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<strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944Contents lists available at ScienceDirect<strong>Child</strong>ren <strong>and</strong> Youth Services Reviewjournal homepage: www.elsevier.com/locate/childyouth<strong>Child</strong> <strong>maltreatment</strong> <strong>dynamics</strong> <strong>among</strong> <strong>immigrant</strong> <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong> children:Findings from the National Survey of <strong>Child</strong> <strong>and</strong> Adolescent Well-being (NSCAW)Alan J. Dettlaff a, ⁎, Michelle A. Johnson ba University of Illinois at Chicago, Jane Addams College of Social Work, 1040 W. Harrison (MC 309), Chicago, IL 60607, United Statesb University of California Los Angeles, School of Public Affairs, Department of Social Welfare, 3250 Public Affairs Building, P.O. Box 951656, Los Angeles, CA 90095-1656, United StatesarticleinfoabstractArticle history:Received 11 November 2010Accepted 20 December 2010Available online 11 January 2011Keywords:Immigrants<strong>Latino</strong><strong>Child</strong> welfareMaltreatmentNational Survey of <strong>Child</strong> <strong>and</strong> AdolescentWell-being (NSCAW)<strong>Latino</strong> children are the largest <strong>and</strong> fastest growing ethnic minority group in the United States, <strong>and</strong> theproportion of child <strong>maltreatment</strong> victims who are of <strong>Latino</strong> ethnicity has been growing since 2000. However,our knowledge of the characteristics, <strong>maltreatment</strong> patterns, <strong>and</strong> risk factors associated with <strong>maltreatment</strong><strong>among</strong> <strong>immigrant</strong> <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong> children <strong>and</strong> their families has been incomplete. The goals of this studyare to establish the national prevalence of <strong>immigrant</strong> <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong> children who come to the attentionof child welfare systems in the United States; to exp<strong>and</strong> our knowledge regarding the role of nativity in child<strong>maltreatment</strong> patterns <strong>among</strong> <strong>Latino</strong>s; <strong>and</strong> to determine if disparities in child <strong>maltreatment</strong> patterns <strong>and</strong> risksexist <strong>among</strong> <strong>Latino</strong> families using data from the National Survey of <strong>Child</strong> <strong>and</strong> Adolescent Well-being. Despiteconsiderable risks, data indicate that <strong>immigrant</strong> <strong>Latino</strong> children are slightly underrepresented <strong>among</strong> childrenwho present to child welfare systems when compared to the general population. Moreover, no significantdifferences were observed between <strong>immigrant</strong> children <strong>and</strong> U.S. <strong>born</strong> children with regard to substantiationpatterns. However, significant differences emerged between the two groups in risk factors <strong>and</strong> <strong>maltreatment</strong>type, warranting further investigation.© 2011 Elsevier Ltd. All rights reserved.1. Introduction<strong>Latino</strong> children are the largest <strong>and</strong> fastest growing ethnic minoritygroup in the United States. In 2008, <strong>Latino</strong> children represented nearlyone quarter (22%) of all children under the age of 18 (Fry & Passel,2009). By 2035, it is expected that one-third of all youth living in theUnited States will be <strong>Latino</strong> (National Council of La Raza, 2010). Inconcert with this growth, the proportion of child <strong>maltreatment</strong>victims that are of <strong>Latino</strong> ethnicity has been growing since 2000, <strong>and</strong>disparities in child welfare <strong>dynamics</strong> have been identified for <strong>Latino</strong>children when compared to other U.S. ethnic groups (U.S. Departmentof Health <strong>and</strong> Human Services [USDHHS], 2002, 2004, 2010).Disparities in child welfare <strong>dynamics</strong> have also been observed withinthe <strong>Latino</strong> population based on factors such as parental nativity <strong>and</strong>generation in the United States (Dettlaff, Earner, & Phillips, 2009;Vericker, Kuehn, & Capps, 2007).Whereas the family histories of some <strong>Latino</strong> children extend backas many as sixteen generations, others are crossing the U.S. bordertoday (Camarillo, 2007). Therefore, to effectively prevent <strong>and</strong> treatchild <strong>maltreatment</strong> in culturally competent ways, the study of child<strong>maltreatment</strong> <strong>among</strong> <strong>Latino</strong> children requires special considerationwith regard to cultural differences based on factors such as nativity.⁎ Corresponding author. Tel.: +1 312 996 0044; fax: +1 312 996 2770.E-mail addresses: al<strong>and</strong>@uic.edu (A.J. Dettlaff), maj@ucla.edu (M.A. Johnson).Our underst<strong>and</strong>ing of the role that cultural difference plays in child<strong>maltreatment</strong> <strong>dynamics</strong> <strong>among</strong> <strong>Latino</strong>s can be enhanced by examiningthe characteristics of diverse <strong>Latino</strong> children that come to theattention of the U.S. child welfare system. The goals of this study are toestablish the prevalence of child, caregiver, <strong>and</strong> household characteristicsof <strong>Latino</strong> children in the United States that come to the attentionof the child welfare system <strong>and</strong> to determine if disparities in child<strong>maltreatment</strong> risks <strong>and</strong> patterns exist <strong>among</strong> <strong>Latino</strong> children based onthe child's nativity.2. Population <strong>dynamics</strong> <strong>among</strong> <strong>Latino</strong>s in the United StatesThe <strong>Latino</strong> population comprised 15.4% of U.S. residents in 2008 or46.8 million people (United States Census Bureau, 2009). A growing<strong>and</strong> diverse population, nearly 40% of the <strong>Latino</strong> population is foreign<strong>born</strong>(Pew Hispanic Center, 2010). The <strong>Latino</strong> population is alsorelatively youthful compared to other major ethnic groups in theUnited States: 34.1% of <strong>Latino</strong>s were children under 18 years of age in2008 compared to 20.8% of Whites, 28.1% of Blacks, <strong>and</strong> 22.0% ofAsians (United States Census Bureau, 2009). Important differencesalso exist between native <strong>and</strong> foreign-<strong>born</strong> children with regard topopulation size <strong>and</strong> distribution. Whereas children comprise 50.3% ofthe native-<strong>born</strong> <strong>Latino</strong> population, only 7.9% of foreign-<strong>born</strong> <strong>Latino</strong>sare children (Pew Hispanic Center, 2010). The age distributions ofnative <strong>and</strong> foreign-<strong>born</strong> children also differ. The age distribution ofnative-<strong>born</strong> <strong>Latino</strong> children is shaped like a pyramid, with younger0190-7409/$ – see front matter © 2011 Elsevier Ltd. All rights reserved.doi:10.1016/j.childyouth.2010.12.017


