Polk County, Oregon

The families being served by the State Office for Services to Children and Families (SOSCF) are changing. More illicit drugs, more criminal involvement, and more domestic violence are examples of the changes in the population being served by Oregon's child welfare agency. Knowing the changes in the client population enable agencies to make adjustments and better serve these needy families.

The "Cohort studies" are a series of research projects conducted each biennium to recognize changes in the SOSCF families. The Cohort studies recognize the maltreatment prompting SOSCF involvement, the child's vulnerability, the severity of the maltreatment, the caretaker's problems or conditions, the children's problems or conditions, the problems preventing children from returning home, and the services offered to caretakers and children.

The Cohort studies are named after the sampling design. A "cohort" of children entering foster care during a six-month period are sampled. The six-month "cohorts" are aggregated to develop a profile of the families served in each SOSCF branch office. The previous Cohort study considered children entering foster care between mid-1992 and 1995; the most recent Cohort study considered children entering foster care between 1995 and mid-1997. Comparison of the family profiles between the previous and current Cohort studies provides an indication of the changing client population served in a SOSCF branch office. The changes cited in this report recognize changes in the client population that occurs during a two-year period.

This research has been conducted by the Child Welfare Partnership at Portland State University. The data derived from the case studies is used to recognize client changes, allocate staff among SOSCF branch offices, quantify differences among families being served in each branch office, and assess the effectiveness of services. The foster care placement data has been analyzed to identify the family characteristics associated with severe child maltreatment, and estimate the likelihood a child will subsequently be maltreated. Printed copies of the Cohort reports and the other reports can be obtained by contacting Don Grossnickle at the Child Welfare Partnership (503-315-4268).

Age of the child victim is important. Infants and preschool children are more vulnerable to maltreatment, less able to verbalize the maltreatment, and more likely to be re-abuse if returned home. The re-abuse rate is highest for the youngest children and lowest for the oldest children. In addition, the maltreatment related to child fatalities usually involves children less than three years of age.

There are age differences between the longer and shorter-term population served by SOSCF. The longer-term population are children who remain in foster care for at least 14 days in the year after their removal; shorter-term children are in foster care for less than 14 days. The longer-term population is younger. Statewide, one of every eight (12%) longer-term children have not had their first birthday; only 7% of the shorter term population are less than one year old. For the longer-term population, about 39% are ages 0-4 years; for the shorter term population, about 31% are ages 0-4 years. For the longer-term population, half are less than seven years old, and only 25% are ages 11-17 years. For the shorter-term population, half are less than eight years and 25 % are 13-17 years. Although both populations have children ages 0-17 years, the shorter-term population is more variable and slightly older; the average age is 8 years for the shorter- term population and 7 years for the longer-term population.

Children less than one year of age are more common in the longer-term population than the shorter-term population; children less than one year of age are likely to stay in foster care longer when compared to children in other groups. Children ages 11-17 are more likely to be in the shorter-term population and are more likely to be returned home and stay home than younger children entering foster care. The pie charts below recognize differences in the ages of children entering longer-term foster care in Polk County during two different time periods.

SOSCF developed a "level of vulnerability" system in the early 1990s. The system was a child welfare priority system intended to identify SOSCF populations that would not be served if resource constraints were imposed. The system assumed the most vulnerable children would always be served and the least vulnerable children would be served if resources allowed.

Currently there are 64 mutually exclusive populations apportioned among the seven vulnerability levels. The most vulnerable children are identified within level 1 and the least vulnerable within level 7. The child's vulnerability is determined by numerous child and family characteristics. Younger and more severely maltreated children are considered more vulnerable and older, less severely maltreated children are considered less vulnerable. Level 1 is composed of the most severe cases of child maltreatment - child fatalities, life threatening neglect, abandonment, and severe sexual abuse. Level 2 is composed of more severe forms of physical abuse to children ages 0-5 years, severe mental/emotional abuse to children ages 0-5 years, more severe forms of sexual abuse to children ages 0-13 years, chronically neglected children ages 0-5 years, children deserted who are ages 0-13 years, children ages 0-13 years threatened by mentally ill parents, and children ages 0-13 years exposed to severe domestic violence. Each level of vulnerability is composed of these sublevels that identify the severity of maltreatment and age of the child victim.

