Short Term Impact of the Alternative Response Approach in Child Welfare Cases
by
Terrence Lee Swadener Jr.
Submitted in Partial Fulfillment of the Requirements
for the Degree of
Master of Science
in the
Criminal Justice
Program
YOUNGSTOWN STATE UNIVERSITY
December, 2013
Short Term Impact of the Alternative Response Approach in Child Welfare Cases.
Terrence Lee Swadener Jr.
I hereby release this thesis to the public.  I understand that this thesis will be made 
available from the OhioLINK ETD Center and the Maag Library Circulation Desk for 
public access.  I also authorize the University or other individuals to make copies of this 
thesis as needed for scholarly research.
Signature:
Terrence Lee Swadener Jr., Student Date
Approvals:
Robert E. Wardle III, Thesis Advisor Date
Dr. John Hazy, Committee Member Date
Dr. Christopher Bellas, Committee Member Date
Dr. Salvatore A. Sanders, Associate Dean of Graduate Studies Date
iii
Abstract
This thesis employs content analysis in order to evaluate the potential 
effectiveness of the alternative response (AR) approach utilized within the child welfare 
system. The United States child welfare system is composed of agencies that investigate 
reports of potential child maltreatment, provides services for families in need, and 
arranges for the best possible placement of children in order to ensure their safety. The 
data used in the evaluation were obtained using information from Mahoning County 
Children Services through the Ohio Statewide Automated Child Welfare Information 
Services (SACWIS) database. Referral information associated with 247 different families 
was collected for analysis. In each case, the family had a minimum of one screened-in 
referral where the alternative response approach was utilized sometime between January 
2011 and December 2011. The family’s history of contact with the Mahoning County 
Children Service agency was recorded, including referrals that were screened in or 
screened out prior to implementation of the alternative response approach, as well as 
those that were screened in or screened out after the AR implementation. It was
hypothesized that the number of referrals screened in after administration of an AR 
approach would be lower than the number of referrals screened in prior to use of the AR 
approach. The findings indicate that the amount of screened-out and screened-in referrals 
prior to the case where alternative response was utilized were more than double the 
amount of referrals screened in and out after the AR approach was employed. This study 
provides a foundation for further research into the applicability of diversified child 
welfare case management techniques and the results suggest that the alternative response 
iv
approach may offer multiple advantages to both clients and agencies when compared to 
other widely used approaches in the child protective services discipline.
v
Acknowledgments
I would like to thank my parents Teresa Kinney, Terrence Swadener Sr., and 
James Kinney. Without their love and support I would have never made it as far as I 
have. 
A special thank you to my girlfriend, Danamarie Donatelli, you are the love of my 
life and the reason I keep pushing. Without you I don’t think I would ever have finished 
the pursuit of my Master’s degree.
I would like to also say thank you to my thesis committee members, Professor 
Robert Wardle, Dr. John Hazy, and Dr. Christopher Bellas. Your guidance and 
encouragement helped me realize I can succeed and complete my thesis.
Thanks also to my brother, Kevin Swadener, Mr. and Mrs. Donatelli, my 
grandparents, and all my other family members and friends. You all make my life worth 
living.
vi
Table of Contents
Abstract…………………………………………………………………………….iii
Acknowledgments…………………………………………………………………v
Table of Contents…………………………………………………………………..vi
List of Graphs and Tables……………………………………………………….viii
Chapter
1. Introduction……………………………………………………………..1
Pathway Assignment……………………………………………………..4
Traditional Response……………………………………………………..6
Alternative Response…………………………………………………….10
Group Supervision……………………………………………………….15
Differential Response System…………………………………………...16
2. Literature Review……………………………………………………….18
Labeling Theory and Alternative Response……………………………...23
3. Methods…………………………………………………………………..25
Design………………………………………………………………….....25
Sample Size……………………………………………………………....27
Analysis…………………………………………………………………..29
4. Results……….…………………………………………………………...31
5. Conclusions...……………………………………………………………34
Limitations……………………………………………………………….36
Future Research…………………………………………………………..37
Future Policy……………………………………………………………..39
vii
References……..……………………………………………………………..40
Appendix 1: NIH Certificate……...………..……………………………….43
Appendix 2: IRB Approval Letter……………………………………….....44
viii
List of Graphs and Tables
Graph 1: Screened Out Referrals……………………………………….31
Graph 2: Screened In Referrals…………………………………………32
Table 1………………………………………………………….…………33
1
Chapter 1 
Introduction
As far back in history as ancient Egypt, there have been people concerned about 
and laws pertaining to children’s rights. However, throughout the world there were no 
organizations specifically authorized to focus on the abuse or neglect of children until a 
shift in established belief was engendered through the highly publicized case of Mary 
Ellen Wilson in New York City. In 1874 Henry Bergh, the leader of the American 
Society for the Prevention of Cruelty to Animals (ASPCA), was approached by a church 
worker named Etta Angell Wheeler who informed him of a potentially imperiled child 
named Mary Ellen Wilson. According to Wheeler, Wilson was being beaten daily by her 
foster mother, Mary Connolly. After seeing the child dirty, thin, and covered in scars and 
bruises, Wheeler felt she had no one else she could depend on for assistance but Bergh. In 
response to the allegations, Bergh sent his attorney, Elbridge T. Gerry to the home of 
Mary Ellen and her foster mother, Connolly. Gerry posed as a census taker in order to 
observe the conditions in the home and the treatment of the child. Gerry confirmed the 
abuse and mistreatment of Mary Ellen to Bergh, who used his position in the community 
to have a petition prepared to remove the child from the abusive household. Through the 
petition, neighbors’ testimonies, and the influence of the ASPCA in society, Mary Ellen 
was removed and the foster mother was put on trial for multiple counts of assault and 
battery (Watkins, 1990). 
Mary Ellen was permitted to testify to the abuse administered by Mary Connolly, 
which included instances of mistreatment involving whips and scissors. Mary Ellen also 
2
testified that she was never kissed nor hugged during her time in the foster home. The 
lack of affection shown to Mary Ellen shocked the community and the ASPCA was able 
to secure custody of Mary Ellen. Mary Connolly was found guilty of felonious assault 
and the extensive media coverage the trial received helped to raise public awareness of 
child mistreatment and resulted in advocacy for the enforcement of laws to protect and 
rescue abused and neglected children. This movement eventually led to the creation and 
structure of the Society for the Prevention of Cruelty to Children (SPCC), the first 
organized child protective service agency (Watkins, 1990). 
