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U. S. DEPARTMENT OF LABOR
JAMES J. DAVIS, Secretary

CHILDREN’S BUREAU
GRACE ABBOTT, Chief

THE CHILDREN’S BUREAU
OF CLEVELAND
A STUDY OF
THE CARE OF DEPENDENT CHILDREN
IN CLEVELAND, OHIO

MARY MATHER LEETE

Bureau Publication No. 177

UNITED STATES
GOVERNMENT PRINTING OFFICE
WASHINGTON
1927

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SINGLE COPIES OF THIS PU BLICATION
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ureau

ADDITIONAL COPIES MAY BE PROCURED FROM
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3(o 2 . »“1
LL^c*>*>, m

CONTENTS
Page
Letter o f transmittal_____________ ___________________ _________ ________
v
Introduction_____________________________________________ __ I I ___II I
1
Purpose and scope of the study—4__________________ I__________ I_I
i
The character o f Cleveland as a community_________________________
3
Cleveland agencies interested in the welfare of children____II ____II
5
The Children’s Bureau of pleveland and its relation to other child-wel
g
fare agencies_______________________
Origin of the bureau____________________________________ ___________
g
13
Institutions cooperating with the bureau_________ _____ !_______!____
Organization of the bureau_________________
15
General board and committees___________________ ______________
15
Executive staff_______ ________________________________________I_
17
Records and reports__________________________________ '________
21
22
Functions and policies of the bureau___________________ ____________
Investigation o f applications________
23
Investigations for adoptions______________________ \_____________
28
2S
Provisions for medical care_____________ _______ ______ _________
Provisions for mental examinations____________________________
32
33
Follow-up work after placement-______________________________
Financial support o f children__________________________________
33
The effect o f the bureau on the development o f institutions for de
pendent children___________________
34
Reduction of congestion in the institutions_____________ ________
34
_■______ -----------------37
New standards o f institutional care
Present needs in the community care of children______________
38
Statistical interpretation of the dependency problem___________________
40
Field and method of study_________________________________________
40
Family background o f the dependent children______________ .________
41
Nativity o f the parents________________
41
Religious affiliation o f the parents__________________ __________
45
Sources o f applications for care o f the dependent children______
45
Whereabouts o f father and mother at time o f application______
47
Reasons for making application__________ _____________________
4g
Conditions o f family life that led to making the applications___1
52
Number and whereabouts of children in families_______________
54
Relation of illegitimacy to application fo r care o f children_____
55
Status of the children in the families__________________________
58
Social agencies to which the families were known_____________
58
The dependent children_____________________
(50
Selection o f children to be considered for care____________ !_____
GO
Whereabouts o f children at time of application_________ ______
64
Recommendations for care o f the children______________________
65
Agencies cooperating with the Children’s Bureau of Cleveland__________
70
The Cleveland Humane Society____________________________________
70
Organization________________________________________________________ 74
The children cared for____________:______________________ I___I
72
Medical care_____________________________________________ I ___II
72
Departments o f the society_________________________________________ 73
The Cleveland Associated Charities______,________________ 2________
77
The Social Service Clearing House—__________________ - ___________
79
The Catholic Charities Bureau__ _____________ ;2i______________ _H
79
The juvenile court________________ _____________________________ I_I
79
Jurisdiction___________________________________________ ~~______
79
The mothers’ pensions department_____________________ __ ______
g0
The bureau of domestic relations o f the court o f common pleas
_
81
The Association for the Crippled and Disabled______________________
81
The day nurseries__________________ __________________________ _ _
04
The Welfare Association for Jewish Children——I _________
g2
The division o f charities, State department o f public welfare_______I
83
The institution-inspection bureau______________________________
83
The child-care bureau_____________________________ I I __I__ _ "I
34

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CONTENTS
Page

Summary------------------------------------- ----------------------------------------------------------------Appendixes :
A. — Constitution o f the Children’s Bureau o f Cleveland---------------B. — Schedule and instructions used in the study------------------------------

85
. 91
92

GRAPH
Number o f children in Cleveland institutions fo r dependent children co
operating with the Children’s B ufeau o f Cleveland and number known
to the bureau during the period 1922-1925----------- ---------------------------------

• w

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LETTER OF TRANSMITTAL

n it e d

S t a te s D

e p a r t m e n t of

L abor ,

C h il d r e n ’ s B u r e a u ,

Washington April 11 1927.
,
There ^transmitted herewith a report o f an investigation of
the Children s Bureau of Cleveland in relation to the care o f depend
ent children in Cleveland, Ohio. Mary Mather Leete, of the socialservice division o f the United States Children’s Bureau, was in
charge or the investigation and has written the report.
Inasmuch as the Cleveland bureau has made the first attempt to
handle as a unit the community problems o f child dependency, it is
believed that this study will be o f general interest to child-placing
agencies and institutions.
6
The helpful cooperation of Lawrence C. Cole, executive secretary
or the Children s Bureau of Cleveland, during the progress of
the investigation and the preparation of the report is gratefully
acknowledged.
J
Respectfully submitted.
H on . J a m e s J. D a v is ,

Secretary of Labor.

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G race A

bbott ,

Chief.

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THE CHILDREN’S BUREAU OF CLEVELAND
INTRODUCTION
PURPOSE AND SCOPE OF THE STUDY

A few years ago the popular conception that orphanages and
children s homes were filled with orphans was proved to be no
longer a tact but a sentimental theory. The public on recovering
trom this unhappy surprise raised the question: I f we have not
° i M^anS’aW mi bave we
our. hundreds o f institutions for dependent
children. I he answer to this question comes slowly, owing to the.
lack or adequate institutional records; but a few studies made o f the
histories o f children in institutions furnish convincing proof
that most o f the children have one or both parents living. The
Children s Bureau o f the United States Department o f Labor has
been able to ascertain the family status o f certain groups o f de
pendent children m nine States. In a total o f 19,879 children 5 per
i cent were reported as full orphans, 30 per cent as half orphans, and
b5 per cent as having both parents living.1
In a study made in 1923 o f the children in four institutions for dependent children in a Middle-Western State it was found that onlv 7
ot the 212 children studied were known to be full orphans, 68 were
nalr orphans, and the remainder represented various types o f broken
families.2 In 1920 a survey was made in Cleveland, Ohio, of 5,035
children who were or who had been in 14 orphanages, and the result
showed that only 8 per cent were full orphans, 43 per cent were half
and 49 per c®nt had both Parents living. In one State in
1923 there were 1,690 children on State support in the 37 orphanages
that receive public wards. O f this number 4 per cent were full
orphans, 29 per cent were half orphans, and nearly 67 per cent were
believed to have both parents living.3
Such investigations as these gradually have revealed the fact that
a large percentage o f institutional children have both parents living.
Consequently there has been growing in communities an increased
interest m knowing as accurately as possible what the family circumstances are that make it necessary for parents to place the responsibi lty for the care o f their children upon the community and that
deprive the children o f their own homes. When the quest for real

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TH E CHILDREN’ S BUREAU OF CLEVELAND

causes o f dependency o f children in institutions led to the institu
tional records it was soon discovered that many institutions were not
able to contribute to a study o f causes for commitment because they
made almost no investigation of the families who sought to place j|j>
children in their care, and furthermore they kept very little record
o f such information as might have been volunteered when the child
was committed.
The department o f welfare in a large Eastern State recently issued
a report on the results o f a study o f the standards maintained by
the 240 institutions in the State for care o f dependent children. The
study disclosed the fact that 76 institutions accepted the child on the
word o f the applicant with practically no investigation o f the situa
tion, 78 made their own investigations more or less carefully, and 86
had their investigation made through a cooperating society. To a
large extent this is the situation to-day in many States as regards the
investigation o f applicants for the care o f children in institutions.
In 1923 there were in the United States 218,623 children in the
care o f institutions and child-placing societies mainly for the care
o f dependents. O f these children 140,312 (64 per cent) were in the
1,558 institutions and receiving homes then established primarily for
the care of dependents.4 I f these institutions were asked to give the
causes o f the dependency o f children in their care based on the records
that they have o f family history it is doubtful whether more than
one-third would be able to furnish accurate information.
Therefore it is still far from clear why so large a percentage o f
children with one or both parents should be receiving care in institu
tions rather than their own homes. Some communities have thought ^
o f a central bureau which should be responsible for a social inquiry
into every application for community care o f a child. The primary
purpose o f such a bureau is adequate investigation o f all applications
for care o f children and recommendation as to the care needed. This
method o f solving some o f the problems of dependency and providing
better care for children is now in use by several groups o f institutions
and agencies. The Catholic Charities o f the Archdiocese o f New
York, the Federation of Agencies Caring for Protestants o f New
York, and the Jewish Children’s Clearing Bureau o f New York all
act as clearing bureaus for institutions and agencies; but their field
is limited by the fact that they are interested only in the children
o f a particular religious faith and also by the fact that they do not
get cooperation from all institutions logically coming within their
jurisdiction. The Colorado Children’s A id Society o f Denver and
the Children’s Service Bureau o f Pittsburgh likewise include in their
service to the community a clearing bureau for certain institutions,
but here again the field is limited because not all the institutions o f
the community are included, and placing also forms a part o f the
work o f the bureau.
Other organizations, believing in the value o f centralized investi
gation, have established central bureaus- endeavoring to cooperate
with all child-caring institutions and agencies and thus seeking to
coordinate and evaluate the work being done by all for the welfare o f
children.

i Children under Institutional Care, 1923, p. 18.
ington, 1927.

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U. S. Bureau o f the Census.

W ash

INTRODUCTION

However, clearing-bureau service represents a Dew movement in
work for the care o f children, and it is yet too early to look for the
results which this new form of cooperation in children’s work will
bring about. There is perhaps only one city where the central clear
ing bureau has been established with the cooperation o f all institu
tions except favo Jewish ones (see p. 13) and with a well-defined
policy o f service, which is investigation o f all applications for institu
tional care o f children and recommendation as to the particular needs
o f each child for whom application had been made. This city is
Cleveland, Ohio ; and through its children’s bureau Cleveland is
undertaking community-wide planning for the care o f dependent
children.
The following study o f the Children’s Bureau o f Cleveland, Ohio,
was undertaken by the Children’s Bureau o f the United States De
partment of Labor to ascertain the administrative methods in use in
that city at present in meeting the problem o f the admission o f de
pendent children to institutions. The study was particularly con
cerned with dependency o f children as it is related to the need for
their separation from their own families and their care by an institu
tion or placing agency in the community. The first section o f the
report o f the findings o f the study consists o f a description o f the
Children’s Bureau o f Cleveland and its relation to other child-wel
fare agencies o f the city. Further knowledge o f adequate methods
for the investigation o f admissions to institutions for dependent
children is so generally sought at the present time by institutions,
both individually and by groups, that it seemed o f value to set forth
in detail the organization and functions of this bureau. The second
section o f the report offers a statistical interpretation o f the depend
ency problem based upon 1,416 family records in the files o f the
Children’s Bureau o f Cleveland. An examination o f these records
to determine something o f the underlying causes o f dependency, as
shown by thorough investigation, was important in order to indicate
just what the problems are that a community must face in planning
for the care o f its dependent children. This bureau offered an un
usual opportunity to make such a study because o f its position as
the central bureau o f investigation for all Catholic, Protestant, and
nonsectarian institutions— in fact all institutions for care o f depend
ent children in Cleveland, Ohio, except the two for Jewish children.
There are 22 institutions represented with an approximate capacity
of 1,570 children (see p. 13). The^ third section o f the report con- ‘
tains a description o f the child-caring agencies in the city that co
operate with the Children’s Bureau o f Cleveland.
A t the time this study was undertaken (April, 1925) the Children’s
Bureau of Cleveland had been functioning for a period o f four years,
which was considered a sufficient length of time to indicate the gen
eral trend o f the work being done.
THE CHARACTER OF CLEVELAND AS A COMMUNITY

Cleveland is the fifth largest city in the United States and in 1920
had a population o f 796,841. There was an increase o f 42.1 per cent
in the population from 1910 to 1920. O f the total population 239,538
were foreign born; 212,247 were native white o f native parentage;

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TH E CHILDREN’ S BUREAU OF CLEVELAND

and 310,241 were native born with one or both parents foreign born
(there were 246,529 with both parents foreign born and 63,712 with
one parent foreign born).5
. . .
A large element o f the foreign born in any city is an important
factor in the general character o f that city. In Cleveland, where *
the percentage o f foreign-born population is unusually high (30 per
cent o f the total population) it is desirable to know something o f the
characteristics o f these people; and especially is this true when ques
tions of community child welfare are being considered. Their
background, their motives for immigrating to this country, and their
adjustment to the conditions o f their adopted country are o f vital
importance in considering the care o f their children. The principal
countries represented by the foreign-born population o f Cleveland
are Poland, with 35,024 natives in the city ; Hungary, with 29,724;
Germany, with 26,476; Czechoslovakia, with 23,907; Russia, with
21,502; Italy, with 18,288; Yugoslavia, with 15,898; and Austria
with 15,228.® Besides the foreign-born population there were 34,451
negroes (more than 4 per cent o f the total population),7 many or
whom came to Cleveland from the Southern States during the war.
The presence o f the negroes, most o f whom had come from agricul
tural districts, in a large industrial city has created .many problems
relating to housing, education, and not least to the care o f their de
pendent children.
, „ . , , ,
In the public schools o f the city only 35 per cent o f the total
number o f pupils were reported in 1922 to be the children o f native
white fathers. Five per cent o f the pupils were^ negroes and the
remaining 60 per cent were the children o f foreign-born parents.
»
In only 55 o f the 97 elementary schools were the greater number
o f pupils o f native white parentage. Similarly the pupils o f native
white parentage predominated in only 10 o f the 16 junior high
schools and in 8 o f the 10 senior high schools. Russian, Hungarian,
and Italian children, respectively, predominated in eight of the
elementary schools, Polish predominated in six, Czechoslovakian
in four, Yugoslavic in two, Austrian in two, and Rumanian in one.
The pupils in three elementary schools were mainly negroes.8
Cleveland’s large cosmopolitan population is due to the fact that
it is one o f the most important manufacturing cities in the United
States. The chief industries center in the steel mills, the clothing,
automobile, and paint and varnish factories, and the stockyards.
' Cleveland’s trade extends around the world. Fifty-three per cent
o f the workmen in the manufacturing and mechanical industries,
which represent the largest part o f the entire industrial field in
Cleveland, are foreign bom .9
The iron and steel industries furnish work for the greatest number
o f unskilled workers in any industry in Cleveland, and these workers
are mostly foreign born. The wages o f unskilled workers do not
allow for a great margin o f saving, and therefore when there is an
b Fourteenth Census o f the United States, 1920, Vol. II, Population, pp. 47, 4 8 ; Vol. I l l ,
Population, p. 784. W ashington, 1922
« Ibid., Vol. I l l , Population, pp. 794-796. W ashington, 1922.

8 A 1*Census^of Nationalities Represented in the Cleveland Public Schools, pp. 4, 9.
Cleveland Board o f Education. November, 1922.
„
, .
L
.
« Fourteenth Census o f the United States, 1920, Vol. IV , Population, Occupations, p.
1084. W ashington, 1923.

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INTRODUCTIOIS'

industrial depression—such as took place in the steel industry,
beginning in 1920 and lasting over a period o f years—the care o f
the children o f these foreign workers becomes a serious problem
for the community. In 1922, the third year of the industrial depres
sion, 200 parents with children being cared for by the Cleveland
Humane Society were unable to continue the support of. their
children because o f unemployment. This made necessary an addi
tional appropriation from the community chest o f $24,000 to this
society in order that the deficit thus created might be met.
The civic spirit o f Cleveland is quite unusual, and for a city o f
its size it has a remarkable unity o f interests. A sense o f coopera
tion has pervaded the entire structure o f its social service. Cleve
land has been a city o f surveys because o f the eagerness to establish
better conditions; and in the whole field of social service this city
ranks among the first in its achievements.
CLEVELAND AGENCIES INTERESTED IN THE WELFARE OF
CHILDREN

The Children’s Bureau of Cleveland is but one .unit in the whole
plan for community care of dependent children in the city, and
the nature of other agencies in Cleveland should be considered in
order to understand the interrelation o f the various phases of
child care. With the organization of this central- bureau it became
increasingly evident that an investigation of the applications for
admission and the discharge o f children would furnish an index
o f the entire problem of child dependency in the community and
would involve not alone the institutions but every organization
whose work touched on the care of dependent children. The prin
cipal agencies interested in the dependent child were at that time
the institutions, the humane society (which acted as a protective
association as well as a placing agency), the associated charities
(which is the chief family agency in Cleveland), and the juvenile
court. In March, 1921, a program for these various agencies was
outlined to indicate 'what the primary functions o f each agency
should be, and this program was approved by them in a community
wide plan for child welfare. This was carefully worked out before
the Children’s Bureau o f Cleveland actually began operation in
April, 1921. The functions of the child-caring and family agencies
as outlined and approved by the agencies in Cleveland interested in
child welfare were as follows:
I. Children’s bureau:
1. Investigation of cases of dependent children where neglect is not
present and guardianship is not involved and there is no definite
reason for depriving parent or near relative of custody o f child,
with the exception o f humane-society cases.
2. Investigation of applicants for admission to children’s institutions either
for temporary or for continued care { a ) from the family, ( 6) from
other agencies.
3. After admission, supervision through the bureau or by the definite
assignment of responsibility to another agency, with a periodic
bureau check up.
4. Investigation and planning for receiving-home inmates before admis
sion; children to be admitted without a study and plan only in
extreme emergencies.
5. Conferences on children’s problems and cases.

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THE CHILDREN’ S BUREAU OF CLEVELAND

II. Institutions, including Catholic charities, Cleveland Protestant Orphan
Asylum, etc.:
1. To provide temporary care for dependent children pending the forma
tion of a plan.2. To provide temporary care pending placement in boarding, free, or
adoptive homes.
3. To prepare children, through discipline, medical care, etc., for place* ment in normal homes.
4. To train children in proper habits and build character in the character
building period.
5. Every child in institutions only as a result of a constructive plan and
with full knowledge on the part of the institution of that plan and
the part for which they accept responsibility.
III. Humane society:
1. Should be the county-wide agency primarily responsible for all placing
and supervision of children in free, boarding, and adoptive homes from
all local agencies including children’s bureau, Catholic charities, juve
nile court, family agencies, and all institutions not having their own
service.
2. Should be responsible for all social service needed because o f the
illegitimacy problem.
3. Should furnish legal advice and counsel on guardianship and on extradi
tion proceedings pending the establishment of family court.
IV. Family agencies, including the associated charities, mothers’ pensions de
partment o f the juvenile court, Hebrew R elief Association, Red Cross,
and outdoor relief.

1. Should be primarily responsible for family rehabilitation and treatment.
2. Should provide care where, through adequate relief, the family for its
best interest can be held together.
3. Should report directly to court situations requiring court action.
4. Should provide when necessary for families under their care temporary
care through relatives and other family resources.
5. Should advise with humane society on all boarding and placement needs
other than with relatives and family resources.
6. Should advise with children’s bureau on all dependent children needing
institutional care.
V. Juvenile cou rt:
1. Responsibility for investigation and prosecution of all complaints o f
neglect, nonsupport, and delinquency involving children either unoffi
cial or official and for subsequent supervision or probation o f children.
2. The investigation and treatment of cases o f neglected children requiring
constructive supervision when there is no need for official court action
existing.
3. Handling and reviewing o f cases of dependent children involving custody
where proper parental care is lacking.
4. Investigation and treatment of all cases o f juvenile runaway out-oftown girls.
5. Investigation and advising with prosecutor’s office on cases of rape,
crimes against children, or others o f criminal prosecution in which
juveniles are involved.
6. Should early establish a bureau o f medical and mental psychiatric work.
VI. Detention hom e:
1. To provide temporary care for delinquent children and juvenile witnesses
in criminal cases.
2. To provide mental and physical examination o f delinquents.
3. To study behavior and problem cases of delinquents.
VII. Institutional care for crippled children.10
The problem of the crippled child is primarily a problem of child welfare,
and every child so handicapped should be treated as far as possible like a
normal child.
1. Every crippled child should receive adequate medical care and be re
stored as far as possible to normal health.
2. Every crippled child needs all the academic training he is capable of
assimilating with such manual training as may help to prepare him
for later intensive vocational training.
10 This general plan was accepted in 1923 by the various agencies concerned.

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INTRODUCTION

3. Every crippled child has the same right to care in his own home if it
is at all possible and should be placed only when home conditions
can not be improved to provide proper care.
4. I f his own home has failed just as for the normal child, every effort
should be made to place him in another home, free, boarding, or
adoptive, where he can receive the specialized care necessary.
5. Only after home care is not possible should the child be placed in an
institution a n d . even then with the ultimate plan o f returning h im
to normal family life as soon as he is prepared mentally, physically,
and morally.
6. As far as possible all children, hospital and institutional, from outside
communities should be supported by public funds through the special
ized resources of the State for cripples.

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THE CHILDREN’S BUREAU OF CLEVELAND AND ITS
RELATION TO OTHER CHILD-WELFARE AGENCIES
ORIGIN OF THE BUREAU

Before the organization o f the Children’s Bureau o f Cleveland
the question o f the facilities for care of Cleveland’s dependent and
neglected children was discussed for some years by the boards of
the various institutions and agencies. The institutions were crowded,
and it became increasingly difficult to place children in need o f im
mediate care. As early as 1917 the congestion o f the institutions
made it almost impossible to secure the admission o f children ur
gently in need o f care. This was especially felt by other child
caring agencies in the community. The juvenile court often found
it impossible to have dependent children admitted to institutions and
was compelled at times to send them back to improper home condi
tions. This congestion was brought to the attention of the com
munity very acutely during the influenza epidemic in 1918, when both
the hospitals and the institutions for children proved inadequate
to handle the needs o f those in distress; and in the case of the chil
dren’s institutions this resolved itself into a demand for the erection
of more institutions or a study o f the community’s methods of caring
for dependent children.
Fortunately the trend of events in Cleveland at this time made
possible a survey of child-caring methods in the community rather
than the erection o f more institutions. Under the direction o f the
Hospital Council, with the cooperation o f the Welfare Federation,
a survey o f all hospitals and agencies promoting public health had
been arranged and was in progress toward the close o f 1919. As
part o f this study it was planned to inquire into the medical care
given by the child-caring agencies and institutions, the health status
o f the children in their care, and the facilities afforded in the com
munity which could be used at times of serious illness. The State
department o f industrial relations in Ohio is required to cause to be
inspected certain classes of public buildings, including children’s
homes, hospitals, medical institutions, and asylums, with special
reference to fire precautions and such other matters as relate to the
health and safety of the occupants. One of the chief responsibilities
o f the division of charities o f the State department of public welfare
is the annual inspection and licensing o f institutions caring for
children. The department is also authorized to inspect the foster
homes in which children are placed by agencies. (See p. 83.) By
combining these two inspections with the medical survey it seemed
possible to gain a better knowledge o f each institution and to obviate
the necessity o f the State inspection later in the year.11
11 The description given here is summarized from mimeographed and typewritten reports,
especially A Community Study o f Child Care (report o f the survey o f children’ s agencies
in Cleveland by the W elfare Federation o f Cleveland, May, 1921) and annual reports of
the Children’s Bureau o f Cleveland for the years 1922 to 1924.

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RELATION TO OTHER CHILD-WELFARE AGENCIES

In the fall of 1918 the Children’s Conference, an organization com
posed o f representatives from the board and staff o f each child-caring
agency in the community, had been formed for the purpose o f discussing problems o f child care. The question of taking advantage
*
medical survey to undertake at the same time a comprehensive
of the other aspects o f care for dependent and delinquent
children by all child-caring institutions and agencies was brought
before the Children’s Conference by the Welfare Federation of
Cleveland.12 The plans as outlined by the federation were discussed,
and the Children’s Conference voted approval and agreed to give
complete cooperation.
The survey was to take the form of a critical self-examination
and was to be made primarily to assist the institutions and agencies
studied j secondarily, to help in the formulation o f a program which
in the light of present-day experience and improved methods could
be used as a chart to guide Cleveland’s future plans for child wel
fare. A ll data concerning an individual institution or agency and
the particular recommendations for this agency were to be regarded
as confidential and given only to the superintendent and board o f
the agency. Only information relating to all the institutions in
general and the main recommendations affecting the entire group
were made a matter of public knowledge and discussion, sensational
publicity being carefully avoided. In January, 1920, the study was
begun under the direction o f Henry W. Thurston, director, childwelfare department, New York School of Social W ork; Joel D.
Hunter, superintendent, United Charities o f Chicago, formerly
^ chief probation officer, juvenile court o f Chicago; W. S. Keynolds.
“ superintendent, Illinois Children’s Home and A id Society; and Mrs.
Margaret Lyman, supervisor, family division, Chicago juvenile court,
as chief o f field workers.
’
The organizations to be included in the survey were the 22 insti
tutions caring for dependent, neglected, delinquent, and crippled
children;13 the Cleveland Humane Society, which is the chief child
placing agency in Cleveland; and the juvenile court, including
the detention home and the mothers’ pensions department. The
attendance department in the public schools and the work o f the
boys school which is a part of that department also were studied
at this time under the direction of Lucia B. Johnson, of the Ohio
Institute for Public Efficiency. Information about each of the
agencies and institutions studied covered the follow ing: Incorpora
tion, objects, and legal powers; plan o f organization and o f admin
istration of both directorate and staff; sanitary survey of each
plant, including medical facilities and procedure; intake methods
and care o f children within the institution; methods o f outgo and
discharge, statistics. Some special studies were made in addition
The W elfare Federation o f Cleveland is a voluntary w orking alliance o f the civic and
social agencies o f Cleveland fo r their mutual strength, economy, and efficiency, and for a
unified attack on the causes o f social distress. I t endeavors to promote the social wel
fa re o f the entire city and to foster the wholesome development o f its human resources
I 01* ofQ
federation fa lls into tw o general d ivision s: 1. Budget f a n n in g and
fin ance, 2. Social planning, research, and education. I t was as an agencv fo r social
research and education that the federation sponsored the children’s survey in 1920 and
w
h
i
c
h
^
i
11£
staff to establish an investigation bureau,
is now known as the Children s Bureau o f Cleveland, Ohio.
and

care* r^ ceiv ^ ^ in ^ h ^ in ^ titu tion StUdy W* S C<mfine(i t0 the health o£ the chlldren

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THE CHILDREN’ S BUREAU OP CLEVELAND

to the information secured through inspection, consultation of rec
ords, and interviews with persons connected with the organizations
studied. These included a medical examination of 15 per cent o f
the current population in the institutions; a mental examination o f
the same children; and a field investigation of the economic and *
social situation of the families o f some of the same children to
compare with the records kept by the institution or agency.
After the survey was completed a report was prepared for each
o f the organizations studied. This was considered confidential and
was reserved for the use of the respective executives and boards o f
directors. I f possible, these reports were reviewed with the execu
tives in charge of the respective institutions so that any misstatement
might be corrected at once. A summary of the main facts revealed
by the study was prepared for the welfare federation, and this was
of the greatest advantage in planning for a new program o f com
munity child welfare.
The sanitary study of institutions showed that in addition to
defects pertaining to fire precautions and such matters there existed
overcrowding, insufficient ventilation, and insanitary use o f toilet
articles and drinking cups. The medical survey, which covered 19
institutions, showed that only 3 of the institutions gave adequate
physical examinations to children upon entrance, and that only 3
maintained an admission quarantine. None o f the institutions studied
had periodic physical examinations for the children in their care.
The medical examination o f about 15 per cent of the current popula
tion of the institutions indicated that all except 14 o f the 371 children
examined had one physical defect or more. This study indicated
very clearly the urgent need for a higher standard o f medical exami #
nation on admission and for periodic reexamination with careful
records o f all medical treatment. The mental examination covered
324 children and showed that 70 o f these (more than 21 per cent)
were so far retarded that the advice o f an expert on mental problems
was desirable as a basis for care and treatment. These ^children
were not all feeble-minded, but their mental state clearly indicated
that the institutions caring for dependent children frequently needed
psychiatric service. It was estimated from the children examined
that at least 400 children under institutional care required special
care and study.
.
. .
The charter powers o f some o f the institutions were found to be
so specific as to be inelastic, and others were liberal enough to author
ize a great variety of forms o f institutional and other care should the
needs of the children o f the city or county so require.
The methods of admission o f the institutions and agencies were
learned through comparison of what the records o f these organiza
tions gave about the social and economic status o f the family and
relatives with what members of the survey staff learned from further
field investigation. This comparison showed the following to be
true : Many of the records o f the 19 institutions as to the economic
and social status o f the children’s families or relatives were so inade
quate that no intelligent decision could be made as to the children’s
need for institutional care. Records were not always accurate in the
matter o f a child’s legal residence ; that is, it was not clear whether
certain boys and girls in Cleveland institutions should be the respon
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RELATION TO OTHER CHILD-WELFARE AGENCIES

^
®

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sibility o f Cleveland or of some other community. Records of
institutions did not always show whether parents or relatives were
paying all they could for the support o f children receiving institutional care. Often the executives knew more than their records
showed in regard to children admitted, but the data in the records
together with this additional information seldom were sufficient as a
basis of action for the admission o f a child.
The following difficulties appeared to be characteristic of all the
institutions: Baffling medical problems connected with the care o f
infants; confusion over responsibility for children from outside the
city; inadequate investigation of family situations; insufficient pay by
parents and relatives who could afford to p a y; admission o f children
who should not have been accepted; and the keeping o f some children
a longer time than the family situation justified.
That the institutions should be in possession o f fuller and more
accurate data about the families from which they take children
was shown clearly by the results o f an investigation o f 5,035 children
in 14 orphanages selected to represent as fairly as possible the total
number cared for during a period o f five years (1915-1919). It was
found that 4,604 (91 per cent)* o f the so-called orphans in these
14 orphanages had at least one parent living. Moreover 66 per
cent o f the 2,502 children discharged within the five years 1915-1919
went back to parents or relatives. The annual turnover o f popula
tion in the 10 most distinctively specialized orphan asylums varied
from 23 per cent to 232 per cent. This indicated that the average
stay per child in one orphanage was more than four years and in
another less than six months; that is, one institution would care in
a given time for eight times as many children as would the other
institution taking the same kind o f children.
What bearing the institutional turnover had on the need for
greater facilities for care for dependent children in the community
could not be determined without more complete knowledge o f the
policies and the results achieved by the institutions, their capacity,
and the number o f children waiting for admission. But the solution
o f this whole problem rests ultimately upon the standardization of
methods o f admission in all institutions. Only by careful investi
gation of each application for the admission o f a child to an insti
tution would it be possible to ascertain whether the facilities for
care o f the dependent children o f the community were adequate for
handling the particular needs o f those children.
The survey brought out very forcibly the fact that a higher
standard of investigation of all available facts in abnormal situations
that are forcing children out o f their own homes is a fundamental
necessity before institutions or agencies attempt to determine the
best course o f treatment for each family concerned. A t the con
clusion of the survey the attention of the institutions and agencies
that had cooperated in the study was called to the following needs:
(1) The correction o f all defects o f plant and sanitation; (2) the
perfection o f facilities and methods for adequate initial physical and
mental examinations o f children, followed by whatever treatment
and periodic reexaminations are necessary, together with adequate
records; (3) provision for such expert help in detecting and caring
for those mentally retarded children who are now under care or
43967°—27----- 2

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THE CHILDREN’ S BUREAU OP CLEVELAND

may hereafter be admitted ; (4) such further and progressive atten
tion to the eare of children within institutions as has been suggested
in reports to individual agencies and as outside progress in child
care and education makes increasingly possible (for example, in
respect to work, play, chances for individuality and education,
contact with outside children, discipline, moral and civic training,
and religious education) ; (5) the care o f many more children in
family boarding homes with regard to the saving o f relationship
between children of the same family and with relatives wherever
these ties are or may be made assets for true affection, character,
and citizenship; (6) more attention to the care o f negro children.
The investigation disclosed the following needs in the community :
A common investigation bureau ; a temporary shelter where medical
care and other temporary service could be given to children while
plans were being made for their care; and certain changes in judi
cial procedure and changes in administration in connection with
the juvenile court.
For some institutions the amount o f investigation and reinvestigation required is not sufficient to warrant engaging the full-time
services o f a highly trained person-for this work; yet for the indi
vidual cases to be handled these institutions need as full and ac
curate information as do those that employ trained field investi
gators to gather and supplement facts for use o f their admission
committees. To remedy this situation and to make the required
information available the survey staff suggested that a bureau o f
investigation be organized, to be financed by the Cleveland Welfare
Federation and conducted by a committee on which each o f the
organizations concerned should be represented.
The survey staff in recommending the establishment o f a bureau
o f investigation outlined as follows the scope o f service which such
a bureau should render: (1) To provide thorough investigation o f
each application for admission to a child-caring institution and to see
that adequate facilities, for medical and mental examinations are
afforded to each child before admission; (2) to furnish f ull and
complete information concerning each child or family which seeks
the help o f the respective child-caring institutions (this information
should go to the admission committees o f institutions through per
sonal presentation by the staff o f the investigating bureau and
through written reports fer the files o f the respective organizations) ;
(3) to keep in touch with all families from which children have
been admitted to institutions and to present information from time
to time o f the changed status o f the families (both when applica
tion is made for the removal o f a child from the institution by the
family and for those children who are allowed to remain indefinitely
in the institution) ; (4) to supervise children who have not been
accepted for institutional care but in whose homes there is some
problem situation requiring supervision but as yet no need o f court
authority; (5) to transfer to the juvenile court the care o f all
'families where there is need o f court authority; (6) to conduct
under the direction of the executive secretary o f the bureau regular
case conferences in problem cases, members o f the case conference
to be composed of representatives from all organizations cooperating
in the use o f the bureau.

