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Protecting seriously mistreated children: Time delays in a court sample
Chrld Abuse & Nqfeci, Vol. 16. pp. 465-474, Printed in the U.S.A. ,411 rights reserved.
1992 Copyright
0
0145-2134/92 $5.00 + .XJ 1992 Pergamon Press Ltd.
PROTECTING SERIOUSLY MISTREATED CHILDREN: TIME DELAYS IN A COURT SAMPLE SANDRA J. BISHOP, J. MICHAEL MURPHY,
MICHAEL S. JELLINEK,
SISTER DOROTHY QUINN Child Psychiatry Service, Massachusetts General Hospital, Boston, MA
JUDGE FRANCIS G. POITRAST Boston Juvenile Court. Boston, MA
Abstract-The study examined the progress through the child protective system of a sample of 206 severely abused and/or neglected children brought before the Boston Juvenile Court (BJC) on Care and Protection (C & P) petitions. Overall, children were in the system an average of 5 years from the filing of the first official report of mistreatment to the resolution of their cases. The families had been known to the state child protective service agency for an average of more than 2.5 years before the current court involvement. Once arraigned in juvenile court on the C & P, the average case took almost I .5 years to reach a disposition. After disposition, children permanently removed from parental custody required, on average, an additional year and a half in Probate Court to reach a permanent placement. Of the more than twenty variables examined, including severity of mistreatment, protective service history, and parental mental illness, no meaningful pattern emerged which could predict delays. Our findings characterize the delays experienced by many abused and neglected children, and highlight the necessity of closer monitoring of the progress of cases througb the protective and court systems. Key Words-Child
abuse and neglect. Adjudication, Time delays, Care and protection petitions.
INTROIXJCTION THE COURTS PLAY a vital role in society’s response to the problem of child mistreatment (Kelly & Ramsey, 1985). Courts often deal with the most severe cases of mistreatment, and in many cases, particularly for very poor children, are the “social service systems of last resort” (Massachusetts Bar Association, 1988, p.3). Furthermore, the number of child mistreatment cases heard by the courts is rising dramatically (Davidson, 1989; Golden, 1990). Despite the increasing involvement of the courts, there has been very little empirical research examining the judicial system’s handling of child mistreatment cases (Kelly & Ramsey, 1985), and this lack of research has impeded efforts to understand and improve the progression of such cases through the courts (Davidson, 1989). The paucity of judicial research is due to both practical reasons, such as court records being closed to the public, and the lack of standards for assessing the effectiveness of court involvement (Kelly & Ramsey, 1985). One standard that can be used to assess the judicial system’s intervention in cases of child mistreatment is the length of time required for resolution. While awaiting the court’s decision,
Requests for reprints may be sent to Michael Jellinek, M.D., Massachusetts General Hospital, Child Psychiatry Service, ACC 725, Boston, MA 02114. 465
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S. J. Bishop, J. M. Murphy, M. S. Jellinek, D. Quinn, and F. G. Poitrast
most mistreated children are separated from their parents and placed in “temporary” foster homes. Having removed the child from immediate danger, the system tends to lose its sense of urgency both in providing services to the family and in working toward a permanent solution to the problem (Derdeyn, 197’7). And, although the child may have been removed from immediate danger at home, out-of-home placement carries dangers of its own. For example, the child is often shifted from placement to placement, without regard for his/her need for a stable, nurturing environment. (Cooper, Peterson, and Meier, 1987). Goldstein, Freud, and Solnit ( 1979) have eloquently described the child’s need for prompt re~lution, arguing that “to avoid irreparable psy~holo~cal injury, placement, whenever in dispute, must be treated as the emergency that it is for the child” (p. 43). In reviewing standards developed by the American Bar Association and other advocacy groups for improving the handling of child mistreatment cases by the courts, Davidson (1989) noted that in report after report, one of the most common and pressing recommendations was for faster resolution of cases. Empirical evidence supporting the extent and negative impact of time delays is provided by an investigation by the New York City Comptroller’s Office (Golden, 1977) which reported that after spending several years in foster care, children displayed significantly increased social and emotional dysfunction, manifested in symptoms such as severe anxiety, enuresis, hyperactivity, or nightmares. Many of these children subsequently required institutionalization. Extended periods in foster care also greatly reduced the chances of a child’s being adopted, resulting in many children spending their entire childhoods in “temporary” foster care. Other investigators have found such children prone to delinquency in adolescence (Pollock et al., 1990). been Time delays in the overall foster care process- not just the court segment-have documented in a number of studies (Fanshel, 1978; Gruber, 1978; Mnookin, 1973). For example, recent statistics indicated that nationally 39% of the 340,000 children in foster care had been in care more than 2 years {U.S. House of Representatives, 1989). This is despite a decade of strong efforts toward permanency planning, involving both federal (Public Law 96-272, 1980) and state laws (e.g., Chapter 197 of the Massachusetts Acts of 1984). Although only a few studies to date have focused on time delays in the court process specifically, there is some evidence that cases of child abuse and neglect are delayed in the courts as well as in the periods before and after court involvement. Aber ( 1980) in a study of 35 child mistreatment cases referred to the Boston Juvenile Court during 197 1- 1973, found that, on average, over 2 years elapsed between the initial filing of the C & P petition and the judge’s final decision. A more recent report by the Family Law Advocacy Project (Elder, 1989) suggested that the average time required for adjudication of C & P’s in the Massachusetts District Courts varied from court to court, with the majority averaging 18 months or more. As of this writing, there have been no studies investigating specific factors associated with time delays in C & P proceedings in the courts. The present study tracked the progress of a sample of cases of serious child abuse and neglect prospectively from their arraignments on C & P petitions, through their dispositions in the court, to the children’s final placements. Review of court records provided retrospective data on case protective history prior to the C & P a~aignment. The purpose of the study was to document the length of time from the first report of mistreatment to the child’s final placement, as well as the time required before, during, and after court involvement. We also wanted to explore factors associated with time delays. It was our hope that alerting practitioners to the continuing problem of time delays could provide a step toward reducing delays and their concomitant detrimental consequences for children.
