New Directions in Child Abuse and Neglect Research (2014) / Chapter Skim
Currently Skimming:
7 Research Challenges and Infrastructure
7 Research Challenges and Infrastructure
Pages 297-348
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The final section presents conclusions. COMPONENTS OF THE CHILD ABUSE AND NEGLECT RESEARCH INFRASTRUCTURE Several components must be in place if a research infrastructure that is both effective in the short term and sustainable over time is to be built.
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incorporate multidisciplinary and multimethod perspectives in research design; (2) initiate research focused on determining the role of cultural factors; (3)
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Multidisciplinary and Multimethod Perspectives Child abuse and neglect research encompasses a wide range of disciplines and research problems. Figure 7-1 depicts 11 of the most salient domains identified by the committee: mental health, physical health, implementation science, child development, policy research, neurobiology, court interventions, child welfare, public health, forensic sciences, and ethical issues.
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Behavioral Science Parenting Interventions 300 Trauma Screening Injury Biomarkers Psychiatry, Psychology, Child Protection Services Therapy Informed Consent Biomechanics Prevention Science Program/Service Implementation Social Work Covert Surveillance Forensic Interviews Epidemiology Social Work Interventions Treatment Development Foster Care Mental Ethical Forensic Public Health Issues Sciences Health Child Welfare Physical Health Court Child Abuse and Interventions Pediatrics Neglect Research Compliance with Court Order Orthopedics Youth Participation Pathology Criminal Sanctions Radiology Judicial Decision Making Neurology/Neurosurgery Implementation Science Child Policy Dissemination of Evidence- Development Neurobiology Research Based Prevention Strategies Physical Mandated Reporting Dissemination of Evidence- Epigenetic Effects Based Treatments Social/Emotional Alternative Response Stress Response Systems Fidelity and Sustainability Cognitive Brain Development Research Influence of Parenting Approaches FIGURE 7-1 Child abuse and neglect research domains.
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Rib fractures and multiple fractures are known to be associated with abuse more commonly than other fractures in young children (Kemp et al., 2008) , but questions remain about when a diagnosis of abuse should be considered and X-rays ordered in potentially related conditions such as acute life-threatening events, seizures, burns, and abusive head injury.
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, and What are the appropriate clinical indications for these tests? Abusive head trauma was first described as shaken baby syndrome more than 40 years ago, yet intense public and legal controversy over this diagnosis persists.
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Areas of research, including in many instances testing of interventions, include addressing child neglect, parent engagement, infant mental health, community-based prevention and parenting education, addressing trauma and meeting the mental health needs of children who experience abuse and neglect, risk and safety assessment, decision making, the impact of substance abuse on child abuse and neglect, links between child abuse and neglect prevention and economic well-being, achieving permanency through guardianship, reducing long-term foster care, and accountability and performance-based contracting. The social work profession provides a large part of this research community, and successful collaborations between child welfare agencies and universities offer a range of examples of how to create productive research partnerships.
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In fact, the small discretionary research program of the Children's Bureau, which also included some funding for doctoral students, was terminated in 1996, when the funds were used to launch the National Study of Child and Adolescent Well-Being as part of the Personal Responsibility and Workforce Investment Act. Unless potential investigators seeking support for field-initiated research approach NIH or CDC, there will be no national funding source for such research or for training for child welfare researchers.
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, aggregating data across multiple independent sources can improve the identification of cases not referred to child welfare agencies. Linking case-based data from two or more datasets has proven especially informative about risk factors.
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In response to this need, for example, Chapin Hall at the University of Chicago instituted Administrative Data Institutes for child welfare managers in the early 1990s. To foster the integration of research with policy and practice, Chapin Hall has since 2007 offered annual sessions in Advanced Analytics for Child Welfare Administration, which focus on using longitudinal administrative data in child welfare decision making, program planning, and outcome monitoring (Chapin Hall, 2012)
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. Box 7-2 presents an example of difficulties faced by child abuse and neglect researchers as a result of ethical concerns of institutional review boards.
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Examples of these populations include American Indian and Alaska Native children and families (Cross, 2012) ; Latino children and families; children with disabilities; children of immigrants; lesbian, gay, bisexual, and transgender (LGBT)
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American Indian and Alaska Native populations (The National Congress of American Indians, 2009; Sahota, 2010) ; the use of community-based participatory research to develop intervention strategies (Baum et al., 2013)
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. Knowledge is lacking about the prevalence of these children in the child welfare system, as well as the prevalence of children who have parents with disabilities, including how they are served and what prevention strategies are effective for their families (Lightfoot and LaLiberte, 2006; National Council on Disability, 2012)
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. Longitudinal Studies, Surveillance, and Registries In addition to a compilation of state child abuse and neglect reports issued annually by the federal government (the Child Welfare Information Gateway)
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Surveillance Systems Numerous limitations characterize the current child abuse and neglect surveillance system, which relies primarily on NCANDS data, supplemented sporadically by the NIS. Critics note that NCANDS captures only children reported to child welfare agencies (Medina et al., 2012)
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Universities and social science research organizations have attempted to unify the evidence base in child abuse and neglect and prevention research. Research Funding A wide array of federal agencies have provided funding for child abuse and neglect research through various legislative initiatives.