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R E L A T IO N

T O O T H E R C H IL D -W E L F A R E A G E N C IE S

It was understood that in order to prevent any hardships, the
institutions were to admit children in emergencies, but investigation
o f such cases was to be made by the bureau before a permanent plan
for such children was formulated.
INSTITUTIONS COOPERATING WITH THE BUREAU

The establishment of the Children’s Bureau of Cleveland in
April, 1921, came as a direct result of the survey o f facilities for the
care o f‘ children made in that city the preceding year. The bureau
is supported by the Cleveland Community Fund and is a member o f
the Cleveland Welfare Federation. As has already been noted,
its principal function is to serve as a central bureau for the investi
gation o f families asking the admission of their children to the
institutions established in Cleveland, and therefore the nature o f the
institutions cooperating in the work o f the central bureau is o f
interest.
Cleveland has a total o f 24 institutions for the care o f delinquent
children, which represent a capacity o f 2,065. Two of these are
for Jewish children and have a capacity of 495 children ; the admis
sions to these institutions are not under the direction o f the Chil
dren’s Bureau o f Cleveland and were not included in this study.
Five o f the 22 institutions covered by the study take only Cleveland
children, and two others cover an area of five States for children
o f a particular religious denomination needing institutional care.
Most o f the others take children from all northern Ohio. A ll insti^ tutions but three are denominational in concept but do not limit
^ the admission o f children'to those whose parents or relatives belong
to the same denomination. Three o f the institutions are for children
needing special physical care—two take crippled children for con
valescent care and training, and one provides all-year preventorium
care for weak, anemic, malnourished, and convalescent children 6
to 12 years o f age. Another institution formerly caring for depend
ent children has been developed into a center for diagnostic service
since the organization o f the central children’s bureau. (See p. 32.)
One institution gave preference to Polish children14 and one to
Ukrainian children,15 but otherwise no distinction was made by the
institutions as to nationality o f children admitted.
Fourteen institutions provided care for both boys and girls, six
took only girls, and two took only boys. Three institutions were
, for children 14 or over, two being training homes for young girls
with difficult behavior problems and one a boarding home for work
ing boys. A ll Cleveland institutions were of the congregate plan,
although two were building cottages and one was building a new
semicongregate building. Institutions were licensed by the State
division o f charities which, as has been stated (p. 8), also had the
right to place children in foster homes. A ll except four o f the
institutions were members o f the Cleveland Welfare Federation, but
equal service was furnished by the bureau for all whether or not
members o f the federation, and the endeavor was also made to
W work out a community program regardless o f financial support.
14 This was operating w ithout the State license required by law.
15 Since 1925 one o f these institutions has been closed. T w o other orphanages for fo r
eign children had been closed previously (in 1922 and 1923).

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THE

C H I L D R E N ’ S B U R E A U OF C L E V E L A N D

The Children’s Bureau of Cleveland was to act as the investigating
agency for those children only who were seeking admission from
Cuyahoga County (where Cleveland is situated). It was under
stood that applications for admission o f children residing outside wL
this county would be handled by the individual institutions; but
more and more assistance with reference to outside applicants is
being asked o f the bureau as its work has developed, and this is
being granted as far as the time o f the staff permits. Cooperation
o f the institutions from the start was such as to make the work o f
the bureau comprehensive and o f real value in meeting the needs
o f dependent children. Since one of the urgent needs o f the com
munity had seemed to be greater institutional facilities for the care
o f dependent children a great part o f the effort o f the bureau’s first
year consisted o f the investigation o f children who already had been
in an institution more than a year.
The bureau has also tried to establish relations with State, denomi
national, and fraternal institutions outside Cleveland so that they
might employ the bureau’s services in the investigation o f children
from Cleveland whose application for admission was under con
sideration. The bureau has always endeavored to secure care in
Cleveland institutions for these children i f their residence was
Cleveland and i f conditions indicated a real necessity for placing
in order that they might be near family or relatives. It has sought
earnestly to have Cleveland institutions carry their full responsi
bility for Cleveland children, as it has also sought—by not accepting
outside children for care in Cleveland— to leave to other communities
their responsibility. In the first year emphasis therefore was placed
on relieving the institutions of as many children as possible in order w
to meet the apparent need at that time o f institutional care for
children in the community who were awaiting admission. Aside from
very careful investigation of all new applications for admission,
which made it possible to refer many families to other agencies than
institutions for the care o f children, the bureau undertook to work
out for each child then in an institution a constructive plan in antici
pation o f returning him to his own family or placing him in a foster
home. The Catholic Charities Bureau, which is the central organi
zation for all Catholic agencies, provided the Children’s Bureau of
Cleveland with a list of all children in Catholic institutions who had
been under care more than two years, requesting that they be studied
and planned for. Other institutions asked for the investigation o f
children who had been in the institution for some years. The result
was that in the first year o f the bureau’s existence 40 more children
were discharged from institutions than were admitted (494 dis
charged and 454 admitted). As many o f the older children who
had grown up in institutions had become useful to those institutions
it was sometimes difficult to carry out a plan for the children’s
welfare that took them away from the orphanages. The following
is an illustration :
One 14-year-old girl had been placed in an institution as a very small child.
The Children’s Bureau o f Cleveland made a careful search for some trace of
her family and finally decided to advertise fo r her people. After a time a
response came from the mother, who lived only a short distance from Cleve
land. The mother’s home was investigated and proved to be entirely satisfac
tory, with the added charm that the mother was unusually happy to find her

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R E L A T IO N

M i

T O O T H E R C H I L D -W E L P A R E A G E N C IE S

daughter and to have her at home. Some difficulty arose when the institution
found that the child’s people had been located and that a good home awaited her.
She was so promising a child that it proved hard to give her up, but interest in
her own welfare finally prevailed, and this young girl now lives in her own
home.

ORGANIZATION OF THE BUREAU
GENERAL BOARD AND COMMITTEES

In April, 1925, when this study was undertaken by the United
States Children’s Bureau, the organization o f executive committee
and staff o f the Children’s Bureau of Cleveland was well established.
This bureau was originally a subcommittee o f the Cleveland Welfare
Federation, and the children’s survey committee o f 1920 appointed
by the federation formed the nucleus of the bureau’s general board.
From time to time representatives from other agencies interested in
work for children were added to the general board until it has be
come representative o f all childrearing interests in the city. This
board now is composed o f two representatives from each o f the
child-placing agencies (the Cleveland Humane Society and the W el
fare Association for Jewish Children), two from the Cleveland
Associated Charities, the Catholic Charities Bureau, the Day Nursery
Association, the juvenile court, and each of the 22 institutions for
children. Membership on the board is open also to persons inter
ested in child welfare who are not representatives of agencies. They
are appointed through the approval of the executive committee. As
the general board o f the bureau included representatives o f every
^ children’s agency in Greater Cleveland the Welfare Federation
™ early requested that this board be responsible for tlie discussion and
solution o f community problems affecting the care o f children. Thus
the board not only carries the work particularly related to the bureau
but also acts as the functional group or children’s council for the
entire children’s field o f Cleveland.
No constitution was approved definitely by the Children’s Bureau
o f Cleveland until March 9, 1926. It seemed wise, as the field of
work undertaken was still comparatively unexplored, that the ad
ministrative organization should be worked out gradually to suit the
needs as the work developed rather than that there should be a fixed
constitution at the beginning.16
Since the Jewish institutions and agencies have representation on
the general board their influence has been felt in the development
o f the bureau, though the bureau has not made the investigations for
admission o f children to the two Jewish institutions. The executive
secretary of the bureau acts as secretary for the general board. This
general board meets bimonthly for a discussion of problems relating
to the work of the bureau in particular and also to the general care
o f children. The changing needs o f the community for care of chil
dren are recognized, and the possibilities for the development or
adaptation o f better methods of meeting these needs are studied.
The scope o f these board meetings is illustrated by the problems
discussed in the year 1924: “ The relation o f the family and children’s
agencies,” “ A modern nutrition program for institutions,” “ Mental
health,” “ Improved medical standards,” [Relationship o f the insti16
F o r text o f the constitution o f the Children’s Bureau o f Cleveland, see Appendix A o f
this report, p. 91.

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T H E C H I L D R E N ’ S B U R E A U OF C L E V E L A N D

tutions and the child-placing agencies,” “ Care o f feeble-minded,”
and “ Institutional-building programs.” These board meetings have
been well attended, and out of the recommendations made after
joint discussion have grown some o f the bureau’s most effective
achievements.
Alternating with the bimonthly meetings o f the general board the
Children’s Conference, a social group o f all children’s workers con
nected with institutions and agencies, meets at the various institu
tions for supper and a social good time. The executive secretary o f
the Children’s Bureau o f Cleveland serves as secretary for this
conference.
For the purpose o f handling specific problems with greater facility,
the general board has six major committees. These are the executive,
annual meeting, case, medical, nutrition, and summer camp registry
committees. The executive committee consists of 18 members elected
for a term o f three^ years by the general board. This committee
meets monthly and is directly responsible for the formulation and
administration o f the bureau’s policies. The annual-meeting com
mittee has borne the responsibility for the annual meeting of the
bureau; usually it assembles only two or three times a year. The case
committee, which is one o f the most important of all the committees,
meets every other week during the winter for the discussion o f
difficult questions arising in connection with the care o f particular
children. On this committee are representatives from institutions,
the family agencies, the humane society, and the juvenile court, as
well as lay members. Hence it has been possible to get cooperative
action and to place definite responsibility for those families and
children in whom several agencies may be interested. The bureau
also has been active in the formation o f case committees within the
institutions so that the boards o f these institutions have kept in
touch with the problems affecting their children. . Very often the
bureau worker connected with the institution acts as the secretary o f
the institution’s case committee. The case committee o f the Chil
dren s Bureau o f Cleveland has been a great factor in molding the
decisions in regard to admissions made by the institutions’ board
members and committees, but it never has relieved the institutions
o f their responsibility in making decisions. The policy of the bureau
from the beginning has been to obtain the facts concerning the
applications and to recommend the proper form of care; but the
actual decision in regard to each case has been left in the control of
the institutions.
The medical committee, which meets on call, usually four or five
times a year, is responsible for plans relating'to the medical atten
tion provided for the child in need of community care and for the
activities o f the children’s bureau clinic at Lakeside Hospital. The
summer camp registry committee, composed of five members o f the
summer-camp council and five appointed by the bureau, meets four
or five times a, year, usually in the summer when the registry is in
active operation. This registry, with an office at the central chil
dren^ bureau, has been operated at the request of the summer-camp
council as a clearing house for both camp agencies and social
agencies. For agencies with camp facilities it is a centralized regis
tration bureau to prevent duplication among themselves and for social

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RELATION TO OTHER CHILD-WELFARE AGENCIES

agencies needing camp service it is a joint, application center for
their clients.17 Other committees are appointed from time to time
to make special studies for the bureau; for example, the committee
on nutrition, which met every week for a year and a half while
making an* intensive study of the nutrition o f children in the Cleve
land institutions and compiling material for distribution to the
institutional directors. This committee is composed not only of
members from the general board o f the bureau but also o f persons
in the community who are specialists in nutritional work. Very
recently a committee on individualizing the child was appointed to
study methods that might be used in institutions for a closer obser
vation o f each child’s nature; and it has prepared printed record
forms to be used by the institutions, which will show the essential
characteristics o f the children and the degree of progress they make
during their stay in the institutions.
The officers o f the bureau consist of a chairman, first and second
vice chairmen, an executive secretary, and a treasurer. These are
elected annually by the executive committee. Because the executive
secretary has duties in connection with the council activities o f the
bureau the election of this officer is subject to the approval o f the
Cleveland Welfare Federation. The bureau has been fortunate in
having since its organization a chairman, vice chairmen, and execu
tive secretary who have a fine vision of work for children and who
have been unprejudiced leaders.
EXECUTIVE STAFF

The executive staff o f the Children’s Bureau of Cleveland con
sisted in April, 1925, of 27 persons: The executive secretary, the
director o f case work, the medical director, the receiving secretary,
a supervisor, 11 case workers, and 11 students in training. There
were also 5 clerical and stenographic helpers.18 The bureau had
started four years previously (April, 1921) with a staff o f only two
persons—the executive secretary and his assistant; but very soon it
was realized that the staff must be enlarged rapidly to meet the
increasing demands of the institutions for case-work study of chil
dren seeking admission.
The executive secretary is the administrative head of the bureau
and is responsible for general supervision of the entire staff and
for carrying out such policies as are formulated by the committee
in regard to cooperation with other agencies, the health program,
and other matters. The director of case work assists the secretary
in the discharge of administrative duties and supervises all case
work. The medical director gives all his time to the examination
of children and to the general health work done for all children
entering institutions and foster homes. The receiving secretary
meets all persons making application for the care o f children.
The receiving secretary holds one o f the most important positions
in the bureau, for on her skill and judgment depend very largely
17 In 1926 the Cleveland W elfare Federation assumed the operation o f the summer-camp
registry.
18 On October 1, 1926, the executive staff consisted o f 28 p e rson s: The executive secre
tary, the director o f case work, 2 part-time medical directors, the receiving secretary, 2
supervisors, 10 case workers, and 11 students in tra in in g ; and there were also 6 clerical
and stenographic helpers.

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THE CHILDREN *S BUREAU OP CLEVELAND

the extent of the bureau’s work and its cooperation with other agen
cies. Information from the records indicated that the number of
applications accepted during the year 1924-25 was much smaller
than that for 1922-23, and this was due in great measure to the
better training of the receiving secretary on the staff in the later
year. The decrease is also due to the fact that in the first one or
two years the institutions were inclined to insist that all applica
tions referred by them to the bureau be investigated by bureau
workers and a report made to the institutions regardless o f the fact
that many of these applications should have been referred directly
to a family agency. However, at the present time the confidence
o f institutions in the work of the central bureau is so great that
many applications formerly investigated by the bureau are now
turned over immediately to other agencies. Each person making
application is carefully interviewed, and a form is filled out with
required information. While the applicant is still in the office the
Social Service Clearing House is consulted in person (it is in the
same building as the bureau) for further information on the family.
I f the family is found to be known to some other agency, this agency
is consulted before any action is taken. I f the application indicates
that the problem might be solved better by some other agency than
by the Children’s Bureau o f Cleveland, the applicant is taken or
sent to the office o f the agency able to assist. The Welfare Federa
tion has been able to house most of the charitable agencies in the
same building, and this often has enabled the bureau to make a
direct contact for the applicant with the agency to which he has
been referred. Much of the former futile effort which applicants
for institutional care o f their children put forth in going from
one institutioh to another and from one agency to another has thus
been largely eliminated. I f some unusual problem is involved in
an application, this is taken up directly with the supervisor of case
work, and all applications accepted are referred to her for distri
bution to the staff members.
Owing to a serious lack o f trained case workers in Cleveland it
seemed necessary to arrange for a training course in connection with
the bureau which would provide training for its staff members dur
ing their service. In this respect a precedent already had been pro
vided by the Cleveland Associated Charities, which had established
a training course in connection with its work as early as 1905, and
in 1916 it affiliated with the school o f applied social sciences of
Western Reserve University. Therefore it was decided that the
Children’s Bureau o f Cleveland and the humane society, which also
felt the need for better-trained children’s workers, should participate
in a joint training course conducted under the auspices o f Western
Reserve University. This course was started in October, 1921, in
the school o f applied social sciences under the direction of an expe
rienced children’s worker, who correlates the theory and the field
work.
Every effort has been made to attract well-qualified students. In
the four years during which this course has been conducted (1921—
1925) the total enrollment has been 83 students, and 52 of these were
college graduates. Students who are not college graduates must
have had normal-school training, teaching experience, or experience

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RELATION TO OTHER CHILD-WELFARE AGENCIES

in social work. In addition a candidate for admission must receive
the approval o f the director of the course and the director o f the
agency where training is to be received. The course originally was
j k planned to cover a year, but in the fall o f 1924 it was extended to
cover two years, leading to the degree of master of science in social
administration on presentation of a thesis acceptable to the univer
sity. Students are assigned special tasks in the agencies em
ploying them, and the course o f instruction is designed to give
to the student an understanding o f the social problems and some o f
the methods o f treatment. Much o f the material used for teaching
purposes is derived from the field experience of these students.
D'uring the year the student is required to work at least 32 hours a
week in one o f the cooperating agencies.19 The college graduate
without experience receives during the first year a monthly salary
o f $75 for the first 6 months, $80 for 6 to 9 months, and $85 for 9
to 12 months. In the second year the student receives $100 for the
first 6 months, $105 for 6 to 9 months, and $120 for 9 to 12 months.
The agencies in which students receive their training pay $90 a
year to the university for each student’s tuition, while the student
pays $35 toward his tuition.90 The agencies also cooperate with
the university by offering opportunities for field work to students
not enrolled on this remunerative basis.
Students qualifying for the course are pledged to stay at least two
years with the agency where they are receiving their practical train
ing. In the four years during which this course has been conducted
69 o f the 83 students have completed their course. Twenty-two
41 later dropped out o f the work entirely, the chief reason being mar
riage. Only 5 left the agency in which they received their training
to go to some other agency. There were 14 who failed to complete
the course, 5 giving ill health as the reason, 8 not being sufficiently
interested to go on with this field o f work, and 1 expecting to travel.
Twenty-eight o f the 83 students enrolled were assigned to the
Children’s Bureau o f Cleveland for their training, and 25 of these
completed the course. Among these 28 students were 19 college
graduates and 9 who did not have college degrees but had had other
experience that made them eligible for training. The desire for
more mature workers for certain phases o f the work and the neces
sity of having workers o f particular religious faiths represented on
the staff do not always make it possible to secure workers who are
college graduates.21 Valuable though this plan is in the present
situation in Cleveland it has the inherent difficulties o f combining
a job with getting an education at the same time, and it necessitates
class work with students o f quite different academic attainments.
Since the bureau finds it necessary to maintain its corps o f trained
workers by providing the means for their training, the organization
o f the staff becomes somewhat more involved than in those agencies
having only trained members. The work of the bureau falls into
two main divisions: The work with the individual institutions and
19 Annual Catalogue, School o f Applied Social Sciences, 1925—26. W estern Reserve
University Bulletin, Vol. X X IX , No. 5 (M ay, 1926), pp. 57-60. Cleveland, Ohio.
20 In October, 1927, the student w ill assume the full amount o f the tuition. Any sav
ing made in this way by the agency will be used to increase the worker’s salary after the
training is completed.
21 The 1926 training class was composed entirely o f college graduates who had chosen
the social sciences as their m ajor subjects, and many applications had t o be refused.

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TH E CHILDREN’ S BUREAU OF CLEVELAND

the district work. One of the greatest services it has been able to
extend to the institutions is providing a full-time case worker who
practically becomes a member o f the institutional staff and through
this close association has been able to know the particular problems A
that the institution has to face. Most o f the Cleveland institutions
are small, so that it would not be possible financially for them to
have their own trained workers; but having one bureau worker
handle the case work for two or three small institutions has made
trained service available for all institutions. This system has made
trained social service possible for the smallest institutions, and
through the intimate contact established by the bureau staff with
the institutions the bureau has been able to balance the needs o f the
community with the institutional facilities. That the work in con
nection with the institutions requires mature judgment and experi
ence in case work has been recognized by the bureau, and only
trained workers have been assigned to these positions. These
workers are responsible for the social work for children in the
institution and those whose families request admission. Much de
pends on the spirit o f the institution as to the amount o f work which
the case worker carries. Most of the institutions have turned over
the records o f all children, although there -are some in which the
social worker is not allowed to investigate every child.
The Children’s Bureau o f Cleveland has had the responsibility o f
demonstrating to the institutions the value of social case work. This
has been done by education in the use o f modern methods o f case
work rather than by insisting that certain standards accepted by the
bureau should be adopted immediately by all institutions cooperating
with it. The result has been that the institutions gradually are turn
ing over all their work to the bureau as their confidence is gained.
Some institutions have responded much more quickly than others,
which has meant that their cooperation with the bureau has been much
more close than that o f others. However, during the four years in
which the bureau has operated, it has known practically all the Cleve
land children in the institutions. The average case load for the
institutional social workers on the bureau staff was 40 to 60 cases.
In April, 1925, 17 o f the institutions had assigned to them trained
case workers from the bureau. Eight large institutions found it
possible to use the full-time services of one worker ; and four workers
were able to handle the problems of investigation and follow-up for
the nine that were small. The other institutions cooperated with the
bureau, but they did not have particular workers specifically as
signed. Besides their work with institutions two of the older trained
workers acted as supervisors o f case work for several students in
training, and all important decisions relating to their own work or
that o f the students whose work they supervised were discussed with
the director o f case work.22
To facilitate the initial investigation of families and the follow-up
work, when it was necessary to place children in institutions or to
supervise them in their own homes, the bureau divided Cleveland
into seven districts and placed a social worker in each o f these dis- ^
22
In 1926, owing to the increased demands fo r the services o f the bureau, arrangements
were made fo r two full-tim e supervisors and three part-tim e supervisors, who also carry
some institutional case work.

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R E LA T IO N " T O O T H E R C H I L D -W E L F A R E A G E N C IE S

tricts. A t the time o f the study these workers were usually students
in training. A ll case records and work done by the student workers
are checked carefully by their supervisors before any action is decided upon. The average case load for the student worker is 30
^ families—sometimes more, but seldom with difficult cases.
The time o f one trained worker is given entirely to the investiga
tion o f petitions for adoption o f children referred to the bureau by
the probate court. Another trained worker gives all her time in
the summer to work connected with the summer-camp registry.
RECORDS AND REPORTS

Every inquiry o f any kind pertaining to the care o f children is
reported on an application blank and is cleared through the Social
Service Clearing House. This is true even for those persons who
are referred directly to another agency without any investigation
whatever, and for those whose application evidently is unimportant
and is dropped by the bureau. The application blank is filled out
by the person interviewing the applicant (usually the receiving sec
retary), and the name and address and the most salient facts in
regard to the family and its social history as well as the Social
Service Clearing House references are noted. I f the application is
accepted this becomes a part o f the case record. I f the applicant is
referred to another agency or for some other reason the application
is not accepted it is marked “ information only,” and is filed alpha
betically in a separate file. A ll facts contained in the application
blank are noted in a register whether, the application is accepted or
{ty not, and a number is given to each application. The name of the
worker to whom the case was referred is added also.
The case records contain a face sheet, running record, summary
reports from other agencies who have known the family, medical
examination record, summaries made by the Children’s Bureau of
Cleveland for other agencies or institutions interested in the family
or for case committees, summaries of social history prepared for
cases where mental examination is needed, reports of mental-hygiene
studies, parental.consents for medical treatment, and contracts made
by parents for the support of children. A ll case records are made
out for the family rather than for the child, and they are filed
according to number.
The complete files of the bureau consist o f a register for applica
tions, a card file o f all cases known to the bureau, a visible-index
file of active cases, a statistical-card file for cases active in the cur
rent year, a case-record file, a card file showing the collections made
for the board o f children, and a file showing the children whose cus
tody the bureau has accepted. The card files are arranged alpha
betically and the file of closed-case records numerically. The activecase records are kept on the desks of the respective workers, arranged
alphabetically in box files.
The executive secretary makes an annual report on the work of
the bureau— a brief summary o f the aims of the bureau and the
^ achievements o f the year, and this is issued in printed form. Once a
^ month a report is rendered to the Welfare Federation o f Cleveland.
, This furnishes information on records open at the first o f the month,
new records, closed records, number o f children in institutions under

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THE. CHILDREN’ S BUREAU OF CLEVELAND

supervision at first o f month, number admitted and number dis
charged during the month, number of children receiving medical and
mental examinations, number o f children referred to family and
placing agencies, cooperation with other community agencies, and A
similar items. A copy of the compilation made from these reports m
for 1924 by the Welfare Federation o f Cleveland is shown in the
following table :
Information compiled by the W elfare Federation of Cleveland from the monthly
reports made during 192'Jj. by the Children’s Bureau of Cleveland
Number
Number
of chil
of chil
Number
dren
in
dren in Number
Records
Infor
of chil
of chil
Re mationvolved Records institu
open at
New opened
dren
dren dis
including
tions
first of records1
only
closed
admitted
charged
records1records1 Chil
under
month
dren’s
care on to insti from in
tutions stitutions
Aid
first of
Society 2
month

Montb (1924)

Total............

«900

901

153

637

3374

1,033

«947

1,154

1,234

January_________
February________
March___________
April______ ____ M ay......................
June_____________
J u ly .....................
August__________
September_______
October__________
November.......... .
December..............

817
897
916
945
968
1,019
1,056
1,023
1,153
981
' 1,029
1,079

102
79
79
68
69
77
85
87
77
62
64
52

25
15
9
7
10
16
10
9
18
10
14
10

39
38
38
24
45
64
62
91
57
88
48
43

405
390
379
264
308
' 424
379
465
424
438
318
298

47
75
- 59
52
28
56
128
84
288
68
57
91

870
927
969
973
1,054
957
891
898
979
901
967
975

95
115
108
76
74
110
81
100
99
113
100
83

59
98
101
77
67
160
132
106
135
132
78
89

1 Figures for each month in columns 2. 3, 4 give total number of families assisted.
2 Figures in column 5 represent the total number of children in those families.
3 Average per month.