Time delays in a court sample
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METHODS Background
In Massachusetts, an offical report of suspected mistreatment is called a “5 1A” (the number of the relevant section of the state law), and the agency that investigates such reports is the Department of Social Services (DSS). Figure 1 presents the steps in the protective intervention process. In about 33% to 50% of reported cases, the investigating social worker confirms or “substantiates” the mistreatment and opens a case so that services can be provided to the family. In the remainder of the reports, the case is not opened due to lack of evidence of significant risk to the child (Commonwealth of Massachusetts, 1989). In Massachusetts, as in national data (Davidson, 1989; Otto & Melton, 1990) the majority (approximately 75-85%) of substantiated cases can be handled by DSS through casework and/or other services, which are usually sufficient to reduce the child’s risk. In the remainder of the cases, however, the parents are so unresponsive or the risk to the child is so great that DSS files a Care and Protection (C & P) petition in court (Murphy et al., 199 1). The C & P requests that the judge transfer custody of the child from the parents to the state. In most of these cases (more than 90% in our sample), the child is placed in foster care until the case is investigated and then heard in court (usually l-4 months later). During this period of “temporary wardship,” until the court’s decision, DSS continues to offer services to the family in an attempt to help the parents rehabilitate sufficiently to adequately care for their child. The purpose of the C & P proceeding is to decide whether to “permanently remove” the child from parental custody or to dismiss the case (placing the child back with the parent). Although Massachusetts law permits the original court to approve a permanent placement when it decides the C & P, in practice virtually all children who are “permanently removed” must go through a second lengthy proceeding (i.e., adoption, permanent guardianship) in a different court (Probate) to be truly permanently removed. Sample
The sampling pool consisted of consecutive cases brought before the BJC and C & P petitions during the years 1985-1986 (N = 5 14). Court Investigators (Cl’s) whose duties involve reviewing all records and making initial reports to judges were asked as part of this research to fill out a risk questionaire (Risk List, Smith et al., 1986) for these cases. The Risk List is comprised of 93 behavioral and observational items which were designed to gauge the degree of risk to the child. Cl’s were asked to exclude children under age 6 months or over age 13 and those who experienced only sexual abuse, and to fill out a Risk List for only one child in each family, focusing on the child who was most at risk. The sampling procedure thus encouraged the selection of the “most at risk” children for inclusion in the study. The resulting sample consisted of 206 seriously neglected and/or physically abused children (40% of all 5 14 BJC cases). The average age of the children at the time of filing the C & P was 4.2 years. The number of boys and girls were approximately equal, and 67% were minorities. Sixty-six percent of the families were in the lowest of Hollingshead’s (1975) five socioeconomic classes, and over half were receiving Aid to Families With Dependent Children (AFDC). (See Murphy et al., 199 1, for further details on the sample.) Procedure Court records. All court records (including court investigators’ written reports, C & P petitions, DSS reports, and medical records) have been continuously monitored since 1985/ 1986, and served as the primary source of data for the present study.
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We examined a variety of parent, child, demographic, case and court variables, in an effort to discover factors associated with time delays. The presence of substance abuse was coded from court records (Murphy et al., 1991). Psychiatric diagnoses were also coded from court records, by two experienced clinical psychologists (Taylor et al., 1991). Data for the other variables were coded independently of the substance abuse and psychiatric diagnosis coding, by masters level research assistants who reviewed each of the case records. Risk list. For the present study, use of the Risk List was confined to the final item, the overall rating of risk in the case. Overall risk was re-coded into either high or low: very severe or severe risk (high) or moderate or slight risk (low). Time frames. From court records, we calculated the time from the date of the first 5 1A on the family to the date the child was permanently placed (i.e., dismissed to original parent(s), or, if removed from parental custody, adopted, guardianed, or placed in permanent custody of noncustodial parent or other relative). For children who had not yet been permanently placed, we used June 30, 1989, as the “final” date. In addition to this overall time frame, we examined the time cases required before, during, and after the C & P proceeding. “Before court” was defined as the time from the filing of the first 51A to the arraignment for the current C & P; “in court” was defined as the period from arraignment to disposition (i.e., the judge’s decision to dismiss the case or to permanently remove the child from parental custody) in the BJC; and “after court” was defined as the time from disposition to the child’s permanent placement (or June 30, 1989). Analyses. We analyzed the time frame data both continuously and categorically, looking for variables associated with significantly longer mean lengths of time or with specific time delays. We defined as “delayed” those cases that took longer than the mean length of time plus one standard deviation for the time overall, as well as before, during, and after court.
RESULTS Status ofcases As of June 30, 1989, 13 cases (6%) were unfinished in the BJC, still awaiting a decision on the C & P. Sixty-three cases (3 1%) had been dismissed, with the children returned to parental custody. In the remaining 130 cases (63%) children had been permanently removed from their parent(s). Twenty (15%) of these children had been adopted, 10 (8%) had been guardianed, 20 ( 15%) had been permanently removed from one parent and placed with the other parent or a relative, and 80 (62%) were still in foster care, awaiting a permanent placement. Overall Time Frames The mean length of time from the filing of the first 5 1A on the family to final child placement (or June 30, 1989 if not yet in a final placement) was 4.9 years (range 0.2 to 16.5 years, SD = 3.4). Sixty-three cases (3 1%) were delayed, taking longer than 8.3 years. Nineteen cases-about 10% of the sample-took longer than 10 years. As seen in Table 1, although we examined over 20 parent, child, demographic, case and court variables, we found very few to be associated with time delays. In the overall process from the first 5 1A to the child’s final placement, none of the factors predicted delays-assessed either continuously or categorically.
470
S. J. Bishop, J. M. Murphy, M. S. Jelhnek, D. Quinn, and F. G. Poitrast Table 1. Factors Associated
with Time Delays
Delays Overall Parent No substance abuse Perpetrator Low IQ/emotional disturbance Severity of disturbance Criminality Marital status History of abuse Maternal age Child Age > 3 at hearing Gender = male Demographics Race Poverty Case DDS history Number of prior 5 I A’s Court history Type of mistreatment Severity of abuse Risk List rating court Accept services Case disposition Adoption
Before Court
In Court
After Court
*
* **
* p < .05, **p < .Ol.
