1

Social Policy Analysis: Child Abuse and Neglect in North Carolina

Molly E. Tuttle

The University of North Carolina at Pembroke

SWK 3480-800-F21

Professor F.H. Stephens

December 1, 2021
 2

Historical, Theoretical & Ethical Analysis

Introduction

The focus of this paper is to review the framework and policy requirements for the state

of North Carolina’s child welfare. This includes what specifically North Carolina policy states as

well as protocols and guidance put in place and listed in the NC Child Welfare Manual for CPS

Intake, CPS Assessments, In-Home, & Permanency Planning but may also include some federal-

level information. The concentrated focus for this paper is the requirements for a CPS referral

and the social problem is the neglect and/or abuse of minor children. To understand where, how,

and why child welfare policies were created, one must first examine the history of the identified

social problem that is child abuse and neglect.

Historical Analysis of Policy and Social Problem

At the beginning of the 20th century, the U.S. was beginning to recognize the need for

social reform when it came to caring for the wellbeing of children, including rehoming Civil War

orphans, addressing high child mortality rates, low school attendance, and widespread poverty

(Yarrow, 2009). A federal Children’s Bureau was proposed in 1906, again in 1909, and finally

signed into law in 1912 by President Taft (Yarrow, 2009). At the same time, the Children’s

Bureau was being created, child labor reform was also happening from the 1880s to the 1930s to

combat the millions of children working at too young of an age and in unsafe conditions

(Yarrow, 2009). While there was work in progress by the federal government to address child

welfare, responsibility for the welfare of children ultimately fell upon communities and

organizations such as orphanages as social work was not yet recognized as a profession, and

certainly not like it is today.

 3

North Carolina’s juvenile court system was created in 1919 and while it was created to

combat youth delinquent conduct, it gave jurisdiction over child neglect cases (Mason, 2014). It

wasn’t until the mid-20th century that child abuse and neglect became a medical and social

“phenomenon” as stated in the document, Reporting Child Abuse and Neglect in North Carolina

(Mason, 2014). Around the same time, child abuse and neglect were being recognized on a large

scale, a new medical diagnosis was created called battered child syndrome (Mason, 2014).

Because of the alarming newfound fame surrounding the care of children, lawmakers in the

General Assembly began enacting child abuse reporting statutes and by 1966, all states minus

one had laws that required doctors to report suspected child abuse (Mason, 2014). On a federal

level, the Child Abuse Prevention and Treatment Act was created in 1974 and “requires states

who receive certain federal child welfare funds to have in place child abuse and neglect reporting

laws” (Mason, 2014). The current North Carolina Juvenile Code (located in G.S. 7B-301)

became effective July 1, 1999, and is updated every few years in accordance with current events;

including the 2013 change where the General Assembly requested the state Division of Social

Services in conjunction with the state Department of Health and Human Services, to study the

current policies and procedures for reporting child abuse in the state and recommend areas of

improvement (Mason, 2014).

The social problem that child welfare policies attempted to solve at the time of initiation

was the abuse and neglect of children at the hands of trusted parents, guardians, and/or

caretakers. In an article published in 1984, data showed that after ten years of a federal act

created to combat child abuse, as many as 1.4 million children were still reported as victims of

child abuse and neglect in the year 1982 (Overview). Nearly 35 years later in 2018, the number

had thankfully decreased but remained at over 673,000 children abused or neglected in one year
 4

(Dawson). Child abuse and neglect was a widespread problem and remains to be to this day.

Child abuse and neglect does not discriminate against gender, sex, specific youth age or

development stage, race, ethnicity, or even socioeconomic status. Although abuse and neglect

predominately occur in lower socioeconomic households. In 2017, 51% of children in foster care

were white, 8% were Hispanic, 31% were black, less than 0.5% were Asian/Native

Hawaiian/Other Pacific Islander, 2% were American Indian/Alaska Native, and 7% were two or

more races (Dawson).

Theoretical Basis for the Policy

The underlying value for child welfare policies is to create legal protection for a

population of people who cannot speak for themselves, especially when compromised or

disadvantaged. All children deserve to and have a right to a safe, permanent, and stable home

free from abuse and exploitation and that meets basic human needs which includes food, water,

and shelter.

The psychosocial theory founded by Erik Erikson explains that humans go through eight

stages in their psychosocial development, from infancy to senior adulthood, and each stage

builds on one another and plays a significant role in understanding oneself and developing one’s

personality. Examining the first stage in Erikson’s theory, trust versus mistrust, a baby who is

abused and/or neglected will likely develop mistrust when it comes to caregivers responsible for

caring for them which can also develop fear and anxiety and a mistrust of people in general

which can also affect relationships with others later in life (Mcleod, 2018). The second stage is

autonomy versus shame and doubt which happens during toddlerhood. The third stage is

initiative versus guilt which occurs in the preschool years of a child’s life. The fourth stage is

industry versus inferiority which occurs in ages 5-13. The fifth stage is identity versus role
 5

confusion which occurs in the teenage years. The last three stages beyond identity versus role

confusion affect adulthood and child welfare is no longer a concern for the at-risk child.