A.J. Dettlaff, M.A. Johnson / <strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944937children represented <strong>among</strong> the largest age groupings. The pyramid isinverted for <strong>immigrant</strong> children; older children form the largest agegroupings while younger children represent a very small proportionof the total foreign-<strong>born</strong> <strong>Latino</strong> child population (Pew HispanicCenter, 2010). Older <strong>immigrant</strong> children tend to be disproportionallymale, reflecting the gendered nature of migration patterns from LatinAmerican countries to the United States (Pew Hispanic Center, 2010).In total, 9% of all <strong>Latino</strong> children living in the United States are foreign<strong>born</strong>(National Council of La Raza, 2010).3. Sources of risk <strong>and</strong> strength for <strong>immigrant</strong> <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong>childrenImmigrant <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong> children <strong>and</strong> families face multipleunique challenges that may place them at risk of involvement withchild welfare systems. Literature on family experiences followingimmigration cites several sources of risk, including poverty, loneliness,isolation, language difficulties, fear, <strong>and</strong> hopelessness (Earner,2007; Finno, Vidal de Haymes, & Mindell, 2006; Maiter, Stalker, &Alaggia, 2009). Additional pressures resulting from acculturation canlead to a variety of strains <strong>and</strong> difficulties on family systems, asparents <strong>and</strong> children experience changing cultural contexts alongwith the loss of previously established support systems (Roer-Strier,2001). Compounding these stressors are legislative initiatives thatrestrict <strong>immigrant</strong> families' access to many supportive services,affecting even those with legal status. The result is not only greatereconomic instability, but also fear that can drive families alreadyunder stress into deeper isolation, resulting in increased vulnerability(Capps, Fortuny, & Fix, 2007; Fortuny, Capps, Simms, & Chaudry,2009).Empirical evidence suggests that the adaptation process for U.S.<strong>born</strong> <strong>Latino</strong>s is qualitatively different from <strong>immigrant</strong>s. Differences inadaptation have been attributed to a range of factors includingvulnerabilities associated with discrimination, segregation, <strong>and</strong>minority status in the United States <strong>and</strong> decreased adherence to thevalues <strong>and</strong> practices that serve as sources of strength <strong>and</strong> resilience in<strong>Latino</strong> families <strong>and</strong> communities (Garcia Coll et al., 1996). Whencompared to <strong>immigrant</strong> <strong>Latino</strong> youth, delinquency <strong>and</strong> substance usetend to be more prevalent for those <strong>born</strong> in the United States. Patternsincluding decreased academic performance, increased school dropoutrates, greater involvement in risky sexual behavior, <strong>and</strong> increasedtobacco use have also been observed <strong>among</strong> more acculturated <strong>Latino</strong>youth when compared to less acculturated <strong>Latino</strong> youth (Gonzales,Knight, Morgan-Lopez, Saenz, & Sirolli, 2002). These patterns areexplained in part by increased exposure <strong>and</strong> vulnerability to deviantpeer models in the United States (Gonzales et al., 2002). Differences inthe cultural orientations, values, <strong>and</strong> behaviors of less acculturated<strong>Latino</strong> parents <strong>and</strong> their more acculturated children contributes tointergenerational–intercultural conflict, which may place certainfamilies at risk of child welfare involvement (Johnson, 2007).At the same time, <strong>immigrant</strong> families' cultural values <strong>and</strong>connections to their countries of origin may serve as importantprotective factors. Although learning to function in a new culture mayserve as a source of stress for many <strong>immigrant</strong> families, researchsuggests that adherence to cultural values <strong>and</strong> beliefs is a significantsource of strength that allows individuals to maintain flexibility <strong>and</strong>cohesion in changing environments (Falicov, 2005; Hancock, 2005).Other studies have found that identification with core values <strong>and</strong>beliefs rooted in their native culture may protect <strong>Latino</strong>s fromexperiencing many negative outcomes including substance use <strong>and</strong>mental health problems (De La Rosa, 2002; Holleran & Waller, 2003).Moreover, certain characteristics often found in <strong>immigrant</strong> familiesincluding strong parental supervision, extended family networks,religious beliefs, <strong>and</strong> social support from <strong>immigrant</strong> communities mayserve as additional protective factors (Dettlaff et al., 2009; Harker,2001; Mirsky, Baron-Draiman, & Kedem, 2002).4. <strong>Child</strong> <strong>maltreatment</strong> patterns <strong>and</strong> trendsAccording to national statistics, the proportion of child <strong>maltreatment</strong>victims that are of <strong>Latino</strong> origin has been growing over the lastdecade. In 2000, <strong>Latino</strong> children accounted for 14.2% of all victims ofchild <strong>maltreatment</strong> (USDHHS, 2002). In 2002, the proportion of victimsof <strong>Latino</strong> ethnicity fell to a low of 11%, but then steadily grew to 20.8% in2008 (USDHHS, 2004, 2010). In 2008, <strong>Latino</strong> children represented20.7% of all physical abuse victims, 20.2% of all sexual abuse victims;22.7% of all neglect victims; <strong>and</strong> 33.8% of all psychological <strong>maltreatment</strong>victims (USDHHS, 2010), suggesting a disproportional representationof <strong>Latino</strong> victims in these latter categories.National <strong>and</strong> local statistics also suggest