Tag: NCANDS

A jumble of standards: How state and federal authorities have underestimated child maltreatment fatalities

This blog was originally prepared as a report for the project, Lives Cut Short: Children Who Have Died of Abuse and Neglect in the United States Since 2022, which is sponsored by the American Enterprise Institute and the University of North Carolina Chapel Hill. A PDF version appears on the project website.

The annual Child Maltreatment reports, produced by the Children’s Bureau of the U.S. Administration for Children and Families, are based on data that states submit to the National Child Abuse and Neglect (NCANDS) data system. These reports are eagerly anticipated in the child welfare policy community because they provide much of the data commonly used to quantify child maltreatment and the operations of child protective services around the country. The latest report, Child Maltreatment 2022 (CM2022), provides data for Federal Fiscal Year (FFY) 2022, which ended on September 30, 2022. This post discusses the findings on child maltreatment fatalities specifically. A more general discussion of the report is provided in a previous post. In general, this analysis shows the extent to which child maltreatment fatality numbers and rates reported by states reflect how they define and determine child maltreatment fatalities. This diversity makes it impossible to use these data to estimate the total number of fatalities, differences between state maltreatment fatality rates, and differences over time.  More specifically, several key points emerge from the analysis.

  1. States reported a total of approximately 1,990 fatalities to the federal government for Federal Fiscal Year 2022. Yet it is widely recognized that states’ reports to the federal government greatly underestimate the number of child fatalities due to maltreatment by most common definitions. States may use restrictive definitions, fail to consult all available sources, or decide not to investigate or substantiate some maltreatment related deaths. Information from the states’ commentaries to Child Maltreatment 2022 reveals great diversity in how they determine child maltreatment fatalities. In states where child death review (CDR) teams estimate the number of maltreatment deaths, their estimates are always higher than the NCANDS estimates, with some CDR estimates as much as twice, three times, or even ten times higher.
  2. CM2022 shows child fatalities increasing every year between FFY 2018 and FFY2022. But year-to-year changes should be approached with caution. Most states report for each fiscal year the number of maltreatment fatalities identified during that year, not the number that occurred during that year. However, at least two states, including the state with the largest number of children (California), report fatalities based on the year of occurrence and report additional deaths in subsequent years as they are identified. For this reason, even five-year trends shown in CM2022 may change over time. Adjusting for the changes in reports for these two states, reported child maltreatment fatalities have indeed been increasing since 2013. Several states report improvements over time in their ability to capture child maltreatment fatalities for NCANDS reporting. Thus, we do not know the extent to which this increase reflects improved reporting as opposed to increasing deaths from abuse or neglect.
  3. The data reported in CM2022 show that child maltreatment fatalities are concentrated in the youngest children and become less frequent as age increases. Boys are somewhat more likely to die of maltreatment than girls. Black children are much more likely to die of maltreatment than White or Hispanic children—two to three times as likely as White children, depending on the year. The broad category of “neglect,” defined as defined as “neglect or deprivation of necessities” was involved in 76 percent of child maltreatment fatalities while abuse was Involved in 42 percent. Another 8.3 percent of child maltreatment fatalities involved medical neglect.

The Number of Child Fatalities

 There is no standard mandated reporting system for child abuse or neglect deaths in this country. Definitions, investigative procedures, and reporting requirements vary from state to state. Attributing a child’s death to abuse rather than to an accident or natural cause is often extremely difficult. The death of a toddler who drowns in a bathtub, for example, may be classified as an accident in one jurisdiction or as a child neglect death in another.

Committee to Eliminate Child Abuse and Neglect Fatalities, Within Our Reach, 2016, https://www.acf.hhs.gov/sites/default/files/documents/cb/cecanf_final_report.pdf

Child Maltreatment 2022 (CM2022) reports an estimated total of 1,990 child maltreatment fatalities for FFY2022.1 But there is widespread agreement among experts that the annual estimates of child fatalities from NCANDS undercount the true number of deaths that are due to child maltreatment by a factor of two to three.2 The National Center on Child Fatality Review and Prevention lists several reasons why this occurs in a given jurisdiction. Jurisdictions may count only deaths substantiated as abuse or neglect using definitions from child welfare civil or criminal law, which may not be comprehensive. Some jurisdictions count only deaths for which the death certificate lists homicide or child maltreatment. Multiple data sources may not be used to identify possible maltreatment deaths. Accidental deaths that were made possible by egregious neglect are often not included,

To get states to use more data sources, the Child and Family Services Improvement and Innovation Act (P.L. 112-34) requires states to describe in their state plans all the sources used to compile information on child maltreatment deaths. To the extent that information from state vital statistics departments, child death review teams, law enforcement agencies and medical examiners or coroners is not included, states must explain the reason for the exclusion and how they plan to include this information in the future. However, this law is clearly not being enforced, and most states do not report using data from all these sources.

In the commentaries that almost all states provided with their NCANDS submissions (included at the end of CM2022), most report drawing on at least some sources external to the child welfare agency, but usually this information is accepted only as a report to the child protection hotline with an allegation of maltreatment. Only if investigated and substantiated by child protective services (CPS) are these deaths included in the counts provided to NCANDS. A few states report taking special measures to ensure that suspected child fatalities are reported to child welfare agencies. In Missouri, coroners and medical examiners are required by law to report all child fatalities to the child abuse hotline. In its commentary, Missouri suggests that it may appear to have a higher child fatality rate than other states because of this law, and indeed its child fatality rate is higher than that of most states. Indiana requires county coroners to report any “suspicious, unexpected, or unexplained” deaths to the Department of Child Services (DCS).  Idaho’s Division of Vital Statistics refers to CPS all child death cases for which the cause of death is homicide. (Except when a link or reference Is provided, information in this post is drawn from CM2022.)

Some state child welfare agencies have an internal fatality review unit that may add maltreatment fatalities to the state’s counts. Minnesota’s child welfare agency has a Critical Incident Review Team that reviews death certificates and directs local agencies to add fatalities that they find were due to abuse and neglect to the cases that they already substantiated. New Jersey’s Department of Children and Families’ Office of Quality maintains a critical incident review process that may add to NCANDS some deaths that were not substantiated as maltreatment by CPS.