Essentially, Erikson stated that if a child is loved, cared for, and supported emotionally and

mentally, along with basic needs being met, then a child can reach their full potential, if not,

mental, and behavioral disorders can develop, and the child will struggle to fit in the world

around them and develop healthy relationships (Mcleod, 2018). Erikson’s psychosocial theory

supports the need for child welfare policies in that by any means necessary and regardless of who

cares for a child, whether it be a biological parent or a foster parent, a child’s emotional

wellbeing is as equally important as their physical wellbeing in order to live a healthy life.

Family Systems Theory, developed by psychoanalyst Murray Bowen in the mid-1950s,

recognized that an individual’s personality, emotions, and behavior could be traced by their

family interactions (Theories). This social theory could support the need for child welfare

policies because of Bowen’s connection of an adult’s personality and emotions to their family

interactions. For a child who grows up in a verbally and physically violent home, they would

likely grow up and display the same or similar behaviors that they experienced as a child. Family

systems therapy has three approaches which include structural, strategic, and intergenerational,

all of which examine family behavior, and recognizes the use of the family genogram (Family,

2018).

The empowerment theory promotes personal power and gives an individual control to

improve their situations. This theory would be a contrast to the need for child welfare policies as

children often do not have the tools, knowledge, or resources to make decisions for themselves

which would lead to personal power and control to improve their situations.

Ethical-Value Analysis
 6

Fortunately, when it comes to the National Association of Social Workers (NASW) Code

of Ethics, there is an entirely separate booklet of standards of social work practice in child

welfare. The NASW Standards for Social Work Practice in Child Welfare is congruent with the

general NASW Code of Ethics because it is essentially an extension of the general edition.

Found on page 12, Standard 1. Ethics and Values states “Social workers in child welfare shall

demonstrate a commitment to the values and ethics of the social work profession and shall use

NASW’s Code of Ethics as a guide to ethical decision making while understanding the unique

aspects of child welfare practice” (National, 2013). This policy promotes social justice because it

is specifically stated as such in the interpretation and is also respectful of diversity because the

NASW and social workers working in child welfare recognize that the welfare of all children is

not limited to race, ethnicity, gender, sex, or socioeconomic background.

Target Population & Implementation Issues

Target Population

The target population that this paper focuses on are children, specifically children who

are being abused and/or neglected. Each North Carolina County is expected to have its own

policies and protocols regarding child abuse reports once a report is received (Child, 2019). CPS

(Child Protective Services) screens the report to determine if the information reported is enough

to open a case. The NCDHHS NC Child Welfare Manual is very extensive in covering the

purpose, philosophy, legal basis, CPS intake, assessments, in-home services, permanency

planning, adoptions, interstate compact on the placement of children, foster home licensing

manual, child fatality prevention, and review, and cross-function (Child, 2019).

Situations that require the attention of CPS due to reports of child abuse or neglect

include intentional injury inflicted upon a juvenile, create or allow the substantial risk of physical
 7

injury to a juvenile, commits, permits, or encourages rape or sexual offenses of a juvenile, incest,

child pornography, human trafficking, creates or allows serious emotional damage to a juvenile,

encourages, directs, or approves of delinquent acts committed by a juvenile, lack of care,

supervision, food, and stable housing (Child, 2019). These are just some of the many eligibility

factors that open a door for the contact between a juvenile and CPS.

The lengthy policies set in place by NCDHHS provide great, uniform guidance for social

workers, but no number of policies or laws can be 100% effective in fully preventing child

abuse, neglect, or even death. Child Welfare statistics presented by UNC at Chapel Hill stated for

the 2019-2020 fiscal year, there were 117,265 investigated reports of abuse and neglect in North

Carolina (Number, 2020). Some could argue current policies are not doing enough because of the

statistical numbers listed above (too many). Others could argue that the policies currently set in

place are working fine also because of the statistical number listed above (not enough). Is the

child welfare system in need of an overall? The answer is likely yes for most. The system could

use additional resources for more staff and more funding to pay and train staff. The system could

also reconsider its criteria for children to be considered safe. Shelter, food, and lack of physical

abuse may not be enough for children. What about children whose parents abuse drugs with

children in the home leaving the adults incapable of adequately caring for the child(ren)? What

about parents who “put on a front” long enough for a home investigation but quickly revert to

their old ways after a worker has left the home? While many children are believed in their

accusations, not all are, and this can create dangerous and dire situations for children in need.

