Child abuse fatalities: The little red needle in the big blue haystack

If you want to get people to surrender fundamental civil liberties you’d better scare the hell out of them. 

Donald Trump understands this; it’s been his m.o. since he began his campaign. So when his administration started tearing apart families at the Mexican border he justified it with hype and horror stories.

The child welfare establishment gets it, too.  For decades they’ve used horror stories – and hyped, misleading statistics - to justify tearing apart families all over America. No, it’s not identical, but there are more similarities than differences.

As early as 1993, under the headline “Damned Lies and Statistics,” Time magazine called out what was then one of the worst offenders – Prevent Child Abuse America (as well as other groups crusading for other causes) for using “flagrantly flimsy figures.”  

Ten years later, PCAA itself admitted to this:

While the establishment of a certain degree of public horror relative to the issue of child abuse and neglect was probably necessary in the early years to create public awareness of the issue, the resulting conceptual model adopted by the public has almost certainly become one of the largest barriers to advancing the issue further in terms of individual behavior change, societal solutions and policy priorities.

It’s not that the numbers themselves are necessarily wrong – but crucial context often is missing.  So we are often told that there are more than three million reports alleging child abuse every year. But we’re not told that more than 80 percent of them turn out to be false and most of the rest involve “neglect” – which often means only that the family is poor.

The most misleading statistic in child welfare

But the single most misleading figure in all of child welfare is the one I discussed recently in connection with the Orange County Register’s descent into “crack baby” journalism – the one about the proportion of child abuse deaths “known to the system.”

It is a figure built around the worst possible tragedy – child abuse fatalities.  The only acceptable goal for such tragedies is zero.  But if one really believes that even one such death is one too many, then there is no need to distort data to leave a misimpression about how often such tragedies occur right under the noses of caseworkers.  And that very distortion makes it harder to reach the goal we all share.

The more one favors a take-the-child-and-run approach, the more one harps on this figure – because the impression it leaves for the casual reader is vastly different from what the number really means.

So we read that “Of all the children who died in [name of state or locality] [fill in percentage] were previously ‘known to the system.’”

Typically, the percentage will be anywhere from one-third to two-thirds; the Register gave an even higher percentage, but did not explain how it came to that conclusion.

So one might read in a news story: “Half of all child abuse deaths involved children previously known to child protective services.”  Wow. That sounds like half the time, children known to CPS die.  Of course the figure means nothing of the sort.  The real meaning becomes clear when you add one crucial bit of context: The actual number of children who become “known to the system” over the course of a year.

So now, let’s look at the numbers nationwide.

According to the latest Child Maltreatment report from the Department of Health and Human Services, there were an estimated 1,720 child abuse deaths in 2017.  Of that total, 27.3 percent were previously known, in some way, to authorities.

Those who promote hype and hysteria are always saying that every figure they want to hype is an underestimate.  But this time, let’s assume they’re right.  Just for the sake of argument, let’s double the number of child abuse deaths and double the proportion “known to the system.”  That would give us a total of 3,440 deaths, of which 1,878 involved children “known to the system.”

Adding the missing number

Sounds like children often, even typically, die right under the noses of child protective services workers, doesn’t it?  But now, let’s add the missing number – the total number of children who become “known to the system” every year.  In 2017 that number was over seven million children - 7,508,000 to be precise.  So now we’re talking not about 1,878 out of 3,440 – but 1,878 out of 7,508,000.

So every year, CPS agencies are expected to figure out which of the 7,508,000 children will die if they don’t intervene in time.  It looks a bit like the graphic at the start of this post. This one:

 A tiny red needle in a big blue haystack.

But even that representation understates the difficulty involved for frontline caseworkers. In the graphic, all of the deaths are in one place.  In real life, they are much smaller needles scattered all over the haystack.

Even showing the needles in a different color can be misleading. Because while some of the case files turn out to have more “red flags” than a Soviet May Day parade, in many others there was no way to predict the tragedy that would follow.  As one former child welfare official put it: “For every one of these [death ‘known to the system’] cases, I can show you ten with identical circumstances where nothing went wrong.”

And then there is the whole definition of “known to the system.”  Again, some of those deaths were in cases where, in fact, the family was extremely well known to authorities, the problems were obvious and anyone should have seen the danger.  But most were not.  Sometimes “known to the system” means only that a report several years earlier had been screened out at a child abuse hotline.  So CPS investigators didn’t really know the family at all.

Where do we put 7.4 million children?

