Academic journal article Child Welfare

Caregiver Substance Abuse among Maltreated Children Placed in Out-of-Home Care

Academic journal article Child Welfare

Caregiver Substance Abuse among Maltreated Children Placed in Out-of-Home Care

Article excerpt

Child protective services (CPS) case records of 639 children placed in out-of-home care due to maltreatment were reviewed, and substance abuse by the child's caregiver prior to the child's placement was evaluated systematically. Based on several different sources of information, 79% of the caregivers were found to meet the criteria for caregiver substance abuse (CSA). Children with and without evidence of CSA differed on age, ethnicity, family composition, and type of maltreatment. The importance of operational specificity in defining CSA and implications for policy and service delivery are discussed.

Parental substance use and abuse have become major issues for the child welfare system [Dore et al. 1995]. Although the link between child abuse and parental substance abuse was identified more than three decades ago [Behling 1979; Leonard & Jacob 1988; Young 1964], the nature and extent of this relationship has yet to be clearly delineated. Many theories about the causal relationships between these two behaviors have been postulated. Some writers have argued that the disinhibitory effects of alcohol and other substances make those who use them more apt to engage in violent behavior [Mitchel & Savage 1991]. Alternatively, the substances may have a sedating effect on users, resulting in their inability to respond to their children's needs appropriately [Hindman 1977]. Others have proposed that the fussiness and difficult behaviors of babies born to substance-abusing women place these children at increased risk for abuse [Griffith 1988]. Still others purport that a third factor, such as poverty, stress, or maltreatment experienced by the parents, could account for both the substance use by and the abusive behavior among caregivers [Orme & Rimmer 1981].

Before attempting to disentangle the complexities of the relationship between substance use/abuse and child maltreatment, basic questions must be answered. First, the prevalence rate of caregiver substance abuse among families of maltreated children must be established. Current estimates vary widely, and methodologies for classifying substance abuse are not only not standardized, but frequently lack operational definitions within studies. For example, even the terms substance use or involvement versus abuse cause some degree of confusion and are responsible for a lack of comparability across reports. Many writers have used these terms almost interchangeably, particularly in reports put forth by committees conducting surveys within the child welfare system [NCCAP 1994; NCPCA 1989]. It is virtually left to readers to draw their own conclusions about what distinguishes the various terms employed to describe parental consumption of alcohol and drugs. In the review that follows, therefore, the terms used in the actual studies will be maintained, rather than arbitrarily selecting one for use in this article for the sake of consistency.

Coincidence of Child Maltreatment and Substance Abuse

A survey by the National Center on Child Abuse Prevention Research (NCCAP) [1994] attempted to investigate the association between parental substance abuse and reported cases of child maltreatment. When the NCCAP committee asked each state to estimate the number of substantiated cases of child abuse in which substance abuse was implicated, only eight of the 50 states were able to respond. This poor response rate demonstrates the lack of empirical data available to estimate the prevalence of parental substance abuse in maltreated populations. Nevertheless, some information was gathered in the report that substantiated the suspected high frequency of cases in which both parental substance abuse and child abuse are present. For example, in the eight states responding, 26% of the total number of maltreatment cases involved parental substance abuse as well, with a range of 3% to 80% in these states. Among all states that noted increases in the rates of maltreatment reports for 1993, substance abuse was named as a likely contributing factor. …

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