Max Rady College of Medicine

Concept: Children in Care (CIC) - Overview of Terminology and Characteristics

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Concept Description

Last Updated: 2020-07-06

Introduction

    This concept provides an overview of the terminology associated with Children in Care and a description of the characteristics related to research in this area. The majority of content for this concept comes from the MCHP Deliverable The Educational Outcomes of Children in Care in Manitoba by Brownell et al. (2015), but also from other MCHP research, including the recent deliverable The Overlap Between the Child Welfare and Youth Criminal Justice Systems: Documenting "Cross-Over Kids" by Brownell et al. (2020).

    The concept provides a list of terms and definitions related to child care that have been developed for MCHP research purposes. It then lists characteristics of children in care in Manitoba, characteristics common to all children in Manitoba compared by three in-Care categories (see below), and provides definitions of these characteristics and links to the research information and findings in Brownell et al. (2015). The concept also provides a brief discussion of how complete the Child and Family Services Information System (CFSIS) is for First Nations children and the history of these types of data being collected, and includes a number of limitations and cautions when using these data. The concept also provides a link to relevant SAS code (internal access only) used in MCHP research for identifying children in care.

    For more information on the educational outcomes investigated and reported on in Brownell et al. (2015), please see the Children in Care (CIC) and Educational Outcomes concept.

Data Sources

Terms and Definitions Related to Children in Care

    The following is a list of terms and definitions that have been used in MCHP research related to children in care. They were developed in conjunction with Child and Family Services (CFS) staff for the purposes of research involving children in care.

    • Allegation of Abuse - an accusation of physical, emotional or sexual abuse.

    • Substantiated Abuse - allegation or incident of abuse is considered substantiated if the balance of evidence indicates that abuse or neglect has occurred.

    • Children in Care – please see the Children in Care (CIC) / Ever in Care glossary term for a detailed description of the term children in care.

    • Children in Care – In-Care Categories - for research analysis purposes, three In-Care categories were developed, including:

      • Ever in Care - children who have been in out-of-home care of Child and Family Services (CFS) for at least one day;
      • Ever Received CFS Services - children who were never in care, but lived in a family that received protection or support services from CFS for at least one day; and
      • Never Involved with CFS - children who were never in care and whose families never received protection or support services from CFS.

    • Episode of Care – an episode of care refers to a section of time that a child is in the care of CFS. If a child goes out of care and then back in to care within seven days, it is considered one episode. Episodes of at least one day were included in the analysis. A child may have more than one episode of care during the time period being examined. In such cases, each episode is counted separately.

    • Legal Status - this is the legal standing of the child in regards to the rest of the community. Legal status categories include:


    • Placement - refers to the location where the child is living when placed in care. These include:

      • Foster Home - an approved home by an agency under the Foster Homes Licensing Regulation. **
      • Foster Home - specialized - an approved foster home with dedicated services for high needs children. May have fixed service fee or be part of a non-mandated agency program. **
      • Place of Safety - a place designated for short term, emergency care (e.g.: family, supervised hotel/motel/apartment, women's shelter.) **
      • Unknown - a living arrangement not approved by agency. **
      • Kinship Care - living arrangements with a caregiver, usually a relative, who was involved in the child's life before the child entered into care by CFS.
        Note: Kinship care is not listed as a type of placement under this variable but requires combining two different variables. In order to determine kinship care, we used a combination of Placement Category and Placement Type. Children whose placement category was "foster home", "place of safety", or "own home relative", AND whose placement type was "child specific family", "safety family residence", or "no placement" were categorized as "kinship care". This method of determining kinship care likely undercounts actual placements in kinship care to some degree.
      • Adoption Probation - the child is being considered for transition into an adopted family.
        (** information obtained in a personal communication with L. Jervis, April 24, 2013)

    • Reasons for Being Taken Into Care - children can be taken into care for a variety of reasons, including abuse (which includes physical, sexual and emotional abuse), neglect, death or conflict in the family (including witnessing intimate partner violence), or if the child has a disability or emotional or behavioural difficulties. CFSIS categorizes these reasons into the groupings below.

      • Conduct of parent or other - parents don't or won't provide proper care (e.g.: abuse, violence, alcohol or drug abuse, etc.). **
      • Conduct of parent / medical refusal - parent or guardian neglects or refuses to permit medical or other remedial care or treatment necessary for the health or well-being of a child. **
      • Conditions of parent - parents can't provide care, temporarily or permanently, due to physical disability, mental illness, emotional illness, severe physical illness, mental deficiencies, etc. **
      • Conduct of child - parents can't provide care, temporarily or permanently, due to the child’s behaviour (e.g.: running away, defiance, etc.). **
      • Abandonment and Desertion - parents leave without stating either the plan for the child or for their return, or parents leave with a plan for the child but no plan for their return. **
      • Conditions of child - parents can’t provide care, temporarily or permanently, due to the child’s mental or physical special needs. **
      • Transfer Supervision - formally changing supervision of the case from one agency to another, or from one region to another. **
      • Transfer In - transfer into care from another province. **
      • Voluntary Relinquishment - legal guardian formally gives the child to an agency. **
      • Missing open reason - likely records where cases are pending and not open yet.
      • Other
        (** information obtained in a personal communication with L. Jervis, April 24, 2013)
        NOTE: Most children go into care due to the conduct or conditions of their parent(s). Specific reasons for why children go into care, such as parental addictions, parental intimate-partner violence, abuse, neglect, or parental illness are not included in the CFSIS data held at MCHP.