Branches with higher estimates for levels 1-3 tend to serve more vulnerable children than the average SOSCF branch office. Branches with higher proportions for levels 6-7 tend to serve a less vulnerable group of children when compared to the average SOSCF branch office.

Child maltreatment is categorized as severe, substantial, or moderate. Severe physical abuse includes child fatalities, drug affected infants with medical problems, and serious injuries such as skull fractures, shaken babies, and children with third degree burns. Substantial physical abuse includes severe bruises, lacerations, fractures to smaller bones, and less severe burns. Moderate physical abuse includes bruising, facial slapping, and hair pulling. There are multiple categories for severity for each type of child maltreatment (e.g. neglect, physical abuse, sexual abuse, emotional/mental abuse). The "severe" category includes severe physical abuse, severe sexual abuse, severe neglect, and other forms of severe child maltreatment. Similarly, substantial child maltreatment includes the less severe forms of neglect, physical abuse, mental/emotional abuse and other types of child maltreatment. Moderate maltreatments are the least severe forms of child maltreatment served by SOSCF.

There are some parental characteristics that are more pervasive with severe child maltreatment than with less severe forms of child maltreatment. Drug involvement, mental illness, poor parenting skills, involvement with law enforcement agencies, social isolation, and new babies are common maternal characteristics identified with cases of severe child maltreatment. Poor parenting skills, new babies in the household, criminal involvement, and chronic neglect are paternal characteristics associated with severe child maltreatment. The likelihood of more severe child maltreatment increases in communities where these parental characteristics are increasing in prevalence.

In addition to the three categories recognizing severity of the maltreatment, there are two other categories. The "no abuse, child's issues" category is recognized when a child's problem or condition prompted the foster care placement. Children entering residential drug/alcohol treatment facilities and children with severe emotional disturbances are examples of situations included in this category. The category "no abuse, parental issues" includes situations where a parental problem or situation resulted in the children entering foster care. Parents incapacitated with severe medical problems is an example of a case included in this category.

Most children entering foster care have recognized problems. Each problem being exhibited by a child is categorized as DSM (Diagnostic and Statistical Manual of Mental Disorders), ICD (International Classification of Diseases), or behavioral. DSM problems are usually diagnosed by psychologists and tend to be mental or emotional problems. ICD problems are usually diagnosed by physicians and tend to be physical or medical problems. Both DSM and ICD are international classification systems that enable comparisons among studies conducted by different groups. Behavioral problems are neither mental nor physical problems, but usually require specialized parenting skills and knowledge.

The schematic below recognizes the different types of problems being exhibited by children entering foster care. Children in the "DSM only" category will exhibit one or more mental/emotional problems. A child in the "DSM and ICD" category exhibits one or more DSM problems, as well as one or more ICD problems. Many of these children have multiple mental/emotional problems and multiple physical/medical conditions.

Each child entering foster care is included in one of the mutually exclusive groups below. The sum of the category percentages is 100%. Statewide, the proportion of children exhibiting DSM problems is 69%, the proportion of children exhibiting behavioral problems is 69%, and the proportion of children exhibiting ICD problems is 31%. Thus, both mental and behavioral problems are recognized with 7 of every 10 children entering longer-term foster care; about 3 of every 10 children are recognized with physical (ICD) problems. Only one of every 10 children are not exhibiting problems when entering foster care. Most likely, many of these children will later exhibit problems related to their child maltreatment.

The problems exhibited by children are monitored by SOSCF. Children exhibiting problems often require specialized services, special rates provided to the foster parent, more specialized training and cooperation of the foster care providers, and more difficulty in finding adoptive homes.

The most pervasive problems exhibited by children entering foster care in Oregon include exposure to domestic violence (42%), angry/aggressive behaviors (29%), victims of sexual abuse (29%), victims of multiple incidents of physical abuse (28%), out of control/acting out behavior (20%), developmental or learning disorders (18%), and adjustment disorder (17%). In Oregon, angry/aggressive disorders and acting out behaviors are decreasing in prevalence; the other pervasive child problems are increasing in prevalence. Other common behaviors such as attention deficit/hyperactivity disorder (14%), mood or depression disorders (13%), and sexually acting out (13%) are neither increasing nor decreasing in prevalence. Post-traumatic abuse disorder (13%) tends to be increasing in prevalence while academic delay is decreasing.

