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Children with Disabilities at Increased Risk for Maltreatment, Neglect

January 05, 2015

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(Boston) – Jan. 5, 2015 – A research letter written by Boston Medical Center (BMC) physicians indicates that children with disabilities are at high risk for maltreatment following a first-time report for child neglect that is not confirmed. Analyzing information from a national database, the authors conclude that while all children with referrals for neglect that were not conclusive have high rates of subsequent maltreatment, children with disabilities experience future maltreatment sooner and more often than other children.

In the United States, more than 70 percent of all reports for child maltreatment each year are for neglect; of those, approximately 60 percent of cases are unsubstantiated, meaning there is insufficient legal evidence of abuse at the time of the investigation. Children with unsubstantiated reports of maltreatment typically do not receive services from Child Protective Services (CPS). The authors sought to focus on this largely unserved population to determine their future incidence of maltreatment.

The study, published in this week’s JAMA, was done in collaboration with Boston University and the Center for the study of Social Policy.

For this cohort study, the physicians examined data reported to the National Child Abuse and Neglect Data System (NCANDS), which collects data from Child Protective Services (CPS) agencies in all 50 states, the District of Columbia and Puerto Rico. They looked at children with and without disabilities with a first-time report for neglect in 2008 that was unsubstantiated and focused on the incidence and timing of re-referral to CPS; substantiated maltreatment; and foster care placement over the next 4 years.

A total of 489,176 children from 33 states and the District of Columbia were included in the study. Of that number, 12,610 were children with disabilities, as classified by the Individuals with Disabilities Education Act. Upon examination, the data demonstrated that children with disabilities were significantly more likely to be re-referred to CPS for maltreatment than children without disabilities (45 percent versus 36 percent, respectively). In addition, children with disabilities were more likely to experience substantiated maltreatment and be placed in foster care than children without disabilities (16 percent versus 10 percent and 7 percent versus 3 percent, respectively).

“Our findings point to the fact that children with disabilities experience far more future maltreatment than children without disabilities,” said Caroline Kistin, MD, MSc, a pediatrician at BMC and assistant professor of pediatrics at the Boston University School of Medicine. “It is imperative that we work to develop targeted interventions that could help support families and prevent these children from experiencing future maltreatment and neglect.”

This study was funded in part by the National Institutes of Health under notice of grant award number K23 HD089503-02.

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