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Slate Page 1 of 5 IHI time, learn more Illons of privately available instantly: Slate 9 hey, wait a minute Child Abuse: Threat or Menace? How common is it really? By Douglas J. Besharov with Jacob W. Dembosky (1,121 words; posted Friday, Oct. 3. to be composted Friday, Oct. 10) With a new government-funded study in hand, Secretary of Health and Human Services Donna Shalala diagnosed a rising epidemic of child abuse last month. She reported that "child abuse and neglect nearly doubled in the United States between 1986 and 1993"--and that was only the beginning of the ugly news. The number of "serious" cases had quadrupled, and the percentage of cases being investigated by the authorities had actually declined by 36 percent, trends that she called "shameful and startling." Is Shalala right? Is an unheeded child-abuse epidemic raging in America? Or, as I think is more likely, is the methodology behind the study and the interpretation of its numbers flawed? And if Shalala overstated the child-abuse peril, is she undermining public interest in the problem by making it appear too big and difficult to fix at a reasonable cost? Look at the Numbers A The secretary drew her statistics from the National Incidence Study of Child Abuse and Neglect, which was conducted by Westat Inc., a consulting firm that conducted similar studies in 1980 and 1986. In the new study, about 5,600 professionals, a representative sample, were asked by Westat whether the children they had served appeared to have suffered specified harms or to be living under specified conditions. Westat then 10/4/96 10:58:39 AM Slate Page 2 of 5 determined if the reported "harms" and "conditions" met the study's definitions of "abuse" 1 and "neglect," and generated estimates of incidence. The odd thing about Shalala's claim that the number of children abused and neglected doubled from 1.4 million in 1986 to 2.8 million in 1993 is that no other signs point to such a dramatic increase in child abuse and neglect. Fatalities arising from child abuse have held roughly steady, ranging from 1,014 in 1986 to 1,216 in 1993, according to the National Committee to Prevent Child Abuse. O f the 1.4 million additional cases reported, almost 80 percent fall into three suspect categories. (Anywhere from 13 percent to 34 percent of the 2.8 million children suffered more than one type of abuse or neglect. Unfortunately, the study did not "unduplicate" these reports. Nevertheless, the proportions I describe below provide a general picture of what is happening.) New Cases of Endangered children account for 55 percent Child Abuse and Neglect * of the increase. These are cases where the child Endangered 1986-1993 was not actually harmed by parental abuse or neglect, but was "in danger of being harmed 60 according to the views of community professionals 55 50 or child-protective service agencies" [emphasis 45 added]. (See Figure 1.) PERCENT 40 35 Emotional abuse and neglect account for 30 20 Emotional another 15 percent of the increase. The great 25 Mattreatment Physical 15 Neglest Educational Neglect Physical majority of emotional-abuse cases, according to the 10 Abuse Sexual Abuse 1986 Westat study, involved "verbal assaults," and 5 more than half of the emotional-neglect cases 0 involved "the refusal or delay of psychological TYPE OF MALTREATMENT care." Educational neglect--the chronic failure to send a child to school--added another 8 percent to the total of new cases. "D efinitional Creep"? All these cases warrant attention, but the explosion of numbers may be caused by the growing reportorial sensitivity of professionals, that is, "definitional creep." Professionals who become more sensitive to possible abuse, or more adept at noticing it, would make more reports to Westat--even if the actual incidence had not risen. In endangerment cases, at least, the study seems to accept this explanation. According to Shalala, the number of "serious" cases increased between 1986 and 1993 from "about 143,000 to nearly 570,000." Her comments left the impression that the cases involved 10/4/96 10:58:40 AM Slate Page 3 of 5 life-threatening assaults, but the study defines "serious" cases as any in which the child suffered "long-term impairment of physical, mental, or emotional capacities, or required professional treatment aimed at preventing such long-term impairment." Emotional maltreatment accounted for fully half of the increase in serious cases. (See Figure 2.) New Cases of n cases labeled as serious physical abuse, the "Serious" Abuse and Neglect reported injury could be mental or emotional. 1986-1993 Even in these "serious" cases, the study Emotional Maitreatment seems affected by definitional creep. For example, in three categories (sexual abuse, physical neglect, and emotional neglect), the number of cases 50 45 40 Physical Neglect described as "moderate" declined even as the 35 number of "serious" ones increased--strongly PERCENT 30 suggesting that cases once viewed as only 25 20 Sexual Abuse 15 Physical Educ ational moderately threatening have now been "upgraded" Abuse Neglect to the most dire category. 10 Uninvestigated Cases? 5 0 Shalala's assertion that investigations of child TYPE OF MALTREATMENT abuse and neglect cases have dropped by 36 percent deserves closer scrutiny. In producing the number of uninvestigated cases, the study compared the number of cases identified by professionals with those known to local agencies. Of the cases not investigated, 33 percent involved educational neglect. (See Figure 3.) Investigated Cases of The main flaw here is that most Child Abuse and Neglect* educational-neglect cases are handled by the 1993 schools; reports are made to protective agencies only when all else fails. 500 Emotional Maltreatment Educational Another 30 percent of uninvestigated cases THOUSANDS OF CHILDREN 400 Physical Neglect Physical Abuse Neglect involved emotional abuse and neglect. But child-protective agencies usually avoid these cases 300 Sexual Abuse because they tend to involve subjective judgments, and there is little that a quasi-law-enforcement 200 agency can do about them. 100 Definitional creep is clearly at play here, too. 0 Professionals who are increasingly willing to TYPE OF MALTREATMENT identify situations as harmful aren't necessarily Known to CPS Unknown to CPS ready to equate them with the sort of abuse and neglect they are legally obliged to report. And even if they did report these instances, child-protective agencies would still be expected to screen them out. D oes Shalala Believe Her Own Hype? Probably not. Radical action would be required if Shalala's figures were even roughly correct. But instead of proposing radical action when she released the report, she outlined modest steps that had long been planned and budgeted. 10/4/96 10:58:40 AM Slate Page 4 of 5 Having worked in the field for 30 years. I can testify firsthand that the problem of child abuse and neglect is real. But however well meant, exaggerating the severity of abuse endangers children. In the late '80s, for example, the nation was told that 375,000 drug-exposed babies were born each year; Washington policy-makers were immobilized by estimates that tens of billions of dollars were needed to protect these children. In fact, the true number was closer to 35,000, and a decade later, the government has yet to mount a meaningful program for the children of addicts. Overstatement may also obscure genuinely worrisome findings. Some of the increases in sexual abuse, physical abuse, and physical neglect uncovered by Westat may well reflect a true deterioration of conditions in disorganized, poverty-stricken households. But Shalala paid scant attention to this possibility. And to claim recklessly that too few cases are investigated is to play with fire. Child-protective agencies are already overwhelmed investigating about 2 million reports a year, two-thirds of which are dismissed as unfounded or inappropriate. For many in the field, the most pressing need is to discourage inappropriate reporting--not to blithely call for more. Links The National Incidence Study is scheduled to be released this fall. For immediate resources on child abuse and neglect, see the National Committee to Prevent Child Abuse and the National Data Archive on Child Abuse and Neglect at Cornell University. Douglas J. Besharov is a visiting professor at the University of Maryland's School of Public Affairs, where Jacob W. Dembosky is a research assistant. Besharov was the first director of the U.S. National Center on Child Abuse and Neglect. His most recent book is Recognizing Child Abuse: A Guide for the Concerned. Graphs: Third National Incidence Study of Child Abuse and Neglect * Figures for specific types of maltreatment exclude endangerment cases. Percentages total more than 100 because some children counted under more than one type of abuse. Percentages total more than 100 because some children counted under more than one type of abuse. * These exclude cases of endangerment. 