Fourth National Incidence Study of Child Abuse and Neglect (NISâ4)

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physically assaulted or sexually abused by persons in any of these latter categories. Theyalso exclude children who are not living in households.It is also important to note that the estimates in this report reflect theunduplicated numbers of children in the U.S. who experienced the maltreatment inquestion. That is, the unit of measurement is the child, and each estimate counts a childonly once. The report provides both the estimated totals and the estimated rates per 1,000children. Estimated totals are annual estimates, reflecting the number of childrennationwide who were maltreated in the course of the study year. The incidence ratesindicate the numbers of children maltreated during the study year per 1,000 children inthe U.S. population. This report also follows the usage of the Congressional mandate inreferring to the estimates as "incidence estimates." In the epidemiological literature,however, they would be more appropriately termed "annual prevalence estimates."Technically, they are period prevalence estimates, where the focal period is a year. 243.1National Incidence of Harm Standard MaltreatmentThis section presents the national estimates of the incidence of children whoexperienced Harm Standard maltreatment during the NIS–4 2005–2006 study year. TheHarm Standard is relatively stringent in that, in general, it classifies a child as“countable” (i.e., counts the child in the study estimates) only if he or she has alreadyexperienced demonstrable harm as a result of maltreatment.24 In epidemiologic usage, "incidence" refers to the number of new cases that occur in the population duringa given period of time (Ahlbom & Norell, 1984). "Prevalence" can mean a number of different things,depending on whether it is used with or without a modifying adjective. When used without a qualifier, itis most often interpreted to mean "point prevalence," which is the total number of cases that exist in thepopulation at a given point in time. Prevalence can also be defined as "lifetime prevalence," which refersto the total number of persons known to have been cases at some time in their lives, or "periodprevalence," which denotes the total number of persons known to have been cases at any time during aspecified period.3–2
3.1.1 Overall Incidence of Harm Standard MaltreatmentTable 3–1 presents the estimates for Harm Standard maltreatment since theNIS–2. The shaded section gives the NIS–4 estimates. These represent annual estimatesfor 2005–2006, the period in which the NIS–4 data were collected. The right-hand sideof the table compares the NIS–4 findings with the estimates for the correspondingcategories from the earlier studies, the NIS–3 and the NIS–2. The NIS–3 estimates reflectthe incidence of maltreatment during 1993, and the NIS–2 estimates index the incidenceof maltreatment in 1986. The statistical significance of the comparison in question isindicated by an asterisk or letter(s), as the table footnotes explain.Table 3–1 shows that an estimated 1,256,600 children experienced HarmStandard maltreatment during the NIS–4 2005–2006 study year. This total reflects anincidence rate of 17.1 children per 1,000 children in the general population nationwide,which is equivalent to 1.71 children per 100, or to one child in every 58 in the UnitedStates. 25,26 The comparisons in the right-hand sections of the table indicate that the 2005–2006 annual incidence of all Harm Standard maltreatment is lower than thecorresponding estimate for 1993, a statistically marginal difference. 27 Specifically, therewas a 19% decrease in the total number of maltreated children since 1993. This decreasecorresponds to a 26% decline in the rate of overall Harm Standard maltreatment since theNIS–3. The rate measure conveys a child’s risk of experiencing the maltreatment, so onecan say that a child’s risk of suffering Harm Standard maltreatment was 26% lower in2005–2006 than it was in 1993. This decrease in incidence rate is statistically marginal,meaning that the estimated change closely approaches statistical significance but does notmeet the traditional statistical standard for concluding that the difference is not due tochance factors.25 The incidence rates in this chapter used the average of the July 2005 and July 2006 annual estimates asthe population denominator (U.S. Census Bureau, 2008a). This computation yielded the estimate that atotal of 73,635,000 children ages 0 through 17 were living in the United States during the NIS–4 2005–2006 study year.26 In this and subsequent chapters, all estimates concerning total numbers of children are rounded to thenearest hundred in order to avoid conveying a false sense of precision. All the estimates have associatedstandard errors which represent their degree of precision, given in Appendices B and C.27 Comparisons across studies use the rate measures (i.e., comparing the number of children maltreated per1,000) in order to take account of any changes in the size of the U.S. child population across the timeintervals. Appendix E gives the details of the between-study significance tests and their specific results.3–3
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Fourth National Incidence Studyof C
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Fourth National Incidence Studyof C
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TABLE OF CONTENTSChapterPageEXECUTI
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ChapterPage5.1.2 Differences in Mal
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LIST OF TABLESTablePage2-1 NIS-4 60
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LIST OF FIGURESFigurePage2-1 Levels
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Figure5-265-275-286-16-26-36-46-56-
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EXECUTIVE SUMMARYThis executive sum
Page 17 and 18: In the NIS classifications, maltrea
Page 19 and 20: 3. The National Incidence of Child
Page 21 and 22: (36%, or 302,600 children) were emo
Page 23 and 24: maltreatment outcomes—rates of ch
Page 25 and 26: details that would exclude legitima
Page 27 and 28: Grandparents as caregivers. The NIS
Page 29 and 30: males more often were abusers (62%
Page 31 and 32: maltreated children to enter CPS in
Page 33 and 34: with Harm Standard maltreatment and
Page 35 and 36: differences in maltreatment rates r
Page 37 and 38: 1. INTRODUCTIONThis report presents
Page 39 and 40: Incorporating the TAG input, DHHS d
Page 41 and 42: • The NIS-4 Data Collection Repor
Page 43: these with the percentages that rec
Page 46 and 47: Rationale. Although CPS investigate
Page 48 and 49: eveal the maltreatment to persons i
Page 50 and 51: Figure 2-3.Schematic Summary of the
Page 52 and 53: CPS recruitment. In order to undupl
Page 54 and 55: format: the Sentinel data form desc
Page 56 and 57: 3. Purposive and Avoidable Acts/Omi
Page 58 and 59: each child substantiated by CPS or
Page 60 and 61: 2.6 Weighting and Estimation 14The
Page 62 and 63: the population. The estimated total
Page 64 and 65: 2.8 Supplementary StudiesThe NIS pr
Page 67: 3. INCIDENCE OF CHILD ABUSE AND NEG
Page 71 and 72: 3.1.2 Incidence of Harm Standard Ab
Page 73 and 74: children represent 58% of all child
Page 75 and 76: From inadequate supervision to the
Page 77 and 78: 3.1.5 Severity of Outcomes from Har
Page 79 and 80: interpreted as less serious than mo
Page 81 and 82: considered to be endangered by thei
Page 83 and 84: totals represent national incidence
Page 85 and 86: Changes since 1986 in the incidence
Page 87 and 88: The NIS-3 found significant increas
