Friday, 14 January 2005 - 2:00 PM

This presentation is part of: Risk for Child Maltreatment

Reconceptualizing Risk and Child Maltreatment

Objective: The purpose of the current study was to begin to integrate models of cumulative environmental risk with empirical research on the etiology of child maltreatment. Despite the well-established developmental psychopathology literature supporting the importance of the accumulation of ecological risk factors, this perspective has yet to infiltrate maltreatment research and its tendency to focus on single risk factor predictor models. The present study sought to compare the capacity of single risks and a cumulative risk index assessed during the neonatal period to predict maltreatment in a prospective longitudinal investigation.

Method: Participants were 842 mothers and their predominantly at-risk newborn infants. Shortly after giving birth, mothers were interviewed using a questionnaire containing items hypothesized to be relevant to the ecological model of child maltreatment. The State Central Registry of Maltreatment was then reviewed until each child reached sixteen years of life. In addition, a subsample of 242 children was given measures for behavioral and cognitive functioning at 4, 6, 8, 10, 12 and 14 years of age.

Results: After controlling for the total number of other risk factors present, most single risks fell to levels of non-significance when predicting later maltreatment, and no single risk variable provided odds-ratios as strong as those of the cumulative risk index. In keeping with prior work on cumulative risk and outcomes, several measures of child and family functioning were also found to correspond to total risk score. Although early maltreatment does appear to be important to early functioning, the cumulative level of risk carries the day when it comes to predicting long term clinical behavioral outcomes as assessed by the Child Behavior Checklist. Thus, maltreatment itself may be best conceptualized as an important, but not singularly so, risk factor for later behavioral problems.

Implications for Practice and Policy: We conclude that cumulative models of ecological risk offer improved capacity for predicting child maltreatment over the first sixteen years of life as compared to any of the single variables that compose the index. Shifting the focus away from single variable predictor models toward an appreciation for the cumulative nature of ecological risk would be an important step forward in the way we conceptualize our intervention and support programs, and concentrate them squarely on alleviating the substantial risk facing so many families.

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