10/4/96 10:58:40 AM Slate http://www.slate.com/Email/96-10-23/Email.asp The Current National Debt is: Slate 23 (posted Wednesday. Oct. 23) Fact Abuse The "Hey, Wait a Minute" column by Douglas J. Besharov and Jacob W. Dembosky ("Child Abuse: Threat or Menace?") seriously misrepresents the methodology, findings, and conclusions of the recently released Third National Incidence Study of Child Abuse and Neglect (NIS-3). As the NIS-3 project director and the supervisor responsible for implementing the NIS-3 definitions, we want to set the record straight. We address only some of the misinformation here. In light of Besharov's criticisms, it is noteworthy that he participated in the Conference of Experts convened in late 1991 by the National Center on Child Abuse and Neglect (the NIS-3 sponsor) specifically to refine the NIS-3 design. Together with the rest of the conferees, Besharov recommended no changes in the NIS methodology and definitions. Now, five years later, Besharov opines that the NIS methodology and definitions are flawed. The NIS-3 findings may run counter to his position, but it is important for Besharov and Dembosky, and for readers of SLATE, to get the facts straight. First, when Besharov and Dembosky characterized the 1.4 million additional children who joined the ranks of the maltreated between 1986 and 1993, they summed up the NIS-3 estimates in inappropriate ways to draw their conclusions. In doing so, they overstated the percent of children who were harmed only by emotional or educational maltreatment (actually 9 percent, not the 23 percent they indicated) and they understated the percent of new children who were harmed by physical abuse, sexual abuse, or physical neglect (actually 37 percent, not the 22 percent they implied). Besharov and Dembosky also glossed over how these percentages translate into numbers of children. The 37 percent just mentioned refers to over one-half million additional children who were harmed by physical abuse, sexual abuse, or physical neglect in 1993--over and above the number who were harmed by these forms of mistreatment in 1986. An estimated 1,249,000 children were 1 of 7 10/25/96 14:10:38 Slate http://www.slate.com/Email/96-10-23/Email.asp harmed by these forms of maltreatment in 1993. Also, in discounting the rise in incidence found in the NIS-3, Besharov and Dembosky contend that "fatalities arising from child abuse have held roughly steady" between 1986 and 1993. But this is contradicted by the numbers they themselves cite, which show that fatalities have risen by 20 percent during this period. from 1.014 to 1,216. Second, Besharov and Dembosky misrepresented the NIS methodology for classifying the severity of injury or harm. (We wish we could ascribe this to misunderstanding. but we clarified this issue for them before their article's publication and they published their misinformation anyway.) In fact, the classification of a child as seriously injured/harmed is relatively objective in that it does not rely on a blanket judgment by a respondent. The criteria for defining serious harm or injury are standardized; they are applied to the described injury itself, not to the respondent's judgment about that injury: and they have been consistent across the three incidence studies. So the recent quadrupling of the number of seriously injured children cannot be ascribed to some vague form of "definitional creep." Third, Besharov and Dembosky's claim that increased sensitivity accounts for the rise in the number of seriously injured children does not make sense in the context of the patterns of NIS findings, which do provide evidence of progressively heightened sensitivity for more subtle maltreatment cues. Respondents' sensitivity to moderate injuries increased between the NIS-1 in 1980 and the NIS-2 in 1986, but did not change after that. Between the NIS-2 and the NIS-3, respondents showed increased awareness of endangerment (i.e., maltreatment events that did not yet cause harm). Note that the significant increases found in the NIS-3 were discontinuous across the outcome spectrum, occurring in only two categories: serious injury/harm and endangerment, both of which essentially quadrupled since the NIS-2 in 1986. If Besharov and Dembosky want to discount both increments by appealing to the same process (enhanced sensitivity) then they need to explain (1) why this process applied discontinuously in the NIS-3 and did not affect the intervening category of moderate injury or harm, and (2) how the NIS-2 respondents managed to overlook three-fourths of the children who had been seriously injured while at the same time evidencing greater sensitivity in identifying moderately injured children. Seriously injured victims of maltreatment are relatively unlikely to escape detection by the study methodology, so the rise in incidence in this category cannot be plausibly explained as due to heightened awareness. Considering all the evidence, 2 of 7 10/25/96 14:10:38 Slate http://www.slate.com/Email/96-10-23/Email.asp the most reasonable interpretation is that there has been a real increase in the incidence of seriously injured children. More than one-half million children were seriously injured by abuse or neglect in 1993. Fourth, Besharov and Dembosky take issue with the documented drop of 36 percent in the rate of Child Protective Services investigations by pointing out that the set of uninvestigated cases includes educational neglect and emotional maltreatment. But a careful reading of their discussion reveals that they do not address the drop per se. Instead, their entire discussion emphasizes their "take" on the relative inappropriateness of CPS investigations for emotional and educational maltreatment. However, educational neglect and emotional maltreatment have always been included in the incidence studies. and eliminating them from the picture would not eradicate the significant drop in the overall rate of CPS investigations from the NIS-2 to the NIS-3. In fact, the percentages of children whose maltreatment was investigated decreased significantly in all categories except educational neglect--from 64 percent to 45 percent among physically abused children, from 75 percent to 44 percent among sexually abused children, from 57 percent to 35 percent among physically neglected children, and from 40 percent to 26 percent among children seriously injured by any maltreatment. Finally, contrary to what Besharov and Dembosky convey, the NIS-3 report does not "blithely call for more" reporting. Nor did we "claim recklessly that too few cases are investigated." Instead, we concluded that the NIS-3 findings "emphasize the need for better targeting, whether by reporters in referring children to CPS, by CPS screening practices in connection with reports, or by both." --Andrea J. Sedlak, Ph.D. associate director of the Human Services Research Area at Westat Inc. --Diane D. Broadhurst, M.L.A. senior researcher at Westat Inc. Douglas J. Besharov Replies: It is difficult to respond to Sedlak and Broadhurst's letter. First, I have great respect for their past work, and appreciate the constraints they faced in this project--as government contractors in an underfunded study. Second, words like "misrepresented" and "misinformation" are, in the world of policy analysis, fighting words. Third, their study is complicated. and numbers can be thrown back and forth until the eyes of the average reader glaze over. Most important, my complaint is not so much with the study as with the 10/25/96 14:10:39 3 of 7 Slate http://www.slate.com/Email/96-10-23/Email.asp interpretation of its findings--and especially with the spin given to it by political appointees in the Department of Health and Human Services. Hence, I will deal with the personal attacks in their letter and then go on to my larger policy--and ethical--concerns about their response. In their letter, Sedlak and Broadhurst correctly point out that I participated in a 1991 Conference of Experts that discussed the study's methodology. In fact. as director of the National Center on Child Abuse and Neglect in the mid-1970s, I helped design the study in the first place--long before either Sedlak or Broadhurst were involved. So, I know well the strengths--and weaknesses--of the study's approach to the difficult task of counting illegal behaviors toward children that largely occur behind closed doors. They claim that, after the 1991 meeting, I "recommended no changes in the [incidence study's] methodology and definitions." But they conveniently leave out two important facts. First, at that meeting, I pointed out that the methodological changes that were planned for the study all would have the effect of raising the count of abused and neglected children. In fact, Sedlak and her colleagues described (in a report to HHS) how they planned to "fine-tune" the study to "ensure that categories of key participants who were most likely to encounter suspected maltreatment cases in the [1986 incidence study] are given higher probability of being included in the [new study]." In other words, they proposed to change the study's methodology so that more reports would be made to Westat. Second, I did urge that the study's conclusions be modified--six months before it was released to the public. On Dec. 7, 1995, Secretary Shalala issued a press release stating that "the number of abused and neglected children rose sharply from 1.4 million in 1986 to 2.9 million in 1993." I tried to get a copy of the report, but was informed that no one outside the government would be given a copy until it was complete. In other words, Shalala issued her press release based on an uncompleted report. Like others, I tried to get more information about the study from Westat, but was rebuffed. In fact, Sedlak sent me a memorandum stating that "the continued contacts from your office on the matter give the appearance of efforts to place me and my staff in a compromising position in relation to our client, NCCAN. Please ensure that your staff refrain from further contacts of this nature." Concerned, I wrote to Secretary Shalala in March, stating: "The Westat findings may be extremely significant, but there is reason to doubt that they reflect an actual increase in abuse and neglect." I went on to explain what the problems 4 of 7 10/25/96 14:10:39 Slate http://www.slate.com/Email/96-10-23/Email.asp seemed to be. and to offer my assistance in interpreting the study's results. In a bureaucratic nonresponse. a political appointee replied by enclosing a defense of the study prepared by Sedlak and stating, "I believe that the enclosed memo concerning the study adequately addresses your concerns." I mention this history, rather than dueling with Sedlak and Broadhurst's statistics, because I think that it exemplifies their selective presentation of information. The last time Sedlak conducted an incidence study, it had to be revised and reissued almost three years later because technical problems in the analysis inflated the estimated number of abused and neglected children by 11 percent. This time around, the problem seems to be more severe. The plain fact is that no attempt was made to conduct the kind of second-level analysis that would have explored whether the increases were real. (The data that they cite in their letter to contradict us, by the way, were not presented in the original report and, in any event, are too incomplete for these purposes.) I realize that one reason this essential work was not performed was that the government was unwilling to pay for it. But that is no excuse for announcing that "child abuse and neglect nearly doubled" without also cautioning the reader about the study's limitations. I hope that, before three years pass, a revised report that does so will be issued. Moreover, I doubt that