disparities for <strong>Latino</strong>children in child <strong>maltreatment</strong> substantiation <strong>and</strong> foster care placement;however, findings suggest a great deal of local variation in case<strong>dynamics</strong>. While some studies have documented that <strong>Latino</strong> childrenare more likely to be substantiated for <strong>maltreatment</strong> than Whitechildren in certain states (Ards, Myers, Malkis, Sugrue, & Zhou, 2003;Church, Gross, & Baldwin, 2005), other studies have shown that they areless likely to be substantiated when compared to Whites (Fluke, Yuan,Hedderson, & Curtis, 2003; Hill, 2007). Further, although <strong>Latino</strong> childrenremain slightly underrepresented <strong>among</strong> children in foster care at thenational level (20% in foster care compared to 22% in the childpopulation as of 2008 [USDHHS, 2009]), current trends at the statelevel suggest an increasing overrepresentation of <strong>Latino</strong> children incertain states. In 2000, a state analysis revealed that <strong>Latino</strong> children wereoverrepresented in foster care in 10 states (Hill, 2005). A similar analysisusing data from 2006 revealed that the number of states in which <strong>Latino</strong>children were overrepresented nearly doubled from 10 states in 2000 to19 states in 2006 (Alliance for Racial Equity in <strong>Child</strong> Welfare, 2010).A few studies have examined disparities in child welfare <strong>dynamics</strong>within the <strong>Latino</strong> population based on gender <strong>and</strong> age. Using nationaldata, Alzate <strong>and</strong> Rosenthal (2009) found a very high likelihood ofphysical abuse for Hispanic boys when compared to non-Hispanic boys.While young Hispanic children were at greater risk for out-of-homeplacement than non-Hispanic children, older Hispanic children were atlower placement risk. In another study, Church (2006) found that 15 to19 year old Hispanics spent the longest duration in out-of-homeplacement when compared to other age groups.Two studies have also examined disparities in child welfare<strong>dynamics</strong> within the <strong>Latino</strong> population based on birthplace. In a Texasstudy of children removed from their homes, Vericker et al. (2007)found <strong>immigrant</strong> Latin American children <strong>and</strong> children of LatinAmerican parents to be underrepresented in the child welfare systemwhile U.S. <strong>born</strong> <strong>Latino</strong> children were overrepresented. They also foundthat <strong>immigrant</strong> Latin American children were more often removedfrom home for sexual abuse when compared to other children in care.Additionally, Dettlaff et al. (2009) found <strong>Latino</strong> children of <strong>immigrant</strong>sto have a higher prevalence of substantiated cases of sexual abusewhen compared to children of native parents in a national, populationbased sample of <strong>Latino</strong> children in in-home settings. However, theyalso found <strong>Latino</strong> <strong>immigrant</strong> parents in the sample to possessstrengths <strong>and</strong> resources that distinguished them from native-<strong>born</strong><strong>Latino</strong> families.Studies exclusively focused on the experiences of <strong>immigrant</strong>families in the child welfare system suggest that <strong>immigrant</strong>s faceconsiderable challenges due to factors such as poverty <strong>and</strong> limitedaccess to benefits, fewer sources of social support, differing language<strong>and</strong> cultural norms, distrust of government, <strong>and</strong> fear of deportation(Earner, 2007;2010). Immigrant families also experience differentservice paths depending on documentation status <strong>and</strong> languageabilities (Ayón, 2009), child's generation in the U.S. (Vericker et al.,2007), <strong>and</strong> race/ethnicity (Rajendran & Chemtob, 2010).This small body of research begins to shed light on the experiencesof diverse <strong>Latino</strong> children <strong>and</strong> families who come to the attention of thechild welfare system. However, our knowledge of the characteristics,


938 A.J. Dettlaff, M.A. Johnson / <strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944<strong>maltreatment</strong> patterns, <strong>and</strong> risk factors associated with <strong>maltreatment</strong><strong>among</strong> <strong>immigrant</strong> <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong> children <strong>and</strong> their families hasbeen incomplete due to sampling <strong>and</strong> data limitations. The goals of thisstudy are to establish the national prevalence of <strong>immigrant</strong> <strong>and</strong> U.S.<strong>born</strong> <strong>Latino</strong> children who come to the attention of child welfaresystems in the United States, to exp<strong>and</strong> our underst<strong>and</strong>ing of the role ofacculturation in child <strong>maltreatment</strong> patterns <strong>among</strong> <strong>Latino</strong>s, <strong>and</strong> todetermine if disparities in child <strong>maltreatment</strong> patterns <strong>and</strong> risks exist<strong>among</strong> <strong>Latino</strong> families based on the child's nativity. We achieve thesegoals by examining the child, caregiver, <strong>and</strong> household characteristicsof all <strong>Latino</strong> children included in the National Survey of <strong>Child</strong> <strong>and</strong>Adolescent Well-being (n=947).5. MethodsThe National Survey of <strong>Child</strong> <strong>and</strong> Adolescent Well-being (NSCAW)is a national probability study of children who were subjects of reportsof <strong>maltreatment</strong> to child welfare agencies. NSCAW was collectedunder contract from the Administration for <strong>Child</strong>ren <strong>and</strong> Families, <strong>and</strong>is the first national study to provide detailed information on theexperiences of children <strong>and</strong> families who come to the attention of thechild welfare system. Data were obtained through first-h<strong>and</strong> reportsfrom children <strong>and</strong> their associated caregivers <strong>and</strong> child protectiveservices (CPS) caseworkers between 1999 <strong>and</strong> 2001 (Dowd et al.,2002). Interviews were conducted in Spanish if respondents indicatedSpanish as their preferred language.The NSCAW sample was derived from a two-stage stratifiedsampling design developed to maximize the accuracy of estimates ofchildren involved with the child welfare system. In the first stage, theUnited States was divided into