This study uses data from the National Child Abuse and Neglect Data System (NCANDS) and the Adoption and Foster Care Analysis and Reporting System (AFCARS) to examine the incidence of maltreatment among children in out-of-home care (OOHC), the nature of that maltreatment (neglect, physical abuse, sexual abuse, or emotional maltreatment), the source of maltreatment reports, and the relationship between maltreatment in OOHC and child characteristics (i.e., age, gender, race, ethnicity, and disability). We found that 6.5% of children in OOHC in a given reporting year were the subject of a child maltreatment report and 0.9% were substantiated maltreatment victims. Children with disabilities were more likely to experience maltreatment in OOHC than children without disabilities. Children who were maltreated while in OOHC were less likely to experience neglect and emotional maltreatment and more likely to experience physical or sexual abuse than other children who were maltreated. Reports involving maltreatment of children in OOHC were less likely to be substantiated than reports involving other children regardless of the report source, maltreatment type, or child characteristics. The relevance of these findings for preventing further harm to children who have already been neglected or abused are discussed.
AhnH.DePanfilisD.FrickK.BarthR. (2018). Estimating minimum adequate foster care costs for children in the United States. Children and Youth Services Review, 84(6), 55–67. https://doi.org/10.1016/j.childyouth.2017.10.045
2.
BenedictM.ZuravinS.BrandtD.AbbeyH. (1994). Types and frequency of child maltreatment by family foster care providers in an urban population. Child Abuse & Neglect, 18(7), 577–585. https://doi.org/10.1016/0145-2134(94)90084-1
3.
BenedictM.ZuravinS.SomerfieldM.BrandtD. (1996). The reported health and functioning of children maltreated while in family foster care. Child Abuse & Neglect, 20(7), 561–571. https://doi.org/10.1016/0145-2134(96)00044-0
4.
BiehalN. (2013). Child maltreatment in foster care: A review of the evidence. Child Abuse Review, 23(1), 48–60. https://doi.org/10.1002/car.2249
5.
BoltonF.LanerR.GaiD. (1981). For better or worse? Foster parents and foster children in an officially reported child maltreatment population. Children and Youth Services Review, 3(1–2), 37–53. https://doi.org/10.1016/0190-7409(81)90029-3
6.
CarbinoR. (2014). Child abuse and neglect reports in foster care: The issue for foster families of “false” allegations. In RobinM. (Ed.), Assessing child maltreatment reports: The problem of false allegations (pp. 233–248). Hawthorne Press.
CourtneyM.OkpychN.CharlesP.MikellD.StevensonB.ParkK.KindleB.HartyJ.FengH. (2016). Findings from the California youth transitions to adulthood study (CalYOUTH): Conditions of foster youth at age 19. Chapin Hall.
9.
CourtneyM.PiliavinI.Grogan-KaylorA.NesmithA. (2001). Foster youth transitions to adulthood: A longitudinal view of youth leaving care. Child Welfare, 80(6), 685–717.
10.
CroslandK.DunlapG. (2015). Running away from foster care: What do we know and what do we do?Journal of Child and Family Studies, 24(6), 1697–1706. https://doi.org/10.1007/s10826-014-9972-x
11.
CrossS.KayeE.RatnofskyA. (1992). A report on the maltreatment of children with disabilities. Washington, DC: Prepared by Westat, Inc.
12.
DePanfilisD.GirvinH. (2005). Investigating child maltreatment in out-of-home care: Barriers to effective decision-making. Children and Youth Services Review, 27(4), 353–374. https://doi.org/10.1016/j.childyouth.2004.11.010
13.
DrakeB.FlukeJ.KimH.OrsiR.StubblefieldJ. (2022). What proportion of foster care children do not have child protective services reports? A preliminary look. Child Maltreatment, 27(4), 596–604. https://doi.org/10.1177/10775595211033855
14.
Dubois-ComtoisK.BussiéresE.CyrC.St-OngeJ.BaudryC.MilotT.LabbéA. (2021). Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis. Children and Youth Services Review, 127(2), Article 106100. https://doi.org/10.1016/j.childyouth.2021.106100
15.
DworskyA.WulczynF.HuangL. (2018). Predictors of running away from out-of-home care: Does county context matter?Cityscape, 20(3), 101–116.
16.
EnglerA.SarpongK.Van HorneB.GreeleyC.KeefeR. (2020). A systematic review of mental health disorders of children in foster care. Trauma, Violence, & Abuse, 23(1), 255–264. https://doi.org/10.1177/1524838020941197
17.