Most of the less common problems being exhibited by children are equally pervasive in the previous and current Cohort studies. Three less common child problems decreasing in prevalence include drug affected infant (3%), low birth weight/premature (2%), and sexual offender (2%). Some change in these child problems is attributable to the changing SOSCF clientele. Today, SOSCF is serving younger children and fewer older delinquents when compared to the population served in the early 1990s. The table below presents comparisons of children entering foster care in Polk County between Cohort 3 and Cohort 4.

The parents of children entering foster care are usually burdened with problems or conditions. These parental problems or conditions are known as family factors. Family factors influence whether or not a child enters foster care, whether or not a child returns home, and whether or not a child is subsequently maltreated. The parental characteristics that are more pervasive with cases involving subsequent child maltreatment are in the graph below for Polk County. In addition to identifying parental characteristics associated with subsequent maltreatment, this research recognized that combinations of parental characteristics are important to assessing a child's risk of further maltreatment. Particular parental characteristics when combined with other parental characteristics can dramatically increase the risk of subsequent maltreatment. Most of the family factors listed below interact with other family factors to determine the overall risk of the child being abused or neglected again. A single isolated parental problem generally does not dramatically increase the risk of another maltreatment.

The maternal characteristics associated with subsequent maltreatment for all types of children maltreatment (neglect, parental absence, physical abuse, sexual abuse) include domestic violence and non-protective parents. In addition, chronic neglect and criminal involvement are important for all types of child maltreatment for single parent households while poor parenting is important for two caretaker households. Other important maternal characteristics include teen at first birth, drug/alcohol abuse, parents abused as a child, frequent relocation, unemployment, previous placements into foster care, incarceration, and inadequate housing.

The paternal characteristics associated with numerous types of child maltreatment include criminal involvement, drug/alcohol abuse, domestic violence, and a history of being abusive. Other important paternal characteristics include poor parenting, incarceration, angry/aggressive behaviors, and chronic neglectfulness.

Approximately 4,350 children entered longer-term foster care in 1998. About one-third of the children entering longer-term foster care remain in foster care for at least 12 months. About 40% return to the same parent(s) in the year after the child's removal. The remaining children are placed with the other parent, placed with relatives, or are reunited with their parent(s) and later re-enter foster care. Family barriers are the problems or situations that need some resolution before children and their parents can be reunited.

Case reviewers identify the single most important parental problem that prevents children from being reunified with their parent(s). For the children not returning home to the same parents, only a half-dozen parental problems are responsible for children not returning home. Drug involvement (27%), parents who are unwilling to fulfill their parental responsibilities (10%), parents who are absent (7%), parents with mental conditions (7%), parents who are chronically neglectful, and parents who abuse alcohol (6%) are associated with 64 % of the children who do not return home. Branch offices where these barriers are pervasive are less likely to have children returning home. These barriers require some resolution before a child can be reunited with his/her parents. Interestingly, drugs and alcohol are responsible for one-third of the children not returning home. Parental drug involvement is four times more likely than alcohol to be a reason a child does not return home.

In addition to identifying the most important parental problems for children not returning home, case reviewers identify problems that require some resolution before children are returned home. There could be one or numbers of "barriers" to family reunification. The graph below identifies the parental problems or conditions associated with family reunification of all children entering longer-term foster care in Polk County.

Services Offered to Families

Most parents with children entering foster care have problems and would benefit from services. SOSCF and their community partners offer services to maltreating caretakers. The services listed below are the most common services offered to caretakers with children entering longer-term foster care in Polk County.

A previous report quantifies the relative effectiveness of services offered to SOSCF families. The service effectiveness report identifies the services effective with returning children home and services effective with preventing subsequent maltreatment. The services effective with promoting family reunification and preventing child maltreatment require significant parental participation. Parents not attending the services are less likely to be reunited with their children and are often more likely to re-abuse.

The services associated with increased return home rates include visitation, parent training, drug/alcohol in-patient treatment, drug/alcohol out-patient treatment, individual counseling, intensive or high-impact family counseling, and Alcoholics Anonymous/Narcotics Anonymous (AA/NA). Both visitation and drug/alcohol in-patient treatment require complete parental participation to improve the likelihood a child will return home.