Delays Before Court The mean length of time from the filing of the first 51A on the family to the current arraignment was 2.7 years (range -0.8 to 14.5, SD = 3.2). Sixty-two cases (30%) were delayed before court (i.e., took longer than 5.9 years). None ofthe variables examined predicted delays before court. Delays in Juvenile Court The mean length of time from arraignment to disposition in the BJC (or to June 1989 if unfinished, n = 13,6%) was 1.4 years (range 0.1 to 4.1, SD = 0.9). Thirty-five cases (17%) were delayed, requiring more than 2.3 years in court. Four variables were found to be related to delays occurring in the Juvenile Court. These variables and their relationships to delays are described in the following paragraphs. Child age. The mean time in court was significantly longer for children older than age three at the initial hearing ( 1.6 years vs. 1.3 for children younger than three, p < .05). In the categorical analysis, older children were also somewhat more likely to be coded as delayed in court (22% vs. 12% for children younger than three, p < .15). Aid to Families with Dependent Children (AFDC). Cases in which the family received AFDC had significantly longer mean times in court (1.6 years vs. 1.3 for non-AFDC, p < .05).
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Families receiving AFDC were also somewhat more likely to be in court longer than 2.3 years (22% vs. 10% for non-AFDC, p < . 10). Substance abuse. Parental substance abuse was associated with a lack of delays (10% delayed vs. 22% for those without substance abuse, p < .05). The mean time in court for families with substance abuse was also somewhat shorter (1.3 years vs. 1.5 for those without substance abuse, p < . 10). Accepting versus rejecting services. Cases in which the family rejected court-ordered services also had a significantly shorter mean time in court (1.1 years vs. 1.3 for accepting services, p < .05). The categorical analysis was not significant. Delays Ajier Court For cases dismissed from the BJC and returned to the original parent(s), the judge’s decision marks the end of the process. For cases permanently removed from parental custody, the process continues. These cases go back to DSS for the formulation of a permanent placement plan. Although the court’s mandate is to tranfer these cases to Probate Court for an adoption or guardianship proceeding, in actuality for some cases, DSS arranges placement with the noncustodial parent (usually the father) or another relative, usually without involving the Probate Court. Most children, however, stay in “temporary” foster care under the custody of DSS until a permanent plan is formulated and a placement can be found. For permanently removed cases (n = 130,63%), the mean length of time from the conclusion of the C & P to final placement (i.e., adoption, guardianship, permanent custody to father/relative), or to June 1989 (n = 80, 62%) if no final placement had been achieved, was 1.6 years (range -0.4 to 4.0, SD = 1.2). Thirty-two (25%) of the permanently removed cases were delayed after court (i.e., took more than 2.8 years). As described in the following paragraphs, two variables were found to be related to delays occurring after court. Child gender. Cases involving boys were significantly more likely to be delayed after disposition of the C & P (33% vs. 16%, p < .05). The sex difference in length of time after disposition was in the same direction (1.8 years for boys vs. 1.5 for girls, p < .20), but not statistically significant. Final placement status. Cases resulting in adoption had significantly longer mean disposition (1.3 years for adoption vs. 0.3 years for guardianship, p < .Ol). The analysis was not significant. Cases in which no final placement had been achieved even longer-an average of 2.3 years (as these cases were still in process at the time analysis, this figure will obviously rise).
times after chi-square had taken of the data
DISCUSSION The findings of this study document that many abused and neglected children continue to experience serious time delays in the Massachusetts protective and court systems. Entering the system at an average of 1.4 years, children in our sample were in process an average of 5 years from the filing of the initial report of mistreatment to the resolution of their cases. For 38% of the children, this process took longer than 8 years; for 10% it was longer than 10 years. These figures underestimate the delays, since 45% of the children were still in foster care and
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S. J. Bishop, J. M. Murphy, M. S. Jellinek, D. Quinn, and F. G. Poitrast
awaiting a permanent placement at the time of the current data analysis. Moreover, the deleterious effects of time delays were often compounded by moving children from one foster home to another: In just the 1.5year-BJC phase of the process, children experienced an average of more than two foster placements. Children in the present study had been known to the state protective service agency for an average of more than 2.5 years before the current court involvement, and 30% had been known for more than 6 years. Once arraigned on the C & P, the average case took almost 1.5 years to reach a disposition. If not dismissed, children required, on average, an additional year and a half after the juvenile court’s removal from parental custody to achieve adoption or guardianship. However, over half of the children removed from parental custody were still in “temporary” foster care at the time of our data analysis. These delays persist despite more than two decades of advocacy by dedicated professionals who have secured the passage of federal and state laws mandating biannual reviews of all children in foster care. Surprisingly, few of the factors examined predicted time delays. For example, neither the severity of mistreatment nor the number of previous abuse reports predicted or altered the slow pace of the system. While none of the variables significantly predicted delays overall or before court, two factors-child age older than three and the family’s being on AFDC-were found to be associated with delays in the juvenile court. Conversely, parental substance abuse and rejecting court-ordered services predicted a lack of delays in court. The latter findings may be at least partially explained by the higher rate of child removal in cases involving parental substance abuse (80%) and rejecting court services (97%), both of which factors may be viewed by judges as making for expedited, although negative, decisions. After court, the only two factors that predicted delays were adoption and child gender being male. Delays associated with adoption may be explained by the complicated legal proceedings involved in the adoption process (in contrast to guardianship), while the finding regarding child gender likely reflects the fact that male children are often more difficult to place than females. Of course, not all time delays are bad; some are intentional and probably in the best interests of the children, while others may be inevitable given the system’s need to be thorough and cautious (Aber, 1980; Derdeyn, 1977; Goldstein et al., 1979). The reasons for delays may also differ depending on the period(s) in which they occur. For example, delays before court, while the child still lives at home and DSS attempts to rehabilitate the family without resorting to court intervention, may have different causes and implications than delays after court when the child lives in a foster home while awaiting a permanent placement. In addition, the present study was limited to a sample from a single juvenile court; the paucity of empirical data from other courts in Massachusetts or from courts in other states prevents an assessment of the generalizability of the results. Unfortunately, there is currently no ongoing effort to assess (a) the specific reasons for delays, (b) the impact of warranted or unwarranted delays on the child’s current functioning, or (c) the long-term effects of delays on the child’s development. Every court should have an ongoing evaluation/research program to highlight time delays and to determine when faster tracks through the system would be helpful to the child. Such a “quality assurance” program could also highlight technical or procedural difficulties, such as the number of continuances or poor interagency cooperation. Foster care reviews, although well-intentioned, can too easily be perfunctory (Stein, 1990) and are too individualized to highlight systematic patterns of delay. Systematic tracking of all cases will hopefully identify patterns of delay that can be addressed and thus limit the unnecessary, sometimes cruel, delays which deprive abused and neglected children of permanent homes.
Time delays in a court sample Acknowledgements-The Foundation.