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In addition, several CDC-funded injury prevention centers, such as the Center for Violence and Injury Prevention at Washington University's Brown School of Social Work, target child abuse and neglect. In 2001, CDC convened 15 abuse and neglect experts to establish 5 71 FR 11427 Children's Bureau Proposed Research Priorities for Fiscal Years 2006-2008 (http://www.gpo.gov/fdsys/granule/FR-2006-03-07/06-2154/content-detail.html [accessed January 27, 2014]
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It invests more than $30 billion annually in medical research; research in the area of child abuse and neglect generally accounts for about $30 million per year. Yet of the funding for child abuse and neglect research in FY 2011, just over one
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After 2010, however, NIMH withdrew from participation.8 NICHD detailed to its council its commitment to research on child abuse and neglect and violence in general in January 2009, stating that within the Social and Affective Development/Child Maltreatment and Violence Program of NICHD's Child Development Behavior Branch, attention to child abuse and neglect includes active involvement in trans-NIH and transagency efforts to advance the science in the field of child abuse and neglect research; this involvement includes co-chairing the NIH Child Abuse and Neglect Working Group. The Child Development Behavior Branch also 6 See http://grants.nih.gov/grants/guide/pa-files/PA-01-060.html (accessed January 27, 2014)
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Currently there are three national quality improvement centers in the research domains of differential response in child protective services, early child experiences, and representation of children in the child welfare system (Children's Bureau, 2013)
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Private Foundations A number of national, local, and regional foundations provide support for child abuse and neglect research initiatives. The following sections highlight the notable contributions of the Doris Duke Charitable Foundation, the Annie E
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Specific areas of interest for research funding include preventing child abuse and neglect; accelerating permanency for children in foster care; improving the well-being of the children and families who encounter the child welfare system, including long-term outcomes such as employment, education, and mental health; and understanding the experiences of older youth who exit the child welfare system. From 2000 to 2011, CFP researchers published 60 peer-reviewed articles.
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As discussed earlier, front-line child abuse and neglect research involving alleged or substantiated cases must be conducted in a crisis-driven atmosphere with unique legal, ethical, and organizational complexities. The high level of family dysfunction, frequent family moves or changes in the out-of-home placement of children, and quality problems with child welfare administrative data increase attrition among subjects and the amount of missing data compared with clinic-based research on middle-class families.
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Discomfort with the topic may contribute to the sparse designated funds available for child abuse and neglect research. The considerable costs of child abuse and neglect are distributed across many sectors, including mental health, medicine, drug and alcohol programs, education, social services, unemployment, law enforcement, and the prison system.
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Child Welfare Researchers Although several policy efforts have focused on enhancing the child abuse and neglect research enterprise, there still are no structured career development opportunities for child maltreatment/child welfare researchers (IASWR, 2008) ; the field lacks policy supporting a clear researcher development strategy or career trajectory within or across disciplines.
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Since 2009, the Children's Bureau has sponsored two National Child Welfare Evaluation Summits, providing funds for state and tribal staff to attend. These meetings have provided an opportunity to present and discuss research on child welfare/child abuse and neglect, but they have not been specific to child abuse and neglect research, nor have they focused especially on career development.
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With few child welfare researchers being supported by major federal institutional funders, there are few mentors and reviewers in the field. Finding: While a wide array of public and private funders have made notable contributions to child abuse and neglect research, high-level, national coordination for research in this field is lacking.
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Finding: Current national child abuse and neglect surveillance efforts rely heavily on data reported to child welfare agencies. The children encompassed by these reports may represent a minority of total abuse and neglect incidents and can vary based on jurisdictional reporting standards.
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. Two recent reviews of child abuse and neglect research strategies and priorities highlight the multiple problems created for researchers and policy makers by the failure to implement this recommendation (MacMillan et al., 2007; Whitaker et al., 2005)
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. Expertise in the measurement of these confounding variables cuts across research disciplines, necessitating the multidisciplinary, multimodal approach to abuse and neglect research discussed earlier in this report.
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. Thus at least two factors -- family dysfunction and male gender -- have been identified as potential confounders of the representativeness of abuse and neglect research samples.