The monthly report o f the executive secretary is compiled from
the written reports made once a month by each visitor on the exec
utive staff. The visitors’ reports are made on a standard form that
calls for information under the three headings (1) families, (2)
visits, and (3) cooperation (referring to cooperation'with other com
munity agencies in solving problems relating to the care o f children).
These records give only a numerical tabulation of applications for
care, case conferences, first investigations, and contacts with indi
vidual agencies.
Monthly reports of the medical and dental services at the clinic
at Lakeside Hospital also are made to the executive secretary of the
bureau, who transmits them to the Welfare Federation o f Cleveland.
FUNCTIONS AND POLICIES OF THE BUREAU

The functions o f the Children’s Bureau o f Cleveland are outlined
as follows: (1) To investigate requests for admission to the chil
dren’s institutions in Greater Cleveland, securing the fullest possible
facts about the child and his family as a basis for a constructive
plan; (2) to follow up the child’s family after placement so that 10
his family may be rebuilt as speedily as possible for his return;
(3) to examine physically all children admitted to institutions and
boarding homes; (4) to provide diagnostic service and planning

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RELATION TO OTHER CHILD-WELFARE AGENCIES

for problem and difficult children through medical, psychological,
and psychiatric examination and observation at -the. Children’s Aid
Society mental clinic; (5) to offer (under Western Reserve Uni
versity) training for children’s workers; (6) to afford a medium o f
exchange o f information and discussion o f joint problems; (7) to
aid-in developing a community plan for child welfare and the part
o f each agency and institution in that plan.
The bureau had the unusual advantage o f possessing as a basis
for operation the wealth of information which the survey had
gathered in regard not only to each institution but also to the
general needs o f the community. It had a working knowledge
from the first o f the position of each o f its member institutions in
relation to the children in its care and to the public, and it knew
the demands being made on these institutions by the community.
The bureau’s task was to plan a program that would increase the
usefulness of institutions to the community and redefine for the
public the place o f the institution in the care o f dependent and
neglected children. A careful study o f all requests for the admis
sion o f children to institutions has been the basis for this program.
The Children’s Bureau o f Cleveland has offered constructive social
service and has aimed with a full knowledge o f all facts to plan
adequately for the best interests o f each child coming to its atten
tion. I f institutional care is needed applicants no longer are com
pelled to travel from one institution to another seeking a vacancy.
I f on the other hand it is to the interest o f the child that he remain
with his family, community resources such as mothers’ pensions, day
nurseries, and family relief may be utilized to the full in lieu o f
institutional care. F or the child placed in an institution the bureau
provides a careful follow-up so that he may be returned as soon as
his family is ready for him. I f a child’s own home is permanently
shattered or is not apt to be ready for the child for a long period
the bureau, through cooperation with a child-placing agency, finds
for the child a suitable home, which may be a free home, a boarding
home, an adoptive home, or a wage home. In the case o f foreign
children the tie with the godparents implies a spiritual obligation,
and it is often possible to place children very happily in the homes
of godparents.
INVESTIGATION OF APPLICATIONS

Through trained and experienced workers all facts concerning the
child and his family are sought from relatives, social agencies,
schools, churches, and medical authorities. A case study o f a child
and his family falls into two parts: First, a study o f the child’s
family ; second, a study o f the child himself. A study of the family
includes the parents’ physical condition, their mental capacity and
personality, their religion and education, their vocation and financial
ability, their control over the children, and related matters. It
usually includes also a knowledge of the near relatives, as many
children are saved from institutional placement through the inter
est and generosity o f relatives.
Use o f the Social Service Clearing House and the securing o f in
formation from the agencies registered frequently make it possible
to know the whole background o f the child before any contact is

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THE CHILDREN’ S BUREAU OE CLEVELAND

made with the family. A call in the home to learn the family’s own
story is not sufficient; for it is not enough to note the symptoms, but
the actual social disease must be diagnosed. This can be accom
plished only through calls on relatives, schools, employers, and other
references. The study o f the child includes his heredity, possible
feeble-mindedness, physical condition, previous environment, home,
companions, and school and church relationships. His physical and
mental capacities, his disposition, and his likes and dislikes all are
considered in determining his future development and how it can
best be provided for. As the result o f such a study o f each child
and his family by competent workers who know the entire com
munity resources, arid the development o f definite policies, the long
lists o f children waiting for admission to institutions which pre
viously existed have been wiped out; and at present all children in
real need are being placed immediately. Careful investigation has
shown that the number o f applications made by the family direct,
from which the institutions formerly drew most of their clients, can
be so reduced by modern methods of social service and planning
that only about one-fifth o f such cases need actual placement; in
the remaining cases the family can be kept together through the
cooperation of other community agencies. Often the need is for
financial aid to keep the family together, fo r court action on the
ground of neglect, for medical or mental diagnosis and care, for
placement with relatives, or for return to the legal residence o f the
family.
The rock upon which all child-welfare work in Cleveland is built
is the principle that the home shall be preserved and the family ties
retained for every child i f it is humanly possible to do so. Place
ment is to be accepted only as a last resort. Where care outside the
child’s own home becomes necessary for a longer or shorter period
two methods o f care are provided by the community— institutional
care and foster-home care. The Children’s Bureau o f Cleveland
stands as the door to institutional care, while the Cleveland Humane
Society is the door through which children pass to foster-home care.
Owing to the limited facilities at the present time for care in foster
homes,23 particularly for the children o f Catholic faith, the bureau
and the humane society after careful consideration decided upon
the following plan in regard to the care o f those children whose place
ment outside their own homes was imperative: The bureau on behalf
o f the institutions which it represents is accepting the children coming
to the attention o f children’s agencies for the first time; this would
include children over 3 years o f age only (unless, as occasionally
happens, infants are given temporary care in St. Ann’s Maternity
Home or the Salvation Army Rescue Home), boys up to 12 or 13
years of age, girls up to 14 years, crippled children to be cared for
in two homes for cripples, and adolescent girls to be cared for in the
two training homes. The humane society is providing care for
children under 3 years, boys and girls over institutional age, many
problem children, a small number of children received from parents
who have indicated their preference for foster-home care, all de23
Lack o f adequate foster-hom e facilities has been due largely to the increasing demand
fo r foster-hom e care which the new child-welfare program has created in Cleveland and
to the fa ct that funds have not been sufficient fo r meeting this demand.

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pendent negro children, and children discharged from institutions
after training or after a period o f institutional care.
It has been recognized that this is not an ideal plan and that the
policy should be changed as soon as more adequate placement service
and boarding-home care could be developed to meet the increasing
need. Moreover this policy has not always been hard and fast,
and frequent exceptions have been made to meet the desires o f par
ents and the child’s special needs. One o f the great advantages of
this system has been the interplay o f institutional and foster-home
care for children and the more exact knowledge which has come as to
the need that institutions and placing agencies may fulfill in com
munity child welfare.
The bureau’s policy in regard to the length o f time that children
accepted for institutional care shall remain in an institution is that
residence for the normal child should be fairly short (not more
than two years at the most and probably much less) but that the
length o f time that each child spends in the institution should be
determined entirely by the condition of his own home and by his
own individual needs. This policy was developed largely because
there were not many homes available for children— chiefly owing to
lack o f finances for boarding-home service. Accordingly it was a
question which group o f children should have first the advantages
of home placement. This never has been an invariable rule, and any
child especially in need o f boarding-home care always has been pro
vided for in a foster home.
In regard to most o f the children coming to the attention o f the
bureau it has been felt that a brief period of training in an institution
is beneficial before they are sent back to their own homes or put in
foster homes. This perhaps has helped to save many foster homes
that formerly were lost when untrained children were placed in them
directly from their own homes and failed to adjust themselves to
these foster homes. The bureau is anxious that the children who
have been in institutions the longest time should be the first ones
considered for boarding-home placement. A t present many children
need to be placed in homes, a few o f these having been in institutions
more than five years. The bureau carefully reviews all children who
have been in institutions more than two years, and i f no other plan
is possible the Cleveland Humane Society is asked to place them in
foster homes.
What children shall be accepted for care outside their own homes
depends, of course, on the individual family circumstances and each
child’s particular need; but principles that have become a definite
guide in the solution of certain family problems have been worked
out from experience in handling many cases. Social agencies in
Cleveland unquestionably stand for the principle that no child shall
be taken from his home because of poverty alone. In the case o f
widows and deserted women with little children, where the ques
tion of lack of support is uppermost, the help of family agencies
and mothers’ pensions are enlisted to save the family unity. Aside
from the consideration o f the child’s best interests, which prompts
the desire to- keep him with his mother if possible, it costs the com
munity less to keep a child in his own home than to place him in
an institution. Though the problem when the father is left with a

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the

c h i l d r e n ’s

BUREAU OF CLEVELAND

family o f little children is much more difficult to solve and more
children o f widowers than of widows are accepted for institutional
care (see Table 17, p. 66), the bureau has accomplished something
for these families by arrangements for nursery care or for a house
keeper.24 For the woman with one child it is possible to make
arrangements for the child’s care in a day nursery; or a home may
be found, where both mother and child can be boarded; or a posi
tion in housework may be obtained where the child can stay with
his mother. During the first years of the bureau’s organization many
institutions were unwilling that applications involving a widow
with children or a woman with one child should be turned over
immediately to a family agency, and it often happened that after
the situation o f a woman with one child was investigated the child
was placed. This attitude on the part of institutions has changed
gradually, until now practically all cases of a woman with one child
are referred directly to family agencies, and so great are their facili
ties for helping to keep the mother and child together that very few
cases are referred back to the bureau for placement of the child.
Divorce and separation undoubtedly constitute to-day one o f the
greatest menaces in the welfare o f children. Studies relating to the
problem o f divorce have shown everywhere that the ease with which
parents are relieved o f responsibility for their children aids divorce
and that in the long run the children suffer neglect. Therefore the
Children’s Bureau o f Cleveland has been extremely careful about
the acceptance of children o f divorced parents, particularly where
the diyorce is pending or contemplated, and has formulated the fol
lowing principles in regard to this problem:
1. I f requests came from parents about to separate it was felt
that in such cases separation should be made as hard as possible
for the parents; the responsibility to be left entirely with the
parents, the children not to be accepted for institutional care, and
the family to be referred to a family agency for treatment.
2. I f parents already had separated and each had engaged an
attorney for divorce proceedings it was decided that as a general
rule the bureau should leave the entire matter to the parents’ legal
representatives. However, it was felt that in certain cases an im
partial investigation should be made as a protection to the children.
Through a special arrangement investigation in these cases was to
be made by the bureau of domestic relations; and only on the recom
mendation o f this bureau and with the full knowledge o f the trial
judge were children to be placed if divorces were pending.
3. I f the divorce was pending, or even if it had been heard and no
order of custody was made, it was decided that for the protection o f
the institutions a custody order should be secured by one parent or
the other. It was recommended that custody before placement be
secured through the juvenile court or the court making the divorce
decision.
4. I f the parent best able to care for the child at the time applica
tion was made had been denied custody at time of divorce, it was
felt that the question o f custody should be reviewed by the court

24 Plans by the bureau fo r a study o f certain situations in the families o f widowers,
which at present are handled by both the bureau and the Associated Charities, are now
under way in order to determine what policies are governing the supervision o f these

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RELATION TO OTHER CHILD-WELFARE AGENCIES

before placement. The general feeling was that unless the mother
was unfit she should be given custody o f the children in most divorce
cases and that if she needed help for the children she should be
^ referred to a family agency.
W
The families in which neglect o f children is the tragedy necessi
tating placement also receive most careful study. I f evidence war
rants prosecution and i f the parents are placed on probation there
is an opportunity to remove the cause of neglect while the child is
receiving care outside his home. I f it proves impossible to rees
tablish the home and the child is permanently removed, the agency
planning for the child’s welfare secures custody o f the child through
court action, as otherwise the parents are apt to demand the child
at any time whether it is for his best interests or not. Children
whose families are not legal residents o f Cleveland are returned to
the community legally responsible for their care except in special
cases or emergencies. These cases sometimes require protracted and
extremely careful investigation, as it is often difficult in small
communities to arouse a real sense of responsibility for the family
that is being sent back. After investigation and verification through
social agencies transportation if necessary is provided for the return
o f children to relatives, guardians, or home community.
Caution in the placing o f children whose families present such
problems as have been described does not prevent emergency place
ment, however. In time o f acute distress, sickness, death, or neglect
it is a vital part o f community child welfare to be able to place
promptly. Agencies are asked to give notice to the bureau several
^ days before hospital admission o f parents or a court hearing, if
™ possible, so that the best service possible may be rendered in the
placement o f the children concerned.
In the course o f the investigation o f applications there arise many
situations that call for the greatest consideration in deciding what
may be the plan best suited to the welfare of the children for whose
care in an institution application has been made. The Cleveland
Children’s Bureau has found that supervising children in the home
where they were living when application was made often does away
with the necessity o f placing them in an institution. Hence the
policy o f the bureau has been supervision without removal in those
cases where there is no emergency need for placement but where
there is some question as to whether ultimately the children may
have to be placed. This supervision is carried on by the district
workers.
At present legal custody o f children is accepted by the Catholic
Charities Bureau, the Cleveland Humane Society, some of the chil
dren’s institutions, the juvenile court, and the children’s bureau.
The children’s bureau has accepted the custody o f children since the
beginning o f 1925, and at present it has the legal custody o f a very
few children. The decision to accept custody o f children was made
largely because it was felt that much time and effort might be saved
in certain cases where this central bureau made all the plans for the
child but his actual custody was given to another organization. Thus
the bureau accepts custody for children needing only very temporary
care, leaving long-time custody problems to other agencies.
43967°—27---- 3

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TH E CHILDREN’ s BUREAU OE CLEVELAND
IN V E S T IG A T IO N S F O R A D O P T IO N S

The law gave to the probate court wide discretionary powers
in regard to investigation o f petitioners for the adoption o f childred,25 but no definite arrangement had been made with an agency A
for this service until 1925. B y an arrangement with the probate ^
court following a study by the Cleveland Conference on Illegiti
macy 26 early in 1925 the children’s agencies were to provide investi
gation service on all petitions for adoption o f children. A ll cases
o f requested adoptions are cleared first through the Social Service
Clearing House and then are referred to the Children’s Bureau o f
Cleveland. A ll petitions which indicate that either the child or the
petitioners are known to some case-work agency are referred directly
to that agency for investigation. Petitions which show that no other
case-work agency is interested are divided equally between the Chil
dren’s Bureau of Cleveland and the Cleveland Humane Society for
investigation. In the division o f these petitions those involving
illegitimacy primarily are turned over to the humane society, though
it frequently happens that in order to divide the number o f investi
gations equally the bureau is obliged to take cases of this type also.
Because o f pressure o f work at the present time in the bureau the
investigation o f petitions where relatives or stepfathers are peti
tioners has been dropped. However, when the court especially re
quests investigation of relatives’ adoptions the bureau makes the
study and report.
This service aims to protect the foster parents through informa
tion concerning the child and his family, his physical and mental
condition, and the advisability o f his adoption and also to protect jk
the child through a study o f the fitness o f the prospective home.
The court is under no obligation to accept the findings o f the
children’s agencies in regard to these investigations o f petitions
for adoption, and the fact seems to be that some recommendations
against the consummation o f adoption have been ignored. How
ever, this service is a long step in advance in the protection of
children placed for adoption, and it is yet too early to determine
the extent o f its success.27 The children most subject to adoption
and therefore most in need o f protection are those born out o f
wedlock and those whose parents are divorced. In the interest o f
the latter group a plan has been developed in Cleveland by which
the probate court refuses to complete an adoption without the con
sent o f the court granting the divorce. The judges o f the court
o f common pleas have ruled that they will not grant such consent
without investigation and recommendation from the bureau of
domestic relations.
P R O V IS IO N S F O R M E D IC A L C A R E

In July, 1923, the bureau added medical service to its already
existing child-welfare organization in order to give improved
medical attention to the children admitted to the care of institutions
26 Ohio, Gen. Code 1910, sec. 8024—1, added by act o f M ay 5, 1921, Laws o f 1921, p. 177.
(Page’ s Ann. Gen. Code 1926, sec. 8024—1, p. 2948.)
26 Cole, Lawrence C .: “ A study o f adoptions in Cuyahoga County.” The Fam ily [New
Y o rk ], vol. 6, no. 9 (January, 1926), pp. 259-264.
27 Since the study w as made a form er judge o f the juvenile court has been elevated to
the probate court, and the agency recommendations alm ost alw ays are follow ed. The
court likewise is now requesting investigations on all adoptions by relatives.

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RELATION- TO OTHER CHILD-WELFARE AGENCIES

;2 9

or placed in foster homes. The children’s bureau clinic was organized
as a definite department of the dispensary o f the Lakeside Hospital
and operates on the same basis as any other dispensary department.
The hospital furnishes rent, light, heat, telephone service, laboratory
and consultation service, etc., and the bureau furnishes the staff,
supplies, and equipment. The medical committee, composed o f rep
resentatives o f the bureau and o f the hospital, is responsible for
policies and administration. The advantages of this associated ar
rangement are quite evident; it eliminates the necessity for a sep
arate clinic, saving duplication o f service already at hand; it pro
vides immediately the highest type o f consultation service in special
conditions as well as all laboratory measures and the proper socialservice direction from the medical standpoint; and it gives ade
quate contact with the modern trend in pediatrics and child-health
work through consultation with the heads o f the department o f pedi
atrics o f Lakeside Hospital.
The medical director of this centralized clinic is a specialist in
pediatrics. He is a member of the children’s bureau staff and o f the
staff o f the pediatric department o f the Lakeside Hospital and gives
all his time to the examination o f the children and to work with the
child-caring institutions and agencies in solving their medical prob
lems.28 An experienced steering clerk has charge o f clearing the
cases, keeping the records, interpreting the examiner’s findings, and
directing the follow-up work— all subject to the approval and su
pervision o f the head social worker in the hospital’s department o f
pediatrics.
The clinic was organized to give medical attention to all dependent
children cared for in institutions through the Children’s Bureau o f
Cleveland and all children over 3 years o f age cared for in foster
homes through the Cleveland Humane Society. As the institutions
usually have their own medical staffs the responsibility for the re
moval of physical defects that had been found in children in the
course o f the examinations was to rest primarily with the institu
tions when the children were placed in their care; and this responsi
bility in regard to the children to be cared for in foster homes was to
rest upon the clinic. The remedial work for the institutional chil
dren generally is performed by the institutions’ medical staffs or by
a conveniently situated hospital, although many children are re
turned to the clinic for treatment at the institutions’ request. The
foster-home children return to the clinic at intervals for further
medical care according to their needs.
Before admission to an institution or a boarding home each child
is brought to the clinic by the worker in charge o f the case. After
the child has been examined the results o f the examination together
with the recommendations for his care are recorded on the triplicate
medical blank. Subsequently one blank is filled in at the clinic, a
second is sent to the institution for the attention o f the medical
attendant', and the third is sent to the social worker in charge o f the
case and is filed with the child’s record at the Children’s Bureau o f
Cleveland.
** In July, 1926, the medical director entered private practice and began giving only
the 9lmiP- A woman pediatrician giving part time was added
staff to handle the examination and treatm ent o f the older girls. M edical direction
o f the receiving home at the Children’ s Aid Society also was assumed on this date to
correlate the service w ith the clinic.

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THE CHILDREN’S BUREAU OF CLEVELAND

The examination of the child includes not merely a negative bill
o f health but a careful examination o f throat, heart, lungs, eyes,
glands, teeth, ears, nose, nutrition, skin, and scalp. Many children
are found to be in a condition of health that requires some arrange
ment to be made for very special care. The importance o f modern
child-health care is brought out strikingly by statistics compiled in
regard to 680 children given complete physical examinations at the
clinic. Ninety-five per cent o f all the children examined showed one
or more defects, as follows: 55 per cent had dental caries, 50 per
cent had goiter, 13 per cent had enlarged tonsils, 22 per cent were
seriously affected by malnutrition, IT per cent had defects o f the
genital organs, 3 per cent had defects o f the nervous system, and 65
per cent had defects o f some other nature. Among the 680 children
were 36 who had diseases requiring hospital treatment before they
could be admitted to institutions or boarding homes.
Apart from its primary object in the physical examination o f
dependent children the most important purpose o f the clinic organi
zation is to aid the various institutions to incorporate modern childhealth measures in their own programs. Since its establishment the
child-caring agencies and institutions have asked the assistance of
the clinic’s medical director in solving their various health problems,
including reexaminations of the institutional children, immuniza
tion against diphtheria, prevention o f goiter, various operative pro
cedures, consultation in obscure cases o f illness, aid in control of
infectious and contagious diseases, advice on orthopedic conditions,
diagnosis and care o f peculiar skin diseases, laboratory tests (includ
ing the tuberculin and Wassermann tests), X -ray examinations, and
adequate recording o f medical conditions. By giving part time to
working in the institutions with their medical staffs the medical direc
tor has been a great force in stimulating improved medical care within
the institutions, so that now practically every institution is reexamining
all children every six months, giving toxin-antitoxin as a matter of
routine, isolating every child on admission, and using similar pre
ventive health measures. I f medical and dental corrections are not
completed on discharge, special arrangements are made for follow-up
to complete these for the child in his own home. As a result o f this
cooperation with the institutions a medical program has been devised
as a goal for which to strive in each institution. This program is as
follow s:
Initial or entrance complete physical examination to include:
General development; state of nutrition ; age ; height;. weight; average
weight ; body temperature ; condition of skin, lymph glands, scalp, head,
ears, eyes, vision, nose, mouth, teeth, throat, tonsils, adenoids, neck
(goiter), chest, heart, lungs, abdomen, genitalia, extremities, osseous
system, neuromuscular system.
A competent physician, either skilled or trained in work with children,
preferably a physician who has vision o f preventive work, should make
the first examination and present exact recommendations for each
individual case.
'
Institutional facilities for the removal and prevention of defects and disease:
Observation ward o f cottage where children may remain two weeks before
mingling in main institutions.
Isolation quarters for cases of contagious and infectious disease.
Hospital quarters for care of the sick (medical care), and hospital quarters
for operative procedures (surgical care)— either of which may be within
an institution or outside it by cooperative relation with a hospital or
dispensary, the preferred arrangement.

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RELATION TO OTHER CHILD-WELFARE AGENCIES

Institutional facilities for the removal and prevention, etc.— Continued.
Preventive measures conducted by visiting physician at the institution—
1. Smallpox vaccination.
2. ( a ) Schick tests; ( 6) Dick test (pending) ; (c) toxin-antitoxin
immunization for diphtheria.
3. Prevention o f goiter by iodide.
4. Nose and throat cultures routine upon admission and during out
break of diphtheria.
Dietary measures:
1. Diet should consist both quantitatively and qualitatively of the required
food elements—protein, fat, carbohydrate, salts, vitamins.
2. Special treatment o f malnutrition, following the removal of all defects,
includes specific additions to diet plus bimonthly weighing, rest periods,
regulation of exercise and sleep.
Laboratory work (usually performed outside institution) :
(1) X-ray examination; (2) Wassermann test; (3) tuberculin test; (4)
vaginal smear (all to be done upon recommendation o f the physician).
Special examination by specialist for eyes, ears, nose, throat. Urinary
tract with examination o f urine, etc. Skin diseases and other consulta
tion necessities.
Dental care:
With admission dental examination and reexamination every six months.
For the larger groups this may be performed by a dentist within the
institution; for the smaller groups by an outside dental association.
Local hygienic measures— such as cleanliness, individual towels, care of teeth,
ventilation, etc.
There should be a reexamination of all children both from medical and dental
standpoint every six months.
Adequate though brief medical records should be kept to record all medical
and dental care performed. (A uniform medical blank has been developed
and is in use in most of the institutions.)
No child should be discharged from the institution until his defects have been
removed. I f this must be done there should be a serious attempt to follow
up those in subsequent charge o f the child.29

Provision for dental care has been made at the Lakeside Hospital
clinic and in two institutions from the funds o f the Children’s
Bureau of Cleveland. These are in addition to those existing in the
large institutions, and at present every institution with more than
150 children under its care (and some with less) has its own dental
equipment. Arrangements are made by the institutions for the
part-time services o f dentists, and at the bureau clinic a dentist gives
three half days a week to the care o f the teeth o f children placed in
foster homes and those for whom service is not available elsewhere.
The dental clinic at Lakeside Hospital has been operating since
January, 1924.30 The importance o f dental care is made evident
by a recent report showing that only 8 of 244 children in one insti
tution did not need dental care.
Health work is a fundamental requirement for the dependent child
since he too often comes from an environment where illness and lack
of care have been the cause o f his dependency and since his physical
examination on entrance to an institution or foster home may be
his only opportunity to have defects discovered that later might
prove a serious handicap to his health.
29W ahl, Spencer A . : “ Keeping children well in institutions.” The Survey [New Y ork],
Vol. L III, No. 8 (Jan. 15, 1925), pp. 461-462.
30 Since January, 1926, six half days a week have been inadequate to meet demands fo r
dental service at the clinic o f the Children’ s Bureau o f Cleveland.

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THE CHILDREN’ S BUREAU OP CLEVELAND
PROVISIONS FOR MENTAL EXAMINATIONS

Through the efforts o f the Children’s Bureau of Cleveland and
owing also to the unusual vision of the board o f directors o f the
Children’s A id Society, who foresaw the need of special care for
the difficult child, this society (an institution having a building o f
the old congregate type) was reopened early in 1922 as a diagnostic
clinic for the examination o f children with difficult mental and be
havior traits. Its purpose is not custodial care but special diagnosis
and treatment for the problem child through physical, psychologi
cal, and psychiatric examination and through careful evaluation
o f the child’s behavior. Retarded, psychopathic, abnormal, misun
derstood, and delinquent children were - referred to this clinic for
study and recommendation before final plans were made for their
care. The average stay at the clinic for each child was about two
weeks. The service o f this clinic was available to all children’s
agencies, the juvenile court, the board o f education, and other social
agencies o f the city. The Children’s Bureau of Cleveland was re
sponsible for the social service necessary in regard to admissions,
relations with other agencies, and discharges; the problems o f actual
mental and medical examination, internal organization, and insti
tutional management have been the responsibility of the clinic. As
this is a new field o f work many problems have arisen. One o f these
was following up cases after diagnosis and giving more careful at
tention to carrying out the treatment recommended. Accordingly
it was early decided to add to the clinic staff a visitor trained in
psychiatric social work in order to make the follow-up work more
effective.
w
In December, 1924, the National Committee for Mental Hygiene
opened a child-guidance clinic as a demonstration in Cleveland.
This was financed by the Commonwealth Fund and was located in
the Children’s A id Society plant. When it took over the society’s
work for difficult children 20 beds were assigned to the Children’s
Bureau o f Cleveland for use as a receiving home.31
The bureau is responsible for all admissions to and discharges
from the receiving home; and the medical director o f the bureau
has been placed in charge o f the medical care at this receiving home
so that it has become closely connected with the clinic at Lakeside
Hospital. The plan is to have children remain in the receiving home
not more than two weeks. During this period they will be given all
medical and mental study necessary in order to fit them for place
ment in an institution or foster home or possibly the return to their
own homes. As capacity is limited in proportion to total number
o f children being placed, only those children are placed in the re
ceiving home who primarily need careful observation or medical
and mental health study to determine what may be best for their
future. This is o f course a very recent development, and it is too
early to predict how this arrangement for a receiving home may
work out. It is quite likely that when the permanent organization
31
On Jan. 1, 1927, this child-guidance clinic becam e permanent and took over the professional direction o f the work fo r difficult children done by the Children’ s Aid Society. ”
The professional staff, including psychiatrist, psychologist, and social workers, became
part o f the staff o f the clinic. Fourteen beds were assigned to the child-guidance
clin ic fo r use in the observation o f behavior cases. T w enty-six other beds were assigned
to the children’s bureau fo r use as a receiving home.

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«gk

RELATION TO OTHER CHILD-WELFARE AGENCIES

o f the child-guidance clinic has been completed there may be other
changes in the provision for the care o f the difficult children which
was first started by the Children’s A id Society.

gx
“

F O L L O W -U P W O R K A F T E R P L A C E M E N T

In accordance with the aim o f the Children’s Bureau o f Cleveland
to retain family ties wherever possible, contact with the family is
continued during the child’s stay in an institution, and every effort
is made to adjust circumstances so that the child may return to his
own home as soon as possible. The chief object is to prevent the
children from indefinite institutional care, by keeping alive the
responsibility o f parents or relatives for the future care of their
children. I f the conditions in the home are such that it is impossible
to return the child to his own people after he has received the training
and care for which he was placed in an institution, he is then removed
and placed in a foster home. It sometimes happens that families
stubbornly refuse to reestablish a home for the children. In such
cases the bureau finds that as soon as a child is removed from the in
stitution and placed in a foster home his own parents, fearing that
the child may become too attached to the foster parents, soon make
arrangements for him in their own home or with relatives. No case
is closed by the bureau until the best possible adjustment for the
child has been made, and usually this means supervision in his own
home after care in an institution, if no other agency is responsible.
The follow-up work had been one o f the important factors in regulating the length o f residence of children in the institutions. Other
central clearing bureaus in this country are making initial investiga
tions, but perhaps no other bureau has developed follow-up work to
the same extent as the Children’s Bureau o f Cleveland.
F I N A N C IA L S U P P O R T O F C H IL D R E N

Through contact with the families the Children’s Bureau of Cleve
land has been able to get from the parents greater financial support
of their children than has been possible before. It has been recog
nized that (because of the lack o f investigation in the past) some
parents have been relieved entirely from financial responsibility or
allowed to pay too small an amount for the care of their children.
The parent’s responsibility for his child’s care comes before other
debts of any kind. The bureau felt that for the child’s sake and his
own, as well as for the community, every parent should be held to this
responsibility by court action i f necessary. When children are ac
cepted for institutional care the case worker makes out a budget for
the family. This is based on a careful study o f the family’s income
and expenses. With this exact knowledge in hand the bureau asks
the parents or guardians to sign a contract for the amount o f payment
they fairly can make toward the support o f their children. Every
parent, if able, should pay something, no matter how small; and he
should be held strictly to as large a percentage of the actual cost of
support as his circumstances permit. It was felt that with the cost
o f institutional care ranging from $3.50 to $13 a week, without count
ing interest on capital investment, parents should not be permitted to
transfer their obligations to the Community Fund.

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THE CHILDREN ’ S BUREAU OF CLEVELAND

When dependent children come through the juvenile court and
the court orders payment, the court also holds itself responsible for
the collection o f the money so far as is possible. This money then
is paid over to the Children’s Bureau o f Cleveland and prorated to
the institutions giving care to the children involved. Other families
are expected to pay for their children at the office o f the ,bureau.
W ith more simple arrangements in handling payments among the
various agencies making collections for the support o f children, and
with more training on the part o f the staff, the collection o f a larger
percentage o f the total cost o f support from those able to pay may
be possible as time goes on.