EthierL.LemelinJ.LachariteC. (2004). A longitudinal study of the effects of chronic child maltreatment on children's behavioral and emotional problems. Child Abuse & Neglect, 28(12), 1265–1278. https://doi.org/10.1016/j.chiabu.2004.07.006
18.
FontS. (2015a). Are children safer with kin? A comparison of maltreatment risks in out-of-home care. Children and Youth Services Review, 54(3), 20–29. https://doi.org/10.1016/j.childyouth.2015.04.012
19.
FontS. (2015b). Child protection investigations in out-of-home care: Perpetrators, victims, and contexts. Child Maltreatment, 20(4), 251–257. https://doi.org/10.1177/1077559515597064
20.
FosterR.StoneF.LinkhD.BesetsnyL.CollinsP.SahaT.ThomsenC.RabenhorstM.MilnerJ. (2010). Substantiation of spouse and child maltreatment reports as a function of referral source and maltreatment type. Military Medicine, 175(8), 560–566. https://doi.org/10.7205/milmed-d-10-00035
21.
Gandarilla OcampoM.DrakeB.SimonJ.Jonson-ReidM. (2024). Does a child maltreatment report source predict differences in immediate and subsequent report outcomes?Child Abuse & Neglect, 147(6), Article 106587. https://doi.org/10.1016/j.chiabu.2023.106587
22.
GarnierP.PoertnerJ. (2000). Using administrative data to assess child safety in out-of-home care. Child Welfare, 79(5), 597–613.
23.
General Accountability Office. (2022). HHS should facilitate information sharing between states to help prevent and address maltreatment in residential facilities. GAO-22-104670. General Accountability Office.
24.
HavlicekJ.CourtneyM. (2016). Child maltreatment histories of aging out foster youth: A comparison of official investigated reports and self-reports of child maltreatment prior to and during out-of-home care. Child Abuse & Neglect, 52, 110–122. https://doi.org/10.1016/j.chiabu.2015.12.006
25.
HoG.BettencourtA.GrossD. (2017). Reporting and identifying child physical abuse: How well are we doing?Research in Nursing & Health, 40, 519–527.
26.
HusseyJ.MarshallJ.EnglishD.KnightE.LauA.DubowitzH.KotchJ. (2005). Defining child maltreatment according to substantiation: Distinction without a difference?Child Abuse & Neglect, 29(5), 479–492. https://doi.org/10.1016/j.chiabu.2003.12.005
27.
JaffeeS.Maikovich-FongA. (2011). Effects of chronic child maltreatment and child maltreatment timing on children's behavior and cognitive abilities. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 52(2), 184–194. https://doi.org/10.1111/j.1469-7610.2010.02304.x
28.
KesnerJ. (2008). Child protection in the United States: An examination of mandated reporting of child maltreatment. Child Indicators Research, 1(4), 387–410. https://doi.org/10.1007/s12187-008-9019-1
29.
KingB.LawsonJ.Putnam-HornsteinE. (2013). Examining the evidence: Reporter identity, allegation type, and sociodemographic characteristics as predictors of maltreatment substantiation. Child Maltreatment, 18(4), 211–275. https://doi.org/10.1177/1077559513508001
30.
KohlP.Jonson-ReidM.DrakeB. (2009). Time to leave substantiation behind: Findings from a national probability study. Child Maltreatment, 141(1), 17–26. https://doi.org/10.1177/1077559508326030
31.
LatzmanN.GibbsD.FeinbergR.KluckmanM.Aboul-HosnS. (2019). Human trafficking victimization among youth who run away from foster care. Children and Youth Services Review, 98, 113–124. https://doi.org/10.1016/j.childyouth.2018.12.022
32.
LightfootE. (2014). Children and youth with disabilities in the child welfare system: An overview. Child Welfare, 93(2), 23–45.
33.
MalhotraG.MachadoS.AslamG. (2023) Trauma informed approaches to data collection. EnCompass.
34.
NadonM.ParkK.LeeJ.WrightM. (2023). Who makes the call? Examining the relationship between child maltreatment referral sources and case outcomes in the United States, 2008-2018. Child Abuse & Neglect, 145(9–10), Article 106404. https://doi.org/10.1016/j.chiabu.2023.106404
35.
PalmerL.FontS.HerdT.PrindleJ.Putnam-HornsteinE. (2024). Rates of emotional disturbance among children in foster care: Comparing federal child welfare data and Medicaid records in two states. Child Maltreatment, 29(1), 8–13. https://doi.org/10.1177/10775595221118931
36.