the people at HHS seriously believe that child abuse doubled in seven years. If it had, America would be in the midst of a child-abuse crisis. Decisive and perhaps radical action would be required, not the puny list of previously planned and budgeted activities that Shalala described in her press release: A demonstration program in Illinois, $23 million in prevention grants, $2.5 million to maternal and child-health programs, past initiatives to fund family preservation programs and to oppose child-welfare block grants, and an "unprecedented" level of technical assistance to the states (again, though, not an increase). But the real reason I write is because of the broader problem created by exaggerating social ills. Cynics might chalk up this latest report as yet another well-meaning effort to build support for child-abuse programs. After all, goes the thinking, if the American people believe that child maltreatment is a big problem, they might be willing to spend more money on treatment and prevention programs. Richard Gelles, a longtime leader in the field and author of The Book of David: How Preserving Families Can Cost Children's Lives, says that he used to "go along" with past 5 of 7 10/25/96 14:10:4( Slate http://www.slate.com/Email/96-10-23/Emal.asp exaggerations. but has come to appreciate the harm that they have done. Exaggerating the severity of cases is what columnist Charles Krauthammer has called "defining deviancy up." The more it seems that such serious maltreatment is common, the less likely are agencies to respond firmly. To put it bluntly. society can consider a tough response to 150,000 serious cases a year--but 560,000 is an entirely different matter, politically and programmatically. I have worked in this field for almost 30 years--first as a young prosecutor in New York City, later as the director of the HHS National Center on Child Abuse and Neglect. and more recently as a trainer and consultant--and I know that child abuse and child neglect are profound national problems. But, time after time I have seen how such overstatements have made the problem seem too big to handle or have distorted policy-making. I am afraid that Shalala's remarks will do the same. Slate - E-Mail to the Editor 11/6/96 http://www.slate.com/Email/96-11-06/Email.asp HUG ME. the road is calling. Slate 24 ANSWER IT. ©LEXUS mail to the editors (posted Wednesday. Nov. 6) Abuse Redux I agree with the overarching point of Douglas J. Besharov and Jacob W. Dembosky's article, "Child Abuse: Threat or Menace?" I am sorry that they were not given more space to flesh out the details and evidence that support their position. I do believe that the administration has used the National Incidence Study of Child Abuse and Neglect (NIS-3) for purely political purposes--to demonize welfare reform and draw attention away from the fact that it (the administration) has no plan to rectify the crisis that afflicts the child-welfare system. Community professionals now see more abuse and neglect because they are trained to see more. Clearly, child-welfare professionals want--and need--to point to bigger numbers in order to bid for what they perceive to be diminished resources. However, there are survey data (that Deborah Daro and I collect) and data on homicide that indicate strongly that it is very unlikely that there is any kind of major increase in the rate of child maltreatment in the country. As to whether an effort should be mounted to get a better analysis of the report--well, the social scientist in me always wants more honest data analysis. On the other hand, many social scientists, myself included, find the NIS studies of such limited value that we rarely use the data or even reference the studies beyond a cursory mention that they have been conducted. On balance, though, I think that as the administration is going to fall back on NIS-3 to support anything they plan to do--and to block programs they don't want--it is wise to push for a more honest accounting of the study. --Richard J. Gelles director, University of Rhode Island Family Violence Research Program Kingston, R.I. 1 of 5 11/08/96 10:27:54 CDF State of America's Children,1994 1994 CHILDREN IN THE STATES 88,89,90,91,93 Children Reported Abused or Neglected, Distribution by Race and Ethnicity, 1991 Number Native Asian/Pacific reported Total White Black Latino American Islands Other Alabama 43,969 100.0% 61.5% 38.0% 0.2% 0.0% 0.2% - Alaska 8,983 100.0 55.3 83 2.8 30.7 15 1.4% Arizona 44.844 100.0 57.9 7.9 25.3 39 0.4 4.0 Arkansas 39.687 100.0 697 29.5 0.4 0.3 01 0.1 California 416,757 100.0 53.2 12.1 29.3 0.6 3.3 15 Colorado 50,874 1000 618 14.2 21.7 1.2 1.0 - Connecticut 22,080 100.0 54.9 26.2 18.1 0.1 0.6 1 Delaware 7.941 100.0 51.5 429 4.2 0.0 0.1 1.3 District of Columbia 9.444 100.0 2.9 87.5 5.1 - - 4.4 Florida 184,370 100.0 63.6 36.1 - 0.1 0.3 - Georgia 68,057 100.0 51.6 45.1 1.2 0.1 0.3 1.8 Hawaii 5,017 100.0 17.7 3.9 0.4 0.9 50.0 27.1 Idaho 19,507 100.0 806 0.5 12.4 1.7 07 4.2 Illinois 117.912 100.0 45.7 46.4 6.3 0.1 0.3 1.2 Indiana 63.192 100.0 80.7 17.4 1.4 0.0 0.1 0.2 Iowa 27,553 100.0 86.7 9.4 1.7 1.3 0.5 0.4 Kansas 19,280 - - - - - - - Kentucky 52,912 100.0 83.2 13.5 0.3 0.0 0.3 2.6 Louisiana 44,612 100.0 41.5 56.4 - - 05 2.2 Maine 9.503 - -- - - - - - Maryland 46,806 - - - - - - - Massachusetts 58,218 100.0 58.2 19.6 156 0.1 1.6 4.9 Michigan 113,932 100.0 64.1 33.0 2.1 0.6 0.2 - Minnesota 26.663 100.0 68.4 170 3.8 8.6 2.1 - Mississippi 20,138 100.0 44.1 55.4 0.1 0.1 0.2 0.1 Missouri 76,249 - - - - - - - Montana 11,029 - - - -- -- - - Nebraska 17,087 100.0 78.6 11.6 4.8 4.5 0.5 - Nevada 20.573 100.0 70.1 17.3 8.1 1.4 1.4 1.7 New Hampshire 10,480 - - - - - - - New Jersey 53,750 100.0 36.6 44.5 16.3 0.1 0.7 1.8 New Mexico 18.234 100.0 40.4 2.9 44.8 11.8 0.2 - New York 212,420 100.0 44.8 34.0 16.8 0.2 0.5 3.7 North Carolina 71,427 100.0 52.0 43.4 - 2.2 - 23 North Dakota 6,435 - - - - - - - Ohio 144,218 100.0 67.0 28.4 1.2 0.1 0.2 3.0 Oklahoma 21.328 100.0 70.5 14.3 1.8 12.4 - 1.0 Oregon 37,648 100.0 83.0 6.0 6.6 2.9 1.4 - Pennsylvania 23,861 - - I - - - - Rhode Island 13,820 100.0 71.2 15.2 10.0 0.4 1.2 1.9 South Carolina 30,978 100.0 44.9 53.6 I - I 1.4 South Dakota 11,205 100.0 46.3 - - 51.6 - 2.1 Tennessee 29.715 100.0 69.5 29.4 0.2 0.1 0.1 0.7 Texas 153,753 100.0 42.2 25.2 31.0 0.1 0.5 0.8 Utah 23.254 100.0 83.6 1.9 6.4 5.3 1.5 1.3 Vermont 2.689 100.0 98.4 0.6 0.2 0.2 0.3 0.2 Virginia 50.732 100.0 55.3 37.4 2.9 0.0 0.4 4.0 Washington 59,311 - - | - - - I I West Virginia 22.221 - - - - - - I Wisconsin 44,963 100.0 68.2 24.0 37 3.1 1.0 - Wyoming 5,379 100.0 73.6 2.0 B.1 101 - 1.2 United States 2,695,010 100.0% 58.2% 27.9% 10.0% 14% 0.8% 1.7% Note: States cannot be compared or ranked because of differing definitions and reporting requirements Furthermore, only some of the states report unduplicated counts, and not all states report data for all the racial and ethnic groups. Source: U.S. Department of Health and Human Services. National Center on Child Abuse and Neglect. National Child Abuse and Neglect Data System, Working Paper 2. [99] Summary Data Component. Calculations by Children's Defense Fund 88 CHILDGEN'S DEFENSE FUND Children Younger Than 18 in Foster Care, FY 1990-FY 1992 Last day Last day Last day Percent change FY 1990 FY 1991 FY 1992 FY 1990-1992 Alabama 4,420 4.383 4.133 -6 5% Alaska 3.852 1,942 1.496 -612 Arizona 3.379 3.618 3,909 15.7 Arkansas 1.351 1.326 1,981 46.6 California 79.482 80,880 83,849 5.5 Colorado 3.892 5,519 4.390 12.8 Connecticut 4,121 4.202 4,252 32 Delaware 663 655 638 -3.8 District of Columbia 2,313 - 2,152 -7.0 Florida 10,664 10,235 9.928 -6.9 Georgia 15.179 15,500 16,999 12.0 Hawaii 1,659 1,600 1.214 -26.8 Idaho 548 877 1,235 125.4 Illinois 20,753 23,776 29.542 42.4 Indiana 7,492 8,126 8,455 12.9 Iowa 3,425 4,609 3.606 5.3 Kansas 3.976 7.112 7.838 97.1 Kentucky 3,810 6.422 6,966 828 Louisiana 5.379 5,799 5.722 64 Maine 1,745 1,814 1.944 11.4 Maryland 6.473 4.859 5,816 -10.1 Massachusetts 11,856 13,232 13,147 10.9 Michigan 9,000 11,282 11.121 236 Minnesota 7,310 7.898 7.895 8.0 Mississippi 2.832 2,830 3.169 11.9 Missouri 8,241 7.143 8.171 -.8 Montana 1.224 1,494 1,691 38.2 Nebraska 2,543 2,660 2,985 17.4 Nevada 2.566 1.563 1,664 -35.2 New Hampshire 1,505 2,095 2.630 74.8 New Jersey 8,879 8,451 8,024 -96 New Mexico 2,042 2,304 2.118 3.7 New York 63,371 65.171 62,705 -1.1 North Carolina 7.170 9,619 10,275 43.3 North Dakota 393 695 759 93.1 Ohio 18,062 17,298 17,099 -5.3 Oklahoma 3,435 3,803 2,892 -15.8 Oregon 4,261 3,996 4,031 -5.4 Pennsylvania 16,665 17,508 18,491 11.0 Rhode Island 2,680 3,311 2.755 2.8 South Carolina 3,286 3,698 5,066 54.2 South Dakota 567 613 674 18.9 Tennessee 4,971 5,217 5,312 6.9 Texas 6,698 7,200 9.965 48.8 Utah 1,174 1,405 895 -23.8 Vermont 1,063 1,088 1.162 9.3 Virginia 6.217 6,590 6.305 14 Washington 13,302 13,956 11,327 -14.8 West Virginia 1,997 1.997 2.315 15.9 Wisconsin 6,037 6,403 6,812 12.8 Wyoming 484 605 907 87.4 United States 404.407 424.379 438.427 8.3% Note: States cannot be compared or ranked because of definitional variations. Source: American Public Welfare Association, Voluntary Cooperative Information System Calculations by Children's Defense Fund. 89 CHILDREN IN THE STATES Number of Children Living in Group Quarters Due to Own or Family Problems, by Race and Ethnicity, 1990 Total, Native Asian/Pacific Other all races White Black Latino American Islander Race Alabama 3,455 2,058 1,347 36 18 23 9 Alaska 598 301 44 25 238 10 5 Arizona 3.019 2.014 441 815 265 43 256 Arkansas 1.696 1,146 514 29 16 1) 11 California 25,235 13.105 6.569 8,459 519 1.098 3.944 Colorado 2.457 1.894 304 560 90 22 147 Connecticut 3,572 1.768 1,446 701 35 25 298 Delaware 364 151 200 21 1 3 9 District of Columbia 1,704 258 1.404 51 5 15 22 Florida 8,876 4,824 3,739 813 73 58 182 Georgia 4,490 2,150 2.268 81 20 23 29 Hawair 644 180 47 117 12 392 13 Idaho 881 755 8 119 37 11 70 Illinois 6,908 3,650 2.890 590 47 82 239 Indiana 4,596 3,400 1,076 141 28 17 75 lowa 2.233 1.954 178 82 40 19 42 Kansas 2.148 1.525 392 196 58 59 114 Kentucky 2.160 1,706 409 23 18 4 23 Louisiana 3,942 1.910 1.976 75 21 17 18 Maine 606 575 9 7 12 8 2 Maryland 3.879 1,424 2.372 124 23 36 24 Massachusetts 4.620 2,985 1,126 841 33 76 400 Michigan 6.043 3.119 2.637 268 128 25 134 Minnesota 2.916 2,041 490 129 273 35 77 Mississippi 1.667 895 746 17 11 11 4 Missouri 4,231 2,714 1,413 84 40 21 43 Montana 573 408 18 28 121 8 18 Nebraska 1,561 1,132 259 124 87 15 68 Nevada 1,265 819 298 189 45 32 71 New Hampshire 601 561 25 18 1 5 9 New Jersey 4,998 1.465 3.132 707 27 36 338 New Mexico 1,238 726 74 488 235 7 196 New York 20,008 6,587 11,189 4,982 147 197 1,888. North Carolina 4.187 2,284 1.741 65 119 19 24 North Dakota 660 347 6 18 302 4 1 Ohio 7,539 4,473 2,891 180 40 26 109 Oklahoma 2,566 1,753 449 102 306 13 45 Oregon 2,122 1,707 131 188 146 40 98 Pennsylvania 9,494 4.782 4,263 664 51 50 348 Rhode Island 563 399 133 48 6 6 19 South Carolina 3,037 1.691 1.308 26 13 7 18 South Dakota 947 513 13 29 396 7 18 Tennessee 4.236 2.951 1.213 57 30 23 19 Texas 13.434 8,904 2.931 3.579 88 123 1,388 Utah 1,299 1.126 28 148 40 22 83 Vermont 177 171 2 4 3 0 I Virginia 4.771 2.578 1.962 243 30 66 135 Washington 3.187 2,179 574 249 269 55 110 West Virginia 926 822 79 X 14 5 6 Wisconsin 3.191 1.936 1.056 167 107 20 72 Wyoming 501 432 8 66 22 to 37 United States 196,021 109.248 67,828 26,781 4,706 2,930 11,309 Note Latino persons may be of any race Source US Department of Commerce. Bureau of the Census. 