Homotypical and Heterotypical Intergenerational Continuity of Child Maltreatment: Evidence from a Cohort of Families Involved with Child Protection Services.

Child maltreatment (CM) in one generation can predict CM in the next generation, a concept known as intergenerational continuity. Yet, the form taken by the intergenerational continuity of CM remains unclear and fathers are mostly absent from this literature. This longitudinal study aimed to document patterns of intergenerational continuity of substantiated CM, on the maternal and paternal sides, by examining the presence of: homotypical CM, which is the same type of CM in both generations; and heterotypical CM, which is different CM types in both generations. The study included all children substantiated for CM with the Centre Jeunesse de Montréal between 1 January 2003, and 31 December 2020, with at least one parent who was also reported to that agency during their childhood (n = 5861 children). The cohort was extracted using clinical administrative data, and logistic regression models were tested with the children's CM types as the dependent variables. Homotypical continuity was found for: (1) physical abuse on the paternal side; (2) sexual abuse on the maternal side; and (3) exposure to domestic violence on the maternal side. Heterotypical continuity was also prevalent, but to a lesser extent. Interventions helping maltreated parents overcome their traumatic past are essential to foster intergenerational resilience.

Profile of Runaway Youths from Residential Care Centers: Variation in Risk-Taking Propensity.

During runaway episodes, adolescents engage in various high-risk behaviors and are exposed to various dangers. This situation is even more pronounced among runaway youths from residential care centers, given their personal and familial backgrounds that place them at risk. The current study attempted to disentangle the heterogeneous characteristics of runaway youths while considering the adolescent risk-taking literature. A latent profile analysis was performed among 112 runaway youths from residential care centers based on runaway characteristics (number, duration, context of return). The Parent involvement, Independent and Police involvement runaway youth profiles were compared on various characteristics involved in risk-taking, their high-risk behaviors and mental health problems. The clinical implications for these three runaway profiles are discussed.

Factors associated with reunification and placement move for children placed in kinship care under the age of thirteen.

BACKGROUND: When a child needs to be placed in substitute care by child protection services, social workers are encouraged to use kinship care (KC), mainly because of the greater stability associated with it. However, current state of knowledge on reunification and placement stability is essentially based on studies that combined children in KC and children in other types of substitute care setting. OBJECTIVES: This paper aims to describe longitudinally the placement trajectory of children placed in KC and to identify the factors associated with the type of exit from KC (move to another substitute care setting or reunification). METHOD: All children in a Québec child protection services agency who started a KC placement in 2014-15 under the age of 13 are observed for three years (N = 172). Data come from the child's casefile and from telephone questionnaires with the caseworker at the beginning and at the end of placement (or at the end of observation if the child has not exited). RESULTS: Several children remained in the same KC setting during the observation (39%). The others were reunified (34%) or moved to another substitute setting (27%). Multivariate regression analyzes indicated that reunification was mostly determined by higher frequency of parent-child contacts, less registrations in clinical programs and absence of parental mental health problems, while placement move was mostly associated with placement beginning as provisional measure, higher frequency of parent-child contacts and presence of parental mental health problems. CONCLUSIONS: This study highlights determinants of stability and permanency that may be specific to kinship placements.

Reunification trajectories in Quebec: Acknowledging chronic family challenges to support stability.

BACKGROUND: While family reunification following out-of-home placement is a goal of child protection policy, complex family needs may not be met at the point that child protection systems reunify families. Permanency legislation creating maximum placement timeframes prompts questions regarding what families need to be supported in stably reunifying following a child's removal from the home. OBJECTIVE: We aim to identify clinical risk factors salient for initial placements and placements following a child reunifying with their family to inform successful reunification and improve children's stability. PARTICIPANTS AND SETTING: The study includes a representative sample of children in Quebec with a child protection investigation in 2008 (N = 3051) followed for nine years. METHODS: Cross-sectional clinical data from the Quebec Incidence Study (QIS) on Evaluated Child Protection Reports (2008) were linked with longitudinal administrative data from 16 provincial child protection agencies. Canadian Census data (2006) were used to create a factorial index measure for poverty. Chi-square automatic interaction detector (CHAID) decision tree analysis was used to compare risk factors salient for initial placements (n = 1120) with post-reunification placements (n = 455). RESULTS: For the placement sample (n = 1120), significant factors were: attachment issues, caregiver drug use, child's suicidal thoughts, child's self-harming behavior, and academic difficulties. Of the children who reunified with their families (n = 847), over half (n = 455; 54%) returned to out-of-home placements. Certain factors remained significant for placement after reunification: academic difficulties, attachment issues, and caregiver drug use. The CHAID model fit estimates suggest 70.9% (SE = 0.008) accuracy predicting out-of-home placement following child protection investigation and 58.2% (SE = 0.017) accuracy predicting re-placement following family reunification. CONCLUSIONS: Complex needs among families most likely to experience reunification breakdown indicate potential service gaps. When legislated placement timeframes prompt quick resolution of family challenges, these analyses can contribute to policy discussions regarding clinical family challenges that impact stability.