The services associated with lower re-abuse rates include parent training, drug/alcohol in-patient treatment, individual counseling and AA/NA. Both parent training and individual counseling require full parental participation to decrease the likelihood of subsequent maltreatment.

Services Offered to Children

Foster care is an alternative living situation for abused and neglected children. Children entering foster care are provided a safe and nurturing environment often consisting of two parents and other children. Foster children are provided the same necessities that parents provide their own children - shelter, food, clothing, dental care, and medicinal care. The services cited below are a compliment to the services provided for all foster children.

Most children entering longer-term foster care are victims of abuse and neglect and most exhibit problems. SOSCF and their community partners provide services to children in foster care. These services moderate the effects of child maltreatment and treat the symptoms of child abuse and neglect. Services provided to children do not influence the likelihood of family reunification nor do they affect the likelihood of subsequent maltreatment; services provided to the caretakers do affect the likelihood a child will return home and the likelihood a child will be subsequently maltreated.

The child services listed below are the most pervasive services for children entering longer-term foster care between 1995 and mid-1997 in Polk County. Unlike caretakers with only fair service attendance, most children attend and complete the services offered.

The Child Welfare Partnership at Portland State University conducted the fourth Cohort study of children entering longer-term foster care for the State Office for Services to Children and Families (SOSCF). Longer-term foster care includes children entering care for 14 days or longer within the year after their removal. The Cohort study includes a stratified random sample of children entering foster care in each SOSCF branch office. This random sample of cases is reviewed by trained researchers to determine the following family characteristics: the reason children enter foster care, the level of vulnerability of children, the severity of maltreatment, the problems affecting the parents, the problems affecting the children, barriers to returning children home, and the services offered to children and their families. This report reflects change among the profiles of families served in Polk County between the Cohort 3 (mid-1992 through 1995) and Cohort 4 studies (1995 through mid-1997). All comparisons are made between Cohort 3 and Cohort 4 for Polk County; however, comparisons between Polk County and the state are made for level of vulnerability, severity of maltreatment, and the categories within child’s problems. Due to the number of changes made in these three areas, comparisons to Cohort 3 would be difficult.

The most common reasons for children entering foster care in Polk County include neglect, treatment needs of the child, threat of harm, child’s behavior, and parental treatment needs. There are more children entering foster care due to neglect (11% to 27%) and parental treatment needs (4% to 9%) in Polk County when compared to the previous Cohort study. Conversely, fewer children are entering foster care in Polk County due to treatment needs of the child (27% to 21%).

The ages of children entering foster care are categorized in three groups - children 0-5 years, children 6-13 years, and children 14-17 years. The estimates associated with the child’s age categories have changed considerably in Polk County. For instance, there are fewer younger children (35% to 21%) and fewer older children (33% to 25%) entering foster care in Polk County when compared to the previous Cohort study. However, Polk County is serving more children between the ages of 6-13. This age group has increased in prevalence 64%, from 33% during Cohort 3 to 54% during Cohort 4. Because agencies such as the Oregon Youth Authority and the Oregon Commission to Children and Families are now serving most of the older children entering foster, the proportion of younger, more vulnerable children entering foster care will continue to increase.

The State Office for Services to Children and Families (SOSCF) developed the level of vulnerability system to differentiate the most vulnerable children (levels 1-3) from the least vulnerable children (levels 4-7). This system is based primarily on the child's age and the severity of maltreatment inflicted upon the child. Eighty-two percent of the children entering foster care statewide are classified as levels 1-3. Nearly 40% of the statewide population are classified as level 3, more than a quarter are classified as level 2, and only 14% are classified as level 1. The estimates associated with level of vulnerability tend to be different in Polk County when compared statewide. For instance, most of the children entering foster care in Polk County are classified as level 3 (46%). Sixteen percent are classified as level 2 and only 9% are classified as level 1. The estimates associated with levels 4-6 are similar to the statewide estimates in Polk County. However, Polk County serves more level 7 cases (13%) when compared statewide (4%).

Severity of maltreatment includes five categories: severe, substantial, moderate, no abuse-child’s issues, and no abuse-parental issues. Nearly 40% of the cases sampled in Polk County involve substantial forms of maltreatment; nearly 15% of the cases involve severe maltreatment, and 12% involve moderate maltreatment. In addition, more than 30% of the cases sampled in Polk County involve children entering foster care due to their own problems which are not related to maltreatment. The estimates associated with severity of maltreatment among the statewide population are somewhat different. Nearly half of the cases sampled statewide involve substantial maltreatment, more than 20% involve severe maltreatment, and 14% involve moderate maltreatment. Furthermore, only 16% of the cases sampled statewide involve children entering care due to their own problems; this estimate is about half of the Polk County estimate.

