Child Maltreatment 2024: Clear Evidence that Federal Trend Data Cannot be Trusted

by Marie Cohen

This post was originally published on Lives Cut Short website.

The Children’s Bureau’s eagerly awaited Child Maltreatment report has been published and the child welfare newsletter The Imprint lost no time in announcing that Maltreatment Reports, Victims and Fatalities All Down in 2024. Others are sure to follow with commentaries celebrating a 10 percent drop in the number of child maltreatment fatalities. This would be great news if it were true, but making any conclusion based on these data is not warranted. The state-by-state data show that the reductions reflect changing policies and practices, as well as reporting problems, rather than actual reductions in child maltreatment deaths.

On January 8, 2025, the Administration on Children and Families (ACF) of the U.S. Department of Health and Human Services published Child Maltreatment 2024 (CM2024), its latest compendium of data on states’ responses to reports of child abuse and neglect. These annual publications, produced by the Children’s Bureau of ACF, are based on data that states submit to the National Child Abuse and Neglect (NCANDS) data system. CM2024 provides data for FFY 2024, which ended on September 30, 2024. Based on reports from all 50 states, the District of Columbia, and Puerto Rico, CM 2024 reports that the number of child maltreatment fatalities dropped from 1,979 or 2.68 per 1,000 children in Federal Fiscal Year (FFY) 2023 to 1,773 or 2.41 per 1,000 children in FFY 2024. Of course,we should celebrate if these numbers are believable. But that is not the case.

An analysis of last year’s Child Maltreatment report explained how the numbers in the annual federal reports cannot be taken as a good estimate of child maltreatment deaths for any given year. It is widely accepted that these numbers greatly understate the actual number of deaths due to child abuse or neglect. Well-functioning child death review teams identify many more child maltreatment fatalities than are reported to NCANDS. Based on only publicly available sources, Lives Cut Short has counted more child maltreatment deaths than those reported to NCANDS in more than half of states in either 2022 or 2023. The undercounts in NCANDS are due to a variety of state policies and practices including restrictive definitions of child maltreatment fatalities, failure to consult all available sources, restrictions on which reports are investigated, and constraints on finding maltreatment in fatality investigations.

Of course it is theoretically possible that while NCANDS underestimates child maltreatment deaths, the trends it finds over time are still valid. But state-by-state data clearly disprove that thesis. The 50 states, the District of Columbia and Puerto Rico reported 206 fewer child maltreatment deaths in FFY 2024 than in FFY 2023. Five states–Texas, Maryland, North Carolina, Illinois and Virginia–together account for a decrease of 210 fatalities–more than 100 percent of the total decrease for the year overall. Explanations from all of these states indicate that the drops they reported reflect factors other than the actual number of child maltreatment deaths.

Child Maltreatment Fatalities, FFY 2023 and 2024
State	FFY 2023	FFY 2024	Total Decline, 2023-2024
Illinois	83	66	17
Maryland	83	46	37
North Carolina	107	46	61
Texas	187	107	80
Virginia	55	40	15
TOTAL (5 states)	515	305	210
United States	1,979	1,773	206

Source: US Department of Health and Human Services, Child Maltreatment 2024, January 2026.

The number of child maltreatment deaths in Texas that were reported in Child Maltreatment 2024 fell from 187 in FFY 2023 to 107 in FFY 2024, an enormous drop. In its own annual report on child fatalities and near fatalities for FY 2024, the Texas Department of Family and Protective Services (DFPS) reports a smaller but still substantial decrease from 164 child maltreatment fatalities in state fiscal year (SFY) 2023 to 99 in SFY 2024.¹ The number of investigated child fatalities fell from 690 to 587–a decline of 587, or 14.9 percent. Out of the investigated families, the number of fatalities where abuse and neglect was confirmed fell from 164 or 23.7 percent of fatalities investigated to 99, or 16.9 percent of fatalities.

In its report, DFPS suggests that the decline in both investigations and maltreatment findings reflects a change in the definition of child neglect adopted by the Legislature that took effect in FY 2022. This change required the agency to find that a parent exhibited “blatant disregard” for the consequences of an act or failure to the act that results in harm or immediate danger to a child. DFPS believes this law affected investigations and dispositions in both FY 2023 and FY 2024. (NOTE: This does not explain the drop in findings of abuse, however.)