A few states explain that they report to NCANDS fatalities that are determined to be maltreatment-related by agencies other than child welfare:3

  • California reports fatalities determined by medical examiners or coroners, and by law enforcement agencies, in addition to county child welfare agencies, to NCANDS.
  • Washington and New Mexico report to NCANDS child fatalities that were determined to be the result of abuse or neglect by a medical examiner that were not already known to CPS.
  • Alabama, Nebraska, and North Dakota add cases from child fatality review teams that were not already in their databases to their NCANDS reports.
  • South Carolina incorporates into its NCANDS submission additional cases received from the State Law Enforcement Division (SLED), which receives reports of all child deaths that were not the result of natural causes. SLED investigates all “preventable” cases and refers its findings to the Department of Social Services.

Since most states’ child welfare agencies report only fatalities substantiated as maltreatment by CPS to NCANDS, the number that are reported will depend in part on the state’s definition of a child maltreatment fatality. NCANDS defines a child maltreatment death as “the death of a child as a result of abuse or neglect, because either: (a) an injury resulting from the abuse or neglect was the cause of death; or (b) abuse and/or neglect were contributing factors to the cause of death.”4 But not all states use this definition. At least one state, Arizona, includes only fatalities where abuse or neglect was the sole cause of death, as described in more detail below. (Iowa indicated that it did not include fatalities where child maltreatment was only a contributing factor until FFY2015 and there may be other states that do the same.)

A state’s maltreatment fatality numbers will also depend on its tendency to accept child fatality referrals for investigation and to substantiate them. Hotline screening methods and tools differ by state, and states report little about their screening practices around child maltreatment fatalities. Ohio, which has a county-run system, reports that some county agencies will not investigate child fatality reports if there are no other children in the home or the other children are not deemed to be at risk of maltreatment. The likelihood of substantiation of a report once accepted for investigation will depend on a state’s standard of proof and other investigation policies, messages transmitted by agency leadership, and staffing issues.  My commentary about CM 2022 shows how much screening and substantiation rates for maltreatment reports differ by state, and there is no reason to think that fatality reports would be any different from other maltreatment reports. Variations in these rates, as well as the sources states draw from and the definitions they use, ensure that states’ child maltreatment fatality counts reflect much more than the actual number of maltreatment fatalities according to a given definition.

It is instructive to compare states’ maltreatment fatality rates displayed in CM2022 with their rankings on an index of child well-being such as the one used in the Annie E. Casey Foundation’s latest Kids Count Data Book. The 12 states with the highest rates of reported child maltreatment fatalities in CM2022 are Mississippi, South Dakota, Arkansas, Maryland, Alaska, Ohio, Missouri, New Mexico, North Carolina, Illinois, Indiana and South Carolina. Only four of these states are among the 12 states with the lowest rankings for overall child well-being, according to Kids Count. The 12 states with the lowest rankings on child maltreatment fatalities in CM2022 are Vermont, Montana, Nebraska, New Hampshire, Arizona, New Jersey, Rhode Island, Kansas, Kentucky, Utah, Maine, Utah and Hawaii.  Five of these states are also among the 12 states with the best child well-being outcomes, and another seven are not. Clearly a state’s rank on child well-being is not an accurate predictor of its rank in reported child maltreatment fatalities. This suggests that the fatality data may reflect more than actual child maltreatment deaths that meet the state’s definition. Particularly striking are the two states—Arizona and Kentucky—that are among those with the lowest reported child maltreatment rates and worst child outcomes. But it is worth noting that there are no states with top-tier child well-being outcomes that have bottom-tier reported child maltreatment fatality rates. Therefore, this exercise suggests that the state fatality rates may reflect in part the “true” incidence of maltreatment fatalities as defined by the states and in part how maltreatment fatalities are identified.

Arizona is one of the states with the lowest reported maltreatment fatality rates despite its low child well-being ranking. Serendipitously, it turns out that Arizona has another estimate of child maltreatment fatalities, thanks to its exceptional Child Maltreatment Fatality Team (CFRT), which is housed in the state’s health department. Arizona’s CFRT analyzes every child death, classifies it by cause and manner, and determines whether the death was caused by abuse or neglect. All child death certificates issued in the state are reviewed, first by the local team in the area where the child lived, and then by the statewide team. For Calendar Year 2022, the team calculated that there were 146 neglect or abuse deaths, or 17 percent of all child fatalities that year. Yet, the Arizona Department of Child Safety (DCS) reported only 14 fatalities to NCANDS for FFY 2022, resulting in its low reported maltreatment fatality rate of 0.88 per 100,000 children.

In its current Child and Family Services Plan, DCS reported that it receives information on all unreported child fatalities from local CFRT’s. But the agency explained that CFRT identifies many more fatalities than it does because CFRT includes deaths where maltreatment was believed to have “contributed” to the death rather than “caused it,” a distinction discussed above, But, as we have seen, the NCANDS Codebook defines a maltreatment death to include cases where abuse and/or neglect were contributing factors to the cause of death.” By not reporting such deaths, DCFS is failing to report all maltreatment fatalities as defined by NCANDS.5 

Arizona’s CFRT clearly has an expansive definition of maltreatment fatalities and probably errs on the side of finding maltreatment. Forty-four of the 146 maltreatment deaths it found (30 percent) were due to suffocation—apparently mainly unsafe sleep deaths. Another 15 (10 percent) were due to drowning. Most of these suffocation and drowning deaths were likely accidental. And as the quote at the top of this post indicates, one jurisdiction (or agency within a jurisdiction) may classify such a death as neglect and another may not.  Another ten percent of the CFRT-identified maltreatment deaths were due to prematurity caused by the mother’s substance abuse or other factors. Fifteen states (including Arizona) and the District of Columbia defined prenatal exposure to harm due to the mother’s abuse of an illegal drug or other substance as neglect as of May 2022. But DCS may not in practice investigate or substantiate such cases.6

The comparison with CFRT provides some insight on why Arizona reports such a low rate of maltreatment fatalities. Leaving out fatalities where maltreatment was a contributing factor and being less likely to find that accidents or premature births involve maltreatment, may help explain the difference between the two estimates. It is also worth noting that Arizona reported a steep drop in maltreatment fatalities from 48 in FFY 2018 to 33 in FFY2019 to 18 in FFY 2020 (followed by no fatalities reported in FFY2021 and 14 in FFY2022). Arizona provided no explanation for these reductions in its commentaries for FFY’s 2019, 2020, and 2022 and did not provide commentary for FFY2021. One cannot help but wonder whether DCS changed its methods or criteria or simply stopped investigating some allegations of child maltreatment fatalities.

