CHILD ABUSE SCREENING - IMPLICATIONS OF THE LIMITED PREDICTIVE POWER OF ABUSE DISCRIMINANTS FROM A CONTROLLED FAMILY STUDY OF PEDIATRIC SOCIAL ILLNESS

• NCJ Number: 56927
• Author(s): J H DANIEL; E H NEWBERGER; R B REED; M KOTELCHUCK
• Date Published: 1977
• Length: 30 pages
• Sale Source: Eric Document Reproduction Service; Childrens Hospital Medical Ctr
• Language: English
• Country: United States of America
• Note: PRESENTED AT THE MEETING OF THE SOCIETY FOR RESEARCH IN CHILD DEVELOPMENT, MARCH 19, 1977 - ERIC REPORTS

Annotation

THE VALUE OF A CHILD ABUSE SCREENING INSTRUMENT FOR UNSELECTED POPULATIONS IS ILLUSTRATED FOR VARIOUS LEVELS OF CHILD ABUSE PREVALENCE TO DEMONSTRATE OUTCOMES OF A HYPOTHETICAL NATIONAL SCREENING PROGRAM.

Abstract

AT ANY LEVEL OF APPLICATION, THE PREDICTION OF FALSE POSITIVES (NONABUSING FAMILIES LABELED AS ABUSING OR POTENTIALLY ABUSING) AND FALSE NEGATIVES SUGGEST LOW PRACTICAL UTILITY AND A LARGE SOCIAL COST. THE REPORT DISCUSSES VARIOUS INTERPRETATIONS OF THE MEANING OF THIS POSSIBLE MISCLASSIFICATION IN THE CONTEXT OF SEVERAL PROGRAM MODELS. IT THEN POSES THE FOLLOWING HYPOTHESES FOR THE MISCLASSIFICATION: SUBJECTS ARE REALLY MISCLASSIFIED DUE TO A WRONG DIAGNOSIS BASED ON EITHER MISINFORMATION OR SOCIALLY INDUCED BIAS; SUBJECTS ONLY APPEAR MISCLASSIFIED BECAUSE OF A LIMITED ABILITY TO DISTINGUISH BETWEEN TYPES OF CASES; AND SUBJECTS ARE MISCLASSIFIED BECAUSE DIAGNOSTIC CATEGORIES ARE OVERLAPPING (FOR EXAMPLE, CHILD ABUSE IS NOT A DISTINCT CATEGORY FROM ACCIDENTS.) THE REPORT GIVES THREE SHORT CASE EXAMPLES THAT DEMONSTRATE THE IMPLICATIONS OF THESE TYPES OF MISCLASSIFICATION FOR CLINICAL PRACTICE PROGRAM AND POLICY. IN CONCLUSION, THE REPORT NOTES THAT THE GOAL OF PROGRAM DEVELOPMENT SHOULD BE FAMILY AND CHILD HEALTH ACTIVITIES WHICH ADDRESS THE POPULATION AS A WHOLE. IN CLINICAL PRACTICE THERE SHOULD BE LESS NEED FOR THE LABELING ASSOCIATE WITH ACTIVITIES DIRECTED TOWARD CHILD ABUSE AND ABUSERS AS SUCH. A MORE NEARLY ADEQUATE AND HUMANE TAXONOMY FOR PEDIATIC SOCIAL ILLNESS WOULD ACKNOWLEDGE CHILDREN'S INJURIES AS SYMPTOMS OF COMPLEX INTERACTIONS BETWEEN A PARTICULAR CHILD, FAMILY AND ENVIRONMENT. LASTLY, BETTER CLINICAL CLASSIFICATION AND PRACTICE WOULD ORIENT PROFESSIONALS FROM THE SEVERAL DISCIPLINES CONCERNED WITH CHILDREN'S HEALTH, DEVELOPMENT, AND WELFARE TOWARD THESE CAUSES RATHER THAN SIMPLY TO PREDICT AND PROTECT THE VICTIMS. THE REPORT INCLUDES REFERENCES AND TABULAR DATA. (AUTHOR ABSTRACT MODIFIED--MJW)