Dec 09, 2013 - 0 Comments - economy, family, healthcare -

The high cost of child neglect

A child walks alone

A child walks alone

This article is about foster care, adoption, child abuse, child neglect and all their related demographics. Why is this important to you and me? Well if we know who is in foster care then we can see where more foster parents are needed. If we see how keeping children with their biological parents or by adoption increases the likelihood of those children doing well in society then we can advocate for more adoptions and keeping more children with their birth parents. If we know how many children are neglected then we can target interventions for such types of abuse. Finally, if we understand where neglected children come from and who is getting adopted or placed in foster care we can facilitate those children returning to their birth parents or advocate for their adoption.

Frequently, the result of a child placed in foster care begins with a report of child neglect or abuse to the local Child Protective Services Agency. Once an allegation, which is often a referral of abuse or neglect is received by that agency, the case must then be either screened for further investigation by CPS or screened out, a determination is made not to continue with the investigation. A screened-in referral is called a report. CPS agencies must respond to all screened in referrals. Most of these screened in reports receive investigations, their purpose is to determine if a child was maltreated or is at-risk of maltreatment. The investigation also has the purpose of establishing whether an intervention is needed by CPS. The amount of referrals, investigations and interventions vary by state but this article will provide the aggregate amounts of each. So the question is then, how many allegations of maltreatment were reported and received an investigation or assessment for abuse and neglect?

During 2011 an estimated 6.2 million referrals nationwide were received by CPS agencies, of this estimate a total of 3.7 million children were included. Of these referrals, 45 States reported counts of both screened-in and screened-out referrals. Based on these data, 60.8 percent were screened in and 39.2 percent were screened out. During 2011 more than 2 million reports were screened in, the result being that they had a CPS response including a disposition. The national rate of reports that received a disposition was 27.4 per 1,000 children in the national population. Over the last five years only slight fluctuations in the number and rate of reports occurred at a national level.

Professionals made the majority of alleged child abuse and neglect reports during 2011, about three-fifths or 57.6 percent of the total number. The definition of professional used in this article means that the person had contact with the alleged child maltreatment victim as part of the report source’s job. These types of professionals typically include social workers, teachers and police officers. Nonprofessional’s include friends, neighbors and relatives submitted the remaining 18.2 percent. Unfortunately, national reports list unclassified sources submitted the remainder of the reports or 24.3 percent. Unclassified sources include anonymous persons which could not be classified under an NCANDS-designated code. The three largest percentages of report sources were from professionals such as teachers at 16.0 percent, legal and law enforcement personnel at 16.7 percent and social services personnel at 10.6 percent.

Foster care length of stay

Foster care length of stay

Knowing this how does the United States fare in its treatment of children? Although the U.S. is ranked first in gross domestic product globally, it is: 25th of 29 among developed nations based on measures of child welfare and astonishingly, 25th of 27 among developed nations based on the rate of child deaths from abuse and neglect. In 2011 of the 3.7 million children screened in for reports, 78 percent were victims of neglect, 18 percent were victims of physical abuse and 9 percent were victims of sexual abuse. Shockingly, children age 2 and under were most likely to be victims of abuse and neglect, with more than 11 percent of victims having a reported disability. In the U.S an estimated 1,570 child deaths per year result of maltreatment, 81.6 percent of those child fatalities were under 4 years old. Of these, 42.4 percent were less than one year old. Although this number may be inaccurate because 37 percent of states restrict information on child deaths and near deaths, so without accurate information coming from the state level it may be difficult to develop a true estimate of how many children in the U.S die from maltreatment each year. The annual estimated direct cost of medical care for child victims of abuse and neglect in the U.S. is astounding as well, at $33.3 billion while the annual estimated direct and indirect cost of child abuse and neglect in the U.S.: $80.2 billion. Again, unfortunately 39 percent of states do not mandate legal representation for children in abuse and neglect proceedings. Why this is I do not understand at all.

All 50 states submitted data to NCANDS about the dispositions of children who received one or more CPS responses. Of the 6.2 million referrals nationwide in 2011, those children who were found to be victims with dispositions were only counted once regardless of the number of times he or she was found to be victim during that reporting year. Victimization of these children was split between both sexes almost equally, with boys accounting for 48.6 percent and girls accounting for 51.1 percent. Eighty-seven percent of those victims were comprised of three races or ethnicities being African-American at 21.5 percent, Hispanic at 22.1 percent and White at 43.9 percent.

Once a report to Child Protective Services has been substantiated intervention become necessary. In some cases placement of the child or children into foster care may be needed. In the U.S. about 400,540 children are living without permanent homes and are instead in the foster care system. About 115,000 of the 400,540 children are eligible for adoption, but nearly 40 percent of these children will wait up to three years or more in foster care before being adopted. Looking globally there are an estimated 153 million orphans who have lost at least one parent while there are 17,900,000 orphans who have lost both parents. These orphans are typically living in orphanages or are homeless, with the lack of basic care and attention required for healthy development. These orphans are at risk for disease, malnutrition and death. However, there is hope, according to the U.S. State Department, U.S. families adopted more than 9,000 children in 2011. Last year, Americans adopted the highest number of children from China followed by Ethiopia and Russia.

