifically, an estimated 1.0 children per 1,000 (or 65,800

nationwide) had been genitally molested, reflecting 45% of all the children who had been

sexually abuse~ 0.7 children per 1,000 (or 43,200 children) had suffered intrusion, which

reflects 32% of all those sexually abused; and 0.5 children per 1,000 (or 29,400 nationwide)

had experienced “other or unknown” forms of sexual abuse, which is 23% of all the children

who had been sexually abused.

When revised definitions were used, the estimated incidence of each form of sexual

abuse increased by about 0.1 child per 1,000. Note that the numerical increase was slightly

lar8er for the “other or unknown” category, where revised standards expanded w perpetrator

and harm requirements beyond those allowable under the original definitional standards.

4

The -pansion of the perpetrator age criterion .llowed tee”.ge ~ adult c.ret.kem; the exp.nsio” of the criterion

co”.erning the perpetrator’s relationship t. the child allowed other caretakers ~ p.rent./,”batit”tes to permit this

ab”ae.

4-6
Table 4-2. Incidence of specific forms of sexual abuse

Original Definitions 1986

1980 1986 1980-86 Revised

Form Increase Definitions

Intrusion 0.3 0.7 0.4” 0.8

Genital Molestation 0.2 1.0 0.8* 1.1

Other or Unknown 0.1 0.5 0.4* 0.6

Total Sexual Abuse 0.7 2.2 1.5” 2.5

Intrusioo 20,500 43,200 22,700* 48,400

Genital Molestation 15,300 65,800 50,500” 70,300

Other or Unknown 8,100 29,400 21,300* 37,600

Total 42,900 138,000 95,100. 155,900

.

The dtffere”c” i“ mte of incidence btwee” 1986 .“d 1980 w.= siwifi.a”t at the p e ,05 level

‘Per 1,WO childr.” i“ the pp”lati.”.

b

T.td ““m&r of .hildm” ro””ded to the “e.rest 10U not .dj”sted by pp”latio” total..

4-7
In Chapter 3, it was reported that the incidence of sexual abuse as a category

increased significantly since the 1980 national incidence study. Here, it can be seen that this

increase occurred for each of the specific forms of sexual abuse. However, proportionally

greater increases occurred for genital molestation and for “other or unknown” sexual abuse. In

1986, estimates for both of these forms of sexual abuse were more than three times their 1980

levels. Note that this pattern of increases led to a reordering of the forms of sexual abuse in

terms of their relative frequency of occurrence in 1980, intrusion had been the most

frequently-occurring form of sexual abuse, whereas (as noted above) genital molestation was

most frequent in the 1986 data.

4.4 Emotional Abuse

The category of emotional abuse encompassed three distinct forms of maltreatment

Close Confinement (Tying or Binding and Other Forms)

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

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

enclosed area (such as a closet) as a means of punishment.5

Verbal or Emotional Assault

Habitual patterns of belittling, denigrating, scapegoating, or other nonphysical

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

forms of maltreatment (such as threats of beating, sexual assault,

abandonment, etc.).b

Other or Unknown Abuse

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

under other forms of abuse, or unspecified abusive treatment. This form

includes attempted or potential physical or sexual assault ,7 deliberate

withholding of food, shelter, sleep, or other necessities as a form of

punishment, economic exploitation, and unspecified abusive actions.

sD=. ~ include se”erally =cept~ practices a“ch - “se of safety h.messes .“ toddlem, ~waddli”g of i. fanta, or discipline

i“volvi”g “m””ding” a child or restricting . child to hislher room.

6.Thts c.t.s.v w- “ot used if verbally ws.”ltive ., abusive treatment occurred .im”lt.”e...ly with other abusive behavior

(..8., d.ri.s . phy.icd ~.ti.g) ..les. adveme effects a..med which were sepatate a“d distinct fmm th.ae i. the other

categow.

‘Where actual physical contxt tid “ot occur (es., throwi”s something at the child).
In order for cases to be countable under the original definitional standards, Table

4-1 indicates that these forms of maltreatment had to be perpetrated by an adult caretaker, or

permitted by a parent/substitute. Moreover, except for the more extreme forms of close

confinement (i.e., except for abuse involving tying or binding), circumstantial or direct evidence

of at least moderate injury/impairment was required. This was not required when tying or

binding was involved, however, since harm was automatically assumed in those cases, given the

extreme nature of the abuse itself.

As shown in Table 4-1, the revised definitions did not alter the perpetrator

requirements on these forms of abuse, but did expand the harm requirement to allow cases

where the child was judged to have been endangered, though not yet actually injured or

impaired, by the maltreatment in question.

Table 4-3 provides the incidence estimates for these maltreatment forms. It

indicates that, under either set of definitional standards and in both 1980 and 1986, verbal or

emotional assault was by far the most frequently-occurring form of maltreatment in the

emotional abuse category. In 1986, under original definitional standards, 1.9 children per 1,000,

or 120,800 children nationwide, had been verbally or emotionally assaulted. This amounted to

68% of the emotionally abused children. In contrast, 29% had experienced “other or unknown

abuse,” and only 5% had been victims of close confinement. The same percentages were found

for the incidence of specific forms of emotional abuse under the revised definitions.

Although, as has been reported, there was not a significant change in the overall

incidence of the category of emotional abuse, the incidence of “other or unknown” abuse has

substantially increased since 1980, and this increase was statistically significant. This specific

form of maltreatment nearly doubled in estimated incidence since the 1980 study. This result is

not so surprising, however, in view of the fact that both physical abuse and sexual abuse

demonstrated overall increases, and “other or unknown” maltreatment included attempted assaults

of both types as well as any abusive actions not specifically referred to in the descriptions of

any of the other forms of abuse.

1

4-9
Table 4-3. Incidence of specific forms of emotional abuse

Original Definitions 19a6

1980 1986 1980-86 Revised

Form Increase Definitions

Close Confinement 0.05 0.14 o.oa o.la.

R Verbal or

A Emot]onal Assault I.a

T

1.9 0.1 2.3

:

s Other or

Unknown Abuse 0.3 0.8 0.5’ 1.0

Total 2.1 2.8 0.7 3.4

Close Confinement 3,200 a,700 5,500 11,100

Verbal or

; Emotional Assault

:

~ Other or

Unknown Abuse

.

115,200

I a,300

I zo,aoo 5,600

51,700 33,400 “

144,300

63.200

I

Total 132,700 174,400 41,700 211,100

.

The diKemnc” in rate of incidence ktwee” 1986 a“d 1980 were si~ific.”t at the p c ,05 level.

~.r 1,000 children i“ tha Wpulation.

bT.t d “-b. of .hildmn mu”ded tothe n.areat lW, not djusted by population tot ala

410
4.5 Physical Neglect

The seven specific forms of physical neglect are listed in Table 4-1. The first two

reflect inattention to remedial health care needs, the next three all involve custody-related

maltreatment, and the last two forms involve inadequate supervision and other types of physical

neglect. The acts or omissions that were classified under each of these forms of maltreatment

we rc

Refusal of Health Care

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

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

condition or impairment.8

Delay in Health Care

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

problem which any reasonable layman would have recognized as needing

professional medical attention.g

Abandonment

Desertion of a child without arranging for reasonable care and supervision.

This category included cases where children were not claimed within two

days, and where children were left by parents/substitutes who gave no (or

false) information about their whereabouts.

Expulsion

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

of a child from the home without adequate arrangement for care by others,

or refusal to accept custody of a returned runaway.

Other Custody Issues

Custody-related forms of inattention to the chilts needs other than those

covered by abandonment or expulsion. For example, repeated shuttling of a

child from one household to another due to apparent unwillingness to

maintain custody, or chronically and repeatedly leaving a child with others

for days/weeks at a time.

s.Th,s catego~ did not apply to treatment need. concerning educational, emotional, or behavior problems, which were

.Im,ifled ““de. ed.cntion.l “egle.ta.dfo. emoti. ”.! neglect, u described i“ subseq”e”t . ..tio”s.

9

Lmk of pmve”tive health care, such w [ail”re to have the child imm””ized, w= “.t i“c!.ded here. [t w= .I=sified .“der

“se.eral neslec~,.definedi. a later section.

411
Inadequate Supervision

Child left unsupervised or inadequately supervised for extended periods of

time or allowed to remain away from home overnight without the

parent/substitute knowing (or attempting to determine) the child’s

whereabouts .10

Other Physical NegIect

Conspicuous inattention to avoidable haards in the homq inadequate

nutrition, clothing, or hygiene; and other forms of reckless disregard of the

child’s safety and welfare, such as driving with the child while intoxicated,

leaving a young child unattended in a motor vehicle, and so forth.ll

The harm and perpetrator requirements for these forms of maltreatment are given

in Section IV of Table 4-1. Under the original definitions, all forms of physical neglect had to

be perpetrated by parents/substitutes. Under the revised definitions, other adult caretakers

were allowable perpetrators of the last two forms of physical neglect inadequate supervision,

and other physical neglect. As outlined in Table 4-1, the harm required for physical neglect

cases to be countable under the original definitions ranged from none (since harm was assumed

to have occurred for the traumatic occurrences of abandonment and expulsion), through

evidence of moderate injury/impairment (for refusal of health care, and for “other” custodyrelated maltreatment), to serious injury/impairment (for delay in health care, inadequate

supervision, and other physical neglect). Under the revised definitions, cases were countable if

a respondent judged the child to have been endangered by the acts in question, or if CPS

officially substantiated the case upon investigation.

Incidence estimates for the specific forms of physical neglect are given in Table 4-

4. Note that, because the numerical codes for expulsion and “other custody issues” were not

differentiated in the NIS-1 data, these two forms of physical neglect are combined in the table

for all estimates reported under “original definitions? Again, because a given child could have

experienced more than one form of physical neglect, the mnsitituent rows of Table 4-4 sum to

more than the total children estimated to have experienced some form of physical neglect.

10Thta fom of mdtreatme”t .1- covem .-.. where the child W- temporarily locked o“t of the home

llThis d.- ~ i“cl”de sit”atio”s where the pmenta were fi”.”ci.lly ““able to provide (or obtain thm.gh AFDC)

mwo”ably safe, hytienic living conditions.

4-12
Table 4-4. Incidence of Specific Forms of Physical Neglect.

Original Definitions 1986

1980 1986 1980-86 Revised

Form Difference Definitions

Refusal of Health Care

Delay in Health Care

Abandonment

:

T

Expulsion

~

I

Other Custody Issues

Inadequate Supervision

Other Physical Neglect

Total

0.6 1.1 + 0.5 1.1

0.2 0.2 0.0 0.6

0.1 0.3 + 0.2 0.3

0.7

0.5

0.1 0.1 0.0 3.0

0.4 0.2 -0.2- 3.5

1.6 2.9 + 1.3 9.1

Refusal of Health Care

Delay in Health Care

Abandonment

:

$ Expulsion

Sb

Other Custody Issues

Inadequate Supervision

Other Physical Neglect

Total

39,100 70,000 + 30,900- 71,600

15,600 13,300 -2,300 37,700

6,400 17,100 + 10,700 17,100

~ ,8,,00 ~ 70>600 ~ ‘52500- ,4,300

45,300

6,600 3,800 -2,800 192,100

23,000 12,500 - lo,500- 223,500

103,600 182,100 + 78,500 571,600

The diflere”cea in rate of incidence b.twee” 1986 .“d 1980 were “.”siwific.”t b“t marginal, with p <.10,

‘Per 1,000 .Ktldre” i“ tbe p.p”lati.”.

b

Total n“mher of ctildm” m“nded to the “e.rest 10U not tij”st.d by pop.1.tie” tot .1s.

4-13
In 1980, the most frequently-occurring forms of physical neglect under the original

definitions were refusal of health care and the combined category involving expulsion and other

custody issues. Each of these forms of maltreatment accounted for 38% of physically neglected

children, with incidence estimated as 1.1 children per 1,000. The least frequently-occurring

category of physical neglect under the original definitions was inadequate supervision,

accounting for only 3% of physically neglected children, with only 0.1 children per 1,000 (or 1

child per 10,000) having experienced inadequate supervision countable under the original

definitions.

When revised standards were applied to the 1986 data, the specific forms of

physical neglect were dramatically reordered in terms of their relative frequency-of-occurrence:

“Other physical neglect” and inadequate supervision emerged as far more frequent than any of

the other forms in the cate80ry. Thirty-three percent of physically neglected children, or 3.0

children per 1,000 (or 192,100 nationwide) met the revised standards for inadequate supervision;

and 38% of the physically neglected children (3.5 children per 1,000 or 223,500 nationwide)

experienced maltreatment classifiable under “other physical neglect” according to the revised

standards. The fact that these two forms shifted so strongly to the forefront when the revised

standards were used is understandable considering that they were the most frequently alleged

forms of physical neglect and that cases met the harm requirement under the revised definitions

as long as the respondent judged the child to have been endangered by the maltreatment.

Although the overal~ increase since 1980 in the general category of physical neglect

was not significant, Table 4-4 indicates that three of the component forms of physical neglect

did show statistically marginal changes. Refusal of health care and the combined form

including expulsion and other custody-related issues both showed marginal increases since 1980.

Maltreatment classifiable under “other physical neglect” marginally decreased during the interim

between the two studies, but the magnitude of this decrease was not very large (involving only

0.2 children per 1,000, or 10,500 children nationwide).

414
4.6 Educational Neglect

Educational neglect was broken down into three specific forms, as follows

Permitted chronic truancy

Habitual truancy averaging at least five days a month was classifiable under

this form of maltreatment if the parent/guardian had been informed of the

problem and had not attempted to intervene.

Failure to enroll/other truancy

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

child to miss at least one month of schoot or a pattern of keeping a schoolage child home for nonlegitimate reasons (e.g., to work, to care for siblings,

etc.) an average of at least three days a month.

Inattention to Special Educational Need

Refusal to allow or failure to obtain recommended remedial educational

services, or neglect in obtaining or following through with treatment for a

childs diagnosed learning disorder or other special education need without

reasonable cause.

As shown in Table 4-1, there were no differences between the original definitions

and revised definitions in the perpetrator and harm requirements for the category of educational

neglect. Under both sets of standards, the parent/substitute was the required perpetrator for all

three forms. Also, under both definitions and for all three forms, the harm criterion was

considered to have been met 12 if the case fulfjlled the descriptive requirements of the

classification, on the assumption that the circumstances would necessarily impair a chil~s

educational development to at least a moderate degree.

Table 4-5 presents incidence estimates for the specific forms of educational neglect.

In the NIS- 1 data, the codes did not distinguish between failure to enroll/other truancy and

inattention to a special educational need, so combined incidence estimates are given for these

forms in the first columns of the table.

In 1986, permitting chrnnic truancy was the most frequently-occurring form of

educational neglect, with 76% of the educationally neglected children (3.5 of 4.6 per 1,000)

having been allowed to continue habitually missing upwards of 25 percent of school days.

4-15
Table 4-5. Incidence of Specific Forms of Educational Neglect.

Original Definitions 1986

1980 1986 1980-86 Revised

Form Increase Definitions

Permitted chronic

truancy 1.8

Failure to Enroll/

Other truancy

0.9

Inattention to Special

Educational Need

Total 2.7

3.5 1.7 3.5

1.2

4.6

I

0.3

1.9

1.1

0.1

4.6

I

Permitted chronic

truancy

T

115,400 219,000 103,600 220,000

+

Failure to Enroll/

~ Other truancy

5*

Inattention to Special

Educational Need 1588001726001’3800 6:

I

Total 174,000 291,100 117,100 292,100

‘Per 1,000 cfildre” in the p.p”l.ti.”.

b

T.t.l””mber ofctildm” mu”dedto the”. a.eatlW; “.t tijusted bypop.1.tio”totd..

4-16
Since, for educational neglect, the same cases were identified as countable under both sets of

definitions, one can examine the “Revised Definitions” column in Table 4-5 to see the relative

frequency of the other two forms of educational neglect in the 1986 data. Failure to

enroll/other truancy accounted for 24% of the educational neglect cases, with 1.1 children per

1,000 (or 66,600 children nationwide) having experienced this maltreatment. The least

frequently-occurring form of educational neglect was inattention to a special educational need.

This occurred to only 2% of the educationally neglected children (an estimated 0.1 children per

1,000, or 6,000 children nationwide).

In the previous chapter it was reported that the increase in incidence for education

neglect as a category was not statistically significant. Here, none of the component forms of

educational neglect are indicated to have shown any significant changes in incidence since 1980.

4.7 EmotionaI Neglect

Seven specific forms of emotional neglect were differentiated in the NIS-2

Inadequate Nurturance/Affection

Marked inattention to the chil~s needs for affection, emotional support,

attention, or competence.ls

Chronic/Extreme Spouse Abuse

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

presence.

Permitted Drug/Alcohol Abuse

Encouragement or permitting of drug or alcohol use by the child; cases of

the childs drug/alcohol use were included here if it appeared that the

parent/gufidian had been informed of the problem and had not attempted to

intervene.

1sC=es of nonorganic failure to thrive were elwsified under this form of m.ltre.tme”t i. add!ti.” to other instances of

p=.i.e emotion.1 rejection of child or .pp.re.t lack of .on.em for child’s emotional well-hei.g or de.el.pme.t. Not

i“ci”ded here were overt expres.io”sof ho,titity a“d rejection, which were cl=.ified ““dervecbal/emotional abuse.

14Administering dmm to a child for “o”medical . . “o”therape”tic purposes w= cl~sified here when the child was of

school-age (and hence hkely to behaviorally predispose the child to self-administer the dr”~), h“t W= cl~sif,ed under

“other or””k”ow” abuse” fo. yo”ngerctildre”.

+17
Permitted Other Maladaptive Behavior

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

assaultiveness, chronic delinquency) under circumstances where the

parent/guardian had reason to be aware of the existence and seriousness of

the problem but did not attempt to intervene.

Refusal of Psychnlogical Care

Refusal to allow needed and available treatment for a childs emotional or

behavioral impairment or problem in accord with competent professional

recommendation.

Delay in Psychological Care

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

behavioral impairment or problem which any reasonable layman would have

recognized as needing professional psychological attention (e.g., severe

depression, suicide attempt).

Other Emotional Neglect

Other inattentimr to the chil&s developmental/emotional needs not classifiable

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

overprotective restrictions which foster immaturity or emotional

overdependence, chronically applying expectations clearly inappropriate in

relation to the childs age or level of development, etc.).

As can be seen in Table 4-1, the revised definitions made no changes in the

perpetrator requirements for these forms of maltreatment, but uniformly relaxed the harm

criteria to endangerment.

These seven specific forms had been collapsed into three subcategories in the NIS1, as shown in Table 4-6, so combined incidence estimates are given for these forms in the first

columns of the table to allow comparisons with the NIS-1 data.

Under the original definitions in 1986, the most frequently-occurring subcategory

of emotimral neglect was that which combined refusal or delay in obtaining needed

psychological care with “other emotional neglect.” This subcategory applied to 0.5 children per

1,000, or 31,200 children nationwide, and accounted for 63% of emotionally neglected children.

The least frequently-occurring subcategory was that which combined inadequate

nurturance/affection with chronic/extreme spouse abuse. That subcategory applied to 0.1

children per 1,000 (or 5,000 children nationwide) and accounted for 13% of children who had

been emotionally neglected.

4-18
Table 4-6. Incidence of Specific Forms of Emotional Neglect.

Original Definitions 1986

1980 1986 1980-86 Revised

Form Difference Definitions

Inadequate

Nurturance/Affection

Spouse Abuse

(..4 io., fo.3* ;

Permitted Drug/

Alcohol Abuse

0.2

Permitted Other

Maladaptive Behavior

0.7

0.4

Refused Psych. Care

Delay in Psych. Care

Other Emotional Neglect lo3 !05 1+02 :

Total 0.9 0.8 -0.1 3.5

Inadequate

Nurturance/Affectimr

Spouse Abuse I

24,900

il

5,000 - 19,900*

48,500

27,100

;:::~er~oo~16800 ~+3,400 ::

Permitted Drug/

$

;

Maladaptive Behavior

s.