In its publication mentioned above, the National Center for Child Fatality Review and Prevention notes that child death review (CDR) teams often identify more maltreatment deaths than states report to NCANDS. Among the reasons are the records from multiple disciplines and agencies are shared, additional information comes to light in the review process, CDR leads to improved investigations, and teams often use broader definitions for maltreatment, as we have seen for Arizona. CDR teams in most states do not review all child fatalities for a given year or identify those that were due to maltreatment, as Arizona does. But a review of the most recent state CDR reports in all states that published statewide reports yielded eight state CDR teams (including Arizona’s) that do such an analysis.  Table 1 shows the differences between the number of maltreatment fatalities identified and reported to NCANDS by child welfare agencies and the number identified by the CDR teams in these eight states in their most recent reports. All the CDR estimates are higher than the NCANDS reports, ranging from 50 percent higher in North Dakota to almost ten times as high in Arizona.

Table 1: Number of Child Maltreatment Fatalities Reported by NCANDS and by CDR
StateNCANDSCDRYear
Arizona141462022
Colorado24432020
Georgia921452021
Indiana62100-1282020
Missouri571982022
Nevada20802019
North Dakota692019
Tennessee43752019

Notes: The number of fatalities reported by the Georgia Child Fatality Review Panel was calculated by multiplying 500 (the number of deaths reviewed) by 28.9 percent, the proportion of reviewed deaths that the panel reported as having “maltreatment identified as causing or contributing to the death or had a reported history of maltreatment.” It was not possible to remove only those children with maltreatment history without losing some of the children who also had maltreatment causing or contributing to the deaths. The Indiana Child Fatality Review Committee did not provide a count of children for whom maltreatment contributed to their death but instead provided separate numbers for exposure to hazards, neglect, abuse, and poor or absent supervision. It was not possible to add these categories as some children may have experienced more than one of these maltreatment types. The committee did report that “poor supervision/exposure to hazards” contributed to the death of 100 children, which means that 100 is a lower-bound estimate of the number of children who died of abuse or neglect according to the committee. It reported that abuse contributed to the deaths of 13 children and neglect to the deaths of 15 children, so the upper-bound estimate is 128.
Table Sources: Arizona Child Fatality Review Team, Thirtieth Annual Report; Colorado Child Fatality Prevention System Data Dashboard; Georgia Child Fatality Review Panel Annual Report; Indiana Statewide Child Fatality Review Committee: 2020 Report on Child Deaths, Preventing Child Deaths in Missouri: The Missouri Child Fatality Review Program Annual Report for 2022; 2019 State of Nevada
Child Death Report, North Dakota Child Fatality Review Panel: Detailed Annual
Report 2017, 2018, & 2019; 2021 Child Fatality Annual Report: Understanding and Preventing Child Deaths in Tennessee.

In contrast to Arizona, Mississippi’s position in the ranking of child maltreatment fatalities is not a surprise. Being 48th in child well-being, the state also has the highest child maltreatment fatality rate—by far—at 10.62 per 100,000 children. But there is an anomaly. Mississippi’s maltreatment fatality rate is almost twice that of the state with the next highest rate. And it almost doubled between 2020 and 2022. Even assuming that Mississippi’s “real” maltreatment fatality rate is closer to the 5.48 per 100,000 it reported in FFY2020 still puts it second from the top of all states. It seems unlikely that Mississippi’s child maltreatment deaths doubled in two years; it is more plausible that something about the way the deaths were defined, identified, or reported changed.

This discussion has illustrated the impossibility of knowing the extent to which state maltreatment fatality numbers reflect real differences in child maltreatment fatalities versus differences in definition or measurement. But if states were consistent over time in their definitions and measures, the difference in fatality numbers over time could still be meaningful. Whether that is the case is discussed below.

Have child fatalities increased?

As mentioned above, CM2022 provides a national estimate of 1,990 children who died of abuse or neglect in FFY 2022 at a rate of 2.73 per 100,000 children in the population. Exhibit 4A from CM2022 shows an increase in reported child maltreatment every year between FFY2018 and FFY2022.7

Source: Child Maltreatment 2022, https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2022.pdf

There are many reasons to be cautious about year-to-year comparisons of child fatalities. Those deaths reported in the 2022 report did not mainly occur in 2022. As CM2022 puts it, the “child fatality count in this report reflects the federal fiscal year (FFY) in which the deaths are determined as due to maltreatment,” rather than the year of death.8 It may take more than a year to find out about a fatality, gather the evidence (such as autopsy results and police investigations) to determine whether it was due to maltreatment, and then make the determination. States explain in their commentaries that the deaths they reported may have occurred as long as seven years before 2022. Because child fatalities are rare, a year-to-year increase, even in a larger state, may reflect a large fatality event that occurred in one year or a delay in determining several fatalities. For example, Illinois reported that an increase from 70 fatalities in FFY2018 to 106 in FFY 2019 resulted from the delayed completion of 15 death investigations and an incident that claimed the lives of ten children.

However, not all states report fatalities in the way described by CM2022. California, as it describes in its annual commentaries, reports for each federal fiscal year the deaths that occurred in the prior calendar year and were known to the state by December of the calendar year following the death. Because counties will continue to investigate fatalities that occurred in previous years, the state submits revised counts if additional fatalities from that calendar year are later determined to be caused by abuse or neglect. For example, California originally reported 135 fatalities in FFY2021, but that number had increased to 159 by FFY2022. Second-year changes were not as large for fatalities first reported in FFY2020 and FFY2021.

Knowing that at least one state changes its fatality data in the next year’s submission raises an intriguing question.  Even accepting that each state’s fatality count has its own meaning, can we even rely on Exhibit 4A in any given year to at least illustrate the trend in reported fatalities? It does not take long to answer that question. Exhibit 4A of CM2021 does not show maltreatment fatality rates increasing each year between FFY2018 and FFY2022, as does the same table in FFY2022. Instead, it shows a decrease in FFY2020 followed by an increase in FFY2021 to just slightly below the level of FFY2019.

Source: Child Maltreatment, 2021, https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2021.pdf

Since each CM report shows five years of data, each year’s figures will eventually be shown in five different reports, starting as the most recent year displayed and ending as the earliest year. Table 2 shows the numbers of fatalities reported for FFY 2018 to FFY2022 in the CM report for each year. The figures for FFY2018 and FFY2019 changed two or three times in the succeeding years, but never by more than 10 deaths. Oddly, the number of deaths reported sometimes decreased from year to year. But the original numbers for FFY2020 and FFY2021 increased considerably in succeeding years. The total number of deaths reported for FFY2020 increased from 1,750 in that year to 1770 in FFY2021 and 1,850 in FFY2022. The total for FFY2021 increased from 1820 in that year to 1930 in FFY2022. Clearly, the 24 fatalities that California added in FFY2022 for the previous year are part of that increase, and presumably one or more other states did the same.  Inserting the new numbers into the table from CM 2021 now shows an increase every year between FFY2018 and FFY2021.

