Risk Assessment Instruments, Child Maltreatment

Risk assessment procedures are used by human services professionals to identify children who may be at risk of harm as a result of maltreatment. Most often, such assessments are conducted by child protection agencies charged with investigating allegations of child abuse. In such instances, risk assessment generally involves determining the likelihood of future maltreatment and deciding whether action is needed to reduce the risk of future harm. The definition of child maltreatment can vary with regard to scope, frequency, and severity, but it generally entails an act of commission or omission that is damaging or harmful, or can result in damage or harm, to the child's physical or psychological well-being. Child maltreatment is categorized into specific acts of physical abuse, sexual abuse, neglect, and emotional abuse including witnessing domestic violence.

Historically, social services workers have relied upon clinical skills derived from a mixture of professional judgment and intuition to make attributions of risk. However, clinical judgment may be an inadequate predictor of future risk and can result in poor decisions that have serious implications for children and families (i.e., children are mistakenly left in homes that are abusive or children are mistakenly separated from their caregivers). Commonly found circumstances contributing to uncertainty in cases of alleged child maltreatment can include differences in parenting styles, cultural variations in parenting, environmental characteristics, the values and policies of agencies and the broader community toward child maltreatment, worker training related to decision making, and the organizational context of child welfare agencies.

Standardized risk assessment measures have been developed in child welfare in an effort to address these shortcomings and to target scarce resources, and these have been adopted widely across the United States, Canada, and Australia. Standardized risk assessment instruments have been used for many [Page 602]years in other practice fields, including medicine, health, and criminology. In general, their improved reliability, validity, and objectivity enhance decision making. Standardized risk assessment tools differ regarding their scope, construction, and reliance on various factors to predict risk, but they share a common goal: to help social service workers more accurately determine the likelihood of child maltreatment based on the presence of certain family characteristics and environmental conditions considered to be highly associated with maltreatment.

Standardized tools generally involve three separate functions: (1) screening for potential maltreatment in the general population, (2) assessing the risk of recurrence of maltreatment in populations being investigated by child protection services, and (3) assessing the risk of maltreatment among children who have been returned to their parents after residing in foster care. Although these categories overlap to some extent, the factors that predict initial occurrence are not necessarily the same factors that predict maltreatment recurrence. Instruments developed within these three areas differ in terms of their underlying construction (e.g., consensus-based vs. actuarial), sources of information (e.g., caregiver, child, caseworker), number of risk factors included, and scoring of risk factors (e.g., range of choices for each category). Although most of the items appear to have been derived or at least supported by empirical studies, many factors have not been validated for use in risk assessment instruments.

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