Caseworker assessments of risk for recurrent maltreatment: association with case-specific risk factors and re-reports.
OBJECTIVE
This article focuses on caseworkers' assessments of risk of maltreatment recurrence among families in contact with social services. Specifically, the article has two primary goals: (1) to examine the association between caseworkers' risk assessments and demographic, child, parent and family-level risk factors; and (2) to examine agreement between caseworkers' risk assessments and any subsequent report, or reports, of maltreatment.


METHODS
Data are from the baseline, 12-month, and 18-month assessments of the National Survey for Child and Adolescent Well-Being (NSCAW), a nationally representative sample of youth and families who were the subjects of allegations of maltreatment investigated by child welfare agencies. The sample consisted of a subset of NSCAW participants: cases with a report of child physical abuse or neglect who were not placed in out-of-home care (N=2,139).


RESULTS
Analyses indicated that parent-level risk factors and a prior report of maltreatment were most strongly associated with caseworkers' assessments of risk for both physical abuse and neglect cases. A smaller set of factors, which varied by the type of maltreatment, were associated with a subsequent report of maltreatment. Despite some overlap in correlates of risk assessment and subsequent reports, analyses indicated that agreement between caseworkers' assessments of risk and re-reports was low.


CONCLUSIONS
Findings suggest that although caseworkers' assessments were associated with a limited set of risk factors from the literature, few of these factors also were associated with a recurrent report of maltreatment. Correspondence between caseworkers' assessments of risk and a subsequent report of maltreatment was low, suggesting that considerable work may be needed to improve accuracy and identification of cases most at risk.


CONCLUSIONS
This study provides information to assist caseworkers, administrators, and policymakers in thinking critically about risk assessment policies and procedures. Although caseworkers' assessments of risk were associated with some of the empirical predictors of recurrent maltreatment, their assessments were only slightly better than guessing. Agreement between caseworkers' risk assessments and actual subsequent reports was better for low-risk cases, but primarily because the majority of cases did not have a subsequent report during the study period. Clearly, considerable improvement in risk assessment is needed so that at-risk families can be better identified and the limited services available can be directed toward those most in need.
Dorsey
Shannon
S
Department of Psychiatry and Behavioral Sciences, Division of Public Behavioral Health and Justice Policy, University of Washington, School of Medicine, 2815 Eastlake Avenue East, Suite 200, Seattle WA 98102, USA.
Mustillo
Sarah A
SA
Farmer
Elizabeth M Z
EM
Elbogen
Eric
E
D000328:Adult; D019090:Case Management / Q000706:statistics & numerical data*; D002648:Child; D002649:Child Abuse / Q000517:prevention & control* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003657:Decision Making; D003710:Demography; D006801:Humans; D019221:Mandatory Reporting; D008875:Middle Aged; D010287:Parent-Child Relations; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology