• Sociodemographic questionnaire (brief child and family phone intake - BCFPI)
  
• Family history (social, psychiatric, biological)
  
• Family resource scale and items
  
• Record abstraction
  
• Suter (2003) Wraparound Fidelity Index 3.0 (caregiver and youth forms)
  
• Debicki (2004) Ontario Wraparound Fidelity Index (Facilitator form)and wait time for services
  
• Canadian Community Health Survey (CCHS) Wellbeing and Kessler 10 Measure of Axis 1 disorders
  
• Child and Youth Resiliency questionnaire (Donnon and Hammond 2005) strength approach
  
• Hodges (1997) child and adolescent functional assessment scale (deficit approach CAFAS)
  
• NLSCY infant development measures
  
• Restrictiveness of living environmental scale (ROLES) number of moves and months involved with child family CAS welfare service
  
• Browne (2006) Health and Social Service Utilization questionnaire (costs)
  
• Browne (2004a) measuring inter-sectoral agency integration
  
• Community resource team assessment (adapted from Walker, 2003)
  

• Follow-up measures at 1 year and 2 year follow-ups.
  

The number of children in child welfare care has increased from 10,000 in the early 1990s to over 18,000. Ontario spends $1.1 billion a year on direct child welfare services, more than twice as much as spent in the late 1990s, with the majority of these resources spent on investigation instead of treatment. In response to this situation, Differential Response models, sometimes called alternative, multiple or integrated system responses, have been implemented in the US, Australia and Canada and are all at the beginning stages of systematic evaluation. These models will help prevent maltreatment cases from becoming ongoing protection cases, or the children ending up in out of home or community placements, and reduce the amount of time in Children's Aid Society care. This research will show the benefits and costs of a differential response approach to Children's Aid Society care, specifically in the Hamilton-Niagara Region.

A majority of substantiated cases (89%) are not severe and therefore have the potential to be diverted from or exit earlier from the protection service of Children's Aid Societies. Communities can design service responses for families without opening (or closing more quickly) a child protection case thereby avoiding highly intrusive and often adversarial service. This alternative response has been called differential response and includes interagency and intersectoral partnerships and community development.

Therefore our purpose is to assess the cost-effectiveness of this differential response wraparound model, in 5 Children's Aid Societies within Hamilton-Niagara Region, in preventing maltreatment cases from either becoming ongoing protection cases, or the children ending up in out-of-home of out-of-community placements, as well as reducing the amount of time in Children's Aid Society care as compared to usual Children's Aid Society risk assessment and protection service alone.

We anticipate a sample size of 500 children randomly selected to receive usual care (250 children) versus differential response wraparound service (250 children). All cases will receive a 1 year follow-up and half will receive a 2 year follow-up during the 3 year study. Decisions for extending the follow-up for the second half of the participants can be made later.