        Maltreatment is one of many reasons why a child may be taken into care. The following are ICD-9-CM codes for hospitalization for non-specific diagnoses suggestive of child abuse. It must be noted that many children with these hospital codes will not be taken into care.

        • cyanosis (7825)
        • choking (7849)
        • colic (7873, 7890)
        • fussy infant (7833)
        • excessive crying, nausea and vomiting (7870)
        • syncope (7802)
        • alopecia (7040)
        • vomiting blood (5780)
        • hemoptysis (7863)
        • esophagitis (5301)
        • dental caries (5210)
        • respiratory conditions not otherwise specified (78600)
        • failure to thrive (7834) and
        • encopresis (7876)

Characteristics of Children in Care in Manitoba

    In The Educational Outcomes of Children in Care in Manitoba deliverable by Brownell et al. (2015), the study population developed for describing characteristics of children in care (Chapter 3) includes all children from birth to 18 years of age who had spent at least one day in the care of Child and Family Services (CFS) between April 1, 2009 and March 31, 2012 (fiscal years 2009/10-2011/12). These children included those with both new (starting between 2009/10-2011/12) and existing (starting before April 1, 2009, but still in care after that date) episodes of care. Those who were 19 years or older at the start of the episode, and those who had previously been in care but were not in care between April 1, 2009 and March 31, 2012, were excluded from this analysis

    The following lists the characteristics investigated in this research and provides links to the corresponding sections in this research, along with a list of figures and tables available in each section.

    • Reason For Being Taken Into Care
      • Table 3.2: Frequency and Percentage of Care Episodes by Reason For Entry into Care, by Year

    • Age
      • Figure 3.1: Percentage of Children in Care between 2009/10 and 2011/12, by Age
      • Figure 3.2: Percentage of Children in Care between 2009/10 and 2011/12, by Age at First Care Episode
      • Figure 3.3: Percentage of Children in Care between 2009/10 and 2011/12 that were Apprehended at Birth

    • Sex
      • Figure 3.4: Percentage of Children in Care between 2009/10 and 2011/12, by Sex

    • Number of Care Episodes
      • Figure 3.5: Percentage of Children in Care between 2009/10 and 2011/12, by Number of Episodes

    • Type of Placement
      • Figure 3.6: Percentage of Children in Care between 2009/10 and 2011/12, by Latest Available Placement Category

    • Number of Placements
      • Figure 3.7: Percentage of Children in Care between 2009/10 and 2011/12, by Number of Placements per Episode

    • Legal Status
      • Figure 3.8: Percentage of Children in Care between 2009/10 and 2011/12, by Latest Available Legal Status
      • Figure 3.9 Percentage of Children in Care between 2009/10 and 2011/12, by Age and Latest Available Legal Status

    • Length of Stay (LOS) in Care
      • Figure 3.10: Number of Years in Care by Age at Entry
      • Figure 3.11: Number of Years in Care by Legal Status

    • Abuse
      • Figure 3.12: Percentage of Children in Care between 2009/10 and 2011/12 with Allegations and Substantiations of Abuse
      • Table 3.3: Perpetrator for Abuse Allegations and Substantiations
      • Table 3.4: Type of Abuse for Allegations and Substantiations

    • Indigenous Group
      • Figure 3.13: Percentage of Children in Care between 2009/10 and 2011/12, by Indigenous Group
      • Table 3.5: Percentage of Manitoba Child Population Taken into Care, by Indigenous Group
      • Figure 3.14: Percentage of Children in Care between 2009/10 and 2011/12 Whose First In-Care Episode Occurred Before Age One, by Indigenous Group
      • Figure 3.15: Percentage of Children in Care between 2009/10 and 2011/12 Who Were Apprehended at Birth*, by Indigenous Group
      • Figure 3.16: Percentage of Children in Care between 2009/10 and 2011/12 Who Are Permanent Wards, by Indigenous Group

Characteristics of Children in Care in Manitoba - By In-Care Category

    For a number of measures that we had available for all children in Manitoba, we compared children by the three in-care categories described above. As with the analyses above, the children in care were defined as those in care at any point during fiscal years 2009/10 through 2011/12. Children receiving services were those who were not in care during this time, but whose families received services from CFS any time during the same period. Children in the general population were neither in care nor received services from CFS during the time period. The time period used for the general population was 2012.

    The following lists the measures investigated, including a link to the glossary definition or concept methodology description, a link to the corresponding Report section including the discussion and figures available in this research.

