E-RISK Index: A screening tool of early precursors of likely neglectful behaviors for clincians and service providers

Approximately 3.3 million referrals concerning the welfare of approximately 6 million children are made to Child Protective Services in the United States annually, with about 899,000 of them substantiated cases of maltreatment (Child Welfare Information Gateway, 2007) Conceptual and operational definitions of child neglect have been discussed widely in the literature (e.g., Dubowitz et al. 2005; Runyan et al., 2005); however, no standardized operational definition of or method for identifying child neglect exists (Feerick et al, 2006). The E-RISK Index, developed as part of the NICHD's Centers for the Prevention of Neglect (4-site prospective study of the early predictors of neglect among children born to 684 adolescent and adult mothers), is comprised of 4 questions administered prenatally: recognition/acceptance of new responsibility; certainty about ability to provide emotional support; certainty about ability to do good job parenting; and belief about parenting. There was significant variation by mom group in risk factors (Table 1). E-RISK was significantly related to home environment and independently observed mother-child interactions at 4, 8, and 18 month home visits (Table 2). Further, the E-RISK index significantly predicted child's development at 24 months (Table 3). We examined which children scored 1 ½ SD below the mean on the Bayley and PLS and found that the E-RISK index was a significant predictor (p<. 01). We will discuss how we can reasonably adapt these questions as a screening tool for service providers and clinicians to best meet children's and families' needs as well as the practical and policy implications.