The next step: Integrating actuarial risk assessment and clinical judgment into an evidence-based practice framework in CPS case management

Shlonsky, Aron; Wagner, Dennis

doi:10.1016/j.childyouth.2004.11.007

Cited by 208 publications

(172 citation statements)

References 26 publications

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Section: Introductionmentioning

confidence: 99%

“…Further, individual items may be redundant and aggregating item scores could actually overestimate risk (Murphy-Berman, 1994). Actuarial assessments improve on consensus-based models by empirically deriving risk assessments that are site-specific, including only the items that continue to predict recurrence while adjusting for the contribution of all other items, and weighting items based on their predictive contribution to the outcome of interest (Gambrill & Shlonsky, 2000;Shlonsky & Wagner, 2005). Although research has suggested that actuarial models are more accurate at risk classification compared to consensusbased models (Baird & Wagner, 2000), the probability of correctly identifying recurrent maltreatment cases (sensitivity) remains low (Gambrill & Shlonsky, 2000).…”

Section: Introductionmentioning

confidence: 99%

“…For example, one family may be categorized as high risk due to poor parenting skills and ability whereas another family may be considered high risk due to poor housing conditions and a child's developmental disability. Identifying subgroups at similar risk for recurrence may increase prediction accuracy and better inform caseworker decisions such as the types of services families may need (Shlonsky & Wagner, 2005).Current risk assessment models do not take constellations of risk factors into account. Consensus-based risk assessments are derived from expert clinical judgment and previous exploratory research and calculate risk by summing item scores (Gambrill & Shlonsky, 2000).…”

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confidence: 99%

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The Use of Risk Assessment to Predict Recurrent Maltreatment: A Classification and Regression Tree Analysis (CART)

et al. 2008

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Research has suggested that recurrent maltreatment may be best predicted by a combination of factors that vary across families. The present study set out to determine whether a pattern-centered analytic approach would better predict families at high risk for recurrence when compared to logistic regression methods. Archival data from substantiated investigations during 2003 were collected from a Connecticut Department of Children and Families county branch. Families (n=244) with a substantiated index case were followed for 18 months to identify the presence of additional substantiated cases within the CPS system. Classification and Regression Tree (CART) analyses revealed that prior CPS involvement was the best predictor of recurrent maltreatment. Further, risk items that were associated with recurrence were different for families with and without previous CPS investigations. Families with only prior unsubstantiated CPS investigations and poor child visibility within the community were at high risk for recurrence. Families without prior CPS involvement that were not actively involved in case planning and had a history of domestic violence were at high risk for recurrence. These findings suggest that pattern-centered analyses may be a useful approach to informing site-specific predictors of maltreatment recurrence by creating clear decision points that delineate high risk subgroups.Keywords child abuse and neglect; recurrent maltreatment; risk assessment; classification and regression tree analysis The primary goal of child protective services (CPS) is to reduce the likelihood of child maltreatment and its recurrence by providing appropriate services to families (Brookes & Webster, 1999); however, approximately 1/3 to 1/2 of families will have a recurret episode of maltreatment with subsequent reentry into the CPS system (DePanfilis & Zuravin, 1998;DePanfilis & Zuravin, 1999; Fluke, Shusterman, Hollinshead, & Yuan, 2005;Inkelas & Halfon, 1997). Risk assessment instruments were developed to aid caseworkers in identifying children who were at high risk for future abuse and neglect (Cash, 2001;Jagannathan & Camasso, 1996;Johnson & L'Esperance, 1984;Pecora, 1991). Although these assessments are now routinely administered during CPS investigations in 42 states (US Department of Health and Human Services, 2003); there remains no standard risk assessment model that clearly informs caseworker case planning and management (Schwalbe, 2004 Camasso & Jagannathan, 1995; Fluke et al., 2005;Hindley, Ramchandani, & Jones, 2006;Johnson & L'Esperance, 1984;Marks & McDonald, 1989;McDonald & Marks, 1991). Families are classified as low, moderate, or high risk for recurrence based on caseworker ratings of these items. An early review comparing eight risk assessment instruments (McDonald & Marks, 1991) found that perpetrator access predicted recurrent maltreatment in three prospective studies (Baird, 1988;Johnson & L'Esperance, 1984; Weedon, Torti, & Zunder, 1988) and a large family size predicted reabuse in two prospective ...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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The Use of Risk Assessment to Predict Recurrent Maltreatment: A Classification and Regression Tree Analysis (CART)

et al. 2008

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“…Gillingham [12] and others have noted that practitioners may subvert the intention of structured decision-making tools to get the outcome they desire or use the language of risk to legitimate decisions they have already made on other grounds [71]. However, if used correctly, actuarial approaches can be combined with consensus or discretionary approaches to produce a more complete method of risk assessment than one or the other would alone, with some research demonstrating that actuarial approaches are more accurate in terms of the actual risk of future notification than professional discretion approaches only [72]. However, using them alone to decrease decision variability is undesirable, as many other factors in addition to future risk must be considered.…”

