Prediction and Prevention of Child Abuse—an Empty Hope?

Lealman, G T; Phillips, JonathanM.; Haigh, David; Stone, Joan; Ord-Smith, Christine

doi:10.1016/s0140-6736(83)92367-x

Cited by 64 publications

(40 citation statements)

References 6 publications

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“…Four are checklists completed by professionals by collecting information directly from the subject (Browne and Saqi, 1988;Gordon, 1977;Lealman et al, 1983;Muir et al, 1989). In one case, information is obtained through both a semi-structured interview and a brief questionnaire (Muir et al, 1989).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…whether parent is indifferent, intolerant or overanxious towards child) (Brayden et al, 1993;Browne and Saqi, 1988;Gordon, 1977;Hunter et al, 1978;Muir et al, 1989;Murphy et al, 1985). Seven of the instruments comprise summative scales and have cutoff points above which respondents are categorized as being 'high risk' (Brayden et al, 1993;Gordon, 1977;Hunter et al, 1978;Lealman et al, 1983;Milner et al, 1984;Muir et al, 1989;Murphy et al, 1985 (Browne and Saqi, 1988). In all included studies except one, children were 6 months or less at screening, and in the remaining study, a small number of children were above 6 months of age (Milner et al, 1984).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…In three studies, instruments were completed while the mother was pregnant (Brayden et al, 1993;Muir et al, 1989;Murphy et al, 1985). In the remaining studies, screening was conducted once the study child had been born (Browne and Saqi, 1988;Hunter et al, 1978;Lealman et al, 1983). One study does not specify when during the perinatal period the instrument was completed (Gordon, 1977).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…The follow-up period for these instruments ranges from a mean of 6.5 months (Milner et al, 1984) to 36 months postnatal (Brayden et al, 1993). The instruments were assessed using a variety of outcomes, including the following: public agency documents for evidence of physical abuse or neglect (Brayden et al, 1993); social services case conference (Browne and Saqi, 1988); overt cases of battering (Gordon, 1977); social services confirmed maltreatment (Hunter et al, 1978); child abuse register or medical report of failure to thrive (FTT) (weight less than 85% expected) (Lealman et al, 1983); programme staff reported presence of abuse, neglect or FTT confirmed by Child Abuse and Neglect Team (Milner et al, 1984); referrals to Department of Social Welfare/child protection team or social admissions to hospital (Muir et al, 1989); hospital charts reviewed for evidence of 'direct and definite' neglect or abuse (Murphy et al, 1985). Table 3 provides a description of the characteristics of the included studies.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…In five of the eight studies, the screening instrument is presented in its entirety, including information about how the category of 'high risk' is assigned (Gordon, 1977;Hunter et al, 1978;Lealman et al, 1983;Muir et al, 1989;Murphy et al, 1985). Three of the studies do not present the instrument in full (Brayden et al, 1993;Browne and Saqi, 1988;Milner et al, 1984).…”

Section: Description Of Instrumentsmentioning

confidence: 99%

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Systematic review of instruments designed to predict child maltreatment during the antenatal and postnatal periods

Peters

Barlow

2003

Child Abuse Review

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The purpose of this review was to identify instruments designed to predict future child maltreatment and to evaluate their predictive accuracy. A number of electronic databases were searched to identify published studies. Only studies that had utilized a prospective methodology and tested at least one standardized instrument designed to identify families during the antenatal or postnatal periods who are at increased risk of maltreatment were included in the review. Eight studies were included that had prospectively tested a standardized instrument to predict child maltreatment during the antenatal or postnatal periods. Only six of the included studies followed up the entire sample, and of these only two did not provide an intervention for some or all of the high-risk group. While many of the included instruments obtained sensitivity and specificity above 80%, only two of the included instruments combined specificity over 80% with a positive predictive value above 25%. Currently available instruments have limited accuracy, suggesting that they should only be used to focus non-punitive interventions. These findings, in conjunction with other issues such as the stigma attached to the use of such instruments and difficulties in their application within a clinical and research context, suggest the need for a new approach to the identification of parents in need of higher levels of intervention.

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