Impact Feature Issue on Children with Disabilities in the Child Welfare System
Children with Disabilities and the Child Welfare System: Prevalence Data
Several studies have examined the characteristics of children with disabilities and/or the relationship between disability and participation in the child welfare system. According to the National Child Abuse and Neglect Data System (NCANDS), in 2003 an estimated 906,000 children were determined to be victims of abuse or neglect by child protective services agencies in the United States (a rate of 12.4 children per 1,000; U.S. Department of Health and Human Services, 2005). In that study, children with disabilities accounted for 6.5% of all child victims. However, this is considered to be an undercount because not every child receives a clinical diagnostic assessment by child protective services. Children identified as having disabilities were 1.57 times more likely to have experienced abuse or neglect and were 1.51 times more likely to experience recurring abuse or neglect as children without disabilities. Approximately 57% of victims, and 25% of children involved in cases not determined to be abuse, received services as a result of an investigation or assessment. Children with disabilities who were abused or neglected were 89% more likely to receive services and twice as likely to be placed in foster care as children without a disability.
While the NCANDS data are very helpful in understanding abuse and neglect from a broad systems perspective, official reports acknowledge its limitations in measuring abuse and neglect specifically among children with disabilities. Several other studies provide more specific information about children with disabilities. For example, one study cross-referenced school records, the foster care system records, and police databases for 50,000 children ages 0-21 in Nebraska to examine the extent to which children who were considered by schools to have a disability were at increased risk of experiencing maltreatment (Sullivan & Knutson, 2000). In that study, 9% of children who did not have disabilities and 31% of children who had disabilities were found to have experienced reported maltreatment. The study concluded that children with disabilities are 3.4 times more likely to be maltreated than their peers who did not have disabilities.
Another study examined the characteristics of children involved in 1,249 cases of substantiated maltreatment from a national sample of 35 Child Protective Services agencies (Crosse, et al., 1992). Data for this study were collected from caseworkers responsible for the cases. That study reported that “the incidence of maltreatment… among children with disabilities was 1.7 times higher than the incidence of maltreatment for children without disabilities” (p. vi). In all, 36 children with disabilities per 1,000 had been maltreated. Among children with disabilities who had been maltreated, caseworkers expressed their opinion that the presence of a disability contributed to or led directly to maltreatment for 47% of the children.
A third study examined whether the experience of being maltreated as a child is associated with later entry into the special education system. A seven- year longitudinal study of 8,000 children whose families received Aid to Families with Dependent Children found that among children who were not already receiving special education services at the time they were abused, children who had experienced substantiated maltreatment were 1.9 times more likely to enter special education than children who did not experience substantiated maltreatment (Jonson-Reid, Kim, Porterfield, & Han, 2004). This was true even after controlling statistically for the presence of medical conditions that pose a developmental risk at birth. This study suggests that not only are children with disabilities at higher risk of entering the child welfare system, but that children who enter the child welfare system are at higher risk of having or acquiring disabilities requiring special education services.
The studies cited above report experiences of children who had contact with the child protection system for some reason. They do not examine the general population of children with disabilities. The 1994/1995 National Health Interview Survey on Disability (NHIS-D), on the other hand, collected nationally representative information from 202,560 people in nearly 100,000 households. In that study, the estimated prevalence of intellectual or developmental disabilities (ID/DD) amongst persons not living in group homes or institutions was 38.4 per 1,000 for children ages birth to five years, and 31.7 per 1,000 for children ages 6 to 17 years (Larson, Lakin, Anderson, Kwak, Lee & Anderson, 2001). An estimated 939,617 children ages birth to five years, and 1,452,359 children ages 6 to 17 years had ID/DD in 1995 (Larson, Lakin, Anderson, Kwak, Lee & Anderson, 2001). In addition, many more children had substantial functional limitations in self-care, expressive or receptive language, learning, mobility, and self-direction, but did not have ID/DD (Anderson, Larson, Lakin & Kwak, 2002). The estimated prevalence of substantial functional limitations but not ID/DD was 39 per 1,000 for children ages 6 to 17 years (an estimated 1.8 million children). Children younger than six with substantial functional limitations were included in the ID/DD group.