Refused Psych. Care

Delay in Psych. Care

Other Emotional Neglect

119,200 131,200 !+12,000 z

Total 56,900 52,200 -4,700 223,100

.

The differences i“ rateof incidence between 1986 a“d 1980 were sig”ifica”t at the p <.05 level.

‘Per 1,000 ctildre” i”thep.p.latio”,

b

T.tal””mber ofctildren ro.nded tothenear.st 100; “ot .dj”sted bypop”l.tio” totala.

4-19
As shown in Table 4-6, the most frequently-occurring form of emotional neglect

under the revised definitions was the “other” category, which applied to 0.9 children per 1,000

(57,600 children nationwide) and accounted for 26% of emotionally neglected children. This

was followed closely in relative frequency by inadequate nurturance/affection (0.8 children per

1,000, or 48,500 children nationwide) and then by permitting drug/alcohol abuse (0.7 children

per 1,000 or 44,900 children nationally), which respectively accounted for 23% and 20% of

emotionally neglected children. The incidence estimates for the remaining four specific forms

of emotional neglect were very similar--all involving an estimated 0.4 children per 1,000, or

between about 24,200 and 27,100 children nationwide).

Note that there was a significant decrease in the first of the subcategories listed in

Table 4-6. The incidence of inadequate nurturance/affection and chronic/extreme spouse abuse

decreased by 0.3 children per 1,000 (or by 19,900 children nationally). This was offset by tbe

(nmrsignificant) increases in the other subcategories in the table, so that the overall category of

emotional neglect showed no significant change in incidence.

4.8 Other Maltreatment

TWO other forms of maltreatment are listed in Table 4-I, where it is shown that

these were countable only under the revised definitions

General or Unspecified Neglect

Used for neglect allegations not classifiable elsewhere, for lack of preventive

health care, and for unspecified forms of neglect or multiple neglect

allegations none of which had been countable under the original definitions.

Other or Unspecified Maltreatment

Problems/allegations not classifiable elsewhere. These included maltreatment

not specified as having involved abuse, neglect, or both; parent/substitute

problems (such as alcoholism, prostitution, drug abuse) alleged to affected the

child in unspecified ways; etc.

Maltreatment classifiable in either of these forms of maltreatment was countable

under revised definitions only when the child was deemed to have been endangered by the

situation or when CPS had officially substantiated or founded the case on the basis of this form

4-20
of maltreatment. 15 It was estimated that 0.6 children per 1,000, or 38,600 nationwide, had

experienced general or unspecified neglect countable under the revised definitions. These

children were included in the totals of those who had experienced some form of neglect under

these standards. “Other or unspecified maltreatment” wcs estimated to have occurred to 0.7

children per 1,000, or to a total of 44,300 in the nation in 1986. Although these children could

not be differentiated as abused vs. neglected, they were included in the total when all those who

had suffered some form of maltreatment countable under the revised definitions were

considered.

4.9 Summary

The following were key findings concerning the incidence of specific forms of

maltreatment

■ The most frequently specific form of sexual abuse was genital molestation.

Under either set of definitions, it accounted for 45% of all sexually abused

children. Original definitions identified an estimated 1.0 children per 1,000

(or 65,800 children nationwide) as 8enitally molested, whereas I. I children

per 1,000 (or 70,300 nationwide) were countable as genitally molested under

revised standards.

■ All forms of sexual abuse increased significantly in the 1980-1986 interval

■ Under either set of definitional standards, verbal oremodonal assault was the

most frequently-occurring form of emotional abuse, accounting for 68% of

the countable children. Under original definitions, 1.9 children per 1,000 (a

total of 120,800 children) had been verbally or emotionally assaulted, whereas

the figure was 2.3 per 1,000 (or 144,300) under the revised definitions.

■ The only form of emodonalabuse toe~idence significant change in incidence

since 1980 was “other or unknown” abuse, which more than doubled in the

interval. [t appeared that this increase might relate to the fact that both

physical and sexual abuse had increased, and that attempted assaults of both

types were classified in this “other or unknown” category.

151t w- “ecesswto tidthae ~co.”t.ble fo-.fm.ltre.tme”t ““der the t.vised defi”itio”s inorder toe”comp-s ail

.Ktci.lly s“batantiatd .-es, whtch W- the pti”cip.1 p.m.. of the “*w standards,

4-21
■ Under original definitions, the most frequently-occurring forms of physical

neglect were refusal of health care and expulsion/other custody issues, each

accounting for 38% of the children countable as physically neglected under

these standards. Each was estimated to have occurred to 1.1 children per

1,000 (or at least 70,000 children nationwide).

● Under revised definitions, the most frequently-occurring forms of physical

neglect were inadequate supervision and “other physical neglect.”

Inadequately supervised children accounted for 33% of those countable as

physically neglected under revised standards, (3.0 children per 1,000 or

192,100 total); 3g% of the physically neglected children (3.5 children per

1,000, or 223,500 nationwide) had suffered other forms of physical neglect,

such as inadequate food, clnthing, nutrition, hamrds in the home, or other

disregard for their physical welfare.

m Under either set of definitions, the most frequent form of educational neglect

was permitting chronic truancy, accounting for 76% of educationally

neglected children (3.5 per 1,000, or about 220,000 nationwide).

■ Under original definitions, most (i.e., 63%) emotionally neglected children

had suffered a lack of needed psychological treatment or had experienced

maltreatment classified as “other emotional neglect” (which included

overprotection, inappropriate age expectations, etc.); these experiences were

estimated to have occurred to 0.5 children per 1,000 or to 31,200 children

nationwide.

■ “Other emotional neglect” was also the most frequent form of emotional

neglect under the revised definitions, where it alone accounted for 26% of

children countable as emotionally neglected under these standards (having

occurred to 0.9 children per 1,000, or 57,600 nationwide).

■ Although the incidence for the overall category of emotional neglect did not

change significantly since 1980, inadequate nurturance/affection (which also

included chrmric/extreme spouse abuse in the NIS- 1 database) showed a

significant decrease. An estimated 0.3 fewer children per 1,000 experienced

this maltreatment (reflecting a decrease of 19,900 children nationwide).

4-22
5. CHARACTERISTICS OF MALTREATED CHILDREN AND THEIR FAMILIES

This chapter examines whether and how child and family characteristics related to

the overall incidence of maltreatment or to its type and/or severity. The following sections

discuss the effects of the child’s sex, age, and race/ethnicity, of their family’s income level and

number of dependent children, and of the metropolitan status of their county of residence.

Each section is organized around the following questions

■ Are there differences in type or severity of maltreatment that relate to the

given characteristic? (e.g., Are males and females at risk for different types

of maltreatment or does one sex experience more severe injury/impairment

than the other?)

■ If there are differences related to the characteristic, do the overall patterns of

child maltreatment described in Chapter 3 still hold true for all children?

(e.g., If there are sex differences in rates of abuse and neglect, does the

overall pattern showing abuse to be more frequent than neglect still applyto

both sexes, or is it only true for one?)

■ Have there been any statistically significant changes since 1980 in the

distribution of child maltreatment by the characteristic in questiOn? (e.g.,

Did the increases in overall abuse since 1980 only occur for children of one

sex and not the other?)

In each section, the first two of these questions are considered separately for results

based on the original definitions versus those derived from the revised definitions. The last

question is considered in relation to the NIS- 1 results and the NIS-2 findings which are based

on the original definitions.

As in the previous chapters, the tables given here present both the rate of

maltreatment per 1,000 children in the population and the estimated total numbers of children

in each category. However, to simplify the presentation here to the extent possible, tables in

this chapter present incidence figures broken down by child or family characteristics only where

these characteristics were found to have significant effects on maltreatment.l

1

As.i., estimated totals.= rounded to the nearest 100. Complete tables providing .11 estim.tes, variances, a“d co” fiden.e

i“temals for each subpop.latio” of children are cent.i”ed i“ Appendices B, C, a“d D. The .“.IYs.s comparing 1980 =nd

1986 rea”lts .r. &v.” in Appe”dIx E.

5-1
5.1 Child’s *X

5.1.1 =x Effects (Using Original Definitions)

The incidence of overall maltreatment under the original definitions did not differ

significantly as a function of the childs sex, but when maltreatment was broken down into

abuse and neglect, differences did emerge. Females experienced abuse mnre often than males

(1 1.1 vs. 7.4 per 1,000, for females and males, respectively). This corresponded to a total of

339,800 females having been abused in 1986 compared to 238,200 males. The pattern is given

in Table 5-1.2 The incidence of neglect did m vary with the child’ sex.

Given this sex difference, it was important to consider whether nr not the general

distribution of abuse vs. neglect which was described in Chapter 3 was, in fact, applicable to

both males and females. The reader will recall that slightly more than half (56%) nf all children

who were countable as maltreated under the original definitions had been abused and that

slightly under half (48%) had been neglected. s The pattern for females was found tn resemble

the overall pattern, with 60% of the maltreated females abused (incidence rates and totals as in

Table 5-1) and 45% neglected (8.2 per 1,000, or 251,900 females nationwide). Among male

children, however, there was essentially no difference between the rates of abuse and neglect

52% of all males had been abused (as in Table 5- 1), and 53% had been neglected (7.6 per 1,000

males or 245,500 males nationwide).

Sex ~fferences in Abuse. Within the subcategories of abuse, only sexual abuse

showed any significantly different rates of incidence as a function of the childs sex. Females

were sexually abused almost four times as often as males. Specifically, 3.5 females per 1,000

compared to 0.9 males per 1,000 were sexually abused, corresponding to 107,000 female children

and 30,400 male children nationwide in 1986.

21t should be “ted, i“ tfis and other tables in thi. chapter, that the numhm and rates siv.n do ti i..i.d. .=.s with

misainc values on the chm=teristics of interest. Th”*, the 0.3% children of “nkn.w” sex are excluded from Table 5-1.

3Si”ce a tiv.n chtld could also experience W abuse and nesle.t. thee P.r...s.~.~ s.m to more th.. 100 P.r..ni.

5-2
Table 5-1. Sex differences in maltreatment original definitions

Category Males Females

All Abuse

R

7.4 11.1

A

T Sexual Abuse

;

0.9 3.5

a

Probable Injury/Impairment 1.5 2.6

All Abuse

:

238,200 339,800

; Sexual Abuse 30,400 107,000

Sb

Probable Injury/Impairment 48,200 79,400

‘P., 1,000ch,ldre” of that sex i“ p.p”l.ti.”.

b

Total ““mber of .Mldre” not tij”st.d by pop”lati.” totals.

NOTE SexW- “nkn.w” for 0.S% of the ,-,,. See footnote 2

5-3
Again, given this sex difference in maltreatment experiences, the relevance of the

overall patterns given in Chapter 3 became important. In the overall pattern for abuse under

the original definitions, physical abuse was most frequent, followed by emotional and then

sexual abuse, which differed little from one another (see Table 3-3). Table 5-2 presents the

incidence of the different forms of abuse separately for males and females. There, it can be

seen that physical abuse was, in fact, the most prevalent form of abuse for both sexes. Note,

however, that the difference in males’ and females’ experiences of sexual abuse did have

implications for the relative incidence of the remaining two subcategories of abuse. In fact, the

overall pattern in which sexual abuse emerged as only slightly lower in incidence than emotional

abuse appears to have been a blend of the patterns for the two sexes. Males experienced

emotional abuse more than twice as often as sexual abuse, whereas sexual and emotional abuse

occurred about equally frequently among females.

Sex Differences in Severity of Injury/Impairment. Although there were no

significant differences between the sexes in the severity of injury/impairment due to

maltreatment, Table 5-1 lists “probable” injuries because there was a (nonsignificant) tendency

for females to experience probable injuries more often than males.’ “Probable” injuries

predominated in only a few categories of maltreatment, and were especially prevalent in relation

to sexual abuse. Thus, the slightly higher incidence of probable injuries among females appears

to have been primarily a function of their particular vulnerability to sexual abuse.5

The general pattern seen in Chapter 3 (see Table 3-5) held for both sexes injuries

of moderate severity were most frequent; probable and serious injuries followed with similar

levels of incidencti and fatalities occurred least frequently.

4

Te”de”cies were co”aidered .mzainal” if their ,t.tisticd pmbab,tity w- Ies. than 0.10 b“t gre.ter than 0.0S.

s

Probable i“j”ries are those where the “.ture of the maltreatment itself cave re-.”.ble ca”ae to -s”me that

inj”v/i”p.irme”t hti probably occurred. They were the minimal level of i“j.w/imp.irme”t given for those children

who experie”.d the forms of m.ltreatme”t where harm W- “hs”med” under the .ri~i”.l defi”itio”s (see Table 4- 1).

5-4
Table 5-2. Distribution of forms of abuse by child’s sex original definitions

Category Total No. per 1,000 % All Abused

Physical Abuse

y

143,400 4.4 60

Sexual Abuse

~

30,400 0.9 13

Emotional Abuse 78,700 2.4 33

F

Physical Abuse 166,500

f

5.4 49

L Sexual Abuse

:

107,000 3.5 31

Emotional Abuse 95,100 3.1 28

5-5
5.1.2 Sex Effects (Using Revised Definitions)

The findings concerning sex differences under the revised definitions essentially

paralleled the patterns described above, except that all incidence figures were slightly elevated.

There W= no significant sex difference in maltreatment overall, but a difference

did emerge when abuse wm distinguished from neglect. As given in Table 5-3, females were

more likely to be abused than males 13.1 females vs. 8.4 males per 1,000, or 401,700 females

compared to 270,900 males having suffered abuse under the new definitions. The incidence of

neglect did m show any relationship to the child’s sex.

Despite the sex difference in abuse, both males and females retained the general

pattern under the revised definitions, where neglect had a higher incidence than abuse (i.e., 63%

of maltreated children were oeglected while 42% were abused, under revised standards).6

Sex Differences in Abuse. Consistent with the pattern found under the original

definitions, when revised standards were applied, only sexual abuse revealed differences

msociated with the sex of the child. As shown in Table 5-3, the rate of sexual abuse for

females waa again nearly four times its rate for males 3.9 per 1,000 females, but only 1.1 per

1,000 males were sexually abused (reflecting totals of 121,000 females and 34,300 males

nationwide).

With the revised definitions, the relative incidence of the three subcategories of

abuse was the same m it was with the original definitions physical abuse > emotional abuse >

sexual abuse. Although physical abuse w= the most frequently occurring form of abuse for

both sexes, males and females again differed in their adherence to the general pattern

concerning emotional and sexual abuse. As can be seen in Table 5-4, males were emotionally

abused more than twice as often as they were sexually abused, while females were equally likely

to be sexually or emotionally abused.

‘Her. ad thmugho.t thi. chapter, when differences <Id @ emerge, the ex=t in.ide.ce fi-.e~ for ,.b~upa .,e .Ot

describd. I“tereat~ madem *ho”Id cons.lt Ap~”dix C for detailed incidence estimate. ““der revised defi”itio”s.

5-6
Table 5-3. Sex differences in maltreatment revised definitions

Category Males Females

All Abuse 8.4 13.1

;

Sexual Abuse

E

1.1 3.9

Sa

Probable Injury/Impairment 2.0 3.5

All Abuse 270,900 401,700

;

: Sexual Abuse 34,300 121,000

Sb

Probable Injury/Impairment 65,600 108,000

%er 1,000 .fildre. of that .ex in ~p”l.tion.

b

Total “umber of .htldre” not tij”sted by Pp”lstion tot.la,

NOTE: Sex w= ““k”own for 0.7% of the .-es. See fmt”ote 2

5-7
Table 5-4. Distribution of forms of abuse by chil~s sex revised definitions

Category Total No. per 1,000 % All Abused

Physical Abuse ]6],300 5.0 60

y

L ~xual Abuse 34,300 1.1 13

:

Emotional Abuse 93,000 2.9 34

F

Physical Abuse 195,700 6.4 49

g

L %xual Abuse 121,000 3.9 30

:

Emotional Abuse 117,500 3,8 29

\,

5-8
Sex Differences in Severity of Injury/Impairment. Conforming to the pattern of

results found with the original definitions, there was a marginal tendency for probable

injury/impairment to occur more frequently among females than among males. Table 5-3

provides the comparative incidence figures on this measure. As discussed above in connection

with the original definitions, the association of this category of injury with sexual abuse seems

to be the basis for the sex difference here.

5.1.3 1980-1986 Differences Related to ChiId’s =x

None of the 1980-1986 differences related to the child’s sex. This means that all

changes in the incidence of maltreatment overall, and by maltreatment type a“d severjtY,

applied equally to male and female rates of maltreatment. Thus, those patterns described in

Chapter 3 as significant 1980-1986 differences occurred for both sexes and are not reiterated

here.

5.1.4 Summary of Child’s Sex as a Risk Factor

Analyses indicated that, in general, the pattern and distribution of child

maltreatment was very similar for both males and females. However, under both the original

definitions and the revised standards, females experienced mOre abuse OVeraII ~ha” did maIeS

and this reflected primarily their greater susceptibility to being sexually abused. Their greater

vulnerability to sexual abuse also made them more likely to experience “probable’,

injury/impairment in comparison to males. Finally, sex of child did not appear to relate to any

of the changes observed between 1980 and 1986 study findings.

5.2 Age of Child

This section presents information cO”cernjng the ~elatjo” between child

maltreatment and the age of the child. Children were categorized into one of six age groups on

the basis of their age as of their last birthday prior to the maltreatment O-2 years, 3-5 years,

6-8 years, 9-11 years, 12-14 years, and 15-17 years.

5-9
5.2.1 Age Effects (Using Original Definitions)

Maltreatment defined according to the original standards increased in incidence

with increming age. This age-related increme, which is graphically depicted in Figure 5-1, was

statistically reliable up through age 8. The incidence estimates for the older age groups tended

to be less reliable, because of greater variability in the experiences of the older children. As a

result, the increases in the incidence of maltreatment ~ age 8 did m emerge as statistically

significant.

Figure 5-1 also shows that there were age differences in both abuse and neglect,

with maltreatment increasing with age in both cases. Specific analyses of the components of

these patterns revealed that, for abuse, O-2 year olds were significantly less abused than

children in all the older age brackets and that the 3-5 year olds were significantly less abused

than the 12-14 year olds. For neglect, children aged 5 years and under were significantly less

neglected than older children, but other differences in overall neglect did not prove to be

statistically reliable.

Given these age differences, the question concerning the relevance of the general

pattern of findings described in Chapter 3 became important. The relationships between the

incidence rates for abuse and neglect graphed in Figure 5-1 indicate that, in fact, the general

pattern of there being slightly more abused than neglected children held for all but the very

youngest and oldest children. At these extreme ages, there was somewhat more neglect than

abuse, as can be seen in the graph in the cross-overs between abuse and neglect for these age

groups.

Age Differences in Abuse. Within the subcategories of abuse, there were significant

age differences for both physical and emotional abuse, and a marginal age trend for sexual

abuse. Figure 5-2 illustrates these patterns graphically.

As for abuse overall, the incidence of physical abuse generally increased with

increasing age. However, the only statistically reliable increase in physical abuse occurred

between the O-2 age group (with 2. I children per 1,000 physically abused) and the 3-5 year olds

5-1o
Age Differences in Maltreatment

z

(Wgiml M.knn.)

mwnmia -

16-

14-

12-

10 -

a6-

4-

2 1 1 1 I I

0-2 3-5 ~-a 9-i 1 i2-14 1s-17

FIGURE 5-1

5-11
0

z

Age Differences in Abuse.

