Prevalence of Children with Disabilities in the Child Welfare System: An Analysis of State Administrative Data
Title IV-E Curriculum Module
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Over the past twenty years, studies have found that children and youth with disabilities experience a higher rate of maltreatment than children and youth without disabilities (AAP, 2001; Crosse et al 1992; Sullivan & Knutsen, 1998; 2000; Verdugo and Bermejo, 1995; Westcott & Jones, 1999). While there has been much exploration into the factors related to these high rates of maltreatment (AAP, 2001; Westcott & Jones, 1999), there is little known about how children with disabilities are served within the child welfare system (Lightfoot & LaLiberte, 2005).
There is limited data on the prevalence, the characteristics, or the out-of-home placement status of children with disabilities who are actively involved in the child welfare system. Without a clear sense of the prevalence of children with disabilities in the child welfare system and the characteristics of these children, it is exceedingly difficult to provide appropriate services and supports for children and their families (Bruhn, 2003; Horner-Johnson & Drum, 2006). The purpose of this study is to explore the prevalence and characteristics of children with disabilities within the child welfare system using administrative data, and to compare the characteristics of children with disabilities with those of children without disabilities, focusing particularly on ethnicity, gender, rural/urban location, and out-of-home placement rates.
Children and youth with disabilities experience a higher rate of maltreatment than children and youth without disabilities (Crosse et al 1992; Johnson-Reid, Drake, Kim, Porterfield, & Han, 2004; Sullivan & Knutsen, 1998, 2000). Crosse et al (1992) found that the incidence of maltreatment among children with disabilities was 1.7 times higher than the incidence of maltreatment for children without disabilities, while Sullivan and Knutsen (2000) found that children with disabilities were 3.4 times more likely to be maltreated than their nondisabled peers. Studies have also found that children in out-of-home placement are disproportionately represented in special education (George & Van Voorhis, 1992; Scherr, 2007; Smithgall, Gladden, Yang, & George, 2005).
Maltreatment rates have been found to vary based on type of disability. Sullivan and Knutsen (2000) found that the maltreatment of children with an “educationally relevant” disability (excluding autism), such as behavior disorders, communication disorders, health or orthopedic disabilities, or mental retardation, exceeded the maltreatment rate of children without an educationally relevant disability (Sullivan & Knutsen, 2000). Crosse et al (1992) found that children with serious emotional disturbances and physical health problems were more likely to have reported maltreatment.
Research has been limited regarding the link between demographic and socioeconomic factors and child maltreatment among people with disabilities. In Sullivan & Knutsen’s (2000) epidemiological study, they found a clear link between the economic status of the child’s family and likelihood of neglect, with children with disabilities from economically disadvantaged community more likely to suffer neglect. Verdugo and Bermejo (1995) found that as family’s socio-economic status decreases, the more severe the maltreatment.
Studies have differing findings regarding gender, age and racial and ethnic background of children with disabilities experiencing maltreatment. Crosse et al. (1992) and Johnson-Reid et al. (2004) found that males with disabilities were more likely to experience maltreatment, while Sullivan & Knutson (2000) found no gender differences. Regarding age of maltreatment, Sullivan & Knutson (2000) found that children with disabilities were more likely to experience maltreatment at earlier ages than children without disabilities, while Crosse et al (1992 found that children with disabilities experiencing maltreatment were more likely to be older than four.
Similarly, Crosse et al (1992) found that children with disabilities were more likely to be white, while Johnson-Reid et al (2004) found that non-white children had an increased likelihood of special education entry.
While the current research information consistently finds that children with disabilities are more likely to experience maltreatment than children without disabilities, and their experiences of maltreatment may vary based on their disability, there is still little known about children with disabilities’ experiences within the child welfare system, such as how likely children with disabilities are to be placed in out-of-home placement. There is no standardized collecting of disability data by state child welfare systems, and the Child Abuse Prevention and Treatment Act of 1988 (CAPTA) does not require states to collect such information. There is a lack of training of child welfare workers in disability, specifically in identifying children with disabilities (Shannon & Agorastou, 2006; AAP, 2001; Bonner, Crow, & Hensley, 1997; Bruhn, 2003; Lightfoot & LaLiberte, 2005), as well as a lack of standardized definitions of disability or eligibility criteria used across programs and states (Bruhn, 2003; Westcot et al. 1992). Thus, researchers have not been able to rely on such data for determining national prevalence rates or for comparing prevalence rates among states.
The purpose of this study is to examine:
The prevalence of children with disabilities with substantiated maltreatment in the child welfare system.
To examine the correlations between demographic characteristics (age, race, location) and the likelihood a child with substantiated maltreatment in the child welfare system with be identified as having a disability.