473
authors wish to acknowledge the support of the Boston Foundation and the Cabot Family
REFERENCES Aber, J. L. ( 1980). The involuntary child placement decision: Solomon’s dilemma revisited. In G. Gerbner, C. Ross, & E. Zigler (Eds.), Child abuse: An agenda_/or action (pp. 156- 182). New York: Oxford University Press. Chapter 197 of the Acts of 1984. An act providing for foster care review. The Commonwealth of Massachusetts. Commonwealth of Massachusetts, Department ofsocial Services, Research Unit. (1989, April 27). Personal communication based on ASSIST extract tapes. Coooer. C. S.. Peterson. N. L.. 8~Meier. J. H. (1987). Variables associated with disruuted _ .placement in a select sample ofabused and neglected children. Child Abuse 6; Neglect, 11, 75-86. Davidson, H. A. (1989). Improving the judicial handling of civil child maltreatment cases. In M. Hofford (Ed.), Families in court. Reno, NV: National Council of Juvenile and Family Court Judges. Derdeyn, A. P. (I 977). Child abuse and neglect: The rights of parents and the needs of their children. American Journal of Orthopsychiatry, 41, 377-387. Elder, J. S. J. ( 1989). Annual report of the Committeefor Public Counsel Services. Boston, MA: Family Law Advocacy Project. Fanshel, D. (1978). Children discharged from foster care in New York City: Where to-when-at what age? Child Welfare, 57, 467-483. Golden, D. (1990, June 3). The fates of families. Boston Globe Magazine, 16-19, 32-40. Golden, H. (1977). The children are waiting: Thefailure to achievepermanent homesforfoster children in New York City. New York: New York City Comptroller’s Office. Goldstein, J., Freud, A., & Solnit, A. J. (1979). Beyond the best interests of the child. New York: The Free Press. Gruber, A. R. (1978). Children in foster care. New York: Human Sciences Press. Hollingshead, A. B. (1975). Four-factor index of social status. New Haven, CT: Yale University Department of Sociology. Kelly, R. F., & Ramsey, S. H. (I 985). Legal and other determinants ofeffective court intervention in child protective proceedings: A policy analysis. Journal of Social Science Research, 8, 25-48. Massachusetts Bar Association. (1988). Report ofthe Governor’s/Massachusetts BarAssociation’s Commission on the unmet legal need.s of children. Boston, MA: Author. Mnookin, R. (I 973). Foster care-in whose best interest? Harvard Educational Review, 43, 599-638. Murphy, J. M., Jellinek, M., Quinn, D., Smith, G., Poitrast, F. G., & Gosko, M. (199 1). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse & Neglect, 15, 197-2 11. Otto, R. K., & Melton, G. B. (1990). Trends in legislation and case law on child abuse and neglect. In R. T. Ammerman & M. Hersen (Eds.), Children at risk: An evaluation offactors contributing to child abuse and neglect (pp. 55-83). New York: Plenum Press. Pollock, V. E., Briere, J., Schneider, L., Knop, J., Mednick, S. A., &Goodwin, D. W. (1990). Childhood antecedents of antisocial behavior: Parental alcoholism and physical abusiveness. American Journal of Psychiatry, 147, 12901293. Public Law 96-272, the Adoption Assistance and Child Welfare Act of 1980. Smith, G. M., Poitrast, F. G., Quinn, D., Fox, A., Lavori, P., & Jellinek, M. S. (1986, August). Child nbuse/neglect: Development ofa Risk List. Paper presented at the conference ofthe American Psychological Association, Washington, DC. Stein, T. J. (1990). LaShawn A. v. Marion Barry, Jr. (case reading). New York: American Civil Liberties Union, The Children’s Right Project. Taylor, C. G., Norman, D. K., Murphy, J. M., Jellinek, M., Smith, G., Quinn, D., Poitrast, F. G., & Goshko, M. (199 I). Diagnosed mental and emotional impairment among parents who seriously mistreat their children: Incidence, type and outcome in a court sample. Child Abuse & Neglect, 15, 389-40 I. U.S. House of Representatives, Select Committee on Children, Youth and Families (1989). No place to call home: Discarded children in America. Washington, DC: U.S. Government Printing Office.
RbumC-Cette etude fait le trace de 206 enfants gravement maltraites ou negliges qui ont comparu devant le tribunal de la protection des enfants dans un grand centre metropolitain americain. Pour ces families, en moyenne cinq ans vont se derouler depuis le premier signalement jusqu’a la conclusion des cas. Avant d’aboutir devant le tribunal, les families seront deja connues des services de protection de I’enfance depuis deux ans et demi environ. Puis, apres la comparution en tour, les cas de maltraitance attendront en moyenne un an et demi avant que la tour rende jugement. Une fois la disposition du cas connue et si les enfant sont places sous la tutelle publique, ils devront attendre en moyenne une annte de plus avant de trouver un foyer permanent. Ces dtlais semblent indtpendants des vingt ou quelque variables ttudites, y compris la gravite de la mahraitance, les services de protection et la Sante mentale des
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parents. L.esdBais que les chercheurs ont document&s s’av&nt typiques des d&is que vivent les enfants maltraitts et n&i&. Raison de plus d’assurer un suivi minutieux d&sque l’enfant franchit le seuil des services de protection et des tribunaux. Resumen-Este estudio examinb el progreso de una muestra de doscientos seis nifios severamente abusados y/o victimas de negligencia, a trav6.s de1 sistema de proteccibn al menor, al ser presentados ante la Corte Juvenil de Boston (CJB) con peticiones de cuidado y proteccibn. En general, 10s nii3os estaban dentro de1 sistema un promedio de cinco aiios desde que se ha&a la primera denuncia oficial de maltrato hasta Ia resoluci6n de sus cases. Las familias habian sido ya conocidas por la agencia de1 estado para la protecci6n infant2 por un promedio de m6s de dos y medio alias antes de la presente situacibn legal. Una vez amonestado por la torte juvenil por C & P, el case promedio tomb casi un aiio y medio para llegar a una disposici6n. DespuCs de la disposicibn, 10s nifios retirados permanentemente de la custodia parental, requerian, en promedio, un aiio y medio adicional en la Corte Probatoria para llegar a una residencia permanente. De mh de veinte variables estudiadas, incluyendo severidad de1 maltrato, historia de1 servicio de proteccidn y enfermedad mental de 10s padres, no surgici ningtin patron significativo que pudiera predecir 10s retrasos. Nuestros hallazgos caracterizan la experiencia de 10sretrasos de muchos niiIos que suffen abuso y negligencia, y destaca la necesidad de una supervisi6n m5s estrecha de 10scases a trav6s de 10ssistemas de proteccibn y legales.
