Child Abuse and Neglect
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- Avis Blankenship
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1 DEFINITION Child abuse and neglect is the total unduplicated number of victims of child abuse and neglect per 1,000 children. Child abuse includes physical, sexual and emotional abuse. Child neglect includes emotional, educational, physical and medical neglect, as well as a failure to provide for basic needs. SIGNIFICANCE Children need love, affection, and nurturing from their parents or caregivers for healthy physical and emotional development. Experiencing child abuse or neglect can have lifelong consequences for a child s health, wellbeing, and relationships with others. Parents or caregivers are at increased risk for maltreatment if they are overwhelmed by multiple risk factors such as poverty, divorce, substance abuse, or mental health problems. 1 The immediate effects of child abuse and neglect include isolation, fear, injury and even death. Children who have been maltreated are at increased risk for delinquency, substance abuse, mental health problems, teen pregnancy, impaired cognition, and low academic achievement in adolescence. 2,3 Responding to reports of child abuse and neglect and ensuring child safety are important functions of child protection systems. Maintaining the capacity to focus 6 20 Rhode Island KIDS COUNT Factbook / Safety on prevention is equally critical and more cost-effective. In Rhode Island, if an investigation does not reveal maltreatment but family stressors and risk factors are identified, Child Protective Services (CPS) refers families to community-based support services to reduce the risk of future involvement with the Department of Children, Youth and Families (DCYF). When maltreatment has occurred, a determination may be made that it is safe for the children to remain at home when families are willing to work with community providers. In both of these cases, DCYF makes referrals to regional Family Care Community Partnerships (FCCP) agencies. They work with the family to identify appropriate services and resources, including natural supports (persons and resources that families can access independent from formal services). 4 In 2014 in Rhode Island, there were 2,413 indicated investigations of child abuse and neglect involving 3,407 children. The child abuse and neglect rate per 1,000 children under age 18 was over two times higher in the four core cities (22.8 victims per 1,000 children) compared to the remainder of the state (.5 victims per 1,000 children). Almost half (45%) of the victims of child abuse and neglect in 2014 were young children under age six and almost one-third (32%) were age three and younger. 5 By Age of Victim* % (320) Under Age 1 22% (757) Ages 1 to 3 14% (460) Ages 4 to 5 33% (1,3) Ages 6 to 11 % (503) Ages to 7% (243) Ages 16 and Older < (1) Unknown < % % 33% 7% Child Abuse and Neglect, Rhode Island, 2014 % 14% 22% n=3,407* By Relationship of Perpetrator to Victims*** 4% (3,402) Parents 3% (5) Relatives/Household Members (32) Foster Parents < (17) Child Care Providers < (14) Residential Facility Staff (47) Other or Unknown 4% 3% < < n=3,617*** Source: Rhode Island DCYF, Rhode Island Children s Information System (RICHIST), Percentages may not sum to 0% due to rounding. By Type of Neglect/Abuse** 8 (3,176) Neglect % (453) Physical Abuse 3% (7) Sexual Abuse (4) Medical Neglect < () Emotional Abuse 2% (83) Other < 2% 3% % 8 n=3,03** Notes on Pie Charts *These data reflect an unduplicated count of child victims. The number of victims is higher than the number of indicated investigations. One indicated investigation can involve more than one child victim. **This number is greater than the unduplicated count of child victims because children often experience more than one maltreatment event and/or more than one type of abuse. Within each type of abuse, the number of child victims is unduplicated. ***Perpetrators can abuse more than one child and can abuse a child more than once. This number is a duplicated count of perpetrators based on their number of victims. Under Rhode Island law, Child Protective Services can only investigate alleged perpetrators who are legally defined as caretakers to the victim(s), except in situations of child sexual abuse by another child.
