Improving Systems, Practices, and Outcomes

Child Maltreatment: Referral Requirements under CAPTA and IDEA

Children under the age of three years of age account for over one-quarter of the victims of child maltreatment. The highest rate of maltreatment is for children under the age of 1. Infants and toddlers who are the subject of a substantiated case of abuse or neglect or are identified as affected by illegal substance abuse or withdrawal symptoms as a result of prenatal drug exposure must be referred to early Intervention/Part C of IDEA. There are two sets of federal laws that apply, which are described below.

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Federal Laws

CAPTA

Since 2003, the Child Abuse Prevention and Treatment Act (CAPTA) has required states that receive CAPTA funds to develop provisions and procedures for the referral of a child under the age of three who is involved in a substantiated case of abuse or neglect to Early Intervention Services funded under Part C of IDEA. Reauthorization of CAPTA in 2010, 2016 and in 2019 updated the requirements with the addition in 2016 of the following:

  • policies and procedures (including appropriate referrals to child protection service systems and for other appropriate services) to address the needs of infants born and identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal drug exposure, or a Fetal Alcohol Spectrum Disorder,
  • a requirement that health care providers involved in the delivery or care of such infants notify the child protective services system of the occurrence of such condition of such infants;
  • the development of a plan of safe care for the infant born and identified as being affected by substance abuse or withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder to ensure the safety and well-being of such infant following release from the care of healthcare providers, including/addressing the health and substance use disorder treatment needs of the infant and affected family or caregiver; and
  • the development and implementation by the State of monitoring systems regarding the implementation of such plans to determine whether and in what manner local entities are providing, in accordance with State requirements, referrals to and delivery of appropriate services for the infant and affected family or caregiver.
  • Additional data reporting requirements related to:
    • the number of children referred to child protective services under policies and procedures established to address the needs of infants born with and affected by illegal substance abuse, withdrawal symptoms or a Fetal Alcohol Spectrum Disorder; and
    • the number of children under the age of three involved in a substantiated case of child abuse or neglect that were eligible to be referred to agencies providing early intervention services under Part C of the Individuals with Disabilities Education Act (IDEA), and the number of these children actually referred to these early intervention services.

For more information, see the following documents:

Part C of IDEA

The Individuals with Disabilities Education Act (IDEA) 2004, Part C, Section 637(a)(6)(A&B) requires states participating in Part C to refer for early intervention services any child under the age of 3 who is involved in a substantiated case of child abuse or neglect; or is identified as affected by illegal substance abuse, or withdrawal symptoms resulting from prenatal drug exposure.

Resources

DaSy and ECTA Centers

Promoting Early Intervention and Child Welfare Collaboration: One Conversation at a Time

This presentation appeared at the 2018 DEC Conference.

Division for Early Childhood (DEC) of the Council for Exceptional Children

Organized in 1973, DEC is one of 17 division of the Council for Exceptional Children. Position statements are developed with input, are reviewed by members, approved by the Executive Board and represent the official position of DEC. In 2016, DEC issued this Position Statement on Child Maltreatment.

U.S. Department of Health and Human Services

Resource Guide to Trauma-Informed Human Services

This guide from the U.S. Department of Health and Human Services provides an introduction to the topic of trauma, a discussion of why understanding and addressing trauma is important for human services programs, and a "road map" to relevant resources. It is meant to help professionals learn about trauma-informed care and improve their practices. Some of the resources in the guide are specific to Early Childhood Programs.

Child Maltreatment

This annual report from the Children's Bureau presents national data about child abuse and neglect reported to child protective services agencies in the U.S. Some key findings in the 2021 report are listed below.

