Hamilton and Browne studied risk factors for rereferral of children for abuse in England. They developed a screening checklist to help identify a child at risk for repeat abuse. the authors are from the University of Birmingham in England.
Parameters (14 items):
(1) family-related (6 items)
(2) child-related (6 items)
(3) index perpetrator-related (2 items)
|
Parameter/Family |
Finding |
Points |
|
history of drug abuse |
no |
0 |
|
|
yes |
4 |
|
history of alcohol abuse |
no |
0 |
|
|
yes |
3 |
|
history of psychiatric problems |
no |
0 |
|
|
yes |
3 |
|
history of previous referral |
no |
0 |
|
|
yes |
3 |
|
family member with learning disability |
no |
0 |
|
|
yes |
3 |
|
sibling known or suspected of being abused |
no |
0 |
|
|
yes |
1 |
|
Parameter/Child |
Finding |
Points |
|
behavioral problems |
no |
0 |
|
|
yes |
4 |
|
conduct disorder |
no |
0 |
|
|
yes |
1 |
|
severe medical problems |
no |
0 |
|
|
yes |
2 |
|
learning difficulties |
no |
0 |
|
|
yes |
3 |
|
history of previous referral |
no |
0 |
|
|
yes |
3 |
|
listed on the Child Protection Register |
no |
0 |
|
|
yes |
1 |
where:
• If the goal is to identify rereferral, then every subject should have a history of having been referred.
|
Parameter/Index Perpetrator |
Finding |
Points |
|
action taken after prior referral |
none |
2 |
|
|
yes (warned, cautioned, charged) |
0 |
|
association with child |
acquaintance or stranger |
0 |
|
|
other (someone in family) |
2 |
total score =
= SUM(points for all 14 items)
Interpretation:
• minimum score: 0
• maximum score: 35
• A score >= 11 indicated a high risk for rereferral.
Performance:
• The sensitivity was 68% and specificity was 82%, with an overall accuracy of 61%.
• It is hard to know if this level of performance is related to the checklist itself or any failures in the referral process.
Specialty: Clinical Laboratory, Emergency Medicine, Pedatrics