In present day, as in the time of the McCormack case, referrals from the 
community serve as fuel for children service agencies. Referrals are the connection 
between agencies and the community. Referrals can be defined as any reports of 
instances of abuse or neglect of children (Tumlin & Green, 2000). A referral can come 
from any person and in any form. Referrals are received by phone, email, letter, and in 
person. Certain professionals are mandated by law to report suspicions of child abuse or 
neglect. Examples of professionals who are considered mandated reporters include 
doctors, teachers, social workers, counselors and others.
According to the U.S. Department of Health and Human Services (2008) “more 
than 3 million referrals alleging child maltreatment are made to public child protective 
service agencies across the U.S. each year” with respect to these 3 million referrals, 
“approximately 62% are screened in” (p.2). The term “screened-in” is used in the child 
protective service discipline to indicate that a referral meets the minimum criteria set by 
the state’s statute for child abuse, neglect, or dependency. If a referral does not meet the 
3
minimum criteria to be screened in, then it is considered screened out and does not 
become a case. However, screened-out referrals are still documented by the agency. 
According to state policies, a child protective services agency must respond in some way 
to all screened-in referrals. Child protective agencies assess each referral to determine if 
the referral merits investigation and in what manner is most appropriate to respond. 
“Child welfare agencies receive many referrals that clearly do not constitute abuse or 
neglect or that provide so little information that the agency has no way to locate 
the perpetrator and conduct an investigation” (Tumlin & Geen, 2000, p.1). The screening 
process serves as a gate-keeping function allowing agencies to decide which families 
need support services and which require a more formal investigation. 
In striving for best practice, child protective services agencies throughout the 
world have utilized a range of approaches, policies and protocols with varying degrees of 
success. In each instance, the presumed objective is to fulfill the unique needs of each 
individual child and family. One of the most common practices implemented is the 
differential response system which includes traditional and alternative response 
approaches.
4
Pathway Assignment
When a referral is brought to the attention of a child protective services agency, it 
is directed to the supervisors, who decide if the referral meets the minimum 
qualifications, set by the state, to constitute a legitimate case. If the referral meets the 
minimum qualifications it is then screened in as a case. Once a referral is screened in and 
becomes a report, the intake/abuse supervisor determines the pathway on which the 
caseworker will proceed. The designated pathway generally consists of either traditional 
response or alternative response. “Pathway assignment depends on an array of factors, 
such as the presence of imminent danger, level of risk, number of previous reports, 
source of the report, and/or presenting case characteristics, such as the type of alleged 
maltreatment and the age of the alleged victim” (NQIC, 2011, p.2).
There are certain cases which the law requires be assigned a traditional approach 
and not alternative response. These cases consist of referrals which contain suspicions 
that may lead to criminal charges of child endangering or charges of sexual misconduct. 
Any concerns which are sexual in nature or which can lead to charges of homicide cannot 
be handled using an alternative response approach. Likewise, no third party 
investigations can be screened in for designation as alternative response cases. The 
phrase “third party investigations” denote referrals in which the perpetrator is employed 
by the child services agency, as in the case of a foster home or a group home.
In Ohio, many counties are currently implementing the AR pathway for a variety 
of circumstances. All agencies in Ohio are utilizing the alternative response approach in 
cases of medical neglect, dirty homes, and abuse, especially without injuries, as in cases 
5
of emotional abuse and/or physical abuse which did not result in current visible injuries 
(OAC, 2009). Alternative response screenings are used only for low to moderate risk 
cases, but original pathway designation can change based on risk assessment throughout 
the existence of a case. Risks toward a child are not static, they can increase and/or 
decrease depending on the familial situation and differing aspects of the family’s life. 
Troublesome events in a household such as marital separations, injuries, loss of 
employment and a variety of others can cause an increase in the stress level experienced 
in a home which in turn results in an increase of risk to the child. 
When a referral (or concern) is reported to a children service agency it is 
examined by either the abuse or intake supervisor who then decides if it meets the criteria 
for designation as a screened-in case. The supervisors use their judgment as well as the 
statewide criteria for screening referrals. If the referral meets the minimum criteria, as 
defined by statue, it is then designated an official case and is assigned to a caseworker. 
All screened-in cases must also be assigned a pathway by the supervisors. For each case, 
either traditional approach or alternative response approach is selected. Referrals which 
do not meet the minimum criteria to be designated as an official case are documented as 
screened-out referrals. Screened-out referrals are not assigned a pathway and are not 
assigned to a caseworker. 
6
Traditional Response
Once a referral is screened in, the historical response of children services agencies 
has been the launch of an investigation in an attempt to determine the veracity of the 
allegations and the identities of potential perpetrators and/or victims. Generally, a 
traditional response involves an approach similar to that used by law enforcement 
agencies in criminal investigations and includes processes for determining if a child is at 
risk for maltreatment or if maltreatment has occurred. The investigative nature of the 
traditional approach focuses on the allegations of abuse and/or neglect of children. Using 
the traditional method of response, allegations include identifying individuals as 
perpetrators and/or victims. In a case utilizing traditional response, a worker investigates 
the household in question and searches for indications which could verify the allegations. 
In many instances the caseworkers utilizing the traditional approach are less concerned 
with the familial circumstances which may have led to the allegations and are more 
focused on determining the veracity of the allegations and recognizing the resulting 
ramifications. A traditional approach often involves an investigation which may include 
the examination of medical reports and school reports, the interview of victims, suspects, 
and witnesses, requests for the performance of physical examinations, photography, and 
in some cases, involving law enforcement personnel or legal agencies. This approach is 
primarily a process for determining if a safety risk to the child or children is active or had 
once been active. The investigative nature of the traditional response has led, in some 
cases, to the development of what is sometimes viewed as aggressive and/or intrusive 
7
behavioral attitudes on the part of child protective services caseworkers. The 
development of these characteristics, and the negative responses to them, has led agencies 
to embrace a more diverse inventory of response options. When an agency only has the 
option of using a single approach, the families being serviced by that agency begin to 
relinquish their specific identities and case responses are not tailored toward a family’s 
individual needs. Consequently, each case becomes generalized in the manner in which it 
is investigated and the same procedure is used for every family and case regardless of 
individual familial needs or specialized circumstances that may exist. After many years 
of exclusively using the traditional approach, caseworkers may begin to develop an 
abrasive attitude and an “us vs. them” mentality in the evaluation and treatment of cases. 