Implementation

In a news article published in 2016 about the NC Child Welfare System failing children

and families, the opening scenario presented was that of a 2013 investigation in Union County
 8

where an 11-year-old boy was handcuffed to the front porch of the home in which he resided,

with dead chicken hung around his neck. More surprising and sad than that, the child’s foster

mother was a supervisor at Union County DSS, the very organization that was responsible for his

protection (Hoban, 2016). When news headlines break regarding situations of severe child abuse

or even death, many social workers get blamed for not doing their job correctly when ultimately

the responsibility falls on the state and policymakers in areas such as meeting standards,

adequate training, appropriate funding for training, high caseloads, and high staff turnover

(Hoban, 2016). Since the 2016 article, research has gone into Child Protective Services via an

NC legislative study. The proposed legislation would include worker retraining every five years,

require counties to only use state guidelines to screen cases (22 counties use extra measures), and

mandate a rapid response telephone hotline for social workers navigating families’ crises

(Martin, 2020).

Policy Strengths and Limitations

Policy Strengths

Given that child welfare is not limited to just one policy but is instead guided by an entire

manual published by the state department of health and human services, the primary strength of

the manual is that it provides the same guidance to all 100 counties in North Carolina. The

manual is in-depth in providing guidance for CPS intake, adoptions, foster home licensing, child

fatality prevention, and even provides an appendix for best practices for social worker well-

being. While the manual itself may not directly empower the children it is meant to protect, it

works to provide guidance for social workers to be empowered to in turn empower the children

they are working with and their families. Within different categories such as foster home

licensing, there are values and a mission statement that clearly outlines expectations.
 9

Has policy, in this case, the child welfare manual, responded effectively to the social

problem that it is designed to address? The answer could be yes and no. In short, the manual

works every day the way that it is intended when comes to promoting and protecting child

welfare, however, the effects of the COVID-19 pandemic and the near yearlong shut down of

2020 of not only North Carolina but the United States and the rest of the world is still unknown.

Many cases of child abuse and neglect are reported through the school system because they are

observed visually by a teacher or other professional adult or the student themselves makes a

report. When schools were forced to close due to the pandemic and children were stuck at home

in abusive or neglectful situations, many had no way of safely reporting what was happening.

Another serious factor was children being at home with parents who would typically be at work

but were no longer due to job layoffs because of the global pandemic. Loss of income combined

with high levels of stress about paying rent and buying groceries as well as parents being with

their children all day every day week after week was also a new challenge that in many instances

went unnoticed. There was no policy or manual for how to navigate child abuse and neglect in a

global pandemic. Many visitations by social workers were also limited for fear of contracting or

spreading COVID.

Are there benefits to the general public concerning the child welfare manual? The answer

is yes because, for the state of North Carolina, the child welfare manual is available online free

of charge and allows anyone willing and able to read to access the manual entirely. This can help

citizens hold agencies and social workers accountable if they suspect rules or policies are not

being met or followed or to better understand perhaps why a case is not opened when there is

suspected abuse or neglect. The manual is even helpful in situations such as college students,
 10

specifically social work students, by being available for students to read to try to help determine

if child welfare is an area of work, they would be interested in working with.

Policy Limitations

Considering that absolutely nothing in the world is perfect or failproof, the child welfare

manual does have limitations – it doesn’t have solutions for every possible scenario. The current

manual was updated in July 2019 meaning it has nothing pertaining to the COVID-19 pandemic.

Things change every day. Laws change, norms change, society changes, and with that there is a

need for updating, however, updating frequently such as once a year can be costly and time-

consuming. From the NCDHHS website, information can be updated or sent out through change

notices and administrative letters before being permanently added or removed from the manual

itself.

While child welfare policies may not have intended consequences, they most certainly

can. Unintended consequences occur when two different policies collide. The current focus of

the foster care system is biological family reunification and because this is the primary goal,

sometimes children are released back to their biological families too soon or when they shouldn’t

be at all, and children sometimes end up dead because of those actions. To avoid situations like

this, some policies should be rewritten such as capping the limit of reports per child/family so a

child cannot return to an abusive home and risk death just for their family to be reunified. Major

increased funding is also needed so reports can be worked through more thoroughly and provide

adequate resources for foster families to help increase the amount available so removing children

from their home isn’t so daunting with the concern of where the child will be placed. A child can

remain in their home so long as the child is not being abused, there is a roof over their head, and

food available, however, the long-term effects of mental or emotional abuse combined with
 11

trauma stemming from parents who abuse drugs and frequently overdose is damaging to children

and should be a more considerable factor when determining child safety. Again, these are simply

signs that reform is needed.