Page 89 and 90: Moderate harm. Moderate harm due to
Page 91 and 92: 4. DISTRIBUTION OF ABUSE AND NEGLEC
Page 93 and 94: Sexual Abuse. Girls experienced Har
Page 95 and 96: Table 4-2. Sex Differences in Incid
Page 97 and 98: 4.2 Age Differences in the Incidenc
Page 99 and 100: Figure 4-4.Age Differences in Incid
Page 101 and 102: graph shows, the incidence rate for
Page 103 and 104: 4.2.2 Age Differences in Endangerme
Page 105 and 106: Physical abuse. The incidence of En
Page 107 and 108: Figure 4-11.Age Differences in the
Page 109 and 110: Figure 4-12.Percent Changes since t
Page 111 and 112: Endangered. Chapter 3 reported that
Page 113 and 114: significantly higher than that for
Page 115 and 116: Changes since the NIS-3 in Rates of
Page 117 and 118: Overall Endangerment Standard Maltr
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Changes since the NIS-3 in Rates of
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4.4.1 Differences in Harm Standard
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Table 4-6. Differences Related to C
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Thus, the incidence rate for childr
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Overall Harm Standard MaltreatmentS
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Table 4-8. Differences Related to C
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Endangerment Standard maltreatment,
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5.1 Differences in the Incidence of
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more than 2 times the rate for chil
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inferring that they were harmed. Th
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Specific Categories of Endangerment
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Endangered. The estimated incidence
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families. The incidence rate for ch
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Educational neglect. Children in fa
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The incidence rate of Endangerment
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Endangered. Children in families of
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Figure 5-1.Incidence of Harm Standa
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Figure 5-2.Incidence of Harm Standa
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higher, the rate for children whose
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maltreatment at a reliably higher r
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Figure 5-6.Percent Changes since NI
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5.3.2 Differences in the Incidence
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Specific Categories of Endangerment
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Figure 5-11.Incidence of Endangerme
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living with a single parent who had
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oth parents showed much smaller cha
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child’s primary caregiver, when t
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Table 5-6. Differences in Incidence
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in households with two children), a
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per 1,000). Also, the rate of moder
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two children, 1.7 times the rate fo
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Emotional abuse. The incidence of E
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Endangered. The estimated incidence
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Figure 5-23.Incidence of Harm Stand
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5.6.2 Differences in Endangerment S
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were 1.5 times more likely to be ph
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Moderate harm. Children residing in
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Second, because multiple persons so
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hierarchy comprises other adults kn
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Table 6-2 also reveals a marked dif
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with the fact that mothers tend to
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Table 6-4. Perpetrator's Sex by Sev
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perpetrator relationship, with the
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earlier (Chapter 4) and did not var
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perpetrator’s alcohol use was a f
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More of the moderately harmed child
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7. RECOGNIZING ABUSED AND NEGLECTED
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classification hierarchy. If more t
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neglected. That is, when school sen
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NIS-4 estimates and rates per 1,000
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largest contributor in this sector,
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schools and social services agencie
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maltreatment situations only to CPS
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that influence sentinels’ respons
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8.1 CPS Investigation of Abused and
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Figure 8-1.Changes in Rates of CPS
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Figure 8-2.CPS Investigation of Mal
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CPS investigated more than one-half
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Figure 8-6. CPS Investigation of Ch
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children recognized at shelters, al
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Figure 8-8.Changes in Rates of CPS
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Just as in the Harm Standard, the i
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Figure 8-11.Changes in Investigatio
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Figure 8-13.CPS Investigation of Ch
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maltreated children. With these chi
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during the extra month but were alr
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Figure 8-15.Uninvestigated Maltreat
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columns, providing the presumptive
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determining whether the child would
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Table 8-2 shows the actual and pres
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8.4 Relationship between CPS Invest
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investigation rates were lower for
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Prioritizing recommended responses
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maltreatment directly to CPS. Among
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columns, the educational neglect pe
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9. CONCLUSIONS AND IMPLICATIONSThe
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sliding scales for the poorer child
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REFERENCESAhlbom, A., & Norell, S.