Table 2: Deaths Reported by Year Reported
Deaths in:Reported In:
 20182019202020212022
201817701780177017651765
2019 1840183018251825
2020  175017701850
2021   18201930
2022    1990
Source: Author’s compilation from Children’s Bureau child maltreatment reports. US Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, “Child Maltreatment,” June 27, 2023, https://www.acf.hhs.gov/cb/data-research/
child-maltreatment.

A plot of the number of child fatalities reported between FFY2013 and FFY2022, using the most recent versions of each number, is shown below as Figure 1. Assuming the numbers for years before FFY2021 will change little if at all, we can see that reported child maltreatment fatalities have increased annually since FFY2013, aside from a slight decrease in FFY2017. And if the numbers from FFY2021 and FFY2022 will increase, as seems likely, the rise in fatalities in FFY2021 and FFY2022 will get steeper.

Source: Source: Author’s calculations using US Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, “Child
Maltreatment,” June 27, 2023, https://www.acf.hhs.gov/cb/data-research/child-maltreatment

The critical question is whether this increase in reported child maltreatment fatalities reflects increasing maltreatment deaths, better measurement, or even changing definitions. Some states attribute increases in reported fatalities to improvements in the accuracy of their reporting.9

  • Through 2018,  North Carolina reported only child fatalities determined by the Chief Medical Examiner as homicide by a parent or caregiver. According to a Senior Media Relations Manager at the North Carolina Department of Health and Human Services, “Since 2018, Child Welfare has: developed closer working relationships with counterparts at OCME, utilized vital statistics data, and enhanced processes to include more law enforcement information. This work has increased our ability to identify maltreatment deaths, as defined in statute…[W]e have also continued to enhance our ability to track the information – resulting in more robust reporting and accounts for the change in numbers.” The Children’s Bureau noted in CM2022 that North Carolina “resubmitted data from multiple prior years to include additional fatalities.”  North Carolina’s reported child fatalities increased from 64 in FFY2018 to 111 in FFY2019, 99 in FFY 2020, 121 in FFY2021, and 93 in FFY2022.10
  • Mississippi reported that the creation of a special investigation unit for child fatalities in FFY 2014 resulted in an increase in reported child maltreatment fatalities in FFY2013, FFY2014, and FFY2015.  The state also reported that public awareness campaigns about deaths caused by unsafe sleep and deaths from heat stroke of children left in hot cars led to more reporting of such deaths as possible maltreatment starting in 2014.
  • West Virginia reported 20 fatalities in FFY 2016 compared to 9 in FFY2015 and attributed the increase to the fact that the state had begun investigating child fatalities in cases where there were no other children in the home.
  • Virginia attributed its increase from 37 maltreatment fatalities in FFY2014 to 54 in FFY 2015 to a change in the law regarding the timing of investigations. The time spent waiting to obtain documents from outside agencies, like autopsies, would no longer count toward the 45-day deadline for completing an investigation. (It is not clear whether child death investigations previously were terminated before these documents arrived, and therefore the deaths were not reported.)
  • Ohio reported in FFY2022 that it required mandated reporters participating on child fatality review boards to report suspected maltreatment fatalities to the local child welfare agency. Reported child maltreatment fatalities increased from 98 in FFY2021 to 115 in FFY 2022. But the state also attributed the fatality increase to the fact that the overall death rate from violence had been on the rise for the past several years, showing the difficulty of disentangling causes for any increase in maltreatment fatalities.
  • Iowa began reporting child fatalities where maltreatment was a contributing factor rather than the sole cause of the fatality in FFY 2015. Reported fatalities increased from 8 to 12 but those are small numbers, and Iowa attributes the increase to the growing under-18 population.

The increase in reported maltreatment fatalities clearly reflects at least in part improved reporting, as documented by some states. But it may also reflect an underlying increase in actual maltreatment fatalities as defined by the states. Such an increase could be due to several factors. Washington’s commentary in the FFY2022 report suggests that the opioid crisis has contributed to its increase in fatalities from 19 in FFY 2021 to 31 in FFY 2022.11 West Virginia also reported an increase in illegal drug use in its commentary to CM2016, probably referring to opioid abuse as well.12  Ohio mentioned increasing violence in recent years as a possible reason for the increase in reported child maltreatment fatalities.

Demographics, type of maltreatment, and perpetrators

We have already discussed the reasons that the child maltreatment fatality numbers may not be accurate, even given different definitions in different states. These problems affect our ability to draw conclusions about demographics and child maltreatment fatalities. If some of the definition and measurement issues affect different groups differently, it is possible that findings on demographics would be less meaningful.

The data presented in CM2022 shows that Infants under a year old are more than three times more likely to die of maltreatment than one-year-olds, and the fatality rate generally decreases with age. Younger children are more fragile, and there are many reasons to believe that the relationship between age and maltreatment fatality rates is correct, despite problems with the data. The age graph has a similar shape every year, with the percentage of child fatalities dropping as age increases.13  The percentage of victims who are under one year old varied between 22.8 percent and 25.3 percent between FFY2018 and FFY2022. There are bigger differences by year in the older age groups, where smaller numbers make the data less reliable.

Boys were between 57 percent and 60 percent of the fatalities in every year between FFY2018 and FFY2022. In contrast, victims of child maltreatment in general, are slightly more likely to be girls.  It is hard to imagine a reason why data problems would affect boys and girls differently, so it is likely that boys are more likely than girls to die from maltreatment.

Reported child maltreatment fatality rates varied greatly by race and ethnicity, and the differences among the larger groups were fairly stable over the five years since FFY2018. Black children had by far the highest maltreatment fatality rate of all the groups for whom information was available. The fatality maltreatment rate for Black children ranged from 5.06 to 6.37 per 100,000 children over the five-year period. Reported maltreatment fatality rates ranged from 3.27 to 4.40 for children of two or more races. White children reportedly died from maltreatment at a rate between 1.90 and 2.18 per 100,000 children, Hispanic children at a rate from 1.44 to 1.89. (The numbers of Native American, Native Hawaiian, and Asian children were too small to be reliable). The reported maltreatment fatality rate for Black children was two to three times as high as the rate for White children, which was always somewhat higher than the rate for Hispanic children. The rates from CM2022 are shown in Exhibit 4-D, reproduced below.