(Wqimt MnWm”.)

7

%-

5-

4-

3-

2 J

1

0 1

0-2 3-5 6-8 9-11 i2-14 15-17

FIGURE 5-2

5-12
(with 4.2 children per 1,000 maltreated). While all older age groups were significantly more

physically abused than the O-2 year olds, they did not differ significantly among themselves in

rates Of physical abuse. Again, this appeared to stem from the greater variability of their

experiences, which decreased the reliability of the incidence estimates for the older age groups.

Emotional abuse also demonstrated age-related differences, as shown in Figure 5-2,

Children aged O-2 years bad significantly lower incidence rates than children aged 6 years and

older, and 3-5 year olds were less emotionally abused than children aged 12 years and older,

Here again, however, there were no statistically reliable differences among the older children i“

their experiences of emotional abuse.

The marginal age trend for sexual abuse is also given in the figure. Subsidiary

analyses revealed that the O-2 year olds were significantly less likely to be sexually abused than

any of the older children, but that the other age groups did not statistically differ from one

another.

Age Differences in Neglect. The general age patter” fOr Overall neglect, where

children 5 years and younger emerged as less neglected, proved to result largely from the

educational neglect pattern--the largest neglect category. This, in turn, reflected the fact that

educational neglect was not an applicable category for children younger than school-age. The

pattern is graphed in Figure 5-3. Note that there also appears to be a dramatic increase

between the 9-1 I and 15-17 year age brackets in the incidence of educational neglect.

Although dramatic in its size, this trend turned out to be only marginally significant, largely

due to the greater variability of the 15-17 year olds’ experiences of educational neglect.

Age Differences in Severity of Injury/Impairment. There were significant age

differences for two of the severity levels fatalities and moderate injuries/impairments, AS

shown in Figure 5-4, the risk for fatalities as a result of maltreatment occurred largely i“ the

lower age brackets. Figure 5-5 provides the incidence rates for moderate injuries/impairments

for the different ages. Analyses revealed that moderate injuries occurred at significantly

different rates for children five years and under compared to thOse 6 years and older, b“t fai~d

to support the statistical reliability of the differences among the older age groups on this

measure.

5-13
Aqe Differences in Neglect.

10-

9-

a7-

6-

5-

4-

3-

2-

1

/

0

0-2 3-5 6-8 9-1 i 12-14 15-17

n

❑ md.ml *m

FIGURE 5-3

5-14
Age Differences in Fatalities.

“,

O.= J

O.m -

O.m -

O,m -

0---

O.m -

O.m -

O.m -

0,01

0 1 1

0-2 3-s 8-8 9-1 i 12-14 1s-17

FIGURE 5-4

5-15
0

z

Age Differences in Moderate Injuries.

m

[Wgiml Mnfim..)

19-

la -

!7 -

16-

15-

14-

13-

12 -

11

10-

9-

s-

?-

a5-

4-

3-

2

0-2 3-5 e-a 9-1 i 12-1A 1s-17

FIGURE 5-5

5-16
Given these age differences, it was necessary to determine whether the general

findings concerning the relative incidence of injuries/impairments of different SeveritY held

true for each age group. It was found that the relative distribution of the different levels of

injuries generally did reflect the same pattern as those given for children overall in Chapter 3.

Moderate injury/impairment was by far the most frequent category for all but the youngest age

group. Among the O-2 year olds, injuries/impairments were most often serious.

5.2.2 Age Effects (Using Revised Definitions)

The findings relating age to incidence under the revised de fi”itiOns resembled the

results for the original definitions in some respects and in other respects differed. Unlike the

pattern described above, there were w age effects for maltreatment overall when revised

standards were applied. Further, age differences only emerged in connection with abuse--the

incidence of neglect as defined by revised standards was not associated with age. The pattern

of abuse in relation to age is graphed in Figure 5-6. Subsidiary analyses showed that the O-2

year olds were significantly less abused than the other age groups and that there was a marginal

(nonsignificant) tendency for the 12-14 year olds to experience more abuse than children aged O

through 8.

Age Differences in Abuse. Within abuse, only the subcategory of physical abuse

proved to be associated with age, and the nature of this association is also shown in Figure 5-6.

Children in the youngest age group were physically abused less often than those in other age

groups, and 3-5 year olds tended to be less physically abused than children aged ]2 and over.

Age Differences in Neglect. Although there were no age differences in neglect

overall, two of the neglect subcategories did evidence age trends--educational and emOtiOna]

neglect. These trends are depicted in Figure 5-7. Again, the fact that educational neglect is

only defined for children of school age is a substantial basis of the relationship shown. Here,

however, there was a marginal difference between the 15-17 year olds and 9- I 1 year olds,

suggesting that this form of neglect may, in fact, increase reliably to some degree within the

oldest age bracket.

5-17
Age differences in abuse.

1% (Md Mtifmns).

15-

14-

13 -

12-

Ii

10-

9-

a7-

a5-

4-

3:

2

I

1 1 1 1 I

0-2 3-5 6-a 9-11 12-iA 15-17

FIGURE 5-6

5-18
—

Age differences in neglect.

“ -

!0 -

9-

8-

?-

%-

5-

4-

3-

2-

1

0 1 1 1 1

0-2 3-s 6-8 9-1 ! 12-14

FIGURE 5-7

5-19
Emotional neglect under revised definitions also evidenced different incidence

levels at different ages as given in Figure 5-7. The differences here are less dramatic, however.

Follow-up analyses revealed that the younger two age groups had significantly lower rates of

emotional neglect when compared with the three older age groups, and that the 6-8 year olds

also differed from the 15-17 year olds. Thus, the risk for emotional neglect appears to climb

gradually throughout the age spectrum.

Age ~fferences in Severity of Injury/Impairment. As for the cases which were

countable under the original definitions, those countable under the revised standards revealed

two significant associations with age fatalities and moderate injuries or impairments. The

function describing the changing risk for fatalities was virtually identical to that found using

the original definitions. That function is graphed in Figure 5-4. The incidence of moderate

injuries for maltreatment defined using the revised standards paralleled the function in Figure

5-5. Except for the overall elevation of the incidence of moderate injuries using the revised

definitions, the two curves were virtually identical. Subsequent analyses revealed exactly the

same pattern of significant intergroup differences children aged 5 years and younger received

significantly fewer moderate injuries than children aged 6 and older.

5.2.3 1980-1986 Differences Related to Child’s Age

As described in Chapter 3, the overall examination of ]980- 1986 differences

(irrespective Of chil~s age) indicated that there had been significant increases in abuse, but not

in neglect, and that within the subcategories of abuse, these increases had occurred in both

physical and sexual abuse (but not in emotional abuse). At the same time, moderate

injuries/impairments had increased significantly above their 1980 levels.

With the exception of moderate injuries/impairments, child’s age was found to be

related to the magnitude of each of these increases. The incidence rates for all abuse, physical

abuse, and sexual abuse are graphed for the two studies in Figures 5-8, 5-9, and 5-10,

respectively. There, the fact that age is related to the 1980-1986 difference is apparent from

the fact that the two lines in each graph are clearly not parallel. The nature of their

relationship is evident from the fact that there is a general “fanning out” of the two curves as

one moves into progressively higher age brackets. This “fanning out” indicates that the increases

5-20
0

0

0.

H

a

0

z

Changes in All Abuse by Age Group.

14-

13-

iz -

11

10-

9-

a7-

6-

5-

4-

3-

2 1 I 1 1 1

,

0-2 3-5 e-a 9-i t 12-14 15-17

E

❑ NB- i t NS-2

FIGURE 5-8

5-21
Changes in Physics I Abuse by Age Group.

1

0-2 3-s 6-8 9-11 12-14 !s-17

E

❑ NE- 1 t NS-2

FIGURE 5-9

5-22
Changes in Sexual Abuse by Age Group.

(Wgiml Mfifen.)

34 I

24-

22-

2-

l.a -

1.6 -

1,4 -

1.2 -

1

aa -

a% -

a4 -

Q2 -

0 1 1 1 I 1

0-2 3-5 e-a 9-11 12-!4 i5-17

E

❑ NE- 1 t Nfi-2

FIGURE 5-10

5-23
since 1980 were progressively larger for successively older age brackets from birth through age

14. In fact, the O-2 year olds experienced equivalent rates of abuse in 1986 and 1980 (2.9 per

1,000 in 1986 versus 2.4 per 1,000 in 1980 for overall abuse). Thus, the 1980-1986 increases in

all abuse, physical abuse, and sexual abuse nccurred disproportionately among older children.

Note also that the patterns in Figures 5-8 through 5-10 indicate that age was more

strongly related to all abuse, and to physical and sexual abuse in the current study than it had

been in the NIS- 1. In fact, analyses indicated that physical abuse was ~ reliably related tO age

in the NIS- 1 at all.

5.2.4 Summary of Child’s Age as a Risk Factor

There were a number of notable patterns in the incidence of maltreatment as a

function of the childs age.

Under the original definitions, the overall incidence of maltreatment increased with

age, and this was reflected in both abuse and neglect. Within abuse, the age-related increase in

maltreatment appeared for all subcategories of abuse. Within neglect, the increase was localized

to the area of educational neglect. With the revised definitions, abuse, specifically physical

abuse, did positively correlate with age. Although neglect under revised definitions had no

overall association with age, two of the subcategories of neglect did sppear to have age as a risk

facton educational neglect and emotional neglect. Again, children were at greater risk for

these forms nf maltreatment with increasing age.

Under both sets of definitions, fatal and moderate injuries showed age

relationships, but of reversed patterns fatalities were more numerous among the younger

children, wherein moderate injuries followed the distribution of maltreatment overall and were

more prevalent among older age brackets. Overall, it appeared that while the youngest children

were not as frequently maltreated as older ones, when they did experience maltreatment it

tended to be more injurious, perhaps due to their greater physical fragility in comparison to

older children.

5-24
The 1980-1986 changes in the incidence of abuse and of two of its subcategories

(physical and sexual) proved to have occurred disproportionately among the older age groups.

Successive age groups generally showed progressively larger increases in the incidence of abuse

over the 1980 levels. The fact that the relationship between maltreatment and age changedi“

these respects since 1980 implies that it may be more related to recoe nition than to the actual

9CCUrrenc e of maltreatment. This point is discussed further in the concluding chapter.

5.3 Child’s Race/Ethnicity

To explore any relationships between the type and severity of maltreatment and

childs race/etbnicity, children were classified into three major categories on the basis of the

race/ethnicity information on the data forms white, black, and other.

There were no significant relationships between the incidence of maltreatment and a

childs race/ethnicity. Analyses performed using both the original definitions of maltreatment

and the revised definitions, and conducted at every level of categorization (i.e., for maltreatment

overall as well as for each subcategory of maltreatment and level of severity Of

injury/impairment) failed tn reveal any reliable systematic relationship with race/ethnicity.

Moreover, none of the overall 1980-1986 differences which were described in Chapter 3 proved

to be differentially distributed across the different race/ethnicity categories (white, black, and

other).

5.4 Family Income

Families were divided into those earning $15,000 or more and those earning less

than $15,000 in 1986,’ and relationships between this factor and the type and severity of child

maltreatment were identified.

7

The NIS-2 data f.- .1s. provided for a third ..tec.~: those ea”ing $S0,000 .r mom in 1986. There w-, however, a

..bsta”tid .m..”t of mi.sing data .“ th,. item (20,0% of c-es ““d.r oriai”.l def,”iti.”. a“d 20.2% of cmes “.der re.ised

d. fi”iti.ns), while .“IY 6 pement .f the c-es with k“.w” ..1”.s were .I-sified i“ the $30,000.. more c.tes.~. Under

the,. cim”mt.”ces, it seemed re-o”able t. collapse the two ti~ber i“c.me categories for p.~.e. of .“aly.i..

5-25
5.4.1 Family Income Effects (Using Original Definitions)

Family income was found to have profound effects on the incidence of abuse and

neglect. There were significant income-related differences on all measures except fatalities, and

there the differences were marginal. Table 5-5 presents the distribution of child maltreatment

defined according to the original standards across children classified into two categories on the

basis of family income. Throughout the table, children from families whose income was less

than $15,000 experienced more maltreatment and injury jimpairment than did those from

families with incomes greater than $15,000. The overall rate of maltreatment was more than 5

times higher among the lower income children who experienced maltreatment under the original

definitions. These children were maltreated at a rate of 32.3 per 1,000 (representing 537,400

children nationwide), as compared to 6.1 children per 1,000 (reflecting 282,500 children) in the

upper income group.

The rate of abuse was 4 times higher among lower income children (16.6 per 1,000

children in this income category, or 275,500 children nationwide) than among the children in

higher income families (4.1 per 1,000, or 190,200 children nationwide). Neglect was nearly 8

times higher for the lower income children (1 7.3 per 1,000 or 287,800 children) compared tn

those from the higher income families (2.2 per 1,000 or 103,200 children). This affected the

relative proportions of children who were abused vs. neglected in each case. The general

pattern (discussed in Chapter 3) was for abuse to be more frequent than neglect. That was the

case for upper income children, whose rate of abuse represented 67% of maltreatment in that

group and whose rate of neglect represented only 36% of maltreatment. Among lower income

children, however, the rates of abuse and neglect were quite similar, with abused and neglected

children representing 51% and 54% of all those maltreated, respectively.

Income Differences in Abuse. Physical abuse was 3+ times more frequent among

lower income children; sexual abuse was 5 times more frequent for children from the lower

income familie$ and emotional abuse was nearly 4+ times more frequent for the lower income

group. Despite the dramatic overall elevation of the incidence of abuse in the lower income

group, the general pattern identified in Chapter 3 of physical abuse being more frequent than

either sexual or emotional abuse held for both income groups.

5-26
Table 5-5. Differences in maltreatment based on family incnme original definitions

Less than

Category

$15,00

$15,000 or more

All Maltreatment

All Abuse

Physical Abuse

Sexual Abuse

Emotional Abuse

All Neglect

Physical Neglect

Educational Neglect

Emotional Neglect

Fatal Injury/Impairment

Serious Injury/Impairment

Moderate Injury/Impairment

Probable Injury/Impairment

32.3

16.6

g.4

4.5

4.g

17.3

6.9

10.1

1.5

0.03

6.0

22.4

4.0

6.1

4.1

2.4

0.9

1.1

2.2

0.7

1.3

0.3

0.01

0.8

4.7

0.6

All Maltreatment

All Abuse

Physical Abuse

Sexual Abuse

Emotional Abuse

All Neglect

Physical Neglect

Educational Neglect

Emotional Neglect

Fatal Injury/Impairment

Serious Injury/Impairment

Moderate Injury/Impairment

Probable Injury/Impairment

537,400

275,500

139,goo

74,300

79,100

287,gO0

115,300

167,300

25,100

500

99,100

372,000

65,900

282,500

190,200

109,400

43,100

52,300

103,200

31,800

58,400

14,900

300

38,400

217,100

26,700

aPer 1,000 children from f.mifies i“ that i“c.me categ.~ i. the p.p”l.ti.”.

b

Total ““mber of children “ot .dj”sted by population totals.

NOTE: Family income wu .“kn.w” f.r 20% .f the CUes. See footnote 2.

5-27
Income Differences in Neglect. Incidence rates for all forms of neglect were

considerably higher for the lower income children physical neglect was nearly 10 times as

frequent, educational neglect close to 8 times as frequent, and emotional neglect 5 times more

frequent among children from lower income families. Still, the overall ordering of educational

neglect > physical neglect > emotional neglect held true for all children, regardless of their

family income level.

Income Differences in Severity of Injury/Impairment. As shown in Table 5-5,

children from lower income families experienced more injury/impairment than did children

from upper income families althou8h the difference for fatalities was only statistically marginal.

Among children from lower income families, fatalities were 3 times more frequent; serious

injuries/impairments were 7+ times as frequent moderate harm occurred at nearly 5 times the

higher income rate; and probable injuries/impairmersts were almost 7 times as frequent for the

children from the higher income families.

The most frequent category of injury/impairment resulting from maltreatment in

both groups, as in the overall pattern seen in Chapter 3, was the moderate level, representing

69% of the injury/impairment in the lower income group and 77% in the upper income group.

Serious injuries were second most frequent for both grnups (19% for lower income and 13% for

hi8her income children), followed closely by probable injuries (12% for lower income children

and 10% for higher income children). Fatalities were the least frequent injury for all children,

accounting for less than 0.2% of injuries regardless of income level.

5.4.2 Family Income Effects (Using Revised Definitions)

The same pervasive effects of family income were apparent when maltreatment was

defined using the revised definitions. Significant differences between the income groups

emerged in every category of maltreatment and injury/impairment except fatalities, and for that

category the income-related difference approached significance (i.e., was statistically marginal).

Table 5-6 presents the incidence of maltreatment according to family income under the revised

definitions.

5-28
Table 5-6. Differences in maltreatment based on family income revised definitions

Less than $15,00

Category $15,000 or more

All Maltreatment

All Abuse

Physical Abuse

Sexual Abuse

Emotional Abuse

All Neglect

Physical Neglect

Educational Neglect

Emotional Neglect

Fatal Injury/Impairment

Serinus Injury/Impairment

Moderate Injury/Impairment

Probable Injury/Impairment

Severity-Endangered

54.0

19.9

10.2

4.a

6.1

36a

22.6

10.1

6.9

0.03

6.0

30.9

5.4

11.7

7.9

4.4

2.5

1.1

1.2

4.1

1.9

1.3

1.5

0.01

0.9

5.5

0.9

0.6

All Maltreatment 897,700 367,100

All Abuse 330,300 204,100

Physical Abuse 169,200 I 17,aoo

Sexual Abuse 90,600 49,700

Emotional Abuse 100,800 53,600

All Neglect 61 I,aoo I aa,900

Physical Neglect 375,900 a5,aoo

Educational Neglect 16a,300 5a,400

Emotional Neglect I 14,400 70,200

Fatal Injury/Impairment 500 300

Serious Injury/Impairment 99,300 4 I,000

Moderate Injury/Impairment 513,300 254,600

Probable Injury/Impairment 90,000 41,000

Severity-Endangered 194,600 30,100

‘Per 1,000ch,ldren from [amities i“ that income c.teg.q i“ the p.p.lati.”

b

Total ““mber .f chtldre” “.ttij”ated by p.p”l.ti.n totals

NOTE: Family i“..me W- ““k”.w” f.. 20.2%.f the cw.e. See f.ot”.te 2.

5-29
Overall maltreatment under the revised definitions was almost 7 times more

frequent amnng children from families whose income was less than $15,000 in 1986 (54.0 per

1,000 or 897,700 children nationwide) than among those from higher income families (7.9 per

1,000 or 367,100 overall). Abuse was 4+ times more frequent and neglect was nearly 9 times

more frequent among lower income as compared to upper income children. (We Table 5-6 for

rates and totals.)

The pattern discussed in Chapter 3 (where, under the revised definitions, neglect

represented a greater percentage of all maltreatment than abuse) held for the lower income

group, where 68% of the children experienced neglect (36.8 per 1,000) as compared to 37% (19.9

per 1,000) having experienced abuse. In contrast, among the upper income children, the

proportions were approximately equivalent, with 51% (4. 1 children per 1,000) of the upper

income children having experienced neglect and 56% (4.4 children per 1,000) having

experienced abuse.

Income Differences in Abuse. As shown in Table 5-6, in every category of abuse,

children from lower income families were significantly more abused than those from upper

income families. They were more than 4 times as likely to be physically abused or sexually

abused and more than 5 times as likely to be emntinnally abused. The relative frequencies of

the different types of abuse within each group resembled that for the. overall findings, with

physical abuse the most frequent, followed by emotional and then by sexual abuse, although for

upper incOme children the rates of emotional and sexual abuse were essentially equivalent.