1992 Copyright
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0145-2134/92 $5.00 + .XJ 1992 Pergamon Press Ltd.
PROTECTING SERIOUSLY MISTREATED CHILDREN: TIME DELAYS IN A COURT SAMPLE SANDRA J. BISHOP, J. MICHAEL MURPHY,
MICHAEL S. JELLINEK,
SISTER DOROTHY QUINN Child Psychiatry Service, Massachusetts General Hospital, Boston, MA
JUDGE FRANCIS G. POITRAST Boston Juvenile Court. Boston, MA
Abstract-The study examined the progress through the child protective system of a sample of 206 severely abused and/or neglected children brought before the Boston Juvenile Court (BJC) on Care and Protection (C & P) petitions. Overall, children were in the system an average of 5 years from the filing of the first official report of mistreatment to the resolution of their cases. The families had been known to the state child protective service agency for an average of more than 2.5 years before the current court involvement. Once arraigned in juvenile court on the C & P, the average case took almost I .5 years to reach a disposition. After disposition, children permanently removed from parental custody required, on average, an additional year and a half in Probate Court to reach a permanent placement. Of the more than twenty variables examined, including severity of mistreatment, protective service history, and parental mental illness, no meaningful pattern emerged which could predict delays. Our findings characterize the delays experienced by many abused and neglected children, and highlight the necessity of closer monitoring of the progress of cases througb the protective and court systems. Key Words-Child
abuse and neglect. Adjudication, Time delays, Care and protection petitions.
INTROIXJCTION THE COURTS PLAY a vital role in society’s response to the problem of child mistreatment (Kelly & Ramsey, 1985). Courts often deal with the most severe cases of mistreatment, and in many cases, particularly for very poor children, are the “social service systems of last resort” (Massachusetts Bar Association, 1988, p.3). Furthermore, the number of child mistreatment cases heard by the courts is rising dramatically (Davidson, 1989; Golden, 1990). Despite the increasing involvement of the courts, there has been very little empirical research examining the judicial system’s handling of child mistreatment cases (Kelly & Ramsey, 1985), and this lack of research has impeded efforts to understand and improve the progression of such cases through the courts (Davidson, 1989). The paucity of judicial research is due to both practical reasons, such as court records being closed to the public, and the lack of standards for assessing the effectiveness of court involvement (Kelly & Ramsey, 1985). One standard that can be used to assess the judicial system’s intervention in cases of child mistreatment is the length of time required for resolution. While awaiting the court’s decision,
Requests for reprints may be sent to Michael Jellinek, M.D., Massachusetts General Hospital, Child Psychiatry Service, ACC 725, Boston, MA 02114. 465
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most mistreated children are separated from their parents and placed in “temporary” foster homes. Having removed the child from immediate danger, the system tends to lose its sense of urgency both in providing services to the family and in working toward a permanent solution to the problem (Derdeyn, 197’7). And, although the child may have been removed from immediate danger at home, out-of-home placement carries dangers of its own. For example, the child is often shifted from placement to placement, without regard for his/her need for a stable, nurturing environment. (Cooper, Peterson, and Meier, 1987). Goldstein, Freud, and Solnit ( 1979) have eloquently described the child’s need for prompt re~lution, arguing that “to avoid irreparable psy~holo~cal injury, placement, whenever in dispute, must be treated as the emergency that it is for the child” (p. 43). In reviewing standards developed by the American Bar Association and other advocacy groups for improving the handling of child mistreatment cases by the courts, Davidson (1989) noted that in report after report, one of the most common and pressing recommendations was for faster resolution of cases. Empirical evidence supporting the extent and negative impact of time delays is provided by an investigation by the New York City Comptroller’s Office (Golden, 1977) which reported that after spending several years in foster care, children displayed significantly increased social and emotional dysfunction, manifested in symptoms such as severe anxiety, enuresis, hyperactivity, or nightmares. Many of these children subsequently required institutionalization. Extended periods in foster care also greatly reduced the chances of a child’s being adopted, resulting in many children spending their entire childhoods in “temporary” foster care. Other investigators have found such children prone to delinquency in adolescence (Pollock et al., 1990). been Time delays in the overall foster care process- not just the court segment-have documented in a number of studies (Fanshel, 1978; Gruber, 1978; Mnookin, 1973). For example, recent statistics indicated that nationally 39% of the 340,000 children in foster care had been in care more than 2 years {U.S. House of Representatives, 1989). This is despite a decade of strong efforts toward permanency planning, involving both federal (Public Law 96-272, 1980) and state laws (e.g., Chapter 197 of the Massachusetts Acts of 1984). Although only a few studies to date have focused on time delays in the court process specifically, there is some evidence that cases of child abuse and neglect are delayed in the courts as well as in the periods before and after court involvement. Aber ( 1980) in a study of 35 child mistreatment cases referred to the Boston Juvenile Court during 197 1- 1973, found that, on average, over 2 years elapsed between the initial filing of the C & P petition and the judge’s final decision. A more recent report by the Family Law Advocacy Project (Elder, 1989) suggested that the average time required for adjudication of C & P’s in the Massachusetts District Courts varied from court to court, with the majority averaging 18 months or more. As of this writing, there have been no studies investigating specific factors associated with time delays in C & P proceedings in the courts. The present study tracked the progress of a sample of cases of serious child abuse and neglect prospectively from their arraignments on C & P petitions, through their dispositions in the court, to the children’s final placements. Review of court records provided retrospective data on case protective history prior to the C & P a~aignment. The purpose of the study was to document the length of time from the first report of mistreatment to the child’s final placement, as well as the time required before, during, and after court involvement. We also wanted to explore factors associated with time delays. It was our hope that alerting practitioners to the continuing problem of time delays could provide a step toward reducing delays and their concomitant detrimental consequences for children.