Caseworkers and social workers should realize that an adversarial focus is not always 
helpful and may even generate counterproductive results (Merkel-Holguin, 2005). In 
addition, and perhaps more importantly, this temperament stands contrary to one of the 
core tenets of the social work discipline. “The mission of the social work profession is 
rooted in a set of core values. These core values, embraced by social workers throughout 
the profession’s history, are the foundation of social work’s unique purpose and 
perspective which are: service, social justice, dignity and worth of the person, importance 
of human relationships, integrity, and competence” (NASW Code of Ethics, 2008). An 
adversarial focus breeds adversarial responses. In many cases there are familial 
complications that underlie maltreatment reports. Caseworkers, and the families being 
served by them, need an approach intended to engage parents more efficiently and assist 
the familial unit in succeeding through a strengthening of the core structure. 
8
Traditional response concludes with a final disposition regarding the alleged 
incident. There are three possible final dispositions available in the traditional response 
approach. The first is termed “unsubstantiated”, which indicates that the allegations have 
been determined to be false and the claim is unfounded. This is the final disposition for a 
majority of cases which come into children service agencies. The second possible 
disposition is termed “indicated”, which suggests that the caseworker cannot prove that 
the allegations are false, but also cannot absolutely confirm them. Lastly, a 
“substantiated” disposition signals that the allegations have been determined to be 
truthful and have been confirmed by the caseworker. The traditional response approach is 
effective in certain situations, but may not be as effective in many others. An example of 
a situation where the traditional method may not provide optimal results is in a situation 
where a family is struggling financially. In this instance there are no perpetrators or 
victims, just a family in need of assistance. Conversely, in cases of sexual abuse or severe 
physical abuse, an investigative approach is more appropriate and may even be mandated, 
due to the possibility that law enforcement agencies will eventually become involved. 
Often though, this investigatory approach may be unwarranted or unnecessary, 
particularly in instances that involve activities that are generally believed to be minor 
allegations.
“The shift from an adversarial approach in which parents are investigated in a 
quasi-law enforcement method to an approach in which parents are partners in 
maintaining child safety is a significant change for most child protective services 
agencies” (American Humane, 2008, p. 12). The traditional response approach is 
9
“generally used for reports of the most severe types of maltreatment or those that are 
potentially criminal” (USDHHS, 2008, p. 12). When a caseworker uses traditional 
response, he or she is gathering forensic evidence in order to come to a formal decision. 
If a children services agency only uses the traditional approach, in many cases the agency 
will miss the opportunity to work in partnership with parents and empower them to parent 
their children in a manner deemed appropriate by society. Sometimes in using the 
traditional approach the caseworker loses sight of helping the family and instead focuses 
only on detecting abuse or neglect and assigning responsibility for those transgressions. 
The traditional or “investigative” approach is most effectively utilized, and should be 
reserved for use, in order to protect and ensure the safety of children in cases where the 
parents are unwilling or unable to change their own destructive behavioral patterns. 
10
Alternative Response
When families are vulnerable and in need of assistance they are more likely to 
seek aid from an individual or agency they view as an ally than from one they consider an 
accuser. The alternative response approach to child protective services is grounded in the 
belief that members of a family do not necessarily have to be separated from one another 
if only assistance is provided to them when it is needed. The alternative response 
approach is intended to create a partnership between families and caseworkers; it is 
designed to ensure child safety (OAC, 2011). The approach is meant to encourage child 
welfare personnel to work in collaboration with families in assessing the specialized 
needs of each individual and of the family as a whole. The workers can build upon the 
family’s strengths in an attempt to allow children to remain safely placed within their 
own homes. The safety of the child is of paramount importance no matter which 
intervention approach is utilized. The alternative response approach allows caseworkers 
to facilitate a strengthening of the familial unit through the institution of applicable 
services and appropriate interventions. The benefits of strengthening individual family 
units not only fulfill the needs of the families directly, but also indirectly serve to 
empower the entire local community by generating a stable core familial framework. 
Alternative response assignments tend to be utilized in cases when a child is deemed to 
be at a lower risk of harm or when it appears that the family could potentially benefit 
from community-based services. Importantly, agencies are able to alter a response 
designation at any time if circumstances change and it is determined that the risk to the 
11
child has increased. In instances where an alternative response designation is altered, the 
case is generally reassigned to a traditional response approach. 
When child protective agencies use an alternative response approach they are 
assessing the family’s strengths and needs, as well as offering services to prevent the 
maltreatment of children. Alternative response uses the terms “adult subject of report” 
and “child subject of report” rather than the terms perpetrator and victim, this substitution 
of terms is believed to remove the stigma that is commonly attached to those labels 
(ODJFS, 2010, p.1). A primary characteristic of the alternative response approach is the 
shift to focusing on a family’s strengths rather than on their weakness. Alternative 
response is designed to use a family’s strengths in order to minimize the vulnerability of 
their weaknesses. When a caseworker utilizes the alternative response approach with a 
family, the goal is to demonstrate to the family that they possess strengths as a family. 
The eventual goal is the empowerment of the family unit. For instance, caseworkers may 
aid the family in a variety of ways including: locating and obtaining benefits from public 
assistance agencies, facilitation of job training for family members, or assistance in the 
admission of family members into substance abuse programs. Fostering a stable 
environment cultivates family empowerment. The caseworker, in showing the family that 
they have strengths in spite of the problems they face, helps build the self-esteem of the 
family as a whole and assists them in realizing that they can overcome obstacles. Some of 
the issues faced by families in need of support may include anything from financial 
concerns to mental health crises. The primary motivation in using the alternative response 
approach is to work toward eliminating condemnation or degradation of a family that is 
12
simply in need of assistance. In time, this type of denouncement may drive a family to the 
point where all hope of recovery is lost.