Income ~fferences in Neglect. There were income-related differences in all

categories of neglect. Children from lower income families were nearly 12 times as often

physically neglected; were nearly 8 times as likely to be educationally neglected, and were

emotionally neglected at more than 4+ times the rate of high income children. A 8reater

proportion of the neglect of lower income children was physical (61%) than was the case among

uPPer income children (46%). Educational neglect was more frequent than emotional neglect

among lower income children (where it represented 27% of neglect, compared to the 19%

represented by emotional negIect). Among upper income children, however, emotional neglect

was about as frequent as educational neglect (representing 37% and 32% of neglect,

respectively).

5-30
Income Differences in Severity of Injury/Impairment. At every level of severity,

lower income children experienced more injury/impairment than upper income children. They

suffered 3 times the fatalities, nearly 7 times the serious injuries, more than 5+ times the

moderate injuries, and 6 times the probable injuries compared to the higher income children.

Lower income children were considered endangered by maltreatment 19* times as frequently as

the higher income children. The distribution of the different severity levels within each income

group essentially paralleled that of children overall. Moderate injury/impairment was by far the

most frequently experienced level, representing 57% of the injury fimpairment in the lower

income group and 70% in the upper income group. The only deviation from the general pattern

presented in Chapter 3 was that, while the endangered category was the second most frequent

category for children overall and for lower income children, it was the least frequent category

for children from the higher income families.

5.4.3 1980-1986 Differences Related to Family Income

Family income failed to affect any of the overall 1980-1986 differences. Thus, the

changes described in Chapter 3 held equally well for both higher and lower income families.

5.4.4 Summary of Family Income as a Risk Factor

Low income was a significant risk factor for child maltreatment. Under the

original study definitions, children from families whose 1986 income was less than $15,000

experienced significantly more maltreatment than those from families earning S15,000 or more.

There was more frequent maltreatment and injury/impairment in every subcategory among the

lower income children. The findings indicate that family income is a potent predictor of child

maltreatment and of maltreatment-related injuries/impairments by any set of definitional

standards.

5-31
5.5 Number of Children in Family

Children were categorized into one of three family size groups on the basis of the

total number of children in their family 1 child, 2-3 children, or 4 or more children.

5.5.1 Family Size Effects (Usiog Original Definitions)

Under the original definitions, there were no significant relationships between

incidence and the number of children in the family for maltreatment overall, for any of the

major subcategories of abuse and neglect, or for any level of injury/impairment.

5.5.2 Family Size Effects (Using Revised Definitions)

In contrast to the absence of family size effects with the original definitions,

several relationships between family size and child maltreatment did emerge when estimates

were based on cases countable under the revised definitions.

The incidence of maltreatment overall waa significantly sasociated with the number

of children in the family, aa shown in Table 5-7. Children in families with four or more

children were more likely to be maltreated (35.6 per 1,000) than those in families with fewer

children, while there waa no difference between the maltreatment rates for only children (21.0

per 1,000) and those for children with fewer than three siblings (20.1 per 1,000).

When abuse w= distinguished from neglect this overall pattern of family size

differences showed up in trends on both memures. That is, as can be seen in Table 5-7, there

was a marginal difference in the rate of abuse (children from the larger households were abused

at a mte of 14.4 per 1,000, compared to 10.0 and 8.6 per 1,000 for the single-child and

medium-sized households, respectively). A similar, but more pronounced, pattern emerged in

connection with neglect, where the rate for the larger families W= nearly double the rate for

families with three or fewer children (23.0 vs. 12.5 or 12.6 per 1,000).

5-32
Table 5-7. Family size differences in maltreatment revised definitions

Category 1 Child 2-3 Children 4+ Children

All Maltreatment 21.0 20.1 35.6

All AbuseC 10.0 a.6 14.4

Physical Abuse 5.7 4.5 7.a

All Neglect’ ]2.5 12.6 23.0

Physical Neglecte 7.0 7.6 13.9

Severity Endangered 2.5 3.4 10.5

All Maltreatment 295,700 795,300 329,600

All Abusee ]40,600 340,400 133,600

Physical Abuse ao,300 177,600 72,200

All Neglect’ 176,200 500,700 212,900

Physical Neglect’ 9a,400 302,aoo 12a,700

Severity Endangered 34,600 134,100 97,600

%.. l,OW children fmm that sim fatily i. the Pp”lati.n.

b

T.td n“mkr of children “.t dj”.td by wp.latio” total..

%w6”.1 O..., “.mi~ificmt) diffemnc- urns. f~ily .i.e mupa, but p <.10

NOTE: Ftily sise WMunknown for 10.4% of the .-.s. Se. fmtnote 2.

5-33
Note that despite these family size differences in overall rates of abuse and neglect,

families of all sizes evidenced the overall pattern of neglect > abuse under the revised

definitions.

Family Size Differences in Abuse. Within the subcategories of abuse, only the

incidence of physical abuse was associated with family size, but the association was a

statistically reliable (i.e., significant) one. In families with four or more children, the physical

abuse rate was 7.8 per 1,000 children, compared with rates of 4.5 and 5.7 per 1,000 in the

smaller families, which did not statistically differ from each other.

Despite the family-size difference in rates of physical abuse, families of all sizes

showed the overall pattern of physical > emotional > sexual abuse.

Family Size Differences in Neglect. Analyses on the subcategories of neglect

revealed only a marginal difference in the rates for physical neglect. As Table 5-7 shows, the

larger families exhibited nearly double the rates of physical neglect found in smaller families,

when countability of cases was assessed in relation to the revised definitions. That is, 13.9

children per 1,000 were physically neglected when children numbered four or more in the

family, but only 7.6 or fewer per 1,000 experienced physical neglect when the family had fewer

children. Single-child families and those with 2-3 children did not differ in incidence rates.

Family Size Differences in Severity of Injury/Impairment. The last entry in Table

5-7 provides tbe incidence mtes for children endangered by maltreatment countable under the

revised definitional standards. There it can be seen that children in the larger families were

considered to have been endangered by some form of countable maltreatment between three and

four times as often as children in the smaller families. Specifically, there were 10.5 endangered

children per 1,000 in families with four or more children, but only 2.5 and 3.4 endangered

children per 1,000 in single-child and 2-3 child families, respectively.

5.5.3 1980-1986 Differences Related to Family Size

There were no significant relationships between the strength and/or nature of the

1980-1986 differences in the incidence of maltreatment and the number of children in a family.

5-34
This means that the changes described in Chapter 3 held equally well for all children, regardless

of the size of their families.

5.5.4 Summary of Family Size as a Risk Factor

Although family size made no difference for the incidence estimates under the

original definitions, it did affect estimates of cases countable under the revised definitions.

Children in families with four or more children showed higher rates of

maltreatment on a variety of measures. They were also more likely to be regarded as

endangered--a fact which may be at the basis of all the other differences they exhibited.

Recall that the revised definitions expanded the original harm criteria by allowing cases to be

countable if the respondent had judged the child to be endangered.g This means that, for

children in the larger families, their greater rates of perceived endangerment should result in

generally higher rates of countable cases. This largely appears to be what occurred these

children had higher rates of countable maltreatment overall, and marginally higher rates of both

abuse and neglect. It is interesting, however, to note that within the subcategories of abuse and

neglect, their higher rates of countable cases were localized in the areas of ghvsical abuse and

phvsical neglect. While it appears reasonable to assume that the limited material resources of

the larger families increase the risk of physical neglect for children in these environments, it

should be noted (1) that physical neglect also included inadequate supervision, and (2) that the

occurrence of physical W should be independent of resources. These considerations indicate

that there are qualitative differences in the experiences of children in the larger families which

increase their perceived risk or endangerment from physical maltreatment in its various forms.

5.6 Metropolitan Status (Metrostatus) of County

As detailed in Chapter 2, in order for maltreatment to be countable under either set

of definitions, it was necessary for the maltreated child to have lived in mte of the study

‘Or if the CM. w= ofi.ially “fo.”ded” or “,”bsta”ti.ted- by CPS--See Secti.” 2.2.

5-35
counties at some time during the study period.g Countable cases were classified into three

major categories on the basis of the metropolitan status (metrostatus) of the county of residence.

Counties which were in one of the 32 largest metropolitan areas in the country were considered

to be “Major urban’ countie~ “Urban” counties were those in other metropolitan area&lo

“Rural” counties were those not included in any metropolitan area.

5.6.1 Effects of County MetrOstatus

There were no significant ovemll effects of county metrostatus on any category of

maltreatment or of injury/impairment under either set of definitional standards. Thus, there

was more than a one-in-twenty likelihood that any metrostatus differences in the incidence of

countable maltreatment simply reflected chance or random factors.

Because the NIS-2 provided a better representation of the major urban counties,

this finding is important in interpreting the meaning of ovemll 1980-1986 differences. That is,

had the incidence of maltreatment been greater in the major urban counties, then one could

explain the overall 1980-1986 differences as a simple effect of the greater number of major

urban counties in the 1986 study. In view of the fact that there was no relation between

incidence and county metros tatus, this explanation of the 1960-1986 differences appears less

credible. Further discussion of this point is given below and in the final chapter.

10Countiw i“ metm~lit m m- wem those i“.l”dd in . “Stmdd Metmplit m St.ti.tical Unit ,“ . . SMSA, by the

B“r.a” of the Ce”sm. SMSA ..u”ti” in.l”de “otody th.m within a city,. S.vemmant d Iitits, b“t d- those .“tlyi”g

~,.., sub”rbm) ..mtia which have elm Konoti. md mid ml.ti.mbip with the city i“ qu”tion, 1“.luti”g m

atablbhed tinimum stmdd Iw.1 of e.-uting tothe city, Thw, the .atesov .Major urbm. i“.l”d- d] co””ties,

“rb- md .“bubm, witbti th. l~~t mt mptitm mu in thenati.”, md the . Urbm. c.te~~ includ” dl c..ntim,

urbm md s“b”rbm, within other metmplit m ~M. The s~cinc clmification. of bth tha NIS- 1 ud NIS -2 .ou”<I..

cm h found b Table 6-10 of the bmti O“ D.t. Pm -si”z and haly.is.

5-36
5.6.2 1980-1986 Dif fererrces Related to Cmrnty Metrostatus

The reader will recall that significant 1980-1986 differences in the incidence of

maltreatment overall were found to reflect differences in the incidence of abuse, and that

within the subcategories of abuse, both physical and sexual abuse had evidenced significant

increases in the 1986 study. Moderate injuries were found to be significantly above their 1980

levels.

1980-1986

categories,

County metrostatus was

differences.11 Although

significantly related to the magnitude of each of these

1986 incidence rates were hi8her across all metrostatus

they were significantly higher only in the major urban and urban counties. The

pattern is illustrated in Figure 5-11 for the incidence of all abuse, but it applies as well to the

incidence of maltreatment overall, of physical abuse, of sexual abuse, and of moderate

12 Thus the the 19g0- 1986 increases occurred disproportiOnallY in urban injuries/impairments.

, locales.

It should be noted that these findings cannot account for the overall 1980-1986

differences in the incidence of maltreatment. That line of reasoning would only be credible if

the unrepresentative selection of urban counties in the NIS- 1 had for some reason systematically

led to -estimates of the incidence of maltreatment in these counties. However, as indicated

above, there were no overall differences in incidence on the basis of metrostatus, which would

be expected if there had been any systematic distortions of this type.

11C..”ty m.troat atus .1.. related t. the - of 1980-1986 i“cide.ce rate dtffere”ces i“ .m.ti.n.l “eslec$, neri..s

injuries, a“d probable injuries. That is, r.. each of these mew”res, 1986 rates were (no.sis”ific.”tly) higher i“ major

“rba” c.unti.a, wh.re= 1980 rate. were (“o”. isnificantly) htgber in rural counties. However, because there were no

.i~ificmt d,ffere”c.n i“ the 1980-1986 i“cide”ce rate., either overall or within a give” mett.stat.a catez.w, these

st.tisticd ft”dtnv are “.t detailed i“ the text here. I“tere. ted readem ..” refer t. Appendices B, C, .“d E for the

tele..”t inform.ti.” c.ncer”i”s these patternn.

12The O“IYexception to this patter” w= that the 1980-1986 dtffere”.e i“ maltreatment overall w= n.t sig”ificn”t i“ the

urban co””ties,

5-31
Changes in AlI Abuse by Metrostatus.

“ .

FIGURE 5-11

5-38
The findings here, however, possibly do reflect the NIS- 1 vs. NIS-2 differences in

county samples.ls This implies that readers should be cautious about over-emphasizing the

importance of these findings concerning

differences in the more urban counties.

the disproportionate occurrence of the 1980-1986

5.6.3 Summary of Effects of County MetrOstatus

The metrostatus of the county had no reliable impact on the incidence of

maltreatment according to any measure of type or severity. This finding indicated that the

improvement in representation of the more urban counties in the NIS-2 could not account for

the higher estimates of the incidence of maltreatment in that study. County metrostatus was

related to the size of the 1980-1986 increases in incidence, but the reliability of this finding was

unclear in view of the differences in the representation of urban counties in the two studies.

5.7 Summary

Only significant results are summarized in this section. Overviews are given

separately here for results based on the original definitions, findings derived from the revised

definitions, and patterns of differences between the 1980 and 1986 data sets.

1sA.codt”K t. thie =.ount, the Ims mpmse”t.tive NIS - 1 -Iectio” of “rbm co.”ties w- the re-o”, “ot for the overall

19a0.19a6 diff.r.”ces, b“t for the f=t that these differences ap~ad to b. dispmvrti.”dly d,strib. ted in the more

urban counties. That is, since only four counties compti.ed the m.j.r urban c.tegov in the NIS-1, the aamplins error

●stim.td for th:s categov may have hen unreliable--and sub.t.ntitily lower than it. .ppmpti.te value. If tree, it would

have artificially inflated the aiwincance of the NIS-1 va. NIs-2 differences i“ thi. catego~. Thts w.”ld mea” that the

19a0- 1988 in.m=ea only apward to recur dispmptiionately i“ the .rbm counties = a ms”[t .1 the underestimation of

the NIS - 1 m.mpbns ●mm for these counties.

5-39
5.7.1 Original Definitions

me following were important relationships between child and family characteristics

and the incidence of maltreatment defllrred as countable under the original definitions

CHILDS SEX

■ Females were more likely to be abused: rates were 11.1 per 1,000 females

and 7.4 per 1,000 male$

■ Only females evidenced the ovemll pattern of abuse > neglect; rates of abuse

and neglect among males were essentially equivalent

■ Females were sexually abused at a rate nearly four times the rate for males

3.5 females vs. 0.9 males per 1,000; and

■ Females experienced more probable injuries, ostensibly because of their

higher rates of sexuaI abuse 2.6 females and 1.5 males per 1,000 had

probable injury/impairment.

CHILD’S AGE

■ Maltreatment overall increased reliably up through age 8; age-related

increases occurred for both abuse and neglec~

■ All but two age groups retained the overall pattern of abuse > neglect under

original definitions; O-2 year olds and 15-17 year olds experienced somewhat

more neglect than abusq

■ Age-related increases in incidence occurred for all subcategories of abuse; for

the most part, these patterns were due to the lower rates of abuse for O-2

year olds;

■ The only subcategory of neglect to show age-related differences was

educational neglect, reflecting the fact that only children of school-age (i.e.,

5 years and older) were countable as educationally neglected;

■ Fatalities as a result of maltreatment were primarily limited to the lower age

brackets (ages 5 and under~

■ The risk of moderate injury/impairment increased with age, reflecting

different mtes of injury for children aged 5 and under compared with those

6 years and oldeq and

5-40
■ There were age differences in the relative distribution of different levels of

injury moderate injuries were most frequent for all but the O-2 year olds,

who suffered serious injuries more frequently than they did moderate

injuries.

CHIL~S RACE/ETHNICITY

■ This characteristic was @ related to the type or severity of maltreatment;

FAMILY INCOME

■

■

■

■

■

■

■

This factor had pervasive effects on the incidence of maltreatmen~ it was

related to all measures of maltreatment and all levels of outcome severit~

Children from families with incomes less than $15,000 had an overall rate of

maltreatment 5 times that of other childrew 32.3 vs. 6.1 children per 1,000 in

the under $15,000 and over $15,000 income categories, respectivelfi

Abuse was 4 times higher among lower income children; 16.6 lower income

children per 1,000 compared to 4.1 upper income children per 1,000;

Physical abuse was 3+ times more frequent in the lower income category;

sexual abuse was 5 times more frequent and emotional abuse nearly 4+ times

more frequen~

Neglect was nearly 8 times higher among the lower income childre~

Compared to children in families with incomes of $15,000 or more, those in

the under $15,000 category were nearly 10 times as likely to be physically

neglected, almost 8 times as likely to be educationally neglected, and 5 times

more likely to be emotionally neglected.

Lower income children experienced more frequent injuries at all levels 0,03

vs. 0.01 fatalities per 1,000, 6.0 vs. 0.8 seriously injured children per 1,000,

22.4 vs. 4.7 moderately injured children per 1,000, and 4.0 vs. 0.6 probably

injured children in families with incomes less than $15,000 compared to those

with higher incomes.

FAMILY SIZE

■ There was no relation between the number of children in a family and the

type or severity of maltreatment.

TYPE OF COUNTY

■ The metrostatus of the county did not relate to the type or severity of

maltreatment.

5-41
5.7.2 Revised Definitions

The following pamlleled the findings for the original definitions

CHILDS SEX

■ Females experienced more abuse overall than did males; 13.1 females vs. 8.4

males per 1,000 were countable as abused under the revised definitions;

m Females evidenced the overall pattern of neglect > abuse under the revised

definitions

■ The rate of female sexual abuse was nearly four times that for males 3.9 per

1,000 females but 1.1 per 1,000 males were sexually abused; and

■ Probable injury/impairment occurred more frequently among females (3,5

females per 1,000 vs. 2.0 males per 1,000) --a result which likely stemmed

from the higher incidence of sexual abuse for females.

CHILVS AGE

■ Abuse increased with age, largely due to the fact that O-2 year olds were

significantly leSS likely to be abused than were older children;

■ Physical abuse was associated with age, with O-2 year olds less frequently

physically abused than all other age groups, and 3-5 year olds less abused

than children 12 years old and over;

m Educational neglect was related to the child’s age, due in part to the

definition Of this form of maltreatment which restricted it tO children Of

school age, but also partially due to an increase in this category of

maltreatment in the 15-17 year old age bracket;

■ The age-pattern for fatal injuries was virtually identical to that found under

the original definitions, reflecting the fact that fatal injury cases which were

countable under the revised standards were nearly all also countable under

the original standard> and

■ Moderate injuries from maltreatment defined by the revised standards showed

exactly the same pattern as with the original defllnitirms children aged 5 and

younger were significantly less likely to be moderately injured than those in

older age categories.

5-42
CHILDS RACE/ETHNICITY

9 m differences in type or severity of maltreatment were significantly related

to race/ethnicitK

FAMILY INCOME:

■ Children from families with incomes under $15,000 per year experienced

more maltreatment (54.0 vs. 7.9 per 1,000 children~

■ Abuse overall was 44 times greater for children from lower income families

(19.9 vs. 4.4 children per 1,0001

■ Lower income children experienced more physical abuse ( 10.2 vs. 2.5 children

per 1,000), more sexual abuse (4.8 vs. 1.I children per 1,000), and more

emotional abuse (6.1 vs. 1.2 per 1,000 children);

■ Maltreatment involving some form of neglect was about 9 times as frequent

for children from lower income families (36.8 vs. 4.1 children per 1,000);

■ There were income-related differences in each subcategory of neglect, with

lower income children consistently more frequently maltreated (physical

neglect 22.6 vs. 1.9 children per 1,000, educational neglecfi 10.1 vs. 1.3

children per 1,000, and emotional neglect 6.9 vs. 1.5 children per 1,000);

and

■ Children from the lower income families experienced more fatalities (0.03 vs.

