Identifying children exposed to maltreatment: a systematic review update

Area of Science:

• Child Health
• Public Health
• Forensic Science

Background:

• Child maltreatment is a global issue requiring effective identification strategies.
• Existing strategies aim to identify children exposed to maltreatment to prevent further harm.
• This review systematically evaluates the accuracy of these identification strategies.

Purpose of the Study:

• To systematically review and evaluate the accuracy of strategies used for identifying child maltreatment.
• To synthesize evidence on the effectiveness and potential harms of child maltreatment identification tools.

Main Methods:

• A systematic search of seven databases was conducted for studies published between 1961 and July 2019.
• Studies estimating the accuracy of instruments for identifying neglect, physical, emotional, and sexual abuse were included.
• Data on accuracy were extracted, and evidence was narratively synthesized; false positives and negatives were calculated for relevant studies.

Main Results:

• 32 articles (31 studies) evaluated identification strategies, including three screening tools: SPUTOVAMO checklist, Escape instrument, and a child sex trafficking screening questionnaire.
• No studies assessed the impact of identification strategies on child outcomes.
• All studies exhibited serious risk of bias, indicating potential over- or under-identification of child maltreatment.

Conclusions:

• Low to very low certainty evidence suggests screening tools may lead to high numbers of false suspicions or missed cases.
• The potential harms associated with inaccurate identification may exceed the benefits of using these tools.
• Further research is needed to develop and validate accurate and reliable methods for identifying child maltreatment.