“Alternative response emphasizes the assessment of the family’s needs and 
provision of services to prevent future maltreatment, but without the need to determine
whether specific allegations can be substantiated” (O‘Grady & Broman, 2005, p.1). The 
idea of preventing the future maltreatment of children is related to the idea of general 
systems theory (Bernard, Paoline, & Pare, 2005). Proponents of general systems theory 
would argue that the norm of society would be for a family to have no involvement with 
child protective agencies. The general systems theory states that everything can be 
explained through the idea of systems. For example, a family exists as a system and 
should function independently as a system. When there are problems within the family, 
which could potentially bring the family to the attention of children protective agencies, 
the system is disrupted. When a family or “system” is functioning normally it should not 
have little or no involvement with external systems such as children services agencies or 
the criminal justice system. Child protective service agencies have been trying to develop 
ways to strengthen a family to reduce their involvement with children protective services 
and enable the family system to function properly on its own. One way to measure a 
family’s involvement within child service agencies is through the analysis of referrals. 
Society has standards or norms in regards to families. When families represent the norm, 
they fit seamlessly into society and are not brought to the attention of child protective 
service agencies. When families do not fit the norm, others in society may make referrals 
which will bring those families to the attention of child welfare agencies.
13
Once the safety of the children is no longer uncertain, the alternative approach 
allows a caseworker to work with a family in building the family’s strengths rather than 
punishing the family for its own weaknesses. An alternative response approach will 
ensure the children’s safety as well as help the caseworker assist the family in minimizing 
the risk of future trouble. The foundation of the alternative response approach is in family 
engagement and creating a working partnership between families, children protective 
service personnel, and other agencies. The elements of alternative response are engaging 
families, being culturally relevant and flexible, matching services to needs, providing 
training and supervision, and maintaining community partnerships. For instance, a 
caseworker might encourage weekly family meetings where members of the family 
discuss goals and goal-setting, achievements, and challenges with other members of the 
family in order to nurture a sense of familial synergy. 
Alternative response focuses on “family engagement and flexible, supportive 
services dictated by needs expressed by the family” (Mahoney & Murphy, 2010, p.1). 
Alternative response incorporates consideration of factors such as the type and severity of 
the reported abuse and the age of the child. The approach also requires that agencies take 
into account the willingness of parents to participate in available services, such as 
counseling, parenting classes or drug treatment. The alternative response approach places 
an emphasis on assessment of the needs of a family and less of an emphasis on 
determining if maltreatment occurred or assignation of blame. Engaging families can 
result in parents making sustainable changes to keep their children safe. Alternative 
response assures the well-being of a child by addressing family issues as early as 
14
possible. The alternative response approach allows a caseworker to work with a family 
and empower the family instead of simply investigating them.
15
Group Supervision
A fundamental strategy utilized by caseworkers through alternative response is a 
technique called group supervision. Group supervision is a key mechanism through 
which social work practice can be strengthened (Lohrbach, 2008, p.19). Group 
supervision consists of one caseworker presenting his or her case to a group of peers. The 
group may be comprised of other caseworkers, supervisors, and/or representatives from 
other departments to exchange a variety of ideas and resources. Mahoning County 
Children Services, along with other county agencies, is expanding group supervision for 
use in traditional response cases as well. “Utilizing group supervision aids the caseworker 
in assessing the core safety concerns, identifying resources and providing concrete next 
steps for the caseworkers” (Mahoning County Children Services, 2011). Mahoning 
County Children Services group supervision meets weekly, presenting a new case each 
week, as well as updating the group on past cases. “The process includes an opportunity 
for shared experiences, emotional support, solution-building to same or similar 
challenges, prevention of stress, and reduction of the impact of stress by direct 
discussions, and remedies provided for social worker safety” (Lohrbach, 2008, p.19).
16
Differential Response System
The dichotomy between traditional response and alternative response led to the 
creation of the differential response system. In order to effectively meet the needs of 
families in crisis, and of society as a whole, it was believed that there should be more 
than a single approach available to agencies who handle child welfare cases. The 
differential response system allows for diversity of action within the child welfare 
system. It provides two different approaches to child welfare casework and gives 
agencies the benefit of choosing which is more appropriate on a case-by-case basis. 
Differential response is an umbrella term that encompasses two distinct pathways: the 
traditional response and the alternative response. In 2004, the Ohio Supreme Court 
Subcommittee on Responding to Child Abuse, Neglect, and Dependency recommended 
implementation of the differential response system throughout the state of Ohio. The 
essential elements of the differential response approach are 1) the existence of multiple 
responses to screened-in reports, 2) protocols of assigning a case response are determined 
by risk and possible danger, 3) there is no formal disposition due to the non-investigative 
response, 4) caregivers are not labeled perpetrators and children are not labeled victims 
(NQIC, 2011).
Mahoning County Children Services Board (MCCSB) utilizes the differential 
response approach, giving the agency the ability to utilize either the traditional pathway 
or the alternative response pathway. MCCSB views alternative response as an approach 
that can aid families in accessing services and support which may alleviate the conditions 
that originally led to the referral. However, MCCSB still utilizes traditional response for 
many of the more severe incidents of abuse and neglect. In the most serious situations, a 
17
law enforcement agency is usually involved and an investigation can lead to criminal 
charges.                      
18
Chapter 2
Literature Review
Many states, including Kentucky, Illinois, Oklahoma, and Ohio, have 
implemented the use of differential response. In Kentucky, the exercise of differential 
response was implemented in 2001. Low risk reports of child abuse and neglect were 
screened in as Family in Need of Service Assessment (FINSA) cases. FINSA is intended 
to offer a less punitive approach that engages families in helping to determine what 
services are needed. The FINSA approach is what is referred to as a strength-based 
approach. Strength-based approaches are social work practices grounded in theories 
emphasizing the self-determination and strengths of a family or client. A caseworker 
employing a FINSA approach will visit the home in question to conduct an assessment. If 
the caseworker determines through the result of the assessment that the family is in need 
of services which the agency can help to provide, then the case is opened. 
