How much of a problem is resident mistreatment in child welfare institutions?

CAPTA and the Residential Placement: A Survey of State Policy and Practice

“…The earlier study by Rindfleisch (1984) 2 was reviewed while designing this study. The interview survey sought information in a number of areas: description of state responsibilities; related history in regard to residential investigations; the independency of investigation activities; established policies and procedures; the availability of specialized training and protocols for CPS workers involved in such investigations; as well as any agreements between protective services and licensing agencies in the state.…”

“…However, as child protective services were established in the states for intra-familial complaints, these services generally were not directed toward child maltreatment in institutions and residential facilities. Noting the professional concern of the time period reflected in the First National Conference on Institutional Abuse and Neglect in 1977, Rindfleisch and Rabb (1984) found that state response to child maltreatment in out-of-home care was less evident than to intra-familial maltreatment, mostly dependent on trying to 'stretch' familial protective statutes:…”

“…Nevertheless, public focus on intra-familial abuse and neglect was eventually joined by national interest in extra-familial abuse in institutional care, brought on by media exposés, family and consumer advocacy, and a series of legal interventions in the fields of mental health and disabilities. It was this unusual public focus on extra-familial or out-of-home care that led to an initiative by the National Center on Child Abuse and Neglect to fund the first comprehensive national study of ''the state of the art of child protection in child welfare institutions and children's protective agencies in the 48 contiguous states'' (Rindfleisch 1984). Under the leadership of NCCAN, the subsequent eligibility standard from CAPTA legislation of 1984 required that the states not only provide statutory language including out-of-home care as a part of the definition of abuse and neglect (Nunno and Rindfleisch 1991), but also establish ''a statute or administrative procedure requiring that when a report of known or suspected child abuse or neglect involves the acts or omissions of the agency, institution, or facility to which the report would ordinarily be made, a different properly constituted authority must receive and investigate the report and take appropriate protective and corrective action'' [45 CFR § 1340[45 CFR § .14(e), 1985.…”

“…When public attention turned to child abuse and neglect in the 1970s, early estimates suggested that the risk was actually higher in out-ofhome care-placement such as institutions, residential treatment facilities, group homes, foster homes, and day care services-than familial care. Although the information is limited, the risk for child abuse and neglect while in residential or institutional placements has been found to be as great or greater than that of the familial setting (Rindfleisch and Rabb 1984;Rindfleisch and Nunno 1992;Spencer and Knudsen 1992) with estimates given at 2-7 times the rate of familial abuse (Nunno and Rindfleisch 1991;Spencer and Knudsen 1992). These early estimates have been challenged in some recent studies (Tittle et al 2008;Garnier and Poertner 2000;Poertner et al 1999); then again, within categories of out-of-home care, rates for full-time care, as found in institutions, and residential facilities, have been found far higher than those in part-time care such as day care (Spencer and Knudsen 1992).…”

Hidden on the ward: the abuse of children in hospitals

“…While many definitions describe abusive incidents such as beating or sexual interference, an important aspect concerns the context in which they occur ( Department of Health (DoH) 1995). This issue of the threshold of abuse has been identified as creating major problems in the identification of, and response to, abuse of children living away from home ( Rindfleisch & Rabb 1984, Nunno & Motz 1988, Thomas 1995).…”