  • For FFY 2021, state data show infants have the highest rate of victimization at 25.3 per 1,000 children of the same age in the national population. (See chapter 3.)
  • For FFY 2021, a national estimate of 1,820 children died from abuse and neglect at a rate of 2.46 per 100,000 children in the population. (See chapter 4.) The child fatality demographics show:
    • The youngest children are the most vulnerable to maltreatment, with children younger than 1 representing 45.6 percent of child fatalities; a fatality rate of 24.39 per 100,000 children in that age range.
    • Boys have a higher child fatality rate at 3.01 per 100,000 boys in the population when compared with girls at 2.15 per 100,000 girls in the population.
    • The rate of African-American child fatalities (5.60 per 100,000 African-American children) is 2.9 times greater than the rate of White children (1.94 per 100,000 White children) and 3.9 times greater than the rate of Hispanic children (1.44 per 100,000 Hispanic children)
  • The Comprehensive Addiction and Recovery Act (CARA) of 2016 includes an amendment to CAPTA to collect and report the number of infants with prenatal substance exposure (IPSE), IPSE with a plan of safe care, and IPSE with a referral to appropriate services.
  • FFY 2021 data show 49,194 infants in 49 states being referred to CPS agencies as infants with prenatal substance exposure. The majority (82.9%) of IPSE were screened-in to CPS to receive either an investigation or alternative response. For FFY 2021, 31 states reported 26,904 screened-in IPSE (70.4 percent) have a plan of safe care and 30 states reported 25,607 screened-in IPSE (67.0%) have a referral to appropriate services. (See chapter 3.)
  • Special Focus Chapter: This special focus chapter highlights the importance of disaggregating data to determine where disproportionality exists, the populations most affected by it and support targeting specific programs to prevent future disproportionality.
    • The screened-in referral rate of African-American children is nearly twice the rate of Hispanic and White children.
    • Nationally victimization rates decreased across recent years, but analyzing by race or ethnicity show some fluctuations.
    • Legal and law enforcement personnel submitted the largest percentage of victim reports for every race or ethnicity.
    • African-American and American Indian or Alaska Native victims have the highest victimization rates across all age group.
  • Part C of the Individuals With Disabilities Education Act (IDEA) (unique count of victims) Federal guidance asks for states to report the number of victims who are younger than 3 years who are eligible for and referred to agencies providing early intervention services under Part C of the Individuals with Disabilities Education Act. However, some states have policies in place to allow older children to be considered eligible for referral and receipt of these services and these states may report victims who are older than 3 years. NCANDS uses the following definitions:
    • Number of Children Eligible for Referral to Agencies Providing Early Intervention Services Under Part C of the Individuals with Disabilities Education Act: a unique count of the number of victims eligible for referral to agencies providing early intervention services under Part C of the Individuals with Disabilities Act.
    • Number of Children Referred to Agencies Providing Early Intervention Services Under Part C of the Individuals with Disabilities Education Act: a unique count of the number of victims actually referred to agencies providing early intervention services under Part C of the Individuals with Disabilities Education Act.
    • Thirty-seven states reported 91,445 victims who are eligible for referral to agencies providing early intervention services and 28 states reported 28,209 victims who are referred. Of the states that are able to report both the victims who are eligible and referred (27 states), 65.6 percent of victims who are eligible are referred to the agencies. (See table 6–8 and related notes).

The Child Welfare Information Gateway

This service of the Children's Bureau, provides access to information and resources on Addressing the Needs of Young Children in Child Welfare: Part C: Early Intervention Services (2018).

See also: National Resource Centers funded by the Children's Bureau

Office of Planning, Research and Evaluation (OPRE)

Benefits of Early Care and Education for Children in the Child Welfare System (2016)

This report by the U.S. Department of Health and Human Services, Office of Planning, Research and Evaluation (OPRE) explores emerging evidence on the value of early care and education services to the Child Welfare System's goals of: (1) child safety, (2) permanency, and (3) wellbeing. It finds that the vast majority of young child welfare system-supervised-children are not utilizing early care and education (ECE) services despite the apparent benefits, and discusses organizational practices that can be used to increase their enrollment ECE programs.

National Center for Children in Poverty (NCCP)

National Center for Children in Poverty, partnering with the True North Group, has issued a 2022 brief titled Child Welfare and Early Intervention: Policies and Practice to Promote Collaboration and Help Infants and Toddlers Thrive. The brief, based on case studies from the states of Colorado, Rhode Island and Texas, examines strategies and policies to support access to Early Intervention services for infants and toddlers involved in Child Welfare, and strong support for their development and mental health. As children of color are often disproportionately involved in the child welfare systems, the brief suggests that the recommendations outlined be considered as a "critical part" of efforts in states to promote equity and opportunities to thrive and succeed.

National Indian Child Welfare Association (NICWA)

The National Indian Child Welfare Association

This organization provides public policy, research, and advocacy information and training on Indian child welfare and community development services. It is the only national Indian organization focused on child abuse and neglect issues that impact Indian children and families. NICWA works to support compliance with the Indian Child Welfare Act of 1978 and other key legislation to support American Indian children and families.

ZERO TO THREE: The National Center for Infants, Toddlers and Families

Child Welfare Survey Report: A Survey of State Child Welfare Policies and Initiatives (2019)

This is an update of a 2013 report which highlights changes and challenges in supporting this population of young children and their families.