What happens to former foster children? Approximately 408,425 children were in the foster care system, 27,854 of those children aged out of foster care. No child under three years of age should be placed in institutional care without a parent or primary caregiver. This is based on results from 32 European countries, including nine in-depth country studies, which considered the “risk of harm in terms of attachment disorder, developmental delay and neural atrophy in the developing brain.” Children raised in orphanages have an IQ 20 points lower than their peers in foster care, according to a meta-analysis of 75 studies (more than 3,800 children in 19 countries). This shows the need for children to be raised in families, not in institutions.

Number of children in foster care by race

Number of children in foster care by race

Few studies utilize large national data sets to provide statistical estimates of the degree of disproportionate representation of African-American children placed in CPS foster care. A study involving 71,802 investigations of primary substantiated maltreatment in 2005 was used to examine the association between foster care placement and racial identity. After controlling for child, caregiver, household and abuse characteristics African-American children had 44 percent higher odds of foster care placement when compared with Caucasian children. In 2002, African American and Native American children had the highest rates of representation in foster care at 17.4 and 14. 1 per 1,000 as opposed to 5.8 per 1,000 among Hispanic children and 4.6 per 1,000 among White children. The lowest rates of foster care occurred for Asian children at 1.3 per 1,000. Fortunately, there have been steady declines in the amount of children being placed in foster care over the last ten years. Those declines were most dramatic for African American children falling 47.1 percent between 2002 and 2012 which accounted for 74 percent of the overall decline. The number of Hispanic children in foster care also decreased by 2.5 percent. In contrast to the general trend, one group, children identified with two or more races, did experience substantial growth over this period, increasing from 13,857 to 22,942. Rates fell modestly for White children, Hispanic children, Asian children and Native American children between 2002 and 2012, though recently those trends have leveled off and in the case of White and Native Americans appear to be climbing modestly. Native American children have had the highest rates of representation in foster care since 2009.

When looking at the state and local levels a relatively small number of geographic areas seem to be driving national foster care trends. While the majority of states did show some level of decline in the size of their foster care population between 2002 and 2012, just ten states accounted for over 90 percent of the total decline and just three states, California, New York and Florida, accounted for 50 percent of that previous figure. Several states between the years 2002 and 2012 showed some increase in foster care placements with larger increases coming from Texas and Arizona. Looking at the county level, a very small number of counties accounted for a large proportion of the national decline. With over 3,000 counties in the U.S., only 10 counties accounted for one half of the overall national decline in foster care between the years 2002 and 2012, both overall and among African American children. Finally, looking at those ten counties indicates to us that targeted regional policy can have a great effect on statewide and national outcomes. What we learn from those counties perhaps can be utilized in other regions across the country. Perhaps, an overall reduction in foster care placements by local CPS agencies indicates a shift to interventions designed to keep children with their biological parents. Much data has come out indicating the disadvantage foster care children have over their peers when aged out of the system. Therefore, either at home interventions are preferable for these children or once in foster care adoption is the best option for them.

Each year, over 27,000 youth “age out” of foster care without the emotional and financial support necessary to succeed. This number has steadily risen over the past decade, perhaps due to the time lag between a reduction of foster care placements and those who age out of foster care. Of those who aged out of foster care, nearly 40 percent had been homeless or couch surfed, nearly 60 percent of young men had been convicted of a crime while only 48 percent were employed, 75 percent of women and 33 percent of men receive government benefits to meet basic needs, 50 percent of all youth who aged out were involved in substance use and 17 percent of the females were pregnant. More disturbing statistics of those who aged out of foster care indicate that nearly 25 percent did not have a high school diploma or GED and just a mere 6 percent had finished a two- or four-year degree after aging out of foster care. On a positive note one study shows 70 percent of all youth in foster care have the desire to attend college. Which means that for those who may be ready to age out, training or college preparatory service may provide benefit.

Unfortunately, not all children removed from their biological parents are placed in foster care, let alone adopted. As of 2011, nearly 60,000 children in foster care in the U.S. are placed in institutions or group homes, not in traditional foster homes. States spent a mere 1.2-1.3 percent of available federal funds on parent recruitment and training services even though 22 percent of children in foster care had adoption as their goal. Considering 60 percent of those young men who age out had been convicted of a crime, perhaps more spending on parent training would not only yield overall state savings but improve the outcomes of those children. Over three years is the average length of time a child waits to be adopted from foster care, while 55 percent of those children who are waiting to be adopted have had three or more placements. One study found that of those children in foster care 33 percent had changed elementary schools five or more times the result being strained relationships and poor educational outcomes. Adopted children make-up roughly 2 percent of the total child population under the age of 18, but 11 percent of all adolescents referred for therapy have been adopted. Again, post-adoption services are important to all types of adoption, whether foster care adoption, international adoption, or domestic infant adoption, in part because adoption rates need to increase which will result in a reduction of youths who age out of the system. The statistics show the reasons why keeping children in their parents’ home, adopting them or adopting them out from foster care is so important. The percentage of the general population that have a bachelor’s degree is 30 percent, while the percentage of former foster children that have a bachelor’s degree: 3 percent, the percentage of the general population in jail or prison is less than 1 percent, while the percentage of former foster children incarcerated since age 17 is 64 percent for males, 32.5 percent for females. The percentage of the general population who experience homelessness over the course of a year is less than 1 percent, while the percentage of former foster children who experience homelessness after aging out of the system is 24 percent. Finally, the percentage of former foster children who are unemployed 1 year after aging out is 61 percent, while the percentage of former foster children who are unemployed 5 years after aging out is 53.5 percent.

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