Many of the children entering foster care are victims of maltreatment, live in dysfunctional homes, and often exhibit more problems than other children. Sometimes children enter foster care not exhibiting any problems; often these children are young and do not display the effects of maltreatment until later in life. Only 8% of the children entering foster care in Polk County do not exhibit any known problems. Although some children do not exhibit any problems, most children exhibit one or more mental (DSM), physical (ICD) or behavioral problems. Nearly half the children entering foster care in Polk County exhibit both mental and behavioral problems, and 28% exhibit at least one of all three mental, physical, and behavioral problems. Clearly, the Polk County SOSCF office is serving children with some difficult problems. Statewide, nearly 40% of the children sampled exhibit both mental and behavioral problems and 15% exhibit at least one of all three mental, physical, and behavioral problems. In addition, slightly more children sampled statewide exhibit just behavioral problems (10% versus 2%) or just mental problems (8% versus 5%) when compared to Polk County.

The most common problems associated with children entering foster care in Polk County include angry/aggressive behavior, victim of sexual abuse, exposure to domestic violence, victim of multiple incidents of physical abuse, and out of control/acting out behavior. Criminal involvement (misdemeanor offenses), Attention-Deficit/Hyperactivity Disorder (AD/HD), drug abuse, mood/depressive disorder, and Oppositional Defiant Disorder are other common problems affecting children entering foster care in Polk County. Children entering foster care in Polk County tend to be exhibiting more severe problems when compared to the Cohort 3 study. Angry/aggressive behavior, exposure to domestic violence, victim of physical abuse, victim of sexual abuse, and drug abuse are problems that have drastically increased in prevalence in Polk County. Often the problems exhibited by children entering foster care are the result of dysfunctional environments, maltreatment, and the problems of the parents.

Family factors are described as parental problems or conditions that affect a caretaker's ability to parent. Alcohol abuse and teen parenthood are risk factors affecting nearly 70% of the families with children entering foster care in Polk County. Although these two factors have increased in prevalence since the previous Cohort study, alcohol abuse increased nearly 50%, from 47% in Cohort 3 to 69% in Cohort 4. More than 60% of the families sampled in Polk County were identified with drug involvement and poor parenting skills. The estimate associated with poor parenting has not changed since the previous Cohort study; however, drug abuse has increased in prevalence over 50%, from 42% to 66% between studies. In addition to these common factors, neglect, past CPS removal, and single parenthood are risk factors affecting more than half the families with children entering foster care in Polk County. Three of the four factors have not drastically changed whereas neglect has increased 49%, from 38% to 56% between Cohort studies. Single parenthood, poverty/inadequate income, unemployment, domestic violence, and criminal involvement are factors affecting 4 out of 10 families with children entering foster care in Polk County. 1 Since the previous Cohort study more families tend to be struggling with unemployment and domestic violence in Polk County. Many of the problems affecting families in Polk County are not only associated with severe maltreatment but many are difficult to resolve and often make family reunification more difficult.

Barriers to returning children home are collected for both children and their caretakers; however, most children remain in foster care due to parental barriers. The most common barriers to returning children home include drug involvement, alcohol abuse, chronic neglect, and overwhelming childcare. These four barriers have drastically increased in prevalence since the previous Cohort study. Other common barriers to returning children home include parental absence, parent-child conflict, parental mental condition, parent allows perpetrator access, and homelessness. Parent-child conflict, parental mental condition, and homelessness are barriers to returning children home found in more families when compared to the previous Cohort study.