0.01 per 1,000 children), more serious injuries (6.0 vs. 0.9 per 1,000

children), more moderate injuries (30.9 vs. 5.5 children per 1,000), and more

probable injuries (5.4 vs. 0.9 children per 1,000) than children from the

higher income families.

TYPE OF COUNTY

■ The metrostatus of the county did not relate to the type or severity of

maltreatment under the revised definitions.

Findings under the revised definitions differed from those under the original

definitions in the following respects

CHILD’S SEX:

■ Males also evidenced the overall pattern of neglect > abuse under the revised

definitions.

5-43
CHILDS AGE

■ There was no relation between age and the incidence of maltreatment overall

or of neglect, defined according to the revised standards;

■ Sexual and emotional abuse did not evidence age-related increases under the

revised standard$ and

■ EmotionaI neglect ~ exhibit a significant relationship to age, with children

from birth through five years less emotionally neglected than those age 9 and

older.

FAMILY INCOME

■ Income differences emerged on the level of injury/impairment unique to the

revised definitions the endangered category; 11.7 per 1,000 children in lower

income families vs. 0.6 children per 1,000 in other families were endangered

by maltreatment countable under the revised standards.

FAMILY SIZE

■ Children in families with four or more children experienced a higher overall

incidence of maltreatment than other children (35.6 vs. 21.0 or fewer children

per 1,000~

■ Physical abuse was more likely for children in the larger households; 7.8

physically abused children per 1,000 in households with 4 or more children,

but 5.7 or fewer per 1,000 in smaller families:

■ Physical neglect was more frequent in the larger household$ 13.9 vs. 7,6 or

fewer children in larger vs. smaller households, respectively and

■ Children from larger families were more often endangered by maltreatment

countable under revised standards (10.5 vs. 3.4 or fewer endangered children

in large vs. smaller families, respectively).

5.7.3 Differences from the 1980 findings

The overall NIS- 1 vs. NIS-2 differences, described in Chapter 3, were ~ affected

by

■ child’s sex;

■ chiltis race/ethnicit~

5-44
■ family income; or

■ family size.

The overall 1980-1986 differences w, however, modified by two factors the

child’s age, and the type of county.

CHILD’S AGE

9 Childs age was related to the magnitude of the incremes for all abuse, for

physical abuse, and for sexual abuse; in all cases, the increased incidence of

maltreatment occurred disproportionately among the nlder children.

TYPE OF COUNTY

■ The 1980-1986 differences were greater in the urban counties for

maltreatment overall, abuse overall, physical abuse, sexual abuse, and

moderate injuries.

The fact that the relationship between age and specific categories of maltreatment

increased since 1980 raised some question about whether a8e is a risk factor for the occurrence

of these forms of maltreatment, nr whether it relates more to the likelihood that these forms of

maltreatment will be recognized. This issue is considered in the final chapter, when the

implications of findings are discussed.

Also note that the reliability of the relation between county type and the magnitude

of 1980-1986 increase was made doubtful by the possibility that it stemmed from the different

in representation of the more Populous counties in the two studies.

5-45
6. SUBSTANTIATION AND REPORTING RATES

Previous chapters have focused on cases countable under the original or revised

definitions. These included cases that had been officially reported to the local CPS agency as

well as cases which had not been reported, but which were recognized and submitted to the

study by some community professional in an investigatory or noninvestigatory agency. The

findings presented in this chapter distinguish between cases known to CPS and those known

only through a non-CPS study source.

To begin with, M cases reported to CPS are considered, whether or not these

turned out to be countable under either of the study’s definitional standards. The overall

number of cases reported to CPS is examined, as is the increase in CPS reports since 1980.

Then, the proportions of reported cases that were countable under the different study

definitions are presented, as are the relationships between countability and CPS substantiation,

and changes since 1980 in the countable proportions of CPS cases.

Following this, recognition and reporting patterns are examined. Considering the

full set of cases which turned out to be countable by the study (whether or not these were

known to CPS), the proportions of this total recognized by professionals at different types of

agencies are presented. Then, the rates of reporting countable cases to CPS are examined. Both

the overall reporting rate, and the rates at which recognized cases are reported by different

agency sources are considered.

6.1 Reports of Suspected Abuse and Neglect

Since the study obtained data from a nationally-representative sample of local CPS

agencies, it is possible to generate national estimates concerning the CPS database. In this

section, the following five questions about cases reported to CPS are addressed:

■ How many cases are reported to CPS nationwide (without regard to whether

these are countable or not)?

■ Has the number of reports to CPS changed since 1980?

6-1
■ Of the cases reported to CPS, what proportion are countable under the

original definitions? What proportion are countable under the revised

definitions?

● Has the proportion of CPScsses countable under original definitions changed

since ]980?

■ What proportion of all CPS cases are substantiated? How does the

substantiation/nonsubstantiatimr of CPS cases relate to countability under

either set of definitional standards?

6.1.1 Patterns in CPS Reports Overall

As given in Table 6-1, CPS received reports concerning an estimated ],657,600

children in 1986,1 reflecting reports on more than 26 children per 1,000 in the U.S. population.

This represented a statistically significant increase of nearly 57% in officially reported children

since 1980. These results are generally consistent with findings from other studies, such as the

results of the data collection project of the American Humane Association and of the survey

this year by the House Select Committee on Children, Youth, and Families, both of which were

based on surveys of states concerning aggregated report totals.z

Table 6-1 also indicates that among the children reported to CPS, 203,700 met the

original definitional standards in 1980 whereas 409,400 met these standards in 1986. These

totals translate into incidence rates of 3.2 children per 1,000 and 6.5 per 1,000 in 1980 and

1986, respectively. Note that this constituted a significant increase in overall incidence of

countable CPS cases. The increase in sheer numbers of CPS cases which were countable to the

study (i.e., where demonstrable harm had occurred) is consistent with the overall increase in

1.,Thzs ,s .“ estim.te.f the “.mber.f different children forwh.m rep.tis wem received a“d accepted f.ri”ve.tigati.”. lt

does “.t i“v.lve d.”ble-c.”ntins .fchildr.n who were rep.tied more than .“ce, “.r does it i“cl”de chtldre” involved i“

rep.ti. wh,ch were ..ree”ed .ut or refereed el~ewhe~ by CPS prior t. . . attempt at investigate.”.

2AHA rep.tied that 1,92S,000 children hd k.” reprted t. CPS i“ 1985, xcordi”s t. their s“wey of states c.”cer”i”g

report total.. Th,n w= ~“ivale”t t. a“ estimated 30.6 child..” per 1,000 p.p”lati.”. (cf. H!.hlichts of Off,cial Child

Nexlect and Abuse Rep.tii”n. 19S6), The Ho”se Select C.tittee S”mey, @ve”i” Ab”sed CYtldre”i” America Victims

.1 Ofncial Neglect, f.””d that a~”t 1.9 AlIi.” cMldre” were reported i“ 198S a“d that between 19S1 and 19S5 the

““mber .f children reprted t. hsve b-” .b”.ed .r neglected i“cre=ed appmxim.tely 55%. The 1986 estimate of

1,657,600 ia ~.misted with a 95% co” fide”c. i“tew.1 ra”ti”~ from 1,2S2,461 t. 2,032,798, a“d so does “.t &ffer

sipific.ntly from these .ther~tim.tea which are within thts rmse.

6-2
Table 6-1. Reports received byCPS

Children ]980 1986 1980-1986

Increase

Total Reported 16.6 26.3 97*

:

T Countable/Original Definitions

:

3.2 6.5 3.3*

Countable/Revised Definitions s

1].6

Total Reported

~

1,055,900 1,657,600 60 1,700*

Countable

I /Original Definitions 203,700 409,400

L

205,700*

Sb Countable

/Revised Definitions 732,300

.

Difl.mn.. ktw..”108”d”d 1086 fiwmsi. simiflca”t .tthepc .061.v.l.

~er 1,~ cfildmn in the Wpul.tion

b

T.tdn”mb.m ofctildre” mundedtothen..mat lW; nottijusted forvpulstion totals

6-3
countable cases described in Chapter 3. As discussed in that chapter, this increase in absolute

numbers may be due to an increase in the actual QcCurrenc~ Of child maltreatment, but the

evidence seems more consistent with the idea that it is due to an increased reco enition of the

cases that exist.

Further arr?lyses also showed that the set of cases known to CPS in ]986 included a

greater concentration of countible cases. That is, the Dercenta w Of cases known to CPS which

turned out to be countable under the original study definitions wcs significantly greater in 1986

than in 1980. In 1980, 19% (i.e., 203,700/1,055,900) of the cases reported to CPS were

countable, whereas this proportion increased to 25% (i.e., 409,400 /],657,600) in 1986. Thus,

there clearly has been an increase in the fsrooortimr of CPS cases which are countable by the

original study standards, changing the general character of the pool of cases which get into the

door at CPS agencies. This result may indicate that there has been an increase in the ability of

reporters to CPS to selectively report the more countable cases to CPS. Alternatively, it may

reflect greater screening on the part of CPS agencies themselves. That is, CPS agencies may

have become more selective about the reports they accept for investigation (what CPS lets into

their agency in the first place, as opposed to those they refer elsewhere at the outset) and the

proportion of countable cases in the set of reports accepted for investigation may have increased

as a consequence of such screening.

When the revised NIS-2 definitional standards were applied, 732,300 children were

classified as countable, or about 44% of the 1,657,600 children reported to CPS. As noted

earlier (Chapters 2 and 4) all cases officially founded by CPS were defined as meeting the harm

criterion for countability under the revised definitions, as were cases where study participants

regarded the children as having been endangered by the maltreatment (or where the children

were actually injured/impaired).

6.1.2 Substantiated/Indicated vs. Unfounded CPS Cases

Table 6-2 presents the distribution of reported children according to whether or not

CPS had officially substantiated the allegations concerning their maltreatment or considered

them “indicated on the basis of the evidence at hand. “Substantiated” (also termed “founded”)

cases were those for which CPS had concluded the investigation and had determined that the

6-4
Table 6-2. Cases reported to Cm substafrtiation rates and proportions countable under

different definitions

Children Reported’ 1980 1986 1980-1986

Increase

All Reported Casex

Subst./Indicatedb 451,200 871,300 + 420, ]00’

Unfounded 604,700 786,300 + 181,600 -

Total 1,055,900 1,657,600 + 601,7009

Proportion Subst./1ndicated 0.43 0.53

.

+ 0.10

Countable Under Original Definitions

Subst./1ndic. Countable

‘ro/~~~/b~bst’’lndicated

Unfounded

Proportion Unfounded Countable

185,300 336,600 + 151,300.

0.41 0.39 -0.02

18,400 72,800 + 54,400”

0.03 0.09

.

+ 0.06

Countable Under Revised Definitions

Subst./Indicated Countable 637,200

Proportion Subst./Indic. Countable 0.73

Unfounded 95,100

Proportion Unfounded Countable 0.12

.

Differ. ”.. between 1980 md 1986 fiwms is si~ifi..”t at the p <.05 level. Ml 1980-1986 aig”ific.”ce tests tij”at for

pop.1.tion totals.

b

S.bsta”tiated .r i“dic.ted. See text f.. specific definition,
allegation was supported by the evidence. “Indicated” coaes were those for which the final CPS

assessment had not yet been made at the time the study data form was required, but where the

investigating CPS caseworker regarded the available evidence as sufficient to warrant continued

investigatimr.s Cases which were not “founded” or ‘indicated,” were classed as “unsubstantiated

(also termed “unfounded”), which meant that the allegation proved false or unsupportable.

Table 6-2 reveals that, in 1986, the alleged maltreatment was founded or indicated

for art estimated 87] ,300 children, or 53% of those who had been offically reported to CPS.

Maltreatment was unfounded for the remaining 786,300, or 47% of those reported. Comparison

with the 1980 data revealed that the number of substantiated/indicated cases had increased by

over 90% and that this increase was statistically significant. The number of unfounded cases

was also above its 1980 level (by 30%), and this increase was statistically marginal. 4 Finally, the

fourth line of Table 6-2 shows that the ~ of CPS cases which were

substantiated/indicated increased from 0.43 to 0.53 between 1980 and 1986, and that this

increase was significant.

Thus, the C= substantiation ~ (which here includes “indicated” cases)

significantly increased during the six year interval between the NIS studies, which means that a

higher proportion of the cases reported to and investigated by CPS are now regarded by” that

agency as warranting official intervention of some sort. As was the case above in interpreting

the finding that the concentration of countable CPS cases had increased, it is not possible to

identify the precise reason for the finding here. That is, since the study obtained CPS data

forms only on those reported cases which were accepted for investigation, it is not possible to

determine whether this increase in substantiation/indication rate was due to an increased

awareness on the part of reporters to provide CPS with cases which are likely to receive

intervention and services or whether it instead indicates that, in the face of increasing reports

and decreasing resources, C~ agencies have become more selective about the cases they accept

for investigation and have screened out more of the cases that would not have been

substantiated or indicated.

s

OK,cidly s.batmti.td md .indi..td. .-s wem .Imsifid tosether i“ them mdyae. t. tinimi.. the effects of time

.o”strti”ts .“ dat. c.ll=ti.” md to c.nrom with the appm=h ttie” in th. NIS -1.

4

1..., p <,10

6-6
The second section in Table 6-2 breaks down the CPS cases countable under the

original definitions into those which were substantiated/indicated vs. those which were

unfounded, showing both the total numbers and the proportions for each of these sectors. In

the current study, 336,600 of the cases substantiated/indicated by CPS were countable under the

original standards. This was a statistically significant increase of 82% above the 1980 estimate

of countable substantiated/indicated cases. While the absolute size of this numerical increase is

both sizeable and significant, the following row in the table indicates that countable cases

represent essentially the same proportion of the set of substantiated/indicated cases in both

studies (0.41 in 1980 and 0.39 in 1986, a difference which was not significant).

The number of unfounded cases which were countable under the original

definitions also increased significantly --from 18,400 in 1980 to 72,800 in 1986 (a nearly 300%

increase). Note that this also involved a small but significant increase in the cO””table

vroo ortion of unfounded cases. That is, cases which were countable under the original

definitions increased from 0.03 to 0.06 of all unfounded CPS cases. The fact that there is now a

8reater proportion of countable cases in the set of those which CPS determines to be unfounded

suggests that there has been a small but detectable shift in CPS substantiation standards, such

that agencies now exclude cases which in the past would have received intervention and

services. Although this doubtless reflects a reasonable adaptation to an environment in which

these agencies have experienced increasing demands and diminishing resources, it must

nevertheless raise concern about the consistency and adequacy of intervention in cases where

children have already experienced demonstrable harm as a result of abuse or neglect.

The last section in Table 6-2 gives the numbers and proportions of

substantiated/indicated and unfounded CPS cases which were countable under the revised

standards. As the table reveals, 637,200 children whose maltreatment was substantiated or

indicated by CPS were countable according to these standards, a number which reflects 73% of

all substantiated/indicated cases. Readers will recall that a primary goal of these revised

definitions was to avoid excluding cases which were offically substantiated by CPS, and that any

case which was of fically substantiated was considered to automatically fulfill the harm criterion

under the revised definitions, and was countable as long as it also met all the other definitional

criteria (e.g., age, residence, time of maltreatment, etc.). The fact that the proportion of

substantiated/indicated cases countable under revised standards is so much higher than the

6-7
proportion countable under original standards (i.e., 0.73 vs. 0.39) conveys the strong impact of

this strategy.

6.2 Patterns in Recognition and Reporting

This section addresses the following six sets of questions

■

■

■

■

■

■

Of all recognized cases which are countable under original definitions, what

number (and proportion) are officially reported to CPS? What number (and

proportion) of cases countable under the revised definitions are officially

reported?

Has the proportion of cases known to CPS changed since 1980?

Which types of agencies recognize greater numbers (proportions) of the cases

countable under original definitions, and which tend to recognize fewer?

How do the recognition rates of the different agency types compare when

cases are defined as countable under the revised definitions.

Has the recognition patterns for the different agency categories changed since

]980?

For recognized cases countable under the original definitions, how do

reporting rates vary across the different non-CPS agency categories? Are

some types of agencies notably better (or worse) at reporting the cases they

recognize than others? How do the reporting rates compare when the set of

recognized cases is defined according to the revised definitional standards?

Have reoortine rates for cases countable under original definitions changed

since 1980? -

6.2.1 Overall Reporting Rate of Countable Cases

Table 6-3 classifies the children who experienced maltreatment countable under

each set of definitions according to whether or not they were known to CPS.5 In 1986, CPS

‘F.. this cl=sificati.”, . mdtm.ted child w- c.”.ide~ t. be k“.w” tO CPS only if there w= some indication that CPS

hd remon to suswct that the child in question w= maltreated. Children who were only listed by CPS m h.vins hved i.

a h.”seh.ld, but not u havi”s bee” either .“ alleged . . i“dt.atd victim of maltreatment were “ot known to CPS u

mdtm.td -d wem “ot denmed m “know” to CPS” for thts clmsificatio”. Ctildr.” who we= cl-ified u “k”own to

CPS” may or may not have hen known tomother participating study agency.

6-8
Table 6-3. Countable cases of child maltreatment classified by CPS and non-CPS source

Original Definitions

1980 1986 1980-1986 1986

Revised

Cate80ry Increase Definitions

Known to CPS 3.2 6.5 3.3*

Known Onl

to Non-C d 6.6 9.8 3.2

1.6

3.5

Total 9.8 16.3 6.5* 25.2

Known to CPS 203,700 409,400 205,700* 732,300

$

Known Onl

; to Non-C d 421,400 616,500 195,100 852,400

Sb

Total 625,100 1,025,900 400,800* 1,584,700

.

The di~em”cm i“ rate of i“.ide”ce btwea” 1986 md 1980 were .i~ifi.mt .t the p <,06 level,

her 1,~ children i“ the Pp”lati.”,

b

Totd ““mhr .[ .hildm” m“”d.d t. the ne-st 10% “.$ dj.sted by pp.lati.n t.tah.

6-9
knew about 409,400 children nationwide (i.e., an incidence rate of 6.5 children per 1,000) who

had experienced maltreatment countable under the original definitions. However, this

constituted only a minority of the total cases countable by these standards. There were an

additional 616,500 children (9.8 per 1,000) who had experienced such maltreatment and who had

Mbeen reported to CPS, but who were known mrlytoa professional in anon-CPS agency like

those included in this study. Thus, CPS knew about an estimated 40% of the cases countable

under original definitions. The picture appears not much better when cases countable under the

revised definitions are considered. There, 732,300 (i.e., 1].6 children per 1,000) were known to

CPS, representing 46%of the l,585,700total cases countable (i.e., of the25.2 children per 1,000

who had been countable under the revised standards).

As given in Table 6-3, the increase in cases countable under original definitions

occurred primarily in the sector of cases known to CPS (i.e., it was only in that sector that the

difference between 1980 and 1986 figures was statistically significant). Thus, while more cases

overall were known to the study in 1986, the incidence rate of cases known only to non-CPS

sources did not significantly change since 1980, although the table shows that they did increase

by about 48%. The fact that this difference failed to achieve traditional levels of statistical

significance may have stemmed from the especially large sampling error associated with the

non-CPS estimates in the NIS-2.

At first glance, because the increase in countable cases in 1986 was not

proportionally distributed across the knnwn-to-CPS and unreported-non-CPS sectors, one might

think that there had been an overall increase in the rate at which cases are reported to CPS.