nine sampling strata. Eight of thesestrata corresponded to the states with the largest child welfarecaseloads. The ninth stratum consisted of the remaining states <strong>and</strong>the District of Columbia. Primary sampling units, defined as thegeographic area containing the population served by a child welfareagency, were selected from within those nine strata. In the secondstage, 5501 children ages 0 to 14 were selected from lists of closedinvestigations or assessments from the sampled areas. Sampling withinprimary sampling units was stratified by age, type of <strong>maltreatment</strong>,receipt of child welfare services, <strong>and</strong> placement in out-of-home care.Weights are applied in the analysis to adjust the sample back to thecharacteristics of the national population of children involved with thechild welfare system. The current analyses are restricted to childrenidentified as being of a Hispanic/<strong>Latino</strong> ethnicity (n=947).5.1. Constructs <strong>and</strong> measures5.1.1. <strong>Child</strong> nativity<strong>Child</strong>ren's nativity was established through primary caregiverreports of whether or not the child was <strong>born</strong> in the United States. Theterm primary caregiver refers to the person with whom children wereliving at the time of the NSCAW interview who had the majority ofresponsibility for their care.5.1.2. <strong>Child</strong> <strong>and</strong> caregiver characteristicsThe child characteristics examined in this study include (a) age,(b) gender, <strong>and</strong> (c) type of placement. Caregiver characteristicsinclude (a) age, (b) gender, (c) relationship to child, (d) maritalstatus, <strong>and</strong> (e) education level. <strong>Child</strong> <strong>and</strong> caregiver characteristicswere established through interviews with primary caregivers.5.1.3. Family <strong>and</strong> household characteristicsThe family <strong>and</strong> household characteristics examined include (a)household yearly income, (b) primary caregiver employment, (c) receiptof public assistance, (d) family composition (i.e., presence of other adultrelatives), (e) caregiver instability (i.e., change of primary caregiver withinthe past 12 months), <strong>and</strong> (f) language use within the home. Householdyearly income, primary caregiver employment, <strong>and</strong> receipt of publicassistance were established through interviews with primary caregivers.Family composition was established from household rosters developedthrough information obtained from children <strong>and</strong> their primary caregivers.To determine the stability of caregivers in children's lives, children'scaregivers were questioned to develop a chronology of changes incaregivers across time. <strong>Child</strong>ren were categorized as experiencingcaregiver instability if one or more changes of caregivers were reportedin the year prior to the NSCAW interview. Language used within the homewas established through primary caregiver reports of the use of languagesother than English <strong>and</strong> caregivers' comfort level speaking English.5.1.4. Alleged <strong>and</strong> substantiated <strong>maltreatment</strong>Information concerning <strong>maltreatment</strong> was obtained from children'sassociated CPS caseworker. Caseworkers first identified all <strong>maltreatment</strong>types included in the investigation report. When multiple types of<strong>maltreatment</strong> were reported, the most serious type of <strong>maltreatment</strong> wasdetermined using a slight modification of the Maltreatment ClassificationSystem (Manly, Cicchetti, & Barnette, 1994). Maltreatment categoriesinclude physical abuse, sexual abuse, emotional abuse, physical neglect(failure to provide), failure to supervise, <strong>and</strong> ab<strong>and</strong>onment. The outcomeof <strong>maltreatment</strong> investigations was determined from CPS caseworkerreports of the final disposition assigned to the <strong>maltreatment</strong> investigation.Outcomes were classified as either substantiated or not substantiated. Themost serious type of substantiated <strong>maltreatment</strong> was determined byanalyzing the <strong>maltreatment</strong> type associated with substantiated investigationsonly (n=391).5.1.5. Parent <strong>and</strong> family risk factorsCPS caseworkers identified parent <strong>and</strong> family risk factors presentat the time of the <strong>maltreatment</strong> investigation based on informationobtained in their assessment of the family. Questions identifying riskfactors were developed by the NSCAW investigators <strong>and</strong> based on riskassessment forms from the Michigan, New York, Washington, Illinois,<strong>and</strong> Colorado child welfare systems. Responses were dichotomous,with caseworkers responding yes or no indicating the presence orabsence of each risk factor. Risk factors included active alcohol abuse,active drug abuse, serious mental health or emotional problems,intellectual or cognitive impairments, physical impairments, poorparenting skills, active domestic violence, use of excessive discipline,caregiver history of <strong>maltreatment</strong>, recent history of arrest, low socialsupport, high family stress, <strong>and</strong> difficulty meeting basic needs.5.2. AnalysesData were analyzed in Stata 10.0 using survey comm<strong>and</strong>s to adjustfor the two-stage sampling design employed in NSCAW (StataCorp,2007). All prevalence rates <strong>and</strong> statistical tests were weighted to yieldnational estimates for the population of children involved with thechild welfare system. Full details of the NSCAW weight derivation areavailable in Dowd et al. (2002). In addition to reporting nationalpopulation estimates, between-group differences were tested usingtests of categorical independence. These tests are based on thePearson chi-square statistic converted to an F-statistic with nonintegerdegrees of freedom using a second-order Rao <strong>and</strong> Scott (1981)correction to account for the complex survey design.6. Results6.1. <strong>Child</strong> <strong>and</strong> caregiver characteristicsResults of the analyses indicate that <strong>among</strong> <strong>Latino</strong> children who cometo the attention of the child welfare system, 7.8% are foreign-<strong>born</strong><strong>immigrant</strong>s, while 92.2% are U.S. <strong>born</strong>. Table 1 displays differences in child<strong>and</strong> caregiver characteristics based on the child's nativity. Overall, fewsignificant differences were present in demographic characteristics.


