In the current rush to make child welfare more “family-friendly,” many proposals are being made for major changes, and even for the total abolition of the current system. But many of these proposals are based on misunderstandings of what we currently know about child abuse, child neglect and child welfare programs. Acting based on these misconceptions may produce policies and practices that actually harm children. A group of eminent child welfare scholars, headed by Richard Barth of the University of Maryland School of Social Work, (and also including leading child welfare scholars Jill Duerr Berrick, Antonio Garcia, Brett Drake and Melissa Jonson-Reid and Johanna Greeson) have addressed ten of the most common misconceptions in one essential article, a must-read for anyone promoting change in our child welfare system.
The article, entitled “Research to Consider While Effectively Re-Designing Child Welfare Services,” was published in the journal Research in Social Work Practice on October 18, 2021. It highlights 10 common misconceptions which the authors assert (rightly in my view) are “inconsistent with the best available contemporary evidence.” Their treatment is structured around ten questions to which a wrong answer is commonly cited and used to justify policy changes. Unfortunately, a paywall blocks access to the article for readers who do not have access to the journal from their institution, though this link provides a one-paragraph summary and the reference list. This post provides a more detailed summary of the article. Readers can contact author Richard Barth at RBarth@ssw.umaryland.edu with questions.
Are Low-Income Children Inappropriately Referred to Child Protective Services (CPS) Due to Implicit Bias?
As the authors describe, there is no doubt that low-income children are referred to CPS at a higher rate than their higher-income peers. One theory is that mandated reporters, who are often middle-class professionals, are biased against low-income parents and their parenting styles. Barth and colleagues cite studies that look at this question in several ways, all suggesting that bias is not the major reason for higher reporting of poor children. First, low-income children experience bad outcomes (in the worst case, death) at differentials consistent with or higher than the differentials in reporting rates. Second, lower-income people are much more likely to self-report maltreatment than their higher-income counterparts. And finally, low-income children who are reported to CPS are more likely to have a range of negative outcomes than their low-income peers who are not reported to CPS.
Are Families who Receive Public Social Services and Have Contact With Mandated Reporters Disproportionately Likely to be Referred to Child Protective Services?
It is often asserted that families that receive more public services (such as clinics rather than private doctors to whom they are known) and encounter more mandated reporters are more likely to be reported to CPS. But the authors show that available evidence does not support this assertion. Two studies estimated “surveillance bias” to increase CPS reporting by less than two percent. Another study found that among children in families receiving income support, those who were reported to CPS also had higher rates of delinquency, mental health problems, and hospital visits for injury. Finally, national and state data show that “as individual or community poverty increases, the proportion of mandated reporters among all reports decreases, making low-income people less likely to be reported by mandated reporters.”
Is the Racial Disproportionality of Black Children in CPS Substantially Driven by Bias?
It is a fact universally acknowledged that Black children are more likely to be involved with child welfare than their share of the population would predict. The latest federal data shows that Black children are more than twice as likely to be reported to CPS than White children. But as I’ve often written, the evidence suggests that bias is not the main reason for this disparity. Among the reasons cited by Barth and colleagues, Black children are more than three times more likely to be poor than white children. Studies suggest that when compared to children with an equal income, Black children are at the same risk or at a slightly lower risk of being reported to CPS. The authors also cite a recent study suggesting that Black substance-abused infants are actually less likely to be reported to CPS than White or Hispanic substance-abused infants. Furthermore, they cite evidence that Black-White disparities in other objective indicators of well-being, such as child mortality, are actually greater than Black-White disparities in CPS reporting. The writers therefore contend that, in order to address racial disproportionality in CPS reporting, we need to address poverty itself, as well as the factors that place Black children at higher risk of growing up in poverty.
I do differ from Barth et al in believing that factors other than poverty affect racial disparities in child abuse and neglect, and the resulting disparities in reports, substantiations, and foster care placements. The importance of factors other than poverty is illustrated by the fact that Hispanic children are less likely to end up in foster care than White children even though their poverty rates are higher, while Native American children, with similar poverty rates, are much more likely to be placed in foster care than Black children. Hundreds of years history of slavery, racial violence, and segregation have left a legacy of intergenerational trauma that has affected mental health, substance abuse, and childrearing styles. Therefore equalizing Black-White poverty rates would probably not immediately equalize their rates of placement into foster care.
