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Children and Youth Services Review Volume (issue): 23 (1) 2001

Assessing and Managing Risk in Child Protective Services
Guest Editors, Eileen Gambrill, Aron Shlonsky

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The assessment and management of risk in child welfare services 1 -- 2
Aron Shlonsky, Eileen Gambrill

This article provides an overview of the context in which decisions about risk are made in child welfare including personal, task, and environmental factors that may contribute to uncertainty and less-than-optimal decision making, as well as some of the methodological challenges posed by the use of current risk assessment instruments. Actuarial, consensus-based, and clinical instruments are discussed and the more successful track record of actuarial decision-making in child welfare and related fields is highlighted. Methodological challenges to assessing risk are also presented including lack of reliability and validity of measures, definitional dilemmas, temporal issues such as changes in risk over time, absence of base rate data, predicting for individuals and sensitivity and specificity of measures. Implications for the design and implementation of risk assessment tools are considered in light of contextual influences and methodological limitations. Lastly, an overview of the contents of Part One of this special issue on risk assessment is provided.
Assessing risk to determine the need for services 3 -- 20
Diane DePanfilis, Susan J. Zuravin

 

In most CPS jurisdictions, the decision to provide continuing services is not made based on substantiation status alone. Even when a case is substantiated, only about 50% may actually be opened for further services (U.S. DHHS, 1999). The purpose of this study was to investigate differences between substantiated cases that were not opened versus those that were opened and to examine differences in characteristics and patterns of child maltreatment recurrences between these two groups. Methods involved collecting data at an index report for a random sample of substantiated cases of physical abuse or neglect in an urban jurisdiction (1167 families) and following them prospectively over five years. Families that experienced a placement of any child during the follow-up period were removed to compare groups of intact families who received services to those who did not. After removing families with child placements, a final sample of 747 families (252 whose cases were closed in intake and 495 who were provided services) were compared with respect to race, age of children, number of children in the family, type of maltreatment, maternal substance abuse, age of mother at index, and prior substantiated reports.

  Significant bivariate differences were observed between the groups with respect to age of children, number of children in the family, type of maltreatment, maternal substance abuse, age of mother at index, and the existence of prior substantiated reports. However after removing multiple types of maltreatment (n=47) and controlling for other variables in the model, only a two variables significantly predicted case opening status. Families with a previous substantiated report were 22% less likely to be opened for service than families without prior substantiated reports and cases substantiated for neglect were 20% less likely to be opened for service than physical abuse cases. Overall the model successfully predicted 94% of the cases that would be opened but only 13% of the cases that would be closed. Despite these problems with the model, there were significant differences in the pattern of recurrences between these two groups. Only 4% of the families who were closed in Intake were identified with a substantiated report within five years compared to 26% of the families who were provided continuing services. Implications of this research for risk assessment are discussed.

Child abuse and neglect referral patterns: A longitudinal study 21 -- 47
Isabel Wolock, Patricia Sherman, Leonard H. Feldman, Barbara Metzger

This study addresses two interrelated problems affecting the resource capacity of child protective services—the high rate of repeated reports and unsubstantiated cases. The reports of 238 families were tracked from the time of their first report through June 1996. General patterns of reports and the impact of case characteristics on numbers of reports and rates of reports were examined. The average family was reported just over four times over an almost five-year period and slightly more than a third of a family’s reports were substantiated.  Type of report, presence of injuries, placement of a child and professional status of reporter affected number of reports and rates of substantiation. Drawing upon interview and case record reviews of an earlier study, the impact of a set of seven family risk factors on number of subsequent reports and substantiation status was also examined. Poorer family functioning, parental substance abuse, receipt of AFDC and number of children were predictors of the number of subsequent reports; poorer family functioning, parental substance abuse and number of children predicted substantiation status of a report. Paired comparisons of the three groups revealed significant differences on family risk factors only between those that had no further reports and those with substantiated re-reports. No significant differences were found between those with unsubstantiated and substantiated re-reports, suggesting that the two types of families are more alike than different in terms of detrimental family and individual factors. Overall, the study findings support those who argue that by sharply restricting the types of cases investigated and/or using substantiation as a key criterion for investigating and opening cases, many seriously endangered children are likely to be overlooked.
Predictors of maltreatment recurrence at two milestones in the life of a case 49 -- 78
Tamara L. Fuller, Susan J. Wells, Edward E. Cotton

This article reports the findings from two studies that examined the usefulness of the Illinois Child Endangerment Risk Assessment Protocol (CERAP) for predicting short-term maltreatment recurrence. The CERAP is a safety assessment tool designed to guide worker decision-making throughout the life of a case and is completed at several critical case milestones. Two milestones were chosen - within 24 hours after the CPS investigator sees the alleged victim and within five days of case opening (for services to intact families) - for analysis in separate studies. For each study, a case control design was used in which a sample of families who experienced an indicated report of maltreatment recurrence within 60 days of CERAP completion was compared to a sample of families who did not experience maltreatment recurrence. Information from the CERAP was examined, as well as other case characteristics that have been shown to be predictive of recurrence, such as type and severity of abuse, number of previous indicated reports, and number of services provided.

  Results indicated that some predictors of maltreatment recurrence varied depending on the milestone (e.g., point in the life of the case) examined, while others were predictive at both milestones. Age of the youngest child, single-parent household, number of child problems (e.g., physical, emotional, behavioral), type of maltreatment and case disposition (e.g., referred for services versus no service referral) were the predictors of short-term recurrence for investigation cases. Five days after the case had been opened for intact family services (usually post-investigation), the absence of a completed CERAP form and lack of service provision were the milestone predictors. At both milestones, the number of previous indicated reports on the perpetrator and the presence of multiple caretaker problems (e.g., alcohol/drug dependency, domestic violence) were predictive of short-term maltreatment recurrence. Results are discussed in terms of their implications for risk/safety assessment and casework practice in general.

The need for comprehensive risk management systems in child welfare 79 -- 107
Eileen Gambrill, Aron Shlonsky

Risk assessment studies in child welfare have largely focused on identifying individual or family risk factors associated with future harm or on the value of various assessment tools constructed of such factors, paying scant attention to the risks posed by the system and its larger context. These risks include services provided to children and families that have little or no evidence of effectiveness, lack of proper assessment of service needs, inadequate linkage of available services to desired outcomes, and an agency culture that is reactive rather than proactive in its pursuit of risk reduction. Drawing on related literature, this article introduces guidelines for the development and implementation of a comprehensive risk management system in child welfare.
see also

Assessing Risk in Child Maltreatment Volume 22:11-12
Guest Editors,
Eileen Gambrill and Aron Shlonsky

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