Childhood Prevalence of Involvement with the Child Protection System in Quebec: A Longitudinal Study.

The goal of this study, the first of its kind in Canada, was to estimate the child lifetime prevalence of child protection involvement in Quebec. Using administrative and population data spanning 17 years, we performed a survival analysis of initial incidents of child protection reports, confirmed reports, confirmation of a child's security or development being compromised, and placement outside the home for one day or more. We found that before reaching the age of 18 years, over 18% of children were reported to child protection at least once, one in every ten children (10.1%) in the province had a report that led to the finding of their security or development being compromised, and over 5% were placed outside the home. We found that neglect was a primary concern in close to half (47.6%) of cases. By using a full population dataset, we obtained a more accurate prevalence estimate than studies using synthetic cohort life tables. These findings only captured initial incidents of involvement with child protection, meaning this study does not show the extent of recurrent involvement for some children. The findings reflect prior results showing that neglect is common in initial child protection involvement but less pervasive than has been shown in incidence studies, suggesting that recurrent child protection involvement is more driven by neglect than initial incidents are.

Child maltreatment investigations and substantiations in child protection services: Factors distinguishing children with intellectual disabilities.

BACKGROUND: Children with intellectual disabilities (ID) are more vulnerable to maltreatment than children without ID. Few studies focused on understanding the experiences of maltreatment of children with ID, limiting our capacity to adequately care for them. OBJECTIVE: This study examined the types of maltreatment with which ID is associated among child protection investigations, and identified the individual, environmental, and service-related factors distinguishing children with ID from those without, among children with substantiated maltreatment. METHODS: Secondary data from an incidence study on investigated child maltreatment including 2053 children aged 6-17 years old were analyzed through univariate and multivariate logistic regressions. ID was present for 5.7% (n = 117) of the children. RESULTS: ID was associated with increased odds of being investigated for neglect and decreased odds of being investigated or substantiated for psychological maltreatment. The factors that most distinguished children with ID from other children were physical disabilities (8.45, p < 0.001) and autism spectrum disorder (11.33, p < 0.001) in the child and having at least one parent with ID (16.21, p < 0.001). Two other environmental factors, including having been reported by a professional (2.13, p = 0.047), distinguished children with ID from the other children. CONCLUSIONS: Children with ID who experienced maltreatment present with greater adversity than children without ID. Professionals play a preponderant role in reporting situations of maltreatment for children with ID and need additional training to properly respond to maltreatment of children with ID.

Recurrent involvement with the Quebec child protection system for reasons of neglect: A longitudinal clinical population study.

Studies in several jurisdictions have found that families become recurrently involved with child protection systems most frequently for reasons of neglect. Child protection involvement for reasons of neglect is shown to correlate with various socioeconomic vulnerabilities. OBJECTIVE: This study, the largest of its kind in Canada, examines when and for whom recurring conditions of neglect were most likely to occur for all children involved with child protection in the province of Quebec over a span of fifteen years. PARTICIPANTS AND SETTING: Specifically, the study population includes all children whose ongoing child protection intervention in Quebec closed between 2002 and 2017 (N = 76,176). METHODS: This clinical population study uses a longitudinal research design drawing anonymized clinical administrative data from all of Quebec's child protection jurisdictions spanning 15 years, and Quebec data extracted from the 2011 Canadian National Household Survey to estimate socioeconomic vulnerability. RESULTS: Of the total population studied, 32.5 % (N = 24,816) experienced a recurrence of maltreatment during the study period, of which more than one third (N = 8707) experienced a recurrence for reasons of neglect. CONCLUSIONS: Because the association between socioeconomic vulnerability and recurrence of neglect indicates a gap in material and social supports-which child protection systems have neither the mandate nor the resources to fill-we propose additional avenues that we urge policymakers and practitioners to consider in supporting the demonstrated needs of these families.