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METHODS Background
In Massachusetts, an offical report of suspected mistreatment is called a “5 1A” (the number of the relevant section of the state law), and the agency that investigates such reports is the Department of Social Services (DSS). Figure 1 presents the steps in the protective intervention process. In about 33% to 50% of reported cases, the investigating social worker confirms or “substantiates” the mistreatment and opens a case so that services can be provided to the family. In the remainder of the reports, the case is not opened due to lack of evidence of significant risk to the child (Commonwealth of Massachusetts, 1989). In Massachusetts, as in national data (Davidson, 1989; Otto & Melton, 1990) the majority (approximately 75-85%) of substantiated cases can be handled by DSS through casework and/or other services, which are usually sufficient to reduce the child’s risk. In the remainder of the cases, however, the parents are so unresponsive or the risk to the child is so great that DSS files a Care and Protection (C & P) petition in court (Murphy et al., 199 1). The C & P requests that the judge transfer custody of the child from the parents to the state. In most of these cases (more than 90% in our sample), the child is placed in foster care until the case is investigated and then heard in court (usually l-4 months later). During this period of “temporary wardship,” until the court’s decision, DSS continues to offer services to the family in an attempt to help the parents rehabilitate sufficiently to adequately care for their child. The purpose of the C & P proceeding is to decide whether to “permanently remove” the child from parental custody or to dismiss the case (placing the child back with the parent). Although Massachusetts law permits the original court to approve a permanent placement when it decides the C & P, in practice virtually all children who are “permanently removed” must go through a second lengthy proceeding (i.e., adoption, permanent guardianship) in a different court (Probate) to be truly permanently removed. Sample
The sampling pool consisted of consecutive cases brought before the BJC and C & P petitions during the years 1985-1986 (N = 5 14). Court Investigators (Cl’s) whose duties involve reviewing all records and making initial reports to judges were asked as part of this research to fill out a risk questionaire (Risk List, Smith et al., 1986) for these cases. The Risk List is comprised of 93 behavioral and observational items which were designed to gauge the degree of risk to the child. Cl’s were asked to exclude children under age 6 months or over age 13 and those who experienced only sexual abuse, and to fill out a Risk List for only one child in each family, focusing on the child who was most at risk. The sampling procedure thus encouraged the selection of the “most at risk” children for inclusion in the study. The resulting sample consisted of 206 seriously neglected and/or physically abused children (40% of all 5 14 BJC cases). The average age of the children at the time of filing the C & P was 4.2 years. The number of boys and girls were approximately equal, and 67% were minorities. Sixty-six percent of the families were in the lowest of Hollingshead’s (1975) five socioeconomic classes, and over half were receiving Aid to Families With Dependent Children (AFDC). (See Murphy et al., 199 1, for further details on the sample.) Procedure Court records. All court records (including court investigators’ written reports, C & P petitions, DSS reports, and medical records) have been continuously monitored since 1985/ 1986, and served as the primary source of data for the present study.
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We examined a variety of parent, child, demographic, case and court variables, in an effort to discover factors associated with time delays. The presence of substance abuse was coded from court records (Murphy et al., 1991). Psychiatric diagnoses were also coded from court records, by two experienced clinical psychologists (Taylor et al., 1991). Data for the other variables were coded independently of the substance abuse and psychiatric diagnosis coding, by masters level research assistants who reviewed each of the case records. Risk list. For the present study, use of the Risk List was confined to the final item, the overall rating of risk in the case. Overall risk was re-coded into either high or low: very severe or severe risk (high) or moderate or slight risk (low). Time frames. From court records, we calculated the time from the date of the first 5 1A on the family to the date the child was permanently placed (i.e., dismissed to original parent(s), or, if removed from parental custody, adopted, guardianed, or placed in permanent custody of noncustodial parent or other relative). For children who had not yet been permanently placed, we used June 30, 1989, as the “final” date. In addition to this overall time frame, we examined the time cases required before, during, and after the C & P proceeding. “Before court” was defined as the time from the filing of the first 51A to the arraignment for the current C & P; “in court” was defined as the period from arraignment to disposition (i.e., the judge’s decision to dismiss the case or to permanently remove the child from parental custody) in the BJC; and “after court” was defined as the time from disposition to the child’s permanent placement (or June 30, 1989). Analyses. We analyzed the time frame data both continuously and categorically, looking for variables associated with significantly longer mean lengths of time or with specific time delays. We defined as “delayed” those cases that took longer than the mean length of time plus one standard deviation for the time overall, as well as before, during, and after court.
RESULTS Status ofcases As of June 30, 1989, 13 cases (6%) were unfinished in the BJC, still awaiting a decision on the C & P. Sixty-three cases (3 1%) had been dismissed, with the children returned to parental custody. In the remaining 130 cases (63%) children had been permanently removed from their parent(s). Twenty (15%) of these children had been adopted, 10 (8%) had been guardianed, 20 ( 15%) had been permanently removed from one parent and placed with the other parent or a relative, and 80 (62%) were still in foster care, awaiting a permanent placement. Overall Time Frames The mean length of time from the filing of the first 5 1A on the family to final child placement (or June 30, 1989 if not yet in a final placement) was 4.9 years (range 0.2 to 16.5 years, SD = 3.4). Sixty-three cases (3 1%) were delayed, taking longer than 8.3 years. Nineteen cases-about 10% of the sample-took longer than 10 years. As seen in Table 1, although we examined over 20 parent, child, demographic, case and court variables, we found very few to be associated with time delays. In the overall process from the first 5 1A to the child’s final placement, none of the factors predicted delays-assessed either continuously or categorically.
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S. J. Bishop, J. M. Murphy, M. S. Jelhnek, D. Quinn, and F. G. Poitrast Table 1. Factors Associated
with Time Delays
Delays Overall Parent No substance abuse Perpetrator Low IQ/emotional disturbance Severity of disturbance Criminality Marital status History of abuse Maternal age Child Age > 3 at hearing Gender = male Demographics Race Poverty Case DDS history Number of prior 5 I A’s Court history Type of mistreatment Severity of abuse Risk List rating court Accept services Case disposition Adoption
Before Court
In Court
After Court
*
* **
* p < .05, **p < .Ol.
Delays Before Court The mean length of time from the filing of the first 51A on the family to the current arraignment was 2.7 years (range -0.8 to 14.5, SD = 3.2). Sixty-two cases (30%) were delayed before court (i.e., took longer than 5.9 years). None ofthe variables examined predicted delays before court. Delays in Juvenile Court The mean length of time from arraignment to disposition in the BJC (or to June 1989 if unfinished, n = 13,6%) was 1.4 years (range 0.1 to 4.1, SD = 0.9). Thirty-five cases (17%) were delayed, requiring more than 2.3 years in court. Four variables were found to be related to delays occurring in the Juvenile Court. These variables and their relationships to delays are described in the following paragraphs. Child age. The mean time in court was significantly longer for children older than age three at the initial hearing ( 1.6 years vs. 1.3 for children younger than three, p < .05). In the categorical analysis, older children were also somewhat more likely to be coded as delayed in court (22% vs. 12% for children younger than three, p < .15). Aid to Families with Dependent Children (AFDC). Cases in which the family received AFDC had significantly longer mean times in court (1.6 years vs. 1.3 for non-AFDC, p < .05).