Oklahoma adopted differential response techniques in 1998. The Oklahoma 
model involved low risk cases being assigned to family assessment. The case assignment 
is intended to engage the family in order to address the safety of the children. The 
caseworker conducts the home visits as unit interviews, interviewing the entire family 
rather than select members of the family. The family then voluntarily accepts or rejects 
service recommendations. If a family rejects the recommended services, the child 
protective service (CPS) agency must then determine if the circumstances justify 
petitioning the court to file a judicial order mandating that the family accept the services 
(Zielewski et al. 2006).
19
In Illinois, differential response was first implemented in 2010. Illinois has made 
it a priority to recognize differential response techniques as pathways used to strengthen 
and support families. In utilizing differential response, the caseworker completes an in-
home assessment and service recommendations are offered to the family based on the 
outcomes of that assessment. The Illinois differential response program is staffed by both 
public and private sector community service agencies. The public sector workers 
complete a safety assessment and if the child is determined to be safe, the private sector 
worker takes over the case and provides the recommended services (Fuller et al. 2012).
In 2002, the National Study of Child Protective Services Systems and Reform 
Efforts conducted a survey looking at a sample of 300 county child protective services 
agencies. The survey examined the use of alternative response approaches across the 
United States. Survey results indicated that sixty-four percent of agencies employed the 
alternative response approach in addition to the traditional approach (American Humane, 
2008). The survey results further suggested that agencies engaged investigatory responses 
when more serious types of maltreatments were reported. Alternative response was used 
more often in cases where the problems of the family could be addressed without a 
formal investigation. Cases assigned to an alternative response approach were generally 
lower risk cases where it was thought that the family would benefit from community-
based services. Both approaches involved a review of child protective agency records, 
interviews, and formal observations of the children and family. Reports where alternative
response was used were less likely to include the following aspects; an assessment of a 
family’s safety needs, a determination of child maltreatment, a recommendation of court 
action, or the removal of a child (USDHHS, 2008).
20
The American Humane Association completed an eighteen month pilot study of 
ten counties in Ohio where a differential response system was initially established. In the 
Ohio pilot study, it was discovered that there appeared to be no statistically significant 
difference between cases where traditional response was utilized and cases where 
alternative response was utilized. The replacement of traditional response with alternative 
response also did not appear to reduce the safety of the children. The Ohio Alternative 
Response Project in March 2010 found that “child safety is best achieved through active, 
collaborative, and respectful engagement of parents, family, community and all other 
CPS stakeholders” (ODJFS, 2010, p. 1). Over time, the study indicated that the families 
who were under the alternative response system had a reduction in new reports of abuse 
and neglect when compared with families operating under the traditional response 
system. Also, alternative response appeared to reduce the number of child removals and 
out-of-home placements for these families. Results further suggested that families in the 
alternative response group were more engaged in the process, more satisfied with the 
caseworkers, and participated in more recommended services. It should be noted that the 
comparisons being made in this study were made on completely different families 
assigned to the two approaches, rather than on the same families reacting to the two 
separate approaches. Every family is unique and has its own strengths and weaknesses; 
these were two very distinct populations. Caseworkers in the study expressed stronger 
positive perceptions of alternative response than with traditional response. Alternative 
response was seen by caseworkers as leading to a more family-friendly, non-accusatorial 
approach in which the families were more likely to participate in the decision-making 
process (American Humane, 2011).
21
Mahoning County is classified by the American Humane Association as a Round 
Two Alternative Response County in the state of Ohio meaning it is a part of the second 
phase of a statewide implementation of alternative response. The original 10 counties -
Clark, Fairfield, Franklin, Greene, Guernsey, Licking, Lucas, Ross, Trumbull, and 
Tuscarawas - were referred to as Round one counties in the American Humane 
Association pilot study. In the initial pathway assignment for all 10 counties, 51.7 % of 
referrals were viewed to be appropriate for the utilization of the alternative response 
approach. “Families determined to be appropriate for the AR pathway were then 
randomly assigned either to an experimental group that received an alternative response 
or a control group that received a traditional response” (Loman et al., 2010, p.4). During 
the pathway assignment stage, researchers found some similar characteristics among the 
families receiving an AR designation. The AR families were more likely to be headed by 
a single mother with lower educational experience and most of the family’s service needs 
stemmed from poverty. Results of this study showed that “AR families were more likely 
to report they were very satisfied with treatment by their workers” (Loman et al., 2010, 
p.2). Families assigned to receive an alternative response designation tended to feel that 
their workers tried to understand their situation. According to workers, families in which 
the AR approach was used were also more likely to participate in recommended services 
(Loman et al, 2010). Arguably, the most important finding of the American Humane 
Association study indicated that when a concern of child safety was identified in a case 
there appeared to be no statistically significant difference detected between families 
assigned to either approach in the extent of improvement or decline in child safety. In 
short, there was no experimental evidence to suggest that replacement of traditional 
22
response by alternative response family assessments reduced the safety of the children. 
Based on these findings, the implementation of the alternative response approach by child
protection agencies does not appear to compromise child safety, but does improve 
interactions between families and agencies as well as helping families to improve their 
situations and living conditions through services and agency assistance. Some of the 
services and assistance an agency can provide might include for example, helping to pay 
bills so the family can focus resources on other difficulties, providing the family with 
food, connecting the family with the appropriate counseling or drug treatment programs, 
etc. The results seem to indicate that the overall improvement of the families’ situations 
helped alleviate some of the risk of child abuse or neglect. The family was able to focus 
more on one another and the positive aspects of their familial dynamic rather than being 
frustrated and agitated by the involvement of children service agencies and personnel.
The landscape and usage of the alternative response approach is rapidly evolving 
and spreading within the child protection discipline. Overall, alternative response 
approaches are yielding positive results in many jurisdictions. Perhaps most importantly, 
evaluations of practices have shown no indication that child safety has been 
compromised. A growing number of states and counties are reforming their responses to 
child welfare through alternative response. “States that have evaluated their systems have 
generally found that a less adversarial, more service-oriented front-end response to 
certain families has had positive outcomes without compromising child safety” (Gilmore, 
2010, p.4 ).