2 DCYF Child Protective Services (CPS) Hotline Calls for Reports of Abuse and/or Neglect, Investigations,* and Indicated Investigations, Rhode Island, TOTAL # % AND # OF REPORTS # OF UNDUPLICATED CHILD WITH COMPLETED INDICATED YEAR MALTREATMENT REPORTS INVESTIGATIONS INVESTIGATIONS ,144 55% (7,188) 2, ,57 5% (8,841) 2, ,542 54% (7,363) 2, ,204 5 (6,214) 1,13 200,18 52% (6,362) 2, ,06 53% (6,56) 2, ,382 4% (6,520) 2, ,540 50% (6,784) 2, ,05 50% (6,75) 2, ,735 5 (7,573) 2,413 Source: Families, RICHIST, *One investigation can be generated by multiple hotline calls. Investigations can result in a finding of indicated, unfounded or unable to complete (as when essential party cannot be found). Emergency Department Visits, Hospitalizations, and Deaths Due to Child Abuse and/or Neglect, Rhode Island, YEAR # OF EMERGENCY DEPARTMENT VISITS # OF HOSPITALIZATIONS # OF DEATHS** TOTAL 7 4 Source: Rhode Island Department of Health, Data for 20 and 2013 are provisional. **Due to a change in data source, data for child deaths due to child abuse and/or neglect are only comparable with Factbooks since Between 200 and 2013, there were 7 emergency department visits, 4 hospitalizations, and deaths of Rhode Island children under age 18 due to child abuse and/or neglect. 11 Nationally, 70% of child maltreatment deaths involved neglect and 44% involved physical abuse (because a victim may have suffered more than one type of maltreatment, these categories are not mutually exclusive). In 2014, Rhode Island experienced more child maltreatment reports, completed investigations, and indicated investigations than any year since Between 2013 and 2014, unduplicated child maltreatment reports increased by 6%, the number of completed investigations increased by %, and the number of indicated investigations increased by 5%. In 2014, there were 2,413 indicated investigations based on child maltreatment investigations, 32% of all completed investigations. 6 An indicated investigation is one in which there is a preponderance of evidence that child abuse and/or neglect occurred. 7 Of the 14,735 maltreatment reports in 2014, 5,820 were classified as information/ referrals (formerly early warnings ). 8 Information/referrals are reports made to the CPS Hotline that contain a concern about the well-being of a child but do not meet the criteria for an investigation. Criteria for investigation include that the victim is a minor, the alleged perpetrator is a legal caretaker or is living in the home, there is reasonable cause to believe that abuse or neglect circumstances exist, and there is a specific incident or pattern of incidents suggesting that harm can be identified. When essential criteria for investigation are not present, the report may lead to a referral to other services or to the information being passed on to a DCYF case-worker (depending on whether the family is active with DCYF)., Child Abuse and Neglect in Rhode Island Communities Many parents at risk of child abuse and neglect lack essential parenting skills and are struggling with a combination of social and economic issues. These families can benefit from programs that enhance social supports, parental resilience, and knowledge of parenting and child development. 13 In addition, providing access to child care, early childhood learning programs, and evidence-based home visiting programs (such as the Nurse-Family Partnership) to families with multiple risk factors can prevent the occurrence and recurrence of child abuse and neglect. 14,,16 In 2014, Rhode Island had 14.5 child victims of abuse and neglect per 1,000 children. With a rate of 38.6 victims per 1,000 children, Central Falls had the highest rate of child victims of abuse and neglect in the state. Other cities and towns with rates higher than 20 victims per 1,000 children were Woonsocket (37.6), Newport (30.4), Warren (24.7), Pawtucket (23.3), and West Warwick (20.5). 17 Safety / 20 Rhode Island KIDS COUNT Factbook 7
3 Indicated Allegations of Child Neglect, by Nature of Neglect, Rhode Island, 2014 Child Sexual Abuse, by Gender and Age of Victim, Rhode Island, 2014 Girls Boys 2% 4% 24% 25% 43% 43% (1,805) Lack of Supervision 25% (1,052) Exposure to Domestic Violence 4% (147) Inadequate Food, Clothing or Shelter 2% (74) Neglect Resulting in Physical Injuries/Death (61) Medical Neglect (45) Specific Other Small Categories 24% (1,006) Unspecified Other 14% () Age 5 and Under 2% (31) Ages 6 to 11 42% (44) Ages to % (16) Ages 16 and Older % 14% 1% () Age 5 and Under 6 (33) Ages 6 to 11 % (8) Ages to 6% (3) Ages 16 and Older 6% 1% % n=4,10* The importance of adequate capacity, affordability, and quality of child care, preschool, other early childhood programs and quality after-school opportunities is highlighted by the fact that of the 4,10 indicated allegations (confirmed claims) of neglect to children under age 18 in Rhode Island in 2014, 43% involved lack of supervision. The second largest category of neglect (25%) is exposure to domestic violence. These are instances where the neglect is related to the child witnessing domestic violence in the home. The specific other small categories include: drug and alcohol abuse (), emotional neglect (), excessive/inappropriate discipline (6), educational neglect (6), abandonment (4), failure to thrive (4), and tying/close confinement (1). *The total refers to indicated allegations of neglect. Some children were victims of neglect more than once. Multiple allegations may be involved in each indicated investigation. Numbers do not include indicated allegations of institutional neglect. 