1990 Census of Population and Housing. special Group Quarters tabulation 90 CHILDREN DEFENSE FUND Number of Children Living in Group Quarters Due to Own or Family Problems, by Reason, 1990 Home- Mental/ Abuse or Drug or Adult Juvenile Physical/ lessness emotional neglect alcohol corrections delinquency medical Alabama 703 414 769 156 345 686 382 Alaska 134 93 86 93 I 172 19 Arizona 580 420 240 90 261 1.293 135 Arkansas 215 297 446 72 172 262 232 California 6.416 3,600 1.965 590 2.890 9.084 690 Colorado 470 738 183 (11) 81 801 109 Connecticut 1.531 763 298 108 270 428 174 Delaware 120 101 38 17 12 76 0 District of Columbia 1,118 87 65 16 213 54 151 Florida 1,648 1.475 888 465 2.267 1.544 589 Georgia 758 996 042 181 1,030 662 221 Hawaii 312 77 0 155 52 41 7 Idaho 185 153 60 86 ++ 280 73 Illinois 1,479 1.331 1.218 162 799 1.351 568 Indiana 679 828 1.316 116 357 1.109 191 lowa 344 751 211 113 90 532 192 Kansas 383 719 325 28 323 269 101 Kentucky 422 528 263 101 178 515 153 Louisiana 413 979 272 207 680 1.113 278 Maine 106 12 % 63 21 283 25 Maryland 812 968 310 45 516 1.007 221 Massachusetts 1.693 1.244 625 107 136 453 362 Michigan 983 1,328 549 44 592 2,293 254 Minnesota 429 655 167 323 303 821 218 Mississippi 223 306 269 60 114 562 133 Missouri 725 1,000 1,000 166 344 735 261 Montana 106 85 48 22 11 285 16 Nebraska 117 275 653 63 94 280 79 Nevada 160 173 199 18 292 359 64 New Hampshire 84 62 86 111 2 183 73 New Jersey 2.529 636 187 166 319 990 171 New Mexico 184 135 279 94 114 267 165 New York 8,305 4,220 1,495 378 1,751 2.846 1,013 North Carolina 529 1.008 1.056 79 533 580 402 North Dakota 50 69 95 22 10 318 96 Ohio 1.100 1.240 1.168 135 176 3,402 318 Oklahoma 614 622 316 255 147 468 144 Oregon 610 384 182 118 60 718 50 Pennsylvania 2,305 1,879 1,212 320 281 3.161 336 Rhode Island 114 56 127 13 3 243 7 South Carolina 321 399 739 18 203 1.082 275 South Dakota 150 96 194 11 56 326 114 Tennessee 506 1,171 886 184 168 947 374 Texas 2.116 3.567 2,939 733 1,264 2,271 544 Utah 112 644 0 21 30 452 40 Vermont 32 29 95 I 3 14 " Virginia 816 992 518 88 171 1.832 354 Washington 1,061 432 159 114 177 1,071 173 West Virginia 185 58 177 32 77 228 169 Wisconsin 488 1,034 243 135 109 1,085 97 Woming 95 101 53 20 22 210 () United States 45,576 39.230 25,407 6,784 18,164 50,044 10.816 Source: U.S. Department of Commerce. Bureau of the Census. 1990 lensus of Population and Housing, special Group Quarters tabulation. 91 CHILDREN'S DEFENSE FUND Maximum Number of Children Allowed per Caretaker and Maximum Group Size in Child Care Centers, by Age of Children Children per caretaker Group size 12 2 4 12 2 .4 months years years months years years Alabama 6 8 20 6 X 20 Alaska 6 6 10 - - - Arizona 'JI 10 15 - - - Arkansas 6 1) 15 - - - California + 12 12 - - - Colorado 5 7 12 10 14 | Connecticut 4 + 10 8 8 20 Delaware 7 10 15 - - — District of Columbia 4 4 10 8 8 20 Florida 6 11 20 - - - Georgia S 10 18 12 16 30 Hawaii 5 % 16 12 - - Idaho 12 12 12 - - - Illinois 4 S 10 12 16 20 Indiana + 5 I2 10 15 - lowa 4 6 12 - - - Kansas 5 7 12 11) 14 24 Kentucky 6 10 14 12 20 28 Louistana 8 12 10 - - - Maine 4 5 8 12 15 24 Maryland ; 6 10 6 12 20 Massachusetts 3 4 10 7 1) 20 Michigan 4 4 12 - - - Minnesota 4 7 10 8 14 20 Mississippi 1) 12 16 10 14 20 Missouri 4 8 10 8 16 - Montana 4 x 8 - - I Nebraska + 6 12 - - - Nevada 6 8 13 - - - New Hampshire + 5 12 12 15 24 New Jersey 4 7 15 -- - -- New Mexico 6 10 12 - - - New York 4 5 8 8 10 16 North Carolina i 12 20 14 24 25 North Dakota 4 5 10 - - - Ohio 6 X 14 12 16 28 Oklahoma () 8 15 12 16 30 Oregon + 4 10 8 8 20 Pennsylvania + 5 10 8 10 20 Rhode Island 4 6 10 8 12 20 South Carolina 7 7 14 - - - South Dakota 5 5 10 20 20 20 Tennessee 7 8 15 14 16 20 Texas 6 13 20 - - - Utah + -1 15 8 8 - Vermont 4 5 10 8 10 20 Virginia 4 10 12 - - - Washington 7 7 10 14 14 20 West Virginia + 8 12 - - - Wisconsin 4 6 13 % 12 24 Wyoming 5 8 15 I - - Recommended 5 6 10 12 12 20 - = Not regulated Source. Rine strug Magrane November 1993 93 (DF, The State If Am's Children, 1994 Children in the Nation 73-77 National Trends Poverty Number of Number of Rate for Children Child Children ] Children Younger than 18 Poverty Younger than Six Younger Year Who Are Poor Rate Who Are Poor than Six 1959 17,552,000 27.3% n/a n/a 1960 17,634,000 26.9 n/a n/a 1961 16,909,000 25.6 n/a n/a 1962 16,963,000 25.0 n/a n/a 1963 16,005,000 23.1 n/a n/a 1964 16,051,000 23.0 n/a n/a 1965 14,676,000 21.0 n/a n/a 1966 12,389,000 17.6 n/a n/a 1967 11,656,000 16.6 n/a n/a 1968 10,954,000 15.6 n/a n/a 1969 9,691,000 14.0 3,298,000 15.3% 1970 10,440,000 15.1 3,561,000 16.6 1971 10.551.000 15.3 3,499,000 16.9 1972 10,284,000 15.1 3,276,000 16.1 1973 9,642,000 14.4 3,097,000 15.7 1974 10,156,000 15.4 3,294,000 169 1975 11.104,000 17.1 3.460,000 18.2 1976 10,273,000 16.0 3,270,000 17.7 1977 10,288,000 16.2 3,326,000 18.1 1978 9,931,000 15.9 3,184,000 17.2 1979 10,377,000 16.4 3.415,000 17.8 1980 11,543,000 18.3 4,030,000 20.5 1981 12,505,000 20.0 4,422,000 22.0 1982 13,647,000 21.9 4.821,000 23.3 1983 13,911,000 22.3 5,122,000 24.6 1984 13,420,000 21.5 4,938,000 23.4 1985 13,010,000 20.7 4.832,000 22.6 1986 12,876,000 20.5 4,619,000 21.6 1987 12,843,000 20.3 4,852,000 22.4 1988 12,455,000 19.5 5,032,000 22.6 1989 12,590,000 19.6 5,071,000 22.5 1990 13,431,000 20.6 5,198,000 23.0 1991 14,341,000 21.8 5,483,000 24.0 1992 14.617,000 21.9 5.781,000 25.0 Total percent change 1969-1992 50.1% 56.4% 75.3% 63.4% 1980-1992 26.6 19.7 43.4 22.0 Average annual percent change 1969-1992 2.2 2.5 3.3 2.8 1980-1992 2.2 1.6 3.6 1.8 'Related children in families. Source: U.S. Department of Commerce, Bureau of the Census. Calculations by Children's Defense Fund. 73 HILDREN IN THE NATION National Trends (continued) I Infant Mortality Rates Percent of Babies Born Low to Mothers Who Received Black- Birth- Late or No Prenatal Care White weight Year Total White Black Ratio Rate Total White² Black 1940 47.0 43.2 72.9 1.69 na n/a n/a n/a 1950 29.2 26.8 43.9 1.64 n'a n/a n/a n/a 1959 26.4 23.2 44.8 1.93 na n/a n/a n/a 1960 26.0 22.9 44.3 1.93 7.7% n/a n/a n/a 1961 25.3 22.4 41.8 1.87 7.8 n/a n/a n/a 1962 25.3 22.3 42.6 1.91 8.0 n/a n/a n/a 1963 25.2 22.2 42.8 1.93 8.2 n/a n/a n/a 1964 24.8 21.6 42.3 1.96 8.2 n/a n/a n/a 1965 24.7 21.5 417 1.94 8.3 n/a n/a n/a 1966 237 20.6 40.2 1.95 8.3 n/a n/a n/a 1967 224 19.7 37.5 1.90 8.2 n/a n/a n/a 1968 21.8 19.2 36.2 1.89 8.2 n/a n/a n/a 1969 20.9 18.4 34.8 1.89 8.1 8.1% 6.3% 18.2% 1970 20.0 17.8 32.6 1.83 7.9 7.9 6.2 16.6 1971 19.1 17.1 30.3 1.77 7.7 7.2 5.8 14.6 1972 18.5 16.4 29.6 1.80 7.7 7.0 5.5 13.2 1973 177 15.8 28.1 1.78 7.6 6.7 5.4 12.4 1974 16.7 14.8 26.8 1.81 7.4 6.2 5.0 11.4 1975 16.1 14.2 26.2 1.85 7.4 6.0 5.0 10.5 1976 15.2 13.3 25.5 1.92 7.3 5.7 4.8 9.9 1977 14.1 12.3 23.6 1.92 7.1 5.6 4.7 9.6 1978 13.8 12.0 23.1 1.93 7.1 5.4 4.5 9.3 1979 13.1 11.4 21.8 191 6.9 5.1 4.3 8.9 1980 12.6 11.0 21.4 1.95 6.8 5.1 4.3 8.8 1981 11.9 10.5 20.0 1.90 6.8 5.2 4.3 9.1 1982 11.5 10.1 19.6 1.94 6.8 5.5 4.5 9.6 1983 11.2 9.7 19.2 1.98 6.8 5.6 4.6 9.7 1984 10.8 9.4 18.4 1.96 6.7 5.6 4.7 9.6 1985 10.6 9.3 18.2 1.96 6.8 5.7 4.7 10.0 1986 10.4 8.9 18.0 2.02 6.8 6.0 5.0 10.6 1987 10.1 8.6 17.9 2.08 6.9 6.1 5.0 11.1 1988 10.0 8.5 17.6 2.07 6.9 6.1 5.0 10.9 1989 9.8 8.2 17.7 2.16 7.0 6.4 5.2 11.7 1990 9.2 7.7 17.0 2.21 7.0 6.1 4.9 11.1 1991 8.9 7.5 16.5 2.20 7.1 5.8 4.7 10.7 Total percent change 1969-1991 -57 4% -59.2% -52.6% - -12.3% -28.4% -25.4% -41.2% 1980-1991 -29.4 -31.8 -22.9 - 4.4 13.7 9.3 21.6 Average annual percent change 1969.1991 -2.6 -2.7 -2.4 - -0.6 -1.3 -12 -1.9 1980-1991 -2.7 -2.9 -2.1 - 0.4 1.2 0.8 2.0 Infant deaths per 1.000 live births. Race of child through 1990: race of mother thereafter. Source: U.S. Department of Health and Human Services. National Center for Health Statistics. Calculations by Children's Defense Fund. 74 CHILDREN'S DEFENSE FUND National Trends (continued) Total Teen Total Unmarried Teen Unmarried Birth Birth Birth Birth Year Rate 2 Rate Rate Rate 4 1959 118.8 21.9 89.1 15 5 1960 118.0 21.6 89.1 15.3 1961 117.1 22.7 88.6 16.0 1962 112.0 21.9 81.4 14.8 1963 108.3 22.5 76.7 15.3 1964 104.7 23.0 73.1 15.9 1965 96.3 235 70.5 16.7 1966 90.8 23.4 70.3 17.5 1967 87.2 23.9 67.5 18.5 1968 85.2 24.4 65.6 19.7 1969 86.1 25.0 65.5 20.4 1970 87.9 26.4 68.3 22.4 1971 81.6 25.5 64.5 22.3 1972 73.1 24.8 61.7 228 1973 68.8 24.3 59.3 22.7 1974 67.8 23.9 57.5 23.0 1975 66.0 245 55.6 23.9 1976 65.0 24.3 52.8 23.7 1977 66.8 25.6 52.8 25.1 1978 65.5 25.7 51.5 24.9 1979 67.2 27.2 52.3 26.4 1980 68.4 29.4 53.0 27.6 1981 67.4 29.5 52.2 27.9 1982 67.3 30.0 52.4 28.7 1983 65.8 30.3 51.4 29.5 1984 65.4 31.0 50.6 30.0 1985 66.2 32.8 51.0 31.4 1986 65.4 34.2 502 32.3 1987 65.7 36.0 506 33.8 1988 67.2 38.5 53.0 36.4 1989 69.2 41.6 57.3 40.1 1990 70.9 43.8 59.9 42.5 1991 69.6 45.2 62.1 44.8 Total percent change 1969-1991 -19.2% 80.8% -5.2% 119.6% 1980-1991 1.8 53.7 17.2 62.3 Average annual percent change 1969-1991 -0.9 3.7 -0.2 5.4 1980-1991 0.2 4.9 1.6 5.7 Per 1,000 women ages 15.44: this rate also is called the fertility rate. Per 1,000 unmarried women ages 15.44. Per 1,000 women ages 15-19. 'Per 1.000 unmarried women ages 15.19. 