Source: Child Maltreatment, 2022, https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2022.pdf

The question of bias must be addressed in evaluating racial and ethnic differences in reported child fatality rates. We have seen that fatality numbers reported by states generally reflect the results of a CPS investigation or a determination by a coroner, medical examiner, or fatality review team. It is possible that racial bias could play a role in whether a fatality is substantiated as due to maltreatment. But Drake et al. found that indicators of risk and harm for Black children were usually between two and three times greater than those for White children in 2019, while the Black-White homicide disparity was four times as great as that for White children.14  While we cannot rule out any role for bias, it is unlikely to be the main cause of the Black-White disparities in child maltreatment fatalities. As Drake et al suggest, they are more likely to stem from the legacy of slavery, Jim Crow, and segregation, which includes intergenerational poverty and the relegation of poor Black families to disadvantaged and often dangerous neighborhoods.

For each fatality, NCANDS collects the types of maltreatment that were substantiated. The authors note that “while these maltreatment types likely contributed to the cause of death, NCANDS does not have a field for collecting the official cause of death.” One child can be found to have suffered more than one type of maltreatment. Over three quarters (76.4 percent) of the children who died were found to have suffered from “neglect” (defined as “neglect or deprivation of necessities” in the Codebook), 42.1 percent were found to have endured physical abuse, 8.3 percent were found to have suffered from medical neglect, and 2.4 percent from sexual abuse.

Most of the perpetrators of reported child maltreatment fatalities were parents, according to NCANDS data submitted by 43 states.  A total of 81.8 percent of the maltreatment fatalities involved “one or more parents acting alone, together, or with other individuals. That includes mothers alone in 13.2 percent of the death, fathers alone in 14.5 percent, “two parents of known sex” in 23.2 percent of the fatalities, and mothers with nonparents (such as boyfriends) in 10.3 percent of the cases. Another 13.2 percent of the fatalities involved nonparents only, including relatives (4.7 percent), “child daycare providers” (1.3 percent), unmarried partners of the parent (1.1 percent), and “other” (3.4 percent). A final 4.9 percent of the fatalities involved unknown perpetrators only. (See Table 4-4 of CM 2022 for all the categories, numbers and percentages).

CM 2022 was originally published on the Children’s Bureau website early in January 2024 without a press release; it then disappeared from the website for about three weeks. It is hard to avoid speculating about the reasons for its removal and the gap before it was finally replaced. One might wonder if officials were trying to figure out how to spin the five years of increase in reported fatalities. Strangely, the press release, when it did come out, reported the increase in child maltreatment fatalities without raising the possibility that changes in how fatalities were defined and measured could have contributed to this increase, which might have supported their optimistic narrative.

In summary, this analysis shows how difficult it is to make any conclusions based on the child maltreatment fatality data contained in the Children’s Bureau’s annual Child Maltreatment reports. Single-year numbers cannot be fairly compared between states because they reflect different ways of defining child maltreatment fatalities, learning of fatalities that may involve maltreatment, and determining whether maltreatment was a contributing factor. Trends over time are difficult to assess because states often change these definitions and practices, and because new data from previous years may be entered after each year’s report is published. There is evidence that improved reporting has contributed significantly to the increase in reported fatalities. But until the federal government imposes a uniform set of standards for counting child abuse and neglect fatalities as recommended by the Committee to Eliminate Child Abuse and Neglect Fatalities, it will be impossible to get a handle on actual levels and trends.

Notes

  1. This estimate is based on the reports of 51 jurisdictions including the District of Columbia, Puerto Rico, and all states but Massachusetts. The maltreatment fatality rate for the reporting jurisdictions was multiplied by the population of all 50 states, the District of Columbia, and Puerto Rico, to obtain the estimate of 1,990.
  2. US Government Accounting Office (2011). Child Maltreatment: Strengthening National Data on Child Fatalities Could Aid in Prevention. Washington, DC; Schnitzer P, Covington T, Wirtz J, Verhoek-Oftedahl W, Palusci V. (2007). Public Health Surveillance of Fatal Child Maltreatment: Analysis of 3 State Programs. American Journal of Public Health. 97:7; Herman-Giddens ME, Brown G, Verbiest S, et al. (199() Underascertainment of child abuse mortality in the United States. JAMA. 282:463–467; Crume TL, DiGuiseppi C, Byers T, Sirotnak AP, Garrett CJ. (2002). Underascertainment of child maltreatment fatalities by death certificates, 1990–1998. Pediatrics. 110(2 pt 1):18.
  3. In contrast to those states that augment their own data with that of other agencies, Alaska delegates the entire process of determining whether a fatality involves maltreatment to medical examiners or coroners.
  4. CAPTA defines maltreatment in part as “an act or failure to act on the part of a parent or caretaker,” but it does not define “caretaker.” There may be some differences among states on who they define as a caretaker, but these are unlikely to affect many cases and cause big differences between states.
  5. DCS also says that CFRT’s fatality count is higher because it counts fatalities caused by a person other than the parent, caregiver, or custodian (which would not normally be counted). Based on CFRT’s tabulations regarding caregivers, this does not seem to be a large issue.  DCS also state that the CFRT counts deaths that occur outside the state’s jurisdiction, such as on an Indian reservations. It is true that CFRT includes any death that occurs in Arizona, even if the child is not a state resident. However out-of-state residents were only three percent of the total number of fatalities in 2022, according to its most recent report, Ten percent of the children who died of all causes were American Indians but they do not report on how many lived on reservations.
  6. The remaining deaths that CFRT identified were due to motor vehicle and other transport (14), poisoning (13), other medical causes (12), blunt force injury (10), undetermined (9) causes, firearm injury (8), and other injury (6). Many of these deaths could also be due to accidents that DCS was reluctant to investigate or find neglectful.
  7. Exhibit 4A counts the District of Columbia and Puerto Rico as states, resulting in up to 52 “reporting states” per year.
  8. Child Maltreatment 2022, p.  52.
  9. Other states report improvements in their data collection, but their data do not suggest that they had a long-term beyond one year on fatality numbers. In FFY 2020, New York reported that it began reporting all fatalities, regardless of date of death, as long as the investigation ended during the reporting period and the fatality had not been reported during a prior year. Before that time, New York reported only those deaths that occurred and were reported in the applicable FFY. New York attributed the increase in the number of fatalities from 69 in FFY 2019 to 105 in FFY 2020 to this change. Perhaps the increase came from reporting an extra “batch” of fatalities in FFY2020. However, the state had reported 118 fatalities in 2018. And it then reported 126 in FFY2021 and 105 in FFY2022, so it is hard to understand how the change resulted in an increase in fatalities reported, except as compared to a year with abnormally few of them. When fatalities rose sharply in Mississippi from 49  in FFY2021 to 72 in FFY2022; the state again used the creation of the special unit in FFY 2014 to explain the increase, but that seems unlikely. I have asked West Virginia to speculate about reasons for the increase but have not yet heard from the state. In FYF2019 or perhaps FFY2018 (when the state did not submit commentary), South Carolina created a special unit to receive and investigate reports of child fatalities. The number of fatalities reported jumped from 39 in FFY2018 to 60 in FFY2019. But it then fell to 36 in FFY 2020, 41 in FFY2021, and 38 in FFY2022. So it is does not appear that the creation of the special unit had a long term effect on maltreatment fatality counts.
  10. North Carolina provided revised numbers for FFY2018 and FFY2019 to NCANDS and provided them to me through their press office
  11. Washington reports that between FFY 2021 and FFY 2022 the percentage of child fatalities in the state that were due to opioid ingestion or overdose rose from less than one percent to 23 percent of child fatalities. Of the deaths and near-fatalities that qualified for a review because they occurred in families touched by the system in the previous year, that percentage jumped from 28 to 44 percent. 
  12. In its Commentary, West Virginia stated that only one of the 13 fatalities reviewed by its critical incident team did not involve substance abuse as a factor either in the death or the family’s history.
  13. However, it must be reported Exhibit 4-B, Child Fatalities by Age, appears to be inaccurate. It looks very different from every other year, with much higher rates for older children. There is no way that the fatality rate per 100,000 17 year olds would increase from 0.42 to 3.3, from 0.57 to 5.0, for example. It looks almost, but not exactly, like Exhibit 3-D, which shows child maltreatment victims (not deaths) by age. The Children’s Bureau referred my inquiry of March 21 to the “appropriate team,” which has not yet responded.
  14. Brett Drake et al., “Racial/Ethnic Differences in Child Protective Services Reporting, Substantiation, and Placement, With Comparison to Non-CPS Risks and Outcomes: 2005-2019. Child Maltreatment 2023, Vol 0(0) 1-17.