However, when this possibility was specifically examined, the analyses showed that, although

the overall reporting rate did increase slightly, the increase was w significant (or statistically

reliable). In 1980, only about one-third of the total countable cases, or 33% (i.e.,

203,700/625,900) were known to CPS. Although, as noted above, the percentage increased to

40% in 1986, this increase was ~ statistically significant. Thus, this study did @ find a

reliable increase in the rate of reporting countable cases to CPS in the interim since 1980.6

6Memi”g that thei"cwUe i"ther.te .[rep.tit"g c..ntable cwesto CPSi"the i.tetim ai"ce19a0 may(withprobaHhty

-.t.r then one in twenty) have ffc.=d due to chance done.

6-10
It is important to use caution in drawing conclusions about the meaning of this

result. That is, one should ~ conclude that this finding necessarily means that reporting rates

have stayed the same. first, the reporting rates did increme (from 33% tO 40%), b“t the

increase turned out to be nonsignificant. Second, and perhaps more importantly, any increased

screening-out of cases by CPS would tend to _ increases in reporting rates, since

screened-out cases would ~ be considered “Known to CPS,” even though they were at least

technically, “reported to CPS.” This caution should also be borne in mind throughout the next

section. It is discussed again in the concluding chapter.

b.2.2 Recognition and Reporting of Countable Cases by Different Agencies

Original Definitions

Table 6-4 presents national estimates, by source, of the number of children

countable as maltreated under the original definitions who had been reported to CPS, the

number of additional in-scope children (who had not been reported to CPS), and the proportion

of the total in-scope children who had been reported. In constructing this table, children were

“credited to an specific type of agency on the basis of a priority system which reflects the

“Ievelof recognition” model presented at the outset of Chapter 2.’ Table 6-4 lists the non-CPS

agency categories in their priority order, from highest to lowest. Thus, the estimate of a total

of 50,900 in-scope children recognized by hospitals is the estimated number of additional

children identifiable from this source, over and above all those who had been recognized by

juvenile probation departments or courts, police agencies, sherif~s departments, or public

health services. Children listed in the table as having been “reported to CPV by a given

7

Thepti.tity aystemf.ll.wd here c._.pndd t.th.t “nedi” the NIS-l, ex.ept that thetiditi.”.l .atego~.f d.yc.re

..”tem ww inseflti just following public achmls, It.h.”ld & noted that there is some arb,trwi”ess in th,s priority

system, sin.. the mdel descri~ i“ Chapter 2 d... “ot dtct.te the ode. of .ge”cies within the i“veatig.t.W sectororof

thetiffere”t n.ni”v~tig.t.~ ase”cie. in rel.ti.” t. emh other,

6-11
Table 6-4. Rate of reporting to CPS by source cases countable under original definitions

Estimated No. In-Scope Children’

Source of Information Reported Not Total Proportion

to CPSand/or Studyb to CPS= Reported Recognized Reported

to cPsd by Source to CPS

(A) (B) (c) (A/C)

Investigatory Agencies

Probation/Courts

Police/sheriff

Public Health

Subtotak

Other Study Agencies

Hospitals

Schools

Daycare Centers

Mental Health

Social Services

Subtotak

Total, All Study Agency Sources

Other Sources

DSS/Welfare Department

Other professional agency

All other sources

Subtotak

Total, All Sources

10,200

59,300

6,800

76,300

33,500

129,900

4,000

11,000

22,500

200,900

277,200

16,700

9,600

105,900

132,200

409,400

35,500

37,400

22,500

95,400

17,400

409,700

20,400

8,700

64,900

521,100

616,500

616,500

45,700

96,700

29,300

171,700

50,900

539,600

24,400

19,700

87,400

722,000

893,700

16,700

9,600

105,900

132.200

1,025,900

0.22

0.61

0,23

0.44

0.66

0.24

0.16

0.56

0.26

0.28

0.31

?

?

?

?

0.40

‘Total ““mberof ctildre. r...d.d t.the”earest lW; “Ot adj.sted bypp.latio”tot.la.

b..Prtiortty .Imsificatio.. See Section 6.2.2. Each row represents childre” over and above those i“ previous rown. Children

reported to CPS by mot”dyso.rce ar. clwaified only in the “reported to CPS” .Ow for th.t ~o.r...

CI”cl.des.h,ldren ide”tifiedt. tbest.dy hthby ptiicipnti”g ”.”-CPS .Ee”ciea a“d by CPS = well -children identified

t. the study O“IYby CPS where so”rceof reprt to cPS w- a “0”-CPS agency of the type i“cl.ded i“ the study design

(e.g., police, hospital, school, etc.)

d

Beta.se.fthe priority cl=sificati.”, ““t r.p.rtedt. CPS. means..t reprted by the .ge”.y type i“ the row i“ qu.sti.n

~by any .thers.urce t. tbe study.

6-12
category of agency include those who were reported to CPS by all such agencies, those which

participated in the study as well as those which did not.s

The first column of Table 6-4 provides a break-down Of the”know” to Cpv ]9s6

estimate given earlier in Table 6-3. This column shows that, in 1986, agencies of the types

included in the nms-CPS sector of this study were estimated to have reported to CPS a total of

277,200 children who had been countable under the original definitions. The remaining 132,200

reports to CPS concerning in-scope children came from sources beyond the types of agencies

included in this study (e.g., from other branches of the Department of Social Services, or DSS,

from other professional agency sources, such as private medical clinics, or physicians in private

practice, or from other sources, such as members of the family, the child him/herself,

neighbors, anonymous callers, etc.

The second column in Table 6-4 differentiates the “Known only to Non-CPS 1986

entry in Table 6-3 into the different agency categories. Note that information is available here

only for those non-CPS agency categories which were included in the study design. There is no

basis in this study for estimating unreported cases which were known to the other sources in the

last rows of the table (i.e., to other branches of DSS, to private medical clinics and physicians,

to relatives, and so forth). For the types of sources included in the study, the overall estimate

is that, in addition to the in-scope children who were reported to CPS, 616,500 more children

countable under the original definitions are recognized by professionals at these various nonCPS agencies.

The third and fourth columns give the recognition patterns and reporting rates,

respectively. That is, the third column gives the overall patterns of recognition, indicating the

total number of in-scope children recognized in each type of agencfi the fourth column shows

the proportion of all recognized children who were reported to CPS.

8When CPSk”ewak”t ."i"-sc.pe cfild, the CPSdataf.rm provided i"f.rmati." .h"tthe so"rce.fther.p.rt to CPS.

This w- the b=ia (together with the priority system described ah...) for .lti~ifyi”g the c=. i“t. a.pecific row in the

“Reptied to CPS” c.l”m”, with the exception that, for c.u. ties with Iarse CPS agencies, a“d sometimes when the SO.rce

.1 repti t. CPS w- .“k”.w”, it w= ~~ible t. take into mc.”nt the .o.-CPS agency categow represented by any

d“ph..te d.t.r.-whtchd.d bee” submitted.

6-13
Patterns of Recognition for Cases Under Original Definitions. ,Nmrinvestigatory, or

“Level 3,” agencies recognized an estimated 722,000 children who countable as maltreated by

original standards. This was more than two times the estimated 171,700 chi[dre” whO were

recognized by the “Level T investigatory agencies, a difference which was statistically

significant. Within the Level 2 sector, police/sherif~s departments recognized the greatest

number of maltreated children (an estimated 96,700 nationwide), which was significantly more

than had been recognized by agencies in the probation/courts category (i.e., 45,700), There was

no statistical difference between the number of children recognized as maltreated by

probation/courts and the number recognized by public health departments (i.e., 29,300). Within

the Level 3 sector, agencies fell into three strata based on their recognition of maltreated

children. The first strata consisted of public schools, which recognized by far the greatest

number of maltreated children (539,600 children nationwide). Social services agencies and

hospitals comprised the second strata, recognizing 87,400 and 50,900 children, respectively,

totals which were not statistically different. Finally, the fewest maltreated children were

recognized by day care centers and mental health agencies--which respectively recognized

24,400 and 19,700 in-scope children.

Agency Differences in Reporting Rates for Cases Under Original Definitions. The

final column in Table 6-4 presents the proportion of recognized cases which were offical]y

reported to CPS. The final row provides the finding noted earlier, concerning the Overall

reporting rate of all cases countable under original definitions, 40% had been officially

reported to and accepted for investigation by CPS. The row entitled “Total, All Study Agency

Sources” indicates the overall reporting rate across all the types of agencies that had been

represented in the non-CPS component of the study, For the represented categories of agencies,

taken together, of all the cases they recognized which had been countoble under original

definitions, 31% had been reported to (and accepted for investigation by) CPS,

Level 2 and Level 3 agencies differed in their tendency to report and have CPS

investigate the cases they recognized. 9 Investigatory agencies reported (and had investigated) an

estimated 44% of the cases they recognized, while noninvestigatory a8encies reported (and had

investigated) only about 28% of their recognized cases--a difference which approached

9Note that because the at”dy . . . only credit c-es m “K”ow” to CPS” if they were rep.rted to and accepted f.r

i“vestixat i.” b~ CPS, the &,fference her. (M well . . other dtff.m”.es i“ “reporting rate.”) may be due t. difrere”ces i“

s“bmitti”grep.rta t. CPS, differences i” CPS.creeningof agencies- rep.rt., .rtob.th.

6-14
significance (i.e., had a less than 10 percent chance of stemming solely from sampling error).

Within the set of investigatory agency categories, maltreated children encountered by

police/sherif~s departments were most likely to appear among CPS reports accepted for

investigation, while there was no statistical difference in the reporting rates for probatiorr/courts

and public health departments. Among rrmrinvestigatory agencies, hospitals and mental health

agencies had the highest rates of reporting (66% and 56%, respectively), and did not reliably

differ in the rates at which their recognized cases appeared in the CPS report base. At the

OppOsite end Of the repOrting spectrum. schools and daycare centers had the lowest rates (24%

and ]6%, respectively). The reporting rates of schools and daycare centers did not statistically

differ from each other, but agencies in both of these categories were significantly less likely to

report (and have CPS investigate) their recognized cases than either hospitals or mental health

agencies. Due to the great variability in reporting rates for social services agencies, the overall

reporting rate for these agencies was not reliably different from that of any other agency

category.

In general, these reporting rates are remarkably low. A majority of the recognized

cases are reported and accepted for investigation by CPS for agencies in only three of the eight

categories (police/sherif~s departments, hospitals, and mental health agencies). In fact, public

schools, which are the single greatest source of repnrts to CPS concerning countable cases, have

more countable cases pnreDorted (409,700) than are reported to and investigated by CPS for all

referral sources combined (409,400).

Above, and throughout this section, it was noted that the screening out of cases by

CPS agencies prior to investigation would tend to underrepresent the actual reporting rates for

non-CPS agencies. Here, it should be noted that there are also upward distortions on the

reporting rates for some nf the agency categories. Apart from reasons which apply generally to

all agency categories and which are discussed in the final chapter, the reporting rates given here

for schools, probatiorr/courts, and mental health are especially likely to overstate the actual level

of reporting by these agencies. This is because the study estimates of unreported children in

these categories represented a more limited set of agencies than the full set of those which

contributed reported cases to CPS during the study. For example, the estimate regarding

unreported cases from schools represents unreported cases from * schools, whereas the

estimated CPS reports from schools undoubtedly includes reports from both public and private.

The study provided no basis for estimating the number of unreported cases from private

6-15
schools, so the total unreported cases from schools which is shown in the table is incomplete in

that respect. Similarly, the estimate of unreported children from mental health

agencies/facilities was based on public mental health clinics, while the estimate for reports to

CPS from agencies in this category included all mental health clinic sources, both public and

private. Finally, the study representation of probatims/courts consisted solely of a single,

nonsampled, agency in this category (the county Juvenile Probation Department), whereas the

the estimate of children reported to CPS from probationlcourts includes reports both from this

agency and from any other courts/probatimr agencies (such as the adult probation department,

adult and juvenile parole departments, family and criminal courts, the District Attorney or

county prosecutor’s office, and so forth).

It is clear from the findings given here that a majority of children who are

recognized as abused and neglected by community professionals do not enter the CPS report

base. Indeed, considering the reporting rates in Table 6-4, one could say that the vasf major;ty

of such cases remain unreported and/or uninvestigated.

Revised Definitimsx

Table 6-5 parallels Table 6-4, but provides the corresponding information for cases

countable under the revised definitions. The first column offers a break-down of the “known

to CPS” entry under revised definitions. It indicates that agencies of the kind studied in the

non-CPS component of the NIS-2 were estimated to have reported a total of 420,800 children

who were countable by revised standards. Other CPS reporting sources accounted for the

remaining 311,500 children reported to that agency. The second column shows the distribution

of the total “Known only to Non-CPS” across the different study reporting sources. The total of

unreported cases from these sources was estimated to be 852,400 children nationwide.

Patterns Of Recognition for Cases Under Revised Definitions. Total numbers of

cases fitting the revised standards which were recognized in different categories of agencies are

given in the third column of Table 6-5. Except for the fact that the numerical totals are all

higher under the revised definitions, the findings here precisely parallel those described above

for the original definitions. Level 3 agencies recognized significantly more cases countable by

revised definitions than did Level 2 agencies. Specifically, noninvestigatory agencies recognized

6-16
Table 6-5. Rate of reportiog to CPS by source cases countable under revised definitions

Estimated No. In-Scope Children’

Source of Information Reported Not Total Proportion

to CPSand/or Studyb to CPS’ Reported Recognized Reported

to CPS by Source to CPS

(A) (B) (c) (A/C)

Investigatory Agencies

Probation/Courts

Police/sheriff

Public Health

Subtotal:

Other Study Agencies

Hospitals

Schools

Daycare Centers

Mental Health

Social Services

Subtotak

Total, All Study Agency Sources

Other Sources

DSS/Welfare Department

Other professional agency

All other sources

Subtotal:

Total, All Sources

15,500

I 15,400

10,200

141,100

52,700

172,000

4,200

13,300

37,500

279,700

420,800

43,300

11,300

256,900

311,500

732,300

46,700

67,300

34,600

14g,600

24,100

548,100

32,300

9,700

89,600

703,800

852,400

852,400

62,200

182,700

44,goo

289,700

76,gO0

720,100

36,500

23,000

127,100

983,500

1,273,200

43,300

11,300

256,900

3 I 1,500

1,584,700

0.25

0.63

0.23

0.49

0.69

0.24

0.12

0,58

0.30

0.28

0.33

0.46

‘Total n.mber.fchildre” r.”nded t. the nearest 100; “.t adj”. ted by Pp.1.ti.nt.t.ls.

b..Prtortty .Iwsificati... Se. Section 6.2.2. Each row tepreaenta children over a“d above those i“ previ.”s r.ws, Children

reported toCPS by ~ study s.”rce are clwsified .“IY i“ the .re~tied t. CPS. row for that s.”rce.

“I”cl”des chtldre”id.ntified t. thest”dy kthby patiicipati.g ”.”-CPS .ge”cies .“d by CPSM well u children identified

to the .t”dy .“ly by CPS where s.”rce of mprt toCPS wu a “0”-CPS .c.”.Y .f the typei“.l”ded in the study design

(e.g., wlice, h.apitd, schml, ●tc.).

6-17
an estimated 983,500 children, which is nearly three times the number recognized by the

investigatory agencies. The distributions within each Level across the specific agency categories

also followed the pattern reported above for recognized cases countable with original definitions

Among investigatory agencies, significantly more cases were recognized by police/sherifPs

departments (182,700 children), and the totals estimated for probation/courts and for public

health departments (62,200 and 44,800, respectively) did not statistically differ from each other,

The specific types of noninvestigatory agencies had the same rank ordering here under the

revised definitions as was described above for cases countable under the original definitions

Schools recognized by far the greatest number of countable cases (720,100), significantly more

than either social services (127,100) or hospitals (76,800), which in turn did not statistically

differ from each otheq daycare centers and mental health agencies recognized the fewest

countable cases (36,500 and 23,000, respectively) and agencies in these last two categories did

not statistically differ in the totals they recognized.

Agency Differences in Reporting Rates for Cases Under Revised Definitions. The

last column in Table 6-5 gives the reporting rates, by agency, for cases countable under revised

standards. As reported in an earlier section, 46% of all the cases which were countable under

revised definitions had been officially reported to and investigated by CPS--a figure reiterated

in the last row of this table. Note that, across all the agency sources which were represented in

the study, the combined reporting rate is given here as 33%.

Again, the pattern under the revised definitions closely paralleled that under the

original definitions. Investigatory agencies reported (and CPS investigated) a significantly

greater proportion of the cases they recognized (49% vs. 28% for noninvestigatory agencies).

Among the categories of investigatory agencies, police/sherif~s departments had a significantly

higher reporting rate (63%) than either probation/courts (25%) or public health departments

(23%), and the reporting rates for latter two agency categories did not statistically differ. In the

noninvestigatory agency sector, the highest reporting rates were again evidenced by hospitals

and mental health agencies (69% and 58%, respectively) and these were not statistically

different, while schools and daycare centers had similar reporting rates which were significantly

lower (24% and 12%, respectively). Social services agencies retained their highly varioble

reporting rates, and so did not reliably differ from any of the other types of noninvestigatory

agencies.

6-18
As with the original definitions, the reporting rates were generally low, with the

same three categories of agencies (police/sheriffs departments, hospitals, and mental health

agencies) the only categories to officially report and have CPS investigate a majority of the

cases they recognized. Note, however, that under the revised definitions, public schools lost

their standing as the single greatest source of reports to CPS concerning countable cases--with

the number of maltreated children reported by the general public, as reflected in the category

“all other sources.”

It is important to recognize that the degree of subjectivity in defining cases of

abuse and neglect which is inherent in the revised definitional standards makes it difficult to

discern the meaning of the findings given in this section. It would not be surprising, for

example, if what was considered to be “endangerment” systematically varied across the different

agency categories, with more stringent requirements applied by some types of professionals and

more Ienient assumptions used by others. If true, the reporting rates given for the different

agency categories would not be comparable, m they would be based on different standards of

evidence. Note, however, that the patterns of reporting under both definitional standards were

remarkably similar. This suggests that whatever subjective variations there were in revised

definitional standards, they did not overshadow some basic differences in reporting patterns

across the different types of agencies.

6.2.3 Changesin Recognition and Reporting Sirrce 1980

This sectimr examines changes since 1980 in three arew sources of reports to CPS,

the ability of agencies in the different categories to recognize cases countable under the original

definitions, and reporting rates by agency category.

Changes irr sources of Reports tOCPS

Earlier, it was noted that there had been a significant overall increase in cases

countable under the original definitions which were reported to and accepted for investigation

by CPS(see Sectimr 6.1.1). Here, this increase is broken down by source. Specifically, Table 6-

6 indicates how the sources of reports accepted by CPS have changed in the 1980-1986 interval.

6-19
Table 6-6. Changes since ]980 in sources of reports to CPS

Estimated No. In-Scope Children

Reported to CPSa

Source of Information

to CPSand/or Studyb 1980 1986’ Differenced

Investigatory Agencies

Probation/Courts

Police/sheriff

Public Health

Subtotak

Other Study Agencies

Hospitals

Schools

Mental Health

Social Services

Subtotak

Total, All Study Agency Sources

Other Sources

DSS/WeIfare Department

Other professional agency’

Daycare Centerse

All other sourcesg

Subtotal:”

Total, All Sourcesg

9,900

21,900

2,300

34,100

]9,800

44,800

8,800

6,700

80.100

114.200

11,800

11,400

66,300

89.500

203,700

10,200 300

59,300 37,400 *

6,800 4,500

76,300 42,200 *

33,500 13,700

129,900 85,100’

11,000 2,200

22,500 15,800 *

196,900” 116,800 ●

273,200 159,000*

16,700 4,900

9,600 - 1,800

4,000 4,000

105,900 39,600 ●

136,200 46,700 *

409,400 205,700 ●

~.tal “umber of children m“”ded t. the “emat 10% .ot dju.ted by pop”l.ti.n total..

b

Tabulated i“ mc.tia”ce with the priority system descrikd i“ Section 6,2,2.

