Child removal in child protection practice: comparing structured professional judgement and actuarial risk assessment instruments
Creators: name: De Bortoli, Lillian
Publisher: name: Monash University
Year: 2016
Subjects: subject: 111099 Nursing not elsewhere classified
subject: FOS: Health sciences
subject: FOS: Health sciences
subject: Medicine

description: The decision to remove a child from the family home is affected by a multitude of factors. The literature describes difficulties experienced by child protection practitioners when making these decisions. Difficulties arise from uncertain contexts and unclear information, leading practitioners to rely upon heuristics that may lead to errors in judgement. In an effort to improve decision-making in child protection, a body of literature on risk assessment instruments has emerged. Currently, in child protection the prevailing body of literature relates to consensus and actuarial instruments. Structured Professional Judgement (SPJ) is a third approach to guiding decision-making and is yet to be meaningfully explored in the field of child protection practice. The aim of the thesis is to report on the development and pilot evaluation of a newly devised SPJ instrument. The Child Protection Removal Assessment (ChiPRA) was developed as a part of the current program of research studies that aim to assist child protection practitioners decide whether protective concerns should be managed while the child resides within or outside the family home. The thesis is organised in three parts (A, B &amp; C). Part A is a literature review of risk assessment in child protection practice and comprises two manuscripts. In the first part of the chapter, decision-aids adopting consensus, actuarial and SPJ are described and compared. In the first manuscript, intuitive and analytical cognition is described and cognitive theory is linked with the development of decision-aids. In the second manuscript, the importance of critically evaluating the empirical research used to inform the development of a decision-aid is described. Limitations of studies establishing a link between the well-established risk factor, substance misuse during pregnancy with subsequent child protection involvement are described. This manuscript highlights the importance of selecting studies that measure relevant outcomes and are conducted in similar contexts in which the instrument will subsequently be used. Part B details the development of ChiPRA and comprises two manuscripts. The results of a selective literature review of studies identifying risk factors associated with child removal and child abuse-related fatalities are presented. Included in the literature review are manuscripts describing the antecedent factors associated with maternal infanticide and neonaticide. Processes involved in developing, establishing a framework and scoring ChiPRA, are also described in this part of the thesis. In Part C, the expanded methodology and empirical results of the program of studies are presented in three manuscripts. Risk variables associated with child removal in the sample are presented. Following this, the specific analyses of relationships between parental substance misuse and Aboriginal and Torres Strait Islander status with child removal are presented in two manuscripts. In the final manuscript, the validity of ChiPRA is compared with an actuarial instrument (Family Risk Evaluation-Structured Decision Makingâ„¢, FRE-SDMâ„¢). The study identified promising preliminary results, however given this is a pilot study, further research is warranted. In the final chapter, key findings are described and their implications for the practitioner, child protection practice and the broader child protection system are described.