DFPS also reported that two other factors affected the fatality numbers. Starting in 2022, the agency changed its screening policy so that reports involving a child fatality but include no explicit concern for abuse and neglect are not investigated if the reporter “or first responders” had no concern for abuse or neglect. According to DFPS, this contributed to the decrease in investigations and ultimately in fatalities reported both in FY 2023 and in FY 2024. DFPS also reported that in FY 2024 it imposed an additional level of review for certain investigations that found neglect (like those involving drowning or unsafe sleep) to ensure that the investigator had followed the new neglect definition incorporating “blatant disregard.” This change almost certainly contributed to the reduced number of maltreatment fatalities found.

North Carolina reported a large drop in child maltreatment fatalities from 107 in FFY 2023 to 46 in FFY 2024. In response to a question about the cause for this large decrease, a spokesperson for the North Carolina Department of Health and Human Services (NCHDHHS) provided the following explanation, which makes clear that the reported decline in child maltreatment fatalities in FFY 2024 is not valid and should not have been included in CM 2024:

NCDHHS is aware of probable discrepancies in the state’s historic child fatality data, particularly in 2023-2025. Prior to 2025, the state was using an outdated database platform that became increasingly unstable and subject to error. Recognizing this, NCDHHS made significant investments in designing and building a new, comprehensive Child Welfare Fatality Information System that launched for state users in 2025. While data from the old database was transferred to the new system, these numbers likely include inconsistencies and should not be used to analyze trends in child fatalities.

Maryland reported 46 child maltreatment deaths in FFY 2024, compared to 83 in FFY 2023.The large drop in Maryland’s child maltreatment fatalities was predictable in advance and is as irrelevant to actual child deaths as those in Texas and North Carolina. In 2025, Maryland’s child maltreatment fatality reports to the Children’s Bureau made the news when a reporter discovered the state had the second highest number in the country. Department of Human Services (DHS) officials soon realized that the agency had for years been reporting the number of death cases investigated for abuse and neglect, whether or not they were confirmed as due to maltreatment. Maryland reported this issue in its commentary to CM2024, stating that it had submitted correct information for 2024. However, Maryland’s entries for previous years have not been corrected, resulting in the misleading appearance of a large reduction in child maltreatment fatalities between FFY 2023 and FFY 2024.

Illinois reported a smaller but still sizable decline from 83 child maltreatment fatalities in FFY 2023 (itself a drop from 110 in FFY 2022) to 66 in FFY 2024. In its commentary, DCFS reported that the decrease in confirmed maltreatment fatalities in both years stems from the introduction of an administrative review process for sleep-related deaths. For any sleep-related death allegation, a senior administrator reviews the investigation “to ensure consistent evaluation of whether the sleep-related death included evidence of blatant disregard,” referring to the parent’s disregard of the danger to the child of unsafe sleeping arrangements. This is the same concept that is included in Texas’ new definition of child neglect. DCFS reports that this new review process has continued to result in fewer sleep-related deaths being “indicated” as due to maltreatment.

Virginia reported a significant decrease in child maltreatment fatalities from 55 in FFY 2023 to 40 in FFY 2024. In its commentary, the Virginia Department of Social Services suggests that this decline was due to a decrease in fatality investigations in FFY 2024, which in turn stemmed from “more local agencies having overdue investigations that were not closed timely or in accordance with VDSS guidance.”

The explanations provided by Texas and Illinois have something in common. In both states, the decline in confirmed child maltreatment fatalities was the intended result of policies–like a changed definition of neglect in Texas and the imposition of administrative reviews to enforce such a restrictive definition in both states–that were designed to find fewer child maltreatment fatalities. Those policies and practices are only part of an overall effort designed to reduce the involvement of child welfare agencies in the lives of families in those two states and in many other states around the country. So it is not surprising that the number of reports accepted for investigation and the number of children found to be victims of abuse or neglect also declined in FFY 2024.

