Intergenerational Child Protection Contact and Child Development Outcomes: A Whole Population Linked Data Study

OBJECTIVES: To investigate maternal child protection histories, and offspring child protection contacts and developmental outcomes, for children at age 5 years. STUDY DESIGN: Observational cohort study using linked South Australian administrative birth, perinatal, child protection and child development data. PARTICIPANTS, SETTING: Children with a South Australian birth registration and a record in the 2009, 2012, 2015 or 2018 Australian Early Development Census (AEDC). MAIN OUTCOME MEASURES: Highest level of child protection system contact for children before starting school, and developmental vulnerability on one or more AEDC domains. RESULTS: Of 69,332 children, 7522 (10.8%) had a mother with a history of any child protection contact, and 1019 (1.5%) had a mother with at least one out-of-home care placement. Maternal child protection history was associated with increasing levels of socio-economic and health disadvantage around the time of birth. For example, overall there were 8245/69,332 (11.9%) children born into a home where the parent(s) were unemployed, compared with 549/1019 (53.9%) with a maternal out-of-home care history. For children whose mothers had child protection contact, 3793/7522 (50.4%) had their own child protection contact by age 5 years, compared with 7033/61,810 (11.4%) for children whose mothers had no contact. Of 6771 children whose mothers had child protection contact, 2724 (40.2% [95% confidence interval], 39.1%-41.4%) were developmentally vulnerable on one or more AEDC domains when they started school, compared with 12,002/58,165 (20.6% [95% confidence interval], 20.3%-21.0%) children with no maternal child protection history. CONCLUSION: Child protection contact is common in both mothers and children, and maternal child protection history carries an increased burden of poor development outcomes at school entry. The scale and intersection of child protection system contact, early life disadvantage and poor development outcomes have implications for appropriately resourcing health-led supportive responses as early as possible during the perinatal and early childhood periods.