CC.rresp.nda t. c.l”mn A i“ Table 6-4, with the exception n.td i“ fmt”.te e, blow.

d

1. .der t. djust for pp”l.ti.” differe”.es, all .ipifica”ce teats were petiormed . . i“cide”ce rate estimates (see

Appndx E.

‘Daycare ce”temarecl=.ified ““der “other pr.fessio”al agency SO”K.S” i“ this table i“ order toconformtotheir tre.t”e”t

i“ the NIS - 1.

.

Diffem”ce &tWee” 1960 a“d 1966 i“cide”ce rate estimates w- sig”ifica”t at p < .05,

‘Test for ,iflifi..nce of dtffere”ce excluded daycace ce”tem.

6-20
It compares the estimates which were given earlier in the first column of Table 6-4 with the

10 The table showS that reports corresponding estimates from the reanalysis of the NIS- 1 data.

accepted by CPS increased significantly at all Levels More than twice as many children were

received and accepted from investigatory agencies (Level 2) in 1986, (i.e., 76,300 children,

compared to 34,100 children in 1980). The number of children reported by nmrinvestigatory

agencies also more than doubled in the 1980-1986 interval, increasing from 114,200 in 1980 to

273,200 in 1986. Reports accepted by CPS from other sources (i.e.,Lthose outside the scope of

the study) were more than 50% above their 1980 level, having increased from 89,500 in 1980 to

136,200 in ]986.

Within the investigatory, Level 2, agencies, the increase in reports was only

significant for police/sheriff departments, which provided CPS with nearly three times as many

children in 1986 as they had in 1980. Among the rmninvestigatory, Level 3, agencies, increases

were significant only for schools and social services agencies. Reports to CPS from schools

nearly tripled since the 1980 study, and reports from social services agencies were more than

three times their 1980 estimate. The only category within the “Other sources” sector to report

significantly more children to 0S in 1986 was category which reflected the general public (i.e.,

“all other sources”). Reports from this source increased by nearly 60% since 1980. Note that

this category reflects Level 4 sources in the model described in Chapter 2.

Whether these shifts in sources of reports received and accepted by CPS reflect any

reliable changes in the numbers of cases recognized by the different types of agencies or in the

tendency to report cases that are recognized is considered in the next two sections.

Changea in Patterns Of Recognition

Previous chapters have explored various facets of the overall increase in cases

countable under the original definitions. Here, this increase is examined by agency category to

determine whether discernible changes in recognition levels occurred for all sources or for only

a few sources. Table 6-7 compares the estimates presented earlier in the third column of Table

10St.tuticd c.mptim”s w.= =t”ally do”. on i“cid.”ce rate wtim.tes, s. - t. adjust for my d,ffem”cea i“ pop”l.ti.”

totti at the two pints in time. Also, d.yc.re ce”tem are placd under “other sources” in this table, i“ tier to conform

with their tmatme”t in the NIS - 1, where they hti be” i“cl”ded m P.* .[ ‘other pr.fesai.”.l .ge”cy sources..

6-21
Table 6-7. Changes since 1980 in sources of total recognized cases countable under the original

definitions

Estimated No. In-Scope Children

Recognized by any source’

Source of Information

to CPS and/or Studyb 1980 1986’ Differenced

Investigatory Agencies

Probation/Courts

Police/sheriff

Public Health

Subtotal:

Other Study Agencies

Hospitals

Public Schools

Mental Health

Social Services

Subtotal:

Total, All Study Agency Sourcex

Other Sources

DSS/Welfare Department

Other professional agency

Daycare Centerse

All other sources

Subtotak

Total, All Sources

41,600

52,100

8,800

102,500

35,300

348,400

27,900

21,500

433,100

535,600

11,800

11,400

66,300

89.500

625,]00

45,700

96,700

29,300

171,700

50,800

539,700

19,700

87,400

697,600e

869,300

16,700

9,600

24,400

105,900

156,600

1,025,900

4,100

44,600 ●

20,500A

69,200 *

15,500

191,300

-8,200

65,900

264,500 ‘

333,700 ●

4,900

- 1,800

24,400

39,600 ●f

67,100 *f

400,800 ●f

%.td numb. .f ctildre” m“”ded t. the “e.r.st 100; “o; adjusted by p.p.lati.” t.t.la.

b

Tab”l.t.d in m..rdance with the priority system described i“ Se.tie” 6.2.2.

CComesp”d. to COI”- C i“ Table 6-4, with the ~cepti.” noted in fmtn.te e, below.

d

1“ order t. dj”st for p.p”l.ti.n differences, all si~ifica”ce t.sta wem pefl.med .“ i“.ide”ce rate eatim.tes (see

Appendix E).

‘Daycme ..ntem m cl~sifid ““de. “other pr.fesi.nd .se”cy s.”xes” i“ thie table in order t. ..”form totheir treatment

i“ the NIS-1.

f

Tbe ai~iflcmce teat acludad daycwe ce”tem from the total for NIS.2.

●

Diffem”ce ~tw~n 1980 md 1986 i“cide”ce rate ●.tim.te. w- eig”ifi.a.t at p < .0s.

St.tiaticdly m~~i”d dnffere”.e: differ. ”.. between 1980 a“d 19a6 i“cide”ce rate estimates were “.t ai~ificant, b“t p <

.10,

6-22
6-4 with the corresponding estimates from the reanalysis of the NIS- 1 data.11 (Note that the

.Other sources” section in this table is only known through reports to CPS and so is identical to

that given in Table 6-6. Since discussion of this section was given above, it is not reiterated ‘

here).

There was a significant increase in the number of children recognized as abused or

neglected by investigatory agencies, and this reflected a significant in increase in children

recognized by policelsherif~s departments. There was also a nonsignificant but marginal

increase in the number of children recognized by nnninvestigatory agencies overall, but this

increase could not be localized within any of the specific types of noninvestigatory agencies.

Changes in Repnrting Patterns:

Earlier, it had been reported that of all children recognized as abused or neglected,

40% had been reported to and investigated by CPS in 1986, and that this reflected a

nonsignificant increase since 1980, when 33% had been reported and invest igated. Table 6-8

gives the 1986 reporting rates by agency type (from Table 6-4) and compares these with the

corresponding rate of reporting estimated from the 1980 data. This table indicates that, among

the types of non-CPS agencies included in both studies, the overall rate of reporting increased

from 0.21 in 1980 to 0.31 in ]986, but that this increase was not statistically significant. In

fact, only one agency category evidence a statistically meaningful increase in its reporting rate --

the mte of reporting by mental health agencies increased from 31% to 56%. This increase was

statistically marginal, meaning that it had a less than 10 percent chance of stemming solely from

sampling error (rather than the less than 5 percent chance, which is traditionally required for a

difference to be considered statistically significant).

These results suggest that the overall increase in tbe number of cases countable

under original definitions among children who are reported to CPS does not stem from any

general increase in the tendency for community professionals (or even all combined sources) to

11Atin, St.tiaticd c.mptisona tij.ated for diflere”c” i“ pp”latio” t.td., a“d daycme ce”tem were cl~sified ““der

..ther .o”me.. t. c.”fom to their tmatme”t i“ the NIS - 1.

6-23
Table 6-8. Changes since 1980 in rate of reporting to CPS by source (cases countable by

original definitions)

Proportion of In-Scope Children

Reported to CPSa

Source of Information

to CPS and/or Studyb 1980 1986’ Difference

Investigatory A8encieS

Probation/Courts 0.24 0.22 -0.02

Police/sheriff 0.42 0.61 4.19

Public Health 0.26 0.23 -0.03

Subtotal: 0.33 0.44 M.11

Other Study Agencies

Hospitals 0.56 0.66 W.lo

Schools 0.13 0.24 4.11

Mental Health 0.31 0.56 M.25-

Social Services 0.31 0.26 -0.05

Subtotahd 0.19 0.28” M.09

Total, All Study Agency Murces 0.21 0.31 4.10

Other sources

DSS/Welfare Department ? ?

Other professional a8ency ? ?

Daycare Centersd ? 0.16 -d

All other sources ? ?

Subtotak ? ?

Total, All Sources 0.33 0.40 o.07e

a(Numkr or in-scow children rewrted to CPS)/(TOkal i“--.~ Childm” Reco~i.ed u Maltreated)

b

T.bulat4 in ~c.ti~ce with the priority system d~cri~d i“ 6.2.2,

‘CO_Wn& to the l~t .oI”w i“ Table 6-4, with the excepti.” noted i“ rmt..te ●, below.

d

Day.= cmtem m cl~sifid ““det “other pm fesai.n.l agency s.”me.. in thi. table i“ order t. co”r.rm to their treatment

b the NIS-1.

%h. #iflin.mc. tmt md”dd dayc~ ce”ten rrom the total ror NIS.2.

Stattiticdly m~nd &ffeR”.a diffem”ce htwee” 1980 ad 19S6 i“.ide”ce rate estimates were “ot ai~iflca”t, b“t p <

.10.

6-24
report and have CPS investigate the cases they recognize. Although reporting rates have, as

shown in this table, increased slightly, these increases were m statistically reliable.

6.3 Summary

The results described in this chapter included the following noteworthy findings

Concerning All Cases Reported to CPS, Countable and Not Co.ntablc

■ The dramatic rise in reports to CPS that has been reported by other

researchers was confirmed. The number of children reported to CPS

increased nearly 57% since 1980. [n 1986, CPS received reports concerning

nearly one and two-thirds million children.

■ In 1986, CPS either considered indicated or officially substantiated about 53%

of the cases for which it received and investigated reports.

Concerning Cases Countable Under Original Definition

■

■

■

■

■

■

■

Among all those cases known to CPS, 25% were countable under original

study definitions.

An estimated 39% of all cases substantiated or indicated by CPS were

countable under the original study definitions.

Noninvestigatory, or Level 3, agencies recognized more than two times the

number of countable children recognized by investigatory (Level 2) agencies.

Among investigatory agencies, police/sherifrs departments recognized the

greatest number of countable children (an estimated 96,700 nationwide

probation/courts and public health departments did not differ in their

recognition of maltreated children.

Among noninvestigatory agencies, the ordering of the different types of

agencies according to tbe numbers of countable children they recognized was:

schools > social services = hospitals > daycare centers = mental health

agencies.

Of the cases countable under original study definitions only 40%, or 6.5

children per 1,000, were known to CPS through official screened-in reports.

Of all the countable cases recognized by agencies of the types included in the

study, only 31% had been reported to and accepted by CPS.

6-25
■ Investigatory agencies reported (and CPS investigated) about 44% of the cases

they recognized, whereas noninvestigatory agencies reported (and CPS

investigated) only about 28% of their recognized cases.

■ Within the investigatory agency sector, police/sheriffs departments had the

highest reporting rates, while reporting rates for probation/courts and p“blj~

health departments were lower and not different from each other.

■ Among nmsinvestigatory agency types, the categories were rank-ordered on

the basis of their reporting rates as follows hospitals = mental health >

schools = daycare centers. Social services agencies exhibited highly variable

reporting rates which did not reliably differ from the reporting rates of any

other agency category.

Cmscerning Cases Countable Under Revised Definition%

■ About 44% of the children reported to and screened-i” CPS were co””table

under revised study definitions.

■ An estimated 73% of all cases substantiated or indicated by CPS were

countable by revised study standards, which was substantially more than the

39% that were countable under the original definitions. This reflected the

fact that virtually all of the cases officially substantiated by CPS were

defined as meeting the revised harm requirement.

■ Of the cmes countable under the revised definitions, only 46% of those

countable (or 11.6 children per 1,000) were known to CPS through official

reports.

■ The different agency categories shOwed the same relative pat[er”~ of

recognition for cases defined by revised definitions as they had when cases

were defined by the original standards Noninvestigatory > investigatory

agencies; police/sheriff > probation/courts = public health; schools > sociol

services = hospitals > daycare centers = mental health.

■ Of the cases countable under revised definitions, 46%, had been reported to

CPS and screened-in by that agency.

■ of all the countable cases recognized by agencies of the types included in the

study, only 33% had been reported to and accepted by CPS.

■ Agency differences in reporting rates showed patterns similar to those for

original definitions Investigatory agencies reported more of the cases they

recognized, (49% vs. 28% for the noninvestigatory agencies~ police/sheriff >

probation/courts = public health; hospitals = mental health > schools =

daycare centers (and social services too variable to reliably differ from any

other category).

6-26
Concerning Changes in Reporting, Substantiatims, and RecOgnitims Since 1980:

A significantly greater proportion of cases reported to (and screened-in by)

CPS were countable in 1986 than had been cmmtabie in 1980 (i.e., 25% vs.

19%), indicating that there has been an increase in selecting cases into CPS

(although it could not be said whether this was due to greater selectivity by

respondents or due to increased screening by CPS).

The proportion of cases which CPS either considered indicated or officially

substantiated increased significantly (from about 43% to 53%). Again, it was

not clear whether this increase reflected an increased awareness by reporters

concerning which cases to report to CPS or an increased selectivity by CPS

agencies as to which reports to accept for investigation.

The proportion of unfounded CPS cases which were countable under the

original study definitions increased slightly but significantly since 1980,

raising some concern about an increasing tendency to exclude cases which in

the past wouid have received intervention and services.

The rise in countable cases of child abuse and neglect occurred principally

among those cases officially known to CPS, where the incidence rate of

countable cases more than doubled since 1980. (Unreported cases ilso

increased, but their increase was not statistically significant. )

kreened-in reports to CPS increased significantly at all levels of sources

investigatory agencies, noninvestigatory agencies, and other (i.e., nonstudy)

sources.

Among the investigatory agencies, mriy the number of screened-in reports

from police/sherif~s departments increased significantly since 1980.

Within the noninvestigatory agency sector, only schools and social services

agencies showed significant increases in the numbers of reports they

submitted to CPS (which CPS accepted for investigation).

Among nonstudy sources, only the general public submitted significantly

more screened-in reports to CPS in 1986 than in 1980.

Taken together, investigatory agencies recognized significantly more children

as abused/neglected in 1986. This refiected a significant increase in the

recognition of maltreated chiidren by police/sherif~s departments.

There was a nonsignificant but marginal increase in the number of

abused/neglected children recognized by noninvestigatory agencies.

Among all cases which involved maltreatment countable by original standards,

the proportion that was known to CPS showed u statistically reliable

increase, indicating that the rate at which countable cases are officially

reported to (and screened-in by) CPS did not change overall.

6-27
■ Among the types of non-C~ agencies included in the 1980 and 1986 studies,

the overall rate of reporting increased from 21% to 31% in the 1980-1986

interval, but this increase was ~ statistically significant.

■ Reporting rates increased with some degree of reliability only for mental

health agencies, where the increase in reporting rate from 31% to 56%

emerged as statistically marginal.

6-28
7. SUMMARY AND CONCLUSIONS

The findings detailed in the previous chapters provide a comprehensive assessment

of the incidence and distribution of child abuse and neglect in the U.S. This final chapter notes

the key results of the study and discusses their implications.

7.1 Incidence of Child Abuse and Neglect

It was estimated that, in 1986, more than one million children nationwide (about

1,025,900) met the stringent requirement of having already experienced demonstrable harm as a

result of abuse or neglect. These results represented a 64% increase in countable cases of abuse

and neglect over the estimate of 625,100 provided by the 1980 incidence study (NIS-1). Only

40% of these children were known to CPS agencies through official, screened-in reports. The

remainder were recognized as maltreated children by non-CPS professionals in various

community agencies. This translates into an annual incidence rate of 16.3 children per 1,000

children in the nation who experienced demonstrable harm from abuse or neglect, of whom 6.5

children per 1,000 had been officially reported to CPS and accepted for investigation.

Even more children were identified as victims of abuse or neglect when the revised

definitional standards were applied, which included children who had been endangered (but not

yet demonstrably harmed) by abuse or neglect. By these standards, more than one and a half

million children (about 1,584,700) were abused or neglected in 1986 throughout the U.S. Again,

less than half (46%) had been officially reported to (and screened-in by) CPS agencies. The

remainder were children who were recognized as maltreated by some community professional in

non-CPS agencies like those recruited for this study. This reflects 25.2 children per 1,000 in

the U.S. endangered or already harmed as a result of abuse or neglect, 11.6 of whom were

known to CPS through official, screened-in reports to that agency.

These findings should na be interpreted as an estimate of the full extent of child

abuse and neglect in the U. S., even for the kinds of cases meeting study definitions. As noted

in Chapter 2, the study design only tapped into cases known to CPS and recognized by

professionals in specific categories of investigatory and non-investigatory community agencies.

7-1
It made no attempt to assess the incidence of cases known to professionals in other agencies and

institutions (e.g., private schools, private physicians, medical clinics not affiliated with hospitals

or health department, clinical social workers or mental health professionals in private practice,

etc.). Nor did it attempt to identify cases known to neighbors, relatives, or parents and children

themselves. In view of the high rate of unreporting for the cases identified to the study, it is

probably reasonable to assume that most of the cases known by persons in these other sectors

are not to be found among the screened-in CPS reports. Thus, the estimates provided by this

study should be regarded as mirl;mum estimates of the numbers of abused and neglected

children.

Given that this study identified significantly more countable cases of abuse and

neglect than the earlier incidence study (NIS-1), can it be concluded that the nationwide

incidence of child abuse and neglect significantly increased in the interim between 1980 and

1986? The answer to this question depends on whether or not there are other plausible

explanations (i.e., competing explanations) for the study results. Two other potential

explanations warrant discussion--changes since the NIS-1 in study methodology, and changes in

the likelihood that cases of maltreatment will be recognized as such by potential reporters.

ChangesIn Study Methodology. Since the study reported here departed from the

NK-I design in a variety of ways (See Section 2.6), it is theoretically possible that these higher

estimates reflect an improved capability of identifying cases of abuse and neglect. Upon closer

examination, however, this explanation cannot account for the observed NIS-1 vs. NIS-2

differences.

First, three of the six methodological changes should have affected orrlyfherrurrrbers

of coses identified in the non-CPS sector of the study. The expanded set of non-CPS agency

categories brought cases into the scope of the study from an extended range of non-CPS

professionals. The introduction of an explicit means of correcting for poor and incomplete

participation applied only to non-CPS participants, and so reduced the downward distortions of

estimates in this sector, but not in the CPS sector of the study. Finally, the use of revised

definitions dramatically expanded the reporting guidelines for non-CPS participants (who were

instructed to be on the lookout for cases which met study definitions), but would not have had

this effect on the number of cases identified from CPS, where eligible cases were identified as

incoming reports accepted for investigation.

7-2
These three methodological changes should have only affected the numbers of

countable cases known to non-CH professional, and should have had no bearing on estimates

of cases officially known to Cm (and not duplicated by non-C~ study reports). Note,

however, that the NIS-1 and NE-2 differences were actually stronger in the Cm sector of the

database than among the in the ewes known only to non-C~ professionals (where estimates

were ~ significantly different). Thus, the three modifications in study procedure described

above cannot explain the finding concerning the overall increase since ]980 in the incidence of

countable child maltreatment.

Second, two of the methodological changes from NIS-1 procedures should not have

had any systematic effect on estimates in one direction or the othen The more extensive use of

sampling strategies and the abbreviated time frame should not have biased the estimates upward

(or downward). In fact, the increased use of sampling increased the sampling error associated

with current estimates and so actually made it more difficult to discern differences since ]980.

Thus, the fact that the observed differences in fact did emerge is even more noteworthy when

the extensive use of sampling is taken into account.