So what do we do? Investigate the families of all 7.4 million children?  Even if that could be done logistically – and it can’t – that would traumatize millions more children for no reason.  And, of course, the overload would be such that all the investigations would be sloppier and even fewer needles in that giant haystack would be found.

Or should we skip the investigating and just take away all 7.4 million children?  That way we know we won’t miss the needles because we’ve vacuumed up the entire haystack.  But where, exactly, would we put all those children?  And what would we do about placing so many of them at high risk of abuse in foster care itself?

So what’s the point of the most misleading statistic in child welfare? It’s not to get us to take away all 7.4 million – but it is an effort to get us to take away more of them, and traumatize more families with needless investigations, and beat back any attempts to impose openness, accountability and due process on the system.

But openness, accountability and due process are exactly what we need.  Because only a system that relies less on coercive intervention will have the time and resources to find those needles in the haystack, before it’s too late.

We know that because of something I’ve written about before, a study done by a liberal Texas think tank, the Center for Public Policy Priorities.  The study looked at what does, and does not, contribute to reducing child abuse deaths.

Let’s start with what doesn’t contribute to more child abuse deaths. The study found:

● The rate at which people report child abuse does not contribute to more or fewer child abuse deaths.

● The rate at which a state takes children from their parents does not contribute to more or fewer child abuse deaths.

● The rate at which a state screens in reports for investigation does not contribute to more or fewer child abuse deaths.

Here’s what does contribute to more child abuse deaths:

● High rates of poverty

● High rates of teen pregnancy

● Low rates of services to prevent child maltreatment.

Which means, of course, the real solutions are pretty obvious.

In contrast, the misuse of the most misleading statistic in child welfare only makes things worse.  It encourages overloading caseworkers with even more false allegations, more cases in which family poverty is confused with “neglect” and more children needlessly torn from everyone they know and love.  And that leaves the workers even less time to find those very small needles in that very large haystack.

Child abuse fatalities commission has found the answer: Throw platitudes at the problem!

Try our "Mad Libs version" of the commission's
latest blog post

 Have you heard about the computer program that can churn out political speeches.  Apparently, such speeches are so predictable and so clichéd that now a literal machine can write for a political machine.

I thought of that as I read the collection of strung-together platitudes that constitutes the latest  blog post from the so-called Commission to Eliminate Child Abuse and Neglect fatalities. Just how devoid of content is this thing?  Well, you can read the original here.

Or, make it a little less painful by just looking below at what I call the Mad Libs version.  I’ve removed all references specific to child welfare and child abuse fatalities.  But other than that, it’s exactly what Comission Chair David Sanders allegedly wrote.  Try filling in the blanks with just about any other pressing problem – race relations, the global economy, education, poverty, environmental protection.  I particularly like the fact that item #1 on the list of “three major problems” can be used for almost anything without changing even one word.

So, for anyone out there who might someday chair a “blue-ribbon commission” file this away.  You never know when you might need it:

THE "MAD-LIBS VERSION" OF AN ACTUAL POST TO THE BLOG FOR THE COMMISSION TO ELIMINATE CHILD ABUSE AND NEGLECT FATALITIES

_______  Today and Envisioning a Stronger ___________ System for the Future

As the Commission nears the end of its work on the issue of ____________, it is clear that there are no simple answers to this complex challenge.

There have been promising findings from a few communities that have come together in ways that appear to be reducing _______________. These approaches are hopeful, and the Commission will build its recommendations off of what we’ve learned about what works and what does not and what approaches appear to hold promise. Unfortunately, we found only a few well-researched programs that are demonstrated to ______________ and only a handful of communities that had chosen to attempt to _______________. Furthermore, we found that a coordinated national response that reflects and responds to the urgency of the present crisis is lacking.

Based on the promising efforts we observed, we identified three major challenges facing communities that hindered efforts to reform _____________:

First, there is a lack of sustained leadership and accountability at the federal, state, and local levels. Leadership on this issue will require strategic planning, coordination across multiple agencies, sustained focus, and a level of resources to bring about significant change.

There is also a lack of evidence-based research and clear data about _________________. There is no standard mandated reporting system _______________, and definitions, investigative procedures, and reporting requirements vary from state to state.

And finally, a lack of cross-system collaboration places too much of the onus on ______ for __________________.

As we have heard from agencies across the spectrum, in order for any strategy to succeed, it will need to include a multidisciplinary model that features meaningful and mutually accountable partnerships among ________________, and more. We recognize that this kind of deeply rooted collaboration, while necessary to generate real and lasting solutions, takes time.