A.J. Dettlaff, M.A. Johnson / <strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944939Immigrant children tended to be older <strong>and</strong> a greater proportion weremale. Although placement situations did not differ significantly, a greaterproportion of <strong>immigrant</strong> children were living in in-home settings, while U.S.-<strong>born</strong> children were more likely to be in out-of-home placements.Caregivers of children differed significantly in their relationships tochildren, with <strong>immigrant</strong> children significantly more likely than U.S. <strong>born</strong>children to be living with a biological parent. In contrast, U.S. <strong>born</strong> childrenwere more likely to be living with a foster/adoptive parent or other adultrelatives. This is likely a reflection of the differences found in children'splacement situations. Other demographic characteristics of caregivers,including age, gender, marital status, <strong>and</strong> education level, did not differsignificantly.6.2. Family <strong>and</strong> household characteristicsAnnual income did not differ significantly between householdsof <strong>immigrant</strong> <strong>Latino</strong> children <strong>and</strong> households of U.S. <strong>born</strong> <strong>Latino</strong>children. However, the majority of both groups were represented inthe two lowest income categories, with 78.7% of <strong>immigrant</strong> <strong>Latino</strong>children <strong>and</strong> 59.6% of U.S. <strong>born</strong> <strong>Latino</strong> children living in householdswith annual incomes less than $20,000. Although annual income didnot differ significantly between the two groups, significant differenceswere present in the receipt of public assistance. Households of U.S.<strong>born</strong> <strong>Latino</strong> children were more likely to be receiving public assistancein the form of housing support or Supplemental Security Income (SSI).Overall, nearly two-thirds of the households of <strong>immigrant</strong> childrenwere not receiving any form of public assistance, compared to lessthan one-third of the households of U.S. <strong>born</strong> children.In other characteristics, <strong>immigrant</strong> <strong>Latino</strong> children were significantlymore likely than U.S. <strong>born</strong> <strong>Latino</strong> children to be living with theirbiological mothers (97.3% to 78.9%), while U.S. <strong>born</strong> <strong>Latino</strong> childrenwere significantly more likely to be living in households with agr<strong>and</strong>parent present (16.2% to 1.9%). Interestingly, households of<strong>immigrant</strong> children were significantly less likely to report speaking alanguage other than English in the home (17.0% to 44.0%), althoughthey were also slightly less likely to report being comfortable speakingEnglish (94.2% to 99.3%). A summary of family <strong>and</strong> householdcharacteristics is included in Table 2.6.3. Alleged <strong>and</strong> substantiated <strong>maltreatment</strong>No significant differences were present in the types of alleged<strong>maltreatment</strong> that brought <strong>Latino</strong> children to the attention of thechild welfare system. Further, there was no significant difference inTable 1<strong>Child</strong> <strong>and</strong> caregiver characteristics (weighted population estimates).<strong>Child</strong> nativityTotal U.S.-<strong>born</strong> ImmigrantSample <strong>Child</strong>ren <strong>Child</strong>ren(N=947) (N=891) (N=56) F sigTotal 100.0 92.2 7.8<strong>Child</strong> characteristicsAge (%)0 to 2 19.8 21.3 0.83 to 5 22.2 22.5 18.76 to 10 36.6 35.7 46.811 <strong>and</strong> older 21.5 20.4 33.7Gender (%)Male 43.8 42.6 58.6Female 56.2 57.4 41.4Placement situationIn home 91.2 90.7 97.5Foster home 3.5 3.8 0.2Kinship home 3.8 4.1 0.9Group home/Other out of home 1.4 1.4 1.4nsnsnsCaregiver characteristicsAge (%)ns15 to 19 3.2 3.5 0.020 to 29 35.7 35.3 40.830 to 39 42.9 43.6 34.640 <strong>and</strong> older 18.2 17.7 24.6Gender (%)nsFemale 10.9 88.2 100.0Male 89.1 11.8 0.0Relationship to child F (1.92, 159.30) =3.62 ⁎Biological parent 88.7 87.9 97.3Foster/adoptive parent 3.7 4.0 0.2Other relative 6.7 7.2 1.2Other non-relative 0.9 0.9 1.4Marital status (%)nsMarried 31.4 30.1 47.1Separated 16.9 17.4 11.8Divorced 17.6 17.5 19.1Widowed 4.3 4.6 1.2Never married 29.7 30.5 20.8Education level (%)nsLess than high school 33.9 33.2 41.9High school diploma 43.0 42.2 52.7More than high school 23.1 24.6 5.4ns=not significant at pb0.05.⁎ pb0.05.


940 A.J. Dettlaff, M.A. Johnson / <strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944Table 2Family <strong>and</strong> household characteristics (weighted population estimates).<strong>Child</strong> nativityTotal U.S.-<strong>born</strong> ImmigrantSample <strong>Child</strong>ren <strong>Child</strong>ren(N=947) (N=891) (N=56) F sigHousehold yearly incomensb$10,000 24.9 24.2 34.0$10,000–$19,999 36.1 35.4 44.7$20,000–$29,999 12.6 12.3 15.5$30,000–$39,999 14.3 15.5 0.2$40,000–$49,999 5.6 5.7 4.3$50,000 <strong>and</strong> higher 6.4 6.8 1.3Public assistanceWIC 38.9 39.7 29.4 nsFood stamps 35.2 36.5 19.9 nsTANF 25.4 26.6 10.9 nsHousing support 8.3 9.0 0.4 F (1, 83) =22.06 ⁎⁎⁎SSI (disability) 11.5 12.48 0.1 F (1, 83) =152.63 ⁎⁎⁎None 33.8 31.2 63.9 F (1, 83) =5.07 ⁎Family compositionBiological father present 31.6 30.3 46.9 nsBiological mother present 80.3 78.9 97.3 F (1, 83) =14.10 ⁎⁎⁎Gr<strong>and</strong>parent present 15.1 16.2 1.9 F (1, 83) =11.00 ⁎⁎⁎Other adult relative present 27.4 28.3 16.2 nsInstabilityChange of primary caregiver in past 12 months 13.1 13.7 6.3 nsLanguage useLanguage other than English spoken in home 41.9 44.0 17.0 F (1, 83) =4.40 ⁎Comfortable speaking English 99.2 99.3 94.2 F (1, 83) =5.53 ⁎ns=not significant at pb0.05.⁎⁎⁎ pb0.001.⁎ pb0.05.the overall rate of substantiated <strong>maltreatment</strong> between <strong>immigrant</strong>children <strong>and</strong> U.S. <strong>born</strong> children. However, significant differences werepresent in the type of <strong>maltreatment</strong> that was substantiated.Immigrant <strong>Latino</strong> children were nearly three times as likely to bevictims of physical abuse than U.S. <strong>born</strong> <strong>Latino</strong> children (75.7% to27.8%). U.S. <strong>born</strong> <strong>Latino</strong> children were significantly more likely than<strong>immigrant</strong> <strong>Latino</strong> children to be victims of emotional abuse (24.2%to 0.2%). A summary of alleged <strong>and</strong> substantiated <strong>maltreatment</strong> isincluded in Table 3.6.4. Parent <strong>and</strong> family risk factorsSignificant differences were present in six risk factors identified byCPS caseworkers, with 5 of those 6 risk factors more likely to bepresent in families of U.S. <strong>born</strong> <strong>Latino</strong> children. Active alcohol abuse<strong>and</strong> active drug abuse were both significantly more likely to bepresent in families of U.S. <strong>born</strong> <strong>Latino</strong> children (15.8% to 1.4% <strong>and</strong> 8.7%to 0.3% respectively). Additionally, families with U.S. <strong>born</strong> childrenwere more than 5 times more likely to be experiencing activeTable 3Alleged <strong>and</strong> substantiated <strong>maltreatment</strong> (weighted population estimates).<strong>Child</strong> nativityTotal U.S.-<strong>born</strong> ImmigrantSample <strong>Child</strong>ren <strong>Child</strong>ren(N=947) (N=891) (N=56) F sigMost serious type of alleged <strong>maltreatment</strong>Physical abuse 32.4 30.9 50.0 nsSexual abuse 11.6 11.9 7.5 nsEmotional abuse 12.6 12.7 11.4 nsPhysical neglect (failure to provide) 14.6 15.4 5.0 nsLack of supervision 25.3 25.4 24.8 nsAb<strong>and</strong>onment 1.8 1.8 1.3 nsInvestigation outcomensSubstantiated 27.9 27.9 27.5Not substantiated 72.1 72.1 72.5Type of substantiated <strong>maltreatment</strong> (N=391) (N=370) (N=21)Physical abuse 31.5 27.8 75.7 F (1, 83) =5.76 ⁎⁎Sexual abuse 8.2 8.7 1.9 nsEmotional abuse 22.4 24.2 0.2 F (1, 83) =68.88 ⁎⁎⁎Physical neglect (failure to provide) 9.6 10.1 3.7 nsLack of supervision 23.1 24.0 13.4 nsAb<strong>and</strong>onment 1.8 1.6 4.6 nsns=not significant at pb0.05.⁎⁎ pb0.01.⁎⁎⁎ pb0.001.