PecoraP.KesslerR.WilliamsJ.O’BrienK.DownsA.EnglishD.WhiteJ.HiripiE.Roller WhiteC.WigginsT.HolmesK. (2005). Improving family foster care: Findings from the Northwest foster care alumni study. Casey Family Programs.
RobersL.ReesA.ElliotD.WoodS. (2024). ‘The worst day of my life’: Foster carers’ experiences of allegations. Adoption and Fostering, 48(1), 7–29. https://doi.org/10.1177/03085759231212501
39.
RoseD.AbramsonL.KaupieC. (2000). The lifetime experiences questionnaire: A measure of history of emotional, physical, and sexual maltreatment. University of Wisconsin-Madison.
40.
RosenbergS.RobinsonC. (2004). Out-of-home placement for young children with developmental and medical conditions. Children and Youth Services Review, 26(8), 711–723. https://doi.org/10.1016/j.childyouth.2004.02.016
41.
RosenthalJ.MotzJ.EdmonsonD.GrozeV. (1991). A descriptive study of abuse and neglect in out-of-home-placement. Child Abuse & Neglect, 15(3), 249–260. https://doi.org/10.1016/0145-2134(91)90069-p
42.
SalazarA.KellerT.CourtneyM. (2011). Understanding social support’s role in the relationship between child maltreatment and depression in youth with foster care experience. Child Maltreatment, 16(2), 102–113. https://doi.org/10.1177/1077559511402985
43.
SchustermanG.FlukeJ.NunezJ.FettigN.KebedeB. (2022). Child maltreatment reporting during the initial weeks of COVID-19 in the US: Findings from NCANDS. Child Abuse & Neglect, 134(3), Article 105929. https://doi.org/10.1016/j.chiabu.2022.105929
44.
SedlakA.MettenburgJ.BasenaM.PettaI.McPhersonK.GreeneA.LiS. (2010). Fourth National Incidence Study of Child Abuse and Neglect (NIS-4): Report to Congress. Washington D.C. U.S.
45.
SkinnerG.BywatersP.KennedyE. (2023). A review of the relationship between poverty and child abuse and neglect: Insights from scoping reviews, systematic reviews and meta‐ analyses. Child Abuse Review, 32(2), Article e2795. https://doi.org/10.1002/car.2795
46.
SpencerJ.KnudsenD. (1992). Out-of-home child maltreatment: An analysis of risk in various settings for children. Children and Youth Services Review, 14(6), 485–492. https://doi.org/10.1016/0190-7409(92)90002-d
47.
SullivanP.KnutsonJ. (2000). Maltreatment and disabilities: A population-based epidemiological study. Child Abuse and Neglect, 24, 1257–1273.
48.
TestaM.BruhnC.HeltonJ. (2009). Comparative safety, stability, and continuity of children’s placements in informal and formal substitute care. In WebbM.DowdK.HardenB.LandsverkJ.Testa JohnM. (Eds.), Child welfare and child wellbeing: New perspectives from the national Survey of child and adolescent well-being (pp. 159–191). Oxford University Press.
49.
TittleG.PoertnerJ.GarnierP. (2001). Child maltreatment in out of home care: What do we know now?Children and Family Research Center, School of Social Work, University of Illinois at Urbana-Champaign.
50.
UliandoA.MellorD. (2012). Maltreatment of children in out-of-home care: A review of associated factors and outcomes. Children and Youth Services Review, 34(12), 2280–2286. https://doi.org/10.1016/j.childyouth.2012.08.003
51.
U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. (2023). The AFCARS report. Preliminary estimates for FY 2022 as of may 9, 2023. No. 30. Available from: https://www.acf.hhs.gov/cb/report/afcars-report-28
52.
U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families Children's Bureau, Child maltreatment 2023 (2025).
53.
U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. (2024a). Child maltreatment 2022.
54.
U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2024b). Child welfare outcomes 2020 report to congress.
WinokurM.CrawfordC.LongobardiR.ValentineD. (2008). Matched comparison of children in kinship care and foster care on child welfare outcomes. Families in Society: The Journal of Contemporary Social Services, 89(3), 338–347. https://doi.org/10.1606/1044-3894.3759
57.
ZuravinS.BenedictM.SomerfieldM. (1993). Child maltreatment in family foster care. The American Journal of Orthopsychiatry, 63(4), 589–596. https://doi.org/10.1037/h0079480
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