75 CHILDREN IN THE NATION Maternal Labor Force Participation of Married Women With Children Younger Than Six In the Labor Force Year Number Percent 1948 1,226,000 10.8% 1949 1,285,000 11.0 1950 1,399,000 11.9 1951 1,670,000 14.0 1952 1,688,000 13.9 1953 1,884,000 15.5 1954 1,808,000 14.9 1955 2,012,000 16.2 1956 2,048,000 15.9 1957 2,208,000 17.0 1958 2,399,000 18.2 1959 2,471,000 18.7 1960 2,474,000 18.6 1961 2,661,000 20.0 1962 2,884,000 21.3 1963 3,006,000 22.5 1964 3,050,000 22.7 1965 3,117,000 23.2 1966 3,186,000 24.2 1967 3,481,000 26.5 1968 3,564,000 27.6 1969 3,596,000 28.5 1970 3,914,000 30.3 1971 3,690,000 296 1972 3,778,000 30.1 1973 4.104,000 32.7 1974 4,274,000 34.4 1975 4,518,000 36.7 1976 4,520.000 37.5 1977 4,547,000 394 1978 4,768,000 41.7 1979 4,939,000 43.3 1980 5,227,000 45.1 1981 5,603,000 47.8 1982 5,690,000 48.7 1983 5,859,000 49.9 1984 6,219,000 51.8 1985 6,406,000 53.4 1986 6,573,000 53.8 1987 6,952,000 56.8 1988 6,956,000 57.1 1989 n/a n/a 1990 7,247,000 58.9 1991 7,434,000 59.9 1992 7,333,000 59.9 1993 7,289,000 59.6 Average annual change 1950-60 107.500 1960-70 144,000 1970-80 131.300 1980-93 158,600 Source: U.S. Department of Labor. Bureau of Labor Statistics. Calculations by Children's Defense Fund. 76 MCHILDREN'S DEFENSE FUND Youth Unemployment Rates, National Trends Total Unemployment Rates, Youth Not Enrolled in Unemployment Rates School, Level of Education Less than High Four Years All Age Age Four Years School or More Year Ages 16-19 20-24 of High School Graduate Only of College 1959 5.5%. 14.6% 8.5%. n/a n/a n/a 1960 55 14.7 8.7 n/a n/a n/a 1961 6.7 16.8 10.4 n/a n/a n/a 1962 5.5 14.7 9.0 n/a n/a n/a 1963 5.7 17.2 8.8 n/a n/a n/a 1964 5.2 16.2 83 n/a n/a n/a 1965 45 14.8 6.7 n/a n/a n/a 1966 3.8 12.8 5.3 n/a n/a n/a 1967 3.8 12.9 5.7 n/a n/a n/a 1968 3.6 12.7 5.8 n/a n/a n/a 1969 3.5 12.2 5.7 n/a n/a n/a 1970 4.9 15.3 8.2 17.2% 9.9% 6.5% 1971 5.9 16.9 10.0 18.0 9.6 6.6 1972 5.6 16.2 9.3 16.8 9.5 7.2 1973 4.9 14.5 7.8 14.9 72 4.9 1974 5.6 16.0 91 192 9.8 50 1975 8.5 19.9 13.6 25.3 136 8.2 1976 7.7 19.0 12.0 24.7 12.1 7.1 1977 7.1 17.8 11.0 20.6 10.5 8.0 1978 6.1 16.4 9.6 18.8 8.8 6.3 1979 5.8 16.1 9.1 19.2 9.9 5.0 1980 7.1 17.8 11.5 25.3 12.5 5.9 1981 7.6 196 12.3 26.9 13.8 5.3 1982 9.7 23.2 14.9 31.8 17.3 9.2 1983 9.6 22.4 14.5 27.3 15.2 7.0 1984 7.5 18.9 11.5 25.8 11.8 5.9 1985 7.2 18.6 11.1 25.9 12.7 5.4 1986 7.0 18.3 10.7 24.3 11.5 4.8 1987 6.2 16.9 9.7 21.8 10.7 5.5 1988 5.5 153 8.7 20.0 10.1 4.8 1989 5.3 15.0 8.6 19.9 101 5.0 1990 5.5 15.5 8.8 20.0 10.4 5.2 1991 6.7 18.6 10.8 23.1 12.7 6.9 1992 7.4 20.0 11.3 24.9 13.9 6.5 Total percent change 1970-1992 51.0% 30.7% 37.8% 44.8% 40.4% 0.0% 1980-1992 4.2 12.4 -1.7 -1.6 11.2 10.2 Average annual percent change 1970-1992 23 1.4 1.7 2.0 1.8 0.0 1980-1992 0.4 10 -0.1 -0.1 0.9 0.9 Source: U.S. Department of Labor. Bureau of Labor Statistics. Calculations by Children's Defense Fund. 77 JUL-25-96 11:58 FROM:ACF/OPS/OMS WASH. D.C. ID:2022054928 PAGE 1/3 HEALTH = FACSIMILE TRANSMISSION COVER SHEET Administr ation for Children and Families Office of Public Affairs 370 L'Enfant Promenade, S.W. Washington, D.C. 20447 Fax (202) 205-9688 Date 7/25 To : ANDREW TOMLINSON From: MICHAEL KHAREEN Phone 456-5578 Phone: 456-7028 Fax 456-7028 Cover + 2 pages Message: JUL-25-96 11:58 FROM:ACF/OPS/OMS WASH.D.C. ID:2022054928 PAGE 2/3 HHS FACT SHEET U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES December 7, 1995 Contact: Michael Kharfen (202) 401-9215 BACKGROUND: Preliminary Findings Regarding Child Abuse and Neglect HHS Secretary Donna E. Shalala cited new preliminary data today which add to the evidence of substantial increase in child abuse and neglect in the United States. Secretary Shalala's prepared remarks were presented in Chicago at a conference of the National Association of Family Based Services. The preliminary data are from the National Incidence Study of Child Abuse and Neglect, performed by Westat, a Maryland social science research corporation, for HHS' National Center on Child Abuse and Neglect. This is the third National Incidence Study -- the first was released in 1981, the second in 1988. The new study is to be released in final form early next year. The National Incidence Studies have been mandated by Congress. This study is designed to estimate the actual extent of child abuse and neglect in the United States, including cases not reported to child protective services. Instead of relying only on official reports of abuse and neglect, the estimates in the study are based on information from 5,700 community professionals who were likely to come into contact with maltreated children in a variety of community settings. The preliminary data indicate that the incidence of child abuse and neglect more than doubled over the seven year period, 1986- 1993: The number of abused and neglected children rose sharply from 1.4 million in 1986 to 2.9 million in 1993, an increase of 105 percent, according to the study. The study also found that the number of children who were seriously injured nearly quadrupled over the same time period from about 143,000 to more than 572,000. These estimates of the actual incidence of abuse and neglect are higher than the number of cases reported, investigated and confirmed. From official data of reported cases investigated by Child Protective Services, we have known that over 1 million children were victims of abuse and neglect in 1993 and that the number of substantiated cases had grown by over 38 percent since 1986. The new estimates cited by Secretary Shalala suggest that many more children are being abused and neglected, and that the problem has been growing more rapidly than official reports indicate. JUL-25-96 11:58 FROM : ACF/OPS/OMS WASH. D.C. ID:2022054928 PAGE 3/3 - 2 - In her remarks, Secretary Shalala said that the increased number of children in danger will place more stress on an already overburdened and under-supported child protection system: "All over this country, children are being hurt more often and more seriously -- and all of us must join hands to stop it, once and for all. We must maintain our national commitment to protect children's safety." "The Republican leadership in Congress claims that they are reforming welfare. But nothing could be further from the truth. They're slashing giant holes in funding for child care, school lunches, and aid to disabled children - - and that's not welfare reform." "So, when Congress tries to slash $4.6 billion dollars - - more than 20 percent - - from foster care, adoption assistance, and child abuse prevention programs - - placing hundreds of thousands of children at additional risk -- we must say No." In vetoing the Congressional reconciliation legislation Wednesday (Dec. 6), President Clinton also addressed the question of welfare reform: "Americans know we have to reform the broken welfare system, but cutting child care that helps mothers move from welfare to work, cutting help for abused and disabled children, cutting school lunch, that's not welfare reform. Real welfare reform should be tough on work and tough on responsibility, but not tough on children or tough on parents who are responsible and who want to work. We shouldn't lose this historic chance to end welfare as we know it by using the words 'welfare reform' as just another cover to violate our values." ### SOCIAL SCIENCE AND MODERN Society Volume Thirty-Three, Number Four May/June 1996 Child Abuse Reporting Douglas J. Besharov with Lisa A. Laumann F or 30 years, advocates, program administrators, children revealed by these initial reporting laws, led many and politicians have joined to encourage even more states to expand their reporting requirements. Now al- reports of suspected child abuse and neglect. Their ef- most all states have laws that require the reporting of all forts have been spectacularly successful, with about forms of suspected child maltreatment, including physi- three million cases of suspected child abuse having been cal abuse, physical neglect, emotional maltreatment, and, reported in 1993. Large numbers of endangered chil- of course, sexual abuse and exploitation. dren still go unreported, but an equally serious prob- Under threat of civil and criminal penalties, these lem has developed: Upon investigation, as many as 65 laws require most professionals who serve children to percent of the reports now being made are determined report suspected child abuse and neglect. About twenty to be "unsubstantiated," raising serious civil liberties states require all citizens to report, but in every state, concerns and placing a heavy burden on already over- any citizen is permitted to report. whelmed investigative staffs. These reporting laws, associated public awareness These two problems-nonreporting and inappropri- campaigns, and professional education programs have ate reporting-are linked and must be addressed to- been strikingly successful. In 1993, there were about gether before further progress can be made in combating three million reports of children suspected of being child abuse and neglect. To lessen both problems, there abused or neglected. This is a twenty-fold increase since must be a shift in priorities-away from simply seek- 1963, when about 150,000 cases were reported to the ing more reports and toward encouraging better reports. authorities. (As we will see, however, this figure is bloated by reports that later turn out to be unfounded.) Reporting Laws Many people ask whether this vast increase in re- Since the early 1960s, all states have passed laws porting signals a rise in the incidence of child mal- that require designated professionals to report speci- treatment. Recent increases in social problems such as fied types of child maltreatment. Over the years, both out-of-wedlock births, inner-city poverty, and drug the range of designated professionals and the scope of abuse have probably raised the underlying rates of child reportable conditions have been steadily expanded. maltreatment, at least somewhat. Unfortunately, so Initially, mandatory reporting laws applied only to many maltreated children previously went unreported physicians, who were required to report only "serious that earlier reporting statistics do not provide a reli- physical injuries" and "nonaccidental injuries." In the able baseline against which to make comparisons. One ensuing years, however, increased public and profes- thing is clear, however: The great bulk of reports now sional attention, sparked in part by the number of abused received by child protective agencies would not be made CHILD ABUSE REPORTING / 41 but for the passage of mandatory reporting laws and