CFSIS - Inclusion of First Nation Children in Care Living On-Reserve

    There are four regulating authorities of Child and Family Services (CFS) in Manitoba (Indian and Northern Affairs Canada [INAC], 2007), including:

    1. First Nations of Southern Manitoba CFS Authority
    2. First Nations of Northern Manitoba CFS Authority
    3. Metis CFS Authority
    4. General CFS Authority

    The Northern and Southern Authorities are federally funded, whereas the latter two are provincially funded. All families, including First Nations families, are free to choose any CFS authority to receive services from. The chosen authority will select an agency within that authority that is best suited to provide services for each case. If the chosen authority does not have an agency for a particular community or area of the province, the services will be provided by an agency from a different authority once a service delivery agreement has been made within these two authorities. Almost all First Nation families (98%) in Manitoba choose to receive services from a First Nation CFS Authority (INAC, 2007).

    The Child and Family Services Information System (CFSIS) is a data management system that supports case tracking and reporting of services provided to children and families as they pass through the CFS system (Brownell et al., 2007). In the past, it was not required that on-reserve children in care (usually federally funded cases) be entered into the CFSIS, therefore use of this data is not wholly representative of all cases of CIC in Manitoba. Beginning April 1, 2010, the Director of CFS requested that all CIC cases (provincial and federal) be entered into and managed by the CFSIS. Therefore, if CFSIS data is used for years prior to 2010, the number of CIC cases in Manitoba will be underestimated due to the absence of many First Nation federal cases in CFSIS. In 2000, the CFSIS captured approximately 100% of non-aboriginal cases in Manitoba but only about 60% of aboriginal cases (Brownell et al., 2007). [Please see Appendix 1: Table A1.1: Counts of children in care by type of agency and data source for more information.] As of March 31st, 2010, only 90% of federal cases from the Northern and Southern Authority were entered into the CFSIS. Caution must be taken when using CFSIS data prior to 2011, because of this deficiency.

    (This information is based on emails from Marni Brownell of MCHP (January 18, 2011), and Richard Asselin (August 5, 2011) and Laurie Jervis of Child and Family Services (January 18, 2011).

Limitations / Cautions

  • Most children in care have the agency that manages their case entered into the database as a text field (email from Laurie Jervis of Child Protection and Support Services - May 22, 2008).

  • As children are often not living at these addresses, using the postal codes of the agencies may be inaccurate for analyses that include geographical or socioeconomic variables. One solution to this problem is to connect retrospectively to the last known address prior to the family services address for each of these children. This can be done using previous years of repository data. Please see the "Child and Family Services (CFS) - Postal Codes and Addresses in Manitoba" concept for more information ( internal access only ).

  • In addition, while postal codes for the head of household for many of the children with blank postal codes through the registry have been found, 70% are still missing.

  • Almost all on-reserve cases are federally funded. A small percentage may be under provincial responsibility if the case was opened off reserve and then moved on-reserve.

  • Depending on the years of CFSIS data used for study (i.e. data prior to 2011), findings may not be representative of all CIC cases in Manitoba because of underreporting of First Nations on-reserve CIC cases in the CFSIS.

  • Although CFSIS data are available from 1992 onward, they are not complete for all years available because not all agencies entered data into the system. The data become more complete after 1998/99; however, previous reports have found that undercounting of children, particularly those living in the North, is still an issue with CFSIS (Brownell et al., 2012). For this reason it is likely that the analyses do not include all children in care in Manitoba and may particularly undercount First Nations children.

Related concepts 

Related terms 

References 

  • Brownell M, Jutte DP. Administrative data linkage as a tool for child maltreatment research. Child Abuse & Neglect 2013;37:120-124. [Abstract] (View)
  • Brownell M, Chartier M, Au W, Schultz J. Evaluation of the Healthy Baby Program. Winnipeg, MB: Manitoba Centre for Health Policy, 2010. [Report] [Summary] (View)
  • Brownell M, Santos R, Kozyrskyj A, Roos N, Au W, Dik N, Chartier M, Girard D, Ekuma O, Sirski M, Tonn N, Schultz J. Next Steps in the Provincial Evaluation of the BabyFirst Program: Measuring Early Impacts on Outcomes Associated with Child Maltreatment. Winnipeg, MB: Manitoba Centre for Health Policy, 2007. [Report] [Summary] (View)
  • Brownell M, Chartier M, Au W, MacWilliam L, Schultz J, Guenette W, Valdivia J. The Educational Outcomes of Children in Care in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy, 2015. [Report] [Summary] [Additional Materials] (View)
  • Brownell M, Nickel N, Turnbull L, Au W, Ekuma O, MacWilliam L, McCulloch S, Valdivia J, Boram Lee J, Wall-Wieler E, Enns J. The Overlap Between the Child Welfare and Youth Criminal Justice Systems: Documenting "Cross-Over Kids" in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy, 2020. [Report] [Summary] [Updates and Errata] [Additional Materials] (View)
  • Indian and Northern Affairs Canada (Departmental Audit and Evaluation Branch). Evaluation of the First Nations Child and Family Services Program. Retrieved July 21, 2011 from: http://www.ainc-inac.gc.ca/ai/arp/aev/pubs/ev/06-07/0607-eng.asp. Ottawa, ON. 2007.(View)

Keywords 

  • Child Abuse
  • disability
  • Foster Home Care


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Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
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