Practice and Policy Considerations for Child Welfare, Collaborating Medical, and Service Providers

This guidance publication is intended to support the efforts of states, tribes, and local communities in addressing the needs of pregnant women with opioid use disorders and their infants and families.1 National data show that from 2000 to 2009 the use of opioids during pregnancy increased from 1.19 to 5.63 per 1,000 hospital births (Patrick, Schumacher, Benneyworth, Krans, McAllister, & Davis, 2012). Because of the high rate of opioid use and misuse among all women, including pregnant women, medical, social service, and judicial agencies are having to confront this concern more often and, in some communities, at alarming rates.

Read the full report: Link to Report

U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment and Administration for Children and Families Administration on Children, Youth and Families Children’s Bureau

Child maltreatment has significant negative effects on a child’s cognitive development, social and emotional competence, psychological and behavioral health, and physical health. Maltreated children fare worse than their peers on many important outcomes within these domains. The effects can persist and have long-term consequences into adulthood, including reduced labor market productivity, increased involvement with the criminal justice system, and increased likelihood of homelessness. Given the far-ranging consequences of child maltreatment, a great deal of attention has been focused on identifying policies and programs that address this issue.

These programs and policies fall into two broad categories: those designed to prevent child maltreatment from occurring and those designed to mitigate the effects once maltreatment has occurred. The purpose of this project is to provide objective analyses that can inform the debate about how best to allocate funds to improve child welfare outcomes. The results of this effort will be of interest to policymakers, practitioners, researchers, community leaders, and others interested in better understanding the impact of investing or reallocating resources at different points within the child welfare system. The work described here can help identify strategies that prevent deeper involvement in the child welfare system, assess the costs and benefits of these different strategies, and ultimately improve outcomes for children.

This research was funded by Pritzker Foster Care Initiative and conducted jointly under the auspices of four units at the RAND Corporation: Health; Labor and Population; Education; and Justice, Infrastructure, and Energy. 

Improving Child Welfare Outcomes: Balancing Investments in Prevention and Treatment.
Rand Research Report; RR1775
Ringel, Jeanne S. Schultz, Dana. Mendelsohn, Joshua. Brooks-Holiday, Stephanie. Edochie, Ifeanyi. Davis, Lauren.
Rand Corporation.

Published in Children's Justice Act

The Standard of Proof in the Substantiation of Child Abuse and Neglect.
Kahn, Nicholas. Gupta-Kagan, Josh. Hansen, Mary.
Journal of Empirical Legal Studies
14(2)p. 333-369


The Standard of Proof in the Substantiation of Child Abuse and Neglect by Nicholas Kahn, Josh Gupta-Kagan, Mary Eschelbach Hansen :: SSRN


We measure the extent to which requiring a high standard of proof for substantiation of child abuse or neglect by child protection agencies actually influences the disposition of a report of abuse or neglect. Using data on nearly 8 million reports from fiscal 2000-2012, we show that a high standard is associated with lower rates of substantiation and that an increase in the standard decreases the probability of substantiation by up to 14 percent. After a change to a high standard, children may be less likely to be placed in foster care, and children and families are more likely to receive other types of services. Increases in the standard seem to be driven by perceptions of the costs of type 1 error – that is, substantiating a report when no abuse occurred. Indeed, states’ decisions to increase the standard are strongly correlated with fatalities in foster care and the size of the foster care system, suggesting that public concern about type 1 error leading to overly-invasive child protection agency action can spur a shift in the standard of proof.


This year’s Resource Guide continues to reflect the theme of the Office on Child Abuse and Neglect’s 20th National Conference on Child Abuse and Neglect, "Building Community, Building Hope," which was held in Washington, DC, in August 2016. Going forward, the Resource Guide will be produced biannually to align with OCAN’s biannual national conference.
This guide is a joint product of the U.S. Department of Health and Human Services’ Children’s Bureau, its Child Welfare Information Gateway, and the FRIENDS National Center for Community-Based Child Abuse Prevention. This annual Resource Guide is one of the Children’s Bureau’s most anticipated publications, offering trusted information, strategies, and resources to help communities support and strengthen families and promote the well-being of children and youth. Its contents are informed by input from some of our National Child Abuse Prevention Partners, as well as our colleagues on the Federal Interagency Work Group on Child Abuse and Neglect. Child abuse and neglect is a national issue that affects us all. The consequences of child abuse and neglect ripple across the lifespan, negatively impacting a child’s chances to succeed in school, work, and relationships. The Administration on Children, Youth and Families supports the promotion of meaningful and measurable results in social and emotional well-being, and we continue to support evidence-based and trauma-informed services and practices to achieve positive outcomes for the children, families, and communities we serve.
The 2016/2017 Resource Guide plays an important role in these efforts—offering support to service providers as they work with parents, caregivers, and children to prevent child maltreatment and promote social and emotional well-being. To do so, the Resource Guide focuses on protective factors that build on family strengths and promote optimal child and youth development. Information about protective factors is augmented with tools and strategies that help providers integrate the factors into community programs and systems. Agencies, policymakers, advocates, service providers, and parents alike will find resources in this guide to help them promote these important elements within their families and communities. 
Effective early prevention efforts are less costly to our nation and to individuals than trying to fix the adverse effects of child maltreatment. We hope this Resource Guide is helpful to you in your efforts to prevent child abuse and promote well-being. We thank you for participating in this important effort and for the work you do each day to build promising futures for our nation’s children and families.
Elaine Voces Stedt, M.S.W.
Office on Child Abuse and Neglect
Children’s Bureau
Administration on Children, Youth and Families
Administration for Children and Families,
U.S. Department of Health and Human Services
Tuesday, 24 January 2017 10:33

Child Maltreatment 2015

Based on State-level data from the National Child Abuse and Neglect Data System (NCANDS), Child Maltreatment 2015 presents an aggregate view of child abuse and neglect in the United States. This resource includes information on the reports made to child protective services (CPS), the children involved in CPS cases, child fatalities, perpetrators of child abuse and neglect, and available services.