23
Labeling Theory and Alternative Response
In the traditional approach cases child welfare agencies have used the labels 
perpetrator and victim when describing the family members. According to Labeling 
Theory, assigning a label or a name to someone will brand that person for life and the 
person will eventually come to fit the label. If society labels someone a criminal, then 
that person will be led to a life of crime without even given a chance (Becker, 1963). A
perpetrator, even if not a perpetrator to begin with, will become a perpetrator and a victim 
will become a victim if the labels are left to stick. When a parent is placed with the 
perpetrator label, they will be looked at and treated as a bad parent. Society will view this 
parent as a bad person and an ill of society. The person will be treated differently and will 
become disenfranchised with the world and will lose any hope of ever overcoming the 
label. This despair will then lead to the parent perpetrating on the child again and again 
whether it is physically, sexually, or emotionally. When a child is labeled a victim, 
society feels sorry for the child. This child becomes a “poor child” and everyone’s view 
of the child is tainted. Labeling someone is condemning them to that way of life. 
Alternative Response does not use labels. The alternative response approach looks at a 
family as a family, as parents and children. Without using the labels, a caseworker using 
the AR approach does not condemn the family members and does not have an assumption 
of a perpetrator or a victim. 
An example of this is a case where a home is deplorable. The home may have 
empty food containers and rotten food scattered throughout the home. There are or have 
been many animals in the home and animal waste is in the living areas of the home 
creating a major health hazard. When a caseworker goes to the home and speaks to the 
24
family, they find that the mother is deeply depressed and untreated. The mother is 
uneducated, has depression and mental illness and does not know why she feels the way 
she does. She is to the point of being unable to clean anything up. A mental illness is no 
one’s fault, there is no perpetrator. The mother suffers from mental illness and needs 
treatment. In a traditional case, the mother would be labeled a perpetrator and neglect 
would be substantiated, meaning she has been branded a neglectful parent. In an 
alternative response case, the mother would not be branded and she would receive the 
proper treatment she needs. The caseworker would work with the family through a 
service plan giving the family steps and goals to achieve to clean the home. There is no 
substantiated decision for the alternative response case because it is not the mother’s fault 
she has a mental illness. 
25
Chapter 3
Methods
Design
This study is designed to determine if utilizing an alternative response approach 
has made a positive impact on select families by indicating a decrease in referrals. The 
decrease in referrals will signify that families have less of a dependency on CPS agencies 
as well as less incidents of maltreatment. Because the alternative response designation 
was used as an intervention on the sample, an experimental design was used to measure 
the decrease in referrals after the alternative response intervention. The same families’ 
referrals were studied before and after the intervention of the alternative response case. 
This study serves as an analysis of the impact alternative response intervention has on 
referrals of a select number of families. There are no independent variables, only 
outcomes were measured. All of the cases were given the alternative response 
intervention in the year 2011. The number of referrals, both screened in and screened out, 
was quantified before the initial use of the alternative response approach and after the 
alternative response approach assignment. Due to the fact that the cases do not change 
before and after the intervention, a two-tailed paired t-test was used through the 
Microsoft Excel program. An alpha value of 5% was used to determine statistical 
significance in the t-test.        
Documentation of approval for use of the data as approved by Mahoning County 
Children Services is found in Appendix 2. Documentation of approval by the Institutional 
Review Board of Youngstown State University is found in Appendix 3. Documentation 
26
of NIH certification for extramural research obtained by this author on August 14, 2012 
is found in Appendix 1.   
27
Sample Size
The data were collected from the Mahoning County Children Services agency, 
using Ohio’s SACWIS (Statewide Automated Child Welfare Information Services) 
computer database. The data were collected by this author on cases designated as 
screened in from January 2011 to December 2011. Each family had at least one case 
assigned to receive intervention using the alternative response approach in 2011. There 
were a total of 247 families who received an alternative response designation. The 
families were all assigned numbers to protect confidentiality. The amount of screened-in 
and screened-out referrals each family had before and after the alternative response case 
was documented. The data collected by this author included all referrals throughout the 
history of a family’s involvement with Mahoning County Children Services up to and 
including February 2013. All of the families in the sample are residents of Mahoning 
County. Referrals are received from a variety of sources including but not limited to, 
neighbors, schools, doctors, family members, and counselors. Once received, the referral 
is entered into SACWIS and forwarded to either the intake supervisor or the abuse 
supervisor. When the concerns in the referral involve either physical or sexual abuse, the 
referral is sent to the abuse supervisor who determines if it meets screen in qualifications 
and decides which pathway to assign. The neglect supervisor makes the decision on 
neglect cases which range from deplorable home conditions to drug exposed babies. The 
supervisor then examines the referral and decides which pathways will be assigned to the 
referral. 
All referrals screened-in and designated for assignment of the alternative response 
approach in the year 2011 were used in the present study. The number of referrals before 
28
and after the alternative response case will provide an indication on the effectiveness of 
the AR approach. The families who had the AR approach should have almost zero cases 
screened-in after the initial AR case was closed. The lack of cases after the initial AR 
case will demonstrate, on a small scale, the effectiveness of using AR in child welfare. 
The hypothesis is that families will have better outcomes throughout a case while using 
the alternative response approach. The core concept behind the better outcomes in the AR 
approach is the strengthening of the family. The concept behind the hypothesis is that if 
the family is strengthened and able to handle many of its own problems then the referrals 
will decrease. The alternative response intervention is intended to strengthen the family. 
This strengthening will enable the family to work through their own problems and allow 
the family members to rely on one another rather than outside agencies. 
29
Analysis
If the alternative response approach works, then the family will have the proper 
services in place and will be strengthen to the point where the amount of referrals will 
decrease. Prior to having an alternative response intervention, the maximum number of 
screened out referrals received by a single family was 15. The maximum number of 
screened out referrals after the alternative response case was 4. A drop of 15 maximum 
screened out referrals to 4 maximum screened out referral is a decrease of 73%. The 
maximum amount of screened in referrals prior to and after the alternative response case 
went from 9 to 8 which is only a decrease of 11%, but a decrease nonetheless. The 
minimum amount of referrals, both screened in and screened out, throughout the entire 
sample set was zero.