A.J. Dettlaff, M.A. Johnson / <strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944941domestic violence than families of <strong>immigrant</strong> children (12.8% to 2.3%).Parents of U.S. <strong>born</strong> children were also more likely to have a physicalimpairment (2.5% to 0.4%) <strong>and</strong> a recent history of arrest (8.1% to 1.4%).However, parents of <strong>immigrant</strong> <strong>Latino</strong> children were more than threetimes as likely to be identified by CPS caseworkers as using excessivediscipline (46.5% to 14.3%), with this risk factor identified in nearlyone-half of all families of <strong>immigrant</strong> <strong>Latino</strong> children. High familystress was the most prevalent risk factor for both groups, although theprevalence of this risk factor did not differ significantly betweengroups. A summary of parent <strong>and</strong> family risk factors is included inTable 4.7. DiscussionWith few exceptions, research examining <strong>Latino</strong> children in thechild welfare system has typically compared <strong>Latino</strong> children as ahomogenous group to children of other races. Yet, given theincreasing size <strong>and</strong> diversity of the <strong>Latino</strong> population in the UnitedStates, it is important to be aware of cultural differences within the<strong>Latino</strong> population <strong>and</strong> to be able to appropriately respond to thosedifferences. This is important not only to provide more effectiveservices when <strong>immigrant</strong> children come to the attention of thissystem, but also to better underst<strong>and</strong> the specific risk factors facing<strong>Latino</strong> children in order to plan prevention efforts.Literature has suggested that <strong>immigrant</strong> children may face anumber of risk factors that make them vulnerable to contact with thechild welfare system. However, data in this study indicate that<strong>immigrant</strong> <strong>Latino</strong> children are slightly underrepresented <strong>among</strong>children who present to child welfare systems, with foreign-<strong>born</strong>children representing slightly less than 8% of <strong>Latino</strong> children involvedin child welfare, although they represent approximately 9% of <strong>Latino</strong>children in the general child population. Nevertheless, significantdifferences exist between <strong>immigrant</strong> <strong>and</strong> non-<strong>immigrant</strong> <strong>Latino</strong>children in the risk factors <strong>and</strong> type of <strong>maltreatment</strong> they experiencethat warrant further research <strong>and</strong> attention.In this study, a large proportion of families of <strong>immigrant</strong> childrenresided at the lowest tiers of the income ladder. However, thosefamilies were significantly less likely to receive any type of publicassistance when compared to their native-<strong>born</strong> counterparts. Thesedifferences partly reflect changes in program eligibility that resultedfrom the targeted <strong>immigrant</strong> provisions of the Personal Responsibility<strong>and</strong> Work Opportunity Reconciliation Act (PRWORA) of 1996. Before1996, most lawfully present <strong>immigrant</strong>s were eligible for the samepublic benefits as U.S. citizens. However, PRWORA barred noncitizensfrom several key federal income supports (Dinan, 2005). Studiessuggest that PRWORA had a “chilling effect” on benefit participation<strong>among</strong> both citizen <strong>and</strong> non-citizen children in low-income <strong>immigrant</strong>families in the late 1990s (Fix & Passel, 2002). Although it is notpossible to determine whether PRWORA's <strong>immigrant</strong> provisionsaffected public assistance program participation in this sample givenlimitations of the data, the large number of families who are living atlow incomes <strong>and</strong> without public assistance highlights the economichardship faced by <strong>immigrant</strong> <strong>Latino</strong> families who come to theattention of child welfare systems.Although <strong>immigrant</strong> children may face risk factors such aseconomic vulnerability along with challenges resulting from theirfamilies' experiences with immigration <strong>and</strong> acculturation, the findingsfrom this study indicate that several risk factors stronglyassociated with child <strong>maltreatment</strong> are significantly more likely tobe present in families with U.S. <strong>born</strong> <strong>Latino</strong> children. Specifically, U.S.<strong>born</strong> <strong>Latino</strong> children are significantly more likely to live in homes withactive alcohol abuse, active drug abuse, <strong>and</strong> active domestic violence,each of which has considerable empirical links to child <strong>maltreatment</strong>.Multiple studies have documented that higher levels of acculturationare associated with higher incidence of family problems includingsubstance abuse (e.g., Ortega, Rosenheck, Alegría, & Desai, 2000; Vega,Sribney, & Achara-Abrahams, 2003) <strong>and</strong> domestic violence (e.g.,Garcia, Hurwitz, & Kraus, 2005; Jasinski, 1998). Therefore, significantdifferences in alcohol abuse, drug abuse, <strong>and</strong> domestic violencebetween U.S. <strong>born</strong> <strong>and</strong> foreign-<strong>born</strong> children are likely due in part todifferences in the acculturation levels of parents — families withforeign-<strong>born</strong> children are likely to have resided in the United Statesfor only a short amount of time <strong>and</strong> thus are <strong>among</strong> the leastacculturated. Additionally, for many <strong>immigrant</strong> families, the desire fora better life for their children that is often associated with theirreasons for migration may be a powerful strength <strong>and</strong> motivatingfactor that may serve as a buffer against many of the risk factorsassociated with <strong>maltreatment</strong>. Undertaking a long, expensive, <strong>and</strong>dangerous journey to a foreign country requires determination,strength, <strong>and</strong> a strong sense of personal <strong>and</strong> family responsibilitythat may serve as deterrents for engaging in illegal or otherwiseharmful activities.Concerning the incidence of <strong>maltreatment</strong>, no significant differenceswere present in the overall incidence of <strong>maltreatment</strong> betweenTable 4Parent <strong>and</strong> family risk factors (weighted population estimates).<strong>Child</strong> nativityTotal U.S.-<strong>born</strong> ImmigrantSample <strong>Child</strong>ren <strong>Child</strong>ren(N=947) (N=891) (N=56) F sigParent <strong>and</strong> family risk factorsActive alcohol abuse 14.8 15.8 1.4 F (1, 83) =40.30 ⁎⁎⁎Active drug abuse 7.9 8.7 0.3 F (1, 83) =44.30 ⁎⁎⁎Serious mental health or emotional problem 9.2 9.7 2.8 nsIntellectual or cognitive impairment 3.4 3.7 0.0 nsPhysical impairment 2.3 2.5 0.4 F (1, 83) =4.20 ⁎Poor parenting skills 26.8 27.6 16.9 nsActive domestic violence 12.0 12.8 2.3 F (1, 83) =12.31 ⁎⁎⁎Use of excessive discipline 16.5 14.3 46.5 F (1, 83) =5.94 ⁎History of <strong>maltreatment</strong> (of caregiver) 25.0 24.5 33.5 nsRecent history of arrest 7.7 8.1 1.4 F (1, 83) =4.61 ⁎Low social support 25.6 25.0 36.0 nsHigh family stress 52.3 52.8 46.8 nsDifficulty meeting basic needs 21.0 20.8 22.5 nsAny risk factor 85.3 85.6 80.0 nsns=not significant at pb0.05.⁎⁎⁎ pb0.001.⁎ pb0.05.


