Academic journal article Child Welfare

Safety and Risk Assessment Frameworks: Overview and Implications for Child Maltreatment Fatalities

Academic journal article Child Welfare

Safety and Risk Assessment Frameworks: Overview and Implications for Child Maltreatment Fatalities

Article excerpt

This article highlights current models used in child protection to assess safety and risk, and discusses implications for child maltreatment fatalities.The authors advance that current risk and safety practice approaches were not designed to accurately estimate the likelihood of low base-rate phenomena and have not been empirically tested in their ability to predict or prevent severe or fatal child maltreatment. They advance that, regardless of the ultimate effectiveness of safety and risk tools, competent assessment and decisionmaking in child protection depend on sound professional judgment and a comprehensive systemic approach that transcends the use of specific tools.

At least since the case of Little Mary Ellen in New York City in 1874 (Shelman & Lazoritz, 2005), issues surrounding severe child maltreatment have been a major concern in the United States. Approximately 3.4 million reports of child maltreatment were made to child welfare agencies in 2011. The victimization rate for FFY 2011 was 9.1 per 1,000 children (U.S. Department of Health and Human Services, or DHHS, 2012). Of those 676,569 substantiated (unduplicated count) victims, an estimated 1,570 children died from abuse and neglect during federal fiscal year 2011 (DHHS, 2012).

Child Protective Services (CPS) agencies are charged with investigating or assessing these reports of maltreatment and intervening to protect children from further maltreatment. Safety and risk assessment are central to decisionmaking regarding what actions should be taken to protect children from maltreatment (White &c Walsh, 2006). They are the "gateways" of CPS practice, upon which most important decisions are predicated. Thus, effective safety and risk assessments depend on the ability of CPS professionals to obtain accurate and timely factual information, as well as processes that promote critical analysis of that available information.

Fortunately, knowledge about what works in child protection has increased over time, in part because of research related to risk factors and characteristics of families whose children have died due to maltreatment or suffered non-accidental inflicted severe head injuries (Berger, Fromkin & Stutz, 2011; Puckett, 2010). For example, it is well understood that babies and other very young children are at highly elevated risk of a maltreatment-related fatality: in 2011, fourfifths (81.6%) of all child maltreatment fatalities were children younger than four years old (DHHS, 2012). Nevertheless, our understanding of the causal processes resulting in serious injuries or death related to maltreatment is incomplete.

As an expert in the field once stated, "working in child protection is not rocket science, but is harder." Three types of problems have been identified: (1) simple problems, (2) complicated problems, and (3) complex problems. Sending a rocket to the moon is considered to be only a "complicated problem" because once the steps necessary to send a rocket to the moon are specified, the steps can be replicated with precision (Gawande,2009). Decisions about complex problems are characterized by ambiguity, inconsistent goals, complexity of decisions and systems, severe time constraints, and inherent unpredictability (Dörner & Wearing, 1995; Funke, 1991).

While there are situations in child protection in which routine processes have been well established, there are many aspects of CPS where precise replication is difficult. For instance, safety and risk assessment tools generally contain discrete factors, yet it is the interactions of these factors-such as parent-child interactions or the interactions of risk and safety factors from disparate domains-that are likely to figure in the causal processes leading to lethal assaults of young children. Hence, there are limits to the ability of professionals, no matter how competent, to assess the safety of a child or to predict the likelihood of future maltreatment. Decisionmaking is subject to errors related to "false negatives" (risk or safety threat is thought not to be present but children are maltreated) and "false positives" (risk or safety threat is identified but children are not maltreated). …

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