Neglect as poverty: the myth that won’t go away

Image: consumerhealthday.com

It’s one of those myths that won’t go away and instead is gathering steam–the idea that parents who are found to be neglectful by child welfare agencies are really just poor people being judged for their inability to provide sufficient material support to their children. It doesn’t matter how much evidence is cited against it. The myth continues because it is an essential part of the narrative that is currently dominant in the child welfare arena. Nevertheless it’s been over a year since my last attempt to shed some light on this issue, and some new research has become available, thus it seems a good time to revisit the topic.

It’s Time to Stop Confusing Poverty With Neglect, exhorted Jerry Milner, Children’s Bureau Commissioner and his special assistant David Kelly back in January, 2020, in a typical statement of this myth. “Most of the reasons for child welfare involvement fall into what we call “neglect” rather than physical abuse or exploitation. Our most recent child maltreatment data tell us that 60 percent of victims have a finding of neglect only…More times than not, poverty and struggles to meet the basic, concrete needs of a family are a part of the equation in all types of neglect.” Miller and Kelly now sell their expertise at Family Integrity & Justice Works, an arm of the Public Knowledge consulting firm which has the goal of “replacing child welfare.”

Media outlets have taken this story and run with it. Here is the Philadelphia Inquirer: “A common misunderstanding is that the leading reason kids are taken into the foster care system is because of physical or sexual abuse. But that accounts for only one of six cases. Children far more often are removed from their homes for ‘neglect,’ which often amounts to symptoms of poverty, like food insecurity or unstable housing.”

The Biden Administration has endorsed the idea that most neglect findings reflect nothing but poverty. The Administration on Children and Families (ACF) has solicited applications for a grant of between one and two million dollars “to support the development and national dissemination of best practices to strengthen the capacity of child abuse hotline staff to distinguish between poverty and willful neglect.”

There is no federal definition of child neglect, and state definitions vary. In contrast to abuse, it is usually defined as an act of omission rather than comission. According to the Child Welfare Information Gateway, neglect is “commonly defined in state law as the failure of a parent or other person with responsibility for the child to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety and well-being are threatened with harm.” The most commonly recognized categories of neglect include physical neglect or failure to provide for basic physical needs, failure to provide adequate supervision , educational neglect or failure to educate the child as required by law, and medical neglect.

There is no dispute that more children are found to be neglected than abused. Based on data collected by the federal government and published in Child Maltreatment 2020, three-quarters (76.1 percent) of the children found to be victims of maltreatment in 2020 were found to be neglected. A total of 16.5 percent were found to be physically abused, 9.4 percent were found to be sexually abused, and six percent were found to be victims of some other type of maltreatment.* Of the children who were removed and placed in foster care, according to the 2020 AFCARS Report, 63 percent had neglect listed as a circumstance associated with the child’s removal, compared to 12 percent with physical abuse and four percent with sexual abuse.

But the idea that neglect findings represent nothing but poverty is questionable. First, the neglect deniers would probably agree that most poor parents do not neglect their children but instead find a way to meet their needs, relying on charity, extra work, or subordinating their own wants to the needs of their children. When poor children are deprived of food, clothing or adequate housing, other factors such as substance abuse, mental illness and domestic violence are often involved. Second, more than half of the states exempt from the definition of neglect any deprivation that is due to the lack of financial means of the parents. Third, the definition of neglect is not confined to the failure to provide adequate food, clothing or shelter but instead includes other acts of omission, such as failure to protect a child from dangerous caregivers, or failure to ensure that children go to school and get needed medical care. Lack of supervision, a common form of neglect, can reflect poverty when parents feel they must rely on inadequate arrangements in order to go to work; we just don’t know the degree to which neglect findings reflect such decisions by parents.