Services offered to families are provided by SOSCF and their community partners to resolve the issues preventing children from returning home and to ensure children can remain safely at home. Services are also offered to children with the intention to minimize the effects of maltreatment and in some situations, to change negative behavior. Visitation is offered to 68% of the parents with children entering foster care in Polk County. More than 40% of the families sampled in Polk County are offered Family Decision Meetings and more than 30% are offered parent training, drug/alcohol outpatient, family counseling, and/or psychological examinations. In addition to the most common services being offered in Polk County, approximately 30% of the families are offered Alcoholics Anonymous/Narcotics Anonymous (AA/NA) and drug/alcohol evaluations. Most of the estimates associated with the services offered to families in Polk County have neither increased nor decreased between Cohort studies. However, more families were offered Family Decision Meetings, parent training, drug/alcohol outpatient treatment, and AA/NA when compared to the Cohort 3 study. Conversely, fewer families were offered drug/alcohol evaluations.

Most children entering foster care are victims of maltreatment while others struggle with their own behavioral issues. All children who enter foster care are provided basic services: food, clothing, and shelter. Additional services offered to children entering foster care are intended to minimize the effects of maltreatment and modify behavior. In Polk County, 15% of the children are offered no additional services. Alternately, the majority of children entering foster care are provided counseling, mental health services, sexual abuse treatment, and/or a variety of other services. The most common services offered to children entering foster care in Polk County include individual counseling, psychological examinations, Individual Education Plans (IEP) and residential treatment. Most of the services being offered to children entering foster care in Polk County have increased in prevalence or have not drastically changed since the Cohort 3 study. However, fewer children were offered individual counseling and residential treatment when compared to the previous Cohort study.

Polk County tends to be serving a more difficult client population when compared to the Cohort 3 study. More than half of the children entering foster care in Polk County are between the ages of 6-13 and many struggle with some serious problems. Not only are child’s problems increasing in Polk County, but parental problems are increasing as well. Drug/alcohol involvement, parental absence, parental mental illness, and perpetrator access are common problems affecting families with children entering foster care in Polk County. Not only are these problems increasing but each are difficult to resolve. The Polk County SOSCF office is making strides in assisting families with their problems by offering more services; AA/NA and drug/alcohol treatment are services being provided to more families in Polk County. These complex issues clearly create challenges for caseworkers in making their daily decisions. After assessing situations and consulting with supervisors, courts, families, and community partners, caseworkers weigh the risk of leaving children in situations that are often volatile or may remove children to ensure their safety. A decision to return a child home is often made only after safety plans have been developed, services have been completed, and agreements have been reached. Caseworkers make these decisions daily while balancing the emotional needs of the parents and the children with the potential for re-abuse. SOSCF and their community partners work together to provide support services to families with the intention to minimize the potential for subsequent re-abuse and the effects of child maltreatment.

1 Tables in this report reflect the ten most common variables. Some variables may be included throughout the summary due to significant changes made between the previous and current Cohort studies; however, these variables may not be the most common found in Polk County. For further information regarding a full listing of all variables collected in the Cohort studies contact the Child Welfare Partnership, Research Unit at Portland State University.

Methods

The Child Welfare Partnership (CWP) conducts the Cohort studies each biennium to better understand the client populations served by SOSCF. These studies include a thorough examination of families with children entering foster care in the state of Oregon. Foster care is a generic term used to describe out-of-home placements. Out-of-home placements include shelter care, foster care, residential treatment, family group homes, and relative care. A statewide stratified random sample of case records are selected for review. All children entering foster care in Oregon during the study period can be included in the sample. Cohort IV is a stratified random sample of children entering foster care between 1995 through mid-1997. All children who enter foster care during this period are eligible to be sampled; however, children must enter foster care from home, a home of a relative, or some other permanent residence outside the state's foster care system to be sampled. Children in continuous foster care before 1995 are excluded from the sample. Other cases excluded from the sample include cases transferred to another branch office after case reading has begun, children placed in foster care where little information is available, cases where the foster care placement occurred in other states, and cases missing important information.

The Cohort studies provide a representative profile of families with children entering foster care in Oregon. The qualifications listed above were developed by SCF and the CWP to efficiently and accurately profile this population of SCF clients. This study includes information regarding the reasons children are placed in foster care, the severity of abuse and neglect, and the problems of the families. In addition, information regarding barriers to returning children home, services offered to families, and information pertaining to why children go home are collected for each case. Cases are followed for one year to determine case outcomes and the effectiveness of services. The data collected in each Cohort study is compiled using an optically scanned information-gathering device. This device is designed to answer many questions related to such topics as outcome measures, the effectiveness of services, return home and re-abuse rates, as well as many other issues designed to fulfill agency needs.