Standard deviation is an indication of how far the data points are spread out from 
the mean. The amount of referrals before an alternative response case had a standard 
deviation of 2.0 (screened out) and 1.9 (screened in). The screened-out referrals prior to
the AR case were 2.0 standard deviations away from the mean of 1.2. The amount of 
screened-in referrals prior to an AR case was 1.9 standard deviations from the mean of 
1.4. The standard deviations for the total number of referrals, prior to an alternative 
response intervention, indicate the amount was 3.4 deviations from the mean of 2.6. The 
data for the referrals after the alternative response case show standard deviations of 0.8 
(screened out) and 1.1 (screened in). The screened-out referrals after the AR case were 
within 0.8 standard deviations of the mean of 0.4 and the screened in were within 1.1 
deviations of mean 0.6. The total amount of referrals after the AR case had a standard 
30
deviation of 1.5 of the mean 1.0.  The median numbers of the screened-out and screened-
in referrals, prior to the alternative response case, were 0 and 1 respectively. The median 
for the screened-out and screened-in referrals after the AR case were both 0.
31
Chapter 4
Results
Graph 1: Screened-Out Referrals
Graph 1 indicates that the total number of screened-out referrals for all families 
combined decreased from 298 to 103 following the use of an alternative response 
approach.
32
Graph 2: Screened-In Referrals
In 2011 there were 247 families who had alternative response referrals screened in 
from a total of over 1000 screened-in cases. There were 349 screened-in referrals prior to 
having the assignment of an alternative response case. As displayed in Graph 2, the 
screened-in referrals decreased by 56% from a total of 349 to a total of 152. Screened-out 
cases prior to alternative response designation were 298. Screened-out referrals after an 
alternative response case assignment were 103, a decrease of 65%. Out of the 247 
families there were 647 total cases prior to the use of an AR designation. After the use of 
an AR approach there were only 255 total cases. The total amount of cases had a decrease 
of 61%.
Three different paired t-tests were run to determine if there was statistical 
significance for the impact of the alternative response approach. The first test was run on 
the screened-out cases. The p-value was set at .05 and the result came to a p-value of less 
than.01 indicating there is statistical significance that the screened out cases will decrease 
after an alternative response case is used for a family. The second test looked at screened 
33
in cases. The result was calculated to be a p-value less than .01 indicating statistical 
significance and suggesting the amount of screened-in cases for a family will decrease 
after an AR approach is utilized. The third and final t-test was on the total amount of 
cases before the alternative response case and the total amount of cases after the 
alternative response case. The obtained p-value on this test was less than .01. This 
suggests that the total number of referrals or cases per family can be decreased due to the 
use of an alternative response approach. 
Table 1
The data appear to show that when the families had an alternative response case, 
the screened-in cases decreased. The screened-out referrals also appear to decrease after 
utilizing the AR approach.
Sum Min Max St. Dev. Median Mean
Screened Out Prior 298 1 15 2.0 0 1.2
Screened In Prior 349 1 9 1.9 1 1.4
Total Prior 647 1 21 3.4 1 2.6
Screened Out after 103 1 4 .8 0 .4
Screened In After 152 1 8 1.1 0 .6
Total After 255 1 10 1.5 0 1
34
Chapter 5
Conclusions
This study has shown a positive trend in the usage of the alternative response 
approach in child welfare cases. The decline of screened-in and screened-out referrals, 
after the alternative response approach was used, suggests the alternative response 
approach may have played a role. The total referrals, after the alternative response 
approach was utilized, decreased by 392. There is a statistically significant difference 
detected before and after, indicating the alternative response approach may decrease the 
amount of referrals a family will have with CPS agencies. While this study may not have 
proven that alternative response is the best approach in child welfare, it does indicate a 
positive trend for the utilization of the approach. The alternative response approach is 
designed to be a more client-driven approach. Utilizing the client’s input creates a sense 
of self-worth for the client. Allowing a client to have some say into where they need 
improvement empowers them to try to help their own family rather than relying on CPS 
agencies to fix their problems. Instead of the client feeling as though they are being told 
what to do, they are given the strength to handle their own issues. When told what to do, 
families are made to feel inferior and therefore do not have a full investment into their 
case. After the utilization of alternative response, the families’ issues seem to decrease as 
shown in the decrease of screened-in referrals following an intervention of this approach. 
Each t-test conducted on the data gathered in this study shows a statistical 
significance in the effectiveness of the alternative response approach. The tests indicate 
the decline in referrals (both screened-in and screened-out) before the alternative 
response case to the referrals after the case is a statistically significant one (i.e. not a fluke 
35
or because of chance alone). The three tests performed were screened-in referrals before 
and after the alternative response case, screened-out referrals before and after the 
alternative response case, and the total amount of referrals before and after. The data and 
subsequent tests seem to suggest that using the alternative response approach for child 
welfare cases can stabilize a family resulting in less referrals in the future.
A possible reason for the decline in screened-in referrals after the AR case is that 
the AR approach may work. If the AR approach is indeed the cause then this could mean 
the families have been empowered and strengthened due to the worker’s approach. The 
strengthening of families to appropriately handle their stresses and problems would lead 
to fewer screened-in referrals. It can also mean that the families respond better to an AR 
approach than to a traditional approach.  The number of screened-in referrals prior to AR 
cases in comparison to after the implementation of the AR approach support the 
hypothesis stating the screened-in referrals would decrease after the alternative response 
approach was used. There is enough evidence to influence continued studies on the AR 
approach. This study seems to suggest that continued studies on the effects of the 
alternative response approach may prove beneficial to the expanded use of the approach 
and a positive trend which will help families and communities. 
36
Limitations to the Study
One thing that cannot be measured by a quantitative study is the emotional impact 
of the AR cases. Both the workers and the clients have expressed, in past studies and this 
author’s personal experiences, feelings of importance and being treated with dignity. 
The data were collected from the beginning of the families’ involvement with the 
agency as recorded in the online database. SACWIS began in 2003. Many of the families 
have records with the agency since the early 1990s. The timeframe examining the years 
after usage of the alternative response approach only consists of the years 2011-2013.
The number of referrals quantified prior to application of the AR approach was from a 
nine year period while those quantified afterwards were collected from a three year 
period. The time discrepancy indicates the families have had at least seven years to 
acquire a case with child protective services and only two years since the AR case to 
acquire any more. It is not unfounded to believe the reason the number of screened-in 
referrals have decreased is due to the fact the families have not had as much time to have 
more cases or referrals. Even if the time discrepancy accounts for differences in the 
amounts, the current data is helpful and provides a positive outlook for the future use of 
AR.
