RE: New bulletin: Updated Trends in Child Maltreatment, 2008

["Finkelhor, David" <David.Finkelhor@xxxxxxx>]

A number of the posts in response to this thread about declines in child maltreatment substantiations have offered explanations that have to do with changed CPS standards or procedures or constrained resources or staffing or new professional reticence.

While such explanations may explain some portion of the decline, they do not account well for some of the evidence from various studies that we have about the period from 1993 through 2005-6.

The NIS study which found substantial declines in cases of maltreatment that were known to professionals in the community, whether or not they passed them on to CPS

The several youth self-report surveys that show declines in sexual abuse and physical assault that the youth themselves say they have experienced.

The fact that the largest declines in CPS substantiations have been for sexual abuse, a form of abuse which is generally taken more seriously. Changes in standards, resource constraints and willingness to report would be likely to most affect the less serious and more ambiguous forms of maltreatment like neglect, which in fact has declined the least.

Two studies, one that we did, and one conducted by folks at the Harvard School of Public Health, looked at state CPS data for indications that resource constraints or changed standards were affecting the rates and were unable to find such evidence.

The possibility that there are administrative changes that may affect the NCANDS numbers is important to investigate, but as a full explanation for the decline, it is not doing a good job of accounting for the accumulating evidence.

David Finkelhor
Crimes against Children Research Center
Family Research Laboratory
Department of Sociology, University of New Hampshire
Durham, NH 03824
Tel 603 862-2761* Fax 603 862-1122
email: david.finkelhor@xxxxxxx


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-----Original Message-----
From: bounce-6222013-6832158@xxxxxxxxxxxxxxxx [mailto:bounce-6222013-6832158@xxxxxxxxxxxxxxxx] On Behalf Of Larry Breitenstein
Sent: 2010-08-27 15:45
To: Child Maltreatment Researchers
Subject: Re: New bulletin: Updated Trends in Child Maltreatment, 2008

In research I have yet to publish, I compared Pennsylvania counties 
operating under a Medicaid managed care model to similar sized counties 
outside of the Medicaid managed care model and found a significant decline 
in some types of reported abuse (bruises and contusions) and indicated 
findings of abuse.

My thought was since managed care (and health care policy) is directing kids 
away from hospitals (changing the front door for who sees the child first), 
those treating the kids (and those kids not receiving medical treatment) are 
being excluded from what in the past would have been reported.  Pennsylvania 
law requires a medical finding to substantiate most reports.  Thus these 
systemic changes could be making it too hard for CPW to get all that is 
needed to substantiate a finding of abuse.  These changes with health care 
could be indirectly forcing CPS workers to focus more on the most serious 
cases and/or preventing them from using what is available.

My findings suggested managed care had no affect on serious injuries like 
fractures.