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Child protection is the primary pathway into the child welfare system. Very little is known about day-to-day risk assessment and decision making in child protection agencies.
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The paucity of knowledgeable reviewers leads to inexpert reviews and a lack of champions for research in the field; thus, perpetuating the absence of a home for child abuse and neglect research. With little success in securing funding, the field continues to be an orphan research area.
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In response to this need, Chapin Hall at the University of Chicago established administrative data institutes for child welfare managers in the early 1990s. To foster the integration of research with policy and practice, Chapin Hall has since 2007 offered annual sessions in advanced analytics for child welfare administration, which focuses on the use of longitudinal administrative data in child welfare decision making, program planning, and outcome monitoring.14 Agencies also view the value of research and its relevance to their practice differently.
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EXISTING OPPORTUNITIES TO CREATE AN INTEGRATED CHILD ABUSE AND NEGLECT RESEARCH INFRASTRUCTURE Fortunately, major developments have occurred since the 1993 NRC report was issued that offer opportunities to create an integrated child abuse and neglect research infrastructure that can bridge the separate systems and services discussed above. The following sections highlight several notable efforts to bring interdisciplinary collaboration to child abuse and neglect research and service delivery.
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University-affiliated CACs in particular have access to the human and physical capital required for a high-quality child abuse and neglect research infrastructure. In addition, they can offer researchers from outside the child abuse and neglect field access to an infrastructure within which to conduct longitudinal, case-based, cross-system, multidisciplinary research.
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As described in Chapter 5, this program awarded more than 50 regional partnership grants in FY 2007 to strengthen crosssystem collaboration and service integration through a number of strategies, including family treatment drug courts, increased staffing to address shortages in both child welfare services and substance abuse treatment systems, reconciliation of conflicting time frames across legal and treatment systems to achieve desired outcomes, and use of evidence-based practice approaches and delivery of trauma-informed services. This emphasis on collaboration has continued under the Child and Family Services Improvement and Innovation Act (P.L.
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Ad Hoc Child Abuse and Neglect Research Networks As discussed in Chapter 2, more than 3 million children are reported to child protection authorities each year, but many of these children are reported multiple times, and only one-third of reported cases are founded or confirmed. Given the wide variety of forms of abuse and neglect and the overrepresentation of some children in the data, specific forms of abuse and neglect, such as abusive head trauma, Munchausen syndrome by proxy, or inflicted burns, may be sufficiently uncommon that careful research on them may be difficult in any one setting.
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, which is hosted by Cornell University and funded by the Children's Bureau, maintains Child-Maltreatment-Research-L (CMRL) .20 CMRL is a listserv whose goal is to create space for scholarly discussion among the hundreds of subscribing child abuse and neglect researchers.
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. The Child Welfare Research Center in the School of Social Welfare at the University of California, Berkeley, conducts groundbreaking research on a variety of child welfare issues, including adoption, case management, foster care, and welfare reform, and has been a leader in the state and nationally in the use of administrative data.
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That proposal, to form Health Child Abuse Research and Evaluation Centers, never received support from any federal agency or Congress and did not move forward. BOX 7-4 The Early Experience, Stress, and Neurodevelopment Center The Early Experience, Stress, and Neurodevelopment Center is an example of an effective multidisciplinary infrastructure for translational research on child abuse and neglect and for training for a new generation of translational research ers.
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Research collaboratives, such as ad hoc child abuse and ne glect research networks and various privately supported child abuse and neglect research centers, serve as a model for support of the multi disciplinary research necessary to advance the field of child abuse and neglect research. abuse.
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Despite notable efforts to support child abuse and neglect research by a number of public and private sources, significant components of the field's infrastructure remain inadequately developed. Future efforts need to focus on recruiting and training a dedicated and capable cadre of researchers, securing stable sources of research funding, and developing sufficient physical capital to conduct research based on sophisticated designs.
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Finally, the formation of child abuse and neglect research centers presents an important opportunity not only to develop and sustain a volume of highquality interdisciplinary research related to child abuse and neglect but also to train and support a new generation of child abuse and neglect researchers to ensure the growth of the field. REFERENCES Amsel, L
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2012. Advance analytics for child welfare administration.
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Child Welfare 87(3)
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2010. Scandalous politics: Child welfare policy in the states (American governance and public policy series)
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2008. Strengthening university/agency research partnerships to enhance child welfare outcomes: A tool kit for building research partnerships.
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Paper presented at National Child Welfare Evaluation Summit, Washington, DC. Medina, S
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2010. Using technology to improve child welfare outcomes: Pilot proj ect completed.
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2004. The case for prospective longitudinal studies in child maltreatment research: Commentary on Dube, Williamson, Thompson, Telitti, and Anda (2004)
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