Appraisal of risk for child maltreatment
Large-scale studies of family and environmental factors that index risk for officially reported child maltreatment have clarified that a short list of variables represent compelling indications for enhanced surveillance and targeted approaches to maltreatment prevention. The extent to which the presence of these factors raises risk is amplified when they co-occur and by the condition of poverty, which affects some 32% of all US children, and with which many of these factors are correlated. Leading predictors are summarized with citations in Box 2. Inventories of these factors have been devised and tested for the ability to specify actionable levels of risk for child maltreatment.10 As an example of the predictive power of combining 2 risk factors, among Missouri offspring of parents with alcohol use disorders enrolled in the Collaborative Study on the Genetics of Alcoholism (COGA), Jonson-Reid and colleagues4 reported that the proportion identified in the state official-report registry for child abuse was 57% for those whose family incomes were below the federal poverty line versus 7% for their counterparts above the federal poverty line. Accumulations of more than 2 risk factors, many of which can be reliably ascertained on the first day of an infant’s life, have resulted in predictions of even higher proportions of children ultimately maltreated.