Temporary placements: A crisis-management strategy for physically abused children?

A large majority of children who are placed outside the family home experience temporary placements (between 1 to 60 days) at some point in time. Yet, information on the use of temporary placements remains fragmentary, with only occasional indirect references. This scant information does, however, suggests a particular link between physical abuse and temporary placements. The objective of the present study is to describe the context in which temporary placements are used by children's services in Quebec (Canada) while analyzing the associative link between temporary placements and physical abuse as the reason for the placement. Our study is based on a population cohort of 10,181 children placed in Quebec who have been followed for four years. Propensity-weighted multinomial regression analysis was used to assess the relative importance of the various individual pre-placement factors that may be associated with physical abuse. Results show that children investigated for physical abuse alone are 6.335 times more likely to have temporary placement trajectories compared to children investigated for other reasons. Cases that involved physical abuse combined with other reasons, were between 33.4% and 41% more likely to involve trajectories with temporary placements, than cases that were investigated for reasons other than physical abuse. Sex, age, and history of services have been used as covariates. In conclusion, the use of temporary placements is discussed with regards to the mandate of child-protection services and of certain etiological profiles of physical abuse.

Moderating Role of the Form of Maltreatment Experienced by Children on the Effectiveness of a Parent Training Program.

The study examines whether the form of maltreatment experienced by the child moderates the effects of a parent training program (PTP) on the probability that the child's case will be closed. This study involved 736 children on whom the Montreal child protective services (CPS) agency had an active file between 2007 and 2015. The experimental group was composed of all children with a parent who participated in the PTP Incredible Years ( n = 368). A control group was matched with the experimental group based on a propensity score. Cox regression revealed that once parents have participated in the PTP, the probability that their children's cases will be closed increases more for children being followed because of neglect than for those being followed because of emotional maltreatment. Results show that a parent's participating in a PTP is associated with an increase of the probability that his or her child's CPS case will be closed and hence with a reduction of the length of time that the child must receive protective services.

Child and family needs profiles among cases substantiated by child protection services.

Differential individual and family needs are explored in a sample of children (n = 1455) whose case has been substantiated by Child Protection Services. Using data from Quebec's 2014 cycle of Incidence Study, latent class analyses led to the identification of 5 profiles, each displaying a specific range of individual and family needs. Profile characteristics were explored in order to obtain a deeper understanding of their specific needs, beyond the initial referral motive. Further, referred services were explored in order to verify their adequacy regarding the identified needs. Together, the obtained results support the relevance of a more in-depth needs assessment when child protection services are solicited, and the necessity to better match the referred services to these needs.

Placement Stability, Cumulative Time in Care, and Permanency: Using Administrative Data from CPS to Track Placement Trajectories.

Objectives: The Quebec Youth Protection Act was amended in 2007. The main goal of this reform was to improve placement stability for children who are removed from their home for their protection. Among several legal provisions introduced was the establishment of maximum age-specific durations of out-of-home care, after which a plan must be established to provide stability for children placed in substitute care by finding permanent homes for them. The purpose of this study is (1) to examine trends in placement use and placement stability since the reform and (2) to document the current frequency of each type of placement setting, the cumulative time in care before the exit to permanency, and the sustainability of the permanency outcome. Methods: The study relies on 3 entry cohorts of all children investigated who received protection measures in the province of Quebec during 3 specific time frames before and after the reform (n = 9620, 8676, 8425). Cohorts were observed for a period varying from 3 to 4 years. Administrative data from all 16 child protection agencies were used to track placement trajectory indicators and to compare cohorts. Results: There has been a decrease in the proportion of children receiving protection measures who were placed in care since the reform, and placement in kinship care has become more frequent among children placed. Placement stability improved slightly after the reform. Overall, for infants, the most frequent type of permanency attained is adoption, while reunification is the option most often indicated for older children. Some children are at a greater risk of experiencing unstable placement trajectories: young children have a high rate of reunification breakdown, some wait a long time to be adopted, and adolescents are frequently removed from the substitute care setting where they were supposed to stay until the age of 18. Conclusions: The results suggest interesting avenues for policy makers and service providers to improve the stability of placement trajectories. Advantages and disadvantages of administrative data are discussed.

The Effects of Socioeconomic Vulnerability, Psychosocial Services, and Social Service Spending on Family Reunification: A Multilevel Longitudinal Analysis.

