Prevention of fatal child maltreatment

Public reaction to deviance and specifically to its severe form such as child abuse is a complex social-cultural process based on changing definitions, societal interests and professional expertise. Each of the 50 states in the USA have passed laws defining child abuse and determining when intervention is required, and have established administrative structures to deal with verified child maltreatment.  However, caseworkers have to make final critical decisions regarding adequate interventions to prevent further harm to the child. Mistakes in risk assessment or provision of ineffective intervention can result in serious injury to the child or death. Research has shown that for many children who had been reported as being maltreated the efforts of the child protection system have not been successful in preventing subsequent victimization including death. Annually about 1500 children die of child abuse and neglect in the U.S. To effectively prevent severe child abuse or child fatality, accurate assessment of the risk for future harm in families who become involved with child protection agencies, is required. In an effort to better understand risk factors for the perpetration of the most serious child maltreatment (fatal or requiring immediate medical care,) this study examined various contextual and perpetrator characteristics using multiple administrative sets including Florida child welfare information system, Medicaid claims, Florida Law Enforcement management data sets, and Florida Substance Abuse and Mental Health records. The findings have shown that caregivers who were not natural parents of their victims were almost 17 times more likely to commit a fatal assault compared to those who were biological parents. Additionally, males, caregivers with a substance abuse history and perpetrators with a history of juvenile justice involvement were more likely to fatally maltreat their children. The implications of the findings for prevention will be discussed.