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Chronic CPS Referral Histories and

the Effects on Children’s Development

(Published by Casey Family Program in January 2013)



Knowledge Management (KM) completed this research brief for Diana English, Senior Director of Strategic Consulting. In completing this brief, KM worked with Casey’s Research staff to review and revise early drafts of the report.




LONGSCAN is a twenty year longitudinal study (1993-2013) which has examined the long term effects of child abuse and neglect on children’s development. Children and their parents in five LONGSCAN sites (Northeast, Northwest, Midwest, Southwest, and Southeast) were interviewed at ages 4, 6, 8, 12, 14, 16 and 18 to obtain information regarding children’s exposure to family violence, violence outside their families, child/youth functioning, and the neighborhood context of family life. Researchers gathered information about children’s health, behavioral and emotional development, risk taking behaviors, school performance, and work relationships. This study provides a wealth of information about the impact of chronicity (i.e., frequent or multiple referrals to CPS) on children’s developmental outcomes.


Two LONGSCAN sites (Southwest and Northwest) include samples of children referred to CPS prior to age four. Researchers in these sites followed CPS referral histories of 501 children from birth to age 18. Children in these two sites were referred to CPS with greater frequency than children in the other three sites. Two published articles[1] on maltreatment chronicity have been based on LONGSCAN data from either the Northwest site or from the Northwest and Southwest sites combined, and a third article[2] drew on a sample of children from all five sites.


What were the CPS report histories of the children in the study?


In the Northwest site, 1,498 CPS reports were made on 254 children between their date of birth and their eighteenth birthday. Approximately one quarter (24%) of these children had one or two reports; slightly more than one-third (35%) of the children were reported three to five times; and almost two-fifths (38%) of the children had six or more reports before their eighteenth birthday. 

                               Number of Referrals by Age 18: Northwest Site









Most CPS reports in the Northwest sample contained allegations of low to moderately severe neglect, though approximately one-third of allegations of lack of supervision were rated as high severity due to the young ages of the children alleged to have been inadequately supervised. However, about one-fourth of the allegations were for physical abuse; and about 70% of these allegations were for physical abuse with no evidence of physical harm.  In addition, children who were reported to CPS several times and at various developmental stages often had referral histories marked by allegations of multiple types of maltreatment, for example neglect, physical abuse and psychological maltreatment. These children who were chronically referred to CPS may often have been “chronically maltreated,” i.e., physically abused and neglected and psychologically maltreated as well. The negative effects of maltreatment on child development were magnified for this group of children when reports of maltreatment began in infancy. 



What were the different report histories of children in LONGSCAN?


LONGSCAN researchers were especially interested in the effects of maltreatment for children reported to CPS at different developmental stages.


Example: Proctor Study (2012): Northwest and Southwest Sites


Referral histories for 501 children ages 4 – 12 were separated into four groups:

No re-reports                                  33%


Early re-reports                              20%

(CPS reports between

ages 4-8)


Intermittent re-reports                 37%                           Authors found “they received 

(CPS reports in at least                                                                             sporadic reports in a pattern that

two 2-year periods                                                                                    suggested (i.e., non-declining) risk over time.”

between ages 4-12

interrupted by at least

one 2-year period of no CPS)


Continuous re-reports                  10%                            This group of children and the children in the intermittent

(CPS reports in at least                                                                              re-reports group combined made up almost half (47%) of the children in the study.

3 of 4 two year periods

between ages 4-12)


AFDC receipt predicted membership in any of the groups with multiple referrals compared to the no reports group, but did not distinguish between groups with multiple referrals (that is, continuous re-reports, intermittent re-reports, and early re-reports). The authors (Proctor et al., 2012) comment that “Physical abuse allegations and caregiver alcohol abuse distinguished the continuous re-reports group from the early reports group…suggesting that these variables are linked to a more chronic pattern of maltreatment re-reporting.” It was not poverty but the presence of alcohol abuse and abusive physical punishment in families that distinguished the groups of children with CPS reports across developmental periods.    



What were the effects of different CPS referral histories on children’s development?


In a 2005 analysis (English et al.) of a sample of 203 children from the Northwest site, researchers divided children into four age groups: before birth to 1.49 years; 1.5–2.99 years; 3-5.99 years and 6-8.99 years, for the purpose of analyzing maltreatment chronicity across developmental periods.


The researchers then classified CPS referral histories as:


  • Situational maltreatment: reports in only one developmental period

  • Limited maltreatment: maltreatment reports in two developmental periods

  • Extended maltreatment: reports in three or four developmental periods

  • Episodic maltreatment: “maltreatment occurring in more than one developmental period, with an intervening developmental period free from reported maltreatment.”