identify children with certain, specified harms or con- the media campaigns that accompanied them. ditions, which were then decoded into a count of vari- This increase in reporting was accompanied by a ous types of child abuse and neglect.) substantial expansion of prevention and treatment pro- Because the information these selected profession- grams. Every community, for example, is now served als provided could be matched against pending cases by specialized child protective agencies that receive in the local child protective agency, Westat was able and investigate reports. Federal and state expenditures to estimate rates of nonreporting among the surveyed for child protective programs and associated foster care professionals. It could not, of course, estimate the level services now exceed $6 billion a year. (Federal expen- of unintentional nonreporting, since there is no way ditures for foster care, child welfare, and related ser- to know of the situations in which professionals did vices make up less than 50 percent of total state and not recognize signs of possible maltreatment. There federal expenditures for these services; in 1992, they is also no way to know how many children the pro- amounted to a total of $2,773.7 million. In addition, fessionals recognized as being maltreated but chose states may use a portion of the $2.8 billion federal not to report to the study. Obviously, since the study Social Services Block Grant for such services, though methodology involved asking professionals about chil- detailed data on these expenditures are not available. dren they had seen in their professional capacities, it Beginning in 1994, additional federal appropriations also did not allow Westat to estimate the number of funded family preservation and support services.) children seen by nonprofessionals, let alone their As a result, many thousands of children have been nonreporting rate. saved from serious injury and even death. The best Westat found that professionals failed to report estimate is that over the past twenty years, child abuse many of the children they saw who had observable and neglect deaths have fallen from over 3,000 a year- signs of child abuse and neglect. Specifically, it found and perhaps as many as 5,000-to about 1,100 a year. that in 1986, 56 percent of apparently abused or ne- In New York State, for example, within five years of glected children, or about 500,000 children, were not the passage of a comprehensive reporting law, which reported to the authorities. This figure, however, seems also created specialized investigative staffs, there was more alarming than it is: Basically, the more serious a 50 percent reduction in child fatalities, from about the case, the more likely the report. For example, the two hundred a year to less than one hundred. (This is surveyed professionals reported over 85 percent of not meant to minimize the remaining problem. Even at the fatal or serious physical abuse cases they saw, 72 this level, maltreatment is the sixth largest cause of percent of the sexual abuse cases, and 60 percent of death for children under fourteen.) the moderate physical abuse cases. In contrast, they only reported 15 percent of the educational neglect Unreported Cases cases they saw, 24 percent of the emotional neglect Most experts agree that reports have increased over cases, and 25 percent of the moderate physical ne- the past thirty years because professionals and layper- glect cases. sons have become more likely to report apparently Nevertheless, there is no reason for complacency. abusive and neglectful situations. But the question re- Translating these raw percentages into actual cases mains: How many more cases still go unreported? means that in 1986. about 2,000 children with ob- Two studies performed for the National Center on servable physical injuries severe enough to require Child Abuse and Neglect by Westat, Inc., provide a hospitalization were not reported and that more than partial answer. In 1980 and then again in 1986, Westat 100,000 children with moderate physical injuries went conducted national studies of the incidence of child unreported. as did more than 30,000 apparently sexu- abuse and neglect. (A third Westat incidence study is ally abused children. And these are the rates of now underway.) Each study used essentially the same nonreporting among relatively well-trained profession- methodology: In a stratified sample of counties, a als. One assumes that nonreporting is higher among broadly representative sample of professionals who less-well-trained professionals and higher still among serve children was asked whether, during the study laypersons. period, the children they had seen in their professional Obtaining and maintaining a high level of reporting capacities appeared to have been abused or neglected. requires a continuation of the public education and (Actually, the professionals were not asked the ulti- professional training begun thirty years ago. But, now, mate question of whether the children appeared to be such efforts must also address a problem as serious as "abused" or "neglected." Instead, they were asked to nonreporting: inappropriate reporting. 42 / SOCIETY MAY/JUNE 1996 At the same time that many seriously abused chil- gation that is inherently a breach of parental and fam- dren go unreported, an equally serious problem fur- ily privacy. To determine whether a particular child is ther undercuts efforts to prevent child maltreatment: in danger, caseworkers must inquire into the most inti- The nation's child protective agencies are being inun- mate personal and family matters. Often it is neces- dated by inappropriate reports. Although rules, proce- sary to question friends, relatives, and neighbors, as dures, and even terminology vary-some states use the well as school teachers, day-care personnel, doctors, phrase "unfounded," others "unsubstantiated" or "not clergy, and others who know the family. indicated"-an "unfounded" report, in essence, is one Laws against child abuse are an implicit recogni- that is dismissed after an investigation finds insuffi- tion that family privacy must give way to the need to cient evidence upon which to proceed. protect helpless children. But in seeking to protect chil- dren, it is all too easy to ignore the legitimate rights of Unsubstantiated Reports parents. Each year, about 700,000 families are put Nationwide, between 60 and 65 percent of all re- through investigations of unfounded reports. This is a ports are closed after an initial investigation determines massive and unjustified violation of parental rights. that they are "unfounded" or "unsubstantiated." This Few unfounded reports are made maliciously. Stud- is in sharp contrast to 1974, when only about 45 per- ies of sexual abuse reports, for example, suggest that, cent of all reports were unfounded. at most, from 4 to 10 percent of these reports are know- A few advocates, in a misguided effort to shield child ingly false. Many involve situations in which the per- protective programs from criticism, have sought to son reporting, in a well-intentioned effort to protect a quarrel with estimates that I and others have made that child, overreacts to a vague and often misleading pos- the national unfounded rate is between 60 and 65 per- sibility that the child may be maltreated. Others in- cent. They have grasped at various inconsistencies in volve situations of poor child care that, though of the data collected by different organizations to claim legitimate concern, simply do not amount to child abuse either that the problem is not so bad or that it has al- or neglect. In fact, a substantial proportion of unfounded ways been this bad. cases are referred to other agencies for them to provide To help settle this dispute, the American Public needed services for the family. Welfare Association (APWA) conducted a special sur- Moreover, an unfounded report does not necessar- vey of child welfare agencies in 1989. The APWA ily mean that the child was not actually abused or researchers found that between fiscal year 1986 and neglected. Evidence of child maltreatment is hard to fiscal year 1988, the weighted average for the sub- obtain and might not be uncovered when agencies lack stantiation rates in thirty-one states declined 6.7 per- the time and resources to complete a thorough inves- cent-from 41.8 percent in fiscal year 1986 to 39 tigation or when inaccurate information is given to percent in fiscal year 1988. the investigator. Other cases are labeled unfounded Most recently, the existence of this high unfounded when no services are available to help the family. Some rate was reconfirmed by the annual Fifty State Survey cases must be closed because the child or family can- of the National Committee to Prevent Child Abuse not be located. (NCPCA), which found that in 1993 only about 34 A certain proportion of unfounded reports, there- percent of the reports received by child protective agen- fore, is an inherent-and legitimate-aspect of report- cies were substantiated. ing suspected child maltreatment and is necessary to The experience of New York City indicates what these ensure adequate child protection. Hundreds of thou- statistics mean in practice. Between 1989 and 1993, as sands of strangers report their suspicions; they cannot the number of reports received by the city's child wel- all be right. But unfounded rates of the current magni- fare agency increased by over 30 percent (from 40,217 tude go beyond anything. reasonably needed. Worse, to 52,472). the percentage of substantiated reports fell they endanger children who are really abused. by about 47 percent (from 45 percent to 24 percent). In The current flood of unfounded reports is over- fact, the number of substantiated cases-a number of whelming the limited resources of child protective agen- families were reported more than once-actually fell by cies. For fear of missing even one abused child, workers about 41 percent, from 14,026 to 8,326. Thus, 12,255 perform extensive investigations of vague and appar- additional families were investigated, while 5,700 fewer ently unsupported reports. Even when a home visit families received child protective help. based on an anonymous report turns up no evidence of The determination that a report is unfounded can maltreatment, they usually interview neighbors, school only be made after an unavoidably traumatic investi- teachers, and