42% 2% n=6 n=54 Source: Families, RICHIST, Percentages may not sum to 0% due to rounding. In Rhode Island in 2014, there were 160 indicated allegations (confirmed claims) of child sexual abuse. Some children were victims of sexual abuse more than once. The victim was a female in 66% (6) of the 160 indicated allegations of sexual abuse. Fortythree percent of the female victims were known to be under age while 80% of the male victims were under age. 18 The perpetrator is a relative or person known to the victim in the majority of cases of child sexual abuse. Sexual abuse by family members is more common than sexual abuse by strangers. 1 6 Source: Families, RICHIST, Rhode Island KIDS COUNT Factbook / Safety
4 Table 31. Indicated Investigations of Child Abuse and Neglect, Rhode Island, 2014 # OF INDICATED INDICATED # OF # OF INVESTIGATIONS INVESTIGATIONS VICTIMS VICTIMS CHILDREN OF CHILD PER 1,000 OF CHILD PER 1,000 CITY/TOWN UNDER AGE 18 ABUSE/NEGLECT CHILDREN ABUSE/NEGLECT CHILDREN Barrington 4, Bristol 3, Burrillville 3, Central Falls 5, Charlestown 1, Coventry 7, Cranston 16, Cumberland 7, East Greenwich 3, East Providence, Exeter 1, Foster Glocester 2, Hopkinton 1, Jamestown 1, Johnston 5, Lincoln 4, Little Compton Middletown 3, Narragansett 2, New Shoreham Newport 4, North Kingstown 6, North Providence 5, North Smithfield 2, Pawtucket 16, Portsmouth 3, Providence 41, Richmond 1, Scituate 2, Smithfield 3, South Kingstown 5, Tiverton 2, Warren 1, Warwick, West Greenwich 1, West Warwick 5, Westerly 4, Woonsocket, Unknown 0 0 NA 4 NA Four Core Cities 73,741 1, , Remainder of State 0,2 1, ,571.5 Rhode Island 223,56 2, , Source of Data for Table/Methodology Data are from the Rhode Island Department of Children, Youth and Families, Rhode Island Children s Information System (RICHIST), Calendar Year Victims of child abuse/neglect are unduplicated counts of victims with substantiated allegations of child abuse and/or neglect. More than one victim can be involved in an investigation. An indicated investigation is an investigated report of child abuse and/or neglect for which a preponderance of evidence exists that child abuse and/or neglect occurred. An indicated investigation can involve more than one child and multiple allegations. City/town reports of indicated investigations omit certain investigations, particularly those where there are data entry errors affecting location. For this reason, the city/town table includes fewer indicated investigations than the chart with reports/investigations and indicated cases. Data cannot be compared to Factbooks prior to 200. The denominator is the number of children under age 18 according to the U.S. Census 20 and the numerator is an unduplicated count of child victims. Previous Factbooks used children under age 21 as the denominator and the indicated investigations as the numerator to calculate the rate of indicated investigations per 1,000 children. In 2008, Rhode Island lowered the eligibility age for entry into DCYF services to under age 18, although some children remain eligible for services after their 18th birthday. Core cities are Central Falls, Pawtucket, Providence, and Woonsocket. References 1,13,14 Administration for Children and Families. Making meaningful connections: 2014 prevention resource guide. (2014). Washington, DC: Government Printing Office. 2 Long-term consequences of child abuse and neglect. (2013). Washington, DC: U.S. Department of Health and Human Services, Children s Bureau, Child Welfare Information Gateway. (continued on page 181) Safety / 20 Rhode Island KIDS COUNT Factbook
