title: Maltreatment following reunification: predictors of subsequent Child Protective Services contact after children return home.
abstract: OBJECTIVE
  This study examined risk of maltreatment among children exiting foster care using a statewide sample of children reunified between 2001 and 2004 in Rhode Island. The objectives were: (1) to compare rates of maltreatment following parental reunification for youth in care as a result of maltreatment with those in care for other reasons; and (2) to assess the effects of child, family, and case characteristics on rates of re-maltreatment among children placed in foster care due to maltreatment.
  
  
  METHODS
  A longitudinal dataset of all reunified cases was matched with state records of substantiated Child Protective Service (CPS) investigations. Two Cox proportional hazards models were tested. The first model compared rates of subsequent maltreatment for two groups: children in foster care as a result of maltreatment, and those in care for other reasons. The second model investigated the effects of child, family, and case characteristics on re-maltreatment rates for those in care as a result of maltreatment.
  
  
  RESULTS
  Children in foster care due to maltreatment were significantly more likely to be maltreated following reunification. Among children in foster care due to maltreatment, factors that raised risk for re-maltreatment included a previous foster care placement, exiting care from a non-relative foster home, and removal due to neglect. Older adolescents had lower rates of re-maltreatment than infants. Child neglect was the primary type of recurrent maltreatment that occurred following reunification.
  
  
  CONCLUSIONS
  Supports are needed for families about to be reunified, particularly when the removal was prompted by incidents of abuse or neglect. Incidents of neglect are particularly likely and appropriate services should specifically target factors contributing to neglect. Cases involving youth with a history of repeated foster care placement or in which non-relative placements are utilized may need additional supports.
  
  
  CONCLUSIONS
  This study suggests that services should be developed to minimize the risk for recurrent maltreatment following reunification. Services would be most useful for high-risk cases prior to reunification and during the first year following reunification. Understanding the risks associated with maltreatment will help guide development of appropriate interventions.
authors.affiliation: Yale University School of Medicine, New Haven, CT 06511, USA.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Connell
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Vanderploeg
authors.forename: Karol H
authors.initials: KH
authors.lastname: Katz
authors.forename: Colleen
authors.initials: C
authors.lastname: Caron
authors.forename: Leon
authors.initials: L
authors.lastname: Saunders
authors.forename: Jacob Kraemer
authors.initials: JK
authors.lastname: Tebes