Screening and Assessment for Family Engagement, Retention, and ...

with more than 10 items do not seem to be significantly more accurate and they are more complex to
administer.
Screens are not assessments and cannot be used to diagnose the nature or extent of substance use
disorders or to make decisions regarding alcohol and drug treatment services. Screening results do
provide important baseline information regarding whether substance use disorders exist and at times,
whether the disorder is such that immediate action is required to address problems such as severe
withdrawal symptoms or likelihood of seizures, or to keep children safe. In making diagnoses or
more permanent decisions regarding parents and children, staff should combine screening results with
information gathered from other sources.
Screening tools are based on self-report responses to questions, and screening results are only as
accurate as the honesty of the replies they yield. Although families under investigation for child
maltreatment may feel frightened or desperate enough to respond honestly to questions about their
substance use patterns, they may also feel that disclosing substance use disorders will jeopardize their
chances of retaining their children. Many families may therefore withhold information about their
substance use. Although families may not reply honestly to screenings conducted as part of initial
investigations, it is likely that indications of substance use disorders will emerge as workers become
more familiar with family histories. For this reason, as noted throughout this guidebook, it is essential
for workers to approach screening as an ongoing and routine part of their work, and not as a one-time
event confined to initial and early investigations.
Screening for Child Safety in the Child Welfare Service System
In the child welfare system, the words “risk and safety assessment” are often used interchangeably. For
the purposes of this guidebook, however, they are separated for clarity. Safety assessments, discussed
here, work to answer the question “What is the immediacy of the issue?” and risk assessments, discussed
later in this section, work to answer the question “What are the nature and extent of the issue?”
Risk and Safety Assessments
Safety Assessments are used by child welfare staff at the “front end” to determine the degree of immediate danger of
maltreatment to the child.
Risk Assessments are used by child welfare staff to assess the likelihood that a child is at risk of near-term abuse and/or
neglect, help predict future maltreatment, or inform decisions about removing children from the home.
When child welfare investigators first visit families’ homes in response to an allegation of maltreatment,
their highest priority is to determine whether children are safe, and if they are not, to locate acceptable
arrangements for them. The Child Welfare League of America published a monograph, “Ours to Keep:
A Guide for Building a Community Assessment Strategy for Child Protection,” which set forth the
following components of safety assessments conducted at early stages:
•
Life-threatening living arrangements (such as young children left alone or caretaker’s behavior is
violent and out of control).
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