day-care personnel to make sure that the CHILD ABUSE REPORTING / 43 child is not abused. And even repeated anonymous and with an overabundance of cases and paperwork. He unfounded reports do not prevent a further investiga- stated, "It's impossible to visit these people within a tion. But all this takes time. month. They're all over New York City." Just before As a result, children in real danger are getting lost Jeffrey's death every worker who had been on the case in the press of inappropriate cases. Forced to allocate had left the department. Ironically, by weakening the a substantial portion of their limited resources to un- system's ability to respond, unfounded reports actu- founded reports, child protective agencies are less able ally discourage appropriate ones. The sad fact is that to respond promptly and effectively when children are many responsible individuals are not reporting endan- in serious danger. Some reports are left uninvestigated gered children because they feel that the system's re- for a week and even two weeks after they are received. sponse will be so weak that reporting will do no good Investigations often miss key facts, as workers rush to or may even make things worse. In 1984, a study of clear cases, and dangerous home situations receive in- the impediments to reporting conducted by Jose Alfaro, adequate supervision, as workers must ignore pending coordinator of the New York City Mayor's Task Force cases as they investigate the new reports that arrive on Child Abuse and Neglect, concluded that "profes- daily on their desks. Decision making also suffers. With sionals who emphasize their professional judgment, so many cases of unsubstantiated or unproven risk to have experienced problems in dealing with the child children, caseworkers are desensitized to the obvious protective agency, and are more likely to doubt the ef- warning signals of immediate and serious danger. ficacy of protective service intervention, are more likely These nationwide conditions help explain why from not to report in some situations, especially when they 25 to 50 percent of child abuse deaths involve children believe they can do a better job helping the family." previously known to the authorities. In 1993, the NCPCA reported that of the 1,149 child maltreatment Shifting Priorities deaths, 42 percent had already been reported to the The emotionally charged desire to "do something" authorities. Tens of thousands of other children suffer about child abuse, fanned by repeated and often sensa- serious injuries short of death while under child pro- tional media coverage, has led to an understandable tective agency supervision. but counterproductive overreaction on the part of the In a 1992 New York City case, for example, five- professionals and citizens who report suspected child month-old Jeffrey Harden died from burns caused by abuse. For thirty years, advocates, program adminis- scalding water and three broken ribs while under the trators, and politicians have all pushed for more re- supervision of New York City's Child Welfare Admin- porting of suspected child abuse and neglect. istration. Jeffrey Harden's family had been known to Potential reporters are frequently told to "take no the administration for more than a year and a half. Over chances" and to report any child for whom they have this period, the case had been handled by four separate the slightest concern. There is a recent tendency to tell caseworkers, each conducting only partial investiga- people to report children whose behavior suggests that tions before resigning or being reassigned to new cases. they may have been abused-even in the absence of It is unclear whether Jeffrey's death was caused by his any other evidence of maltreatment. These "behavioral mother or her boyfriend, but because of insufficient indicators" include, for example, children who are un- time and overburdened caseloads, all four workers usually withdrawn or shy as well as children who are failed to pay attention to a whole host of obvious warn- unusually friendly to strangers. However, only a small ing signals: Jeffrey's mother had broken her parole for minority of children who exhibit such behaviors have an earlier conviction of child sexual abuse, she had a actually been maltreated. past record of beating Jeffrey's older sister, and she Thirty years ago, even fifteen years ago, when many had a history of crack addiction and past involvement professionals were construing their reporting obligations with violent boyfriends. narrowly to avoid taking action to protect endangered Here is how two of the Hardens' caseworkers ex- children, this approach may have been needed. Now, plained what happened: Their first caseworker could though, all it does is ensure that child abuse hotlines will not find Ms. Harden at the address she had listed in her be flooded with inappropriate and unfounded reports. files. She commented, "It was an easy case. We couldn't Few people fail to report because they do not care find the mother so we closed it." Their second case- about an endangered child. Instead, they may be un- worker stated that he was unable to spend a sufficient aware of the danger the child faces or of the protective amount of time investigating the case, let alone make procedures that are available. A study of nonreporting the minimum monthly visits because he was tied down among teachers, for example, blamed their "lack of 44 / SOCIETY MAY/JUNE 1996 knowledge for detecting symptoms of child abuse and facts, such as the child's physical condition, that sug- neglect." Likewise, few inappropriate or unfounded gest that the child has been abused or neglected. Be- reports are deliberately false statements. Most involve havioral indicators, however, should not by themselves an honest desire to protect children coupled with con- be considered a sufficient basis for a report. fusion about what conditions are reportable. Direct evidence includes eyewitness observations of Confusion about reporting is largely caused by the a parent's abusive or neglectful behavior; the child's vagueness of reporting laws and aggravated by the fail- description of being abused or neglected, unless there ure of child protective agencies to provide realistic is a specific reason for disbelief; the parent's own de- guidance about deciding to report. In 1987, a national scription of abusive or neglectful behavior, unless it is group of thirty-eight child protection professionals from long past; accounts of child maltreatment from spouses nineteen states met for three days at Airlie House, Vir- or other family members; films, photographs, or other ginia, under the auspices of the American Bar visual material depicting sexually explicit activity by Association's National Legal Resource Center for Child a minor; newborns denied nutrition, life-sustaining care, Advocacy and Protection in association with the Ameri- or other medically indicated treatment; children in can Public Welfare Association and the American En- physically dangerous situations; young children left terprise Institute. The "Airlie House group," as it has alone; apparently abandoned children; demonstrated come to be called, developed policy guidelines for re- parental disabilities (for example, mental illness or re- porting and investigative decision making. (I was the tardation or alcohol or drug abuse) severe enough to rapporteur for the effort.) One of the group's major make child abuse or child neglect likely; and demon- conclusions was that "better public and professional strated parental inability to care for a newborn baby. materials are needed to obtain more appropriate re- Circumstantial evidence includes "suspicious" in- porting." The group specifically recommended that juries suggesting physical abuse; physical injuries or "educational materials and programs should: (1) clarify medical findings suggesting sexual abuse; for young the legal definitions of child abuse and neglect, (2) give children, signs of sexual activity; signs of severe physi- general descriptions of reportable situations (includ- cal deprivation on the child's body suggesting general ing specific examples), and (3) explain what to expect child neglect; severe dirt and disorder in the home sug- when a report is made. Brochures and other materials gesting general child neglect; apparently untreated for laypersons, including public service announcements, physical injuries, illnesses, or impairments suggesting should give specific information about what to report- medical neglect; "accidental" injuries suggesting gross and what not to report." inattention to the child's need for safety; apparent pa- Based on these recommendations, a relatively clear rental indifference to a child's severe psychological or agenda for reform emerges; we must developmental problems; apparent parental condona- 1. clarify child abuse reporting laws, tion of or indifference to a child's misbehavior sug- 2. provide continuing public education and profes- gesting improper ethical guidance; chronic and sional training, unexplained absences from school suggesting parental 3. screen reports, responsibility for the nonattendance; and newborns 4. modify liability laws, showing signs of fetal exposure to drugs or alcohol. 