THE EFFECT OF THE BUREAU ON THE DEVELOPMENT OF
INSTITUTIONS FOR DEPENDENT CHILDREN
R E D U C T IO N O F C O N G E S T IO N I N T H E IN S T IT U T IO N S

Cleveland institutions for dependent children were so crowded at
the time of the establishment o f the Children’s Bureau o f Cleveland
in 1921 that many institutions were making plans for the addition
o f new buildings to the old institution or were intending to build
entirely new plants. Through careful investigation o f applications
for the admission o f children to institutions and the acceptance of
only those children who were most in need, the bureau soon dem
onstrated that the capacity o f the institutions at that time was
sufficient for the real needs of Cleveland children. It is a significant
achievement that the building programs which have been carried
out have been replacements of antiquated plants and not exten- #
sions. Parmadale, the new Catholic cottage project, is a replace
ment and combination o f two old orphanages. The Cleveland
Protestant Orphanage likewise replaced its antiquated plant with
a modern cottage system in the country. The new Cleveland Chris
tie1) Home was approved with the understanding that the increased
facilities were to meet primarily the out-of-town responsibilities
o f the Christian Church. It was also shown that one or two other
institutions could be closed without affecting in any way the needs
o f the community for institutional care of children, or that the
facilities which these institutions had might be used for the chil
dren in need o f some special care. The Children’s Aid Society in
1922 requested the help of the Children’s Bureau o f Cleveland in
the removal o f all children in its institution at that time in order
that it might reopen as a center for the study o f problem children.
(See p. 32.) A number of organizations that had made applica
tion to the State for permits to construct new institutions were
unable to prove the need for such institutions, and consequently
were not allowed to build, and two institutions for certain foreign
groups were closed and the children provided for elsewhere in the
community.
T h e re co m m e n d a tio n o f a te m p o r a r y sh elter m a d e in 1920 a fte r
th e su rv ey (see p . 12) has n o t been c a r r ie d ou t. A t th e tim e o f
esta b lish in g th e C h ild r e n ’s B u re a u o f C le v e la n d a sum o f $10,000
w as m a d e a v a ila b le th r o u g h th e W e lfa r e F e d e r a tio n f o r th e con stru c
tio n o f a re c e iv in g h o m e in c o n n e ctio n w ith o n e in stitu tio n b u t f o r
the co m m o n use o f a ll in stitu tion s. B u t the in v e s tig a tio n o f a p p lic a
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RELATION TO OTHER CHILD-WELFARE AGENCIES

tions for institutional care of children has so reduced the number
o f children admitted that usually there have been sufficient vacancies
in institutions to accommodate those children for whom immediate
mL shelter is necessary while they await further plans for their care.
w The arrangement made by the Children’s Aid Society to assign
20 beds to the Children’s Bureau o f Cleveland for use as a receiving
home has provided satisfactory receiving-home facilities rendering
an additional building unnecessary.
Under the guidance o f the Children’s Bureau o f Cleveland the
institutions o f the city are acquiring a new value in the scheme of
child welfare. Gradually the realization has come that dependency
alone should not be the basis for institutional care. Institutions
should meet special needs o f children by offering special service.
There is no longer a question o f institutional care versus foster. home care, but rather the combination o f the two is advisable, and
the function o f each should be determined by the particular child in
need. Those in charge o f institutions have realized as never before
that their real field is in the whole plan o f community care o f
children. It is no longer a question o f sheltering great numbers o f
children to the glory o f the institution; it is rather a question of
the individual care the institutions may give the child to the glory
o f the child himself. This attitude has not come about easily, and
moreover it has meant infinite adjustments on the part o f the in
stitutions to .adapt themselves to the new program. There have
been difficulties in the matter o f admissions and discharges. It
was difficult at first for the institutions to realize that certain
^ applications should be referred directly to a family agency without
further investigation by the bureau. This meant learning to dis
criminate in the applications for admission and to realizer that not
all applications are o f equal importance.
It is interesting to note that as the Children’s Bureau o f Cleveland
has become better known the number of direct applications from
families has decreased, while the number of applications for institu
tional care from social agencies has increased. Such agencies as the
associated charities, the health agencies, the humane society, and the
juvenile court now can place their most needy children. Instead o f
long waiting lists and lack o f institutional room there are vacancies
to-day in nearly all the institutions’, and it is possible to place any
child as soon as necessary. The time and effort o f agencies have been
saved by the bureau because it is no longer necessary to communicate
with different institutions in order to locate vacancies. The depend
ent and neglected child coming through the juvenile court is no
longer returned to his unfit home or held indefinitely in the deten
tion home. I f the bureau is notified before the hearing the child
usually can be placed immediately after the judge’s decision.
The number o f children in Cleveland institutions cooperating with
the Cleveland Children’s Bureau and the number known to the
bureau during the period 1922—1925 are shown in the accompanying
chart. The total number o f children in Cleveland institutions (ex^ elusive o f Jewish children) includes many children from outside
W Cleveland who are placed in institutions o f sectarian or regional
character that have responsibility for a larger territory than the
city. The children known to the bureau represent practically all

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THE

C H IL D R E N * S B U R E A U

OF C L E V E L A N D

children from the city of Cleveland with the exception of those
mentioned. The chart shows some seasonal variation in the number
of children in institutions known to the bureau. There is a general
tendency toward increase in the population o f both types during
the first half o f the year and a gradual falling off during the second
half. This probably is. associated with the effort o f the bureau to
arrange after the close o f school for the removal o f children no
longer in need of institutional care. An interesting feature of the
chart is the gradual increase in the number o f children known to the
bureau. This numerical increase is also a proportional one.32 The
increase in proportional relationship was abrupt during the first two
years o f the period and subject to considerable variation. This was
the period during which the bureau was in process of development
and was initiating certain social policies regarding institutional care.

The new policy of making the institution a training center which
prepares children physically, mentally, and morally for better
adjustment in their own homes, or if necessary in roster homes,
has led to an increased turnover in the institutions. The average
stay o f children in Cleveland institutions to-day is little more than
a year, in spite of the fact that one or two institutions with an
average stay of five to seven years bring up the average for the
community as a whole. The institutions are now serving a greater ^
32
Whereas approxim ately 50 per cent o f the children w ere known to the bureau during
the calendar year 1922, 72 per cent o f the total population o f the institutions were known
to the bureau in January to August, 1926.

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R E L A T IO N

T O O T H E R C H I L D -W E L F A R E A G E N C IE S

number of children because their residence is more temporary. This
has placed a greater burden on the institutional staff, but they have
been more and more willing to make any adjustments possible to
better their service to children.
NEW

S T A N D A R D S O F IN S T I T U T IO N A L C A R E

The standards o f care given by the institutions have risen steadily
since the establishment o f the Children’s Bureau o f Cleveland. Per
haps the greatest progress has been made in the medical attention
that now is within the reach of all children in institutions. Medical
examinations and corrective and preventive work are a part of the
program o f care in most o f the institutions. The centralized medi
cal service has meant that even the smallest institution can have
the benefit o f the most modern medical attention. The Cleveland
Nutrition Clinic has served a number of the institutions, and through
activities o f the bureau’s nutrition committee very great improve•ments in diet have been instituted. Several institutions also have
provided more adequate facilities for isolation than formerly. Much
more attention is given to dental care through the establishment of
a number of dental centers. A better understanding o f the care
needed by the retarded child, the child of border-line mentality, and
the child of difficult behavior has been brought to the institutions
by the facilities provided by the Children’s Aid Society clinic for
study of such cases. In order to reach these children and to provide
care commensurate with their need, group tests have been made of
^ all children in most of the institutions, followed by individual tests
™ and study at the Children’s A id Society clinic. Out of this planning
for difficult children has grown an intense interest in each individual
child entering the institution, and the bureau committee on indi
vidualizing the child has issued a record form which will be used
by the institutions to study the progress of children during their
institutional life.
The bureau provides uniform medical blanks and family-record
forms for such institutions as wish to have them, and it stands ready
to help in the keeping of better records. Poor records often have
meant tragedies in later years for children who have tried to find
their family or relatives. The bureau furnishes the institutions with
summaries o f the histories o f all children admitted to them, so that
they have complete information in their files concerning the children
they accept. Thus institutional records are much more complete
than ever before. Perhaps no one factor in the improved standards
o f care which institutions have adopted since the organization of the
bureau is more important than the realization o f the necessity o f ade
quate family records for each child. The bureau’s careful investiga
tion of applications has demonstrated vividly to the institutions the
great importance o f family histories in the consideration o f plans for
the child’s best interests. A striking example of this is shown in the
regeneration of one institution in Cleveland. This institution had a
combined maternity hospital and infant home, and a large percentage
ilp o f the cases handled were those o f unmarried mothers. For years
this institution cared for women during confinement, and then
accepted the babies for adoption or care in the nursery if the mothers
felt they could not take the children with them. The result was,

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THE CHILDREN’ S BUREAU OE CLEVELAND

o f course, that almost nothing was known o f these children. The
cooperation o f this institution has developed in a remarkable way
until now practically all applications are investigated by the bureau,
which has two full-time workers assigned to the work o f this institution. Five years’ operation of a central bureau o f inquiry not only
has kept hundreds o f children from admission to institutions but
has improved the standard o f care given to those whose admission
was necessary. Institutional life has been greatly enriched through
better medical attention, recreation programs, specialized training,
and deeper interest in the individual child.
P R E SE N T N E E D S IN

T H E C O M M U N IT Y C A R E O F C H IL D R E N

With the promotion o f a community-wide program to meet the
changing needs of Cleveland’s children all institutions and agencies
are asked to modify their methods and programs. Not all the needs
o f children in Cleveland have yet been met; there are still many
serious problems ahead. A n outstanding problem has been the lack '
of proper facilities both in institutions and in foster homes to handle
properly some o f the difficult types of children. A n institution
designed for normal children should not be asked to take the psycho
pathic or encephalitic cases, the sex offenders, and other abnormal
types; yet if the child’s own home is not equipped to handle the
problem, finding a new home and financing proper care in it has
been very difficult. As the State provides only limited facilities for
the care o f feeble-minded children there is need for some local pro
vision for emergency cases. The border-line child usually can be -M
placed in the ordinary institution, but some institution or home is
still to be developed for care of imbecile children.33
Institutional facilities for dependent Catholic boys are limited,
there being room for approximately .500 girls but only 250 boys.
Furthermore it is much easier to find foster homes for girls than
for boys, as relatives frequently are willing to take the girls in a
family while the boys are left for the community to provide for.
In order to relieve the situation it has been suggested that one of the
Catholic institutions now caring for girls make provision to take
some o f the younger Catholic boys. There is also need for more
vocational and manual training for older boys. Some adjustment has
been made in two training homes for girls in order that more girts,
who must assume the responsibility for the care o f younger brothers
and sisters and upon whom often rests the only hope of reestablishing
the family, can receive a training which will equip them to carry their
new responsibilities. This was achieved by raising the minimum age
limit for admission to these homes from 12 years to 14 years, inas
much as other institutions can care adequately for girls up to the
age o f 14. Delinquent girls o f 12 years or under with sex experience
also need more adequate institutional care, as they are too young to
enter the reformatory class o f the only institution giving care to
this type o f girl, and it is not fair to place them with the normal
children of their own age. It has been hoped that one o f the in- ^
33
In 1925 appropriations were made fo r tw o new institutions fo r the feeble-minded o f
Ohio, and this probably will make the need fo r temporary institutional care in Cleveland
less acute. (F ourth Annual Report o f the Department o f Public W elfare fo r the F iscal
Y ear Ended June 30, 1925, p. 31. [Columbus, 1 9 25,])

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R E L A T IO N

T O O T H E R C H I L D -W E L F A R E A G E N C IE S

stitutions now caring for older delinquent girls would be willing to
adjust its work so that the small group o f dependent girls at present
cared for might be replaced by a group o f very young delinquent
girls.
Difficulties no less intricate than those relating to institutional care
o f children have arisen in regard to foster-home placement. The
facilities for boarding-home care are by no means adequate to meet
the increasing demand. This is due not alone to the raising o f
standards o f child welfare in the community but also to other
causes that have been mentioned, such as the normal increase in the
population o f the city, the influx o f southern negroes during the past
five years with no provision o f institutional care for negro children,
and long periods o f unemployment beginning with 1920. The board
ing-home situation is somewhat different in Cleveland from that in
other cities in the respect that almost every dependent child has to
be provided for out o f private funds, and although some board is
paid for from public funds even the supervision o f State wards in the
city is provided for from private funds.

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STATISTICAL INTERPRETATION OF THE DEPENDENCY
PROBLEM
FIELD AND METHOD OF STUDY

The study o f the records o f the Children’s Bureau o f Cleveland
included the new applications received by the bureau for institu
tional care o f children during the two years April 1, 1922, to March
31, 1923, and April 1, 1924, to March 31, 1925/ These two years
represent the second and fourth years o f the bureau s existence and
were selected to show the general characteristics o f the bureau s
work. It was desirable that the report should indicate clearly what
a central bureau with a staff o f trained workers to make initial in
vestigation o f applications was able to do in having parents and
other agencies o f the community carry their share o f responsibility
for the needs o f children whose application for admission to insti
tutions had been received. It was therefore necessary to exclude
certain applications; namely, (1) applications for care of children
already in institutions for dependent children, in special institutions
for long-time care (such as a hospital for crippled children), or in
foster homes under the supervision o f a child-placing agency, (2)
applications made by the Cleveland Humane Society, associated
charities, and other agencies, for the observation of problem chil
dren at the Children’s A id Society clinic, (3) applications for the ad
mission o f children to summer camps, (4) applications made by the
probate court for the investigation o f children for adoption.
As this report is concerned with the primary causes o f dependency
as shown by family conditions making necessary the application for
institutional care o f children and with the prevention o f dependency
as shown by the recommendations made by the Children’s Bureau
o f Cleveland for the care o f children the information has bee»,
grouped according to whether it related mainly to the families or to
the children.
The new applications included those accepted for investigation and
follow-up by the bureau and those registered by the bureau as in
formation only,” which were referred directly to other agencies or
dropped. It seemed advisable to include the infortnation-only appli
cations, since they help to give the complete picture of the demand
on the bureau by families in need of care for their children, and they
also indicate the bureau’s position as a routing agency.
Necessarily the information contained on the information-only
applications was not so complete as for those applications which
were accepted by the bureau for investigation and follow-up, but
most o f these records contained practically all the information
40

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S T A T IS T IC A L IN T E R P R E T A T IO N O F D E P E N D E N C Y P R O B L E M

needed for the study. The bureau has more and more endeavored
to obtain in the first interviews with applicants only such informa
tion as will enable it to determine what agency can best handle the
situation and thus to avoid the distress o f having clients tell their
stories to two or three agencies. In connection with the tables, there
fore, it should be remembered that where a considerable number o f
items are “ not reported ” the lack of information thus indicated
usually relates to the information-only applications; but it was also
found that information in the case-work records was not always
complete, particularly in regard to nationality. The records o f
1,416 families with a total o f 3,074 children were included in this
study—736 families and 1,647 children for the year April 1, 1922,
to March 31, 1923, and 680 families with 1,427 children for the year
April 1, 1924, to March 31, 1925. The figures for number of fami
lies and number o f children used in the tables are those for the two
specified years combined.
A ll information secured from the records included in this study
was confined to conditions found in the family at the time o f first
application and the first recommendation made by the bureau for
the care o f the child or children for whose care application had been
made. No items pertaining to the family included in a reapplica
tion or further plans for the care of the children were considered.
Owing to the imiformly high standards for case work and record
keeping which have been maintained by the Children’s Bureau o f
Cleveland throughout its existence, the study was based entirely
upon data from the bureau records without any follow-up work
w în connection with the families or institutions or other agencies
interested in the cases studied. The generous cooperation o f the
executive secretary and staff o f the bureau and the fact that the
study was made at its office— which greatly facilitated the handling
o f records— made it possible to check up and verify doubtful in
formation as questions arose. The records were read and the sched
ules filled out by young women all o f whom had had experience
in social work in Cleveland. Instructions had been carefully worked
out so that the information as finally recorded in the schedules was
as nearly uniform as possible. The schedule used in the study
was so planned as to give the home conditions of the children as
reported at the time application was made for their care, previous
contacts o f social agencies with these families, relation o f the child’s
own family to the application for care, relation between family con
ditions and the recommendation o f the bureau as to the disposition
o f children, and the cooperation o f agencies and institutions in
rendering service to children and families. (F or the schedule used
in the study and the instructions see Appendix B o f this report
pp. 92-98.)
F ’
FAMILY BACKGROUND OF THE DEPENDENT CHILDREN
N A T IV IT Y O F T H E P A R E N T S

In a city like Cleveland with a high percentage o f foreign-born
population the nationality o f the parents is o f interest in a study
o f child dependency. The race and nativity o f the parents o f the

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THE

C H I L D R E N 'S B U R E A U

OF C L E V E L A N D

families applying to the Children’s Bureau o f Cleveland for care
o f their children were as follow s:
Number of
families

Race and nativity o f parents

Total—>
------------------ -------------------------------------------------- 416

W h ite_____________________________________________________ 1, 363
506
Foreign born__________________________________________
324
Native___________________________________ ____________ -144
One parent native, other foreign born—----------------------43
One parent native, nativity of other not reported--------62
One parent foreign born, nativity of other not reportedNativity of neither parent reported------- ------------------? 284
142
C olored -___
11
Not reported.

Color was reported for 1,405 o f the 1,416 families; 1,363 were
white, and 41 were negro. Nativity was reported for at least 1
parent in 1,079 o f the white families. Both parents were foreign
born in 47 per cent of the families; at least one parent was foreign
born in 19 per cent. The foreign birth o f one or both parents thus
enters into consideration in at least 66 per cent of the families. I f
information in regard to nativity of parents had been available for
all families this percentage doubtless would have been much larger,
but the records studied often lacked definite information on this

point*

How serious a cause o f dependency the adjustment o f foreign
people to a new environment may be can not be stated here con
clusively. The numbers of children in the families show some
interesting contrasts. O f the 324 families in which both parents ^
were native white there were 57 per cent who had only 1 or 2
children; and 52 per cent o f these 324 families requested placement
o f all their children. It would appear that the family ties were
not so strong in native white families for whose children provision
had to be made by the community as were those in the foreign-born
families; for in only 32 per cent of the families were there fewer
than 3 children, yet only 34 per cent of these 506 families in
which both parents were foreign born requested placement o f all
their children. A comparison o f these two groups in respect to
these data raises the question as to the possibilities for rehabilitation
o f the families. This of course depends also on the marital rela
tion o f the parents at the time when the application was made. O f
the families in which both parents were foreign born for whom
information as to marital status was given 49 per cent were married
and living together, 10 per cent were divorced or separated, in 13
per cent, one or both parents had deserted, in 26 per cent one or
both parents were dead, and in only 1 per cent o f these families the
parents were unmarried. O f the families in which both parents
were native and marital status was reported 31 per cent were married
and living together, 26 per cent were divorced or separated, in 21
per cent one or both parents had deserted, in 19 per cent one or both
parents were dead, and 3 per cent o f these parents were unmarried.
Contact with other agencies before coming to the bureau was ^
shown by Social Service Clearing House records for 88 per cent T
of the families in which both parents were foreign born and for
1 Includes one fam ily in which the mother was Indian and the father white.

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STATISTICAL INTERPRETATION OF DEPENDENCY PROBLEM

^
^

79 per cent o f the families in which both parents were native.
Although this difference is only 9 per cent it is o f considerable sig
nificance. There is also quite a difference in the nature o f the
trouble that brought these two groups to the attention o f the Children’s Bureau o f Cleveland. For the foreign-born group the out
standing problems among those reporting only one problem were
death, 19 per cent; divorce and separation, 7 per cent; desertion, 5
per cent; physical disability, 42 per cent; mental disability, 12 per
cent. For the native group the problems were death, 19 per cent;
divorce and separation, 23 per cent; desertion, 14 per cent; physical
disability, 18 per cent; and mental disability, 5 per cent.
In the light o f the problems most pronounced in these two groups
of families, one where both the parents are native and one where
both the parents are foreign born, there would appear to be a sig
nificant difference in causes of dependency. In the native group
there seems to be a disintegration of family life as manifested in the
percentage o f divorce, separation, and desertion—not a very promis
ing foundation on which to preserve a home for the child. In the
foreign-born group the situation o f families is more hopeful in that
the factors causing dependency are much less disastrous to family
life though none the less unfortunate. It is probably true too that
a better type of family comes to the attention of agencies in the
foreign-born group, as in a strange country they have fewer friends
and relatives to turn to in distress than the American families have.
Table 1 shows the race and country of birth o f the fathers and
mothers o f the children for whose care application was made to the
Children’s Bureau o f Cleveland. As the information in the records
o f the bureau in regard to country o f birth did not invariably relate
to the countries as constituted after the W orld War 2 it is not pos
sible to make an exact comparison of the foreign-born population
groups and the race and country of birth of the parents in the
families coming to the attention of the bureau. The countries o f
birth of the foreign-born population of Cleveland were as follows,
in the order o f numerical importance, for the eight most frequently
designated countries: Poland, Hungary, Germany, Russia and
Lithuania, Czechoslovakia, Italy, Jugoslavia, and Austria.®
1.— Race and country of birth of the fathers and mothers of children
for whose care application was made to the Children's Bureau of Cleveland

T able

Fathers

Mothers

Total.________________

1,416

White_____________________
United States. _______
Foreign_________________

1,364
401
627

1,363
435
591

Austria and Hungary.
Italy. ____________ Poland_____________
Germany___________
Russia______ _______
Czechoslovakia______

169
104
66
33
32
30

186
87
55
28
20
28

Race and country of birth

Fathers

Mothers

White—Foreign—Continued.
Canada.:.. ------------England_______
Ireland_____ ___
Rumania_______ . . .
Other.. ___________
Not reported________

21
17
17
14
85
39

15
18
18
12
80
44

Country not reported____
Colored. --------------------------Race not reported------ ---------

336
41
11

337
42
11

2 Since 1925 the Children’ s Bureau o f Cleveland has established the policy o f relating
birthplaces o f foreign born to the countries as constituted after the. W orld War.
8 Fourteenth Census o f the United States, 1920, Vol. II, Population, p. 740. W ashing
ton, 1922.

43967°— 27------4

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THE

C H IL D R E N ’ S BU R E AU

OF C L E V E L A N D

Table 2 shows the length o f residence in the United States o f
fathers and mothers of children for whose care application was
made to the Children’s Bureau o f Cleveland. A large proportion
o f records did not give information on length o f residence of foreignborn parents in the United States, and the data were inadequate for
a study o f any relation that might obtain between length o f
residence o f parents and dependency o f children. It might be sup
posed that the longer a foreign-born family was in this country the
better its adjustment would be, and therefore the need o f help from
the community would be diminishing. However, when immigrants
arrive in this country young and with small families some years
may pass with increasing responsibility and the physical and mental
strain of adjustment before a family reaches the point where it must
ask for help in the care o f its children.

M
®

T able 2.— Length of residence in the United States of fathers and mothers of

children for whose care application was made to the Children's Bureau of
Cleveland

l
Length of residence in United
States

Fathers Mothers

Total______________ !..

1,416

Native ________ _____
Foreign b om _______________

434
627

470
691

Never in United States_____
In the United States—
Less than 5 years_______
5 years, less than 10_____

14
20

32
40

Length of residence in United
States

Fathers Mothers

Foreign born—Continued.
In the United States—Contd.
Number of years not reNot reported whether native or
foreign born__

285

217

305

300

355

Possibly the length o f residence o f the foreign-born families
applying to the bureau for care o f their children was analogous in
some way to the age o f the parents and also to the duration o f their
marriage. Table 3 shows the ages o f the fathers and mothers for
care o f whose children application was made to the Children’s
Bureau o f Cleveland.
T able 3.—Ages of fathers and mothers for care of whose children application

was made to the Children's Bureau of Cleveland
Age of parents
Total....... ................
Under 20 years _____
20 years, under 25______
25 years, under 35______ __

Fathers 1 Mothers1
1,416

1,416

35
360

21
151
451

Age of parents

45 years and over.Not applicable (parent d ead )...

Fathers1Mothers1

139
155
347

52
222
279

1 Own, step, or foster.

Application for the care of the children was requested most fre
quently when fathers were between the ages o f 25 and 45 (18 per
cent) and mothers between the ages o f 25 and 35 (49 per cent).
Few requests came when fathers were under 25 years o f age (4 per
cent), and in 15 per cent o f the cases the fathers were 45 years old
and over. The age o f the mother, on the other hand, was less than
25 in 19 per cent o f the cases; 49 per cent were between 25 and 35,

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S T A T IS T IC A L IN T E R P R E T A T IO N - OE D E P E N D E N C Y P R O B L E M

26 per cent were between 35 and 45, and 6 per cent were 45 years
and over.
The duration o f marriage o f the parents o f the children is shown
in the following list. In this tabulation all cases were considered
applicable in which the marital status o f the father and mother
was reported as “ married ” and in which all children were the
children o f the present marriage. Families with stepchildren or
adopted children and families of widowed, divorced, or deserting
parents consequently do not appear in the applicable group.
Duration o f marriage

Number o f
fam ilies

T ota l---------------------------------------------------------------- 'x.___1,416
Total reporting_4.__ _______________________________ ______

316

Less than 2 years_________________________ ____________
2 years, less than 3_____________ _________________ _____
3 years, less than 5__________________________________
5 years, less than 10_______________
10 years and more_______________________

10
10
17
75
204

Not reported_______________________________________________
Inapplicable_______________________________________________

112
988

R E L IG IO U S A F F I L IA T I O N O F T H E P A R E N T S

In view o f the fact that the Children’s Bureau of Cleveland rep
resents all the Catholic and Protestant institutions of the city, it
was advisable to ascertain the religious belief of parents in order
to know whether the children should be assigned to Catholic or
Protestant institutions when accepted for care. The total capacity
o f Catholic institutions is about three times as great as that o f the
Protestant institutions, and therefore the former can accommodate
the greater number o f children assigned to them.
As the institutions for Jewish children do not use the services o f
the bureau for investigations, any applications for the care o f Jewish
children received were referred directly to the Welfare Association
for Jewish Children. The religious affiliations of the parents of
children for whose care application was made to the Children’s
Bureau of Cleveland were as follows:
R eligious affiliation o f parents

fam ilies

T otal--------- ------------------------- ------ ------ ----------------- ¿ __ 1, 416
Catholic____ ™ __ _____________________________ I___ j_______
Protestant_________________ ______________ j j g __________ ____
Jewish-------------------------------------------- ;____________________ 9
Not reported__________ _________________________ 711________

844
467
99

S O U R C E S O F A P P L I C A T I O N S F O R C A R E O F T H E D E P E N D E N T C H IL D R E N

The sources o f applications received by the Children’s Bureau of
Cleveland furnish an interesting index o f the channels through which
child dependency becomes known to the community, and they indicate
the importance o f a clearing bureau as a center through which these
numerous channels can converge, making it possible in this way to
know the entire problem o f dependency in a community.
Applications made to the bureau may be divided into two groups
as to source: Those made by the family or friends, representing
43 per cent o f all applications; and those made by some social agency

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THE

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(including institutions), representing 51 per cent. Where the family
made the application the mother was the one who made the contact
with the bureau in most cases. This did not always mean that the
father was no longer in the home; in fact where the mother made the
application there generally was a need for family adjustment, and
consequently most o f these applications were not accepted by the
bureau but were referred directly to family agencies for care. When
application was made by the father, relatives, or friends, it was
found usually that the family was broken by the death o f the mother;
and this presented a situation that made it more difficult to hold
the family together. Hence the bureau accepted more o f these
applications for investigation and recommendation.
Many o f the applications made by the families had been made
originally to an institution and from there referred to the Children’s
Bureau of Cleveland.
O f the applications made by the family or friends 49 per cent were
accepted by the bureau for investigation and recommendation for
care, whereas o f the applications made through an agency 89 per cent
were accepted. The large percentage o f the latter applications ac
cepted is probably due to the present understanding that the bureau
has with other social agencies o f Cleveland in regard to the children
acceptable for institutional care. The bureau in cooperation with the
institutions has gradually developed a policy on the nature o f institu
tional care that has emphasized the needs of certain children for
temporary care and special training. The agencies for the most part
were seeking temporary placement o f children. The mother’s need
o f hospital care was the reason most frequently given by agencies.'
This was particularly true o f the applications made by the associated
charities. Table 4 shows the source of application for care of
children made to the Children’s Bureau of Cleveland and the
acceptance and nonacceptance o f the applications.
T able 4.— Sources of application for care o f children made to the Children's

Bureau of Cleveland, ~by acceptance and nonacceptance o f applications
Applications for care
Source of application

Total
Not
Accepted accepted

Total___________

1,416

1,007

409

Total reported by—
Family and friends.

599

295

304

Both parents...
Father________
M other...........
Relatives_____
-Friends_______

11
145
351
60
32

5
98
129
41
22

635

564

145
136
131
83
63
77

125
117
119
79
63
61

77
96
9

65
78
5

12
18
4

Agencies_____ ____ _____ ________
Health agencies______ _____ _
Catholic Charities Bureau____
Cleveland Associated Charities.
Cleveland Humane Society___
Juvenile court_______________
Other agencies...........................
Institutions.
Other.........
Not reported__

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6
47
222

19
12

S T A T IS T IC A L . IN T E R P R E T A T IO N OF D E P E N D E N C Y P R O B L E M

Applications indicated as made by institutions were made for the
most part by the family or friends but were referred to the bureau
in such a way that it was not clear what person had actually made
application. Two institutions in a few instances had accepted
children in emergencies and then asked for investigation.
In 1922-23 there were 587 applications accepted, and in 1924-25
there were 420 applications accepted. The decrease was due not to
fewer applications for care but to the fact that through better under
standing on the part of institutions the bureau was able to refer
more applicants to family agencies equipped to aid parents in keep
ing their children with them. Applications not accepted increased.
In 1922-23 there were 149 rejected; in 1924-25 there were 260
rejected.
W H E R E A B O U T S O F F A T H E R A N D M O T H E R A T T IM E O F A P P L I C A T I O N

Table 5 shows the whereabouts of the mothers and fathers of the
children for whose care application was made to the Children’s
Bureau of Cleveland. It will be noted that among the 1,416 fami
lies there were only* 324 in which the father and mother were together
in their own home at the time when application was made for the
care o f their children. For a large number of these families tem
porary care of the children was requested while the mother went to
the hospital, and several children presenting some particular prob
lem came from these homes. Other items in this table help to give
a vivid picture of the scattered membership that makes the care of
dependent children difficult.
T able 5.— Whereabouts of mothers at date of application for care of children

referred to the Children’s Bureau of Cleveland, by whereabouts o f fathers on
the same date
Whereabouts of father

Whereabouts of mother

Total
families

Board
ing or
In
living
correc
At
with Dead tional
home rela
insti
tives or
tution
friends

In
general
hospital
or
sana
torium
for
tuber
culosis

In
hos
Absent
pital Other from
for in
family 1
sane

Total........................... ...............

1,416

607

175

154

410

At home_________ ____ ____________
Boarding or living with relatives or
friends....................... .....................
Dead,............... ...............
In correct] onal institution. . _.
In general hospital or sanatorium for
tuberculosis____
In hospital for insane..
Living’ at place of employment (domestic service)____
Other____________
Absent from family i..................

640

324

6Î

182

242
221
23

25
108
4

46
49
3

31
36
'3

6
7
2

129
21
9

138
16

92
9

4
2

22
5

25
10
101

1
4
40

5
2
27

9
3

10
4
28

1Not otherwise specified.

The marital status o f the parents, which is of interest in this con
nection, is shown in Table 6.

