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Public Health Agency of Canada Injury and Child Maltreatment Section Health Surveillance and Epidemiology Division

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Title: Public Health Agency of Canada Injury and Child Maltreatment Section Health Surveillance and Epidemiology Division


1
Public Health Agency of CanadaInjury and
Child Maltreatment Section Health Surveillance
and Epidemiology Division
2
The Canadian Incidence Study of Reported Child
Abuse and Neglect The methodological challenges
of child maltreatment surveillance
Barbara Fallon (Centre for Excellence for Child
Welfare, University of Toronto) Nico Trocmé
(Center for Research on Children and Families,
McGill University) Bruce MacLaurin (Assistant
Professor, Faculty of Social Work, University of
Calgary)
3
Defining Child Maltreatment
  • Child maltreatment refers to the range of abusive
    and neglectful acts perpetrated by adults or
    older youth against children.
  • Four general categories physical abuse, sexual
    abuse, neglect and emotional maltreatment

4
Physical Abuse
  • Ranges from severe assaults against children that
    can permanently injure or kill children to
    abusive physical punishment to shaking of infants

5
Sexual Abuse
  • Sexual abuse includes intercourse, fondling, acts
    of exposure, sexual soliciting and sexual
    harassment

6
Neglect
  • Neglect includes a caregivers failure to
    supervise or protect a child and failure to meet
    a childs physical, medical or educational needs

7
Emotional Maltreatment
  • Emotional maltreatment includes extreme or
    habitual verbal abuse (threatening, belittling
    etc) and systematic lack of nurturance or
    attention required for a childs healthy
    development
  • Exposure to family violence is increasingly being
    recognized as a form of emotional maltreatment

8
Incidence and Prevalence
  • Incidence refers to the measurement of child
    maltreatment over a specific time period, for
    example how many children are investigated for
    abuse and / or neglect in one year
  • Prevalence is a measurement of child maltreatment
    within a defined population over a long period of
    time, for example How many adult women
    experienced sexual abuse during their childhood

9
Detection
Screened Out Reports
Unsubstantiated Reports
Child Welfare Investigations
Police Investigations
Unreported Cases
Unknown Cases
10
Goals of a Child Maltreatment Surveillance System
  • Measure incidence of child maltreatment
  • Measure severity of child maltreatment
  • Measure family, caregiver and child
    characteristics associated with child
    maltreatment
  • Measure interventions in child maltreatment
    investigations
  • Inform policy makers of possible risks and trends
    affecting health and safety
  • Inform program development and prevention
    initiatives
  • Identify areas of research
  • Inform professional practice
  • Set priorities for prevention and intervention
  • Health Canada. A conceptual and Epidemiological
    framework for Child maltreatment Surveillance.
    Ottawa Minister for Public Works and Government
    Services, 2001.

11
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12
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13
Child Maltreatment in Canada
  • Surveillance of child maltreatment investigations
    and outcomes is facilitated by Health Canada,
  • With co-operation and support of every province
    and territory
  • Team of University Researchers conduct the
    surveillance activities

14
What is the CIS?Background
  • Canadian Incidence Study of Reported Child Abuse
    Neglect
  • Only national source of statistics describing
    children and families coming into contact with
    child welfare system
  • First national study conducted in 1998 second
    cycle conducted in 2003

15
Objectives of the CIS
  • Examine rates of reported physical abuse sexual
    abuse, neglect and emotional maltreatment as well
    multiple forms of maltreatment
  • Examine severity of maltreatment as measured by
    specific types of maltreatment, level of harm and
    duration
  • Examine selected determinants of health for
    investigated children and their families
  • Monitor, short-term investigation outcomes,
    including substantiation, placement, child
    welfare court and criminal charges.

16
What is the CIS?Funding
  • Health Canada
  • Provincial and Territorial Governments of Canada
  • Bell Canada
  • Centre of Excellence for Child Welfare
  • First Nations Child and Family Caring Society

17
Scope of CIS
Screened Out Reports
Unsubstantiated Reports
CIS Cases
Child Welfare Investigations
Police Investigations
Unreported Cases
Unknown Cases
18
Stages of Case Identification
Incidents of Child Maltreatment
Detected
Undetected
Unreported
Report protection concerns to Child Welfare
Reported to Child Welfare Services
Reported to Police
Report criminal issues to police
Screened out
Case already open for child welfare services
Investigation
Unsubstantiated
Suspected
Substantiated
19
Study Phases
  • Instrument Development (March - September 2003)
  • Enlistment (June 2003 - January 2004)
  • Training (September 2003 - February 2004)
  • Data Collection (October 2003 - September 2004)
  • Data Verification (November 2003 - October 2004)
  • Data Analysis (September 2004 - May 2005)
  • Final Report (June 2004)
  • Dissemination

20
Sampling Case selection
Annual CIS estimates
Cases open Oct to Dec 2003

Regional weight Region child population / Site
child population
CIS Intake Sheet
No alleged maltreatment
Maltreatment alleged
X
Annual weight Cases opened in 2003 / Cases
opened Oct to Dec
Screened out
Open for assessment
Unsubstantiated
CIS Household Child Sheets
Suspected
Substantiated
Closed after investigation
Open for on-going services
21
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22
Enlistment
  • Agencies were enlisted in June 2003 for September
    2003 participation
  • 8 refusals
  • Most expressed support for the study at the same
    time concerned about workload issues
  • Recruiter stressed the minimal commitment
    required for participation
  • Most Aboriginal agencies were not enlisted until
    2004 (more extensive process)

23
Data Collection
  • Data collected directly from workers
  • Anchored to main investigation report / intake
    assessment
  • Half-day training and regular site visits
  • Data Collection Instrument (Child Maltreatment
    Assessment) 3 pages
  • Intake Face Sheet
  • Household Information Sheet
  • Child Assessment Sheet

24
Data Verification
  • Local Research Associates reviewed all cases,
    returned cases with missing or problematic data.
  • Reviewed for scanability, missing data and
    incorrect codes of maltreatment, 5-25 of forms
    returned to RAs to contact the investigating
    worker for changes.
  • Item completion rate 95 to 100

25
Duplication
  • Child investigations conducted ? number of
    children investigated
  • Most North American data systems report numbers
    of investigations not investigated children. In
    12 States reporting unduplicated 1996 NCANDS
    data, unduplicated child based counts were 22
    lower than the incident based counts.
  • In the CIS 22 of children had been previously
    investigated and had had their case closed within
    six months of the current investigation.

26
Increasing rates of reports substantiated
investigations (CIS 98-03)
38.33
21.52
27
Public Health Agency of CanadaInjury and
Child Maltreatment Section Health Surveillance
and Epidemiology Division
barbara.fallon_at_utoronto.ca
www.cecw-cepb.ca
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