In conclusion, five states account for over 100 percent of the decline in child maltreatment fatalities reported in Child Maltreatment 2024. All of these states have acknowledged that the decline in fatalities that they reported for FFY 2024 was caused by the fatality determination and reporting process itself, not real trends in child maltreatment deaths. The bottom line is that the numbers contained in the Children’s Bureau’s Child Maltreatment reports are not reliable for determining national or state-level trends in child maltreatment deaths, or in child maltreatment in general. Responsible reporters and researchers should know by now not to rely on these data, but they continue to do so, confusing the public and depriving policymakers of the information they need to make good decisions.

It is not clear why the SFY numbers are so different from the FFY numbers, as the two years overlap by 11 months, DFPS has not yet responded to a request for an explanation. ↩︎

Maryland needs full transparency on child fatality cases

By Naomi Schaefer Riley and Marie Cohen

This post was originally published as a guest commentary in the Baltimore Sun.

Last month, the Baltimore Banner reported on an alarming rise in the number of child fatalities due to maltreatment in Maryland, as shown by a federal report. The number of child abuse and neglect deaths reported by Maryland to the federal Children’s Bureau was 83 for Fiscal Year 2023, up from 27 a decade before, a rate higher than any state but Mississippi.

After initially responding with confusion, the Maryland Department of Human Services (DHS) explained that the numbers it reported to the feds were erroneous. Actually, the state was aware of 47 children who died of abuse or neglect in 2023, which was still a 75% increase from 2013. “We continue to discover where data was routinely released without any validation or reconciliation,” a deputy DHS secretary told the Banner.

But members of the legislature were already alarmed and began talking about withholding funds until the agency was able to report accurate data about child fatalities as well as the conditions of children in foster care. Eager to demonstrate its desire for transparency, DHS announced that it was pivoting to support a bill requiring the agency to promptly release information about children in foster care who die from suspected maltreatment.

But this legislation would not apply to children who died while in the custody of their parents or guardians. It would not apply, for instance, to five-year-old Zona Byrd, who starved to death last year after being returned to her parents’ custody; four-year-old Amir James, who arrived at the hospital covered in cuts and bruises and died from skull fractures that caused his brain to bleed, while his twin brother survived similar injuries; 16-month-old Zavier Giron, who had several broken ribs, a dislocated femur and a perforated intestine when he died; and two-year-old Charlee Gamble, who was shot in the head by an unsecured gun that her father purchased illegally and left on a TV stand. The bill would apply only to cases of abuse or neglect in foster care — even though they are a rare occurrence. Indeed, less than 1% of perpetrators of child maltreatment fatalities reported nationwide for Fiscal Year 2023 were foster parents or staff of a group home or residential treatment facility.

The chair of the Maryland House Judiciary Committee conducting a hearing on the bill wondered if the bill was too narrow, but one of the sponsors, Del. Susan McComas, responded, “Whether it’s a little step or a big step, I don’t really care. I think we need to do something. And I think we could start with just this.”

The sentiment to do something is admirable, but in this case it will likely not even make a dent in the lack of public accountability and transparency when children die of maltreatment.

To prevent such tragedies, we need improved data collection, timely notification and greater transparency by agencies that investigate such fatalities and are responsible for protecting children. Maryland should pass a bill that requires prompt notification of any child fatality that has been reported to child protective services. Eleven other states already do this. Without such notifications, legislators and the public may never know about some child abuse deaths, especially those that did not result in criminal charges. In addition, DHS should be required to respond promptly to requests for further information about all suspected child maltreatment fatalities, not just those where the child was in foster care or state custody. It is only by achieving such transparency that DHS can work with the legislature, researchers and child advocates to prevent these tragic events in the future.

The child placement crisis: It’s time to lose the slogans and find real solutions

By Judith Schagrin

A note from Child Welfare Monitor: It is a privilege to publish this important essay by Judith Schagrin. Judith earned an undergraduate degree from the University of Pennsylvania and a master’s degree in social work (MSW) from the University of Maryland School of Social Work. She unexpectedly found her passion in public child welfare, and more specifically, foster care after helping start an independent living preparation program for young people in care. After a decade as a foster care social worker specializing in adolescence in a large Maryland county department of social services, she supervised two different units before becoming the county’s director of foster care and adoptions, serving in this position for twenty years. She also worked part-time for the Agency’s after-hours crisis response for a decade. For almost 10 years, she served as a respite foster parent for a private foster care agency, and since 2008, has mentored a young person who aged out of care in California and came east for college. In 2001, with a little help from her friends, Judith founded Camp Connect, a weeklong sleepaway camp to reunify brothers and sisters living apart in foster care and provide memorable experiences siblings can share for a lifetime. For the past 23 years – one year virtual – she has spent the week at Camp Connect immersed in the care of Maryland’s foster children and youth.