Implications for Rural Communities and Recommendations

The North Carolina child welfare manual is written and intended for equitable use in all

one hundred counties across the state from city to suburb to hills and hollers to beaches and

streets. A considerable concern however regarding the use of the manual in the social work

practice of child welfare are welfare checks, specifically in rural areas where “outsiders” are not

welcome (met with guns), there is little to no cell service, and police are not quickly accessible.

Although the manual should be accessible for all, it may be more difficult to utilize in rural areas

due to the time required for travel and the distance required to travel. For example, if a parent

was required to take parenting classes in the city but the city was a 30-minute drive, it’s not very

accessible.

When applying the child welfare manual to rural areas, it is especially important to be

aware of the community – education, culture, perceived thoughts – and to be respectful and

present oneself in a way that is approachable and understanding. It is also important to keep an

open mind when working in rural settings because individuals who live in rural communities

may do things differently than they would if they lived in the city, for instance running around

barefoot or kids doing chores on the farm.

Recommendations

The biggest recommendation I have for the child welfare manual was mentioned

previously in policy limitations. Drug use and emotional/mental abuse should be heavily

considered when doing home evaluations or welfare checks. I do not believe that a child can be
 12

properly cared for if a parent(s) is constantly getting high or even overdosing and children should

not be subjected to that type of home environment, especially if politicians are adamant about

cracking down on opioids and reducing the number of drug overdose deaths. The second

recommendation I have for child welfare is increased funding to hire more social workers and

train them better to avoid situations such as the Gabriel Fernandez case in California. A child

who died at the hands of his parents as a result of failed investigations by CPS and failure to

remove and keep him permanently removed from his parent’s care, instead, trying to maintain

the biological family. I support the continuation of the child welfare manual created by the state

of North Carolina and the department of health and human services as it has provided guidance

and instruction for so many years and has done so effectively. With the continued support of the

NCDHHS child welfare manual, I support yearly updates provided by social workers from across

the state who can meet together to discuss issues and work towards resolutions that can benefit

the state as a whole and the child welfare and protection system.

Conclusion

To conclude, given the research information provided, North Carolina has done a great

job at providing guidance and resources for trained professionals to work together for the

protection and safety of children at risk of abuse and neglect in North Carolina for at least one

hundred years. The general assembly seeks to regularly maintain the state’s in-depth manual

every few years but like with all modern civilizations, can stand to do more work, make more

improvements, and certainly allocate better funding to continue moving forward and avoid

stagnation or regression and to help retain awesome social workers who work so diligently to

protect children who cannot speak for or fight for themselves.

 13

References

Child Welfare Manual. (2019, July). Policies and Manuals.

https://policies.ncdhhs.gov/divisional/social-services/child-welfare/policy-manuals/

modified-manual-1

Dawson, B. (n.d.). The State of America’s Children 2020 - Child Welfare. Children’s Defense

Fund. https://www.childrensdefense.org/policy/resources/soac-2020-child-welfare/

Family Systems Therapy. (2018, January 30). Goodtherapy.org.

https://www.goodtherapy.org/learn-about-therapy/types/family-systems-therapy

Mason, J. (2014). Reporting Child Abuse and Neglect in North Carolina Third Edition 2013.

https://www.sog.unc.edu/sites/www.sog.unc.edu/files/full_text_books/Mason_

%20Reporting-Child-Abuse_complete.pdf

Mcleod, S. (2018). Erik Erikson’s stages of psychosocial development. Simply Psychology.

https://www.simplypsychology.org/Erik-Erikson.html

National Association of Social Workers. (2013). NASW standards for social work practice in

child welfare. National Association of Social Workers.

Number of Children with Investigated Reports of Abuse and Neglect. (n.d.). Sasweb.unc.edu.

Retrieved November 2, 2021, from http://sasweb.unc.edu/cgi-bin/broker?

_service=default&_program=cwweb.graReport.sas&county=North

%20Carolina&label=&fn=ALLCHILD&format=html&entry=11

Overview - The National Center on Child Abuse and Neglect (From Perspectives on Child

Maltreatment in the Mid ’80s, P 28-30, 1984 - See NCJ-105544) | Office of Justice

Programs. (n.d.). Www.ojp.gov. Retrieved October 5, 2021, from

 14

https://www.ojp.gov/ncjrs/virtual-library/abstracts/overview-national-center-child-abuse-

and-neglect-perspectives-child

Theories & Practice Models Used in Social Work. (n.d.). Social Work License Map.

https://socialworklicensemap.com/social-work-resources/theories-and-practice-models/

#family-systems

‌Yarrow, A. (2009). History of U.S. Children’s Policy, 1900-Present. https://firstfocus.org/wp-

content/uploads/2014/06/Childrens-Policy-History.pdf