Yet we know that there is no time to waste if we are to ______________right now, today. As we completed this work, we read hundreds of headlines about ____________________. Not a day has gone by that we haven’t thought about _____________.

That is why, as we near the release of our final report, our Commission is reviewing options for both immediate recommendations that will begin to ____________ right away and comprehensive changes to create a redefined _______________ of the 21st century.

Solving the issue of _____________________is within our reach, if we can apply the lessons of the past, act with urgency to _______________, and create a new vision for a more effective ____________ system of the future.

                                                                        

There is, however, a very serious side to all this.  Whatever problem you used to fill in the blanks, odds are it was an issue with serious consequences for a lot of people.  The issue of child abuse fatalities is among the most serious imaginable. But it is throwing platitudes at the problem that trivializes it, not pointing out that those platitudes and recycled bad ideas are all this commission has got.

The Keystone Kops of commissions holds another conference call: We listen, so you don’t have to!

The "Commission to Eliminate Child Abuse and Neglect Fatalities"
held a conference call Saturday.

● Commission chair suggests raiding scarce prevention funds to pay for more child abuse investigations.

● The Commission vs. the evidence base.

● Meet Michael Petit, born again fiscal conservative.

● One commissioner raises questions about keeping drafts hidden from the public.

 After NCCPR issued its comprehensive “pre-buttal” to draft recommendations by the “Commission to Eliminate Child Abuse and Neglect Fatalities” the Commission responded immediately – they stopped making their drafts public.  (See the discussion below concerning whether this is legal.)  So now they conduct long, drawn-out conference calls discussing later drafts and other documents that no one outside the commission can see.  It’s sometimes been necessary, therefore, to draw inferences concerning what, exactly the commission is talking about.

If any commissioner feels these inferences are inaccurate, the Commission is welcome to set the record straight – by releasing the documents and the tape recordings it makes of its conference calls.

When we last left the “Commission to Eliminate Child Abuse and Neglect Fatalities” they were debating a recommendation for a “surge” in which states would be forced to reopen thousands of cases of alleged child maltreatment in which children were allowed to stay in their own homes, in order to see which ones should be torn from everyone they know and love and consigned to the chaos of foster care after all.  There would be no comparable look at children already trapped in foster care to see if they could go home.

Another draft recommendation calls for prohibiting state child abuse hotlines from “screening out” any call alleging child abuse or neglect involving a child under age 5, no matter how patently absurd that call might be.  Even among calls that are screened in, 87 percent turn out to be false.  We estimate this recommendation would increase investigator caseloads by 44 percent, and almost all of that time will be spent spinning their wheels as they look where abuse and neglect are least likely to be found – stealing time and effort from finding children in real danger.

The Commission has been going around in circles debating which would scare Congress more: saying out loud that they want $1 billion in new funds just for the “surge,” or whether they should just say, in effect: “If you don’t throw gobs of money at our unscientific recommendation that has no evidence behind it, children will die!”

But on a conference call that lasted nearly three hours Saturday (about one-third of which was devoted just to figuring out whether there would be an up-or-down vote on all recommendations) Commission Chair David Sanders floated a new idea:

Either instead of, or in addition to, asking for more money, it’s not clear which, Sanders suggested that the Commission might want to recommend letting states use money from something called Title IV-B.  This is the meager pot of money the federal government now makes available, in part, for prevention and family preservation. 

Even though the evidence is clear that it is prevention programs, as well as broader anti-poverty efforts, that actually curb child abuse fatalities, Sanders is proposing allowing states to divert money from such efforts and pour it into investigating more families and taking away more children.

This is a bit like telling states: Hey, you know that federal money that now goes to food stamps for poor families – how would you like to spend it on hiring more cops instead?  It’s not hard to imagine the result. 

Actually, we know the result because it’s already happening: Many states already raid funds from the Temporary Assistance for Needy Families program (TANF) – the program that replaced “welfare as we knew it” to fund child abuse investigations and foster care, now Sanders is proposing to rob poor families again.

At another point there was some discussion of making the far bigger program that funds foster care and adoption, Title IV-E available for these investigations as well.  And one time I would have thought that wasn’t so bad.

But, as it happens, right now, for the first time in decades there is serious discussion in Congress about actually allowing those foster care funds to be used for prevention and family preservation – soon there may even be legislation to that effect.  But some on the Commission already appear ready to swoop down and urge that some of that money be carried off to fund giant schemes for traumatizing thousands – maybe more than a million – children every year with needless child abuse investigations.

Ignoring the evidence base

Sanders made his suggestion at a particularly revealing moment in the deliberations.  He’d just finished admitting, in effect, that the Commission had failed.