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T able 6.—Marital status of parents of children referred for care to the Chil

dren's Bureau o f Cleveland, by whereabouts» o f father at the date of applica
tion for care
Whereabouts of father

Marital status of parents

Total____________________

Total
fami
lies

Board
ing or
living
At
Dead
home with
rela
tives or
friends

In gen
eral
In cor hospital
rection or sana
al insti torium
tution for tu
bercu
losis

In
hos
pital
Absent
for Other from
the
family1
in
sane

1,416

607

175

154

410

Total reported____________________

1,385

607

174

154

382

Married._____________________
Separated___________ _______
D ivorced.._______________
Mother dead______________ . . .
Father dead_____________ _____
Both parents dead_____________
Father deserting______________
Mother deserting________ _____
Unmarried................................„

532
130
104
185
118
36
177
64
39

430
17
10
108

25
50
29
49

11
5

25
63
58
21

Not reported______________ _______

2
7
118
36

40
2

15
1
1

*
1

1
1

172
9
34
28

1 Not otherwise specified.
R E A S O N S F O R M A K I N G A P P L IC A T IO N

T a b le 7 sh ow s th e reasons g iv e n f o r re q u e stin g a id in care o f
ch ild re n g iv e n b y the in d iv id u a l o r a g e n cy a t th e tim e a p p lic a tio n
w as m ad e. T h e in fo r m a tio n in th is ta b le is b a sed o n th e reasons
as g iv e n b y th e f a m ily o r th e a g e n c y r e fe r r in g th e fa m ily , a lth o u g h
o f cou rse th e reason s w e re sta ted in m a n y d iffe r e n t w a y s. F o r th e
m ost p a r t th e im m e d ia te rea son f o r re q u e stin g a id w a s g iv e n b y the
a p p lica n t. W h e n m o re th a n on e reason w as g iv e n th e o r d e r (1 )
d eath , ( 2 ) illn ess, (3 ) d e s e rtio n w as u sed in c la s s ify in g th em . F o r
in stan ce, i f th e rea son stated w a s “ m o th e r d e a d , fa t h e r u n a b le to
k eep ch ild re n to g e th e r ,” th is w a s ta b u la te d as “ m o th e r d e a d .” I t
w as fo u n d th a t d ea th w a s in th e m a jo r ity o f cases th e im m e d ia te
reason g iv e n , even i f n o t the e m e r g e n cy n e ce ssita tin g the a p p lic a tio n
f o r ca re o f th e c h ild re n . S o m e m o th e rs in su ch cases h a d been d ea d
as lo n g a tim e as tw o y ea rs, th o u g h in m ost o f th e m th e m o th e r ’s
d ea th h a d o c cu r r e d v e r y recen tly .
S t ill oth er e x a m p le s m a y be g i v e n : T h e reason g iv e n as “ m o th e r
tu b ercu lou s, n o on e to care f o r c h ild r e n ,” w as ta b u la te d as “ m o th e r
i ll.”
T h e reason g iv e n as “ m o th e r deserted, n o ' on e to ca re f o r
ch ild re n ,” w as ta b u la te d as “ m o th e r d eserted .” T h e rea son g iv e n
as “ g ra n d m o th e r m o v e d a w a y , n o on e to care f o r c h ild ,” w a s ta b u
la ted as “ n o ca re ta k e r.” S u ch cases as th e la st o f these th ree
e x a m p les in clu d e d p r im a r ily th ose c h ild re n w h o w ere n o t w ith
th eir im m ed ia te fa m ilie s w h en th e difficulties a rose th a t n ecessitated
th e a p p lic a tio n f o r th e ir ca re b y th e co m m u n ity .
D e a th a n d illn ess (in c lu d in g b o th p h y s ic a l an d m en ta l d is a b ility )
are th e o n ly reasons sh ow n in T a b le 7 th a t in a n y m easure in d ica te
th e fu n d a m e n ta l n a tu re o f th e fa m ily n eed to p la c e th e ch ild re n .
T h e o th e r reason s are p r im a r ily an in d ic a tio n o f em erg en cies th a t

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*

S T A T IS T IC A L IN T E R P R E T A T IO N OP D E P E N D E N C Y P R O B L E M

upon investigation reveal the undermining o f the home by death,
illness, desertion, divorce and separation, or lack o f parental
responsibility.
The Children’s Bureau o f Cleveland accepted 533 (81 per cent)
o f the 66^ applications in connection with which death, illness, or
desertion was given as the reason necessitating the application for
aid; it did not accept 129 (19 per cent) o f this total. It accepted
470 (63 per cent) o f the cases in which reasons other than death,
illness, or desertion were given for application for aid; and it did
not accept 275 (37 per cent) o f them.
Under “ other reasons ” in Table 7 are included the cases of 14
families in which it was evident that the illegitimacy o f the child
was the real reason for requesting aid, 16 families in which the
mother’s immorality was the reason, 22 families in which one or
both parents were in correctional institutions, and 50 families in
which the parents were separated or di vorced—although other reasons
than these were given.
T able 7.—Reasons for requesting aid in care of children'reported to the Chil

dren’s Bureau of Cleveland, by acceptance and nonacceptance o f applications
Applications for care
Reason for requesting aid

ac
Accepted Not
cepted

Total

1,416

1,007

409

1,407

1,003

404

134

112

20
102
10
2

12
89
9
2

8
13
1

Illness, physical or mental disability_______________________ _______

413

345

Both parents____ _________ _____ _____________________________
Child
__________________________________________

16
334
12
51

11
288
10
36

5
46
2
15

115

70
44
1

45
30
1

25
14

201
88
87
61
109
26
173

85
67
58
42
93
15
110

116
21
29
19
16
11
63

5
M

Both parents________________________________________________

Mother working or intending to work_____________________________
Child in need of discipline________________________________________
Relatives or friends unable or unwilling to keep longer--------------------Home conditions unsatisfactory (including neglect and c ru e lty )...!...
Boarding home unsatisfactory................... . ........................................

Illness was given as the immediate reason in 29 per cent o f the
applications for care o f children outside their homes. In 24 per
cent the reason given was the illness of mother. An analysis of
T* the nature o f the illness brings out some interesting facts: There
were 78 women in need o f an operation, 53 were confined, 50 had
tuberculosis and were receiving treatment, and 58 were ill from other

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causes. The kind of illness was not reported for 44 women. Cases
o f mental disability included 36 women diagnosed as insane and 15
who were either feeble-minded or epileptic.
Death of parents or other caretaker was given as an immediate
reason in the case of only 134: (10 per cent) o f the families for whom
aid was requested; and, as would be expected, the death was that of
the mother in 76 per cent o f the cases in which death was given as
the main reason for placement of children outside their own homes.
It is interesting to note the difference in the number of applica
tions accepted by the bureau in cases where death o f mother was
reported and those where death o f father was reported. Families
in which the mother is living usually can be provided for through
a family agency, if it functions well, through the mothers’ pensions
department o f the juvenile court, or through arrangements for care
o f children at a day nursery. The solution for keeping together a
family in which the father is left with a flock o f little children is
still to be found.4 Death of both parents appears to be only a small
factor in causing the dependency o f children.
Only slightly less serious a problem than death is that o f deser
tion, which causes 8 per cent o f the immediate reasons for request mg placement of children outside their own homes. Desertion is
closely allied to separation and divorce and constitutes a problem
requiring great skill in rebuilding the home for the child. These
three are signals o f distress rather than the distress itself which is
destroying the family life.
The families (754) for which other reasons than death, desertion,
or illness were given represent mostly those in which the home,
situation was much more complicated. The immediate reason
mother working or intending to w ork ” was given in 201 (14 per
cent) o f the applications. The records showed that divorce, separa
tion, desertion, and nonsupport were fundamental factors in these
family situations, although they were not given as the emergency
cause o f application. The impression given is o f families lacking a
well-developed sense o f responsibility for the maintenance o f a home
and the proper care o f their children. As an illustration o f the gen
eral caliber o f these families the following history o f one family is
given:
J
A woman 30 years old applied at the Children’s Bureau of . Cleveland for
institutional care of her 5-year-old boy. She stated that she was divorced
xrom her husband, who was 38 years old. The divorce had been mutually
agreed upon when she had become pregnant as her husband had not wanted any
children After their divorce she had gone to live with her mother and had
taken a bookkeeping position. The grandmother had looked after the boy until
recently she felt she could do it no longer. Since the birth o f the baby the
father has become very fond o f him and the mother, who still cares for her
former husband, hopes that she may remarry him, but in the meanwhile she
teels that she will have to place their son. She had supposed that institutional
v i« i

„ ¿i1$
qb-2 Jewish W elfare Society o f Philadelphia, which has organized a staff o f
chosen8 and tvn1nAar hv1S+hPpr0^Cilins a ,so,luti ° n for th is problem. These women, carefully
cnosen and trained by the society, go into homes every day in time to give the children
breakfast and get them off to school. The care o f the children, the preparation o f meals
keemng the house in order, and the care o f the m other i f she is ill at home, are taken
over by these women. They give the children the evening meal and stay until the father
returns from work. See
The visiting housekeeper,” by Salome S. C. Bernstein, in The
Jewish Social Service Quarterly, vol. 2, no. 1 (M ay, 1925), pp. 10-21.

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care o f children w as all that w as available but preferred foster-hom e care
when this w as suggested to her. Through the Cleveland Humane Society the
little boy was placed in a licensed boarding home where the mother paid
fo r him.

The history o f this family indicates a curious irresponsibility on
the part o f the parents in their attitude toward the obligations that
marriage entails. A situation o f this character makes the rehabili
tation o f a child’s own home much more difficult than in a family
where placement is made necessary by the mother’s illness.
The bureau’s policy o f turning many of these cases over to a family
agency for adjustment unless other conditions made it necessary to
place the children is being more and more carefully followed. In
the year 1922-23 a total of 98 applications were made by mothers
who were working or intended to go to work, and 57 were accepted
by the bureau, 41 being referred elsewhere. In the year 1924-25
the situation was very different; only 28 of the total o f 103 appli
cations made by mothers working or intending to work were
accepted, 75 being referred elsewhere. This indicates that such
families are recognized as needing family readjustments rather than
the placing of children.
When “ child in need of discipline ” was given as the reason for
requesting aid, this, in fact, was only a surface indication of the
real trouble in the home, which frequently involved the absence of
the father from home through death or separation and divorce, and
also abusive treatment by one parent or the other. When “ no care
taker ” was given as a reason necessitating placement o f chila dren, the absence of the mother through death, illness, or working
W away from home during the day usually caused this need. When
“ relatives or friends unable or unwilling to keep longer ” was given
as a reason for requesting aid, this, again, was but an indication of
homes broken for other reasons. Many relatives grow impatient
with the necessity of carrying responsibility not theirs, or grand
parents become old and find it too difficult longer to control children
whose parents have failed to carry the responsibility for them.
Placement of the child for families reported as having only one
child was asked in 27 per cent of the cases because the mother was
working or wished to work. Illegitimacy of the child, which implies
that the mother is entirely responsible for support, was not an
acknowledged reason for asking placement in the case of these fami
lies. In families having more than one child the illness of the
mother was the most frequent reason for requesting aid in placement
o f the children.
Where the reason aid was requested was “ unsatisfactory home
conditions ” this group o f families very often was found to have
been known to the juvenile court for neglect of children through
immorality of the mother, abuse by parents, or poor family environ
ment—conditions that on the whole give only a very slight margin
for reshaping the family life to the needs of the children.

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C O N D IT IO N S O F F A M I L Y L IF E T H A T L E D TO M A K IN G T H E A P P L IC A T IO N S

In contrast to Table 7, which shows the reasons given for request
ing the placement of children, Table 8 shows the actual conditions
brought to light by the careful investigation o f the Children’s 0
Bureau o f Cleveland. A comparison of these two tables suggests
how the conditions more fundamental to the dependency of the
children are concealed consciously or unconsciously by persons seek
ing institutional care of children and indicates the necessity for
thoroughgoing social investigation of all applications for admission
of children.
T a b l e 8.— Conditions

contributing to dependency of children at time o f application to the Children's Bureau of Cleveland for care of children, by number of
conditions contributing to dependency found in families

Number of conditions con
tributing to dependency
found in families
Conditions contributing to dependency of children

Total

Illness or physical disability.
Death_____________ ______ _
Desertion________ .________
Mental disability... ......... .
Inadequate income________
N e g le ct......._____________
Sex immorality___________ _
Intemperance_____________
Separation.............................
Divorce____________ _____
Incorrigible child__________
Imprisonment_____________
Illegitimacy_______________
Delinquent child__________
Problem child_____________
Other____________________

471
304
•235
228
215
163
124
120
119
101
99
51
51
32
31
231

Two or
One con more
con
dition
ditions
197
110
66
52
7
13
7
4
41
37
20
11
15
2
7
43

274
194
169
176
208
150
117
116
78
64
79
40
36
30
24
188

The number of difficulties confronting the families at the time o f
application for the care of their children appears in Table 9.
Although only one major difficulty was reported for 682 of the
families applying for aid, there were 512 families in which two
difficulties entered into the need for placement of children, and 193
families in which there were three. For the remaining 79 families
four or more adverse conditions had contributed to the breakdown
o f family life. It is of considerable interest to note the unfavorable
conditions that often occurred together. In families having but two
main causes for dependency physical disability was most often
coincident with inadequate income, mental disability, death, or
desertion. Death often was associated with physical disability of
remaining parent, neglected or difficult children, and inadequate in
come. W ith divorce and separation are found inadequate income
and sex immorality, also ill health. Desertion is accompanied fre
quently by ill health and lack o f sufficient income. In most cases
insufficient income was one of the contributing factors.

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T able 9.—Number of conditions found in families, at time of application for

care o f children referred to the Children's Bureau o f Cleveland, by acceptance
and nonacceptance of applications
Applications for care
Num ber of conditions found in family

Total

Total___
One_________
T w o . . . ...........
T h ree............
F o u r .............
Five or more.

Not
Accepted accepted

1,416

1,007

409

632
512
193
61
18

418
355
164
52
18

214
157
29
9

How great a part the financial resources o f these families as re
flected in the employment or unemployment o f father or mother
played in the dependency of their children can not be stated defi
nitely. The scattered information on family resources and occupa
tion o f parents contained in the records o f the Children’s Bureau of
Cleveland did not furnish sufficient data to show the direct influ
ence o f unemployment on child dependency. From the general in
formation, however, unemployment due to industrial depression did
not appear as an acute problem in the dependency of these children.
Possibly the long period of unemployment, which began in 1920 and
lasted into 1922 in Cleveland, started in these families the disinte
grating forces reflected in ill health, desertion, and the need o f the
mother to go to work. The problem o f unemployment as the chief
cause for the destitution o f families should be met by family agencies
such as the associated charities, and consequently it would be a
less direct problem for an agency particularly interested in the care
o f dependent children. Though the industrial depression was felt
in Cleveland early in 1920 it was 17 months after general unem
ployment started that the high peak o f relief to these families was
given by the Cleveland Associated Charities. This indicates that a
long period o f hardship and uncertainty elapsed before these families
of very limited surplus sought public relief. The most serious
feature of unemployment is its effect on family morale: The father
is idle about the house, unsettled, disheartened; the mother goes out
to work if she can find work, consuming all her strength in the
double task o f providing for the family’s maintenance and caring for
the household and the children; the children suffer from depression
and uncertainty as to the future, which is even more to be dreaded
than the discomforts o f the immediate present.5
In many o f the families applying for institutional care o f their
children the lack o f family unity and responsibility was the most
serious obstacle to the rehabilitation of the family home for the child,
and this may be not distantly related to the question o f economic
struggle during periods o f unemployment. Especially might this
5 Unemployment and Child W elfare ; a study made in a middle-western and an eastern
city during the industrial depression o f 1921 and 1922, by Emma O. Lundberg, p. 3.
U. S. Children’ s Bureau Publication No. 125. W ashington, 1923.

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be true in an industrial city like Cleveland. The fact that so large
a number of these families were known to the associated charities
before making application to institutions is o f interest too in this
connection. Certainly unemployment has a direct bearing on the
support o f children accepted for care, and inability to help to sup
port one’s own children has a direct influence on the breakdown o f
family life.
The records of the Children’s Bureau o f Cleveland indicate that
during the two years covered by the study intemperance was not
one o f the great problems related to the dependency o f children.
Intemperance was shown to be the factor contributing to dependency
in only 4 o f the 632 families that had but one contributing condi
tion. But it was demonstrated as a contributing condition in 120
(15 per cent) o f the 784 families in which more than one condition
contributed to dependency.
N U M B E R A N D W H E R E A B O U T S O F C H IL D R E N I N F A M IL IE S

Table 10 shows the number o f children in families and their
whereabouts at the time of the application for their care. It is
noteworthy that 337 (24 per cent) o f the families had but one child.
In 225 of all the families with one child this child was under 7
years o f age at the time application was made. In 244 o f the 337
families the child was with one or both parents. What then were
the conditions in these homes that made it impossible for the families
to solve the problem o f their one child’s care without community
aid ? Some explanation may be found in the marital status o f this
group, inasmuch as 33 per cent were separated, divorced, or un
married, and 21 per cent had deserted. In fact 21 per cent o f all the
desertion recorded was found in this group; yet this group represents
only 18 per cent o f the total number of families for whom marital
status was reported. Marital status was reported in 83 of the 91 onechild families where the child was not with either parent. In 11 (13
per cent) o f these 83 families the parents were married and living
together, in 32 (39 per cent) they were divorced, separated, or unmar
ried, in 31 (37 per cent) one or both parents were dead, and in 9 (11
per cent) one parent had deserted.
Other social agencies had known 68 per cent o f the families in
which the child was with one or both parents before application was
made to the Children’s Bureau o f Cleveland, but only 30 per cent
o f these families made their application through an agency or insti
tution. The application was made by the mother o f the child in 43
per cent o f the requests. The reason for requesting aid was illness
o f mother in 38 families, mother working or intending to work in 81
families, and child in need o f discipline in 18 families.

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T able 10.— Number and whereabouts of children who were members of families

for care of whose children application was made to the Children's Bureau of
Cleveland
Whereabouts of children

Number of children in family

Number
of
families

With one or both
parents
All
children

Some
children
192

Total______________________________________

1,416

892

One___________ ____ __________________ ■.
____
T w o...
____________________________________
Three_________ . _____ _______ ____________
Four______________ •_________ ____ _____ _____ ___
F ive..___________________________________________
Six____________ . . . . ___________ _________ : ____
Seven_______________________________ ______ _____
Eight or more___________________________________

337
331
286
195
120
80
39
28

244
232
165
108
65
47
21
10

34
47
43
28
16
12
12

Not with
parents

Un
known
for one
or more

256

91
56
52
31
15
8
3

2
9
22
13
12
9
3
6

I f these 244 families had made their application directly to an
institution in the absence o f a central bureau o f investigation a
large percentage might have been relieved o f a responsibility that
could make for stability and development. As it was, the Children’s
Bureau o f Cleveland accepted the applications o f only 138 of these
families, and 106 families were referred directly to other agencies
or dropped when the evidence did not warrant action by the bureau
or when the applicants made their own plans.
R E L A T IO N O F IL L E G IT IM A C Y TO A P P L IC A T IO N F O R C A R E O F C H IL D R E N

The Children’s Bureau of Cleveland deals with two groups of
children born out o f wedlock : ( 1) Those who have been relinquished
for adoption, and (2) those who though not relinquished for adop
tion nevertheless are in need of community care. In this study only
the second group, consisting o f 90 families, is considered. There
fore illegitimacy o f children as a factor in their dependency is shown
only to a very limited extent in this study. The reaêons for this
are: 1. Most institutions do not take children under 3 years of
age, yet it is under this age that a child’s illegitimacy is most likely
to come to the attention of institutions and agencies. 2. Most insti
tutions that care for children born out of wedlock are primarily
maternity homes; hence unmarried mothers enter them for confine
ment care, and when they are ready to go away the children are
placed in the nursery. As such children were already in the insti
tution before a report was sent to the Children’s Bureau of Cleve
land they were not included in the study. (See p. 40.) 3. The
Cleveland Humane Society has a special department for unmarried
mothers, (see p. 74), and most of the children born out of wedlock
who are in need o f community care receive attention from this
department.

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Table 11 shows the legitimacy o f the children in families where
application for care o f children was made to the Children’s Bureau
o f Cleveland. Though there were but 90 families in which one or
more children had been born out o f wedlock the recommendations
made for the care o f these children considered by the bureau are o f ^
interest. In these 90 families there were 215 children, 113 o f whom
had been born out of wedlock. Many o f these children were not
in the homes when the families became known to the bureau; and
in most o f these families disintegration through divorce and sepa
ration, desertion, immorality, and death had been going on for some
years. The records contained very little or no information in regard
to the fathers. In 46 o f the 74 families in which only one child had
been born out o f wedlock the illegitimate child was the only child
in the fam ily; in 34 of this number the mother had never been
legally married, and in 12 the mother had previously -been married.
In the remaining 28 families o f the 74 there were children o f legiti
mate birth also. The 34-families in which the mother had not been
married presented the most difficult problem as the mother’s reluc
tance to have the fact o f her child’s birth known to relatives or
friends complicated the adjustment. Fifteen ©f these families were
referred directly to the Cleveland, Humane Society to be cared for
through its department for unmarried mothers; 10 o f the 15 fami
lies had previously been known to the society, but the remaining 5
had had no contact with any agency other than the hospital where
confinement took place. The bureau recommended the children of
7 o f the remaining 19 families for care in an institution and super
vised the children in 6 others in their own homes or arranged for ja
care in a day nursery. The remaining 6 families made their own ^
plans before the bureau completed its investigation.
11.—Legitimacy of children in families for whom application for care o f
children was made to the Children’s Bureau of Cleveland, by acceptance and
nonacceptance of applications

T able

Applications for care
Legitimacy of child
Total
Total..........................
All children born in wedlock...
One or more children born out of wedlock
One child..... .........
Two children or more_____

Not
Accepted accepted

1,416

1,007

409

1, 326
90

939
68

387
22

74
16

54
14

20
2

In the 12 families where the mother had formerly been married
the family had been disrupted by divorce, separation, and desertion
o f the husband for some time before application for care o f the chil
dren was made to the Children’s Bureau o f Cleveland. It was not
the fact of illegitimacy that brought these families for help, but
rather a sudden emergency. In regard to 5 o f these families the ±
bureau took no action, as it was deemed unnecessary; the family ^

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made its own plans or an agency continued supervision. The bureau
placed three children in the remaining seven families in institutions;
one was placed with relatives, two were referred to other organiza
tions, and the disposition o f the seventh child had not yet been
W determined.
Only 10 o f the 28 families in which there were one or more chil
dren o f legitimate birth as well as the one child o f illegitimate birth
made application to the bureau for care o f the child o f illegitimate
birth. Four o f these families were referred directly to the humane
society, and two families were referred to other agencies without
further action by the bureau. The bureau investigated the four re
maining families and made the following recommendations as to
care: One family was referred to an institution for the care o f the
child for whom application was made, one family was referred to the
associated charities, the child o f the third family was returned to
his own home from a home in which the mother had placed him for
adoption, and supervision o f the child in the fourth family in his
own home was undertaken by the bureau.
Seven families o f the 28 made application to the bureau for the
care o f both legitimate and illegitimate children, and illegitimacy
was not a reason for making application to the bureau. One appli
cation was not considered, as care was asked only in case a specified
emergency should arise. Two o f the six remaining children born
out o f wedlock for whose care application was made were referred
to the humane society for foster-home care, one was sent to a hospi
tal, one needed observation and temporary institutional care, one was
¿v placed with friends, and the recommendation for care o f the sixth
W child was delayed pending further investigation.
It is noteworthy that for none o f the 11 remaining families o f the
28 in which one child was o f illegitimate birth and the others born
in wedlock was care requested for the illegitimate child in the family.
In nine families the child o f illegitimate birth was not a member of
the family group at the time when application was made, seven chil
dren being with relatives, one in an adoptive home, and one boarding
away from home.
In the 16 families in which there were two or more children o f
illegitimate birth there were 57 children, 39 of whom were illegiti
mate. In eight of these all the children were o f illegitimate birth,
and in these families the fact o f illegitimacy had no direct bearing
on the application for care. In the families in which all children
were illegitimate there usually had been a common-law marriage, and
the conditions necessitating care o f the children outside o f their
own homes were such as might occur in families where the parents
had been legally married. In the other eight families with two or
more illegitimate children the fact of illegitimacy had no bearing on
the application for care, as the application was made for legitimate
children in these families as well as for those born out o f wedlock.
In fact seven children born out o f wedlock in these families had been
provided for already in other homes (adoptive, relatives’, and hu
mane-society boarding homes) so that there was no question of
their care by the Children’s Bureau o f Cleveland.

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THE

C H IL D R E N ’ S B U R E AU

OF C L E V E L A N D

S T A T U S O F T H E C H IL D R E N IN T H E F A M IL IE S

Table 12 shows the status of the children in relation to the family.
A study o f the make-up o f families containing stepchildren does
not reveal any ground for believing that the presence of a stepchild or stepchildren in the home is o f itself a cause o f dependency.
It is interesting, however, that in the two groups— one numbering
120 families with stepchildren and own children, the other number
ing 108 familes with stepchildren only—there is quite a difference in
the reasons for requesting aid. In the group including stepchildren
and own children the illness of the mother was the greatest single
cause for requesting institutional care o f children, whereas in the
families including only stepchildren the desire o f the mother to go
to work was the greatest single cause. More families with step
children only had children in need of discipline (14 per cent)
than the families including both own children and stepchildren (8
per cent). Fifty-four per cent of the families having only step
children requested placement o f all the children, whereas only 9
per cent o f the families having both own children and stepchildren
requested placement of all children. Divorce, 'separation, and de
sertion were relatively more frequent (23 per cent) in the families
having stepchildren than in the total number of families (17 per
cent). The total number o f children in the 120 families with step
children and own children was 499; the number of children in the
108 families with stepchildren only was only 264.
12.— Relationship of parents and children in families for care o f whose
children application was made to the Children’s Bureau of Cleveland, by
acceptance and nonacceptance of applications

T able

Applications for care
Relationship of parents and children
Total

Not
Accepted accepted

1,416

1,007

409

Families with—
Own childrdfi only.............- ---------------------------------------------------------Own children and stepchildren----------------------------------------------------Stepchildren only---------------------- --------------------------------------------------

1,129
120
108

785
98
80

344
22
28

Children of father.----------------------------------------------------------------Children of mother----------- ----------------------------------------------------Children of each parent------------------------------ ---------------------------

68
24
16

49
21
10

19
3
6

Children of unmarried mothers-------------- -------------------------------------Adopted children i________________________________________ ri........

42
17

30
14

12
3

i Includes 4 families with own or stepchildren also.
S O C IA L A G E N C IE S TO W H IC H T H E F A M IL IE S W E R E K N O W N

Table 13 shows the social agencies to which families were known
prior to the time o f application to the Children’s Bureau of Cleve
land. It will be noted that comparatively few families were known
to the Catholic Charities Bureau. This is explained by the fact
that this bureau does not deal primarily with families, but deals Kf

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S T A T IS T IC A L IN T E R P R E T A T IO N OE D E P E N D E N C Y P R O B L E M

with Catholic institutions and organizations. Likewise the Ameri
can National Red Cross, although it does family work, extends care
in Cleveland to a special class o f families; hence there would be
studied in this report only a very small number o f families that had
been known previously to that organization. The mothers’ pensions
department o f the juvenile court, having very limited appropria
tions, is unable to give extensive service, and this accounts for the
small number ojf families that had been known to that department.
Social agencies to< which families were known prior to application
to the Children's Bureau of Cleveland for care of their children, by acceptance
and nonacceptance of applications

T able 13.

Applications for care
Agencies to which families were known
Total
Medical agencies (clinics, dispensaries, hospitals).
Cleveland Associated Charities.......... ......
Cleveland Humane Society..._____ _______ _
Juvenile court_________ ____ ___________ .
Legal Aid Society .............. ..........................
Institutions__ ____ ___ _____ ________ ____
Outdoor relief..............................................
Probation office and bureau of domestic relations
American Red Cross............. ...............
Catholic Charities Bureau........................
Mothers’ pensions department of juvenile court
Other agencies...................................... .

1,072
614
436
316
266
250
187
102
79
79
70

Accepted

Not
accepted

830

242

uv
42

This table suggests the troubled existence of these families be
fore they were referred to the Children’s Bureau o f Cleveland for
institutional care for some or all of their children. The community
medical facilities (hospitals, clinics, and dispensaries) had given
some service to 76 per cent o f the families. Forty-three per cent
were known to the Cleveland Associated Charities—which does not
always mean that material relief was given, as a large part of the
work of the associated charities consists of family adjustment not
requiring relief. Thirty per cent had been known to the humane
society. Thirty-two per cent had had some contact with the juvenile
court either through delinquency o f some child or on charges o f
neglect but not through the mothers’ pensions department o f that
court.
Table 14 shows the number o f agencies to which the families
were known prior to application to the bureau. The application
was made by the family or friends for 64 per cent o f the families
not known to any agency before the application to the bureau, but
for only 27 per cent of the families previously known to six or more
agencies.
43967°— 27----- 5

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THE

C H I L D R E N ’ S B U R E A U OF C L E V E L A N D

T able 14.— Number of agencies to which families were known prior to applica

tion to the Children's Bureau of Cleveland for care o f children, by acceptance
and nonacceptance of applications
Applications for care
Number of agencies to which families were known
Total

None............... ...... ........... ............ ............ .................................... ...... .........
One___ ______ _______________________ ___________________ _______ ___
T w o.:___________________________________ _____________
__________
T h r e e .............................................................................. ..............................
Four__ ________________ __________________________ ______________
Five________________i ________________ ______ __________ ______ _______
Six, less than ten .. ............ ..........................................................................
Ten or more...................... ...................................................................... ........
Not reported________________________________________________________

Not
Accepted accepted

1,416

1,007

409

' 254
180
190
160
134
112
280
102
4

154
114
141
112
98
81
215
88
4

100
66
49
48
36
31
65
14

THE DEPENDENT CHILDREN

The transition from the background of child dependency as shown
in the study of families to the children in those families and the
care that was recommended for them leads to one o f the most hope
ful chapters written so far in the history of provision for dependent
children. It must be remembered that the chief function o f the
Children’s Bureau of Cleveland is to serve as a center o f investiga
tion o f applications for the admission of children to institutions,
and it necessarily follows that those referring families are seeking
institutional placement of some or all of the children in those fami- w
lies. To understand the important part that institutions play in
the popular conception of child welfare it is very necessary to con
sider the great number of children whose care was asked for in the
two years which this study covers. Owing to the lack of unity of
interest on the part o f institutions and other social agencies in the
community many children during the first years o f the bureau’s
organization were accepted for institutional placement contrary to
the recommendation of the bureau, but as the decision on admission
was left entirely to the institutions this could not be avoided until a
finer interplay of service had been worked out between institutions
and other agencies.
S E L E C T IO N O F C H IL D R E N TO B E C O N SID E R E D F O R C A R E

In considering the family group all children were included except
those who had died or been married previous to the date of applica
tion. T h is does not mean that all the children were actually resid
ing with one or both parents when the application was made, for
any child who was in a relative’s home or in a hospital or an in
stitution at the time application was made was included whenever
the child was still considered a unit o f the family group. The
children o f greatest interest in this study are: (1) Those for whom
the original application for care was. made and (2) other children

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S T A T IS T IC A L IN T E R P R E T A T IO N OF D E P E N D E N C Y P R O B L E M

in the family whom the investigation of the bureau indicated to be in
need o f care. These two groups o f children have been termed “ case
children.” The remaining children who were members o f the fami
lies have been termed “ noncase children.” In this section special
attention is given to the case children. In the 1,416 families there
were 4,236 children ; and o f these 3,074 were case children and 1,162
were noncase children. The 726 case children in families the appli
cation for whom was not accepted by the bureau are included because
though no intensive study was made of these families a recommenda
tion for the care o f the child was made nevertheless. These children
were planned for as truly as were those in families in regard to
whom applications were accepted, but the agencies equipped to give
them the best care were called upon to make the initial investigation
and to plan for them.
The action taken by the Children’s Bureau o f Cleveland in re
gard to the applications for the care o f case children is shown in
Table 15. Only 27 per cent o f the 3,074 children for whom insti
tutional care was sought were found to be in need of care in an
institution for dependent children; and 3 per cent were in need
of care in special institutions. This indicates the great value o f
adequate diagnosis before placement.
Twenty-three per cent of the children were in families referred
to a family agency for care. Those families whose applications
immediately indicated the kipd of care needed for the children or
which had had a previous contact with a family agency were re
ferred directly to the agency. The great number o f families whose
applications were not accepted by the children’s bureau but who
were referred to other agencies for assistance is an indication of the
cooperation of agencies which Cleveland has achieved. The use of
the Social Service Clearing House in getting the records of fam
ilies and a competent .receiving secretary who makes the first con
tact with the applicant are the greatest factors in determining which
applications will be accepted and which should be referred to
another agency. In the first year studied (1922-23) 203 children
in families whose applications had been accepted were referred to
family agencies, and 145 children in families whose application was
not accepted; in the second year studied (1924—25) there were only
106 children in families whose applications were accepted and 267
children in families referred directly to family agencies without
acceptance by the children’s bureau. Acceptance o f an application
meant that the bureau would make the initial investigation or accept
an investigation made by a referring agency and make its recom
mendation for care accordingly. It therefore happens that the
children recommended to the care of a family agency after investi
gation are from families where a different disposition may have
been recommended for other children in the family; this is not true
o f those children in families referred directly to a family agency.