Socio-environmental factors such as poverty, psychosocial services, and social services spending all could influence the challenges faced by vulnerable families. This paper examines the extent to which socioeconomic vulnerability, psychosocial service consultations, and preventative social services spending impacts the reunification for children placed in out-of-home care. This study uses a multilevel longitudinal research design that draws data from three sources: (1) longitudinal administrative data from Quebec's child protection agencies; (2) 2006 and 2011 Canadian Census data; and, (3) intra-province health and social services data. The final data set included all children (N = 39,882) placed in out-of-home care for the first time between 1 April 2002 and 31 March 2013, and followed from their initial out-of-home placement. Multilevel hazard results indicate that socioeconomic vulnerability, controlling for psychosocial services and social services spending, contributes to the decreased likelihood of reunification. Specifically, socioeconomic vulnerability, psychosocial services, and social services spending account for 24.0% of the variation in jurisdictional reunification for younger children less than 5 years of age, 12.5% for children age 5 to 11 years and 21.4% for older children age 12 to 17 years. These findings have implications for decision makers, funding agencies, and child protection agencies to improve jurisdictional resources to reduce the socioeconomic vulnerabilities of reunifying families.

Québec Incidence Study on the situations investigated by child protective services: Major findings for 2008 and comparison with 1998.

OBJECTIVE: The Québec Incidence Study on situations investigated by child protective services (QIS) has been conducted in 5-year cycles since 1998 in collaboration with all 16 Québec child protection agencies. It provides reliable estimates of the incidence and characteristics of investigated children. The aim of this paper is to discuss major findings from the QIS-2008 and to compare them with the findings from QIS-1998. METHODS: Two representative samples of children who were investigated by child protection services during the same three-month time frame in 1998 (N = 4,771) and in 2008 (N = 3,079) were constituted. Caseworkers were asked to complete the QIS data collection form for each sampled child. Annual estimates of the number of children investigated with different characteristics were computed and compared across both cycles. Statistical tests were performed to identify significant differences. RESULTS: While the rate of children investigated increased between 1998 and 2008, the rate of substantiated cases remained stable at 12 and 11 per 1,000 children in the population respectively. Furthermore, substantiated cases in 2008 were less severe than in 1998 along several dimensions, such as co-occurrence, emotional harm and duration. CONCLUSION: Combined with the stability in the rate of substantiated cases, the decline in the severity of the situations seems encouraging but questions the necessity of a CPS intervention for some of these families. These findings are consistent with the ones reported in other countries, but Québec rates are below the rates estimated for Canada, where substantiated maltreatment almost doubled during the same time frame. Aspects of social policies in Québec may play a role in this situation and need to be examined in future research.

A developmental approach to the risk of a first recurrence in child protective services.

The objective of this study is to estimate the risk of a first recurrence over a five-year period following initial child protective services (CPS) intervention and identify the characteristics associated with the risk of recurrence for three different age groups. Recurrence is defined as the first substantiated report within the observation period after initial services have ended. The study involved a cohort of 25,897 Quebec children who received postinvestigation services for the first time and whose cases were closed between 2005 and 2009. Survival analysis was used to estimate the five-year risk of recurrence and Cox regression to model the risk of recurrence for three age groups. The covariates introduced into the regression analyses were characteristics of the child and initial services. The risk of recurrence in the five years following termination of initial CPS services was 36% for the entire cohort and varied depending on the child's age at the time of case closure. Children aged 6-11 when their cases were closed had the highest risk of recurrence. Although Aboriginal descent and prior CPS investigations have a consistent effect on the risk of recurrence in all three age groups, the effects of other covariates, such as out-of-home placement and court involvement, vary or are even reversed, depending on the child's age. These findings highlight the need to adopt a differential approach that takes into account the child's age, both in the provision of protective services and in research involving the population receiving such services.

Child protection policy reform in Quebec: its impact on placement and stability in substitute care.

In recent years, the Government of Quebec has struggled to address the number of out-of-home child-protection placements as well as the problem of placement instability among children in care. In 2007, the Youth Protection Act (YPA) was modified to ensure that children benefit from continuity of care, stable relationships, and stable living conditions that correspond to their age and needs. This paper explores the effects of the new YPA by examining the changes in out-of-home placements and the stability of the children. Once the changes to the Act had come into effect, the number of children who were placed in substitute care decreased and their situations became more stable. Given that the social conditions of the families remained stable in the three years preceding and following 2007 (number of reports, funding), this result suggests that the changes to the Act have led to the observed effects.