Risk Assessment and Decisionmaking in Child Protection

By Steib, Sue | Children's Voice, November/December 2003 | Go to article overview

Risk Assessment and Decisionmaking in Child Protection


Steib, Sue, Children's Voice


CFSR OUTCOME AREA-CHILD SAFETY*

* Protection of children from abuse and neglect

* Safe maintenance of children in their own homes whenever possible

A distraught father telephones child protective services (CPS) to report he has learned from a neighbor that his estranged wife has left their three young children at home alone at least twice during the last week.

The agency intake worker says CPS cannot accept his report for investigation because the information is secondhand and he is not reporting the children are home alone at the time of the call. The worker notes in the file that this report may have been prompted by a child custody dispute.

Is this response typical? Might the father have received a different response if he had spoken with another individual or called another agency?

Accepting all reports, however questionable, may seem the better choice, since the alternative might deny children needed protection. But is this realistic when agencies are trying to allocate limited resources to the most serious situations? Is accepting more reports warranted when CPS agencies substantiate less than a third of the reports investigated?

Questions about decisionmaking also arise when reports of child abuse and neglect are investigated. Can a caseworker trust a parent who admits he lost control and was wrong to badly bruise his child during a spanking? Is this situation different from that of a parent who also bruises her child but believes harsh discipline is necessary for the child's own good? What's the likelihood either child will be injured again, perhaps more severely, if left in the care of his or her parents?

Public concern, even outrage, is understandable when CPS agencies fail to intervene and abuse or neglect results in a child's injury or death. But how much do we know about what's involved in determining whether a child is abused or neglected? How straightforward are such decisions?

Increasingly, research is shedding light on ways in which child welfare professionals can improve the accuracy and consistency of their decisions using written tools. Such tools serve two broad functions-to structure risk assessment for child maltreatment, and to guide decisions about intervention.

The development of risk assessment protocols in child protection began in the early 1980s. By 1991, all but a few states were using some type of written instrument to structure CPS decisions. This trend is not unique to child protection-research in other fields has shown that structured protocols can improve clinical decisions.

As reasonable as the use of risk assessment tools might be, developing and implementing them has not been easy. Questions and controversy have arisen about definitions of abuse and neglect and the kinds of measures and statistical methods used. Risk itself is variously defined at different points in the decisionmaking process. As in the case illustration that opens this article, the concept may be applied in decisions about accepting a report or, as in the second example, about the disposition of a confirmed report. Child welfare professionals also may rely on risk assessments to distinguish immediate danger from threats of long-term harm, or to guide decisions about specific service needs.

Tools for Assessing Risk

Risk assessment systems commonly fall into two broad categories: consensus-based and actuarial, with some representing a composite of the two. Strictly defined, consensus-based instruments are derived from opinions of experts in the field or reviews of professional literature; actuarial instruments comprise factors demonstrated through research to predict the recurrence of abuse or neglect, usually in the jurisdiction where the model is used.

The distinctions between these two models are often blurred. Many consensus instruments, for instance, use only items for which empirical support exists. Some researchers believe the two models are becoming more similar as they evolve. …

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