Friday, October 15, 2010

Has CPS Outlived Its Usefulness?

From the NY Times:

Child Protective Services investigated more than three million cases of suspected child abuse in 2007, but a new study suggests that the investigations did little or nothing to improve the lives of those children.

Researchers examined the records of 595 children nationwide, all at similar high risk for maltreatment, tracking them from ages 4 to 8. During those years, Child Protective Services investigated the families of 164 of these children for suspected abuse or neglect. The scientists then interviewed all the families four years later, comparing the investigated families with the 431 families that had not been investigated.

The scientists looked at several factors: social support, family functioning, poverty, caregiver education and depressive symptoms, and child anxiety, depression and aggressive behavior — all known to increase the risk for abuse or neglect. But they were unable to find any differences in the investigated families compared with the uninvestigated in any of these dimensions, except that maternal depressive symptoms were worse in households that had been visited.

One possible interpretation of this result would be that the investigated families were at greater risk to begin with, and that the investigation helped them to recover to the expected level of risk. But if this were so, the authors write, households with recent investigations would have greater risk than households with more distant investigations. Statistical analysis found no such association. They concluded that Child Protective Services investigations had little or no effect.

The researchers were in some ways unsurprised by their findings. Even when services are offered, they usually take aim at immediate risks — substance abuse, for example, or domestic violence — not abiding problems like poverty or poor social support. Whatever interventions were offered apparently failed to reduce the risk for future child abuse.

The authors acknowledge that the study, which appears in the October issue of The Archives of Pediatrics & Adolescent Medicine, has certain weaknesses: some potentially modifiable risk factors — intimate partner violence and substance abuse, for example — were not included in the data they used. And not all of the five different geographical sites systematically collected information on all risk factors.

In an editorial published with the study, starkly titled “Child Protective Services Has Outlived Its Usefulness,” Dr. Abraham B. Bergman suggests some essential changes: child abuse, because it is a crime, should be investigated by the police; public health nursing services should be the first to respond to concerns of child neglect; social workers should assess appropriate living situations and work with families to obtain services, and not be engaged in law enforcement. But Dr. Bergman, who is a pediatrician at the Harborview Medical Center in Seattle, expressed considerable skepticism that such changes would happen.

Read the full article here.

AC

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