Children with disabilities in child protection services TONINO ESPOSITO Universite de Montreal – School of Social Work, Montreal, QC, Canada. doi: 10.1111/dmcn.12722 This commentary is on the original article by Berg et al. on pages 564– 570 in this issue.
Increasingly, studies show that children with disabilities represent a significant proportion of children receiving child protection services. The most recent child maltreatment report published by the US Children’s Bureau suggests that 13.3% of children receiving child protection services were identified as having an intellectual, physical, or behavioural disability, or a combination of these.1 Similarly, the most recent cycle of the Canadian Incidence Study of Reported Child Maltreatment – currently the only pan-Canadian source of data on child protection services – suggest that in 10.3% of maltreatment-related investigations, children have a noted intellectual, developmental, or physical disability or a combination of these.2 While these national data have helped delineate the scope of the representation of children with disabilities in child protection services in Canada and in the US, looking into ways in which the child protection system can respond to the needs of this particularly vulnerable population remains a nascent area of research. As Berg et al.3 argue, encouraging the participation of children with disabilities in developmentally salient activities is, indeed, a critical issue in child protection. The impact of a disability, in and of itself, often leads to participation restrictions which are then compounded by the effects of maltreatment. This nationally representative study demonstrates the point well, reporting that young people in child protection services (11–17y old) with
disabilities were two times less likely to participate in developmentally salient activities and close to seven times less likely to participate if they were polyvictimized. The authors provide a significant contribution to the examination of the participatory needs of maltreated children with disabilities. However, the extent to which restricted participation is explained by maltreatment, disability, or a combination of the two, is an area that would benefit from further examination. Differences have been revealed in risk of maltreatment between children with disabilities and non-disabled children, with the former reported to be at increased risk.4,5 Future work can benefit from examining the mediating effects of disability on restricted participation using propensity models, which rigorously adjust for differences between children with disabilities and non-disabled children, and risk of maltreatment. For example, conditional probability of maltreatment can be estimated in order to match children with disabilities and non-disabled children using parent and child risk factors, socio-economic vulnerabilities, etc.6 This method can help solve the problem of endogeneity bias between children with disabilities and non-disabled children in investigating their risk of maltreatment, and will provide robust estimates of the mediating effects of disability on participation in developmentally salient activities. In my opinion, the study by Berg et al. will stimulate thought around the conceptual and methodological directions of future research in this area. These new lines of inquiry will provide additional insight concerning the difficulties faced by maltreated children with disabilities and their families, while monitoring the impact of innovations in child protection services aimed at addressing these difficulties.
REFERENCES 1. US Department of Health & Human Services, Children’s Bureau. (2013) Child Maltreatment 2012. Avail-
en/Children_with_Disabilities_133E_1.pdf (accessed 2 February 2015).
abilities. Maltreatment of children with disabilities. Pediatrics 2007; 119: 1018–25.
http://www.acf.hhs.gov/programs/cb/
3. Berg KL, Shiu C-S, Msall ME, Acharya K. Victimiza-
5. Spencer N, Devereux E, Wallace A, et al. Disabling
resource/child-maltreatment-2012 (accessed 2 February
tion and restricted participation among young people
conditions and registration for child abuse and
2015).
with disabilities in the US child welfare system. Dev
neglect: a population-based study. Pediatrics 2005;
Med Child Neurol 2015; 57: 564–70.
116: 609–13.
able
from:
2. Bogossian A, MacCulloch R, Trocme N. (2014) Maltreatment-Related Investigations Involving Children and
4. Hibbard R, Desch LW, American Academy of Pediat-
6. Guo S, Fraser MW. Propensity Score Analysis: Statisti-
Youth with Disabilities in Canada in 2008. Available
rics Committee on Child Abuse and Neglect, American
cal Methods and Applications. Thousand Oaks, CA:
from:
Academy of Pediatrics Council on Children with Dis-
Sage, 2014.
http://cwrp.ca/sites/default/files/publications/
Commentaries
501
Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Increasingly, studies show that children with disabilities represent a significant proportion of children receiving child protection services. The most recent child maltreatment report published by the US Children’s Bureau suggests that 13.3% of children receiving child protection services were identified as having an intellectual, physical, or behavioural disability, or a combination of these.1 Similarly, the most recent cycle of the Canadian Incidence Study of Reported Child Maltreatment – currently the only pan-Canadian source of data on child protection services – suggest that in 10.3% of maltreatment-related investigations, children have a noted intellectual, developmental, or physical disability or a combination of these.2 While these national data have helped delineate the scope of the representation of children with disabilities in child protection services in Canada and in the US, looking into ways in which the child protection system can respond to the needs of this particularly vulnerable population remains a nascent area of research. As Berg et al.3 argue, encouraging the participation of children with disabilities in developmentally salient activities is, indeed, a critical issue in child protection. The impact of a disability, in and of itself, often leads to participation restrictions which are then compounded by the effects of maltreatment. This nationally representative study demonstrates the point well, reporting that young people in child protection services (11–17y old) with
disabilities were two times less likely to participate in developmentally salient activities and close to seven times less likely to participate if they were polyvictimized. The authors provide a significant contribution to the examination of the participatory needs of maltreated children with disabilities. However, the extent to which restricted participation is explained by maltreatment, disability, or a combination of the two, is an area that would benefit from further examination. Differences have been revealed in risk of maltreatment between children with disabilities and non-disabled children, with the former reported to be at increased risk.4,5 Future work can benefit from examining the mediating effects of disability on restricted participation using propensity models, which rigorously adjust for differences between children with disabilities and non-disabled children, and risk of maltreatment. For example, conditional probability of maltreatment can be estimated in order to match children with disabilities and non-disabled children using parent and child risk factors, socio-economic vulnerabilities, etc.6 This method can help solve the problem of endogeneity bias between children with disabilities and non-disabled children in investigating their risk of maltreatment, and will provide robust estimates of the mediating effects of disability on participation in developmentally salient activities. In my opinion, the study by Berg et al. will stimulate thought around the conceptual and methodological directions of future research in this area. These new lines of inquiry will provide additional insight concerning the difficulties faced by maltreated children with disabilities and their families, while monitoring the impact of innovations in child protection services aimed at addressing these difficulties.
REFERENCES 1. US Department of Health & Human Services, Children’s Bureau. (2013) Child Maltreatment 2012. Avail-
en/Children_with_Disabilities_133E_1.pdf (accessed 2 February 2015).
abilities. Maltreatment of children with disabilities. Pediatrics 2007; 119: 1018–25.
http://www.acf.hhs.gov/programs/cb/
3. Berg KL, Shiu C-S, Msall ME, Acharya K. Victimiza-
5. Spencer N, Devereux E, Wallace A, et al. Disabling
resource/child-maltreatment-2012 (accessed 2 February
tion and restricted participation among young people
conditions and registration for child abuse and
2015).
with disabilities in the US child welfare system. Dev
neglect: a population-based study. Pediatrics 2005;
Med Child Neurol 2015; 57: 564–70.
116: 609–13.
able
from:
2. Bogossian A, MacCulloch R, Trocme N. (2014) Maltreatment-Related Investigations Involving Children and
4. Hibbard R, Desch LW, American Academy of Pediat-
6. Guo S, Fraser MW. Propensity Score Analysis: Statisti-
Youth with Disabilities in Canada in 2008. Available
rics Committee on Child Abuse and Neglect, American
cal Methods and Applications. Thousand Oaks, CA:
from:
Academy of Pediatrics Council on Children with Dis-
Sage, 2014.
http://cwrp.ca/sites/default/files/publications/
Commentaries
501
Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