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Youth and Families, Administration
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U.S. Census Bureau. (2004). Current
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Appendix A Design and Methods Summa
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weighted the records (so the sample
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design. The measure of size was the
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optimal sample sizes from law enfor
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CPS RECRUITMENT In order to develop
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SENTINEL AGENCY RECRUITMENT The sen
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Table A-2.NIS-4 Agency Participatio
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DATA COLLECTIONThe goals of the NIS
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Table A-5. Participating Sentinel A
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• The nature of harm (injuries to
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The evaluative coders recorded thes
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Table A-9. Agreement Rates for Over
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probability-based matching software
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WEIGHTING Sampling weights were dev
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eport the child to CPS, which in tu
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Table A-12. Topics Covered in the 4
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CPS SCREENING POLICIES STUDY (SPS)
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• 52 agencies provided their own
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SENTINEL DEFINITIONS SURVEY (SDS) T
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The first surveys were mailed in Ma
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TABLE B-1.CATEGORIES OF MALTREATMEN
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TABLE B-4.AGE BY CATEGORIES OF MALT
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TABLE B-4. (Continued)AGE CLASS = 1
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TABLE B-5. (Continued)RACE/ETHNICIT
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TABLE B-6. (Continued) NCHILDR = 4
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TABLE B-8.CHILDREN COUNTABLE UNDER
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TABLE B-8. (Continued)CLASS = NOT I
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TABLE B-10.FAMILY STRUCTURE AND PAR
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TABLE B-10. (Continued)FAMILY STRUC
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TABLE B-11. (Continued)FAMILY STRUC
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TABLE B-13. (Continued)PARENTS' EMP
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Appendix C Endangerment Standard Es
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TABLE C-3.SEX BY CATEGORIES OF MALT
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TABLE C-4. (Continued)AGE CLASS = 6
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TABLE C-5.RACE/ETHNICITY BY CATEGOR
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TABLE C-6. (Continued)NCHILDR = 2 C
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TABLE C-7. (Continued)METROSTATUS =
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TABLE C-8. (Continued)CLASS = INVES
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TABLE C-9.PROPORTION OF ENDANGERMEN
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TABLE C-10. (Continued)FAMILY STRUC
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TABLE C-11.FAMILY STRUCTURE BY CATE
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TABLE C-12. (Continued)SOCIOECONOMI
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TABLE C-14.GRANDPARENTS AS CAREGIVE
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APPENDIX DWITHIN STUDY ANALYSES Thi
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Table D-3. T-statistics for age dif
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Table D-3. ContinuedAge 6-8 vs 9-11
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Table D-4. ContinuedAge 0-2 vs 12-1
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Table D-4 ContinuedAge 9-11 vs 12-1
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Table D-6. T-statistics for racial/
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Table D-8. T-statistics for parent'
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Table D-11. T-statistics for family
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Table D-11. ContinuedUnmarried Pare
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Table D-12. ContinuedMarried Parent
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Table D-12. ContinuedSingle ParentW
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Table D-17. T-statistics for metros
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Table D-19. Chi-squared Results for
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APPENDIX E BETWEEN-STUDY ANALYSES T
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Table E-1a. T-statistics for compar
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Table E-3. Chi-squared tables for s
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Table E-3. (Continued)Emotional Neg
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Table E-4. (Continued)Sexual Abuse0
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Table E-4. (Continued)Severity, Mod
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Table E-5. (Continued)Physical Negl
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Table E-6. Chi-squared tables for p
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Table E-6. (Continued)Educational N
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Table E-7. Chi-squared tables for f
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Table E-7. (Continued)Emotional Neg
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Table E-8. (Continued)Sexual AbuseL
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Table E-8. (Continued)Severity, Mod
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Table E-9. (Continued)Emotional Abu
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Table E.9. (Continued)Severity, Inf
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Table E-10. (Continued)Emotional Ab
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Table E-10. (Continued)Severity, In
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Table E-17. T-statistics for Source
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Fourth National Incidence Study of Child Abuse and Neglect (NISâ4)