Child welfare triage: Use of screening threshold analysis to evaluate intake decision-making. (January 2023)

• Record Type: Journal Article
• Authors: Kearney, Aubrey D.; Wilson, Elisabeth S.; Hollinshead, Dana M.; Poletika, Michael; Kestian, Heather H.; Stigdon, Terry J.; Miller, Eric A.; Fluke, John D.
• Is Part Of: Children and youth services review. Volume 144(2023)
• Publication Date: 2023-01
• Subjects: Child welfare screening -- Decision-making -- Outcomes -- ROC -- Methodology; Social work with children -- Periodicals; Social work with youth -- Periodicals; Adolescent -- Periodicals; Child Welfare -- Periodicals; Social Work -- Periodicals; Service social aux enfants -- Périodiques; Service social à la jeunesse -- Périodiques; Electronic journals; 362.705
• DOI: 10.1016/j.childyouth.2022.106710
• Languages: English
• ISSNs: 0190-7409

Abstract

Highlights: This child welfare agency's screening rate over 90% indicates a risk averse screening process. The accuracy of the screening process for this system was slightly better than random. Both false positives and false negatives are sensitive to changes in screening. Changes to screening practice must be carefully examined before implementation. Decision making in child welfare can be actionable with more detailed analyses. Abstract: Objective: Child welfare agencies across the U.S. investigate a high number of reports of maltreatment with low rates of substantiation. Investigations take time, resources, and increased involvement with families, yet maltreatment is largely not confirmed by these investigations. The primary goal of this article was to establish a baseline understanding of the screening accuracy of the Indiana Department of Child Services' centralized intake unit. Methods: A screening threshold analysis (STA) was utilized to measure decisional outcomes of the intake decisions at the Indiana Department of Child Services' central intake unit. All reports made from July 2016 to June 2018 were filtered into a 2X2 matrix and used to produce a ROC curve. We also regressed false positive and false negative rates against the screening rate using report level data aggregated to county level. Results: With a screening rate of 92.87%, we found an AUC of 0.558. While the intake unit quite accurately identified reports on which maltreatment was confirmed or services were provided in the study (94.6%), the unit was poor at correctly identifying reports on which maltreatment was not confirmed or services were not provided (8.5%). When analyzed at the sub-jurisdictional level false positive rates were found to have a positive correlation with screening rate slightly stronger than the corresponding negative correlation of the false negative rate. Conclusions: Our findings indicate that the agency's intake system is risk averse, resulting in high false positive rates. This highlights concerns that agency resources may be inappropriately directed towards investigation and away from intervention, in turn necessitating testable decision making changes to reduce false positive errors.