Section: Risk and Safety In A Risk Societymentioning

confidence: 99%

Current Debates on Variability in Child Welfare Decision-Making: A Selected Literature Review

Keddell

2014

Social Sciences

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This article considers selected drivers of decision variability in child welfare decision-making and explores current debates in relation to these drivers. Covering the related influences of national orientation, risk and responsibility, inequality and poverty, evidence-based practice, constructions of abuse and its causes, domestic violence and cognitive processes, it discusses the literature in regards to how each of these influences decision variability. It situates these debates in relation to the ethical issue of variability and the equity issues that variability raises. I propose that despite the ecological complexity that drives decision variability, that improving internal (within-country) decision consistency is still a valid goal. It may be that the use of annotated case examples, kind learning systems, and continued commitments to the social justice issues of inequality and individualisation can contribute to this goal.

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“…(Shlonsky & Wagner, 2005). O discurso de risco social, segundo Howe (1992), fomentou que os agentes públicos da rede, na maioria profissionais do Serviço Social, atuassem como investigadores e não colaboradores na solução de conflitos.…”

Section: Introdução I N T R O D U ç ã O | 31unclassified

Redes de proteção e garantia de direitos: representações sociais por conselheiros tutelares

Paula¹

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Aos meus familiaresÀ Raquel, minha esposa, que conhece todos os percalços desta jornada. Por ter sido tão atenciosa, cuidadosa e amorosa em todos os momentos. Por ser uma pessoa afetuosa, dedicada e sincera comigo.À minha mãe, Maria Sebastiana, que sempre acreditou e sonhou com minhas conquistas, lutou por isso com muita fé e amor, acompanhou meus passos de perto. Referência de perseverança, força, alegria e motivação.A meu pai, Luiz, por ter trabalhado tanto tempo por isso, por priorizar a realização dos sonhos dos seus filhos. Investiu suas energias e se dedicou muito por mim e meus irmãos. Por ser um homem honesto, prudente, simples e justo.A meu irmão, Luiz Fernando, companheiro, amigo e pai exemplar. Por acreditar em meu potencial e me incentivar para que estivesse mais aberto à alteridade e à valorização das amizades sinceras.A meu irmão, Ricardo, meu amigo inesquecível de infância. Por me inspirar a buscar sempre a humildade e ser uma pessoa correta, fiel àqueles que estão do nosso lado. Aos mestresAo meu orientador, Prof. Dr. Sérgio Kodato, minha referência em Psicologia Social, por ter me ensinado, com tanta paciência e afinco, a ser um pesquisador comprometido com a sociedade. Por exigir sempre o melhor de mim, com seu jeito sincero, digno e transparente.Sou grato por ter me acolhido nesta instituição, por acreditar que poderíamos trabalhar juntos e produzir conhecimentos relevantes.Ao Prof. Dr. José Aparecido da Silva, pesquisador reconhecido e premiado mundialmente, por me chamar atenção para aspectos fundamentais da pesquisa no Exame de Qualificação, por aceitar o diálogo com a pesquisa social, com questionamentos coerentes que contribuíram muito com este trabalho. À Profa. Dra. Maria Paula Panúncio Pinto, pela leitura criteriosa e minuciosa do texto no Exame de Qualificação. Por discutir e apontar questões que enriqueceram o estudo. Pela postura pertinente e desafiadora perante a estrutura da tese, o que reflete o seu brilhantismo e lucidez perante o tema. Sou extremamente grato por suas contribuições, críticas e sugestões.Ao Prof. Dr. Paulo de Carvalho por ser uma fonte de inspiração e referência contínua em Psicologia Social, conhece os meus primeiros passos e sabe onde tudo começou. Agradeço por ter compartilhado seus conhecimentos e experiências, durante a minha formação e iniciação na pesquisa. À Profa. Dra. Jane Teresinha Domingues Cotrin e à Profa. Dra. Zeyne Alves Pires Scherer, por terem aceitado o convite para este momento especial e único. Sou grato pela presença marcante na banca, pela leitura criteriosa e pelas críticas muito bem colocadas.Às minhas alunas: Ada, Dianninfer e Mariana que participarem ativamente deste estudo. Por terem aceitado o desafio de conhecer de perto a realidade do Conselho Tutelar, pelo envolvimento com esta pesquisa que possibilitou relatos tão ricos e reveladores. À Thais e Antônia, por estarem disponíveis, me ajudaram muito na organização e coleta de informações.Aos conselheiros tutelares que participaram desta pesquisa. Por terem propiciado a oportunidade de...

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The next step: Integrating actuarial risk assessment and clinical judgment into an evidence-based practice framework in CPS case management

Cited by 208 publications

References 26 publications

The Use of Risk Assessment to Predict Recurrent Maltreatment: A Classification and Regression Tree Analysis (CART)

The Use of Risk Assessment to Predict Recurrent Maltreatment: A Classification and Regression Tree Analysis (CART)

Current Debates on Variability in Child Welfare Decision-Making: A Selected Literature Review

Redes de proteção e garantia de direitos: representações sociais por conselheiros tutelares

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