To examine the likelihood that a child with a disability label in the child welfare system has been placed in a formal, out-of-home
Minnesota’s Social Service Information System (SSIS) database contains all the descriptive information on child welfare cases in the 87 Minnesota counties, with records for child protection created based on reports of child maltreatment and investigations. All of the information is entered by case workers. TheS University of Minnesota has access to these records through the School of Social Work’s Center for Advanced Studies in Child Welfare’s MINN-LINK system, which collects and matches a variety of statewide databases. The SSIS includes demographic information about children, information about type of abuse or neglect and reason for removal.
This study uses all SSIS child protection records included between January 1, 2005 through December 31, 2005. In our sample, we only included children who had substantiated cases of maltreatment, meaning that the caseworker determined that maltreatment did occur. The final sample that we used for our study had 6270 children ages 0-18 who had active child welfare cases through a county child protection agency in Minnesota during 2005.
Children were classified as having a disability or not having a disability if they had at least one of the 23 disability codes related to children present in the SSIS database. For this analysis, several of the codes were collapsed into a single category. For example, children could have chemical dependency codes that indicated specifically alcohol or drug abuse; these were collapsed into a single “chemical dependency” code.
Children who had been coded with multiple disability codes were re-coded one of two ways. If the codes were codes that would have otherwise been collapsed, than they were recoded into the “new” code for those disabilities. Children with multiple, different disability codes (ie: visual impairment and emotional disturbance), were recoded into a new category of multiple disabilities. We also created a category of children with a disability code who were over age five. Other variables included race and ethnicity, metro or non-metro residence, and out of home placement.
We first calculated descriptive statistics regarding the prevalence of children with disabilities with substantiated cases of maltreatment within the child welfare system, and the characteristics of these children, including demographic data, types of disability, geographic location, out of home placement and reason for placement.
To estimate the relationship between disability and other characteristics, we conducted a series of binary logistic regression analyses looking at the likelihood a child would have a disability diagnosis based on gender, race, or geographic location. Next, to estimate the associations between disability and out of home placement, we used multiple logistic regression, with covariance adjustments of gender, age, and rural/urban county.
Basic demographic variables of children with disability codes in SSIS were compared to children without a disability diagnosis. A higher percentage of children with disabilities were male (55.8%), Caucasian (63.8%), and over the age of 5 (80.4%) than children without disabilities. Maltreatment was reported in metro-area counties in 45.8% of cases involving children with disabilities, compared to 50.6% of cases involving children without disabilities. Children with disabilities were placed in out-of-home placement in 64.2% of cases of substantiated maltreatment, while their non-disabled peers were placed in out-of-home placement in 48.9% of cases.
Of children with disabilities, the most common disability codes were emotional disturbance (37.5%), intellectual/developmental disabilities (10.7%) and multiple disabilities (9.5%). These numbers were slightly different for children over the age of 5. although the order of prevalence remained the same.
Next, we did a logistic regression to see if gender, race and county location had an effect on likelihood for a disability label. We found that females were about 38% less likely to not have a disability diagnosis than males (O.R.=.616, SE ..072, p<.001), non-Caucasians with substantiated maltreatment cases were 1.35 times more likely to not have a disability diagnosis in their records than Caucasians (p.<.001, SE=.074, O.R.=.1.35, SE=.082, p<.001), and children living outside the metropolitan region were about 24% less likely to have no disability diagnosis than those living in the seven county metro region (O.R.=.765, SE=.079, p.<.001).
A logistic regression was then performed to examine the relationship between disability and out of home placement, with the dependent variable being out of home placement, and the independent variables being disability diagnosis, gender, race, and metro/non-metro county. Children of all ages with a disability diagnosis were about 1.87 times more likely to be placed out of home than children without disabilities (p.<.001, SE =.063). As school-age children are more likely to have a disability diagnosis due to the prevalence of school-based testing and services, a separate logistic regression was run just with children over age 5, and among these school-age children, children with disabilities were about 2.16 times more likely to be placed out of home than children without disabilities placement data for children over age five.
The findings from this study support previous research (Crosse et al, 1992; Sullivan & Knutsen, 2001) that indicates that children with disabilities are a sizable minority in the child welfare population. Additionally, our findings indicate that children who are labeled as having a disability within the child welfare system are more likely to be placed in out-of-home placement than then peers without disabilities. These findings give rise to the following implications:
There needs to be more training on disabilities, and the services and supports available to people with disabilities for foster care providers, child welfare workers, and others involved in the child welfare system.
There should be specific, targeted efforts to recruit foster care providers who have expertise in disability services and in working with young people with disabilities.
Community parenting classes should include a focus on children with disabilities so that parents of these children are able to access appropriate supports.
Child welfare providers should collaborate with the disability organizations (i.e: PACER, ARC, Centers for Independent Living) in their communities in order to build strong connections between service providers.