5 References Roberts, A. L., Gilman, S. E., Fitzmaurice, G., Decker, M. R. & Koenen, K. C. (20). Witness of intimate partner violence in childhood and perpetration of intimate partner violence in adulthood. Epidemiology, 21(6), U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (2005). Family violence statistics including statistics on strangers and acquaintances. Retrieved January 2, 20, from 14 Domestic Violence and Sexual Assault/Child Molestation Reporting Form, Rhode Island Domestic Violence Training and Monitoring Unit, 2005 revision. 16 (2014) annual report. Warwick, RI: Rhode Island Coalition Against Domestic Violence. 17 Data are from January 1, 2014 to December 31, DeBoard-Lucas, R. Wasserman, K., McAlister Groves, B. & Bair-Merritt, M. (2013). 16 trauma-informed, evidence-based recommendations for advocates working with children exposed to intimate partner violence. Retrieved February 21, 2014, from promising.futureswithoutviolence.org 1 Safety for children: A report on the impact of Rhode Island s custody system on victims of domestic violence and their children. (20). Warwick, RI: Sisters Overcoming Abusive Relationships & Rhode Island Coalition Against Domestic Violence. 20 Domestic violence child safety bill. (20). Warwick, RI: (continued from page ) References for Child Abuse and Neglect 3 Mills, R., et al. (2011). Child abuse and neglect and cognitive function at 14 years of age: Findings from a birth cohort. Pediatrics, 7(1), Families, Child Protective Services, 20. 5,6,8,17,18 Families, Rhode Island Children s Information System (RICHIST), Families. (n.d.). Child welfare. Retrieved January 31, 20, from Families. (2006). Information/Referral (I/R) Reports (Policy ). Retrieved January 31, 20, from Families. (2014). Criteria for a child protective services investigation (Policy ). 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(n.d.). Description of the law. Retrieved January 11, 2013, from 4 Final report: Rhode Island child and family services review. (20). Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families. 5 Lewis, C., Beckwith, J., Fortin, K. & Goldberg, A. (2011). Fostering health: Health care for children and youth in foster care. Medicine & Health/Rhode Island, 4(7), Healthy Foster Care America. (n.d.). things every pediatrician should know about children in foster care. Retrieved January 1, 20, from www2.aap.org 8 National Working Group on Foster Care and Education. (2011). Education is the lifeline for youth in foster care. Retrieved January 1, 20, from Golonka, S. (20). The transition to adulthood: How states can support older youth in foster care. Economic, Human Services and Workforce Division, NGA Center for Best Practices. Retrieved January 1, 20, from Policy actions to reduce racial disproportionality and disparities in child welfare: A scan of eleven states. (200). Washington, DC: Alliance for Racial Equity in Child Welfare. The Fostering Connections Resource Center. (n.d.). Rhode Island s guardianship assistance program. Retrieved January 11, 2013, from 13,14 Safety, permanency, and well-being in Rhode Island: Child welfare outcomes annual report for FY (20). New Haven, CT: Prepared by the Consultation Center, Yale University School of Medicine for the Data Analytic Center of the Rhode Island Department of Children, Youth and Families. Families, Rhode Island Children s Information System (RICHIST), December 31, 20 and December 31, (continued from page 113) References for Permanency for Children in DCYF Care 4,7 Avery, R. J. (20). An examination of theory and promising practice for achieving permanency for teens before they age out of foster care. Children and Youth Services Review, 32, Permanency Roundtable Project -month outcome report. (2011). Seattle, WA: Casey Family Programs. 6 Never too old: Achieving permanency and sustaining connections for older youth in foster care. (2011). New York, NY: Evan B. Donaldson Adoption Institute. 8 Administration for Children and Families, Children's Bureau, Child Welfare Information Gateway. (n.d.). Working with the courts for permanency. Retrieved February 20, 20, from Sciamanna, J. (2013). Reunification of foster children with their families: The first permanency outcome. Washington, DC: State Policy Advocacy and Reform Center. Administration for Children and Families, Children's Bureau, Child Welfare Information Gateway. (n.d.). Achieving and maintaining permanency: Overview. Retrieved February 23, 20, from 11,16 Fostering Connections Resource Center. (n.d.). Description of the law. Retrieved January, 2013, from Fostering Connections to Success and Increasing Adoptions Act (H.R.683) Summary. (2008). Washington, DC: Children s Defense Fund and Center for Law and Social Policy. 13,17 Stoltzfus, E., Fernandes-Alcantara, A. L., & Solomon- Fears, C. (2014). Child welfare and child support: The Preventing Sex Trafficking and Strengthening Families Act (P.L ). Washington, DC: Congressional Research Service. 14 Stern, I. R. & Nakamura, L. (20). Improving outcomes for youth transitioning out of foster care. Honolulu, HI: University of Hawai i, Center on the Family. Kleinberg, R. & Moore, P. (2011). Preparing foster youth for adulthood. Children s Rights Litigation, 13(3), ,1,20,21,24,27,28,2,30,32 Safety, permanency, and well-being in Rhode Island: Child welfare outcomes annual report for FY (20). 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