Are Decisions to Substantiate or Place in Foster Care Largely Driven by Racial Bias?
Not only are Black children disproportionately more often reported to CPS; they are disproportionately more often the subject of substantiated allegations and placed in foster care. This is clearly a concern of the authors although their analysis indicates that what is commonly asserted– that this discrepancy is largely due to a racist decision making in the child welfare system—is not supported by the evidence. The authors report that the large majority of recent studies find that “as they move through the system, socioeconomically disadvantaged Black children are generally less likely to be substantiated or removed into foster care compared to White children.” Black children do stay in foster care about 25 percent longer than White children, perhaps because they are less likely to be reunified with their parents or adopted. However, the frequently-cited idea that they are more often substantiated once economic status is taken into account has been roundly disproved, according to the paper’s authors. As I have pointed out relative to this question and the previous one, attempting to reduce disparities that are due to different levels of need might require establishing lower standards for the care of Black children by their parents, allowing them to remain in situations that would cause White children to be removed.
Is Child Neglect Synonymous With Family Poverty?
The trope that child neglect is synonymous with poverty is one of the most common myths used by advocates of child welfare reform, and I devoted part of a recent post to dismantling it. It is true, as Barth and colleagues state, that 70 percent of maltreatment reports and fatalities include neglect as a factor. And they acknowledge that there “is clear evidence establishing the relationship between poverty and child neglect.” However, this association does not mean that poverty and neglect are one and the same. Barth et al point out that studies examining the impact of both poverty and neglect have found distinct negative impacts on children for each one. They also found that studies using both officially reported and self-reported neglect found “unique constellations of risks and/or parenting behaviors” for neglect as opposed to poverty. As the authors point out, much of of the confusion between poverty and neglect is due to the fact that some states allow parents to be found neglectful when a child’s material needs are unmet, even when this deprivation was involuntary on the part of the parent. In those cases, neglect could be seen as reflecting poverty alone. But the authors point to a study showing that only a small proportion of neglect referrals (maybe one in four) is due to material needs, and that these referrals are only about a quarter as likely to be substantiated as other neglect referrals. This is not surprising, since many jurisdictions would respond in such cases by helping the family address the material need rather than substantiating an allegation of neglect by the parent.
Barth et al make an important point that “[N]arratives that conflate poverty and child neglect unfairly characterize low-income families, the majority of whom provide appropriate care for their children.” Most poor parents do not neglect their children, and eliminating poverty alone would not eliminate neglect caused by mental illness, substance abuse, or other non-material factors. Moreover, characterizing neglect as nothing more than poverty risks obscuring the harms caused by neglect, which the authors discuss in their response to the next question.
Is Child Neglect Harmful to Children?
The seriousness of child neglect is often minimized by those who say it is just a reflection of poverty. Yet, Barth and colleagues remind us that severe neglect means “the lack of the basic nurturing, care, and supervision needs of a child.” When such severe neglect is chronic or occurs at critical periods in child development, it can lead to death, hospitalization, and impaired development. The authors cite multiple studies showing the many poor outcomes that have been associated with neglect, including poor cognitive outcomes, mental illness, trauma symptoms, and substance abuse, and point out that such poor outcomes have been found even when controlling for poverty.
Are Research-Supported Practices Effective for Families of Color?
With the passage of the Family First Prevention Services Act allowing Title IV-E funding to be used to pay for “evidence-based practices” to keep families together, some advocates are asserting that programs deemed evidence-based are not actually shown to be effective for people of color. Barth and colleagues cite a study showing that four of popular programs in the California Evidence-Based Clearinghouse for Child Welfare – Parent Child Interaction Therapy, Trauma-Focused Cognitive Behavioral Therapy, Level Four Triple P and Multi-Systemic Therapy – have been found to be well-supported in studies with samples that include at least 40 percent children and families of color. Moreover, Cognitive Behavioral Therapy, the basis of many interventions, has been shown to be broadly effective across populations. Nevertheless, it is clear that the overwhelming majority of the interventions in the clearinghouse have not included many people of color. I am more persuaded by the authors’ suggestion that just because an intervention study did not include people of color does not mean it would not be effective for them with modifications to make them more relevant to families of color. However, I do feel compelled to report on my skepticism about many of these programs that have been found to be “evidence-based,” regardless of the nature of the families served. In the enthusiasm to replace foster care with family preservation, at least one popular program (Homebuilders) has been approved for Family First funding even though the evidence does not strongly support its effectiveness for any families, as I have discussed previously.