The closing of children’s mental hospitals in the 1980s, the subsequent closure of detention centers leaving foster care to take up the slack, the movement to shutter all group homes and residential treatment programs and the prohibition of out-of-state placements have created a slow-motion train wreck whose results could have been predicted easily at every new chain in the sequence. Those results include children and youth staying in psychiatric hospitals long after being ready for discharge, “boarding” in emergency rooms and “placed” in hotels at a cost of $30,000 to $60,000 per child per month. From my 35-year vantage point as a caseworker, supervisor, and then running foster care and adoptions in a large Maryland county, I’ve had a front row seat to the evolution of this crisis and the failure to come up with real solutions.

Deinstitutionalization

The first in a series of events that created this crisis occurred in the 1980s, when the deinstitutionalization that began for adults in the 1960’s with the civil rights movement expanded to include children. Until then, youth remained in state hospital facilities for as long as a year or even more. The closure of those state facilities led to the expansion of Medicaid-funded residential treatment centers (RTC’s), that stepped in to provide the longer term care once provided in the state hospitals. In turn, group homes proliferated to meet the needs of youth discharged from RTC’s. The advent of Medicaid was instrumental in expanding prIvate psychiatric treatment options, including hospitals. But over time, Medicaid stopped funding even 30 days of treatment, limiting payment to only a few days of crisis intervention.

Today, many youth, especially older youth, are entering foster care not because of what we traditionally think of as maltreatment, but due to parental incapacity or unwillingness to care for them due to acutely problematic behavior, and behavioral health and/or developmental needs. Services to meet these needs are often missing or inadequate, and parents of children with high-intensity needs cannot find residential treatment except through the child welfare system. Medicaid doesn’t pay for treatment and care in a group home of any kind; access in Maryland requires the child welfare system’s physical or legal custody.

New approach to juvenile justice

In the early 2000’s, a series of Supreme Court decisions brought welcome changes to juvenile justice and shifted the country from the ‘get tough’ approach of the ‘80’s and 90’s to the ‘kids are different’ era. Moving from punishment to rehabilitation and minimizing detention in favor of community services makes sense on both humanitarian and neuroscience grounds. But it meant that youth who once fell under the purview of Juvenile Services now required child welfare intervention when parents or other caregivers were unwilling or unable to continue to provide care. The mother evicted from four apartments because of her son’s property damage; the grandmother who stepped in years ago and is no longer able to cope with her granddaughter after the third vehicular misuse charge and chronic episodes of running away; or a parent with younger children afraid that an older sibling known to have rages and episodes of violence will harm his siblings, are examples of desperate caregivers I have come across.

In Maryland, the first alarm that child welfare was ill-equipped to care for these youth was sounded in 2002 by local department directors in a memo to the head of the Department of Human Services. Closing detention centers was a good thing, but alternatives weren’t developed for those youth unable to live at home, and no resources were provided to help child welfare accommodate its new clients. As the closure of state psychiatric facilities and detention beds was widely celebrated, the belief that every youth had a family eager and able to provide a home was more than a touch naive, as would soon become clear.

Group home closures

Another domino fell in the early 2000’s, when group homes, many poorly administered with little oversight, became a scandal in Maryland. A series of articles in the Baltimore Sun exposed the flaws of many group care programs, and some were forced to close. With the scandals around bad group homes, the timing was perfect for state leadership, encouraged by a national advocacy group with deep pockets and the laudable dream of a family for every child, to lead a movement to shutter congregate care placements. Funding constraints, too, forced some providers out of business. Reimbursement rates did not keep up with costs, and some programs closed their doors due to inadequate reimbursement. The state lost roughly 450 beds in five or six years, including entire residential treatment center programs. Rate-setting ‘reform’, which began in October of 2021, will not be completed until July of 2026 if it stays on schedule.