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THE CHILDREN’ S BUREAU OF CLEVELAND

T able 15.—Actum taken in cases of children considered for care by the Chib-

dren’s Bureau of Cleveland, by acceptance or nonacceptance for care
Children considered for care
Action by the Children’s Bureau of Cleveland
Not
Accepted accepted

Total

Total___________________

3,074

2,348

726

Total reported_____ ______ ___

3,069

2,346

723

Action taken_____________

2,305

1,727

578

911

910

816
33
24
14
13
8
3

815
33
24
14
13
8
3

Referred to family agencies.

721

309

412

Associated charities.
Other_____________

681
40

293

388
24

Referred to placing agencies.

320

189

131

311
9

188
1

123
8

58
161
91
43

35
155
90
39

23
6
1
4

685

542

143

131
554

29
513

102
41

231
323

223
290

8
33

255
68

238
52

17
16

Action pending.

Not reported...___

Referred to institutions.
For dependents___________
For mental diagnosis______
For the tuberculous.........
For the physically disabled.
For general medical care___
For delinquents___________
For the feeble-minded_____

Humane society.
Other___ ______
Referred to other agencies...
Supervised without removal.
Placed with relatives............
Other___ _________________
No action taken.
No investigation_____________
Consideration showed no need.
Original situation indicated no need......................
Situation changed during period of consideration.
Child’s family, relatives, or friends made adjustments.
Other agency continued or resumed supervision______

Foster-home care was recommended for 10 per cent o f all children
who were considered for care by the bureau, and practically all the
families with these children were referred to the Cleveland Humane
Society. Some of the families comprised an unmarried mother
and her child, and often it was not a case of placing the child but
rather of working out with the mother a plan to keep her baby.
(The humane society has a special department for the care of the
unmarried mother. (See p. 74.) What has been said in regard to
the number o f children finally recommended to family agencies in
families whose application was accepted and those in families whose
application was not accepted is also true o f those referred to the care
of the placing agencies. In the first year studied (1922-23) there
were 122 children in families whose applications were accepted and
later referred to placing agencies, and 52 in families referred di
rectly to the placing agencies; in the second year studied (1924-25)

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S T A T IS T IC A L IN T E B P B E T A T IO N OF D E P E N D E N C Y P E O B L E M

there were only 67 children in families for whom the bureau made
the first investigation and 79 children in families referred for in
vestigation to the placing agencies. The development of the policy
o f the bureau as illustrated in the difference in number o f applications accepted by the bureau and those referred directly to other
agencies in the earlier and the later year is toward finer organiza
tion o f work within the bureau and better coordination o f work
with all institutions and agencies providing care for dependent
children. In families where an investigation o f the application
has been made by the bureau a different recommendation for care
o f the children may be made for each child. Thus in a family of
three children where the mother needed hospital care one child
may have been recommended for institutional care and a second
for foster-home care, and the third may have been placed with
relatives. The children whom the bureau supervised without re
moval from the place in which they were living at the time they
were referred for care constituted 5 per cent o f the number referred.
The policy o f the bureau to supervise some children in their homes
developed through the need to watch very carefully certain con
ditions in the home in order to prevent if possible the placement
o f the children.
It was unnecessary for the bureau to take action in regard to 685
(22 per cent) of the children. In 131 of these cases no investigation
was made. (In 29 of the 131 cases some need seems to have been
indicated at the interview, but the situation evidently changed very
shortly in these 29 cases.) In 554 cases the bureau found on investiLv gation that there was no need for action. In 231 o f these cases the
w original situation indicated no need, in 255 cases the child’s family
or friends made adjustments during the period of investigation that
obviated the need for community care of the child, and in the
remaining 68 cases an agency that had known the child or his family
previously either continued or resumed supervision. It is interest
ing to note the number o f children (255, or 8 per cent o f the total)
whose families— or those directly responsible for them—made their
own plans, either because they did not wish to have their circum
stances investigated or because they were able to make adjustments
without help. Most of the 68 cases in which an agency had con
tinued or resumed supervision had been referred to the bureau for
institutional placement of the children pending the outcome of court
action or decision by a case committee; and as plans were worked
out later that made the placement unnecessary these children
remained under the supervision of the agencies referring the case,
though the bureau stood ready to recommend care in an institution
if an emergency should arise. Some o f the community agencies that
were to continue care whether for a longer or shorter period were
dispensaries, summer camps, day nurseries, the board o f education,
the State board of public welfare, the Visiting Nurse Association,
and the Association for the Crippled and Disabled. The greater
number o f children for whom continued care was recommended were
under the care o f the juvenile court, the bureau of domestic rela% tions, or the Women’s Protective Association.

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THE

C H IL D R E N s B U R E A U

OF C L E V E L A N D

It is understood that the foundation of the Children’s Bureau of
Cleveland is the welfare of the individual child and every recom
mendation is made with this in view. Hence, the records contained
a great deal on'individual characteristics, but for the purpose o f
this study the characteristics of these children other than their age
are of little importance, since the emphasis of the study is placed
on dependency of children rather than the dependent child. The
recommendations made for the care of Cleveland’s dependent chil
dren as related to their family history and background constituted
the chief interest.
W H E R E A B O U T S O F C H IL D R E N A T T IM E O F A P P L IC A T IO N

Table 16 shows the whereabouts o f the case children at the time
o f application and the home situation as indicated by the presence
or absence o f parents in the home. This shows clearly that the
family was usually shattered when the Children’s Bureau o f Cleve
land was called upon to help in readjustments. Only 725 (24 per
cent) o f the 3,039 children for whom whereabouts was reported were
with both parents in their own homes at the time of application.
This does not necessarily mean that both parents- were actually in
the home, as some of them may have been temporarily in the hos
pital, but it does mean that all but 17 o f these parents were living to
gether and maintaining homes. This group o f children is perhaps
the least difficult to provide care for, as the situation in the home
generally calls for only temporary placement o f children, the cause
of dependency being in most cases illness o f mother, though neglect
of children by parents also is found as a cause in this group.
A greater number o f children were with their mother only than
with their father only. But 72 per cent o f the mothers o f these
children maintained homes for them, as compared with 87 per cent
o f the fathers o f the children who were with father only. This
would seem to indicate that children left with the father come much
more quickly to the attention o f the community than do children left
with their mother. A woman left without her husband usually en
deavors to provide care for her family without assistance from the
community, even though often the struggle is too great, and some
o f the children or all o f them are placed with relatives or friends
or placed for adoption before the mother makes an appeal for help.
A man left with children is apt to think it impossible to provide care
for the children without the mother, so that he will seek assistance
at once, and in most cases the children have not been scattered before
the family comes to the attention of a child-caring agency.

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S T A T IS T IC A L IN T E R P R E T A T IO N OP D E P E N D E N C Y P R O B L E M

T able 16.— Whereabouts of children at the time of application for care to the

Children's Bureau o f Cleveland, by specified parent maintaimny home
Children considered for care
Specified parent maintaining home

Whereabouts of child
Total

Both
Total__________

3,074

Total reported.............

3,039

With both parents
With mother only.
With father only...
With relatives____
With friends_____
In boarding home..
In adoptive home..
In institution____
In hospital_______
Other____________

725
912
743
274
107
53

Not reported.

752

Mother Father Neither Not re
only
only .
ported
715

770

708

17
241
86
201
61
36

651

2
198

47
10
84

292
35

799

707

1Includes 82 children temporarily in the detention home, 62 of whom were dependent and 20 of whom
were delinquent; 16 other children were placed in an institution in emergency, the Children’s Bureau of
Cleveland to make investigation before final placement.
2Includes 67 children who were in their own homes without the parents, both of whom had been removed
by death or other circumstances (such as father deserted, mother in hospital).
R E C O M M E N D A T IO N S F O R C A R E O F T H E C H IL D R E N

Table IT shows the action taken by the Children’s Bureau o f
Cleveland in regard to the applications for care, classified by the
whereabouts o f the child at the time o f application. Institutional
care was recommended for 29 per cent o f the children with both
parents, 20 per cent o f the children with mother only, 35 per cent
o f the children with father only, and 28 per cent of those who were
with relatives at time o f application. Care by a family agency,
in most cases the associated charities, was recommended for 21 per
cent o f the children with both parents, 43 per cent o f those with
mother only, 12 per cent o f those with father only, and 16 per cent
o f those with relatives. Care by a home-finding agency, in most
cases the Cleveland Humane Society, was recommended for 11 per
cent o f the children with both parents, 10 per cent o f those with
mother only, 9 per cent of those with father only, and 11 per cent
o f those with relatives.

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T able 17 — Action taken in cases of children considered for care by the Children's Bureau of Cleveland, by whereabouts of child at

the time of application for care

05
05

Children considered for care
Action taken

3,074

3,069

3,039

3,034

With both parents
With mother only.
With father o n ly ..
In relative’s home.
In friend’s home...
In boarding home.
In adoptive home.
In an institution. _
In a hospital_____
In other place__ _

725
912
743
274
107
53
2
98
33
92

725
908
742
274
107
53

Not reported____ ____

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*
Federal Reserve Bank of St. Louis

Consideration showed no
need

Agencies
Insti
tutions

911

Fam
ily

721

Plac
ing

Placed
with
rela
tives

Other

No in
vesti
gation
made

Other

320
319

213
179
257
78
39

Super
vised
without
removal

91
58

152
393
90
44
8

161

Total

Situation
Original changed
situation during
indicated period of
no need consider
ation

549

319

170
115
157
56

105
79
71
29
11
6

43
42

323
128

98
33
92

7
5
6

Action Action
pend not re
ing
ported

OF C L E V E L A N D

Total__________
Total reported_______

Referred to—

C H IL D R E N ’ S B U R E AU

Total

Total
for
whom
action
was re
ported

THE

Whereabouts of child at time of
application

No action taken

6
5

S T A T IS T IC A L IN T E R P R E T A T IO N

w
®

OF D E P E N D E N C Y

PROBLEM

Confusion as to the exact whereabouts o f children at the time of
application is shown by the number included under “ in other
place ” at the time of application. The records of a number o f ehildren did not give definite information on this point. Children in
free homes were included in this classification, children with the
mother at a hospital, and some children who were apparently in
boarding homes. That the condition of most o f the children was
very unsatisfactory is indicated by the fact that 52 per cent of these
children were recommended for institutional care.
The ages o f the children whom the Children’s Bureau o f Cleve
land considered for care are of particular interest, as they not only
indicate something o f the cause of dependency, but also had to be
taken into consideration in determining the kind of care to be recom
mended. Table 18 shows the ages o f the children for whose care
the bureau made recommendations.

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T able 18.—Action taken in cases of children considered for care by the Children's Bureau of Cleveland, by age of child at the time

of application for care
Children considered for care
Action taken

Total........................
Total reported_____

Not reported.... ..............

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* of St. Louis

Consideration showed
no need

Agencies
Insti
tutions

Fam
ily

Plac
ing

Other

Super
vised
without
removal

Placed
with
relatives

Other

No in
vesti
gation
made

Total

Action Action
Situation pend not re
Original changed
ing
ported
situation during
indicated period of
no need consider
ation

3,074

3,069

911

721

320

161

131

554

231

323

3,048

3,043

909

713

317

157

128

550

230

320

109
70
645
484
1,271
417
52

109
70
644
483
1,269
417
51

16
4
124
166
459
133
7

28
23
168
118
282
83
11

33
23
117
33
69
35
7

16
8
23
7
1

1
30
18
73
32
3

21
13
34
17
4

2
1
10
5
17
7
i

3
2
18
21
64
19
i

23
16
129
88
213
69
12

6
59
34
83

70
64
130

11
13
35

1
1
2

OF C L E V E L A N D

Under 6 months______
6 months, under 1 year.............
1 year, under 4 years_________
4 years, under 6 years_______ _____
6 years, under 12 years____________
12 years, under 16 years___________
16 years, and over________ ______

Referred to—

C H IL D R E N ’ S BU R E AU

Total

Total
for
whom
action
was re
ported

THE

Age of child at time of application

No action taken

S T A T IS T IC A L IN T E R P R E T A T IO N O F D E P E N D E N C Y P R O B L E M

The general policy as it has been worked out by the agencies inter
ested in child welfare has been that children under 4 years of age
should be given foster-home care, as it is almost impossible for an
institution to give the individual care that is necessary for the best
development o f the children. Table 18 shows that 124 (19 per cent)
of the children between 1 and 4 years of age who were considered
for care by the Children’s Bureau o f Cleveland were recommended
for institutional care, 117 (18 per cent) were recommended for care
by a placing agency, and 168 (26 per cent) were in families referred
to a family-welfare agency for care.
It is significant that 80 o f the children recommended for institu
tional care were from 72 families o f Catholic faith. The difficulty
in finding sufficient Catholic boarding homes is largely responsible
for the need o f placing these children in an institution at so early
an age. Furthermore the majority of these children were o f foreignborn parents, and it is not easy to find good boarding homes for such
children. There was the additional difficulty that the humane society
was not financially able to develop boarding-home care as rapidly as
was needed. Consequently the institution often was the only place
ready to accept a Catholic child between 1 and 4 years o f age.
For the 40 Protestant families having children between 1 and 4
years o f age for whom institutional care was recommended there
seems to have been an effort to place together regardless o f age all
the children o f a family (as in families o f two or three children) if
all were in need o f placement. . This evidently was the case in regard
to 13 families, the children under 4 years o f age having been placed
with the older brothers and sisters in the institutions so that the
family groups were not subject to further separation. For the
remaining 27 families o f this Protestant group there was not sufficient
information in the records to reveal the circumstances that led to
institutional placement for children o f this age. Some cases may
be accounted for by the fact that a maternity hospital with an infant
department has developed excellent facilities. Accordingly prema
ture infants and young children presenting difficult medical problems
have been sent to this home. Later when the conditions requiring
treatment and special care have been cleared up these children are
referred to the Cleveland Humane Society for boarding-home care.
It is hoped that eventually this maternity hospital can accept more o f
the special types to be discharged on recovery to boarding homes, as
such an arrangement would save much time and effort in regard to
the difficult medical cases. Other cases among the 27 are also those
of the children who are placed for a short time only and then
returned to their own homes.
The general plan and future method of solving the problem in
regard to the institutional placement o f children under 4 years
of age are under discussion at the present time, but the situation
during the earlier days o f the existence o f the Children’s Bureau of
Cleveland seemed to make such placement the most satisfactory
method.
The bureau recommended institutional placement for 166 children
between 4 and 7 years of age (33 per cent o f the total), care by a
family agency for 118 children of this age (24 per cent), and care
by a child-placing agency for 33 (7 per cent).

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AGENCIES COOPERATING W ITH THE CHILDREN’S
BUREAU OF CLEVELAND
THE CLEVELAND HUMANE SOCIETY

In 1923 the Cleveland Humane Society celebrated its fiftieth anni
versary. In 1871 a citizen of Cleveland introduced a resolution in
the city council for the organization o f a humane society. The reso
lution was adopted, but nothing was done about actual organization
until 1873 when the Cleveland Humane Society started its work.
It was organized for the protection o f animals, but in 1876 a case
of unusual cruelty to a child was reported to the society, and this
first brought the protection o f children into its work. As years
have passed the relative importance o f the work for protection of
children and the protection o f animals has been reversed, until to-day
this society is concerned chiefly with the care o f children. It is as
the most important child-placing organization of Cleveland that it
is of interest in the present study, and the information given in the
following paragraphs applies only to the child-welfare work o f the
society.
The Cleveland Humane Society acts as a child-placing organiza
tion for the entire county o f Cuyahoga as well as for the city of
Cleveland. It is a member of the Welfare Federation o f Cleveland,
and. is supported chiefly through the Community Fund. The de
mand for foster homes has increased greatly in the past five years.
The increase has been due to a large extent to the new program for
community care o f children, particularly institutional care, under
taken when the bureau was established in 1921.1 It has been neces
sary to double the amount allowed to the society by the Welfare Fed
eration for the board o f children, and even then the financing—with
$80,000 appropriated for board in 1925—is insufficient.
The society issues an annual bulletin, which shows the work ac
complished during the year, and it renders to the Welfare Federa
tion o f Cleveland a monthly report on the work o f all its depart
ments. A copy o f the compilation o f information from these re
ports for 1924 that the federation made is shown in the following
table:
1 Sixty-five per cent o f all dependent children were in institutions, and 35 per cent were
in boarding homes in 1025.

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A G E N C IE S C O O P E R A T IN G W I T H

TH E BUREAU

Information compiled by the W elfare Federation of Cleveland from the monthly
reports of the Cleveland Humane Society during 1924

Month in
1924

February..April______
July______
September..
November—
December..

Total
chil
dren
on
first
of
month

Chil
dren
re
ceived
dur
ing
month

Chil
dren
dis
charged
during
month

1,284
1,316
1,347
1,378
1,391
1,470
1,490
1,521
1,533
1, 518
1,471
1,456

93
67
73
73
86
59
76
75
59
60
40
31

61
36
42
60
39
39
45
63
74
107
55
45

Stateboard
wards
not in
cluded
in pre
ceding
figures

130
139
139
149
148
152
157
173
193
197
203
215

Total
chil
dren in
board
ing
homes
on last
day of
month

507
521
529
505
518
507
508
538
481
454
417
418

Num
ber of
chil
dren for
whom
humane
society
was re
spon
sible

Amount
Num
for
ber of Total
which Amount
Amount parents
board cost
paid by
of
expend
ing
parents '
and
ed by
homes board
and
guardi
ing
humane
in use
guardi
ans
chil
society
on last dren
ans
were
day of
respon
month
sible

242
251
253
239
247
240
228
258
206
225
201
191

304
312
325
323
325
325
323
330
318
309
305
268

$128,713 $64, 904

$63,806

$48,230

5,986
5,762
5,399
5,556
6,147
5,132
5,707
6,428
5,330
5,265
4,422
3,770

4,987
4,938
5,838
4,812
5,373
4,945
5,819
5,575
5,402
5,627
5,375
5,115

4,484
3,822
4,167
4,326
3,532
5,025
3,377
3,188
4,646
4,483
3,396
3,784

10,973
10,700
11,237
10,368
11, 520
10, 078
11, 526
12,004
10, 732
10,892
9,798
8,885

O R G A N IZ A T IO N

™

The board o f directors is made up o f 60 members, one-third
being elected each year for a term o f three years. They _ meet
quarterly or upon call. The directors are representative individuals
interested in work for children, such as the judge of the juvenile
court, the judge o f the court o f common pleas, the director o f public
welfare, ministers o f the Catholic, Protestant, and Jewish faiths,
physicians, lawyers, and a representative from the school depart
ment. A list o f new members for the board is presented annually
by the nominating committee, and election takes place at the annual
meeting o f the board. The officers o f the society are elected for
a term o f one year. Appointments to the various committees are
made by the president and approved by the executive committee.
The executive committee consists o f 11 members of the board of
directors. This committee meets once a month or upon call. The
children’s committee is composed o f members of the board of
directors and also other interested people, including professional
social workers. This committee has 19 members and meets bi
monthly for the discussion of general policies in relation to children
cared for by the society. The boarding-case committee is composed
o f 12 members who are social workers from all the agencies inter
ested in work for children. This committee is also responsible for
a definite decision as to case work when more than one agency is
interested in the family. Thus is avoided the common error of
having workers from various agencies visit the same family over
the same period o f time. This committee considers problems re
lating to children placed in boarding homes, and recently it has
undertaken a study of dependent children in Cleveland in order to
determine the best possible methods of meeting the increasing need
for foster-home placement. The clothing committee has 13 mem
bers, some o f them from the board o f directors, others whose serv
ices are valuable because of their contact with church societies and

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THE

C H I L D R E N 'S

BUREAU

CLEVELAND

women’s clubs—organizations that have given a great deal o f help
in making clothes for distribution by the society. This committee
holds about five meetings each year. The Christmas committee has
five members from the board of directors and is responsible for the
Christmas plans for more than 1,000 children. The investigation
made by one agency is accepted by the others, and summaries o f the
cases are submitted when the case work is taken over by another
agency.2
T H E C H IL D R E N C A R E D F O R

Children are received chiefly from three sources: The juvenile
court, the Children’s Bureau o f Cleveland, and individuals. Most
o f the children coming from the court are made dependent through
neglect, but there are also a few in this group who come because
o f delinquency and who, the judge feels, may be benefited by a
normal family home. Court action has been taken only as a last
resort to save these boys and girls when other methods o f adjust
ment have failed. Every effort is made to remove such children
directly from the court to foster homes so that it will be unnecessary
to keep them in the detention home. At the present time most o f
the commitments by the juvenile court for custody o f children are
made to the Cleveland Humane Society, but if the child whose
custody is received is to be placed in an institution the Children’s
Bureau o f Cleveland takes the child directly from court. I f later
the child returns to his.family the bureau often turns the family
over to the Cleveland Associated Charities, and in cases o f this
nature the society has practically an empty custody of the child—
the only connection with the case being that it renews the custody
if necessary.3 The children received from the Children’s Bureau o f
Cleveland are those who are thought to have received all the pos
sible benefit from institutional life but whose homes are either per
manently broken or not yet sufficiently reconstructed for them to
return and who therefore must be placed in foster homes, and some
are children who do not fit into institutional life and become a dis
turbing element. The third group of children, those received di
rectly from parents or friends, come from homes broken by death,
illness, insanity, or some other emergent circumstance.
M E D IC A L C A R E

The medical work for infants and all children under 3 years of
age is carried on from the Babies’ Dispensary and Hospital and is
under the direction of a physician who is a pediatrician. This phy
sician is a member o f the Cleveland Humane Society staff and gives
part time to the medical examination o f the babies in care of the
society. After examination the child is placed in one o f the sub
sidized homes maintained by the society. In these homes the chil
dren’s diet is carefully regulated and their development watched by
the physician, who visits all babies twice a week.
2 On January 1, 1925, the Cleveland Humane Society’s executive staff was composed o f
the executive secretary, field secretary, director o f case work, attorney, 9 supervisors, and
47 case workers— 18 o f whom were students in training. There was a legal consultant
at court, and tw o physicians gave part time to medical exam inations for the society.
There were also a receiving secretary, a training-class director, and a clerical staff.
8 Since 1925 the bureau has been accepting under its license a lim ited number o f tem
porary com m itm ents; the humane society still is asked to accept custody in long-tim e
cases.

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A G E N C IE S C O O P E R A T IN G W I T H

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*

TH E BUREAU

Medical attention for children over 3 years of age is given at the
Children’s Bureau of Cleveland clinic at Lakeside Hospital. Where
the need is indicated for continued medical care this clinic takes the
full responsibility for giving it, and the child returns to the clinic
as long as attention is needed. Dental work for the children under
the care o f the Cleveland Humane Society also is provided at the
clinic.
The board of health nurses visit once a month every humanesociety boarding home where there are children. Cleveland is dis
tricted in health units, and each district nurse sends to the humane
society once a month a report on children in boarding homes in
her district. Children with difficult personality and mentally back
ward children are given special attention. With the opening of
the Children’s A id Society clinic for the study of problem children
it has been possible to plan more wisely for these children.
D E P A R T M E N T S O F T H E S O C IE T Y

The society’s work for children is carried on in five departments
covering home finding, infant care, children of unmarried mothers,
child protection and foster-home care, and State children.
The home-finding department.

The home-finding department is responsible for furnishing a suffi
cient number o f foster homes for the children requiring such care.
These are found in various ways. Visitors are constantly in the
field seeking new homes for childrenboarding mothers are encour
aged to interest their friends in boarding children for the society;
W and committees o f representative persons have been organized from
various racial groups. Through appeals to clubs, church groups,
and other community organizations the publicity department at
tracts public interest to the child needing a foster home. Consider
able assistance is received from newspapers, especially the foreignlanguage papers. Special effort must be put forth to find homes
for infants under 2 years o f age, psychopathic children, those o f low
mentality, those who need special training in behavior, and physi
cally handicapped children. There is also difficulty in finding homes
o f the right standards for the negro child and the child o f foreign
■parentage. In order to help provide immediate shelter for these
children, a number of homes have been subsidized by the Cleveland
Humane Society. One of these is for boys over 3 years o f age, one
is for girls over 3 years o f age, three are for infants, and one is for
negro children.
Every home from which there comes an application to care for
children is visited, and a detailed report is made covering family
history, home life, income, health, motive for taking the child, and
ability to give intelligent and understanding care. Several ref
erences are secured, including one from the family physician and
one from the pastor. Besides this preliminary work, every home
must be licensed and then relicensed each year. Both the city board
of health and the State department of public welfare license these
m homes. The licenses must be secured by all persons boarding chil
dren, whether for the Cleveland Humane Society or not. The
society acts as the representative of the State department of public

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THE

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welfare and makes investigations throughout the county o f all appli
cants who wish to board children. The home-finding department
gives special attention to the education o f foster mothers in order
to help them give better care to the children in their charge. Instruc- u
tion as to diets for children and the general care o f health is given ®
to foster mothers by staff members whose training has equipped
them for this work. The staff o f this department consists o f one
supervisor and four other workers, one o f whom gives all her time
to investigation of private boarding homes throughout the county.
During 1924 there were 711 applications from persons wishing to
care for children in their homes, 452 o f which were approved.
The department for infant care.

The department for infant care, which deals with dependent chil
dren under 3 years of age, was created in June, 1923. As the com
munity work for children in Cleveland became more specialized
after the survey in 1920, the work of placing children under 3 years
of age was made a definite part of the humane-society service. This
was in accordance with the outline for coordination of The work of
all agencies. The agencies and institutions are glad to have the
babies cared for in foster homes. The work with babies is a special
problem demanding experienced workers, superior foster homes, and
a well-defined medical program. Acting on this theory, the society
has worked out a routine for their care. A ll babies received are
first given a medical examination at the Babies’ Dispensary and
Hospital, and here instructions as to care are given and diet pre
scribed. The child is then placed in one o f the subsidized homes
maintained by the society. These are temporary homes, where each
child’s diet is carefully regulated before he is placed in a private
home. The subsidized homes are in charge of women experienced
in nursing and especially interested in the child’s early develop
ment. The length of stay in a home o f this kind depends a great
deal upon the infant’s physical condition and upon the ability of
the society to find a home best adapted for his particular need. The
physician visits all babies in the subsidized homes twice a week and
gives advice as to their diet and general care. The department
maintains a staff of six workers—a medical director, a supervisor,
and four case workers. The average number of cases carried by the
workers is 50.
The department for unmarried mothers.

The department for unmarried mothers is concerned with the care
and protection of children born out of wedlock. The work neces
sarily involves the care of the mother before and during confine
ment, plans for keeping the mother and child together, and pro
ceedings to secure support from the father. The work in connection
with these problems has followed as closely as possible the prin
ciples defined by the Cleveland Conference on Illegitimacy in 1923;4
these principles embrace the rights of the child, the rights of the
mother, the rights of the father, and the rights o f the community.
This department works in close cooperation with the hospitals and
maternity homes o f Cleveland, which have given valuable assistance &
in the care of young mothers and their children. In the endeavor

*Cole, Lawrence C . : “ The need o f the case work method in dealing w ith illegitim acy.”
Hospital Social Service [N ew Y o rk ], vol. 13 (1 926), pp. 430-442.