But until now we did not have quantitative data concerning the types of neglect being investigated or the importance of risk factors like substance abuse and mental illness. A recent study from California, the nation’s most populous state, begins to fill this data gap. Palmer and colleagues used a representative sample of 295 neglect investigations that took place in California in 2017. They found that only 14 percent of the investigations involved physical neglect–the deprivation of food, clothing, and housing that is most closely connected with poverty. The most common types of neglect that were investigated were inadequate supervision, investigated in 44 percent of the cases, and failure to protect (leaving the child in the care of a known abuser or failure to intervene with known abuse), in 29 percent of cases. Moreover almost all (99 percent) of the investigations of physical neglect included concerns related to substance use, domestic violence, or mental illness; or they involved another type of maltreatment such as physical or sexual abuse or an additional neglect allegation. Thus, the authors conclude that almost no parent was investigated for material deprivation alone, although it is true that they did not separate out any lack of supervision cases that involved the inability to obtain adequate childcare for work or other necessary activities.

The evidence from California is very suggestive, but as the authors caution, it is possible that other states receive more reports that focus on unmet material needs, are less likely to screen out such reports, or emphasize them more during the investigation. This is possible because California, according to a recent study of state neglect definitions, is one of five states that have adopted an “expanded” definition of child neglect, including more neglect types and allowing for the threat of harm, rather than actual harm, in neglect findings. Studies similar to the Palmer study from other states with more limited neglect definitions would be useful.

While the California study is not sufficient to negate the presumption that findings of neglect represent nothing more than poverty, it is important to note that there are no studies supporting this viewpoint. So why does the myth that child welfare treats poverty as neglect persist despite the lack of evidence supporting it, and the many reasons for skepticism? It persists because it supports the narrative and associated policy prescriptions of the child welfare establishment today–child welfare leaders, administrators, legislatures, and influential funders like Casey Family Programs. The dominant narrative describes a racist family policing system that persecutes people only because they are Black, Indigenous or poor. The policy prescriptions involve radically shrinking or even abolishing child welfare systems.

According to the prevailing view, if omissions that are labeled neglect are strictly due to poverty, there is no need to intervene with social services or child removal. Instead, governments should provide economic benefits to neglectful parents. There is a body of research suggesting that economic support for families does help reduce maltreatment, perhaps not only by helping parents meet their children’s financial needs, but also enabling them to provide better childcare and improving parents’ mental health through stress reduction. Independent of their impact on maltreatment, I strongly support increases in the safety net for families and children. But available information suggests that it will take more than financial assistance to cure neglect in most cases. Improved economic supports will not be a replacement for services to help parents address challenges with substance abuse, domestic violence, mental health, and parenting, and for child removal when there is no other option.

What can be done to alleviate the confusion and misinformation around child neglect and poverty? Collecting better data from the states would be helpful. In its annual Child Maltreatment reports, the Children’s Bureau uses data from the National Child Abuse and Neglect Data System (NCANDS). When reporting on the type of maltreatment alleged and then found, states must pick up to four out of eight categories, including physical abuse, “neglect or deprivation of necessities,” medical neglect, sexual abuse, psychological or emotional maltreatment, sex trafficking, no alleged maltreatment, other or “unknown or missing.” It is not clear whether the “neglect” category is supposed to indicate all types of neglect or just those involving “deprivation of necessities,” but there is no way for states to clarify what they mean or to distinguish between the most common types of neglect. The same problem exists with the AFCARS data used to compile federal reports on foster care and adoption.

Clearly, a reform of the data elements that states are required to submit is needed so that resesarchers can see the types of neglect that are being alleged and found for each child. However, such an improvement would not substitute for careful research like the California study cited above because it will never be possible to rely on the thoroughness of database entries by overworked social workers. We cannot be sure they will enter all of the applicable categories, for many reasons, including that not all the applicable categories may be substantiated for a particular case. Moreover, while states are required to report on some caregiver risk factors contributing to abuse and neglect, such as alcohol and drug abuse, emotional disturbance and domestic violence, these seem to be vastly understated by the social workers who enter these factors in state databases. For example, only 26.4 percent of caregivers of maltreated children were found to have the risk factor of drug abuse and only 36 percent of removals involved parental drug abuse, according to federal data. Yet anecdotal reports from states and localities tend to indicate a much higher percentage of cases that involve substance abuse.

Thus, a reform of data collection might help, but would not solve the problem, especially considering that that many child welfare leaders and funders seem inclined to maintain the hypothesis that CPS confuses poverty with neglect. Ideally, the federal government and other funders would support more studies like that of Palmer et al, and more academics would consider performing such studies.

The myth that CPS confuses neglect with poverty is pernicious because, like other myths currently prevalent in child welfare, it runs the risk of hurting abused and neglected children. It is being used to justify dismantling child protective services, eliminating mandatory reporting, or more modest proposals to hamper these critical protections for children. The federal government should improve data collection on child neglect and associated risk factors as well as supporting additional research to provide more accurate estimates of their prevalance.

*According to the report’s authors, “other” could be anything that does not fit into the categories offered by the Child Abuse and Neglect Reporting System and includes threatened abuse and neglect, drug addiction, and lack of supervision according to state comments submitted with the data.

Declining child abuse? The misuse of data in child welfare

Lowest number of maltreatment victims in five years, crowed the Administration on Children and Families (ACF), summarizing its annual report, Child Maltreatment 2019. Child welfare newsletter The Imprint eagerly repeated the claim, claiming that the Number of Child Abuse and Neglect Victims Reached Record Low in 2019. The venerable Child Welfare League of America followed suit in its Children’s Monitor saying “Data Shows Decline in Child Abuse in FY2019.” It is only by reading the report that one learns that the decline was not actually in the number of victims of abuse or neglect. Instead, it was a decline in the number of children who were found by Child Protective Services (CPS) to be abused or neglected, which is not the same thing at all.

Child Maltreatment, the Children’s Bureau’s annual report on child abuse and neglect, is based on data from the states, the District of Columbia, and Puerto Rico collected through the National Child Abuse and Neglect Data System (NCANDS). Child Maltreatment 2019 is based on data from Federal Fiscal Year (FFY) 2019, which ended September 30, 2019. (Note that these data reflect the year before the inception of the coronavirus pandemic.) Displayed below is a summary of four key national rates reported by ACF between 2015 and 2019. The first indicator shown is the referral rate, which describes the number of calls and other communications describing instance of child maltreatment per 1,000 children. Next is the screened-in referrals rate, which includes referrals that are passed on for investigation or alternative response. Once screened in, only some reports are referred for investigation, and the third set of bars represents children who received an investigation per 1,000 children. The fourth group shows the rate of children found to be abused or neglected–or those who received a substantiation. Let us go over these numbers in more detail.

