“…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).…”