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A G E N C IE S C O O P E R A T IN G W I T H

^
“

TH E BUREAU

to keep the child with the mother, i f she is mentally and physically
normal, for at least a year, special funds were appropriated to be
used to board some of these mothers and their babies while other
plans were being made. The amount is limited, but it has been
very helpful as far as it could be applied. The staff for this depart
ment is composed of a supervisor and five case workers. The amount
of work handled in 1924 included 299 new cases and 306 cases car
ried over from the previous year. During the year 238 o f these
cases were closed.
The department o f child protection and foster-home care.

x.
*

The department of child protection and foster-home care was
formerly two departments, one o f child protection and the other of
child placing. In 1923 the work of these departments was reorgan
ized and combined for the purpose o f centralizing in one visitor
the responsibility for the family and the child concerned rather than
having the responsibility divided between an investigating visitor
and a child-placing visitor. There are, however, two distinct phases
o f work—one having to do with all complaints o f neglect, the other
with placing children in foster homes. The protective work, which
involves problems of physical, medical, and moral neglect, improper
guardianship, and nonsupport and desertion, involves the most care
ful inquiry into all the facts and an analysis o f these facts before
a plan for the child is ultimately decided upon. Preservation o f
the child’s own home and natural family relationships has been
the foremost endeavor. I f family ties are broken for a while, re
construction o f the home nevertheless is worked for continually.
Proper guardianship has been secured for those children whose
parents have failed in their responsibility. It is also often neces
sary to have children removed from their parents through juvenilecourt action. The custody o f the majority of dependent children
removed from their parents by the court has been given either tem
porarily or permanently to this society, which has a worker to handle
all juvenile-court work in connection with commitments and other
court action.
The child-placing work o f the society parallels to a large extent
the work o f the Children’s Bureau o f Cleveland, the methods o f
investigation and follow-up being based upon the same standards.
The work o f this society and that o f the bureau are so interdepend
ent that policies adopted by one agency in regard to the care o f
children seriously affect the work of the other agency; and con
sequently a well-defined program has been outlined as to children
who should be recommended for foster-home care and those who
should be recommended for institutional care. (See p. 24.
The Cleveland Humane Society makes its own investigation o f
all complaints and applications coming directly to it, but there is
a clear understanding with the Children’s Bureau o f Cleveland
that the investigations made by one agency shall be accepted by
the other. A division o f labor on the basis o f the kind o f service
each is best equipped to give has been worked out.
The policy o f limiting the institutional residence o f children to
as brief a period as possible has increased greatly the demand for
foster homes, and the work o f the child-placing department o f the
43967°— 27----- 6

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THE CHILDREN’ S BUREAU OF CLEVELAND

Cleveland Humane Society therefore has become the largest branch
o f the society’s work since the establishment o f the Children’s
Bureau of Cleveland in 1921. It is the responsibility o f this depart
ment to place children in foster homes, supervise them as long as
they are under care, and work out a plan for their return, to their
own or relatives’ homes. Foster homes are o f four types—the board
ing home, the wage home, the free home, and the adoptive home.
Most o f the children because of the more or less temporary nature
o f their care are placed in boarding homes, but those accepted by
the society for permanent care are placed in adoptive or free homes.
Particular attention is given to the older children o f this group, for
lyhom it is often possible to find wage homes; that is, homes in
which boys or girls do some work in return for the care received
and are paid small wages or furnished with the necessary clothes.
The staff o f the department o f child protection and foster-home
care consists of 3 supervisors and about 25 case workers, o f whom 16
are students in training. The records are kept according to f a m i l y
cases and children’s cases. A ll records open as family cases; later if
children in the family are placed a record is made for each o f these
children, and those become children’s cases. I f children are placed
and contact still is maintained with the family, a family-case record
and a children’s case record are carried at the same time. The aver
age case load for the first-year student is 32 family cases and 20
children’s cases; the second-year student carries an average case load
of 47 family cases and 45 children’s cases; and the trained worker
carries considerably more than this. The society does not district
the work but prefers to have the same worker carry the child or
family from investigation o f applicant to closing o f record. Dis
tricting is apt to mean the frequent transfer o f family or children
from one worker to another. A ll decisions as to plans for each child
are taken up with the supervisor and referred to the director o f case
work for further discussion when necessary. The amount of super
vision o f children in foster homes depends on the needs o f the respec
tive children and the homes where they have been placed.5 On
account o f the difficulties that arise in the placement o f older chil
dren, particularly the boys, a man trained in work with boys has
been added to the staff o f the foster-home department to have charge
o f the placement and supervision of all problem boys over 10 years
of age.
The department o f State children.

The department o f State children has the care and supervision of
children who have become wards o f the State. (See p. 84.) In
June, 1921, the Cleveland Humane Society entered into an agreement
with the division of charities o f the State department o f public wel
fare by which the society became the local representative of the State
to place and supervise its wards in Cuyahoga County. B y this ar
rangement it is possible to turn over to the State for support chil
dren requiring protracted care because o f physical or mental
handicaps. The society provides visitors for the placement and
supervision o f these children, and the State is responsible for their
5
On October 1, 1926, the Cleveland Humane Society had under care 1,667 children.
these, 856 were in boarding homes, 370 being State wards.

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A G EN CIES COOPERATING W I T H

T H E BUREAU

board and clothing. Three visitors devote all their time to work
with these children. On December 31, 1924, there were 215 children
placed and under supervision for the State department o f public
welfare.6
THE CLEVELAND ASSOCIATED CHARITIES

The Cleveland Associated Charities was founded in 1884 and reor
ganized and incorporated in 1900, when the city’s population was
about 400,000. Before 1900 the work of relief had been carried on by
several agencies, and it was as the result o f an effort to prevent
duplication o f the work that the Cleveland Associated Charities was
reorganized. The work is carried on under the general direction o f
officers and a board o f trustees. Committees are responsible for the
following branches of the w ork: Advisory, finance, home economics,
educational work, sewing center, volunteer service, child study, way
farers’ lodge, publicity, annual public meeting, annual published
report, location o f offices, unemployment, and district committees.
The associated charities is distinctly a family-welfare organiza
tion. It deals with the family as a whole, planning that every unit
of it shall receive such consideration as will enable the family to
become a community asset instead o f a liability. A well-defined
program has been worked out for handling material relief, health
problems, marital difficulties, and other exigencies. The aim in
relief o f course is to use material relief only to help a family long
enough for it to recover from the distress that has made necessary
the request for assistance from the associated charities. While relief
is being given, existing problems in the family are studied. An
effort is made to improve health, adjust marital difficulties, find em
ployment, plan recreational opportunities, and strengthen the feel
ing of moral and physical responsibility o f parents toward children.
In cases needing long-time relief, such as those due to widowhood,
desertion that is permanent, or chronic physical disability of the
wage earner, the handling o f relief is somewhat different. An
allowance is provided for each family, for which the family accounts
to the associated charities’ visitors, who are constantly in touch with
the family, building up every possible resource that will make it
independent as soon as possible. Attention has been given to the
solution o f marital problems in relation to other difficulties, as the
former frequently arise from poor health, poor management, in
sufficient income, and sex intemperance and lead to desertion, divorce,
and separation, all o f which often cause the dependency o f children.
The families receiving relief constitute between one-fourth and onefifth of the total number o f families under supervision. When only
supervision is given some families are carried from three months
to six years, the visitor acting as an advising friend, often asking
the cooperation o f other organizations in solving the problems. It
is in the capacity o f general supervisor and family counselor and
in its cooperation with the Children’s Bureau o f Cleveland and the
humane society that the associated charities has rendered greatest
service in working out the child-welfare program of the city.
6
O n O ctob er 1, 1926, t h is n u m b er h a d increased! t o 460 ch ild ren , S70 o f w h om w e re in
b o a rd in g hom es. T h e d ep a rtm en t o f S ta te children, th en co n siste d o f seven v is ito r s a n d a
su p e rv isor in ch a rge.

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T H E C H IL D R E N ’ S B U R E A U OF CLEVE LAN D

The Cleveland Associated Charities has a definite program for the
children in the families under care. This includes close cooperation
with the nutrition clinic at Lakeside Hospital and other health
classes in the city and with the children’s fresh-air camp; the work
ing out o f diet lists for mothers by the home-economics department
o f the associated charities, and demonstrations in the home by the
workers in this department on the principles o f cooking; and a childstudy committee which deals with problems of discipline and general
child care. Close cooperation is maintained with the Children’s
Bureau o f Cleveland; and all cases where there is a need, temporary
or permanent, o f placing children away from their families are
referred to the bureau. It is becoming more and more customary
to have case conferences in which the situation is discussed by
workers from both organizations before cases are referred. Court
cases in which the associated charities expects to file affidavits and
in which it is likely that the children will be placed are discussed
with the Children’s Bureau o f Cleveland for a comprehensive plan
before court action is taken. Certain cases likewise are discussed
with the Cleveland Humane Society. Thus a plan is made for the
judge’s approval, and when the case is heard a worker from the
bureau is present in the court "to take the children after the hearing
so that placement in the detention home is unnecessary. In this
way a presentation o f the problem is given and a solution for the
care o f each child arrived at— with responsibility for child and
family resting upon the organization best equipped to handle it.
Frequently the Children’s Bureau of Cleveland is responsible for
children whose family is under the supervision o f the associated
charities. Periodic reports on the progress o f the children and on
the family are exchanged. There has been a very fine spirit o f
cooperation between this bureau and the associated charities, due
perhaps to some extent to the location of both organizations in the
same building on the same floor and to the fact that the bureau’s
executive secretary and director of case work formerly were members
o f the staff o f the associated charities.
The existence of a central children’s bureau in the last four years
has not appreciably increased the case load o f the associated chari
ties, as the cases referred by this bureau to the associated charities
have been balanced by those referred by the associated charities to
the bureau.
The Cleveland Associated Charities carries on its work through
the division o f the city into districts, o f which there are 12 at the
present time. In each district is a supervisor with a staff o f visitors.
There are 163 members on the staff, 85 o f whom are case workers—
including senior visitors, second-year training students, and firstyear training students. The training class instituted in 1905, which
now is conducted under the school o f applied social sciences of
Western Reserve University, has proved a success in helping to
meet the need for trained case workers. The average active-case
load o f senior visitors is 50, of second-year workers 40, and of firstyear workers 25.

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A G EN CIES COOPERATING W I T H

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THE SOCIAL SERVICE CLEARING HOUSE

The Social Service Clearing House has been invaluable in organizing the community care o f dependent children. Organized by the
associated charities in 1909, it has been for 10 years under the super
vision o f a committee elected by the agencies using it and is financed
by the Welfare Federation. It maintains a central index o f the wel
fare agencies and of all the families served by them, the purpose
being to promote cooperative and constructive care for persons in
need and to prevent duplication of effort and relief on the part of
all the charitable and correctional agencies. Most of the families
making application to the Children’s Bureau o f Cleveland have been
known previously to other agencies. The clearing-house service
makes it possible to learn what agencies these were and when the
families had been known to them. The ability to get this infor
mation in regard to each family when the application is made is
o f great value in planning for the welfare of the children for whom
application is made. I f a family is under the active care o f some
agency the family can be referred back to it; and if the family
merely has been known to some agency at a previous time that agency
nevertheless can furnish information useful in planning for the
children’s future. It was found that many families were being
planned for by other agencies, but still disregarded every effort that
was made to help them keep their children with them and applied
for admission to an institution. A number o f children in such fami
lies might have been admitted to institutions were it not for the
service rendered by the Social Service Clearing House, which made
W it possible to cooperate with the agency actively interested in keep
ing the children in their own homes.

^
*

THE CATHOLIC CHARITIES BUREAU

The Catholic Charities Bureau has general supervision over all
Catholic charitable organizations; this includes institutions for the
care o f dependent children. Before the establishment o f the Chil
dren’s Bureau o f Cleveland the Catholic Charities Bureau was re
sponsible for all investigations of applications for the care o f chil
dren in Catholic institutions. Formerly most o f these investigations
were made through the associated charities. Since the organization
o f the central children’s bureau all Cleveland applications for insti
tutional care have been turned over to this bureau for investigation
and recommendation. Permission to place children found to be in
need o f institutional care in any Catholic institution must be secured
first from the Catholic Charities Bureau. The unlimited coopera
tion which the Catholic Charities Bureau has given in the work o f
the Children’s Bureau o f Cleveland has been no small factor in the
latter’s success.
THE JUVENILE COURT
JURISDICTION

4|r

The juvenile court is a branch o f the insolvency court and has
jurisdiction over all delinquent, dependent, and neglected children
under 18 years o f age and over all adults who contribute to the de-

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linquency, dependency, or neglect o f children under 18 years o f age.
The court may commit any dependent or neglected child to the care
o f some suitable State or county institution, or to the care o f some
reputable citizen or training or industrial school, or to the care o f
some association willing to receive him which embraces in its objects
caring for dependent, neglected, or delinquent children or obtaining
homes for them and which has been duly accredited by the State
department o f public welfare. The judge also may commit the child
to a private or public hospital. A child committed to an association
or institution for permanent care becomes a ward subject to the sole
and exclusive guardianship o f such association and institution, and
such agency may place in a family home; it also must be made party
to any proceeding for the adoption o f the child and may assent to the
adoption. An individual to whose care such a child is committed
may not consent to adoption without further order o f the court. All
associations receiving children under the juvenile court act" are sub
ject to supervision by the State department o f public welfare.7
The Children’s Bureau of Cleveland and the juvenile court have
become more interdependent as the bureau has developed. The ac
ceptance o f custody o f children by the bureau and the working out
o f plans for children in conjunction with the probation officers be
fore the case is heard in order to avoid having dependent and neg
lected children kept in the detention home while awaiting placement
has brought the bureau in close touch with the juvenile court.
THE MOTHERS’ PENSIONS DEPARTMENT

In 1913 the Ohio Legislature enacted a mothers’ pension law to ^
be administered by the juvenile court. This made it possible upon
application for the juvenile court to give aid for the support o f
children to women whose husbands are dead, permanently disabled,
prisoners, or deserters (provided the desertion had been for a period
o f three years). The family must have had two years’ legal resi
dence in the county granting assistance. The maximum allowance
is $35 a month for the first child and $10 for each other child who is
not eligible for age and schooling certificates. The order making
allowances is not effective for a longer period than six months and
is subject to change from time to time.8 Owing to the small appro
priation the mothers’ pensions department can not care for many
families, and therefore the Children’s Bureau o f Cleveland refers
the majority o f widows’ families to the associated charities for
assistance.
7 Ohio, Gen. Code 1910, secs. 1352, 1352-1, 163T, 1639, 1642, 1653, 1672, pp. 286, 349,
351, 354, 358, as added and amended by acts o f May 9, 1913, Laws o f 1913, p. 8 6 4 ; act
o f Feb. 17, 1914, Laws o f 1914, p. 1 7 6 ; acts o f Mar. 27 and May 9, 1919, Laws o f 1919,
pp. 46, 2 6 0 ; act o f Apr. 17, 1923, Laws o f 1923, p. 127.
(P age’s Ann. Gen. Code 1926,
secs. 1352, 1352-1, 1637, 1639, 1642, 1653, 1672, pp. 613, 614, 884, 885, 891, 896.) Be
fore Sept. 1, 1925, the insolvency court had jurisdiction concurrent with the court
o f common pleas in actions fo r divorce and alim ony, but since that tim e all such cases
are considered in the court o f common pleas. See Ohio, Gen. Code 1910, sec. 1637, p. 349,
as amended by act o f May 6, 1913, Laws o f 1913, p. 4 0 5 ; act o f Feb. 17, 1914, Laws o f
1914, p. 1 7 9 ; act o f Apr. 15, 1925, Laws o f 1925, p. 2 3 4 ; and Page’s Ann. Gen. Code
1926, sec. 1637, p. 882.
8 Ohio, act o f M ay 9, 1913, Laws o f 1913. d . 864. as amended bv act o f June 2. 1915.
Laws o f 1915, p. 436 ; act o f June
Laws o f 1921, p. 70, (P age’s Ann. G

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THE BUREAU OF DOMESTIC RELATIONS OF THE COURT OF
COMMON PLEAS

The bureau of domestic relations o f the court o f common pleas was
Jty established in July, 1920, by the judges o f the common-pleas court.
The purpose o f the bureau was the investigation' o f families with
children in which divorce proceedings were pending or contemplated.
The staff is very small, and the work is confined chiefly to office con
ferences with the applicants. Where the question o f divorce is para
mount in families that have come to the attention of the Children’s
Bureau o f Cleveland they have been referred primarily to the asso
ciated charities because the latter has better facilities for making in
vestigations.
THE ASSOCIATION FOR THE CRIPPLED AND DISABLED

The Association for the Crippled and Disabled aims to insure to
every crippled person in Cleveland, whether child or adult, the best
physical condition he is able to attain, the most useful education he
is capable o f receiving, and the most suitable employment he is
competent to undertake. The activities o f this organization include
supervision o f the work o f the Rotary Club for crippled boys and
girls throughout the county. The work o f the association is very
closely allied to that o f Rainbow Hospital for crippled children
and the two institutions for care o f crippled children in Cleveland.
Thus the association constantly works with the central children’s
bureau in planning for the care of the boys and girls in these
4j)T institutions.
The Association for the Crippled and Disabled has its own wellorganized social-service department, which is responsible for having
all needs o f its individual clients met adequately through the re
sources o f the association or in cooperation with agencies o f the
city. It provides for the training o f the crippled, for the finding
o f suitable employment, and for many other services which further
the interests o f the physically handicapped, whether children .or
adults. The association has rendered great service in the care which
it has given to crippled and handicapped children referred to it by
the Children’s Bureau of Cleveland and the Cleveland Humane
Society.9
THE DAY NURSERIES

On April 1, 1925, there were in the city o f Cleveland nine day
nurseries with a total capacity of 555 children. Most o f these
nurseries are in factory districts, but there are also a few in the
districts where many women go out from their homes to do day
work.
Families are referred to the nurseries by all case-work organiza
tions, such as the Children’s Bureau o f Cleveland, the associated
charities, and the mothers’ pensions department o f the juvenile
court. No reinvestigation is made for families referred by these
agencies; but all applications are cleared in the Social Service
Clearing House, and before accepting a child not known to any
9
In 1925, 49 per cent o f aU persons under care o f the Association fo r the Crippled and
Disabled were children,

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T H E C H IL D R E N ’ S B U R E A U OF CLEVELAN D

agency the nursery makes an investigation. The Children’s Bureau
of Cleveland refers many cases to the nurseries. The nurseries did
not seem able to meet entirely the demand made upon them. One
family which the bureau moved into such a district in order to
provide day-nursery instead o f institutional care was unable to have
the children admitted because of a long waiting list; and it was
found also that the associated charities had under care 11 families
with 19 children waiting for admission to this same nursery.10 A
study o f the children in the nursery and those on the waiting list
showed that the children in the nursery were sturdier, their family
contact was better, and their attendance at school was more regular.
A ll nurseries are required to obtain licenses from the State de
partment o f public welfare,11 which makes an annual inspection.
A license also must be obtained from the city board of health. The
nurseries make a charge of 10 to 50 cents a day, depending upon
the financial situation o f the families concerned.
THE WELFARE ASSOCIATION FOR JEWISH CHILDREN

The work o f the Welfare Association for Jewish Children has been
outlined as follows:
In Cleveland there are three agencies responsible fo r the care o f Jew ish
children a w a y from their n atu ral h o m e s: T h e W e lfa r e Association fo r Jew ish
Children, our child-placing a g en cy ; the Jew ish O rphan H o m e ; and the Ortho
dox Jew ish Orphan H om e. T h e Jew ish C hildren’s Conference w as established
about a year and a h a lf ago fo r the purpose o f centralizing th e intake o f children
and determ ining their allocation. O n th is conference a re represented the three
child-care agencies, the fa m ily agency, the Jew ish D a y N ursery, and a number
o f other agencies involved directly or indirectly in th e care o f children. T he
conference m eets w eekly, h as its ow n chairm an, w ho is a la y person, the
agencies being represented on the conference b y th e professional director and a
board member, each individual present having a vote in the decision m ade.
A lth ough great benefit h as been derived by having the cases considered
jo in tly , definite standards o f allocation h ave not as yet been form ulated and
hence there is room fo r controversy. A ll cases o f children w here there is a ques
tion o f placem ent a w a y from the n atu ral hom e are referred to the conference,
but the reception o f the applications fo r adm ission is not centralized, each
agency still receiving its own applications and bringing them to the conference.
T h is absence o f centralization o f applications tends to engender in the repre
sentatives o f the various agencies proprietary interests in their respective appli
cations. T his, added to the prevailing differences in th e philosophy o f child
care and p articu larly the placem ent o f norm al children fo r prolonged periods,
prevents the children’s conference fro m functioning a s sm oothly a t it m ight.
A positive result o f the conference proceedings h as been the relative increase
o f the number o f children who have rem ained in their n atu ral hom es.12

Though the Children’s Bureau of Cleveland has not been the case
work agency for the two Jewish institutions in the city a very close
relation has been maintained with the Jewish group who are workiiig
in the interest o f children. This has been due to the fact that there
are representatives on the bureau’s general board from the Welfare
Association for Jewish Children, the Jewish Orphan Home, and the
Orthodox Jewish Orphan Home. Moreover a representative from
10 This nursery made a study o f fam ilies in the district w ishing day-nursery care o f
their children, and it reached the conclusion that additional fa cilities were needed so as
to perm it the care o f 15 more children on a yearly basis.
11 Ohio, Gen. Code 1910, sec. 1352-1, added by act o f May 9, 1913, Laws o f 1913, p. 864.
12 Slawson, John : “ Cleveland.” The Jewish Social Service Quarterly [N ational Con
ference o f Jewish S ocial Service, New Y o rk ], Vol. II, No. 4 (June, 1926), p. 306.

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the bureau has been on the Jewish Children’s Conference, so that there
has been a valuable exchange o f information on the methods o f care
for Cleveland children. The medical director o f the bureau has
worked with both the Jewish institutions in their medical programs.
THE DIVISION OF CHARITIES, STATE DEPARTMENT OF PUBLIC
WELFARE

In the reorganization of Ohio State boards doing welfare work
in 1921 and in the final creation of a department of public welfare
the State board of charities became the division of charities within
the State department o f public welfare.13 The work of the division
is done through three bureaus : Support, institution inspection, and
child care. Since the establishment of the Children’s Bureau of
Cleveland two of these bureaus have cooperated with it in many
ways to bring about a new community attitude toward the care of
dependent children; but the division’s chief service has been ren
dered in inspecting and licensing children’s institutions and acting
as guardian for certain dependent children.14
THE INSTITUTION-INSPECTION BUREAU

The institution-inspection bureau is responsible for approving all
articles of incorporation for new agencies or institutions wishing to
care for children and must approve all building plans for public
institutions.15 An annual examination of all child-caring institu
tions and agencies is required to be made and a certificate issued
é t to such as are satisfactory. Institutions and agencies also must
report on children cared for. This has been o f great value to the
Children’s Bureau o f Cleveland in studying the children in the
institutions in the city. On the other hand, the division of charities
has been particularly interested in the results achieved by the bureau
in limiting the number o f children placed in institutions by carefully
investigating all applications for admission and thereby eliminating
the necessity of building more institutions.
In 1920 the policy of the division of charities was to curtail the
building of any more institutions for normal dependent children.
Every effort has been made to convince Ohio that its present institu
tional system, which represents an investment of $3,000,000, is an
expensive and unwieldy machine with excessive overhead cost and
that a large proportion of the 25,000 children in Ohio institutions
are there unnecessarily, for with adequate family case work a large
proportion of these children would have been saved from institu
tional life.16

18 Ohio, Gen. Code 1910, secs. 154—1 to 154—58, added by act -of Apr. 26, 1921. Laws o f
1921, p. 105. (P age’ s Ann. Gen. Code 1926, secs. 154-1 to 154-58, pp. 49—61.)
14 Ibid., sec. 1852, p. 286, as amended by act o f May 9, 1913, p. 864, and by act of
Mar. 27, 1919, Laws o f 1919, p. 4 6 ; secs. 1352—1 and 1352-3, added by act of May 9,
1913, Law s o f 1913, p. 864.
(Page’ s Ann. Gen. Code 1926, secs. 1352, 1352-1, 1352-3,
pp. 613, 614.)
15 Ibid., secs. 1352—2 (added by act o f May 9, 1913, Laws o f 1913, p. 86 4), 1353, p. 286.
(P age’ s Ann. Gen. Code 1926, secs. 1352—2, 1353, pp. 614, 617.)
16Atkinson, Mary Iren e: “ Ohio’s dependent children.” The Survey [New Y ork ], Vol.
X L IV , No. 15 (July 17, 1920), pp. 514-516.

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THE

C H IL D R E N ’ s B U R E A U OE CLEVELAND
THE CHILD-CARE BUREAU

The child-care bureau created within the division o f charities is
responsible for the acceptance o f actual guardianship o f neglected
and dependent children committed by the juvenile court or trans
ferred from a child-caring agency or institution.17 The aim is to
receive such children as can not be handled in their local community
or to serve local communities by acting as placing agent for the
county children’s home until such time as the community is in a
position to handle its own work. Special arrangements have been
made with several counties for the handling o f particular pieces of
work, such as the long-time boarding cases, the mentally subnormal
children, and the boarding of problem boys and girls. By a co
ordinated plan between local communities and this State department
no dependent or neglected child should fail to receive care and pro
tection.18 Children transferred to the guardianship of the division
o f charities have become known as State wards. This policy o f the
State in taking over the responsibility for the most unfortunate
children has been a great factor in relieving the Cleveland Humane
Society from the burden o f expense for prolonged care o f these
children. Though the society is responsible for placement and super
vision, the State furnishes board and clothing.
Other functions o f the child-care bureau of the division o f chari
ties are: (1) Acting as “ next friend ” to a child sought to be adopted
upon the request o f any probate court and filing the proper papers
and reports in such cases; (2) receiving crippled children in order
to provide suitable medical and surgical care and treatmeiit; (3) in
vestigating special schooling cases with a view to granting certifi
cates permitting children to work in accordance with the child labor
law; (4) rendering service to local agencies or juvenile courts in
the solution o f special or problem children’s cases (all cases o f chil
dren suffering neglect or dependency reported to the division o f
charities are investigated, and if there is no local child-caring agency
that can handle the case the division assumes' this responsibility);
(5) visiting children for agencies outside the State.19
In 1921 a law was passed which provided for the investigation o f
all adoptive homes by a representative of the division o f charities
if requested by the court and for the filing o f a report in court.20 In
Cleveland and Cuyahoga County the Children’s Bureau o f Cleveland
and the Cleveland Humane Society have acted as the agents o f the
State in this work.
In counties where there is little or no provision for mothers’ pen
sions a plan has been worked out by which the division o f charities
through State commitments boards the children with their own
mothers, the county paying the mothers for their care. This has
been a great aid in keeping families together.
" O h io , Gen. Code 1910, sec. 1352-3, added by act o f M ay 9, 1913, Laws o f 1913, p. 864 :

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fo J J *,0' “ W 5. I921-

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«*

SUMMARY
Any form of public welfare that strengthens the integrity o f the
family operates to the benefit o f the children o f the family and
reduces the likelihood o f their becoming charges upon outside in
dividuals and organizations.
As a form of public welfare the Children’s Bureau o f Cleveland
has become an effective organization for strengthening the family
ties of those who are seeking community care of their children and
has decreased the number o f children accepted for care outside their
own homes. How far-reaching and fundamental the ultimate re
sults of work in the preservation o f the home ties o f dependent
children may be can not yet be determined, but there can be no
question of the opportunity which such a central clearing bureau
affords a community to search out methodically the underlying
causes o f child dependency and to work consistently toward their
eradication.
The primary function o f the central clearing bureau is investiga
tion o f applications for admission o f children to institutions, and
through this investigation a definite insight into family conditions
causing dependency is gained. From this it follows that the clear^ i n g bureau necessarily has two other distinct functions: PreservaW tion o f the home ties through supervision and follow-up, and
interpretation o f social phenomena with a view to enlarging the
knowledge o f maladjustments that affect the lives o f children and
to devising methods for improvement.
The Children’s Bureau o f Cleveland has carried on the investiga
tion o f applications and the follow-up work with families with un
usual success, but up to the present time no organized effort has
been made to cover the field o f interpretation o f the great volume
of social data being collected as a result of the careful case work
done on applications. It is important that such a bureau should
have a research worker, all of whose time might be given to the
analysis o f social and economic conditions which are disrupting
family life; and doubtless this phase o f the work will be developed
in the not distant future. Already the children’s bureau and other
child-welfare agencies of Cleveland are aware o f the outstanding
forces destroying children’s homes and are formulating policies as
to how best to meet the needs o f children with whom these forces
have played such havoc, but much more research must be done to
know the subtler forces causing dependency. The extensive knowl
edge o f causes of dependency has been made possible only by the
uniform and thorough investigation o f applications for the admis
sion o f children to institutions made by the Children’s Bureau o f
Cleveland and o f applications for foster-home care o f children made
4§r by the Cleveland Humane Society.
The data indicate that illness o f father or mother, chiefly o f
mother, was the first great cause o f dependency o f children in
85

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Cleveland; that divorce, separation, and desertion constituted the
second greatest cause; and that death o f one or both parents, but
usually death of the mother, was the third.
From one point o f view the increase in the number o f children in '0
need o f community care due to illness of the mother is one o f the
most hopeful indications o f the new sense o f responsibility that is
awakening in the community. The influence that health centers and
hospital clinics have had in promoting better health for mothers and
babies is shown in the greater demand for hospital care during ill
ness, particularly during confinement. With the completion o f a
new maternity hospital in connection with Western Reserve Uni
versity in Cleveland, it is expected that the need for temporary insti
tutional care of children whose mothers are confined in the hospital
rather than at home will be increased. Better health facilities have
had a direct influence on the population o f children’s institutions and
agencies—temporary care o f children during illness o f mother be
coming more extensive.
Separation, divorce, and desertion are the most baffling o f all
causes o f dependency. It is hardly possible to speak o f them as
causes, since they are in reality symptoms o f other conditions such as
unemployment, ill health, mental defect, and difficult personality
traits that are destroying the structure o f the home. No other prob
lem related to the dependency o f children is so great a tax on the
financial resources and on the skill o f the staffs o f social-welfare
agencies as that o f divorce, separation, and desertion.1 The diffi
culties in families broken by divorce or desertion are so complex that
the work o f medical and social agencies o f a community must be w e ll^
coordinated in order to salvage as many o f these wrecked families
as possible. This coordination o f the agencies in Cleveland has been
one o f the distinct services o f the children’s bureau.
Death, usually o f one parent but not often o f both, as a cause o f
dependency, though still a serious problem in planning for the care
o f children, is no longer so difficult to meet as formerly. The em
phasis on better health, its promotion by local health authorities
through clinics and by national organizations through educational
propaganda, and the provision for aid to children in their own homes
have accomplished much in the preservation o f family ties. Cleve
land unfortunately has not had a sufficient appropriation for the
mothers’ pensions department o f the juvenile court to make it a real
asset in the care o f Cleveland families where the death or incapacity
o f the father has occurred. The result has been that the greatest
number o f these families have been carried by the Cleveland Associ
ated Charities, which receives its support from the public at large
through subscription to the Community Fund. The appropriation o f
an adequate amount o f money to carry on the work o f the mothers’
pensions department would release the funds now used by the associ
ated charities for care o f widowed families, and then these funds
might bet used for the development o f foster-home care o f children
A recent questionnaire sent to social agencies: o f Cleveland indicates that those agen
cies under the Community Fund spent, excluding the cost o f service and overhead, more
than $200,000 a year, or $547 a day, fo r the support o f the dependents o f deserters and
nonsupporters. The Cleveland Humane Society alone spent $17,000' in 1925 fo r the care
o f these dependents (A nnual Bulletin, Cleveland Humane Society [C leveland], Vol. X IV ,
No. 1 (M ay, 1926), p. 14 ).