37
Future Research
Because alternative response is an approach being implemented throughout the 
country, the research will continue. Future analysis should look into collecting data from 
studies conducted across the state and country in greater detail large in scope. These 
future studies should also examine these families over a longer period of time. This study 
was a short term basic study on the effectiveness of alternative response approach for 
Mahoning County Children Services. Future studies may wish to examine cohorts who 
have had experience with alternative response against those who have not. There are 
factors which need to be taken into account for future studies such as the content of the 
referrals and the supervisor’s discretion. The content of the referrals may include how 
severe the concerns are as well as if the referent has an ulterior motive such as revenge.
The motives of the person who initially created the report should also be noted. The 
referral could have been made by a truly concerned citizen or a mandated reporter 
(someone mandated by law to report any suspicions of abuse or neglect such as a 
teacher). However, the referral could have also been made by someone with a personal 
vendetta against the family, creating a false report. Another factor is the discretion of the 
supervisor. The supervisor makes a decision regarding the validity of the referral and
whether the referral meets the qualifications to screen it in and make it a case. The 
supervisor takes into consideration the family’s history, including any recent cases and 
similarities among cases. The severity of the concerns will also influence the supervisor’s 
decision. The supervisor’s discretion could also be skewed by the content and details of 
the referral.
38
Future studies should attempt to measure the satisfaction and the feelings of case 
workers and families using the AR approach and compare it to the satisfaction and 
feelings of those assigned to utilize a traditional approach. The feelings can be best 
measured by either interviewing the family and workers after the case or having them 
complete surveys. The types of recommended services utilized by families can also be 
examined. Exploring the types of services can institute an increase on the services most 
often used and a decrease on the services which are not utilized which will consequently 
save money and resources for agencies. 
39
Future Policy
If the research results remain positive for the institution of alternative response 
approach within child protective service agencies, then perhaps work can begin on 
establishing an alternative response unit for Mahoning County Children Services. There 
are other counties in Ohio who have separate units dedicated to cases that have been 
assigned to an AR approach. These counties, and their child protective service agencies, 
need to be examined in order to determine if it is feasible to restructure an agency to 
include an AR unit. In theory, an AR unit will allow caseworkers to focus on a more 
selective caseload and invest more time into their individual cases, which in many cases 
is exactly what families need. An AR unit would have no cases which have been assigned 
to the traditional case model and the traditional units would likewise have no AR cases. 
In limiting the types of cases assigned to caseworkers, it is believed that the decrease in 
caseloads would free time for caseworkers to perform their jobs most effectively.  
40
References
American Humane Association (2008). Another Look at the National Study on 
Differential Response in Child Welfare. Protecting Children vol 23, numbers 
1&2, page 5-21.
Becker, Howard S. (1963). Outsiders: Studies in the Sociology of Deviance. New York,  
Free Press.
Bernard, T.J., Paoline, E.A., & Pare, P.P. (2005). General Systems Theory and Criminal 
Justice. Journal of Criminal Justice, vol. 33, p. 203-211.
Fuller, T., Kearney, K., & Lyons, S. (2012). Differential Response in Illinois: 2011 Site 
Visit Report. Illinois: University of Illinois School of Social Work.
Gilmore, Debra (2010). Beyond Investigations: Current Innovations in Responding to 
Reports of Child Maltreatment. National Quality Improvement Center on 
Differential Response in Child Protective Services Issue Brief 1, December, 2010.
Lohrbach, Suzanne (2008). Group Supervision in Child Protection Practice. Social Work 
Now, August 2008. Pg 19-23.
Loman, L. Anthony, Christine Filonow, and Gary Siegel (2010). Ohio Alternative 
Response Evaluation: Executive Summary. Institute of Applied Research St. 
Louis, Missouri, 2010.
Mahoney, Nancy and Julie Murphy. (2010). SOAR Consortium (The Ohio Project) 
National Quality Improvement Center on Differential Response in Child             
Protective Services, June, 2010.
41
Merkel-Holguin, Lisa. (2005). Differential Response: a Common Sense Reform in Child 
Welfare Differential Response in Child Welfare: Protecting Children, Vol. 20 
Number 2/3. Pg. 2-4.
National Association of Social Workers. (1996 revised in 2008). Code of Ethics.
Retrieved from http://www.socialworkers.org/pubs/code/code.asp
National Quality Improvement Center. (2011). Differential Response in Child Protective 
Services: U.S. Department of Health and Human Services American Humane 
Association.
OAC (2011). MCCS Policies and Procedures for the Department of Family Services 
Chapter X: Differential/Alternative and Traditional Response Case Assignment, 
5/13/11
OAC 5101:9-14-03 (2009). Implementation of Pilot Protocols for Public Children 
Services Agencies Participating in the Alternative Response Pilot Program.
ODJFS (2010). Ohio Alternative Response Project: Alternative Response Fundamentals  
in Support of Ohio’s Child Protection Practice Model.
O’Grady, Michael and Barbara Broman (2005). Alternative Responses to Child 
Maltreatment: Findings from NCANDS, ASPE Research Brief, August  2004.  
Pg.1-2.
Tumlin, Karen C. & Geen, Rob. The Decision to Investigate: Understanding State Child 
Welfare Screening Policies and Practices. New Federalism Issues and Options for 
States. Series A, No. A-38, May (2000). p. 1-8.
Watkins, S.A. (1990). The Mary Ellen myth: Correcting child welfare history. Social 
Work, 35(6), pp. 500-503.
42
US Department of Health and Human Services (2008). Differential Response to Reports 
of Child Abuse and Neglect. Child Welfare Information Gateway, Feb. 2008.
Zielewski, E.H., Macomber, J., Bess, R., & Murray, J. (2006). Families’Connections to 
Services in an Alternative Response System. Washington D.C.: Child Welfare.
43
Certificate of Completion
The National Institutes of Health (NIH) Office of Extramural Research 
certifies that Terrence Swadener successfully completed the NIH 
Web-based training course “Protecting Human Research Participants”.
Date of completion: 08/14/2012
Certification Number: 963162
44