At the same time group homes were being closed in Maryland, state agency leadership began to frown on out-of-state placements for youth with highly specialized needs when no placement in Maryland to meet those needs was available. Public officials with little understanding of placement resources pronounced these out-of-state placements to be evil incarnate, and an overwhelming number of bureaucratic obstacles made them nearly impossible.

With the loss of group homes as an option, we were urged to ‘re-imagine’ care for children, yet discouraged from developing individualized plans of care because insufficient flexible funding was allowed to make that happen. We’re fond of slogans in child welfare, as if words will change outcomes, but too many initiatives are about clever slogans and not about substance. If only we would review every child in group care, we were told, we would realize how many had other options. With consultation from the national advocacy group, we spent hours seriously poring over the needs of our children in congregate care and attempting to find matches with kin or foster families. Not at all surprising to our staff, “low hanging fruit” didn’t exist.

We also initiated a rigorous “Family Finding” practice, in hopes of finding kin willing to become providers with services and supports. What we learned is that youth in congregate care had already exhausted family and “kin of the heart” resources. Today it’s not clear that public officials and child welfare leaders grasp that children and youth wouldn’t be in hotels if there were any kin – fictive or otherwise – willing and able to provide care, or if parents could and would be a safe resource.

Youth with intensive, complex needs

As other doors closed, the child welfare system became increasingly tasked with providing residential behavioral health care for children and youth with high-intensity and complex needs for supervision and treatment. The differences between those involved with the juvenile justice system (and may have gone to detention centers in the past) and those who are not are often hard to discern. Both groups tend to engage in behaviors that pose a serious safety hazard to themselves or others. These behaviors may include physical violence; property damage; compulsive self-harm such as cutting or swallowing objects; chronic truancy; frequent runaway episodes; sexual victimization of siblings; aberrant sexual behaviors such as public masturbation; molesting younger siblings; participating in petty crimes; harming family pets; and generally oppositional and dysregulated behavior.

Contrary to the popular notion that the public child welfare system is tearing families apart, these are children whose families are typically frustrated, exhausted, and often eager to place their child. Some even view foster care as a much-needed punishment, imagining that when the youth is ready to “behave,” they can return home. Of course these young people have many strengths to be nurtured, but they need intensive supervision and therapeutic intervention by professionals trained to evaluate and address their special needs and work with families.

The gist of the matter is that we are serving two different out-of-home placement populations with very different needs. One is a younger population in foster care primarily due to maltreatment stemming largely from parental substance abuse and/or untreated mental illness. The other is older youth with complicated behaviors, and behavioral health needs and/or developmental disabilities. The parents and kin of the older group are asking for placement, not objecting to it, and are typically worn out and adamantly opposed to more in-home services. In spite of the stark differences in these two populations, our policymakers and those upon whom they rely have failed to recognize their needs are not the same.

In Maryland and other states, treatment, or ‘therapeutic,’ foster care stepped in to accommodate this new population of older, harder to serve foster youth. To some extent this approach has been effective as an alternative to congregate care, but it’s not the panacea some would like to believe. The desperate need for foster families willing to care for these youth means there’s a certain amount of pressure to lower expectations and even turn a blind eye to foster parents that do a less than stellar job. Tales of locked refrigerators and youth left sitting on the stoop at the end of the school day until the caregiver came home soon proliferated. However, we were told by representatives of a national advocacy group that, “Youth are better off moving from shabby foster home to shabby foster home than in the very best congregate care.” In my own experience, instability begets instability and there’s little more soul-sucking than being rejected from family after family.

Setting aside the question of quality, foster care, whether treatment or not, has great challenges recruiting homes for youth with weapons charges, those with a history of drug dealing, or whose parents have refused to pick them up from the police after another runaway episode. “Cutters” and “swallowers” need 24/7 supervision to keep them safe and in general, kin have already tried to provide care long before the child’s entry into state custody. With the closure of group homes and residential treatment centers in Maryland and the prohibition on out-of-state placements, finding placements willing to accept youth with high-intensity needs became literally impossible. As a result, for years now children have been left in psychiatric hospitals (sometimes for months) after “ready” for discharge, and others are ‘boarding’ in emergency rooms for weeks or months.