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SUM M ARY

through the Cleveland Humane Society, which has been hampered
greatly through lack of funds. No entirely satisfactory method of
providing for the widowers’ families without placing the children
^ away from their fa’thers has been evolved, but much attention is now
* being given to' this problem.
A central clearing bureau such as is represented by the Children’s
Bureau o f Cleveland performs a fourfold service:
1. It has a responsibility to institutions. Through the assignment
to each institution o f a worker who becomes part o f the institutional
staff it provides all institutions, however small, with facilities for
making careful investigation o f all applications for admission. Such
provision o f workers who have been trained in modern case-work
methods makes it possible to give the most careful consideration to
the problems o f admissiojn peculiar to the institution. The investi
gation o f applications has not involved the institution’s right as to
the final decision on admission o f children. Recommendations have
been made as to the care needed after making the investigation, but
the decision in all cases has rested entirely with the superintendent
and board o f the institutions. Recommendations by the bureau have
not always been followed by the institution, and the admission o f
children has been allowed when it did not seem for their best in
terests; but there has never been any coercion or attempt to use
the bureau for centralization o f decisions as to admissions. The
consistent policy has been to develop case committees in each insti
tution and through these committees to raise the standards for ad
missions by showing what other possibilities there are within the
^com m unity for care o f children.
™ The existence o f a central bureau permits the assignment o f work
in such a way that service rendered to the institutions as a whole
can be developed evenly and carried on continuously. The centralbureau method enables the institutions as a group and the community
to have better-trained social workers. Training courses can be de
veloped for preparing new workers, and more skilled supervision
can be given to individual case workers. Still another great psy
chological advantage accrues to the individual workers under the
central-bureau system in that they have a greater stimulus toward
endeavor because o f the mutual encouragement and cooperation that
result from united effort. They do not feel that they are standing
alone, overwhelmed and unaided among manifold problems.
2. It has a responsibility to the individual child. The Children’s
Bureau o f Cleveland has raised the standards of care for dependent
children as a whole. This has been particularly demonstrated in the
medical and dental attention which has been given to each child
through the bureau’s clinic. This feature o f the bureau has been one
o f the most striking developments o f the central-bureau plan.
Through this program for determining the medical needs o f individ
ual children a clinical program for meeting the nutritional needs o f
children, the correction o f defects, and other special problems has
developed. This not only has benefited the children concerned but
k has been used as a means o f improving the institutions’ and agencies’
y medical facilities for all children under their care. The bureau
also has stressed the importance o f better facilities for mental exam
inations, and through the cooperation o f one institution it has pro
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Federal Reserve Bank of St. Louis

the

c h il d r e n ’s b u r e a u

Cl e v e l a n d

vided the means o f examination for children with complex mental
difficulties.
3. It has a responsibility to the family. The Children’s Bureau
o f Cleveland has been a great factor in the preservation of family
ties through the follow-up and supervisory work. Keeping alive m
the interest o f parents and relatives in rebuilding the home for the
child’s return has been a task carried on by the bureau with great
perseverance.
4. It has a responsibility to the community. As a central plan
ning bureau it has been largely responsible for the coordination o f
work o f all agencies concerned with the welfare o f children. It
has had an opportunity through its general board o f representatives
from both institutions and child-caring agencies to correlate the
work of all so that each agency and institution is aware o f its most
important contribution toward solving thé whole problem of child
dependency. It also has been able to accomplish an even develop
ment of case-work service to institutions, and because of its extensive
knowledge it is able to present the financial needs o f case work so that
the work for children is, as a whole, more adequately financed. Since
it does not have to depend for its support on contributions fj?om the
institutions which it is serving, it does not run the risk o f failure that
has faced other central bureaus when they endeavored to collect
from institutions for a service that in fact often was inadequate
because the central bureau had not a staff large enough to carry on
the work expected o f it. Through the careful investigation o f
applications for admission of children to institutions the bureau
has saved the community the financial support o f many children >
whose parents or relatives have been made to carry as large a part W
as possible o f their financial responsibility.
The development o f the Children’s Bureau of Cleveland has been
so rapid that some phases o f the work as yet have not been worked
out to the bureau’s satisfaction. Though the staff has grown pro
digiously there are still demands which the bureau can not meet be
cause the staff is inadequate, and workers are asked to carry what
seems to be too great a case load. It is not difficult to understand
how the decision by a group of people interested in child welfare
to have case work applied to the admission o f all children to insti
tutions has taxed the resources of the community to supply the
workers needed to carry out this monumental plan, but through the
cooperation of the local school of social work in organizing training
classes this handicap is being removed.
There is also some question in regard to the soundness o f the
present policy adopted by the child-welfare group o f Cleveland as
to the children accepted for institutional care and those referred for
foster-home care. It is doubtful whether placing in institutions for
a period of training all children over 3 years o f age who must be
cared for away from their own families for the first time is the best
plan. Some children never do well in an institution, and others
thrive on an institutional régime; and consideration must be given
to the personality and needs o f each child. This fact has not been
overlooked by the bureau in its recommendation for the care o f yf
children, and there have been many exceptions in carrying out its
policy. Considering the facts that most o f the institutions for which

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SU M M AR Y

the central bureau was the case-work agent were not in the beginning
aware o f the interrelation of institutions and other child-caring
agencies o f the community and that the facilities for foster-home
care in Cleveland are limited, this was perhaps the best policy that
could be formulated at the time. With the better understanding of
community problems that the institutions have acquired through the
guidance o f the bureau over the past five years and with the more
adequate provision for the foster-home care o f children this policy
will be changed. It seemed to meet the conditions in Cleveland at
the time the bureau was started, and as such it is not to be discred
ited ; but in the establishment o f such a central bureau in other com
munities the decision as to which children should be placed in
institutions and which in foster homes must depend on local condi
tions and above all upon consideration of the individual needs o f
each child.
The Children’s Bureau o f Cleveland is something o f a pioneer in
the field o f centralized bureaus for the investigation o f applications
for admissions to institutions, and therefore its work can not be
measured by any formulated standards. It is now in the process o f
making standards for this type o f children’s work, and at this time
its accomplishments must be judged by the results it has obtained
over the period o f its five years o f existence :
1. It has relieved the congestion of the institutions and made room
for those children most in need o f institutional care.
2. It has raised the standard o f care provided for the individual
child.
3. It has decreased the length o f time that children remain in
institutions.
4. It has been the inspiration for coordination of the work o f
child-welfare agencies in Cleveland.
5. It has saved the community the financial support o f many
children by compelling parents to pay what they can.
6. It has saved the community the expense of building new institu
tions by demonstrating that they were not needed.
7. It has stimulated more than the average increase in child plac
ing and boarding-home care so that an increasingly larger proportion
o f children may have normal home life.
8. It has maintained a high standard o f case work and provided
each institution with adequate social service.
9. There has been attained among all religious groups a fine feel
ing that has made possible the application o f certain principles con
cerning religious placements, in consequence of which all groups—
Catholic, Protestant, and Jewish—have felt that they were treated
with fairness and consideration.

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APPENDIXES
APPENDIX A.—CONSTITUTION OF THE CHILDREN’S BUREAU OF
CLEVELAND
(Approved March 9, 1926)
A r t i c l e I. N a m e .— The name of this organization shall be the Children’s
Bureau o f Cleveland, Ohio.
A r t . II. P u r p o s e —The purpose o f the children’s bureau shall be to promote
mutual cooperation and coordination among the children’s institutions and
agencies in Greater Cleveland; to study any particular problems affecting
childrens w ork; to develop standards of child care; to perform such common
services for the children s field as may be deemed advantageous and necessary;
to do all other things necessary and incidental to the proper conduct o f the
affairs o f the bureau and its members.
A r t . III. M e m b e r s h i p .— The governing body of the organization shall be a
general board consisting of two representatives, preferably one executive
and one board member, from each of the children’s agencies and institutions
in Greater Cleveland; two representatives o f each o f the public agencies
dealing with children; and any other persons interested in child welfare who
are approved by the executive committee but not representatives o f agencies.
A r t . IV. O f f i c e r s .— The officers of the children’s bureau shall consist of a
chairman, a first and second vice chairman, an executive secretary, and a
treasurer, elected annually by the executive committee at the first meeting
following the annual meeting. The duties o f each officer shall be those usually
pertaining to that office. The executive secretary shall be appointed by the
executive committee with the approval of the Welfare Federation. He shall
be the chief executive officer and responsible for the management o f affairs
under the supervision o f the executive committee.
A r t . V. T h e e x e c u t i v e c o m m i t t e e . — The executive committee shall consist o f
18 members elected for a term of three years by the general board at the
annual meeting, one-third being elected annually.
The executive committee
shall have control of all activities o f the organization and shall direct the
carrying out of the general policies, subject to the approval of the general
board.
Some time prior to the regular annual meeting the general board shall elect
a nominating committee o f five, who shall present to the annual meeting
nominations for the executive committee for the ensuing year.
A r t . VI. C o m m i t t e e s .— Such committees as the executive committee deems
necessary may be appointed in order that the organization may properly
function.
A r t . VII. A m e n d m e n t . — Amendments may be made to the constitution by
two-thirds o f the members present at a regular or special meeting upon 10
days’ written notice to each mejnber specifying the nature of the proposed
amendment.

43967°—27-----'7

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APPENDIX B — SCHEDULE AND INSTRUCTIONS USED IN THE STUDY

C L E V E L A N D C E N T R A L IZ E D IN V E S T IG A T IO N O F D E P E N D E N T C H IL D R E N —F A M IL Y S C H E D U L E

1. Record No__________

2. Date o f application_______________

3. Cath. Prot------------------------------------

4. Schedule No

T H E C H IL D R E N ’ S B U R E A U OF CLEVE LAN D

Other members of household: (o) Mar. c h . --------------------------- ( b ) Other R e l._________________ (c) B&L-------------------------Yrs. U. S.
9. Fa.: W BONF Country of birth____________ Yrs. U. S------------- 10. M o.: W BONF Country of birth------------ 11. Source of appl.: Both p a r .------ F a .------ M o .------ R e l.------ Friends____ Court (spec.)-------------Other (spec.)---------12. Aid requ ested :---------------------------------------------------------------------- 13. Reason aid requ ested:-------------------------------------------------(h) Inst, (spec.) Y N ___________
(d ) Mo. Pen. Dept. Y N
14. Known to other agencies: Y N
(i) Hosp. (spec.) Y N __________
(a) Asso. Char. Y N-------------------------------------- (e) Humane Soc. Y N ______
Clinic (spec.) Y N __________
(5) Cath. Char. Y N ________________________ (/) Juv. Ct. Y N___________
(c) Am. Red Cross Y N -------------------- ------------ (g ) Prob. & Dom. Rei. Y N_
cfc) Other (spec.) Y N __________
15. Father: Occupation and earnings____________________________________ _____________ ____________________________________
16. Mother: Gainful empl.— kinds and earnings-----------------------------------------------------------------------------------------------------------------17. Children: Occu. and wages (spec, no.)---------------------------------- ------------------------------------------------------m V i -----------------------18. Other income: Sources and amounts----------------------- ------------------------------------------------ 19* Approx. Mo. Total---------------20. Summary of family conditions: -------------------------------------- v------------------------ --------------------------------- -- - ---------------------------(m )
Incor.
------- 21 . Problems found by investigator (spec, person except for Div., Sep., Inad. Inc.):
(a) Death__________ ( d ) D e s .____________ (g ) Im prison .---------- (j) Negl. or c r . ------------------ ( n ) Phys. dis. (spec.)
(b) D iv___________ (e)Child ille g ._____ (h ) Sex. im------------------(fc) Juv. d e l.---------------------- (o) Ment. dis. (spec.)
Inad. i n c .___ ( i ) Intemp__________ ( l ) Problem c h . ---------------- ( p ) Other (spec.)-----(c) Sep. _________ (/)
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*
* of St. Louis
Federal Reserve Bank

A P P E N D IX E S
PU R PO SE OF TH E ST U D Y

The purpose of the study is to discover what are the conditions in a com
munity that force children out o f their own homes into care o f institutions or
child-caring agencies and what a well-organized community can do to combat
these conditions. Information is to be secured covering the following points :
A. Home conditions o f children for whom application for care is made.
Economic conditions, family standards, environment.
B. Previous work of social agencies with these families.
C. Relation of child’s own family to application and disposition.
D. Decision as to removal from own home in relation to findings on family
conditions.
E. What was done with children not removed.
F. Cooperation of institutions and community agencies.
The study will be based entirely on records o f the Cleveland Children s
Bureau ( according to inclusion defined under “ Instructions ” ), with no agency
or family follow-up inquiry.
IN S T R U C T IO N S F O R S T A T IS T IC A L C A R D

Cases to be included.
This study is to cover, with certain exceptions (see “ Cases not to be in
cluded” ), new applications to the children’s bureau during the two years
April i, 1922, through March 31 , 1923, and April 1, 1924, through March 31, 1925,
for the care of children away from their own homes (in institutions or foster
homes). By “ n ew ” application it is meant that no previous application has
ever been made to the children’s bureau for the care o f the children.
These new applications will include those made up into case records and
worked on by the children’s bureau as well as those applications referred with
out investigation to another agency and those dropped after investigation with
out further action.

Cases not to be included.
Applications for care of children already in institutions for dependent chil
dren, in hospitals, or special institutions for long-time care, such as a hospital
for crippled children, or in foster homes under the supervision o f a child-placing
agency.
Applications made by the Cleveland Humane Society, Associated Charities,
and other agencies for the observation of problem children at Children’s Aid
Society clinic.
Applications for the admission of children to summer camps.
Applications by the probate court for the investigation of children for
adoption.

Entering and checking of items on schedules.
A schedule if? to be made out by family for each application or case record
as above defined.
,
^ . , |1 _ ,
All items checked or entered on this schedule should pertain to the first
application, the investigation following this application, and the first dis
position of each child made as a result o f this investigation (even though the
first dispositions of the several children in a family may not all be made at
the same time). I f an application is made to the bureau and the case closed
so far as further action is concerned, or referred to another agency and later
a reapplication is made, this second application and the disposition following
it should not be considered in this study.
Check marks should be made directly to the right o f each item.
I f information regarding any item is not available enter N. R.— i. e., not
reported.
1. R e c o r d N o .— This means number of family-case record. For applications
treated as “ Information only ” enter I. O. before number.
2. D a t e o f a p p l i c a t i o n .— The date on which the case first became known to
the bureau. (In the Cleveland Children’s Bureau records this is found under
“ Date ” in the upper right-hand corner o f the face sheet and is also the date
of the initial entry on the running record.) Enter year, month, day.
3. C a t h . P r o t .— Check family religion. Check as Protestant famdies not
definitely affiliated with the Protestant church but not definitely affiliated

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T H E C H IL D R E N ’ S B U R E A U OE CLEVE LAN D

with the Catholic or Hebrew. The purpose o f this check is to indicate whether
the case would be assigned to a Catholic or Protestant institution or agency.
4. S c h e d u l e N o . — This means statistical-division number and will be entered
in Washington office. Do not make entries here.
5. C o m p o s i t i o n o f f a m i l y a t a p p l i c a t i o n . — This heading applies to the tabular
items below, a to h .
a.
M e m b e r : Enter all members o f the family group who would normally live
together (excluding married children— see instruction for item 8). Enter
names of all children lightly in pencil. This is simply as an aid in checking
schedules, so the names may be abbreviated; this entry will be erased when
the schedules have been completed.
When referring to children elsewhere on the schedule numbers will be used;
for instance—juv. court (3) stealing; incorrigibility (5 ). I f any o f the
children are stepchildren or adopted children of father or mother indicate by
placing to the left o f the numbers o f these children * f o r s t e p c h i l d o f F , A f o r
s t e p c h i l d o f M , and O f o r a d o p t e d c h i l d o f F
o r M , indicating adoptive parent
by writing either F or M, or F and M after “ of ” in note “ O adopted child of.”
Entries for items date o f birth, status o f parents, occupation, race, national
ity, time in United States, etc. will always be made for one parent even though
dead, divorced, or for some other reason outside the family group, bracketing
the father or mother or both if absent from the family group. I f the remain
ing parent whose husband or wife is dead or divorced has remarried (this
being the parent with whom one or more o f the children concerned in the
application are living) consider the step-parent as real parent, entering items
accordingly. In step-parental families the marital status and whereabouts of
the child’s own parents will be entered opposite the number o f the child.
(This will indicate the combination o f groups of children.)
This may be clearer if presented in outline fo rm :
The family group is the father, mother, and children. In many cases this
will represent the family group living together. Exceptions will b e :
(a )

O n e

p a re n t

d ea d ,

d iv o r c e d ,

d es er ted ,

a n d

c h ild r e n

liv in g

w ith

r e m a in

Enter items for both own parents,
the entries under “ Marital status ” and “ Whereabouts ” o f parents
accounting for missing parent. Put brackets around missing parent.
(&) O n e o f o w n p a r e n t s d e a d o r d i v o r c e d , o t h e r p a r e n t r e m a r r i e d c m d h a s
th e ch ild r e n .
Enter items for F or M referring to step-parent, ignoring
the parent whose place he has taken.
(c) P a r e n t s s e p a r a t e d o r n o t l i v i n g t o g e t h e r ( n o t l e g a l l y d i v o r c e d ) , e a c h
h a v in g
so m e
o f
th e
c h ild r e n .
Enter items for each o f parents, the
entries under “ Whereabouts o f children ” showing with which parent
they are. Bracket parent not considered as living in the home.
(d ) P a r e n t s d i v o r c e d , e a c h h a v i n g s o m e o f c h i l d r e n . Consider as two
separate family groups, making a schedule only for the group concerned
in the application. (I f both groups o f children are involved, two sched
ules must be made.) Bracket missing parent except where step-parent
has taken his place, in which case make entries for step-pprent.
(e )
Definition of inclusion states that the children are considered for
removal from their own homes, but the s t u d y w i l l i n c l u d e s o m e c h i l d r e n
in g

p a re n t

liv in g

w ith

w h o

n o t

re m a r r ie d .

g ra n d p a ren ts

o r

o th e r

r e la tiv e s

o r

h o a r d in g

h o m es

w h e r e

(Children already in the cutsody of
agencies or institutions are excluded.) For children living with rela
tives or other families as above indicated entries will apply to own
parents, both of whom will be bracketed. The entries under “ Where
abouts o f child ” will show with whom they are living.
( / ) C h i l d r e n i n a d o p t i v e h o m e s . Items F and M will apply to adoptive
parents, ignoring own parents.
h . L e g : Means “ legitimacy.”
It will be assumed child is o f legitimate birth
unless ill.” is entered opposite child’s number.
c . S e x : Enter h for boy, g for girl.
d . D a t e o f h i r t h : Secure specific date whenever possible.
Enter year, month,
day. I f date o f birth can not be secured, enter in date-of-birth column best
approximation o f age at date of application.
A - f f e . This will be edited in Washington office.
Do not make entries in
this column.
f.
M a r ita l s ta tu s
(o f parents) : The purpose o f this item is to show the
relation of F and M. to each other at the time of application. The following
list should be kept in mind as possible entries opposite F and M :
th e y

h a v e

b een

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Federal Reserve Bank of St. Louis

p la ced

h y

p a ren ts.

APPENDIXES

Enter this for F and M married to each other and not divorced,
separated, deserted, or widowed.
U n m a r r i e d : Enter this for F and M not married to each other.
D i v o r c e d : Enter this for F and M legally divorced from each other.
S e p a r a t e d : Enter this for F and M when they are not living together for
reasons other than desertion, divorce, or absence of one or the other in
a hospital or correctional institution.
W i d o t c e d : Enter this for the parent whose husband (F ) or wife (M ) has
died, and enter a dash (— ) for the parent who has died.
D e s e r t i n g : Enter this for the parent deserting the family, and enter a
dash (— ) for the parent who has been deserted by husband (F ) or
wife (M ).
C h i l d a f o u n d l i n g : Enter for both parents if child was abandoned in in
fancy and nothing is known about parents.
O t h e r : Enter any other marital status of F or M.
When F or M applies to step-parents o f some of children, account for marital
status of own parents in this column opposite the numbers o f the children.
g. W h ere a b o u ts
(of parents) : Applies to time o f application. Keep in mind
the following list as possible entries opposite F and M :
H o m e : Enter this if parent is living in the home with the family group
(as described under “ Member ” in “ Composition of family at time of
application” ). .
M a r r ie d :

D ea d .

Enter hospital, specify kind, i. e., insane, t. b., infirmary, etc.,
for parent absent from home because o f confinement in such hospital.
C o r r e c t i o n a l i n s t i t u t i o n : Enter corr. inst., specifying kind, i. e., jail, reform
atory, workhouse, penitentiary, etc. for parent outside of home because of
commitment to such institution.
O th er :
specify whereabouts of parents, as boarding, domestic service,
etc. when above items do not apply.
When F or M applies to step-parent o f some o f children account for where
abouts of own parent in this column opposite the numbers of the children.
h . W h e r e a b o u t s o f c h i l d : Enter fo r each child, keeping in mind the follow
ing list of possible entries :
H o m e : Enter for child living in the home with the family group
(as
described under “ Member ” in “ Composition o f family at time of appli
cation ” ).
W ith
f a t h e r : Enter this fo r child living with father who is not in the
home ; may be in father’s own home, in a boarding home, or elsewhere
with the father.
W ith
m o t h e r : Enter this for child living with mother who is not in the
home ; may be in mother’s own home, place of employment, or else
where in her custody.
W i t h r e l a t i v e s : Other than parents.
O th er h o m e
(specify) : Any private home in which a child is living away
from his parents or step-parents. Write, after “ other home,” adoptive
home, friends, boarding home, or free home (specify if placement was
made by an agency).
In s titu tio n
(specify) : Enter name of institution, specifying kind for
dependent, delinquent, feeble-minded, deaf, blind, crippled, etc.
H o s p ita l
(specify) : Enter name of hospital, specify kind, i. e., t. b.,
crippled, etc.
W o r k in g a w a y fr o m
h o m e : Enter this for older unmarried children living
and working away from home.
6. Disposition of child (refers to first disposition).
H o s p ita l:

T y p e

o f

d is p o s itio n :

Enter name of agency to which, after investigation, child
was referred for foster-home care (board, wage, free, or adoptive).
F a m i l y a g e n c y : Enter name of agency to which after investigation whole
family was referred for care.
I n v e s t i g a t i o n , n o a c t i o n : This item to be entered when after investigation
of the application no action seems warranted either by the children’s
bureau or any other agency.
N o i n v e s t i g a t i o n ; p l a c i n g a g e n c y : Enter name o f agency to which without
investigation child was referred for foster-home care (board, wage, free,
or adoptive).
P la c in g

a g e n c y :

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Federal Reserve Bank of St. Louis

T H E C H IL D R E N ’ S B U R E A U OF C LEVE LAN D

i n v e s t i g a t i o n ; f a m i l y a g e n c y : Enter name o f agency to which without
investigation whole family was referred for care.
N o
in v e s tig a tio n ; n o
a c t i o n : Enter this item when application does not
seem to warrant either investigation or action by children’s bureau or
other agency.
I n s t i t u t i o n : Enter name of institution to which child was referred for
care.
P la c e d
w i t h r e l a t i v e s : Relatives other than parents.
R e tu rn e d
t o h o m e : Enter this item when child has been living outside of
home with other parent, with relatives, in institution, in boarding home,
or elsewhere outside family group.
S u p e r v i s i o n w i t h o u t r e m o v a l : This item to be entered when the plan for
the child was not to remove him from his present whereabouts but to
retain supervision for a period. This will apply chiefly to children in
families where application was made for the admission of all the
children in . the family to an institution but when only part were ad
mitted and the rest left in the home under supervision.
N o a c t i o n : Enter this item for children not living in the home and with
whom no contact was made.
D is p o s itio n
p e n d i n g : Enter this item when case is still in process o f
investigation and disposition has not yet been made.
O t h e r (specify) : Enter briefly any other disposition o f child.
b.
S u p p o rt
b y
p a r e n t s : Indicate extent to which parents are assuming re
sponsibility for support outside of own home by entering full, partial, none,
or N. R.
7. D a t e o f m a r r i a g e o f F a n d M : Enter year, month, and day.
8. O t h e r m e m b e r s o f h o u s e h o l d :
M a r r ie d
c h i l d r e n : Indicate whether married sons or daughters and their
families are living in the household. Specify number of such sons and
daughters and their children.
O t h e r r e l a t i v e s : Indicate number and relationship of relatives other than
sons or daughters living in the household.
B o a r d e r s a n d l o d g e r s : Indicate number and sex.
9. F a t h e r (refers to F ).
10. M o t h e r (refers to M ).
R a c e : Check W fo r white, B for black or negro (negro should include all
negroes whether of pure or mixed blood). O fo r other, N for native
born, F. for foreign born. Specify if Jewish, Polish, Lithuanian, etc.
C o u n try
o f
b i r t h : Enter country of birth and specify if Jewish, Polish,
Lithuanian, etc.
Y r s . i n U . S . : Indicate time in the United States at time of first application
by years. I f father or mother was dead at time of application enter
time in United States up to date of death.
11. S o u r c e o f a p p l i c a t i o n : Refers to persons, agency, or institution making
the application.
B o th
p a re n ts
(F and M) : To be checked when both parents are actively
concerned in the application.
F a th e r
(F ) : To be used when father only is actively concerned in the
application.
M o th er
(M ) : To be used when mother only is actively concerned in the
application.
R e l a t i v e s : Other than parents.
F r i e n d s : Private individuals other than relatives.
C o u r t : Name court referring directly to children’s bureau.
O t h e r : Applications from all other sources.
Specify by writing name o f
institution, agency, etc. (I f own parent who has been replaced by F
or M makes application specify here.)
12. A i d r e q u e s t e d .— Enter briefly type o f aid requested by the person making
the application, as “ temporary institutional care o f ( 1) and ( 2),” “ boardinghome care,” etc.
13. R e a s o n a i d r e q u e s t e d .— Enter reason given by person making application,
as “ illness of mother,” “ death o f father,” etc.
14. K n o w n t o o t h e r a g e n c i e s .— Check Y (yes) or N (no) according to
whether or not family was known to social agencies at any time prior to
first application especially as shown by the Social Service Clearing House
N o

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A P P E N D IX E S

report. Check T or N for each agency according to whether or not family
was known to it and specify briefly the nature of each agency’s contact with
the family ; for instance, associated charities, five years, family relief ; juvenile
court 1/10/15 (4) stealing.
15. F a t h e r ; o c c u p a t i o n a n d e a r n i n g s . — Enter briefly the nature of father’s
(F ) occupation at the time of application. Be as specific as information on
record will permit. Avoid general terms such as “ laborer.” I f man is a,
laborer, write “ laborer in street department ” or “ laborer in steel mill,” etc. ;
if a conductor, “ conductor on street car,” “ conductor on railroad,” etc. Enter
also the approximate amount earned, i. e., amount per week or month. Enter
here if F is not working, works irregularly, or enter any other pertinent fact
regarding work habits.
16. M o t h e r ; g a i n f u l e m p l o y m e n t , h i n d s a n d e a r n i n g s . — Enter only informa
tion regarding gainful employment, i. e., other than household duties. Indicate
whether in or out o f home as “ Washing at home,” “ Canvassing out o f home.”
Enter amount earned per day, per week, etc., from each kind o f gainful
employment if M engages in more than one.
17. C h i l d r e n ; o c c u p a t i o n a n d w a g e s (specify number).— Enter occupation
and wages per day, per week, etc., o f unmarried working children living at
home, specifying children by entering numbers given under “ member.”
18. O t h e r i n c o m e ; s o u r c e s a n d a m o u n t s . — Contributions from unmarried
children living and working away from home, relatives, social agencies, etc.;
amount paid for board by married children, other relatives, and boarders
living with the fam ily; and amount received for rental o f property or part
of house.
19. A p p r o x i m a t e m o n t h l y t o t a l . —Total monthly income received by family
from all sources specified under 15, 16, 17, and 18.
20. S u m m a r y o f f a m i l y c o n d i t i o n s . — State briefly any unusual conditions
existing in the family bearing upon the application for child’s care.
21. P r o b l e m s f o u n d l y i n v e s t i g a t o r . — Check the problem or problems found
to be existing as a result of the investigation following the first application
and preliminary to the first disposition. Only those problems are to be checked
that have a direct bearing upon the removal of the child from his present
whereabouts or his admission to an institution.
Opposite all items except divorce, separation, and inadequate income, specify
person to whom item applies, indicating each child by number and parents by
F and M ; for instance, death: M, mental disability— epilepsy (3 ).
a . D e a t h : Check this item when the death of one or both parents is one
of the reasons for the application. Check only fo r other deaths when they
have a direct bearing on the application, as for instance the death o f a grand
mother or older sister who has been helping to care for the children.
ft. D i v o r c e : Check this item where the fact o f the parent’s divorce is a
direct factor in the application ; that is, where the divorce results in the
children’s lacking home care.
c . S e p a r a t i o n : Check this item where the fact o f the parents living apart
for reasons other than divorce, desertion, or absence o f one or the other in
a hospital or correctional institution is a direct factor in the application.
d . D e s e r t i o n : Check this item if the desertion o f one or both parents has
a direct bearing upon the application.
e. C h i l d i l l e g i t i m a t e : Check this item only when the fact that a child was
born out of wedlock has a direct bearing upon the application.
f . I n a d e q u a t e i n c o m e : Check this item when the total income does not meet
family budget. This item will usually be checked in connection with some
other item except when it is the sole problem and the disposition is to a
family agency for relief.
g . I m p r i s o n m e n t : Check this item only when the absence o f ^one or both
parents in a correctional or penal institution has a direct bearing upon the
application.
h . S e x u a l i m m o r a l i t y : This applies to the conduct o f the parents and should
be checked not only when proved but also when the implication o f such con
duct is serious enough to cause consideration of the removal of the children.
i . I n t e m p e r a n c e : Check this item when the use o f liquor by either or both
parents seriously interferes with the functioning o f the home.
j. N e g le c t
o r
c r u e lty :
Check this item when there is willful omission or
incapacity other than lack of income to provide food, clothing, shelter, medical
attention, or proper guardianship for children or when there is physical abuse

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T H E C H IL D R E N ’ s B U R E A U OF CLEVELAND

of children by parents or person having care o f children in home Indicate
the parent or person who is cruel or neglectful.
e
Jo J u v e n i l e
d e l i n q u e n c y : Check this item when a child’s behavior is such
as to bring him before the juvenile court at time o f application.
L P r o b le m
c J w l d : Check this item when a child’s behavior presents such a
problem as to necessitate study o f him at Children’s Aid Society e li t e ^
^

ya^

“
th is item w hen P aren tal d iscip lin e fs in ad eq u a te
r S r ^ . . . DOt ™ Ch n e e e sa ta te s d e c k i n g «
£

of physical dIsabiuty after Specify,”
Deaf.
Blind.
Crippled.

Other permanent handicap.
Venereal disease.
Tuberculosis.

ttfa p p S “

disabUities nre to *» “

the M fo w in g * c C S a tfo n s ef
fS m in d e d n e s s .

Confinement.
Abortion.
Other.

"-ied as hare a direct bearing

° £ m<mtal d‘ SabUIty t ó e r “ « * « * * ”

PsySonenrosis.

Oondltion undiagnosed.

upon^ap^ication!14“ 1 dlsabiIItles are to be included as have a direct bearing
t h f appUratlOT.t6r h6re a“ y " ' " er IJrol,lems whIci ha™ a direct bearing upon
The agent in charge o f the study will settle methods of handlin«- comnli
w iil°bl unUorm

Wlth

m a M n g

note o f decisions 80 that interpretation

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Full text of The Children's Bureau of Cleveland : A Study of the Care of Dependent Children in Cleveland, Ohio, Bureau Publication No. 177

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