Trends in child protection and out-of-home care.
BACKGROUND
Over the past decades, increased knowledge about childhood abuse and trauma have prompted changes in child welfare policy, and practice that may have affected the out-of-home (OOH) care population. However, little is known about recent national trends in child maltreatment, OOH placement, or characteristics of children in OOH care. The objective of this study was to examine trends in child maltreatment and characteristics of children in OOH care.


METHODS
We analyzed 2 federal administrative databases to identify and characterize US children who were maltreated (National Child Abuse and Neglect Data System) or in OOH care (Adoption and Foster Care Analysis and Reporting System). We assessed trends between 2000 and 2010.


RESULTS
The number of suspected maltreatment cases increased 17% from 2000 to 2010, yet the number of substantiated cases decreased 7% and the number of children in OOH care decreased 25%. Despite the decrease in OOH placements, we found a 19% increase in the number of children who entered OOH care because of maltreatment (vs other causes), a 36% increase in the number of children with multiple (vs single) types of maltreatment, and a 60% increase in the number of children in OOH care identified as emotionally disturbed.


CONCLUSIONS
From 2000 to 2010, fewer suspected cases of maltreatment were substantiated, despite increased investigations, and fewer maltreated children were placed in OOH care. These changes may have led to a smaller but more complex OOH care population with substantial previous trauma and emotional problems.
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 777, Rochester, NY 14642. anne-Marie_conn@urmc.rochester.edu.
Anne-Marie
AM
Conn
Moira A
MA
Szilagyi
Todd M
TM
Franke
Christina S
CS
Albertin
Aaron K
AK
Blumkin
Peter G
PG
Szilagyi
D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000639:trends*; D002669:Child Welfare / Q000639:trends*; D002675:Child, Preschool; D016208:Databases, Factual / Q000639:trends; D005260:Female; D005581:Foster Home Care / Q000379:methods / Q000639:trends*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014481:United States / Q000453:epidemiology; D055815:Young Adult
child welfare; children; foster care; maltreatment; mental health