He noted that after two years of searching the Commission had found exactly one approach to reducing child abuse deaths that met the standard for being “evidence based.”  (A few others were “promising.”  The terms are not just rhetoric, there actually are formal definitions.) 

But that one evidence-based practice had nothing to do with screening in more hotline calls or “substantiating” more cases or taking away more children.  No, the one and only evidence-based practice they found was a well-known, highly regarded home visiting program known as the Nurse Family Partnership.  In other words, a prevention program.  That’s exactly the kind of program that might be funded by, say, Title IV-B – if David Sanders doesn’t succeed in getting that money diverted into all those things that don’t work!

Indeed, Sanders even admitted that there’s “no evidence” that a “case review” – apparently the new euphemism for the surge – “will reduce fatalities.”

The new shade of lipstick

In a previous post about the Commission, I noted that changing the exact language in the surge

Graphic by Murdocke23 

recommendation is just putting lipstick on a pig.  Now, Sanders seems to have come up with a new shade of lipstick.

Michael Petit, the actual guiding force behind the Commission, and the person who, judging by the discussion at Saturday’s conference call, suddenly sprang the surge idea on the group late in its deliberations, has made clear that the purpose of the surge is to investigate more families and remove children who might be at risk.

But Sanders now is trying to reframe the surge – as a research project!  (After all, he admits there’s no evidence it will actually reduce fatalities.)  The theory is that by looking at all fatalities for the past five years (which, in small states, is likely to be an extremely low number) and finding common “risk factors” and then barging into every family that has at least one such “risk factor” we’ll somehow learn more about how to prevent child abuse deaths, even if we don’t actually prevent any.

Sanders offered no evidence that this approach to “research” actually works, nor did he cite any researchers who know how to study the issue who are clamoring for this approach to studying it.

Meet the new fiscal conservative

Michael Petit is the commissioner whose constant cry can be boiled down to “Spend more money!  Spend more money!  Spend more money!”  But on Saturday, he was singing a different tune.

That’s because the issue was a prevention initiative.  A subcommittee dealing with issues that include racial bias proposed a plan involving a special kind of court in which representatives of all the organizations providing services to families were right there at the courthouse, ready to step in immediately to provide the help a family needed to prevent abuse and neglect and stay together safely.  Instead of a collection of referral slips, the family would get immediate help with whatever was needed, perhaps housing, or job training, or drug treatment.

It’s not entirely clear how it would work – because the actual document under discussion is secret – but it sounds similar to this initiative in San Antonio.

Michael Petit was peeved.  He kept denouncing the idea – because it would cost too much money!  (He calmed down when assured the recommendation was only for a pilot project.) And, he argued, it wouldn’t stop fatalities.  “In terms of the immediacy of stopping child fatalities” he said, this was the wrong priority.  Yes, it’s a good idea “long term” Petit said, “But how much does this contribute to stopping children’s deaths now?”

Quite a lot, probably.  As noted above, and in our full report, there is no evidence at all that a surge or anything similar will prevent child abuse deaths.  David Sanders himself admitted as much.  In contrast, both ChildTrends (speaking of abuse in general) and the Center for Public Policy Priorities, speaking specifically about fatalities, found that serious prevention efforts are about the only things that do work.

Hiding behind secrecy

If there’s one thing child protective services agencies love to do it’s hide their errors behind “confidentiality.”  In fact, the Commission appears likely to recommend that Congress demand more transparency from state child welfare agencies when it comes to how they investigate child abuse fatalities.

But for the Commission, transparency does not begin at home.

On Saturday’s call, one of the commissioners, Theresa Covington, said people had complained to her about being unable to follow deliberations because the actual documents being discussed are now withheld from the public.  She asked in particular about written comments commissioners have circulated about the drafts.  It’s not clear if she was aware of the fact that even the drafts themselves are secret.

Sanders blithely assured her that the secrecy is just fine because the Commission regularly checks with the General Services Administration.  That is the federal agency which tells commissions like this one whether what they’re doing is legal under various statutes, including open government laws.

There are two problems with this:

● It’s not hard to get a government agency to tell another government agency what it wants to hear.  Look at the handstands the Bush Justice Department did to justify torture, for example.

● Even if, in fact, hiding the drafts and other documents is legal, that doesn’t make it right.  There is nothing in any law prohibiting the Commission from demonstrating the sort of transparency it appears ready to demand of others.

But apparently David Sanders, Michael Petit and some others on the Commission want to wait until they’ve found enough lipstick for the pig.