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Families receiving AFDC were also somewhat more likely to be in court longer than 2.3 years (22% vs. 10% for non-AFDC, p < . 10). Substance abuse. Parental substance abuse was associated with a lack of delays (10% delayed vs. 22% for those without substance abuse, p < .05). The mean time in court for families with substance abuse was also somewhat shorter (1.3 years vs. 1.5 for those without substance abuse, p < . 10). Accepting versus rejecting services. Cases in which the family rejected court-ordered services also had a significantly shorter mean time in court (1.1 years vs. 1.3 for accepting services, p < .05). The categorical analysis was not significant. Delays Ajier Court For cases dismissed from the BJC and returned to the original parent(s), the judge’s decision marks the end of the process. For cases permanently removed from parental custody, the process continues. These cases go back to DSS for the formulation of a permanent placement plan. Although the court’s mandate is to tranfer these cases to Probate Court for an adoption or guardianship proceeding, in actuality for some cases, DSS arranges placement with the noncustodial parent (usually the father) or another relative, usually without involving the Probate Court. Most children, however, stay in “temporary” foster care under the custody of DSS until a permanent plan is formulated and a placement can be found. For permanently removed cases (n = 130,63%), the mean length of time from the conclusion of the C & P to final placement (i.e., adoption, guardianship, permanent custody to father/relative), or to June 1989 (n = 80, 62%) if no final placement had been achieved, was 1.6 years (range -0.4 to 4.0, SD = 1.2). Thirty-two (25%) of the permanently removed cases were delayed after court (i.e., took more than 2.8 years). As described in the following paragraphs, two variables were found to be related to delays occurring after court. Child gender. Cases involving boys were significantly more likely to be delayed after disposition of the C & P (33% vs. 16%, p < .05). The sex difference in length of time after disposition was in the same direction (1.8 years for boys vs. 1.5 for girls, p < .20), but not statistically significant. Final placement status. Cases resulting in adoption had significantly longer mean disposition (1.3 years for adoption vs. 0.3 years for guardianship, p < .Ol). The analysis was not significant. Cases in which no final placement had been achieved even longer-an average of 2.3 years (as these cases were still in process at the time analysis, this figure will obviously rise).
times after chi-square had taken of the data
DISCUSSION The findings of this study document that many abused and neglected children continue to experience serious time delays in the Massachusetts protective and court systems. Entering the system at an average of 1.4 years, children in our sample were in process an average of 5 years from the filing of the initial report of mistreatment to the resolution of their cases. For 38% of the children, this process took longer than 8 years; for 10% it was longer than 10 years. These figures underestimate the delays, since 45% of the children were still in foster care and
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awaiting a permanent placement at the time of the current data analysis. Moreover, the deleterious effects of time delays were often compounded by moving children from one foster home to another: In just the 1.5year-BJC phase of the process, children experienced an average of more than two foster placements. Children in the present study had been known to the state protective service agency for an average of more than 2.5 years before the current court involvement, and 30% had been known for more than 6 years. Once arraigned on the C & P, the average case took almost 1.5 years to reach a disposition. If not dismissed, children required, on average, an additional year and a half after the juvenile court’s removal from parental custody to achieve adoption or guardianship. However, over half of the children removed from parental custody were still in “temporary” foster care at the time of our data analysis. These delays persist despite more than two decades of advocacy by dedicated professionals who have secured the passage of federal and state laws mandating biannual reviews of all children in foster care. Surprisingly, few of the factors examined predicted time delays. For example, neither the severity of mistreatment nor the number of previous abuse reports predicted or altered the slow pace of the system. While none of the variables significantly predicted delays overall or before court, two factors-child age older than three and the family’s being on AFDC-were found to be associated with delays in the juvenile court. Conversely, parental substance abuse and rejecting court-ordered services predicted a lack of delays in court. The latter findings may be at least partially explained by the higher rate of child removal in cases involving parental substance abuse (80%) and rejecting court services (97%), both of which factors may be viewed by judges as making for expedited, although negative, decisions. After court, the only two factors that predicted delays were adoption and child gender being male. Delays associated with adoption may be explained by the complicated legal proceedings involved in the adoption process (in contrast to guardianship), while the finding regarding child gender likely reflects the fact that male children are often more difficult to place than females. Of course, not all time delays are bad; some are intentional and probably in the best interests of the children, while others may be inevitable given the system’s need to be thorough and cautious (Aber, 1980; Derdeyn, 1977; Goldstein et al., 1979). The reasons for delays may also differ depending on the period(s) in which they occur. For example, delays before court, while the child still lives at home and DSS attempts to rehabilitate the family without resorting to court intervention, may have different causes and implications than delays after court when the child lives in a foster home while awaiting a permanent placement. In addition, the present study was limited to a sample from a single juvenile court; the paucity of empirical data from other courts in Massachusetts or from courts in other states prevents an assessment of the generalizability of the results. Unfortunately, there is currently no ongoing effort to assess (a) the specific reasons for delays, (b) the impact of warranted or unwarranted delays on the child’s current functioning, or (c) the long-term effects of delays on the child’s development. Every court should have an ongoing evaluation/research program to highlight time delays and to determine when faster tracks through the system would be helpful to the child. Such a “quality assurance” program could also highlight technical or procedural difficulties, such as the number of continuances or poor interagency cooperation. Foster care reviews, although well-intentioned, can too easily be perfunctory (Stein, 1990) and are too individualized to highlight systematic patterns of delay. Systematic tracking of all cases will hopefully identify patterns of delay that can be addressed and thus limit the unnecessary, sometimes cruel, delays which deprive abused and neglected children of permanent homes.
Time delays in a court sample Acknowledgements-The Foundation.