942 A.J. Dettlaff, M.A. Johnson / <strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944<strong>immigrant</strong> <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong> children. However, considerabledifferences were found in the type of substantiated <strong>maltreatment</strong>,with <strong>immigrant</strong> <strong>Latino</strong> children experiencing physical abuse at a ratenearly three times that of U.S. <strong>born</strong> <strong>Latino</strong> children. It is possible thatthe higher rates of substantiated physical abuse reflect a higherproportion of <strong>immigrant</strong> families that use excessive discipline whencompared to the families of U.S. <strong>born</strong> children. Traditionally oriented<strong>Latino</strong> families have been described as using an authoritarianparenting style that serves to instill the cultural values <strong>and</strong> norms ofparental obedience, family loyalty (i.e., familismo) <strong>and</strong> appropriatebehavior (Zayas, 1992; Fontes, 2002). It is not unusual for traditionallyoriented <strong>Latino</strong> parents to incorporate corporal punishment in theirchild rearing approach (Zayas & Solari, 1994), or to combine corporalpunishment with verbal reasoning, intimacy, <strong>and</strong> support (Buriel,Mercado, Rodriguez, & Chavez, 1991; Fontes, 2002). While statutorydefinitions of physical abuse vary across states, it is possible that theuse of corporal punishment by traditionally oriented parents may beinterpreted by some child welfare practitioners as excessive discipline.Moreover, traditionally oriented <strong>Latino</strong> parents who observetheir children behaving in a disobedient or disrespectful manner inpublic are likely to respond in public, thereby increasing thelikelihood of child <strong>maltreatment</strong> reporting (Fontes, 2002). The fewstudies that have examined group differences in <strong>Latino</strong> child rearingattitudes <strong>and</strong> behaviors suggest that less acculturated families aremore likely to use harsher disciplinary practices when compared totheir more acculturated counterparts (Rauh, Wasserman, & Brunelli,1990; Buriel et al., 1991). According to Fontes (2002), the moreacculturated <strong>and</strong> educated the family is, the closer their childdiscipline norms will be to those of U.S. culture. However, moreresearch is necessary regarding the specific behaviors that areassociated with physical abuse reports <strong>among</strong> <strong>immigrant</strong> families<strong>and</strong> how these reports are h<strong>and</strong>led by child welfare practitioners.While <strong>immigrant</strong> <strong>Latino</strong> children were more likely to experiencephysical abuse, U.S. <strong>born</strong> <strong>Latino</strong> children were significantly morelikely to experience emotional abuse. Nearly one-quarter of all U.S.<strong>born</strong> <strong>Latino</strong> children involved in a substantiated case of <strong>maltreatment</strong>were victims of emotional abuse, compared to less than 1% of<strong>immigrant</strong> children who experienced this form of <strong>maltreatment</strong>. Thisfinding is difficult to interpret as statutory definitions of emotionalabuse vary widely across states (Hamarman, Pope, & Czaja, 2002), <strong>and</strong>the data available do not provide information on the behaviorsassociated with these allegations. However, it is possible that some ofthis difference may be attributed to exposure to domestic violence<strong>among</strong> U.S. <strong>born</strong> <strong>Latino</strong> children, which is included in most statesdefinitions of emotional or psychological <strong>maltreatment</strong> (U.S. Departmentof Health <strong>and</strong> Human Services, Administration for <strong>Child</strong>ren <strong>and</strong>Families, Administration on <strong>Child</strong>ren, Youth <strong>and</strong> Families, <strong>Child</strong>ren'sBureau, 2010). According to caseworker reports of risk in this study,active domestic violence was present in 12.8% of families of U.S. <strong>born</strong><strong>Latino</strong> children, a rate more than five times that of <strong>immigrant</strong>children. This is consistent with other research, which documents thatrates of domestic violence are significantly higher <strong>among</strong> U.S. <strong>born</strong><strong>Latino</strong>s as compared to <strong>immigrant</strong> <strong>Latino</strong>s (Aldarondo, Kantor, &Jasinski, 2002; Jasinski, 1998; Kantor, Jasinski, & Aldarondo, 1994).However, while exposure to domestic violence may account for someof the observed differences in emotional abuse, the extremedifferences in rates of emotional abuse as documented in this studywarrant additional research in order to fully underst<strong>and</strong> the reasonsfor this difference.7.1. LimitationsAs data in NSCAW were not collected specifically for the purpose ofidentifying differences between <strong>immigrant</strong> <strong>and</strong> non-<strong>immigrant</strong>populations, the findings presented in this study have severalimportant limitations. First, we were unable to identify differenceswithin <strong>immigrant</strong> families related to immigration status (i.e., whethera parent or child has legal status in the U.S.) as this variable was notcollected. Families with undocumented members likely experienceeven greater stress than those with legal status, <strong>and</strong> differences in riskfactors <strong>and</strong> <strong>maltreatment</strong> between those with legal status <strong>and</strong> thosewithout legal status could not be determined. Moreover, we wereunable to examine indicators other than nativity that might provide amore detailed account of the acculturative status of children. Amongthe families of <strong>immigrant</strong> children, the relatively low self-report of alanguage other than English spoken in the home (17%) <strong>and</strong> the highlevel of comfort reported in speaking English (94%) suggests either ahigh level of acculturation <strong>among</strong> the <strong>immigrant</strong> group surveyed orraises questions regarding the reliability of those language indicators.Future research on the relationship between acculturation <strong>and</strong> child<strong>maltreatment</strong> should seek to incorporate more sophisticated measuresthat assess the multidimensional nature of cultural change <strong>and</strong>preference.Additionally, the reliability <strong>and</strong> validity of caseworker reports ofparent <strong>and</strong> family risk factors used in these analyses have not beenestablished, <strong>and</strong> the correspondence between parents' self-report onthese variables <strong>and</strong> caseworker assessments has not been examined.However, it is the caseworker's perceptions of risk that often guidecase decision-making, <strong>and</strong> as such, the measures of risk included inthis study provide valuable information for underst<strong>and</strong>ing <strong>immigrant</strong>families' involvement with child welfare systems. Finally, as thesedata only include families who have already come to the attention ofchild welfare systems, no conclusions can be drawn regarding thepresence of risk or <strong>maltreatment</strong> in the general <strong>Latino</strong> population.7.2. Implications of findingsThe findings in this study represent the first national data availableconcerning the involvement of <strong>immigrant</strong> <strong>Latino</strong> children in the childwelfare system. The findings document important differencesbetween <strong>immigrant</strong> <strong>Latino</strong> children <strong>and</strong> U.S. <strong>born</strong> <strong>Latino</strong> childrenthat need to be considered by child welfare professionals whenassessing for risk <strong>and</strong> service needs. Although <strong>immigrant</strong> children areoften considered particularly vulnerable, these findings demonstratethat they are less likely to experience many of the risk factorsassociated with <strong>maltreatment</strong> than their native-<strong>born</strong> counterparts<strong>among</strong> those families who come to the attention of child welfaresystems.Although <strong>immigrant</strong> families may face a number of challengesupon entering the U.S., they also possess a number of strengths thatmay often be often overlooked by child welfare professionals. Theseinclude families' reasons for migration, their aspirations for theirchildren, <strong>and</strong> the challenges they have overcome as part of theirmigration experience. In addition, families' culture <strong>and</strong> connections totheir country of origin can be significant sources of strength that canbe built upon in practice to facilitate positive outcomes. Yet, althoughit is important to identify strengths that may be unique to <strong>immigrant</strong>families, it is also important to identify unique risk factors that may beoverlooked, particularly <strong>among</strong> families with undocumented members,as they may be particularly vulnerable to stress due to fears ofdeportation <strong>and</strong> possible separation from their children. This stress islikely to be heightened in states with harsh immigration enforcementpolicies. Thus, child welfare practitioners need to be familiar with thelarger political context in which <strong>immigrant</strong> families live <strong>and</strong> function.In addition to underst<strong>and</strong>ing the consequences that may result fromdiscovery <strong>and</strong> deportation, child welfare practitioners need tounderst<strong>and</strong> how forms of immigration status affect benefit eligibility<strong>and</strong> the resulting implications for service delivery.Given the differences in rates of physical abuse involving<strong>immigrant</strong> children, <strong>immigrant</strong> families may benefit from educationon cultural norms concerning discipline <strong>and</strong> the prevention of<strong>maltreatment</strong>. <strong>Child</strong> welfare agencies can partner with community-


A.J. Dettlaff, M.A. Johnson / <strong>Child</strong>ren <strong>and</strong> Youth Services Review 33 (2011) 936–944943based service providers in <strong>immigrant</strong> communities to facilitate thiseducation <strong>and</strong> to develop a sense of trust within the <strong>immigrant</strong>community. In addition to providing education, child welfareprofessionals need to be culturally sensitive when responding to<strong>immigrant</strong> families, recognizing <strong>and</strong> respecting the differences incultural norms that may have led to their involvement, while alsoeducating families on appropriate disciplinary practices. In all cases,child welfare staff need to be sensitive to the fear <strong>and</strong> confusionthat many <strong>immigrant</strong> families may have regarding child welfareintervention.Finally, although these findings indicate that foreign-<strong>born</strong> childrenrepresent just a small portion of <strong>Latino</strong> children who come to theattention of this system, it is important to acknowledge reasons thatmay lead to underreporting within this population. Families withundocumented members are likely to be particularly fearful of contactwith child welfare agencies <strong>and</strong> may underutilize other publicservices due to concerns over eligibility or immigration status. Thus,children in <strong>immigrant</strong> families may be less likely to come into contactwith many of the systems that serve as m<strong>and</strong>ated reporters to childwelfare agencies. Members of <strong>immigrant</strong> communities may also behesitant to report cases of child abuse due to the potentialrepercussions to families if members are undocumented. Thus, lackof involvement with child welfare agencies is not necessarilyindicative of greater family functioning. Rather, it may be an indicatorof deepening social isolation, avoidance of social service systems, orlack of access to linguistically competent service providers.AcknowledgementsFunding for this research was provided by the American HumaneAssociation, <strong>Child</strong>ren's Division.ReferencesAldarondo, E., Kantor, G. K., & Jasinski, J. L. (2002). A risk marker analysis of wife assaultin <strong>Latino</strong> families. Violence Against Women, 8, 429−454.Alliance for Racial Equity in <strong>Child</strong> Welfare. (2010). How are our kids: State scorecards.http://www.policyforresults.org [Retrieved from].Alzate, M. M., & Rosenthal, J. (2009). 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