Jay Matthew A, Troncoso Patricio, Bilson Andy, Thomson Dave, Dorsett Richard, Pearson Rachel, De Stavola Bianca, Gilbert Ruth
UCL GOS Institute of Child Health, Population, Policy & Practice Research & Teaching Department, 30 Guilford Street, London WC1N 1EH.
University of Edinburgh, Moray House School of Education and Sport, Holyrood Road, Edinburgh EH8 8AQ.
Int J Popul Data Sci. 2025 Jan 30;10(1):2454. doi: 10.23889/ijpds.v10i1.2454. eCollection 2025.
Each year, children's social care (CSC) recognises around 3% of all children as children in need (CiN) of intervention, including those who receive a child protection plan due to risks of substantial harm and those who become looked after in state care. A previous cumulative estimate of the incidence of becoming CiN of 14% to age 5 indicates that the childhood lifetime incidence is likely very high.
We aimed to estimate the cumulative incidence of referrals, social work assessments, being recognised as a CiN or made subject to a child protection plan (CPP) before age 18 in England.
The annual CiN census contains all-of-England longitudinal records of CSC referrals. Data collection began in 2008, meaning there is no cohort that can be followed up from birth to age 17 (i.e., before 18 birthday). Analyses revealed data quality issues before 2011/12. We estimated the above cumulative incidences in three cohorts and combined them, adjusting numerators to account for left-censoring. The three cohorts were children born in: (a) 2012/13, followed to age 5; (b) 2005/06, followed from age 6 age to 12; and (c) 2000/01, followed from age 13 to 17. We carried out sensitivity analyses to address possible bias induced by linkage error using one of two encrypted identifiers in the dataset.
Of all children living in England, before turning 18, 35.4% were referred, 32.3% were assessed, 25.3% were recorded as CiN and 6.9% were subject to a CPP (37.5%, 34.6%, 26.0% and 7.1%, respectively, in sensitivity analyses).
By age 18, an estimated 1 in 4 children are identified by CSC as needing support at some point. Government should monitor the cumulative incidence of ever receiving CSC support with a view to addressing upstream health and social determinants.
每年，儿童社会关怀部门（CSC）将约3%的儿童认定为需要干预的儿童（CiN），其中包括因面临重大伤害风险而接受儿童保护计划的儿童以及进入国家照料体系的儿童。先前一项对5岁前成为需要干预儿童的累计发生率的估计为14%，这表明儿童期的终生发生率可能非常高。
我们旨在估计在英格兰18岁之前被转介、接受社会工作评估、被认定为需要干预儿童或被纳入儿童保护计划（CPP）的累计发生率。
年度需要干预儿童普查包含全英格兰儿童社会关怀部门转介的纵向记录。数据收集始于2008年，这意味着没有一个队列能够从出生追踪到17岁（即18岁生日之前）。分析揭示了2011/12年之前的数据质量问题。我们在三个队列中估计了上述累计发生率并将其合并，对分子进行调整以考虑左删失情况。这三个队列分别是：（a）2012/13年出生的儿童，追踪至5岁；（b）2005/06年出生的儿童，从6岁追踪至12岁；（c）2000/01年出生的儿童，从13岁追踪至17岁。我们使用数据集中的两个加密标识符之一进行敏感性分析，以解决因关联错误导致的可能偏差。
在所有居住在英格兰的儿童中，18岁之前，35.4%的儿童被转介，32.3%的儿童接受了评估，25.3%的儿童被记录为需要干预儿童，6.9%的儿童被纳入儿童保护计划（在敏感性分析中分别为37.5%、34.6%、26.0%和7.1%）。
到18岁时，估计每4名儿童中就有1名在某个时候被儿童社会关怀部门认定为需要支持。政府应监测曾经接受儿童社会关怀支持的累计发生率，以便解决上游的健康和社会决定因素。
