Although a dramatic nationwide drop in the incidence of suspected child abuse and neglect occurred in recent years, according to a new government study, the number of children removed from families and placed in foster care continues to rise. The increase in child removals may be fueled by a near doubling in the rate of suspected "emotional neglect," the use of which has drawn criticism from reform advocates.
The findings were featured in the Fourth National Incidence Study of Child Abuse and Neglect (NIS-4) released in January. The study—only the fourth such analysis since Congress mandated these assessments 36 years ago—aims to estimate abuse and neglect rates nationwide and provide a point of comparison with previous years.
The number of children who experienced any form of abuse dropped from 743,200 in 1993 to 553,300 in 2005-2006, according to the Administration for Children and Families (ACF) in the Department of Health and Human Services (HHS).
Meanwhile, the number of "emotionally neglected" children rose in the same timeframe, from 584,100 to 1,173,800.
The study, which is based on reports filed in 2005 and 2006 from more than 10,000 "sentinels" who are connected in various ways to child-protection services, found that the incidence of all forms of maltreatment was down 26 percent since the last study in the mid-1990s. Drops included a 47 percent decrease in the rate of sexual abuse cases and a 29 percent decrease in ones involving other types of physical abuse.
"This decrease returned the incidence of ... maltreatment to a level that does not differ from the NIS—2 estimate for 1986," the study's authors noted.
Those large drops in abuse came as the number of children removed from their families and placed in foster care continued to rise from 1995 to 2006 to the highest levels on record, according to the most recent data available from the National Data Analysis System of the Child Welfare League of America.
The contrary decrease in abuse and increase in child removals may be linked to the only area of child welfare where the federal report noted an increase: suspected "emotional neglect," which rose 83 percent. The recent study does not define emotional neglect, although the NIS-3 study explained that it included "inadequate nurturing," permitting a child to abuse drugs or alcohol, permitting "maladaptive behavior" (such as chronic truancy), and refusing or delaying needed psychological care.
The authors concluded that the large increase in emotional neglect could stem from both an increased incidence of this type of neglect and an increased focus by Child Protection Service agents on this issue.
Experts in child welfare differed on the reasons behind the spike in cases of suspected emotional neglect, with some citing the possibility that many of the study's sentinel reporters—including law-enforcement officers and teachers—are encouraged by child-welfare agencies to report suspected emotional neglect, though few have adequate mental health training to identify such cases.
"In the study, the observers are asked to report when they see a child exhibiting certain symptoms, and they are not asked whether those symptoms are necessarily the result of any behavior of the parent," explained Douglas Besharov, former director of the federal government's National Center on Child Abuse and Neglect, in an interview with Psychiatric News.
Besharov said that spikes in reports of emotional neglect also could stem from ever-expanding definitions used by researchers to label behaviors that qualify as emotional neglect.
Another possible explanation is that community services that could prevent such neglect may have been reduced or eliminated by budget cuts in recent years. When various professionals in areas where services have been cut suspect neglect, they may believe their only option is to report such families to child-welfare agencies instead of referring them to services that could help them.
"Similar programmatic losses have occurred in family-court systems across the country, so judges and court social workers now have fewer treatment options available in their efforts to salvage troubled families," said Ronald Davidson, Ph.D., of the University of Illinois at Chicago (UIC), in comments to Psychiatric News.
Davidson, director of the UIC Mental Health Policy Program, has been a key advisor in a federal-court-supported overhaul of the Illinois child-welfare system since the mid-1990s. That overhaul refocused the state's child welfare system on preserving families instead of removing children as the first response to a neglect report and has led to a major reduction in the number of children taken from their families and placed in the foster-care system. However, recent budget cuts in social services, as are occurring in many states, may impact Illinois' ability to provide alternatives—short of removing these children—for families in which neglect is suspected.
Another definition for emotional neglect, according to the NIS-3, is when children witness domestic violence. Although the recent NIS-4 does not specify which types of emotional neglect are driving the increase in such reports, a growing focus by the child-welfare system on domestic violence may also be behind the increase, according to at least one reform advocate.
"Emotional maltreatment is inherently hard to define, so it is inherently easier to broaden the definition to cover anything and everything," Richard Wexler, executive director of the National Coalition for Child Protection Reform, told Psychiatric News. "And one area where this is particularly dangerous is in the area of witnessing domestic violence, which appears to be the big growth area."
Wexler has found an expanding focus on child exposure to domestic violence among welfare agencies nationwide, which he tracks, and these agencies justify removing the child from the victim parent as a way to protect the child's mental health.
"While it is always emotionally harmful to take away a child, the harm is actually worse if you take that child from the nonoffending parent in these situations," he said.
Although ACF officials declined to be interviewed by Psychiatric News, they submitted a written statement from Carmen Nazario, assistant secretary for children and families at HHS, who specifically cited an increased focus on the federal level on "supporting children" who witness domestic violence.
The domestic violence focus by child welfare agencies was highlighted in a 2003 New York class-action case, Nicholson v. Williams, in which an appeals court barred New York City's Administration of Children Services from using an attack by a husband or boyfriend on a mother as grounds for finding emotional neglect and justifying the permanent removal of her children.
A copy of the Fourth National Incidence Study of Child Abuse and Neglect is posted at <www.acf.hhs.gov/programs/opre/abuse_neglect/natl_incid/index.html#reports>.