5. give feedback to persons who report, and Provide continuing public education and profes- 6. adopt an agency policy. sional training. Few people fail to report because they Clarify child abuse reporting laws. Existing laws want children to suffer abuse and neglect. Likewise, are often vague and overbroad. They should be rewrit- few people make deliberately false reports. Most in- ten to provide real guidance about what conditions volve an honest desire to protect children coupled with should and should not be reported. This can be accom- confusion about what conditions are reportable. Thus, plished without radically departing from present laws educational efforts should emphasize the conditions that or practices. The key is to describe reportable condi- do not justify a report, as well as those that do. tions in terms of specific parental behaviors or condi- Screen reports. No matter how well professionals tions that are tied to severe and demonstrable harms are trained and no matter how extensive public educa- (or potential harms) to children. tion efforts are, there will always be a tendency for It would help, for example, to make a distinction persons to report cases that should not be investigated. between direct evidence, meaning firsthand accounts Until recently, most states did not have formal policies or observations of seriously harmful parental behav- and procedures for determining whether to accept a ior, and circumstantial evidence, meaning concrete call for investigation. Such policies should be adopted CHILD ABUSE REPORTING / 45 by all states and they should provide explicit guidance erly, an increasing number of public and private agen- about the kinds of cases that should not be assigned cies are adopting formal agency policies about report- for investigation. ing. Some state laws mandate them. The primary purpose Reports should be rejected when the allegations fall of these policies, or agency protocols, is to inform staff outside the agency's definitions of "child abuse" and members of their obligation to report and of the proce- "child neglect" as established by state law. Often, the dures to be followed. Such formal policies serve another family has a coping problem for which they would be important function: They are an implicit commitment more appropriately referred to another social service by agency administrators to support frontline staff mem- agency. (Prime examples include children beyond the bers who decide to report. Moreover, the very process specified age, alleged perpetrators falling outside the of drafting a written document can clarify previously legal definition, and family problems not amounting to ambiguous or ill-conceived agency policies. child maltreatment.) Reports should also be rejected when the caller can give no credible reason for sus- Prospects for Change pecting that the child has been abused or neglected. The problem of inappropriate reporting was entirely (Although actual proof of the maltreatment is not re- foreseeable. In fact, as early as 1977, sociologist Saad quired, some evidence is.) Reports whose unfounded Naji predicted that unfounded reports would increase or malicious nature is established by specific evidence, as total reporting rose. In describing the effect of con- of course, should also be rejected. (Anonymous reports, temporary increases in the number of reports on con- reports from estranged spouses, and even previous firmation rates, he wrote: "As the rates of reporting unfounded reports from the same source should not be increased, the rates of confirmed maltreatment in- automatically rejected, but they need to be carefully creased rapidly up to a certain point, after which the evaluated.) And, finally, reports in which insufficient rate of increase tended to lessen considerably. The information is given to identify or locate the child should relations between the rates of reporting and the esti- likewise be screened (although the information may be mated probability that maltreatment cases will be con- kept for later use if a subsequent report about the same firmed, however, exhibited the reverse pattern: the child is made). probability of confirming reports of suspected cases In questionable circumstances, the agency should dropped sharply as the rates of reporting increased." recontact the caller before deciding to reject a report. As mentioned above, some level of inappropriate re- When appropriate, rejected reports should be referred porting is the inescapable result of a system that relies to other agencies that can provide services needed by on reports from hundreds of thousands of friends, neigh- the family. bors, and family members-as well as often poorly Modify liability laws. Current laws provide immu- trained professionals. nity for anyone who makes a report in good faith but What was thoroughly unpredictable was the great give no protection to those who, in a good-faith exercise resistance to doing something about the problem. As of professional judgment, decide that a child has not described below, some efforts to reform the system have been abused or neglected and hence should not be re- been made, but many advocates still deny that there is ported. This combination of immunities and penalties a problem (or at least try to minimize its importance). encourages the overreporting of questionable situations. Why has it proven so difficult to mount a concerted Give feedback to persons who report. If persons who effort to reduce the number of inappropriate or un- report are not told what happened, they may conclude founded reports? First and foremost has been the well- that the agency's response was ineffective or even harm- intentioned fear that any attempt to limit inappropriate ful to the child, and the next time they suspect that a reporting would inevitably reduce the number of real child is maltreated, they may decide not to report. In cases reported. The more careful people are about re- addition, finding out whether their suspicions were valid porting and the more aggressive agencies are about also refines their diagnostic skills and thus improves the screening, the more likely it is that a child in serious quality and accuracy of their future reports. Reporters danger will escape notice. A formal legal opinion from also need such information to interpret subsequent events lowa's attorney general explained the rationale for this and to monitor the child's condition. broader approach to reporting: "We will never know if Adopt an agency policy. Appropriate reporting of a report of child abuse is valid or not until the appro- suspected child maltreatment requires a sophisticated priate investigation is made." knowledge of many legal, administrative, and diagnostic But this practical wisdom has been taken to unrea- matters. To help ensure that their staffs respond prop- sonable extremes. Too many advocates have ignored 46 / SOCIETY MAY/JUNE 1996 the severe burden that so many inappropriate cases more middle-class families than before. Unlike the poor, place on the system's resources. They seem unwilling who have grown used to governmental intrusions, to make-or even to recognize-the trade-off between middle-class parents who feel that they have been gaining large numbers of additional reports and the wrongly accused and unnecessarily investigated fight system's ability to respond. back. Thousands have joined groups like Victims of Second, there has been a certain expediency to well- Child Abuse Laws (VOCAL) to lobby for changes in publicized increases in reports. Ever rising numbers state and federal laws as well as in agency procedures. of reports have helped mobilize public and profes- The continuing pressure of state budget cuts has sional support for expanded funding. News stories added another group of players to the process. In many about brutal cases of child abuse make our hearts go states, senior managers have, for the first time, focused out to its innocent victims. We all want to do some- their attention on the issue. They are eager, if not des- thing to alleviate their pain and to prevent other chil- perate, for any ideas that would enable them to do more dren from suffering a similar fate. Thus, advocates with existing or pared down resources. If they could and program administrators have had an incentive to be convinced that a shift away from simply seeking remain quiet about the number of cases closed after more reports and toward encouraging better ones would an initial investigation. save money without unreasonably endangering chil- Third, although many inappropriate reports do not dren, they would push for the change. amount to "child abuse" or "child neglect," they nev- Hence, it seems that the coming years will see an ertheless involve families who need social service as- acceleration of this shift. And, notwithstanding the sistance. Thus, accepting and investigating unfounded opposition of advocates, I believe that reasonable ef- reports is seen as a means of providing needed services forts to reduce the number of unfounded reports would to families in trouble. In effect, the child protective strengthen the overall child protective system as well system is being used to fill gaps in what should be as public support for it. community-wide child welfare systems. Even if this strategy was more likely to succeed, it should be shunned. The child protective process is coercive- SUGGESTED FURTHER READING and often traumatic-and should be limited to situa- tions in which the child is so endangered that social Douglas Besharov. Recognizing Child Abuse: A Guide For the Concerned. New York: Free Press, 1990. services must be forced upon unwilling parents. Douglas Besharov, ed. Protecting Children From Abuse Fourth, for many years, the child protective system and Neglect: Policy and Practice. Springfield, III.: was able to absorb the increase in reports by hiring Charles C Thomas, 1988. more staff. Although money was never plentiful, the Saad Naji. Child Maltreatment in the United States: A 1970s and much of the 1980s saw expansion in many Challenge to Social Institutions. New York: states. But, of course, by the end of the 1980s, state Columbia University Press, 1977. budgets became progressively tighter-and programs Barbara Nelson. Making an Issue of Child Abuse: were being cut rather than expanded. Political Agenda Setting for Social Problems. Change is apparent, however. Most states, as well Chicago: University of Chicago Press, 1984. as most research studies, are now careful to distinguish between total reports and substantiated ones. And as Douglas J. Besharov is a resident scholar at the Ameri- mentioned above, the 1987 recommendations of the can Enterprise Institute for Public Policy Research and a Airlie House group gave a legitimacy to those con- visiting professor at the University of Maryland School of cerned about inappropriate reporting and provided the Public Affairs. He was the first director of the U.S. Na- outlines for reform. In scattered communities across tional Center in Child Abuse and Neglect. His most recent book is Recognizing Child Abuse: A Guide for the Con- the nation, various elements of the recommendations cerned, from which some of this chapter is derived. Lisa A. listed above (as well as other ideas) are being adopted. Laumann was a research assistant at the American Enter- And there is reason to expect still more change. prise Institute and is currently pursuing a doctoral degree Recently, the flood of unfounded reports has involved in clinical psychology at the University of Virginia.