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authors wish to acknowledge the support of the Boston Foundation and the Cabot Family
REFERENCES Aber, J. L. ( 1980). The involuntary child placement decision: Solomon’s dilemma revisited. In G. Gerbner, C. Ross, & E. Zigler (Eds.), Child abuse: An agenda_/or action (pp. 156- 182). New York: Oxford University Press. Chapter 197 of the Acts of 1984. An act providing for foster care review. The Commonwealth of Massachusetts. Commonwealth of Massachusetts, Department ofsocial Services, Research Unit. (1989, April 27). Personal communication based on ASSIST extract tapes. Coooer. C. S.. Peterson. N. L.. 8~Meier. J. H. (1987). Variables associated with disruuted _ .placement in a select sample ofabused and neglected children. Child Abuse 6; Neglect, 11, 75-86. Davidson, H. A. (1989). Improving the judicial handling of civil child maltreatment cases. In M. Hofford (Ed.), Families in court. Reno, NV: National Council of Juvenile and Family Court Judges. Derdeyn, A. P. (I 977). Child abuse and neglect: The rights of parents and the needs of their children. American Journal of Orthopsychiatry, 41, 377-387. Elder, J. S. J. ( 1989). Annual report of the Committeefor Public Counsel Services. Boston, MA: Family Law Advocacy Project. Fanshel, D. (1978). Children discharged from foster care in New York City: Where to-when-at what age? Child Welfare, 57, 467-483. Golden, D. (1990, June 3). The fates of families. Boston Globe Magazine, 16-19, 32-40. Golden, H. (1977). The children are waiting: Thefailure to achievepermanent homesforfoster children in New York City. New York: New York City Comptroller’s Office. Goldstein, J., Freud, A., & Solnit, A. J. (1979). Beyond the best interests of the child. New York: The Free Press. Gruber, A. R. (1978). Children in foster care. New York: Human Sciences Press. Hollingshead, A. B. (1975). Four-factor index of social status. New Haven, CT: Yale University Department of Sociology. Kelly, R. F., & Ramsey, S. H. (I 985). Legal and other determinants ofeffective court intervention in child protective proceedings: A policy analysis. Journal of Social Science Research, 8, 25-48. Massachusetts Bar Association. (1988). Report ofthe Governor’s/Massachusetts BarAssociation’s Commission on the unmet legal need.s of children. Boston, MA: Author. Mnookin, R. (I 973). Foster care-in whose best interest? Harvard Educational Review, 43, 599-638. Murphy, J. M., Jellinek, M., Quinn, D., Smith, G., Poitrast, F. G., & Gosko, M. (199 1). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse & Neglect, 15, 197-2 11. Otto, R. K., & Melton, G. B. (1990). Trends in legislation and case law on child abuse and neglect. In R. T. Ammerman & M. Hersen (Eds.), Children at risk: An evaluation offactors contributing to child abuse and neglect (pp. 55-83). New York: Plenum Press. Pollock, V. E., Briere, J., Schneider, L., Knop, J., Mednick, S. A., &Goodwin, D. W. (1990). Childhood antecedents of antisocial behavior: Parental alcoholism and physical abusiveness. American Journal of Psychiatry, 147, 12901293. Public Law 96-272, the Adoption Assistance and Child Welfare Act of 1980. Smith, G. M., Poitrast, F. G., Quinn, D., Fox, A., Lavori, P., & Jellinek, M. S. (1986, August). Child nbuse/neglect: Development ofa Risk List. Paper presented at the conference ofthe American Psychological Association, Washington, DC. Stein, T. J. (1990). LaShawn A. v. Marion Barry, Jr. (case reading). New York: American Civil Liberties Union, The Children’s Right Project. Taylor, C. G., Norman, D. K., Murphy, J. M., Jellinek, M., Smith, G., Quinn, D., Poitrast, F. G., & Goshko, M. (199 I). Diagnosed mental and emotional impairment among parents who seriously mistreat their children: Incidence, type and outcome in a court sample. Child Abuse & Neglect, 15, 389-40 I. U.S. House of Representatives, Select Committee on Children, Youth and Families (1989). No place to call home: Discarded children in America. Washington, DC: U.S. Government Printing Office.
RbumC-Cette etude fait le trace de 206 enfants gravement maltraites ou negliges qui ont comparu devant le tribunal de la protection des enfants dans un grand centre metropolitain americain. Pour ces families, en moyenne cinq ans vont se derouler depuis le premier signalement jusqu’a la conclusion des cas. Avant d’aboutir devant le tribunal, les families seront deja connues des services de protection de I’enfance depuis deux ans et demi environ. Puis, apres la comparution en tour, les cas de maltraitance attendront en moyenne un an et demi avant que la tour rende jugement. Une fois la disposition du cas connue et si les enfant sont places sous la tutelle publique, ils devront attendre en moyenne une annte de plus avant de trouver un foyer permanent. Ces dtlais semblent indtpendants des vingt ou quelque variables ttudites, y compris la gravite de la mahraitance, les services de protection et la Sante mentale des
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parents. L.esdBais que les chercheurs ont document&s s’av&nt typiques des d&is que vivent les enfants maltraitts et n&i&. Raison de plus d’assurer un suivi minutieux d&sque l’enfant franchit le seuil des services de protection et des tribunaux. Resumen-Este estudio examinb el progreso de una muestra de doscientos seis nifios severamente abusados y/o victimas de negligencia, a trav6.s de1 sistema de proteccibn al menor, al ser presentados ante la Corte Juvenil de Boston (CJB) con peticiones de cuidado y proteccibn. En general, 10s nii3os estaban dentro de1 sistema un promedio de cinco aiios desde que se ha&a la primera denuncia oficial de maltrato hasta Ia resoluci6n de sus cases. Las familias habian sido ya conocidas por la agencia de1 estado para la protecci6n infant2 por un promedio de m6s de dos y medio alias antes de la presente situacibn legal. Una vez amonestado por la torte juvenil por C & P, el case promedio tomb casi un aiio y medio para llegar a una disposici6n. DespuCs de la disposicibn, 10s nifios retirados permanentemente de la custodia parental, requerian, en promedio, un aiio y medio adicional en la Corte Probatoria para llegar a una residencia permanente. De mh de veinte variables estudiadas, incluyendo severidad de1 maltrato, historia de1 servicio de proteccidn y enfermedad mental de 10s padres, no surgici ningtin patron significativo que pudiera predecir 10s retrasos. Nuestros hallazgos caracterizan la experiencia de 10sretrasos de muchos niiIos que suffen abuso y negligencia, y destaca la necesidad de una supervisi6n m5s estrecha de 10scases a trav6s de 10ssistemas de proteccibn y legales.