Third, the remaining methodological change which could have had substantive

bearing on the level of estimated incidence was the method of county sampling used in the

current study. Compared to the NIS-1, the NIS-2 better represented the larger and more

populous counties in the nation. If there are higher-of child abuse and neglect (i.e., higher

per capita incidence of countable cases and not just higher numbers of countable cases) in the

more populous counties, then the higher national estimates of countable cases in the present

study could reflect the improved representation of these counties. However, analyses did ~

confirm the existence of this type of relationship between the metropolitan status of the county

and incidence rates of abuse and neglect.1

The above considerations make it unlikely that the 1980 vs. 1986 differences stem

from any of the methodological differences between the two studies.

lTh”., diRem”cm btwwn the twosmpl=.f counti= cmnot-pltin the_ 1980 -1988 &frerence intheincidenc. .f

..””table .-. However, - &scuh in Swtion 6.7.2, such county.wple diffem”ce. may pati,dly =c..nt f.. the

-“it mptid in that .mti.”, which showd that the & of the 19W-1986 dtfiemn.. w- flat.. in I.rge .rbm md

urbm counti= thmi” mrti . ..ntiw.

7-3
Changes In Recognition. Does the increase in countable cases known to the study

mean that the actual occurrence of cases of child abuse and neglect have increased since 1980,

or is it that community professionals are more likely to recognize cases than they were in ]980.

As discussed in Chapter 3, the fact that the increase in countable maltreatment occurred

principally for cases involving moderate injuries/impairments suggests that this latter

explanation is a plausible interpretation of the findings reported here. That is, the incre~e in

countable cases may have reflected an increase in the likelihood that professionals will recognize

maltreatment rather than an increase in the actual occurrence of maltreatment (i.e., in incidence

per se). This inference is based on the assumption that cases which involve highly noticeable

harm, such as fatal or serious injury/impairment would have been recognized at close-to-ceiling

level in ]980, so that their numbers should not appreciably increase as professionals improve

their ability to recognize abuse and neglect. Cases involving moderate injury, however, should

increase with improved recognition--which accords with the pattern of findings that emerged in

this study. Thus, it seems reasonable to suggest that the findings reported here do ~

necessarily imply an increase in the actual incidence of child abuse and neglect in the nation,

but are consistent with the suggestion that, in the interim since 1980, professionals have become

better attuned to the cues of maltreatment (particularly to cues concerning physical and sexual

abuse--the two areas where estimates were significantly above their 1980 levels, and especially

fortheolder children--since increases were more prmrounced in theolder age groups).

7.2 Distribution of Child Abuse by Type and Severity

Children who had experienced demonstrable harm (i.e., were countable under

original definitions) were approximately equally divided into those who had been abused and

those who had been neglected, with abused children slightly outnumbering those who were

neglected.2 When endangered children were added to their numbers (i.e., when revised

definitions were used), neglected children outnumbered abused children bya ratio of about 32.

Another way of regarding these findings is to note that the number of children defined as

abused was not remarkably increased when endangered children were added tn those who had

2

Ati..n.~ild whow=kth .b.=d mdneslutti w=countti ine=hclmific.ti.n.

7-4
already experienced harm (i.e., 9.2 vs. 10.7), but the number of neglected children essentially

~ when endangered children were included vs. when they were not (7.9 vs. 15.9).

Clearly, many children are recognized as having had inadequate care who have not yet

evidenced any injury impairment as a result of their neglect. Given that the definition of

“endangerment” was not standardized, but was left to the discretion of study respondents, it is

difficult to assess the implications of these figures. That is, one cannot determine whether the

inadequate care experienced by these additional children warranted preventive measures or

whether it merely reflected discrepancies in standards of care applied bysome respondents vis a

vis the standards exercised by some parents or caretakers.

Among children who had been abused, by either set of definitional standards, the

most frequent form of maltreatment was physical abuse (53% of those abused), followed by

emotional abuse (30%), which in turn was only slightly more prevalent than sexual abuse (24%),

This translates into 4.9 children per 1,000 who were harmed by physical abuse in 1986

(increasing to 5.7 per l,OOOwhen those endangered areadded), 2.8 children per 1,000 who were

harmed or demonstrably impaired by emotional abuse (increasing to 3.4 when those endangered

are included), and 2.2 sexually abused children per 1,000 under the more stringent criteria (2.5

per 1,000 with the addition of endangered children).

In contrast to the patterns for abuse, the distribution of neglected children across

the subcategories of neglect depended on which definitional standard W= used. When

demonstrable harm was required, educationally neglected children far outnumbered those who

had been physically neglected (58% vs. 37%) or those who had been emotionally neglected

(10%). When children who had been endangered but not yet harmed were included in the

estimates, those who had been physically neglected far outnumbered both educationally

neglected children (57% vs. 29%) and emotionally neglected children (22%). These shifts in the

relative predominance of the neglect subcategories indicates the differential impact of including

children considered to have been endangered by neglect. The numbers of children educationally

neglected remained virtually the same under both definitional standards, but there was a threefold increase in the number of physically neglected children and a four-fold increase in the

number of emotionally neglected children. The stability of the incidence of educational neglect

reflects the fact that it was primarily defined on the basis of objective circumstances under both

7-5
sets of defirtitions.s The fact that large numbers of children were considered endangered (but

not yet harmed) by emotional and physical neglect may, as noted above, reflect the potential

scope of these problems and have preventive implications, or it may stem from reasonable

disagreements about the standards of adequate emotional and physical care.

As noted above, the increase in incidence estimates since the 1980 study primarily

reflected a significant increase in the incidence of abuse. The rate of abuse in 1986 was 74%

greater than it had been in the 1980 study, involving 9.2 children per ],000. Among abused

children, there were significant increases in those physically and those sexually abused. Physical

abuse increased by 58% over its 1980 level, while sexual abuse in 1986 occurred af more fha)t

triple ils 1980 rate. Only the category of moderate injuries demonstrated changes since the

NIS-1, increasing 89% relative to its ]980 rate. As discussed above, this can be interpreted as

an indication that the increases since ]980 have primarily been increases in recognifiorr, rather

than in the actual occurrence of maltreatment.

7.3 Relation of Abuse arrd Neglect to Child, Family, and County Characteristics

Of the child, family, and county characteristics discussed in Chapter 4, three had

Weffect on maltreatment countable under the nriginal study definitions--childs race/ethnicity,

famiIy size, and county metrostatus. Race/ethnicity and county metrostatus were also not

associated with maltreatment countable under the revised definitions. All other characteristics

did show some relationship to the incidence or type of maltreatment and/or injury/impairment.

Under both the original and the revised definitions, the childs sex affected

maltreatment. Specifically, females experienced more abuse than did males (13.1 per 1,000

females vs. 8.4 per 1,000 males),’ reflecting primarily a greater vulnerability to sexual abuse.

There were 3.9 sexually abused females per ],000 compared to ].1 sexually abused males per

1,000. This higher rate of female sexual abuse was associated with a greater likelihood of

s.Chtldre” wh.w cim”mtm.es mat the mq”irements of tiuc.ti.”d “ecleck were automatically =crib.d . rating of

mdemte h- ““der the .tisi”d, etri”g.”t .tmdd.. The standds .pplyin8 to thts .ateg.w of maltreatment

mm.i.d _ntidly the am. ““der the mvi.d definitional atmdds (See Table 4-1).

4Whemdefiniti.”d stad&. we.otamifled, rehem, th. mdercm =“meth.t eatim.tes .ref.r.titi”.l definitions.

7-6
female children experiencing “probable” injury/impairment--a category of harm that was more

frequently assigned in cases of sexual abuse.

The incidence of abuse, particularly of physical abuse, increased with agq this

increase essentially reflected the lower frequency of abuse among O-2 year olds compared to

children in the other age brackets. When the youngest children were abused, however, they

were more likely than older children to experience fatal injury, reflecting their greater

vulnerability to physical harm. The distribution of moderate injuries/impairments was similar

to that of abuse and this level of harm was more prevalent in the older age brackets. The only

form of neglect to vary with age was educational, due in large part to the fact that this category

was only defined for children of school-age under both sets of definitional standards. There

was, however, some tendency toward a higher incidence of educational neglect among the 15-17

year olds, at least under the revised definitions.

Family income had wide-ranging effects on both the incidence and severity of

child maltreatment. Children from families earning less than $15,000 in 1986 were more likely

than those from higher income families to experience maltreatment and injury. Whether under

original or revised definitions, there were extensive differences between the groups, with the

lower income children always experiencing the greater frequency of maltreatment or injury. It

is notable that these dramatic income-related differences occurred using a very rough binary

categorization of family income level, with nn adjustment to into account factors likely to

obscure its effects, such as family size or poverty level differences between the two study-years.

Finally, under revised study definitions, family size was found to reassociated with

the incidence of maltreatment. Specifically, children from larger families (i.e., those with four

or more children) bad higher estimated incidence of both abuse and neglect than did their

counterparts from smaller families, and were more likely to be regarded as endangered.

In considering the implications of relationships found between the estimated

incidence of maltreatment and these various child and family characteristics, the distinction

between the occurrence of maltreatment and its recognition warrants some discussion. This

study (and, in fact, any research on the subject of child maltreatment) cannot distinguish with

absolute certainty between those characteristics which are related to the actual occurrence of

maltreatment (and therefore constitute what is generally meant by “risk factors”) and those

7-7
related only to the recognition of maltreatment (and therefore factors which may affect

perceptions of the problem, rather than its actuaI occurrence). However, there are sometimes

cues in the patterns of results which indicate whether a factor may be related more to the

recognition of maltreatment than to its occurrence .6 There are indications that in at least three

cases, the relationships that emerged in this study may have involved recognition more than

actual occurrence.

First, the increase in the relationship between age and abuse (specifically physical

and sexual abuse) in the interim since 1980 raised the question ss to whether it had been

between the child’s age and recognition of these forms of abuse (moreso than between age and

the actual occurrence of physical or sexual abuse). On the one hand, it seems reasonable to

suppose that true risk factors, which at least partially reflect aspects of the context and

dynamics that precipitate maltreatment, should be relatively slow to change over time, while

factors relating more to the tendency to recognize maltreatment might be expected to show

change as rapidly as public perceptions can be affected. On the other hand, as discussed above,

there are independent indications that the overall increases in the incidence of maltreatment

since 1980 is primarily one of increased recognition, rather than increased occurrence. To be

consistent, when these increases occurred disproportionately in the higher age groups they

should still be interpreted as increases in recognition, rather than ss increases in the actual

occurrence of maltreatment.

Second, note that these same arguments would apply to the findings concerning

county metrostatus. If the disproportionate increases in the incidence of maltreatment for the

urban counties is not merely an artifact of the differences in county samples in the two studies

(a possibility noted above), then they too are best interpreted as disproportionate increases in

recognition in the more urban counties. Third, it was observed that the fact that children in the

larger families were more likely to be regarded as endangered might plausibly account for all

the other differences they exhibited in the incidence of countable maltreatment, since perceived

endangerment would allow more of these children to be countable across the various types of

maltreatment.e

a

tionote that sincethw w.m not mom Hk.lyto hinj.redfimp.ir~ i”.ther w.y., they pmb.bly were not mom likely to

=tudly =Prience mdtre.tment =talodmi.na.

7-8
What are the implications of deciding that certain characteristics are linked more to

the recognition of maltreatment than they are to its actual occurrence? This decision has an

important bearing on the design of prevention and public education strategies. In general,

deciding that a characteristic relates more to the recognition of maltreatment than to its

occurrence should lead one to direct more resources to the still unrecognized sectors, whereas

deciding that a characteristic relates to the occurrence of maltreatment should direct prevention

and services to sectors where occurrence is greatest. For example, concluding that observers are

now more likely to recognize sexual and physical abuse of older children implies that sexual and

physical abuse of younger children may still go undetected, and efforts can be focused on

improving recognition in this area. The conclusion that recognition rates have possibly

increased more in the more urban counties than in the rural areas might imply ‘that public

education programs in the rural areas have not kept pace with those in the more metropolitan

locales, and efforts could be directed toward clarifying the status of public education in rural

areas and upgrading it where it is indicated to be needed.

7.4 Reporting and Substantiation

Several studies,’ including the one reported here, have now systematically

confirmed what most people in child protective services have known from personal experience--

reports to CPS concerning suspected cases of child abuse and neglect have substantially (and

significantly) increased since 1980. The NIS-1 and NIS-2 estimates are especially informative in

this regard, since they represent undup/ica(ed counts of children reported to a nationally

representative sample of local CPS agencies. As reported in Chapter 6, an estimated 1,657,600

children were reported to CPS in 1986, reflecting an increase of nearly 57% since 1980 in the

numbers of officially reported children.

There has been a great deal of speculation as to the reason for the dramatic increase

in the number of CPS reports. At least three alternative explanations have been offered

■ Actual incidence is up--More children wbo are now being abused or

neglected;

7

Sw Chapter 6, Imt”ota2,

7-9
■ Recognition is up--Those children who are abused or neglected are now more

likely to be recogrrized aa such;

■ Reporting rates are up--Those children who are recognized as abused or

neglected are now more likely to be reported than they were in the PSSC

In section 7.1 above, the first and second explanations were considered, and the

evidence from the NIS-2 was seen as more strongly supporting the second explanation--that

people are now more likely to recognize cases of child maltreatment (especially those involving

physica[or sexual abuse and those leading to moderate injuries/impairments). Here, the NIS-2

evidence concerning the third explanation (i.e., reporting rates) is evaluated.

To being with, note that no change in reporting rates can account for the overall

increase in countable cases found in the present study. That is, more than simply a change in

rate of reporting cases to CPS must have occurred in the interim between the NIS-I and NIS-2.

Had this been all that had occurred, one would have merely seen a shift in the distribution of

the total countable study cases without much change in the overall total--the proportion known

to CPS would have increased while the proportion known only to non-CPS professionals would

have decreased. Clearly, the number known to non-CPS professionals did W decrease--in fact,

it increased (although not significantly). Thus, the overall increase in the number of countable

cases indicates that more than simply a change in reporting rates has occurred. As discussed

above, it is most consistent with the assumption that more cases are now being recognized than

had been in the past.

Granted that there cannot simply have been an increase in reporting rates, have

reporting rates increased at all? It is, after all, possible for M recognition and reporting rates

to have increased. The evidence presented in this report has shown that, although the reporting

rates for respondents included in the study design have increased over their 1980 rates, the

increase was not statistically significant. The lack of any appreciable change in reporting rates

is especially disconcerting in view of their overall low levels, which indicates that the majority

of children recognized as maltreated still fail to enter the CPS report base. In ]980, of all

children countable under original study definitions, 33% had been reported to CPS and accepted

for investigation. The percentage increased to 40% in 1986, but this increase was not

significant. When one considered only those children recognized by professionals at the types of

non-CPS agencies which were studied, 21% had been reported and screened-in in 1980 and 31%

7-10
in 1986--again, an increase which proved to be nonsignificant (not statistically reliable). The

increase in reporting rates approached significance only for mental health agencies, where the

increase from 31% to 56% in the reporting of recognized cases proved to be statistically

marginal.8

In the previous chapter, it was pointed out that the reporting rates given here are

subject to different types of distortions--in both upward and downward directions. On the one

hand, they could be over-estimates of the actual reporting rate for some of the agency

categories, because there is an inherent linkage between the estimated reporting rate for a given

agency category and the study’s abiIity to identify unreported countable cases for agencies in

tbe category. For this reason, the relatively higher rates of official reporting seen for

police/sherif~s departments, for hospitals, and for mental health agencies may indicate that

these agencies actually do report the cases they recognize to a greater extent than other agencies,

or it may mean that the study procedures were relatively less successful at uncovering the

unreported cases that exist in these categories of agencies. Similarly, the relatively low

reporting rates for schools and daycare centers may mean that these agencies, relative to other

agency categories, see substantially more cases that they do not report, or it may mean that the

study did a relatively better job of uncovering the cases which were unreported i“ these types

of agencies.

On the other hand, the reporting rates observed here may seriously under-estimate

the actual reporting rates because there is also a linkage between the estimated reporting rate

and the study’s ability to determine whether CPS knew about recognized cases. Only those cases

which were accepted for investigation by CPS could be classified as “known to CPS,” and

counted as cases officially reported. For this reason, relatively low reporting rates may mean

that there is a substantial amount of screening-out of reported cases by CPS prior to any

investigation. However, observe that, even if this occurred, the reporting rates given here

would still validly reflect the numbers and proportions of children recognized as maltreated who

receive CPS attention.

8,.Ltmkdtim. mdm.o”m~c.”strd”d thei”itid mdy_.”th. NIa-2datab~. t.th.semptied hem. Fufiherm.lys~

.{ ..”Id pmvides”betmtiva imight. .n n“”mbrofimptiant im”w, F.rex.mple, itwould hinr.mazive t. k“.w what

ty~,ofm~tm,tm..t mdwh.tlev.ls ofhj.qlimpdme.t w.r. in.ol..d in.=.er.wrt.dto (.nd==...d i. by) CPS

vs. h those CU.. wht.h dtd notreceive CPS attention.

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Overall then, the weight of the available evidence suggests that there ~ been an

increase in the likelihood that abused and neglected children will be recognized, but that these

children are not reliably more likely to appear among the screened-in reporfi to CPS than they

were in 1980. That is, the majority of children who are recognized as maltreated (and who are

countable by the study according to the demonstrable harm criterion) a do not receive CPS

attention. What is not clear is the extent to which this is due to potential reporters failing to

submit official reports on these children or to CPS agencies screening out reports that are

submitted on these children. These alternatives have different policy implications.

If it is due to the failure of reporters, it would imply that the concerted efforts to

educate non-CPS professionals as well as the public at large concerning the indicators of

maltreatment have affected public perceptions, but they have not had comparable impact on

public behaviors. Clearly, these education efforts have successfully increased recognition,

especially of physically and sexually abused children, and particularly of maltreated older

children. However, simply increasing the recognition of these children has clearly not been

enough. In order to appreciably affect the likelihood that these children will be reported to

CPS, those who recognize them as abused and/or neglected must reconvinced of the benefits of

officially reporting them to CPS.

If, instead, the failure is due to CPS screening-out reports on these children, then

the blame must be placed on the inadequacy of the resources allocated to the problem. Some of

tbe other findings reported here are consistent with this latter interpretation, as noted below.

Among the children reported to CPS, a significantly greater proportion are now countable as

maltreated under the original study definitions than had been countable in 1980. Moreover, a

significantly greater proportion of reported children are now officially substantiated and/or

judged to be indicated by CPS than had been substantiated/indicated in 1980. These findings

imply that there is now greater selectivity concerning the kinds of cases that wind up being

investigated by CPS. As noted earlier in this report, this study does not provide a basis for

determining whether this increased selectivity is currently being imposed by reporters or by

CPS. Note, however, that if reporters are currently the source, it must only be because they

have learned (from CPS response to their reports) which cases are likely to be accepted for

investigation and so be more restrictive about the kinds of cases they report in the first place.

So whatever the current source of this selectivity, it inevitably must have derived from CPS

using more stringent screening standards when accepting cases for investigation than had been

7-12
used in ]980. The finding that a significantly greater proportion of the unfounded CPS cases

are countable under the original study definitions also suggests that CPS standards have, in the

face of increased reports and decreased resources, becnme more restrictive. This context

provides no basis for supporting the current high rate of recognition of maltreatment by

community professionals and the public at large, and, as a result, may jeopardize the gains that

have been made in this respect.

‘It h i“&.at- that s.m of the .hildm” who w.”id, i“ the p-t, have hd their cm” .“ktmti.t.d/indicated (md

Puibly=eivd aewices-smsult) W“.w-cl.dd -“”f..”ded.

7-13