The NHIS-D asked questions about both disability status and about services people received. Among children with ID/DD or functional limitations, 10% received social work services through school (Anderson, Larson, Lakin & Kwak, 2002). An estimated 11% of children with ID/DD (an estimated 263,000 children) and 6% of children with functional limitations but not ID/DD (an estimated 108,000 children) received social work services in other settings. The NHIS-D did not specifically ask whether the social work services received were provided by the child protection system or whether they were provided through the human services system.
As noted earlier, several of the reviewed studies reported that children with disabilities were more likely to experience abuse or neglect than were other children. Factors reported to be associated with an increased risk of child sexual abuse include gender (girls are at higher risk), age (older children are at higher risk), disability (children with disabilities are at higher risk), and family constellation (the absence of one or both parents is a significant risk factor) (Putnam, 2003). Factors reported to increase the risk of physical abuse or neglect include younger age, lower socio-economic status, teenage parents, parents who abuse substances, single parents, and parents with cognitive limitations (Putnam, 2003; Kaplan, Pelcovitz & Lubruna, 1999). The NHIS-D data describe the extent to which these and related risk factors are present among children with disabilities living with their families or in other non-institutional settings. For example, children with ID/DD were significantly less likely to live with both parents than other children (61% versus 70%). They were also significantly more likely to live in families with below poverty level incomes (Larson, Lakin, Anderson & Kwak, 2001). Furthermore, more than 30% of families of children with disabilities reported that the child’s disability caused parents to make one or more of the following accommodations: not accepting a job offer, changing work hours, working fewer hours, quitting work, changing sleep habits, turning down a better job, changing jobs, or having severe financial problems (Anderson, Larson, Lakin & Kwak, 2002). The presence of a child with a disability increases stress for many families, and for some families the combination of stressors and other family characteristics or problems leads to involvement with the child welfare system.
These studies show that having a disability puts a child at increased risk of abuse or neglect. It also puts the child at increased risk of participating in the child welfare system and the foster care system. Furthermore, the experience of abuse or neglect increases the risk that children who had not previously been receiving special education services will receive those services. The NCANDS study estimated that approximately 59,000 children with disabilities had experienced abuse or neglect in 2003. This is lower than the estimated 86,000 children with intellectual or developmental disabilities or the estimated 151,000 children with any type of disability who could be expected to have experienced abuse or neglect if the incidence of abuse of 36 per 1,000 in the Crosse study is combined with the estimated prevalence of intellectual or developmental disabilities (2.39 million children) or estimated prevalence of any type of disability among children (41.9 million children) from the NHIS-D. Whichever numbers are used, it is clear that the child welfare system must be prepared and equipped to support and serve substantial numbers of children with disabilities. This may require increased cooperation between child protective service systems and disability service systems at both the state and local levels. This cooperation should address the provision of supports that can help prevent abuse and neglect in at-risk families, such as respite care, parent education and training, and other supportive services.
Anderson, L., Larson, S. A., Lakin, K. C., & Kwak, N. (2002). Children with disabilities and social roles: An analysis of the 94/95 NHIS-D. DD Data Brief, 4(1).
Cross, S. B., Kaye, E., & Ratnofsky, A. C. (1992). A report on the maltreatment of children with disabilities. Washington, DC: Prepared by Westat, Inc., and James Bell Associates for the National Center on Child Abuse and Neglect, U.S. Department of Health and Human Services.
Jonson-Reid, M., Drake, B., Kim, J., Porterfield, S., & Han, L. (2004). A prospective analysis of the relationship between reported child maltreatment and special education eligibility among poor children. Child Maltreatment, 9(4), 382–394.
Kaplan, S. J., Pelcovitz, D., & Lebruna, V. (1999). Child and adolescent abuse and neglect research: A review of the past 10 years. Part 1: Physical and emotional abuse and neglect. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1214–1222.
Larson, S. A., Lakin, K. C., Anderson, L., & Kwak, N. (2001). Demographic characteristics of persons with MR/DD living in their own homes or with family members: NHIS-D analyses. MR/DD Data Brief, 3(2).
Larson, S. A., Lakin, K. C., Anderson, L., Kwak, N., Lee, J. H., & Anderson, D. (2001). Prevalence of mental retardation and developmental disabilities: Estimates from the 1994/1995 National Health Interview Survey Disability Supplements. American Journal on Mental Retardation, 106, 231–252.
Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 269–278.
Sullivan, P. M., & Knutson, J. F. (2000). Maltreatment and disabilities: A population-based epidemiological study. Child Abuse and Neglect, 24(10), 1257–1273.