Do Children Grow up in Foster Care?
It is very common to read about children “growing up” in foster care, but as Barth et al point out, that is a rare occurrence today. While long-term foster care was common in the past, today’s emphasis on permanency has made stays much shorter. Barth et al cite “overwhelming” evidence that fewer than one percent of infants and ten percent of children 13 and under who enter foster care grow up in care. Infants entering care spend only about 10% of their time between 0 and 18 in care; children who are older when they enter care spend less time in care. Children who “age out” of care are mostly those who entered as teenagers, and many of them were admitted to foster care because of behavioral problems. As the authors point out, talking about children who “grow up” in foster care overemphasize the importance of the foster care experience as part of the life trajectory for most children and understate the importance of foster care as a temporary, last-resort option.
Does Foster Care Cause Poor Outcomes for Children and Youth?
There is no doubt that studies of young adults who have spent time in foster care show that they have worse outcomes than those who have not. Sadly, some commentators use this research to argue that being in foster care leads to worse outcomes than remaining at home. But as Barth and his colleagues had already explained in a previous section of their paper, child maltreatment has been shown to have many negative outcomes, which should not be confounded with the effects of foster care. Another review by Barth and others of “dozens of methodologically rigorous studies” examining outcomes in multiple domains suggests that it is unlikely that foster care worsens outcomes, and it improves them in some areas like child safety–as one would hope. Barth et al attribute the widespread misstatements about the role of foster care in adult outcomes to the strong impact of anecdotes from some foster care alumni about their bad experiences. This is despite the fact that studies reviewed by the authors show that most young people reported satisfaction with their foster care experiences.Majorities of young people in multiple studies reported that they had positive relationships with their caregivers, received quality care, felt safer in their foster homes than in their original homes, and felt that their removal was justified by the circumstances. Another reason for inaccurate conclusions about foster care, according to the authors, may be an over-reliance on studies of youth who aged out of care. This is a group that tends to have more issues even before entering care than other youth. In summary, as the authors state, “an evidence-informed understanding of the role of foster care in the lives of maltreated children indicates that the average experience of care is more favorable than conditions in the birth home at the time of removal.”
Is Adoption Breakdown Common for Former Foster Children?
The final misconception addressed by Barth and his colleagues is that a large fraction of adoptions end in breakdown. They mention commentators who have expressed concerns that the push to permanency may result in some adoptions being finalized too quickly, resulting in later dissolution. Instead, Barth et al show that research suggests adoption dissolution rates typically fall below five percent across a range of studies. Instead of the embracing the misconception that adoptions are likely to dissolve, Barth and his colleagues suggests that advocates for children in foster care should think of adoption as “a stable permanency alternative for children who otherwise cannot be reunified.” As they rightly state, “reform efforts that seek to curtail the opportunity for adoption among children who cannot be reunified would deny… children the lifetime of permanency that our laws seek to promote.”
Policy based on wrong assumptions is likely to be bad policy. Yet, the daily child welfare news is full of reports of child welfare leaders spouting these misconceptions–and worse, making policy and passing legislation based on them. In just one recent example, the New York City Council recently passed legislation requiring the Administration on Children’s Services “to report on various demographic information including race, ethnicity, gender, community district, and primary language of parents and children at every step of the child welfare system and to create a plan to address any disparities identified as a result of such reporting.” Perhaps those voting for this legislation had no idea that anything besides bias could contribute to these disparities, nor that “creating a plan to address them” could mean imposing a lower standard of parental care for children who come from over-represented groups–leaving aside the waste of time and money that could be better spent in helping children.
The misconceptions highlighted by Barth and his colleagues are already affecting child welfare policy and practice around the county in ways that are likely to put abused and neglected children at risk of further harm. This magisterial review, with its more than 140 references, is essential reading for anyone who prescribes or develops child welfare policy or practice. Let us hope it receives the attention it deserves.