A failure to recognize reality

Instead of recognizing the lack of capacity to serve those youth with nowhere to go after being hospitalized, hospital representatives, public officials, and legislators blamed caseworkers for not ‘picking children up’, as though they were simply lazy and incompetent. “Advocates” proposed legislation imposing more caseworker accountability as the solution, as though if caseworkers worked harder and filled out more forms, placements that didn’t exist would magically appear. Fortunately, none of the legislation passed, but being a lonely voice trying to explain the source of the problem wasn’t lazy caseworkers or enough forms was painful. Public officials, leaders and advocates also clamored for more “prevention” services, not recognizing the acute needs of older youth developed over many years and that new services authorized today are not going to keep them safely at home.

During my 20 years as the director for my county’s foster care and adoptions program, I can’t count the nail-biting times we came close to not finding a placement for a child – but we were always able to pull something together. The state made funding available for a 1:1 staff person (or sometimes 2:1) we could offer existing providers, allowing us to use that as a bargaining chip. Of course, increasing reimbursement rates and staff salaries would have been far less expensive than millions for extra staff to support ill-equipped placements, but that change in fiscal allocation has yet to happen.

Five years have now passed since I retired, and hotel placements have become not a rarity but a regular necessity. At the rate of $30,000 to $60,000 per child each month (not including damages to hotels) to warehouse children in hotel rooms supervised by an untrained aide – one can only imagine what that kind of money could be doing productively for children. Caseworkers are overseeing the most precarious and risky “placements,” and being ‘hotel reservation clerks’ isn’t the reason competent social workers choose to do the work. We’ve all heard the tales of youth stealing their 1:1’s car; or youth locking themselves in their rooms doing what we don’t know; a youth who overdosed on his medication; parties taking place with the acquiescence of the 1:1; youth harassing guests; and the youth who leaped over the reservation desk to try to steal cash.

Over the years there have been many, many meetings among high ranking state officials and others; ironically, these meetings didn’t include the experienced and knowledgeable child welfare staff responsible for the children. Lots of strategies, goals, and plans too – a personal favorite was the goal of instructing local department staff on hospital discharge planning, as if they weren’t already experts. Despite all the meetings and all the hand-wringing, progress meeting the needs of the children in our care, or soon to be in our care when parents abandon them at the hospital or elsewhere, has been negligible. Years that could have been spent on developing and promoting new model programs have been wasted. In the meantime, Congress saw fit based on testimony from well-heeled advocacy groups to pass the Family First Prevention Services Act, which limited congregate care even more by restricting funding to approvable options based on criteria seemingly pulled out of a hat.

Today, the deepening and pervasive placement crisis is affecting nearly every state and attracting media attention around the country. Given the financial resources dedicated to keeping children in hotels, finances clearly aren’t the issue. And it certainly isn’t about quality of care, since hotel rooms, overstays in hospitals, and boarding in emergency rooms rank far below a quality congregate care program as a suitable home for a child.

What is to be done?

In the short run, Maryland and other states need respite programs for young people awaiting placements in hospitals, emergency rooms, and hotels. In the long run, we must acknowledge child welfare’s responsibility not only for maltreated children, but also those with high-intensity needs for supervision and treatment once served by other child-serving organizations. We need to bring the finest minds together to reimagine how residential care is provided, and its role in the continuum of child welfare resources to meet the needs of older youth entering foster care because of needs related to behavioral health and/or developmental disabilities. That process should include some of the scholars who have been studying the use of congregate care in other countries where it is more highly valued as a treatment and a professional field. Exploring the development of real alternatives to congregate care is also a worthy investment. Finally, the unintended consequences of the Family First Prevention Services Act that disincentivized needed placements without a credible replacement must be remedied.

How many more years until we wake up? And how many children will have to be harmed? A colleague had a quote in her office that stays with me always, “when we are doing something with somebody else’s child we wouldn’t do with our own, we need to stop and ask ourselves why.” Who among us would consent to our own children boarding in emergency rooms, on overstay at hospitals, or ‘placed’ in hotel rooms? If that’s not okay for our own children, it shouldn’t be okay for the children in our state’s custody either.