*Note that Investigation and Substantiation Rates are based on number of children, not referrals
Source: Child Welfare Monitor tabulation of data from Child Maltreatment 2019, available from
https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2019.pdf

Total referrals: A referral is a call to the hotline or another communication alleging abuse or neglect. In 2019, agencies received an estimated total of 4.4 million referrals, including about 7.9 million children. The “referral rate” was 59.5 referrals per 1,000 children in FFY 2019. This rate has increased every year since 2015, when it was 52.3 per 1,000 children. It is worth noting that the referral rate differs greatly by state, ranging from 17.1 referrals per 1,000 children in Hawaii to 171.6 per 1,000 children in Vermont, as shown in the report’s state-by-state tables. These differences in referral rates may stem from cultural differences regarding the duty to intervene in other families, differences in publicity for child abuse hotlines and ease of reporting, or temporal factors like a recent highly-publicized recent child abuse death.

Screened-in referrals (reports): A referral can be either “screened in” or screened out because it does not meet agency criteria. In FFY 2019, agencies screened in 2.4 million referrals, or 32.2 referrals per 100,000 children. This was a decrease in the rate of screened-in referrals per 1,000 children after three straight years of increases. This percentage of referrals that were screened in varied greatly by state, ranging from 16 percent in South Dakota to 98.4 percent in Alabama. States reporting a decrease in screened-in referrals gave several reasons, such as a change in how they combine multiple reports and a decision to stop automatically screening in any referral for a child younger than three years old.

Children who received an investigation (child investigation rate): Once a report is screened in, it can receive a traditional investigation or it can be assigned to an alternative track, which is often called “alternative response” or “family assessment response.” (Two-track systems are often labeled as “differential response.”) This rate represents the number of children who received an investigation as opposed to an alternative response. Only an investigation can result in a finding of abuse or neglect; an alternative response generally results in an offer of services. Like the referral rate, the investigation rate increased from 2015 to 2018 and then decreased in 2019. This rate also varies widely between states and over time. Some states eliminated or expanded their differential response programs in 2019, resulting in more or fewer investigations, as described in the report.

Substantiation: A “victim” is defined in NCANDS as a “child for whom the state determined at least one maltreatment was substantiated or indicated; and a disposition of substantiated or indicated was assigned for a child in a report.” The report’s authors refer to the number of such children per 1,000 as the “victimization rate.” But clearly substantiation does not equal actual victimization. The difficulty of making a correct decision on whether maltreatment has occurred is well-documented. Stories of families with repeated reports that are never substantiated or not confirmed until there is a serious injury or even death are legion. So are reports of parents wrongly found to be abusive or neglectful. Therefore, we have chosen to use the term “substantiation rate” instead of ‘victimization rate.” This rate varies greatly by state, from 2.4 per 1,000 children in North Carolina to 20.1 in nearby Kentucky.[1] The national substantiation rate in FFY 2019 was 8.9 per 1,000 children, down from 9.2 per 1,000 in FFY 2019 and FFY 2015. States reported a total of 656,000 (rounded) victims of substantiated child abuse or neglect in FFY 2019–a decline of four percent since 2015.

So does this decline in the number and rate of substantiations really connote a decline in child abuse and neglect? The range in substantiation rates among states argues against this idea. Unless states differ by almost a factor of 10 in the prevalence of child abuse and neglect, these numbers must reflect factors other than the actual prevalence of maltreatment. And indeed the report’s authors acknowledge that “[s]tates have different policies about what is considered child maltreatment, the type of CPS responses (alternative and investigation), and different levels of evidence required to substantiate an abuse allegation, all or some of which may account for variations in victimization rates.” Changes in these policies and practices can account for changes in these rates over time. Moreover, changes in all the earlier stages of reporting, screening, and assignment to investigation or alternative response contribute to changes in the substantiation rate. In 2019, screened-in referrals and investigations per thousand-children both decreased, which clearly contributed to the decrease in the substantiation rate.

It is interesting to note that while referrals increased every year between FFY 2015 and FFY 2019, both screened-in referrals and investigations decreased in FFY 2019. This suggests a general tendency among states to be less aggressive in responding to allegations of maltreatment, perhaps in accord with the prevalent mindset among child welfare leaders nationally and around the country, as discussed below.

Understanding the difference between “victimization” and “substantiation” and the many possible causes of a decrease in this rate reveals the deceptiveness of ACF’s statement that “[n]ew federal child abuse and neglect data shows 2019 had the lowest number of victims who suffered maltreatment in five years.” Lynn Johnson, the HHS assistant secretary for children and families, is quoted in ACF’s press release as saying that “[t]hese new numbers show we are making significant strides in reducing victimization due to maltreatment.” Unless Johnson and the ACF leadership intended to mislead, it appears they are woefully ignorant of the meaning of these numbers.

Most regular leaders of this blog already know why ACF wants to support the narrative of declining child maltreatment. The current trend in child welfare policy, regardless of political party, is to oppose intervention in families. Republicans who oppose government spending and interference in family life have made common cause with Democrats who think they are reducing racial disparities and supporting poor poor families by allowing parents more freedom in how they raise their children, even if it means leaving children unprotected. Members of both parties came together to pass the Family First Act, which encoded this family preservation mindset into federal law.

Child Welfare Monitor has pointed out many other instances where ACF or by other members of the child welfare establishment in the interests of supporting the family preservation mindset. For example, we wrote about the Homebuilders program, which was classified by a federally-funded clearinghouse as “well-supported” despite never having been proven effective for keeping families together. In fact, Homebuilders had to be classified as well-supported because it was one of the key programs touted by ACF and others in promoting the Family First Act and other policies promoting family preservation.

So if ACF’s “victimization” data do not in fact tell us what is happening to abuse and neglect rates, what else is available? We call on Congress to pass an overdue re-authorization of the Child Abuse Prevention and Treatment Act and include a fifth National Incidence Study of Child Abuse and Neglect. Data for the last study was collected in 2005 and 2006; it is high time for an update which should put an end (at least temporarily) to the misuse of NCANDS data as an indicator of trends in child maltreatment.

President Biden has called for ending a “culture in which facts themselves are manipulated and even manufactured.” We hope that ACF under its new leadership, as well as the rest of the child welfare establishment, will take these words to heart and commit themselves to truth and transparency from now on.

[1]: Pennsylvania has a substantiation rate of 1.8, even lower than that of North Carolina, but in Pennsylvania, many of the actions or inactions categorized as “neglect” are classified as “General Protective Services” and not included in the substantiation rate, making its data not comparable to that of the other states and territories.

[2]: Massachusetts did not provide data on FFY 2019 child maltreatment fatalities.