 Highlights from Child Maltreatment 2015 include the following:

  • Neglect was the most common type of child maltreatment in 2015, which 75.3 percent of victims experienced.
  • For States able to report on the alcohol abuse caregiver risk factor, 10.3 percent of victims and 5.5 percent of nonvictims were reported with this caregiver risk factor. For reporting States, 25.4 percent of victims and 8.1 percent of nonvictims were reported with the drug abuse caregiver risk factor.
  • For 2015, an estimated 1,670 children died of abuse and neglect at a rate of 2.25 deaths per 100,000.

The U.S. Department of Health and Human Services' Administration for Children and Families (ACF) released this report as the 26th in a series designed to collect and analyze State child abuse and neglect statistics. The Child Maltreatment series is used to assess the efficacy of Federal programs and inform researches, practitioners, and advocates around the world.

The full Child Maltreatment 2015 report is available to view and download on the Children's Bureau website, along with access to archived Child Maltreatment reports 1995–2014.

 Published January 2017.


Published in Data & Technology
Wednesday, 20 July 2016 10:12

A Practitioner’s Guide to Cost Analysis

The FRIENDS National Center is pleased to announce the addition of a cost analysis page to their website.  On the webpage you will find four briefs that address a three-part framework that were originally released in November, 2015.  The framework was developed in partnership with the Center for Public Partnerships and Research (KU-CPPR) at the University of Kansas (KU-CPPR), and was based on interviews with ten CBCAP State Leads.  State Leads shared their experiences collecting data, identifying stakeholders, and conducting other activities in preparation for analyzing costs related to program activities and outcomes.

As a follow-up to the briefs, a Practitioner’s Guide to Cost Analysis:  First Steps & Cost Analysis Case Study from Children’s Trust Fund of Missouri has been released and is also available on the website,

This new Guide offers:

  • A map to follow in determining where to start with this type of work
  • Recommended action steps for each element of the three-part framework
  • Experiences from CBCAP State Leads shared in the interviews
  • A description of storytelling through numbers, or using social math
  • A detailed case study outlining the experience and results of a cost analysis conducted of CBCAP funded services by the Children’s Trust Fund in Missouri
  • An appendix with additional resources


Published in Data & Technology

Pediatricians are encouraged to screen their patients' parents for substance abuse, be alert for symptoms of child abuse or neglect, monitor children for developmental and academic delays and be familiar with mandatory reporting requirements for suspected neglect or abuse, according to an AAP clinical report. The report can be accessed online - click here.

Tuesday, 19 January 2016 00:00

VIDEO: Building Community, Building Hope

VIDEO: Building Community, Building Hope

The Children's Bureau and Office of Child Abuse and Neglect (OCAN) recently released the video, Building Community, Building Hope, as part of a series of actions preventing and responding to child maltreatment.  This video follows three programs, located in Iowa, Oregon, and California, that experienced success to innovatively engage parents and communities as a means to prevent and respond to child maltreatment. 

Watch the Building Community, Building Hope video and visit the National Child Abuse and Neglect Technical Assistance and Strategic Dissemination Center (CANTASD) website for access to a discussion guide, FAQs, and more background on the series.

Published in Children's Justice Act

Adam Walsh State Contacts for Child Abuse Registries. Updated March 27, 2017.

This study identifies the prevalence of mental health comorbidity in a large multistate foster care alumni sample as well as early childhood and trauma-related predictors of comorbidity. Secondary analysis of case record and interview data for 1,038 alumni served by Casey Family Programs in 13 states were used to assess pre-foster care, during foster care, and post-foster care predictors of comorbidity, defined as 2 or 3 mental health conditions. Findings indicate that 9.8% of alumni had 2 mental disorders and 10.4%
had 3 disorders. Multivariable analyses show that alumni who were female, lived below the poverty line, and who were unmarried were more likely to have comorbid mental disorders. Controlling for these significant factors, alumni who had childhood behavioral disorders or who were maltreated during foster care were more likely to have comorbid mental diagnoses. Alumni who perceived their foster parents as helpful some or a lot compared with a little had less comorbidity. The prevalence of comorbidity in this adult foster care alumni sample is higher than youth still in foster care and adults in the general population. This research highlights the need to prevent trauma-related interpersonal violence within foster families and ensure alumni access to health-care provisions long after they exit foster care. Recommendations focus on the need for comprehensive mental health assessments and quality treatment that addresses multiple conditions. Future research examining the effects of alumni mental health and treatment access on intergenerational outcomes is also recommended.
Read the full report, click here.
December 2015
  • Lovie J. Jackson Foster, University of Pittsburgh
  • Chereese M. Phillips, Allegheny County Office of Children, Youth, & Families, Pittsburgh, Pennsylvania
  • Jonathan Yabes, University of Pittsburgh
  • Joshua Breslau, RAND Health Division, Pittsburgh, Pennsylvania
  • Kirk O’Brien, Casey Family Programs, Seattle, Washington
  • Elizabeth Miller, Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center
  • Peter J. Pecora, Casey Family Programs, Seattle, Washington, and University of Washington
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