  • Continuous maltreatment: “maltreatment reports in two or more adjacent developmental periods with ’no gaps.’”


The 203 children in the analysis were reported to CPS 824 times from birth to age 8. Again, most of the allegations were classified as low to moderate level neglect, but just over one-fifth (22%) of the allegations were for physical abuse, and about one-sixth of allegations were for psychological maltreatment.


Some of the most important findings of these studies include:


  • As the number of CPS reports increased, there was an increased likelihood that children would be reported for more than one type of maltreatment. Multiple referrals of children across developmental periods, was moderately associated with allegations of multiple types of child maltreatment.

  • Early neglect was found to have an especially powerful effect on children’s development. A child’s age at first report, especially CPS reports on children younger than 1, was associated with relatively high levels of externalizing behavior problems at age 8.

  • Experiences of early nurturance were found to be a source of children’s resilience. “Children who receive adequate care in earlier developmental stages are more likely to have the ‘strengths’ to cope with later adversity,” according to the authors of the study.

  • The older age of children at the time of the first CPS report did not protect children from trauma, especially when referral histories included allegations of sexual abuse. Allegations of multiple types of maltreatment and children’s older age at first report were associated with higher levels of trauma symptomatology, i.e., anger, posttraumatic stress and dissociation.

  • The type of neglect that endangers young children’s physical safety the most, i.e., lack of supervision, had the least effect on children’s development, whereas the neglect type which endangered children’s immediate safety the least, i.e., failure to provide basic care, had a strong negative effect on children’s development. Allegations of lack of supervision were not associated with children’s behavior problems despite often being rated as “severe” because of the risks to young children, whereas failure to provide basic necessities (a type of neglect) was a significant predictor of both children’s behavior problems and adaptive functioning, despite being usually rated as less severe by researchers.  

  • Referral histories suggesting chronic neglect throughout early childhood and that included emotional maltreatment were associated with children’s behavior problems. Chronicity of maltreatment reports across developmental periods combined with allegations of failure to provide basic necessities and emotional maltreatment “resulted in higher (i.e., worse) Child Behavior Checklist (CBCL) scores.”

  • Chronic child maltreatment affects children’s ability to make and keep friends.  Chronicity of CPS reports across developmental periods was associated in school age children with troubled peer relationships resulting, in part, from children’s highly aggressive behavior.

  • Referral histories suggesting the possibility of severe abuse or neglect were associated with school age children’s problems in adaptive functioning. A high degree of severity of allegations of maltreatment (based on researchers’ ratings) was associated with children’s poor adaptive functioning at age 8.



The LONGSCAN studies utilize a definition of chronicity based not simply on numbers of CPS referrals but on multiple CPS reports across children’s developmental periods. Defining chronicity of child maltreatment reports in this way has revealed that a third to a half of children reported to CPS have chronic referral histories that may reflect an ongoing pattern of child maltreatment, often involving multiple types of maltreatment and reports in which low severity allegations of neglect and physical abuse predominate. Many of these children develop serious behavior problems or have significant challenges in adaptive functioning by age 8. Early onset of child maltreatment reports, severity of the type of maltreatment alleged in reports, and chronic reports across developmental periods (especially when allegations of emotional maltreatment are a part of children’s referral histories) appear to lead to problematic child behavior and compromised social adaptation.


In addition, among families with chronic referral histories as defined in LONGSCAN, there appear to be distinct sub-types that reflect very different family dynamics. Most of the allegations in CPS reports of chronically referred families concerned low to moderate level neglect; but there were a significant percentage of these families reported for physical abuse and emotional maltreatment as well. Children’s parenting experiences in families reported for neglect only, even when neglect is chronic, may be very different from children’s experiences  in families reported to CPS multiple times for several types of maltreatment.





D.J. English, M.P. Upadhyaya, A.J. Litrownik, J.M. Marshall, D.K. Runyan, J.C. Graham, & H. Dubowitz. (2005).

Maltreatment’s wake: The relationship of maltreatment dimensions to child outcomes. Child Abuse and Neglect, 29. 597-619.

L.J. Proctor, G.A. Aarons, H. Dubowitz, D.J. English, T. Lewis, R. Thompson, J.M. Hussey, A.J. Litrownik, & S.C. Roesch. (Aug. 2012). Trajectories of maltreatment re-reports from ages 4 to 12: Evidence for persistent risk after early exposure. Child Maltreatment, 17. 207-217.

J.C. Graham, D.J. English, A.J. Litrownik, R. Thompson, E.C. Briggs, & S.I. Bangdiwala.(2010). Maltreatment chronicity defined with reference to development: Extension of the social adaptation outcomes findings to peer relations. Journal of Family Violence, 25. 311-314.

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